ckmjx/CounselingBench huggingface dataset:
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: An appropriate response from the counselor would be?
(A): "I see. Tell me what brought you in today."
(B): "It seems like you may have needed it sooner."
(C): "Mmm Hmmm..."
(D): "Where did you hear that from?"

Correct Answer: "I see. Tell me what brought you in today."
Explanation: Choice A acknowledges what Molly stated but the allows Molly to also give her reasons for changing her mind and attending counseling. Option B is defensive and option C is judgmental and assumptive. Although Option D indicates that the counselor is listening, it does not address Molly's statement. Therefore, the correct answer is (A)
Competency: treatment planning
Case Study
Patient Demographic:  Initial Intake: Age: 16 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Biracial Relationship Status: Single Counseling Setting: High School Social Worker Type of Counseling: Individual
Mental Status Exam: Autumn came to intake session, during her lunch period. She appeared younger than her stated age because she was so underweight. The counselor greeted Autumn and told her that she was welcome to eat during their session if she wanted to. Autumn looked down and responded, “It’s okay- I don’t like to eat in front of anyone- I can just eat later.” Erin seemed tired during the interview but was cooperative and friendly.
Presenting Problem: History:
Autumn is a junior in high school. Her parents divorced about a month ago. Recently, the teacher noticed a change in Autumn’s mood. Autumn’s teacher also noticed that she was taking her lunch and eating it outside by herself. Oftentimes, she didn’t seem to eat much of it at all. When asked about it, Autumn seemed embarrassed and stated that she was fine.

Question: The counselor responds to Autumn's last statement with “Whatever you are most comfortable with is completely fine. Just know that it's an option.” This is an example of?
(A): Alliance building
(B): Creating an atmosphere of comfort and trust
(C): Exploring religious and spiritual beliefs
(D): Informed consent

Correct Answer: Creating an atmosphere of comfort and trust
Explanation: Creating an atmosphere of comfort and trust is one of the first stages of counseling. By allowing Autumn a choice of not eating, even if is her lunch time, she is acknowledging and validating Autumn's feelings. Creating a physically comfortable environment is also important. Counselors should make the counseling area warm and inviting for the client. Alliance building is a process and occurs over some time. Informed consent is an explanation of the nature of counseling, what it will entail as well as the risks and benefits. Religious and spiritual beliefs should always be considered. In this case Autumn not wanting to eat stems from her anxiety and not her beliefs. 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: Tony is displaying symptoms of?
(A): Gender Dysphoria
(B): Transvestic Disorder
(C): Fetishistic Disorder
(D): Frotteuristic Disorder

Correct Answer: Transvestic Disorder
Explanation: Transvestic disorder is characterized by sexual arousal through cross dressing which causes serious impairment in areas of functioning. Fetishistic disorder is ruled out because of Tony's thoughts of looking like a woman is the cause of his arousal. Gender dysphoria is ruled out because Tony does not desire to be a woman. However, in some cases transvestic disorder may progress to gender dysphoria. Frotteuristic disorder is ruled out as this disorder is characterized by arousal by touching or rubbing against a non-consensual person. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
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: Carlos seems disengaged currently. Which of the following statements by the counselor would be an appropriate response?
(A): "Do you want to tell me more about yourself?"
(B): "Carlos, you know that you have to be involved in therapy as per court, right?"
(C): "Tell me what you want to accomplish in our time together."
(D): "Wow, it sounds like things are getting worse for you."

Correct Answer: "Tell me what you want to accomplish in our time together."
Explanation: An open-ended question gives Carlos control as well as a sense that the counselor values his opinion. Carlos is aware that he is mandated to attend therapy. Reminding him of this may seem authoritarian or confrontational. Choice b focuses on the negative and would not add motivation for Carlos to engage. Choice c could be answered with a no. A better way to ask the question would be, "Tell me something about yourself". Therefore, the correct answer is (D)
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: What is a highly effective modality of therapy for someone diagnosed with Schizophrenia?
(A): Family systems Therapy
(B): Cognitive Behavioral Therapy
(C): Existential Therapy
(D): Psychoanalysis

Correct Answer: Cognitive Behavioral Therapy
Explanation: Cognitive behavioral therapy has been proven effective for clients diagnosed with Schizophrenia. Psychoanalysis would not be beneficial as it focuses on the subconscious process and childhood. Existential therapy is not suggested for those who are actively psychotic. Family systems therapy is not the best option as it focuses on family dynamics which is currently a trigger for Mark. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
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: Molly meets the diagnostic criteria for?
(A): Panic Attacks
(B): Agoraphobia
(C): Generalized Anxiety Disorder
(D): Anxiety disorder due to medical condition

Correct Answer: Generalized Anxiety Disorder
Explanation: Molly meets the criteria for generalized anxiety disorder which include symptoms of excessive worry, difficulty controlling the worry, as well as difficulty sleeping, poor concentration and muscle tension. There is no indication that Molly has a medical condition causing symptoms of anxiety. Panic attack is not a coded mental disorder but is included in the DSM-V as a specifier used to identify one of the symptoms of Panic Disorder. Agoraphobia is the intense fear of leaving the house, which Molly does not have. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Name: Anxiety Group Therapy Clinical Issues: Worry and anxiety Diagnostic Category: Anxiety Disorders Provisional Diagnosis: F41.1 Generalized Anxiety Disorder Age: 0 Sex Assigned at Birth: Female Gender and Sexual Orientation: Not applicable, Ethnicity: Various Marital Status: Not Applicable Modality: Group Therapy Location of Therapy : Agency  
Mental Status Exam: The group members appear to be insightful about their illness. Clients ages are 25 and older. All members are well-groomed and present with clean hygiene.
Presenting Problem: First session You are a therapist in an agency starting a group for clients with anxiety. The group will consist of seven participants. It is a homogeneous, closed group which will meet once a week on Wednesday evenings for an hour and a half for twelve weeks. The group's goal is to help clients diagnosed with Generalized Anxiety Disorders and other anxiety-related issues. An intern will co-facilitate the group with you. You are forming an outline for the group's goals, screening questions, and termination process. You will be observing candidates for the group to facilitate participant selection.

Question: What is the most important element to take into consideration when initially establishing your group?
(A): Setting of the group
(B): Issues at termination
(C): Maintaining confidentiality outside the group
(D): Having a psychiatrist on site

Correct Answer: Setting of the group
Explanation: The group setting is the most important consideration because the group environment needs to be safe, private, consistently available. It should also be comfortable and contain adequate furniture. Therefore, the correct answer is (C)
Competency: professional practice and ethics
Case Study
Patient Demographic: Name: Anxiety Group Therapy Clinical Issues: Worry and anxiety Diagnostic Category: Anxiety Disorders Provisional Diagnosis: F41.1 Generalized Anxiety Disorder Age: 0 Sex Assigned at Birth: Female Gender and Sexual Orientation: Not applicable, Ethnicity: Various Marital Status: Not Applicable Modality: Group Therapy Location of Therapy : Agency  
Mental Status Exam: The group members appear to be insightful about their illness. Clients ages are 25 and older. All members are well-groomed and present with clean hygiene.
Presenting Problem: First session You are a therapist in an agency starting a group for clients with anxiety. The group will consist of seven participants. It is a homogeneous, closed group which will meet once a week on Wednesday evenings for an hour and a half for twelve weeks. The group's goal is to help clients diagnosed with Generalized Anxiety Disorders and other anxiety-related issues. An intern will co-facilitate the group with you. You are forming an outline for the group's goals, screening questions, and termination process. You will be observing candidates for the group to facilitate participant selection.  Fourth session All seven members have been coming to your group for three weeks. The group is made up of married, single, and divorced females. Some have children and some do not. Ages range from 25 to 33 years old. It is multiculturally diverse. As group sessions progress, you note that some group members are starting to take risks, while others are still not fully trusting you and the group's co-facilitator. Most of the clients generally worry about their family and loved ones. Some are more afraid of getting ill and dying because of COVID-19. You lead the group in a guided meditation before you start making the rounds to calm everyone down and have them feel centered.

Question: In this group, you will be working with clients that have Generalized Anxiety Disorder. According to the DSM-5-TR, what is considered a differential for Generalized Anxiety Disorder?
(A): Panic Disorder
(B): Agoraphobia
(C): Schizoid Personality Disorder
(D): Anorexia Nervosa

Correct Answer: Panic Disorder
Explanation: Panic Disorder is a differential for Generalized Anxiety Disorder. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
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: Which of the following screening tools for substance use would not be appropriate for Sandy?
(A): CRAFFT 2.0
(B): TAPS
(C): DAST-10
(D): ANA

Correct Answer: CRAFFT 2.0
Explanation: The CRAFFT 20 is for children 12-18 and would not be appropriate of Sandy. The tobacco, alcohol, prescription medication and other substance use- brief screening tool (TAPS) is only useful for screening of a forementioned drugs. The Drug abuse screening test- self screen (DAST) takes 5 minutes to yield quick results. The Addictions Neuroclinical Assessment (ANA) measures behavior, brain imaging and genetics for a comprehensive measure the levels and origins of addiction. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
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: You are meeting with the client for the termination session. You review the treatment goals and the client’s progress. The client is no longer experiencing panic attacks, and she reports that she has felt panic attacks coming on but that she intervenes early and often to prevent them from occurring. You and the client have prepared for this date during the last few sessions in order to prepare the client for transitioning to independence from therapy. You and the client discuss her use of coping skills and natural supports to continue to manage panic symptoms. You also inform the client of how to reconnect if she needs to receive therapeutic support again and then terminate services

Question: All of the following are primary focuses of the termination session, EXCEPT:
(A): Signaling an end to the therapeutic relationship
(B): Identifying that growth has occurred
(C): Evaluating the effectiveness of therapy
(D): Encouraging ongoing therapeutic changes

Correct Answer: Evaluating the effectiveness of therapy
Explanation: Evaluating the effectiveness of therapy should have occurred throughout the entirety of the counseling services; therefore, it is not a primary focus of termination. At the end of services, you want to focus on what the client has achieved and not on what you have done as a counselor. The termination session focuses on ending the relationship, encouraging the client to continue to use the learned skills without you, and helping the client to realize what has been accomplished. Therefore, the correct answer is (D)
Competency: professional practice and ethics
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: rded. Family History: Most of the clients report distressed relationships with their parents or guardians and that they have not had stable relationships throughout their lives

Question: All of the following are criteria for borderline personality disorder, EXCEPT:
(A): Recurrent suicidal behavior
(B): Binge eating
(C): Inappropriate, intense anger or difficulty controlling anger
(D): Recurrent depressive episodes

Correct Answer: Recurrent depressive episodes
Explanation: Depressive episodes are not a symptom of borderline personality disorder. There is a long list of diagnostic criteria for borderline personality disorder, five of which must be present for diagnosis. One category of criteria for borderline personality disorder, according to the DSM-5-TR, is impulsive behavior, which includes binge eating in addition to excessive spending, inappropriate sexual relations, substance abuse, and dangerous driving. Intense anger and suicidal ideation are additional elements in the list of diagnostic criteria for borderline personality disorder. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis