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: An assessment that would be most beneficial to gain initial information is?
(A): Adult Behavior Checklist
(B): Myers-Briggs Type Indicator
(C): Strong Interest Inventory
(D): NEO Personality Inventory

Correct Answer: Adult Behavior Checklist
Explanation: The Adult Behavior Checklist (ABCL) is a brief, self-report checklist in which someone selects whether he/she is having difficulty in the areas of attention, mood, conduct, anxiety and worry. This would be an appropriate and non-invasive assessment for Darrel to complete. If it is indicated that Darrel is indeed unsure of his career path, the Strong Interest Inventory can help Darrel match his interests with potential education, career, and leisure activities. The Myers-Briggs Type Indicator is used to evaluate personality types to help clients better understand themselves including learning style, social interaction styles, which occupational path they may be suited for, or insight into their behaviors. The NEO is another personality inventory widely used in career and individual counseling, career development and employee training. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
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: When Autumn sat down, she noticed some files of some other students in front of the counselor. Autumn suddenly stated that she had to go and left the counselor's office. Although Autumn could only read the names and not see the content of the files, this is a violation of the ethical code regarding?
(A): Confidentiality
(B): Providing information to third parties
(C): Supervision
(D): Trust

Correct Answer: Confidentiality
Explanation: The counselor seems to have violated the confidentiality of other students which goes against the ethical codes B1c. Respect for Confidentiality and B6b Confidentiality of Records and Documentation. Although this may be an issue to be addressed in supervision, it is not a violation of supervision standards. Providing information to third parties sometimes occurs when information is requested by third party payors. This must be authorized by the client. Although there is not ethical code for trust, seeing the files on the counselor's might affect Autumn's feelings of trust. Therefore, the correct answer is (C)
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: The best referral for the counselor to make after the second session is?
(A): Nothing else currently
(B): Psychological testing
(C): Group therapy
(D): Psychiatric consult

Correct Answer: Group therapy
Explanation: Shar's comments of not feeling like they belong, along with their positive outlook from knowing they are "not alone" shows that they may benefit most from group counseling at this time. Psychological testing or a psychiatric consult do not seem necessary currently. Individual therapy alone may be okay, but the addition of group therapy seems warranted at this time so that Shar can have a feeling of belonging. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic:  Initial Intake:   Age: 38 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: VA Type of Counseling: Individual
Mental Status Exam: Carl came to the intake session alone and angrily stated, “I really don’t know why they are making me come to therapy - it doesn’t help anyway.” Carl appeared edgy throughout the interview and responded to questions with minimal effort.

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

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

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

Question: All of the following statements are true regarding counseling, except?
(A): It would be an ethical breach to take sides in this situation.
(B): At the onset of couple's counseling, the counselor must clearly define roles in the counseling relationship.
(C): The counselor should respond that they are both wrong.
(D): The couple is considered the client.

Correct Answer: The counselor should respond that they are both wrong.
Explanation: It would not be appropriate for the counselor to indicate who is right or wrong. It is up to the counselor to help the couple to communicate with one another. According to ethical standards, the counselor must clearly define roles at the onset of counseling, which includes the understanding that the couple is considered the client in marital counseling. Taking sides in couple's counseling is unethical and can damage the therapeutic process. Therefore, the correct answer is (B)
Competency: professional practice and ethics
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: In determining a preliminary diagnosis, the counselor should first consider?
(A): Cultural factors
(B): Subject of the hallucinations
(C): Time of day
(D): Substance use

Correct Answer: Substance use
Explanation: Delusions and hallucinations may be caused by substance use. It is important to first rule out any physical causes such as substance use, brain injury, or other medical conditions. After these are ruled out, it is important to consider cultural factors. In certain cultures, hallucinations and delusions are part of the cultural norm. Time of day and subject of the hallucinations are not relevant for determining a preliminary diagnosis. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis
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: Based on the Initial Intake, which of the following can be ruled out?
(A): Schizotypal (ability to maintain a relationship)
(B): Brief psychotic disorder
(C): Schizophrenia
(D): Schizoaffective disorder

Correct Answer: Schizotypal (ability to maintain a relationship)
Explanation: The essential feature of schizotypal disorder is "a pervasive pattern of social and interpersonal deficits marked by and acute discomfort with, and reduced capacity for close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior". It is not likely that he would meet the criteria for schizotypal disorder as he has been able to maintain a stable relationship. From the information provided, Mark's symptoms can be indicative of brief psychotic disorder, schizophrenia and schizoaffective disorder. To rule out any of these, it would be helpful to know the length of time symptoms have occurred. Brief psychotic disorder has a timeframe of less than one month, where in schizophrenia, the disturbance lasts for more than 6 months. Schizoaffective disorder is characterized by one depressive or manic episode. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
Case Study
Patient Demographic: Client Age: Client 1: Age 18 Client 2: Age 21 Client 3: Age 22 Client 4: Age 19 Client 5: Age 18 Sex: Male and female Gender: Male and female Sexuality: Heterosexual Ethnicity: Multiracial Relationship Status: All members are single Counseling Setting: Counseling clinicType of Counseling: Group and individual counseling Presenting Problem: All individuals are seeking support for struggles related to borderline personality disorder. Diagnosis: Borderline personality disorder (F60.3)
Mental Status Exam: Mental Status Exam: All clients appear to be oriented to time, situation, location, and person. The clients are all dressed appropriately for the weather. No clients appear to experience any visual or auditory hallucinations. Most of the clients are presenting as friendly but gua
Presenting Problem: You are a licensed therapist running a dialectical behavior therapy (DBT) group for young adults. You also provide a weekly individual counseling session for each group member, which is common practice for DBT group therapy. During the first session, you provide psychoeducation on DBT and the group process. Most of the members seem closed off and sometimes aggressive in response to being asked to speak during the first session, which can be consistent with borderline personality disorder. Client 3 becomes upset about halfway through the session, stating that he does not need to participate because the group will eventually end, so he does not need to build relationships with the group members. You end the session by planning individual therapy sessions with each group member.
Other Contexts: You meet with the group and continue DBT psychoeducation regarding distress tolerance. About halfway through the group, you notice that client 4 has not shared much, and you ask her about this. The client states that every time she wants to talk, she cannot find a way into the conversation because others are talking. This group is in the working stage of group therapy, they are actively engaged in the session, and they are all also actively engaged in individual therapy

Question: All of the following would provide space for client 4 to participate more, EXCEPT:
(A): Active listening
(B): Rounds
(C): Cutting off
(D): Dyads

Correct Answer: Active listening
Explanation: Active listening, although helpful, is not proactive in helping members participate more when they feel like they cannot get space to speak. Dyads and rounds (enlisting a question to the group and then providing every group member the opportunity to answer) provide an individual with an unobstructed opportunity to speak and participate. Cutting off can be helpful in this situation because cutting off members that are dominating conversation and redirecting questions to client 4 can help her feel that she has an opportunity to speak. Therefore, the correct answer is (C)
Competency: counseling skills and interventions
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 in the session, the counselor should not?
(A): Explain to Theodore that the most sensible place to live is with Nate
(B): Obtain more information about the relationship between Nate and Theodore
(C): Explore other resources for places Theodore can live
(D): Make a diagram of Theodore and those who are a support to him

Correct Answer: Explain to Theodore that the most sensible place to live is with Nate
Explanation: It is not up to the counselor to verbalize his/her opinion about who Theodore should live with. And it would be judgmental to assume that because of Theodore's age he is not able to live on his own. At this point in the session, the counselor should explore other resources that are available for Theodore. It is also important to better understand the relationship dynamics and history between Nate and Theodore. One way to explore resources and to get a better understanding his relationships and support systems is by drawing a diagram of people he knows and his relationships with them. Therefore, the correct answer is (B)
Competency: counseling skills and interventions
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: Which of the following situations would possibly hinder the creation of a therapeutic alliance with Carl?
(A): Ask Carl what qualities he likes in a counselor
(B): Sit with Carl in the center of the room, in an L shape
(C): Sit with Carl on one side of a desk and you on the other
(D): Ask Carl about his expectations for counseling

Correct Answer: Sit with Carl on one side of a desk and you on the other
Explanation: Body posture and the physical space of the counseling office is important to keep in mind to create an environment conducive to the counseling process. Placing a structure, such as a desk, between a client and counselor can serve as a barrier to openness. Ideally, the counselor and client should be sitting with no objects between them. This can be face to face, or in an L shape. Due to Carl's history of assaulting a counselor, it would be advisable for the counselor to sit near an exit. Other ways to help build a therapeutic alliance would be to ask Carl about his expectations of counseling in order to provide structure and allow for a conversation about informed consent. Also, by asking Carl what he likes in a counselor, the counselor can see what has worked for Carl in the past. Therefore, the correct answer is (A)
Competency: counseling skills and interventions