ASWB LCSW Exam Questions

Page 7 of 50

121.

You are assigned the case of Jem, a young adult woman who is in a rehabilitation facility recovering from an auto accident in which she incurred a head injury. Jem's medical chart includes nursing notes indicating, "Patient continues to display signs of ideational apraxia noted earlier by attending, particularly affecting her ADLs in dressing and hygiene practices."

Which of the following is the BEST inference that can be made about this information?

  • Jem is having difficulties with performing the required movements/coordinating her activities to dress and groom herself independently, which may be a result of her head injury, and may or may not be resolved with appropriate remedial work.

  • Jem may be suffering from depression or another diagnosable psychiatric problem, secondary to the traumatic incident and adjustments to her current situation, which is likely to have a negative effect on her motivation and create apathy toward engaging in activities of daily living.

  • Jem has become comfortable with and/or dependent on others in the inpatient setting to help her accomplish everyday, basic tasks such as self-care and dressing, and it may be likely that her ideas about autonomy and self determination will become a focus of treatment during her rehabilitation.

  • Jem may be malingering or taking on a victim/sick role to obtain special treatment, possibly to build a case for legal or government assistance purposes, and her behavior is probably designed to demonstrate how disabled she has become as a result of her accident.

Correct answer: Jem is having difficulties with performing the required movements/coordinating her activities to dress and groom herself independently, which may be a result of her head injury, and may or may not be resolved with appropriate remedial work.

According to the DSM-5's section on Neurodevelopmental Disorders, apraxia is a result of damage to the brain's cerebral hemispheres, specifically those areas of the brain that control voluntary movements. Apraxia creates deficits in performing movements that a person knows how to do, is physically able to carry out, and is motivated to do. For example, an apractic individual may be willing and able to do something, but there is a disconnect between the concept/idea of the activity and the actual motor signals sent by the brain that direct the required sequence of activities to do it correctly. Ideational apraxia is the inability to do an activity that involves performing a sequence of motor activities. Activities frequently affected are those like dressing, eating, or bathing. It is also known as conceptual apraxia.

Ideational apraxia does not indicate that the client is suffering from depression, does not indicate that the client lacks autonomy, and does not indicate that the client is malingering due to secondary gains.

122.

Which Freudian psychosexual stage coincides with Erik Erikson's psychosocial crisis stage, trust versus mistrust?

  • Oral

  • Anal

  • Phallic

  • Latency

Correct answer: Oral

Trust versus mistrust is the first stage in Erikson's psychosocial theory of human development. This stage, which lasts from birth until about 18 months of age, children learn whether they can trust the world, and the child learns whether their caregivers can/will meet their needs. Similarly, the first stage of Freud's psychosexual theory of development is the oral stage, during which time the infant learns whether their needs will be met through feeding. 

Freud's later stages of psychosexual development include the anal, phallic, latency, and genital stages. The anal stage lasts from about 1-3 years, the phallic stage from 3-6 years, the latency stage from 6-11 years, and the genital stage from puberty until death.

123.

Mike informs you that he has just been diagnosed with liver cancer, and that he has decided he does not want to spend the last few months of his life going back and forth to the clinic for treatments that will only make him sick. You disagree with Mike's course of action, as you feel that the treatments could prolong his life. 

The FIRST thing you should do is:

  • Understand the self-determination rights of the client, Mike

  • Persuade Mike to seek treatment for his condition

  • Speak to Mike's physician to see if treatment could cure his condition

Correct answer: Understand the self-determination rights of the client, Mike

The question asks for the first thing you should do, which is to understand Mike's right to self-determination, regardless if you agree or disagree.

The other options are incorrect because you should not persuade Mike to do something that he does not want to do, nor should you speak to his physician without his consent.

124.

You ask the parents of three children what their parenting style is. The mother informs you that they have established strict rules for all of their children, and that if one of the children breaks a rule, nothing is up for discussion, and the child is grounded from one of their favorite activities.

The following parenting style is MOST likely being used:

  • Authoritarian

  • Authoritative

  • Uninvolved

  • Permissive

Correct answer: Authoritarian

Authoritarian parents, like the ones in this question, establish strict rules with no reasoning behind said rules, and their children are punished if they break the rules.

Authoritative parents communicate, establish rules for their children, nurture and forgive their children when the rules are broken. Uninvolved parents have very few demands and communicate very little with their children. Permissive parents are indulgent, have few demands, and hardly ever discipline their children.

125.

Frankie, a client whose mother has recently died after a protracted illness, begins a session with you by self-reporting, "I really feel bad this week." The following would be the BEST formulation of a statement of primary empathy with which you could respond:

  • "It seems like lately you've had a lot of disturbing things to deal with, so let's talk about what might have happened this week that was particularly difficult for you, Frankie."

  • "I'm sorry you're not feeling good right now. With your mother's death and all the things you've had to face, perhaps you're a little let down."

  • "It's pretty obvious, by the way you're saying that, that you're feeling miserable right now."

Correct answer: "It seems like lately you've had a lot of disturbing things to deal with, so let's talk about what might have happened this week that was particularly difficult for you, Frankie."

When presented with a very generalized statement such as the one Frankie said to you, it is important to refrain from jumping to conclusions when interpreting his communication without obtaining clarification. While it might be likely that feeling bad might be tied to the specific events known by you, it is also possible that Frankie is referring to something unrelated to that event.

Because of this, the other options are incorrect. You should not assume that Frankie is feeling badly about a certain issue, but should give him time to explain in his own words. Your language should match the intensity level of his, so using a word like "miserable" is inappropriate in this situation.

126.

Out of the following classes of drugs, which would be MOST likely to induce synesthesia as a prominent effect?

  • Hallucinogens

  • Stimulants

  • Benzodiazepines

  • Opioid narcotics

Correct answer: Hallucinogens

Synesthesia is a sensory phenomenon that is characterized by experiences of a crossover between one sensory modality and another. Those who experience synesthesia report things like seeing sounds and hearing colors. This is a phenomenon that, in some individuals, a relative minority of the population, may occur in the absence of drugs. However, the class of drugs that includes synesthesia as a prominent/likely effect is the hallucinogens.

The other options are incorrect because stimulants, benzodiazepines, and opioid narcotics usually do not produce synesthesia.

127.

If you were studying rational emotive behavior therapy (REBT), which therapeutic technique would you MOST likely be interested in?

  • Beliefs

  • Emotions

  • Actions

Correct answer: Beliefs

Rational emotive behavior therapy (REBT) was developed from the assumption that people have emotional disturbances due to how they construct views of reality through beliefs.

The other options are incorrect because REBT does not focus on emotions or actions.

128.

You are a social worker in a crisis center and are working with your client, Ross, who has entered crisis after being repeatedly sexually assaulted by his wife. The two of you have worked together through an assessment, established rapport, and have now moved on to discuss the problem at hand. Part of this discussion is around the causes of the situation. Ross wants to know what the point of that is.

What is your BEST response?

  • Identifying causes will help Ross navigate future crises

  • Identifying causes will help Ross process his emotions

  • Identifying causes will help Ross implement his crisis plan

  • Identifying causes will help Ross access further resources

Correct answer: Identifying causes will help Ross navigate future crises

So far, Ross has done half of the work up to this stage of crisis intervention. Problem identification is generally easy for clients, who want to discuss their problems anyway, whereas addressing causation can be much more difficult. However, a crisis is a teaching process, and part of that learning is for Ross to understand both the process of current events and the style of his reaction to them.

While the other answers have some merit, the real purpose of this part of crisis intervention is still to enable the client's learning. Addressing causation may help Ross process his emotions and it will contribute to implementing his crisis plan, and through doing so, it can then grant Ross access to resources.

129.

Suicides and violent acts toward others are the MOST common in this population:

  • Individuals using substances

  • Individuals experiencing divorce

  • Children who are victims of sexual abuse

  • Individuals who have a high socioeconomic status

Correct answer: Individuals using substances

Individuals who abuse substances are at a much higher risk of attempting and committing suicide than those who are not addicted. This could be because these individuals are also more likely to suffer from mental disorders and sometimes use substances to mask symptoms. Additionally, individuals who abuse substances are also much more likely to commit violent acts and be the victims of violent crimes.

The other options are incorrect because these groups are less likely to commit both suicide and violent acts than individuals who abuse substances.

130.

The Miller family is being seen at a social service agency after their apartment was almost destroyed in a fire that started in the next-door neighbor's residence. They present to you a long list of needs and concerns, most of which are related to the fire and recovering from it. The family also has a lot of opinions regarding priorities and any related sequence of activities to undertake. 

Which option describes the BEST use of a partialization process that can be used by you and will be MOST effective in yielding the Miller family's list of workable goals?

  • Engage the Miller family in an activity where each member is provided with a stack of slips of paper and asked to write one of their priorities/concerns. Collect the completed slips, present the contents to the family and have them work together to sort the pile into three sets categorized: Immediate, Short-term and Long-term.

  • After an initial session with the entire Miller family, interview each individually so all members have the opportunity to voice their own concerns and views privately. After seeing each in turn, you will assemble a list of tasks/activities and, based on your opinion, rank them from high priority/immediate to low priority/remote. The Miller family will then be given the list and each member is assigned appropriate tasks by you.

  • You create a structured interview process in which family members are given a limited time to speak about their feelings about the crisis, with you taking careful notes and the others listening without interrupting. After each has spoken, you then respond to each with an empathic statement about the material expressed, as well as summarize to the family unit the common elements shared by all. These then can act as a ranked list of priorities.

  • You silently observe the Miller family as an interactive system throughout the session. Near the end of the session, you explain the concept of partialization in terms the family can understand and utilize. Afterward, you give the Miller family a homework assignment to return for the next session with their list of initial priorities on which to focus.

Correct answer: Engage the Miller family in an activity where each member is provided with a stack of slips of paper and asked to write one of their priorities/concerns. Collect the completed slips, present the contents to the family and have them work together to sort the pile into three sets categorized: Immediate, Short-term and Long-term.

Partialization techniques involve breaking down what may initially be very complex and multifaceted problems into manageable parts. In extreme crisis situations, such as the one in this question, they help define these areas, and also help clients clarify their priorities in a collaborative and organized fashion. The optimal means of using almost any technique is to create a way to actively engage and empower any client unit to participate in the process.

Assembling a list of tasks/activites and ranking them and their priority based on your own opinion, and not the family's wishes, would be viewed as unprofessional. The remaining answer options are incorrect, as they all take more time than is appropriate in the crisis represented in this question. 

131.

Davine refuses to drive her car, even though it causes her family much disorganization. A result of her refusal to drive is that her husband has to take her everywhere, sometimes even missing work if she has an appointment. 

Which of the following defense mechanisms is Davine demonstrating?

  • Regression

  • Displacement

  • Sublimation

Correct answer: Regression

Psychological Defense Mechanisms are unconscious, involuntary techniques that reduce anxiety. Regression involves taking the position of a child in some problematic situation, rather than acting in a more adult way. This is usually in response to stressful situations, with greater levels of stress potentially leading to more overt regressive acts.

The other options are incorrect. 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. Sublimation occurs when a person chooses to divert their desires that are consciously intolerable and cannot be directly realized into creative activities that are acceptable. Sublimation channels this energy away from destructive acts and into something that is socially acceptable and/or creatively effective.

132.

Which theorist is affiliated with the extended family systems theory?

  • Bowen

  • McGregor

  • Linehan

Correct answer: Bowen

Murray Bowen is a family therapist known for his contributions to extended family systems theory, which regards the family system as a unit being treated rather than isolating one family member as the identified patient.

The other options are not correct. Marsha Linehan is known for her extensive contributions to the treatment of borderline personality disorder, and Douglas McGregor is known for the development of the Theory Y approach.

133.

One month ago, Tasha experienced a panic attack on the beach when she thought she was drowning. Now, she starts to tremble and feel faint whenever she is near the beach. Which of the following disorders is Tasha MOST likely exhibiting?

  • Panic disorder

  • Conduct disorder

  • Adjustment disorder

Correct answer: Panic disorder

According to the DSM-5, an individual who experiences recurring panic attacks in situations in which there is no life-threatening stressor demonstrates a panic disorder. In this question, Tasha experiences anxiety when near a beach due to the fact that she had previously had a panic attack and thought she was drowning.

An individual who is unable to adapt successfully to stressors in the environment demonstrates an adjustment disorder. An individual who repetitively demonstrates a patterned behavior that violates age-appropriate norms and social rules demonstrates a conduct disorder. These two options do not best fit what is described in the information offered in the question. 

134.

There are a number of defense mechanisms that clients can use in order to protect themselves during treatment sessions. Which of the following BEST describes the defense mechanism, "displacement"?

  • Taking emotion intended for one person and displacing it into another

  • Unconsciously forgetting certain unacceptable memories

  • Replacing an unattainable goal with an attainable goal

  • Transforming anxiety into physical manifestations

Correct answer: Taking emotion intended for one person and displacing it into another

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

Repression involves placing uncomfortable thoughts in relatively inaccessible areas of the subconscious mind. Substitution is a defense mechanism in which a client will replace an unattainable goal with an attainable goal, and conversion is a defense mechanism in which anxiety is transformed into overt physical manifestations.

135.

You are meeting with Selena, a 16-year-old female, for individual therapy, though sometimes, her parents join her for sessions. Selena recently disclosed to you that she is sure that she is a lesbian, but that she does not want anyone else to know. You received a phone call after that session from Selena's father, who is worried about her and wanted to know what you two have discussed recently in their individual sessions. 

You should: 

  • Acknowledge Selena's father's concerns about her, but explain the limits of confidentiality during therapy sessions

  • Hang up with her father, obtain consent from Selena, and call Selena's father back to discuss the details of the therapy session

  • Give her father very vague information about Selena's progress in therapy

  • Immediately hang up the phone

Correct answer: Acknowledge Selena's father's concerns about her, but explain the limits of confidentiality during therapy sessions

It is clear from the information offered in the question that, because Selena's parents have joined her during sessions with you, Selena's father is aware that she is receiving treatment. Because of this, you can acknowledge that Selena is receiving services without breaking/breaching confidentiality. However, you ethically should not discuss details of your individual sessions with Selena unless there is something specific that you believe is extremely important to talk about with her parents and, in this case, you should directly inform Selena that her father is asking what they are discussing and give Selena the opportunity to talk with her parents in the context of a family session. 

Though Selena's sexual identity is an important issue, you should explain the limits of confidentiality to her father to model healthy and appropriate boundaries. Obtaining consent from Selena to give her father specific information and providing very vague information about Selena's progress would not be modeling boundaries in the best way. Additionally, immediately hanging up the phone may be perceived as rude and unprofessional, and could cause her father to become defensive.

136.

You receive a referral to provide case management for a family who has just immigrated from Afghanistan and needs to be connected to services to meet some basic needs. The 15-year-old daugher in the family is the only one who speaks English, as well as Dari, which is exclusively spoken by her parents. However, you, who only understands and speaks English, accept the referral. 

This action is:

  • Unethical because you cannot speak to or understand all family members

  • Ethical because the daughter will be available to translate for/to the parents

  • Unethical because you have not determined if the daughter is willing to translate

Correct answer: Unethical because you cannot speak to or understand all family members

Because the parents do not speak or understand English, you should arrange for a qualified interpreter/translator. The use of their 15-year-old daughter, whether she is available and/or willing, is not appropriate because her parents may be apprehensive about identifying family needs to their teenage daughter. Additionally, in this question, what you hear from the parents will be through the daughter, so information might get lost and vice versa when the daughter relays what you say to her parents.

137.

Which of the following would MOST successfully distinguish a patient with delirium from a patient with dementia?

  • Abrupt progression

  • Irritable emotions

  • Memory impairment 

  • Impairment in ADLs

Correct answer: Abrupt progression

In cases of delirium, progression is abrupt. On the contrary, progression in dementia is slow but stable. The abrupt progression seen in delirium would easily distinguish this condition from dementia.

Irritable emotions can occur with both delirium and dementia, so this would not distinguish dementia from delirium.

Both dementia and delirium involve memory impairment. With delirium, recent and immediate memory are impaired; with dementia, recent and remote memory are impaired. While there are differences in the type of memory impairment between dementia and delirium, some type of memory impairment is seen in both, so this would not distinguish the two from each other.

Finally, impairment in ADLs can occur in both dementia and delirium, so this alone would not distinguish the two conditions from each other.

138.

Ginny and Harry, a couple who are both struggling with addictions, have decided to end their relationship, but their breakup was full of anger and catastrophic. However, you are the social worker at the local community center and someone they trust, so they approach you to help them decide how to move forward without more serious trouble. You are being a:

  • Mediator

  • Change agent

  • Broker

  • Advocate

Correct answer: Mediator

Hopefully, you will be able to act as a mediator between the two parties, as your stance remains neutral, and you act mostly as a resource.

Change agents address the needs of groups/organizations, brokers concentrate on the availability of useful resources, and advocates assume leadership for the rights of others.

139.

The following social work role concentrates the MOST on empowering clients:

  • Counselor

  • Change agent

  • Broker

  • Advocate

Correct answer: Counselor

Counselors act to empower or re-empower clients through concentration on individual issues.

Change agents are more concerned with the needs of groups, teams, or organizations. Brokers attempt to find and distribute resources, and advocates step in to speak on behalf of their clients and advocate for their clients' rights.

140.

The following is TRUE about Kendra, a client who is transgender: 

  • Kendra is likely to experience discrimination, bias and/or stigma as a result of her gender identity

  • Kendra is likely to undergo sexual reassignment surgery in the future

  • Kendra is likely to be a cross dresser

Correct answer: Kendra is likely to experience discrimination, bias and/or stigma as a result of her gender identity 

Individuals, like Kendra, who are transgender will often experience discrimination, bias and/or stigma due to misconceptions. 

Most individuals who are transgender do not undergo surgery, and a cross dresser is someone who enjoys dressing in the opposite gender's clothing, but may not identify with said gender. This does not apply in this question, so these options are incorrect.