Licensed Clinical Social Worker (LCSW) Practice Exam

What should a social worker do FIRST if a client shifts the conversation to unrelated topics during a session?

1. Perform a mental status exam

2. Redirect the conversation

3. Allow the client to speak freely

4. Set an agenda for the session

The correct answer is: Perform a mental status exam

In this scenario, it is important to consider the best initial approach when a client diverts from the intended topic of conversation during a session. The correct action is to restrict the focus back to therapeutic objectives, which is accomplished through redirecting the conversation. By doing so, the social worker maintains the effectiveness of the session, addressing the client's issues more productively. Engaging in a mental status exam is not the most immediate response in this situation, as it is typically utilized for assessing a client's cognitive function, mood, and behavior. It may not effectively address the current diversion and could lead to confusion about the session's purpose. Allowing the client to speak freely can sometimes be beneficial for rapport, but it may not address the core issues at hand, leading to inefficiencies in therapeutic progress. It is essential to guide the session towards objectives that serve the client's needs. Setting an agenda for the session can be helpful but may not be the most immediate step if the client is already midway through a topic shift. This can interrupt the flow of the session more than necessary. Redirecting the conversation allows the social worker to reaffirm the therapeutic goals, ensuring that the session remains focused and productive. This also creates a structured environment that can help the client feel more