ASWB Clinical Exam
The fourth level of ASWB exams is the Clinical exam. The Clinical examination is designed for individuals with a Master’s degree in Social Work and at least 2 years of experience.
- Human Development and Behavior in the Environment (22% of the exam; includes theories of human development and behavior; human development in the life cycle; human behavior; impact of crises and changes; family functioning; addictions; and abuse and neglect);
- Issues of Diversity (6%; includes effects of culture, race, and/or ethnicity; effects of sexual orientation and/or gender; and effects of age and/or disability);
- Diagnosis and Assessment (16%; includes assessment; information gathering; diagnostic classifications; indicators of abuse and neglect; indicators of danger to self and others);
- Psychotherapy and Clinical Practice (16%; includes intervention theories and models; intervention process; treatment planning; intervention techniques; intervention with couples and families; and intervention with groups);
- Communication (8%; includes communication principles and techniques);
- The Therapeutic Relationship (7%; includes relationship theories and practice);
- Professional Values and Ethics (10%; includes value issues; legal and ethical issues; and confidentiality);
- Clinical Supervision, Consultation, and Staff Development (4%; includes social work supervision; consultation and interdisciplinary collaboration; and staff development);
- Practice Evaluation and the Utilization of Research (1%; includes evaluation techniques and the utilization of research);
- Service Delivery (5%; includes policies, procedures, and processes of service delivery);
- Clinical Practice and Management (5%; includes advocacy; finance; and management and human resource issues).
The exam consists of 170 multiple-choice questions, 20 of which are pretest questions that will be used to develop future versions of the exam and they do not contribute to the test score. The minimum passing score is established by the jurisdiction in which the candidate takes the exam. The ASWB examinations are administered at special testing centers throughout the year in locations around the United States.
This site has no affiliation with the ASWB and is not endorsed by the ASWB.
1. In treating a client in crisis, the caseworker should focus on
a. the immediate presenting problem
b. a few specific problems in day-to-day functioning
c. a wide range of problems in day-to-day functioning
d. underlying personality problems
2. A social worker is interviewing a new patient who presents some symptoms of depression. The patient reports recent changes such as diminished functioning, marked weight gain, early morning awakening, fatigue, inability to concentrate, suicidal thoughts and headaches. The patient mentions that he started a new medication for a medical condition three weeks ago. The worker would first:
a. arrange a psychiatric consultation in order to have an anti-depressant prescribed
b. ascertain the prescribed medication and investigate its side-effects
c. proceed with a thorough psychosocial history and precipitating events
d. hospitalize this patient until the suicidal ideation passes
3. A social worker is utilizing environmental manipulation as a technique when he/she:
a. represents the agency at a health and welfare council meeting
b. uses a psychosocial framework
c. suggests the use of psychoactive medications
d. helps the client find more satisfying employment in a supportive environment
4. A diagnosis of Schizophreniform Disorder is generally applied to clients whose psychotic symptoms:
a. are related to substance abuse
b. are very long term
c. show a marked and continuing decline in functioning
d. are similar to those of schizophrenia and have existed more than one month, but less than six months.
5. A 15 year old female patient at a mental health clinic complains that for the past three weeks she has been uncharacteristically angry and irritable and has had difficulty concentrating on school work. She says that she feels “down in the dumps”. Her appetite has diminished and though weighing 120 pounds a month earlier, she has lost 9 pounds. She has difficulty sleeping and has withdrawn from after school activities that she had previously found interesting and enjoyable. During the interview she seems constantly in motion, rising several times and walking around the room before returning to her chair. It is most likely that she is suffering from:
a. a drug induced depression
b. a somatoform disorder
c. a depressive episode
d. an adolescent behavior disorder
6. The policy of providing Permanency Planning refers to:
a. children who are at risk of removal or are removed from their own homes
b. the development of a plan through which abused and neglected children will be assured of a stable family situation throughout childhood
c. a stable foster care plan for children removed from their homes
d. the use of adoption for children at risk
7. DSM IV permits certain diagnoses for mental disorders to be made, even though the diagnosis does not totally fit DSM IV criterion. These diagnoses are normally modified by the word:
8. A social worker and his agency supervisor are sued for malpractice by the family of a teen age boy who made several attempts at suicide and finally succeeded in killing himself. Which statement best reflects the supervisor’s legal status in this lawsuit?
a. Since the supervisor was not the direct clinician and had never personally treated the youth, she is not liable for any negligent actions committed by others in the agency.
b. The supervisor shares vicarious legal liability and is responsible for carefully monitoring and evaluating the status of every case under treatment by her supervisees, and for keeping records concerning the supervisee’s work on the case.
c. The agency is the only legally liable party and the workers are not individually responsible.
d. In cases such as these, parents often believe that a finding of negligence on the part of the clinician will reduce their sense of loss and failure. The lawsuit is probably frivolous and neither the worker, nor the supervisor is responsible.
9. A patient presents at an ambulatory care facility and is in obvious psychological distress, showing severe anxiety and paranoia. The clinician is unable to determine the exact configuration of the patient’s symptoms, but is certain that it is an Anxiety Disorder. The worker is unable to determine if the is order is primary, caused by the patient’s severe kidney disease or related to other factors such as the patient’s continuing substance abuse. The most likely DSM IV diagnosis is;
a. Anxiety Disorder, with generalized anxiety
b. Anxiety Disorder, undifferentiated
c. Anxiety Disorder, NOS
d. Anxiety Disorder, provisional
10. A school social worker interviews a 15 year old male student with an IQ of 70. Though assigned to slower classes, the student maintains social relationships and is able to respond appropriately to teachers and class mates. His school work is within the range that would be expected for his recorded IQ. He can read somewhat below grade level. and is able to do very basic arithmetic. He is also able to follow instructions and is generally amiable in responding to coaching and correction. In developing a plan with this student and the family, the social worker would:
a. plan for eventual supervised residence in a facility for the mentally disabled
b. establish a plan that includes vocational preparation and that will eventually lead to independent living.
c. emphasize vocational achievement in the near term
d. provide coaching and tutoring to improve his reading
11. A DSM IV diagnosis of a specific disorder generally includes a criterion of:
a. a clinically significant impairment, or distress in a social, occupational, or other important area.
b. a description that includes an identifiable etiology
c. distress that exceeds 6 weeks
d. no medical involvement
12. A DSM IV diagnosis:
a. provides sufficient information for developing a treatment plan
b. ends the treatment planning process
c. is insufficient by itself for treatment planning
d. is an early or intermediate step in the treatment planning process.
13. A DSM IV diagnosis often includes a specifier or suffix to delineate the severity of the disorder. The usual specifier is:
a. mild, moderate or severe
b. in partial remission
c. in full remission
d. prior history
14. A client begins treatment with a social worker and tells the social worker that he must promise never to involuntarily hospitalize him no matter how depressed or suicidal he may seem. The underlying ethical principle that determines the social worker’s response is:
a. The obligation to start where the client is
b. The expectation that the client has good reasons to raise this issue.
c. The need to do what is necessary to keep a severely ill client from ending treatment.
d. Never to make a promise that is in conflict with legal and ethical requirements.
15. A social worker who attempts to impose her judgments on clients is most likely to elicit clients’:
16. In a first interview, a worker observes that the client moves slowly, with stooped posture, talks slowly and in a lifeless way, lacks spontaneity, and shows little change in facial expression as they discuss the client’s problem.
The worker would most likely suspect:
b. a manic stage
d. delusional thinking
17. In a first session at an HMO mental health clinic with a couple who want to address marital problems, the wife complains that the biggest problem in their marriage is the husband’s nasty temper. The worker’s best response is:
a. can you tell me more about this problem?
b. 2.have you done anything that might provoke his anger?
c. at our session today he doesn’t seem to have a problem with self control.
d. to ask the husband if he wishes to discuss his problems with his temper
18. A social worker at a health center is working with a young adolescent group concerned with drug and alcohol prevention. The social worker is uneasy about conflicts within the group and is fearful that they may interfere with group process. The worker’s supervisor might initially:
a. seek to delineate and resolve the worker’s personal history with regard to conflict
b. communicate support, indicating that controversy and conflict may be normal and natural means for resolving issues
c. inquire about the concerns of the worker and reflect back the issues without resolving them
d. suggest that the worker not reach any conclusions and bring in any issues which might arise
19. Children who suffer physical, mental or emotional injuries inflicted by caretaking adults are commonly termed:
a. children of poverty
b. abused or neglected children
c. developmentally masochistic
20. Under most state laws, mental health professionals must alert child welfare agencies or other lawful authorities to:
a. suspicion of child abuse
b. evidence of child sexual abuse
c. imminent threats to a child
d. child custody battles
21. A supervisor wants to observe a supervisee’s client interview through a two way mirror. Because the supervisor is a professional staff member with overall responsibility for all cases in treatment by staff, the worker would:
a. not need to obtain the client’s informed consent since the observation’s purpose is supervision
b. not have to obtain informed consent of the client, since such consent is given when clients sign a release form for information at intake
c. have to obtain the client’s informed consent on the observation and its use
d. have to obtain informed consent only if the session is to be recorded
22. A social worker is conducting a small counseling group. The members seem to have some difficulty in beginning. A statement the worker would not make is:
a. In what way can I help you to begin?
b. Who might like to begin?
c. It’s sometimes difficult to begin
d. It seems hard to begin today
23. A hospital patient is referred to social services after she complains of insufficient money for food. After talking with the patient, the worker’s diagnosis is that the patient, although from a low income family, is not indigent. She seems to consistently have difficulties managing money and does not appear to handle her funds appropriately. Her diet appears nutritionally adequate. The worker’s most suitable action would be to:
a. help the patient obtain assistance from a casework agency for help with money management
b. provide continuing casework treatment through the hospital social service department to insure that her diet remains adequate
c. suggest to the patient that she apply to the public welfare agency to determine eligibility for public assistance
d. reassure the patient that her income can be made to cover her essential needs
24. A social worker using a psychosocial casework approach is not likely to:
a. consider the client-worker relationship to be a basic therapeutic tool
b. rely on psychiatric diagnostic-classifications
c. be concerned with the client’s interaction with the environment
d. frequently use novel, unconventional treatments
25. The process of assessment is the task of the:
a. social worker
c. social worker and the client
d. agency psychiatrist
ASWB Clinical Exam Answer Key
1. The correct answer is (a).
The immediate presenting problem as it is perceived by the client is the only possible arena in which a social worker can intervene. Other responses will be perceived by the client as non-responsive to his or her concerns.
2. The correct answer is (b).
Medications can have powerful side effects and should be ruled out as a causative factor. 1. a psychiatric consultation is unnecessary at this time 2. the clients current mental state and inability to concentrate suggest that a psychosocial history will not be feasible.
3. The correct answer is (d).
Environmental manipulation suggests the employment of specific changes in the client’s life that will improve their immediate situation.
4. The correct answer is (d).
5. The correct answer is (c).
The only other possible answer is 1, however drug use is not mentioned as a factor in the girl’s life and no history of drug use is cited.
6. The correct answer is (b).
It is the most general answer and describes the broad outlines of the policy’s intention in regard to children at risk.
7. The correct answer is (b).
This is a fact question and is unambiguous.
8. The correct answer is (b).
A supervisor is legally responsible for cases under supervision and shares personal responsibility with the supervisee. The agency is also liable since their agents performed the actions leading to the alleged damage.
9. The correct answer is (c).
This is a fact question. NOS is an abbreviation for Not Otherwise Specified.
10. The correct answer is (b).
The youth’s functioning seems appropriate for his IQ and his achievement are within normal range. The question refers to the development of a plan and the answer should reflect a planning response. Given the youth’s age and high functioning, it is likely that he can eventually find employment and live independently. This should be a focus of the social worker.
11. The correct answer is (a).
This is a fact question and refers to specific criteria of DSMIV.
12. The correct answer is (d).
1 is incorrect since DSM IV is descriptive. 2. Is incorrect as treatment planning is dynamic and continues throughout treatment. 3. does not account for the need for narrative that captures the tone and attitude of family members. A DSM IV diagnosis is ordinarily an early step in the diagnostic phase of work with the client and is normally an early stage of treatment planning.
13. The correct answer is (a).
This is a fact question and is based on information found in DSM IV.
14. The correct answer is (d).
Answer 1 refers to a practice principle not an ethical principle. Answer 2 is irrelevant and 3 would seem opportunistic and manipulative. The social worker’s obligation is to be honest and make his or her professional obligations clear to the client.
15. The correct answer is (c).
Resistance usually occurs when a practitioner attempts to impose a judgment that a client is not prepared to accept.
16. The correct answer is (a).
No other response fits the constellation of factors described in the question.
17. The correct answer is (a).
It is the only response that is responsive to the wife’s statement.
18. The correct answer is (b).
In this question, the correct response is the one that emphasizes the supervisor’s educational function, while reassuring the worker that conflict is a part of group process. Answer 1. – helping the worker deal with his or her own issues regarding conflict alters the supervisory relationship and tilts it into a therapeutic situation.
Answers 3 and 4 do not help the worker with the immediate problem.
19. The correct answer is (b).
The stem of the question is a common definition of child abuse.
20. The correct answer is (a).
A good faith child abuse report requires only that the worker suspect that abuse has occurred. Evidence (response #2) is a much higher standard and is not required for a report.
21. The correct answer is (c).
When third parties are viewing sessions it is ethically imperative that the client is aware of the situation. Even if they have previously signed a release, the worker is required to let the client know when actual observations are taking place.
22. The correct answer is (a).
The other three responses place the responsibility on the group to find a way to begin interacting. Answer number one places the responsibility on the worker and suggests that it is the worker’s obligation to take charge. The worker’s role is to encourage and reflect to the group.
23. The correct answer is (a).
After identifying money management as the primary problem, the best strategy is to provide help for the problem. The other three responses are not germane to the client’s presenting problem. She neither needs public assistance or assistance with nutrition issues since she has an adequate diet.
24. The correct answer is (d).
All of the issues described in responses 1-3 are part of the psychosocial approach. Novel or untested approaches would not be used without the permission of the client.
25. The correct answer is (c).
Assessment is a shared responsibility of client and social worker. It is also a pragmatic approach to achieving client cooperation in working on the identified problems.