LMSW EXAM - Bootcamp!, LMSW, LMSW (Updated Spring 2023) A+ guide.

3 Areas to identify in each question (PPL)

Problem
Person
Last Sentence (guide to answer question)

Key words

Person/Client “hot seat”
SAFETY Red Flags – suicide, abuse, life-threatening, unexplained marks, alcohol, recent loss
Strong words/adjectives
Age
Diagnosis
Symptoms/Duration
Who are you?
Where are you in session?
Quotations
Direct requests/concerns
Qualifiers (First/Next/Best)

Distractors
FARM GRITS ROAD – Answers that look appealing at first glance but are often wrong – ELIMINATE! Exam is here and now

DO NOT CHOOSE FARM GRITS ROAD

FOCUS on unresolved issues/past
ADVICE – giving/judging
RECOMMEND “to a support group”
MAKE an appt.
GIVE pamphlets/literature
RECOMMEND a session
INFORM parents/speak to parents (when child/ado)
TERMINATE (Exceptions: Moving, client reaches goals/no new crisis, client does not pay)
SPEAK to supervisor (except transference/counter)
RESPECT self-determination (If mentally UNSTABLE)
OFFER contract as a reminder
ALLOW the clients to lead the session
DO nothing/say nothing

How do you answer first/next questions?
90% of exam is SAFETY FIRST.

How does the exam want you to have a CLEAR understanding of client’s issues?
ASSESS BEFORE ACTION.

RUSAFE

RULE out medical
UNDER the influence/delusional/hallucinating Do Not Treat
SAVE Lives – Safety first (Answers: Duty to warn, report child/elder abuse, 911, mobile crisis, ER)
ASSESS before action – (Answers: ASSESS, ASK or DICE – Determine, Identify,Clarify, Explore)
FEELINGS – (Answers: ACKNOWLEDGE person’s feelings) CONCERNS (AID ASSIST, INFORM client, DISCUSS concerns)
EMPOWER – If client is mentally stable/alert (Answers: Respect client’s decisions)

COE: Ethical responsibilities towards clients

Client’s best interests are primary
Respect/promote right to self-determination if client is mentally alert/stable, NOT unstable/intoxicated/psychotic
Informed consent, written agreement by client to undergo treatment, risks/benefits/costs disclosed
Avoid conflicts of interest (Things that interfere with SW’s impartial judgment/discretion)
DO NOT promote individual therapy sessions to ppl who have a relationship w/ each other (except couples, family, group treatment) – Provide family members with appropriate referrals
Avoid dual/multiple relationships
Avoid bartering (unless common practice in community)
Obtain a professional translator FIRST if client does not speak the language of SW
Do not disclose client information w/out consent unless req’d by law
Provide client with reasonable access to records (First explore/discuss reason for request) Follow laws of state.
Ensure CONTINUITY of services
NO relations with clients past or present

Mandated reporting
SW’s are req’d and responsible for reporting any instances of abuse that is suspected. Abuse includes physical, emotional, sexual, neglect, CHILD AND ELDER ABUSE

Duty to Warn
SW’s MUST WARN a threatened victim of any harm that his/her client may cause when there is a REAL INTENT (PLAN)

HIV Decisions
NOT DUTY TO WARN! 3 options:

FIRST urge client to disclose to partner
FIRST encourage client to engage in safe sex
Research/follow state laws as needed

Subpoena by the court
SW may be req’d by law to disclose confidential information

COE: Ethical responsibilities to colleagues

Refer to colleague who may be better trained in an area than SW. SW can take client but must be COMPETENT.
When CONSULTING with colleague, disclose least amount of information
FIRST speak to a colleague to discourage/prevent/correct unethical behavior
AVOID relationships with colleagues (conflict of interest)

COE: Ethical responsibilities in practice settings

Accurately document services in client’s records while keeping best interests in mind
Maintain records securely for a period of time consistent with state laws

COE: Ethical responsibilities as professionals

MONITOR/EVALUATE policies and implementation of programs
ADVOCATE when necessary

HMO Insurance/Short term Care/MANAGED CARE

Emphasizes short term, discourages long term treatment
Cases assigned to case manager to whom provider must justify necessity for treatment for payment and services.
More precise diagnosis = greater likelihood of reimbursement
Encourages Cognitive/Behavioral short term TX.
Contracts are INFLEXIBLE, abide by rules to receive reimbursement

Disorders in Infancy, Childhood, Adolescence
Autism, ADHD, Oppositional Defiant Disorder, Conduct Disorder, Enuresis, Separation Anxiety Disorder

Adult Disorders
Delirium, Dementia, Amnestic/Cognitive Disorders, Schizophrenia and other Psychotic Disorders, Mood Disorders, Anxiety Disorders, Somatoform Disorders, Factitious Disorders

Autistic Disorder

Deficits in social interaction and nonverbal COMMUNICATION
Lack of peer relationships. eye contact, abnormal body movement,
Restricted, repetitive patterns of behavior
Inflexibility to routine, Fixed interests

Attention Deficit Hyperactivity Disorder

Symptoms at least 6 months
Inattentive: Difficulty focusing, staying on task follow-through, listening, easily distracted, loses things, forgetful
Hyperactive: Impulsive, fidgeting, running around, talking excessively
Several symptoms present prior to age 12
Must occur in 2 or more settings
6.. Behaviors can increase/decrease based on settings.
TX: Behavior modification

Oppositional Defiant Disorder
At least 6 months – Angry, irritiable, defiant, talking back to adults, rebellious behavior, attitude, blames others, cursing, lying

NO SERIOUS VIOLATIONS OF OTHERS RIGHTS

Conduct Disorder

Violates other’s rights, bullies, shoplifts, truancy, DX up to age 17
TX: Family, schools, community, client, parent/child behavior modificationq skills

Enuresis

Repeatedly urinating during day/night
Up to 5 years old
Rule out medical first

Separation Anxiety Disorder

Excessive distress when separated from major attachment figures.
Clinging, school refusal, sleep refusal
School Phobia is a form of separation anxiety.
Brought on when leaving home/family members to attend school.
At least 1 month of symptoms

Impulse control disorders
Trichotillomania, Intermittent Explosive Disorder, Gambling, Kleptomania, Pyromania,

Delirium

Disoriented
Short period of time
Sometimes due to medical condition/substance use: DEHYDRATION, HEAD TRAUMA

Dementia

Slow onset
Deterioration of memory/cognition
Alzheimer’s, HIV, Parkinson’s

Amnestic Disorders
Memory impairment w/out cognitive impairment

Korsakoff’s Syndrome
Chronic alcoholism causes inability to recall previously learned information

Schizophrenia

Hallucinations, delusions, disorganized speech, disordered/catatonic behavior, impaired thinking, negative symptoms (diminished emotional expression or avolition) THOUGHT DISORDER
Duration at least 1 month, but more than 6 months
TX = Medication and ego-supportive therapy (No INSIGHT therapy!)

Schizophreniform

Same symptoms of schizophrenia
DURATION is at least 1 month, but less than six months
Triggered by turmoil/high stress
TX = Mediation and supportive therapy

Delusional Disorder

NON-BIZARRE/IRRATIONAL beliefs/delusions
Hallucinations absent or not prominent
Persecutory/Jealous Types of delusions
NO IMPAIRED FUNCTIONING

Brief Psychotic Disorder

1 Symptoms of criterion A Schizophrenia
DURATION LESS THAN 1 MONTH

Psychotic symptoms may also occur during which other conditions?
Bipolar 1 Disorder, Major Depression, Substance Induced Mental Disorders, Mental disorders due to a medical condition (ex. Amphetamine induced psychotic disorder with delusional features), Delusional Disorder, Borderline Personality Disorder, Brief Psychotic Disorder, Schizophreniform Disorder, Schizoaffective Disorder

Differential diagnosis Schizophrenia and Delusional Disorder

Delusions occur in both
Schizophrenia experience other symptoms (hallucinations, bizarre delusions)
DD less functional impairment

schizoaffective disorder
Same symptoms of schizophrenia with a major depressive episode, manic episode, or mixed episode

Disruptive Mood Dysregulation Disorder
a childhood disorder (diagnosed after age 6, before age 18) marked by severe recurrent temper outbursts along, persistent irritable or angry mood, 3 or more times per week period of 12 months

Major Depressive Disorder

Symptoms: (most of day, nearly every day for 2 weeks)
-Depressed mood
-Lack of pleasure
-weight loss/gain
-insomnia/hypersomnia,
-psychomotor agitation
-sad/empty/worthlessness
-suicidal ideation

fatigue
difficulty concentrating
excessive guilt
MDD and bereavement differences- excessive guilt, anhedonia, suicidality

Dysthymic Disorder

MDD symptoms but LESS SEVERE
Chronic
Duration more than 2 years (Children 1 year)
Symptoms cannot be absent for longer than 2 consecutive months

Bipolar 1 Disorder

One or more manic episodes (Elevated, expansive, irritable mood, or excessive mood and increased energy) usually accompanied by a major depressive episode)
Symptoms may last at least 1 week to a few months
3 or more manic symptoms
Impaired functioning

Manic symptoms
Inflated self-esteem, decreased need for sleep, loud/rapid speech, restlessness, racing thoughts, increased sociability and goal-directed activity, impairment of normal activities/relationships

Bipolar II Disorder

1 or more depressive episodes with at least 1 or more hypomanic episode
NO manic episodes or mixed episodes

Depressive Symptoms
Sadness, loss of interest in usual activities, sleep/appetite disturbance, feelings of worthlessness/guilt, difficulty concentrating, suicidal thoughts/death

Neurovegetative symptoms of depression
changes in appetite of weight, sleep disturbances, fatigue, decrease in sexual desire/function

Rapid Cycling
4 or more manic episodes of illness over 12-month period

Mixed State
Both depression and Mania occur at the same time

Children and Adolescents with Bipolar Disorder

Can occur, more likely if parents have illness
Children/Ados may experience very fast mood swings b/t depression and mania in one day
Children with mania likely to be irritable and prone to tantrums than to be overly happy
Bipolar difficult to tell apart from other problems in this age group

Hyperthyroidism can mimic
Mania

Hypothyroidism can mimic
Depression

Mood disorder
Refers to a disturbance of mood and other symptoms that occur together for a minimal duration of time and not due to physical/mental illness

Panic Disorder

Brief, recurrent, panic attacks
Followed by persistent worry of another panic attack and behavior change
TX = Desensitization techniques

social anxiety disorder
intense fear of social situations, leading to avoidance of such

Generalized Anxiety Disorder

Excessive worry and physical symptoms (restlessness, fatigue, headache, stomachache)
Ex. client reports frequently irritable and unable to focus, tension, insomnia
At least six months
Worry impedes functioning

Panic attack or depression caused by substance
Substance Induced Anxiety Disorder or Mood Disorder

Panic attack caused by medical illness
Anxiety or Mood disorder caused by General Medical Condition

Somatoform Disorders
Disorders characterized by physical complaints that appear to be medical in origin but that cannot be explained in terms of physical disease (emotional connection)

obsessive-compulsive disorder
An anxiety disorder characterized by unwanted repetitive thoughts (obsession) and/ or actions (compulsions).

Body Dysmorphic Disorder

Excessive preoccupation with one body part
Severe, impairment in functioning
Cause of decline = obsessing about defect

Conversion Disorder
Involuntary loss of voluntary function, however client does not control or produce them voluntarily

Factitious vs. Malingering

Intentionally produced symptoms, differing incentives
Malingering fakes symptoms for external gain/goal
Factitious produces symptoms due to need to be “sick patient”

Munchausen’s Syndrome
Faking an illness/producing symptoms to receive sympathy as patient

Munchausen’s By Proxy
Abuse of another (typically a child) in order to seek attention for the abuser

PTSD

Exposure and response to life-threatening event
Arousal, intrusive, avoidance symptoms (distressing memories, dreams, dissociations,
LAST A MONTH AND BEYOND
Impairment to functioning/life pursuits

acute stress disorder
PTSD symptoms that appear for a month or less

Reactive Attachment Disorder

Disorder caused by lack of attachment to caregiver – NEGLECT
2.

Adjustment disorder
a disorder in which a person’s response to a common stressor, is maladaptive and occurs within 3 months of the stressor

Disinhibited Social Engagement Disorder (DSED)
a trauma-related attachment disorder characterized by indiscriminate, superficial attachments and desperation for interpersonal contact

Somatization Disorder
Recurrent/multiple somatic complaints that cannot be explained medically of several years. STRESS.

Substance related Disorder
Drug/Alcohol Intoxication and Withdrawal, Drug/Alcohol Abuse and Dependence

Disorders that are chronic
All personality disorders, Schizophrenia (> 6 months), Dysthymic and Cyclothymic (> 2 years), Generalized Anxiety Disorder (> 6 months), Hypochondrias (> 6 months), Somatization Disorder (several years)

Paraphilias vs. Sexual Sexual Dysfunction
Inappropriate sexual object or practice vs. inhibition of sexual response

Parasomnias vs. Dyssomnia
Abnormal event that occurs during sleep, b/t sleep/waking VS. disturbance in amount/timing of sleep

Personality Disorders

An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture
2 or more areas (cognition, affectivity, interpersonal functioning, impulse control)

Cluster A personality disorders
odd/eccentric
paranoid, schizoid, schizotypal

Schizoid PD
LONER, introverted, withdrawn, detachment from social relationships, RESTRICTED RANGE OF EMOTIONAL EXPERIENCE AND EXPRESSION, NO DESIRE FOR FOR SOCIAL RELATIONSHIPS

Paranoid PD
Interpreting actions of others as deliberately threatening or demeaning, distrustful and suspicious

Schizotypal
Odd/strange/bizarre behavior/beliefs/mannerisms and interpersonal/social deficits due to fear/paranoia

Magical thinking
ideas that one’s thoughts or behaviors have control over specific situations

ideas of reference
The false impression that outside events have special meaning for oneself.

Cluster B personality disorders
dramatic, emotional, erratic

antisocial, borderline, histrionic, narcissistic

antisocial personality disorder

Disregard for the rights of others, Impulsive/irresponsible/callous
Must be > 18 (symptoms can occur at 15)

Borderline PD

Unstable in interpersonal relationships, behavior, mood, and self-image.
Abrupt and extreme mood changes
Stormy interpersonal relationships
Fluctuating self-image
self-destructive actions

Narcissistic PD
Exaggerated self-importance, absorbed fantasy for success, seek constant attention/admiration, oversensitive to failure

Histrionic PD
Melodramatic, attention-seeking, excessive emotionality, sexually seductive

Cluster C personality disorders
Anxious, fearful

avoidant, dependent, obsessive compulsive

Avoidant PD
Hypersensitive to rejection, unwilling to be involved, fear of not being liked

Dependent PD
Pattern of dependent and submissive behavior

Obsessive Compulsive PD
preoccupation with perfection, control, and orderliness

Multiple Personality Disorder
Dissociative Identity Disorder

Mental Status Exam
Structured way of observing and describing current state of mind – appearance, attitude, affect, behavior, cognition, insight, judgment, mood, perception, speech, thought process, thought content

Displacement
Place unwanted/unpleasant feelings onto someone less threatening or innocent bystander – ex. angry at boss, take it out on spouse

Dissociation
A person often loses track of time or themselves and their usual thought processes and memories. People who have a history of any kind of childhood abuse often suffer from some form of dissociation

Projection
Taking your emotions and placing it on others – ex. All of my coworkers are greedy, but I am not

Introjection
To incorporate someone else’s emotions into one’s self, internalized beliefs of others

Idealization
overestimation of an admired aspect or attribute of another

Identification
a person patterns oneself after a significant other

Identification with the aggressor
mastering anxiety by identifying with a powerful aggressor

Isolation of affect
Expressing no emotionality when confronted with difficult events

Projective Identification
BPD Clients, Unconsciously perceiving other’s behavior as a reflection of one’s own identity

Reaction formation
Turning unwanted or dangerous thoughts, feelings or impulses into their opposites. Ex. Person with a sudden loss shows a happy mood

Regression
return to infantile patterns of thinking/being

Sublimation
maladaptive behaviors/impulses diverted to more socially acceptable channels, healthy redirection of emotion

Turning against the self
defense to deflect hostile aggression or other unacceptable impulse from another to self

Splitting
Also clients with BPD – identify a person as either all good or all bad

Denial
Refusal to acknowledge external reality that are intolerable. Ex. I am not a shopaholic, but credit cards are maxed out.

Repression
Unconsciously wipes out, “forgets” painful feelings/memories

Suppression
Consciously put painful thoughts/feelings memories to the side

Undoing
Taking Back unwanted behaviors through praise/gifts. Ex. buying gifts, obsessively washing hands to deal with obsessive thoughts.

Compensation
Enables one to make up for real or fancied deficiencies, Ex. short man becomes cocky

Conversion
Repressed urge is expressed as a disturbance of body function – pain, deafness, blindness

Reflection
Reflecting clients feelings back to them- YOU SEEM TO BE OVERWHELMED

Exploring silence
Being attentive and remaining silent during the time when client is silent. SILENCE EQUALS SILENCE

Partialization
Taking client’s OVERWHELMING feelings and breaking them down into smaller more manageable parts

Confrontation
Challenging an ESTABLISHED CLIENT to think about DISCREPANCIES in what he/she says/does. Can be used with addictions/perpetrators or resistance to treatment. Ex. changes subject, always late, denial, rationalization, cancelations. Not aggressive.

Rational Emotive Behavioral Therapy REBT
Confrontational approach, assists clients to discontinue negative/irrational thoughts

Paradoxical Directive
Instructing clients to continue their maladaptive behaviors with the goal of bringing awareness and change. ex. Couples bickering in couples therapy.

Crisis Intervention

Assist the person in distress to resolve immediate problem and regain emotional equilibrium = GOAL IN FIRST SESSION, emphasis on coping mechanisms

Narrative therapy

Therapist co-constructs alternative positive stories with client
Externalizing the problem, problem-saturated stories, mapping problem’s domain, unique outcomes, spreading the news

Ecological/Life Model
Environmental pressures, focus on life transitions, Fit between individual/family and environment

Gestalt
Assist client with awareness of here/now – ex. Empty chair

Heightened awareness
Not good for impulsive clients

Behavior Modification
Techniques to modify behaviors, ex. positive reinforcement

Behaviorist
Observe/measure the way clients respond to certain triggers

Operant techniques
Positive reinforcement – add praise,
Negative reinforcement – take away shock,
Positive punishment – add spanking,
Negative punishment – take away something desirable

Classical conditioning
Pavlov’s dog, stimulus response approach to behavior

Shaping
Technique to train a new behavior by prompting and reinforcing successive behaviors

In vivo desensitization
Exposure from least to most anxiety situation – REAL LIFE SETTING

Systemic desensitization
Anxiety producing stimulus paired with relaxing response

Flooding
Anxiety reduced by prolonged real or imagined exposure to high-intensity feared stimuli

Modeling/Observational learning
Learning by observing others

Operant conditioning
Events precede behaviors which in turn are followed by consequences

Cognitive therapy
Identifying and changing dysfunctional negative THOUGHTS, change thoughts to change behaviors

Strengths perspective
Identify strengths and build on to empower clients

Psychoanalysis
Long term treatment, resolve inner, unresolved conflicts of past

Family Therapy

Treats whole family system and identifies the individual symptom bearer as indicative of a problem in the family as a whole, identify client in crisis/hot seat

Couple Therapy
Treats couples to understand and resolve conflicts to improve their relationship. To communicate better, negotiate differences, problem solve in a healthier way

Margaret Mahler
Process of separation-individuation, All Small Dogs Practice Reaching Out

Autistic – Attachment Phase
Newborn to 1st month, infant focused on self

Symbiotic Stage – Attachment Phase
1 to 5 months, breaks out of autistic shell, feels unity with mother, begins to understand mother as a separate being

Differentiation – Separation-Individuation Phase
6 to 9 months – Inward focus to outward focus, separates from caregiver by crawling, stranger anxiety 6-8 months

Practicing – Separation-Individuation Phase
9 to 14 months – crawls/walks freely, explores, becomes distant from mother, separation anxiety 12 months

Rapprochement – Separation-Individuation Phase
14 to 24 months – Desires to be independent, moves away from mother but returns regularly, prolonged separation anxiety 18 months

Object constancy – Object Constancy Phase
After 24 months, capacity to recall mother despite absence, sees mother as separate individual

Anti-psychotic Medications

Neuroleptics – Help Zany People Towards Reality Acceptance Soon
Haldol, Zyprexa, Prolixin, Thorazine, Risperdal, Abilify, Seroquel – Also used for bipolar
Tardive Dyskinesia – muscle disorder
Clozapine – atypical, increased risk for agranulocytosis

Bipolar Medications
Live To Dream Always Towards Top, Lithium Tegretol, Depakote, Abilify Trileptal Topamax- kidney problems, liver problems, monitor blood work

Anti-Anxiety Meds

Benzodizepines, View Karen’s X-rays After Ballet
Valium, Klonopin, Xanax, Ativan, Busbar
Short acting and addictive
Impaired muscle coordination and impairment of short term memory, PAM

Antabuse
medication for alcohol, form of AVERSION THERAPY

ADHD Disorders

Amphetmines/SPEED – CAR speed, Paradoxical effect
Concerta, Aderall, Ritalin
Non-Amphetimine – Strattera – can not be abused, 2 to 4 weeks for effective

Anti-Depressants

SSRI’s, People’s Zoom Power, Will ,Never, Cure, Everything, Except, Little, Tiny, Cats
Prozac, Zoloft, Paxil, Wellbutrin, Celexa, Effexor, Lexapro,Trazadone Cymbalta
Often causes loss of libidinal desire, several weeks to be effective, 4. PRAM, INE,

Atypical Anti-depressants

Eat Clean Worms
Effexor, Cymbalta, Wellbutrin

Tricyclic Anti-depressants

ET= Tricycle – Elavil, Trofanil
Can cause dry mouth

MAOI’s

Antidepressants
Hypertension if high dose taken
TCA/Stimulant taken
Dietary restriction: Foods with high levels of Tyramine – avoid beer, wine, cheese, smoked/pickled fish, etc.

Community Organization Key Points

NOT direct practice, indirect practice
SW role is to work WITH THE community, not directly for them
No individual counseling or family counseling
Empower members to strengthen community to prevent future dilemmas
Members must have a COMMON INTEREST – KW’s consensus, agreements
Advocate for disadvantaged

Locality Development, Model of Community Organizational Practice

Purpose: Join efforts to solve a common problem with community/local level
SW Role: Enabler – help members use own resources to problem solve/empower
Broker: Mediates/Negotiates b/t community groups, links community with services

Social Planning Model of Community Organizational

Purpose: Determine a range of solutions to problems. Develops programs
SW Role: Expert, gather data and facts used to resolve problems, Ex. planning homeless shelters and after school recreation programs

Social Action, Model of Community Organizational

Purpose: Clients who NEED assistance and disadvantaged, take action, confrontation
SW Role: ADVOCATE, represent disadvantaged and ACTIVIST, bargaining and confrontation, Ex. Tenant Association, Landlord/Tenants, women’s rights mov’t

Social Reform, Model of Community Organizational

Purpose: Work with other organizations. Form coalitions
2 SW Role: Organizer, joins groups and institutions together to take joint action towards specific goals, ex. improve economic development and resolve unemployment problems

Group Therapy Key Concepts

Group members SHARE A COMMON PROBLEM
Group members are there to SUPPORT EACH OTHER
Therapist there to ALLOW THE GROUP to come to resolutions and resolve conflicts
Therapist intervenes only if there is threat of violence
Therapist must acknowledge feelings of an individual in crisis
Therapist must ALLOW confrontation when there is denial or rationalization.
Contraindications – client in crisis, suicidal, need for attention, psychotic, paranoid

Group polarization
Discussion strengthens a dominant point of view, group shifts to this extreme viewpoint

Groupthink
Group cohesion and loyalty undermines decision making in order to maintain the we-ness

Irvin Yalom, M.D.
Pioneer in group therapy.
Universality – helps ppl see what they are going through is universal, not alone,
Catharsis – Venting feelings to group members to relieve pain, guilt, stress

Boston Model, People Perceive Information Differently Separately

Preaffiliation: Ambivalence, leader must establish authority/discuss guidelines and review philosophy
Power/Control: Struggle over control of the group, conflict among subgroups
Intimacy: Conflicts diminish, sense of “we-ness” increases and COHESION
Differentiation: Personal expression, improved group skills in analyzing and working through problems
Separation: Achieve termination

Administration Key Concepts

Key Words’s = TEAM WORK, CONVENE STAFF MEETINGS & BROAD BASED COMMITTEES
Admin. establishes a broad based “committee” that brings together all segments of the agency, including staff and sometimes clients to develop methods for assessing the problem, decision making, proposing solutions

The Board of Directors

NOT on SW’s TREATMENT TEAM
Executive directors are concerned with funding NOT with immediate staff issues

3 functions of supervision
Administrative, Educational, Supportive

Supervisor Key Concepts

Supervisor there to EDUCATE the SW and IMPROVE job performance
Supervisor is in charge of SW’s and or intern’s caseloads
TRANSFERENCE/COUNTERTRANSFERENCE
Supervisor DOES NOT EXPLORE sw’s inner feelings
Main purpose – advance agency goals and improve service to clients.

Culture Bound Syndrome
Appendix 1 in DSM-IV: A client’s cultural beliefs and how they impact the interviewer while assessing their behaviors Ex. Ataque de nervios – Hispanic Culture

Native Americans and Alaskan Natives

Tradition of oral story telling
Great respect for elders, hand down traditions
Spiritual healers are traditional leaders (shaman/medicine man)
Value listening and comfortable with silence
High degrees of suicide and alcoholism
Avoid eye contact as a sign of respect

Latino – Hispanic

Mostly roman catholic and extended family system
Demonstrate shame when seeking mental health assistance
Excessive emotionality when confronted with crisis – ataque de nervios

Asian/Pacific Islander

Obligation to parents and respect to elders
Elders are family decision makers
Resolve conflicts within the family
Less emotional expressiveness
Use alternative healing methods (ex. coining, acupuncture, homeopathic TX)

Elderly Clients

Remain patient and respectful – do not use aggressive approach
Mr. or Mrs. as a sign of respect
Frequent appts. may be needed during beginning of treatment – home visits
Respect self-determination if they are mentally alert
Client is Frail/medical issues – assess their abilities, r/o medical FIRST

Gender, Identity Clients – gay, lesbian, transgender

Be aware that clients have concerns about your values
Support client in understanding their own sexual orientation prior to sharing with family/friends
Be aware of your own values/cultural competence with ALL DIVERSE clients

Clients with Disabilities

Explore your clients need for SPECIAL ACCOMMODATIONS first
Respect self-determination if mentally stable
Do not challenge clients who have lower level of functioning

Substance Dependence
Increased tolerance, withdrawal symptoms

Substance abuse
Abuse interferes with obligations: causes social, legal, medical problems

Methadone
Synthetic narcotic for Opiate use

Addicts defense mechanisms
Denial and Rationalization

Family members role with Addicts
Enablers, allow for addictions to continue/progress

Technique to use with established clients with addictions
Confrontation

Addict withdrawal symptoms
May require medical intervention

Signs of alcohol use
Slurred speech, odor or alcohol on breath, unsteady gait, coordination problems, staggering

Strongest predictor for developing an alcohol problem
Family history of alcoholism

Alcohol withdrawal
Seizures and tremors

Signs of cocaine use
Talkative, pale, hyperactive, thin, loss of appetite, dilated pupils, restlessness

Cocaine withdrawal
Depression, vomiting, fatigue

Mild Mental Retardation
-60-69

Borderline Intellectual Functioning
-70-84

Tourette’s Disorder
Multiple motor tics and one or more vocal tics – BOTH TICS!

Reactive Attachment
Lack of attachment to caregiver (ex. foster care kids)

Trichotillomania
Compulsive urge to pull out one’s hair leading to hair loss

Schizophrenia subtypes:

Catatonic (immobility)
Disorganized (disorganized speech/behavior)
Paranoid (Persecutory)
Undifferentiated (Delusions/Hallucinations)
Residual (Absence psychotic features)

Cyclothymic
Mood Disorder, chronic, fluctuating mood with many hypomanic and many depressive symptoms

Obsessive-compulsive disorder
Intrusive recurrent thoughts or compulsive behaviors

Phobia

Fear of specific objects/situations
Ex. Acrophobia, fear of heights
TX – Desensitization Techniques

Dissociative identity disorder
Multiple personality disorder, 2 or more personalities

Dissociative Fugue
Sudden and unexpected travel from home, Memory eventually returns, FUGITIVE

Depersonalization Disorder
Feeling detached from/observe one’s mental processes or body

Intellectualization
Using logic to avoid dealing with emotions

Active listening
A technique focused on both verbal and nonverbal communication

Paraphrasing
Re-statement of client’s issues to show understanding of what client says. C: Whenever I go to the nursing home to visit my mother, I start to cry and feel like I can’t breathe. SW: It sounds lil you are saying that your mother in the nursing home is very difficult for you.

Clarification
Encouraging questions to be more explicit and expand what he says. Helping obtain understanding of issues. C: I don’t want to give up the baby. I want to find him a family that can give him everything he wants. SW: Are you saying that you want to keep the baby but you don’t think you can afford it?

Generalist Framework (Theory)
“Eclectic approach” uses a variety of theories/models/methods of treatment

Problem Solving (Theory)
To solve one problem at a time, assist clients with COPING SKILLS

Task-centered (Theory)
Focuses on accomplishing tasks. Assist client with identifying goals first.

Feminist Framework (Theory)
Gender or sex role stereotyping and discrimination, women’s rights

Sigmund Freud Structural Theory

ID – pleasure principle, unconscious source of basic desires
EGO – reality principle, seeks to satisfy basic desires in socially acceptable way
SUPEREGO – Moral/ethical ability to choose right from wrong

Fixated (unresolved) Personality Types
ORAL: Infantile, Demanding, Dependent
ANAL: Stinginess and Inflexibility
PHALLIC: Exploits others sexually with no regard for needs/concern

Signs of Heroin Use
Drowsiness, euphoria, and slow breathing

Heroin withdrawal
Bone pain, Anxiety, muscle spasms, restlessness

Hallucinogen use
Hallucinations, confusion anxiety, suspicion

Hallucinogen withdrawal
Non-existent with Hallucinogens (LSD, PEYOTE, ECSTASY)

Social work process
Purpose, knowledge, values, and sanctions

Stages in the Helping Relationship **

Beginning, Middle, Ending phases
Contact, Contract, Action, Termination

Problem S0lving process **

Engaging
Assessing
Planning
Intervening
Evaluating
Terminating

Interventive Roles

Consultant
Advocate
Case manager
Catalyst
Enabler
Broker
Mediator
Facilitator
Instructor
And Other

Interventive Skills

Relationship
Communication (listening, observing, interviewing, verbal, nonverbal, etc.)
Helping/problem-solving
Resource finding, linking, developing
Professional use of self
Working with different systems – individual, groups, institutions, communities

The Referral Process

CLARIFYING the need or purpose
RESEARCHING resources
DISCUSSING and SELECTING options with clients
PLANNING for initial contact
INITIAL CONTACT b/t client and referral source
Follow Up to see if need was met
*Keep in mind client’s right to self-determination!

Maslow’s Hierarchy of Needs
Assumptions: Optimism, human nature is trustworthy, rational-movement towards self-fulfillment, full functioning, personal adequacy, or self-actualization

5 Levels of Maslow’s Hierarchy of Needs

Physiological needs (Basic needs)
Safety needs (Basic needs)
Love and Belonging needs (Growth needs)
Esteem Needs (Growth needs)
Self-actualization (Growth needs)

A person must satisfy lower level needs before moving on to meet higher-level growth needs. After meeting lower levels of needs, a person scan reach the highest level of self-actualization,

Physiological Needs
Biological needs such as food, water, oxygen, constant body temperature.

Safety needs
Feel safe from harm, danger, threat, or destruction. Need regularity, some predictability (origin of cognitive needs – to understand, makes sense of world)

Love and Belonging Needs
Assurance that one is loved, is worthy, is acceptable because he is accepted. Love needs unconditional acceptance.

Ego/Esteem Needs
People need stable, firmly-based level of self-respect and respect from others.

Self-actualization Needs
Need to be oneself, to act consistently with whom one is.

Stranger Anxiety
6-8 months

Separation Anxiety
12 months

Prolonged separation anxiety
18 months

Ventilation
Technique in supervision to air out feelings.

How long should you store records?
Number of years dictated by law.

Bright but unmotivated student
May indicate a learned problem, refer to educational psychologist

Confidentiality
Important to discuss issues of confidentiality and the factors that would cause disclosure

Privileged communication
Legal rights, under certain circumstances, that protect clients from having the communications revealed in court w/out permission

Ecomap
Identifies systems that are part of a family’s life

Institutionalized vs. Residual Care
Residual welfare – in place purely for the poorer in society, providing a safety net for those otherwise unable to cope financially.
Institutional welfare – needs are a part of everyday life, welfare should be provided as a public service.

Risk factors for suicide

History of attempts – best indicator
family history of suicide
severe hopelessness
substance abuse
losses
A person who was depressed an instantly becomes brighter, “not depressed”

Medical necessity commitment for involuntary commitment to a hospital
Danger to self, danger to others, inability to care for self. SW must get a release from client before releasing medical information to managed care company.

Child Abuse
Report of reasonable suspicion, even if against supervisor, vignette will try and dissuade you from reporting

Indicators of Abuse
Physical signs/injuries, behavioral signs – opp. defiant symptoms, interest in sexual activity, school performance problems and difficulties

Beginning Phase of Treatment

Engagement
Assessment – biopsychosocial – strengths and weaknesses
Planning how to achieve goals
Addressing confidentiality/insurance
Contract = Client/Worker roles and responsibilities, problems to be worked on, goals, interventions to be implemented, evaluation, time/place/fee

Middle Phase of Treatment

Intervention
2.Universalization, clarification, confrontation, interpretation, reframing, labeling
Worker can be an advocate or mediator
Modifying thoughts/actions

Ending Phase

Evaluate – the degree to which client’s goals have been attained
Cope with issues of ending process/relationship
plan steps client may take relevant to the problem that do not involve SW
Discharge planning
Termination

Cognitive dissonance
arises when a person has to choose between 2 contradictory attitudes and beliefs

Congruence
matching awareness, experience, and communication – all essentially for a relationship

Double bind
offering two contradictory messages and prohibiting the recipient from noticing

Feedback
How one’s behavior has affected his or her internal states and surroundings

Limit setting
Boundaries, good for clients who do not feel safe or accepted in a completely permissive environment

Symmetrical relationship
two have equal power

Complementary relationship
one-up/one down position, unequal power

Thought broadcasting
The belief that other’s can be aware of hear one’s thoughts

What is most important for group functioning?
Participants level of functioning, often can be a wide range of diagnoses, family status, intellectual capacity and functioning

Ex. Suicide patient, inexperienced student SW
In situations where a SW requires expert information that he/she lacks it is always prudent to see supervisor guidance

Systems Theory

Framework for analyzing problems
Interaction among parts of the system – all parts affect the the system
Focus on environment

Homeostasis
Steady state order necessary for movement

Equifinality
capacity to receive identical results from different initial condition

Psychosocial Approach

Used past experiences to understand present action

Ego Psychology
Assessment of ego functions, reality testing, ego strengths/weaknesses

Self Psychology
Mirroring – validates child’s sense of self
Idealization – identifies with someone more capable
Twinship – sense of belonging

Alfred Adler
Holistic theory on personality, striving for perfection

Institutionalized discrimination
discriminatory attitudes that can occur on a institutional level

Way to evaluate progress in treatment
Compare client’s current level of functioning in relation to original treatment goals

Family life cycle crisis
SW helps family resolve crisis by addressing life cycle issues and preparing family to manage future problems

Structural family therapy

Stresses family organization, worker joins the family in an effort restructure it
Boundaries

Paradoxical Instruction
prescribe symptomatic behavior so client realizes they can control it, use strength of resistance to change to move towards goals

Prison culture
Environmental influence does not promote participant self-disclosure

Court mandated services
Provide limitations of disclosure in writing, protects confidentiality of child and addresses mom’s request

Lack of community awareness of a problem
Use multiple media communication techniques to bring awareness

First task of multidisciplinary team
discuss, clarify, and commit to overall purpose

Principle goal of an agency
Goal of improved services, computer program can help standardize information that could in turn be used to evaluate services

MDD
at least 2 weeks of symptoms

First task with involuntary clients
Meet parent’s needs

First step to analyze new social welfare policy that may affect the community
research history of problems that led to policies

Only time you can present client’s info without consent
Request from SW’s supervisor

Middle childhood life crisis
Industry vs. inferiority, 6 to 12

Problem solving planning phase
identification of goals and potential solutions

Common Psychological Tests

WAIS – adult intelligence scale
WISC-R – Intelligence scale for children
Standford-Binet – Intelligence test children
Draw-a-person test – children’s self image
MMPI – predominant personality traits/behavior
Projective tests – Rorshach, TAT

Cycle of abuse
Abuse is often used as an effort to retain control

Social Exchange theory
Totaling potential benefits and losses to determine behavior. ex. Women remains in an abusive relationship because of the high cost of leaving.

Domestic Violence

Medical/Safety issues priority
SW not under legal obligation to report DV, but should encourage victim to protect herself
Provide education, information, resources, support, DEVELOP A SAFETY PLAN, make referrals to shelter, attorney physician
Safety, trust, validation, re-empowerment

collateral observers
sources who are close to a situation but not directly impacted by it, witnesses of abuse

First step in program evaluation
Determining goals and objectives

Immediate concern if client is being evicted
Help to appeal to housing authority first – losing home!!! Basic needs

Quasi-experimental
Most practical research design for conducting agency program evaluation

comparison of control group with an experimental group

Single subject design
Study of a single individual
Poor generalizability

pre/post – AB
pre/treatment/removal – ABA Reversal design

Independent variable
Variable being manipulated or controlled – treatment

Dependent variable
Variable affected by I.V., outcome

Validity
Are we measuring what we think we are measuring?

External validity
Can results be generalized?

Internal validity
Did the experiment make a difference in outcome?

Reliability
Can you get the same answer repeatedly?

Client does not pay fees
According to COE’s, services can be discontinued if a client has not paid fees and after ensuring safety

Key step in resolving ethical dilemmas
Analize the impact of each principle, look to COE, identifying ethical standards to see what has been violated

Board of directors handles:
Broad-agency wide, gov’t issues, financial reports – not day to day operations/staffing

Sexual harrassment
Document complaints and follow-up with agency policy, LEGAL ISSUES

Preferred goal of Permanency Planning foster care:
Family reunification

Sustaining procedures
activities that strengthen the SW to client relationship such as reassurance, encouragement, and acceptance for effective case work

If an argument occurs b/t parent and child during an intake:
Help facilitate the dev’p of a process for conflict resolution

How to determine program effectiveness?

How well are goals being met
How well are programs reaching targeted population

Continuous reinforcement
Target behavior is reinforced each time it occurs

Crisis Theory
coping mechanisms

Cojoint therapy
Both partners seen by TWO therapists

Conscious use of self
Way in which worker influences the client

Ethnocentric
Viewing the world soley from the perspective of their own culture, culture is superior

Stratification
Structured inequality of entire categories of people who have unequal access to social rewards

Pluralism
Diverse members maintain own tradition while cooperatively working together and seeing other’s traits as valuable

Problem solving process

Acknowledge the problem
Analyze/Define the problem
Generate possible solutions/brainstorm
Evaluate each option
Implement the option of choice
Evaluate outcome of problem solving process
Keep basic concepts in mind when working with individuals, policy, or task group.

Alfred Adler
Early cognitive theorist, worked directly with Freud: 1) individual’s personality is best perceived as a whole 2) social relationships drive behavior more than sexual motivations 3) current beliefs and thoughts play a far greater role in human behavior than is suggested via psychoanalytic theory

Kohlberg’s stages of morality
Pre-conventional

Stage 1, punishment/avoidance
Stage 2, Rewards,
Conventional,
Stage 3, Good boy/bad girl,
Stage 4, Law and Order,
Post-conventional,
Stage 5 – Moral vs. Legal Right
Stage 6 – Individual state of concsiousness

4 A’s of Schizophrenia
Affect, associations, ambivalence, and autism.

Secondary prevention
Also called “screening,” refers to measures that detect disease before it is symptomatic. The goal of secondary prevention is to identify and detect disease in its earliest stages, before noticeable symptoms develop, when it is most likely to be treated successfully.

Tertiary prevention
Focus on people already affected by disease and attempt to reduce resultant disability and restore functionality.

Primary prevention
The inhibition of the development of disease before it occurs.

To protect against disease and disability, such as getting immunizations, ensuring the supply of safe drinking water,
General action to promote health is the other category of primary prevention measures.

Enmeshment
The inappropriate closeness of family members

Father-daughter incest
Daughter-Father communication will be distorted and symbolic, family structure is very strict, with highly moralistic expectations, reversal between mother-daughter roles and expectations

CBT
Changing thoughts to change behaviors, individual intervention, seeking behavioral change

Dual Diagnosis
Focus on the most severe symptoms first.

In adult survivors of childhood sexual abuse, the most frequently encountered defense mechanism is
Denial

Age 0-1
Oral – mouth fixation,
Sensory motor stage – 0-2, lack of language,
Trust vs. mistrust

Age 2-3
Bowel movement/toilet training,
Preoperational age 2 to 7, preschool years, egocentric, absolutes, Autonomy vs. self-doubt

Age 3-6
Phallic – explore sexual organs,
Preoperational,
Initiative vs. Self-doubt

Age 6-11
Latency – basic desires are repressed and expressed in socially acceptable ways,
Concrete Operational age 7 to 11, logic and rules,
Industry vs. inferiority – SCHOOL, MIDDLE childhood

Age 11 and 12 to 18
Genital – Puberty onward, No longer driven by instant gratification only and is independent and has concern for others, has relationships and responsibilities,
Concrete Operational age 11 and onward, Abstract thought, Identity vs. Role Diffusion

Age 18 to young adulthood
Intimacy vs. Isolation

Age 30 to 50
Generativity vs. Stagnation

Age 50+
Ego Integrity vs. Despair

5 Stages of Death and Dying
DABDA

Denial
Anger
Bargaining
Depression
Acceptance
*Hope is not a separate stage

Cultural Competence for EXAM
Self-awareness about one’s own attitudes, values, beliefs, about cultural differences

Acculturation
The process of adopting the attitudes, values, beliefs, language of a a new or dominant culture

Assimilation
Identify only with dominant culture

Integration
Identify with both cultures

Separation
Identify only with ethnic culture

Marginality
Do not identify with either cultures

Basis for Social Power
Coercive – power from control of punishments,
Reward – power from control of rewards,
Expert – power from superior knowledge,
Referent – power from acceptance/likeability,
Legitimate – power from having legitimate authority,
Informational – power from content of messages leading to new cognitions

Stages of Change, People Cook Pineapple Avocado Mango Recipes
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Relapse

3 Areas to identify in each question (PPL)

Problem
Person
Last Sentence (guide to answer question)

Key words

Person/Client “hot seat”
SAFETY Red Flags – suicide, abuse, life-threatening, unexplained marks, alcohol, recent loss
Strong words/adjectives
Age
Diagnosis
Symptoms/Duration
Who are you?
Where are you in session?
Quotations
Direct requests/concerns
Qualifiers (First/Next/Best)

Distractors
FARM GRITS ROAD – Answers that look appealing at first glance but are often wrong – ELIMINATE! Exam is here and now

DO NOT CHOOSE FARM GRITS ROAD

FOCUS on unresolved issues/past
ADVICE – giving/judging
RECOMMEND “to a support group”
MAKE an appt.
GIVE pamphlets/literature
RECOMMEND a session
INFORM parents/speak to parents (when child/ado)
TERMINATE (Exceptions: Moving, client reaches goals/no new crisis, client does not pay)
SPEAK to supervisor (except transference/counter)
RESPECT self-determination (If mentally UNSTABLE)
OFFER contract as a reminder
ALLOW the clients to lead the session
DO nothing/say nothing

How do you answer first/next questions?
90% of exam is SAFETY FIRST.

How does the exam want you to have a CLEAR understanding of client’s issues?
ASSESS BEFORE ACTION.

RUSAFE

RULE out medical
UNDER the influence/delusional/hallucinating Do Not Treat
SAVE Lives – Safety first (Answers: Duty to warn, report child/elder abuse, 911, mobile crisis, ER)
ASSESS before action – (Answers: ASSESS, ASK or DICE – Determine, Identify,Clarify, Explore)
FEELINGS – (Answers: ACKNOWLEDGE person’s feelings) CONCERNS (AID ASSIST, INFORM client, DISCUSS concerns)
EMPOWER – If client is mentally stable/alert (Answers: Respect client’s decisions)

COE: Ethical responsibilities towards clients

Client’s best interests are primary
Respect/promote right to self-determination if client is mentally alert/stable, NOT unstable/intoxicated/psychotic
Informed consent, written agreement by client to undergo treatment, risks/benefits/costs disclosed
Avoid conflicts of interest (Things that interfere with SW’s impartial judgment/discretion)
DO NOT promote individual therapy sessions to ppl who have a relationship w/ each other (except couples, family, group treatment) – Provide family members with appropriate referrals
Avoid dual/multiple relationships
Avoid bartering (unless common practice in community)
Obtain a professional translator FIRST if client does not speak the language of SW
Do not disclose client information w/out consent unless req’d by law
Provide client with reasonable access to records (First explore/discuss reason for request) Follow laws of state.
Ensure CONTINUITY of services
NO relations with clients past or present

Mandated reporting
SW’s are req’d and responsible for reporting any instances of abuse that is suspected. Abuse includes physical, emotional, sexual, neglect, CHILD AND ELDER ABUSE

Duty to Warn
SW’s MUST WARN a threatened victim of any harm that his/her client may cause when there is a REAL INTENT (PLAN)

HIV Decisions
NOT DUTY TO WARN! 3 options:

FIRST urge client to disclose to partner
FIRST encourage client to engage in safe sex
Research/follow state laws as needed

Subpoena by the court
SW may be req’d by law to disclose confidential information

COE: Ethical responsibilities to colleagues

Refer to colleague who may be better trained in an area than SW. SW can take client but must be COMPETENT.
When CONSULTING with colleague, disclose least amount of information
FIRST speak to a colleague to discourage/prevent/correct unethical behavior
AVOID relationships with colleagues (conflict of interest)

COE: Ethical responsibilities in practice settings

Accurately document services in client’s records while keeping best interests in mind
Maintain records securely for a period of time consistent with state laws

COE: Ethical responsibilities as professionals

MONITOR/EVALUATE policies and implementation of programs
ADVOCATE when necessary

HMO Insurance/Short term Care/MANAGED CARE

Emphasizes short term, discourages long term treatment
Cases assigned to case manager to whom provider must justify necessity for treatment for payment and services.
More precise diagnosis = greater likelihood of reimbursement
Encourages Cognitive/Behavioral short term TX.
Contracts are INFLEXIBLE, abide by rules to receive reimbursement

Disorders in Infancy, Childhood, Adolescence
Autism, ADHD, Oppositional Defiant Disorder, Conduct Disorder, Enuresis, Separation Anxiety Disorder

Adult Disorders
Delirium, Dementia, Amnestic/Cognitive Disorders, Schizophrenia and other Psychotic Disorders, Mood Disorders, Anxiety Disorders, Somatoform Disorders, Factitious Disorders

attention-deficit/hyperactivity disorder (ADHD)

Symptoms at least 6 months
Inattentive: Difficulty focusing, staying on task follow-through, listening, easily distracted, loses things, forgetful
Hyperactive: Impulsive, fidgeting, running around, talking excessively
Several symptoms present prior to age 12
Must occur in 2 or more settings
6.. Behaviors can increase/decrease based on settings.
TX: Behavior modification

Oppositional Defiant Disorder
At least 6 months – Angry, irritiable, defiant, talking back to adults, rebellious behavior, attitude, blames others, cursing, lying

NO SERIOUS VIOLATIONS OF OTHERS RIGHTS

a childhood disorder in which children are repeatedly argumentative and defiant, angry and irritable, and in some cases, vindictive. Lasting at least 6 months

Conduct Disorder

Violates other’s rights, bullies, shoplifts, truancy, DX up to age 17
TX: Family, schools, community, client, parent/child behavior modificationq skills

a disorder that involves severe antisocial and aggressive behaviors that inflict pain on others or involve destruction of property or denial of the rights of others. Has a childhood onset however it is more likely to continue into adulthood. Adolescent onset less likely to display aggressive behaviors. Symptoms occurred in the last year with at least one occurring in the last six months

Enuresis

Repeatedly urinating during day/night
Up to 5 years old
Rule out medical first

involuntary discharge of urine, usually referring to a lack of bladder control

Repeated bed wetting, wetting clothes, wetting at least twice a week for approximately three months, must be five years or older

Separation Anxiety Disorder

Excessive distress when separated from major attachment figures.
Clinging, school refusal, sleep refusal
School Phobia is a form of separation anxiety.
Brought on when leaving home/family members to attend school.
At least 1 month of symptoms

Impulse control disorders
Trichotillomania, Intermittent Explosive Disorder, Gambling, Kleptomania, Pyromania,

Dementia

Slow onset
Deterioration of memory/cognition
Alzheimer’s, HIV, Parkinson’s

Amnestic Disorders
Memory impairment w/out cognitive impairment

Korsakoff’s Syndrome
Chronic alcoholism causes inability to recall previously learned information

an amnestic disorder caused by thiamine (vitamin b1) deficiency associated with prolonged ingestion of alcohol. Memory loss, lack of insight, apathy etc

Schizophrenia

Hallucinations, delusions, disorganized speech, disordered/catatonic behavior, impaired thinking, negative symptoms (diminished emotional expression or avolition) THOUGHT DISORDER
Duration at least 1 month, but more than 6 months
TX = Medication and ego-supportive therapy (No INSIGHT therapy!)

a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression. This involves impairment in functioning and must be longer 6 than months

Schizophreniform

Same symptoms of schizophrenia
DURATION is at least 1 month, but less than six months
Triggered by turmoil/high stress
TX = Mediation and supportive therapy

A Psychotic disorder that exhibits the characteristics of schizophrenia but the duration is different. This disorder episode last at least one month but less than six months

Delusional Disorder

NON-BIZARRE/IRRATIONAL beliefs/delusions
Hallucinations absent or not prominent
Persecutory/Jealous Types of delusions
NO IMPAIRED FUNCTIONING

Brief Psychotic Disorder

1 Symptoms of criterion A Schizophrenia
DURATION LESS THAN 1 MONTH

Differential diagnosis Schizophrenia and Delusional Disorder

Delusions occur in both
Schizophrenia experience other symptoms (hallucinations, bizarre delusions)
DD less functional impairment

schizoaffective disorder
Same symptoms of schizophrenia with a major depressive episode, manic episode, or mixed episode

Psychotic disorder featuring symptoms of both schizophrenia and major mood disorder. Hallucinations and delusions last two or more weeks.

Major Depressive Disorder

Symptoms: (most of day, nearly every day for 2 weeks)
-Depressed mood
-Lack of pleasure
-weight loss/gain
-insomnia/hypersomnia,
-psychomotor agitation
-sad/empty/worthlessness
-suicidal ideation

fatigue
difficulty concentrating
excessive guilt
MDD and bereavement differences- excessive guilt, anhedonia, suicidality

Dysthymic Disorder

MDD symptoms but LESS SEVERE
Chronic
Duration more than 2 years (Children 1 year)
Symptoms cannot be absent for longer than 2 consecutive months

Bipolar 1 Disorder

One or more manic episodes (Elevated, expansive, irritable mood, or excessive mood and increased energy) usually accompanied by a major depressive episode)
Symptoms may last at least 1 week to a few months
3 or more manic symptoms
Impaired functioning

a type of bipolar disorder marked by full manic and major depressive episodes.

Bipolar II Disorder

1 or more depressive episodes with at least 1 or more hypomanic episode
NO manic episodes or mixed episodes

a type of bipolar disorder marked by mildly manic (hypomanic) episodes and major depressive episodes. Depressive episode must last at least 2 weeks

Depressive Symptoms
Sadness, loss of interest in usual activities, sleep/appetite disturbance, feelings of worthlessness/guilt, difficulty concentrating, suicidal thoughts/death

Neurovegetative symptoms of depression
changes in appetite of weight, sleep disturbances, fatigue, decrease in sexual desire/function

Rapid Cycling
4 or more manic episodes of illness over 12-month period

Mixed State
Both depression and Mania occur at the same time

Children and Adolescents with Bipolar Disorder

Can occur, more likely if parents have illness
Children/Ados may experience very fast mood swings b/t depression and mania in one day
Children with mania likely to be irritable and prone to tantrums than to be overly happy
Bipolar difficult to tell apart from other problems in this age group

Hyperthyroidism can mimic
Mania

Hypothyroidism can mimic
Depression

Mood disorder
Refers to a disturbance of mood and other symptoms that occur together for a minimal duration of time and not due to physical/mental illness

Panic Disorder

Brief, recurrent, panic attacks
Followed by persistent worry of another panic attack and behavior change
TX = Desensitization techniques

social anxiety disorder
intense fear of social situations, leading to avoidance of such

Generalized Anxiety Disorder

Excessive worry and physical symptoms (restlessness, fatigue, headache, stomachache)
Ex. client reports frequently irritable and unable to focus, tension, insomnia
At least six months
Worry impedes functioning

Panic attack or depression caused by substance
Substance Induced Anxiety Disorder or Mood Disorder

Panic attack caused by medical illness
Anxiety or Mood disorder caused by General Medical Condition

Somatoform Disorders
Disorders characterized by physical complaints that appear to be medical in origin but that cannot be explained in terms of physical disease (emotional connection)

obsessive-compulsive disorder
An anxiety disorder characterized by unwanted repetitive thoughts (obsession) and/ or actions (compulsions)

Body Dysmorphic Disorder

Excessive preoccupation with one body part
Severe, impairment in functioning
Cause of decline = obsessing about defect

Conversion Disorder
Involuntary loss of voluntary function, however client does not control or produce them voluntarily

a disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found. Not able to be explained by a neurological disease but also provide why it is not a neurological disease

Factitious vs. Malingering

Intentionally produced symptoms, differing incentives
Malingering fakes symptoms for external gain/goal
Factitious produces symptoms due to need to be “sick patient”

Munchausen’s Syndrome
Faking an illness/producing symptoms to receive sympathy as patient

Munchausen’s By Proxy
Abuse of another (typically a child) in order to seek attention for the abuser

post-traumatic stress disorder (PTSD)

Exposure and response to life-threatening event
Arousal, intrusive, avoidance symptoms (distressing memories, dreams, dissociations,
LAST A MONTH AND BEYOND
Impairment to functioning/life pursuits

a disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia that lingers for four weeks or more after a traumatic experience

acute stress disorder
PTSD symptoms that appear for a month or less following exposure to one or more traumatic events

Reactive Attachment Disorder

Disorder caused by lack of attachment to caregiver – NEGLECT… i.e. foster care kids

Attachment disorder in which a child with disturbing behavior neither seeks out a caregiver nor responds to offers of help from one; fearfulness and sadness are often evident. Onset between 9 months to 5 years

Adjustment disorder
a disorder in which a person’s response to a common stressor, is maladaptive and occurs within 3 months of the stressor

Disinhibited Social Engagement Disorder (DSED)
a trauma-related attachment disorder characterized by indiscriminate, superficial attachments and desperation for interpersonal contact

Somatization Disorder
Recurrent/multiple somatic complaints that cannot be explained medically of several years. STRESS.

Substance related Disorder
Drug/Alcohol Intoxication and Withdrawal, Drug/Alcohol Abuse and Dependence

Paraphilias vs. Sexual Sexual Dysfunction
Inappropriate sexual object or practice vs. inhibition of sexual response

Parasomnias vs. Dyssomnia
Abnormal event that occurs during sleep, b/t sleep/waking VS. disturbance in amount/timing of sleep

Personality Disorders

An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture
2 or more areas (cognition, affectivity, interpersonal functioning, impulse control)

Cluster A personality disorders
odd/eccentric
paranoid, schizoid, schizotypal

Schizoid PD
LONER, introverted, withdrawn, detachment from social relationships, RESTRICTED RANGE OF EMOTIONAL EXPERIENCE AND EXPRESSION, NO DESIRE FOR FOR SOCIAL RELATIONSHIPS

Schizotypal
Odd/strange/bizarre behavior/beliefs/mannerisms and interpersonal/social deficits due to fear/paranoia

Magical thinking
ideas that one’s thoughts or behaviors have control over specific situations

ideas of reference
The false impression that outside events have special meaning for oneself.

Cluster B personality disorders
dramatic, emotional, erratic

antisocial, borderline, histrionic, narcissistic

Borderline PD

Unstable in interpersonal relationships, behavior, mood, and self-image.
Abrupt and extreme mood changes
Stormy interpersonal relationships
Fluctuating self-image
self-destructive actions

Psychological disorder characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and emotions, and of marked impulsivity beginning by early adulthood and present in a variety of contexts.

Histrionic PD
Melodramatic, attention-seeking, excessive emotionality, sexually seductive

a personality disorder characterized by excessive emotionality and preoccupation with being the center of attention; emotional shallowness; overly dramatic behavior; the sexualization or forced closeness of most relationships; a very dramatic interpretation of most events in life

Cluster C personality disorders
Anxious, fearful

avoidant, dependent, obsessive compulsive

Avoidant PD
Hypersensitive to rejection, unwilling to be involved, fear of not being liked

A personality disorder characterized by consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluation.

Multiple Personality Disorder
Dissociative Identity Disorder

Relatively coarse preliminary test of a client’s judgment, orientation to time and place, and emotional and mental state; typically conducted during an initial interview.

Displacement
Place unwanted/unpleasant feelings onto someone less threatening or innocent bystander

ex. angry at boss, take it out on spouse

EX: A client is angry at his doctor, does not express it, but becomes verbally abusive with the nurse.

Dissociation
A disturbance or change in the usually integrative functions of memory, identity, perception, and consciousness

A person often loses track of time or themselves and their usual thought processes and memories. People who have a history of any kind of childhood abuse often suffer from some form of dissociation

Projection
Taking your emotions and placing it on others… Attributing feelings or impulses unacceptable to oneself to another person.

Ex. All of my coworkers are greedy, but I am not

EX: Sue feels a strong sexual attraction to her track coach and tells her friend, “Hes coming on to me!”

Introjection
To incorporate someone else’s emotions into one’s self, internalized beliefs of others

EX: Children integrate their parents value system into the process of conscience formation.

Idealization
Opposite of devaluation. Attributting exaggeratedly positive qualities to the self or others

regression
Responding to stress by retreating to an earlier level of development and the comfort measures associated with that level of functioning.

EX: When 2 year old Jay is hospitalized for tonsillitis he will drink only from a bottle, although his mother states he has been drinking from a cup for over 6 months.

Identification
a person patterns oneself after a significant other

an attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires

Identification with the aggressor
mastering anxiety by identifying with a powerful aggressor

Isolation of affect
unacceptable impulse, idea or act is separated from its original memory source , thereby removing the emotional charge associated with it. You think the feeling but do not really feel it

Projective Identification
BPD Clients, Unconsciously perceiving other’s behavior as a reflection of one’s own identity

Reaction formation
Turning unwanted or dangerous thoughts, feelings or impulses into their opposites… warding off an uncomfortable thought by overemphasizing its opposite

Ex. Person with a sudden loss shows a happy mood

Sublimation
maladaptive behaviors/impulses diverted to more socially acceptable channels, healthy redirection of emotion

EX: Mom of son killed by drunk driver, president of MADD.

Turning against the self
defense to deflect hostile aggression or other unacceptable impulse from another to self

Splitting
Also clients with BPD – identify a person as either all good or all bad

Denial
Not accepting reality because it is too painful. “rejecting the thought or feeling”. Ex. I am not a shopaholic, but credit cards are maxed out.

Repression
Involuntary blocking of unpleasant feelings and experiences from ones awareness. ” amnesia”

EX: An accident victim can remember anything about the accident

Suppression
The voluntary blocking of unpleasant feelings and experiences from ones awareness.

EX: “I don’t want to think about that now. I’ll think about that tomorrow.”

Undoing
Trying to reverse or undo your feeling by doing something that indicates the opposite feelings….Taking Back unwanted behaviors through praise/gifts.

Ex. buying gifts, obsessively washing hands to deal with obsessive thoughts.

Compensation
Enables one to make up for real or imagined/fancied deficiencies,

Ex. short man becomes cocky

EX: a person who stutters becomes an expressive writer

Conversion
Repressed urge is expressed as a disturbance of body function – pain, deafness, blindness

unconscious transformation of anxiety into a physical symptom with no organic cause. EX: loss of eyesight after witnessing horrific accident

Reflection
Reflecting clients feelings back to them- YOU SEEM TO BE OVERWHELMED

Exploring silence
Being attentive and remaining silent during the time when client is silent. SILENCE EQUALS SILENCE

Partialization
Taking client’s OVERWHELMING feelings and breaking them down into smaller more manageable parts

Rational Emotive Behavioral Therapy REBT
Cognitively oriented … therapy seeks to change client’s irrational beliefs … teaches client to counter self-defeating thinking

Paradoxical Directive
prescribe symptomatic behavior so client realizes they can control it, use strength of resistance to change to move towards goals. ex. Couples bickering in couples therapy.

Crisis Intervention

Assist the person in distress to resolve immediate problem and regain emotional equilibrium = GOAL IN FIRST SESSION, emphasis on coping mechanisms

a treatment approach that tries to help people in a psychological crisis to view their situation more accurately, make better decisions, act more constructively, and overcome the crisis

Narrative therapy

Therapist co-constructs alternative positive stories with client
Externalizing the problem, problem-saturated stories, mapping problem’s domain, unique outcomes, spreading the news

Ecological/Life Model
Environmental pressures, focus on life transitions, Fit between individual/family and environment

Gestalt
Assist client with awareness of here/now – ex. Empty chair

Heightened awareness
Not good for impulsive clients

Behavior Modification
Techniques to modify behaviors, ex. positive reinforcement

Behaviorist
Observe/measure the way clients respond to certain triggers

Operant techniques
Positive reinforcement – add praise,
Negative reinforcement – take away shock,
Positive punishment – add spanking,
Negative punishment – take away something desirable

Classical conditioning
Pavlov’s dog, stimulus response approach to behavior

a type of learning in which one learns to link two or more stimuli and anticipate events.

Neutral (conditioned) stimulus with an unconditioned (involuntary) stimulus

Shaping
Technique to train a new behavior by prompting and reinforcing successive behaviors

In vivo desensitization
Exposure from least to most anxiety situation – REAL LIFE SETTING

Pairing and movement through anxiety hierarchy from least to most anxiety provoking situation; takes place in “real” setting.

Systemic desensitization
An anxiety management strategy that includes general relaxation techniques and visualization of success.

Flooding
a treatment for phobias in which clients are exposed repeatedly and intensively to a feared object and made to see that it is actually harmless

A treatment procedure in which a client’s anxiety is extinguished by prolonged real or imagined exposure to high-intensity feared stimuli.

Modeling/Observational learning
Method of instruction that involves an individual (the model) demonstrating the behavior to be acquired by a client

Operant conditioning
behavior that operates on the environment, producing consequences. Voluntary. (walking and talking)

Strengths perspective
Identify strengths and build on to empower clients

Psychoanalysis/theory
Long term treatment, resolve inner, unresolved conflicts of past

A theory developed by Freud that attempts to explain personality, motivation, and mental disorders by focusing on unconscious determinants of behavior

Family Therapy

Treats whole family system and identifies the individual symptom bearer as indicative of a problem in the family as a whole, identify client in crisis/hot seat

New goal is to interrupt the circular pattern of pathological communication and behaviors and replace it with a new pattern that will sustain itself without the dysfunctional aspects of the original pattern

Couple Therapy
Treats couples to understand and resolve conflicts to improve their relationship. To communicate better, negotiate differences, problem solve in a healthier way

Margaret Mahler
Process of separation-individuation, object relations theory

Object Relations Theory
the psychodynamic theory that views the desire for relationships as the key motivating force in human behavior

object refers to representation of caregivers based on subjective experiences during early infancy

-these objects persist into adulthood & impact our relationships

Normal Autism Phase
0-1 months

infant is detached and self-absorbed
spends most if his/her time sleeping

normal symbiotic phase
1 to 5 months

feels unity with mother, becomes aware of her

Separation-Individuation Phase
infant breaks away from stage and learns to differentiate

Practicing Subphase
9-15 months

brought by the infant’s ability to walk crawl and then walk freely. exploring

child experiences himself or herself as one with his or her mother

Rapprochement Subphase
15- 24 months

Desires to be independent, moves away from mother but returns regularly

Object Constancy Phase
24-38 months

describes the phase when the child understand that the mother has a separate identity and is truly a separate individual

Antimanic/Bipolar Medications
depakene
lamictal
lithium
tegretol
topamax

+++kidney problems, liver problems, monitor blood work

Anti-Anxiety Meds- Benzos
Benzodizepines:
ativan
buspar
klonopin
valium
xanax

1.) Short acting and addictive
2.) Impaired muscle coordination and impairment of short term memory, PAM

drugs used to control anxiety and agitation and reduce stress

Antabuse
medication for alcohol, form of AVERSION THERAPY

Anti-Depressants: SSRIs
a group of second-generation antidepressant drugs that increase serotonin activity specifically, without affecting other neurotransmitters

Selective serotonin reuptake inhibitor (SSRIs):

celexa
lexapro
luvox
paxil
prozac
zoloft

1.) Often causes loss of libidinal desire, several weeks to be effective

Atypical Anti-depressants
Effexor, Cymbalta, Wellbutrin

Tricyclic Anti-depressants
block reuptake of serotonin and norepinephrine

anafranil
asendin
elavil
norpramin
pamelor
sinequan
surmontil
tofranil
vivacil

1.) Can cause dry mouth

Monoamine Oxidase Inhibitors (MAOIs)
class of antidepressant drugs sometimes used for treating depression

nardil
parnate

1.) Hypertension if high dose taken
2.) TCA/Stimulant taken
3.) Dietary restriction: Foods with high levels of Tyramine – avoid beer, wine, cheese, smoked/pickled fish, etc.

Community Organization Key Points

NOT direct practice, indirect practice
SW role is to work WITH THE community, not directly for them
No individual counseling or family counseling
Empower members to strengthen community to prevent future dilemmas
Members must have a COMMON INTEREST – KW’s consensus, agreements
Advocate for disadvantaged

Locality Development, Model of Community Organizational Practice

Purpose: Join efforts to solve a common problem with community/local level
SW Role: Enabler – help members use own resources to problem solve/empower
Broker: Mediates/Negotiates b/t community groups, links community with services

Social Planning Model of Community Organizational

Purpose: Determine a range of solutions to problems. Develops programs
SW Role: Expert, gather data and facts used to resolve problems, Ex. planning homeless shelters and after school recreation programs

Social Action, Model of Community Organizational

Purpose: Clients who NEED assistance and disadvantaged, take action, confrontation
SW Role: ADVOCATE, represent disadvantaged and ACTIVIST, bargaining and confrontation, Ex. Tenant Association, Landlord/Tenants, women’s rights mov’t

Social Reform, Model of Community Organizational

Purpose: Work with other organizations. Form coalitions
2 SW Role: Organizer, joins groups and institutions together to take joint action towards specific goals, ex. improve economic development and resolve unemployment problems

Group Therapy Key Concepts

Group members SHARE A COMMON PROBLEM
Group members are there to SUPPORT EACH OTHER
Therapist there to ALLOW THE GROUP to come to resolutions and resolve conflicts
Therapist intervenes only if there is threat of violence
Therapist must acknowledge feelings of an individual in crisis
Therapist must ALLOW confrontation when there is denial or rationalization.
Contraindications – client in crisis, suicidal, need for attention, psychotic, paranoid

Group polarization
occurs when group discussion strengthens a group’s dominant point of view and produces a shift toward a more extreme decision in that direction

Groupthink
Group cohesion and loyalty undermines decision making in order to maintain the we-ness

Phenomenon by which members take on a collective identity that believes itself to be invulnerable and practices rationalization about group values and in which members are afraid to speak their mind, thus engaging in self censorship

Boston Model, People Perceive Information Differently Separately

Preaffiliation: Ambivalence, leader must establish authority/discuss guidelines and review philosophy
Power/Control: Struggle over control of the group, conflict among subgroups
Intimacy: Conflicts diminish, sense of “we-ness” increases and COHESION
Differentiation: Personal expression, improved group skills in analyzing and working through problems
Separation: Achieve termination

Administration Key Concepts

Key Words’s = TEAM WORK, CONVENE STAFF MEETINGS & BROAD BASED COMMITTEES
Admin. establishes a broad based “committee” that brings together all segments of the agency, including staff and sometimes clients to develop methods for assessing the problem, decision making, proposing solutions

The Board of Directors

NOT on SW’s TREATMENT TEAM
Executive directors are concerned with funding NOT with immediate staff issues

3 functions of supervision
Administrative, Educational, Supportive

Supervisor Key Concepts

Supervisor there to EDUCATE the SW and IMPROVE job performance
Supervisor is in charge of SW’s and or intern’s caseloads
TRANSFERENCE/COUNTERTRANSFERENCE
Supervisor DOES NOT EXPLORE sw’s inner feelings
Main purpose – advance agency goals and improve service to clients.

Culture Bound Syndrome
Appendix 1 in DSM-IV: A client’s cultural beliefs and how they impact the interviewer while assessing their behaviors Ex. Ataque de nervios – Hispanic Culture

American Indian/ Alaska Natives
1) Respect is highly valued–avoid eye contact as a sign of respect
2) Mothers to not talk much to their kids
3) Value learning through listening and observing rather than speaking and interacting… comfortable with silence
4) Native language speaking is discouraged until articulation is judged acceptable
5) Silence is valued–if you are speaking, you are not listening and learning
6) Quick answers undesirable–waiting to speak is more respectful and shows you thought about the question
7) May not respond to questions that are not understood
8) Public behavior tends to be restrained
9) high degrees of suicide and alcoholism
10) tradition of oral story telling
11) great respect for elders, hand down traditions
12) Spirituality: fundamental part of life, interconnectedness of all living things, sacredness of all creation,… spiritual healers are traditional leaders (shaman/medicine man)
13) indirect communication
14) Complex family organizations that include relatives without blood ties, strong kinship bonds (multigenerational extended families), group valued over individual
15) harmony within the group very important, common sharing of material goods, groups decision making

Latino – Hispanic
1.) Demonstrate shame when seeking mental health assistance
2.) Excessive emotionality when confronted with crisis – ataque de nervios

extended family system, deep sense of commitment and obligation to family, family unity, welfare, and honor are important. emphasis on group rather than individual, male has greater powers and authority

often speak spanish but do not assume that they wish to receive services in native language

Most are Roman Catholic, emphasis on spiritual values, strong church and community orientation/ interdependence

wish to improve their life circumstances belief in the innate work of all individuals and that people are born into their lot in life, respect for dignity of self and others, respect for elders, respect for authority, very proud of heritage- never forget where they came from

Asian
1.) Obligation to parents and respect to elders
2.) Elders are family decision makers
3.) Resolve conflicts within the family
4.) Less emotional expressiveness
5.) Use alternative healing methods (ex. coining, acupuncture, homeopathic TX)
6.) Family values include a patriarchal system in which a wife has lower status and is subservient to her husband
7.) Indirect, patriarchal family system, strict roles in the family
8.) Spirituality inspired by Confucian and Buddhist philosophies.
9.) Maybe more sensitive to psychotropics, might require lowe dose. May experience more severe side effects
10.) may prefer homeopathic methods

Hawaiian/ Pacific Islander
Family is not restricted to those who are related by blood, ties cannot be broken, even by death, cherish their ancestors with generation upon generation

Native Hawaiian and Pacific islanders subgroups, representing different languages and customs to speak. English has a tremendous impact on access to health information, public services; Hawaii is the only state in the United States that has designated a native language , Hawaiian as one of its two official state languages

polytheistic, believing in many deities, belief that spirits are found in nonhuman beings and objects as animals, waves, and the sky

Importance of culture welfare of all living in a community, focus on ensuring the health of the community as a whole, everyone has a responsibility to use his or her talents to the benefit of the whole sharing is central

African American
Relatives extended to those without blood ties, flexible family roles, women are often viewed as being “all sacrificing)

Spirituality: turns to community/ religious leaders for help if needed

strong work orientation, strong religious orientation, informal support network

history of racism and oppression

White American Culture (most prominent)
family: parents with young children, divorce common, personal desires put over family, parents try to be friends with their children, avoid physical punishment

communication: language American standard English, communication can be long-winded and impersonal

Spirituality: religion is a private affair but mainly Protestant and bible based

Values: capitalism (future is what you make it), poverty is a moral failing and wealth is held in high esteem, physical beauty is valued with white skin, blonde hair and thin body being ideal, sports are an important part of life, democracy and freedom, individual rights.

Elderly Clients

Remain patient and respectful – do not use aggressive approach
Mr. or Mrs. as a sign of respect
Frequent appts. may be needed during beginning of treatment – home visits
Respect self-determination if they are mentally alert
Client is Frail/medical issues – assess their abilities, r/o medical FIRST

Gender, Identity Clients – gay, lesbian, transgender

Be aware that clients have concerns about your values
Support client in understanding their own sexual orientation prior to sharing with family/friends
Be aware of your own values/cultural competence with ALL DIVERSE clients

Clients with Disabilities

Explore your clients need for SPECIAL ACCOMMODATIONS first
Respect self-determination if mentally stable
Do not challenge clients who have lower level of functioning

Substance Dependence
Increased tolerance, withdrawal symptoms

Substance abuse
Abuse interferes with obligations: causes social, legal, medical problems

Methadone
Synthetic narcotic for Opiate use, to help treat opoid addiction

Addicts defense mechanisms
Denial and Rationalization

Family members role with Addicts
Enablers, allow for addictions to continue/progress

Technique to use with established clients with addictions
Confrontation

Addict withdrawal symptoms
May require medical intervention

Signs of alcohol use
Slurred speech, odor or alcohol on breath, unsteady gait, coordination problems, staggering

Strongest predictor for developing an alcohol problem
Family history of alcoholism

Alcohol withdrawal
Seizures and tremors

Signs of cocaine use
Talkative, pale, hyperactive, thin, loss of appetite, dilated pupils, restlessness

Cocaine withdrawal
Depression, vomiting, fatigue

Mild Mental Retardation
-60-69

Borderline Intellectual Functioning
-70-84

Tourette’s Disorder
Multiple motor tics and one or more vocal tics – BOTH TICS!

Trichotillomania
Compulsive urge to pull out one’s hair leading to hair loss

Schizophrenia subtypes:

Catatonic (immobility)
Disorganized (disorganized speech/behavior)
Paranoid (Persecutory)
Undifferentiated (Delusions/Hallucinations)
Residual (Absence psychotic features)

Cyclothymic
a disorder marked by numerous periods of hypomanic symptoms and mild depressive symptoms. Cannot meet the hypomania or depressive criteria for Bipolar one or two. Last two years in adults, one year in children.

Phobia

Fear of specific objects/situations
Ex. Acrophobia, fear of heights
TX – Desensitization Techniques

Dissociative Fugue
Sudden and unexpected travel from home, Memory eventually returns, FUGITIVE

Depersonalization Disorder
Feeling detached from/observe one’s mental processes or body

Intellectualization
An attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual process of logic, reasoning and analysis.

Active listening
A technique focused on both verbal and nonverbal communication

Clarification
reformulate problems in a client’s words to make sure the social worker is on same wavelength. See to reformulate a problem in a clients words

C: I don’t want to give up the baby. I want to find him a family that can give him everything he wants. SW: Are you saying that you want to keep the baby but you don’t think you can afford it?

Generalist Framework (Theory)
“Eclectic approach” uses a variety of theories/models/methods of treatment

Problem Solving Approach
The goal is to enhance client’s mental, emotional, and action capacities for coping with problems and/or making accessible the opportunities and resources necessary to generate solution to problems

focuses on identifying the problem, thinking of solutions, picking a solution, and having the client try the solution.

Task-centered Approach
Focuses on accomplishing tasks. Assist client with identifying goals first.

very concrete approach that uses specific techniques, such as contracts and homework assignments to help clients make the changes they want to by following discrete steps that are laid out along the way.

Feminist Framework (Theory)
a theoretical approach that looks at gender inequities in society and the way that gender structures the social world

Fixated (unresolved) Personality Types
ORAL: Infantile, Demanding, Dependent
ANAL: Stinginess and Inflexibility
PHALLIC: Exploits others sexually with no regard for needs/concern

Signs of Heroin Use
Drowsiness, euphoria, and slow breathing

Heroin withdrawal
Bone pain, Anxiety, muscle spasms, restlessness

Hallucinogen use
Hallucinations, confusion anxiety, suspicion

Hallucinogen withdrawal
Non-existent with Hallucinogens (LSD, PEYOTE, ECSTASY)

Social work process
Purpose, knowledge, values, and sanctions

Stages in the Helping Relationship **

Beginning, Middle, Ending phases
Contact, Contract, Action, Termination

Interventive Roles

Consultant
Advocate
Case manager
Catalyst
Enabler
Broker
Mediator
Facilitator
Instructor
And Other

Interventive Skills

Relationship
Communication (listening, observing, interviewing, verbal, nonverbal, etc.)
Helping/problem-solving
Resource finding, linking, developing
Professional use of self
Working with different systems – individual, groups, institutions, communities

The Referral Process

CLARIFYING the need or purpose
RESEARCHING resources
DISCUSSING and SELECTING options with clients
PLANNING for initial contact
INITIAL CONTACT b/t client and referral source
Follow Up to see if need was met
*Keep in mind client’s right to self-determination!

Maslow’s Hierarchy of Needs
Assumptions: Optimism, human nature is trustworthy, rational-movement towards self-fulfillment, full functioning, personal adequacy, or self-actualization

5 Levels of Maslow’s Hierarchy of Needs

Physiological needs (Basic needs)
Safety needs (Basic needs)
Love and Belonging needs (Growth needs)
Esteem Needs (Growth needs)
Self-actualization (Growth needs)

A person must satisfy lower level needs before moving on to meet higher-level growth needs. After meeting lower levels of needs, a person scan reach the highest level of self-actualization,

Physiological Needs
Biological needs such as food, water, oxygen, constant body temperature.

Safety needs
Feel safe from harm, danger, threat, or destruction. Need regularity, some predictability (origin of cognitive needs – to understand, makes sense of world)

Love and Belonging Needs
Assurance that one is loved, is worthy, is acceptable because he is accepted. Love needs unconditional acceptance.

Ego/Esteem Needs
People need stable, firmly-based level of self-respect and respect from others.

Self-actualization Needs
Need to be oneself, to act consistently with whom one is.

Stranger Anxiety
6-8 months

Separation Anxiety
12 months

Prolonged separation anxiety
18 months

Ventilation
Technique in supervision to air out feelings.

How long should you store records?
Number of years dictated by law.

Bright but unmotivated student
May indicate a learned problem, refer to educational psychologist

Confidentiality
Important to discuss issues of confidentiality and the factors that would cause disclosure

Privileged communication
Legal rights, under certain circumstances, that protect clients from having the communications revealed in court w/out permission

Ecomap
Identifies systems that are part of a family’s life

Risk factors for suicide

History of attempts – best indicator
family history of suicide
severe hopelessness
substance abuse
losses
A person who was depressed an instantly becomes brighter, “not depressed”
social isolation

Child Abuse
Report of reasonable suspicion, even if against supervisor, vignette will try and dissuade you from reporting

Beginning Phase of Treatment

Engagement
Assessment – biopsychosocial – strengths and weaknesses
Planning how to achieve goals
Addressing confidentiality/insurance
Contract = Client/Worker roles and responsibilities, problems to be worked on, goals, interventions to be implemented, evaluation, time/place/fee

Middle Phase of Treatment

Intervention
2.Universalization, clarification, confrontation, interpretation, reframing, labeling
Worker can be an advocate or mediator
Modifying thoughts/actions

Ending Phase

Evaluate – the degree to which client’s goals have been attained
Cope with issues of ending process/relationship
plan steps client may take relevant to the problem that do not involve SW
Discharge planning
Termination

Cognitive dissonance
Inner tension that a consumer experiences after recognizing an inconsistency between behavior and values or opinions

Congruence
matching of awareness, experience, and communication. This is essential for the validity of a relationship and to facilitate true helping as part if the problem solving process

Double bind
offering two contradictory messages and prohibiting the recipient from noticing contradiction

Limit setting
Boundaries, good for clients who do not feel safe or accepted in a completely permissive environment

Symmetrical relationship
two have equal power

Complementary relationship
one-up/one down position, unequal power

Thought broadcasting
The belief that other’s can be aware of hear one’s thoughts

What is most important for group functioning?
Participants level of functioning, often can be a wide range of diagnoses, family status, intellectual capacity and functioning

Ex. Suicide patient, inexperienced student SW
In situations where a SW requires expert information that he/she lacks it is always prudent to see supervisor guidance

Systems Theory

Framework for analyzing problems
Interaction among parts of the system – all parts affect the the system
Focus on environment

a theory stating that an organization is a managed system that changes inputs into outputs

Homeostasis
Steady state order necessary for movement

Equifinality
capacity to receive identical results from different initial condition… Arriving at the same end from different beginnings

Psychosocial Approach

Used past experiences to understand present action

Ego Psychology
a school of psychodynamic thought that emphasizes the skills and adaptive capacities of the ego

Self Psychology
A theory that emphasizes how we use interpersonal relationships (self objects) to develop our own sense of self.

1) mirroring: validates the child sense of a perfect self

2) idealization: child borrow strength from others and identifies with someone more capable

3) twinship or twinning: child needs an alter ego for sense of belonging

Alfred Adler
Holistic theory on personality, striving for perfection

Early cognitive theorist, worked directly with Freud: 1) individual’s personality is best perceived as a whole 2) social relationships drive behavior more than sexual motivations 3) current beliefs and thoughts play a far greater role in human behavior than is suggested via psychoanalytic theory

Institutionalized discrimination
discriminatory attitudes that can occur on a institutional level

Way to evaluate progress in treatment
Compare client’s current level of functioning in relation to original treatment goals

Family life cycle crisis
SW helps family resolve crisis by addressing life cycle issues and preparing family to manage future problems

Structural family therapy

stresses the importance of family organization for the functioning of the group and well-being of its members
social worker joins/engages the family in an effort to restructure it
restructuring is based on observing and manipulating interactions within therapy sessions

Mental health issues are viewed as signs of dysfunctional family, so it focused more on changing the family structure than changing family members, The goal is to improve communications and interactions among family members and to highlight appropriate boundaries to create a healthier family structure

Prison culture
Environmental influence does not promote participant self-disclosure

Court mandated services
Provide limitations of disclosure in writing, protects confidentiality of child and addresses mom’s request

Lack of community awareness of a problem
Use multiple media communication techniques to bring awareness

First task of multidisciplinary team
discuss, clarify, and commit to overall purpose

Principle goal of an agency
Goal of improved services, computer program can help standardize information that could in turn be used to evaluate services

MDD
at least 2 weeks of symptoms

First task with involuntary clients
Meet parent’s needs

First step to analyze new social welfare policy that may affect the community
research history of problems that led to policies

Only time you can present client’s info without consent
Request from SW’s supervisor

Middle childhood life crisis
Industry vs. inferiority, 6 to 12

Problem solving planning phase
identification of goals and potential solutions

Common Psychological Tests

WAIS – adult intelligence scale
WISC-R – Intelligence scale for children
Standford-Binet – Intelligence test children
Draw-a-person test – children’s self image
MMPI – predominant personality traits/behavior
Projective tests – Rorshach, TAT

Cycle of abuse
Abuse is often used as an effort to retain control

Social Exchange theory
Totaling potential benefits and losses to determine behavior. ex. Women remains in an abusive relationship because of the high cost of leaving.

Domestic Violence

Medical/Safety issues priority
SW not under legal obligation to report DV, but should encourage victim to protect herself
Provide education, information, resources, support, DEVELOP A SAFETY PLAN, make referrals to shelter, attorney physician
Safety, trust, validation, re-empowerment

collateral observers
sources who are close to a situation but not directly impacted by it, witnesses of abuse

First step in program evaluation
Determining goals and objectives

Immediate concern if client is being evicted
Help to appeal to housing authority first – losing home!!! Basic needs

Quasi-experimental
Most practical research design for conducting agency program evaluation

Uses intervention and comparison groups, but assignment to the groups is nonrandom. Common in social science research.

Non-equivalent group: pre/posttest for treated and comparison groups

Regression Discontinuity design: assignment to treatment group using a cutoff score on pretreatment variable

Single subject design
Aims to determine whether an intervention has the intended impact on a client, or on many clients who form a group.

Poor generalizability

pre/post – AB
pre/treatment/removal – ABA Reversal design

Independent variable
Variable being manipulated or controlled – treatment

Dependent variable
Variable affected by I.V., outcome

Validity
Are we measuring what we think we are measuring?

the extent to which a test measures or predicts what it is supposed to

External validity
Can results be generalized?

Internal validity
Did the experiment make a difference in outcome?

Reliability
Can you get the same answer repeatedly?

consistency of measurement

Client does not pay fees
According to COE’s, services can be discontinued if a client has not paid fees and after ensuring safety

Key step in resolving ethical dilemmas
Analize the impact of each principle, look to COE, identifying ethical standards to see what has been violated

Board of directors handles:
Broad-agency wide, gov’t issues, financial reports – not day to day operations/staffing

Sexual harrassment
Document complaints and follow-up with agency policy, LEGAL ISSUES

Preferred goal of Permanency Planning foster care:
Family reunification

Permanency Planning
An effort by child-welfare authorities to find a long-term living situation that will provide stability and support for a maltreated child. A goal is to avoid repeated changes of caregiver or school, which can be particularly harmful to the child.

Sustaining procedures
activities that strengthen the SW to client relationship such as reassurance, encouragement, and acceptance for effective case work

If an argument occurs b/t parent and child during an intake:
Help facilitate the dev’p of a process for conflict resolution

How to determine program effectiveness?

How well are goals being met
How well are programs reaching targeted population

Continuous reinforcement
Target behavior is reinforced each time it occurs

Crisis Theory
coping mechanisms

Cojoint therapy
Both partners seen by TWO therapists

Conscious use of self
Way in which worker influences the client

Ethnocentric/ism
an orientation that holds one’s own culture, ethnic, or racial group as superior

Stratification
Structured inequality of entire categories of people who have unequal access to social rewards

A structured ranking of entire groups of people that perpetuates unequal economic rewards and power in a society.

Individuals social order is based on his wealth, prestige, and power

Pluralism
Diverse members maintain own tradition while cooperatively working together and seeing other’s traits as valuable

Problem solving process

Acknowledge the problem
Analyze/Define the problem
Generate possible solutions/brainstorm
Evaluate each option
Implement the option of choice
Evaluate outcome of problem solving process
Keep basic concepts in mind when working with individuals, policy, or task group.

4 A’s of Schizophrenia
Affect, associations, ambivalence, and autism.

Secondary prevention
Also called “screening,” refers to measures that detect disease before it is symptomatic. The goal is to identify and detect disease in its earliest stages, before noticeable symptoms develop, when it is most likely to be treated successfully.

Tertiary prevention
Focus on people already affected by disease and attempt to reduce resultant disability and restore functionality. Directed at managing the long term consequences of acquired conditions

Primary prevention
The inhibition of the development of disease before it occurs.

To protect against disease and disability, such as getting immunizations, ensuring the supply of safe drinking water,
General action to promote health is the other category of primary prevention measures.

Enmeshment
The inappropriate closeness of family members

Cognitive Behaioral Therapy (CBT)
is a hands on, practical approach to problem solving. Its goal is to change patterns of thinking or behavior that are responsible got clients’ difficulties and so change the way they feel. Focuses on changing the clients’ attitudes and their behavior by focusing on the thoughts, images, beliefs, and attitudes that are held and how it relates to behavior, as a way of dealing with emotional problems.

Dual Diagnosis
Focus on the most severe symptoms first.

In adult survivors of childhood sexual abuse, the most frequently encountered defense mechanism is
Denial

Age 0-1
Oral – mouth fixation,
Sensory motor stage – 0-2, lack of language,
Trust vs. mistrust

Age 2-3
Bowel movement/toilet training,
Preoperational age 2 to 7, preschool years, egocentric, absolutes, Autonomy vs. self-doubt

Age 3-6
Phallic – explore sexual organs,
Preoperational,
Initiative vs. Self-doubt

Age 6-11
Latency – basic desires are repressed and expressed in socially acceptable ways,
Concrete Operational age 7 to 11, logic and rules,
Industry vs. inferiority – SCHOOL, MIDDLE childhood

Age 18 to young adulthood
Intimacy vs. Isolation

Age 30 to 50
Generativity vs. Stagnation

Age 50+
Ego Integrity vs. Despair

Cultural Competence for EXAM
Self-awareness about one’s own attitudes, values, beliefs, about cultural differences

Acculturation
The process of adopting the attitudes, values, beliefs, language of a a new or dominant culture

Assimilation
Identify only with dominant culture

Integration
Identify with both cultures

Separation
Identify only with ethnic culture

Marginality
Do not identify with either cultures

Stages of Change
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Relapse

Values clarification
… is the process in which a person works to become clear about their personal values in order to facilitate their understanding of how their values influence their goals and decisions that affect their social work practice

Social learning theory
the theory that we learn social behavior by observing and imitating and by being rewarded or punished

Multi tier model of classroom intervention
Tier one universal prevention programs in practice is that teach positive behaviors and promote social emotional development

Tier 2 small group short term interventions focused on improving academic and social engagement to reduce problem behavior

tier 3 individual in long term interventions provided to students to have serious academic behavioral or social emotional problems

Metacommunication
Phenomena by which a person communicates in ways other than through language, such as through posture vocalizations, body language, nonverbal communication, and so on

Which of the following is a true statement about the assessment phase of working with clients?
Assessment is an ongoing activity that begins with the social worker using a strengths-based perspective to attempt to understand the client in the context of their environment

Pre-contemplation stage
stage of change in which people are unwilling to change their behavior. Denial, ignorance of the problem

Contemplation stage
stage of change in which people are considering changing behavior in the next 6 months. Ambivalence, conflicted emotions

preparation stage
stage of change in which people are getting ready to make a change within the coming month. Experimenting with small changes, collecting information about change

Action stage
Stage of change in which people are actively changing a negative behavior or adopting a new, healthy behavior. Taking direct action toward achieving a goal

maintenance stage
stage of change in which people maintain behavioral change for up to five years. Maintaining a new behavior, avoiding temptation

relapse stage
old behavior is resumed for a while. Feelings of frustration and failure

symbolic modeling
Social Learning Technique: Presentation of desired behaviors via audio or videotape, through written materials, or by observing another

participant modeling
A social-learning technique in which a therapist demonstrates and encourages a client to imitate a desired behavior.

covert modeling
Draws upon imagination and visualization to help the client see themselves doing the desired behavior

Live modeling
watching a real person perform the desired behavior

Social policy analysis process
1) verify define in detail the problem

2) establish evaluation criteria

3) identify alternative policies

4) evaluate alternative policies

5) distinguish between alternative policies

6) monitor the implemented policy

Pre-affiliation
trust building in groups

Minnesota Multiphasic Personality Inventory (MMPI)
Inventory of 550 questions statements meant to assess psychopathology

personality and psychopathology psychometric test that is used to measure depression, hypochondria, hysteria, paranoia, schizophrenia, etc.

object permanence
The realization that people and things continue to exist even when they cannot be seen or heard. research shows that infants as young ….me understanding of object permanence.

Individual Supervision
Considered to offer the best opportunity for skill development and professional enhancement owing to the full one on one concentration of the supervisor and the supervisor

Family Systems Theory
A perspective on family functioning that emphasizes interconnections among different family relationships (such as marital, parent-child, sibling).

The practice of exchanging goods for social work services
Bartering in exchange for services is not an accepted practice in most areas of the US only in some usually rural community it is allowed in some circumstances and extreme care should be taken

Privilege is supposedly based on what?
Gender, race, and class

Social Betterment
Belief in the fundamental importance of improving the quality of social interaction for all people.

Interpersonal therapy involves 5 phases
1) assessment

2) initial sessions

3) middle sessions

4) termination of sessions

5) maintenance sessions

interpersonal therapy was originally designed to treat depression and is a time limited approach that generally last between 6 and 20 weeks

Symptoms of a traumatic brain injury
Trouble with concentration, a feeling of fuzziness, and memory problems

Psychoanalyst versus behaviorist
Psychoanalyst believe that individuals suffering from psychiatric problems experience some early childhood trauma that prohibited them from moving normally through developmental stages.

Behaviorists believe that individuals behaviors are molded by others responses.

Closed system
uses up its energy and dies

Differentiation
becoming specialized in structure and function

Entropy
Closed, disorganized, stagnant; using up available energy

Input
Obtaining resources from the environment that are necessary to attain the goals of the system

Negative entropy (systems theory)
exchange of energy and resources between systems that promote growth and transformation

Open system
a system in which exchanges of matter or energy occur across system boundaries

output
a product of the system that exports to the environment

Subsystem
a major component of a system made up of two or more interdependent components that interact in order to attain their own purpose(s) and the purpose(s) of the system in which they are embedded

suprasystem
An entity that is served by a number of component systems organized in interacting relationships

Throughput
Energy that is integrated into the system so it can be used by the system to accomplish its goals

macro level interventions
Look at the whole community of people as well as the greater community in which they exist

Psychosocial Assessment
Assessment written by the social worker that summarizes the clients problems that need to be solved

Allocation
The way in which resources are distributed to achieve maximum benefit

Broker
Helps direct a person or family to needed resources and follows up with the client to make sure resources were obtained

Which of the following groups has a propensity to respond to psychotropic drugs differently than clients from other ethnic group?
Asian clients tend to require lower dose days in may experience more severe side effects another groups

Strategic alliance
In these situations, therapist may suggest that they meet with one member of the family alone in order to help that person change, which can then alter the dynamics of the entire family system

Prescribing indecision
Technique in which therapist encourage family members to take time in making decisions rather than rushing into anything

Family sculpting technique
Family therapy technique in which family members physically pose other family members as a demonstration of family dynamics

Peer counseling
When one listens, shares, empathizes with, and support someone’s problem

Interpretation
Attempts to draw together behavioral patterns for deeper understanding

Reframing or relabelling
stating problem in a different way so a client can see possible solution

dual relationship
refers to any situation where multiple roles exist between a therapist and a client. Examples of dual relationships are when the client is also a student, friend, family member, employee or business associate of the therapist.

How many core values does the NASW code of ethics have?
Six

1) service
2) social justice
3) dignity and worth of the person
4) importance of human relationships
5) integrity
6) competence

cognitive inflexibility
rigid thinking, difficulty generalizing and considering alternatives

cognitive flexibility
Being open and receptive to new ideas, even when an individual’s past experiences have been disappointing

Which of the following options is true in regards to the use of DSM 5 to diagnose an individual?
Best practice involves eliminating possibilities until you reach the correct diagnosis

According to the DSM 5, why is it clinical diagnosis of encopresis not given until child has reached 4 years of age?
Some children are not developmentally ready to be toilet trained until age 4

In what type of family system are members most likely to form coalitions?
Disengaged families are those in which family members are emotionally distant from one another and find it difficult to connect in a meaningful way; in disengaged families members are more likely to form coalitions

Which of the following is an approach social workers used to gather information on a client quickly?
Standardized questionnaires

According to the DSM 5, dissociative disorders are frequently associated with what?
Trauma

Countertransference
Circumstances in which a psychoanalyst develops personal feelings about a client because of perceived similarity of the client to significant people in the therapist’s life.

counteracting behaviors
Occur when an individual acts out against negative behavior in order to neutralize it

Which of the following types of validity/reliability in social work research measure the extent to which the conclusions of research can be generalized?
External validity

face validity
Measures whether a test looks like it tests what it is supposed to test.

examines whether the assessments measure the constructs

Test retest reliability
using the same test on two occasions to measure consistency

Parallel forms reliability
assesses the consistency of the results of two tests constructed in the same way from the same content domain

Functional behavior analysis
When using the functional behavior assessment technique to assess a client, the social worker first helps the client identify problem behaviors and discuss is the interfering behaviors with the client.

the planned observation and determination of the antecedents and consequences of a behavior

emotional blunting
A muffled or apathetic response to material that would typically evoke a stronger response

Inordinate apprehension
Refers to signs of fear, anxiety, or suspicion, such as hand wringing and constant fidgeting

Anhedonia
a diminished ability to experience pleasure

Which of the following types of social work research is considered the most robust?
Experimental social work due to its design; the presence of intervention in comparison groups as well as random assignment of participants to those groups

Which of the following drugs is the most likely to be used to treat bipolar disorder?
Valproic acid

According to the DSM 5, how early after beginning an anti depressant my individuals experienced sexual dysfunction?
8 days

According to the DSM 5, autism spectrum disorder is in what category
Neurodevelopmental disorders

Which of the following classes of drugs is most likely to have a negative reaction with certain foods?
maoi

A type I error occurs when
Invalid rejection of a null hypothesis that is true– detection of an affect that was not actually present

type 2 error
When one fails to detect an effect that is actually present

Which of the following is the most accurate statement regarding solicitation of information from client according to the NASW code of ethics?
Information gathering should consist of obtaining the least amount of information possible to achieve the purpose

Harm reduction strategy
A treatment approach to drug addiction that seeks to reduce the negative consequences of addiction without necessarily requiring drug abstinence

In the community engagement phase of macro social work, which is the stage characterized by the growing acquaintance of community member?
Orientation

This stage in which community members began to agree on a course of action
Emergence stage

The final stage in which community members decide in justified the decision
Reinforcement stage

essential steps in ethical problem solving

Determine… whether there is an ethical issue or dilemma.
Identify ethical standards…. as defined by NASW Code of Ethics, which are being compromised.
Weigh ethical issues…. in light of key social work values and principles as defined by the NASW Code of Ethics.
Suggest modifications… in light of the prioritized ethical values and principles that are central to the dilemma.
Implement modifications… in light of prioritized ethical values and principles.
Monitor…. for new ethical issues or dillema

Which of the following is an intervention principle used in structural family therapy?
In that dysfunctional transactional patterns that the family encounters in order to learn the family structure

Which of the following management theories stresses the importance of work groups?
According to human relations theory ( theory y ), the tough authoritarian structure of scientific management theory (theory x) was not sufficient to address management issues. Theory Y stresses the importance of work groups and genuine concern for human needs in an organization.

Sociotechnical approach
considers the organization as composed of a social system, technical system, and its environment. These interact with each other, so it is necessary to balance them appropriately for effective functioning of the organization.

contingency approach
CS organizations as complex interactions of individuals, community, an organizations

The respect principle listed in the NASW code of ethics states…
Social worker should avoid on warranted negative criticism of colleagues in communications with clients or with other professionals.

Fetal death, maternal preeclampsia, and low birth weight are most common in what maternal age group?
50-55

Which of the following is untrue of somatic symptom and related disorders?
Somatic symptom and related disorders generally speaking our problems encountered by people who are experiencing symptoms without a defined medical cause. These symptoms are positive, rather than negative, and can include such elements as chronic pain and distress about illness itself.

What are the 4 class statuses is in the United States in order from highest to lowest?
upper class
middle class
working class
lower class

Which of the following is a key component of social constructionist theory?
People learn how to understand the world in their place in it through their interactions with others.

According to social constructionist theory, human understanding both produces and drive social interaction. Humans are social beings who interact with each other on the basis of a shared understanding about the world, which in itself developed in social interaction.

In working with parents and children, what layers of informed consent must be gained?
Consent must be obtained from the parents as a responsible parties, and the minor daughters assent must also be had, as it is unethical to treat the child if she is unwilling in there is no court mandated treatment

The first step and ethical problem solving according to the NASW code of ethics is…
To identify the ethical standards that might be compromised.

Then one will need to determine whether a dilemma exists.

Followed by weighing the issues according to the NASW code of ethics.

Suggestions and modifications will follow in light of the values in conflict, and then the situation will need to be monitored for further ethical issues.

What is the definition of a value?
I believe about what should or should not be, based on a complex belief system.

Ethic
A system of moral principles that guide decision-making process.

In the internalization in commitment stage of cultural development…
An individual has had time to encounter in process new data about areas of different. they have had a chance to seek out more knowledge and find themselves more comfortable both in their own cultural identity and those of others.

Delirium
a state of temporary but acute mental confusion,signs; anxiety, tremors, hallucinations, delusions, attention problems, decline in level of consciousness, memory problems.

It can occur in fevers, intoxication, and other disorders characterized by restlessness, illusions, and incoherence of through and speech

In delirium, emotionality often changes to a hostile, aggressive, or fearful presentation, particularly in older adults.

Disoriented
Short period of time
Sometimes due to medical condition/substance use: DEHYDRATION, HEAD TRAUMA

Self disclosure problematic aspects
acquisition by the client of the professionals personal information

blurring of boundaries between that which is personal and that which is professional in character

is unacceptable for therapist to South disclose for therapeutic needs of their own

deonotological theory
Asserts that the morality of an action is based on whether the action adheres to a set of rules

who’s actions or decisions that do not adhere to the rules are wrong and those that adhere to the rules are right

Steps for ethical problem solving
1) decide if there is an ethical issue or dilemma

2) identify the main principles and values that are involved

3) rank the main principles and values that are most relevant to the issue

4) develop an action plan

5) implement the action plan

6) reflect on the outcome

Consultation
Emphasizes the responsibility of the social worker to seek out the advice and counsel of colleagues when in the best interest of clients

cycle of violence
Tension-building stage
Acute battering stage
Honeymoon stage

Integrity of the profession
Requires social workers to contribute to the knowledge base of social work and contribute time and professional expertise to activities such as research and consultation

Which role of a social worker involves locating and helping clients access services?
Case manager

The social work value of service
Is the value associated with doing the right thing or attempting to deliver good to people and society in general

Societal value
Access to an opportunity for healthful in safe living conditions

Human service practice value
Avoiding exploiting or abusing clients

Organizational and institutional value
Considerate and respectful treatment of all persons by agency employees

Professional value
Focusing on the delivery of service rather than making money

clinical orientation
The enhancement of ethical practices in social work for the benefit of our clients

Strategic family therapy
active, brief, directive, task-centered

change in behaviors

pretend technique
first order changes (superficial)
2nd order – systemic interaction pattern changes
relabeling – a personal or problem
paradoxical directive – prescribe the symptomatic behavior so a client realizes he or she

Bowenian Family Therapy

the goal of this approach is not symptom reduction rather it is interested in improving the intergenerational transmission process
important interconnected concepts are differentiation, emotional system, multigenerational transmission, emotional triangle, nuclear family, family projection process, sibling position, and societal regression

Bowenian Family Therapy: Differentiation
Core concept of this approach

the more differentiated, the more a client can be an individual while in emotional contact with the family

Emotional fusion (Bowenian Family Therapy)
Counterpart of differentiation, in which it is the tendency for family members to share an emotional response

a result or poor interpersonal boundaries between family members
little room for emotional autonomy

Group theories
Social worker helps members come to an agreement regarding the purpose, function, and structure of a group

a group is the major helping agent

Stages of Group Development
Pre-Affiliation – Forming (Develop trust)

Power and Control – Storming (struggle for individual autonomy and group identification)

Intimacy – Norming (Use of self in service of the group)

Differentiation – Performing (Accept each other as unique individuals

Separation – Adjourning (Seek independence)

causes of groupthink

Illusion of invulnerability – creates excessive optimism that encourages taking extreme risks
Collective rationalization – members discount warnings and do not reconsider their assumptions
Belief in inherent morality – members believe in the rightness of their cause and ignore the ethical or moral consequences of their decisions
Stereotyped views of those “on the out” – negative views of the “enemy” make conflict seem unnecessary
Direct pressure on dissenters – members are under pressure not to express arguments against any of the group’s views
Self-censorship – doubts and deviations from the perceived group consensus are not expressed
Illusions of unanimity – the major view and judgments are assumed to be unanimous
Self-appointed “mindguards” – members protect the group and the leader from info that is problematic or contradictory to the group’s cohesiveness, views, and/or decisions

psychodynamic theories
emphasizes the importance of early childhood experiences, unconscious or repressed thoughts that we cannot voluntarily access, and the conflicts between conscious and unconscious forces that influence our feelings, thoughts, and behaviors

3 different levels of awareness
1) the conscious contains all the information that a client is paying attention to at any given time

2) the preconscious contains all the information outside of the clients attention or readily available if needed– thoughts and feelings that can be brought into consciousness easily

3) the on conscience contains thoughts feelings desires and memories of which clients have no awareness but that influence every aspect of their day to day lives

The opedius complex occurs during what stage?
Phallic

Stages of Psychosocial Development (Erikson)
Trust vs. Mistrust 0-2 years (based on consistency of caregiver)

Autonomy vs. Shame and Doubt 2-4 years ( children assert independence in should be encouraged and supported)

Initiative vs. Guilt 4-6 years (here children will develop a sense of initiative and feel secure in their ability to lead or develop a sense of guilt/feel like a nuisance if not affirmed)

Industry vs. Inferiority 6-12 years (children begin to develop a sense of pride in their accomplishments or feel inferior and doubt their abilities)

Identity vs. Role Confusion 12-22 years (during adolescence they form their own identities)

Intimacy vs. Isolation 22-34 years (Young adulthood connect intimately or avoid intimacy)

Generativity vs. Stagnation 34-60 years (middle adulthood develop a sense of being a part of the bigger picture or without success feel unproductive)

Integrity vs. Despair 60+ years (satisfaction with life fulfillment or dissatisfaction and despair)

He was interested in how children socialize and how this affects their sense of self. He saw personality as something that develops across the lifespan and identity cries are the focal points of each stage

Operant Conditioning (Skinner)
a type of learning in which behavior is strengthened if followed by a reinforcer or diminished if followed by a punisher

Positive is adding
Negative is removing

Reinforcement affirms a behavior and increases
Punishment decreases behavior

aversion therapy
A behavior therapy in which an aversive stimulus is paired with a stimulus that elicits an undesirable response… treatment that uses punishment to decrease the frequency of undesirable behaviors

using Antabuse for treating alcoholism

Biofeedback
Behavior training program that teaches a person how to control certain functions such as heart rate, blood pressure, temperature, and muscular tension.

Often used for ADHD AND Anxiety

Piaget’s stages of cognitive development
Sensorimotor (ages: 0-2 years): Involves learning to perceive the world using senses. During this stage they learn object permanence, the concept that even if you hide a ball under the rug, the ball continues to exist.

Preoperational Stage (ages: 2-7 years): The child learns that objects and ideas can be shown using symbols, such as images and words. They also learn to speak. During this period of time the child is very egocentric, and do not understand other people’s perspectives.

Concrete Operational Stage (ages: 7-11 years): During this period of time the child learns the principle of conservation, which is the concept that a tall slender cup can hold the same amount of fluid as a short wider cup, even though the cups are different. The child is also able to think logically about actual events.

Formal Operational Stage (ages 12- adulthood): During this period of time people learn how to reason based on morals, how to form hypotheses, and other forms of abstract reasoning.

This theory explains how humans acquire knowledge gradually. Children learn through interacting with their environment and the people within it.

Social workers should aim to develop opportunities to foster capacity and skills to improve learning

Learning Theory

Behaviorist (Pavlov, skinner): learning is viewed through change in behavior and the stimuli in the external environment are the locus of learning. Social workers aim to change the external environment in order to bring about desired change.
Cognitive (piaget): learning is viewed through internal mental processes (including insight, information processing, memory, and perception) In the locus of learning is internal cognitive structures. Social workers aim to develop opportunities to foster capacity and skills to improve learning.
Humanistic (maslow): Learning is viewed as a person’s activities aimed at reaching his or her full potential, and the locus of learning is in meeting cognitive another need. social workers aim to develop the whole person.
Social/situational (bandura): Learning is obtained between people and their environment and their interactions in observations in social context. Social workers established opportunities for conversation and participation to occur.

Community development theories
Long term

aims to address imbalances in power and bring about change founded on social justice, quality, and inclusion

keep purpose is to build communities based on justice, a quality, and mutual respect

universal prevention
Prevention intervention tactic used on the general public in which the prevention efforts are applied to everyone

selective prevention
Prevention intervention tactic that is used on a select group of individuals, not the general public

indicated prevention
prevention intervention tactic that is only used on specific individuals that exhibit specific conditions, not the general public

administrative supervision
Making sure that the supervised he is accountable in their job and performing to the standard

Supported supervision
Aimed at reducing job related stressors

Educational Supervision
Concerned with teaching the worker what he/she needs to know in order to do the job and helping him/her to learn it. Relates to the transmission of knowledge, skill, attitudes, and values needed by the worker. Teaching involves increasing workers’ knowlege and understanding to deepen professional attitudes

social work philosophy and the history and policy of the agency
Social work knowledge, techniques and skills
Self- awareness
Available resources in the agency and community
Priorities of case service and management of time

Biopsychosocial assessments involve….
Using empathy and client centered interviewing skills and helps clients determine their needs and strengths

psychological assessment
the use of specified procedures to evaluate the abilities, behaviors, and personal qualities of people

Sociological assessment
Look at how a client interact with others or acts in social situations

Systemic assessments
Involve conducting systemic interviews and developing and instituting systemic interventions

stages of ethnic identity development

PRE-ENCOUNTER: absorbed many beliefs and values of the dominant white culture, including the notion that “white is right” and “black is wrong”; de-emphasis on one’s racial group membership; largely unaware of race or racial implications
ENCOUNTER: forced by event or series of events to acknowledge the impact of racism in one’s life and the reality that one cannot truly be white; forced to focus on identity as a member of a group targeted by racism
IMMERSION/EMERSION: simultaneous desire to surround oneself with visible symbols of one’s racial identity and an active avoidance of symbols of whiteness; actively seek out opportunities to explore aspects of one’s own history and culture with support of peers from one’s own racial background
INTERNALIZATION: secure in one’s own sense of racial identity; pro-black attitudes become more expansive, open, and less defensive; willing to establish meaningful relationships with whites who acknowledge and are respective of one’s self-definition
INTERNALIZATION-COMMITMENT: found ways to translate one’s personal sense of blackness into a plan of action or a general sense of commitment to concerns of blacks as a group, which is sustained over time; comfort with one’s own race and those around them

FAREAFI
For test questions like ‘what do you do “FIRST” or “NEXT”‘ use this order of :
*safety first
Feelings,
Assessment,
Refer,
Educate,
Advocate,
Facilitate,
Intervene

AASPIRINS
For “Best”/”Worst” or “MOST reasonable” questions :
AASPIRINS
A: Acknowledge
A: Assess before action (discuss, ask, clarify, inquire, explore, determine, etc.)
S: Start where the client is
P: Protect Life (of the individual and community…this one is about
determining/preventing danger to self and others)
I: Informed Consent
R: Rule out medical conditions, send to Dr. if medical
I: Intoxication (don’t treat if intoxicated)
N: Non-judgmental
S: Support self-efficacy / determination

David Olsen’s Circumplex model “FACES”
This family assessment tool identifies adaptability, cohesion, and flow of communication, which either facilitates or limits the first two, as the most important family characteristics.

rational choice model
Barachel choice model uses the net value ration to determine the alternative that maximizes all values, not just economical, to be the most efficient; Therefore, the alternative with the highest net value is the most likely to be selected.

Work hardening
Facilitating the return of a worker to the work force

Disclosure statement
A document that details the therapist policy regarding the extent of confidentiality

family therapy IP
Persons whose behavioral manifestations reflect the families dysfunction

interoceptive training
A type of conditioning technique where the therapist helps the client become more capable of recognizing and coping with the social cues, triggers and early signals of a panic attack.

Sacral
4 vertebrae in the lowest portion of the back

Deemed Consent to treat
May be imposed without an individual Authorizing consent to treat if a health care worker, public safety officer, or other person is exposed to bodily fluids that may transmit infection

expansive mood
Lack of restraint in expressing one’s feelings, frequently with an overvaluation of one’s significance or importance.

cohort effects (generation effects)
differences between age groups that are caused by characteristics or experiences other than age

According to contextual therapists, family dysfunction is caused by
Low levels of equity and trust

According to bowen, what is differentiation?
The ability to recognize thoughts and feelings as things different from one another

belief that a clients secondary gain is too great so overcome
The advantages derived from the illness outweigh the discomfort created by the illness

The following anti depressants should be prescribed with extreme caution to patients with history of seizures:
bupropion and ludiomil

Contemporary field instruction is driven by…
The supervisee’s case needs, focusing on case planning and problem solving

Professional ethics and professional values differ in which of the following:
Values deal with what is right or wrong in practice and ethics deal with the principles of practice

ethical standards focus on behavior a…. the highest ideals of human behavior.

interpersonal therapy (IPT)
A brief, psychodynamic psychotherapy that focuses on current relationships and is based on the assumption that symptoms are caused and maintained by interpersonal problems.
Focus:
-role disputes
-role transitions
-unresolved grief
-social deficits

Tardive dyskinesia (TD)
potentially disabling motor disorder that may occur following regular use of antipsychotic drugs

echolalia and echopraxia
Parrotlike repeating of someones speech in catatonic schizophrenia is _ and the movements are .

Max Weber
Develop the 3 component theory of stratification

Delusion
a false belief, often of persecution or grandeur, that may accompany psychotic disorders

Hallucinations
hearing or seeing things that are not there

Paranoid Personality Disorder
a personality disorder marked by a pattern of distrust and suspiciousness of others. Other’s actions are interpreted as malevolent.

Interpreting actions of others as deliberately threatening or demeaning, distrustful and suspicious

Schizoid Personality Disorder
a personality disorder characterized by a lack of concern for social relationships and a restricted range of emotional experience and expression. Incapacity to form inmate social relationships/ experience affect for others. Lack of caring about others reponses

schizotypical personality
A personality Disorder Characterized by deficits in interpersonal connectedness; peculiarities in various thought, perception, speech and behavior patterns
Magical thinking
Ideas of reference
Recurrent illusions
Acute discomfort with and reduced capacity for, close relationships

anitisocial personality disorder

Disregard for the rights of others, Impulsive/irresponsible/callous
Must be > 18 (symptoms can occur at 15)

Narcissistic Personality Disorder
characterized by a grandiose sense of self-importance, a preoccupation with fantasies of success or power, and a need for constant attention or admiration

Exaggerated self-importance, absorbed fantasy for success, seek constant attention/admiration, oversensitive to failure

Dependant Personality Disorder
A personality disorder characterized by a pattern of clinging and obedience, fear of separation, and an ongoing need to be taken care of.

Pattern of dependent and submissive behavior

Somatic Symptom Disorder
Psychological disorder in which the symptoms take a bodily form without apparent physical cause.

Illness Anxiety Disorder
condition marked by intense preoccupation with the possibility of a serious undiagnosed illness

Factitious Disorder
a condition in which an individual acts as if he or she has a physical or mental illness when he or she is not really sick

Voyeuristic Disorder
paraphilic disorder in which sexual arousal is derived from observing unsuspecting individuals undressing or naked. Lasting at least six months

Frotteuristic Disorder
A paraphilic disorder consisting of repeated and intense sexual urges, fantasies, or behaviors that involve touching and rubbing against a non-consenting person. At least six months

Exhibitionistic Disorder
a paraphilic disorder in which persons have repeated sexually arousing urges or fantasies about exposing their genitals to others, and may act upon those urges. At least six months

Sexual Sadism Disorder
A paraphilic disorder characterized by repeated and intense sexual urges, fantasies, or behaviors that involve inflicting suffering on others.

Sexual Masochism Disorder
A paraphilic disorder characterized by repeated and intense sexual urges, fantasies, or behaviors that involve being humiliated, beaten, bound, or otherwise made to suffer.

Pedophilic Disorder
a paraphilic disorder in which a person has repeated and intense sexual urges or fantasies about watching, touching, or engaging in sexual acts with children, and either acts on these urges or experiences clinically significant distress or impairment. At least 6 months

Festishistic Disorder
A paraphilic disorder where sexual arousal from either the use of nonliving objects or a highly specific focus on non genital body parts. At least 6 months

Transvestic Disorder
Paraphilia in which individuals, usually males, are sexually aroused or receive gratification by wearing clothing of the opposite sex. At least 6 months

Alcohol Related Disorders
a cognitive, biological, behavioral, and social problem associated with alcohol use and abuse. Symptoms occur within 12-month period.

Cannabis Use Disorder
defined by the DSM-5 as cannabis use meeting the criteria for a substance use disorder

Hallucinogens related disorders
Following the use of a hallucinogen, the reexperiencing of one or more of the perceptual symptoms that were experienced while intoxicated

Autism Spectrum Disorders
Neurodevelopmental disorders marked by impaired social cognition, social skills, and social interaction, presumably due to a brain abnormality; extreme forms often associated with significant cognitive and linguistic delays and highly unusual behaviors. Restrictive, repetitive patterns of communication. Usually recognized by age 12 -24 months but can be seen earlier

Deficits in social interaction and nonverbal COMMUNICATION
Lack of peer relationships. eye contact, abnormal body movement,
Restricted, repetitive patterns of behavior
Inflexibility to routine, Fixed interests

Pica
compulsive eating of nonnutritive substances such as clay or ice. At least on month and is developmentally inappropriate.

Rumination Disorder
repeated regurgitation of food

Avoidant/Restrictive Food Intake Disorder
a disorder in which individuals avoid eating out of concern about aversive consequences or restrict intake of food with specific sensory characteristics. Infancy/ early childhood

Anorexia Nervosa
an eating disorder in which an irrational fear of weight gain leads people to starve themselves

Bulimia Nervosa
An eating disorder characterized by repeated cycles of bingeing and purging, laxatives, at least once per week for 3 months

Binge Eating Disorder (BED)
Eating disorder characterized by recurrent episodes of consuming large amounts of food during which the person feels a lack of control over eating.

Defense Mechanisms
Protect us from being consciously aware of a thought or feeling that we cannot tolerate. The defense only allows the unconscious thought or feelings to be expressed indirectly in disguised from. Originally created by Freud but then his daughter Anna Freud added other DM’s.

Acting out (defense mechanism)
emotional conflict dealt through actions rather than feelings. Ex: acting so as to get in trouble to get attention

Decompensation defense mechanisms
Deterioration of existing defense

devaluation (defense mechanism)
Opposite of idealization. When a person views themselves, an object, or another person as completely flawed, worthless, or having exaggerated negative qualities. Frequently used by those with Borderline Personality Disorders

Incorporation defense mechanism
Primitive psychic representation of a person is figuratively ingested

Inhibition (defense mechanism)
Loss of motivation to engage in activity or avoid activity that might stir up forbidden impulses

Rationalization (defense mechanism)
Attempting to make excuses or formulate logical reasons to justifying unacceptable feelings or behaviors. Third line of defense

EX: John tells the rehab nurse, “I drink because its the only way I can deal with my bad marriage and awful job.”

Substitution defense mechanisms
Unattainable or unacceptable goal, emotion or object is replaced by one that is more obtainable or acceptable

Sensorimotor stage
(From birth to about 2 years of age) during which an infant knows the world in terms of their sensory impressions and motor activities.

Infants learn about objects permanence (things continue to exist though they cannot see it)

They realized that their actions cause things to happen in their environment

preoperational stage
(from about 2 – 7 years of age) during which a child learns to use language but does not yet comprehend the mental operations of concrete logic. They start to think symbolically and learn to use words and pictures to represent objects.

Children tend to be egocentric and struggle to see things from the perspective of others

concrete operational stage
(from about 7 to 11 years of age) during which children gain the mental operations that enable them to think logically about concrete events. Beginnings of abstract thought. Cause and effect relationship are understood

formal operational stage
(normally beginning about age 12) during which people begin to think logically about abstract concepts. Thinks hypothetically and assumes adult roles and responsibilities.

basic trust vs. mistrust
(Birth-1 year) From warm, responsive care, infants gain a sense of trust that the world is good. Mistrust occurs if infants are neglected or handled harshly. This may result in anxiety, heightened insecurities, and feelings of mistrust in the world around them.

Autonomy vs. Shame and Doubt
(1-3 years) Toddlers learn to exercise their will and do things for themselves, or they doubt their abilities and develop shame and doubt. Both parents play a role

Initiative vs. Guilt
3-6 years old . Children begin to take initiative, if they are encouraged they can follow their interest. If children are held back and told what they do is silly they develop guilt. Children will start to feel like nuisances to others and will therefore remain followers, lacking self-innitiative

Industry vs. Inferiority
(6-puberty) children learn the pleasure of applying themselves to tasks, or they feel inferior and become unmotivated.

identity vs. role confusion
adolescence

individuals learn that they have different social roles. Sometimes develop in an identity crisis . If they are pushed to confirm they will experience role confusion and feel lost.

Intimacy vs. Isolation
Young adulthood

individuals form deeply personal relationships, marry, begin families. If they can’t form intimate relationships we might end up feeling isolated

Generativity vs. Stagnation
Middle-aged
Individual’s begin to devote themselves more to fulfilling one’s potential and doing public service. If individuals do not resolve some conflicts earlier we become pessimistic and experience

ego vs despair
Individuals try to achieve wisdom, spiritual tranquility, and acceptance of their lives. If not many will experience dissatisfaction with life and develop despair, leading to depression and hopelessness

Freud’s Theory of Psychosexual Development
Oral, Anal, Phallic, latency, genital

oral stage
Birth to 12 months
Freud’s first stage of psychosexual development during which pleasure is centered in the mouth.

Result of fixation: excessive smoking, overeating, dependence on others

anal stage
Age 2

Freud’s pychosexual period during which a child learns to control his bodily excretions. i.e. potty trained

Result of fixation: an overly controlling personality( anal-retentive) or easily angered personality (anal-expulsive)

Anal Stage (2, when the child is being toilet trained)
Bowel movements – result of fixation: an overly controlling personality (anal retentive) or and easily angered personality (anal expulsive)

phallic stage
Age 3-5
Freud’s third stage of development, when the gentals becomes the focus of concern and pleasure

Result of Fixation: guilt or anxiety about sex

latency stage
Age 5 to puberty

psychosexual stage in which sexual impulses are submerged into the unconscious

no fixation

sexuality is latent or dormant during this period

gential stage
Puberty and up
psychosexual stage in which sexual impulses awaken and typically begin to mature into romantic attraction toward others

the genitals; sexual urges return

Kohlberg’s Theory of Moral Development
Developing children progress through a predictable sequence of stages of moral reasoning (preconventional, conventional, postconventional).

preconventional morality
Elementary school age (before age 9)
first level of Kohlberg’s stages of moral development in which the child’s behavior is governed by the consequences of the behavior. Obedience/ punishment

conventional morality
Early adolescents
second level of Kohlberg’s stages of moral development in which the child’s behavior is governed by conforming to the society’s norms of behavior.

postconventional morality
Adult
third level of Kohlberg’s stages of moral development in which the person’s behavior is governed by moral principles that have been decided on by the individual and that may be in disagreement with accepted social norms

Behaviorlists
Pavlov, Skinner

Learning is viewed through change in behavior and the stimuli in external environment are the locus of learning.

Social workers aim to change the external environment in order to bring about desired change

Behavioral Theories
Personality is a result of our interaction between the individual and the environment. The goal is to modify the behavior

Classical conditioning

Operational conditioning

Two fundamental classes of behavior
respondent; operant

respondent behavior
behavior that occurs as an automatic response to some stimulus.

(anxiety, sexual response)

Operational Conditioning
a learning process through which the strength of a behavior is modified by reward or punishment

Antecedent –> response/behavior –> consequence

positive reinforcement
Increasing behaviors by presenting positive stimuli, such as food. A positive reinforcer is any stimulus that, when presented after a response, strengthens the response.

Praising, Giving tokens

negative reinforcement
Increasing behaviors by stopping or reducing negative stimuli, such as shock. A negative reinforcer is any stimulus that, when removed after a response, strengthens the response. (Note: negative reinforcement is not punishment.)

positive punishment
Presentation of undesirable stimulus following a behavior for the purpose of decreasing or eliminating that behavior

hitting or shocking

negative punishment
the removal of a stimulus to decrease the probability of a behavior’s recurring

removing something positive like cell phone

Extinction
withdrawing or failing to provide a reinforcing consequence

Time- out
Removal of something desirable – negative punishment technique

token economy
a client receives tokens as reinforcement for performing specific behaviors. The token functions as currency within the environment and can be exchanged for desired goods, services, and privileges

Ethinicty
the idea that one is a member of a particular cultural, national, or racial group that may share culture, religion, race, language, or place of origin.

two people can share the same race but have different ethnicities**

race
A group of human beings distinguished by physical traits, blood types, genetic code patterns or genetically inherited characteristics.

cultural identity
Ones belief in belonging to a group or certain cultural aspect

attachment theory
the idea that early attachments with parents and other caregivers can shape relationships for a person’s whole life

attachment styles
secure, avoidant, ambivalent, disorganized

Discovered by Mary Ainsworth

John Bowlby
Attachment theory. Identified the characteristics of a child’s attachment to his/her caregiver and the phases that a child experiences when separated from the caregiver.

Biological theory of personality
focus on biological contributions to certain traits because person’s genome contributes to formation of personality
-influenced by heredity
-‘baseline’ temperament

Behavioral theory of personality
Behavioral theories suggest that personality is a result of interaction between that individual and environment.

Humanist theory of personality
Studied by Carl Rogers

People are driven by actualizing tendency to realize their highest potential, those raised with unconditional positive regard are able to

Self-concept is made up of subjective perceptions and beliefs about oneself, and if experiences contradict self-concept then incongruence occurs

Uses person-centered therapy

Trait theory of personality
Personality consists of a set of traits which are characteristics that vary between people and are STABLE over the course of the lifetime.

Conflict Theroy
Focus on stratification and access to resources

authoritarian parenting
style of parenting in which parent is rigid and overly strict, showing little warmth to the child. Generally lead to those who are obedient and proficient but are lower in happiness, social competence, and self-esteem

authoritative parenting
parenting style characterized by emotional warmth, high standards for behavior, explanation and consistent enforcement of rules, and inclusion of children in decision making. Generally results in those who are happy, capable, and successful

permissive parenting
A parenting style characterized by the placement of few limits on the child’s behavior. Generally results in children who rank low in happiness and self regulation, experiencing problems with authority and tending to perform poorly in school

uninvolved parenting
Style of parenting that provides neither warmth nor control and that minimizes the amount of time parents spend with children. Generally child lack self control, low self-esteem, and are less competent than their peers.

rank lowest

Radical Feminist Theory
oppression of women is result of patriarchal society. Violence against women results from this

The family life cycle
a family’s progression from formation to retirement, each phase bringing with it distinct purchasing behaviors.

substance use disorder
continued substance craving and use despite significant life disruption and/or physical risk

Goals of treatment for substance use
abstinence from substances

maximizing life functioning

preventing or reducing frequency and severity of relapse

Stages of substance use disorder treatment
Stabilization, rehabilitation, maintenance

Treatment approaches for substance use disorders
medication- assisted treatment

Psychosocial or psychological interventions

behavioral therapies

self-help groups

applications to social work of the system and ecological perspectives theories
social workers need to understand interaction between the mirco, mezzo, and macro

Problems at one part of a system may be manifested at another

ecomaps and genograms can help understand system dynamics

understanding “person-in-environment” (PIE) is essential to identifying barriers or opportunity for change

problem and change are viewed within larger context

Entrophy
closed, disorganized, stagnant, using up available energy

equalifinality
Arriving at the same end from different beginnings

role theory
a theory that hypnotized people act in accordance with a special social role that provides a socially acceptable reason to follow the hypnotist’s suggestions

when assessing social workers view problems as differences between clients’ behavior and expectations of other with regard to role

role ambiguity
lack of clarity of a role

Role complementarity
The role is carried out in an expected way

Role discomplementarity
role expectations of others differs from one’s own

role reversal
two or more individuals switch roles

role conflict
Incompatible demands of different roles, such as the demands of a manager’s superiors conflicting with those of the manager’s subordinates.

Theories of Group Development and functioning
Group work is a method of social work that helps individuals to enhance their social functioning through purposeful group experiences

social worker focuses on helping each member change his or her environment or behavior through interpersonal experience

Psychodrama
group therapy in which a patient expresses feelings by acting out family and social roles with other patients

Preaffiliation Stage
Group Development
Forming
Development of trust

Power and control stage
Group Development
Storming
Struggles for individual autonomy and group identification

Intimacy stage
Group planning occurs most often during this stage. known as norming

differentiation stage
Group Development
Performing
Acceptance of each other as distinct individuals

Separation/Termination Stage
Group Development
Adjourning
Independence

Groups help through:
Instillation of hope, universality, altruism, interpersonal learning, self-understanding & insight

Factors affecting group cohesion
group size
homogeneity
participating in goal and norm setting for group
interdependence
member stability

Group think definition
develops when a group has been working together begins to place to much value in the group itself

crisis intervention stages
plan and conduct through biopsychosocial

Make psychological contact and rapidly establish the collaborative relationship

identify the major problems

encourage an exploration of feelings and emotions

generate and explore alternatives and new coping

restore functioning through implementation of an action plan

plan follow – up

Echolalia
repeating noises and phrases

associated with catatonia, autism, schizophrenia, and other disorder

infromation processing
An important memory-related function of sorting and shifting through the day’s experiences.

information processing block
failure to perceive and evaluate potentially useful new information

Three levels of consciousness

Conscious
Preconscious
Unconscious

conscious
contains all the information that a client is paying attention to at any given time

Preconscious
Contains all information that is not conscious but is retrievable into conscious awareness

unconscious
contains thoughts, memories, and desires that are well below the surface of conscious awareness but that nonetheless exert great influence on behavior

Id
amoral, pleasure, devil.

contains a reservoir of unconscious psychic energy that, according to Freud, strives to satisfy basic sexual and aggressive drives. The id operates on the pleasure principle, demanding immediate gratification. (p. 555) & Freud’s original system of the personality; it operates on the pleasure principle and seeks immediate gratification of its wants and needs; unconscious reservoir of primal urges and libido.

Ego
decides between angel and devil

The conscious, rational part of the personality, charged with keeping peace between the superego and the id.

the largely conscious, “executive” part of personality that, according to Freud, mediates among the demands of the id, superego, and reality. The ego operates on the reality principle, satisfying the id’s desires in ways that will realistically bring pleasure rather than pain. (p. 555) & Freud’s personality structure that is the only rational component; it serves as the mediator between the id and superego and also as the decision-maker for the personality.

Superego
moral, society, angel

the moral component of personality that incorporates social standards about what represents right and wrong

the part of personality that, according to Freud, represents internalized ideals and provides standards for judgment (the conscience) and for future aspirations. (p. 555) & the third part of Freud’s personality systems which makes us feel proud when we obey its strict morality and feel guilt when we give in to the id’s more pleasure-seeking urges.

Ego-syntonic
behaviors in sync with ego (no guilt)

ego-dystonic
behavior dis-n-sync with the ego (guilt)

ego strength
the ability of the ego to function despite competing demands of the id, superego, and reality

mirroring
behavior which validates the child’s sense of a perfect self

Twinship/Twinning
child needs an alter ego for a sense of belonging

Kubler-Ross stages of dying

Denial
Anger
Bargaining
Depression
Acceptance

denial and isolation
Kubler-Ross’ first stage of dying, in which the dying person denies that she or he is really going to die

Anger
Kubler-Ross’ second stage of dying, in which the dying person’s denial gives way to anger, resentment, rage, and envy

bargaining
Kubler-Ross’ third stage of dying, in which the dying person develops the hope that death can somehow be postponed

depression
kubler-ross fourth stage of dying. A period of sadness and loneliness will then occur in which a person reflects in his or her grief and loss

Acceptance
Kubler-Ross’ fifth stage of dying, in which the dying person develops a sense of peace, an acceptance of her or his fate, and, in many cases, a desire to be left alone

Ecological Systems Theory
explains how the inherent qualities of a child and his/her environment interact to influence how he/she will grow and develop

Bronfenbrenner

Microsystem
Mesosystem
exosystem
Macrosystem
Chronosystem

Microsystem
the people and objects in an individual’s immediate environment

Mesosystem
provides connections across microsystems because what happens in one microsystem is likely to influence others

Exosystem
links between a social setting in which the individual does not have an active role and the individual’s immediate context

Macrosystem
the larger cultural and social context within which the other systems are embedded

Chronosystem
adds the dimension of time: change or constancy in the person and the environment

Stages of Alzheimer’s
Stage 1: No impairment
Stage 2: Very mild cognitive decline; forgetfulness
Stage 3: Mild cognitive decline; losing important objects, short term memory loss, decreased attention span, difficulty in work or social situations.
Stage 4: Moderate cognitive decline; Personality changes, clearly detected, obvious memory loss, difficulty performing tasks that require planning (paying bills)
Stage 5: Moderately Severe: Inability to recall important details but can remember info about self and family. Disoriented to time and place.
Stage 6: Severe decline: Continued worsening of memory, wandering behavoir, assistance w/ADL req. Violent tendencies, urinary and fecal incontinence.
Stage 7: Loss of ability to respond to environment, stupor or coma. Death freq r/t choking or infection.

signs and symptoms of child abuse/ neglect and elder abuse/ neglect
Avoid eye contact
experience intense loneliness
anxiety and despair
have flat/ superficial way of relating
little empathy
engaging in bullying, disruptive/ aggressive behaviors
engage in self harming/ self destructive behaviors
lowered capacity to engage appropriately
Physical signs/injuries
behavioral signs – opp. defiant symptoms, interest in sexual activity, school performance problems and difficulties

physical abuse
intentionally causing physical harm to another person

sexual abuse
any sexual act without consent

psychological abuse
any behavior that causes a person to feel threatened, fearful, intimidated, or humiliated in any way

( emotional/ verbal/ mental injury)

neglect
the failure to meet a person’s basic physical and emotional needs

a past history of violence is
the best predictor of future violence

sexual orientation
refers to an individual’s pattern of physical dnd emotional arousal towards other persons

people do not choose their sexual orientation it is simply part of who they are

sexual behavior
actions that produce arousal and increase the likelihood of orgasm

sexual identity
the recognition, or internalization, of a biological sex category

Culturally competent social worker
social workers should

understand culture and function in human behavior and society

knowledge base of their clients’ cultures and be able to demonstrate competence in provisions of services that are sensitive to clients’ cultures and to differences among people and cultural groups

obtain education about and seek to understand a person culture

not use derogatory language

gender identity
the individual’s sense of being male or female.

Globalization
interconnectedness of persons across the world

circulatory system
(aka cardiovascular system) This system works as the transportation highway for the body. It consists of the heart, blood, and blood vessels. It transports substances such as oxygen, carbon dioxide, and nutrients in the body.

digestive system
Breaks down food into absorbable units that enter the blood for distribution to body cells.

endocrine system
Consists of glands that control many of the body’s activities by producing hormones.

immune system
A system (including the thymus and bone marrow and lymphoid tissues) that protects the body from foreign substances and pathogenic organisms by producing the immune response

lymphatic system
Defense against infection and disease

Muscular System
Consists of skeletal muscles, tendons that connect muscles to bones, and ligaments that attach bones together to form joint

nervous system
the body’s speedy, electrochemical communication network, consisting of all the nerve cells of the peripheral and central nervous systems

reproductive system
system of organs involved in producing offspring

respiratory system
Brings oxygen into the body. Gets rid of carbon dioxide.

skeletal system
Protects and supports body organs and provides a framework the muscles use to support movement. Made up of bones and joints

urinary system
eliminates waste from the body in the form of urine . Kidneys remove waste from the blood. The waste combines with water to urine

differential diagnosis
systematic method of diagnosing a disorder used to identify the presence of an entity where multiple alternatives are possible

comorbid
existing with or at the same time; for instance, having two different illnesses at the same time

contraindicated
not recommended under these circumstances

disorientation
confusion about person, place, or time

endogenous depression
depression caused by biochemical imbalance rather than psychosocial stressors

Exogenous depression
depression caused by external events or psychosocial stressors

Folie a deux
shared delusion

Postmorbid
subsequent to the onset of an illness

premorbid
prior to the onset of an illness

psychotic
experiencing delusions or hallucinations

Genogram
A family diagram that depicts each member of the family and shows connections between the generations.

organic brain syndrome
Temporary or permanent dysfunction of the brain, caused by a disturbance in the physical or physiologic functioning of brain tissue.

Antipsychotics
used for the treatment of schizophrenia and other disorders that involve psychosis or mania

Typical Antipsychotics
Haldol
haldol Decanoate
Loxitane
Mellaril
Navane
Prolixin
Serentil
Stelazine
thorazine
trilafon

atypical antipsychotics
Antipsychotics that do not have significant side effects common to older antipsychotics

Abilify
clozaril
geodon
risperdal
seroquel
zyprexa

tardive dyskinesia
involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors

stimulants
used to treat ADHD

adderall
concerta
dexedrine
dexedrine spansules
metadate
ritalin

Amphetmines/SPEED – CAR speed, Paradoxical effect
Concerta, Aderall, Ritalin
Non-Amphetimine – Strattera – can not be abused, 2 to 4 weeks for effective

Avair Diskus
used to treat asthma and chronic obstructive pulmonary disease

Cymbalta
Selective Serotonin and norepinephrine re-uptake inhibitor (SSNRI) Used for the treatment of major depressive disorder.

Diovan
treats heart disease or heart failure

hydrocodone/acetaminophen
most popular pain killer use to treat moderate to severe pain

Levothyroxine Sodium
used to treat hypothyroidism

Lantus
sterile solution of insulin

Lisinopril
Prinivil, Zestril used to treat high blood pressure medication

Lyrica
used to control seizures, treat nerve pain and fibromyalgia

Metoptolol
generic version of lopressor is used to treat high blood pressure and also helps reduced the risk of repeated heart attacks, heart failure and heart pain or angina

Nexium
used to treat symptoms of gastroesophageal reflex disease and other conditions involving excessive stomach acid

Simvastatin
Treats high cholesterol

Synthroid
man- made thyroid hormone used to treat hypothyroidism

Ventolin
Used in inhalers for asthma

Vyvanse
used to treat hyperactivity and impulse control disorders

QID
four times a day

BID
two times a day

TID
three times a day

QD
once a day

PRN
as needed

Encopresis
a childhood disorder characterized by repeated defecating in inappropriate places, such as one’s clothing. Four years or older

Rett Syndrome
A rare non-inherited genetic postnatal neurological disorder that occurs almost exclusively in girls and lead to severe impairments affecting nearly every aspect of the child’s life: ability to speak, walk, eat, and even breathe. Hallmark for this syndrome is near constant repetitive hand movements while awake

Beck Depression Inventory
psychometric assessment created by cognitive theorist Aaron Beck used to assess the severity of depression that has already been diagnosed.

21-item test present in multiple formats used with adults and adolescents

Myers-Briggs Type Indicator (MBTI)
psychological test that identifies individuals’ preferences for source of energy, means of information gathering, way of decision making, and lifestyle, providing information for team building and leadership development.

Rorschach inkblot test
the most widely used projective test, a set of 10 inkblots, designed by Hermann Rorschach; seeks to identify people’s inner feelings by analyzing their interpretations of the blots

Stanford-Binet Intelligence Scale
A test designed for testing cognitive abilities. It provides verbal, performance, and full scale scores for children and adults

Thematic Apperception Test (TAT)
projective test requiring examinees to tell a story in response to ambiguous pictures. Provides information on a clients perceptions and imagination for use in the understanding of a clients current needs , motives, emotions, and conflicts, both conscious and unconscious.

Wechsler Intelligence Scale
Designed as a measure of a child’s intellectual and cognitive ability. Four index scales and full scale score

Psychological Test
instrument for assessing a person’s abilities, cognitions, or motivations.

personality, achievement, intelligence, and neurological functioning

often questionnaires. Referred to as scales, surveys, screens, checklist, assessments,measures, inventories

may be written, verbal, or pictorial test

Educational Tests
measure cognitive (thinking) abilities and academic achievement.

measures provide a profile of strengths and weaknesses that accurately identify areas for academic remediation and insight into the best learning strategies

provide documentation for legal purposes of establishing the presence of disabilities but do not guarantee their findings will be accepted by schools and/or accommodation provided

Social work assessment
more comprehensive process that may utilize the results from educational and psychological tests, but can also involve interviewing a client and/or family, reviewing client’s history , checking existing records, and consulting with previous or concurrent provided

Achievement and aptitude tests
typically used in education, measure how much clients know (have achieved) in a certain subject or subjects, or have the ability (aptitude) to learn

intelligence test
Measures intelligence

job/occupation test
Match interest with career

Personality test
measures basic personality traits/ characteristics

Neuropsychological test
assess and measure cognitive functioning ( how a particular problem with the brain affects recall, concentration, etc)

specialized clinical test
investigates areas of clinical interest, such as anxiety, depression, PTSD, and so on

dialectical behavior therapy
developed to treat people with suicidal thoughts and actions. Social worker assures client that their feelings are valid and understandable. Coaches him to understand that their feelings however, are unhealthy and disruptive and the client must achieve balance

Eye Movement Desensitization and Reprocessing (EMDR)
is an evidence based psychotherapy intervention developed to help individuals process and cope with past traumatic events. This approach uses bilateral stimulation while the client remembering the event. This intervention was originally developed to treat PTSD however, it has shown to be effective in treat various other disorders as a well.

Critical Incident Stress Debriefing
A specific type of psychological debriefing that follows a strict, step-by-step agenda. A 7 phase, small group, supportive intervention process. Not psychotherapy but just a supportive crisis focused discussion of trauma event

7 phases of critical incident stress debriefing
Introduction, facts, thoughts, reactions, symptoms, teaching, re-entry

intellecutal disability
The stages of intellectual disabilities and corresponding IQ scores.

Test used to Rate IQ
WAIS ( Wechsler Adult Intelligence Scale)
WISC (Wechsler Intelligence Scale)
Stanford-Binet

Hero
The one who does the best job of bringing esteem to family. Heros work hard to demonstrate responsibility seeking achievement in any form possible

Mascot
Often cracks jokes or finds other ways of trying to provide entertainment. try to alleviate the family’s stress but sometimes it backfires

Lost Child
Stands apart, in that we characterize this tole primarily by inaction. Try not to rock the boat. Needs were neglected, lost in bedlam of family drama.

Risk assessment
The process of measuring the clients risk of hurting themselves. Social Worker must review all assessment data in order to determine the appropriate level of care and a treatment plan. The assessment must include examining risk and protective factors, and presence of behavioral warning signs

The development, review, and implication of crisis require
Actions aimed at crisis stabilization, resolution, and mastery

What should social workers do when making crisis intervention plans

plan and conduct a thorough biopsychosocial and lethality/ imminent danger assessment
make psychological contact rapidly establish the collaborative relationship
identify major problems including crisis precipitant
Encourage an exploration of feelings and emotions
generate and explore alternatives and new coping strategies
restore functioning through implementation of an action plan
plan follow-up and booster sessions

SOAP
subjective, objective, assessment, plan

Subjective (SOAP)
a client’s own description of the problem or issue

Objective (SOAP)
A description of what is actually observed

Assessment (SOAP)
Social worker pulls together the objective and subjective findings and consolidates into a hort assessment

Plan (SOAP)
The plan includes what will be done as a consequence of the assessment

research design
is a blueprint with the research problem determining the type of design used

research process will
Identify the research problem clearly and justify its selection

review previously published literature associated with the problem areas

clearly and explicitly specify hypotheses central to the problem selection

Effectively describe the data that will be necessary for an adequate test of the hypotheses and explain how such data will be obtained

Describe the methods of analysis that will be applied to the data in determining whether or not hypotheses are true or false

Three broad types of research
experimental, quasi-experimental, and pre-experimental

Experimental /randomized experiment design
a study in which the researcher assigns the treatments to the experimental units at random. These are the most rigours. Allows research to test their hypothesis by reaching valid conclusions about relationships between independent and dependent variables. Strongest internal vailidty and for establishing cause and effect

Classic- pretest-posttest
posttest only
Solomon four-group: distinguish testing vs. intervention effects
Alternative treatment

Pre-experimental designs
contain intervention group only and lack comparison/ control groups, making them the weakest

Most common Single Subject research
pre-and-post test or single- case study (AB)

AB,A,BAB, ABAB Research (single subject)
A stands for baseline ( measures taken when treatment is not provided)

B stands for intervention ( measures taken when treatment is being delivered)

fewest threats to internal validity

Quantitative Research
experiments, survey, and statistical analysis

Qualitative Research
participant observation, interviews, and content analysis .

Interview, observation, archives/ historical data, artifacts

descriptive research
Those whose aim is observe and describe

case
naturalistic observation
survey

predictive research
Those whose aim is to predict

case control study
correlation (observational study)
longitudinal study
cross sectional study

meta-analysis
analytical methodology designed to systematically evaluate and summarize the results from a number of individual studies, thereby, increasing the overall sample size and the ability of the researcher to study effects of interest

Pilot study
a small trial versions of proposed studies to test their effectiveness and make improvements; helpful in identifying potential issues early which can then be rectified before committing to a full investigation

Two type of sampling methods
non probability and random/ probability sampling

interrater reliability
Assess the degree to which different raters/ observe give consistent estimates of the same phenomenon

internal consistency reliability
assess the consistency of results across items within a test

content validity
examines whether all of the relevant content domains are covered

criterion-related validity
examines whether constructs perform as anticipated in relation to other theoretical construct

predictive, concurrent, convergent, and discriminant validity

predictive validity
assesses whether constructs predict what they should theoretically be able to predict

concurrent vailidity
assesses whether constructs distinguish between groups that should be able to be distinguished

convergent vailidity
assesses the degree to which constructs are similar to (converge on) other constructs to which they should be similar

discriminant validity
assesses the degree to which constructs are different from (diverge away from) other constructs to which they should be dissimilar

cultural pluralism
Respecting and encouraging cultural differences

institutional racism
patterns of discrimination based on ethnicity that have become structured into existing social institutions

Intervention Planning
-The formulation of the plan for intervention based upon an analysis of evaluation results according to selected frame(s) of reference. Engagement, assessment, planning, intervention, evaluation, termination

Does the DSM-5 address cultural sensitivity
yes, throughout the DSM-5 . In the DSM-5 specific diagnostic criteria were changed to better apply across diverse cultures. The Cultural Formulation Interview Guide is included to help social workers assess cultural factors influencing clients perspectives of their symptoms and treatments options

Contractual agreement of intervention plan
between client and a social worker, may be informal or written, specifies problems to be worked on, the goals to reduce the problems, client and social worker roles in the process, the intervention or techniques to be employed, the means of monitoring progress, stipulations for renegotiating the contract and the time,place, fee, and frequency of meetings

Should a social worker terminate services to clients and professional relationships with them when such services and relationships are no longer required or no longer serve the client needs or interest
Yes under the codes of ethics a social worker should terminate service if it no longer serves the client needs or intrest

Should a social worker take reasonable steps to avoid abandoning clients who are still in need of service?
Yes, a social work should withdraw service only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. The social worker should assist in making appropriate arrangements for continuation of services when necessary

Can Social workers who are in fee-for-service settings terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to a client
Yes they may in this types of situations. If a client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed.

Should a social worker terminate services to pursue a social, financial, or sexual relationship with a client
Absolutely not

Should a social worker who anticipates the termination or interruption of service notify the client as soon as possible?
Yes, a social worker should inform the client as soon as they are able to. This way they can seek the transfer, referral, or continuation of service in relation to the clients needs and preferences

Should a social worker who plan on leaving an employment setting inform the client of appropriate options for the continuation of services and of the benefits and risk of the option
Yes

Is it unethical to continue to treat clients when services are no longer needed or in their best interest?
Yes

Interruption of services (sw ethics)
Mandates that social works should make reasonable efforts to ensure continuity of services in the event that services are interrupted by factors such as unavailability, relocation, illness, disability, or death

Should a social worker involve clients and their families (when appropriate) in making their own decisions about following-up services or aftercare
Yes. Involvement must include at a minimum, discussion of client and family preferences ( when appropriate). Social workers are often responsible for coordination of clients follow-up services when needed

Comorbid
existing with or at the same time; for instance, having two different illnesses at the same time

Contraindications
not recommended or safe to use ( medication or treatment that is contraindicated would not be perscribed because it could have serious consequences

Economic Justice
A set of moral principles for building economic institutions. Ultimate goal of which is to create an opportunity for each person to create a sufficient material foundation upon which to have a dignified, productive, and creative life

Universalization (interviewing techniques)
the generalization or normalization of behavior

Interpretation (interviewing techniques)
pulling together patterns of behavior to get a new understanding

Using an interpreter
It is NOT appropriate to use family members to interpret or provide services in social work practice

The Phases of Intervention and Treatment
Step 1: engagement with client, group, or community

Step 2: assessment of strengths and needs to be used in the intervention process

Step 3: Planning or design of intervention to address problems

Step 4: Intervention aimed at making change

Step 5: evaluation of efforts

Step 6: termination and anticipation of future needs

Social worker engages in problem solving process through these steps
engaging
assessing ( includes focus on clients strengths and not just weakness)
planning
intervening
evaluating
terminating

If you are working with an involuntary client, what are some methods that can be helpful when working with them?
Acknowledge the client’s circumstances and understanding how they came about given the client’s’ history

Listening to clients’ experiences in order to try to understand how they feel about intervention

engaging in clear communication because involuntary clients struggle to understand what is happening to them

Making clear what the purpose if the intervention is, what the client has control of and what they do not, what is going to happen next

Showing empathy and viewing clients as more than the problems that brought them into services

building trust

paying attention to what is positive in the client’s behavior

When a social worker is functioning as an observer, what roles can they take?
Complete Participant
participant as an observer
observer as a participant
complete observer

complete participant
living the experience as a participant

participant as observer
interacting with those who are participating

observer as participant
Limited relationship with others participating–primarily observer

complete observer
removed from activity – observer only

Reflecting or validating
show empathetic understanding of clients’
problems. These techniques can also assist client in understanding negative through patterns

Reframing
shows clients that there are different perspectives and ideas that can help to change negative thinking patterns and promote change

group thinking
when a group makes faulty decisions because of group pressure

Positive Regard
ability to view client as being worthy of caring about and as someone who has strengths and achievement potential

Four steps of managing conflict

The recognition of existing or potential conflict
assessment of the conflict situation
the selection of an appropriate strategy
intervention

Structuring in conflict resolution

decreasing the amount of contact between the parties in the early stages of conflict
decreasing the amount of time between problem-solving sessions
decreasing the formality of problem-solving session
Limiting the scope of the issue that can be discussed
5.using a third party mediator

Crisis intervention plan
The process of actively influencing the psychosocial functioning of the clients during the period of disequilibrium or crisis. The goals are to alleviate stress and mobilize coping skills, psychological capabilities, and social resources.

Goals of Crisis Intervention
A. relieve the impact of stress with emotional and social resources
B. return client to a previous level of functioning ( regain equilibrium)
C. help strengthen coping mechanisms during the crisis period
D. develop adaptive coping strategies

LMSW EXAM – Bootcamp!, LMSW, LMSW (Updated Spring 2023) A+ guide.

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