ASWB LCSW Exam Questions

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181.

You are meeting with Ivan, a 21-year-old client who admits that he tried to kill himself yesterday by taking an excessive amount of pain medication mixed with alcohol. Which of the following should you do FIRST?

  • Instruct Ivan to take himself to the hospital, or you will have the patient involuntarily committed

  • Conduct a suicide assessment

  • Process Ivan's feelings about the event

  • Contact Ivan's family members

Correct answer: Instruct Ivan to take himself to the hospital, or you will have the patient involuntarily committed

In this situation, Ivan's health and safety are a priority. Because he ingested what could be an unsafe amount of medication very recently, you should insist that the patient be evaluated by a medical professional in case the medication causes fatal effects.

As a social worker, you do not need to conduct a suicide assessment, as the patient has admitted that he tried to kill himself. A social worker may process the client's feelings about the event during subsequent sessions, but the most important issue is for the client to be medically evaluated. A social worker should not contact the client's family members unless they have consent from the client to do so.

182.

The following is NOT a structuring technique for conflict resolution:

  • Increasing contact between the involved parties

  • Decreasing contact between the involved parties

  • Limiting the scope of issues addressed

  • Using an impartial, third-party mediator

Correct answer: Increasing contact between the involved parties

Increasing contact between parties is not considered an effective strategy in adding structure to conflict resolution; doing so could actually have the opposite effect. 

The other options are recognized as methods that add structure to a conflict resolution.

183.

Your client developed a severe problem with chemical dependency in early adolescence and entered an abstinence-based rehabilitation/recovery in early adulthood. Which of the following would you MOST expect to see in your client as a result?

  • Delays or relative deficits in social, cognitive, and academic skill development that roughly correspond to the age at which the problem originated, which may or may not be fully resolved over time

  • Resumption of social and cognitive development, with development of relationship skills and cognitive capacity well into early adult years, in a pattern parallel to that usually seen in adolescence, with a high likelihood of successful resolution in all major functional areas

  • As length of abstinence and recovery increases, relatively rapid gains in cognitive and social domains that are likely the results of residual neural plasticity that emerges as the influence of chemicals returns to premorbid levels

Correct answer: Delays or relative deficits in social, cognitive, and academic skill development that roughly correspond to the age at which the problem originated, which may or may not be fully resolved over time

The capacity for individuals to initiate and sustain significant recovery after adolescent-onset addiction is influenced by many factors. There is little rationale for predicting a significantly poor prognosis, as many with adolescent addiction histories go on to lead productive lives. However, there is much evidence to support the idea that social/cognitive development may be subject to critical periods during adolescence which, if derailed or delayed, may create functional gaps, the resolution of which may be quite variable and uncertain.

As stated above, social and cognitive development may suffer due to adolescent-onset substance dependence, but in some cases, it can be quite good, depending on other factors in the individual's life. Neural plasticity is not known to go into a state of dormancy in the presence of drug dependence. In fact, the case may be quite the opposite. For example, the effects of drugs may diminish or shorten normal periods of neural plasticity that might be expected to last into adult years.

184.

Penny has been attending sessions with her social worker for a few months now and openly discusses how she is addicted to cocaine. Today, Penny's father is attending a session with her. He feels that his daughter's problems are simply depression. 

What type of defense mechanism is Penny's father demonstrating?

  • Denial

  • Rationalization

  • Projection

  • Minimalization

Correct answer: Denial

Psychological Defense Mechanisms are unconscious, involuntary techniques that reduce anxiety. In this question, the father denies that Penny has a cocaine addiction by stating that she is "simply" depressed.

Since the father is not even acknowledging Penny's cocaine addiction, he is not demonstrating rationalization or minimalization. He is also not using projection, as he is not engaged in attaching unacceptable facets of his own personality to others.

185.

If you were developing a program evaluation system within your agency, what type of information should you be MOST concerned about providing?

  • Information that will improve program outcomes for clients

  • Information that will positively identify the agency within the community

  • Information that will satisfy the government’s requirements

Correct answer: Information that will improve program outcomes for clients

A program evaluation system is established to improve client outcomes. Because of this, while developing a program evaluation system, you should be most concerned with providing information that will improve the program outcomes for its clients.

A well developed program evaluation system may positively identify the agency within the community and/or satisfy the government's requirements, but that is not what you should be most concerned with.

186.

Prinka is a 20-year-old single mother of two children. She did not finish high school due to becoming pregnant as a teenager, and struggles to find gainful employment while also caring for her children. Prinka self reports that she currently lives with friends and often engages in substance use.

Prinka's children are MOST likely at high risk for:

  • Neglect

  • Physical abuse

  • Disease and/or infection

  • Cognitive delays

Correct answer: Neglect

Neglect occurs when a child's needs are not met by their parents or caretakers. A list of factors present in parents that indicate a high risk for child neglect include: single parents with multiple children, a low level of education, unemployment, an unstable living situation, and substance abuse. In this question, Prinka has all of these factors so, unfortunately, her two children are at high risk for neglect.

Prinka's children are probably at some risk for physical abuse as well as neglect, but there is no indication in the question of such. Prinka's children might be at higher risk for disease if she does not get them vaccinated, but this is not stated in the question's information. Intellectual ability is primarily biologically determined, and the question does not indicate that her children are at risk for cognitive delays.

187.

It is MOST important that a social work supervisor does which of the following?

  • Regularly meet with supervisees and document the supervision

  • Supervise their supervisees’ treatment sessions

  • Regulate treatment session pricing

  • Distribute clients evenly between supervisees

Correct answer: Regularly meet with supervisees and document the supervision

A social worker supervisor can be named in ethical complaints and lawsuits for ethical breaches by social workers who are under their supervision. Because of this, it is very important that the supervising social worker meets with and documents the supervision of their supervisees.

At times, supervisors may sit in on supervisees' treatment sessions, but this is not common and certainly not the most important thing a supervisor should do. The other options are definitely within the scope of the supervisor's duties but, again, are not the most important.

188.

Sexual dysfunction is MOST commonly identified for further assessment through:

  • Client self reports

  • Relationship problems

  • Biopsychosocial assessments

Correct answer: Client self reports

In many cases, clients recognize that there is a problem interfering with the enjoyment of a sexual relationship. From the client's self reports, social workers can then begin with complete histories for symptoms and referrals for physical exams.

Sexual dysfunction is not going to be initially identified through medical screening or social work assessments, and while sexual relationships are linked to the health of relationships, most relationship problems do not involve sexual dysfunction and vice versa.

189.

Nick is going through a midlife crisis and starts dating a woman in her mid-twenties to make himself feel younger. What type of defense mechanism is Nick MOST likely using?

  • Displacement

  • Reaction formation

  • Projection

Correct answer: Displacement

Psychological Defense Mechanisms are unconscious, involuntary techniques that reduce anxiety. Displacement is the shifting of actions from a desired target to a substitute target when there is some reason why the first target is not permitted or not available.

The other options are incorrect, as they are not the correct defense mechanism that Nick is using. Projection occurs when a person has uncomfortable thoughts or feelings, so they may project these onto other people, assigning the thoughts or feelings that they need to repress to a convenient alternative target. Reaction formation happens when a person feels an urge to do or say something and then actually does or says something that is effectively the opposite of what they really want.

190.

The perspective of behavioral treatment of depression is that depressive symptoms result from:

  • Absent or inadequate positive reinforcement

  • Ineffective learning of interpersonal skills

  • Failure to apply previously learned coping behaviors

Correct answer: Absent or inadequate positive reinforcement

Behavioral methods usually focus most heavily on stimulus/response/reinforcement triads, with the underlying theory that the element that determines the strength/duration of any given behavior pattern is reinforcement, or lack thereof. 

It can be true that some individuals with depression engage in ineffective interpersonal skills and/or poor coping skills, but the question specifically asks about behavioral treatment.

191.

Substance Induced Major Neurocognitive Disorder is BEST characterized by:

  • Problems with cognitive functioning that are often severe enough that they significantly impair functioning, for which the cause and prognosis for recovery vary widely, related to individual factors, what substances were used, etc.

  • A syndrome of cognitive symptoms that may include memory deficits, that is almost always chronic and irreversible and, in most cases, may require long-term assistance in daily functioning

  • A type of memory disorder that is caused by chronic use or abuse of controlled substances, such as tranquilizers or narcotic pain medications

  • Severe memory problems that persist for significant periods after withdrawal or active dependence on substances that directly affect memory, which usually resolve very slowly over time, and, in most cases, can be markedly improved with appropriate remedial methods

Correct answer: Problems with cognitive functioning that are often severe enough that they significantly impair functioning, for which the cause and prognosis for recovery vary widely, related to individual factors, what substances were used, etc.

Substance Induced Major Neurocognitive Disorder is characterized by marked cognitive decline that interferes with independence in daily functioning due to exposure to a substance.

Neurocognitive disorders caused by alcoholism do not generally improve significantly over time, although in isolated cases, the condition may resolve almost completely. In many alcohol-related cases, symptoms are so severe that they warrant long-term care to assure protection and meet daily needs. Other sufferers have variable rates of recovery and a more hopeful prognosis. In many nonalcohol-induced cases, full recovery eventually occurs. Neurocognitive disorders affect many areas of cognition, not just memory.

192.

When dealing with a client in crisis, you should:

  • Focus on the presenting problem and ask factually-based questions

  • Suggest cognitive behavioral therapy

  • Call members of the client's support system to gather more information

  • Focus on personality traits that could be contributing to the crisis

Correct answer: Focus on the presenting problem and ask factually-based questions

When faced with a client in crisis, a social worker should keep the focus on the presenting problem. Asking questions that are based on factual information can help the client focus on concrete information rather than their emotions, and this can help the client think rationally rather than become overwhelmed. 

Cognitive behavioral therapy might be helpful to some clients in crisis, but it is better to focus on the presenting problem. The social worker should not call members of the client's support system unless the client specifically asks the social worker to do so, and there is no information in the question that implies this as an overall general rule. If the client continues to see the social worker for therapy, exploring personality traits may be helpful, but is not necessarily the most helpful course of action for the social worker to take in case of a crisis.

193.

If you're performing cognitive behavioral therapy, which of the following would you be MOST likely to do to with your clients?

  • Help them replace destructive thoughts with healthier thoughts

  • Use guided imagery

  • Teach them to walk away from situations that provoke anger

Correct answer: Help them replace destructive thoughts with healthier thoughts 

The cognitive behavioral approach to therapy views distress as arising from distorted, faulty thinking patterns. If you are doing cognitive behavioral work, you'd be most likely to help clients replace destructive thoughts with healthier thoughts.

Using guided imagery is a relaxation technique.

Learning to walk away from anger-provoking situations is an environmental change.

These practices, while helpful, do not align specifically with the cognitive behavioral approach.

194.

You are assisting a family with a therapeutic objective, and you have already helped them by initiating the use of resources. What is the NEXT step that you should take in this process?

  • Monitor your clients' success

  • Set goals and action plans

  • Recommend resources for/to the family

Correct answer: Monitor your clients' success

You have helped the family to start using resources to solve their problem, which means you have already helped them set goals and action plans, and recommended resources. Because you have already completed these steps, the next step for you to take is to monitor the family’s success.

195.

Yang has been in recovery from opioid dependence for several years. Which of the following would be among the LEAST likely factors contributing to relapse?

  • Failure of previous treatment professionals to assure that Yang is integrated into adequate post-treatment support networks, prior to terminating treatment

  • Yang returns to environmental or social situations that were present during the period of active drug use

  • Yang experiences extremely stressful life events such as serious illness, changes in family structure/functioning, etc.

  • Yang has drug exposure (either casually or in the course of necessary medical treatment/procedures)

Correct answer: Failure of previous treatment professionals to assure that Yang is integrated into adequate post-treatment support networks, prior to terminating treatment

The assumption that "professional treatment" would necessarily have been involved in any given case is inherently flawed. There is an increasing accumulation of research evidence indicating that the majority of recovering individuals may never have sought/received "professional treatment" and have achieved success in recovery through other means. Because of this, "professional failure" would be the least significant factor among the available choices.

Environmental, social, and geographic factors are frequently cited by individuals and recovery programs as triggers for relapse, thus promoting advice to those developing recovery-based lifestyles to find ways to avoid such potential triggers. Generalized stress levels and re-exposure to substances, especially those closely related to previous drugs of choice, are also found to be significant factors in relapse.

196.

Brittaney appears at the crisis center on a very hot day and wishes to be admitted, claiming to be suffering from auditory hallucinations. You know that Brittaney has been diagnosed with schizophrenia and that she is compliant with a long-acting pharmaceutical treatment regimen that is meant to control her symptoms. When admitted to the air-conditioned facility, Brittaney appeared only to be experiencing great relief from the heat. Though her symptoms appear to still be present when she is observed by the security cameras without her knowledge, she does not appear to be suffering from them quite as badly. When urine-tested, Brittaney tests positive for cocaine and PCP.

Which kind of malingering is Brittaney MOST likely guilty of?

  • False imputation

  • Brittaney is not malingering at all.

  • Pure

  • Partial

Correct answer: False imputation

False imputation is the attribution of symptoms to another source for gain. In this question, Brittaney's symptoms are very likely the result of her drug experience rather than her actual mental illness, which is schizophrenia. Based on the information in the question, we know that she is compliant with pharmaceutical treatment and should therefore not be experiencing troublesome hallucinations based on her diagnosis.

The other kinds of malingering stated do not match the circumstances and information that is offered in the question.

197.

Rica was in a very serious car accident about three months ago that led to a two-week hospitalization. All of the following are probable emotional and/or psychological symptoms of trauma related to the accident, EXCEPT:

  • Unrealistic optimism

  • Anxiety and fear

  • Withdrawal from others

  • Anger and mood swings

Correct answer: Unrealistic optimism

After a traumatic event that causes physical impairment, it is natural and expected that the injured person has some negative reactions. Unrealistic optimism is not an expected reaction, though a few individuals may use this approach as a defense mechanism to accept the reality of the physical/emotional damage that was done.

It would be normal and expected for Rica to exhibit anxiety, fear, social withdrawal, anger, and mood swings following her car accident. A social worker meeting with her may provide a safe place for her to express these feelings out loud and may help her work through the grieving process associated with the accident.

198.

Akari is a social worker who has been working for about a month with Kai, who is in a crisis after being released from prison without anywhere to go. After the two have developed trust and Kai has had a chance to explore his feelings, Akari and Kai are now meeting to develop a concrete list of things for Kai to do in order to start solving his problem(s). 

Which of the four goals of crisis intervention does Akari's approach MOST exemplify?

  • Returning Kai to a previous level of functioning

  • Relieving the impact of stress with emotional and social resources

  • Helping strengthen coping skills during Kai's crisis

  • Developing adaptive coping skills

Correct answer: Returning Kai to a previous level of functioning

Akari and Kai are about to begin working on a crisis plan together. This plan is aimed at providing a path toward the reestablishment of functioning for Kai.

Kai does need resources to turn to if/when his own inner coping skills fail, and he also needs education, not only in using his inner coping skills in the present moment, but training those coping skills to be available in later crises, if some come up. However, while these other steps are essential too, these do not show which of the four goals of crisis intervention Akari's approach most exemplifies.

199.

Carly, a staff member in an intensive day treatment program for adolescents, conducts a group art activity in which members are encouraged to "draw whatever is on your mind." One client with a history of drug use draws a marijuana leaf. After seeing this, Carly comments, "Your obsession with drugs is not appropriate material for this group, and I do not appreciate you doing that." 

Which of the following statements is MOST accurate?

  • Carly's behavior in this context evidences a loss/lack of professional boundaries.

  • Carly has committed a breach of confidentiality.

  • Carly initiated an appropriate confrontation of the client's provocative behavior.

  • This statement to the client will most likely promote group cohesiveness through voicing other members' discomfort and/or disapproval of this client's focus on drug use related material.

Correct answer: Carly's behavior in this context evidences a loss/lack of professional boundaries.

The statement quoted strongly indicates a violation of boundaries in the fact that Carly expresses personal opinions and judgments about the client, especially in this circumstance where no specific constraints were implied by the instructions for the art activity.

The other options are incorrect because there is no information offered in the question that indicates this constitutes a breach of confidentiality, that the intent of the client was "provocative," or that other group members had negative reactions. Additionally, this behavior would be likely to engender splits rather than cohesiveness in the group.

200.

The following statement is TRUE about Asian American populations:

  • Family characteristics, cultural histories, and personal preferences are extremely diverse

  • They are inherently better at science and math than most people of other ethnicities

  • They value collectivism and family values

  • They experience medical disorders related to their cultural history

Correct answer: Family characteristics, cultural histories, and personal preferences are extremely diverse

Many stereotypes exist toward Asian Americans. Some examples of these beliefs are that all Asian American families are close-knit, that Asian Americans are good at science and math, and that females are subservient to males. However, it is very important to acknowledge that family characteristics, cultural histories, and personal preferences of Asian Americans, as well as all other racial and ethnic groups, are extremely diverse.

Research has not established that Asian Americans are inherently better at science and math than others, and there is no evidence that Asian Americans experience medical disorders related to their cultural history. As stated above, Asian American individuals are very diverse, and while some may value collectivism, others are much more individualistic.