ASWB Clinical 3 — Questions and Answers
Question 1: A social worker notices a client is consistently arriving late, forgetting appointments, and avoiding emotionally charged topics. This pattern is best understood as:
- Transference
- Resistance (Correct answer)
- Countertransference
- Projection
Correct answer: Resistance
Resistance refers to conscious or unconscious behaviors that impede therapeutic progress, such as avoidance, lateness, or topic deflection.
Question 2: Which eating disorder is characterized by recurrent episodes of binge eating without compensatory behaviors, occurring at least once a week for 3 months?
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating Disorder (Correct answer)
- Avoidant/Restrictive Food Intake Disorder
Correct answer: Binge Eating Disorder
Binge Eating Disorder involves recurrent binge eating episodes without the purging or compensatory behaviors seen in Bulimia Nervosa.
Question 3: A client on lithium therapy complains of tremor, nausea, and confusion. The social worker's most appropriate first action is to:
- Reassure the client that these are common side effects
- Encourage the client to skip the next dose
- Refer the client to their prescribing physician immediately (Correct answer)
- Document the symptoms and review at the next session
Correct answer: Refer the client to their prescribing physician immediately
These symptoms may indicate lithium toxicity, a medical emergency requiring immediate evaluation by the prescribing physician.
Question 4: In family therapy, the concept of 'triangulation' refers to:
- Using three therapeutic modalities simultaneously
- A third party being pulled into tension between two others to reduce anxiety (Correct answer)
- A three-generational analysis of family patterns
- Three family members attending the same session
Correct answer: A third party being pulled into tension between two others to reduce anxiety
Triangulation occurs when a dyadic conflict is stabilized by involving a third person, diverting tension away from the original pair.
Question 5: A client with Borderline Personality Disorder idealized the social worker last week but is now expressing intense anger and calling the worker incompetent. This shift exemplifies:
- Reaction formation
- Projection
- Splitting (Correct answer)
- Displacement
Correct answer: Splitting
Splitting is a hallmark defense mechanism in BPD where others are viewed as all good or all bad, with sudden shifts between the two extremes.
Question 6: According to Kübler-Ross, a terminally ill client who refuses to believe the diagnosis and continues planning a 5-year business expansion is in which stage of grief?
- Anger
- Bargaining
- Denial (Correct answer)
- Depression
Correct answer: Denial
In Kübler-Ross's model, denial is the initial stage where the individual refuses to accept the reality of the diagnosis.
Question 7: A social worker is conducting a mental status examination. Which element assesses whether a client can perform serial sevens or spell 'world' backwards?
- Orientation
- Insight
- Concentration and attention (Correct answer)
- Abstract thinking
Correct answer: Concentration and attention
Serial sevens and spelling 'world' backwards are standard tasks used to evaluate concentration and attention during a mental status examination.
ASWB Clinical 3
A social worker notices a client is consistently arriving late, forgetting appointments, and avoiding emotionally charged topics.
This pattern is best understood as: