LMSW - Licensed Master Social Worker LMSW 1 — Questions and Answers
Question 1: A social worker is conducting an initial assessment with a new client who presents with symptoms of depression. The client mentions they have been experiencing thoughts of suicide but denies any specific plan or intent. What should the social worker do FIRST?
- Immediately hospitalize the client involuntarily
- Conduct a thorough suicide risk assessment to determine the level of danger (Correct answer)
- Refer the client to a psychiatrist and end the session
- Contact the client's family members to inform them of the disclosure
Correct answer: Conduct a thorough suicide risk assessment to determine the level of danger
A thorough suicide risk assessment is the first step to determine lethality, intent, means, and protective factors. This information guides the appropriate level of intervention and whether hospitalization, a safety plan, or outpatient care is indicated.
Question 2: 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
- 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
- Recommend the client seek a social worker from the same cultural background
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 3: 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
- 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
- Transfer the client to another social worker since the relationship has become too close
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 4: 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?
- Immediately disclose the information to the parents to ensure the teenager's safety
- 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
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 5: A social worker learns that a colleague is billing Medicaid for services that were never rendered. What is the social worker's ethical obligation?
- Discuss the issue with the colleague privately and encourage them to stop
- Take action through appropriate channels, such as reporting to a supervisor or ethics board (Correct answer)
- Ignore the situation because it does not directly involve the social worker's clients
- Document the behavior but wait to see if it continues before taking action
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 6: 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?
- Discharge the client from services since they are non-compliant
- Continue engaging the client, explore barriers to accepting housing, and document the refusal (Correct answer)
- Contact a judge to obtain a court order compelling the client to accept placement
- Limit contact with the client to monthly check-ins until they agree to housing
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.
LMSW - Licensed Master Social Worker LMSW 1
A social worker is conducting an initial assessment with a new client who presents with symptoms of depression.
The client mentions they have been experiencing thoughts of suicide but denies any specific plan or intent.
What should the social worker do FIRST?