ckmjx/CounselingBench huggingface dataset:
Case Study
Patient Demographic: Client Age: Client 1: Age 18 Client 2: Age 21 Client 3: Age 22 Client 4: Age 19 Client 5: Age 18 Sex: Male and female Gender: Male and female Sexuality: Heterosexual Ethnicity: Multiracial Relationship Status: All members are single Counseling Setting: Counseling clinicType of Counseling: Group and individual counseling Presenting Problem: All individuals are seeking support for struggles related to borderline personality disorder. Diagnosis: Borderline personality disorder (F60.3)
Mental Status Exam: Mental Status Exam: All clients appear to be oriented to time, situation, location, and person. The clients are all dressed appropriately for the weather. No clients appear to experience any visual or auditory hallucinations. Most of the clients are presenting as friendly but gua
Presenting Problem: You are a licensed therapist running a dialectical behavior therapy (DBT) group for young adults. You also provide a weekly individual counseling session for each group member, which is common practice for DBT group therapy. During the first session, you provide psychoeducation on DBT and the group process. Most of the members seem closed off and sometimes aggressive in response to being asked to speak during the first session, which can be consistent with borderline personality disorder. Client 3 becomes upset about halfway through the session, stating that he does not need to participate because the group will eventually end, so he does not need to build relationships with the group members. You end the session by planning individual therapy sessions with each group member.
Other Contexts: rded. Family History: Most of the clients report distressed relationships with their parents or guardians and that they have not had stable relationships throughout their lives

Question: Which of the following would be an appropriate short-term goal for the first month of the weekly therapy sessions?
(A): Identify the ways in which borderline personality disorder affects the individuals’ relationships.
(B): Reduce client urges to engage in self-harming behavior.
(C): Improve the relationship quality with people of importance to the individuals.
(D): Improve communication skills with people of importance to the individuals.

Correct Answer: Identify the ways in which borderline personality disorder affects the individuals’ relationships.
Explanation: The first step will be assisting the clients with acknowledging that they have borderline personality disorder and understanding how it affects their life because this diagnosis can be difficult for an individual to accept. Improving relationship quality, reducing urges to self-harm, and improving communication will likely take more than a month to initiate and achieve. These goals will require you to first establish a secure relationship with the group, in order for them to feel comfortable enough to explore the required complexities of their condition and its impact on relationships and feelings toward themselves. Therefore, the correct answer is (A)
Competency: treatment planning
Case Study
Patient Demographic: Initial Intake: Age: 22 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: African American Relationship Status: In a long-term relationship Counseling Setting: Adult inpatient psychiatric Type of Counseling: Individual
Mental Status Exam: Mark was unable to complete a mental status exam as he was not speaking coherently and was displaying violent behavior towards hospital staff. The ER nurse interviewed Mark’s girlfriend, Erin.
Presenting Problem: Mark came into ER after his girlfriend Erin called 911 when Mark attacked someone on the bus.
 
History:
Erin told the ER nurse that Mark has been displaying increasingly irrational behaviors. Erin shared that Mark recently took a trip to Africa. Since then, Mark told Erin that he was hearing the voice of God, telling him that it was his responsibility to rid the world of evil. At first Erin noticed Mark staying up late at night, writing all his thoughts in a journal. When Erin read the journal, the content was incoherent. Erin also shared that Mark was recently put on probation at work for going into the women’s restroom. Mark told his boss that God told him to keep an eye on one of his coworkers.

Question: Possible short-term goals may include?
(A): Engage in family counseling with father
(B): Identify stressors which precipitated event
(C): Taking antipsychotic medication on his own without reminders
(D): Implement an effective crisis plan

Correct Answer: Identify stressors which precipitated event
Explanation: Short term goals are important because they are usually attainable and can build confidence in completing long term goals. A short-term goal may be for Mark to identify stressors that happen prior to an event. Mark may have difficulty taking medication on his own, without reminders, so this may be a long-term goal. Also, before implementing an effective treatment plan, the plan must be created first. Marc's father reaching out to him was a contributing factor to the stress Mark was facing prior to his first psychotic episode. Since Mark's father seems to be a trigger for him, this would be a long-term goal, if it is a priority for Mark. Therefore, the correct answer is (B)
Competency: treatment planning
Case Study
Patient Demographic: Client Age: 25 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Counseling Clinic Type of Counseling: Individual Presenting Problem: Depression and Suicidal Ideation Diagnosis: Major Depressive Disorder, Recurrent, Mild (F33.0)
Mental Status Exam: Mental Status Exam: The client appears to not have bathed recently because his hair is greasy and unkempt. The client has food stains on his clothing; however, he is dressed appropriately for the season. His motor movements are within normal limits. He is engaged in therapy, but he appears anxious as evidenced by hesitating before speaking and by his hand wringing. The client reports suicidal ideation with no plan or intent. The client reports a depressed mood more often than not and difficulty enjoying most activities. The client is oriented to person, place, time, and situation. The client reports that his appetite has increased lately and that he is experiencing hyperso
Presenting Problem: You are a resident in counseling practicing in a private practice agency. During the initial counseling session, the 25-year-old single male client reports feeling depressed and hopeless. He has difficulty enjoying activities that he has enjoyed in the past and feels unsatisfied with most areas of his life. The client identifies that he is not happy at work and wants to make a career change. The client verbalizes feeling sad more often than not, and that this has been going on for about 2 years. The client decided to start counseling when he began experiencing suicidal thoughts. The client reports no plan or intent to attempt suicide but is concerned about his own well-being.
Other Contexts: The client contacted you to reschedule a session sooner than the one you had originally scheduled. The client reported that he continues to have difficulty getting to work on time and was told that he needs to meet with his supervisor on Friday. The client expresses anxiety surrounding this because he worries about getting fired. The client began to cry during the session when talking about worry regarding being unemployed. The client came to the session in clothes that had stains on them, and his hair was messy and appeared greasy

Question: Which assessment would be helpful in monitoring progress in this client’s management of depressive symptoms?
(A): Five Facet Mindfulness Questionnaire
(B): Minnesota-Multiphasic Personality Inventory-2
(C): Patient Health Questionnaire-9
(D): Pittsburgh Sleep Quality Index

Correct Answer: Patient Health Questionnaire-9
Explanation: Focusing on mindfulness and sleep will be important in treatment; however, the Patient Health Questionnaire-9 is helpful in monitoring ongoing progress in depression symptoms and their effects on functioning. The Minnesota-Multiphasic Personality Inventory-2 is used to assess the client’s mental state or the presence of psychiatric illness, and it does not specifically measure depressive symptoms or their effects on functioning. Therefore, the correct answer is (A)
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: To be culturally sensitve, the counselor should not?
(A): Role play conversations with his boss
(B): Provide psychoeducation on his symptoms and developmental stage
(C): Encourage autonomy from his parents
(D): Encourage the practice of hobbies and interests

Correct Answer: Encourage autonomy from his parents
Explanation: Although Darrel is at the stage where he is developing autonomy from his parents, it is important for the counselor to remember that traditional Chinese families emphasize obedience of parental wishes. It may be more beneficial to provide Darrel with psychoeducation about possible dissonance with his culture and feelings of autonomy at his developmental stage. Darrel is also hesitant about speaking to his boss about changing his hours. The counselor can role play the conversation to help Darrel become more comfortable. Darrel mentioned his desire to return to the hobbies he used to enjoy doing. Helping Darrel find ways to reincorporate these things in his life would be beneficial as a coping mechanism. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake:   Age: 35 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Employee Assistance Program Type of Counseling: Individual
Mental Status Exam: Harold comes into the office, visibly upset, stating, “I really don’t know why I am here, but I am sure you will see that too after some time together. And I am sure that anything I say here- you can’t report it to anyone anyway, right?” Harold did not display any self-awareness of his actions when speaking to the counselor. At times he showed defensiveness and irritability and other times he was making jokes and complimenting the counselor.
Presenting Problem: Harold, an accounting executive, was referred for counseling by his supervisor after Human Resources received several complaints about Harold’s attitude towards others.
 
History:
Harold has been successful in his career and is knowledgeable in his field. However, he stated that he is often not well liked. Harold attributes this to people being envious of him. Harold told the counselor that recently he was called to human resources because of complaints from his peers. Complaints included allegations of rude remarks, bullying, and Harold taking credit for work that others did. One coworker stated that Harold took frequent breaks and suspected he may be using drugs.

Question: Despite the counselor's prior feelings, he can put this aside and try to put himself in Harold's shoes to better understand his perspective. This is called?
(A): Congruence
(B): Empathy
(C): Genuineness
(D): Self-awareness

Correct Answer: Empathy
Explanation: Empathy is the ability for someone to put themselves in the shoes of another and is a critical quality for a counselor to have. Although the counselor is not familiar with the issues Harold is presenting, by being empathetic he can gain a deeper understanding. Congruence occurs when a counselor gives feedback to a client in a genuine manner. For the counselor to be genuine, he/she must be sincere in their statements and not be pretentious. Self-awareness of a counselor is important but is not accomplished by the counselor putting himself in Harold's shoes. Therefore, the correct answer is (B)
Competency: core counseling attributes
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: Carlos is displaying symptoms indicative of all the following, except?
(A): Adjustment Disorder
(B): Unspecified Disruptive, Impulse Control and Conduct Disorder
(C): Intermittent Explosive Disorder
(D): Conduct Disorder

Correct Answer: Adjustment Disorder
Explanation: Carlos does not meet the criteria for adjustment disorder. Although symptoms started after a significant event (his parents' divorce), symptoms remain six months after the termination of the stressor or its consequences. Adjustment disorder is ruled out since he meets the criteria for conduct disorder. Intermittent explosive disorder does show high rates for aggression; however, this is often impulsive and not premeditated. Unspecified, Disruptive, Impulse Control and Conduct Disorder is only diagnosed when someone does not fully meet criteria for all other disorders. 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: What information should be gathered first to rule out medical complications?
(A): Family history
(B): Health information
(C): School progress and achievement
(D): Supportive relationships

Correct Answer: Health information
Explanation: It is always important to first rule out any health complications such as gastrointestinal diseases or hypothyroidism to account for Autumn's weight loss. After ruling out a medical issue, a thorough assessment should also include family history of disorders, as genetic loading may be risk factors. Since Autumn is falling asleep in class, it may be helpful to know her progress and achievement before and after symptoms occurred. Obtaining information on her support system is important as well to see if this is something that should be built up. Therefore, the correct answer is (A)
Competency: professional practice and ethics
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: An appropriate counselor response to Michael's description of his situation in the second session would be?
(A): "It shouldn't matter to you what they think"
(B): "That must be difficult for you, what can we do?"
(C): "Don't worry, I am sure they are not staring at you."
(D): "Who do you think can help with that?"

Correct Answer: "That must be difficult for you, what can we do?"
Explanation: Option C would be the most appropriate response at it acknowledges Michael's feelings and then presents a prompt to begin to problem solve. Option A may not be true. Option B is dismissive of Michael's feelings. It is developmentally appropriate for Michael to worry about what his peers think. Therefore, the correct answer is (C)
Competency: treatment planning
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: According to Racial Identity Development, Darrel is in the stage of?
(A): Integrative awareness
(B): Emersion
(C): Dissonance
(D): Introspection

Correct Answer: Dissonance
Explanation: Darrel is in the Dissonance stage of Racial Identity development which is characterized by confusion and conflict both in positive and negative feelings about the majority race and one's own minority race. The emersion stage is characterized by active rejection of the dominant society. Introspection occurs when there is conflict between the previous rejection of the dominant society, loyalty, and autonomy. Integrative awareness occurs when a person can maintain a sense of satisfaction with their cultural identity and also have a multicultural perspective. Therefore, the correct answer is (B)
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: A possible diagnosis includes all the following, except?
(A): Abnormal movements due to a medical condition
(B): Paroxysmal Dyskinesias
(C): Tic disorders
(D): Autism

Correct Answer: Autism
Explanation: Although individuals diagnosed with autism may show repetitive movement, they often do not have. Tic disorders are characterized by the presence of motor and/or vocal tics absent of any known cause such as a medical condition or substance abuse. Paroxysmal Dyskinesias are involuntary movements usually following normal motor activity, said to be caused by exertion, stress of fatigue. It is possible that the voluntary movements Michael is experiencing may be a result from a medical condition. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis