A Look at Two ASWB Exam Sample Questions

I was interested in the contents of professional licensing exams developed by the Association of Social Work Boards (ASWB). ASWB said that its exams all contained 150 scored questions and 20 unscored pretest questions. As elaborated in another post, the 150 questions that determined the test-taker’s passing or failing grade were drawn from a much larger pool of available questions.

I would emphasize that this post is not just for the benefit of people who are studying for ASWB exams. There are some surprises here, and they go to the question of exam legitimacy.

I did not have access to ASWB’s full pool of questions. To view even a sample of 150 such questions, ASWB required me to register for one of its exams (approximate price: $250) and spend another $85 for one of its practice exams. Alternately, I could get a much smaller set of about 40 sample questions by spending $38 for a copy of its study guide.

Other than that, options were limited, for members of the general public who might like to see official ASWB exam questions, answers, and explanations. There was an example of a question from the Clinical exam on ASWB’s Exam Content Outlines webpage. On the Exam Preparation webpage, there was a link to a Candidate Handbook that offered a few sample questions. And that seemed to be pretty much it.

I was particularly interested in the Masters exam, so I looked at the two free sample Masters exam questions provided in the Candidate Handbook. For these questions, no discussion was available, but at least ASWB provided what it considered the right answers. In this post, I look at those two questions and discuss the multiple-choice answers provided. At the end, there is also a look at a sample question from the Clinical exam.

A Question from the Masters Exam

The first of the two sample questions in the 2014 Candidate Handbook read as follows:

A social worker is receiving repeated telephone calls from a previous client who has completed treatment and resolved the targeted problem. What should the social worker do?

(A) Inform the client that the therapeutic relationship is finished
(B) Refer the client to another social worker in the agency
(C) Limit the number of calls that the social worker will accept
(D) Schedule a session to assess the client for further problems

I hadn’t studied for the Masters exam at all – in fact, it had been four years since I had finished my MSW, and I had not been working in the field since then. Even so, I did not think this question was very difficult.

I wasn’t sure what the official explanations would be, but I could guess at some possibilities. There seemed to be two problems with answer (A). One problem was that I assumed the exam’s general instructions, not reproduced on that page in the Candidate Handbook, would instruct us to choose the BEST answer. Just telling the client that the relationship was finished would leave some important things undone, as illustrated in answers (B) and (D). So answer (A) did not immediately strike me as the best answer. The other problem with answer (A) was that I was not so sure the therapeutic relationship was finished. Just because the client has completed treatment for a targeted problem does not mean that s/he has no other issues. And even if s/he has no issues at the time, I would hardly want to be trying to get rid of him/her. New issues come up from time to time. My recollection was that the therapeutic relationship is larger than a specific issue.

When I read answer (B), I wondered whether the question was phrased to push buttons in female social workers whose experiences of receiving repeated phone calls might tend to involve male acquaintances. That is, I wondered whether ASWB was trying to provoke a knee-jerk reaction in a social worker who would hear “repeated telephone calls” and would immediately think, “Unwanted male! Take evasive action!” There certainly could be grounds for referring a client to someone else – not only in cases of harassment, but also when some other professional has expertise that the client needs. But the question didn’t say that that was the situation at hand.

Answer (C) did not sketch out a clear scenario. Did it mean that I would tell a receptionist to count how many calls I receive each day, and stop bothering me when the number rises above a specified threshold? How would that work if my agency had an automated voice menu on its incoming number? Did answer (C) mean that the client had not been able to get through to me, and that I would not listen to his/her voice mail messages? If I did talk to him/her or hear his/her voice mail messages, I probably would have been able to get a sense as to whether this was a new issue. Ultimately, as a matter of test-taking instinct, it seemed to me that the test-writers had not bothered to think this one through, which was a hint that it was probably the wrong answer. But if I did have to engage with the substance of answer (C), I would have to consider it the worst yet, combining the coldness and brainlessness of answers (A) and (B).

That said, from the perspective of empathy for previously traumatized practitioners, it seemed there might be grounds for a workplace improvement argument that social workers, having to deal with large numbers of often difficult and sometimes frightening clients, may deserve arrangements that offer some protections from, or assistance with, clients and job situations that do push their buttons. From that perspective, I wondered whether it was ethical to bar from the profession those people who would thrive in a suitably supportive ambiance, simply because they would have emotional responses arising from deep personal experience that could actually be a strength for some purposes. Clients have enough struggles without having to deal with useless clinicians. I would not want to be a social worker, or the client of a social worker, who would respond as described in answers (A) through (C).

So I came to answer (D). It depended upon two assumptions not supported by the question. One assumption was that the client was willing and able to schedule a session; the other was that the client was calling because of “further problems.” The question had not stated facts supporting either such assumption. It had just said that the client was calling me. That is, answer (D) forced me to make assumptions about what the client wanted to do, and why. But my assumptions could vary, depending on my pre-exam social work training and experiences. When I read the question, I might visualize a client who only wanted to talk on the phone – who, for reasons of poverty or social phobia, would be very unlikely to meet me in a regular session. Or I might think of a client who had been most effectively treated, not with face-to-face sessions, but rather with online tools or via homework. Or maybe I would be oriented toward clients in prison, who might have no option of scheduling a session with me. Or maybe the client was just desperate to ask if I would help his/her brother through a crisis. Really, it could be anything. I could not get to the point of deciding to schedule a session until I first exercised the basic civility of returning the client’s call, and that seems to be the option that should have been provided in answer (D). Given the actual choice offered in answer (D), I chose it as the least bad alternative because it was the only answer that did not involve the kinds of overt evasion found in answers (A) through (C).

ASWB indicated that answer (D) was, in fact, the correct answer. Note, however, that answer (D) would probably have been chosen by most people having basic education and/or experience in client service. It did not take two years in a graduate social work program to know that you don’t just tell callers that your relationship is finished; you don’t pass them around to random people in the organization; you don’t arbitrarily cut off the number of incoming calls you will take.

In reading these remarks, bear in mind that this is one of the two questions that ASWB offers to the public as being especially typical of the Masters exam. This discussion supports the research finding, discussed in a separate post, that ASWB examinees may be able to guess the correct answers to many licensing exam questions. ASWB’s reasons for producing exam questions of this nature are explored in the middle section of another post.

Another Question from the Masters Exam

The second of the two sample questions provided in ASWB’s 2014 Candidate Handbook was more difficult. It read as follows:

How can a social worker BEST establish rapport with a client in the first interview?

(A) Understand the client’s view of the problem
(B) Ask only factual information about the problem
(C) Conduct the interview on a first-name basis
(D) Allow time for informal, personal conversation

Once again, answer (A) suffers from the fatal flaw of requiring the test-taker to assume facts that are not provided in the question. First, the question does not say that there is a problem. It says only that there is a first interview. The test-taker cannot assume that the client has identified a problem. Some clients just want someone to talk to, without necessarily proceeding on to the conclusion that there must be a problem behind this desire. In addition, some clients fail to recognize the existence of a problem even when it becomes palpable. Moreover, if the client has identified a problem, the test-taker cannot assume that it is the real problem. With clients experiencing serious mental illness, pursuit of imagined problems could completely derail therapeutic efforts. Nor can the test-taker assume that every first interview can be devoted to problem-solving. In institutional settings (e.g., school, hospital, prison, nursing home), a social worker’s first meeting with a client may be scheduled automatically, upon the client’s arrival, and the social worker’s goal for that meeting may be just to achieve a mutual introduction, to orient the client to basic procedures (e.g., you will be meeting with me periodically), and to let the client know that s/he is welcome to contact the social worker at any time if problems do arise. Where the client does not begin with the perception that there is a problem to be solved, it could be inappropriate for the social worker to begin with the assumption that there is. Doing so could amount to forcing the social worker’s perspective upon the client; it could convey the disempowering and alienating message that clients represent problems and social workers represent solutions. For a variety of reasons, then, answer (A) actually raises threats to rapport. Understanding the client’s view of a problem makes great sense if there is a problem, and if a foundation has been laid for its exploration. But rapport is part of that foundation; it logically precedes the problem-identification phase.

Answer (B) has the same problem as answer (A) – the assumption that there is a problem. On the other hand, answer (B) has the virtue of allowing the client to set the level of discussion – to decide, that is, whether the facts to be discussed will be limited to external realities (e.g., what s/he said, what someone else did), or will instead include internal realities (e.g., what s/he felt or believed). The wording, “only factual information,” seems to be intended to provoke a knee-jerk reaction, as we saw in some of the answers to the first question (above): there is an implication that a “factual” inquiry would be cold and unfeeling, when it might actually be more protective of the client’s right to decide whether, and when, s/he is ready to be subjected to the kind of invasive scrutiny for which social work has sometimes been criticized (e.g., Denzin, 2002, p. 35, citing inter alia Foucault and Margolin, 1997, p. vi). Hence, answer (B) might be a second-best choice for this question.

Answer (C) exhibits greater cultural and interpersonal sensitivity than some of the other answers. It would be strange to address a child by anything other than his/her first name; likewise for members of mononymic cultures (i.e., where people have only one name) (e.g., Indonesia, Afghanistan, some parts of India). Some contemporary American cultures see it as a sign of respect to refer to someone by his/her surname with prefix (e.g., Mr. Smith); for others, that form of address can imply distancing and even rejection, with the sort of formality that is reserved for people who are being kept at arm’s length (as in e.g., the handling of criminal defendants in the courtroom). The question does not state the client’s preference. Without that information, the safest course is not to make assumptions, one way or the other, but simply to verify which form of address the client would prefer. This conclusion is not consistent with the practice of some social workers, who prefer to position themselves in a superior role, rather than as the client’s collaborator in a shared therapeutic effort. But the question asks for the BEST practice, not for the practice that the social worker might find most gratifying. The chief problem with answer (C) is that it seems to be another answer that ASWB’s question-writers have not thought about in much detail, suggesting that they have probably preconceived it as a wrong answer.

Answer (D) does not suffer from the drawback of assuming that there is a problem, seen in answers (A) and (B). Answer (D) could seem to share, with answer (C), the drawback of assuming that the client would prefer informality. Here, the wording is crucial: the answer says only that the social worker will “allow time” for informal, personal conversation. If the client expresses no inclination toward that sort of thing, there is no implication that the social worker would insist upon it. Opening the door for a bit of informal chit-chat is a great way to develop rapport, if the client would find that helpful. Casual conversation is commonly practiced in everyday life, and will thus provide many clients with a familiar starting point for what may otherwise be an unfamiliar and even uncomfortable setting. Answer (D) seems to incorporate another attempt to trigger a knee-jerk reaction, with its use of the word “personal”; that may imply a degree of familiarity that a professional would avoid. But the literature is clear: in many cross-cultural settings, familiarity is essential. For instance, Graham et al. (2009, p. 554) say, “Practitioners can also increase client comfort by using a sense of familiarity” when working with Muslims. Walsh-Mooney (2009, p. 68) found that, for Maori in New Zealand, rapport is “a process of warming, connecting, and coming closer together and about feeling the other person’s wairua … mauri … energy.” When discussing social work oriented toward clients with spiritual concerns that may be alien to the social worker, Hodge (2001, p. 207) says, “To facilitate trust care should be taken to foster a relaxed, conversational atmosphere that mitigates the power differential inherent in therapy.” Again, as in answer (C), the emphasis here is upon the best practice, as opposed to e.g., the temptation to adopt an officious tone or otherwise to place oneself in a position of superior power vis-à-vis the client. In short, answer (D) appears to be the best answer.

These remarks lead to the conclusion that, in fact, ASWB chose answer (A). To repeat, answer (D) was indeed the ASWB-preferred answer to the first question (above), and answer (A) is what ASWB names as the best answer to this second sample question, as you can verify by checking the Candidate Handbook for yourself.

In other words, my discussion of the first question was exactly as it seemed; but in my discussion of answers (A) through (D) for this second sample question, I deliberately defended the “wrong” answer and criticized the “right” one. I did this with good reason. My discussion of Question 2 underscores several realities about ASWB, its questions, and the concept of social work that it prefers.

Discussion

Bear in mind that, at this writing, I have not taken any ASWB exams. These remarks are based solely upon my experience with other standardized exams, my years in social work MSW and PhD programs, and my review of the ASWB questions and answers provided here. I could be completely mistaken about all of this. I urge everyone to consider my remarks in light of the views and experiences offered by others who may disagree.

Note also that some of the following remarks are rather sharp. The goal of such remarks is to convey vivid impressions of certain kinds of individuals and behavior. In that sense, these remarks are intended less as cautious analysis and more as creative nonfiction — to evoke impressions, that is, rather than to recite dry facts. I would apologize to the social workers to whom these sharp remarks do not apply, but I suspect most of them are way ahead of me — that they know exactly what I am talking about, and have been dealing with it for some time.

With those caveats, let’s look again at the first question, above. In my discussion of answer (D), which ASWB says is the right answer, I noted some problems: that answer required assumptions that were not stated in the question, and it would probably have been selected by anyone with common sense and ordinary human experience, regardless of social work training.

Those problems suggest two working conclusions. First, you should not get too hung up on the rule about not making assumptions, because ASWB itself does so to some extent. It seems you are probably safe in assuming that they are talking about a general-purpose ordinary social worker. The answer they prefer may not apply to many different kinds of social workers and social work practices in the real world. Second, as discussed in another post, ASWB does not need to use trick questions and deep reasoning to weed out the weak test-takers. ASWB’s situation is much the opposite.

Let us be clear on that. ASWB provides a list of 191 topics in which, it says, its Masters examinees must display minimum competence. That list of topics is absurdly broad: it covers far more fields of knowledge than do the licensing exams in any other major profession, including law and medicine. ASWB’s question-writers do not possess expertise across all those fields. If they did, and if they tested rigorously across those 191 topics, nobody would pass. This would reflect badly on key players in social work education: ASWB itself, and also schools of social work and state licensing authorities. People have to pass at a reasonable rate. ASWB has made clear, for many years, what that rate needs to be: at least three out of four, and more recently nearly five out of six Masters examinees will pass that exam.

In that case, as described in that other post, ASWB has a problem. It must find a way to help the large majority of Masters examinees pass an exam that would be impossible, if ASWB’s own words about that exam were true — if, that is, ASWB really did test people for minimal competence across 191 areas of knowledge, skill, and ability. In pursuit of an acceptable number of exam-passers, ASWB faces a challenge. First, on average, social workers are not the most academically inclined people. Second, ASWB is not able to give examinees specific study materials to help them along. Nobody could write a study guide that would succinctly cover those 191 topics, some of which — according to ASWB itself — are as vast as the fields of psychopharmacology and human genetics. A specific study guide, conformed to actual ASWB exams, would constitute a public admission that the areas being tested are much narrower than ASWB claims. Third, while multiple choice exam questions are easier than some other kinds of questions, they can still be quite difficult. On an impartial exam, the odds of guessing correctly are only one in four.

In the face of those difficulties, there are certain things that ASWB can do to increase the pass rate. It can lower the bar, and it does. To pass, the typical exam-taker needs to choose the correct answer to only about 100 out of 150 (i.e., two out of three) scored questions on the exam. ASWB can limit its testing to relatively easy and general material, as opposed to requiring highly specific and complex knowledge. And it can write its multiple choice answers so that the odds are improved. Elimination of two obviously wrong answers will increase the test-taker’s chances of guessing right from 25% to 50%.

In other words, ASWB’s question-writers are not going to be indulging trick questions and deep reasoning. There’s no need for that. They could easily achieve their target failure rate just by asking straightforward questions about everyday life (e.g., How many pints in a quart? Which of these cities is the capital of Kentucky?), and by setting the pass rate accordingly (requiring e.g., 140 correct out of 150 questions). They can’t get away with that sort of thing, obviously, so their challenge is to write questions, about social work, that will not completely baffle most social work graduates. Ideally, they would give credit for the best answer, but that is not absolutely necessary: they just need questions to which most test-takers will give the same answer.

As described in another post, there is no research demonstrating that the exam identifies the people most qualified to practice social work. ASWB does not make its testing data available to researchers. As shown in the foregoing discussion of sample questions and answers, it is quite possible to be too thoughtful, sensitive, or knowledgeable for this exam. The exam does not reward careful attention to phrasing. It may penalize the use of knowledge not possessed by the average MSW.

That little discussion of cross-cultural education — in my writeup of answer (D) for the second question (above) — provides a good illustration of several errors that a test-taker might commit. Forget about the Maori and the Muslims. Focus on the stereotypical, imaginary setting of ordinary American social work, not on the many different possible social work practice situations that might exist in the real world. Do not take account of situations that the person who wrote the question may never have heard of. Remember that, to achieve the desired pass rate, the Masters exam is trying to be approximately as difficult as a test that would require people to locate Idaho on a map, calculate the square root of 4, and name the person who was president before Barack Obama.

Although we can’t be sure with a set of just two sample questions, it appears we might develop a few other working hypotheses about what ASWB is looking for in its exam questions. For one thing, it appears that ASWB will sometimes lead you to the right answer by repeating the same mistake across two or three of the wrong answers. In Question 1, as mentioned above, answers (A) through (C) kept thumping the drum of poor client service; similarly, the repeated theme of answers (C) and (D) in Question 2 was unprofessional familiarity. It does appear that, as a strategy of desperation, an exam-taker running out of time might just eliminate any answers that seem to share disapproved features with any other answers. That strategy, by itself, would have led directly to answer (D) in Question 1 and to answers (A) or (B) in Question 2.

Question 2 suggests that it may be helpful to adopt the perspective of the kind of social worker who badly wants to see him/herself as a Professional, with a capital P. Such a person might prefer a sort of stilted niceness, letting people know that s/he accepts and supports them despite their flaws. So, sure, go ahead and waste time trying to understand the viewpoint of a client who happens to be hallucinating (answer (A)). Don’t be a geek, seeking “factual information” (answer (B)); don’t roll up your sleeves and get your hands dirty unless somebody is watching. Empowerment is fine, if that’s what the exam question is asking about, but otherwise friendliness and informality (answers (C) and (D)) are not desirable: you want to establish subtle power differentials and position yourself as the expert. (For more on abuse of power in social work practice, search for the reference to Margolin in another post.)

As these remarks suggest, ASWB’s Masters exam conveys tacit messages that conflict with the profession’s ostensible ethics. My detailed analysis of ASWB’s question-development process demonstates numerous problems in the conception and creation of that exam. The present post contributes to the perception that a multiple-choice exam may simply not be an appropriate tool with which to gauge qualification to practice social work.

Bonus: Another ASWB Exam Question

In the course of revising another post, I developed a critique of the sample Clinical exam question currently provided on ASWB’s website. It appears I don’t need that critique in that other post. Thus, at least for now, I am parking it here. This is a rough writeup; it may bear revision or correction.

The question presented in that sample question is as follows:

A six-year-old child lives with a foster family. His father is in prison and his mother is in residential treatment for alcohol dependence. The child is small for his age, often has temper outbursts, and has difficulty completing schoolwork. The social worker notes that his speech is immature. What should the social worker do FIRST?

The answer given on the website is, “Refer the child for assessment for fetal alcohol syndrome.” This answer has numerous problems:

  • The preferred answer assumes that the social worker has not already completed an informal assessment. But if the social worker is not already convinced that fetal alcohol syndrome (FAS) is the issue, it could be harmful to close off all other options and tell the client to wait two months for an appointment with a psychiatrist — to seek the assessment FIRST.
  • It could be unethical for the social worker to pass the buck, putting the client on hold for that waiting period, if the social worker him/herself is capable of performing the assessment.
  • The question seems to assume that social workers lack competence and/or legal authorization to conduct their own FAS assessments. Those assumptions appear to be untrue for many social workers.
  • This preferred answer assumes that FAS is an available diagnosis. At the time of this writing in July 2014, it is not: it does not appear in the fourth edition of the Diagnostic and Statistical Manual (DSM-IV), which is the edition that ASWB’s website says will be used for ASWB’s exams until July 2015. FAS does appear in alternate classification systems (e.g., the World Health Organization’s International Classification of Disease), but ASWB’s Clinical exam Content Outline specifies the DSM as the only classification system with which clinical social workers should be familiar.
  • According to the Centers for Disease Control and Prevention (CDC, 2004, pp. 21-22 and 2014), the question provides insufficient information to determine whether a FAS assessment referral would be appropriate. Specifically, we are told nothing about the mother’s circumstances six years ago, and there is also no information about relevant facial features (see also National Organization on Fetal Alcohol Syndrome, n.d.). Again, one can make assumptions, but the decision to put all other courses of action on hold becomes increasingly questionable.

This writeup is limited to a rebuttal of ASWB’s preferred answer. The other post provides additional criticism of the question and its answers, taken as a whole.

Collectively, this post’s discussions of three ASWB sample exam questions raise the concern that ASWB’s exams may actually penalize knowledgeable and thoughtful examinees. It appears, that is, that deep knowledge and awareness of multiple experiential and intellectual perspectives on a problem may be detrimental, for purposes of passing these exams. A more ignorant person, attuned to the social work mindset, may enjoy the advantage of being able to dismiss some exam answers because they don’t sound right, without any clue as to whether they might actually be right.

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