ckmjx/CounselingBench huggingface dataset:
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Status: Single Counseling Setting: Private Practice Type of Counseling: Individual Counseling Presenting Problem: Withdrawn and Avoidant Behavior Diagnosis: Undetermined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 The client was withdrawn for most of the session but was able to open up slightly about what was going on with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 The client’s parents report that their daughter has been withdrawn and has refused to return to school for the past 6 school days.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

Question: All of the following are appropriate short-term treatment goals EXCEPT:
(A): Assisting the client with identifying barriers to school attendance
(B): Referring for psychological testing to determine the cause of the refusal to attend school
(C): Building trust so the client can feel comfortable enough to begin to identify and express feelings regarding her school attendance
(D): Beginning to discuss increasing social connectedness due to withdrawn behavior

Correct Answer: Referring for psychological testing to determine the cause of the refusal to attend school
Explanation: Referral for psychological testing likely would not return much helpful information because the client is not comfortable enough to talk about what is happening. The goals should be achievable and should be relevant to the presenting situation. Building trust and identifying barriers to school attendance are important because this is the only obvious presenting problem even with minimal client participation. The focus on improving social connectedness is important due to withdrawn behavior. Therefore, the correct answer is (B)
Competency: treatment planning
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: All of the following are core concepts of distress tolerance in DBT, EXCEPT:
(A): A pros and cons list
(B): Thought stopping
(C): Self-soothing
(D): TIPP

Correct Answer: Thought stopping
Explanation: Thought stopping is a CBT technique that is focused on stopping unhelpful thoughts before they affect functioning. TIPP (temperature, intense exercise, paced breathing, and paired muscle relaxation) is a method that helps support management of the physical symptoms of distress, therefore building distress tolerance. A pros and cons list supports the decision-making process and is part of building distress tolerance in DBT. The ability to self-soothe is also important in building distress tolerance in DBT because it involves coping with present emotions and feelings. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
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:  Diagnosis: Premature Ejaculation, Acquired, Generalized, Mild (F52.4)   ions. Family History: The client reports that he has been in a relationship with his girlfriend for 3 years. The client says that he is close with his parents and his younger brother

Question: Which of the following would be the most helpful area to explore to determine the course of treatment for this client?
(A): Determine if the premature ejaculation is based on medical limitations.
(B): Identify the client’s personal goals for treatment.
(C): Explore the effects of sexual dysfunction on the client’s relationship with his girlfriend.
(D): Determine the effect of the client’s anxiety’s on daily functioning in all settings.

Correct Answer: Determine if the premature ejaculation is based on medical limitations.
Explanation: It is most important to determine what medical limitations the client might have because it is possible that the client’s penis may be excessively sensitive and the premature ejaculation may not be improved through cognitive and behavioral interventions. Identifying the client’s goals, exploring the sexual dysfunction’s effects on his relationship, and identifying the effects that his anxiety has on his daily functioning are all important, but these factors do not matter if biological factors inhibit his progress. Therefore, the correct answer is (A)
Competency: treatment planning
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 would be the most appropriate diagnosis based on the client’s presenting symptoms?
(A): Adjustment disorder, with depressed mood
(B): Post-traumatic stress disorder, with depersonalization
(C): Post-traumatic stress disorder, with delayed expression
(D): Acute stress disorder, with depressed mood

Correct Answer: Post-traumatic stress disorder, with delayed expression
Explanation: The symptomatology is consistent with post-traumatic stress disorder, with delayed expression due to presenting symptoms and the 6 months it took for symptoms to reach full post-traumatic stress disorder criteria. Post-traumatic stress disorder with depersonalization is the feeling of experiencing the trauma from the perspective of an outside observer, which is not consistent with reported symptoms. Acute stress disorder would require a time period of 30 days or less, so this would not be an appropriate diagnosis. Adjustment disorder presents as difficulty managing adjustment to life’s stressors; this is not an appropriate diagnosis due to the presenting symptoms. 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: Destiny's treatment goals should include?
(A): Look for other placement alternatives
(B): Reviewing past negative experiences
(C): Keeping Destiny from other children for now
(D): Building new attachment relationships between the child and caregiver

Correct Answer: Building new attachment relationships between the child and caregiver
Explanation: Destiny and Ms Maze would benefit from some work on their relationship and this may help destiny develop a sense of emotional security. Reviewing past negative experiences may increase the guilt and tension that is already present. Although Ms Maze appears frustrated, it is not necessary yet to look at other placement alternatives. Destiny is acting the way that she is because of her early attachment experiences. Finally, it would be beneficial to provide Destiny with positive social experiences so she can see the value of supportive relationships and practice social skills. Keeping Destiny from other children would not allow her to have these experiences. Therefore, the correct answer is (C)
Competency: treatment planning
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: A non-projective assessment that measures emotional symptoms, functioning, social behavior and hyperactivity is?
(A): Stanford Binet
(B): Thematic Apperception Test (TAT)
(C): The Strengths and Difficulties Questionnaire (SDQ)
(D): House-Tree-Person (HTP)

Correct Answer: The Strengths and Difficulties Questionnaire (SDQ)
Explanation: The Strengths and Difficulties Questionnaire is used to measure emotional symptoms, functioning, social behavior, and hyperactivity. The Stanford Binet is an intelligence test with an age range of 2 years through adulthood. The house-tree-person test (HTP) is a projective test intended to measure different aspects of personality. Test takers are asked to draw a house, a tree, and a person. The interpretation of these drawings is used to create a picture of the person's cognitive, emotional, and social functioning. The Thematic Apperception Test (TAT) is a projective test comprised of ambiguous pictures of scenes. The subject is asked to describe what is happening in the scene. Similar to the House-Tree-Person, the interpretation of the drawings is used to determine current problems and functioning. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic:  Initial Intake:   Age: 38 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: VA Type of Counseling: Individual
Mental Status Exam: Carl came to the intake session alone and angrily stated, “I really don’t know why they are making me come to therapy - it doesn’t help anyway.” Carl appeared edgy throughout the interview and responded to questions with minimal effort.

Presenting Problem: Carl is a 38-year-old Army Veteran who is attending counseling at the local VA. Carl was referred after he was arrested for a DUI last week.

History:
Carl has been on four deployments to the Middle East, he returned from the most recent tour 11 months ago, after he was injured during a military strike. Some of his team members were injured as well.
Since his return, Carl and his civilian wife, Lori, have discussed separation because of their frequent arguing and Carl’s drinking. Carl began drinking when he was deployed and since then has used it as a coping mechanism to combat the frequent flashbacks and nightmares that he gets. Carl and Lori mostly argue about money since Carl has not been able to sustain employment as a construction worker because of his drinking problems. Carl has been arrested several times for assault and disorderly conduct. Carl recently assaulted his last counselor after he had made a comment about Carl not being able to sustain work.

The counselor thanked Carl for his service and reviewed with him that he was referred as a part of his probation. He must attend individual therapy and an anger management group for veterans. The counselor then described to Carl the purpose of the meeting and what would be reviewed and discussed during their time together. This included the intake paperwork, including informed consent and several assessments.

Question: Carl's statement of realizing he has a problem is which of the Prochaska and DiClemente's stages of change?
(A): Precontemplation
(B): Action
(C): Contemplation
(D): Preparation

Correct Answer: Contemplation
Explanation: Carl's statement indicates that he is in the contemplation stage in which he is aware that he has a problem but has not yet committed to change. Precontemplation is a stage when a person does not see that he/she has an issue and has no intention of changing his/her behavior. In the preparation stage, the individual is determined to make changes and believes that he/she is capable of change. In the action stage, the person is taking the established steps to make change. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
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: To assess cognitive and adaptive functioning in Nadia, the counselor may use all of the following, except?
(A): SIB-R (scales of Independent Behavior- Revised)
(B): CBCL
(C): ABAS
(D): Vineland

Correct Answer: CBCL
Explanation: The Child Behavior Checklist (CBCL) is used to detect emotional or behavioral problems in children and adolescents. This would not be an appropriate test for Nadia as she is 18 years old. The Vineland Adaptive scales are used as a tool to diagnose intellectual and developmental disabilities and other disorders, ages birth-90. The scales of independent behavior revised is for individuals 3 months to 80 + years old and measures functional independence and adaptive functioning. The adaptive behavior assessment system is used to evaluate those with developmental delays, autism spectrum disorder, intellectual disability, etc. 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 effective treatment for anxiety is?
(A): Benzodiazepines
(B): Corticosteroids
(C): Cognitive Behavioral Therapy
(D): Cardiovascular exercises

Correct Answer: Benzodiazepines
Explanation: Benzodiazepines have been shown effective for anxiety. Corticosteroids treat conditions such as asthma, allergies, arthritis and bronchitis. They have also been shown to make people anxious. Cardiovascular exercises are not proven to help prevent panic attack. Cognitive behavioral therapy can be used to target irrational thought which may trigger anxiety. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis