Licensed Clinical Social Worker (LCSW) Practice Exam

When using cognitive restructuring with a depressed 16-year-old, what should the social worker do?

1. Ignore the client's emotional state

2. Work with the client to set a concrete, time-specified goal

3. Focus only on the client's negative thoughts

4. Encourage the client to abandon self-reflection

The correct answer is: Work with the client to set a concrete, time-specified goal

In cognitive restructuring, particularly with a depressed adolescent, it is essential to work collaboratively with the client to set specific, achievable goals. This approach helps establish a framework for the therapeutic process and provides a sense of direction and purpose. When a goal is concrete and time-specified, it enables the client to have clear expectations and to monitor progress, which is crucial in cognitive-behavioral approaches. Setting goals also fosters a sense of agency in the client, allowing them to actively participate in their treatment. This empowerment can counter feelings of helplessness that often accompany depression. Not only does goal-setting facilitate the identification and challenge of negative thoughts, but it also encourages the adolescent to work towards positive changes in their behavior and mindset. The option to ignore the client's emotional state undermines the foundational principle of establishing safety and rapport in the therapeutic relationship. Focusing solely on negative thoughts without addressing the underlying feelings and context can lead to a lack of engagement and may reinforce the client’s negative self-perception. Additionally, encouraging the client to abandon self-reflection would not support the therapeutic process. Self-reflection is vital for understanding the relationships between thoughts, feelings, and behaviors, particularly in adolescents who are navigating complex emotional landscapes.