One of the most common challenges students I work with face is not so much their grasp of the content (you earned your MSW, after all), but a struggle with “reading” what the question is asking for.
Let’s look at the following question for an example:
“A social worker is working with a 25 year-old transgender man who recently came out to his family, and was met by rejection and ridicule. During the second session, client tells the social worker that he does not know what to do, and has been feeling very depressed. He denies suicidal ideation, but states struggling with low mood, low self-esteem, and low concentration. What should the social do FIRST?”
A. Provide a referral to physician who can provide hormone treatment.
B. Bring the family in to provide psychoeducation and family therapy to increase their knowledge about gender identity.
C. Validate the client’s feelings about people’s reactions in these situations, and normalize the gap in social support transgender people experience.
D. Refer the client to an LGBT support group.
A couple of important things that will help you answer the question here:
- Who is the identified client? A 25 year-old transgender man. (Be aware of developmental stages, struggles, and tasks at this age—remember Erikson’s stages)
- What stage of treatment are we in? Since it’s a second session, we are still in the engagement phase (where rapport and building the alliance is important).
- Staying where the client’s at. The client is feeling depressed triggered by their social circumstances. Especially in the beginning, it’s important to stay here, rather than jumping to “fix” it with a premature referral or intervention.
The answer, then, is C. We want to normalize the client’s experience and validate their feelings as legitimate reactions to their stressors before moving on. While ensuring client has appropriate medical care (A), and building on their support system (D) is important, these would either be premature and outside of the scope of what the client is presenting with immediately. Choice (B) might be appropriate later on, but not as an immediate intervention, and only with the client’s consent.
Takeaway Tip: The test isn’t testing for a simple right or wrong intervention, but the intervention that’s appropriate at a certain point in time and with a certain client.
*Question is hypothetical test item and does not include and is not based on any real client nor publication.