1. Janie is a sophomore in high school who finds herself struggling.

She has
been arrested on drug possession, suspended from school for behavioral
issues, and believes her family and teachers do not care about her. What
service delivery method will aid her in altering her attitudes, behaviors,
habits, and perceptions most effectively?
Your answer: Individual counseling

Correct answer: Individual counseling

Explanation: Individual counseling could be useful in exploring the "root" of her

presenting issues and hopefully initiate the process of change

2. Tom is struggling. He says, "No one likes me and nothing I do seems to get
me anywhere." His social worker says, "What is one thing you have done
that you like about you that has helped you persevere in the past?" This is an
example of:
Your answer: Reframing

Correct answer: Reframing

Explanation: This is an example of reframing, helping Tom take something from

the past and applying it today in a new way so he may see a new possible solution.

3. According to Maslow, when does a need stop motivating an individual?

Your answer: When the need is mostly satisfied

Correct answer: When the need is mostly satisfied

Explanation: When a need is mostly satisfied, it no longer motivates, and the next
higher need takes its place.

4. When providing information about a client's mental status on an assessment,

a counselor should incorporate all indices, EXCEPT:
Your answer: Perception of others

Correct answer: Perception of others

Explanation: When providing information about a client's mental status on an

assessment, a counselor should incorporate information regarding the client's
affect, orientation, appearance, insight, cognitive functioning, memory, behavior,
judgment, and perception of self.

5. You are providing counseling for appropriate parenting skills to a mother

seeking help to best manage her two boys, ages 7 and 9. The mother has
been actively engaged in services, making progress and accomplishing goals
and objectives. Several months into your work together, the mother reports a
"break" in her ability to effectively parent her children; she spanked them
the previous evening, leaving welts and one cut on the upper leg of the 9-
year-old. She begs you not to report, sighting her extensive work, progress,
and ongoing commitment to work. What is your best course of action?
Your answer: Contract with the client for an appropriate safety plan to ensure the
children's welfare and monitor follow-through, knowing she will continue to make
progress

Correct answer: Report the abuse, knowing the therapeutic relationship may be
damaged

Explanation: The abuse must be reported, though you suspect the relationship will
be damaged. Clients should be notified at the outset of treatment what the limits of
confidentiality are. Duty to protect the children outweighs the mother's right to
self-determination.

6. Denial of substance abuse is common for all ages; however, this denial tends
to be ______ in the older adult population.
Your answer: Exaggerated

Correct answer: Exaggerated

Explanation: Denial of substance abuse is common for all ages; however, this
denial tends to be exaggerated in older adults population. This may be due to
problems such as shame, memory, pessimism about recovery, and/or the desire to
continue the use of alcohol.

7. Julie is 17. She was raised in the Catholic Church and is active in her faith.
She becomes pregnant and is confused, angry, and frustrated with herself
after allowing herself to be put into this position. She seeks help from a
social worker from a family service organization who should:
Your answer: Listen and help Julie explore her ambivalence, anger, and
frustration
Correct answer: Listen and help Julie explore her ambivalence, anger, and
frustration

8. Billy is in 3rd grade and is identified as a bully in the school. He has poor
social skills, is physically aggressive, struggles with reading and has
difficulty paying attention. Billy has not been identified as having special
school needs. Billy's social worker is addressing his social skills, anger, and
physical aggression. Despite improvements in all of these areas, Billy
continues having difficulties with his reading and struggles with math
concepts. He is not able to pay attention for any significant length of time.
The NEXT step is to:
Your answer: Refer for academic assessment in the school

Correct answer: Refer for academic assessment in the school

Explanation: Billy needs to be referred for assessment for his academic and
attentional issues. Play therapy will not resolve reading, math, and attentional
issues. Recommending a tutor is not helpful if there is an underlying learning
disability, so testing needs to be completed.

Explanation: The social worker should begin where the client is, which is a highly
emotional state sorting through a crisis pregnancy.

9. Manny has many needs that are beyond the scope of the Mental Health
Clinic. His social worker identifies the need for legal help with
discrimination in both housing and employment, temporary financial needs,
and health care. After identifying the needs, the social worker solicits
assistance from another social worker in the setting who begins with Manny.
He discusses details of the specific legal, financial and health needs,
provides information on available options for each, and identifies possible
resources. Manny selects the resources that are consistent with what he is
able to do and signs a release of information for the social worker to make
contact with the other resources, as well as to allow for a referral letter for
each. Two weeks later, the social worker follows up with Manny to see
where he is in the process. This describes the:
Your answer: Referral process
Correct answer: Referral process

Explanation: The referral process is a series of steps designed to link a client(s) to

needed resources, from identifying the need, discussing the purpose of the referral,
considering options for the referral, signing of releases (as indicated, with records
as relevant), making the referral and following up. Manny has the right to be
treated with respect, to experience communication without judgment, to have
options presented, to experience facilitation rather than direction, to experience
cultural competence, all of which are elements of the empowerment perspective;
however, the scenario is laid out with a series of steps specific to referral, and
though Manny is treated with dignity and respect, this is not the best answer. Self-
determination is the empowerment of the client to make the choice the client
believes is in the client's own best interest, though it may or may not be consistent
with what another person would see as most effective, which is part of the referral
process.

10.James said, "I don't know how much more of this I can take. My wife's
illness is demanding. I love her, but it is hard. I work at least 50 hours each
week, then come home and have to do all of the cooking, cleaning, laundry
and anything she needs. I feel as though I will break." As a therapist, an
empathetic response is to say:
Your answer: "What can you do to make it different?"

Correct answer: "You sound overwhelmed with everything required just to get
by."

Explanation: Empathy is about putting yourself in the other's shoes, reflecting

what is occurring from their perspective. The best response is, "You sound
overwhelmed with everything required just to get by." Problem-solving about what
can change cannot occur until addressing how overwhelmed James is, and
downplaying what is occurring by saying it could be better or worse is dismissive
of James and the situation.

11.In older adult populations, mental health disorders are frequently:

Your answer: Comorbid

Correct answer: Comorbid

Explanation: In the elder population, mental health disorders are frequently

comorbid, occurring in conjunction with any one of a number of common chronic
illnesses such as arthritis, respiratory problems, diabetes, and cardiac disease. In
combination, these disorders impact physical performance, perceived well-being,
and quality of life.
12.According to the Discrimination Model (which falls under integrated
supervision models), which is NOT one of the three supervisory roles?
Your answer: Discriminator

Correct answer: Discriminator

Explanation: The Discrimination Model combines an attention to three

supervisory roles with three areas of focus. Supervisors take on roles of teacher,
counselor, and/or consultant. Each of the three roles is task-specific for the purpose
of identifying issues in supervision.

13.Which is NOT one of the stages in the referral process?

Your answer: Discuss and select an option for the client

Correct answer: Discuss and select an option for the client

Explanation: Self-determination is primary to counseling values, so clients make

their own decisions, when at all possible, not the therapist.

14._____ statements should be used for the primary purpose of outlining events or
experiences without giving advice or making an evaluation.
Your answer: Descriptive

Correct answer: Descriptive

Explanation: Descriptive statements can be used to provide a verbal account of a

situation, behavior, option, or feeling. When an account is offered without an
evaluation or advice, it is identified as descriptive. Both overt and covert
information can be used with descriptive statements.

15.A 28-year-old male presents with a history of combat trauma, self-

mutilation, and one incident of childhood sexual abuse at the age of 7 or 8 by a
boy who was a late adolescent. He is highly reticent to discuss any of the events
around the childhood incident that is resurfacing and intruding on his daily life
since returning from war. What is your first step?
Your answer: Continue to establish rapport and trust, allowing the client to tell his
story in his time, recognizing avoidance is part of trauma work
Correct answer: Continue to establish rapport and trust, allowing the client to tell
his story in his time, recognizing avoidance is part of trauma work

Explanation: Continuing to establish rapport and trust, allowing the client to tell
his story in his time and recognizing avoidance is part of trauma work is the best
course of action in early treatment.

16. Ms. Massey recalls three words (i.e. elephant, pencil, bus) immediately after
hearing and repeating the words, but she was not able to do so again after 20
minutes. With prompting, she could recall one of three items. This is an indication
of:
Your answer: Impairment in short-term memory

Correct answer: Impairment in short-term memory

Explanation: This component of the mental status exam indicates impairment in

short-term, but not immediate memory. This is not an indication of long-term
memory, which can be assessed by asking about distant events from the
individual's life.

17. Julie's speech altered in its timing. She repeats the first syllable in a word, as if
her lips are locked in a repetitious cycle. Julie has an issue with:
Your answer: Stuttering

Correct answer: Stuttering

Explanation: Individuals who stutter may repeat a syllable (bo-bo-bo-bo-bowl) or

hold one particular sound for an extended time (waaaaaaaake). Other sounds may
not emerge at all. Receptive speech is not impacted by stuttering

18.The least effective mode of therapeutic intervention to use with a 6-year-old

whose sibling has died is:
Your answer: Discussion

Correct answer: Discussion

Explanation: Play therapy is a better option for children.

19. Victor's mother caught him using marijuana and has brought him in for
therapy. In the first session, the social worker discovers that there is a lot of family
strife. To work with the conflict, she asks the whole family in for a session. If she
is practicing from Bowenian theory, her main goal is:
Your answer: To help each individual recognize the role he or she plays in the
family while being on the lookout for his or her own emotional reactivity

Correct answer: To help each individual recognize the role he or she plays in the
family while being on the lookout for his or her own emotional reactivity

Explanation: Bowenian therapists are less interested in the issues that brought the
client to therapy and more interested in helping them to understand the roles they
play in the family system.

20. The relationship between social class and children's academic ability seems to
be shaped by:
Your answer: The cognitive surroundings furnished to children of different socio-
economic status

Correct answer: The cognitive surroundings furnished to children of different

socio-economic status

Explanation: The National Assessment of Educational Progress has documented

substantial differences in the reading and writing ability of children as a function of
the economic level of their parents. For example, among African-American and
Hispanic students in the U. S. (two groups who experience disproportionate rates
of poverty), the percentages of Grade 4 students reading below the basic level are
64 percent and 60 percent, respectively (National Center for Educational
Statistics). Moreover, we know that there are large social class differences in
children's exposure to experiences that might support the development of emergent
literacy precursors to academic success. For instance, research has shown that
mothers from lower income groups engage in less shared picture-book reading and
produce fewer teaching behaviors during shared reading than mothers from
middle-class groups.

21. Child Protective Services were called to investigate physical abuse and neglect
of three siblings, ages 6, 8, and 10. The results were founded, and the case was
referred for family preservation services to address multiple levels of behaviors
and dynamics within the case. What system will the worker target for services?
Your answer: Family system

Correct answer: Family system

Explanation: In this example, the entire family system would be the target for
change.

22. Which is NOT a necessary element of the consultation process?

Your answer: Directive consultant led meeting

Correct answer: Directive consultant led meeting

Explanation: The consultation process is based on the effectiveness and success of

a voluntary relationship in which both parties focus upon the issue at hand,
brainstorm possible solutions, and leave the consultee better prepared to manage
future problems. The consultation process does not rely upon a leader-follower
type relationship in which the consultant is the director, but rather concentrates on
building a mutually beneficial relationship between consultant and consultee.

23. What healthcare entitlement program is means-tested and is funded by both

federal and state governments, with state governments having significant program
controls?
Your answer: Medicaid

Correct answer: Medicaid

Explanation: Medicaid provides health coverage to eligible low-income adults,

children, pregnant women, elderly adults and people with disabilities. Medicaid is
administered by states, according to federal requirements.

24. While in session with a client, the client indicates to the social worker that her
husband has recently been in a fight in their home, in which he drunkenly knocked
out a 19-year-old with a beer bottle. The social worker keeps this information
between herself and her client. The social worker has acted:
Your answer: Ethically by not breaking confidentiality

Correct answer: Ethically by not breaking confidentiality

Explanation: In the situation described, there are no minors involved as the person
that the man had an altercation with is 19 years old. In this case, confidentiality
would not be broken.

25. Sue is a group therapist who observes her group membership taking on
different roles at different times, rotating leadership depending on the group needs
or issues being addressed. Most activity focuses on moving toward group goals,
and she has a sense of achievement each time the group ends. She is observing
what stage in group development?
Your answer: Performing

Correct answer: Performing

Explanation: Stage 4: Performing. The performing stage is not reached by all

groups. If group members are able to evolve to stage four, their capacity, range,
and depth of personal relations expand to true interdependence. Performing is the
stage of group work in which members are actively engaged in the work of the
group. No significant issues remain about how tasks will be carried out or who will
do them, and sufficient trust is established for sharing and comfort in receiving
feedback.

26. The social worker is treating a family in which the father suffers from long-
term, severe Alcohol Use Disorder. The social worker knows that the young
children are likely to be most worried about:
Your answer: Parental conflicts

Correct answer: Parental conflicts

Explanation: Research shows that young children are often exposed to parental
fighting in homes where one or both parents suffer from Alcohol Use Disorder.
Evidence indicates that this issue worries them more than the drinking itself.
Young children are unlikely to be concerned about neighbor attitudes. At their age,
they are unlikely to understand concepts such as being evicted due to parental
drinking.
27. What is the last step in aiding a family with on-site basic crisis intervention
following a natural disaster, once initial safety, mental status, physical concerns,
coping skills, and imminent concrete services are met?
Your answer: Provide handouts on resources, common psychological reactions,
and hotline contact information for follow-up if mental health safety becomes a
concern

Correct answer: Provide handouts on resources, common psychological reactions,

and hotline contact information for follow-up if mental health safety becomes a
concern

Explanation: The final step in aiding a family is to provide handouts on resources,

common psychological reactions, and hotline contact information for follow-up if
mental health safety becomes a concern.

28. Garret, age 6, was removed from his home following discovery of physical
abuse perpetrated by his stepfather and an older sibling. Mom is emphatic she can
protect Garret now that she is aware of the situation, and the identified perpetrators
are demonstrating remorse and a desire to change. To assist in sorting the situation
out
, a _________ will be appointed to secure Garret's interests.
Your answer: Guardian ad litem

Correct answer: Guardian ad litem

Explanation: A guardian ad litem is a lawyer or non-lawyer appointed in court

proceedings by the court to represent the best interests of the child or children
involved in that case.

29. Mr. Thomas is a 75-year-old preparing for discharge from the hospital
following hospitalization for burns suffered when falling asleep with a lit cigarette.
His assisted-living facility will not allow him to return because his forgetfulness
and smoking are a danger to self and others. What is the first service to provide in
this scenario?
Your answer: Case management to locate a place to live

Correct answer: Case management to locate a place to live

Explanation: The first service to provide is case management to secure a safe and
immediate place to live. Smoking cessation is secondary, given the immediacy of
the situation.

30. Mr. Xavier presents to you at his company's Employee Assistance Program
following a medical crisis secondary to smoking. His physician requires that Mr.
Xavier stop smoking immediately, though he is not currently in crisis. What is the
first treatment to consider?
Your answer: Individual therapy with the goal of smoking cessation

Correct answer: Individual therapy with the goal of smoking cessation

Explanation: The first type of treatment to administer is individual therapy with

the goal of smoking cessation. Family therapy is not indicated, and he has access to
medical and psychological services through his employer.

31 An elderly woman refuses to take life-saving heart medication. What is the first
thing you should do?
Your answer: Learn her reasons for refusing treatment

Correct answer: Learn her reasons for refusing treatment

32. You receive a call from the Human Resources department where one of your
clients works. Your client has applied for unemployment compensation, because
he thinks that he is entitled to be considered "disabled" due to his psychological
condition. Human Resources needs to verify that the employee is currently a client
of yours and is really suffering from a mental disorder. In this situation you have
to:
Your answer: Indicate to Human Resources that you cannot indicate if this
individual is a client of yours

Correct answer: Indicate to Human Resources that you cannot indicate if this
individual is a client of yours
Explanation: Without a signed release by client to specifically provide
information to the Human Resources department, no information can be released.

33. Mary presents for counseling services and reports she was up all night with a
gun, contemplating shooting herself in the head. She convincingly denies current
suicidality and contracts for safety. What is your best course of action?
Your answer: Listen to Mary's story and set up a safety plan that includes removal
of the weapon from the home and involves at least one trusted friend or family
member

Correct answer: Listen to Mary's story and set up a safety plan that includes
removal of the weapon from the home and involves at least one trusted friend or
family member

Explanation: The best course of action is to listen to Mary's story and set a safety
plan
in place that includes at least one other trusted friend or family member and
involves removal of the weapon from Mary's home.

34. Jim was recently suspended from school twice for smoking on campus. The
school therapist referred the family to you. The family has just moved into the
district following dad's job relocation. Jim's grandmother was diagnosed with
terminal cancer, his younger brother was caught stealing a video game, and the
parents are focused on dealing with the brother's recent theft and truancy issues.
What is the best treatment modality?
Your answer: Family therapy to deal with adjustment reactions to the move and
the grandmother's illness, addressing Jim's current issue in terms of the family
structure and patterns

Correct answer: Family therapy to deal with adjustment reactions to the move
and the grandmother's illness, addressing Jim's current issue in terms of the family
structure and patterns

Explanation: Family therapy is the best treatment modality to address Jim's recent
acting out, clearly in the context of multiple family issues
35. John initiates therapy, frustrated by years of arguments with his spouse and
says, "Please just fix Jane so we can have a normal life." The social worker's BEST
response is to:
Your answer: Discuss realistic goals of therapy with John

Correct answer: Discuss realistic goals of therapy with John

Explanation: The best response is to clarify what therapy can and cannot
accomplish. John does not have a realistic perspective, and focusing on seizing
control over something or someone that one does not have control over is an
exercise in frustration. Initiating couple's therapy, asking him what he would like,
or encouraging patience would be appropriate later in the process.

36. A client is seeing a new social worker after transitioning from another social
worker she had been working with for some time. The new social worker proposed
a behavioral intervention plan based on the client's stated goals discovered in their
assessment together, but the client protested, saying the previous social worker's
methods were better suited. The new social worker should FIRST:
Your answer: Ask what was most helpful to the client in her previous work

Correct answer: Ask what was most helpful to the client in her previous work

Explanation: The first step is to understand what was most helpful in the previous
work, beginning where the client is and adjusting the treatment plan, if needed,
accordingly. This empowers the client and honors self-determination.

37. In group therapy Marie spends 15 minutes describing an event from the
previous week, then proceeds to redirect the group back to her event each time a
member shares something about their current life situation. She is monopolizing
the group and creating tension that needs to be dealt with in one way or another.
The BEST way to address the issue is:
Your answer: Verbalize the behavior, ask about the need to maintain the spotlight
and inquire about the impact on the group

Correct answer: Verbalize the behavior, ask about the need to maintain the
spotlight and inquire about the impact on the group
Explanation: Clients need to become aware of their defensive behaviors
(monopolizing, dependency, intellectualizing, isolating, advice giving, rejecting)
and be challenged to go beyond them. This must be done in a caring manner, not
labeling them as a "monopolizer" or simply telling them to "share the air" but to
explore the specific behavior without blame.

38. Becca worked hard to complete college early, graduated with honors, and has
received three job offers in her field. She is now feeling remorse and fear, unable
to decide where to go from this point in her life. What is your focus of work?
Your answer: Problem-solving and decision-making skill development

Correct answer: Problem-solving and decision-making skill development

Explanation: The focus of the work in this case should be on developing problem-
solving and decision-making skills. These are essential skills for Becca to have in
order to make an informed choice from among her three job offers. By working
with you, Becca can gain insights into what factors are important for her to
consider when making a decision, practice various problem solving strategies, and
hone her decision-making skills to ensure she makes the best choice for herself.
This approach will enable Becca to make a confident and secure decision about
where to go next in her life.

39. When a client presents with suicidal ideation, a social worker should:
Your answer: Openly discuss and assess intent, means, and plan

Correct answer: Openly discuss and assess intent, means, and plan

Explanation: Be aware of warning signs: talking about suicide, neglecting self,

worsening mood, sudden loss, sudden change in mood, talking about
worthlessness, withdrawal from fun and friends. Take all claims seriously.

40. A family member has been given a diagnosis of a terminal illness with less
than four months to live. When the hospital social worker visited the family, they
were laughing and planning a family reunion in one month. This is BEST an
example of:
Your answer: Acceptance
Correct answer: Acceptance

Explanation: The family has accepted the diagnosis and is working to bring
closure to the family and celebrate the life of the family member while still living,
when it matters.

41. A client presents with a long history of intravenous drug use. She has never
been tested for HIV/AIDS, but fears she has contracted the disease. The social
worker is attempting to conduct an evaluation, but the client's fear is
overwhelming. The social worker's best course of action is to say:
Your answer: "This fear seems overwhelming to you. Tell me more about your
concerns."

Correct answer: "This fear seems overwhelming to you. Tell me more about your
concerns."

Explanation: The best course of action is to begin where the client is, which is her
fear. This is blocking the interview from proceeding, and exploring it further will
likely provide pertinent evaluation information data as well as build rapport.
Redirecting the client by deflecting or educating about the disease may put the
client off or make the client feel unimportant, and the reasons for not being tested
are not relevant.

42. You have a relatively passive client who is going to an assertiveness-training

weekend. After the weekend, your client reports back to you that at first, the
techniques being practiced and discussed made him feel uneasy, distressed, and
unsettled. These feelings would be consistent with:
Your answer: Cognitive dissonance

Correct answer: Cognitive dissonance

Explanation: Cognitive dissonance occurs when what is being advocated and

brought to one's cognitive schema does not harmonize with previously assimilated
cognitions.

43. n the first crisis therapy session, the crisis should be:
Your answer: Defined
Correct answer: Defined

Explanation: Crisis theory is a cluster of principles or assumptions that have

received the attention of practitioners and researchers. A crisis is a temporary state
of upset and disorganization characterized chiefly by an individual's inability to
cope with a particular situation using customary methods of problem solving, and
by the potential for a radically positive or negative outcome.

44. Organizational approaches that enhance the professional's resiliency to stress

and burnout do NOT include:
Your answer: Flexible delineation of roles and responsibilities

Correct answer: Flexible delineation of roles and responsibilities

Explanation: Burnout reactions of professionals have been connected to role

conflict, role ambiguity, and role overload. Organizations employing school
psychologists should work toward reduction or elimination of these factors.
Organizational approaches that enhance the professional's resiliency to stress and
burnout include the following: good supervision opportunities, formalized peer
support groups, minimal role conflict, clear delineation of roles and
responsibilities, and avoidance of role overload.

45. Marcus, a family preservation worker, is assigned to the Redding family. There
are three school-aged children in the home, ages 5, 7, and 9, and the findings were
for physical abuse and neglect. Marcus has met with the family, developed a case
plan, and has a contract with the family. Where will primary services be delivered?
Your answer: Client home

Correct answer: Client home

Explanation: In this example, it would be more effective to provide services to the

family in their own home, their environment.

46.Jana, age 14, has been in and out of foster care since age six. She has multiple
behaviors that are disruptive in both school and home environments. Her former
placement, a therapeutic foster home says Jana requires intensive, structured
treatment to ensure her safety and the safety of others, much more than they could
provide. What must be sought for Jana?
Your answer: Placement in the least restrictive environment

Correct answer: Placement in the least restrictive environment

Explanation: The goal would generally be to provide the client needed services in
the least restrictive environment possible.

47. Someone with four years of sobriety fears current intense life-stressors will
trigger a relapse. What is your next step?
Your answer: Work with the client to reinforce his relapse prevention plan,
attending to specific trigger concerns and engaging problem-solving

Correct answer: Work with the client to reinforce his relapse prevention plan,
attending to specific trigger concerns and engaging problem-solving

Explanation: The next step is to work with the client to reinforce his relapse
prevention plan, attending to specific trigger concerns and engaging him in
problem-solving.

48. Economic justice for clients in need involves:

Your answer: Fair and equitable resource distribution to those in need

Correct answer: Fair and equitable resource distribution to those in need

Explanation: Economic justice is a set of moral principles for building economic

institutions, the ultimate goal of which is to create an opportunity for each person
to create a sufficient material foundation upon which to have a dignified,
productive, and creative life.

49. You are called to evaluate a 21-year-old female brought to the emergency room
who has a blood alcohol level of 0.13. She is uncoordinated, slurs her speech, and
demonstrates memory impairment. What is your first diagnostic impression?
Your answer: Alcohol Intoxication

Correct answer: Alcohol Intoxication

Explanation: The diagnosis most consistent with the presentation is alcohol

intoxication. She may have a substance use disorder, but there is not enough
evidence at time to make that determination.

50. Which theoretical approach provides clients with a way to question their own
beliefs and helps them identify values that may no longer be functional?
Your answer: Rational Emotive Behavior Therapy

Correct answer: Rational Emotive Behavior Therapy

Explanation: Rational Emotive Behavior Therapy provides clients with a way to

question their own beliefs and helps them to identify values that may no longer be
functional. It focuses more on thinking and rationality vs. expressing feelings.

51. A woman presents for therapy after the death of her brother. You lost your
brother last year and have difficulty maintaining your composure during the
session. What is your best course of action?
Your answer: Refer the client to someone who can maintain emotional boundaries

Correct answer: Refer the client to someone who can maintain emotional
boundaries

Explanation: You are ethically obligated to refer the client to someone who can
best assist her and is not compromised.
Previous Question Next Que stion

52. Developmental models of supervision usually follow the idea that there are
three levels of supervisees: beginning, intermediate, and advanced. Which is NOT
a concept that helps to define these levels?
Your answer: Reliance

Correct answer: Reliance

Explanation: Supervisors who identify with developmental supervision models try

to help supervisees identify their own strengths and growth areas, enabling them to
be responsible for their lifelong development as both interventionists and
supervisors. The supervisees' levels of awareness, motivation, and autonomy help
to define their levels of competency.

53. Jeremiah, age 7, is the only child of his single-parent mother. They are isolated
from other family members, and his mother has a limited number of friends on
whom she can rely. Mom is employed full time and has some opportunities for
advancement. Child Protective Services is involved following a founded case of
neglect. A service delivery plan is to be developed to address risk factors for
Jeremiah. What is a key factor in Jeremiah's case?
Your answer: Lack of extended family

Correct answer: Lack of extended family

Explanation: The lack of a support system is likely a central issue to this case. It
would be beneficial to investigate possibilities of how to develop a more extensive
support system and to provide resources for the mother and her child.

54 John drinks to the point of blacking out every weekend, and he has taken
reckless chances with the family's safety. He says he does not get out of hand with
his drinking, citing his ability to always make it to work on Mondays. This is an
example of:
Your answer: Denial

Correct answer: Denial

Explanation: John is in denial. Denial is one's refusal to accept reality, acting as if

a painful reality, thought, feeling, or event was not in existence. Reaction
formation is the process of converting unwanted thoughts, impulses, or feelings
into their opposites. Dissociation is a separation of one's self from time, place, or
person to better cope with the current reality. Projection is misattributing one's
undesired thoughts, impulses, or feelings onto another.

55. During Erikson's stages of psychosocial development "autonomy vs shame and

self-doubt", a toddler ideally will develop an appropriate sense of autonomy. If not,
he or she will then:
Your answer: Suffer from a sense of inadequacy
Correct answer: Suffer from a sense of inadequacy

Explanation: During the "Autonomy vs. Shame and Self-doubt" stage (18 months
to three years), the child is focused on developing a sense of control over
themselves and their environment. If successful in this stage, the child will feel
secure and confident. If unsuccessful, they may suffer with a sense of inadequacy
and self-doubt.

56. In the initial meeting, a client tells you that he feels jealous and has never been
so angry in his life, because his girlfriend of five years is currently seeing someone
else. You sense that besides being depressed, your client may suffer from poor
impulse control. The first thing you should do in this situation is:
Your answer: Talk to the client about confidentiality and what you might have to
do depending on his disclosure

Correct answer: Talk to the client about confidentiality and what you might have
to do depending on his disclosure

Explanation: This would be a good opportunity to discuss the limits of

confidentiality with the client.

57. Angela would like to receive therapy from you but courts have determined she
is unable to give informed consent. It would be appropriate for you to:
Your answer: Seek informed consent from Angela's legal guardian

Correct answer: Seek informed consent from Angela's legal guardian

58. Linda's family moved from one side of town to the other and she is now going
to attend a new school. Linda refuses to believe that her friends will no longer be
going to school with her and makes plans for what they will do when school starts
again. Which defense mechanism does this scenario best represent?

Suppression
Reaction Formation
Regression
Projection
59 Donna has an extensive history of depressive symptoms she believes started in
adolescence. She reports chronic difficulties rising in the mornings, occasional
 insomnia, poor self-esteem, limited appetite, and a sense of hopelessness that her
life will never improve. Donna never remembers feeling particularly happy. What
is the best diagnostic impression of Donna's presentation?
Your answer: Persistent Depressive Disorder

Correct answer: Persistent Depressive Disorder

Explanation: Persistent Depressive Disorder is a mood disorder marked by a

depressed mood and at least two of the following symptoms: low energy, poor
appetite or overeating, too much or too little sleep, low self-esteem, feelings of
hopelessness, and difficulty making decisions or concentrating. For diagnosis, the
symptoms must be present for a minimum of 2 years, during which there must be
no more than two-month periods of abatement.

60 A parent who imposes no boundaries of any kind on her child's behavior may be
said to be employing a style of parenting referred to as:
Your answer: Permissive

Correct answer: Permissive

Explanation: There are four popular parenting styles practiced throughout society
today. The four types of parenting styles are: Overindulgent, permissive,
authoritarian and authoritative. A permissive parent tends to allow much freedom
to the adolescent (basically whatever the adolescent desires to do, they can do it.)
This style differs from the overindulgent style in that parents do not go out of their
way to constantly satisfy their adolescent's every desire and need.

10 Defense Mechanisms: What Are They and How They Help Us Cope

 How they work

 Common defense mechanisms

 Treatment
 Takeaway
Defense mechanisms refer to psychological strategies or behaviors that people may
use to cope with difficult feelings, thoughts, or events.

What are defense mechanisms?

Defense mechanisms are behaviors that people use to separate themselves from
unpleasant events, actions, or thoughts.

The idea of defense mechanisms comes from psychoanalytic theory, a

psychological perspective of personality that sees personality as the interaction
between three components: id, ego, and super-ego. These psychological strategies
may help people put distance between themselves and threats or unwanted
feelings, such as guilt or shame.

First proposed by Sigmund Freud, this theory has evolved over time and contends
that behaviors, like defense mechanisms, are not under a person’s conscious
control. In fact, most people do them without realizing it.

According to these theories, defense mechanisms are a natural part of

psychological development. Identifying which type you, your loved ones, and even
your co-workers use may help you in future conversations and encounters.

How do defense mechanisms work?

Defense mechanisms are ways you react to situations that bring up negative
emotions. According to psychoanalytic theoryTrusted Source, when you
experience a stressor, the subconscious will first monitor the situation to see if it
might harm you. If the subconscious believes the situation might lead to emotional
harm, it may react with a defense mechanism to protect you.

Usually, you are unaware of the defense mechanism, though the behavior may
appear odd to others around you.

Many researchersTrusted Source place defense mechanisms on a continuum, with

more mature defenses improving cognitive processes and less mature ones causing
harm.

In the long term, mature defense mechanisms may not be particularly detrimental
to your emotional or mental health. Using more mature mechanisms may help you
face the anxieties and situations that might normally cause stress and emotional
duress.

Other defense mechanisms, however, are not as mature and helpful. Prolonged use
of these defenses can lead to lingering problems. In fact, they may prevent you
from ever facing emotional issues or anxieties because they block you from seeing
the root cause.

Some signs that defense mechanisms are getting in the way of your everyday life
and mental health may include:

 feeling sad or depressed

 having difficulty getting out of bed
 avoiding usual daily activities, things, or people that once made you happy
 having difficulty forming or maintaining healthy relationships
 communication problems that hinder your professional or personal life

Top 10 most common defense mechanisms

Dozens of different defense mechanisms have been identified. Some are used more
commonly than others. Here are a few common defense mechanisms:

1. Denial

Denial is one of the most common defense mechanisms. It occurs when you refuse
to accept reality or facts. People in denial may block external events or
circumstances from the mind so that they don’t have to deal with the emotional
impact. In other words, they avoid painful feelings or events.

This defense mechanism is one of the most widely known, too. The phrase,
“They’re in denial,” is commonly understood to mean a person is avoiding reality
despite what may be obvious to people around them.

2. Repression

Unsavory thoughts, painful memories, or irrational beliefs can upset you. Instead
of facing those thoughts, people may unconsciously choose to hide them in hopes
of forgetting them entirely.

That does not mean, however, that the memories disappear entirely. They may
influence behaviors, and they may impact future relationships. You just may not
realize the impact this defense mechanism is having.

3. Projection
Some thoughts or feelings you have about another person may make you
uncomfortable. When people project those feelings, they misattribute them to the
other person.

For example, you may dislike your new co-worker, but instead of accepting that,
you choose to tell yourself that they dislike you. You start to interpret their words
and actions toward you in the worst way possible, even though they don’t actually
dislike you.

4. Displacement

You direct strong emotions and frustrations toward a person or object that doesn’t
feel threatening. This allows you to satisfy an impulse to react, but you don’t risk
significant consequences.

A good example of this defense mechanism is getting angry at your child or spouse
because you had a bad day at work. Neither of these people is the target of your
strong emotions, but your subconscious may believe reacting to them is likely less
problematic than reacting to your boss.

5. Regression

Some people who feel threatened or anxious may unconsciously “escape” to an

earlier stage of development.

This type of defense mechanism may be most obvious in young children. If they
experience trauma or loss, they may suddenly act as if they’re younger again. They
may even begin wetting the bed or sucking their thumb as a form of regression.

Adults can regress, too. Adults who are struggling to cope with events or behaviors
may return to sleeping with a cherished stuffed animal, overeat foods they find
comforting, or begin chain-smoking or chewing on pencils or pens. They may also
avoid everyday activities because they feel overwhelmed.

6. Rationalization

Some people may attempt to explain undesirable behaviors with their own set of
“facts.” This allows you to feel comfortable with the choice you made, even if you
know on another level it’s not right.

For example, someone who didn’t get a promotion at work might say they didn’t
want the promotion anyways.

7. Sublimation

This type of defense mechanism is considered a mature, positive strategy. That’s

because people who rely on it choose to redirect strong emotions or feelings into
an object or activity that is appropriate and safe.

For example, instead of lashing out at your coworkers during a stressful shift, you
choose to channel your frustration into a kickboxing class. You could also funnel
or redirect the feelings into music, art, or sports.

8. Reaction formation

People who use this defense mechanism recognize how they feel, but they choose
to behave in the opposite manner of their instincts.

A person who reacts this way, for example, may feel they should not express
negative emotions, such as anger or frustration. They choose to instead react in an
overly positive way.
9. Compartmentalization

Separating your life into independent sectors may feel like a way to protect many
elements of it.

For example, when you choose to not discuss personal life issues at work, you
block off, or compartmentalize, that element of your life. This allows you to carry
on without facing the anxieties or challenges while you’re in that setting or
mindset.

10. Intellectualization

When you’re hit with a trying situation, you may choose to remove all emotion
from your responses and instead focus on quantitative facts.

You may see this strategy in use when a person spends their days creating
spreadsheets of job opportunities and leads after they are let go from a job.

Treatment for unhealthy defense mechanisms

Defense mechanisms can sometimes be viewed as a type of self-deception. You

might be using them to hide emotional responses that you don’t want to deal with
from yourself. However, it’s done mostly on an unconscious level. You’re not
always aware of the way your mind or ego will respond.

That doesn’t mean, however, that you can’t modify or change the behaviors.
Indeed, you can transform unhealthy defense mechanisms into ones that are more
sustainable. These techniques may help:

 Find accountability. Friends and family members can help you recognize
defense mechanisms you may be using. By drawing attention to the self-
 deception, they can help you identify the moment you unconsciously use
self-deception. That allows you to then decide in the conscious state what
you really want to do.
 Learn coping strategies. Therapy with a mental health expert, such as a
psychotherapist, psychologist, or psychoanalyst, may help you recognize the
defense mechanisms you use most often. They can then help you learn active
responses to make choices on a more mindful level.