ASWB LCSW Exam Questions

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81.

You observe that Maggie is struggling with communicating to her husband, Steven, so she often confides in her sister-in-law about her issues and worries, hoping that her sister-in-law will be able to assist her. However, Maggie's sister-in-law is finding that she is becoming more "in the middle" of the problems between Maggie and Steven than she feels comfortable with.

This situation is known as:

  • Triangulation

  • Family therapy

  • Familial regression

Correct answer: Triangulation

Triangulation happens when anxiety and tension between two individuals (in this situation, Maggie and Steven) causes them to not communicate directly, leading them to go through a third person (the sister-in-law). 

The other options are incorrect because they do not best fit the situation that is described in the question.

82.

The following is MOST characterized by the experience of hallucinations with an added component of mood dysfunction:

  • Schizoaffective Disorder

  • Schizophreniform Disorder

  • Schizophrenia

  • Schizotypal

Correct answer: Schizoaffective Disorder

Schizoaffective Disorder is characterized by the experiences and disturbances of Schizophrenia with an additional component of mood dysfunction.

The other disorder options that are listed, while similar, do not meet the stated symptoms offered in the information in the question.

83.

Keith feels that everyone thinks he is a slow learner, so he spends extra time making sure that everything he does is correct before he shows others. What type of defense mechanism is Keith MOST likely using?

  • Compensation

  • Rationalization

  • Substitution

Correct answer: Compensation

Psychological Defense Mechanisms are unconscious, involuntary techniques that reduce anxiety. Compensation is a defense mechanism in which an individual tries to make up for imaginary characteristics that are considered undesirable.

The other options are incorrect because substitution is a defense mechanism in which the individual replaces an unattainable goal with one that is attainable, and rationalization is when something happens that we find difficult to accept and we make up a logical reason why it has happened.

84.

Caroline recently received a promotion at work, but it requires her to travel across the country multiple times a year and she is very anxious about this due to her having an intense fear of flying. Caroline wants to keep her job, so she meets with you to address this fear. As her social worker, you begin treatment by teaching Caroline relaxation skills that she can use while flying, such as box breathing and meditation. You gradually lead Caroline through images, videos, and role-play situations associated with flying until Caroline feels able to discuss and cope with her feelings until they are lessened.

This form of treatment is BEST known as:

  • Systematic desensitization

  • Psychoanalysis

  • Flooding

  • Cognitive behavioral therapy

Correct answer: Systematic desensitization

Systematic desensitization is a type of behavior therapy in which the social worker helps the client overcome a phobia of a specific stimulus. In this question, you first help Caroline learn relaxation skills, and then gradually expose her to the identified stimulus until the stimulus evokes a response that can be controlled through these learned relaxation skills. The hope for Caroline is that, after your intervention, she will be able to fly on an airplane for work without panicking or feeling unmanageable levels of anxiety. 

The other options are incorrect, as they are forms of therapy that do not match Caroline's needs and/or the information offered in the question.

85.

The following individual is the MOST likely to have a panic disorder:

  • A 23-year-old female

  • A 70-year-old male

  • A 14-year-old adolescent

  • An individual between the ages of 40 and 60

Correct answer: A 23-year-old female

Even though onset after age 45 can occur, it is extremely unusual, and research has shown that the median age of panic disorder is 20 to 24 years.

86.

You are treating a client with a mood disorder and the client’s current diagnosis is Bipolar I disorder. The client is functioning in a slow manner and has lost weight due to a diminished appetite. 

What specifier is MOST appropriate to add to the client’s diagnosis?

  • Bipolar I disorder, with melancholic features

  • Bipolar I disorder, with atypical features

  • Bipolar I disorder, with catatonia

Correct answer: Bipolar I disorder, with melancholic features

According to the DSM-5, melancholic features include loss of pleasure in almost all activities or lack of reactivity to usually pleasant stimuli and, in some cases, decreased appetite and weight loss.

The other options are incorrect. Atypical features include mood reactivity, hypersomnia, increase in appetite, feelings of rejection, and/or a heavy feeling in the arms or legs. Catatonia involves a marked psychomotor disturbance and involves extreme inactivity or excessive motor activity.

87.

You are hired as a consultant to a school district with the focus on implementing a series of "best practice" protocols derived from research on classroom-based behavior management techniques.

Of the following, which factor would be MOST likely to have an effect on the successful integration of the new program into the system?

  • The degree to which "organizational change management" is incorporated into the overall plan for implementation, throughout the duration of the project

  • Limitations on time involved school staff/administrators reviewing and understanding the underlying research literature on which the program was founded

  • Difficulties in obtaining parents' investment/participation in adopting the methods to use outside of the school setting in order to provide consistency between practices employed by the schools and those of children's home environments

Correct answer: The degree to which "organizational change management" is incorporated into the overall plan for implementation, throughout the duration of the project

The concept of change management is critical to the success of most activities that require modifications or adjustments among members of an organization, and the design and quality of change management activities can "make or break" the outcomes of any such effort. The application of this concept is one example of assessing organizational function and applying the results.

The optimal method for delivering staff education/training related to evidence-based practice research would not require the involved recipients to read/understand original "source material," but instead, training materials would be "translated" in advance, to easily comprehensible, practically stated materials that could be presented in training sessions. One of the primary benefits/rationales for a well designed and thorough change management plan is to assist involved personnel in accepting the methods being adopted, and incorporate methods of minimizing or effectively addressing resistance. 

Finally, any expectation that home- and school-based methods would/should match may be unrealistic, and parents' rights to self-determine home-based practices are a given. While educators may not always agree with parents' attitudes or behaviors and may work to suggest things to improve those, the idea that this level of consistency would be possible is probably quite unrealistic.

88.

In the course of an ongoing therapeutic relationship with a client, if you are offered a small gift from the client, which of the following would be the LEAST relevant factor to consider in terms of ethical behavior for you in this situation?

  • Whether the gift is something that you feel is appropriate

  • The degree to which acceptance of the item in question would symbolize or communicate a dual relationship with your client

  • The cultural background and influences of your client, and the impact of accepting or refusing the item from their perspective

Correct answer: Whether the gift is something that you feel is appropriate

The least significant factor in such an instance is your personal affinity for the item in question, with judgments about how to proceed based on a variety of other factors on a case specific basis or determined as a standard policy by yourself/the individual social worker or agency.

While some activities/transactions between therapists and clients are universally agreed to be clear cut boundary violations and constitute dual relationships, the matter of gift giving is more equivocal, not only in social work, but in many other helping professions.

89.

Rica, a new client who is elderly, appears to have difficulty attending to the conversation with you. She looks at the floor often to avoid eye contact and seems to be distracted easily by noises and changes in the environment. Her affect is flat while her responses are delayed.

Which of the following is MOST congruent with Rica's clinical presentation?

  • Depression

  • Delirium

  • Dementia

  • Stroke

Correct answer: Depression

Rica is expressing some of the common markers of depression: a flat affect, distraction, and avoidance of eye contact.

In someone with delirium, one would expect to see much greater impairment. With dementia, the depressive signs may not be as evident and attention would be more normal. There are no major signs of stroke here, except perhaps speech latency, but this question does not offer enough information to choose that as the answer.

90.

You are working with your client, Mick, in a crisis center. Mick has bipolar disorder, is addicted to methamphetamine, lies about his legal situation, and is very resistant to treatment. At the time of this session, Mick has just been evicted from his apartment and states that he does not know what to do. You work out a detailed, ten-step plan that will help Mick out with his immediate situation and with housing, and present it to him in a detailed and compassionate conversation.

What have you done WRONG?

  • You did not involve Mick enough

  • You chose the wrong goal

  • You did not suggest inpatient treatment

  • You did not address his diagnosis

Correct answer: You did not involve Mick enough

The key ingredient to any crisis plan is the client's empowerment. In fact, a big part of creating such a plan is to train clients that they can use an organized process to solve problems on their own. In this question, if Mick has not had a chance to arrive at his own goal (which very well might not be housing), then the plan you have created will not mean a lot to him.

All of the other answer options reflect goals that Mick may or may not have. Again, his end goal may not be housing. Without involving him in formulating a plan, we do not know how to proceed.

91.

There are two views of social welfare: institutional and residual. Which of the following BEST represents the institutional view of social welfare?

  • A program that focuses on prevention

  • A program that provides benefits to all members of society

  • A program that provides benefits to a restricted group who demonstrate need

Correct answer: A program that focuses on prevention

In doing effective program analysis, having an understanding of some basic concepts and terminology is important. An institutional view of social welfare is one which is focused on prevention.

Universal social welfare provides program benefits to all members of society, and selective social welfare provides program benefits to a restricted group who demonstrate need. These do not fit what the question is asking for, so these options are incorrect.

92.

Emily is the daughter of Ms. Henry, a 75-year-old woman with dementia. Emily calls you, Ms. Henry's former social worker, to complain that the hospital where her mother was recently admitted is discharging Ms. Henry prematurely. Emily asks you to intervene with the hospital.

You should:

  • Encourage Ms. Henry and her daughter, Emily, to discuss their concerns with the hospital treatment team

  • Schedule an appointment with Ms. Henry

  • Suggest that Ms. Henry and Emily go along with the current discharge plan, then make an appointment with you following the discharge

  • Call Ms. Henry's doctor to gather additional details about the situation

Correct answer: Encourage Ms. Henry and her daughter, Emily, to discuss their concerns with the hospital treatment team

Because you are no longer working with Ms. Henry, you should respect the opinions of the hospital treatment team. There are ethical issues involved in resuming a relationship with a former client who is currently receiving services from a different agency. You should encourage Ms. Henry and Emily to discuss their concerns with the hospital treatment team.

The other options are incorrect, as they do not best match the information included in the question.

93.

A social worker was asked to be a guest speaker in a high school health class where he could educate the students about the effects of drugs and alcohol on adolescent brain development and decision making. 

What type of prevention strategy is this an example of?

  • Primary

  • Secondary

  • Tertiary

  • Quatinery

Correct answer: Primary

Primary prevention has the goal of protecting people from developing a disease or, in this case, engaging in a behavior in the first place. 

Secondary prevention occurs after the disease or injury occurs. Tertiary prevention focuses on managing complicated and/or long-term diseases or injuries. "Quatinery" is a fabricated answer choice.

94.

The MOST characteristic personality trait of anorexia nervosa is:

  • Perfectionism

  • Ambivalence

  • Codependence

  • Manipulation

Correct answer: Perfectionism

Anorexia nervosa is an eating disorder where the extreme fear of getting fat leads to a restriction of calories and a disturbance in the way in which one's body is developed. Individuals with this condition often struggle with perfectionism, as no measure of thinness is ever viewed as "good enough" for many individuals with anorexia nervosa, no matter how unhealthy they become.

Individuals with anorexia nervosa do not often struggle with ambivalence and there is no evidence that indicates individuals with anorexia nervosa are typically manipulative or codependent.

95.

The following BEST illustrates the concept of gender fluidity:

  • Gender fluidity is a changing and personal concept of gender that can be expressed via gender-related signifiers.

  • Gender fluidity refers to having no personal concept of gender.

  • Gender fluidity is the choice of a particular gender, contrary to one's biologically expressed gender.

  • Gender fluidity refers to the pattern of sexual attraction.

Correct answer: Gender fluidity is a changing and personal concept of gender that can be expressed via gender-related signifiers.

Gender fluidity refers to the changing and personal concept of gender that can be expressed via internal/external signifiers of gender. There is no set of norms or expectations about how the phenomenon will manifest in any individual. The change in gender expression may exhibit itself in one's dress, mannerisms and self-identification, but it is not limited to these. 

The other options are incorrect because gender fluidity does not suggest that there is no such thing as gender at all, nor is it specifically directed at expressing a gender contrary to one's biologically expressed gender. It also may or may not have to do with a pattern of sexual attraction relative to gender roles or expectations.

96.

The MOST appropriate action you should take to help a family who is coping with a client who is in the early stages of Alzheimer’s disease is:

  • Help the family accept the fact that the client’s personality and behavior will change

  • Recommend that the family join an Alzheimer’s support group

  • Gain an understanding of how the family would like to see the client behave

Correct answer: Help the family accept the fact that the client’s personality and behavior will change

By helping the family accept that the client’s personality and behavior will change, the family will be more apt to cope with changes as they start to appear.

The other answers are incorrect, as an Alzheimer’s support group may be beneficial for the family, but this should not be recommended as the main treatment. Gaining an understanding of how the family would like to see the client behave is also incorrect, as the client’s condition will not permit them to adapt to their wishes.

97.

All of the following are examples of in-kind assistance EXCEPT:

  • Federal tax refunds

  • Medicaid

  • Food stamps

  • Public housing assistance

Correct answer: Federal tax refunds

Some key terms are important when assessing how policy affects service delivery. In-kind assistance refers to aid provided in the form of a specific service rather than in cash. A government health insurance program for the poor like Medicaid, food stamps, and public housing assistance are all examples of in-kind assistance.

Cash reimbursements like federal tax refunds are not in-kind assistance.

98.

You run a support group for individuals who were members of cults as children. Which of the following statements is MOST true for this group?

  • Members are strongly encouraged to socialize outside of group sessions

  • Members lead the group

  • The main focus of the group is on how members interact with each other

  • Your sole task is to teach group members about coping skills

Correct answer: Members are strongly encouraged to socialize outside of group sessions

This is an example of a supportive group, in which the purpose of the group is for members with shared experiences to accept and give support to each other. When members socialize outside of group sessions, they are decreasing social isolation and benefiting from friendships with others who understand what they have been through. 

Typically, a social worker or other clinician facilitates support groups, and the focus of the group is on increasing positive relationships between group members. In this question, your task is to facilitate a support group and encourage members to accept and give support to each other, not to teach group members material.

99.

Dawn, whose child was recently placed in foster care, is beginning to work with you at a family service agency. During the initial session with her, you encourage Dawn to discuss her feelings about the placement of her child. Dawn begins talking in great detail instead about her multiple physical health problems. 

In this situation, what is the BEST thing for you to do?

  • Engage in a discussion of Dawn's health problems and concerns, in order to begin forming a relationship and acquire information to contribute to an assessment of her self-perception

  • Inquire about ways in which Dawn's health problems may be related to the recent placement of her child

  • Refocus the interview by reminding Dawn that the purpose of the service is designed to focus on the child, reasons for the foster care placement, and setting goals related to that situation

Correct answer: Engage in a discussion of Dawn's health problems and concerns, in order to begin forming a relationship and acquire information to contribute to an assessment of her self-perception

It is critical to take cues from clients regarding subject matter and the pace at which they are comfortable with addressing it. In this question, the fact that Dawn, in this case, was given an opportunity to address topics related to the child's placement, yet chose to focus on something else, should be a signal to you. This is especially true in the early phase of the relationship, prior to the establishment of any foundation of trust, mutual respect, or rapport.  Perhaps even most significant, the relationship is a mandated one in which rapport will be essential to progress.

Insisting that Dawn immediately focuses on directly relevant information when she has demonstrated some form of reluctance to do so is likely to impede, slow, or outright derail formation of an optimal therapeutic relationship.

100.

The following is MOST characterized by faking an illness for some sort of personal gain:

  • Malingering

  • Factitious Disorder

  • Somatic Symptom Disorder

  • Illness Anxiety Disorder

Correct answer: Malingering

Malingering is faking a physical or mental illness for the purpose of some kind of external reward and personal gain. This is not to be confused with Factitious Disorder, which is done for inner psychological reasons, and not external reward and personal gain. 

The other options do not match the information offered in the question, though they are also all listed under Somatic Symptom and Related Disorders.