Licensed Clinical Social Worker (LCSW) Therapist Development Center Practice Exam

If a 17-year-old client with Bipolar Disorder refuses medication due to religious beliefs, what should the therapist consider as their next step?

1. Initiate a 5150 involuntary hospitalization

2. Respect the parents' wishes to avoid medication

3. Explore the impact of the medication refusal with the client

4. Immediately inform child protective services

The correct answer is: Explore the impact of the medication refusal with the client

Exploring the impact of the medication refusal with the client is the most appropriate next step when a 17-year-old with Bipolar Disorder refuses medication due to religious beliefs. This approach respects the client's autonomy and acknowledges their personal beliefs while allowing for an open dialogue about their concerns regarding the medication. By engaging the client in a conversation about their refusal, the therapist can better understand the underlying reasons for this decision, including the specifics of their religious beliefs, fears or misconceptions about medication, and any past experiences with treatment. This understanding is crucial for therapeutic rapport and can lead to a more collaborative treatment plan that addresses the client's values while considering their mental health needs. Additionally, exploring these feelings may open opportunities for the therapist to educate the client about the potential benefits and risks of medication, which could help them reconsider their stance in the future. Building a trusting relationship also enhances the likelihood that the client will engage in further discussion about managing their bipolar disorder. In the context of this situation, the other options are less appropriate. Involuntary hospitalization, respecting the parents' wishes without considering the client's perspective, or immediately contacting child protective services could undermine the therapeutic alliance and the client's sense of agency, possibly leading to counterproductive outcomes in treatment.