ckmjx/CounselingBench huggingface dataset:
Case Study
Patient Demographic: Initial Intake: Age: 16 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: Molly muttered one-word answers during the intake session, made little eye contact and frequently rolled her eyes. She started to warm up towards the middle of the intake session, with some prompting from her mother. She reluctantly agreed to continue counseling sessions- only due to the fact her mother stated that she could not use the family car unless she went to counseling.
Presenting Problem: Molly is a 16-year-old female who was referred to an outpatient mental health clinic after a two-week admission at a local psychiatric hospital. Molly was brought to the hospital by ambulance after she disclosed to the school psychologist that she wanted to kill herself.
 
History:
When asked what brought the family to the session, Molly’s mother was tearful as she disclosed that her husband died in a car accident 11 months ago. Molly and her father had been close, spending time together as Molly played recreational softball and her father was the coach. Since her father’s death, she has been distant with her mother, and often picks fights with her. Additionally, Molly frequently complains of stomach aches, stating that the pain is so severe, she cannot go to school. Before her father’s death, Molly was in Advanced Placement classes and maintained a high average. Recently, Molly’s grades have been declining and she is no longer interested in softball. She states that when she goes to the softball field, she can almost hear her father speaking to her.

Question: A referral that can be made prior to the next session would be?
(A): A medical referral for Molly's stomach aches
(B): A support group for teens who have lost a parent
(C): Extra help for Molly's decline in grades
(D): A psychiatrist for medication

Correct Answer: A medical referral for Molly's stomach aches
Explanation: It is important to first rule out medical issues. Molly's stomachaches have had a significant impact in her school functioning, and it should be determined if the cause is medical or psychological. Although a support group may be beneficial later, it does not seem that Molly is ready for that yet. It is important to first address the areas of functioning that have significantly declined such as her schoolwork and her relationship with her mother. This can be a possible long-term goal. Part of the reason that Molly's grades have declined was due to missing a lot of school. Prior to her father's death Molly was in advanced placement classes and achieved high scores. Molly was not discharged from the hospital with medication. If it is determined that her hearing her father's voice is a hallucination, or if suicidal ideation worsens, medication may be warranted later. At this point it would benefit Molly to try therapy first. Therefore, the correct answer is (A)
Competency: treatment planning
Case Study
Patient Demographic:  Initial Intake:   Age: 38 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: VA Type of Counseling: Individual
Mental Status Exam: Carl came to the intake session alone and angrily stated, “I really don’t know why they are making me come to therapy - it doesn’t help anyway.” Carl appeared edgy throughout the interview and responded to questions with minimal effort.

Presenting Problem: Carl is a 38-year-old Army Veteran who is attending counseling at the local VA. Carl was referred after he was arrested for a DUI last week.

History:
Carl has been on four deployments to the Middle East, he returned from the most recent tour 11 months ago, after he was injured during a military strike. Some of his team members were injured as well.
Since his return, Carl and his civilian wife, Lori, have discussed separation because of their frequent arguing and Carl’s drinking. Carl began drinking when he was deployed and since then has used it as a coping mechanism to combat the frequent flashbacks and nightmares that he gets. Carl and Lori mostly argue about money since Carl has not been able to sustain employment as a construction worker because of his drinking problems. Carl has been arrested several times for assault and disorderly conduct. Carl recently assaulted his last counselor after he had made a comment about Carl not being able to sustain work.

The counselor thanked Carl for his service and reviewed with him that he was referred as a part of his probation. He must attend individual therapy and an anger management group for veterans. The counselor then described to Carl the purpose of the meeting and what would be reviewed and discussed during their time together. This included the intake paperwork, including informed consent and several assessments.

Question: Which of the following steps should be taken in the intake stage?
(A): Convince Carl to include his wife in counseling sessions
(B): Tell Carl that he if he does not attend individual or group therapy, he is violating his probation
(C): Assess the severity of Carl's alcohol use
(D): Ensure Carl goes to group therapy

Correct Answer: Assess the severity of Carl's alcohol use
Explanation: Alcohol use seems to be a contributing factor in Carl's current issues. A comprehensive assessment would include assessing the severity of Carl's alcohol use to gain an accurate clinical picture and to help determine goals. Although it may be beneficial to have Carl's wife in therapy sessions, that may come later, after the intake and assessment. Group therapy would benefit Carl, but the question is, what needs to be completed as part of the intake session. Finally, the counselor is trying to build rapport and trust with Carl. If the counselor comes across as confrontational to Carl about violating his probation, this may hinder the alliance building process. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic:  Initial Intake: Age: 48                Sex: Female Gender: Female Sexuality:  Heterosexual Ethnicity: Caucasian Relationship Status: Divorced Counseling Setting: Acute Inpatient Psychiatric Hospital Type of Counseling: Individual
Mental Status Exam: Sandy wandered into the ER waiting room asking for a police officer. After further conversation, it was clear that Sandy thought she was in a police station and repeatedly called once of the nurses Officer McKinney, as if she knew him.
 
During the intake, the nurse practitioner mentioned that she was running a temperature, had a rapid heartbeat and breath smelled foul. In addition, her hands were trembling as well as her tongue and lips. Sandy’s behavior was somewhat irritable and erratic. At one point she was seemed to be hallucinating and stated that that she saw rats.

Presenting Problem: Sandy was sent to the inpatient psychiatric from the emergency department for symptoms of hallucinations, memory loss, and disorientation.
 
History:
Sandy currently lives alone and is unemployed. She has a history of alcohol abuse and has been admitted to the hospital before because of this. Sandy has gotten into trouble with the law and has alienated most of her family and friends because of her alcohol use. She currently attends alcoholics anonymous.

Question: A psychosocial cause of drug addiction is?
(A): Drugs stimulate the brain producing immediate pleasure
(B): Exposure to substances in utero
(C): Genetics
(D): Failures in parental guidance

Correct Answer: Failures in parental guidance
Explanation: Children with parents who abuse drugs or alcohol may not have the proper guidance to avoid drugs/alcohol themselves. Other psychosocial causes include using drugs/alcohol to relieve tension and an expectation or social norm which portrays alcohol to "loosen up" or increase their popularity in social settings. Genetics, exposure to substances in utero, and the positive feeling drugs may give are the physical causes of addiction. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake: Age: 16 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: Molly muttered one-word answers during the intake session, made little eye contact and frequently rolled her eyes. She started to warm up towards the middle of the intake session, with some prompting from her mother. She reluctantly agreed to continue counseling sessions- only due to the fact her mother stated that she could not use the family car unless she went to counseling.
Presenting Problem: Molly is a 16-year-old female who was referred to an outpatient mental health clinic after a two-week admission at a local psychiatric hospital. Molly was brought to the hospital by ambulance after she disclosed to the school psychologist that she wanted to kill herself.
 
History:
When asked what brought the family to the session, Molly’s mother was tearful as she disclosed that her husband died in a car accident 11 months ago. Molly and her father had been close, spending time together as Molly played recreational softball and her father was the coach. Since her father’s death, she has been distant with her mother, and often picks fights with her. Additionally, Molly frequently complains of stomach aches, stating that the pain is so severe, she cannot go to school. Before her father’s death, Molly was in Advanced Placement classes and maintained a high average. Recently, Molly’s grades have been declining and she is no longer interested in softball. She states that when she goes to the softball field, she can almost hear her father speaking to her.

Question: Informed Consent should?
(A): Explain the risks, benefits, and limitations of the counseling process
(B): Be regularly revisited and reassessed
(C): All of the above
(D): Allow the client to decide about which provider they should use for treatment

Correct Answer: All of the above
Explanation: The counselor should always act in the best interest of the client. If the client is a minor, it is necessary to discuss confidentiality and the limitations with the legal guardian. Collaboration is necessary to have a therapeutic alliance with all parties. Informed consent should include information such as client background, credentials, methods of payment, etc. so that the client can have the information needed to choose the provider who would best meet their needs. Clients must be informed of procedures that may be utilized in counseling. Risks, benefits, and limitations of the counseling process should be discussed, as well as any risk or benefits in using different modalities of treatment such as telemental health. Informed Consent is fluid and should be revisited throughout the life of the counseling relationship. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake: Age: 22 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: African American Relationship Status: In a long-term relationship Counseling Setting: Adult inpatient psychiatric Type of Counseling: Individual
Mental Status Exam: Mark was unable to complete a mental status exam as he was not speaking coherently and was displaying violent behavior towards hospital staff. The ER nurse interviewed Mark’s girlfriend, Erin.
Presenting Problem: Mark came into ER after his girlfriend Erin called 911 when Mark attacked someone on the bus.
 
History:
Erin told the ER nurse that Mark has been displaying increasingly irrational behaviors. Erin shared that Mark recently took a trip to Africa. Since then, Mark told Erin that he was hearing the voice of God, telling him that it was his responsibility to rid the world of evil. At first Erin noticed Mark staying up late at night, writing all his thoughts in a journal. When Erin read the journal, the content was incoherent. Erin also shared that Mark was recently put on probation at work for going into the women’s restroom. Mark told his boss that God told him to keep an eye on one of his coworkers.

Question: When interviewing someone who is actively psychotic you should first asses?
(A): Symptoms
(B): Treatment
(C): Diagnosis
(D): Safety

Correct Answer: Safety
Explanation: Ensuring safety is a top priority. Considerations include seating arrangement, whether to have family members in the room and ensuring the comfort of the client. Although the diagnosis is helpful in determining effective treatment, it is the least important factor when interviewing someone who is actively psychotic. The assessment of severity of symptoms is necessary to establish level of functioning and help formulate treatment goals. Discussing treatment options is also important as part of the informed consent process and can be done after safety is assessed. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic:  Initial Intake:   Age: 38 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: VA Type of Counseling: Individual
Mental Status Exam: Carl came to the intake session alone and angrily stated, “I really don’t know why they are making me come to therapy - it doesn’t help anyway.” Carl appeared edgy throughout the interview and responded to questions with minimal effort.

Presenting Problem: Carl is a 38-year-old Army Veteran who is attending counseling at the local VA. Carl was referred after he was arrested for a DUI last week.

History:
Carl has been on four deployments to the Middle East, he returned from the most recent tour 11 months ago, after he was injured during a military strike. Some of his team members were injured as well.
Since his return, Carl and his civilian wife, Lori, have discussed separation because of their frequent arguing and Carl’s drinking. Carl began drinking when he was deployed and since then has used it as a coping mechanism to combat the frequent flashbacks and nightmares that he gets. Carl and Lori mostly argue about money since Carl has not been able to sustain employment as a construction worker because of his drinking problems. Carl has been arrested several times for assault and disorderly conduct. Carl recently assaulted his last counselor after he had made a comment about Carl not being able to sustain work.

The counselor thanked Carl for his service and reviewed with him that he was referred as a part of his probation. He must attend individual therapy and an anger management group for veterans. The counselor then described to Carl the purpose of the meeting and what would be reviewed and discussed during their time together. This included the intake paperwork, including informed consent and several assessments.

Question: All of the below therapeutic techniques may be beneficial to treat Carl's PTSD symptoms, except?
(A): Pet therapy
(B): Exercise program
(C): Anti-epileptic medication
(D): Anger Management

Correct Answer: Anti-epileptic medication
Explanation: Anti-epileptic medication has not been proven effective to treat PTSD. SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) have been found to be effective for PTSD. Anger management skills can teach Carl coping skills to manage his reactions. Pet therapy has also been found to be an effective form of intervention for combat veterans diagnosed with PTSD. Exercise also helps to release endorphins which can help combat Carl's irritability and aggression. Therefore, the correct answer is (D)
Competency: treatment planning
Case Study
Patient Demographic:  Initial Intake: Age: 48                Sex: Female Gender: Female Sexuality:  Heterosexual Ethnicity: Caucasian Relationship Status: Divorced Counseling Setting: Acute Inpatient Psychiatric Hospital Type of Counseling: Individual
Mental Status Exam: Sandy wandered into the ER waiting room asking for a police officer. After further conversation, it was clear that Sandy thought she was in a police station and repeatedly called once of the nurses Officer McKinney, as if she knew him.
 
During the intake, the nurse practitioner mentioned that she was running a temperature, had a rapid heartbeat and breath smelled foul. In addition, her hands were trembling as well as her tongue and lips. Sandy’s behavior was somewhat irritable and erratic. At one point she was seemed to be hallucinating and stated that that she saw rats.

Presenting Problem: Sandy was sent to the inpatient psychiatric from the emergency department for symptoms of hallucinations, memory loss, and disorientation.
 
History:
Sandy currently lives alone and is unemployed. She has a history of alcohol abuse and has been admitted to the hospital before because of this. Sandy has gotten into trouble with the law and has alienated most of her family and friends because of her alcohol use. She currently attends alcoholics anonymous.

Question: A physical cause of drug addiction is?
(A): A person's biological makeup
(B): Alcohol flush reaction
(C): Expectations of social success
(D): Failure of parental guidance

Correct Answer: A person's biological makeup
Explanation: The physical causes of drug addiction include the pleasurable feeling drugs may cause, craving and genetic vulnerability, as well as exposure to substances. Expectations of social success and failures of parental guidance are psychosocial causes of drug addiction. Alcohol flush reaction is a physical reaction to alcohol seen primarily in people of Asian descent in which the body cannot break down the enzymes in alcohol. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic:  Initial Intake: Age: 18 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Chinese Relationship Status: Single Counseling Setting: College Counseling Center Type of Counseling: Individual
Mental Status Exam: The counselor noticed that Darrel’s clothes look disheveled, he had bags under his eyes and made very little eye contact. When asked, Darrel stated that he was working late the day before and he just needed to rest.

Presenting Problem: Darrel is an 18-year-old freshman who comes into the college counseling center for some career counseling.
 
History
Darrel is a transfer student from China, living with a boarding family close to the college campus. He is an Advertising major at college. Darrel stated that he is unhappy at school. He didn’t know if he was unhappy with his major selection even though he couldn’t see himself doing anything else. Darrel described how recently he just doesn’t like anything he used to, including anything that has to do with Advertising. Darrel stated that his parent would be greatly disappointed if they knew that he was switching his major.  He questioned why he had to do what they want anyway. The counselor suspected that the issues may be deeper than Darrel’s initial intake suggested.

Question: In response to Darrel's sharing, the counselor should?
(A): Deny feelings about counselor's own cultural identity
(B): Encourage Darrel to assimilate to American culture
(C): Focus on understanding Darrel's cultural view of the world
(D): Tell Daniel that his feelings will soon pass

Correct Answer: Focus on understanding Darrel's cultural view of the world
Explanation: An effective counselor will develop an important skill of being able to see things from the client's perspective, including multicultural views. The counselor should not encourage Darrel to assimilate to American culture or dismiss his feelings of racial dissonance. The counselor should also be self-aware of her feelings about the topic and regarding her own cultural identity. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Client Age: 25 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: In a Relationship Counseling Setting: Private Practice Clinic Type of Counseling: Individual Counseling Presenting Problem: Premature Ejaculation Diagnosis: Provisional
Mental Status Exam: Mental Status Exam: The client is oriented to person, place, time, and situation. The client appears comfortable in the session as evidenced by his openness, congruent affect, and verbal express
Presenting Problem: You are a counseling resident at an outpatient clinic. Your 25-year-old male client reports he was in a bicycle accident a year ago and that, resultingly, he had reconstructive surgery to his penis. The client identifies that it takes approximately 30 seconds to a minute to ejaculate following vaginal penetration. The client reports that the symptoms occur every time he engages in sexual activities with his girlfriend. The client is a car salesman and also reports anxiety about performance at work and other areas of life. You suspect that the client may also have generalized anxiety disorder. The client reports that his girlfriend does not seem to mind that sex does not last long, but he feels bad because he also wants her to feel good during sex.
Other Contexts:  Diagnosis: Premature Ejaculation, Acquired, Generalized, Mild (F52.4)   ions. Family History: The client reports that he has been in a relationship with his girlfriend for 3 years. The client says that he is close with his parents and his younger brother.  You suspect that the client also has generalized anxiety disorder

Question: You suspect that the client also has generalized anxiety disorder. All of the following would confirm this diagnosis EXCEPT:
(A): Fear of panic attacks
(B): Having trouble falling asleep
(C): Excessive anxiety experienced on more days than not for 6 months
(D): Being easily fatigued

Correct Answer: Fear of panic attacks
Explanation: The fear of panic attacks meets the criteria for panic disorder, but it is not part of the required criteria for generalized anxiety disorder. Excessive anxiety that is present for more than 6 months, being easily fatigued, and trouble falling asleep are all criteria for generalized anxiety disorder. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis