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LCSW EXAM

Lcsw Exam

by elmcasborn11, May 2009

Subjects: and clinical communication ethics evaluation fresearch lcsw of practice professional relationship supervision therapeutic utilization values

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60 Cards in this Set

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	Which of the following characteristics is most often found in families in which incestuous relationships have occured? a. enmeshment of family members b, distorted patterns of communication c. symbiotic mother-child relationships d. relaxed attitude toward sexuality	enmeshment of family members
	A 28 year old client with a long standing history of drug use is referred to a SW by a concerned relative. In the assessment interview, the client tells the SW about frequent cocaine use. The SW should FIRST: a. conduct a family interview b. begin treatment, focusing on the reason for drug abuse c. refer the client for substance abuse treatment d. evaluate the client's motivation for change	refer the client for substance abuse treatment
	When a SW and a client are of different racial backgrounds, what is the MOST important factor in determining the success of treatment by the SW? a. the SW ability to identify with the client b. the client's ability to experience transference toward the SW c. the SW awareness of self d. the client's ability to communicate openly	the SW awareness of self
	In working with adult survivors of childhood sexual abuse, the MOST frequently encountered defense mechanism is: a. denial b. intellectualization c. devaluation d. projection	denial .
	Parents of a 4 year old child are referred to a SW after an examination reveals no physical problem preventing the child from being toilet trained. The parents reveal that the child has not been able to separate from them to attend nursery school, and often sleeps with them even though they have tried to get him to sleep in his own room. During the assessment phase, the SW's MOST important focus is the: a. parents' use of rewards and punishmnets with the child b. early developmental history of each parent c. parents' understanding of the child's developmental processes d. ways in which the child affects the parents' own relationship	parents' understanding of the child's developmental processes
	An individual who believes, despite evidence to the contray, that feelings, thoughts or actions are imposed by an external source, is suffering from: a. delirium b. delusion c. dissociation d. dysphoria	delusion.
	You gave a much needed referral to a very dysfunctional, chemically dependent client. The client seems interested but, when you see her a week later, she tells you that she is ambivalent about following through with the referral and has not yet called to set up an appointment. You should... a) call to make the appointment for the client to help break through the client's inertia b) clarify the purpose of the referral, explore the client's ambivalence, and encourage the client to follow through c) clarify the purpose of the referral, explore the client's ambivalence, and arrange for a repdresentative of the referral agency to make a home visit to the client d) accept the client's right ro refuse this or any other referral unless she is in imminent danger	clarify the purpose of the referral, explore the client's ambivalence, and encourage the client to follow through.
	Your client is a 10 yr. old boy who is persistently and pervasively irritable. He alienates peers with a negativistic, "grouchy" attitude. Your client should be assessed for... a) depression b) borderline personality disorder c) impulse control disroder d) cognitive impairment	Depression
	In treating a 42 yr. old M who has a panic disorder, you should encourage the client to a) try to supress the symptoms so they will come under the client's conscious control b) exaggerate the symptoms so they will spontaneously extinguish c) allow himself to have symptoms so they will spontaneously extinguish d) distract himself from a conscious ecperience of the symptoms	allow himself to have symptoms so they will spontaneously extinguish
	If you are using the classic DBT model with a borderline personality disorder client, you would provide and/or arrange for the client to receive a) an eclectic combination of interventions involving weelky group and individuals sessions over a 1 yr period b) primarily group therapy emphasizing social skills development over an intensive 3 month period c) primarily individual therapy sessions with special attention to behavorial goals addressed in sequence over an intensive 6 week period d) primarily behaviorally oriented case management services including work with collaterals over a 1 yr period	an electric combination of interventions involving weekly group and individuals sessions over a 1 yr. period.
	An 11 yr. old client with conduct d/o has been physically abused and lacks a sense of empathy for others whom he has abused. He also lacks a sense of safety and security and is socially isolated. In order to help the child develop a greater sense of emapthy for others you should... a) help the client become conscious of, and verbalize, what it was like to be victimized himself b) encourage the client to apologize to the individuals he has abused c) teach communication skills through demonstration and role play practice in sessions d) model and encourage appropriate expressions of anger	help the client become conscious of, and verbalize, what it was like to be victamized himself.
	In developing a diagnostic formulation for a 27 yr. old client who appears to be in the prodromal stage of schizophrenia, the mental status exam is useful in determining.. a) the cause of the individual's symptoms b) the factors which trigger the onset of symptoms c) the nature of the individual's mental state at a point in time d) the individual's course of deterioration from the time of initial onset of symptoms	the nature of the individual's mental state at a point in time
	A 25 yr. old depressed client has been abusing alcohol, marijuana, and hallucinogens. He has made several recent suicide gestures but his current suicide risk is low to moderate. He claims that he only becomes depressed when he is intoxicated or shortly thereafter, and is never depressed when he has been abstinent for several days. Your treatment plan should focus on... a) the depression since the depression is causing the suicide risk b) the substance abuse since the client says he is only depressed when he uses drugs c) whichever of these two conditions is determined to be causing the other d) whichever of these two conditions the client is most ready to work on with you	whichever of these two conditions the client is ready to work on with you
	Your client is a person of about your age who appears to feel somewhat attracted to you. The client responds to your warmth and acceptance as if it were an attempt at seduction. You should... a) explore the client's history of sexual abuse or harassment because it is likely cause of this kind of distoration b) comment on how the therapy relationship is an intimate relationship and distinguish it from other intimate relationships c) explain that appropriate porfessional distance between a SW and client should not involve sexual feelings d) prepare for termination and refer the client to another service provider who can meet the client's needs	comment on how the thrapy relationship is an intimate relationship and distinguish it from other intimate relationships
	Your client is a single mother whose 15 yr. old son has been experiencing a variety of behavorial problems associated with oppositional, defiant behavior and thrill seekling with a group of rowdy group of peers. Because she has been socially isolated most of her life, she ventilates her emotions freely during sessions wtih you, to the point where she feels embarassed. The first thing you should do is... a) paraphase her comments in a way that directs attention away from affect and more to factual aspects of the situation until she is ready for greater self revelations b) assure her that you are taking a professionally detached, nonjudgemental stance and that she should feel safe c) encourage her to participate more actively in social support networks so that she will not feel pressured to reveal so much in any one relationship d) encourage her to see you for conjoint therapy sessions with her son in order to reduce the focus of herself	paraphrase her comments in a way that directs attention away from affect and more to factual aspects of the situation until she is ready for greater self revelations.
	Your client is a 55 yr. old M with a problem of alcohol dependence and dysthymic d/o. He comes to see you in crisis, complaining of problems with inappropriate anger, appetite disturbance, low self esteem, and social withdrawal. Which of the following would be the most appropriate objective for inclusion in this client's treatment plan? a) reduce depression by 50% by 6 months from this date b) eliminate appetite disturbance by 6 months from this date c) restore client to pre-crisis level of functioning d) attend at least 2 recreational groups at least 1 x per week for two months by May 1	attend at least 2 recreational groups at least 1 x per week for two months by May1.
	Your new client is a 26 yr. old carpenter who is troubled by depression. In order to determine whether or not he has a major depressive d/o vs dysthymia, you will need to find out.. a) whether or not he experiences vegetative symptoms of depression b) whether or not his depression is caused or exacerbated by use of substances c) if he has ever been suicidal while depressed d) is he is depressed most of the day nearly every day	if he is depressed most of the day nearly every day.
	You have been assigned by your employer, a community MHC, to be the case manager for Mr, K, a 43 yr. old M with schizophrenia. This means that you should... a) facilitate the client's access to resources in the community b) not provide psychotherapy services but should coordinate your efforts with the client's psychotherapist c) serve as the cleint's single point of responsibility for coordination of services throughout your county's mental health service system d) provide services to the client in his natural community settings, not in an office	facilitate the client's access to resources in the community.
	In order to determine a group's leadership hierarchy you should find out... a) which individual has the greatest influence on group decisions b) which individuals do the members turn to for expertise, activity leadership, and affective leadership c) which individuals do the members feel most comfortable talking to d) who is the best liked member	which individuals do the members turn to for expertise, activity leadership, and active leadership.
	After developing a problem formulation, you and your client should select an intervention method that has demonstrated efficacy for treatment of that particular problem. This means that you will be using an intervention method that... a) will be effective in this case b) will probably be effective in this case c) has been shown to be effective when used by others d) has been shown to achieve a high level of client satisfaction	has been shown to be effective when used by others.
	A client says of her SW "She may understand me but she does not know how I feel" This indicates that the client precieves the SW to be weak with regard to.. a) genuiness b) non-possessive warmth c) acceptance d) accurate empatthy	accurate empathy
	You are providing SW services to a fly. of a 5 yr old autistic child. Although a through diagnostic assessment has not yet been completed, the child's autism DX has now been confirmed. Further diagnostic assessment should be done to determine the presence of... a) childhood disintegrative disorder b) Asperger's disorder c) mental retardation d) sterotypic movement disorder	mental retardation
	Mrs. S. is a 62 yr. old woman who was referred to you, a hospital SW, by her husband's MD. Mr. S. has experienced a massive stroke. The MD wanted you to provide supportive counseling to Mrs. S. who has become extremely anxious and guarded since her husband's medical crisis. The problem is that, even before meeting you, Mrs. S calls and leaves a message saying that "everything is just fine" and that she dosen't need your help. You should... a) consult with the MD and ask to be present the next time the MD meets with Mrs S so that you might have an opportunity to introduce yourself to her b) arrange to be at Mr S's bedside during visiting hours so that you might have an opportunity to meet Mrs S and introduce yourself to her c) accept Mrs S's right to reject your services and don't pursue this unless she contacts you again d) ask the MD to refer Mrs S to psychiatry since her level of denial is so severe	consult with the MD and ask to be present the next time the MD meets with Mrs. S. so that you might have an opportunity to introduce yourself to her
	In assessing your adolescent client's developing sense of identity, you should determine a) how well the client recognizes his common personhood with pepole of other cultures and generations b) whether or not the client is able to derive a sense of self-esteem by caring for others within the extended family or larger community c) how well the client is adapting to social demands to begin making adult role choices d) whether or not the client has a sense of time perspective, a sense that there will be a future and that he will be there in the future	how well the client is adapting to social demands to begin making adult role choices
	You are providing psychotherapy to a 34 yr. old AA/F whose goal is to reduce her social phobia anxiety so that she can preform effectively once again on the job. The most appropriate treatment plan objective is... a) help the client obtain anti-anxiety medications by a specified date b) improve ego functioning by a specified date c) make eye contact and say hello to at least 5 people at a social gathering by a specified date d) improve self-esteem as reported by client by a specified date	make eye contact and say hello to at least 5 people at a social gathering by a specified date.
	You have been helping a substance dependent client overcome obsessive compuslive behavior that is not directly related to the substance use. His substance dependence has been characterized by denial and avoidance, but recently he has been considering either reducing or abstaining from substance use. Your best intervention at this stage is to.. a) shift the treatment focus primarily to his SA b) discuss SA use in a general way and help the client understand the effects and consequences of the substances he is using c) help the client identify his abstinence and sobriety goals and objectives d) work with the client to remove temptations and arrange positive substitutes for the substance and its associated harmful habits	discuss substance use in a general way and help the client understand the effects and consequences of the substance he is using.
	When taking a psychodynamic approach to group therapy you would... a) expect hostility from the group and accept it b) avoid hostility laden issues c) focus on resolution of current life problems, not the group process d) encourage supportive socialization among group members outside of the group sessions	expect hostility from the group and accept it
	Mr. and Mrs J., a couple in their late 60's, seek help because of recent changes in Mr. J's behavior. According to his wife he started having problems of immediate recall 3 yrs ago just before his 66th birthday. Nothing appeared to change until last yr. when he suddenly developed problems calculating numbers and putting his thoughts into writing, even when he could say what he was thinking. Things stabilized again until just last month when Mr. J. began showing evidence of problems remembering events that have occurred over the previous few days and weeks. Mr. J's DX is most likely.. a) amnestic disorder and Parkinson's disease b) delirium and a primary degenerative dementia c) vascular dementia d) dementia of the Alzheimer's type	vascualr dementia
	Mrs. J is having second thoughts about the toddler placed with her for adoption. He is not at all interactive with her, shows no warmth, and appears to be internally preoccupied. She fears that he might be autistic, but your assessment indicates that his DX is reactive attachment d/o. The adoption is not yet complete and Mrs. J is considering terminating the process and returning the child to a foster care placement. You should help Mrs J.. a) make a commitment to keep the child since he will probably overcome his symptoms in time b) follow through with her desire to terminate the adoptive proceedings since her ambivalence will likely interfere with bonding c) improve her parenting skills so that the child will be more affectionate and responsive to her d) make a decision about proceeding or not proceeding with the adoptive placement	make a decision about proceeding or not proceeding with the adoptive placement.
	You are providing field instruction in clinical SW to a graduate student. You met the student in a social setting 1 yr ago and the two of you indicated your attraction for one another at that time, but no further social contact developed.. a) you should redirect the student to another field instructor because this relationship would be a dual relationship in view of your prior relationship b) because the student is an adult and is not a therapy client, the student is responsible for setting clear and appropriate boundaires in this field instruction relationship c) because the student is and adult and is not a therapy client, you and the student have a mutual responsibility to set clear and appropriate boundaries in this field instruction relationship d) even though the student is an adult and is not a therapy client, it is your responsibility to set clear and appropriate boundaries in this field instruction relationship	even though the student is an adult and is not a therapy client, it is your responsibility to set clear and appropriate boundaries in this field instruction relationship.
	Your client is a 50 yr. old M with unresolved grief over the loss of a close loved one. He feels that he is "in crisis" and is confused about the next steps to take in adjusting to the loss. In the early stages of therapy your comminuications with the client should focus on a) small, readily reachable goals that are percieved by the client as involving "hard work" b) concrete and specific goals that are percieved by the client as "easy" c) eliminating the negative rather than achieving the positive d) his here and now experience rather than goals envisioned for some future time	small readily reachable goals that are precieved by the client as involving "hard work"
	Your newly referred client, a 42 yr old F who has been a victim of domestic violence, says "I don't think there's much point in me coming to this support group. I had a friend who came here 5 or 6 times and she didn't seem to get much out of it. I have my doubts." Which response will best encourage the client to elaborate on expressing her concerns.... a) Why don't you talk to some of the other people who attended? I think you'd get a different perspective b) Why don't you come back in a few days after you've had a chance to think it over and we'll discuss it some more. c) What are some of those doubts? d) Many women in your situation are reluctant to reach out for fear of retribution. Could that be why you feel this way?	What are some of those doubts?
	Your client is a 37 yr old M who has avoided air travel since the 9/11/01 terrorist attack. He says that air travel is much too dangerous because terrorists have relativey easy access to airplanes and because the potential damage and publicity value is so high. His avoidance of air travel has curtailed his business productivity as he has had to limit himself primarily to local business relationships. He wishes he could fly, but says "I wouldn't dare" Your client's feelings about flying are best described as... a) acrophobia b) specific phobia c) fear d) histrionics	fear
	Your client is overly compliant. He is very sensitive to cues indicating what your values and preferences are. As a result, he acts as if he accpts your advice and suggestions without question, even though you would expect disagreement based on other things he has said over the past few weeks. Which of the following responses best demonstrates an honest labeling of the client's behavior? a) "You're accepting a lot of my advice without question, but I sense that you disagree." b) "I'm concerned that you're not allowing yourself to express yourself freely with me. Let me reassure you that I accept you and care about you regardless of your opinions." c) "I sense that you might have been exposed to a lot of judgemental treatment by others in the past. Can you tell me something about that?" d) "Your response to my advice suggests a very dependent way of relating to me."	"You're accepting a lot of my advice without question, but I sense that you disagree"
	You are conducting an assessment of a 45 yr old alcohol dependent veteran. You should use "serial sevens" as an element of the MSE to test for this client's.. a) concentration and orientation b) calculation ability and concentration c) calculation ability and orientation d) calculation ability and intellegence	calculation ability and concentration
	The Cunninghams have sought your advice in order to help them better care for, and adjust to the stress of caring for Mrs C's mother who has dementia of the alzheimer's type. Mrs C's mother, who lives in an extended care facility, does not usually recognize either of them. You should advise your clients to.. a) visit infrequently since the mother doesn't recognize them, but work with care facility administratior to be sure she is getting good physical care b) visit on a regular basis along with others from the extended family c) visit infrequently to reduce stress on themselves, but visit for full days at a time d) maintain social contact, limit visits to one or two visitors at a time, and keep visits short	maintain social contact, limit visits to one or two visitors at a time, and keep visits short
	When taking a Psychodynamic approach to therapy, with a Self Psychology emphasis, you should provide an anxious, adult client with... a) an opportunity to develop an adequate selfobject by nonjudgementally empathizing with the client's affective experience b) self-instruction skills that the client can use to reframe his or her own distorted perceptions c) encouragement to participate in self help groups d) information about principles of psychodynamic interpretation so that the client can learn to interpret his or her own motivations as they arise	an opportunity to develop an adequate selfobject by nonjudgementally empathizing with the client's affective experience
	When conducting an assessment of a client whose primary language is different than your own, you should temper your impressions with an awareness that.. a) flow of thought may reflect indicators of cognitive disturbances in the absence of true cognitive disturbances b) expression of affect is emphasized when speaking in a secondary language c) deferential behavior expressed during a clinical interview should be recognized as reflecting a general pattern of social anxiety, even though it may be culturally based socail anxiety d) self effacing behavior is less likely when a client speaks in a secondary language because the individual is likely to take pride in his or her bilingual skills	flow of thought may reflect indicators of cognitive disturbances in the absence of true cognitive disturbances.
	Your client is a 35 yr old M who hunts for reasons to justify his behavior and beliefs. The reasons he comes up with are often inconsistent with one another, but he is unable to recognize the inconsistency and has a strong defensive reaction when his reasons are questioned. Your client is using which of the following defenses? ) rationalization b) intgellectualization c) displacement d) reaction formation	rationalization
	As an employee of a comminituy MHC you have been assigned to provide case mangement services to a 43 yr old F with Bipolar II D/O who has an 11 yr old daughter. She is irritable, socailly withdrawn person who is intermittently homeless. The primary goal of your work with this client should be to... a) make the unconscious conscious in order to resolve the motivation for her social isolation b) improve the quality of the relationship between the woman and her daughter c) optimize the client's functioning by providing services in the most efficient and effective manner possible d) provide opportunities for this isolated client to talk about her concerns	optimize the client's functioning by providing services in the most efficient and effective manner possible

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