ckmjx/CounselingBench huggingface dataset:
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: The technique the counselor is demonstrating during the session is?
(A): Capping
(B): Focusing
(C): Proxemics
(D): Structuring

Correct Answer: Structuring
Explanation: Structuring is letting the client know what to expect from the counseling session. It is an important aspect of the counseling process as it helps to organize the session and keep things on track. It can also help establish a rhythm for future sessions. Capping occurs when the counselor de-escalates the emotions of the client when the client is starting to lose control. Proxemics is the study of the client's body language and movements to determine emotions, thoughts, and feelings. Focusing is non-verbal attention to the client's words which can help the counselor to see things from the client's perspective and to help determine next steps. Therefore, the correct answer is (C)
Competency: treatment planning
Case Study
Patient Demographic: Initial Intake: Age: 26                Sex: Female Gender: Female Sexuality:  Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: Molly was initially guarded, but pleasant, during the intake session. After some time, she became tearful. Molly stated to the counselor that although she always had a level of anxiety, she never came to counseling before because she thought that only unsuccessful people with serious issues get counseling.
 
Presenting Problem: Molly came into individual counseling due to increased feelings of anxiety. 

History:
Molly began showing symptoms of anxiety when she was in high school. Molly was star of the track team and on the honor roll. During her senior year she was writing for the yearbook and preparing to attend college at an Ivy League university.  She successfully finished college and law school. Despite the symptoms she experienced throughout her educational career, she was able to ride it out and has been extremely successful in her law career.

Question: The counselor code of ethics states that?
(A): Bartering is not allowed.
(B): Bartering is acceptable.
(C): Counselors should discontinue therapy for those who offer bartering.
(D): Counselors may barter under certain circumstances.

Correct Answer: Counselors may barter under certain circumstances.
Explanation: ACA code of ethics A10e. bartering states that counselors may only barter if the bartering does not result in exploitation or harm, if the client requests it, and if such arrangements are an accepted practice among professionals in the community. There is no hard and fast rule that bartering is or isn't allowed, there must be careful consideration for each scenario. Additionally, a counselor should not dismiss the client solely due to the client asking this question. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
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: Conduct disorder is often a pre-cursor to?
(A): Histrionic personality disorder
(B): Schizotypal personality disorder
(C): Borderline personality disorder
(D): Antisocial personality disorder

Correct Answer: Antisocial personality disorder
Explanation: Antisocial personality disorder is diagnosed at the minimum age of 18. The individual must have a history which is congruent with the criteria for conduct disorder. Borderline personality disorder is characterized by, "instability in interpersonal relationships, self-image and affects, and marked impulsivity". This commonly co-occurs with depressive or bipolar disorders. The essential feature of schizotypal personality disorder is a pattern of interpersonal/social deficits which results in the inability to have close relationships. Histrionic personality disorder is characterized by excessive attention-seeking behavior. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Client s Age: Client 1: age 12 Client 2: age 14 Client 3: age 14 Client 4: age 16 Client 5: age 13 Client 6: age 16 Sex: Males Gender: Males Sexuality: Varying Ethnicity: Multiracial Relationship Status: Single Counseling Setting: Juvenile Justice Facility Type of Counseling: Group Counseling Presenting Problem: Involvement with the Justice System That Includes Various Mental Health Disorders and Crimes Diagnosis: Imprisonment (Z65.1)
Mental Status Exam: Mental Status Exam: All of the clients appear to maintainappropriate hygiene, and they are all oriented to person, place, time, and situation. They are all somewhat reserved with regard to going into deeper topics, but theyparticipate f
Presenting Problem: You are a licensed counselor working in a juvenile justice facility for teenage males. The group comprises six males that are required to attend as part of their incarceration with the expectation that it will shorten their sentences. The purpose of the group is to work on emotional regulation and to work together to share common experiences and identify goals that can be helpful in preventing reincarceration. During the intake session, you explained the purpose of the group and started with an ice-breakeractivity. The clients participated in the ice-breaker activity that required you to redirect them back to the activity several times because they would joke and get off task. You attempt to go a little deeper by encouraging your clients to start talking about what happened to get them incarcerated, and they appear to be taking pride in the reasons they were in juvenile detention and making fun of those with lesser sentences. You redirect the clients to another topic.
Other Contexts:    ully. Family History: Several clients report coming from a single-parent home, whereas others are from a two-parent home. All clients report that they have siblings. Several clients reported having parents that were or are involved in the justice system

Question: All of the following are helpful in drawing out a group member EXCEPT:
(A): Dyads
(B): Written activities
(C): Cognitive reframing
(D): Rounds

Correct Answer: Cognitive reframing
Explanation: Cognitive reframing might help manage anxiety in a group setting, but it does not specifically focus on encouraging participation and drawing out members. Written activities can be used to prompt responses and may be used in the context of rounds to promote the expectation that each member has a voice and is expected to provide a response. Dyads separate the members up into groups of two to discuss various topics and can ease some of the discomfort associated with larger group formats while promoting discussion in a smaller setting prior to returning to a group setting to report on what was discussed. Therefore, the correct answer is (B)
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: A treatment intervention that would not be beneficial is?
(A): Strengthening Carlos' positive support system, including his family
(B): Determining what Carlos gets out of being in a gang
(C): Collaborate with school to come up with an intervention plan
(D): Ending treatment if Carlos continues to be resistant

Correct Answer: Ending treatment if Carlos continues to be resistant
Explanation: A counselor will often come across resistant clients. Carlos has a history of abuse and neglect, and he appears to be using anger as a defense mechanism. He may be distrustful of authority but shows signs of wanting to belong or be accepted. Some clients may take longer to engage than others. One beneficial intervention is to pinpoint what Carlos' motivation is to be part of a gang and see if he can get that same result through a more positive outlet. Also, by building up Carlos' positive support system, this may decrease his involvement with negative influences. Carlos seems to be having the most difficulty in school. By collaborating with the school, a plan can be constructed that is more motivating for Carlos than punitive. Therefore, the correct answer is (C)
Competency: treatment planning
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.

Question: After potential clients are made aware that the group is available, what is the next step?
(A): Establish relationship parameters with group members
(B): Prepare to handle monopolizers in the group
(C): Discuss how to handle clients receiving individual/group with the same therapist
(D): Establish group norms

Correct Answer: Establish group norms
Explanation: Although the norms may change based on clients' makeup, it is important to create a rough blueprint for group norms so that counselors and clients will understand how the group operates. Therefore, the correct answer is (C)
Competency: professional practice and ethics
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: The client comes to the session reporting that he and his girlfriend attempted to have sex the past week, and he wrote down some thoughts he was having on his CBT thought log. The client and the clinician reviewed his thoughts and engaged in cognitive reframing to support him in creating new scripts to use when engaging in sex. The client also wrote down physical responses to anxiety that he was experiencing before and during sex that included muscle tension and increased heart rate

Question: All of the following are effective behavioral techniques used to reduce premature ejaculation EXCEPT:
(A): The use of antidepressants
(B): Pelvic floor exercises
(C): Focus on foreplay
(D): The use of condoms

Correct Answer: The use of antidepressants
Explanation: The use of antidepressants is not a behavioral approach that would affect premature ejaculation; rather, it is a medical approach that helps delay the time to ejaculation. Pelvic floor exercises affect the client’s ability to refrain from ejaculation and are an effective behavioral technique in delaying it. Foreplay in a sexual encounter can delay ejaculation and reduce anxiety prior to sexual intercourse. Condoms reduce sensitivity and can aid in delaying premature ejaculation. Therefore, the correct answer is (D)
Competency: treatment planning
Case Study
Patient Demographic: Initial Intake: Age: 58 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: The client reports that in the past six months she has lost 40 pounds, which leaves her looking thinner than seems appropriate for her 5’8” frame. Her hair is combed and neat, but looks thin and lacks a healthy shine. Her clothes, while clean, appear rumpled as if they have been slept in. She is cooperative and engaged, but moves slowly and pauses in her speech, causing you to wonder if she is lost in thought or if speaking is too painful. She reports she has difficulty falling asleep at night and never feels like she has any energy, though she does go to work each day.  She denies any suicidal thoughts but states she feels sad all the time and “can’t wait to see him again.” She admits she blames herself for not keeping him home that evening, which would have prevented his death.
Presenting Problem: You are a counselor in a private practice setting.  You receive a telephone call from an attorney that would like to refer their client, who is engaged in a civil suit, to you for counseling treatment. The attorney provides you with a detailed description of a traumatic event, death of her son, and expresses concerns about the client’s well-being. The attorney requests that you work with their client and be prepared to testify in court when the case goes to trial.
Other Contexts: Family History:
During the intake session, the client reports that her youngest son was killed in a car accident eighteen months ago, which was caused by an impaired driver.  Her son was the youngest of her five children and while she said she loves them all equally, she reported that her children have always said their youngest brother was her favorite.

Question: Based on your assessment, which of the following diagnoses is the most accurate for the client at this time?
(A): Post Traumatic Stress Disorder
(B): Adjustment Disorder
(C): Major Depressive Disorder
(D): Bereavement

Correct Answer: Major Depressive Disorder
Explanation: The client meets five or more criteria for a Major Depressive (MDD) diagnosis, including depressed mood most days in at least 2-week period; significant weight loss when not dieting; insomnia nearly every day; psychomotor retardation; loss of energy nearly every day; inappropriate guilt; symptoms cause clinical distress in social and occupational functioning; symptoms are not attributable to other medical condition. While the event was traumatic, the client is not exhibiting symptoms that fulfill criteria for a PTSD diagnosis, such as intrusion symptoms, prolonged distress at exposure to internal or external cues, or dissociative reactions. The client's symptoms do include bereavement symptoms, such as prolonged sadness, mourning behaviors, weight loss, rumination, and insomnia, but the severity and progression of symptoms are better reflected as MDD. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Client Age: 12 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Private Practice Type of Counseling: Individual Counseling Presenting Problem: Withdrawn and Avoidant Behavior Diagnosis: Undetermined
Mental Status Exam: Mental Status Exam: The client appears oriented to person, place, time, and situation. The client is dressed appropriately for the weather and appears to be maintaining appropriate hygiene. The client was withdrawn for most of the session but was able to open up slightly about what was going on with
Presenting Problem: You are a licensed therapist working in private practice. A 12-year-old female client comes into your office for the intake session and is accompanied by her parents. The client’s parents report that their daughter has been withdrawn and has refused to return to school for the past 6 school days. The client is avoiding eye contact with anyone and is slouching with her arms crossed. You try to engage the client in open questions to initiate the intake session with her, and she does not answer you or look at you. You ask her if privacy would make her more comfortable, and she nods, so you ask her parents if they would mind waiting in the lobby, and they agree. The client continues to refuse to talk about school, but she does engage in conversation with you about other topics.
Other Contexts: her. Family History: The client says that she has a good relationship with her parents. She says that they are encouraging and supportive of her. The client says that she has a younger brother who is 6 years old and an older brother who is 16 years old. The client states that she has a good group of friends and spends time with them regularly

Question: Which one of the following is an effective use of nonverbal attending?
(A): Minimize the use of hand gestures and head nods.
(B): Maintain an appropriate distance of approximately 4–8 feet.
(C): Lean back in your chair in order to seem less threatening or less dominant.
(D): Maintain eye contact to increase the closeness of the relationship because it demonstrates the desire to help.

Correct Answer: Maintain eye contact to increase the closeness of the relationship because it demonstrates the desire to help.
Explanation: Engaging with eye contact is an effective use of nonverbal attending because it demonstrates attention and interest, which supports the client in feeling comfortable. Leaning forward, using hand gestures, and nodding (vs leaning back and minimizing the use of gestures and head nods) all demonstrate warm attending behaviors that will also increase the client’s comfort. The most appropriate distance for personal conversation is 15–4 feet with approximately 3–4 feet being the most comfortable spacing for individuals. Therefore, the correct answer is (A)
Competency: counseling skills and interventions