ckmjx/CounselingBench huggingface dataset:
Case Study
Patient Demographic:  Initial Intake:   Age: 82 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Widowed Counseling Setting: Community Clinic Type of Counseling: Individual
Mental Status Exam: Theodore is tearful most days and has dropped a significant amount of weight. He has not been sleeping and stays up watching videos of his deceased wife.
Presenting Problem: Theodore is an 82-year-old who was referred for grief counseling by his son, Nate. Theodore’s wife, Nancy died one month ago after a 4-year battle with cancer.

History:
Theodore was the primary caretaker for Nancy and has not paid attention to his own health in years. Nate would like his father to move in with him and his family and sell the house his parents lived in to pay off their debt. However, Theodore refuses to sell the house and stated that he will not give away or sell anything that they owned. Nate drove Theodore to the initial session and sat in for the intake, with Theodore’s consent.
 
Once everyone sat down, Theodore looked at the counselor and stated, “I am only here so my son stops bugging me about selling the house. I am not getting rid of anything in that house- and especially not the house itself!” Nate explained that his father cannot maintain the house on his own and is worried about him being lonely. Theodore insists that he has other options and thinks that living with Nate would put a burden on him.

Question: The counselor recently lost her father, so she feels sad to hear about Theodore's loss. She has a sudden urge to buy Theodore some groceries, so he has food at home. This is an example of?
(A): Countertransference
(B): Empathy
(C): Case management
(D): Transference

Correct Answer: Countertransference
Explanation: Countertransference occurs when something in the therapeutic relationship brings up feelings for the counselor due to unresolved needs or personal conflicts. If the counselor recently lost her father and has a need to do something outside of her role, this is an example of countertransference. It is important for the counselor to recognize this and bring this to a colleague or supervisor. It would not be appropriate to work this out in the client's session. Transference occurs when the client projects their feelings, desires and drives onto the counselor. Case management is a service in which a client is set up with resources. An example of Case Management would be referring Theodore to a pantry or helping him to apply for food stamps. Empathy is an important skill to have as a counselor. It allows the counselor to put themselves in the shoes of their clients. Although the counselor may be feeling empathy, this is an example of the counselor's urge to attend to her own needs, not the needs of the client. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
Case Study
Patient Demographic: Initial Intake: Age: 12 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Hispanic Relationship Status: Single Counseling Setting: Outpatient Clinic       Type of Counseling: Individual
Mental Status Exam: Carlos came to the intake with his mother, Claudia. Claudia did most of the talking during the intake while Carlos sat in his chair, slumped down low and avoiding eye contact.
Presenting Problem: Carlos is a 12-year-old male referred to an outpatient community clinic by the court after he was caught breaking into several cars on his block.
 
History:
Claudia reported that she and Carlos’ father separated two years ago. Since then, Carlos has had frequent suspensions in school for bullying others and fighting. Carlos often threatens students on social media prior to the altercations. Claudia reported that she no longer knows what to do anymore and she hoped that the counselor can fix him or at least report to her what he is thinking when he does these things.

Question: Which referral would be most beneficial to Carlos?
(A): Narcotics anonymous
(B): Military school
(C): Big Brother/Big Sisters
(D): Alcoholics anonymous

Correct Answer: Big Brother/Big Sisters
Explanation: Big Brothers/Big Sisters may be a beneficial program which would provide Carlos with a positive role model. Additionally, Carlos is lacking a positive male role model. There is no indication that Narcotics or Alcoholics anonymous are warranted at this time. Military school would not address the underlying psychopathology. Therefore, the correct answer is (A)
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: Kathleen states at the end of the session that they cannot come in because she has a doctor's appointment. Tony states that he could come anyway by himself. How should the counselor respond?
(A): Yes, we can do that
(B): Couples in Marital Counseling can only be seen as a unit
(C): Let me ask my supervisor
(D): Let's talk about if that would be beneficial

Correct Answer: Let's talk about if that would be beneficial
Explanation: There is no definitive rule that a client can only be seen as a couple in marital counseling. Individuals in the marriage may be seen as well. Counselors should be aware of this and have the appropriate clinical knowledge before seeing part of the couple separately. In determining whether one member of the couple can be seen individually, the counselor should consider the impact it may have on the therapeutic process. Additionally, it is important that ground rules are set prior to the individual session, such as: whatever is said in session will be shared in the next session when both members can attend. Therefore, the correct answer is (C)
Competency: counseling skills and interventions
Case Study
Patient Demographic:  Initial Intake:   Age: 82 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Widowed Counseling Setting: Community Clinic Type of Counseling: Individual
Mental Status Exam: Theodore is tearful most days and has dropped a significant amount of weight. He has not been sleeping and stays up watching videos of his deceased wife.
Presenting Problem: Theodore is an 82-year-old who was referred for grief counseling by his son, Nate. Theodore’s wife, Nancy died one month ago after a 4-year battle with cancer.

History:
Theodore was the primary caretaker for Nancy and has not paid attention to his own health in years. Nate would like his father to move in with him and his family and sell the house his parents lived in to pay off their debt. However, Theodore refuses to sell the house and stated that he will not give away or sell anything that they owned. Nate drove Theodore to the initial session and sat in for the intake, with Theodore’s consent.
 
Once everyone sat down, Theodore looked at the counselor and stated, “I am only here so my son stops bugging me about selling the house. I am not getting rid of anything in that house- and especially not the house itself!” Nate explained that his father cannot maintain the house on his own and is worried about him being lonely. Theodore insists that he has other options and thinks that living with Nate would put a burden on him.

Question: An immediate objective for Theodore should be?
(A): to find housing
(B): to find another way to make meals for himself
(C): to tell his son he doesn't want to live with him
(D): to determine his own goals

Correct Answer: to determine his own goals
Explanation: Although there are several areas of concern, it is important for the client to make choices for themselves and establish their own goals. By establishing their own goals, this also increases the likelihood of attainability and success. Housing is a priority for Theodore, but it was not stated that this is an emergency. Theodore was able to care for his wife, so he is likely able to care for himself. It is also not an emergency for Theodore to tell his son he doesn't want to live with him. If that is something that Theodore would like to set as a goal, then it can be made a priority. Making meals is a more pressing matter in terms of overall health. However, it is a goal that Theodore should be making for himself. Therefore, the correct answer is (B)
Competency: treatment planning
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: Not feeling pain or having an out of body experience is called?
(A): Disassociation
(B): Displacement
(C): Projection
(D): Hallucination

Correct Answer: Disassociation
Explanation: Disassociation is the feeling that you are separated from yourself, which often happens when someone experiences a very painful or traumatic event. Displacement is a defense mechanism in which a negative emotion is redirected to a less threatening object. Projection is a defense mechanism in which feelings are placed onto another object or person. Hallucinations are experiences that are not real and are created by your mind. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Client Age: 12 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Private Practice Type of Counseling: Individual Counseling Presenting Problem: Withdrawn and Avoidant Behavior Diagnosis: Undetermined
Mental Status Exam: Mental Status Exam: The client appears oriented to person, place, time, and situation. The client is dressed appropriately for the weather and appears to be maintaining appropriate hygiene. The client was withdrawn for most of the session but was able to open up slightly about what was going on with
Presenting Problem: You are a licensed therapist working in private practice. A 12-year-old female client comes into your office for the intake session and is accompanied by her parents. The client’s parents report that their daughter has been withdrawn and has refused to return to school for the past 6 school days. The client is avoiding eye contact with anyone and is slouching with her arms crossed. You try to engage the client in open questions to initiate the intake session with her, and she does not answer you or look at you. You ask her if privacy would make her more comfortable, and she nods, so you ask her parents if they would mind waiting in the lobby, and they agree. The client continues to refuse to talk about school, but she does engage in conversation with you about other topics.
Other Contexts: The client reports that a worker from the local child protective services office met with her and that she is worried about what the coach will do in response when he finds out that she reported him. The client says that she has not returned to school but that the school has provided the classwork and homework needed to keep up; she feels like the school is supporting her well enough to not fall behind. The client confirms that all of the symptoms that she described during her last session are still present

Question: Which of the following is LEAST likely to be a long-term effect of this client’s trauma if left untreated?
(A): Difficulty with trust
(B): Adjustment disorder
(C): Clinical depression or anxiety
(D): Difficulty with intimacy

Correct Answer: Adjustment disorder
Explanation: Adjustment disorders arise in reaction to major events or life changes that disrupt an individual’s prior way of life. These events may be positive or negative in nature. Common causes include the divorce of parents, moving to a new home/state/school, marriage, having children, loss of a job, loss of a loved one, or retirement. Although an adjustment disorder may be peripherally linked to stress from trauma or retraumatization, it is the least likely of all of the options to result from sexual trauma (post-traumatic stress disorder would be more likely). Intimacy and trust might be difficult for the client in the future because they are directly related to the sexual assault. Depression and anxiety symptoms are already present and may progress to clinical levels if untreated. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake: Age: 12 Sex: Male            Gender: Male Sexuality:  Heterosexual Ethnicity: 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: The counselor should gather information on?
(A): How long Michael will be suspended
(B): How Michael's teacher reacted
(C): What triggered the fight
(D): What punishment the other student received

Correct Answer: What triggered the fight
Explanation: It is important for the counselor to understand what triggered the fight, especially since it is out of character for Michael. The length of time that Michael will be suspended as well and the ramifications that the other student had are not relevant to understanding Michael's symptoms. Knowing how Michael's teacher reacted may be important if she was not supportive of him, but there is no indication of that currently. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
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: You meet with the group and continue DBT psychoeducation regarding distress tolerance. About halfway through the group, you notice that client 4 has not shared much, and you ask her about this. The client states that every time she wants to talk, she cannot find a way into the conversation because others are talking. This group is in the working stage of group therapy, they are actively engaged in the session, and they are all also actively engaged in individual therapy

Question: In DBT, all of the following are main focuses of therapy, EXCEPT:
(A): Distress tolerance
(B): Emotional regulation
(C): Mindfulness
(D): Systematic desensitization

Correct Answer: Systematic desensitization
Explanation: Systematic desensitization is an intervention that uses aspects of CBT and applied behavioral analysis; it is not a DBT technique. Systematic desensitization focuses on progressive exposure to greater anxiety-inducing stimuli coupled with relaxation techniques. Mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness are the four focuses of DBT in improving life skills. Mindfulness focuses on becoming more aware of oneself and being present in the moment. Emotional regulation focuses on identifying, labeling, and addressing certain emotions. Distress tolerance focuses on experiencing strong emotions and not reacting impulsively or destructively. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
Case Study
Patient Demographic: Initial Intake: Age: 12 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Hispanic Relationship Status: Single Counseling Setting: Outpatient Clinic       Type of Counseling: Individual
Mental Status Exam: Carlos came to the intake with his mother, Claudia. Claudia did most of the talking during the intake while Carlos sat in his chair, slumped down low and avoiding eye contact.
Presenting Problem: Carlos is a 12-year-old male referred to an outpatient community clinic by the court after he was caught breaking into several cars on his block.
 
History:
Claudia reported that she and Carlos’ father separated two years ago. Since then, Carlos has had frequent suspensions in school for bullying others and fighting. Carlos often threatens students on social media prior to the altercations. Claudia reported that she no longer knows what to do anymore and she hoped that the counselor can fix him or at least report to her what he is thinking when he does these things.

Question: Based on the first session notes, Carlos is showing symptoms of?
(A): Bipolar Disorder
(B): Antisocial Personality Disorder
(C): Avoidant personality Disorder
(D): Conduct Disorder

Correct Answer: Conduct Disorder
Explanation: Carlos meets the criteria for conduct disorder because of the following symptoms: initiating physical fights, bullying others, destruction of property, breaking into cars and school truancy. Carlos does not display episodes of mania (elation, self-importance, irritated or agitated) or depression (feelings of sadness, pessimism, hopelessness, difficulty sleeping or concentrating). The minimum age for antisocial personality disorder is 18. Avoidant personality is characterized by social inhibition due to feelings of inadequacy, fear of being ridiculed or hypersensitivity to criticism. Therefore, the correct answer is (B)
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: Cognitive behavioral therapy does not include?
(A): Empty chair technique
(B): Behavioral experiments
(C): Deep muscle relaxation
(D): Cognitive restructuring

Correct Answer: Empty chair technique
Explanation: The empty chair technique is a Gestalt method in which an empty chair is used so the client can express themselves to a "person" unavailable to them. Deep muscle relaxation is a progressive tightening and loosening of muscles which allows the person to relax muscles they may not have realized were tense. Cognitive restructuring is a CBT method where someone identifies their irrational thoughts and replaces them with more realistic and productive ones. Behavioral experiments are used often in CBT for someone to test their catastrophic thinking so they can see whether what they fear the most occurs. Therefore, the correct answer is (C)
Competency: professional practice and ethics