ASWB LCSW Exam Questions

Page 6 of 50

101.

You are working with a client struggling with depression. Rather than using a specific therapeutic method like CBT, you focus your work on helping the client realize their capacity for growth and positive change.

From which approach are you operating?

  • Humanistic 

  • Psychoeducation

  • Psychodynamic

Correct answer: Humanistic 

The humanistic approach is a strengths-based perspective that assumes clients have the ability for growth, change, and adaptation. This approach also assumes that clients come with knowledge of how their problems can be solved. This approach aligns with the description given in the question.

Psychoeducation involves providing information to a client to help the client make an informed decision. This approach is not described in the question.

The psychodynamic approach helps a client gain insight into their lives and current problems by evaluating emotions, thoughts, beliefs, and early childhood experiences. This approach is also not described in the question.

102.

A client’s supervisor makes her extremely anxious, and when she knows that he will be in the office, she starts complaining of nausea, dizziness, or a migraine. What type of defense mechanism is the client MOST likely using?

  • Conversion

  • Rationalization

  • Displacement

  • Substitution

Correct answer: Conversion

Psychological Defense Mechanisms are unconscious, involuntary techniques that reduce anxiety. Conversion is a defense mechanism in which anxiety is transformed into overt physical manifestations. 

Substitution is a defense mechanism in which the individual replaces an unattainable goal with one that is attainable. 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. Rationalization is when something happens that we find difficult to accept and we make up a logical reason why it has happened.

103.

The following is an unavoidable dual relationship:

  • You are the only clinician in a small town and see several residents for therapy.

  • You are at a prison conducting assessments, and sometimes individual therapy, for prisoners.

  • You are in a large metropolitan area and see a teenager who goes to your book club for therapy.

  • You have been holding sessions with a man for several months and just found out that the man is your cousin's ex-husband.

Correct answer: You are the only clinician in a small town and see several residents for therapy.

Dual relationships refer to any time multiple roles exist between a social worker and a client. These are very common, and social workers often have to make decisions regarding dual relationships because they are not always unethical or illegal. An unavoidable dual relationship is one in which there are limited resources, so the social worker and client have no choice but to try to make the therapeutic relationship work. Being the only clinician in a small town is an example of when there are limited resources, so you have to try to make it work with several residents for therapy.

Assuming that there are enough clinicians to provide services at prisons, social workers can be tasked with conducting assessments and therapy, and while this is not always unethical, it can be avoidable. It is assumed that there is a wide range of choices for mental health treatment in a large metropolitan area, so again, this situation is avoidable. Finally, if you were to find out your client is your cousin's ex-husband, it is an unexpected dual relationship, but you should work to refer the client to another clinician and, therefore, this situation is avoidable.

104.

Research related to ethical decision making in social work indicates that which of the following is the least influential element in arriving at resolutions of ethical dilemmas?

  • Guidelines specified by the NASW Code of Ethics

  • The social worker's body of knowledge derived from practice experience

  • Personal and professional values

  • Supervision and/or peer consultation

Correct answer: Guidelines specified by the NASW Code of Ethics

The idea that personal and professional values are key elements in ethical decision-making is strongly supported by a variety of literature on this topic. Research on connections between values and ethical decision-making in social work has indicated that the Code of Ethics is not usually the primary influence in ethical decision-making.

When social workers are in the position to make ethical decisions, much more prominent factors include wisdom from practice experience, values held by the social worker, and supervisory guidance.

105.

The following is NOT a category of symptoms supporting a diagnosis of Autism Spectrum Disorder:

  • Aggressive gestures

  • Social communication and/or interaction

  • Restricted behaviors

  • Repetitive behaviors

Correct answer: Aggressive gestures

Aggressive gestures can appear as part of Autism Spectrum Disorder, but they are not explicitly part of its diagnosis. 

The DSM-5 arranges autistic behavior into the broad categories of social communication and/or interaction, and restrictive and repetitive behaviors.

106.

You're working with a family in which there is ongoing conflict between the husband and wife, who cannot agree on how to parent their child. The focus of your sessions is on helping the family to build healthy boundaries, in which each member maintains their autonomy while still being interdependent on each other.

What sort of family therapy are you practicing?

  • Structural family therapy

  • Bowenian family therapy

  • Strategic family therapy

  • Group work

Correct answer: Structural family therapy

Structural family therapy focuses on family organization and its impact on the well-being of each family member. Social workers using this approach join with the family to help them restructure themselves. A social worker practicing structural family therapy focuses on changing unhealthy boundaries within families to restructure them. The example given aligns with structural family therapy.

Bowenian family therapy operates according to the belief that improving family functioning will reduce negative symptoms among family members. This method focuses on concepts like differentiation, which is a person's ability to maintain their individuality while still being emotionally close with the family. This approach also focuses on connections between current and past generations of a family.

Strategic family therapy has roots in structural family therapy and is focused on behavioral change rather than understanding. It is brief and task-centered, assuming that families are flexible enough to adjust when solutions do not work.

Group work occurs with two or more people who are focused on personal growth. This method is used with people who are all coping with the same problem, such as low-self esteem, rather than with families.

107.

You are treating a client, Margo, with a mood disorder, and her current diagnosis is Bipolar I disorder. Recently, Margo has become extremely inactive and moves extremely slowly. What specifier is MOST appropriate to add to Margo's diagnosis?

  • Bipolar I disorder, with catatonia

  • Bipolar I disorder, with atypical features

  • Bipolar I disorder, with melancholic features

  • Bipolar I disorder, with peripartum onset

Correct answer: Bipolar I disorder, with catatonia

Catatonia involves a marked psychomotor disturbance including extreme inactivity or excessive motor activity.

Atypical features include mood reactivity, hypersomnia, increase in appetite, feelings of rejection and/or a heavy feeling in the arms or legs. Melancholic features loss of pleasure in almost all activities or lack of reactivity to usually pleasant stimuli and, in some cases, decreased appetite and weight loss. Peripartum symptoms begin when a woman is pregnant or within 4 weeks of giving birth. These three options do not match with the information offered in the question.

108.

What is a "mascot" in the context of family therapy? 

  • A family member who jokes to alleviate pain

  • The standout performer academically

  • A family member who takes the blame for dysfunction

  • The family member who fades into the background

Correct answer: A family member who jokes to alleviate pain 

In family therapy, it is important to address what could be persistent roles within a family that have come about in reaction to an issue of dysfunction such as substance use. One such role is the "mascot," a family member who becomes a joker to distract from or alleviate the pain of unresolved conflict within the family.

The standout academic performer would most likely be the "hero" role. Taking the blame for dysfunction most closely corresponds with the "scapegoat" role, and a family member who fades into the background becomes the "lost child."

These concepts are somewhat plastic in practice, but these are the major roles.

109.

You work at a psychiatric facility on the floor of adolescent girls. One of the patients, Nadine, age 15, recently disclosed to you that she has a crush on a male staff member. Nadine also shows you letters the staff member has written her, in which he declares his love for her. She self reports to you that they have had some sexual contact when other people were not around. 

Nadine happily blushes and giggles about this, but which of the following should you do FIRST?

  • Immediately contact the patient advocate to make a report, as there is a strong suspicion that the staff member has had inappropriate relations with Nadine

  • Confront the staff member about his actions to find out if Nadine was being honest

  • Contact administrative staff to inform them of the violation of boundaries

  • Ask Nadine more questions about her relationship with the male staff member to gather as much information as possible

Correct answer: Immediately contact the patient advocate to make a report, as there is a strong suspicion that the staff member has had inappropriate relations with Nadine.

In this question, you should be concerned that the male staff member seems to be taking advantage of Nadine. While it is possible that she may be fabricating her sexual relationship with him, the fact that she has letters that are seemingly written by him is concerning. You should err on the side of caution, and immediately report the situation to the patient advocate to prevent further harm being done to Nadine, or other girls. 

All of the remaining options are feasible options, but the best choice is for you to make an advocacy report. If you were to ask, it is possible he would become defensive. Administrative staff will be notified by the patient advocate, and you could ask Nadine for more information about her claims, but this should not distract you from making a report, nonetheless.

110.

You are conducting a session in a women's shelter with a woman, Teddi, who has recently experienced sexual assault and displacement. You have established that Teddi is not a danger to herself or others, and you have been able to form a rapport and even make her smile once or twice. 

What is the NEXT thing you should do to help Teddi resolve her crisis?

  • Identify the major problems

  • Encourage an exploration of feelings and emotions

  • Generate alternatives and coping strategies

  • Implement an action plan

Correct answer: Identify the major problems

Once safety and rapport have both been established, the work of identifying the major problems to be addressed can begin.

While you should never discourage the exploration of feelings and emotions, this comes after identifying the sources (or perceived sources) of the problems facing the client. Finding alternatives and coping skills, as well as implementing an action plan, are both things that will also come in later stages of the process.

111.

The following type of practice evaluation is completed AFTER services are finished:

  • Summative evaluation

  • Formative evaluation

  • Conclusive evaluation

  • Concurrent evaluation

Correct answer: Summative evaluation

A summative evaluation of practice is done after services are finished, whereas a formative evaluation is done as services are being delivered. The options conclusive and concurrent evaluations are evaluations that are not used to gauge social work practice.

112.

Tiffany is a 23-year-old woman who comes to you complaining that she is tired of "making bad things happen." She tells you that every time she forgets to brush her teeth, a natural disaster occurs somewhere in the world. Tiffany also states that sometimes she thinks "bad thoughts" about other people, causing them to become injured or otherwise harmed. 

She is MOST likely showing signs of:

  • Magical thinking

  • Hallucinations

  • Dementia

  • Grandiosity

Correct answer: Magical thinking

Magical thinking is a kind of thinking in which the client illogically believes that their thoughts or actions can influence others' behaviors or change events. In this question, Tiffany wrongly believes that her own actions are directly connected to disastrous events in other places of the world. She also believes her thoughts can cause others to be harmed.

The remaining answers are all common symptoms of mental disorders, but they do not describe Tiffany's experience based on the information in the question. Hallucinations occur when someone sees or hears people or things that do not actually exist. Dementia is a general term for a decline in mental ability, and grandiosity refers to an unrealistic sense of superiority.

113.

You have been meeting with Kirby, a mother, and her child, Leo, who is five years old, for several months now. At the beginning of every session, Kirby complains about Leo's behavior, while often acting as the victim in the relationship, as well as becoming tearful and needing some time to calm down. Kirby also complains that Leo is aggressive at home toward her, and very oppositional. You suggest that Leo meet with you individually for several sessions, and while Kirby is hesitant to agree to this, eventually she complies.

After meeting with Leo individually, you begin to believe that Kirby might be provoking him to the point that he becomes so frustrated he is unable to handle it anymore. You also believe that Kirby makes unreasonable demands of Leo, leading to the power struggles within the relationship that Kirby has brought up, and giving her additional reasons to continue the family therapy sessions.

Kirby is MOST likely suffering from:

  • Factitious disorder imposed on another

  • Somatic symptom disorder

  • A psychotic disorder

  • Malingering

Correct answer: Factitious disorder imposed on another

Factitious disorder imposed on another is defined by the falsification of psychological or physical signs/symptoms and presenting the other individual as impaired. In this question, Kirby is presenting her child, Leo, as poorly adjusted, but you strongly believe the mother is falsifying this information in an attempt to receive attention from you, and possibly others.

Somatic symptom disorder applies to an individual suffering from physical symptoms, which is not the case in this question. There is also no indication that Kirby is suffering from psychotic symptoms, such as delusions or hallucinations. Malingering is the process of engaging in manipulative behavior in order to gain or avoid something. While this is somewhat true for this question, factitious disorder is a much more appropriate diagnosis.

114.

Jones is a 73-year-old man who recently lost his husband to cancer. You should present which of the following interventions to Jones to help him work through his grief MOST effectively:

  • Group treatment that focuses on mourning and loss

  • Individual treatment with you to address trauma

  • Behavioral interventions

  • Psychoanalysis

Correct answer: Group treatment that focuses on mourning and loss

There is plenty of research that shows that clients who have suffered significant losses are able to discuss their feelings and move more rapidly toward recovery in group situations. There are many mourning groups, as well, that focus on grief work to help individuals in a variety of situations work through issues surrounding grief and loss.

While Jones may benefit from individual treatment, group treatment is going to be the most effective, and the option says "trauma," not "mourning and loss." Psychoanalysis would not necessarily be helpful for Jones because the focus would be on early childhood experiences, and his current situation is feelings of loss. He also does not need behavioral interventions, as the question does not have information that indicates that Jones is exhibiting any problematic behaviors.

115.

At an initial session, you notice that Yulia, your client, has hair that appears to be gone in patches all over her head. Throughout the session, Yulia nervously picks at her eyebrows and the hair on her arms.

You will MOST likely consider a diagnosis of:

  • Trichotillomania

  • Pica

  • Bipolar disorder

  • Borderline personality disorder

Correct answer: Trichotillomania

Trichotillomania is also known as hair-pulling disorder and is characterized by recurrent pulling out of one's hair, so much so that it results in hair loss. Yulia seems to have a tendency to pull hair out from her scalp, eyebrows, and off her arms. In this question, you should continue to collect additional information from Yulia to make a definitive diagnosis of trichotillomania, but it is likely that she will meet the criteria.

Pica is an eating disorder in which individuals eat non-edible substances. Bipolar disorder is marked by drastic changes in moods or periods of mania. Individuals with borderline personality disorder tend to act impulsively in relationships and engage in superficial suicidal gestures.

116.

If Elizabeth, a client, is diagnosed with bipolar disorder, she will MOST likely start taking:

  • Carbamazepine (Tegretol)

  • Phenelzine (Nardil)

  • Tranylcypromine (Parnate)

Correct answer: Carbamazepine (Tegretol)

Carbamazepine treats bipolar disorder, seizures, and nerve pain. Some brand names include (but are not limited to): Tegretol, Carbatrol, Equetro, and Epitol.

Phenelzine and tranylcypromine are both monoamine oxidase inhibitors that are used to treat atypical depression.

117.

Which of the following codependent roles is the MOST angry?

  • Scapegoat

  • Family Hero

  • Mascot

  • Lost Child

Correct answer: Scapegoat

In a family, the one who takes on the role of Scapegoat also takes on the blame for family issues, therefore developing the most anger.

The Family Hero acts to distract through achievement, the Mascot distracts through clowning, and the Lost Child becomes invisible.

118.

You are working with your client, Jesse, who has an addiction to methamphetamine. Jesse occasionally talks about maybe quitting and sometimes acknowledges the harm the addiction has brought to himself and others. 

Which stage of change is Jesse currently in?

  • Contemplation

  • Precontemplation

  • Action

  • Preparation

Correct answer: Contemplation

Contemplation is the stage of change that occurs with an exploration of one's own emotions about the focus area as a primary change activity. In this question, based on the information provided, Jesse's externalized processing is indicative of this stage.

The other stages mentioned happen either earlier or later in the change process.

119.

You are meeting with a client for the first time. What is the MOST important thing to consider, regarding a successful clinical outcome?

  • The therapeutic alliance between you and the client

  • Shared values between you and the client

  • The commitment of the client to attend every therapy session

  • The client's self-esteem

Correct answer: The therapeutic alliance between you and the client

No matter what your client is presenting with, the therapeutic alliance between yourself and the client is always the most important aspect of therapy to consider. If there is mutual respect and trust that exists between you and the client, there is a greater likelihood of the client making progress in therapy and maintaining lasting changes.

It can be helpful in some cases for you and the client to share values, but it is not necessary for the client to successfully meet goals. Clients should be committed to attending therapy sessions and work to make progress, but you should not insist that clients commit to attending every therapy session. Additionally, a client's self-esteem might be a topic for therapy sessions, but whether a client has low or high self-esteem does not necessarily predict clinical outcomes.

120.

All of the following are variables taken into consideration when assessing socioeconomic status EXCEPT:

  • Marital status

  • Education

  • Income

  • Skill(s) required by one's job

Correct answer: Marital status

When researchers assess socioeconomic status (SES), the researchers look at more than just income. However, marital status is never a factor taken into consideration because there are many single individuals with a higher SES than married individuals.

Factors taken into consideration when assessing for SES include years of education, income, and the amount of skill(s) required by one's job. Individuals with more years of education and a higher level of skill(s) required by one's job typically have a higher SES.