1. You are called to evaluate a 64-year-old male with chronic obstructive pulmonary disease. He lives in an assisted living facility, and was brought to the emergency room by his daughter. She had taken him to lunch, and became distressed when he refused to return to the facility. He states he wants to live in his motor home, as he resents the loss of privacy at the facility. His daughter confirms he owns a working, fully self-contained motor home (i.e., stove, shower, refrigerator, etc). He has adequate funds. He plans to park the motor home in a nearby Kampgrounds of America (KOA) campground, where all utilities can be hooked up. He can have food and other supplies delivered. However, it is November and it is unseasonably cold. The doctor confirms that the patient is prone to pneumonia, and the daughter states “he will die if he doesn’t return to the facility.” The patient refuses to consider any other living situation. In this situation, the social worker should:
a. Call the police and have them take the patient back to the facility.
b. Call adult protective services for further intervention.
c. Allow the patient to move into his motor home.
d. Place the patient on an involuntary hold for suicidal behavior.
2. You have just had your first session with a 24-year-old college student. She is seeing you following the break-up of a two-year relationship, which occurred without warning about six weeks prior to this visit. As she explained it, “He met someone else and just moved on.” She has been having trouble sleeping and concentrating on her studies since that time. Today she presents as dysphoric and tearful, but is affectively expressive and responsive to humor and other interactive stimuli. The university she attends is a considerable distance from her family and friends, leaving her with limited support during this difficult time. The most appropriate diagnosis would be:
a. Primary insomnia.
b. Major depression.
c. Adjustment disorder with depressed mood.
d. Acute stress disorder.
3. You are hired by a private practice therapist who operates a court-supervised violent offender treatment program. One of your responsibilities is to screen new client referrals, to ensure that only low-risk, first-time offenders are accepted into the program. In this process, you are to have each client sign a treatment consent form, which also includes a detailed consent for release of information. You note that instead of the usual time and target limits, the form allows information to be released at any time to “any law enforcement agency,” “any spouse, ex-spouse, or significant other,” “any welfare or abuse protection agency,” etc. You ask about the ethics of having clients sign this form, and you are told, “It’s a hassle to try and get specific information releases, and the safety of the public is at stake. Use the form.” Your BEST response is to:
a. Use the form as directed.
b. Refuse to use the form.
c. Call your licensing board and discuss the form.
d. Call law enforcement and discuss the form.
4. In statistical research, a “Type I Error” (also called an “alpha error,” or a “false positive”) refers to:
a. Failing to reject the null hypothesis when the null hypothesis is false.
b. A failure to randomize research participants, thereby potentially introducing bias.
c. Rejecting the null hypothesis when the null hypothesis is true.
d. Assuming a normal statistical distribution when it is skewed.
5. Identify the missing step in Albert R. Roberts seven-stage crisis intervention model: 1) assess lethality; 2) establish rapport; 3) __________; 4) deal with feelings; 5) explore alternatives; 6) develop an action plan; 7) follow-up. The third step is:
a. Evaluate resources.
b. Identify problems.
c. Environmental control.
d. Collateral contacts.
6. Self-Psychology, as postulated by Heinz Kohut, acknowledges that personality is partly formed by social structure. A cohesive self is achieved by incorporating the perceptions and functions of healthy significant others and objects into an internalized self structure through a process called:
a. Empathic mirroring.
d. Transmuting internalization.
7. An early cognitive theorist, who worked directly with Freud, established a theoretical orientation that differed from Freud’s in three key features: 1) an individual’s personality is best perceived as a whole, rather than as having hierarchical segments or parts; 2) social relationships drive behavior more than sexual motivations; and 3) current beliefs and thoughts play a far greater role in human behavior than is suggested via psychoanalytic theory, which is based largely in the unconscious and in past experiences and beliefs. The name of this theorist is:
a. Lawrence Kohlberg.
b. Anna Freud.
c. Albert Ellis.
d. Alfred Adler.
8. In working with a client, you become aware that she persistently behaves in ways to please or gain the approval of others. While this is not always problematic, you discover that she is obsessed with wearing the “right” clothes, living in the “right” neighborhood, and marrying the “right” person. At present, her finances are in a shambles as she tries desperately to “keep up with the Joneses,” and her romantic life is suffering, as she only pursues relations that she believes others think are optimum, rather than judging relationships on more personally relevant values, such as her feelings for them, baseline compatibility, etc. Utilizing Kohlberg’s Theory of Moral Development, specify the Level and Stage of moral development that applies to this individual:
a. Conventional Level, Stage 3.
b. Pre-conventional Level, Stage 1.
c. Post-conventional Level, Stage 6.
d. Conventional Level, Stage 4.
9. You have been contacted by a couple to assist them with issues of marital discord. They have been married about six months. The wife presents as vulnerable, tearful, and anxious, and the husband presents as angry and overwhelmed. The wife openly claims that “he has never loved me,” and expresses anger that he married her without “the proper feelings.” The husband responds that he has “done everything possible” to “prove” his love (to the point of near bankruptcy and jeopardizing his employment with frequent absences), but nothing is sufficient. During the interview, you discover that she has had many short-term relationships in the past, that she has a history of suicide gestures and “fits of rage.” Further, she frequently demands a divorce and then begs him to stay, is routinely physically assaultive, etc. The most likely diagnosis is:
a. Intermittent explosive disorder.
b. Histrionic personality disorder.
c. Paranoid personality disorder.
d. Borderline personality disorder.
10. All but one of the following are National Association of Social Workers (NASW) standards for cultural competence:
a. Social workers should endeavor to seek out, employ, and retain employees who provide diversity in the profession.
b. Social workers shall endeavor to resources and services in the native language of those they serve, including the use of translated materials and interpreters.
c. Social workers should develop the skills to work with clients in culturally competent ways, and with respect for diversity.
d. Social workers should work with diverse clients only if they have had specific training in that client’s unique cultural background.
11. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is used to diagnosis mental disorders. It also allows for the entry of related factors through a multi-axial coding approach. Name the proper axis (in the corresponding order) for entry of each of the following: a) the Global Assessment of Functioning; b) relevant physical disorders; c) personality disorders and mental retardation; d) relevant psychosocial factors; and e) clinical disorders:
a. Axis I; Axis III; Axis II; Axis IV; and Axis V.
b. Axis V; Axis III; Axis II; Axis IV; and Axis I.
c. Axis II; Axis IV; Axis III; Axis V; and Axis I.
d. Axis IV; Axis III; Axis II; Axis V; and Axis I.
12. You are seeing a 16-year-old youth who has, for the past year, been losing his temper frequently, is regularly argumentative with adults, often refuses to follow direct requests, is easily annoyed, and routinely uses blaming to escape responsibility. Approximately four months ago he was caught in a single episode of shoplifting. The most appropriate diagnosis for this youth is:
a. Oppositional defiant disorder.
b. Conduct disorder.
c. Impulse-control disorder.
d. Disruptive behavior disorder, not otherwise specified.
13. Encopresis is defined as:
a. The voluntary or involuntary passage of stool in an inappropriate place by a child over the age of four.
b. The voluntary or involuntary passage of stool in an inappropriate place by a competent adult.
c. Deliberate fecal incontinence only in a child over age four.
d. Involuntary fecal incontinence only in a developmentally delayed adult.
14. The following criteria are all used to distinguish substance abuse from substance dependence except:
a. Symptoms of substance abuse are usually less severe than those of dependence.
b. The problematic effects of abuse are usually limited to family, finances, employment, and legal issues (e.g., driving under the influence), while dependence also involves significant physiological problems.
c. Substance abuse typically involves narcotics, while dependence typically involves non-narcotic drugs.
d. Abuse is typically limited to recreational use, while dependence involves the need for increasing doses for the desired effect and withdrawal symptoms of not used regularly.
15. Name the four classic diagnostic “A’s” of schizophrenia:
a. Awareness, ambivalence, autism, and associations.
b. Agitation, awareness, associations, and autism.
c. Affect, anxiety, ambivalence, and awareness.
d. Affect, associations, ambivalence, and autism.
16. You are called to see a young black man in his mid-twenties. Two adult sisters brought him for an urgent appointment. The young man is clean, neatly dressed in slacks, dress shoes, and a tweed sport coat. He is also calm, relaxed, and without any signs of agitation. The two sisters, however, appear disheveled, frazzled, and almost histrionic. They blurt out the he “has problems” and urge you to talk with him. Privately, he tells you that he is fine. Later, however, the ladies tell you he left home abruptly and traveled cross-country with no destination. He didn’t sleep for three days (with them pursuing him), was spending money excessively and writing checks he couldn’t cover. He ended up in a nationally famous amusement park at 3:00 a.m. (having scaled a fence), sitting on an empty roller coaster “waiting for the ride to start.” When confronted, he admits all of this, but says he’s now rested, and doing better. The most likely diagnosis would be:
a. Brief psychotic disorder.
b. Bipolar I, single manic episode, in full remission.
c. Bipolar I, single hypomanic episode, in full remission.
d. Cyclothymic disorder.
17. A therapeutic approach that views the client from a social context, that sees behavior as derived from unconscious drives and motivations, that views disorders and dysfunction as emerging from internal conflicts and anxiety, and that seeks to facilitate the conscious awareness of previously repressed information is called a:
a. Cognitive approach.
b. Psychoanalytic approach.
c. Gestalt approach.
d. Behavior approach.
18. The concepts of “pre-affiliation” (becoming acquainted), “power and control” (setting the roles), “intimacy” (developing cohesion), “differentiation” (independent opinion expression), and “separation” (moving to closure and termination) are all stages in:
a. The lifecycle of a therapeutic relationship.
b. General relationship cycles.
c. Group development.
d. Team cohesion.
19. When a client seems overwhelmed or uncertain how to share further, it can help to break down the concerns at hand into smaller, more manageable parts. This communication technique is known as:
20. “Single system” research designs involve observing one client or system only (n=1) before, during, and after an intervention. Because of their flexibility and capacity to measure change over time, single system designs are frequently used by practitioners to evaluate:
a. Their practice.
b. Difficult clients.
c. Conformation to policy.
d. Regulation adherence.