ckmjx/CounselingBench huggingface dataset:
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: Harold is having difficulty thinking of goals that he needs to work on. The counselor should?
(A): Tell Harold some goals that have been successful in similar situations
(B): Terminate sessions with Harold
(C): Ask Harold what are some things he would like to see changed
(D): Ask Harold's supervisor for some suggestions

Correct Answer: Ask Harold what are some things he would like to see changed
Explanation: Asking Harold some things he would like to see changed highlights the standard of client centered therapy. The process of making goals in therapy can be daunting, especially for someone who does not feel like they need to be in therapy. Even though Harold's supervisor and HR recommended counseling, it would not be appropriate for Harold's supervisor to make his goals as goals should be client centered regardless of the reason for counseling. This helps to ensure success and motivation. Although the counselor may have done research in what types of goals can be effective, each person is individual and their goals should be as well. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Client Age: 25 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Counseling Clinic Type of Counseling: Individual Presenting Problem: Depression and Suicidal Ideation Diagnosis: Major Depressive Disorder, Recurrent, Mild (F33.0)
Mental Status Exam: Mental Status Exam: The client appears to not have bathed recently because his hair is greasy and unkempt. The client has food stains on his clothing; however, he is dressed appropriately for the season. His motor movements are within normal limits. He is engaged in therapy, but he appears anxious as evidenced by hesitating before speaking and by his hand wringing. The client reports suicidal ideation with no plan or intent. The client reports a depressed mood more often than not and difficulty enjoying most activities. The client is oriented to person, place, time, and situation. The client reports that his appetite has increased lately and that he is experiencing hyperso
Presenting Problem: You are a resident in counseling practicing in a private practice agency. During the initial counseling session, the 25-year-old single male client reports feeling depressed and hopeless. He has difficulty enjoying activities that he has enjoyed in the past and feels unsatisfied with most areas of his life. The client identifies that he is not happy at work and wants to make a career change. The client verbalizes feeling sad more often than not, and that this has been going on for about 2 years. The client decided to start counseling when he began experiencing suicidal thoughts. The client reports no plan or intent to attempt suicide but is concerned about his own well-being.
Other Contexts: The client reports that he has been sleeping more than usual and that this is affecting his ability to get to work on time. He reports that his boss started noticing his tardiness and has given him a verbal warning. Combined with the fear of losing his job, he expressed worry regarding increased conflict with his girlfriend and feeling more “on edge.”  Due to the client’s difficulty with sleep, you provide psychoeducation on sleep hygiene

Question: Due to the client’s difficulty with sleep, you provide psychoeducation on sleep hygiene. Sleep hygiene involves all of the following foci EXCEPT:
(A): Room temperature
(B): Time of initiation of sleep and time of waking
(C): Maintaining 9 to 12 hours of sleep per 24 hours for a 25-year-old
(D): Mindfulness activities prior to bed

Correct Answer: Maintaining 9 to 12 hours of sleep per 24 hours for a 25-year-old
Explanation: At age 25, it is recommended to get at least 7 hours of sleep per night. The 9- to 12-hour range is more appropriate for the age range of 6 to 12 years old. Consistent times of sleep initiation and waking are important in improving sleep. The room temperature also impacts the quality of sleep, although temperature needs vary from person to person. Mindfulness and relaxation activities can help calm the body as a means to better prepare him for sleep. Therefore, the correct answer is (C)
Competency: treatment planning
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: At this point in counseling, what referrals might be appropriate to consider in addition to individual/family therapy?
(A): Applied behavior analysis
(B): Occupational therapy
(C): Play therapy
(D): Psychiatry for medication management

Correct Answer: Play therapy
Explanation: Play therapy may be beneficial because it can help children to improve communication and explore/express their emotions. Applied behavior analysis would not be indicated because the client is able to engage in cognitive counseling, which means talk therapy would be more beneficial. Medication management may be beneficial at some point, but there are no Food and Drug Administration-approved medications for oppositional defiant disorder, and therapy tends to be more effective than medication. Occupational therapy is not indicated because the individual appears to have no cognitive, physical, or sensory issues that would require skill development. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
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: You meet with the group, and they appear to be starting to become more comfortable with one another. You noticed that throughout the past week, when you saw your clients on their unit, they were spending more time together and that they are all talking when they come in for the session. During the session, you and the clients discuss past experiences that led to them engaging in the crimes that led to their incarceration. During this conversation, client 1 is talking about his father and how he killed a pedestrian while driving. Client 4 then asserts that client 1’s father is going to hell for killing someone. You cut off client 4 and redirect the attention back to client 1

Question: According to Tuckman’s stages of group development, which stage is this group in?
(A): Performing
(B): Forming
(C): Storming
(D): Norming

Correct Answer: Storming
Explanation: The storming phase focuses on group members establishing a hierarchy and often involves conflict even as group cohesion is developing. The forming stage is the initial stage in which the group comes together and becomes acquainted. The storming phase follows the forming stage. The norming phase is when the group members agree on how the group should be run and how individuals should interact. The performing stage is when the group is most productive and is working toward their goals. Therefore, the correct answer is (D)
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: Ideally, the initial session of the group should involve:
(A): Reminding members that confidentiality is guaranteed
(B): Urging members to refrain from discussing all of their feelings
(C): Encouraging members to confront others' behavior to build norms
(D): A review of group structure and basic tasks

Correct Answer: A review of group structure and basic tasks
Explanation: This should be reviewed in the initial stage of the group. Therefore, the correct answer is (C)
Competency: treatment planning
Case Study
Patient Demographic: Client Age: 20 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Asian Relationship Status: Single Counseling Setting: College counseling clinic Type of Counseling: Individual counseling Presenting Problem: Panic attacks Diagnosis: Provisional diagnosis: panic disorder (F41.0)
Mental Status Exam: Mental Status Exam: The client is oriented to person, place, time, and situation. The client does not appear anxious or depressed and was friendly and eng
Presenting Problem: You are a counselor working in a college counseling department. The client comes in after being late to class several times over the last month due to reported “freak-outs” in the morning. The client experiences the following panic symptoms: accelerated heart rate, sweating, shaking, shortness of breath, and a feeling of impending doom. The client reports a feeling of impending doom when she wakes up on days when she has classes, and this anxiety tends to escalate into fear of having a panic attack on a daily basis, often making her late to her first class. The client is worried that she will have panic attacks every day for the rest of her life. She says that her parents have put a lot of pressure on her to get a high grade point average at college. The client is worried about how this pressure and the panic attacks are going to affect her doing well at college and engaging socially.
Other Contexts: aged. Family History: The client reports that she is close with her parents but that they often have high expectations of her and that she worries about disappointing them. The client has an older brother who is 25 and is a lawyer. The client says some of the pressure is wanting to be as successful as her brother because she thinks her parents are really proud of him

Question: Although you suspect that the client has panic disorder, all of the following diagnoses or areas should be assessed as differential diagnoses, EXCEPT:
(A): The possibility of generalized anxiety disorder
(B): The possibility of major depressive disorder
(C): Cognitive processes that occur when experiencing a panic attack
(D): Whether the panic attacks are expected, unexpected, or both

Correct Answer: The possibility of major depressive disorder
Explanation: Major depressive disorder is not indicated as a possible differential diagnosis for this client, although depression and anxiety often present together. Generalized anxiety disorder and other anxiety disorders should be assessed because the client might be having panic attacks that are based on underlying anxiety that she is experiencing. Panic disorder is characterized by unexpected panic attacks; therefore, it would be helpful to determine if the attacks are related to other anxious thoughts and cognitive processes or if they occur on their own. Therefore, the correct answer is (C)
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: Li should be referred to?
(A): Care manager
(B): A group for human trafficking survivors
(C): All of the above
(D): Employment counselor

Correct Answer: All of the above
Explanation: All of the above would be helpful for Li. Being part of a group for human trafficking survivors can provide support for Li while helping her to see that she is not alone. An employment counselor can help her target a job congruent with her skills and interests. A care manager can help Li to coordinate her services. Therefore, the correct answer is (D)
Competency: professional practice and ethics
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: The approach the counselor chose is consistent with?
(A): Cognitive Behavioral therapy
(B): Behavior therapy
(C): Adlerian therapy
(D): Feminist therapy

Correct Answer: Cognitive Behavioral therapy
Explanation: The approach described above is cognitive behavior therapy. The focus in cognitive behavior therapy is to demonstrate to the client their faulty beliefs. It is short term and directive. Adlerian therapy is longer term and looks at childhood experiences and family constellations. Behavior therapy does not look at the causes of behavior but focuses on repeating positive behaviors and extinguishing negative. Since there are no gender specific issues that Elaine would like to work on, Feminist therapy would not be an ideal modality. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
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: Harold is showing symptoms of?
(A): Unspecified Personality Disorder
(B): Antisocial personality disorder
(C): Histrionic Personality Disorder
(D): Narcissistic personality Disorder

Correct Answer: Narcissistic personality Disorder
Explanation: Harold meets the criteria of narcissistic personality disorder as evidenced by his grandiose sense of self-importance, belief that he is irreplicable at his company, his sense of entitlement, bullying of others and the belief that others envy him. Antisocial personality disorder is ruled out as there is no evidence of aggression, disregard for safety or failure to conform to social norms. Histrionic personality disorder is ruled out as it is characterized by attention seeking behavior with symptoms such as inappropriate sexualized behavior, shallow expressions of emotions, dramatic in the expression of emotion and the use of physical appearance for attention. Unspecified personality disorder is used when one does not meet the full criteria for a specific personality disorder. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis