ASWB Clinical MCQ 2 ā Questions and Answers
Question 1: A client with borderline personality disorder frequently calls the crisis line between sessions and threatens self-harm when the social worker sets limits. This pattern BEST illustrates:
- Passive-aggressive behavior
- Splitting and emotional dysregulation (Correct answer)
- Malingering for secondary gain
- Antisocial manipulation
Correct answer: Splitting and emotional dysregulation
Splitting and emotional dysregulation are hallmark features of BPD, driving intense reactions to perceived abandonment or limit-setting.
Question 2: A social worker suspects a child client is being sexually abused but the child denies it. The MOST appropriate next step is to:
- Accept the child's denial and close the case
- File a mandated report based on reasonable suspicion (Correct answer)
- Confront the suspected abuser directly
- Obtain written consent from the parent before reporting
Correct answer: File a mandated report based on reasonable suspicion
Mandated reporters must report reasonable suspicion of abuse; a child's denial does not override the legal and ethical duty to report.
Question 3: Which theoretical framework emphasizes that psychological distress arises from irrational beliefs rather than external events?
- Object relations theory
- Rational emotive behavior therapy (REBT) (Correct answer)
- Attachment theory
- Structural family therapy
Correct answer: Rational emotive behavior therapy (REBT)
REBT, developed by Albert Ellis, holds that irrational beliefsānot events themselvesāare the primary cause of emotional disturbance.
Question 4: A social worker working with a trauma survivor notices strong feelings of protectiveness and anger toward the client's abuser. This MOST likely represents:
- Countertransference (Correct answer)
- Vicarious liability
- Parallel process
- Compassion satisfaction
Correct answer: Countertransference
Countertransference refers to the clinician's emotional reactions to a client, which can be triggered by the client's trauma narrative.
Question 5: A client is prescribed an antidepressant and asks the social worker if it will 'fix' their depression. The BEST response is to:
- Reassure the client that medication will resolve their symptoms
- Explain that medication may help manage symptoms while therapy addresses underlying issues (Correct answer)
- Defer entirely to the prescriber and avoid the topic
- Discourage medication reliance and emphasize therapy alone
Correct answer: Explain that medication may help manage symptoms while therapy addresses underlying issues
Integrated psychoeducation about the complementary roles of medication and therapy supports informed decision-making and collaborative care.
Question 6: Which defense mechanism involves unconsciously attributing one's own unacceptable feelings to another person?
- Reaction formation
- Rationalization
- Projection (Correct answer)
- Sublimation
Correct answer: Projection
Projection involves attributing one's own unwanted thoughts or feelings onto another person to reduce internal anxiety.
Question 7: A social worker in a community mental health center has a caseload that includes a client who is also the sibling of a close personal friend. The FIRST action should be to:
- Immediately terminate the therapeutic relationship
- Disclose the relationship to the client and discuss potential impact
- Continue treatment without disclosure since it is incidental
- Consult with a supervisor to assess the dual relationship (Correct answer)
Correct answer: Consult with a supervisor to assess the dual relationship
Consulting with a supervisor is the appropriate first step when a dual relationship is identified, to assess risk and determine the best course of action.
ASWB Clinical MCQ 2
A client with borderline personality disorder frequently calls the crisis line between sessions and threatens self-harm when the social worker sets limits.
This pattern BEST illustrates: