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A severely depressed and suicidal client agrees to several rounds of electroconvulsive therapy (ECT). When she returns to her outpatient clinic, she reports that her symptoms of depression have lifted, but that she doesn't remember much about the weeks when she was receiving ECT. Her response to this treatment is:   

A. Typical; ECT often causes some short-term memory loss.   

B. An indication that the depression really hasn't lifted at all.   

C. An indication that she is very conflicted about the treatment; the clinician needs to help her work through these issues.    

D. Critical; she needs to see her psychiatrist as soon as possible to prevent permanent brain damage.

What's your answer?

Let's take a look at rationales from the bottom up.

D. ECT is not associated with lasting or progressive brain damage. The client might find it reassuring to speak to her psychiatrist about her concerns, but there's no medical emergency.

C. Other than having some questions about side effects, the client does not appear conflicted about or hostile towards the treatment.

B. The client says her symptoms of depression have lifted, and there's no reason for the clinician to doubt her.

A. ECT is often associated with short-term memory loss. The memories of this time period may or may not return to the client.

So there you have it.

One of the side effects of ECT is some short-term memory loss. These memories may or may not return over time. The client is not in any danger and appears to be doing well after the treatments.

Now you know. Want to know more? Here's the Mayo Clinic's ECT info page.

Get lots more practice and explanations and deep info links with SWTP's complete exams. Sign up to get started and we'll send you our free ASWB exam study guide.

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Here's a question from our free study guide. (You receive the study guide when you create an account--no purchase necessary!) It goes something--exactly--like this:

A social worker provides services at a rural health care facility. The physicians in the practice are starting to do some telemedicine work. The physicians approach the social worker about treating people who may not be able to travel to the health center regularly. How should the social worker respond?'

❏ Begin incorporating telemedicine along the same lines as face-to-face services.

❏ Inform the physicians that telemedicine does not tend to be an effective means of doing social work, since it presents difficulties in establishing a therapeutic relationship.

❏ Tell the physicians that confidentiality concerns make telemedicine unethical for social workers.

❏ Discuss the need for informed consent to warn patients of possible limitations of telemedicine versus face-to-face contact.

What's your answer?

Let's take the answers one at a time.

A: There are differences between face-to-face services and telemedicine, and clients should be made aware of them before beginning telemedicine sessions.

B: Telemedicine may not work for everyone, but it can be an effective treatment method for many people.

C: It is ethical for social workers to conduct sessions remotely, which may open doors to people who don't have easy access to services in person.

D: It's appropriate to discuss with the doctors the possible limitations of telemedicine, and to review how informed consent would explain these limitations to clients.

So you have your answer (it's D).

Social workers can conduct therapy over the phone or via the internet, but clients must be informed of the possible limitations of doing such work. Working remotely may impact the therapeutic relationship, confidentiality issues may arise, and third party payers may not reimburse for treatment.

The most recent version of the Social Work Code of Ethics has new language regarding telemedicine and other interactions of technology and social work. Rereading the code is a great way to study. Then take full-length practice tests to see how well the info has stuck.

Happy studying!

During a therapy session, a client suddenly becomes enraged. She stands up, slams her fist on the desk, and throws a book across the room, breaking a picture frame. How should the clinician respond FIRST?

A. Shout for help.

B. Tell the client to sit back down in her chair so that the two of you can discuss whatever is upsetting her.

C. Order the client out of the office.

D. Remain composed and speak in a calm, soothing manner.

What's your answer?

Let's take them one at a time.

A. Shouting for help is a valid option if the clinician is or is about to be physically attacked. That's not what's happening here.

B. The client is apparently unable to talk rationally about the source of her upset at the moment-and probably in no mood to take event simple orders (e.g., "sit back down").

C. If a clinician orders a client to do something, the client may interpret this as an attempt to gain general control over her behavior, and will most likely become angrier.

D. Though it is somewhat vague, this is the correct answer. Most people cannot maintain intense anger in the face of a calm, soothing response.

So, you have your answer (it's D).

Sometimes social work licensing exam questions use as much common sense as they do textbook learning. Combining the two can get you successfully through a big bulk of the exam. But it takes practice. Get started by signing up for complete exams.

Happy studying and good luck on the exam!

A school social worker meets with a parent and child. The child has been refusing to come to school at least one day per week for the past two months. The social worker wants to gather some subjective data about the client's school refusal. Which of the following is an example of subjective data?

A. The client's grades.

B. The child's attendance at school.

C. The client's daily ratings of anxiety.

D. The client's IQ score.

What's your answer?

This is one of those vignettes that requires a simple item of knowledge. Do you or don't you know what subjective data means? And if you don't know, can you figure it out given a common sense understanding of the term subjective? That answer to that is yes.

Subjective data is client reported, based upon their internal experience. Grades? Objective. Attendance records? Also objective. IQ score? Objective. The only one of the offered answers that presents client-reported experience is C, a daily anxiety rating.

And, like that, you have your answer.

Do that 170 times with a reasonable percentage of correct answers and you're licensed! Then you can brag on IG, maybe get a raise, a better job--the whole package.

To get ready for that, try full-length practice tests. We've got a bunch of them. Sign up to get started.

Happy studying 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.