LCSW Exam: Therapist Development
Center Exam Questions With Correct
Answers 2023
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 - Answer 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 across state lines.
C. Determine whether the state board of the client's residence allows teletherapy across
state lines.
D.Continue to provide therapy due to the longstanding relationship established between
therapist and client. - Answer 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 - Answer 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. - Answer 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 individual therapist.
D. Refer the client to someone who specializes in depression and suicide. - Answer 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. - Answer 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 pregnancy
C. Inform the client that she is required to disclose this information with the client's parents
D. Inform the client's parents of the client's pregnancy - Answer 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 experienced difficulty during which developmental stage?
A. Trust vs. Mistrust
B. Industry vs. Inferiority
C. Autonomy vs. Shame and Doubt
D. Initiative vs. Guilt - Answer 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 that are occurring with the supervisee
D. Terminate her supervisory relationship with the social worker - Answer 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, but has not told her husband about the baby. What should the social worker do NEXT?
Refer the client to a doctor for prenatal care
Suggest couples treatment to address issues of stress around the move
Redirect the client back to issues of absence and incomplete job performance
Assess the woman for domestic violence and help her create a safety plan - Answer 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 incident, brought her
flowers while she was in the hospital, and promised never to hurt her again. What should the social worker do FIRST?