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LICSW exam
| Question | Answer |
|---|---|
| A. Extend the session to preserve rapport; B. Terminate services for noncompliance; C. Review attendance policy and address impact therapeutically (Correct); D. Ignore the behavior to avoid conflict | |
| A. Warn the coworker; B. Call law enforcement; C. Conduct a risk assessment and document (Correct); D. Terminate therapy | |
| A client asks you to store personal belongings at your office. What is the MOST appropriate response? | A. Agree to support the client; B. Store items temporarily; C. Decline and explain professional boundaries (Correct); D. Refer the client elsewhere |
| A client reports nightmares after a recent sexual assault. What should the social worker do FIRST? | A. Begin trauma narrative processing; B. Assess trauma symptoms and focus on stabilization (Correct); C. Refer immediately to psychiatry; D. Encourage avoidance of reminders |
| A client requests that uncomfortable details be removed from their medical record. What is the BEST response? | A. Amend the record as requested; B. Delete sensitive content; C. Explain records cannot be altered and document discussion (Correct); D. Transfer the client |
| A client asks, “Do you think life is worth living?” What is the MOST appropriate response? | A. Share personal beliefs; B. Redirect the question; C. Respond empathically and assess suicide risk (Correct); D. Reassure without assessment |
| A client wants therapy sessions by phone while driving. What should the social worker do? | A. Allow if client insists; B. Proceed with caution; C. Decline due to safety and reschedule (Correct); D. Terminate services |
| A client reports binge drinking but denies consequences. What intervention is MOST appropriate? | A. Confront denial; B. Mandate abstinence; C. Use motivational interviewing and assess severity (Correct); D. Refer immediately to inpatient care |
| A client makes repeated inappropriate jokes toward the therapist. What should the social worker do FIRST? | A. Ignore the behavior; B. Terminate therapy; C. Set clear boundaries and address therapeutically (Correct); D. File an incident report |
| In couples therapy, one partner asks you to keep a secret from the other. What is the BEST response? | A. Agree to maintain confidentiality; B. Disclose immediately; C. Clarify limits of confidentiality in couples work (Correct); D. Terminate couples therapy |
| A client relapses after a period of sobriety and feels ashamed. What is the MOST appropriate response? | A. Emphasize consequences; B. Normalize relapse and refocus on coping (Correct); C. Recommend discharge; D. Increase confrontation |
| A client asks for a diagnosis solely to obtain workplace accommodations. What should the social worker do FIRST? | A. Assign a provisional diagnosis; B. Refuse outright; C. Conduct an appropriate assessment (Correct); D. Refer to HR |
| A client becomes tearful but says, “I’m fine.” What is the BEST response? | |
| A client needs a higher level of care but refuses group therapy. What should the social worker do? | |
| A client reports suicidal thoughts but states their religion prevents action. What is the MOST appropriate action? | A. Accept the reassurance; B. End assessment; C. Complete full suicide risk assessment (Correct); D. Refer to clergy only |
| A client reports memory loss after a head injury. What should the social worker do FIRST? | A. Begin psychotherapy; B. Ignore symptoms; C. Refer for medical evaluation (Correct); D. Diagnose dissociation |
| A client asks whether physical discipline of a child is acceptable. What is the BEST response? | A. Approve culturally; B. Avoid discussion; C. Educate on nonviolent alternatives and assess risk (Correct); D. Immediately report to CPS |
| A client demands sessions longer than scheduled. What should the social worker do? | A. Extend sessions; B. End therapy; C. Maintain boundaries and process needs (Correct); D. Reduce session frequency |
| A client accuses the therapist of favoritism in group therapy. What is the BEST response? | A. Defend yourself; B. Remove the client; C. Address the concern openly and reinforce norms (Correct); D. Ignore the comment |
| A client reports panic symptoms that resemble a heart attack. What should the social worker do FIRST? | A. Diagnose panic disorder; B. Provide reassurance only; C. Assess medical rule-out and provide psychoeducation (Correct); D. Refer immediately to inpatient psychiatry |
| A client discloses passive death wishes but denies intent. What should the social worker do FIRST? | A. Refer immediately for hospitalization; B. Ignore since there is no intent; C. Complete full suicide risk assessment (Correct); D. Encourage positive thinking |
| A client asks you to testify as an expert outside your specialty. What is the MOST appropriate response? | A. Agree if requested; B. Testify fully; C. Decline and practice within scope of competence (Correct); D. Provide a written opinion |
| A client reports dissociation during sessions. What should the social worker do FIRST? | A. Begin trauma processing; B. Assess grounding capacity and prioritize stabilization skills (Correct); C. Ignore and continue therapy; D. Prescribe coping skills |
| A client wants therapy notes released immediately. What is the BEST action? | A. Release without delay; B. Follow agency policy and legal timelines (Correct); C. Refuse; D. File complaint |
| A client expresses fear of mandated reporting. What should the social worker do FIRST? | A. End therapy; B. Ignore the concern; C. Explain reporting laws clearly before continuing disclosure (Correct); D. Encourage client secrecy |
| A client presents with rapid mood shifts and impulsivity. What is the BEST first step? | A. Assess for mood disorder and rule out substance use (Correct); B. Terminate services; C. Begin CBT; D. Provide reassurance |
| A client reports workplace harassment but fears retaliation. What is the MOST appropriate response? | A. Provide resources and support without pressuring action (Correct); B. Confront the employer; C. Ignore; D. Advise quitting |
| A client reports passive suicidal thoughts. What should the social worker do FIRST? | A. Wait for client to act; B. Complete full risk assessment (Correct); C. Reassure only; D. Encourage social engagement |
| A client asks for help accessing disability benefits without evidence. What is the BEST response? | A. Complete application; B. Provide advocacy resources without giving legal advice (Correct); C. Decline and terminate; D. Refer to HR |
| A client becomes verbally aggressive toward staff. What is the BEST first step? | A. Ensure safety, set limits, and assess need for higher level of care (Correct); B. Ignore behavior; C. Terminate client; D. Confront immediately |
| A client reports flashbacks during intimacy. What should the social worker do FIRST? | A. Assess trauma response and provide grounding interventions (Correct); B. Encourage discussion immediately; C. Avoid topic; D. Terminate therapy |
| A client wants immediate solutions. What should the social worker do FIRST? | A. Set realistic expectations and emphasize collaborative process (Correct); B. Provide all solutions; C. Refer elsewhere; D. Ignore requests |
| A client expresses anger toward a protected group. What is the MOST appropriate first step? | A. Maintain safety and address behavior ethically without endorsing views (Correct); B. Ignore; C. Join discussion; D. Agree to client |
| A client reports poor concentration due to anxiety. What intervention is BEST? | A. Assess anxiety severity and implement CBT skills (Correct); B. Prescribe medications; C. Ignore; D. Refer to family |
| A client misses sessions after disclosure of abuse. What should the social worker do FIRST? | A. Attempt outreach, assess safety if contact occurs, and document (Correct); B. Terminate; C. Ignore; D. Report to law enforcement |
| A client requests texting outside sessions for emotional support. What is the BEST response? | A. Set boundaries and offer appropriate crisis resources (Correct); B. Text anyway; C. Ignore; D. End therapy |
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