August 12, 2015

ASWB Advance Generalist Practice Questions Answer Key and Explanations

1. Key: A Content Area: Comm.

Evaluate what the couple means by “improved communication.” Before attempting to address their vague request, clarity must be obtained. The difference between “argument winning” and “communication” must be made plain, and the concepts of compromise and fair play in negotiating need to be understood. Once clarity has been obtained, the other options noted may offer considerable insights.

2. Key: C Content Area: PV&E

Document the patient’s request and the rationale for nonrelease. The key words here are “concerned that serious harm may result.” Consequently, an immediate release of records to the client would not be indicated. One option would be to release records (or perhaps a clinical summary might suffice) to the newly engaged therapist. Ideally, any release of information form signed would also allow the social worker to discuss any concerns with the new clinician directly. Regardless, any rationale for nonrelease at any point must be properly documented in the client’s file.

3. Key: D Content Area: PE&UR

Pre-test/post-test control group. This is the only possible answer. There is no static group, nor is there just a single group (i.e., there is both a control and an intervention group). Finally, quasi-experimental design lacks random assignments to the groups created, and so the study does not fit this as well.

4. Key: B Content Area: SD

Social justice. See: McInnis-Dettrich, K. (1994) Integrating Social Welfare Policy and Social Work Practice. Pages 126-131.

5. Key: D Content Area: RI

Goal congruence, which, according to Drisko (2009), is the fourth of five key factors required for a quality therapeutic relationship between client and clinician.

6. Key: A Content Area: HD&BE

Female, 3-7 years of age. The “Electra Complex” is the female counterpart to the “Oedipus Complex” and typically occurs between the ages of three and seven.

7. Key: D Content Area: Diversity

Culture-bound syndromes. Some apparent mental health symptoms may arise from certain culture-specific dictates of behavior, mood, or thought processes. For example, talking with ghosts or other spirits, seeing hallucinations or visions, hearing voices, etc, can all be attributed to certain cultural and/or religious groups. In such situations, the individual should not receive a mental illness diagnosis.

8. Key: D Content Area: D&IDP

Cognitive approach. Considerable work must be done to seek out and clarify a client’s false beliefs and misconceptions that underlie problem behaviors and interpersonal issues. This approach has a significant educational component, as the client must be taught ways to identify these errant thoughts and how to circumvent and/or overcome them using new strategies and coping skills.

9. Key: C Content Area: AD&IP

Depressants. Most anxiolytics (anti-anxiety medications) are benzodiazepines, which makes them depressants in their action on the central nervous system. There are exceptions, however, such as buspirone (BuSpar), which is a psychotropic drug that is a serotonin receptor stimulant.

10. Key: D Content Area: PV&E

Contact the client’s wife to inform her of the danger. According to recent interpretations of the Tarasoff v. Regents of the University of California case (1976, California Supreme Court ruling) confidentiality, in this situation, may be breeched if: 1) the HIV infection is known; 2) unprotected sex (or sharing of needles) is occurring; 3) the behavior is actually unsafe; 4) the client refuses to modify his behavior even after being counseled regarding the harm; and 5) if HIV transmission will likely occur.

11. Key: C Content Area: HD&BE

6-12 years old. A “latency-aged” child is one between the ages six and twelve.

12. Key: C Content Area: SD

Changes in policy and law that led to the release of many mental health patients who would have otherwise remained in institutional settings. Involuntary hospital commitment (i.e., in an asylum) became increasingly common up to the 1950s. However, the Community Mental Health Act of 1963 began to reverse this trend, as did the 1999 US Supreme Court ruling in Olmstead vs LC. In 1970 there were 413,066 beds in state and county mental hospitals, which fell to 119,033 by 1988, and to 63,526 by 1998. This era has since come to be called the era of “deinstitutionalization.” Sometimes over done, issues of homelessness among the mentally ill, and “re-institutionalization” in the prison system have been noted.

13. Key: C Content Area: AD&IP

Transference/countertransference conflicts. Transference (client to therapist) and countertransference (therapist to client) include emotions, reactions, defenses, desires, and feelings that come to bear on the relationship and/or the problem, whether consciously or unconsciously.

14. Key: C Content Area: HD&BE

Classical conditioning and operant conditioning. Stimuli that induce a reaction without training are called “primary” or “unconditioned” stimuli. They include food, pain, and other “hardwired” or “instinctive” stimuli. Stimuli that do not induce a desire reaction until after conditioning has occurred are called secondary or conditioned stimuli.

15. Key: B Content Area: SD

Means tested programs. Universal programs are open to everyone, without any exclusion criteria. Exceptional eligibility programs are only available to certain groups with common needs, such as the Veteran’s Health Administration. Selective eligibility programs are either “means tested” (including asset evaluation) or “income-tested” (looking solely at financial income).

16. Key: B Content Area: AD&IP

Schizophrenia. This is the only diagnosis, among the options given, that fits the client’s overall presentation

17. Key: C Content Area: PV&E

Disclosures to an employer providing insurance coverage. There is no requirement that information be disclosed to an employer providing coverage, unless the employee has previously stipulated information to be released in consenting to coverage and services. Payment for coverage by an employer does not, in and of itself, entitle the employer to any private client information. Even under conditions of subpoena, social workers may be able to limit the scope of information shared, or even claim “privileged communication” status in response to orders to testify.

18. Key: A Content Area: D&IDP

Attention, retention, reproduction, motivation. Bandura and his colleagues demonstrated that consequences (reinforcement, punishment, etc) were not always necessary for behavioral change or other learning to take place. Simply observing someone else’s activity could be sufficient. The four step pattern was as follows:

Attention – the individual notices something in the environment. 2. Retention – he remembers what was noticed. 3. Reproduction – he copies what was noticed. 4. Motivation – the environment delivers a consequence (reinforcement or punishment), that affects the probability that the behavior will be repeated. Most advertising uses these principles: a product is presented as socially desirable (attention). The ad is remembered (retained), the purchase is made (reproducing the ad’s direction to buy), and if social approval is forthcoming then further purchases will be made.

19. Key: C Content Area: Comm.

Discuss with him the difficulty he is experiencing, and encourage him to take more time. “Sentence finishing” often substitutes the therapist’s thoughts in place of the clients, which the client may then accept to relieve the burden he is feeling. Pressing the client to continue will often make the problem worse. Ignoring the problem and waiting indefinitely may lead to premature termination.

20. Key: D Content Area: Comm.

Acknowledge the strong ambivalent feelings she is feeling. The tendency is to jump in and clarify for the client the classic features of relationship abuse. However, doing so is likely to immediately alienate the client, who has already told the social worker of her ambivalent feelings. Allowing her to process those feelings, and then moving on to explore other past relationships and reality-testing this one will be a much more successful approach.