ckmjx/CounselingBench huggingface dataset:
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: During the screening/intake for this group, which would be an advantageous step to take to ensure that group therapy is successful?
(A): Request that each member present a detailed autobiography
(B): Only hold individual screening appointments
(C): Suggest the members participate in a mindfulness exercise
(D): Encourage clients interview the group leaders about their experience and how they run groups

Correct Answer: Encourage clients interview the group leaders about their experience and how they run groups
Explanation: This empowers clients to become more active participants of their therapy experiences rather than just being passive interviewees. It sets a positive atmosphere for the group experience to come. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
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 modality of treatment that is person centered and focuses on helping the client through the stages of change is called?
(A): Aversion therapy
(B): Medicated assisted treatment
(C): Motivational interviewing
(D): Behavior therapy

Correct Answer: Motivational interviewing
Explanation: Motivational Interviewing uses unconditional positive regard and empathy to examine the client's motivation to change and helps them progress through the stages to get there. Medicated assisted treatment uses a combination of medication as well as counseling and behavioral therapies. Aversion therapy suppresses unwanted behaviors by associating it with a negative experience and behavior therapy focuses on modifying harmful behaviors associated with psychological distress. Therefore, the correct answer is (B)
Competency: treatment planning
Case Study
Patient Demographic: Client Age: 54 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Multiracial Relationship Status: Divorced Counseling Setting: Local Government Mental Health Agency Type of Counseling: Individual Presenting Problem: Opioid Use Diagnosis: Opioid Use Disorder, Severe (F11.20), Homelessness (Z59.0)
Mental Status Exam: Mental Status Exam: The client has not maintained hygiene, as evidenced by him not smelling clean and wearing clothes that are visibly dirty. He appears to have bilateral tremors in his hands. The client is oriented to person, place, situation, and time. The client appears malnourished because he is very thin and f
Presenting Problem: You are a mental health counselor working at a local government mental health agency, specializing in substance use counseling. An individual came in today to become a client for mental health case management and was encouraged to meet with a counselor to begin receiving therapy. The 54-year-old male client is currently living in a tent in the woods behind a local grocery store and reports that he lost his job a year ago following a divorce from his wife of 26 years. The client stated that about 3 years ago he had a back injury and following surgery was prescribed oxycodone. The client continued that he had difficulty stopping his use of the medication when the prescription ran out and connected with a friend to get fentanyl. He reports that he spends a lot of time on a street corner asking for money to get fentanyl and that he cannot seem to go a day without it. The client feels that he cannot sleep or function without the use of fentanyl and that this has affected his housing, marriage, employment, and social life. He acknowledges that fentanyl has negatively affected his life and that he is not sure if he wants to stop using it because he knows it would be hard to deal with life without it.
Other Contexts: rail. Family History: The client got divorced about 1 year ago. He states that his wife left him because he lost his job and because of his fentanyl use. The client has two children that are 18 and 22 years old. The client no longer has contact with his ex-wife or children. The client reports no known mental health history or substance use history in his family

Question: Which one of the following controlled substances is also an opioid?
(A): Heroin
(B): Cocaine
(C): Marijuana
(D): LSD

Correct Answer: Heroin
Explanation: Heroin is an opioid along with morphine, fentanyl, Oxycontin, oxycodone, and many more. Opioids are very effective in treating intense pain but are easily abused due to their effects. Cocaine is a stimulant, and stimulants increase the activity of the central nervous system. Marijuana is a psychoactive drug because it affects the functioning of the nervous system by altering consciousness, mood, perception, behavior, and cognition. LSD is a hallucinogenic drug that affects consciousness, thoughts, and emotions and oftentimes causes hallucinations and distortions in perception. Therefore, the correct answer is (C)
Competency: professional practice and ethics
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: Which of the following information is critical to gather prior to determining the treatment plan?
(A): What client has been doing to manage her symptoms to date
(B): All of the above
(C): Previous experiences with death and loss
(D): How client is functioning at work

Correct Answer: All of the above
Explanation: Knowing how the client has handled loss in the past, how she is functioning in the professional realm, and what she is doing to manage her symptoms assesses resilience, coping skills, and level of functioning. Many of the client's symptoms could be caused by medical reasons which need to be ruled out. The appropriateness of the court case has not been identified by the client as a counseling concern. Therefore, the correct answer is (D)
Competency: treatment planning
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’s girlfriend comes to the session to give input about what she experiences when they have sex. The client started by saying he wanted to share his self-talk from the thought log. The client’s girlfriend denies any of the thoughts he thinks that she is having. You encourage the client to use her response as evidence for reframing his self-talk when he is nervous during sex. The client states, “the fact that she even has to say that means that I am inadequate.” The client’s girlfriend says she can tell that he is tense and “in his head” when they are having sex. She also notes that he appears sad after sex and often isolates himself for a while afterward. She also identifies that she feels tense when she notices that he is tense and that this makes her less likely to initiate sex. You empathize with the couple and provide psychoeducation regarding positive communication surrounding sex.  During this session, you identify that the client’s girlfriend does not send any signals that sex is not pleasurable

Question: During this session, you identify that the client’s girlfriend does not send any signals that sex is not pleasurable. Which of the following terms defines the use of focusing on the information available to manage thoughts and feelings?
(A): Mindfulness
(B): Relaxation skills
(C): Cognitive challenging
(D): Cognitive reframing

Correct Answer: Mindfulness
Explanation: Mindfulness is focusing on the present situation, which would be helpful in conjunction with using evidence to counteract cognitive distortions. Cognitive reframing and challenging are helpful techniques in managing cognitive distortions, but they do not directly focus on present evidence for beliefs. Relaxation skills are helpful, but they do not focus on cognitive functions. Therefore, the correct answer is (A)
Competency: counseling skills and interventions
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: The best approach for the counselor to take considering Molly's disposition is?
(A): Tell Molly she knows how she feels because she lost her dad around the same age
(B): Remind Molly that if she doesn't participate the car will be forfeited
(C): Address questions only to Molly's mother
(D): Ask more open-ended questions to allow Molly to expand on her answers

Correct Answer: Ask more open-ended questions to allow Molly to expand on her answers
Explanation: Asking open ended questions allows Molly to expand on her responses and leads to deeper conversations. Rapport building is key in an initial session. Although the car is what persuaded Molly to come in the first place, it would not wise for the counselor to bring this up as a way to force her to participate. It is best for the client to participate on their own terms especially as Molly seemed hesitant and possible distrustful of her counselor. If the counselor were to stop speaking to Molly altogether and only to her mother, this would hinder the engagement process as Molly was initially showing resistance. The counselor should acknowledge Molly and allow her opportunities to participate at her own pace. Finally, though self-disclosure can be beneficial, it is usually a purposeful intervention. This type of self-disclosure can be interpreted as minimizing the other person's feelings. Therefore, the correct answer is (B)
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: How should the counselor respond to Li's description of her situation?
(A): "That sounds like a tough job."
(B): "You should not be treated this way."
(C): "How was it like in your homeland?"
(D): "This happens all the time."

Correct Answer: "You should not be treated this way."
Explanation: Li is in an exploitive situation, and it must be addressed that this is not safe or appropriate. Choices a and b minimize what Li is experiencing and disregards her safety and well-being. Choice c is assuming that Li had a worse experience where she came from and also minimizes what she is currently going through. Therefore, the correct answer is (D)
Competency: professional practice and ethics
Case Study
Patient Demographic: Initial Intake: Age: 18 Sex: Female        Gender: Female Sexuality:  Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Community Residence Type of Counseling: Individual
Mental Status Exam: Nadia was initially resistant to the interview. She stated that she had been seeing counselors her whole life and none of them ever helped. Nadia had limited insight regarding her risk-taking behaviors. The counselor assessed that Nadia’s cognitive functioning appeared low. She stated that although she had contemplated suicide in the past, she currently had no intention or plan.

Presenting Problem: Nadia is an 18-year-old in a community residence for children in foster care. She was referred for counseling because she has been running away from the group home, often for days at a time. Currently she is not getting along with her peers and gets into fights when they make comments about her activities, which is starting to affect everyone in the house.

History:
Nadia is one of 10 children by her birth parents. She has an extensive history of abuse and sexual exploitation by her parents until the age of 14 when she was removed from her parent’s care. Her and her siblings were sent to various foster homes as they could not all stay together. This is a subject that Nadia does not like to talk about since she was the oldest and had the responsibility to care for the younger ones. She feels as if she let them down. Nadia is frequently truant from school. For the past 4 years Nadia was in and out of foster homes due to her risk-taking behaviors and disrespect for others. She does have a good relationship with two staff members in the group home.

Question: Which of the following factors should be considered in an assessment in addition to a client's record?
(A): Biases
(B): All of the above
(C): Influence of professional orientation
(D): Trust and rapport

Correct Answer: All of the above
Explanation: Although the client's record can provide a wealth of information, it should be reviewed in conjunction with interviews of client, family and collateral sources, as well as recent tests, evaluations or assessments. A counselor should also consider his/her professional orientation and how it may influence case conceptualization. It is also important to evaluate the trust and rapport in the relationship to understand whether there is possibly information that has been withheld. A counselor should also be aware of his/her biases in order to reflect upon those and how they may influence the assessment process. Therefore, the correct answer is (D)
Competency: treatment planning
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: Molly requested that the counselor not tell her mother about the consideration of cutting. The counselor should?
(A): Call 911 to have Molly assessed for suicide risk
(B): Immediately call mom in the room because it is a safety risk
(C): Tell Molly not to worry, she will not tell her mom what is disclosed in session
(D): Provide psychoeducation to Molly regarding self-harm

Correct Answer: Provide psychoeducation to Molly regarding self-harm
Explanation: Currently Molly is not at immediate risk of suicide. Self-harm is not necessarily an indication of suicide risk. Typically, cutting provides a release of built-up emotions and is not an indication of suicidal ideation. The best route is to provide Molly with facts about cutting. Telling her mom would also cause mistrust in the therapeutic relationship and Molly may not be honest in future sessions. During the informed consent process, confidentiality should be discussed. Although the therapist maintains confidentiality, there are exceptions to this. During the intake, the counselor must review confidentiality, the limits to confidentiality and the fact that they are a mandated reporter. Therefore, the correct answer is (C)
Competency: professional practice and ethics