LMSW Practice Questions 5 — Questions and Answers
Question 1: According to Family Systems Theory, when one family member improves in therapy while other members develop new symptoms, this process is BEST described as:
- Enmeshment
- Triangulation
- Symptom substitution
- Homeostasis (Correct answer)
Correct answer: Homeostasis
Homeostasis in family systems theory refers to the family's tendency to maintain a stable equilibrium, sometimes producing new symptoms in other members when one member changes.
Question 2: An LMSW conducts an intake assessment and determines that a client does not meet criteria for any DSM-5 diagnosis but is clearly struggling. The MOST appropriate documentation is:
- Defer diagnosis pending further evaluation
- Document 'No Diagnosis' and describe presenting concerns thoroughly (Correct answer)
- Assign the closest matching diagnosis to facilitate insurance billing
- Close the case as the client does not meet treatment criteria
Correct answer: Document 'No Diagnosis' and describe presenting concerns thoroughly
Documenting 'No Diagnosis' with a thorough clinical description is accurate, ethical, and allows treatment planning without misrepresenting the client's condition.
Question 3: A social worker is facilitating a grief support group when one member begins to dominate sessions by repeatedly sharing extended personal narratives. The BEST intervention is to:
- Address the behavior with the member privately between sessions
- Gently redirect the group by summarizing and inviting other members to share (Correct answer)
- Remove the member from the group for disruptive behavior
- Allow the behavior to continue as it may represent their grief process
Correct answer: Gently redirect the group by summarizing and inviting other members to share
Redirecting within the group setting balances the dominant member's needs while maintaining a therapeutic environment for all members.
Question 4: A social worker using a strengths-based approach would MOST likely ask a client who is struggling with unemployment:
- What obstacles have prevented you from finding work so far?
- How have you successfully navigated challenges in the past? (Correct answer)
- What specific skills do you lack that employers are looking for?
- What steps have you failed to take that could have helped your job search?
Correct answer: How have you successfully navigated challenges in the past?
Strengths-based practice focuses on identifying and building upon existing competencies and past successes rather than deficits.
Question 5: A client with a history of alcohol use disorder has been sober for six months and wants to celebrate by having 'just one drink.' The social worker recognizes this thinking as:
- Abstinence violation effect
- Euphoric recall
- Cognitive dissonance
- Permission-giving thinking (Correct answer)
Correct answer: Permission-giving thinking
Permission-giving thoughts are rationalizations that allow a person to justify substance use, and recognizing them is a key relapse prevention skill.
Question 6: When an LMSW learns that a client is being financially exploited by an adult child, and the client asks the social worker not to report it, the social worker should FIRST:
- Honor the client's confidentiality and document the situation only
- Report immediately because elder abuse is a mandated reporting obligation
- Assess the client's cognitive capacity to make an informed decision (Correct answer)
- Explore the client's reasons for not wanting to report before taking action
Correct answer: Assess the client's cognitive capacity to make an informed decision
Assessing cognitive capacity first determines whether the client can make an informed autonomous choice, which guides all subsequent decisions including mandatory reporting obligations.
Question 7: In Cognitive Behavioral Therapy (CBT), the technique of 'behavioral activation' is PRIMARILY used to address:
- Panic attacks by exposing clients to feared stimuli gradually
- Depression by increasing engagement in meaningful and rewarding activities (Correct answer)
- Trauma by processing intrusive memories through narrative restructuring
- Anxiety by identifying and challenging automatic negative thoughts
Correct answer: Depression by increasing engagement in meaningful and rewarding activities
Behavioral activation targets the withdrawal and inactivity that maintain depression by scheduling and reinforcing engagement in positive activities.
LMSW Practice Questions 5
According to Family Systems Theory, when one family member improves in therapy while other members develop new symptoms, this process is BEST described as: