Narcissistic Personality Disorder on the ASWB exam

By Heidi Tobe on March 1, 2021

Today we're back with more on Narcissistic Personality Disorder (NPD). As mentioned in last month’s blog, every other month for the next several months, we are covering a topic and comparing a recall vs. reasoning question to highlight how the same topic can be tested in different ways. Last month’s blog highlighted a recall question on NPD. This month we are taking the same topic, but giving you a reasoning question to practice with. 

What do I need to know about Narcissistic Personality Disorder?

When thinking about how a client with NPD may present, you want to first and foremost be thinking of someone presenting with a sense of self-importance, grandiosity, and entitlement. Clients with NPD tend to view themselves as superior to/above others. They lack the ability to empathize with others, and see themselves as special or unique. People with NPD tend to exaggerate their achievements and often fantasize about power and success.

ASWB Practice Question:

A social worker has been meeting with a client diagnosed with Narcissistic Personality Disorder for the past two months. The social worker observes that anytime they make a suggestion in working toward their identified goals, the client dismisses the suggestion and explains that the issue is with other people, not himself. What should the social worker do NEXT?

A. Remind them that they came to therapy to work on themselves

B. Validate the client’s concerns

C. Bring up this pattern to the client

D. Review the client’s goals

(Scroll for answer and rationale)












The correct answer is C: to bring up this pattern to the client. (A) does not directly address the pattern the social worker is observing and will not necessarily impact this concern. (B) is not something we would want to validate and also ignores the observed pattern. (D) is also a good option, but it would make sense to do this after doing C.

ASWB Masters and Clinical Exam Preparation

How did you do with this month's reasoning question Narcissistic Personality Disorder? Did you find it more challenging than last month’s recall question? Many people find the recall questions on the exam simpler and easier to prepare for than the reasoning questions. But 85%+ of the ASWB clinical exam is made up of these reasoning based scenarios, so you want to make sure you feel ready for them. The good news is that TDC's LMSW and LCSW exam prep programs have hundreds of practice questions and rationales to prepare you for these unique questions. Here at TDC, we also have coaches available to answer any questions that come up as you’re studying. We’ve helped THOUSANDS of social workers pass their LMSW and LCSW exams and we’re ready to help you PASS with CONFIDENCE this year!


Commenter Name
March 22, 2021

I’m signed up with your LCSW study program. This is one of those questions were i just don’t understand the answer and explanation. Considering the characteristics of a person with NPD I believe that it would be better to do D first and then C. The reason being that we can discuss the goal the client has set and then as a Therapist I point out the pattern which will keep him from reaching the goal. Please help.

Commenter Name
March 23, 2021

Hi Samara,

The issue isn't whether or not the client is familiar with the goals (if it were, we could do D). Doing D isn't doing anything to address the pattern the social worker has observed. The issue is that the client is dismissing suggestions and placing blame onto others for presenting issues. Just reviewing the goals isn't going to resolve the issue. For purposes of the test, when the social worker identifies a therapy interfering behavior occurring, the expectation of the exam is that this observation be brought up and discussed with the client.

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