National Dental Specialty Examination (NDSE) – Dental Public Health

Correct: In clinical social work, the safety and well-being of a minor are the highest priorities. When there are indicators of potential exploitation, neglect, or fear of a caregiver/adult, the social worker is ethically and legally obligated to assess for immediate danger and fulfill mandated reporting requirements to protective services. This takes precedence over administrative or purely therapeutic interventions.

Incorrect: Contacting the fund administrator to freeze accounts is an administrative action that does not address the immediate physical safety of the minor and may violate confidentiality without proper authorization. Applying developmental theory is a secondary clinical task that should occur only after safety is secured. Scheduling a joint session with a suspected abuser or exploiter is dangerous and contraindicated as it could place the adolescent at further risk of retaliation.

Takeaway: When clinical indicators suggest the exploitation or maltreatment of a minor, the social worker’s primary responsibility is to ensure safety through risk assessment and mandated reporting compliance.

Correct: According to the NASW Code of Ethics, social workers should take reasonable steps to avoid abandoning clients who are still in need of services. When a client is non-compliant or misses appointments, the social worker must still attempt to provide a structured termination. This includes communicating the termination clearly and providing appropriate referrals to ensure continuity of care, particularly for high-risk clients with diagnoses like major depressive disorder.

Incorrect: Terminating immediately without referrals is considered client abandonment, which increases rather than decreases liability. Suspending a case indefinitely fails to provide the necessary clinical structure and leaves a high-risk client without a clear path to care. Notifying a supervisor about missed appointments without the client’s specific consent is a breach of confidentiality and does not address the clinical requirement for a transition plan.

Takeaway: Ethical termination requires proactive communication and the provision of referrals to prevent abandonment, especially when the client remains in clinical need.

Correct: According to the NASW Code of Ethics and clinical standards, self-disclosure should only be used when it is clearly for the benefit of the client. When a disclosure inadvertently leads to a boundary blur—such as the client seeking personal advice—the social worker must take responsibility for re-establishing the professional nature of the relationship. This involves processing the client’s reactions and the impact of the disclosure to ensure the therapeutic work remains focused on the client’s needs and goals.

Incorrect: Referring the client immediately (option b) may be seen as client abandonment and does not address the clinical issue that occurred. Adopting a rigid, strictly clinical stance (option c) ignores the need to process the existing boundary confusion, which is essential for the therapeutic alliance. Simply documenting the event without addressing the client’s shift in behavior (option d) fails to manage the boundary violation and risks further compromising the professional relationship.

Takeaway: When self-disclosure leads to boundary confusion, the social worker must proactively process the impact with the client to re-center the therapeutic focus and maintain professional standards of practice.

Correct: According to the NASW Code of Ethics, social workers should terminate services when they are no longer required or no longer serve the client’s needs. When a termination is necessary due to a conflict of interest or dual relationship, the social worker must take reasonable steps to avoid abandoning the client. This includes providing appropriate referrals and facilitating the transfer of responsibility to another provider to ensure continuity of care.

Incorrect: Ceasing all contact immediately is considered client abandonment, which is a violation of ethical standards. Continuing treatment until a new provider is seen might be inappropriate if the dual relationship poses an immediate risk or ethical breach that necessitates prompt termination. Requesting a waiver does not fulfill the social worker’s professional obligation to provide a clinical termination process and facilitate a warm handoff to a new clinician.

Takeaway: Ethical termination requires social workers to proactively facilitate the transition of care to a new provider to prevent client abandonment and minimize harm.

Correct: In high-conflict co-parenting situations, clinical social workers should promote strategies that protect the children’s best interests while minimizing parental friction. A structured communication plan using neutral media (such as specialized co-parenting apps or email) ensures that essential information regarding health and education is exchanged—meeting legal and ethical obligations—without requiring the high-stress, face-to-face interactions that trigger conflict.

Incorrect: Strict parallel parenting that withholds essential information is clinically and often legally inappropriate as it may constitute medical or educational neglect and violates the ‘best interests of the child’ standard. Moving immediately to collaborative co-parenting via joint sessions is often contraindicated in high-conflict cases as it can escalate volatility and may be unsafe if there is a history of domestic violence. Appointing a family member as an intermediary is a form of triangulation that often increases family system tension and rarely provides a sustainable or professional solution for information exchange.

Takeaway: In high-conflict family systems, the social worker should prioritize structured, low-emotion communication methods that ensure the child’s needs are met without escalating parental disputes.

Correct: In the treatment of Somatic Symptom and Related Disorders, the most effective safeguard is interdisciplinary collaboration. This approach ensures that the social worker and medical providers are aligned, preventing the client from receiving conflicting information or undergoing unnecessary and potentially harmful medical procedures. It addresses the client’s distress holistically while maintaining professional boundaries and ensuring that psychological factors are integrated into the overall care plan without dismissing the client’s physical experience.

Incorrect: Supporting a high-risk surgical intervention against medical advice fails the principle of non-maleficence and ignores the clinical reality of the disorder. Confronting the client directly about the lack of evidence often destroys the therapeutic alliance and leads to treatment dropout. Encouraging further ‘doctor shopping’ or additional evaluations typically reinforces the somatic preoccupation and delays necessary psychological intervention, potentially exacerbating the client’s anxiety and disability.

Takeaway: The gold standard for managing Somatic Symptom Disorders is integrated, interdisciplinary care that bridges the gap between medical and psychological services to prevent fragmented or harmful treatment paths.

Correct: The scenario describes a family in the Families with Adolescents stage of the family life cycle. According to the model developed by Carter and McGoldrick, the key developmental task for this stage is increasing the flexibility of family boundaries to permit children’s independence and to accommodate the shifting needs of the older generation (grandparents). This stage is often characterized by the sandwich generation effect, where parents are simultaneously managing the autonomy of their children and the increasing dependency of their own parents.

Incorrect: Renegotiating the marital system as a dyad and developing adult-to-adult relationships with children is the primary task of the Launching children and moving on stage, which occurs after the children have actually left the home. Accepting exits and entries while adjusting to retirement is characteristic of the Families in later life stage. Adjusting the marital system to make space for children and taking on parenting roles is the hallmark of the Families with young children stage.

Takeaway: The Families with Adolescents stage requires boundary flexibility to balance the adolescent’s need for autonomy with the care requirements of aging parents.

Correct: According to Structural Family Therapy (Minuchin), the scenario describes ‘parentification,’ where a child takes on adult responsibilities and emotional roles. The priority is to restructure the family hierarchy by strengthening the parental subsystem. This involves empowering the mother to reclaim her leadership role and establishing clear boundaries that allow the adolescent to return to an age-appropriate developmental role, which is the most direct way to resolve the systemic boundary violation.

Incorrect: Referring the adolescent for individual therapy is incorrect because it treats the symptom (anxiety) as an individual pathology rather than a systemic issue, potentially reinforcing the child’s role as the ‘identified patient.’ Reporting to child protective services is premature and inappropriate in this context as the scenario describes a boundary and role confusion issue rather than actionable abuse or neglect. Circular questioning is a technique from Milan Systemic therapy used to highlight patterns, but it does not prioritize the structural realignment of the hierarchy which is the primary clinical need in this case.

Takeaway: In family systems work, addressing parentification requires the social worker to strengthen the parental hierarchy and restore age-appropriate boundaries for children.