LMSW Intervention and Treatment Planning 2 — Questions and Answers
Question 1: 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?
- Psychodynamic therapy
- Dialectical Behavior Therapy (DBT) (Correct answer)
- Solution-Focused Brief Therapy
- Rational Emotive Behavior Therapy
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 2: When developing a treatment plan for a client experiencing complicated grief, which element distinguishes it from major depressive disorder treatment?
- Psychopharmacology referral should always be made first
- Grief-specific interventions focus on meaning-making and continuing bonds (Correct answer)
- Cognitive restructuring alone is sufficient
- Treatment plans for grief do not require measurable goals
Correct answer: Grief-specific interventions focus on meaning-making and continuing bonds
Complicated grief treatment focuses on meaning-making, processing the loss, and maintaining a healthy connection to the deceased, which differs from standard depression protocols.
Question 3: A social worker is treating a veteran with PTSD using Prolonged Exposure therapy. The client avoids discussing the traumatic event and requests to switch topics. The best response is to:
- Immediately honor the request to preserve the therapeutic alliance
- Gently encourage the client to stay with the distress as part of the treatment protocol (Correct answer)
- Terminate the session to prevent retraumatization
- Switch to a non-trauma-focused approach permanently
Correct answer: Gently encourage the client to stay with the distress as part of the treatment protocol
Prolonged Exposure requires graduated approach to trauma memories; encouraging engagement with distress while maintaining safety is central to the protocol's effectiveness.
Question 4: A treatment plan goal states: 'Client will feel better about relationships.' This goal is problematic primarily because it:
- Focuses on relationships rather than individual functioning
- Is not measurable or time-bound (Correct answer)
- Does not include a medication component
- Requires family involvement
Correct answer: Is not measurable or time-bound
Effective treatment plan goals must be specific, measurable, achievable, relevant, and time-bound (SMART); 'feel better' cannot be objectively measured.
Question 5: Which motivational interviewing technique involves the social worker summarizing the client's ambivalence about change to highlight discrepancy?
- Rolling with resistance
- Double-sided reflection (Correct answer)
- Affirmation
- Open-ended questioning
Correct answer: Double-sided reflection
A double-sided reflection acknowledges both sides of the client's ambivalence, helping the client hear their own contradictory statements and increasing motivation for change.
Question 6: A social worker is planning treatment for a client with co-occurring major depression and alcohol use disorder. Best practice indicates:
- Treat depression first before addressing substance use
- Treat substance use first before addressing depression
- Address both disorders simultaneously using an integrated treatment approach (Correct answer)
- Refer to separate providers for each disorder
Correct answer: Address both disorders simultaneously using an integrated treatment approach
Integrated treatment that addresses co-occurring disorders simultaneously is the evidence-based standard of care, producing better outcomes than sequential or parallel treatment.
Question 7: During a functional behavioral assessment, the social worker identifies that a child's tantrums are consistently followed by being allowed to leave class. This suggests the behavior is maintained by:
- Sensory stimulation
- Attention-seeking
- Negative reinforcement (escape) (Correct answer)
- Positive reinforcement (tangibles)
Correct answer: Negative reinforcement (escape)
When a behavior allows the individual to escape or avoid an aversive situation (like class), it is maintained by negative reinforcement.
LMSW Intervention and Treatment Planning 2
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?