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: A few days later, after Harold informs the counselor he no longer wants her as a counselor, Harold came to the counselor's office with a small, wrapped box. Harold stated that it was just a small token to say thank you. Under ethics rules, the counselor should?
(A): Thank Harold and wish him the best, opening the gift later.
(B): Tell Harold she needs to speak to her supervisor first and then will get back to him
(C): Thank Harold but tell him that she cannot accept any gifts
(D): Open the box in front of Harold and give it back to him if it seems expensive

Correct Answer: Thank Harold and wish him the best, opening the gift later.
Explanation: In most cases, a is the best choice since Harold is no longer a client. Counselors should be aware of the code of ethics which state that "Counselors understand the challenges of accepting gifts from clients and recognize that in some cultures, small gifts are a token of respect and gratitude. When determining whether to take gift from a client, counselors consider the therapeutic relationship, the monetary value of the gift, the client's motivation for giving the gift and the counselor's motivation for wanting to accept or decline the gift". In this scenario, the client and counselor have terminated their relationship and the gift is a token to say thank you. By telling Harold she cannot take any gifts, Harold may be offended. This may cause undo harm, which goes against ethical standards. Opening the gift in front of him and then possibly giving it back can be uncomfortable for both parties. Choice d leaves the situation in a limbo and the counselor should be aware of the code of ethics when presented with a gift. Therefore, the correct answer is (A)
Competency: counseling skills and interventions
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:    mnia. Family History: The client reports that he has two younger brothers who are 19 and 22 years old. His parents divorced when he was 10 years old, and he grew up living with his mother but maintained a strong consistent relationship with his father. The client reports no history of trauma, neglect, physical abuse, sexual abuse, or emotional abuse. The client denies drug or alcohol use, although he reports that his father previously was an active alcoholic

Question: What would be the most appropriate short-term goal for management of depression symptoms?
(A): Improve happiness
(B): Improve hygiene
(C): Improve self-talk
(D): Change careers

Correct Answer: Improve hygiene
Explanation: Improving hygiene is a good first step in managing depressive symptoms because it helps the patient show himself that he has value and promotes general well-being. Improving happiness and self-talk are usually more long term in nature because they require many things to change including behavior and cognition. Changing careers is a decision that the client will need to process and move toward, but it likely will not happen in the short term unless it is already in progress. Therefore, the correct answer is (B)
Competency: treatment planning
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: If the counselor acknowledges she has her own biases regarding Shar's issue, she should?
(A): Do not refer out, no matter what.
(B): Refer the client to someone who specializes with this issue.
(C): Self-disclose this conflict in session.
(D): Try to understand where the biases are stemming from.

Correct Answer: Try to understand where the biases are stemming from.
Explanation: Biases will come up, but it is important for the counselor to first acknowledge them and figure out where they are coming from. If the counselor can do this, it is not necessary for the counselor to refer out. If the counselor cannot do this, it would be beneficial to the client to refer out, especially to someone who specializes in similar issues. It would not be appropriate to share this bias in session, as sharing would make the session about the counselor and not the client. Therefore, the correct answer is (B)
Competency: professional practice and ethics
Case Study
Patient Demographic: Client Age: 60 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Private Practice Clinic Type of Counseling: Individual Counseling Presenting Problem: Unemployment; Anxiety; Depressed Mood Diagnosis: Adjustment Disorder with Mixed Anxiety and Depressed Mood (F43.23)
Mental Status Exam: Mental Status Exam: The client appears to have a depressed mood as evidenced by his affect, slow speech pattern, and body posture. The client is dressed appropriately for the season and is in clean clothing. The client is oriented to person, place, time, and situa
Presenting Problem: You are a private practice therapist working in an outpatient clinic. Your 60-year-old male client comes into the intake session, sits down, and sighs deeply. You verbally acknowledge that the client looks as though he is carrying a big mental weight, and he nods. The client begins to talk about how he was let go from his job at an assembly plant a month prior due to budget cuts. The client says that he worked there for about 30 years and that he was most recently a plant manager for the past 10 years. The client states that the plant shut down because the automotive company moved their manufacturing to another country. The client expresses anxiety surrounding what he is going to do for work next. The client states that he worries that he does not have much to offer other employers due to the extent of time he spent at his last job and also that his age will make him unemployable. The client says that he has been isolating himself, feels down more often than not, and often worries about making ends meet. The client states that his wife is currently receiving cancer treatment and, because of this, they have significant, regular medical bills.
Other Contexts:    tion. Family History: The client has been married for 25 years. He has three children, a 23-year-old son, a 21-year-old son, and an 18-year-old daughter. The client reports a strong relationship with his wife and children and states that they regularly spend quality time together

(A): Informed consent includes a discussion of the risks of counseling.
(B): Informed consent includes a discussion of copays, fees, and legal processes for nonpayment.
(C): The client has the right to engage in or refuse counseling services.
(D): Informed consent only occurs during the intake session.

Correct Answer: Informed consent only occurs during the intake session.
Explanation: Informed consent occurs throughout the counseling relationship, not solely during the intake session, because you need to explain the changes in treatment and the risks involved throughout the counseling process. The risks of counseling, copays/fees, and the counselor’s and client’s rights and responsibilities are covered as part of this process. 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: At the conclusion of the second session, the counselor asks Shar and Nadia to complete a satisfaction survey. This request is?
(A): Unnecessary paperwork.
(B): Not common in counseling practice.
(C): A practice that can empower families.
(D): Foreshadowing the desire for termination.

Correct Answer: Foreshadowing the desire for termination.
Explanation: Satisfaction surveys are useful in providing counselors with necessary feedback while showing families the importance of their input in the counseling process and is common in counseling. Although some clinicians may use this type of survey during discharge, it is important to constantly assess satisfaction throughout the therapeutic relationship. It is also important that the feedback is taken into consideration and changes are implemented when possible. In a value-based system of care, client satisfaction is a priority. Therefore, the correct answer is (A)
Competency: professional practice and ethics
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: The counselor should respond to Darlene?
(A): "You know that it's not you, it's something going on with Destiny, right?"
(B): "Just keep at it, she will eventually change her feelings."
(C): "This is difficult for everyone"
(D): "It's okay to be frustrated, let's talk about how to get through this."

Correct Answer: "It's okay to be frustrated, let's talk about how to get through this."
Explanation: This response validates Ms Maze's feelings but also gives her some hope and guidance. Choice a is dismissive of what Ms Maze is feeling and may make her feel guilty about her feelings. Choice b may be giving false hope and can also be seen as dismissive. Option d, although empathizes with Ms Maze, does not offer much more than a sympathetic response. Therefore, the correct answer is (C)
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: Autumn is likely to be successful in her goals because?
(A): They are built on her strengths and interests
(B): They are all long term
(C): It was counselor initiated
(D): She is diminishing her support system

Correct Answer: They are built on her strengths and interests
Explanation: Goals are also more likely to be successful and worked on when they are built upon client's strengths and interests. Goals should be a mix of long term and short-term goals so progress can be seen, and goals are attainable. Clients are also more likely to be successful when they have a support system. Goals should be client driven- initiated by the client. Therefore, the correct answer is (A)
Competency: treatment planning
Case Study
Patient Demographic: Initial Intake: Age: 18 Sex: Female        Gender: Female Sexuality:  Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Community Residence Type of Counseling: Individual
Mental Status Exam: Nadia was initially resistant to the interview. She stated that she had been seeing counselors her whole life and none of them ever helped. Nadia had limited insight regarding her risk-taking behaviors. The counselor assessed that Nadia’s cognitive functioning appeared low. She stated that although she had contemplated suicide in the past, she currently had no intention or plan.

Presenting Problem: Nadia is an 18-year-old in a community residence for children in foster care. She was referred for counseling because she has been running away from the group home, often for days at a time. Currently she is not getting along with her peers and gets into fights when they make comments about her activities, which is starting to affect everyone in the house.

History:
Nadia is one of 10 children by her birth parents. She has an extensive history of abuse and sexual exploitation by her parents until the age of 14 when she was removed from her parent’s care. Her and her siblings were sent to various foster homes as they could not all stay together. This is a subject that Nadia does not like to talk about since she was the oldest and had the responsibility to care for the younger ones. She feels as if she let them down. Nadia is frequently truant from school. For the past 4 years Nadia was in and out of foster homes due to her risk-taking behaviors and disrespect for others. She does have a good relationship with two staff members in the group home.

Question: A possible diagnosis based on the information provided in this case is?
(A): Attention Deficit Hyperactivity Disorder
(B): Persistent Depressive Disorder (Dysthymia)
(C): Intellectual Developmental Disorder
(D): Adjustment disorder

Correct Answer: Intellectual Developmental Disorder
Explanation: Nadia is displaying low cognitive functioning which may be an indication of intellectual developmental disorder. Attention deficit hyperactivity disorder is ruled out because Nadia is not showing symptoms with inattention or hyperactivity. There is not enough information for a diagnosis for Persistent Depressive Disorder (Dysthymia) in which one criterion is that the symptoms persist for at least two years or Adjustment Disorder, where the initial criteria is an emotional response to an identifiable stressor, within three months. Therefore, the correct answer is (D)
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: The first thing to assess for at this point is?
(A): Any medical conditions
(B): Mental status exam
(C): Family history of mental illness
(D): Any recent substances used

Correct Answer: Any medical conditions
Explanation: Due to the physical symptoms of fever and rapid heartbeat, it is important to stabilize her health and look at any medical conditions Sandy may have. Other items to assess for after the initial assessment are: any recent substances used as they can trigger symptoms that Sandy is displaying; family history of mental illness can give information on possible genetic loading of psychiatric disorders. Finally, a mental status exam can help to assess current mental capacity after the initial assessment. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis