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. You ask the client what his life would be like if he did not feel that he can’t satisfy his significant other, and he does not respond immediately

Question: You ask the client what his life would be like if he did not feel that he can’t satisfy his significant other, and he does not respond immediately. All of the following are important aspects of the use of silence EXCEPT:
(A): The client appears uncomfortable with the silence, so you provide him with a prompt to say whatever is coming to his mind.
(B): Your client may provide a meaningful response as a result of the silence, so you maintain the silence.
(C): After providing a period of silence, you use attending skills to let the client know it is his turn to speak.
(D): The client is not responding to the silence, so you continue talking to try to elicit more information.

Correct Answer: The client is not responding to the silence, so you continue talking to try to elicit more information.
Explanation: You should continue to maintain silence instead of continuing talking because you are missing the opportunity to use silence by continuing silence. Maintaining silence, providing a prompt to respond to the silence, and the use of attending skills to encourage silence are all helpful skills to prompt a response to the use of silence. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
Case Study
Patient Demographic: Initial Intake: Age: 15 Sex: Non-binary        Gender: chose not to answer Sexuality: chose not to answer Ethnicity: East Indian Relationship Status: Single Counseling Setting: Community Outpatient Clinic Type of Counseling: Individual
Mental Status Exam: Shar is 15-years old and looks younger than stated age due to their weight. Shar had a flat affect throughout the interview and looked down frequently. Despite there being an empty seat on the couch next to their mother, Shar sat in a chair across the room.
Presenting Problem: Shar was brought it by their mother, Nadia, for concerns about being isolated and argumentative.
 
Mental Status:
Shar is 15-years old and looks younger than stated age due to their weight. Shar had a flat affect throughout the interview and looked down frequently. Despite there being an empty seat on the couch next to their mother, Shar sat in a chair across the room.
 
History:
Shar and Nadia reported that they used to have a close relationship. There have been no issues or discord until now. Recently, Nadia noticed Shar staying to themself more in their room, which is unlike them. Shar recently lost a significant amount of weight and teachers reported their grades have declined. Nadia shared problems started when the topic of the sophomore dance came up and Nadia asked Shar what boy they were going with.
 
When this topic came up during the intake, Shar rolled their eyes at this and stated, “Mom, you are so narrow minded. Why do I have to go with a boy, why can’t you just ask me WHO I am going with?” Nadia looked at the counselor and stated, “Do you see why I brought her here? She is so disrespectful, and she is lucky that her father did not hear her say these things. We used to be so close.”

Question: By conducting extensive research, the counselor is demonstrating
(A): Multicultural sensitivity
(B): Non-judgmental stance
(C): Unconditional positive regard
(D): Empathetic Attunement

Correct Answer: Multicultural sensitivity
Explanation: Culture encompasses many things that make the client unique such as gender. By the counselor taking the time to do extensive research on a topic they are not familiar with, they show multicultural sensitivity. Unconditional positive regard is warmth and acceptance towards the client while not focusing on past transgressions. Empathetic attunement is the ability to put oneself in the shoes of another. Having a non-judgmental stance in not judging in comparison to personal standards. 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: Theodore made positive changes in a short amount of time because?
(A): The goals were attainable
(B): Both b and c
(C): The goals were made by Theodore
(D): The goals were agreed upon by Theodore and the counselor

Correct Answer: Both b and c
Explanation: It is evident that Theodore made a tremendous amount of progress in a short amount of time. Since the goals were made by Theodore, he was able to focus on something he was motivated to work on. Although some goals may seem small and short term, early successes build confidence in the ability to change. Whether or not a counselor agrees with a goal does not determine the likelihood for success. A counselor can discuss possible outcomes or barriers, but ultimately, the goal setting is up to the client. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
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: A theoretical approach that may work for Darrel is?
(A): Person-Centered therapy
(B): Family systems therapy
(C): Psychoanalysis
(D): Cognitive Behavioral therapy

Correct Answer: Cognitive Behavioral therapy
Explanation: Cognitive behavioral therapy provides a structured, focus-active approach which seems congruent with Darrel's request to learn coping skills and assertiveness training. A psychoanalytic or person-centered approach would be too passive and long term. Family Systems therapy focuses on dysfunctional family relationship problems which are not evident currently. Therefore, the correct answer is (C)
Competency: counseling skills and interventions
Case Study
Patient Demographic: Client Age: 20 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Asian Relationship Status: Single Counseling Setting: College counseling clinic Type of Counseling: Individual counseling Presenting Problem: Panic attacks Diagnosis: Provisional diagnosis: panic disorder (F41.0)
Mental Status Exam: Mental Status Exam: The client is oriented to person, place, time, and situation. The client does not appear anxious or depressed and was friendly and eng
Presenting Problem: You are a counselor working in a college counseling department. The client comes in after being late to class several times over the last month due to reported “freak-outs” in the morning. The client experiences the following panic symptoms: accelerated heart rate, sweating, shaking, shortness of breath, and a feeling of impending doom. The client reports a feeling of impending doom when she wakes up on days when she has classes, and this anxiety tends to escalate into fear of having a panic attack on a daily basis, often making her late to her first class. The client is worried that she will have panic attacks every day for the rest of her life. She says that her parents have put a lot of pressure on her to get a high grade point average at college. The client is worried about how this pressure and the panic attacks are going to affect her doing well at college and engaging socially.
Other Contexts: aged. Family History: The client reports that she is close with her parents but that they often have high expectations of her and that she worries about disappointing them. The client has an older brother who is 25 and is a lawyer. The client says some of the pressure is wanting to be as successful as her brother because she thinks her parents are really proud of him

Question: All of the following are short-term goals for treatment for the first month of therapy, EXCEPT:
(A): Processing aspects of the client’s relationship with her parents
(B): Implementing calming and coping strategies for panic symptoms
(C): Providing psychoeducation on cognitive reframing
(D): Reducing the frequency and intensity of anxiety and panic attacks

Correct Answer: Reducing the frequency and intensity of anxiety and panic attacks
Explanation: A panic attack is a triggered fight-or-flight response, and this response takes time to reduce when triggered. Reducing the frequency and intensity of panic attacks is a longer-term goal because some psychoeducation and practice with coping skills need to occur first. At this point, the client would be prepared to learn and implement coping skills and cognitive reframing. It would also be helpful for the client to begin processing the thoughts, feelings, and experiences related to her relationship with her parents. Therefore, the correct answer is (C)
Competency: treatment planning
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: The memory deficit which Sandy experienced is result of?
(A): Sedative withdrawal
(B): Alcohol withdrawal
(C): Alcohol poisoning
(D): Psychosis

Correct Answer: Alcohol withdrawal
Explanation: Sandy is showing signs of alcohol withdrawal as evidenced by disorientation of time and place, vivid hallucinations of fast-moving animals and perspiration, fever and rapid heartbeat. Alcohol poisoning may cause amnesia or mental confusion and is accompanied by physical symptoms such as difficulty remaining conscious, vomiting, seizure, trouble breathing, and slow heart rate. Psychosis and sedative withdrawal are ruled out since symptoms are caused by alcohol. Therefore, the correct answer is (A)
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: Which of the following is a projective test that can be administered to Destiny to assess representation of significant relationships?
(A): Sentence Completion Test
(B): Story Stem Assessment Profile
(C): Draw a Family Picture Test
(D): Strengths and Difficulties Questionnaire

Correct Answer: Draw a Family Picture Test
Explanation: The Draw-a-Family-Picture-Test is a projective test instrument developed to determine children's attitude, fears, needs, maturity level, stressors, gender tendencies and self-perception in relation to their family and significant others. The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioral screening questionnaire for individuals aged 3- 16 which measures emotional symptoms, conduct problems, hyperactivity, peer relationship problems and prosocial behavior. It is not a projective test. Sentence completion test is appropriate for individuals ages 12 and older so it would not be appropriate for Destiny. The Story Stem Assessment Profile uses a narrative base measure of internal representations for children between the ages of 4 and 11. Therefore, the correct answer is (D)
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: What would be an area to focus on?
(A): Hopelessness
(B): Gender Identity Development
(C): Recommitment
(D): Behavioral Problems

Correct Answer: Recommitment
Explanation: Both Tony and Kathleen felt hurt by the other to the point where they questioned the future of their relationship. However, after some exploration they both decided on working things out. Recommitment to the relationship would be an area of focus. Gender identity is not an issue as transvestic disorder is not an indication that one is not happy with the gender with which they were born. Tony and Kathleen have not expressed feelings of hopelessness individually or as a couple system. There are no behavioral issues to be addressed as a couple system. Therefore, the correct answer is (B)
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: her. Family History: The client says that she has a good relationship with her parents. She says that they are encouraging and supportive of her. The client says that she has a younger brother who is 6 years old and an older brother who is 16 years old. The client states that she has a good group of friends and spends time with them regularly.  You noted that the client is withdrawn and appears uncomfortable

(A): Ask the client what she does for fun.
(B): Ask the client to talk about anything she wants.
(C): Ask about the musical group depicted on the client’s t-shirt.
(D): Ask open-ended questions to provide the client with the opportunity to answer in a way that she chooses to.

Correct Answer: Ask open-ended questions to provide the client with the opportunity to answer in a way that she chooses to.
Explanation: Open-ended questions were not helpful during the intake session; therefore, you need to take a different approach. If you ask the client about the musical group depicted on her t-shirt or what she does for fun, you show interest in the client and what she values, which could lead to building rapport. It can be helpful to open things up and allow the client to identify whatever goals she wants or to start talking about whatever is easiest for her to start talking about. This gives the client control and lets her lead with what she is most comfortable talking about. Therefore, the correct answer is (A)
Competency: counseling skills and interventions