LMSW (Licensed Master Social Worker) Exam — Questions and Answers

Question 1: A social worker at a community mental health center notices that Latinx clients consistently drop out after the second session. The MOST appropriate macro-level intervention is to:

Increase the frequency of reminder calls to Latinx clients
Survey departing clients individually about their reasons
Refer these clients to a different agency
Advocate for hiring bilingual/bicultural staff and culturally adapted services (Correct answer)

Correct answer: Advocate for hiring bilingual/bicultural staff and culturally adapted services

Advocating for bilingual staff and culturally adapted services addresses the systemic barrier rather than placing the burden of change on individual clients.

Question 2: In structural family therapy, the term 'enmeshment' describes a family pattern where:

Family members are disengaged and emotionally distant
Boundaries between family members are diffuse, limiting individual autonomy (Correct answer)
Boundaries between family members are too rigid and inflexible
One parent is excluded from family decision-making

Correct answer: Boundaries between family members are diffuse, limiting individual autonomy

Enmeshment, as described by Salvador Minuchin, refers to overly diffuse boundaries where individuals lose a sense of separate identity.

Question 3: Elisabeth Kübler-Ross's five stages of grief are most accurately described as:

A framework of common emotional responses that may occur in any order (Correct answer)
A set of behavioral reinforcements used in grief counseling
A biological process tied directly to the nervous system
A fixed linear sequence every bereaved person must complete

Correct answer: A framework of common emotional responses that may occur in any order

Kübler-Ross's stages—denial, anger, bargaining, depression, and acceptance—represent common experiences in grief but do not occur in a rigid, universal order.

Question 4: A client calls a crisis hotline stating they have a loaded gun and plan to use it tonight. What is the FIRST priority for the social worker?

Assess the lethality of the plan and access to means (Correct answer)
Provide empathic listening and validate feelings
Contact the client's next of kin immediately
Schedule an emergency in-person appointment

Correct answer: Assess the lethality of the plan and access to means

Lethality assessment including means, plan, and intent is the immediate priority to determine level of danger and appropriate intervention.

Question 5: A social worker is treating a veteran with PTSD using Prolonged Exposure therapy. This intervention is best categorized as:

Psychodynamic intervention
Trauma-focused cognitive behavioral intervention (Correct answer)
Strengths-based case management
Motivational enhancement therapy

Correct answer: Trauma-focused cognitive behavioral intervention

Prolonged Exposure is an evidence-based trauma-focused CBT intervention that reduces PTSD symptoms through systematic confrontation of trauma memories and triggers.

Question 6: A client presents with persistent depressed mood, loss of interest, fatigue, and hypersomnia lasting 3 weeks. Which DSM-5 diagnosis is most appropriate to consider?

Bipolar II Disorder
Major Depressive Disorder (Correct answer)
Persistent Depressive Disorder
Adjustment Disorder with Depressed Mood

Correct answer: Major Depressive Disorder

Major Depressive Disorder requires at least 5 symptoms during a 2-week period, including depressed mood or anhedonia, which this client meets.

Question 7: A social worker learns that a 17-year-old client is sexually active with a same-age peer and both parties are consenting. The social worker personally disapproves. What is the ethical obligation?

Terminate services due to the ethical conflict
Respect the client's self-determination and continue services without imposing personal values (Correct answer)
Report the situation to child protective services
Inform the client's parents because the client is a minor

Correct answer: Respect the client's self-determination and continue services without imposing personal values

Social workers must respect client self-determination and set aside personal values when they do not present a legal or safety concern, including in matters of sexuality.

Question 8: Which of the following is NOT one of the six core values identified in the Preamble of the NASW Code of Ethics?

Integrity
Self-Determination (Correct answer)
Service
Social Justice

Correct answer: Self-Determination

The Preamble of the NASW Code of Ethics outlines six core values: Service, Social Justice, Dignity and Worth of the Person, Importance of Human Relationships, Integrity, and Competence. While Self-Determination is a fundamental ethical principle (Standard 1.02), it is not listed as one of the six core values.

Question 9: Which principle guides social workers to involve clients as active partners in all aspects of the case management process?

Self-determination (Correct answer)
Duty to warn
Privileged communication
Confidentiality

Correct answer: Self-determination

Self-determination requires social workers to respect and support clients' rights to make decisions about their own lives and services.

Question 10: Which of the following best differentiates Social Anxiety Disorder from Avoidant Personality Disorder in assessment?

Avoidant Personality Disorder is limited to performance-based social situations
They are identical disorders differentiated only by DSM edition
Social Anxiety Disorder is more severe and pervasive across all situations
Social Anxiety Disorder may be situationally triggered while AvPD is ego-syntonic and pervasive (Correct answer)

Correct answer: Social Anxiety Disorder may be situationally triggered while AvPD is ego-syntonic and pervasive

Social Anxiety Disorder is often situational (e.g., public speaking) while Avoidant Personality Disorder involves a pervasive, ego-syntonic pattern of social inhibition and feelings of inadequacy across contexts.

Question 11: A social worker employed by a child welfare agency has a personal belief that same-sex couples should not adopt children. When assigned a case involving a same-sex couple seeking to adopt, the social worker should:

Provide competent, unbiased services consistent with the NASW Code of Ethics (Correct answer)
Inform the couple of the social worker's beliefs before proceeding
Request the case be reassigned without disclosing the reason
Decline the case based on personal religious convictions

Correct answer: Provide competent, unbiased services consistent with the NASW Code of Ethics

The NASW Code of Ethics requires social workers to practice without discrimination and to provide competent services regardless of personal values.

Question 12: In outcome evaluation, a logic model is used to:

Visualize the relationships between program inputs, activities, outputs, and outcomes (Correct answer)
Replace the need for formative evaluation
Select a random sample of clients
Statistically analyze program data

Correct answer: Visualize the relationships between program inputs, activities, outputs, and outcomes

A logic model graphically maps the theory of change by linking resources and activities to the expected short- and long-term outcomes of a program.

Question 13: Which intervention is MOST consistent with a harm reduction approach when working with a client who uses substances?

Mandating inpatient detox as a condition of treatment
Connecting the client to a needle exchange program (Correct answer)
Discharging the client for continued drug use
Requiring abstinence before providing any services

Correct answer: Connecting the client to a needle exchange program

Harm reduction focuses on minimizing the negative consequences of substance use without requiring abstinence, and needle exchange programs are a core harm reduction strategy.

Question 14: An LMSW working in a faith-based agency is asked to incorporate religious teachings into sessions with all clients. The social worker is ethically obligated to:

Follow agency policy and incorporate religion into all sessions
Ensure clients are informed of the agency's approach and can choose whether to receive religiously-integrated services (Correct answer)
Resign from the agency immediately
Report the agency to the state licensing board

Correct answer: Ensure clients are informed of the agency's approach and can choose whether to receive religiously-integrated services

Informed consent and client self-determination require that clients know about the nature of services and have the right to accept or decline religious components of care.

Question 15: A social worker conducting a biopsychosocial assessment is PRIMARILY trying to:

Establish rapport before beginning formal therapy
Understand the interplay of biological, psychological, and social factors affecting the client (Correct answer)
Determine the client's eligibility for public benefits
Diagnose the client using DSM-5 criteria

Correct answer: Understand the interplay of biological, psychological, and social factors affecting the client

A biopsychosocial assessment examines the intersecting biological, psychological, and social dimensions of a client's presenting problem to inform holistic treatment planning.

Question 16: A social worker uses the SOAP format in clinical documentation. In which section would the client's report of sleep disturbance be recorded?

O (Objective)
S (Subjective) (Correct answer)
A (Assessment)
P (Plan)

Correct answer: S (Subjective)

The Subjective section captures what the client reports, including self-described symptoms like sleep disturbance.

Question 17: A social worker using motivational interviewing (MI) should primarily do which of the following?

Assign homework tasks to build accountability
Confront the client about the negative consequences of their behavior
Evoke the client's own reasons and motivation for change (Correct answer)
Provide expert advice on how the client should change

Correct answer: Evoke the client's own reasons and motivation for change

Motivational interviewing is a client-centered approach that evokes the client's own intrinsic motivation and commitment to change.

Question 18: A social worker of color discloses experiencing racial microaggressions from a supervisor. The agency's best response is to:

Suggest the worker develop thicker skin and focus on client work
Transfer the worker to a different supervisor without addressing the behavior
Remind the worker that microaggressions are unintentional and not harmful
Investigate and address the pattern through formal channels while supporting the worker (Correct answer)

Correct answer: Investigate and address the pattern through formal channels while supporting the worker

Organizations must take microaggressions seriously, investigate formally, and support affected employees to create equitable workplaces.

Question 19: A social worker is formulating a treatment plan for a client with social anxiety. The plan includes sessions focused on identifying and challenging automatic negative thoughts, such as 'I will say something foolish,' and gradually participating in feared social situations, starting with low-stakes interactions. This approach is most characteristic of which therapeutic model?

Cognitive Behavioral Therapy (CBT) (Correct answer)
Solution-Focused Brief Therapy (SFBT)
Psychoanalytic Therapy
Gestalt Therapy

Correct answer: Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is an evidence-based practice that focuses on the interplay between thoughts (cognitions), feelings, and behaviors. The two components described—challenging negative thoughts (cognitive restructuring) and gradual exposure to feared situations (behavioral experiments)—are hallmark techniques of CBT, particularly for anxiety disorders.

Question 20: A social worker who is recovering from substance use disorder begins working in an addiction treatment program. Which is TRUE regarding ethical practice?

Self-disclosure of recovery status is always required for rapport
The worker may practice if competent and the history does not impair practice (Correct answer)
The worker must disclose their history to all clients
Personal history of addiction disqualifies a worker from this field

Correct answer: The worker may practice if competent and the history does not impair practice

Personal history does not bar practice; what matters is whether the worker can perform duties competently and without impairment.

Question 21: A social worker learns that a colleague is billing Medicaid for services that were never rendered. What is the social worker's ethical obligation?

Take action through appropriate channels, such as reporting to a supervisor or ethics board (Correct answer)
Document the behavior but wait to see if it continues before taking action
Discuss the issue with the colleague privately and encourage them to stop
Ignore the situation because it does not directly involve the social worker's clients

Correct answer: Take action through appropriate channels, such as reporting to a supervisor or ethics board

The NASW Code of Ethics requires social workers to take action when they become aware of colleagues' unethical conduct. Medicaid fraud harms clients and the public; reporting through appropriate channels — supervisor, licensing board, or ethics committee — fulfills this professional duty.

Question 22: Which of the following best describes environmental justice as it relates to social work practice?

Ensuring equal access to parks and recreational facilities
Teaching clients about recycling and environmental conservation
Addressing the disproportionate burden of environmental hazards on low-income and minority communities (Correct answer)
Advocating for green energy policies at the federal level

Correct answer: Addressing the disproportionate burden of environmental hazards on low-income and minority communities

Environmental justice recognizes that toxic facilities, pollution, and climate risks are disproportionately sited in communities of color and low-income areas.

Question 23: A client with borderline personality disorder frequently calls the social worker in crisis between sessions. Which intervention framework is most evidence-based for this presentation?

Solution-Focused Brief Therapy
Rational Emotive Behavior Therapy
Psychodynamic therapy
Dialectical Behavior Therapy (DBT) (Correct answer)

Correct answer: Dialectical Behavior Therapy (DBT)

DBT was specifically developed by Marsha Linehan for borderline personality disorder and has the strongest evidence base for reducing self-harm and crisis behaviors.

Question 24: The biopsychosocial model in social work assessment integrates which three domains?

Brain, perception, and social roles
Biology, psychology, and sociology (Correct answer)
Behavior, personality, and society
Biology, psychiatry, and social services

Correct answer: Biology, psychology, and sociology

The biopsychosocial model examines biological factors, psychological factors, and social/environmental factors as interconnected influences on health and behavior.

Question 25: A school social worker learns that a 15-year-old student made a suicide attempt over the weekend. What is the PRIORITY intervention upon the student's return to school?

Conduct a private risk assessment and develop a safety plan (Correct answer)
Notify all teachers so they can monitor the student
Document the incident and refer to outside therapy only
Inform peers so they can provide peer support

Correct answer: Conduct a private risk assessment and develop a safety plan

A private risk assessment and collaborative safety planning with the student is the priority clinical intervention upon school reentry after a suicide attempt.

Question 26: The concept of 'White privilege' in social work practice refers to:

A form of reverse discrimination
Financial benefits given to White clients
A belief that White people are superior
Unearned advantages conferred to White individuals by systemic racism, often invisible to those who hold them (Correct answer)

Correct answer: Unearned advantages conferred to White individuals by systemic racism, often invisible to those who hold them

White privilege describes unearned systemic advantages that benefit White individuals without their necessarily being aware of them.

Question 27: Which of the following is a difference between professional ethics and professional values:

Values and ethics are basically the same and are evaluated based on the specific situation
Values are a subset of ethics.
When a social worker makes a judgment that is ethical, you can assume it is a judgment that also upholds professional values.
Values deal with what is right or wrong in practice, and ethics deals with the principles of practice. (Correct answer)

Correct answer: Values deal with what is right or wrong in practice, and ethics deals with the principles of practice.

Professional ethics provide the guiding principles and norms that define proper conduct and behavior within the profession, while professional values serve as the foundation for what professionals regard as significant and desirable in their sector. While ethics focuses on the principles of practice, offering a framework for professional behavior and decision-making, values deal with what is right or wrong in practice, reflecting personal and cultural ideas.

Question 28: A social worker in a community mental health center is working with a client from a cultural background different from their own. The client describes a spiritual healing practice that the social worker is unfamiliar with. The BEST approach is to:

Educate the client about evidence-based treatments as superior alternatives
Recommend the client seek a social worker from the same cultural background
Ask the client to explain the practice and explore how it fits into their care (Correct answer)
Consult with a supervisor about discontinuing work with the client

Correct answer: Ask the client to explain the practice and explore how it fits into their care

Cultural humility requires social workers to approach unfamiliar practices with curiosity and openness. Asking the client to share their perspective fosters trust and ensures the care plan is culturally responsive and client-centered.

Question 29: A social worker is providing case management services to a client who is homeless and has a severe mental illness. The client refuses all housing placements offered. What is the MOST appropriate next step?

Continue engaging the client, explore barriers to accepting housing, and document the refusal (Correct answer)
Limit contact with the client to monthly check-ins until they agree to housing
Contact a judge to obtain a court order compelling the client to accept placement
Discharge the client from services since they are non-compliant

Correct answer: Continue engaging the client, explore barriers to accepting housing, and document the refusal

Client self-determination means the social worker must respect the client's right to refuse services while continuing to engage and explore underlying barriers such as past trauma, distrust, or specific housing concerns. Ongoing engagement and documentation are essential in harm-reduction-oriented practice.

Question 30: Which of the following BEST describes the concept of 'precipitating event' in crisis theory?

The immediate stressor that triggers a state of crisis (Correct answer)
A longstanding pattern of maladaptive coping
The cumulative effect of multiple life stressors over time
A client's baseline level of psychological functioning

Correct answer: The immediate stressor that triggers a state of crisis

A precipitating event is the specific, identifiable trigger — often a recent loss, threat, or change — that disrupts equilibrium and initiates the crisis state.

Question 31: A case manager conducts a comprehensive biopsychosocial assessment. Which area is MOST important to assess when determining eligibility for intensive case management services?

Client's insurance coverage only
Educational history exclusively
Geographic proximity to the agency
Level of functioning across biological, psychological, and social domains (Correct answer)

Correct answer: Level of functioning across biological, psychological, and social domains

A biopsychosocial assessment examines functioning across all domains to determine the level and type of services a client needs.

Question 32: A social worker at a nonprofit learns that a proposed city budget cut will eliminate funding for three youth after-school programs. The MOST appropriate first response is to:

Organize affected families, youth, and staff to advocate collectively before the city council vote (Correct answer)
Write an anonymous letter to the local newspaper
Immediately file a lawsuit challenging the budget decision
Wait to see if the cuts are finalized before taking action

Correct answer: Organize affected families, youth, and staff to advocate collectively before the city council vote

Organizing stakeholders to advocate before the vote is proactive and uses collective power at the most effective decision-making moment.

Question 33: Which practice model centers clients' strengths and community assets rather than deficits and problems?

Medical model
Strengths-based perspective (Correct answer)
Diagnostic and Statistical Model
Pathology-based assessment

Correct answer: Strengths-based perspective

The strengths-based perspective, associated with Dennis Saleebey, focuses on client capacities, resilience, and community resources rather than deficits.

Question 34: A social worker notices that participants in a study tend to answer questions in ways they believe are socially acceptable. This is an example of:

Selection bias
Recall bias
Confirmation bias
Social desirability bias (Correct answer)

Correct answer: Social desirability bias

Social desirability bias occurs when respondents answer to appear favorable rather than honestly.

Question 35: A social worker learns that a 16-year-old client is sexually active with a 17-year-old peer, both consenting. The MOST appropriate response is:

Discuss safety and contraception without mandatory reporting (Correct answer)
Inform the client's parents without consent
Terminate services due to illegal behavior
Report to child protective services immediately

Correct answer: Discuss safety and contraception without mandatory reporting

Consensual sexual activity between teens close in age is generally not reportable; the worker should focus on safety and education.

Question 36: A client in the contemplation stage of change is best supported by which type of intervention?

Celebrating recent behavioral successes
Focusing on relapse prevention strategies
Providing a specific action plan with behavioral assignments
Exploring ambivalence and increasing discrepancy between current behavior and goals (Correct answer)

Correct answer: Exploring ambivalence and increasing discrepancy between current behavior and goals

Clients in contemplation are aware of a problem but ambivalent; exploring ambivalence and raising discrepancy is the appropriate stage-matched intervention.

Question 37: A customer just received a Multiple Sclerosis diagnosis. She started reading books, journal papers, and the most recent experimental studies as soon as she could to learn as much as she could about the sickness. Which type of defense mechanism is demonstrated by the client's reaction to her diagnosis?

Intellectualization (Correct answer)
Repression
Sublimation
Regression

Correct answer: Intellectualization

A defense mechanism known as intellectualization involves a concentration on thought and analysis in an effort to prevent or lessen emotional suffering. It entails directing emotionally charged or anxiety-inducing circumstances into cerebral and logical endeavors. In this instance, the client's fervent research and education regarding her diagnosis serve as a means for her to remove herself from the emotional toll and unpredictability brought on by the condition.

Question 38: The Social Security Act of 1935 originally established which two major social insurance programs?

Old-Age Insurance and Unemployment Compensation (Correct answer)
Medicare and Medicaid
TANF and SNAP
Workers' Compensation and Disability Insurance

Correct answer: Old-Age Insurance and Unemployment Compensation

The Social Security Act of 1935 created Old-Age Insurance (retirement benefits) and Unemployment Compensation as its two cornerstone social insurance programs.

Question 39: Ally behavior in social justice practice is characterized by:

Using one's privilege to amplify marginalized voices and challenge oppression while following the lead of affected communities (Correct answer)
Attending diversity training workshops only
Speaking on behalf of marginalized groups at all times
Avoiding political discussions in the workplace

Correct answer: Using one's privilege to amplify marginalized voices and challenge oppression while following the lead of affected communities

Effective allyship involves leveraging privilege to support marginalized communities while centering those communities' leadership and direction.

Question 40: After four weeks of working on a treatment plan goal to reduce social isolation, a client reports no change in their behavior or mood. The client expresses frustration, stating, "Nothing is working." What is the social worker's BEST initial action?

Revisit the treatment plan with the client to reassess the problem, explore barriers, and consider alternative interventions. (Correct answer)
Continue with the current plan for another four weeks to see if progress can be made.
Refer the client to a different therapist who may have a more suitable approach.
Suggest terminating services, as the client may not be motivated to change at this time.

Correct answer: Revisit the treatment plan with the client to reassess the problem, explore barriers, and consider alternative interventions.

Treatment planning is a dynamic process, and lack of progress is a signal to review and revise the plan collaboratively. The best course of action is to engage the client in a discussion to reassess the problem, identify any new or unforeseen barriers, and explore whether the chosen interventions are a good fit. This reinforces the therapeutic alliance and empowers the client in their own treatment.

Question 41: In the context of human development, 'epigenetics' as used by Erikson (not molecular biology) refers to the principle that:

Environmental factors can permanently alter DNA expression
Development stops after adolescence
Each stage of development builds upon the successful resolution of prior stages (Correct answer)
Genetics fully determine personality development

Correct answer: Each stage of development builds upon the successful resolution of prior stages

Erikson used the epigenetic principle to mean that each psychosocial stage emerges in a predetermined sequence and builds on the resolution of earlier stages.

Question 42: A client shares information during a session that suggests they may have committed tax fraud years ago. How should the social worker respond?

Terminate services to avoid legal liability
Confront the client and demand they turn themselves in
Maintain confidentiality, as past tax fraud is not a mandated reporting situation (Correct answer)
Immediately report the client to the IRS

Correct answer: Maintain confidentiality, as past tax fraud is not a mandated reporting situation

Past financial crimes by a client do not fall under mandated reporting requirements, so the social worker must maintain confidentiality per ethical and legal standards.

Question 43: A social worker is treating a client from a collectivist cultural background who defers all treatment decisions to family elders. The most culturally competent response is to:

Acknowledge the cultural value of family involvement and explore how to include elders appropriately (Correct answer)
Insist the client make independent decisions to build autonomy
Document that the client lacks capacity for informed consent
Refer to a culturally matched therapist without discussing it with the client

Correct answer: Acknowledge the cultural value of family involvement and explore how to include elders appropriately

Culturally competent practice respects collectivist values and finds culturally appropriate ways to engage the family while maintaining the client's well-being.

Question 44: A client with Generalized Anxiety Disorder reports that their worry is difficult to control and is accompanied by muscle tension, irritability, and poor sleep. How many total symptoms does DSM-5 require for this diagnosis in adults?

2 of 6 associated symptoms
5 of 6 associated symptoms
4 of 6 associated symptoms
3 of 6 associated symptoms (Correct answer)

Correct answer: 3 of 6 associated symptoms

DSM-5 requires at least 3 of 6 associated symptoms (restlessness, fatigue, concentration problems, irritability, muscle tension, sleep disturbance) for adults with GAD.

Question 45: A social worker is preparing testimony for a city council hearing on affordable housing. Which type of evidence is MOST persuasive for policy change?

A detailed history of housing policy in the United States
Personal stories from affected residents only
The social worker's professional opinion about best practices
Aggregate data combined with specific client stories illustrating systemic impact (Correct answer)

Correct answer: Aggregate data combined with specific client stories illustrating systemic impact

Combining aggregate data with personal narratives addresses both the logical and emotional dimensions of policy advocacy most effectively.

Question 46: An LMSW is subpoenaed for a client's records. The client does NOT consent to disclosure. The social worker should FIRST:

Release only a summary rather than the full record
Comply fully with the subpoena to avoid legal penalties
Destroy the records to prevent disclosure
Consult an attorney and seek a protective order or quash the subpoena (Correct answer)

Correct answer: Consult an attorney and seek a protective order or quash the subpoena

A subpoena is not a court order; the worker should consult legal counsel and attempt to protect confidentiality before complying.

Question 47: In Bowen Family Systems Theory, 'differentiation of self' refers to:

The process of separating from one's family of origin permanently
The capacity to maintain a clear sense of self while staying emotionally connected to others (Correct answer)
The ability to function independently of family roles
The development of distinct subsystems within a family

Correct answer: The capacity to maintain a clear sense of self while staying emotionally connected to others

Differentiation of self in Bowen theory means balancing autonomy and emotional connection—neither fused with nor cut off from the family system.

Question 48: A client presents with a 2-week period of depressed mood most of the day, loss of interest in previously enjoyed activities, hypersomnia, psychomotor retardation, and feelings of worthlessness. There is no history of manic or hypomanic episodes. Which diagnosis BEST fits this presentation?

Cyclothymic Disorder
Major Depressive Disorder (Correct answer)
Persistent Depressive Disorder (Dysthymia)
Bipolar I Disorder, depressive episode

Correct answer: Major Depressive Disorder

A discrete episode of at least 5 DSM symptoms (including depressed mood or anhedonia) lasting at least 2 weeks, without a history of mania or hypomania, meets criteria for Major Depressive Disorder. Persistent Depressive Disorder requires symptoms lasting at least 2 years. Bipolar diagnoses require a manic/hypomanic history.

Question 49: A social worker is treating a client who struggles with forming secure and lasting adult relationships. The therapy sessions frequently explore the client's relationship with their primary caregivers during infancy and childhood, focusing on how these early attachment experiences created an 'internal working model' that now unconsciously influences their current patterns of relating to others. This therapeutic approach is most characteristic of which practice model?

Narrative Therapy
Dialectical Behavior Therapy (DBT)
Psychodynamic Therapy (Correct answer)
Task-Centered Practice

Correct answer: Psychodynamic Therapy

Psychodynamic Therapy, heavily influenced by attachment theory, focuses on how past experiences, particularly early childhood relationships, shape current behaviors and relationships. The goal is to bring unconscious thoughts and feelings into conscious awareness, allowing the client to gain insight into how their past is influencing their present difficulties, especially in interpersonal dynamics.

Question 50: Which term describes a social worker's obligation to keep client information private unless the client consents to disclosure or a legal exception applies?

Informed consent
Fiduciary duty
Privileged communication
Confidentiality (Correct answer)

Correct answer: Confidentiality

Confidentiality is the ethical duty of social workers to protect private client information from unauthorized disclosure.

Question 51: Carol Gilligan critiqued Kohlberg's moral development theory primarily because:

It focused too heavily on emotion over reason
It overemphasized cultural relativism
It was based on samples that excluded women and undervalued care ethics (Correct answer)
It did not account for cognitive development stages

Correct answer: It was based on samples that excluded women and undervalued care ethics

Gilligan argued that Kohlberg's model was androcentric, based on male subjects, and failed to capture the ethics of care more commonly voiced by women.

Question 52: Which ethical principle in social work research requires that participation must be free from coercion and that participants fully understand what they are agreeing to?

Informed consent (Correct answer)
Beneficence
Confidentiality
Justice

Correct answer: Informed consent

Informed consent requires that participants voluntarily agree to participate after receiving complete, comprehensible information about the study's purpose, risks, and benefits.

Question 53: The Psychosocial model of social work practice, developed by Florence Hollis, primarily draws from:

Behavioral and cognitive theories
Systems theory and ecological perspectives
Existential and humanistic frameworks
Psychoanalytic theory and ego psychology (Correct answer)

Correct answer: Psychoanalytic theory and ego psychology

The Psychosocial model integrates ego psychology and psychoanalytic concepts to understand the person in their social context.

Question 54: Solution-Focused Brief Therapy (SFBT) is distinguished from problem-focused approaches because it:

Directs attention to client strengths, exceptions, and future goals rather than problems (Correct answer)
Uses confrontational techniques to challenge unhelpful behaviors
Emphasizes the therapeutic relationship as the primary agent of change
Requires a thorough assessment of the problem's history and origins

Correct answer: Directs attention to client strengths, exceptions, and future goals rather than problems

SFBT concentrates on what is already working (exceptions) and where the client wants to go, deliberately minimizing analysis of problem causes.

Question 55: A 72-year-old client in a life-review group expresses a sense of peace and satisfaction with his life, his accomplishments, and the relationships he has built. He feels he has made a meaningful contribution to his family and community. According to Erikson, this client is successfully resolving which developmental crisis?

Intimacy vs. Isolation
Generativity vs. Stagnation
Trust vs. Mistrust
Ego Integrity vs. Despair (Correct answer)

Correct answer: Ego Integrity vs. Despair

Erikson's final stage, Ego Integrity vs. Despair, occurs in late adulthood (65+). Successful resolution of this stage involves reflecting on one's life and feeling a sense of satisfaction and accomplishment (integrity). The client's feelings of peace and meaning indicate a positive outcome for this stage.

Question 56: Kohlberg's 'postconventional' level of moral development is best represented by which behavior?

Conforming to social norms to gain peer approval
Making moral decisions based on universal ethical principles (Correct answer)
Obeying laws because authority figures demand it
Following rules to avoid punishment

Correct answer: Making moral decisions based on universal ethical principles

Postconventional morality involves reasoning based on self-chosen ethical principles that may transcend societal laws, representing the highest level of moral development.

Question 57: A social worker is facilitating the first meeting of a new coalition aimed at addressing youth homelessness. The coalition includes diverse stakeholders from the school district, a local shelter, a faith-based organization, and a mental health clinic. Which of the following is the MOST critical initial task for the social worker to accomplish?

Develop a comprehensive five-year strategic plan.
Facilitate the development of a shared vision and common goals. (Correct answer)
Secure long-term funding commitments from community partners.
Immediately assign tasks and roles to each member organization.

Correct answer: Facilitate the development of a shared vision and common goals.

In the initial stage of coalition building, it is essential to establish a foundation of mutual understanding and purpose. Bringing together diverse stakeholders requires creating a shared vision and common goals that all members can agree upon before moving on to specific tasks, funding, or long-term planning.

Question 58: A child who watches an adult behave aggressively and then imitates that behavior is demonstrating which learning theory concept?

Operant conditioning
Observational learning (Correct answer)
Cognitive dissonance
Classical conditioning

Correct answer: Observational learning

Observational learning, central to Bandura's social learning theory, occurs when a child acquires new behaviors by watching and imitating others.

Question 59: A social worker's agency serves primarily Latino clients but all written materials are available only in English. This is an example of:

An institutional barrier that limits access and equity (Correct answer)
Standard agency practice acceptable under NASW Code of Ethics
A client responsibility to learn English
Appropriate cost-saving measures

Correct answer: An institutional barrier that limits access and equity

Providing materials only in English creates an institutional barrier that disproportionately excludes non-English-speaking clients, undermining equity.

Question 60: A client with a history of trauma presents with intrusive memories, emotional numbing, hypervigilance, and sleep disturbances following a car accident six weeks ago. The MOST appropriate diagnosis is:

Acute Stress Disorder (Correct answer)
Adjustment Disorder
Generalized Anxiety Disorder
PTSD

Correct answer: Acute Stress Disorder

Acute Stress Disorder is diagnosed when trauma symptoms occur within one month of the traumatic event and last between three days and one month.

Question 61: A client in a rural area asks to connect with their social worker on social media. The MOST ethical response is to:

Ignore the request without explanation
Decline and explain the professional boundary rationale (Correct answer)
Accept to avoid seeming rude in a small community
Create a separate personal account to connect with clients

Correct answer: Decline and explain the professional boundary rationale

Social media connections blur professional boundaries and can compromise therapeutic neutrality, regardless of community size.

Question 62: Which stage of case management involves regularly checking whether clients are receiving services and whether those services are meeting their needs?

Termination
Planning
Assessment
Monitoring (Correct answer)

Correct answer: Monitoring

Monitoring involves ongoing review of service delivery and client progress to ensure the care plan remains appropriate and effective.

Question 63: Margaret Mahler's object relations theory is primarily concerned with which of the following developmental processes?

The development of moral reasoning through social dilemmas.
The child's process of separating from the primary caregiver and developing an individual identity. (Correct answer)
The resolution of psychosocial crises across the entire lifespan.
The impact of observational learning and modeling on behavior.

Correct answer: The child's process of separating from the primary caregiver and developing an individual identity.

Margaret Mahler's object relations theory focuses on the intrapsychic process of separation-individuation, where a child develops a sense of self as separate from their mother/primary caregiver during the first three years of life. This process is crucial for forming a stable identity and healthy relationships in adulthood.

Question 64: A client who is grieving the death of a spouse reports she has been feeling sad for 14 months and cannot return to work. According to the DSM-5, this presentation may meet criteria for:

Adjustment Disorder with Depressed Mood
Persistent Depressive Disorder (Dysthymia)
Major Depressive Disorder, Single Episode
Prolonged Grief Disorder (Correct answer)

Correct answer: Prolonged Grief Disorder

Prolonged Grief Disorder (added in DSM-5-TR) describes grief that persists beyond 12 months and significantly impairs functioning.

Question 65: A social worker is conducting a risk assessment and asks about the client's specific plan, means, and timeline for suicide. This line of inquiry is designed to assess:

Hopelessness and cognitive distortions
Passive suicidal ideation
Protective factors and reasons for living
Suicidal intent and lethality (Correct answer)

Correct answer: Suicidal intent and lethality

Assessing plan, means, and timeline evaluates the lethality and intent of suicidal ideation, which guides clinical decision-making about safety.

Question 66: A social worker notices that a neighborhood's high asthma rates correlate with proximity to an industrial facility. This analysis reflects which practice concept?

Environmental justice (Correct answer)
Risk assessment
Community profiling
Epidemiological screening

Correct answer: Environmental justice

Environmental justice examines how marginalized communities disproportionately bear environmental hazards and links health disparities to systemic inequity.

Question 67: Which of the following best describes the diagnostic concept of 'specifiers' in DSM-5?

Additional descriptors that communicate clinical information beyond the core diagnosis (Correct answer)
Subtypes that replace the primary diagnosis
Alternative diagnoses to consider when primary diagnosis is uncertain
Severity ratings used only for psychotic disorders

Correct answer: Additional descriptors that communicate clinical information beyond the core diagnosis

Specifiers are extensions of diagnoses that provide more detail about course, severity, or features without changing the primary diagnosis.

Question 68: A community coalition is experiencing conflict between two member organizations over resource allocation. The social worker's most appropriate role is:

Facilitate dialogue to reach a mutually acceptable resolution (Correct answer)
Step back to avoid taking sides
Report the conflict to the funding agency
Advocate for the organization with fewer resources

Correct answer: Facilitate dialogue to reach a mutually acceptable resolution

Facilitating dialogue preserves the coalition's functioning and models collaborative problem-solving consistent with community practice ethics.

Question 69: Which research approach is BEST suited for exploring the lived experience of LMSW clients who have recovered from trauma?

Single-subject design
Survey research
Phenomenological study (Correct answer)
Randomized controlled trial

Correct answer: Phenomenological study

Phenomenological research focuses on capturing and interpreting the subjective, lived experiences of participants in depth.

Question 70: A social worker is assessing a 4-year-old who engages in cooperative play, shows empathy, and can follow two-step directions. Which theorist's framework would classify this child as functioning in the preoperational stage?

Piaget (Correct answer)
Freud
Kohlberg
Vygotsky

Correct answer: Piaget

Piaget's preoperational stage (ages 2–7) is characterized by symbolic thinking, egocentrism, and emerging language use.

Question 71: Which situation represents an appropriate use of self-disclosure by a social worker?

Briefly disclosing relevant experience to normalize a client's struggle (Correct answer)
Discussing personal relationship problems to model vulnerability
Sharing extensive personal trauma history to build rapport
Revealing political beliefs to align with a client's values

Correct answer: Briefly disclosing relevant experience to normalize a client's struggle

Appropriate self-disclosure is purposeful, brief, and clinically beneficial to the client rather than meeting the worker's own needs.

Question 72: The Empowerment model in social work practice is MOST aligned with which underlying value?

Professional neutrality is essential to avoid dual relationships
Clients gain power and control over their own lives and environments (Correct answer)
Symptom reduction is the primary measure of success
Therapist expertise guides all clinical decisions

Correct answer: Clients gain power and control over their own lives and environments

The Empowerment model centers on helping clients develop a sense of personal and collective power to effect change in their own lives and communities.

Question 73: A social worker discovers that a client's 8-year-old child has unexplained bruising and the client offers inconsistent explanations. What is the social worker's FIRST obligation?

Document findings and schedule a follow-up visit
Confront the client directly about the abuse
Report the suspicion to child protective services immediately (Correct answer)
Consult with a supervisor before taking any action

Correct answer: Report the suspicion to child protective services immediately

Mandated reporters must report reasonable suspicion of child abuse immediately, without waiting for confirmation or supervisor approval.

Question 74: Bowlby's attachment theory proposes that infants form attachments primarily because:

Social learning from peers shapes attachment patterns
Infants are conditioned through operant reinforcement
Caregivers provide food and reduce hunger drives
Proximity-seeking behavior is evolutionarily adaptive for survival (Correct answer)

Correct answer: Proximity-seeking behavior is evolutionarily adaptive for survival

Bowlby argued attachment is an innate biological system that keeps vulnerable infants close to caregivers for protection and survival.

Question 75: Alzheimer's disease is frequently misdiagnosed in older people when the more correct diagnosis is

Anxiety
Delirium
Depression (Correct answer)
Thyroid Disorder

Correct answer: Depression

It is true that older people are occasionally given the wrong diagnosis of Alzheimer's disease when the correct one is depression. <br> When working with older people who are suffering cognitive and behavioral changes, healthcare practitioners must undertake a complete evaluation, taking into account both physical and mental health factors. Before making a diagnosis, this entails checking for depression symptoms and excluding any other conceivable reasons. To properly care for and support older people who are depressed, a proper diagnosis and suitable therapy are crucial.

Question 76: A client presents with recurrent, intrusive memories of a traumatic event, nightmares, avoidance of trauma reminders, and hypervigilance lasting more than one month. The MOST likely DSM-5 diagnosis is:

Generalized Anxiety Disorder
Post-Traumatic Stress Disorder (PTSD) (Correct answer)
Acute Stress Disorder
Adjustment Disorder with anxiety

Correct answer: Post-Traumatic Stress Disorder (PTSD)

PTSD requires symptoms in all four clusters (intrusion, avoidance, negative cognitions/mood, hyperarousal) lasting more than one month following trauma.

Question 77: A hospital social worker is part of an interdisciplinary team creating a discharge plan for an elderly patient. The patient wants to return home, but the medical team has serious safety concerns. The patient's family is divided on the best course of action. What is the social worker's PRIMARY role in this situation?

Advocate solely for the patient's stated desire to return home, upholding their self-determination above all else.
Refer the family to a legal expert to determine guardianship and decision-making authority.
Facilitate communication between the patient, family, and medical team to develop a plan that balances safety and patient autonomy. (Correct answer)
Make the final decision on the discharge plan based on the medical risks.

Correct answer: Facilitate communication between the patient, family, and medical team to develop a plan that balances safety and patient autonomy.

The social worker's key role on an interdisciplinary team is often to be a facilitator and mediator, ensuring a holistic, person-centered approach. This involves bridging the gap between the medical team's safety concerns and the patient's right to self-determination. By facilitating a meeting, the social worker helps all parties share information, explore options (like home health care or environmental modifications), and collaboratively create a plan that respects the patient's wishes while mitigating risks.

Question 78: When a researcher measures what they intend to measure, the instrument is said to have:

Validity (Correct answer)
Sensitivity
Specificity
Reliability

Correct answer: Validity

Validity refers to the degree to which a measurement tool accurately captures the construct it is designed to measure.

Question 79: Which term describes the process by which immigrant communities are encouraged to abandon their cultural identities and adopt the dominant culture?

Enculturation
Cultural brokering
Acculturation
Assimilation (Correct answer)

Correct answer: Assimilation

Assimilation involves absorbing into and adopting the dominant culture, often at the cost of original cultural identity, whereas acculturation involves navigating between two cultures.

Question 80: According to Jean Piaget, a child in the 'concrete operational stage' is best characterized by the ability to:

Engage only in sensorimotor exploration of the environment
Perform logical operations on abstract concepts
Understand conservation and classify objects by multiple dimensions (Correct answer)
Use symbolic thinking and language

Correct answer: Understand conservation and classify objects by multiple dimensions

During the concrete operational stage (ages 7–11), children master conservation tasks and can classify objects by more than one attribute simultaneously.

Question 81: A trauma-informed approach to treatment planning prioritizes which of the following?

Rapid exposure to traumatic memories in early sessions
Building safety and stabilization before processing trauma (Correct answer)
Minimizing discussion of trauma to prevent re-traumatization
Focusing exclusively on cognitive distortions

Correct answer: Building safety and stabilization before processing trauma

Trauma-informed care follows a phase-based model in which establishing safety and stabilization precedes trauma processing.

Question 82: Which level of measurement assigns numbers to categories with no implied ranking or order?

Interval
Ratio
Ordinal
Nominal (Correct answer)

Correct answer: Nominal

Nominal measurement classifies variables into mutually exclusive categories (e.g., gender, race) with no inherent order or numerical meaning.

Question 83: A social worker has been seeing a client in individual therapy for six months. The client asks to become friends on social media and invites the social worker to their birthday party. How should the social worker respond?

Accept the social media request but decline the party invitation
Transfer the client to another social worker since the relationship has become too close
Decline both and explain the importance of maintaining professional boundaries (Correct answer)
Attend the party briefly to show support, but decline the social media request

Correct answer: Decline both and explain the importance of maintaining professional boundaries

Maintaining clear professional boundaries is a core ethical obligation. Dual relationships — such as becoming social media friends or attending personal events — can compromise objectivity, exploit the power differential, and harm the therapeutic relationship.

Question 84: During an intake assessment, a client describes hearing voices that comment on their behavior, believing their thoughts are being broadcast on television, and having had these experiences for eight months. Which diagnosis best fits this presentation?

Schizophreniform Disorder
Delusional Disorder
Schizophrenia (Correct answer)
Brief Psychotic Disorder

Correct answer: Schizophrenia

Schizophrenia requires two or more positive symptoms lasting at least six months, with at least one month of active-phase symptoms.

Question 85: A social worker realizes mid-treatment that a client's presenting problem exceeds their competence level. The MOST ethical response is to:

Refer the client to a more qualified professional and assist with transition (Correct answer)
Consult with a colleague but continue providing services
Continue treatment while researching the issue independently
Terminate the client immediately to avoid harm

Correct answer: Refer the client to a more qualified professional and assist with transition

When a client's needs exceed a social worker's competence, ethical practice requires referring to an appropriate provider while ensuring continuity of care.

Question 86: A social worker who consistently interprets a client's behavior through the lens of their own cultural background rather than the client's is engaging in:

Empathic attunement
Reflective practice
Strength-based assessment
Cultural imposition (Correct answer)

Correct answer: Cultural imposition

Cultural imposition occurs when practitioners apply their own cultural values and norms to clients without regard for the client's own cultural framework.

Question 87: A social worker is conducting a biopsychosocial assessment with a new client who presents with depression. Which component should be included in the biological domain of this assessment?

Employment status and work history
Family communication patterns
Cultural beliefs about mental illness
Current medications and medical history (Correct answer)

Correct answer: Current medications and medical history

The biological domain of a biopsychosocial assessment includes physical health, medical history, medications, and neurological factors.

Question 88: Which of the following cognitive abilities is the primary developmental milestone achieved during Piaget's sensorimotor stage (birth to 2 years)?

Symbolic thought
Logical reasoning
Object permanence (Correct answer)
Hypothetical-deductive reasoning

Correct answer: Object permanence

Object permanence is the understanding that objects continue to exist even when they cannot be seen, heard, or otherwise sensed. According to Piaget, this is the main cognitive achievement of the sensorimotor stage, which typically develops between 4 and 8 months of age.

Question 89: A social worker is using Cognitive Processing Therapy (CPT) with a rape survivor. A core component of this intervention is:

In vivo exposure to trauma-related stimuli
EMDR bilateral stimulation techniques
Identifying and challenging 'stuck points' — distorted beliefs about the trauma (Correct answer)
Psychodynamic exploration of childhood attachment

Correct answer: Identifying and challenging 'stuck points' — distorted beliefs about the trauma

CPT specifically targets 'stuck points,' which are maladaptive cognitions about the trauma, self, and world that maintain PTSD symptoms.

Question 90: A social worker is using Roberts' Seven-Stage Crisis Intervention Model. After conducting an assessment and establishing rapport (Stages 1 & 2) and identifying the major problems (Stage 3), which of the following is the immediate NEXT step?

Implement a concrete action plan.
Generate and explore alternatives.
Deal with feelings and emotions. (Correct answer)
Establish a follow-up plan.

Correct answer: Deal with feelings and emotions.

According to Roberts' Seven-Stage Crisis Intervention Model, after assessing the situation, establishing rapport, and identifying the precipitating problem(s), the next critical step (Stage 4) is to deal with feelings and emotions. This involves allowing the client to express their feelings, which the social worker validates through active listening before moving on to more action-oriented stages like exploring alternatives (Stage 5) and implementing a plan (Stage 6).

Question 91: Which theoretical framework emphasizes the ongoing, reciprocal transactions between a person and their environment, viewing adaptation as a dynamic process rather than a fixed trait?

Psychoanalytic theory
Cognitive-behavioral theory
Classical conditioning theory
Life model / ecological perspective (Correct answer)

Correct answer: Life model / ecological perspective

The life model (Germain & Gitterman) applies ecological principles to social work, framing human functioning as shaped by continuous transactions between people and their environments. Adaptation is an active, ongoing process — not a static property of the individual.

Question 92: Which theoretical orientation emphasizes that psychological problems stem from distorted thinking patterns and cognitive distortions?

Cognitive-behavioral theory (Correct answer)
Psychodynamic theory
Solution-focused brief therapy
Narrative therapy

Correct answer: Cognitive-behavioral theory

Cognitive-behavioral theory holds that maladaptive thoughts (cognitive distortions) drive emotional distress and problematic behavior.

Question 93: A social worker uses the acronym OARS (Open questions, Affirmations, Reflections, Summaries) in sessions. This technique is central to which model?

Solution-Focused Brief Therapy
Cognitive Behavioral Therapy
Motivational Interviewing (Correct answer)
Psychosocial Model

Correct answer: Motivational Interviewing

OARS represents the core communication skills in Motivational Interviewing, designed to build rapport and elicit change talk from the client.

Question 94: During a family therapy session, a teenager discloses to the social worker that they have been using marijuana recreationally but asks the social worker not to tell their parents. The teenager does not appear to be in danger. What is the MOST appropriate response?

Honor the teenager's confidentiality and explore the behavior further within the session (Correct answer)
End the session and file a report with child protective services
Dismiss the teenager's concerns and redirect the family session to other topics
Immediately disclose the information to the parents to ensure the teenager's safety

Correct answer: Honor the teenager's confidentiality and explore the behavior further within the session

Recreational marijuana use by a teenager, while concerning, does not constitute imminent danger and does not automatically trigger a duty to breach confidentiality. The social worker should explore the behavior further while respecting the client's privacy within the bounds of applicable law.

Question 95: During the middle phase of a treatment group, a social worker should PRIMARILY focus on:

Facilitating member-to-member interaction and deepening therapeutic work (Correct answer)
Reviewing member progress and preparing for termination
Establishing ground rules and orienting members to the group purpose
Screening members for appropriate level of care

Correct answer: Facilitating member-to-member interaction and deepening therapeutic work

The middle (working) phase is when cohesion has developed enough for meaningful therapeutic work. The worker's role shifts from structure-setter to facilitator, promoting member-to-member interaction, self-disclosure, feedback, and change work.

Question 96: In program evaluation, a needs assessment is conducted PRIMARILY to:

Assign a monetary value to program benefits
Determine whether a program should continue
Measure the outcomes of an existing program
Identify gaps between current services and community needs (Correct answer)

Correct answer: Identify gaps between current services and community needs

A needs assessment identifies the difference between current service availability and what is actually needed by the target population to inform program planning.

Question 97: A social worker reviews multiple studies on a topic and combines their statistical results into one overall estimate. This is called a:

Meta-analysis (Correct answer)
Narrative review
Systematic review
Content analysis

Correct answer: Meta-analysis

A meta-analysis statistically combines results from multiple studies to produce a single, more precise estimate of an effect.

Question 98: A client is diagnosed with Major Depressive Disorder with Peripartum Onset. According to DSM-5, when must symptoms begin for this specifier to apply?

Exclusively after delivery
Within 6 months of delivery
During pregnancy or within 4 weeks of delivery (Correct answer)
Only during pregnancy

Correct answer: During pregnancy or within 4 weeks of delivery

DSM-5's peripartum onset specifier applies when a major depressive episode begins during pregnancy or within 4 weeks after delivery.

Question 99: A client with a history of trauma reports that they sometimes feel detached from their own body and experience the world as unreal. This symptom is best described as:

Dissociative amnesia
Derealization/depersonalization (Correct answer)
Thought insertion
Nihilistic delusion

Correct answer: Derealization/depersonalization

Depersonalization refers to feeling detached from oneself, while derealization involves experiencing the external world as unreal; both can occur together in Depersonalization/Derealization Disorder and in trauma responses.

Question 100: When assessing a client for PTSD, which symptom cluster involves persistent negative alterations in cognition and mood?

Cluster B — Intrusion symptoms
Cluster C — Avoidance symptoms
Cluster E — Alterations in arousal and reactivity
Cluster D — Negative alterations in cognition and mood (Correct answer)

Correct answer: Cluster D — Negative alterations in cognition and mood

DSM-5 Cluster D of PTSD includes persistent negative beliefs, distorted blame, emotional numbing, and diminished interest in activities.

Question 101: Daniel Levinson's concept of the 'Dream' in his adult development theory refers to:

Unconscious wish fulfillment during sleep
A mid-life crisis triggered by career failure
An idealized vision of what one hopes to accomplish in life (Correct answer)
Fantasies about childhood that resurface in therapy

Correct answer: An idealized vision of what one hopes to accomplish in life

Levinson described the 'Dream' as an imagined possibility of the self in the adult world — a guiding vision of what one wants to become — that shapes early adulthood.

Question 102: A social worker is working with an undocumented immigrant client who needs emergency housing. The client fears deportation if their status is revealed. What is the most ethical course of action?

Reassure the client and connect them to services that do not require documentation (Correct answer)
Decline to serve the client to avoid legal liability
Report the client's immigration status to authorities as required
Advise the client to self-disclose their status to access better services

Correct answer: Reassure the client and connect them to services that do not require documentation

Social workers are bound by the NASW Code of Ethics to serve all clients with dignity and respect, connecting them to accessible resources regardless of immigration status.

Question 103: Which statement best describes the role of psychoeducation in a treatment plan for a client with bipolar disorder?

It replaces medication management when clients prefer non-pharmacological care
It is contraindicated because it increases anxiety about the diagnosis
It helps clients recognize early warning signs of mood episodes to prevent relapse (Correct answer)
It is only appropriate during the acute phase of illness

Correct answer: It helps clients recognize early warning signs of mood episodes to prevent relapse

Psychoeducation teaches clients to identify prodromal symptoms, improving self-monitoring and reducing hospitalizations.

Question 104: A social worker notices that a group member who has been isolated begins to open up after hearing another member describe a very similar experience. Yalom would describe this therapeutic factor as:

Altruism
Imitative behavior
Catharsis
Universality (Correct answer)

Correct answer: Universality

Yalom's therapeutic factor of universality is the experience of discovering that one is not alone — that others share similar problems, thoughts, or feelings. It counters isolation and shame and is among the earliest and most impactful factors in group therapy.

Question 105: A social worker is working with a client who experienced significant early childhood neglect. Which attachment pattern, identified by Ainsworth, is most commonly associated with unresponsive caregiving?

Avoidant attachment (Correct answer)
Secure attachment
Anxious-ambivalent attachment
Disorganized attachment

Correct answer: Avoidant attachment

Avoidant attachment develops when caregivers are consistently unresponsive, leading children to suppress attachment needs and show minimal distress upon separation.

Question 106: A social worker discovers that a colleague is billing Medicaid for sessions that never occurred. What is the MOST appropriate first step?

Confront the colleague privately and give them a chance to self-report (Correct answer)
Ignore it to avoid workplace conflict
Report the behavior directly to the state licensing board
Inform the client whose name is being used

Correct answer: Confront the colleague privately and give them a chance to self-report

NASW Code of Ethics encourages addressing colleague misconduct through direct communication first, before escalating to formal channels.

Question 107: In object relations theory, the concept of 'splitting' refers to:

Repressing traumatic memories into the unconscious
Viewing people as all-good or all-bad without integration (Correct answer)
Displacing emotion from one object to another
Projecting one's feelings onto another person

Correct answer: Viewing people as all-good or all-bad without integration

Splitting is a defense mechanism where a person fails to integrate positive and negative qualities of the self or others, seeing them as entirely good or entirely bad.

Question 108: A youth group is being led by a social worker. One of the group members phones the social worker because she is quite unhappy about something she said in the group being revealed to others in her school by another group member. The social worker's BEST course of action in this circumstance is to:

Individually contact the group member who disclosed the information to discuss the concern
Develop a confidentiality agreement to be signed by all members at the next group session
Suggest that the upset group member bring up her concern at the next group session (Correct answer)
Terminate the group member who disclosed the information in order to create a “safe” environment for the other participants

Correct answer: Suggest that the upset group member bring up her concern at the next group session

Members of groups are not required by law to protect information shared in groups. However, this disclosure might go against the guidelines the group set for itself. It is proper for the group to deliberate and choose what steps, if any, need to be taken. Such revelations can jeopardize the group's therapy objectives, but any confrontation should take place in a group setting.

Question 109: A treatment plan goal states: 'Client will feel better.' This goal is problematic because it is:

Not measurable or specific (Correct answer)
Focused on strengths
Culturally inappropriate
Too time-limited

Correct answer: Not measurable or specific

SMART goals must be specific and measurable; vague emotional language like 'feel better' cannot be tracked objectively.

Question 110: A client tells the social worker they plan to stop taking their prescribed antipsychotic medication without consulting their psychiatrist. The social worker's best initial response is to:

Immediately contact the prescribing psychiatrist without the client's consent
Explore the client's reasons for wanting to stop and discuss potential risks (Correct answer)
Document the statement and take no action
Advise the client to follow the psychiatrist's orders

Correct answer: Explore the client's reasons for wanting to stop and discuss potential risks

The social worker should first explore the client's reasoning and educate them about risks while respecting autonomy, before considering further action.

Question 111: An IRB (Institutional Review Board) requires informed consent because it protects participants' right to:

Voluntarily decide whether to participate with full information (Correct answer)
Receive compensation for participation
Be debriefed after each session
Know the researcher's hypothesis

Correct answer: Voluntarily decide whether to participate with full information

Informed consent ensures participants voluntarily agree to research participation after receiving all relevant information about risks and benefits.

Question 112: A client asks a social worker whether she should join an individual therapy or a group therapy program for social anxiety. Which of the following is the STRONGEST evidence-based argument for recommending group treatment?

Group therapy is always less expensive and therefore more accessible
Individual therapy is contraindicated for anxiety disorders
Groups eliminate the need for a trained facilitator
The group setting itself provides in-vivo exposure to feared social situations (Correct answer)

Correct answer: The group setting itself provides in-vivo exposure to feared social situations

For social anxiety disorder, the group modality offers a naturally occurring social environment, making it an especially potent treatment setting. Members practice real interpersonal skills, receive peer feedback, and benefit from exposure within the group itself — not just through discussion.

Question 113: Which theoretical framework guides a treatment plan that focuses on identifying and modifying a client's distorted automatic thoughts?

Cognitive-behavioral therapy (CBT) (Correct answer)
Psychodynamic theory
Solution-focused brief therapy
Narrative therapy

Correct answer: Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy specifically targets automatic thoughts and cognitive distortions as central mechanisms of change in treatment planning.

Question 114: A Black client tells an LMSW that they distrust mental health services because of historical abuses such as the Tuskegee study. The social worker should FIRST:

Acknowledge and validate the client's historical mistrust as a legitimate response to documented harm (Correct answer)
Reassure the client that modern medicine is different and move on
Document the client as resistant to treatment
Refer the client to a physician instead

Correct answer: Acknowledge and validate the client's historical mistrust as a legitimate response to documented harm

Acknowledging historical trauma and systemic abuses is foundational to building trust with clients from marginalized communities.

Question 115: When a social worker and client collaboratively develop a treatment plan, which of the following represents the BEST-written, measurable objective?

The client will attend at least three out of four scheduled weekly support group meetings for the next month. (Correct answer)
The client will feel happier and more engaged in life.
The client will learn better communication skills.
The client will improve their relationship with their spouse.

Correct answer: The client will attend at least three out of four scheduled weekly support group meetings for the next month.

This objective is the best example because it is SMART: Specific (attend support group meetings), Measurable (three out of four), Achievable (a reasonable attendance goal), Relevant (presumably to the client's goals), and Time-bound (for the next month). The other options are vague and not easily measured.

Question 116: A client reveals they are undocumented and fears that disclosing their status to a government agency will lead to deportation. The social worker's PRIMARY ethical obligation is to:

Protect confidentiality and not report immigration status (Correct answer)
Consult with the client's employer about their status
Report the client's status as required by federal law
Refer the client to immigration services immediately

Correct answer: Protect confidentiality and not report immigration status

Social workers are bound by confidentiality and must protect client information; immigration status is generally not a mandated reporting category.

Question 117: Which crisis intervention model emphasizes assessing lethality, ensuring safety, and providing immediate stabilization?

Narrative Therapy
Roberts' Seven-Stage Crisis Intervention Model (Correct answer)
Solution-Focused Brief Therapy
Cognitive Behavioral Therapy

Correct answer: Roberts' Seven-Stage Crisis Intervention Model

Roberts' Seven-Stage Crisis Intervention Model is widely used in crisis work and includes lethality assessment as a core early step.

Question 118: Which theorist introduced the concept of 'object permanence' as a milestone in cognitive development?

Erikson
Ainsworth
Piaget (Correct answer)
Bandura

Correct answer: Piaget

Piaget described object permanence — understanding that objects continue to exist when out of sight — as a key achievement of the sensorimotor stage (0–2 years).

Question 119: A client meets criteria for both Alcohol Use Disorder and Major Depressive Disorder. To determine whether the depression is a separate diagnosis or substance-induced, the social worker should PRIMARILY consider:

The client's current BAC level at the time of assessment
Whether depressive symptoms preceded alcohol use or persist after a period of sustained abstinence (Correct answer)
Whether the client acknowledges having a drinking problem
Whether the client has a family history of depression

Correct answer: Whether depressive symptoms preceded alcohol use or persist after a period of sustained abstinence

Substance-induced depressive disorder is distinguished from an independent depressive disorder by temporal sequencing: if depressive symptoms substantially predate the substance use OR persist (typically 1 month or more) after cessation of the substance, an independent diagnosis is supported. The DSM-5-TR emphasizes this temporal criterion.

Question 120: Which of the following is an example of a negative symptom of schizophrenia?

Grandiose delusions
Auditory hallucinations
Disorganized speech
Alogia (Correct answer)

Correct answer: Alogia

Alogia (poverty of speech) is a negative symptom reflecting diminished thought and communication, contrasted with positive symptoms like hallucinations and delusions.

Question 121: A social worker in private practice wants to terminate services with a client who has repeatedly missed appointments. Which action is ethically required?

Transfer all records to the next provider without client consent
Bill the client for missed sessions then terminate
Provide adequate notice and referrals to ensure continuity of care (Correct answer)
End services immediately without notice

Correct answer: Provide adequate notice and referrals to ensure continuity of care

Ethical termination requires appropriate notice and referrals to prevent client abandonment and ensure continuity of care.

Question 122: A client with borderline personality disorder is frequently calling the LMSW between sessions in crisis. The MOST appropriate intervention is to:

Refer to a psychiatrist for medication management only
Terminate services due to boundary violations
Incorporate DBT skills training and crisis coaching as part of the treatment plan (Correct answer)
Increase session frequency to daily appointments

Correct answer: Incorporate DBT skills training and crisis coaching as part of the treatment plan

Dialectical Behavior Therapy (DBT) was specifically developed for BPD and includes skills training and structured crisis coaching protocols to manage between-session crises.

LMSW (Licensed Master Social Worker) Exam

The LMSW (Licensed Master Social Worker) Exam exam validates essential knowledge and skills required for certification or licensure in this field.

122

Questions

240 min

Time Limit

70%

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Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

op.nysed.gov — Eligibility, fees · verified Oct 2026
bhec.texas.gov — Renewal, eligibility · verified Oct 2026
aswb.org — Fees, retake policy, passing score, exam format, time limit, exam information · verified Oct 2026