ckmjx/CounselingBench huggingface dataset:
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: Darrel is showing symptoms of?
(A): Persistent Depressive Disorder
(B): Other specified depressive disorder
(C): Adjustment Disorder with mixed anxiety and depressed mood
(D): Major depressive disorder

Correct Answer: Major depressive disorder
Explanation: Darrel's symptoms are consistent with Major Depressive Disorder marked by a depressed mood and loss of interest in any activity, weight loss, difficulty sleeping, feelings of worthlessness and inability to concentrate, all causing severe impairment in functioning. Although Daniel's symptoms occurred within three months of a stressful event, his symptoms are beyond those of an adjustment disorder. Additionally, to meet the criteria for persistent depressive disorder, symptoms must have lasted for two years, which they have not. Other specified depressive disorder also cannot be used since Darrel meets the criteria for Major Depressive Disorder. Therefore, the correct answer is (B)
Competency: core counseling attributes
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: The counselor is not familiar with East Indian culture. It is important for the counselor to approach this by?
(A): Suppressing bias.
(B): a and b
(C): Acknowledging any bias he or she feels.
(D): Learning more about the East Indian cultures.

Correct Answer: a and b
Explanation: Counselors must be culturally competent and be self-aware of any biases that he/she has. Biases occur naturally and can be addressed so they do not affect the therapeutic relationship. Learning about East Indian culture can be beneficial if the counselor also considers the individuality of the client/family as well. Suppressing bias would not be beneficial to the counselor or therapeutic progress. At times counselors may be surprised or embarrassed to acknowledge their biases. However, this is an important part of equity, diversity and inclusion in the counseling process. Therefore, the correct answer is (D)
Competency: professional practice and ethics
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: Sexual arousal from cross dressing is characteristic of?
(A): Transvestic Disorder
(B): Gender Dysphoria
(C): Nonconformity to Gender roles
(D): Depression

Correct Answer: Transvestic Disorder
Explanation: Transvestic disorder is characterized by sexual arousal from cross dressing. Nonconformity to gender roles as an openness to atypical gender expressions. Gender dysphoria is a noncongruence with the gender someone is born with. Depression is characterized by sadness and hopelessness. 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: Nadia should be referred to?
(A): A trauma support group
(B): Social skills group
(C): A group for sex addiction
(D): Couples counseling

Correct Answer: A trauma support group
Explanation: Nadia may benefit from attending a group of victims of trauma for support to help her process her past and help her to see that other have been through similar situations. There is no indication that Nadia has a sex addiction. Seeking sexual partners in this case has to do with the trauma she has experienced. Nadia is having difficulty with her peers, but an anger management group may be more beneficial than a social skills group. Although Nadia is having difficulties in her current relationship, couples counseling will only be effective if both people are willing. Therefore, the correct answer is (C)
Competency: treatment planning
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: At this time, it may be beneficial to refer?
(A): Lori to have individual therapy with the same counselor
(B): Carl and Lori to a financial advisor to manage their finances
(C): Carl to a career specialist at the VA
(D): Lori to attend Carl's group for anger management

Correct Answer: Carl to a career specialist at the VA
Explanation: Besides Carl's drinking, a primary source of stress is Carl's inability to retain employment. It is important for a counselor to be aware of available resources and refer to them when beneficial. Now that Carl is ready to make changes, a career specialist at the VA may be able to help Carl obtain and sustain employment. A financial advisor is not necessary currently. Although they are having financial difficulties, nothing indicates that they are not able to manage their finances once Carl has steady employment. The counselor is seeing Carl individually and brings Lori into some sessions to work on their communication. It is not advisable for the counselor to also see Lori individually as this may cause triangulation and confusion. It is also not advisable for Lori to attend Carl's group for anger management as it is a closed group for those who have been in combat. Therefore, the correct answer is (A)
Competency: treatment planning
Case Study
Patient Demographic: Initial Intake: Age: 12 Sex: Male            Gender: Male Sexuality:  Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: School Counselor Type of Counseling: Individual
Mental Status Exam: Michael came to the office and looked upset as he sat down. When asked about how he felt about what happened, Michael respectfully stated that he was sorry but that he did not want to talk about it.

Presenting Problem: Michael came to the counselor’s office after he was suspended for fighting with one of the other students.

History:
Michael, who was a new student this year, did not typically get in trouble. Michael has excelled academically since his arrival and joined several school clubs. When the teacher was questioned regarding what happened, she stated that the other student made a gesture to Michael that could not see. Suddenly, she stated that they were both throwing punches. Michael’s teacher stated that now that she thought about it, she recently noticed Michael exhibiting some repetitive movements that she never witnessed before.

Question: Which of the following is not relevant to a comprehensive assessment of Michael?
(A): Michael's medical history
(B): Any recent significant events in Michael's life
(C): Michael's current support system
(D): If the suspension goes on Michael's permanent record

Correct Answer: If the suspension goes on Michael's permanent record
Explanation: Whether the suspension goes on Michael's permanent record is not relevant information for a comprehensive assessment. Relevant information would include assessing Michael's current support system. Also, since this recent event seems uncharacteristic for Michael, it is important to understand any recent events that could have triggered this behavior. Finally, a person's medical history can provide a holistic framework and thorough assessment. Therefore, the correct answer is (D)
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: The counselor states, "Let's take a step back and take deep breaths. The good thing is that you are both here. Now let's try to talk to each other, using I statements and focus on your feelings." This is an example of?
(A): Paraphrasing
(B): Capping
(C): Reflection of feeling
(D): Regrouping

Correct Answer: Capping
Explanation: Capping is an intervention that counselors use when they observe the escalation of emotions. By giving the couple a task, it switches their thinking from an emotional level to a cognitive one. Regrouping means to be regrouped or reassembled. It is not a clinical intervention. Paraphrasing is a skill that lets the client know that they are heard by the counselor repeating the client's words. Reflection of feeling is when the counselor focuses on the feeling regarding what was just expressed to also show understanding. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
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: When reviewing confidentiality, the counselor should not include?
(A): Limits of confidentiality
(B): Confidentiality of electronic communication
(C): What information will be provided to Harold's supervisor
(D): What information Harold should share with his supervisor

Correct Answer: What information Harold should share with his supervisor
Explanation: Confidentiality does not apply to what the client chooses to share with others about themselves. In accordance to the code of ethics, a counselor should review the limits of confidentiality which includes duty to warn. Confidentiality of electronic communication including the use to text messages, email and social media should be reviewed as well. Since the counseling was suggested as the result of coworker's grievances, what will or will not be reported to Harold's supervisor should also be reviewed. Therefore, the correct answer is (D)
Competency: professional practice and ethics
Case Study
Patient Demographic: Initial Intake: Age: 12 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Hispanic Relationship Status: Single Counseling Setting: Outpatient Clinic       Type of Counseling: Individual
Mental Status Exam: Carlos came to the intake with his mother, Claudia. Claudia did most of the talking during the intake while Carlos sat in his chair, slumped down low and avoiding eye contact.
Presenting Problem: Carlos is a 12-year-old male referred to an outpatient community clinic by the court after he was caught breaking into several cars on his block.
 
History:
Claudia reported that she and Carlos’ father separated two years ago. Since then, Carlos has had frequent suspensions in school for bullying others and fighting. Carlos often threatens students on social media prior to the altercations. Claudia reported that she no longer knows what to do anymore and she hoped that the counselor can fix him or at least report to her what he is thinking when he does these things.

Question: The counselor responds to Carlos by stating, "It's okay to be angry or hopeless. I can see your strengths. You came today which is a start." The counselor is expressing?
(A): Denial
(B): Positive regard
(C): Congruence
(D): Empathy

Correct Answer: Positive regard
Explanation: Positive regard is the display of warmth and acceptance by the counselor. This also includes the counselor's belief that the client is capable of positive changes. Denial is a Freudian defense mechanism in which a person refuses to see the truth because it brings up feelings of discomfort or pain. Empathy is the ability for the counselor to "walk in the shoes" of the other person. Congruence is when the counselor gives honest feedback regarding the client and his progress. Therefore, the correct answer is (C)
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: At this point Theodore would not need a referral to a?
(A): Cognitive assessment to make sure he can live on his own
(B): A physician for a physical exam
(C): Care manager for housing
(D): Group for bereaved spouses

Correct Answer: Cognitive assessment to make sure he can live on his own
Explanation: There is no indication that Theodore's cognitive functioning is in question. It would also be unethical to refer him to an assessment that is not necessary. A care manager may be able to help Theodore during this stressful time and find appropriate housing for him. A bereavement group may also be a support for Theodore, so that he can be around others who have suffered the same type of loss. Theodore's physical health is just as important as his mental health. Since he has been neglecting himself and dropped a significant amount of weight, a physical exam would be beneficial. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis