ASWB Clinical Social Worker 5 ā Questions and Answers
Question 1: A client with obsessive-compulsive disorder engages in handwashing rituals to relieve contamination fears. The evidence-based treatment of choice is:
- Psychoanalytic therapy to uncover symbolic meaning of the rituals
- Exposure and Response Prevention (ERP) (Correct answer)
- Dialectical Behavior Therapy (DBT)
- Eye Movement Desensitization and Reprocessing (EMDR)
Correct answer: Exposure and Response Prevention (ERP)
ERP, a form of CBT, is the gold-standard treatment for OCD, exposing clients to feared stimuli while preventing compulsive responses.
Question 2: A social worker in a hospital setting learns that a terminally ill client has an advance directive refusing artificial nutrition. The family demands the team override it. The social worker's role is to:
- Side with the family to maintain rapport and support
- Advocate for the client's documented wishes and facilitate an ethics consultation if needed (Correct answer)
- Defer entirely to the medical team's judgment
- Encourage the client to revise the directive to reduce family conflict
Correct answer: Advocate for the client's documented wishes and facilitate an ethics consultation if needed
Social workers are ethicaly obligated to advocate for client self-determination, including honoring advance directives.
Question 3: Which of the following best illustrates the concept of 'triangulation' in Bowen Family Systems Theory?
- A parent setting clear generational boundaries with a child
- Two parents pulling a child into their marital conflict to reduce tension between them (Correct answer)
- A therapist joining with one family member to restructure hierarchy
- Siblings developing an alliance independent of parental subsystems
Correct answer: Two parents pulling a child into their marital conflict to reduce tension between them
Triangulation occurs when anxiety between two people is managed by involving a third person, such as a child, to diffuse tension.
Question 4: A client reports they have been sober for six months and are considering returning to social drinking. Using the Stages of Change model, the client is most likely in which stage?
- Precontemplation
- Contemplation
- Preparation
- Maintenance (Correct answer)
Correct answer: Maintenance
Considering a return to use while in sustained recovery indicates the client is in the Maintenance stage, where relapse prevention is critical.
Question 5: During a group therapy session, a member begins to talk about another member's personal disclosures outside the group. The group facilitator should FIRST:
- Expel the breaching member immediately
- Address the confidentiality breach directly in the group and reinforce group norms (Correct answer)
- Ignore it to avoid shaming the member
- Contact the disclosed-about member privately without group discussion
Correct answer: Address the confidentiality breach directly in the group and reinforce group norms
Addressing confidentiality breaches openly reinforces group norms and protects all members' trust in the process.
Question 6: Which of the following is the MOST important predictor of positive psychotherapy outcomes across treatment modalities?
- The specific theoretical orientation of the therapist
- The quality of the therapeutic alliance (Correct answer)
- The number of sessions provided
- The use of manualized treatment protocols
Correct answer: The quality of the therapeutic alliance
Research consistently identifies the therapeutic allianceāmutual trust, agreement on goals and tasksāas the strongest predictor of positive outcomes.
Question 7: A social worker who frequently works with trauma survivors begins feeling emotionally numb, hopeless, and detached from their work. This is most consistent with:
- Burnout only, unrelated to client exposure
- Compassion fatigue / secondary traumatic stress (Correct answer)
- Countertransference requiring clinical supervision
- Vicarious resilience
Correct answer: Compassion fatigue / secondary traumatic stress
Emotional numbing, hopelessness, and detachment following repeated exposure to others' trauma are hallmark signs of compassion fatigue.
ASWB Clinical Social Worker 5
A client with obsessive-compulsive disorder engages in handwashing rituals to relieve contamination fears.
The evidence-based treatment of choice is: