ckmjx/CounselingBench huggingface dataset:
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: The attorney also asks that you provide regular updates on the client, which will be used in preparing for the trial. How should the counselor respond to the attorney's request?
(A): State that regular summaries can be provided since the client was referred by her attorney.
(B): State that the attorney will need to provide a release of information signed by the attorney as well as a letter stating that the client has retained the attorney for litigation.
(C): State that the attorney will need to provide a release of information signed by the client.
(D): State that regular summaries can be provided to the attorney because the client is involved in litigation and represented by the referring attorney.

Correct Answer: State that the attorney will need to provide a release of information signed by the client.
Explanation: Counselors disclose information for non-mandated clients only with appropriate, written consent from the client or their legal guardians, in the case of minors or incapacitated clients. Representing a client's interests in court is not equivalent to a court-order and only the client may provide release of information. Therefore, the correct answer is (D)
Competency: professional practice and ethics
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: Prior to the next counseling session, the therapist felt weary about seeing Harold again. Upon reflection, the counselor realized that Harold reminded him of a past coworker who did not treat the counselor well. The best thing for the counselor to do in this situation is?
(A): Speak to Harold about the issue
(B): Terminate with Harold
(C): Ignore the issue
(D): Speak to his supervisor about the issue

Correct Answer: Speak to his supervisor about the issue
Explanation: Countertransference occurs when the client brings up feelings in the therapist that have nothing to do with the client themselves but has to do with something within the therapist. In this instance it would be best for the counselor to speak to his/her supervisor to process what is occurring. Countertransference is a common occurrence, and it is not necessary for the counselor to terminate with Howard currently. Speaking to Harold about the issue would be inappropriate as the cause of the discomfort has nothing to do with what Harold has done and that would make the session about the counselor and not Harold. Ignoring the issue can result in negative consequences and would affect the quality of care Harold receives. Therefore, the correct answer is (B)
Competency: professional practice and ethics
Case Study
Patient Demographic: Initial Intake:   Age: 19 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: African American Relationship Status: Single Counseling Setting: Group home run by the Office of Children and Family Services Type of Counseling: Individual
Mental Status Exam: Elaina has little insight into her behaviors and is currently involved in an abusive relationship. Staff members are concerned for her safety, as well at the safety of her child. She is not functioning well socially or academically.
Presenting Problem: Elaina is a 19-year-old female who is living in a residence for pregnant teens in foster care. She has been displaying risk taking behaviors such as running away and fighting.
 
History:
Elaina has an extensive history of abuse and neglect. She entered foster care at the age of 5 when her mother was incarcerated for prostitution and drugs. Since then, she has been in and out of foster care homes and had several failed trial discharges back to her mother’s care. Elaina ran away from her foster homes multiple times. Another trial discharge date is set for the near future, after the baby is born.
 
Elaina never finished high school. She had difficulty focusing on her classes and was often teased because the other children knew that she was in foster care. Elaina would frequently get into fights, resulting in suspensions. She has a tumultuous relationship with the father of her child, and she recently told her case planner that he sometimes hits her.
 
Elaina walked into the counselor’s office, sighed, and stated, “Great- someone new- I have to tell my story again?”
 
The counselor responded “It sounds like you have told your story many times. I can imagine how that feels for you.”
 
Elaina stated, “It is very frustrating and annoying.” To which the counselor responded, “I like to hear from clients, their history in their own words as opposed to reading it on paper. When we make your goals, I would like you to be involved as well.”
 
Elaina visibly relaxed and began to tell the counselor about her history and current challenges. Elaina agreed to think about what she wanted her goals to be and agreed to discuss it next session.

Question: The counselor was able to get Elaina to relax by?
(A): Defending the therapeutic process
(B): Challenging the client
(C): Establishing rapport
(D): Establishing trust

Correct Answer: Establishing rapport
Explanation: Rapport building is one of the first stages of the therapeutic process. Rapport is built when there is a positive feeling between counselor and client, there is a mutual understanding and positive communication. Challenging the client and defending the therapeutic process would not be advisable as way to put a client, who is frustrated, at ease. It is too early in the therapeutic process to have established trust. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
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: According to the Corey and Corey stages of group therapy model, what stage is this group currently in, and what stage might they move to next?
(A): The group is experiencing anxiety and some members are having difficulty establishing trust with others.They are currently in the transition phase, not the initial phase. During the initial phase, the group members are getting acquainted with each other and establishing groups rules and norms.
(B): Transition; Working
(C): Initial; Transition
(D): Working; Final

Correct Answer: Transition; Working
Explanation: The group is experiencing anxiety and some members are having difficulty establishing trust with others. During the transition stage, group members may experience anxiety, difficulty establishing trust with other group members and the group leader, and defensiveness. There may be conflicts between members and problem behaviors may become evident. The issues that have cropped up during the transition phase must be dealt with in order for the group to successfully navigate to the working stage. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
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: Treatment of eating disorders include which of the following?
(A): Both a and b
(B): Teach coping skills to target anxiety of eating in front of others
(C): Address addiction issues
(D): Provide psychoeducation on the effect of social media on body image

Correct Answer: Both a and b
Explanation: One of the main causes of eating disorders is the unrealistic portrayal of body images on social media. By providing psychoeducation about what a normal body looks like as well as how common eating disorders are, this may help Autumn realize that she is not alone. Teaching Autumn effective coping skills to manage her anxiety may allow her to feel more comfortable eating in front of others and allowing her to be part of the social setting of her cafeteria. There are no addiction issues indicated. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
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: Which of the following would be an inappropriate intervention at this time?
(A): Assisting Kathleen and Tony in communicating to each other without blaming either
(B): Providing psychoeducation on Tony's diagnosis
(C): Focusing on trying to change Tony's behavior
(D): Exploring Tony and Kathleen's support system

Correct Answer: Focusing on trying to change Tony's behavior
Explanation: Interventions in couples counseling should focus on the couple, aligning with the counseling modality. By assisting Kathleen and Tony in communicating in a more efficient manner, they can see each other's perspectives without becoming defensive. An example of this would be the use of "I" statements. By providing both with psychoeducation on Tony's diagnosis they can both have a common understanding and address misconceptions. By building up their natural supports, Tony and Kathleen will develop a support system which can continue when therapy ends. Therefore, the correct answer is (A)
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: When a counselor encounters clinical issues that he is not familiar with, he should?
(A): Hope for the best
(B): Conduct internet research
(C): Refer out to another therapist
(D): Consult with supervisor/colleagues

Correct Answer: Consult with supervisor/colleagues
Explanation: It is not uncommon for counselors to encounter clinical issues that they are not familiar with. Other licensed clinicians, especially one's supervisor can help to inform/train counselors. Referral out should only be chosen if it is determined that the counselor does not have the capacity to work with the client and shouldn't be a first option. Being hopeful that positive changes can occur is an important trait for a counselor, but they should not just hope that they will gain the knowledge they need. This would be to the detriment to the client. Only professional or peer reviewed research should be conducted in this situation. Therefore, the correct answer is (C)
Competency: professional practice and ethics
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: An appropriate response from the counselor to Li's situation would be?
(A): How much can you pay?
(B): We must use your name for our records.
(C): We can use a pseudo name if that is what you are most comfortable with.
(D): Don't worry, if we use your real name, nothing will happen.

Correct Answer: We can use a pseudo name if that is what you are most comfortable with.
Explanation: There may be times when a client may not want to use their real name. If they are not paying through insurance, this should be accommodated. A client should not be forced to use their legal name. In this instance the client is concerned because they are not documented. It would be misleading to tell client to not worry and that nothing would happen to them. Asking about payment is not addressing the client's question and is insensitive to what the client is expressing. Therefore, the correct answer is (C)
Competency: counseling skills and interventions
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: What historical data is important to gather currently?
(A): Early family history
(B): Immunization records
(C): Seasonal mood patterns
(D): Quality of Darlene and Tony's relationship

Correct Answer: Early family history
Explanation: Destiny's early family history may fill in some important pieces of information such as attachment with early caregiving figures. Although health information is needed, immunization records are not needed. There are no patterns to Destiny's behaviors so there is no need to track seasonal mood patterns. Currently, there is no information to suggest that Darlene and Tony are having conflict. If there was some indication, it would important information to review as Destiny has lost parental figures in the past. Therefore, the correct answer is (A)
Competency: professional practice and ethics