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A mother and her twleve-year-old son meet with a social worker after the child was referred by his primary care physician, who has diagnosed the boy with encopresis. The boy makes it clear he doesn't want to talk about the condition and doesn't want to meet with the social worker. What treatment goal is likely to be MOST effective in reducing symptoms of encopresis?

A. The child will learn to identify and replace cognitive distortions that contribute to his feelings of shame.

B. The child's mother will establish a behavior plan that rewards him for using the toilet at regular intervals.

C. The child will learn to talk to his mother about his feelings about encopresis in family therapy.

D. The child will learn to talk openly about the encopresis to reduce his shame and embarrassment.

 

What do you think?

Let's take the answers one at a time. Remember you're looking for a treatment goal, not an intervention.

A. Identify cognitive distortions (intervention: CBT). Replacing cognitive distortions might be effective in reducing the child's shame but won't likely reduce his behavioral symptoms. So, no.

B. Behavior modification--rewarding the child for regular toilet habits--is likely to reduce the child's symptoms. This one's in the running. But always read through all answers. There may be a still better answer in the bunch.

C. Voice feelings. While there may be a psychodynamic route to symptom reduction in this case, having the child talk about his feelings about encopresis in family therapy isn't likely to reduce his symptoms.

D. More talking. Talking about his symptoms might help reduce this child's embarrassment but won't likely resolve his encopresis.

So, really only one contender this time. Which makes it easier than many questions on the ASWB exam, which often have two decent answers doing battle. This time, provided you aren't drawn to the CBT and talk-therapy options, you've got your answer without too much difficulty: B, behavior mod.

To read up about encopresis symtpoms and treatment, here's a good resource. To keep preparing for the social work licensing exam, you're already in the right place. Sign up to get started with full-length exams.

Happy studying, stay safe, and good luck on the exam!

You may travelling ahead. First, you have this free ASWB exam practice question about flying phobia:

A client seeks therapy to address his phobia about flying. Every time he gets near an airport, he breaks out in a sweat, and if he tries to board an airplane, he has a full-blown panic attack. The MOST effective treatment option is:

A. Exposure therapy

B. Cognitive behavioral therapy

C. Referring the client to a psychiatrist for anti-anxiety medication he can take when he has to fly.

D. Psychodynamic psychotherapy

How do you answer?

Let's take the answers one by one, from the bottom.

D. Psychodynamic psychotherapy involves looking into one's past experiences and conflicts to resolve a current situation. It's a long-term therapy and often not practical for the treatment of phobias. There's also little clinical research on its efficacy in cases of phobia.

C. Medication is a temporary solution at best. It may get the client through one or two instances when he has to fly, but over the long term, it makes more sense to work on extinguishing the irrational fear.

B. Cognitive behavioral therapy is evidence-based treatment for anxieties and phobias. It's a good answer. But is it the best offered answer here? The best answer is the more specific answer. It is...

D. Exposure therapy, in which the client is gradually exposed to more intense fear-inducing stimuli (discussion, pictures, a visit to an aiport, and, in time, a flying). Exposure therapy--which sits under the wide umbrella that makes up all CBT treatments--is the most effective of the treatments listed.

And you have your answer!

For LOTS more questions from the DSM and all corners of the ASWB exam outline, sign up for complete, 170-question SWTP practice.

Happy studying and good luck with the exam.

Some more free ASWB exam practice.

A mother and her 8-year-old son meet with a social worker after the child was referred by his primary care physician, who diagnosed the boy with encopresis. The boy makes it clear he doesn't want to talk about the condition and doesn't want to meet with the social worker. What treatment goal is likely to be MOST effective in reducing symptoms of encopresis?

A. The child will learn to identify and replace cognitive distortions that contribute to his feelings of shame.

B. The child's mother will establish a behavior plan that rewards him for using the toilet at regular intervals.

C. The child will learn to talk to his mother about his feelings about encopresis in family therapy.

D. The child will learn to talk openly about the encopresis to reduce his shame and embarrassment.

What's your answer?

The question tests for a combination of DSM and practice knowledge. First the diagnostic part: What's encopresis? Even if you've never encountered the word before, you can glean from the content of the answers a rough definition--"using the toilet at irregular intervals." (It's more accurately "the repeated passing of stool (usually involuntarily) into clothing.") That takes care of the DSM portion of the question.

The question asks about a MOST effective treatment goal. Let's take the answers one at a time:

For A. Replacing cognitive distortions might be effective in reducing the child's shame but won't likely reduce his behavioral symptoms.

B. Behavior modification--rewarding the child for regular toilet habits--is likely to reduce the child's symptoms.

C. While there may be a psychodynamic route to symptom reduction in this case, having the child talk about his feelings about encopresis in family therapy isn't likely to reduce his symptoms.

D. Talking about his symptoms might help reduce this child's embarrassment but won't likely resolve his encopresis.

The rationales for C&D are reenforced by the boy's unwillingness to participate in treatment. The correct answer is B.

Encopresis can be a big problem for children, causing embarrassment and shame, particularly in older children. Although talking about the encopresis with this child may reduce some of his embarrassment, it isn't likely to reduce his symptoms. Behavior plans can be effective in helping children develop regular toilet habits. Children with encopresis often avoid going to the bathroom and become constipated. Establishing regular toilet times can reduce their avoidance.

Make sense? Any childcare or family therapy you've done might also help with getting a question like this right. For behavioral changes, behavioral-oriented treatments are usually the best approach to try first.

Another way to get questions like this right: practice, practice, and more practice. We've got plenty of that at SWTP. Sign up to get started!

Let's take a look at the Disruptive, Impulse-Control, and Conduct Disorders chapter of the DSM. How do you distinguish the diagnosis from one another? This could come in handy on the licensing exam. 

First, the criteria. Then some quick practice questions.

Oppositional Defiant Disorder

A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months.

Intermittent Explosive Disorder

Recurrent behavioral outbursts representing a failure to control aggressive impulses as manifested by either verbal or physical aggression for a period of 3 months or three outbursts involving damage or destruction to property or physical injury within a 12-month period.

Conduct Disorder

A repetitive and persistent pattern of behavior in which the basic rights of others or major societal norms are violated in the past 12 months with criteria present in the last 6 months (aggression, destruction of property, deceitfulness or theft, serious violation of rules).

The other diagnoses in the chapter differentiate themselves: Pyromania (fire setting), kleptomania (stealing).

And then there's antisocial personality disorder, which requires a pervasive pattern of disregard for and violation of the rights of others occurring since before age 15. Not diagnosed before age 18.

So...got all that? There are some basic ideas that are easy to memorize, and several numbers that, depending upon your memory, might get confused. How many months required? What ages?

Here are some quick practice questions to test how well you've absorbed the above info. The choices for each:

A. Oppositional defiant disorder

B. Intermittent explosive disorder

C. Conduct disorder

D. Antisocial personality disorder

and let's throw in another option (one more that you'll get on the ASWB exam)

E. Doesn't meet criteria for a DSM diagnosis.

Your practice questions:

A social worker sees a client who...

1. ...is 17, has been caught torturing small animals with regularity since he was 14. He denies the behavior, even when caught in the act. He shows little remorse and has few friends.

2. ...is 18 and a member of a gang. He has been participating in fights, vandalism, and some drug dealing since he joined last year.

3. ...is 14 and refuses to listen to anything his parents ask him to do. When they insist that he do household chores, he covers his ears to avoid hearing, sometimes chanting or humming loudly to block them out.

4. ...is 13 and, while generally well-behaved, ever since entering puberty a year ago, throws huge tantrums when she doesn't get her way, sometimes smashing a plate or punching the wall.

5. ...is 15 and for the last year has skipped school regularly, instead smoking pot and hanging out in the local convenience store parking lot. Confronted by his mother, the moody teen demands to be left alone and sometimes has laughed when she begins to tear up.

What is the BEST diagnosis for these clients?

Scroll down for answers...

 

 

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Answers:

1. C. Conduct disorder. (Sounds like ADD, but ADD can't be diagnosed till age 18.)

2. C. Conduct disorder.

3. E. Doesn't meet criteria for a DSM diagnosis.

4. B. Intermittent explosive disorder.

5. A. Oppositional defiant disorder

How's you do?

If you found this helpful, please post and share. And just imagine how helpful complete practice exams will be.

Happy studying and good luck on the exam!

A client previously diagnosed with major depressive disorder reports that she has recently been experiencing unusual giddiness at work and has been spending more than usual on groceries. She reports sleeping much more than she's used to. The most likely new diagnosis for the client is...

Check out this new video walk-through for offered answers and how to get to the correct answer. Subscribe to SWTP on YouTube for the whole exam question walk-through series, old and new.