ASWB BSW Exam Questions

Correct answer: Written notice to the client 

The NASW Code of Ethics states, "Social workers in fee-for-service settings may terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to the client, if the client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed with the client." It does not require written notice of pending termination as long as the other requirements have been met.

However, it may be appropriate to send a written notice as part of informing/clarifying financial obligations with the client. It is appropriate for social workers to discuss sliding-scale payment options and/or referral to lower-cost service providers if these would be helpful to the client. 

Correct answer: The combined impact of biopsychosocial factors on Sue Ellen's ability to complete activities of daily living 

The process of aging can have a significant impact on all areas of biopsychosocial functioning. It is crucial to understand the impact of aging across multiple domains, including physical, cognitive, emotional, and social. In order to provide the most comprehensive but least restrictive level of care, a comprehensive biopsychosocial assessment should be completed and all elements of functioning should be taken into account. 

Assessing physical abilities is important because decreased strength, flexibility, and mobility are common challenges for the elderly, but it would not be appropriate to focus on only one area of functioning. Cognitive functioning can also impact a person's ability to live independently and the required level of care, but it is possible to modify a living situation to accommodate a particular issue, and other factors would need to be considered as well. Mental wellness of the elderly can also impact their ability to live independently. However, if strong social supports exist, it may be appropriate for an individual to live at an array of levels of care. As a result, all elements of biopsychosocial functioning must be assessed because they can strongly influence one another and impact overall functioning. 

Correct answer: An open group

It is essential to know the difference between group types, specifically open vs. closed group types. Open groups allow new members to join at any point during the course of the group without a specified start date and generally do not require attendance at each session. 

Closed groups have a specified start and end date and do not allow new members to join between those dates. These groups tend to have a structured curriculum and run in cycles. This group could have members who are experiencing crisis, but it is important to remember that crisis does not have to be precipitated by a major life event (such as the loss of a loved one) or, conversely, a major life event does not necessarily lead to crisis. Self-help groups are typically led by members and include groups such as AA and Weight Watchers. 

Correct answer: Flooding

Flooding is a type of behavioral therapy in which the client is exposed to an imagined or real stimulus that produces anxiety for prolonged periods of time in an effort to extinguish the anxious response. Spending time in a car (VR or real) is using flooding to reduce the client's response. 

Biofeedback entails teaching a client to control certain bodily functions, such as heart rate, blood pressure, or muscular tension, in an effort to manage symptoms with greater control. It is often used in treatment of ADHD and/or anxiety. Aversion therapy entails pairing an unwanted stimulus with a behavior in an attempt to reduce and/or eliminate that behavior. An example of aversion therapy is prescribing Antabuse for alcohol use disorder. In vivo desensitization entails moving through hierarchical anxiety-provoking situations in a real setting, from least intense to most, in an effort to reduce the response. 

Correct answer: Ecological

The ecological systems perspective is rooted in systems theory which views coping as a transactional process that reflects the “person in environment” relationship. Using this perspective, the focus of intervention is the interface between a client and a client’s environment.

The psychoanalytic perspective addresses the ways in which early childhood experiences affect current functioning. The social learning perspective emphasizes the impact that observation of others has on our attitudes and behaviors. The attachment perspective focuses on early relationships with primary caregivers.

Correct answer: Reaction formation

Reaction formation is a defense mechanism that is employed subconsciously to protect a person's psyche from potential harm by taking on beliefs or ideas that are actually in opposition to what a person truly believes (whether this is on a conscious or unconscious level). Making public statements that are in direct contrast to one's personal identity is an example of the reaction formation defense mechanism. 

Regression is another defense mechanism, and it involves a return to an earlier and inappropriate phase of development. An example is an adult throwing a tantrum when angry, as though they are a child. Sublimation is a defense mechanism that involves engaging in behaviors that are acceptable in place of harmful or unacceptable behaviors. An example is going to the batting cages to release anger instead of hitting people.

Correct answer: Systems

The systems theory is based on the biological phenomenon that when one system in an organism fails, it greatly affects the remaining systems. In social work, this means that when one system (such as a family unit) changes, it affects the related systems and subsystems, such as the extended family or neighborhood.

The person-in-environment theory describes a person as being affected by their environment and vice versa. The psychodynamic theory describes personality in terms of conscious and unconscious forces.

Correct answer: Living situation

There are two kinds of risk factors of violence: static and dynamic. Static risk factors would be things that will not change or change significantly over time, such as demographic information (race), past history of abuse, and socioeconomic background.

A dynamic risk factor is something that might change over time, such as one's living situation.

Correct answer: Creating a daily to-do list and prioritizing tasks based on importance and deadlines

Creating a daily to-do list and prioritizing tasks based on importance and deadlines is an effective time management strategy. It helps the social worker organize their workload, focus on high-priority tasks, and maintain a sense of control over their responsibilities. 

Multitasking may seem efficient, but it often leads to reduced productivity and increased stress. It is not an effective time management strategy, especially for tasks that require focused attention, like client interactions and paperwork. Reactively responding to tasks as they arise can lead to a lack of structure and control over time. This approach may result in neglecting important tasks and feeling overwhelmed. Extending work hours to complete tasks is not a sustainable time management strategy. Overworking can lead to burnout and negatively impact both the social worker's well-being and the quality of their work.

Correct answer: The client is experiencing a crisis 

A crisis is defined as the disruption of an individual's emotional homeostasis wherein their typical coping skills do not work to regulate emotions and there is disruption to their everyday functioning. As the client has described challenges at work and in her social life and stated that her coping skills are not helping, she is most likely experiencing a crisis and would benefit from crisis intervention. 

Trauma results from extremely stressful life experiences that shake a client's sense of safety and security. Clients who have experienced trauma can experience an array of symptoms that may include disruption in everyday life or coping skill use, but this is not necessarily experienced by all clients who experience trauma. Complicated grief is a DSM-5 diagnosis that involves typical symptoms of grief that linger or worsen as time passes. We do not have enough information to determine whether this diagnosis is appropriate for the client. Psychosis is characterized by hallucinations, delusions, and thought disorganization. This does not align with what the client has reported. 

Correct answer: Permissive 

Permissive parenting is characterized by a lack of demands and rules on children, high levels of nurturing, and high levels of communication. Children with permissive parents often view their parents in a friend-type role rather than as parental figures. As a result, these children often struggle academically, have difficulty with self-regulation, have problems with authority, are less happy, and perform poorly in school. 

Uninvolved parents meet the basic needs of the child but otherwise place few to no demands or expectations on a child, are minimally communicative, and are minimally responsive. As a result, their children often lack self-control, experience low levels of self-esteem, and struggle academically. Authoritative parents place reasonable expectations and demands on their children, are democratic when it comes to punishment and decision-making, and are communicative with their children. As a result, their children tend to lead happy, fulfilling, and successful lives. Authoritarian parents place high demands and expectations on their children, are strict in regard to punishment, and do not explain reasons behind rules and decisions to their children. As a result, these children tend to follow rules well and struggle with happiness, social development, and self-esteem. 

Correct answer: Feelings of desperation

There are many types of risk factors that may predispose a person toward the use of substances. These fall into four major groups:

1. Psychiatric risk factors such as one's feelings of desperation or low self-esteem
2. Family risk factors such as family trauma, lack of family routine
3. Social risk factors such as the availability and accessibility of drugs or alcohol
4. Behavioral risk factors such as the use of other substances or rebelliousness in childhood

Correct answer: Two colleagues engage in lighthearted banter about relationships and share stories about their dating experiences

It is possible for each of the examples to be considered sexual harassment, depending on the context and elements of nonverbal communication in the interaction. The NASW Code of Ethics states, "Social workers should not sexually harass supervisees, students, trainees, or colleagues. Sexual harassment includes sexual advances; sexual solicitation; requests for sexual favors; and other verbal, written, electronic, or physical contact of a sexual nature." The banter is "lighthearted," which likely indicates that the context and nonverbal messaging were superficial in nature and not sexual. This is the least likely scenario to be considered sexual harassment. 

A supervisor making sexually explicit comments and advances toward a subordinate (regardless of requests for him to stop) is sexual harassment per the Code of Ethics and most laws. Complimenting a colleague on an outfit may be benign in most circumstances. However, the implication of attractiveness may be perceived as sexual harassment when coupled with context and nonverbal communication. A coworker pursuing a colleague in a romantic way is sometimes acceptable (check agency policies) but also holds the risk of making them feel uncomfortable. This is another situation in which context is essential because tone or body language may shift the interaction into being perceived as harassment. 

Correct answer: Acknowledge any feelings the client may have about discussing sexuality

Some clients might not be comfortable talking about their sexual history or preferences. Social workers should attempt to help clients feel at ease by acknowledging and normalizing feelings surrounding discussions about sexuality. Social workers can also explain to clients that taking a sexual history is an important part of the assessment process that is administered to all clients.

The social worker might inform the client that they will not discriminate based on the client's sexual preferences, but this does not need to be done first. Written questionnaires about sexuality are available but are not necessary if clients are willing to participate in a face-to-face interview. The social worker should explain the course of treatment to the client, but it is not necessary that the client sign a consent giving permission to the social worker to ask questions related to sexuality.

Correct answer: Notify the authorities and warn the girlfriend 

The Tarasoff decision set the precedent that social workers have a "duty to warn" if they deem a client a credible, imminent threat to another person. In that event, the social worker is expected to notify the authorities of the threat and to warn the individual in danger. 

An involuntary commitment may be indicated if a client is deemed a danger to themselves and/or others, but it is not relevant to the Tarasoff decision and would fall under ethical guidelines and/or local law. It is essential to attempt to warn the girlfriend if the client is a credible threat to her well-being; however, warning just the individual in danger would not be sufficient. The authorities would need to be informed because they have the ability to provide protection and intervention in ways that the social worker does not. 

Correct answer: Seeking supervision and discussing challenging cases with colleagues

Secondary trauma is the result of intimate knowledge of another person's traumatic experiences and can include symptoms such as insomnia, chronic irritability, anger, fatigue, avoidance, and/or issues with concentration. One of the best ways to protect against secondary trauma is to seek supervision and discuss challenging cases with colleagues. This response best reflects an awareness of the potential impact of the work on the social worker's emotional well-being and a proactive effort to manage the effects. This proactive approach may lead to engaging in self-care, taking breaks, or attending workshops, but those responses are all reactive rather than proactive. 

Correct answer: Directive

Empathic communication is a cornerstone of the therapeutic alliance in social work. It is characterized by "starting where the client is" and being aware of and responding to all messages (verbal and nonverbal) that the client offers. It also involves doing all that is necessary to establish therapeutic rapport. In order to demonstrate empathic understanding, a social worker must convey three critical components, including that they will hear what the client shares and refrain from passing judgment, that they will accept the client as they are, and that they are genuine in their words and actions. 

Directive actions are not generally incorporated into the development of therapeutic rapport or demonstrative of empathic communication and should be reserved for specific cases. 

Correct answer: Psychological abuse 

Psychological abuse is defined as repeated inappropriate behavior with a goal of threatening, isolating, belittling, teasing, humiliating, confusing, and/or ignoring. It can have negative impacts on an individual's intelligence, memory, social interactions, attention, imagination, and moral development. The most prominent signs of psychological abuse include avoidance of eye contact, increased loneliness, increased anxiety, increased feelings of despair, a flat affect, lack of empathy for others, inappropriate interactions with peers, bullying behaviors, self-harm, and/or reckless behavior.

Physical abuse is an intentional trauma or injury as a result of hitting, punching, kicking, biting, and/or burning. It is often indicated by physical marks left on an individual and can be the result of physical discipline. The most prominent indicators that physical abuse is occurring include unexplained bruises, unexplained burns, unexplained fractures, and/or unexplained cuts. Evidence of sexual abuse includes demonstration of an abnormal level of interest in sexual issues, abnormal level of knowledge of sexual matters, or inappropriate sexual behaviors. The behaviors listed in the question are notable indicators of abuse, specifically psychological abuse.

Correct answer: Awareness is impaired

Depression can affect the thinking of people in ways that make it resemble other illnesses such as delirium. For example, memory in depression can be selective or patchy. One's thinking is generally intact but hopeless and self-deprecating. Depressed individuals commonly neglect basic-self care.

In depression, awareness is not typically impaired, such as it is in delirium.

Correct answer: Learned stress reduction skills

There are risk factors that social workers should consider when conducting an assessment because they are linked to a risk of suicide or violence. Risk factors for suicide include a history of a previous suicide attempt, living alone and having few or no social supports, recent job or relationship stressors, the presence of a psychiatric disorder, substance abuse, family history of suicide, exposure to suicidal behavior of others, and easy access to a firearm or other lethal methods.

Stress reduction skills can help individuals at risk of committing suicide learn to effectively manage their emotions in healthy ways.