ckmjx/CounselingBench huggingface dataset:
Case Study
Patient Demographic:  Initial Intake: Age: 16 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Biracial Relationship Status: Single Counseling Setting: High School Social Worker Type of Counseling: Individual
Mental Status Exam: Autumn came to intake session, during her lunch period. She appeared younger than her stated age because she was so underweight. The counselor greeted Autumn and told her that she was welcome to eat during their session if she wanted to. Autumn looked down and responded, “It’s okay- I don’t like to eat in front of anyone- I can just eat later.” Erin seemed tired during the interview but was cooperative and friendly.
Presenting Problem: History:
Autumn is a junior in high school. Her parents divorced about a month ago. Recently, the teacher noticed a change in Autumn’s mood. Autumn’s teacher also noticed that she was taking her lunch and eating it outside by herself. Oftentimes, she didn’t seem to eat much of it at all. When asked about it, Autumn seemed embarrassed and stated that she was fine.

Question: Based on the first session notes, what should the counselor do next?
(A): Refer client to inpatient treatment
(B): Definitively state that trust and therapeutic alliance is established
(C): Identify client driven goals and objectives
(D): Discuss transferring to someone who specializes in eating disorders

Correct Answer: Identify client driven goals and objectives
Explanation: Now that the diagnosis has been established, it is important to formulate a treatment plan that focuses on the needs and priorities of the client. Autumn is not currently a safety risk to herself or others, so hospitalization is not warranted. Throughout the counseling process, the quality of the therapeutic alliance should be monitored and addressed if any issues arise. There is no indication that the counselor cannot properly treat the client. 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: Which of the following can be ruled out based on the stated symptoms?
(A): Ketoacidosis
(B): Sedative, hypnotic or anxiolytic withdrawal
(C): Alcohol withdrawal
(D): Psychosis

Correct Answer: Ketoacidosis
Explanation: Ketoacidosis is a diabetic complication in which the body over produces ketones and may cause hallucinations. However, one of the symptoms of ketoacidosis is sweet smelling breath. In the intake summary, it is noted that Sandy had foul smelling breath. Sandy may be showing symptoms of alcohol, sedative, hypnotic or anxiolytic withdrawal which can all cause hallucination or disorientation. Sandy may also be showing symptoms of psychosis. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake: Age: 4 Sex: Female        Gender: Female Sexuality: Heterosexual Ethnicity: African American Relationship Status: Single Counseling Setting: Community Clinic Type of Counseling: Individual
Mental Status Exam: Destiny was engaging with the counselor throughout the interview although her affect was flat. She played by herself while the counselor spoke to Darlene and Tony. She did not look up at her parents or engage with them during the entire session.
Presenting Problem: Destiny is a 4-year-old who was referred for therapy by her preschool teacher. Destiny arrived at the intake session with her adoptive parents, Darlene and Tony Mase. Darlene and Tony shared that they were concerned about Destiny because she never wants to interact with other children, rarely smiles or laughs, and has mood fluctuations with little or no pattern or trigger. Reactions include irritability, sadness, and tearfulness.

History:
Destiny arrived at the Mases’ when she was two years old and was nonverbal at the time. Destiny also showed cognitive delays in her early intervention screening. Darlene and Tony noticed Destiny’s lack of interest in playing with other children when Destiny arrived and she did not want to interact with the other children in the home. The irritability and mood fluctuations began over a year ago. Darlene and Tony were hopeful that once Destiny started preschool that she would start interacting with others, however this is not the case.

Question: To further explore relationships, the counselor should use the following technique?
(A): Ask the child to write a story
(B): Ask the caregiver to ask the child why she doesn't want to live with them anymore
(C): Ask the child numerous questions about the quality of her relationship with caregivers
(D): Explore the child's memories of their caregivers through role-play with puppets

Correct Answer: Explore the child's memories of their caregivers through role-play with puppets
Explanation: The best way at this point to explore the relationships Destiny has with others is by the counselor exploring Destiny's memories. This can be done through play, such as using puppets. Feelings may come out organically as opposed to through direct questions. Asking numerous questions may cause Destiny to shut down. Looking at the child's age, as well as their past trauma, Destiny may not comprehend, let alone verbalize her feelings about living with her foster parents. Additionally, she may not want to be asked this question by Ms Maze. Having the child write a story may be too difficult for Destiny at such a young age. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake: Age: 12 Sex: Male            Gender: Male Sexuality:  Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: School Counselor Type of Counseling: Individual
Mental Status Exam: Michael came to the office and looked upset as he sat down. When asked about how he felt about what happened, Michael respectfully stated that he was sorry but that he did not want to talk about it.

Presenting Problem: Michael came to the counselor’s office after he was suspended for fighting with one of the other students.

History:
Michael, who was a new student this year, did not typically get in trouble. Michael has excelled academically since his arrival and joined several school clubs. When the teacher was questioned regarding what happened, she stated that the other student made a gesture to Michael that could not see. Suddenly, she stated that they were both throwing punches. Michael’s teacher stated that now that she thought about it, she recently noticed Michael exhibiting some repetitive movements that she never witnessed before.

Question: Which of the following, if recommended by the counselor, would likely worsen Michael's tics?
(A): Engage in sports and hobbies
(B): Identify and challenge his irrational thoughts
(C): Monitor sleep
(D): Increase the consumption of energy drinks

Correct Answer: Increase the consumption of energy drinks
Explanation: Energy drinks and increased consumption of caffeine may worsen tics. Ways to alleviate or suppress tics can be through monitoring sleep to ensure the individual is well rested. Engaging in sports and hobbies can also reduce tics as it gives the individual something to focus on. Also, by identifying and challenging Michael's irrational thoughts, this can help to reduce stressful situations. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
Case Study
Patient Demographic: Initial Intake: Age: 48 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Counselor Private Practice Type of Counseling: Marital
Presenting Problem: Kathleen and Tony came in for marital counseling because of arguing due to recent events in their relationship.
 
History:
Kathleen and Tony have been married for two years and had a generally positive relationship. They have no children. Kathleen, who works in travel, is frequently away from home. Recently, when Kathleen came home early from a work trip, she found her husband in their bedroom with one of her nightgowns on. Kathleen was convinced that there was another man in their house, and they must have heard her at the door and snuck out of the back
 
Kathleen started the initial session by stating that she feels that her husband is lying to her. At this comment, Tony threw his hands up in the air and stated, “It doesn’t matter what I say- you are not going to believe me anyway!”

Question: If the counselor responds, "It sounds like you feel hurt that your wife does not believe you." This may make the client feel?
(A): Validated
(B): Annoyed
(C): Vindicated
(D): Confused

Correct Answer: Validated
Explanation: By using the intervention of reflection of feelings, a client is aware that they are heard, and their feelings are validated. Tony would likely not feel annoyed as the counselor is reflecting what he stated. Nor would he feel vindicated as that denotes some sort of feeling of satisfaction. Although the client seems conflicted about his wanting to be with his wife, the question is asking how the counselor's comments make him feel. Therefore, the correct answer is (A)
Competency: professional practice and ethics
Case Study
Patient Demographic: Name: Anxiety Group Therapy Clinical Issues: Worry and anxiety Diagnostic Category: Anxiety Disorders Provisional Diagnosis: F41.1 Generalized Anxiety Disorder Age: 0 Sex Assigned at Birth: Female Gender and Sexual Orientation: Not applicable, Ethnicity: Various Marital Status: Not Applicable Modality: Group Therapy Location of Therapy : Agency  
Mental Status Exam: The group members appear to be insightful about their illness. Clients ages are 25 and older. All members are well-groomed and present with clean hygiene.
Presenting Problem: First session You are a therapist in an agency starting a group for clients with anxiety. The group will consist of seven participants. It is a homogeneous, closed group which will meet once a week on Wednesday evenings for an hour and a half for twelve weeks. The group's goal is to help clients diagnosed with Generalized Anxiety Disorders and other anxiety-related issues. An intern will co-facilitate the group with you. You are forming an outline for the group's goals, screening questions, and termination process. You will be observing candidates for the group to facilitate participant selection.  Fourth session All seven members have been coming to your group for three weeks. The group is made up of married, single, and divorced females. Some have children and some do not. Ages range from 25 to 33 years old. It is multiculturally diverse. As group sessions progress, you note that some group members are starting to take risks, while others are still not fully trusting you and the group's co-facilitator. Most of the clients generally worry about their family and loved ones. Some are more afraid of getting ill and dying because of COVID-19. You lead the group in a guided meditation before you start making the rounds to calm everyone down and have them feel centered.

Question: Which therapeutic factor is most often linked with healthy, well-functioning groups?
(A): Transparency
(B): Universality
(C): Stonewalling
(D): Structure and Framework of the group

Correct Answer: Universality
Explanation: Universality means members recognize that others share similar feelings, thoughts and problems. Therefore, the correct answer is (C)
Competency: counseling skills and interventions
Case Study
Patient Demographic:  Initial Intake:   Age: 82 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Widowed Counseling Setting: Community Clinic Type of Counseling: Individual
Mental Status Exam: Theodore is tearful most days and has dropped a significant amount of weight. He has not been sleeping and stays up watching videos of his deceased wife.
Presenting Problem: Theodore is an 82-year-old who was referred for grief counseling by his son, Nate. Theodore’s wife, Nancy died one month ago after a 4-year battle with cancer.

History:
Theodore was the primary caretaker for Nancy and has not paid attention to his own health in years. Nate would like his father to move in with him and his family and sell the house his parents lived in to pay off their debt. However, Theodore refuses to sell the house and stated that he will not give away or sell anything that they owned. Nate drove Theodore to the initial session and sat in for the intake, with Theodore’s consent.
 
Once everyone sat down, Theodore looked at the counselor and stated, “I am only here so my son stops bugging me about selling the house. I am not getting rid of anything in that house- and especially not the house itself!” Nate explained that his father cannot maintain the house on his own and is worried about him being lonely. Theodore insists that he has other options and thinks that living with Nate would put a burden on him.

Question: Using Erikson's stages of psychosocial development, what stage is Theodore in?
(A): Intimacy vs. isolation
(B): Immortality vs extinction
(C): Integrity vs. despair
(D): Generativity vs stagnation

Correct Answer: Immortality vs extinction
Explanation: Theodore seems to be in Erikson's stage of Immortality vs. Extinction in which a person is accepting of death and believes that they have led a satisfying and meaningful life. Intimacy vs isolation occurs around the age of early adulthood when an individual is developing true autonomy from their parents and establishes their own values and ideals. Integrity vs despair occurs in later adulthood when the individual has not yet accepted death but is beginning to develop a point of view about it. Generativity vs stagnation is a stage that occurs in middle adulthood. Developmental tasks include parenting, nurturing of adult relationships and the management of career and householdThe immortality vs extinction stage was added by Joan Erikson for persons over 75 years of age. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic:  Initial Intake: Age: 45 Sex: Female Gender:  Female Sexuality:  Heterosexual Ethnicity: Asian   Relationship Status: Single Counseling Setting: Community outpatient clinic Type of Counseling: Individual
Mental Status Exam: During the intake she looked visibly anxious. She appeared jumpy and kept looking at her watch. Although hesitated at times when she was asked a question. The counselor was concerned when Li paused for a long time when asked if she ever thought of hurting herself. Li eventually responded no. The counselor noticed that Li’s clothes looked disheveled and soiled. Li was not forthcoming with information about her past.
 
Presenting Problem: Li is a self-referral. She walked into the clinic and stated that she had been experiencing feelings of anxiety.
 
History:
Li came into the community outpatient clinic asking to pay a sliding scale fee in cash. When asked for identifying information, Li asked if she had to give that information. She explained that she was undocumented and was weary of leaving any information that may lead government officials to her. Li did not want to give the counselor much of her history and cut the intake session short, stating that she had to get back to work.

Question: Which of the following steps should the counselor take?
(A): Tell her she needs to find another place to live.
(B): Suggest finding another job.
(C): Give Li a referral to a shelter.
(D): Encourage Li to go to the police.

Correct Answer: Encourage Li to go to the police.
Explanation: Li is a victim of human trafficking and exploitation, and the police should be involved. The counselor should encourage Li to go to the police. If she does not, the counselor must consider the level of risk there is. Ethical Code B2a. Serious and Foreseeable Harm and Legal Requirements states that "The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception". A referral to a shelter, would be beneficial after the authorities are contacted. Telling Li she needs to find another place to live would not be the appropriate choice. Although this must be done, simply stating that without calling the authorities or giving her resources would not be appropriate. Li will also have to find another job eventually but the priority is keeping her safe and reporting what happened to authorities. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake:   Age: 35 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Employee Assistance Program Type of Counseling: Individual
Mental Status Exam: Harold comes into the office, visibly upset, stating, “I really don’t know why I am here, but I am sure you will see that too after some time together. And I am sure that anything I say here- you can’t report it to anyone anyway, right?” Harold did not display any self-awareness of his actions when speaking to the counselor. At times he showed defensiveness and irritability and other times he was making jokes and complimenting the counselor.
Presenting Problem: Harold, an accounting executive, was referred for counseling by his supervisor after Human Resources received several complaints about Harold’s attitude towards others.
 
History:
Harold has been successful in his career and is knowledgeable in his field. However, he stated that he is often not well liked. Harold attributes this to people being envious of him. Harold told the counselor that recently he was called to human resources because of complaints from his peers. Complaints included allegations of rude remarks, bullying, and Harold taking credit for work that others did. One coworker stated that Harold took frequent breaks and suspected he may be using drugs.

Question: The counselor states, "It sounds like you are wondering about the reason you were referred to me. Perhaps we should review this together and discuss the details of our what our time together will consist of. I can then address any questions or concerns you may have." This is an example of?
(A): Paraphrasing and structuring
(B): Paraphrasing and informed consent
(C): Confrontation and structuring
(D): Confrontation and informed consent

Correct Answer: Paraphrasing and structuring
Explanation: Paraphrasing is rewording the client's words to convey understanding. It can also be used for clarification. The counselor reiterates what the client stated and demonstrates that she is listening. Structuring is when the counselor reviews what will be reviewed in the session. The counselor does this by outlining the different things the session will cover. Confrontation is not the counselor confronting the client but rather the client confronting something within themselves. Informed consent is the review of the counseling process including payment, procedure, risks, and benefits. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
Case Study
Patient Demographic: Initial Intake: Age: 12 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Hispanic Relationship Status: Single Counseling Setting: Outpatient Clinic       Type of Counseling: Individual
Mental Status Exam: Carlos came to the intake with his mother, Claudia. Claudia did most of the talking during the intake while Carlos sat in his chair, slumped down low and avoiding eye contact.
Presenting Problem: Carlos is a 12-year-old male referred to an outpatient community clinic by the court after he was caught breaking into several cars on his block.
 
History:
Claudia reported that she and Carlos’ father separated two years ago. Since then, Carlos has had frequent suspensions in school for bullying others and fighting. Carlos often threatens students on social media prior to the altercations. Claudia reported that she no longer knows what to do anymore and she hoped that the counselor can fix him or at least report to her what he is thinking when he does these things.

Question: In coming up with treatment plan goals, the following is least important?
(A): Consideration of other service providers
(B): Treatment planning should be a collaborative process with Carlos
(C): Prior history of success with similar goals
(D): Discussion of termination

Correct Answer: Prior history of success with similar goals
Explanation: One of the goals of therapy is to change patterns of behavior and one of the beliefs in therapy is that people are capable of change. Although Carlos may not have been successful in the past with some goals, he may be successful if he tries again with additional support. The treatment planning process should always be client driven, with the client establishing the priorities. Termination should be discussed in the beginning of the therapeutic relationship, so the client is aware of the expectation that the goal is for them to be self-sufficient. When treatment planning, it is important to include formal and natural supports. It is also beneficial to understand the goals that the client may be working on with others to ensure that goals do not overlap or contradict one another. Therefore, the correct answer is (D)
Competency: counseling skills and interventions