ckmjx/CounselingBench huggingface dataset:
Case Study
Patient Demographic: Initial Intake: Age: 58 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: The client reports that in the past six months she has lost 40 pounds, which leaves her looking thinner than seems appropriate for her 5’8” frame. Her hair is combed and neat, but looks thin and lacks a healthy shine. Her clothes, while clean, appear rumpled as if they have been slept in. She is cooperative and engaged, but moves slowly and pauses in her speech, causing you to wonder if she is lost in thought or if speaking is too painful. She reports she has difficulty falling asleep at night and never feels like she has any energy, though she does go to work each day.  She denies any suicidal thoughts but states she feels sad all the time and “can’t wait to see him again.” She admits she blames herself for not keeping him home that evening, which would have prevented his death.
Presenting Problem: You are a counselor in a private practice setting.  You receive a telephone call from an attorney that would like to refer their client, who is engaged in a civil suit, to you for counseling treatment. The attorney provides you with a detailed description of a traumatic event, death of her son, and expresses concerns about the client’s well-being. The attorney requests that you work with their client and be prepared to testify in court when the case goes to trial.
Other Contexts: Family History:
During the intake session, the client reports that her youngest son was killed in a car accident eighteen months ago, which was caused by an impaired driver.  Her son was the youngest of her five children and while she said she loves them all equally, she reported that her children have always said their youngest brother was her favorite.

Question: In evaluating the client's current condition, which of the following would you NOT expect to do?
(A): Explore family of origin patterns related to loss
(B): Assess for Schizoaffective, Schizophrenia, or Delusional Disorder in family history
(C): Perform a Mental-Status Exam (MSE)
(D): Assist client in exploring what would happen if she acknowledged his death

Correct Answer: Assess for Schizoaffective, Schizophrenia, or Delusional Disorder in family history
Explanation: The client's actions are purposeful and consciously focused on relieving her feelings over her son's death. These may be cultural or familial patterns that she has learned to minimize the pain of grief. The MSE assesses for at-risk or bizarre thinking to ensure the client's safety; however, there is no indication of familial psychosis or schizophrenia-type illnesses at this time. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Clients Age: Husband: 45 Wife: 43 Sex: Husband: Male Wife: Female Gender: Husband: Male Wife: Female Sexuality: Heterosexual Ethnicity: Both Individuals Are Caucasian Relationship Status: Married Counseling Setting: Private Practice Counseling Clinic Type of Counseling: Couples Counseling Presenting Problem: Marital Distress Diagnoses: Couple Diagnosis: Adjustment Disorder with Anxiety (F43.22) and Relationship Distress with Spouse or Intimate Partner (Z62.898) Individual Diagnosis (Wife): Generalized Anxiety Disorder (F41.1)
Mental Status Exam: Mental Status Exam: The husband and wife were both oriented to person, place, time, and situation. Both individuals were dressed appropriately for the season and appeared clean. The husband presented as angry, and the wife presented as remors
Presenting Problem: You are a licensed therapist working at a private practice. The couple comes to counseling in order to work on their relationship following an infidelity. The wife has difficulty expressing what happened, and the husband interrupts her and expresses that his wife had an affair with a coworker 3 weeks ago. The couple states that they are currently talking very little aside from conversations that involve their children. The wife states that she is regretful of what she did and that she does want her marriage “to be saved.” The husband explains that he is very hurt by her infidelity and that he is unsure if he can forgive her and continue being married to her. The couple has been married for 25 years and report that they both are in counseling to see if they can continue to be married following the affair. The husband expresses strong anxiety following the revelation of the affair and questions how he can be in a relationship with his wife following the infidelity. The wife is experiencing anxiety regarding her husband leaving her because she reports regretting the sexual interaction with her coworker and does not want to get divorced.
Other Contexts:    eful. Family History: The couple has been married for 25 years. They have two children,a 14-year-old son and a 17-year-old daughter, and they report good relationships with their families of origin

Question: Which of the following would be important to discuss when reviewing informed consent that would be uniquely different for couples counseling?
(A): The clinician promoting the well-being of the individuals involved in counseling
(B): The nature of counseling
(C): The risks of counseling that includes dealing with difficult topics during sessions
(D): Confidentiality

Correct Answer: Confidentiality
Explanation: A unique limit to confidentiality is the clinician’s inability to ensure that both individuals in couples counseling will not share information about the other. It is important to encourage both individuals to maintain confidentiality for each other in order to ensure a safe environment in the couples counseling session. The nature of counseling, the risks involved, and promotion of well-being are all common factors in the counseling setting. Therefore, the correct answer is (A)
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: Elaina has suffered from multiple traumatic events. The capacity for positive adaptation after a significant negative event or threat is called?
(A): Resilience
(B): Dynamics
(C): Plasticity
(D): Risk

Correct Answer: Resilience
Explanation: Resilience is the capacity for adaption after a significant event. The amount of resilience one has can determine positive or negative outcomes in situations. Risk factors are things that increase the likelihood of negative outcomes. Plasticity is the ability for brain cells to change from various experiences. Dynamics are the behavioral and relationship patterns between people. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
Case Study
Patient Demographic: 39   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: According to Erikson's stages of psychosocial development, Darrel is in the stage of?
(A): Autonomy vs. shame and doubt
(B): Trust vs. mistrust
(C): Industry vs. inferiority
(D): Individual identity vs identity confusion

Correct Answer: Individual identity vs identity confusion
Explanation: Darrel appears to be in the stage of Individual identity vs identity confusion evidenced by the conflicting feelings of wanting autonomy from his parents and not wanting to disappoint them and questioning his career path. Industry vs inferiority occurs in middle childhood when an individual is focused on friendships, learning life skills and team play. Autonomy vs shame and doubt as well as trust vs mistrust occurs between the ages of birth to 3 years old. 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: Li's reaction on the subway meets the criteria for?
(A): Panic Disorder
(B): Hyperventilation
(C): Panic Attack
(D): Paroxysmal episode

Correct Answer: Panic Attack
Explanation: What Li described meets the criteria for a panic attack. It does not yet meet the criteria for Panic Disorder which consists of repeated attacks. Hyperventilation is rapid or deep breathing often caused by panic. A Paroxysmal episode can mimic a seizure and may include loss of consciousness. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
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: Which of the following is not part of an assessment interview?
(A): Past evaluations and assessments
(B): Structured interview
(C): Unstructured interview
(D): Observation of behavior

Correct Answer: Past evaluations and assessments
Explanation: Past evaluations and assessments can be helpful in the overall clinical picture and can confirm information provided by the client but can be gathered later. The assessment interview should include a structured interview which follows a standard format or form, an unstructured interview which is more conversational and observation of behavior/non-verbal cues. Therefore, the correct answer is (B)
Competency: treatment planning
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

Question: All of the following interventions are clinically appropriate therapeutic approaches to treating major depressive disorder, recurrent, mild EXCEPT:
(A): Support groups
(B): Referral for electroconvulsive therapy
(C): Cognitive behavioral therapy (CBT)
(D): Referral for psychiatric medication management

Correct Answer: Support groups
Explanation: CBT and electroconvulsive therapy are clinically proven, effective treatments for depressive disorders. Medications may be beneficial in the treatment of depression, and a referral to a psychiatrist or psychiatric nurse practitioner is required for that assessment and prescription because prescribing medications is outside of the scope of the counselor. Although support groups may be beneficial to a client, they are not clinical in nature. Therefore, support groups would not provide treatment; rather, they would provide a support system for a client. Therefore, the correct answer is (A)
Competency: treatment planning
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: By saying, "Tell me about your experience coming into a new culture and going through what you did" the counselor is demonstrating the attribute of?
(A): Empathy
(B): Curiosity
(C): Inclusion
(D): Cultural awareness

Correct Answer: Cultural awareness
Explanation: Cultural awareness is understanding that someone's cultural experiences and views are unique and may differ from your own. Curiosity is being inquisitive about a different culture. Empathy is trying to put yourself in the shoes of another and inclusion is providing equal access or opportunities to others who may be marginalized. Therefore, the correct answer is (A)
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: What is the least important for the counselor to review currently?
(A): Assess competency to provide informed consent
(B): Clarify that it is not the counselor's role to "fix" the child but to help identify patterns and reasons for behaviors
(C): Review Carlos' successes and strengths
(D): Discuss limits of confidentiality

Correct Answer: Assess competency to provide informed consent
Explanation: There is no indication that Carlos and his mother are not capable of providing informed consent. It is important to address Claudia's commend about "fixing" Carlos. This can be incorporated in the informed consent process. Also, discussing confidentiality and the limits of confidentiality when you are treating a minor is imperative. Given Carlos' response, reviewing his successes and strengths will not only help his mother focus on the positive but it can also be a way to engage Carlos. Therefore, the correct answer is (D)
Competency: professional practice and ethics