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: A possible treatment which involves repeated contact to the stimuli associated with the negative events is called?
(A): Confrontation
(B): Intermittent reinforcement
(C): Conditioning
(D): Direct therapeutic exposure

Correct Answer: Direct therapeutic exposure
Explanation: Direct therapeutic exposure has been proven effective for those diagnosed with PTSD. By real life or imagined exposure of the feared stimuli, skills like relaxation training are taught to help control client's reactions. Intermittent reinforcement and conditioning are used to reward behavior and would not be warranted here. Confrontation is a therapeutic technique that happens within the client when they are taking a realistic look at their actions or patterns. Therefore, the correct answer is (B)
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: All of the below can be used to screen for developmental status, EXCEPT?
(A): ASQ
(B): WISC
(C): SWYC
(D): PEDS

Correct Answer: WISC
Explanation: The Wechsler Intelligence Scale for Children (WISC-V) is an intelligence test that measures a child's intellectual ability and five cognitive domains that impact performance. The Parent Evaluation Developmental Screening (PEDS) is a parent report screening tool which helps to identify disabilities in areas of learning, language, mental health and other areas. The Ages and Stages Questionnaire (ASQ) is a developmental and social-emotional screening tool. The Survey for Well Being in Young Children (SWYC) is a screening tool used for children under the age of 55 which helps to identify risk in development/behavioral issues. Therefore, the correct answer is (C)
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: The counselor's targeting of Autumn's distortions about eating and body image is an example of?
(A): Gestalt Therapy
(B): Humanistic Therapy
(C): Cognitive Behavioral Therapy
(D): Feminist Therapy

Correct Answer: Cognitive Behavioral Therapy
Explanation: One of the methods of cognitive behavioral therapy is to detect irrational beliefs and understand how they affect behavior. One of the goals of CBT is to restructure or change the client's self-talk. CBT has been proven to be an effective treatment for individuals diagnosed with an eating disorder. Feminist therapy focuses on gender specific issue derived from power inequities and social systems. Gestalt therapy is a more experiential approach where the counselor can be very directive and sometimes confrontational. Humanistic therapy is nondirective and is not the best modality of treatment for what Autumn is experiencing as she needs more directive, short term interventions. Therefore, the correct answer is (A)
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: Destiny is not displaying symptoms for the following diagnosis?
(A): Separation anxiety disorder
(B): Intellectual disability (Intellectual developmental disorder)
(C): Reactive attachment disorder
(D): Autism spectrum disorder

Correct Answer: Separation anxiety disorder
Explanation: Destiny is not displaying symptoms of Separation Anxiety Disorder as that is characterized by excessive fear and anxiety concerning separation from whom the individual is attached. From the information given, Destiny may be showing signs of autism spectrum disorder in the lack of interest in playing with other children and mood fluctuations. Cognitive delays and poor social and emotional skills can be symptoms of intellectual disability. These symptoms can also be a sign of reactive attachment disorder. Therefore, the correct answer is (D)
Competency: treatment planning
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: At the initial intake, the counselor should first?
(A): Choose an appropriate treatment intervention
(B): Assess if further testing/assessment is needed
(C): Gather clinical report and school evaluations
(D): Conduct a clinical interview including mental status exam

Correct Answer: Conduct a clinical interview including mental status exam
Explanation: The first step would be to conduct a clinical interview including a mental status exam so the counselor can gain relevant background information and assess if Carlos is a safety risk to himself or others. This would help also to determine if further testing and assessments are warranted. Although the counselor is aware of some symptoms, treatment interventions should not be chosen without a better understanding of the client's history, severity of symptoms and any pertinent information from other sources. Any past clinical reports and/or school evaluations should be collected at this time. Therefore, the correct answer is (A)
Competency: counseling skills and interventions
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: An attribute the counselor is displaying is?
(A): Attentiveness
(B): Observation
(C): Empathy
(D): Genuineness

Correct Answer: Empathy
Explanation: Empathy is a counselor attribute in which the counselor puts themselves in the client's shoes to try to understand the issues within the client's world view and cultural values. Attentiveness is being able to focus on the client and what they are saying in the present moment. Genuineness refers to the ability of the counselor to be their authentic self in session and not put on a façade. Observation is the ability for the counselor to pick up on nuances in the counseling session such as non-verbal communication. Therefore, the correct answer is (C)
Competency: counseling skills and interventions
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: Elaina is showing symptoms indicating a diagnosis of?
(A): Unspecified Bipolar and Related Disorder
(B): Cyclothymic Disorder
(C): Bipolar I
(D): Bipolar II

Correct Answer: Bipolar I
Explanation: Elaina is showing symptoms consistent with Bipolar I Disorder as evidenced by at least one lifetime Manic episode. Although Elaina also shows symptoms of Major Depressive Disorder, this is not required for a diagnosis of bipolar disorder. Bipolar II is characterized by hypomania episodes (lasting only a few days) as opposed to mania episodes which last over a week. From what Elaina has shared, her episodes lasted more than a few days. Since Elaina has met the criteria for a depressive and manic episode, both Cyclothymic and Unspecified bipolar and Related Disorder are ruled out. 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 is an appropriate response for the counselor?
(A): Why would you get into a fight like that?
(B): Tell me what happened and we can see how to get through this.
(C): Do you want to talk about what happened?
(D): Well, this isn't like you at all!

Correct Answer: Tell me what happened and we can see how to get through this.
Explanation: This choice is the best response as it is an open-ended question with a statement that indicates hope. Choices a and b may cause feelings of defensiveness or guilt. Choice d is a closed question as the only response is "yes" or "no". Michael is already upset and can simply say no, that he does not want to talk about what happened. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
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: Ineffective treatments of generalized anxiety disorder include?
(A): Journaling
(B): Psychoeducation
(C): Benzodiazepine
(D): Stimulants

Correct Answer: Stimulants
Explanation: Stimulants would not be effective in treating someone with generalized anxiety disorder. Benzodiazepine can be used for tension relief and relaxation. Psychoeducation on symptoms and effective treatments can be helpful. Journaling can also be helpful as an outlet for anxious thoughts. Therefore, the correct answer is (D)
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: How should the counselor proceed?
(A): Tell Darrel he may need more than vocational counseling
(B): Offer Darrel a vocational assessment
(C): Ask Darrel if he has been feeling depressed
(D): Ask open ended questions while trying to gain trust

Correct Answer: Ask open ended questions while trying to gain trust
Explanation: Although Daniel came into the counseling center for vocation counseling, it seems like there may be more going on than the need for a vocational assessment. However, the counselor does not know how Daniel feels about therapy, so it is best to try to gain more information while gaining Darrel's trust. Although Darrel may need a vocational assessment, the information doesn't necessarily suggest that and ethically, assessments should only be given if needed. The counselor should not immediately tell Daniel that he may need more than vocational counselor or ask him if he is feeling depressed, as these may be off-putting to Darrel, and he may end the session altogether. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis