ckmjx/CounselingBench huggingface dataset:
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: An appropriate response by the counselor would be?
(A): What if she chose to go with a girl, what harm is that?
(B): Why don't you both tell me more.
(C): Yes, I can see the issue. I am glad you brought her in.
(D): I see that there seems to be conflict between you both- let's talk about it.

Correct Answer: Why don't you both tell me more.
Explanation: This choice is a neutral statement which prompts more information from both parties. Choice a seems to side with Nadia and choice b seems to side with Shar. When working with families it is important to remain objective and to also discourage splitting among family members. Choice c focuses on the negative by highlighting conflict. Therefore, the correct answer is (D)
Competency: counseling skills and interventions
Case Study
Patient Demographic: Initial Intake:   Age: 35 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Employee Assistance Program Type of Counseling: Individual
Mental Status Exam: Harold comes into the office, visibly upset, stating, “I really don’t know why I am here, but I am sure you will see that too after some time together. And I am sure that anything I say here- you can’t report it to anyone anyway, right?” Harold did not display any self-awareness of his actions when speaking to the counselor. At times he showed defensiveness and irritability and other times he was making jokes and complimenting the counselor.
Presenting Problem: Harold, an accounting executive, was referred for counseling by his supervisor after Human Resources received several complaints about Harold’s attitude towards others.
 
History:
Harold has been successful in his career and is knowledgeable in his field. However, he stated that he is often not well liked. Harold attributes this to people being envious of him. Harold told the counselor that recently he was called to human resources because of complaints from his peers. Complaints included allegations of rude remarks, bullying, and Harold taking credit for work that others did. One coworker stated that Harold took frequent breaks and suspected he may be using drugs.

Question: The counselor's statement is an example of?
(A): Confrontation
(B): Congruence
(C): Reflection of feeling
(D): Engagement

Correct Answer: Congruence
Explanation: The counselor is showing congruence as he is being honest in his feedback regarding the client's progress and demeanor. The client's inconsistency may be because of his awareness and bringing this to the client's attention can be a turning point. Confrontation is the client confronting something within themselves, not the therapist confronting the client. Engagement is prompting or encouraging the client to actively participate. Therefore, the correct answer is (A)
Competency: counseling skills and interventions
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: To establish an effective therapeutic relationship, the counselor must?
(A): Collaborate with others to support the client
(B): Have clinical knowledge
(C): Be able to establish trust
(D): Write an appropriate treatment plan

Correct Answer: Be able to establish trust
Explanation: One of the most important qualities that the counselor should have to establish an effective therapeutic relationship with a client is the ability to establish trust. This is especially important with a client who is suffering from delusions and hallucinations. Clinical knowledge and the ability to write appropriate plans are important skills to have but will not determine whether the counselor will be able to form a positive therapeutic relationship. Collaboration with others is also an important part of being a therapist. There may be family members or other providers who are integral in the care of the client. However, if the trust is not established, the client may be skeptical of the counselor speaking with others. Therefore, the correct answer is (B)
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: A symptom of Panic Disorder is?
(A): Symptoms are only precipitated by social situations
(B): Persistent worry about panic attacks and maladaptive change for 2 weeks
(C): Caused by separation from home or attachment figures
(D): Recurrent panic attacks

Correct Answer: Recurrent panic attacks
Explanation: Panic Disorder is characterized by recurrent panic attack with symptoms such as sweating, trembling, nausea, dizziness or derealization. Persistent worry about panic attacks and or maladaptive changes must be present for at least a month. If panic attacks are caused by separation from home or attachment figures, this would be separation anxiety disorder. Additionally, if symptoms are only precipitated by social situations, this is indicative of social anxiety disorder. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis
Case Study
Patient Demographic: Initial Intake: Age: 4 Sex: Female        Gender: Female Sexuality: Heterosexual Ethnicity: African American Relationship Status: Single Counseling Setting: Community Clinic Type of Counseling: Individual
Mental Status Exam: Destiny was engaging with the counselor throughout the interview although her affect was flat. She played by herself while the counselor spoke to Darlene and Tony. She did not look up at her parents or engage with them during the entire session.
Presenting Problem: Destiny is a 4-year-old who was referred for therapy by her preschool teacher. Destiny arrived at the intake session with her adoptive parents, Darlene and Tony Mase. Darlene and Tony shared that they were concerned about Destiny because she never wants to interact with other children, rarely smiles or laughs, and has mood fluctuations with little or no pattern or trigger. Reactions include irritability, sadness, and tearfulness.

History:
Destiny arrived at the Mases’ when she was two years old and was nonverbal at the time. Destiny also showed cognitive delays in her early intervention screening. Darlene and Tony noticed Destiny’s lack of interest in playing with other children when Destiny arrived and she did not want to interact with the other children in the home. The irritability and mood fluctuations began over a year ago. Darlene and Tony were hopeful that once Destiny started preschool that she would start interacting with others, however this is not the case.

Question: What source of information is least important at this time?
(A): Behavioral observation from teacher
(B): Relationship with birth parents
(C): Traumatic life events
(D): Current household members

Correct Answer: Current household members
Explanation: Information about current household members may not be as important at this time. Foster homes are screened and there is no indication or mention of issues surrounding the foster home or anyone living in it. A main problem area for Destiny is her interaction with other children. What happens in a school setting can provide great information. It is important to understand Destiny's relationship with her birth parents to see what the short term and long-term permanency goals are. Finally, it is important to get a comprehensive trauma history to better understand Destiny's early experiences. Therefore, the correct answer is (D)
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: In determining the course of treatment, the counselor should first consider?
(A): What treatment would take the shortest amount of time because of the client's financial situation.
(B): A holistic view of the client.
(C): What has worked in the past for similar clients.
(D): What treatment has been successful with this client thus far.

Correct Answer: A holistic view of the client.
Explanation: In determining the course of treatment, it is important for the counselor to not look at just fragments of the clinical picture. By looking at the client's history, culture and physical and mental health, an effective treatment plan can be more effectively established. Although what has worked in the past with similar cases can be helpful, each person is unique. In addition, although the client may have tried things in the past that did not work, does not mean they may not be successful in trying it again. Finally, putting a short timeframe on the course of treatment because of monetary constraints is not ethical. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis
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 least important area to focus on currently is?
(A): Helping Shar develop coping skills
(B): Psychoeducation on Shar's diagnosis
(C): Shar's relationship with their mother
(D): Shar's decline in school functioning

Correct Answer: Shar's decline in school functioning
Explanation: Although Shar's academic functioning has suffered, this is likely a result of other symptoms Shar is experiencing. Once those are addressed, Shar's grades are likely to improve. Shar and Nadia used to have a positive relationship. Nadia can be a support to Shar as they go through this difficult time. Shar needs some coping skills as evident by their feelings of anger and hopelessness. It would also be beneficial for Shar to receive psychoeducation on their diagnosis, so they understand that their feelings of not belonging are not unique to them. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis
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: The ACA code of ethics states that counselors should consider diversity when assessing and diagnosing a client. A possible diversity factor which may have been overlooked in the intake/assessment process is?
(A): Darrel's feelings about his assertiveness
(B): Darrel's desire to not allow his parents to make decisions in his life
(C): Darrel's stage of Racial identity
(D): Darrel's lack of eye contact during the intake

Correct Answer: Darrel's lack of eye contact during the intake
Explanation: Darrel's lack of eye contact during the assessment process can be misconstrued as being evasive, when it is often a sign of respect in Asian cultures. It is important for counselors to take into consideration verbal and non-verbal behavior with a multi-cultural lens. Darrel's dissonance about his desire to not allow his parents to make decisions in his life is developmentally appropriate considering the life stage he is in. This idea was also openly stated by Darrel when he questioned why he had to do what they wanted anyway. Issues regarding racial identity and Darrel's feelings about assertiveness were shared in the second therapy session, so they were not relevant during the intake/assessment process. Therefore, the correct answer is (A)
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: All of the following are relevant areas of information for Molly's assessment, except?
(A): Eating and sleeping habits
(B): Social support
(C): Parent/child relationship issues
(D): Levels of daily stress

Correct Answer: Parent/child relationship issues
Explanation: Although the quality of her relationship with her parents can lend some important information, this does not seem to be an issue at this point. Molly identified anxiety as the reason she came in. It is important to examine Molly's existing supports. Asking about her eating and sleeping patterns can help identify the severity of her symptoms and how they may be affecting her functioning. Stress seems to be a trigger for Molly so asking about her existing levels of stress would be relevant. 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: Caucasian Relationship Status: Single Counseling Setting: School Counselor Type of Counseling: Individual
Mental Status Exam: Michael came to the office and looked upset as he sat down. When asked about how he felt about what happened, Michael respectfully stated that he was sorry but that he did not want to talk about it.

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

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

Question: An important part of goal setting in this instance is?
(A): Only setting long term goals
(B): Getting parent approval
(C): Involving the school in goal setting
(D): Ensuring the school counselor agrees

Correct Answer: Involving the school in goal setting
Explanation: Since Michael's difficulties seem to center around school, it would benefit Michael to have the school involved in his goals. Although the parent may be involved in the planning process, it is not necessary for them to approve of the goals. It is also not necessary for the counselor to agree on the goals, as goals should be client driven. Setting both short term goals and long-term goals allows for the likelihood of success. Therefore, the correct answer is (B)
Competency: treatment planning