ckmjx/CounselingBench huggingface dataset:
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 comes to the session reporting that he and his girlfriend attempted to have sex the past week, and he wrote down some thoughts he was having on his CBT thought log. The client and the clinician reviewed his thoughts and engaged in cognitive reframing to support him in creating new scripts to use when engaging in sex. The client also wrote down physical responses to anxiety that he was experiencing before and during sex that included muscle tension and increased heart rate. The client identified that one thought he had during sex was “I feel inadequate as a man; therefore, I must be inadequate because I can’t fully satisfy my girlfriend

Question: The client identified that one thought he had during sex was “I feel inadequate as a man; therefore, I must be inadequate because I can’t fully satisfy my girlfriend.” Which of the following cognitive distortions best defines this thought?
(A): Overgeneralization
(B): Fortune-telling
(C): All-or-nothing thinking
(D): Emotional reasoning

Correct Answer: Emotional reasoning
Explanation: Emotional reasoning is the cognitive distortion displayed here because the client is accepting his emotion as a reality even though just feeling something does not make it true. The client is not experiencing all-or-nothing thinking because he is not experiencing polarized thinking. The client is not fortune-telling because he is not predicting future experiences based on present feelings. The client is not overgeneralizing because he is not applying his current feelings to other situations. Therefore, the correct answer is (A)
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: Theodore decides that he would like to tell Nate about his decision to not move in with him. A Gestalt technique in which Theodore can practice, by playing both sides of the conversation, would be?
(A): Role playing
(B): Empty chair technique
(C): Rehearsal technique
(D): Drama therapy

Correct Answer: Empty chair technique
Explanation: The empty chair technique is a Gestalt technique in which Theodore practices the conversation between him and Nate. This can show the counselor the expectations that Theodore has of Nate. This technique is also used in counseling for internal conflicts where an individual may have a conversation with a part of themselves, or a younger self. Role playing would be the client playing himself or Nate and the counselor playing the other. Drama therapy describes many techniques, not specific to Gestalt. The rehearsal technique is used to enhance memory and is a way to practice a speech or dialogue. It is not a two-way conversation. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
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: Later in the day, the counselor realized what had occurred in his office and went to find Autumn in class. The counselor explained that the other school counselor had left some of her files on her desk of graduated students college essays. The counselor stated that regardless of this, all files should have been put away and she made a serious mistake. Autumn considers this for a few moments and agreed to return. The counselor demonstrated?
(A): Non-judgement
(B): Genuineness
(C): Congruence
(D): Positive regard

Correct Answer: Genuineness
Explanation: In this situation, the counselor is displaying the attribute of genuineness as she is speaking honestly and apologizing for her mistake without being defensive or pretentious. Congruence is when a counselor gives feedback on the client's progress in a genuine manner. Positive regard describes when a counselor can focus on the positive and demonstrated the belief that everyone can make positive changes in their lives. Non-judgement is the acceptance of the client and their actions. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
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: The severity of Mark's symptoms can be assessed by administering all of the following, except?
(A): Calgary Depression Scale for Schizophrenia
(B): Brief Psychiatric Rating Scale (BPRS)
(C): The scale of assessment for Positive symptoms (SAPS)
(D): The scale for the assessment of Negative symptoms (SANS)

Correct Answer: Calgary Depression Scale for Schizophrenia
Explanation: The Calgary depression scale for schizophrenia should not be used as Mark did not mention any symptoms of depression. The SANS measures 25 negative symptoms of schizophrenia including lack of facial expressions, social inattentiveness, lack of interests and relationships. SAPS checks for 34 positive symptoms including hallucinations and delusions. The SANS and SAPS can be administered together. The BPRS is the most common test that psychiatrists use when they want to check how severe someone's symptoms of schizophrenia are. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
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: To understand Theodore in the context of his family, a systemic counselor would?
(A): Use tools, such as a genogram, to show relationships
(B): Teach Theodore coping mechanisms when he is frustrated with Nate
(C): Focus on a diagnosis
(D): Focus on Theodore's experiences since his wife's passing

Correct Answer: Use tools, such as a genogram, to show relationships
Explanation: A systemic counselor tries to look at a client within his/her system and not just individually. One way to do this, is by using a genogram. A genogram would be particularly helpful in this situation to understand the dynamic between Theodore and Nate. A systemic counselor would not just focus on obtaining information to come up with diagnosis. As opposed to teaching Theodore coping mechanisms when frustrated with Nate, they may bring Nate into a session. And instead of focusing on Theodore's experience with his wife passing, a systemic counselor may look at how the death affected the system. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
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 does not need immediate assessment in Nadia's case?
(A): Mental status
(B): Where Nadia goes when she is away
(C): Cognitive and adaptive functioning
(D): Parent/child relationship

Correct Answer: Parent/child relationship
Explanation: Although it is important to explore Nadia's relationship with her parents, there are more immediate concerns. These include knowing where Nadia goes when she runs away, to assess for safety. It is also important to assess Nadia's cognitive and adaptive functioning since her cognitive functioning seems low. This is not uncommon for those who have experience extensive abuse and trauma. A mental status exam would also assess for risk and current mental capacity. Therefore, the correct answer is (D)
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: An important area to gain more information on at this point is?
(A): Source of anxiety
(B): Cultural factors
(C): Financial situation
(D): Social support

Correct Answer: Source of anxiety
Explanation: It is evident that Li is distressed enough to come to counseling even though she believes she is putting herself at risk and maybe cannot afford it. Starting with the source of her anxiety is important. This may lead to discussion about the other areas which would all be discussed during a comprehensive intake. However, the source of Li's anxiety should be addressed first. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
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 is a nonprojective test that can be administered to Nadia?
(A): Achenbach tests
(B): Thematic apperception test
(C): Rorschach
(D): Sentence completion test

Correct Answer: Achenbach tests
Explanation: The Achenbach tests are a collection of question-based assessments for ages 1 ½ to 90, and are not projective. Achenbach tests look at several areas of functioning. Projective tests use ambiguous stimuli which are identified or completed by an individual and are said to bring forth unconscious feelings or desires. The thematic apperception test uses ambiguous scenes in which the individual tells a story of what they think is happening. The Rorschach uses inkblots in which the individual identifies what the object is. In the sentence completion test, a sentence stem is given which the individual completes. Therefore, the correct answer is (C)
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: The counselor should respond?
(A): "I have a colleague here, if you want to just see them?"
(B): "All therapists abide by the same confidentiality laws and principals, but we can find you someplace where you feel most comfortable."
(C): "I don't know if that is a good idea as we already started talking about goals, I can definitely help you."
(D): "If that is what you want, I will gladly do that."

Correct Answer: "All therapists abide by the same confidentiality laws and principals, but we can find you someplace where you feel most comfortable."
Explanation: Sometimes clients will ask for a referral out, for diverse reasons. Clients must be able to assert their freedom of choice of who conducts their treatment. Choice d respects Harold's autonomy but lets Harold know he should expect the same standards of confidentiality with whomever he sees. Although the counselor and Harold did start the work, this statement seems more about the counselor and his/her feelings about the rejection. Choice b seems a little cold, as if the counselor is relieved that Harold suggested this. Choice c dismisses why Harold is requesting a referral out. The counselor is obligated to make an appropriate referral. Therefore, the correct answer is (D)
Competency: professional practice and ethics
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 necessary factor for Sandy to overcome alcohol abuse is?
(A): Support from family
(B): A sponsor
(C): Medication to alleviate withdrawal symptoms
(D): Motivation to change

Correct Answer: Motivation to change
Explanation: Sandy can have all the resources above available to her, but if she does not have the motivation to change, she will not be successful. Once she has the motivation to change, support from others will be important to prevent relapse. One example of support is a sponsor, someone who has been through the stages of recovery. Medication to relieve the symptoms of withdrawal also makes this process more bearable. Therefore, the correct answer is (B)
Competency: treatment planning