Are these real ASWB exam questions?

No. They were written for this post, to the 2026 Clinical outline and ASWB's published rules for building questions. The only practice questions drawn from previously administered ASWB exams are in ASWB's own online practice test, US$85, sold to registered candidates.

How many questions are on the LCSW exam?

The ASWB Clinical exam has 122 questions in two sections of 61, with two hours for each section. 110 questions are scored and 12 are unscored pretest questions, mixed in among the scored ones.

What score do you need to pass the LCSW exam?

ASWB says the passing score generally ranges from 66 to 78 correct answers out of 110 scored questions, depending on the difficulty of the version you take. There is no single number.

Does the LCSW exam have three-option questions?

Yes. ASWB's Guidebook for exams from August 3, 2026 says the exam may contain both three- and four-option questions, which is why four of the ten questions in this post have three options.

LCSW exam practice questions, with full rationales

These are ten practice questions for the ASWB Clinical exam, the exam most states require for the LCSW. We wrote them for this post, to the content outline that took effect on August 3, 2026, and each comes with its answer and the reason every other option is wrong. Answer all ten before you read any of the answers.

They are not ASWB questions. ASWB does not publish its exam questions, and the only practice questions built from items used on past exams are in ASWB's own practice test, which costs US$85 and is sold to registered candidates. What these questions do is follow ASWB's published rules for how a question is built, closely enough to show the reasoning the real ones reward.

How these ten are built

The mix follows the Clinical outline. Values and Ethics carries 36% of the Clinical exam, and Assessment and Planning and Intervention and Practice carry 32% each. Four questions below come from the first area and three from each of the others.
Some have three options. ASWB's August 2026 Guidebook says the exam "may contain both three- and four-option questions." Four of these ten have three. What one fewer option changes has its own post.
Only one answer is correct. ASWB's writing rules allow a single correct answer and never use "All of the above", "None of the above" or combinations of options. Wrong options are written to be plausible, so expect at least one that would be right at a different moment.
The qualifier is in capitals. FIRST, BEST and MOST appear as they do on the exam, and they often decide the question.
Most ask you to apply something, not remember it. ASWB says the Clinical exam carries a smaller share of recall questions than the Associate and Bachelors exams. Two of these ten are close to recall; the rest ask what to do, or what fits.

Give yourself about two minutes a question. That is the exam's own pace: four hours for 122 questions.

The questions

Values and Ethics, questions 1 to 4

1. A client who did not choose to be here

A court orders a client to attend substance use counseling after a second arrest for driving while intoxicated. At the first session, the client says, "I'm only here because the judge made me." What should the social worker do FIRST?

A. Begin a structured assessment of the client's drinking history.
B. Explore how the client feels about being ordered into counseling.
C. Explain what information will be reported to the court and what the client may decline.

2. The parents call

A 15-year-old client is seeing a social worker for anxiety. At intake, the social worker, the client and the client's parents agreed that what the client says in sessions will stay private unless someone's safety is at risk. The client has since mentioned using marijuana on some weekends, and the social worker has no concerns about safety. The parents call and ask whether their child has said anything about drugs. What should the social worker do FIRST?

A. Tell the parents what the client has said, because they consented to treatment.
B. Encourage the client to talk with the parents about the marijuana use.
C. Assess whether the client's marijuana use calls for substance use treatment.
D. Remind the parents of the confidentiality agreement made at intake.

3. A decision made with the family

A client who moved to the United States three years ago is deciding whether to start a medication that a psychiatrist has recommended. The client explains that in the client's family, important decisions are made together with the elders, and asks to bring an uncle to the next session. What should the social worker do?

A. Agree, and ask how the client would like the uncle to take part.
B. Explain that treatment decisions are confidential and must be made by the client alone.
C. Agree, and ask the uncle to decide whether the client should take the medication.

4. Something the client wants left out

During a session, a client mentions an arrest from many years ago, then asks the social worker not to put it in the record because the client is applying for jobs and worries that an employer could see it. What is the BEST response?

A. Agree, and keep a separate personal note of the arrest outside the record.
B. Explain who can see the record, and document only what is relevant to the services.
C. Assure the client that records are confidential and can never be released.
D. Document the disclosure in full, because records must be complete.

Assessment and Planning, questions 5 to 7

5. A question about sleep

During an assessment, a social worker asks a client how the client has been sleeping. The client describes the layout of the apartment, a neighbor's barking dog and a recent repair to the heating, and then says the client has been waking at 4 a.m. every night. The client's thought process is BEST described as:

A. Tangential
B. Flight of ideas
C. Circumstantial
D. Perseveration

6. Two weeks after the crash

Two weeks after a car crash in which a friend was seriously injured, a client reports nightmares and intrusive memories of the crash, avoids driving and talking about it, startles easily, has trouble concentrating, and says the client feels detached, "like watching my life on a screen." The client had none of these problems before the crash. Which diagnosis is MOST consistent with this presentation?

A. Posttraumatic stress disorder
B. Acute stress disorder
C. Adjustment disorder

7. A change over two days

A social worker in a skilled nursing facility is asked to see a 79-year-old resident who was alert and oriented last week. Over the past two days, the resident has become confused and agitated, especially at night, says there are insects on the walls, and dozes through much of the day. What should the social worker do FIRST?

A. Complete a cognitive screening to assess for dementia.
B. Recommend a psychiatric evaluation for new-onset psychosis.
C. Add structured daytime activities to improve the resident's sleep.
D. Arrange for the resident to have an urgent medical evaluation.

Intervention and Practice, questions 8 to 10

8. Three generations on one page

A social worker asks a client to help draw a diagram of the client's family across three generations, marking repeated patterns of conflict and the relatives who have cut off contact with one another. The social worker is MOST likely working from which model?

A. Structural family therapy
B. Strategic family therapy
C. Bowen family systems therapy
D. Solution-focused brief therapy

9. The polite first meeting

At the first meeting of a new support group, members are polite and quiet, speak mostly to the social worker rather than to one another, and ask what they are supposed to do. What should the social worker do?

A. Clarify the purpose of the group and help members agree on ground rules.
B. Step back so that members can take over the leadership of the group.
C. Ask members to share their most painful experiences to build closeness.

10. Anger in supervision

In supervision, a social worker describes intense anger toward a client whose controlling behavior reminds the social worker of a former partner. The social worker wants to keep working with the client. What should the supervisor do FIRST?

A. Transfer the client to another social worker.
B. Help the social worker examine how these feelings are affecting the work with the client.
C. Recommend that the social worker begin personal therapy.
D. Advise the social worker to set firmer limits with the client.

Answers and reasoning

1. C: explain what will be reported

A client who has been ordered into counseling is owed an explanation before anything else. The NASW Code of Ethics says that when clients receive services involuntarily, social workers should tell them about the nature and extent of the services and how far they can refuse them (standard 1.03(d)). That has to happen before the client says anything the court might later hear about. B is good engagement and belongs right after it; resistance often eases once a client knows the rules. A gathers exactly the information the client has not yet agreed to share on informed terms.

Tests informed consent and work with involuntary clients. Free lesson: informed consent.

2. D: remind the parents of the agreement

The question was settled at intake, which is what the agreement was for. The Code asks social workers to discuss confidentiality and its limits with clients and other interested parties as early as possible in the relationship. There is no safety risk, so the agreement's exception does not apply, and A breaks a promise made to the client in front of the parents. B and C may both be worth doing, but neither one answers the parents' call, and the qualifier is FIRST. Rules on minors' records differ from state to state; a question like this one turns on the agreement and the absence of risk, not on a statute.

Tests confidentiality with minors and families. Free lesson: confidentiality.

3. A: involve the uncle, on the client's terms

Self-determination includes the right to choose who helps you decide. A keeps the decision with the client and respects how decisions are made in the client's family. B imposes an individualist norm and gets confidentiality backward, because a client can always choose to share. C swings too far the other way and hands the decision to someone else. The test is whose choice it remains.

Tests culture and its effect on behavior, and self-determination. Chapter: Diversity and Social Justice.

4. B: explain access, and document what is relevant

The Code's standard 3.04(c) asks that documentation protect clients' privacy as far as is possible and appropriate, and include only information directly relevant to the services. B applies that and tells the client the truth about who can see the record. A creates a second, unofficial record, which helps no one, the client included. C promises something no one can promise, since records can be released with the client's consent or when the law requires it. D treats completeness as permission to record everything.

Tests documentation and privacy. Chapter: Ethical Service Delivery.

5. C: circumstantial

The client takes the long way round but arrives: the question about sleep gets answered. That return is what separates circumstantial thinking from tangential thinking (A), which drifts away and never comes back to the question. Flight of ideas (B) is a rapid jump from one idea to the next, usually with pressured speech, as in mania. Perseveration (D) is coming back again and again to the same word or idea.

Tests the mental status examination. Chapter: Assessment Methods and Techniques.

6. B: acute stress disorder

The deciding fact is time. In the DSM-5-TR, acute stress disorder covers symptoms from three days to one month after a traumatic event, and posttraumatic stress disorder (A) requires that symptoms last more than a month. The VA's National Center for PTSD draws the line in the same place. At two weeks, PTSD cannot yet be diagnosed. Adjustment disorder (C) fits distress after a stressor when the picture does not meet the criteria for a trauma disorder; here both the event and the symptoms (intrusion, avoidance, arousal and detachment) do. If the symptoms last past a month, PTSD is the diagnosis to assess for.

Tests applying the DSM. More in the DSM-5-TR and the ASWB exam.

7. D: get the medical evaluation first

A sudden change in thinking over a couple of days, worse at night, with drowsiness and things seen that are not there, is the pattern of delirium. MedlinePlus defines it as sudden severe confusion due to rapid changes in brain function, and lists causes such as infections, medicines and withdrawal. It is often temporary and reversible once the cause is treated, which is why the cause has to be found first. A mistakes a sudden change for a gradual one, since dementia usually develops slowly. B assumes a psychiatric cause before a medical one has been ruled out. C treats a symptom. When behavior changes suddenly, the exam's answer is to rule out a medical cause FIRST.

Tests assessment of older adults, and medical causes of a change in mental status. Chapter: Assessment Concepts.

8. C: Bowen family systems therapy

A diagram of three generations, patterns repeated across them, and relatives who have cut off contact all belong to Bowen: emotional cutoff and multigenerational transmission are two of the eight concepts in Bowen theory. Structural therapy (A) works with boundaries, subsystems and hierarchy in the family as it is now, often through joining and enactment. Strategic therapy (B) uses directives to interrupt the sequences that keep a problem going. Solution-focused therapy (D) looks for exceptions and future goals rather than family history.

Tests family therapy models, which are on the Clinical, Masters and Advanced Generalist outlines but not the Bachelors one. Chapter: Intervention Methods and Techniques.

9. A: give the group structure

Members who are polite, tentative and focused on the leader are in the early stage of a group, called forming in Tuckman's model and preaffiliation in Garland, Jones and Kolodny's. At that stage the leader's job is structure: what the group is for, and the rules members will keep, including confidentiality. B hands over leadership before the group can hold it; shared leadership comes later. C asks for the kind of disclosure that needs trust the group has not built yet, and can drive members away.

Tests group work. Same chapter: Intervention Methods and Techniques.

10. B: examine the feelings in supervision

Strong reactions to a client are expected, and supervision is where they are examined first. The 2026 outline places transference and countertransference within the supervisory relationship, which is exactly this conversation. Transferring the client (A) may become necessary if the feelings cannot be managed or begin to harm the work, but it is not the first step. Personal therapy (C) may follow if the feelings persist, but supervision is not therapy, and recommending it skips the examination the supervisor can do now. D acts on the feeling instead of understanding it.

Tests transference and countertransference in supervision. Chapter: Supervision and Administration.

What your score on ten tells you

Less than it seems. Ten questions is a small sample: one lucky guess or one misread stem moves you ten percentage points. ASWB says the passing score generally ranges from 66 to 78 correct answers out of 110 scored questions, roughly 60% to 71% depending on the version, so seven out of ten is in the right territory, and nine out of ten proves very little either way. How the exam is scored explains why the number moves, and how hard the exam is puts first-time and eventual pass rates side by side.

What ten questions are good for is the reasoning. If you missed one, name the rule you broke and look for it in the next set you try. The signal worth trusting is a full-length timed exam taken under exam conditions: how to use practice exams covers when to take one and how to review it, and how to know you are ready covers what the score means.

The rules behind the ten

Tell a client what will be shared before you ask for anything (question 1).
An agreement made at the start governs the hard moment later (2).
The client decides who helps decide (3).
A record protects privacy and holds what is relevant (4).
Read the criteria: whether the answer returns to the point (5), and how long since the trauma (6).
Rule out the medical before the psychological (7).
Know each model by its vocabulary (8).
Give a new group structure before you ask for closeness (9).
Examine your own reactions before acting on them (10).

LCSW exam practice questions: ten clinical vignettes, worked