LCSW EXAM: THERAPIST DEVELOPMENT CENTER
QUESTIONS AND ANSWERS
A group for women experiencing depression has been meeting for 3 weeks. Several
group members approach the group leader expressing concern that another group
member regularly interrupts and dominates the conversation. What stage of group
formation is the group most likely in?
A. Forming
B. Storming
C. Norming
D. Performing - Answers - The correct answer is B: Storming. During this stage it is
common for subgroups to emerge, like the one approaching the leader.
A social worker has been meeting with a client for two years who is about to graduate
from college and move back to her home state. The client wishes to continue therapy
with the social worker via teletherapy. The social worker is only licensed in the state the
social worker resides. What is the FIRST thing the social worker should do?
A. Decline to provide teletherapy because it is illegal to do so across state lines.
B. Determine whether the social worker's state board allows teletherapy acros -
Answers - The correct answer is B: to determine whether the social worker's state board
allows teletherapy across state lines. If they do, then we could do C after this (if the
social worker's state board does not allow this, then there would be no need to do C,
which is why we would do B first). A is incorrect because that is not a true statement as
some states do allow this. D is similarly incorrect because it does not acknowledge the
fact that some states do not allow teletherapy across state lines. (Even if there is a
longstanding relationship).
A social worker meets with a 22-year-old woman who reports she is experiencing
increased feelings of anxiety, agitation, and irritability. What should the social worker do
NEXT?A. Consider a diagnosis of hyperthyroidism
B. Refer the client for a psychiatric evaluation
C. Complete a biopsychosocial assessment
D. Refer the client for a medical evaluation - Answers - The correct answer is D, to refer
the client for a medical evaluation. The client reports increased feelings of anxiety,
agitation, and irritability. Before doing anything else, we want to discuss the need for a
medical evaluation to rule out a possibly underlying medical reason for her condition.
While we aren't expected to know any and every medical condition, we are expected to
know that a medical referral for new symptoms is best practice. A is outside of our
scope of practice; it wouldn't be our job to consider this specific medical diagnosis, but
to refer her to someone who can rule out this and any other underlying biological cause
for her symptoms. B is incorrect, because while at some point we may make a referral
to a psychiatrist for medication, it is not what we would do FIRST. C could occur after
we do D.
,All of the following statements describe defense mechanisms EXCEPT:
A. Conscious behavior used by the client to protect the client from the influence of the
therapist.
B. Justifying actions or thoughts to make them seem acceptable when unconsciously
they are not.
C. Rejecting or attributing unacceptable aspects of one's personality to another
individual.
D. The process of protecting oneself from anxiety, feelings of guilt, or undesirable
thoughts. - Answers - The best answer here would be A. If we look at the definition
provided above we notice that B, C, and D all incorporate various aspects of defense
mechanisms. On the other hand, A is discussing conscious behaviors or thoughts,
whereas defense mechanisms are on a more unconscious level. That is why as
clinicians we need to help client's identify the various defense mechanisms they may
use and bring them to a conscious level.
A social worker has been meeting with a 28-year-old woman for the past six months to
work on issues of depression and suicidal ideation. The social worker observes that on
days that she meets with this client, later in the day she spends a lot of time thinking
about death and her mood is lower. What should the social worker do FIRST?
A. Use her emotional reaction to explore how the client's suicidal ideation may be
impacting those around her.
B. Seek supervision.
C. Begin meeting with an individ - Answers - The correct answer is B, to seek
supervision. A is inappropriate because we should not be using countertransference
(which is about our emotional reactions as the therapist) in therapy. Although it is
possible that the therapist may begin their own therapy (C) at some point, this isn't the
FIRST thing we would do. Individual therapy is something that could be discussed in
supervision as one way to manage the therapist's countertransference. D is premature,
as the therapist and client have been meeting for 6 months and have an established
relationship. At this point, there is no need to refer out.
A social worker has been meeting with a 28-year-old woman for the past six months to
work on issues of depression and suicidal ideation. The social worker observes that on
days that she meets with this client, later in the day she spends a lot of time thinking
about death and experiences a lower mood. What is this an example of?
A. Poor Boundaries.
B. Transference.
C. Countertransference.
D. Trauma Response. - Answers - The correct answer is C, countertransference. The
therapist is having an emotional reaction to what the client is sharing.
A social worker meets with a 14-year-old client who shares with the social worker that
she is pregnant. She does not want her parents to know she is pregnant. The social
worker practices in a jurisdiction where social workers are required to share this
information with the parents of a minor child. What should the social worker do FIRST:
,A. Maintain confidentiality per the client's request
B. Maintain confidentiality due to safety issues that may arise if the parents are informed
of her pregnanc - Answers - The correct answer is C. While we may want to honor our
client's self-determination and her wishes to have confidentiality maintained (A), the
question stem specifies that the social worker practices in a jurisdiction where we must
inform the client's parents of her pregnancy. Despite our own beliefs about this, we are
required to follow the law. (B) is incorrect because nothing in the question stem states
that a safety issue is present regarding telling the parents. While her parents will need
to be informed of her pregnancy (D), telling the client about this (C) should come first.
Additionally, we should explore with the client how she wants her parents to be
informed; she may want to be a part of this rather than the social worker disclosing this
on her behalf.
A 32 year-old man seeks treatment from a social worker for ongoing problems with both
his personal and professional functioning. He reports that even though he has been
moderately successful in his career, he continues to feel uncertain about his abilities,
feeling as if at any moment he will be exposed as a fraud. When the social worker
inquires about his personal relationships, he looks down and says that he doesn't really
let anyone get close to him. According to Erikson, this client likely e - Answers - C,
Autonomy vs. Shame and Doubt. The prevailing characteristic that comes through
about the client is his lack of self-assurance. We see him doubting himself
professionally and perhaps also personally. This may explain his tendency to keep
others at arm's length (protecting himself from failure). If the 'building blocks' strategy
doesn't work for you, keeping playing with it and find something that does - it's not
important why it works, only that it helps you remember and apply the information when
you need to!
A social work supervisor meets with one of her supervisees for supervision. During this
meeting, the supervisee shares they have become sexually involved with a client. They
share they want to refer the client to another social worker in order to pursue a
relationship with them. What is the FIRST action the supervisor should take?
A. Immediately report the social worker to the board
B. Assist the supervisee in transferring the client to a different social worker
C. Discuss the ethical violations - Answers - The correct answer is C, to discuss the
ethical violations that are occurring with the supervisee. While A, B, and D are all
possible actions that the supervisor could take at some point, we should always start by
speaking with the social worker first. The social worker is engaging in unethical
behavior, so the supervisor needs to address the ethical violations the social worker is
engaging in. The supervisor may report the supervisee to their board (A), but it wouldn't
occur before talking directly to the supervisee. The supervisee should absolutely end
their relationship with the client. Even once that occurs, the client should be transferred
to a different social worker (B). But again, this wouldn't happen until first speaking with
the supervisee about the ethical violations. If the supervisee isn't willing to engage in
ethical practice, they may decide they're unable to continue providing supervision (D).
This still wouldn't occur until after first speaking with the supervisee.
, A woman is referred to a social worker by her EAP. The referral indicates that the
woman is frequently absent from work and has difficulty completing projects. During the
initial assessment, the woman avoids answering questions about her relationship with
her spouse. The woman becomes tearful when asked about her family and social
supports. The woman shares that her husband does not "allow" her to go out in the
evening or on weekends. She goes on to tell the social worker that she is pregnant, b -
Answers - In the item above, the strongest answer is D, since the stem provides the
test-taker with multiple risk factors for domestic violence. Answer A is incorrect because
our priority is to assess for domestic violence. A referral to a doctor for prenatal care
would follow risk assessment and safety planning. Additionally, answer A wrongly
assumes the woman is not receiving prenatal care. Answer B is incorrect as we would
need to rule out domestic violence before considering couples counseling. Couples
counseling is contraindicated if domestic violence is suspected. Answer C is incorrect
because issues of safety warrant immediate attention and this answer disregards the
red flags raised in the vignette.
A hospital-based social worker meets with a new client who was admitted following a
domestic assault perpetrated by her boyfriend. The woman shares that her boyfriend,
with whom she lives, was upset because she was texting with a male coworker and
went out for drinks with him after work. She shares that her boyfriend is very insecure
and she should have known how this would affect him due to similar instances in the
past. She tells the therapist that her boyfriend felt terrible about the inciden - Answers -
The correct answer in this LCSW practice question is B. It is clear that domestic
violence exists-the woman was hospitalized following the most recent incident and
indicates similar instances in the past. The client appears to be unaware of the cycle of
violence. It would be important to shed light on this dynamic so the client has an
awareness of the likelihood of future violence and how to identify when it is more likely
to occur. In addition, providing resources to the client would allow her to access support
on her own terms. Answer A pushes the therapist's agenda, as the client has not
indicated a desire to locate alternative living arrangements. Answer C is incorrect
because the focus should be on the client, not her boyfriend. Finally, the actions
described in answer D could be done after B, but the priority is helping the client
understand the cycle she is engaged in with her boyfriend and providing resources.
An 82-year-old client was admitted to a hospital after experiencing a fall down the stairs.
The client is ready to be discharged from the hospital and wishes to return home where
she lives independently despite the fact that she is still recovering physically from her
injuries. Both the client's doctors and her adult children want the client to move into an
assisted living facility where she can be better supported during her recovery, but the
client is adamant about living independently. What s - Answers - The correct answer is
A, to work with the client to determine ways she can support her independence while
maintaining safety. There is nothing in the question stem that indicates a need for a
competency hearing (B). The client has already expressed her desire to live at home, so
C and D are both going against the client's self-determination. Answer option A honors
the client's self-determination while also addressing potential safety concerns that may
arise during her recovery.
QUESTIONS AND ANSWERS
A group for women experiencing depression has been meeting for 3 weeks. Several
group members approach the group leader expressing concern that another group
member regularly interrupts and dominates the conversation. What stage of group
formation is the group most likely in?
A. Forming
B. Storming
C. Norming
D. Performing - Answers - The correct answer is B: Storming. During this stage it is
common for subgroups to emerge, like the one approaching the leader.
A social worker has been meeting with a client for two years who is about to graduate
from college and move back to her home state. The client wishes to continue therapy
with the social worker via teletherapy. The social worker is only licensed in the state the
social worker resides. What is the FIRST thing the social worker should do?
A. Decline to provide teletherapy because it is illegal to do so across state lines.
B. Determine whether the social worker's state board allows teletherapy acros -
Answers - The correct answer is B: to determine whether the social worker's state board
allows teletherapy across state lines. If they do, then we could do C after this (if the
social worker's state board does not allow this, then there would be no need to do C,
which is why we would do B first). A is incorrect because that is not a true statement as
some states do allow this. D is similarly incorrect because it does not acknowledge the
fact that some states do not allow teletherapy across state lines. (Even if there is a
longstanding relationship).
A social worker meets with a 22-year-old woman who reports she is experiencing
increased feelings of anxiety, agitation, and irritability. What should the social worker do
NEXT?A. Consider a diagnosis of hyperthyroidism
B. Refer the client for a psychiatric evaluation
C. Complete a biopsychosocial assessment
D. Refer the client for a medical evaluation - Answers - The correct answer is D, to refer
the client for a medical evaluation. The client reports increased feelings of anxiety,
agitation, and irritability. Before doing anything else, we want to discuss the need for a
medical evaluation to rule out a possibly underlying medical reason for her condition.
While we aren't expected to know any and every medical condition, we are expected to
know that a medical referral for new symptoms is best practice. A is outside of our
scope of practice; it wouldn't be our job to consider this specific medical diagnosis, but
to refer her to someone who can rule out this and any other underlying biological cause
for her symptoms. B is incorrect, because while at some point we may make a referral
to a psychiatrist for medication, it is not what we would do FIRST. C could occur after
we do D.
,All of the following statements describe defense mechanisms EXCEPT:
A. Conscious behavior used by the client to protect the client from the influence of the
therapist.
B. Justifying actions or thoughts to make them seem acceptable when unconsciously
they are not.
C. Rejecting or attributing unacceptable aspects of one's personality to another
individual.
D. The process of protecting oneself from anxiety, feelings of guilt, or undesirable
thoughts. - Answers - The best answer here would be A. If we look at the definition
provided above we notice that B, C, and D all incorporate various aspects of defense
mechanisms. On the other hand, A is discussing conscious behaviors or thoughts,
whereas defense mechanisms are on a more unconscious level. That is why as
clinicians we need to help client's identify the various defense mechanisms they may
use and bring them to a conscious level.
A social worker has been meeting with a 28-year-old woman for the past six months to
work on issues of depression and suicidal ideation. The social worker observes that on
days that she meets with this client, later in the day she spends a lot of time thinking
about death and her mood is lower. What should the social worker do FIRST?
A. Use her emotional reaction to explore how the client's suicidal ideation may be
impacting those around her.
B. Seek supervision.
C. Begin meeting with an individ - Answers - The correct answer is B, to seek
supervision. A is inappropriate because we should not be using countertransference
(which is about our emotional reactions as the therapist) in therapy. Although it is
possible that the therapist may begin their own therapy (C) at some point, this isn't the
FIRST thing we would do. Individual therapy is something that could be discussed in
supervision as one way to manage the therapist's countertransference. D is premature,
as the therapist and client have been meeting for 6 months and have an established
relationship. At this point, there is no need to refer out.
A social worker has been meeting with a 28-year-old woman for the past six months to
work on issues of depression and suicidal ideation. The social worker observes that on
days that she meets with this client, later in the day she spends a lot of time thinking
about death and experiences a lower mood. What is this an example of?
A. Poor Boundaries.
B. Transference.
C. Countertransference.
D. Trauma Response. - Answers - The correct answer is C, countertransference. The
therapist is having an emotional reaction to what the client is sharing.
A social worker meets with a 14-year-old client who shares with the social worker that
she is pregnant. She does not want her parents to know she is pregnant. The social
worker practices in a jurisdiction where social workers are required to share this
information with the parents of a minor child. What should the social worker do FIRST:
,A. Maintain confidentiality per the client's request
B. Maintain confidentiality due to safety issues that may arise if the parents are informed
of her pregnanc - Answers - The correct answer is C. While we may want to honor our
client's self-determination and her wishes to have confidentiality maintained (A), the
question stem specifies that the social worker practices in a jurisdiction where we must
inform the client's parents of her pregnancy. Despite our own beliefs about this, we are
required to follow the law. (B) is incorrect because nothing in the question stem states
that a safety issue is present regarding telling the parents. While her parents will need
to be informed of her pregnancy (D), telling the client about this (C) should come first.
Additionally, we should explore with the client how she wants her parents to be
informed; she may want to be a part of this rather than the social worker disclosing this
on her behalf.
A 32 year-old man seeks treatment from a social worker for ongoing problems with both
his personal and professional functioning. He reports that even though he has been
moderately successful in his career, he continues to feel uncertain about his abilities,
feeling as if at any moment he will be exposed as a fraud. When the social worker
inquires about his personal relationships, he looks down and says that he doesn't really
let anyone get close to him. According to Erikson, this client likely e - Answers - C,
Autonomy vs. Shame and Doubt. The prevailing characteristic that comes through
about the client is his lack of self-assurance. We see him doubting himself
professionally and perhaps also personally. This may explain his tendency to keep
others at arm's length (protecting himself from failure). If the 'building blocks' strategy
doesn't work for you, keeping playing with it and find something that does - it's not
important why it works, only that it helps you remember and apply the information when
you need to!
A social work supervisor meets with one of her supervisees for supervision. During this
meeting, the supervisee shares they have become sexually involved with a client. They
share they want to refer the client to another social worker in order to pursue a
relationship with them. What is the FIRST action the supervisor should take?
A. Immediately report the social worker to the board
B. Assist the supervisee in transferring the client to a different social worker
C. Discuss the ethical violations - Answers - The correct answer is C, to discuss the
ethical violations that are occurring with the supervisee. While A, B, and D are all
possible actions that the supervisor could take at some point, we should always start by
speaking with the social worker first. The social worker is engaging in unethical
behavior, so the supervisor needs to address the ethical violations the social worker is
engaging in. The supervisor may report the supervisee to their board (A), but it wouldn't
occur before talking directly to the supervisee. The supervisee should absolutely end
their relationship with the client. Even once that occurs, the client should be transferred
to a different social worker (B). But again, this wouldn't happen until first speaking with
the supervisee about the ethical violations. If the supervisee isn't willing to engage in
ethical practice, they may decide they're unable to continue providing supervision (D).
This still wouldn't occur until after first speaking with the supervisee.
, A woman is referred to a social worker by her EAP. The referral indicates that the
woman is frequently absent from work and has difficulty completing projects. During the
initial assessment, the woman avoids answering questions about her relationship with
her spouse. The woman becomes tearful when asked about her family and social
supports. The woman shares that her husband does not "allow" her to go out in the
evening or on weekends. She goes on to tell the social worker that she is pregnant, b -
Answers - In the item above, the strongest answer is D, since the stem provides the
test-taker with multiple risk factors for domestic violence. Answer A is incorrect because
our priority is to assess for domestic violence. A referral to a doctor for prenatal care
would follow risk assessment and safety planning. Additionally, answer A wrongly
assumes the woman is not receiving prenatal care. Answer B is incorrect as we would
need to rule out domestic violence before considering couples counseling. Couples
counseling is contraindicated if domestic violence is suspected. Answer C is incorrect
because issues of safety warrant immediate attention and this answer disregards the
red flags raised in the vignette.
A hospital-based social worker meets with a new client who was admitted following a
domestic assault perpetrated by her boyfriend. The woman shares that her boyfriend,
with whom she lives, was upset because she was texting with a male coworker and
went out for drinks with him after work. She shares that her boyfriend is very insecure
and she should have known how this would affect him due to similar instances in the
past. She tells the therapist that her boyfriend felt terrible about the inciden - Answers -
The correct answer in this LCSW practice question is B. It is clear that domestic
violence exists-the woman was hospitalized following the most recent incident and
indicates similar instances in the past. The client appears to be unaware of the cycle of
violence. It would be important to shed light on this dynamic so the client has an
awareness of the likelihood of future violence and how to identify when it is more likely
to occur. In addition, providing resources to the client would allow her to access support
on her own terms. Answer A pushes the therapist's agenda, as the client has not
indicated a desire to locate alternative living arrangements. Answer C is incorrect
because the focus should be on the client, not her boyfriend. Finally, the actions
described in answer D could be done after B, but the priority is helping the client
understand the cycle she is engaged in with her boyfriend and providing resources.
An 82-year-old client was admitted to a hospital after experiencing a fall down the stairs.
The client is ready to be discharged from the hospital and wishes to return home where
she lives independently despite the fact that she is still recovering physically from her
injuries. Both the client's doctors and her adult children want the client to move into an
assisted living facility where she can be better supported during her recovery, but the
client is adamant about living independently. What s - Answers - The correct answer is
A, to work with the client to determine ways she can support her independence while
maintaining safety. There is nothing in the question stem that indicates a need for a
competency hearing (B). The client has already expressed her desire to live at home, so
C and D are both going against the client's self-determination. Answer option A honors
the client's self-determination while also addressing potential safety concerns that may
arise during her recovery.
