Licensed Clinical Social Worker (LCSW) Practice Exam

What is the FIRST action a social worker should take with a 78-year-old involuntary client at risk of self-harm and expressing desire for outpatient support?

1. Encourage the client to be compliant with hospital rules

2. Refer the client to an outpatient program immediately

3. Remind the client that the hospitalization is not voluntary

4. Discuss the client's depression symptoms

The correct answer is: Remind the client that the hospitalization is not voluntary

The chosen action, which involves reminding the client that the hospitalization is not voluntary, is significant in establishing the framework for the social worker's approach. Involuntary clients often experience feelings of powerlessness and may resist treatment due to their circumstances. By clarifying the nature of their hospitalization, the social worker can help the client understand the seriousness of their situation and the rationale for the current intervention. This acknowledgment can serve as a bridge to build rapport and trust, which are essential when working with clients who might be resistant or fearful. This action sets the stage for further engagement with the client by validating their feelings and making it clear that the hospital setting is temporary and primarily aimed at ensuring their safety and well-being. It opens the door for a more in-depth discussion about their mental health and the outpatient support they desire, allowing the social worker to explore the client’s needs and preferences further. Discussing the client's depressive symptoms could follow as a subsequent step, but first addressing the context of their hospitalization allows for a more effective conversation about treatment options and can help the client feel less anxious about the process. Other choices may bypass the critical initial understanding of the client’s current state, which is a fundamental aspect of establishing a therapeutic alliance.