ckmjx/CounselingBench huggingface dataset:
Case Study
Patient Demographic: Client Age: 8 Sex: Male Gender: Male Sexuality: Unknown Ethnicity: Hispanic Relationship Status: Single Counseling Setting: Home Health Outpatient Therapy Type of Counseling: Individual with Family Involvement Presenting Problem: Behavioral Issues Diagnosis: Oppositional Defiant Disorder, Severe (F91.3)
Mental Status Exam: Mental Status Exam: The client was argumentative and did not engage in the entire intake session. The client was oriented to person, place, situation, and time. He was dressed appropriately for the weather and appeared well groomed. The client appeared clean and had appropriate hyg
Presenting Problem: You are a home health outpatient therapist working with an 8-year-old male in the home setting. The client’s parents will be actively involved in counseling due to the client’s age. The client was referred to receive counseling by his school social worker. He has been having behavioral issues in school that have led to difficulty staying in the classroom and is resultantly falling behind in academics. During the first session, the client refuses to engage and leaves the room. The client’s parents prompt him to return, and he calls them “jackasses” and leaves the room again. The parents finish the intake session with you and provide you with a report on their observations in the home and reports from the school social worker. The client reportedly often loses his temper and is generally easily annoyed or angered. The client has trouble taking direction from his teachers and parents. The client’s parents also state that he often blames his younger sister for things that he does and often tries to annoy her. The parents have trouble identifying any of the client’s friends and state that he does not get along with his peers.
Other Contexts:    iene. Family History: The client’s parents are married, and he has a younger sister who is 6 years old. The client often deliberately annoys or angers his younger sister and has difficulty following directions from his parents

Question: All of the following are considered a differential diagnosis for oppositional defiant disorder EXCEPT:
(A): Attention-deficit/hyperactivity disorder
(B): Social anxiety disorder
(C): Disruptive mood dysregulation disorder
(D): Generalized anxiety disorder

Correct Answer: Generalized anxiety disorder
Explanation: Generalized anxiety disorder would not be considered a differential diagnosis because anxiety about everyday situations does not generally lead to defiance to authority. Attention-deficit/hyperactivity disorder would be considered a differential diagnosis if failure to conform to requests of others occurs in situations that require sustained attention. Disruptive mood dysregulation disorder also presents as negative mood and temper outbursts, but these are often much more intense than in oppositional defiant disorder. Social anxiety disorder can be considered if the defiance occurs because of the fear of judgment and negative evaluation of others. 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: If the counselor responds, "So, you are not eating because it is too painful to go into the kitchen and cook for yourself and not because of a loss of appetite?" This is an example of what counseling skill?
(A): Reflection of feelings
(B): Open ended questions
(C): Clarification
(D): Confrontation

Correct Answer: Clarification
Explanation: The counselor is demonstrating the skill of clarification. The purpose of clarification is to make sure that the counselor understands the situation correctly. In this situation, the counselor is trying to determine the reason behind Theodore's significant weight loss which will also aid in the formulation of the diagnosis. A reflection of feelings would focus on the how being in the kitchen makes Theodore feel. Confrontation is not a confrontation between the client and counselor, it occurs within the client through self-examination. The question can be answered with a yes or a no, therefore it is not an open-ended question. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
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: Possible stand-alone treatment modalities for Tony to work in with this individual therapist include all of the following except?
(A): Aversion therapy
(B): Sex therapy
(C): CBT
(D): Medication

Correct Answer: Medication
Explanation: Medication alone will not be effective in treating Tony's symptoms. Medication in conjunction with the other modalities mentioned has been proven effective in treating transvestic disorder. A sex therapist has expertise in this area and may use cognitive behavioral therapy to examine Tony's thoughts which lead him to cross dress. Aversion therapy uses classical conditioning to deter unwanted behaviors. Therefore, the correct answer is (D)
Competency: treatment planning
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: Risk factors for generalized anxiety disorder include?
(A): Childhood experiences of physical and sexual abuse
(B): History of separation anxiety
(C): Genetic loading
(D): Respiratory disturbance

Correct Answer: Genetic loading
Explanation: One third of the risk of developing general anxiety disorder is genetic. The other two thirds are a combination of temperamental and environmental factors. Respiratory disturbance is associated with panic disorder, as well as reports of negative childhood experiences such as physical and sexual abuse. There is no evidence that a history of separation anxiety can lead to generalized anxiety disorder later in life. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Client s Age: Client 1: age 12 Client 2: age 14 Client 3: age 14 Client 4: age 16 Client 5: age 13 Client 6: age 16 Sex: Males Gender: Males Sexuality: Varying Ethnicity: Multiracial Relationship Status: Single Counseling Setting: Juvenile Justice Facility Type of Counseling: Group Counseling Presenting Problem: Involvement with the Justice System That Includes Various Mental Health Disorders and Crimes Diagnosis: Imprisonment (Z65.1)
Mental Status Exam: Mental Status Exam: All of the clients appear to maintainappropriate hygiene, and they are all oriented to person, place, time, and situation. They are all somewhat reserved with regard to going into deeper topics, but theyparticipate f
Presenting Problem: You are a licensed counselor working in a juvenile justice facility for teenage males. The group comprises six males that are required to attend as part of their incarceration with the expectation that it will shorten their sentences. The purpose of the group is to work on emotional regulation and to work together to share common experiences and identify goals that can be helpful in preventing reincarceration. During the intake session, you explained the purpose of the group and started with an ice-breakeractivity. The clients participated in the ice-breaker activity that required you to redirect them back to the activity several times because they would joke and get off task. You attempt to go a little deeper by encouraging your clients to start talking about what happened to get them incarcerated, and they appear to be taking pride in the reasons they were in juvenile detention and making fun of those with lesser sentences. You redirect the clients to another topic.
Other Contexts:    ully. Family History: Several clients report coming from a single-parent home, whereas others are from a two-parent home. All clients report that they have siblings. Several clients reported having parents that were or are involved in the justice system

Question: Which of the following would be the most appropriate short-term goal in the next month for the group?
(A): The group will demonstrate the effective use of anger management strategies.
(B): The group will build trust and cohesion.
(C): The group will use assertive communication skills.
(D): The group will demonstrate empathy in the group setting.

Correct Answer: The group will build trust and cohesion.
Explanation: The group would most benefit from building trust and cohesion at this point in counselingbecause the correctional setting often encourages individuals to refrain from disclosure due to the fear of being targeted. Assertive communication skills, anger management strategies, and demonstrating affection will all be longer term goals as they work to develop these skills and implement them. 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: To help understand Mark's present functioning and safety risks, the counselor should first gather information on?
(A): Previous hospitalizations
(B): Length of time at job
(C): History of mental illness in family
(D): Duration of severity of symptoms

Correct Answer: Duration of severity of symptoms
Explanation: The duration and severity of symptoms helps to understand the client's present functioning and possible safety risks. After this is discussed, part of a comprehensive intake is gathering information on the history of mental illness in family members. There is a strong contribution for genetic factors in determining risk for schizophrenia. Previous hospitalizations are important to understand severity of illness and level of functioning. The length of time that Mark was at his job is not relevant to understand his psychological history. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake:   Age: 19 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: African American Relationship Status: Single Counseling Setting: Group home run by the Office of Children and Family Services Type of Counseling: Individual
Mental Status Exam: Elaina has little insight into her behaviors and is currently involved in an abusive relationship. Staff members are concerned for her safety, as well at the safety of her child. She is not functioning well socially or academically.
Presenting Problem: Elaina is a 19-year-old female who is living in a residence for pregnant teens in foster care. She has been displaying risk taking behaviors such as running away and fighting.
 
History:
Elaina has an extensive history of abuse and neglect. She entered foster care at the age of 5 when her mother was incarcerated for prostitution and drugs. Since then, she has been in and out of foster care homes and had several failed trial discharges back to her mother’s care. Elaina ran away from her foster homes multiple times. Another trial discharge date is set for the near future, after the baby is born.
 
Elaina never finished high school. She had difficulty focusing on her classes and was often teased because the other children knew that she was in foster care. Elaina would frequently get into fights, resulting in suspensions. She has a tumultuous relationship with the father of her child, and she recently told her case planner that he sometimes hits her.
 
Elaina walked into the counselor’s office, sighed, and stated, “Great- someone new- I have to tell my story again?”
 
The counselor responded “It sounds like you have told your story many times. I can imagine how that feels for you.”
 
Elaina stated, “It is very frustrating and annoying.” To which the counselor responded, “I like to hear from clients, their history in their own words as opposed to reading it on paper. When we make your goals, I would like you to be involved as well.”
 
Elaina visibly relaxed and began to tell the counselor about her history and current challenges. Elaina agreed to think about what she wanted her goals to be and agreed to discuss it next session.

Question: Brain abnormalities in those diagnosed with bipolar disorders occur in this area of the brain which controls cortisol levels?
(A): Brain stem
(B): Hippocampus
(C): Hypothalamic-pituitary-thyroid axis
(D): Thalamus

Correct Answer: Hypothalamic-pituitary-thyroid axis
Explanation: The Hypothalamic-pituitary-thyroid axis is responsible for the production of cortisol. Abnormalities in thyroid function are frequently accompanied by changes in mood. The Thalamus communicated motor and sensory signals to the cerebral cortex. The hippocampus has a primary role in learning and memory. The brain stem is responsible for regulating some involuntary body 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: What type of treatment would not be beneficial for treating Mark?
(A): Self-management strategies
(B): Assertive community treatment
(C): Supportive therapy with psychoeducation
(D): Antipsychotic medications alone

Correct Answer: Antipsychotic medications alone
Explanation: Antipsychotic medication alone is not as effective for treating Schizophrenia. Effective treatment includes a combination of antipsychotic medication as well as wraparound services. These services include supportive therapy with a focus on psychoeducation to help the person better understand their diagnoses. Services also include assertive community treatment which includes a team of a psychiatrist therapist and peer advocate to help manage crises medication and community resources. Finally, self-management strategies are useful in helping the client with everyday life skills. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake: Age: 58 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: The client reports that in the past six months she has lost 40 pounds, which leaves her looking thinner than seems appropriate for her 5’8” frame. Her hair is combed and neat, but looks thin and lacks a healthy shine. Her clothes, while clean, appear rumpled as if they have been slept in. She is cooperative and engaged, but moves slowly and pauses in her speech, causing you to wonder if she is lost in thought or if speaking is too painful. She reports she has difficulty falling asleep at night and never feels like she has any energy, though she does go to work each day.  She denies any suicidal thoughts but states she feels sad all the time and “can’t wait to see him again.” She admits she blames herself for not keeping him home that evening, which would have prevented his death.
Presenting Problem: You are a counselor in a private practice setting.  You receive a telephone call from an attorney that would like to refer their client, who is engaged in a civil suit, to you for counseling treatment. The attorney provides you with a detailed description of a traumatic event, death of her son, and expresses concerns about the client’s well-being. The attorney requests that you work with their client and be prepared to testify in court when the case goes to trial.
Other Contexts: Family History:
During the intake session, the client reports that her youngest son was killed in a car accident eighteen months ago, which was caused by an impaired driver.  Her son was the youngest of her five children and while she said she loves them all equally, she reported that her children have always said their youngest brother was her favorite.

Question: Which of the following counseling skills or interventions should be employed during this session?
(A): Open-ended questions
(B): Reflection
(C): Self-disclosure
(D): Exploring family of origin patterns related to loss

Correct Answer: Reflection
Explanation: Reflections of feelings or affect allow the client to feel heard and understood. This is particularly important when a client feels others are not listening to them. Open-ended questions and family patterns can be helpful in treating loss but are not effective without a strong therapeutic bond. Self-disclosure focuses on the counselor's experience, rather than on the client's experience. Therefore, the correct answer is (A)
Competency: counseling skills and interventions