LCSW

Base answers on what you study and learned in classroom and textbook.

Think, How should I handle this question?

The questions are universal as they're a ton of different specialities in the field so everyone needs to know how to answer.

what did I study in this guide that relates to the question?

Focused to a scenario and applying the information.

Focus, remember you are being tested on content of the book. The application of social work knowledge.

Don't get lost in the scenario.

application of sw knowledge and does not change regardless of the setting

The content might be different but each discharge plan has to contain the same things in each area. Focus on content being tested.. CORE SOCIAL WORK CONTENT is being tested

There is only one correct answer. Don't think about your state, think any state - answers apply to the country

the best answer is not always the correct answer. No catchy social work phrases. Make sure answer FITS scenario. What is the right answer to this question on this exam

Choose from the answers you do know.

you have plenty of time. answer questions in order listed, Do not skip. Should not have to re-read more than 3 times

look for qualifying words: best, next, least, most , first and not. When you read the response choices or answers. Put the qualifying word in front of it in order to focus on what, in this question, is important.

trust vs mistrust - birth to 1- confidence and security

Autonomy vs. shame and guilt - 1-3 looking for independence

Initiative vs. Guilt - 3-6 - initiative, feel secure with abilities , lead and make decisions

industry vs. inferiority - Puberty - if encouraged they are confident and industrious.

identity vs. role confusion adolescence - begin to form their own identity

intimacy vs. isolation young adulthood - look to others outside to have a relationship

generatively vs. stagnation - middle adulthood establish careers and settle down. part of a bigger picture

ego integrity vs. despair - senior citizen - develop a sense of integrity

know an inch deep and a mile wide - do't have to know everything thoroughly.

look at things from a theory, practice model and perspective. Answer through that lens. look at what lens they want you to use. identify what answer most related to paradigm.

theory - concepts from explains every day life

practice model -way theory is used
perspective broader concept

Don't add material to the question. Ask yourself how would a non social worker answer this question. STAY with the material from the question and do not add information based upon practice experience

knowledge - recall fo facts

comprehension -understanding what the facts mean

application - correct use of the facts

analysis - breaking down information into component parts

synthesis - combination of facts, ideas and information to create whole

evaluation - judging and forming an opinion about info

sensormotor- (0-2) action, objects, imitate concrete

pre-operational - (2-7) abstract thinking, comprehend time and speech, magical thinking, imaginary friends. night terrors

concrete operational - (7-11) abstract thinking , cause and effect, games with rules, thinking separateLY,.

Formal operations (11 and up) future planning, adult roles

pre-conventional - elementary school
1 - obeys to avoid punishment
2 - obeys to receive reward

conventional - early adolescence
3 - follow rules to gain approval
4 - follow rules to avoid guilt. rules are rules

post conventional - adult
5 - Welfare of others
6 - morality, ethical principles

- physiological - oxygen, food, water
- safety and security
- social - love, friends, sex
- esteem - respect
- self actualization - on going process, place of growth

positive (added) reinforcement - increases that behavior will occur (give token)

positive (added) punishment - behavior increases. (shock to eliminate behavior)

negative (subtracted) reinforcement- behavior increases bc negative is removed (remove shock)

negative ( subtracted) punishment - take away token for the purpose of decreasing behavior

Dog/Bell

look for quotation marks, clues in the last sentence before response. Both key to right answer

exposure therapy

Engaging
Assessing
Planning
Intervening
Evaluating
Terminating

First, Next, Most - Go through Maslow's Hierarchy of Needs. Health and Safety First w/o this they cannot meet higher needs

Don't dx if person doesn't have All of the symptoms needed. Use a generalist approach. All behaviors and feelings do not have to be part of the intervention. Some things are not clinical issues that need to be addressed.

intellectual disability- IQ

Austim - difficulty emotion, communication. Rigid thinker, likes routine sensory issues, Must appear by 12 y/o

ADHD - hyper, active, unable to control emotions, unable to sustain interest or focus. Must appear by 12

Specific Language disorder - unable to improve even with tutoring

Motor disorder - onset early on. Clumsy, performance below average

tic disorder - tourettes, unexpected movements

stuttering

Delusions - can be w/o AH/VH. Functioning isn't always affected

Brief psychotic - 1 day - 1 month

Schizophrenform - ?

schizophrenia - symptoms for 6 months, 1 month of active symptoms.

schizoaffective - schizophrenia paired with another mood disorders

catatonia - 3 of 12 Could be a specifier of dx

Bi-Polar 1 ( previously known as manic depression) and Bipolar 2
can have mixed features
Manic and depressed at the same time
Manic or hypo-manic - changes in activity and energy

Bi=Polar 2 - absence of delusions or psychosis

Cyclothymic - period of 2 years hypo mania and major depression has come and gone.

MDD - 2 week time before dx ( single or recurrent episodes)

* with anxious distress - when there is a possibility of mania

DMDD - Childhood Bi-Polar Disorder, dx up 18 y/o

Persistent Depressive dx - used to be be called Dysthima.

NEW - Premenstrual Dysphoric Disorder - 5 or more of symptoms occur final week before period, improves around 5 days after period starts

seperation anxiety - was part of early onset
selective mutism - was a part of early onset

phobias - disproportionate fear to something

social anxiety ( used to be social phobia) - fear of situation where evaluated by others. Must persist for at least 6 months. This Phobia must effect social and work and every day activities

agoraphobia - public transportation, being in crowded or enclosed space. This is for 6 months

GAD - anxiety more days than not for 6 months. Worry, ruminates

body dysmorphic - not realistic view of body. See defects and flaws physical appearance

hoarding (new)- not getting rid of things. There are specifiers

trichotilomania - hair pulling

excoriation (new) - skin picking

Obsessive compulsive - new

rumination - any age ( feeding and eating disorder)

Bulimia - 2 times a week for 6 months at let's 1 time a week for 3 months

Pica

PTSD - lasts at least a month. After traumatic event

adjustment disorder- within 3 months of events. experience multiple symptoms and anxiety. if continue for 6 months

enuresis - urine
encopresis - feces

gender dysphoria - cross gender identification, discomfort of their sex

Gambling Disorder- new

somatic - no evidence that client is deceiving

factitious Disorder - slight agitation of physical symptoms. The most extreme is Munchausin. This person wants to feel the sick role

sexual dysfunction require 6 months and more exact criteria

gender dysphoria - now it's own category cross gender and aversion to ones own gender

somatic - mental turn into physical symptoms, last 6 months

factitious -slight exaggeration of physical symptoms, extreme form is Munchausen Syndrome and person seeking invasive procedures, sometimes risk of life. provide untrue information

Malingering - focus of clinical attention , not in DSM though. Provide untrue information

conversion - unexplained symptoms that suggest a neurological / medical condition

General - inflexible and enduring behavior patterns that impair social functioning

CLuster A - odd/ecentric
Paranoid - distrust and suspicious. Negative, all based without evidence, aggressive angry out bursts

Schizoid - detachment from relationships. Flat affect, lack of emotion. introverted

Schizotypal - lacking social skills, strange, odd behaviors and beliefs, odd and eccentric, paranoid, magical thinking

Cluster B dramactic/emtional
Anti Social - Impulsive, irresponsible, legal difficulties, no respect for others

Borderline - instability of interpersonal relationships, impulsive , abandonment issues, mood changes, self destructive

Histrionic - excessive attention seeking behavior, emotional, need to be appreciated, overestimating abilities

Narcissistic - need admiration and lack of empathy. Exaggerated self importance, over sensitive to failure

Cluster C anxious/fearful
Avoidant - preoccupied with dis approval, socially rejected. chronic feelings of inadequacy

dependent - chronic need to be taken care of, fear of abandonment, passive, trouble making decisions

Obsessive - Compulsive - perfectionism

Civil Rights Act 1964 - no person should be excluded due to colorace. NOt be subjected to discrimination

The Child Abuse Prevention Act 1974 - child abuse and neglect. Provides Grants to go towards prevention

Older American ACT - services for elders. Fund to those over 60. provide service for those in need

Family Educational Rights and Privacy act 1974 - privacy of educational records after 18, Allowed to dispute if misleading or

The Education for all Handicapped Children Act of 1975 ( Individuals with Disabilities Education Act- public education for a kids with disabilities from 3-21, IEP

Indian Child Welfare Act of 1978 - tribe , cultural continuation. Law specifies placement in Indian home before anywhere else

The adoption Assistance and Child Welfare Act - keep families together and keep kids out of foster homes, child welfare cases reviewed a lot, children need to be seen every 6 months if not home. Adoption reimbursement if child has disabilities

The Americans with Disabilities Act -protect disabled from being discriminated against., employers need to have resonable accommodations.

The Patient Self-Determination Act - Advanced Directives. Can be paired with living will to give themselves some control at end fo life

Family and Medical Leave Act - 12 weeks unpaid medical leave and job will be there when you return

The Multiethnic Placement Act - Can not refuse adoption or placement due to color or race. Have to recruit people from everywhere to provide diversity

The Violence against Women Act - Strengthing penalties about violence against women. Ensuring assistance to re-build life. It now includes Indians and LGBTQ.

The personal Responsibility and Work
opportunity Reconciliation Act -federal cash assistance to the poor. Added opportunities to learn to get back into workforce. Lifetime 5 year limit

Closed system - uses energy and dies

Differentiation - becoming specialized

Entropy - closed, disorganized, used up energy

Equifinality - arriving at the same end from a different beginning

Homeostasis - steady state

Input - obtaining resources necessary to obtain a goal

Negative entropy - exchange of energy and resources btw systems to promote change

Open system - system with cross boundary exchange

Subsystem - made up of 2 or more components that interact in order to obtain their purpose of the system they are embedded

Output - a product of a system that exports into the environment

Supra-system - entity that is served by a number of component systems organized in interacting relationships

Throughout - energy that is integrated into the system

Denial is the refusal to accept reality

Regression is the reversion to an earlier stage of development

Acting Out is performing an extreme behavior in order to express feelings

Dissociation is when a person loses track of time and/or person, and instead finds another representation of their self in order to continue in the moment. A person who dissociates often loses track of time or themselves and memories

Conversion - physical manifestation of a feeling

Compartmentalization - parts of oneself are separated from awareness

Projection- feelings or impulses onto another person who does not have those thoughts, feelings or impulses.

Reaction Formation - unwanted or dangerous thoughts, feelings or impulses that are the opposite of those she harbors consciously or unconsciously

Repression is the unconscious blocking of unacceptable thoughts, feelings and impulses.

Displacement is the redirecting at one person or object, but taken out upon another person or object.

Intellectualization- avoids uncomfortable emotions by focusing on facts and logic

Rationalization - believable explanation for irrational behavior

Incorporation - parts of a person is figurative ingested

Undoing - attempt to take back an unconscious negative behavior or thought

Sublimation - channeling of unacceptable impulses, thoughts and emotions into more acceptable ones.

Compensation - counterbalancing perceived weaknesses by emphasizing strength in other arenas.

Assertiveness - person's needs or thoughts in a manner that is respectful direct and firm.

Devaluation - BPD person attributes exaggerated negative qualities to self and others

Isolation of Affect - unacceptable impulse or idea removed from memory , thereby remove the emotional charge associated with it

Projective Identification - BPD seeing others people behavior as a reflection

1. Differentiation - maturity level and be independent from family and return

2. Emotional Fusion - emeshed with family. family is too fused than it is hard to be objective.

3. Multigenerational Transmission - gives present context in history, passing things down from generation

4. Emotional Triangle - Relationship btw 2 pp. When anxiety is introduced, the 3rd party is introduced to reduce anxiety

5. Nuclear family - your family, basic unit

6. Societal Regression - viewed society like a family

the verb choice can help and provide clues, Explore and engage are active verbs - less empowerment and relies on client too much
Provide - asks what a sw should do in situation
Ignore or sw isn't taking action right away.
Use when looking at 2 choices

1. Clarifying problem

2. Formulating goals

3. Identifying conditions

4. Selecting target behaviors

5. treatment plan

6. Implementing treatment plan

7. Evaluating the success

8. Changing the treatment plan if need be

Behaviorist - Pavlov (ringell and Skinner (operant)

Cognitive - Piaget (internal mental process)

Humanistic - Aimed at reaching full
potential (Maslow Hierarchy of Needs)

Social - Bandura (learning through people and environment)

How to determine the correct order. When asked what steps should be taken, you need to figure out what part of the assessment ... what comes first or next....

EAPIET
Engagement
assessment
Planning
intervention
evaluation
termination

if age is mentioned then it's the main part of question. If someone has an imaginary friend at 4 vs. 40 different steps would be taken. Also indicates life course

when there is a barrier to meeting the clients needs, sw needs to take responsibility removing the barrier. CLient is the expert and ensure client he will get what is needed. WHAT IS BEST FOR THE CLIENT

understand the question FIRST before looking at answers
1. read, look for verbs, quotes FIRST
2. What is this questions about - decide FIRST
3. Now look at answers and read carefully
4. Eliminate, each time, read the question and the answers that are left

Buzz Words - Read the rest of the question. Don't be influenced by Buzz words, doesn't mean it's right. Have to read the question crictally

Answer needs to stand on its own merits. Some buzz words:
rapport
empathy
support system
joining with the client
strengths perspective
clients perspective

Dont always have to have a resolution in the answer, they dont ask "solve the problem"... What you should do FIRST. Need to follow chain of command

It will lead to trauma IF happened unexpectedly, unprepared, powerless to stop it, happened repeatedly, intentionally cruel, happened in childhood

Flooding - flood with anxiety

In Vivo Desensitization - anxiety with increasing intensity - gradually increasing anxiety-triggering stimuli at a rate that is pleasant EDMR

Systemic Desensitization - cognitive oriented anxiety pair with relaxation, behavior is reinforced by reward

Rational Emotive Therapy (RET)- change irrational beliefs by intro new non distressing self statements

Token Economy - token/economy serves as currency and can be exchanged for desired goods

Aversion Therapy - treating alcoholism with Antabuse

Conflict - compete for scare resources. Social change is driven by conflict

Rational Choice - goal directed. Power comes from unequal resources. Maximize rewards, minimize costs

Social Constructionist - common understanding of the world

Psychodynamic -conscious and unconscious. Early childhood are central motivating force. Use defense mechanisms to avoid being overwhelmed

Developmental - defined age builds upon each other. bio, psycho and social factors

Social Behavior - when clients interact with the environment. all behaviors can be changed through conditioning classic and operant

Humanistic Perspective - clients have capacity to change themselves. Driven by desire for growth and competence

cognitive - mental skills/knowledge (knowledge)

Affective - growth in feelings in emotional (attitude)

Psychomotor - manual or physical (skills)

Respondent - involuntary behavior ( anxiety, sexual response)

Operant - involuntary controlled by its consequences in the environment.( walking and talking)

Infants/Toddlers ( 0-3) - build trust, "baby talk"

Young Children ( 4-6) - improving motor skills, symbols and memory, toilet train, sensitive to others. Need safety habits, clear rules

Older Children (7-12) - going into puberty, cause and effect, sense of self, independence. Talk about peer pressure, drugs and alcohol, tobacco. . Communication. Build self esteem

adolescence (13-18) - critical because they learn abstract thinking, moral, moving to bigger sense of self, growth, abstract thinker, own identify, balance peers/family. Promote sexual response

Young Adult (18-35) -hits sexual and physical maturity, skills to problem solve, career, closeness of others, family

Middle age (36-64) - women menopause, might have health problems, life experiences, avoids feeling stuck, focus on strengths, , plan retirement

Older (65-79) - age gradually, help issues, takes on new family roles, memory might decline acceptance of aging

Elders (80 - up) -accepts end of life changes, major health problems, encourage independence, support end of life decisions and self care

· Universalism - there is one acceptable norm or standard for everyone

· Dichotomous Thinking - "either or" thinking

· Heightened ability/value on separating, categorizing, numbering "left brain"

· High value on control, constraint, restraint rather than feelings and emotions. Ideal to be objective

· Measure of self comes from the outside and only in contrast to others rather than from within

· Power defined as "power over" others vs. mastery of environment or in harmony with others by sharing power

countertransference - a redirection of the SW feelings toward client; entanglement with client. Gives insight. Role of Supervisor is also played out

transference - redirection of clients feelings for another person to social worker.

Parael Process - unconscious identification with the client-and can be used as a part of the supervisory process

- identify and manage challenges
- become aware of vulnerabilities
- Achieve balance in life
- Enhancing overall well well-being - health, stress, emotional and spiritual beliefs, relationships, and managing work life balance
- burnout/emotional fatigue
-secondary trauma
- compassion fatigue

Sexuality changes with each stage of development

infants - boys erections in uterus, masturbation and orgasm, know gender by 2 and why different

children - playing doctor or house

pre-adolescent - puberty begin 9-12 y/o. masterbation, uncomfortable undressing in front of different sex. Group dating

adolescent youth ( 13-190 interest in romance, sex, relationships, sex at 20,

adult - varied, around 50 menopause, women orgasm whole life, men erections slower and less often, less ejaculation,

Read Code of Ethics
Determine if there is an issue,
Read Code of ethics
Suggestions
Implement modification
Monitor for new issues

Replaced by the GAF. Used worldwide, scales to ADL's, how you get along with other. Global assessment on functioning. ADL's day to day life

individuals are unwilling to accept will greater than own. reckless and chaotic. Lack of empathy

blind faith in authority - right/wrong

Science Skepticism and questioning critical
individuals , does not accept faith

enjoys the mystery of existence no faith, only convinced if logical

ethnic - member of a racial group

race - not fixed

cultural identity - defined by the identity of group , culture

3 stage of Identity Development

1. unexamined - cultureacial and ethic identity

2 Identity search - cultural, racial and identity search, exploration

3. identity achievement - clear sense of culture, racial and ethic

pre-counter - not aware
encounter - promotes thought about role
emersion - period of exploration
internalization/commitment - clear sense of identity

people that don't fit the majority were disabled

infants are biologically/ born predisposed to form attachments. Attachment important for firs 5 years

- attachment - classical conditioning - learned behavior - who feeds baby, learns smiling will get positive response

- insecure attachment - links to psychiatric disorders

biological - genetics are responsible for personality

behavioral - interaction btw individual and the environment

psychodynamic - unconscious mind

humanist - individual experience in development of personality. CApactity to grow and change

Trait - characteristic

authoritarian - strict rules, punishment, dont explain ( kid not as happy)

Authoritative - rules expected to follow, democratic, parents more nurturing an forgiving ( happy and capable)

permissive - few demand on kids, dont disipline ( issues with self regulation and school

uninvolved - few demands, little communication ( low self esteem and less competent )

A sequence of stages that families tend to progress through. SW use person in environment often

family origin - develop foundation of family life

leaving home - adult to adult relationship with parents

pre-marriage stage -select partner, own home

couples stage - live together, include partner

Family with young children- parenting, making space for kids, peer relationships

Family with Adolescents- more autonomy, mid-life relationship and career

Launching children- nid-life issues, adult relationship with kids, dealing with disabilities and death

Late family life- decline in self and others, preparing for death, value elders

-partnership with client

-creating opportunities to display competency \environmental modification

- resource and target intervention

Positive with this approach:
instill hope
change is possible
glass half full
empathy
nonjudgemental
partner in treatment

Denial and Isolation - this cant be happening to me

Anger - why me, emotional confusion

bargaining - negotiate with one self or higher power to attempt to change what occurred

Depression - sadness and loneliness

Acceptance - eventually will have peace

interplay btw bio, psycho, social

understand individual in light of environmental context, developed as an alternative to the commonly disease and moral models ( DSM). Client centered

environment- can have strong impact

· Id - newborns, it allows us to get our basic needs met, whatever feels good at the time. "Pleasure Principle"
·
Ego - Reality Principle the awareness that gratification of impulses has to be delayed to accommodate demands of real world. Ego to determine

Ego syntonic - in sync with ego (no guilt)

Ego dystonic - out of sync with ego (guilt)

Ego strength ego can effectively deal with the demands of the id, the super ego and reality

Superego moral part of the personality, and ethical restraints

1. Pre-affiliation - development of trust ( forming)

2. Power and control - (Storming) assert individual personalities and group identification

3. Intimacy -(Norming) utilizing self in service of group

4. Differentiation -(Performing) acceptence of each other as distinct individuals

5. Separation - (adorning) independence

· Adaptation: The human ability to adapt.

· Aim Inhibition: lowering sights to what seems more achievable.

· Altruism: Helping others to help self.

· Avoidance: mentally or physically avoiding something that causes distress.

· Conversion: subconscious conversion of stress into physical symptoms.

· Emotionality: Outbursts and extreme emotion.

· Help-Rejecting Complaining: Ask for help then reject it.

· Idealization: Playing up the good points and ignoring limitations of things desired.

· Identification: Copying others to take on their characteristics.

· Introjection: Bringing things from the outer world into the inner world.

· Passive Aggression: Avoiding refusal by passive avoidance.

· Performing Rituals: Patterns that delay.

· Post-Traumatic Growth: Using the energy of trauma for good.

· Provocation: Get others to act so you can retaliate.

· Somatization: psychological problems turned into physical symptoms.

· Substitution: Replacing one thing with another.

· Suppression: consciously holding back unwanted urges.

· Symbolization: turning unwanted thoughts into metaphoric symbols.

· Trivializing: Making small what is really something big.

Past history of violent behavior is best predictor of future violence

Static Risk Factors - cant be changed by interventions. Past violent behavior or demographic info

Dynamic Risk Factors -can be changed, each person has own set of risks, will need individualized plan

Risk Factors - stressors, poor skills, family issues

Intervention-to reduce risk - pharmacological, substance, psychosocial, remove weapons, increase supervision

A crisis is to Upset a steady state
Clients emerge happier when crisis is understood, dealt with, and overcome

life event occurs, seen as threatening, family response disorganized, family searches solutions, family adopts new coping skills

Goal is to solve strengthen problem solving skills, solve constructivly

S- Specific
M- Measurable
A- Achievable
R- Relevant
T- Time Specific

-plan and conduct biophysical- spiritual --assessment of lethality first
-establish relationship
-identify problems
-exploration of feelings ( validate)
-new coping - brainstorm
-Action plan - restore functioning
-Plan Follow up

family-control/provide - regulate sex, children, economical and emotional maintenance, socialization for kids

religion -to support/provide-solutions unexplained, support structure of society, diversion from unwanted life situations

government -enforce laws, conflict in court, welfare members of society, protect external threats

education - transmit culture, to prepare for jobs and roles, evaluate and select competent individuals, transmit function skills

economics - production and distribution of goods and service, allow others to buy what produced

romance - (attachment), differences minimized, putting needs of others before own

power struggle - differences from mate, notice things over looked, focus on differences, time away needed or seeing someone distinct within the relationship, accepts partner without a need to change them

stability - focus on personal needs, acceptance of each other, power struggle is minimized. balance intimacy and self discovery, Accept them without the need to change them

commitment - marriage

co-creation - appreciation for love, support and mutual growth

sexual, gambling are considered addictive
Korasoffs syndrome - has memory problems from abuse

Goals of Treatment
-abstinence
-maximizing functioning
-Preventing or Reducing the frequency or severity of relapse( happens usually at the beginning)

Stages of Treatment
- Stabilization - committing to self to make a change

- Rehabilitation - focus on remaining substance free. need coping skills, increasing supports and grieving loss

- Maintenance - focus on gains made, relapse prevention and termination

Treatment Approaches - medications, modify maladaptive with therapeutic intervention, Behavioral therapies, behavioral therapies - stop the behavior, self help groups

Drugs can create destructive patterns of co-dependncy

illusion of invulnerability - excessive optimism

collective rationalization - do not reconsider assumptions

belief in morality - believe in the rightness of their cause ignore negative consequences

Stereotyped views - on "the out"conflict enemy makes conflict seem unnecessary

Direct Pressure - under pressure to not start conflicts with group

Self Censorship - doubts not expressed from previous groups

Illusion of unanimity -assumed to be unanimous

self appointed mind guards - members of group and leader to protect - problematic

cognitive dissonance - choose btw 2 different beliefs

double blind - offering contradicting information and prohibiting the client from noticing

meta-communication - interpret the context of message through non-verbal

echolalia - repeating noises and phrases

Social Order is maintained by consensus with the greatest power and resources

a physical or mental condition that limits a person's movements, senses, or activities.

poverty has a relationship with disability, environment plays a role when outside of institutional settings

personal desires put over family, try to be friends to avoid punishing them
long winded and impersonal
religion is a private affair
capitalism
poverty a moral failing
white skin, blonde hair, thin is ideal look
sports
democracy and freedom and individual rights

complex family org
group valued over individual
husband and wife communicate with their gender group
avoid direct eye contact
indirect and comfortable with silence
holistic, interconnectedness
spirituality fundamental part of life

patriarchal system, wife has lower status to all men including son
hierarchal family structure
less emotional and reserved
spirituality Confucius and Buddhism
shaming, adhering to the rules toi conduct self and family
require lower doses of medication
resistant to try meds rather they prefer homeopathic ways

multi -generalization family system, kinship bonds
adoption of others outside family
flexible family roles
women viewed as the strength of the family
animated, physical touch, respect at all times
church central
distrust of government and social services
strong sense of pride

family is not restricted to those of blood, we are all related
many different languages and customs. . 1 of 2 official states with native language, knowing english access to health
believe that spirts are found in nonhuman beings and objects
focus on community; benefit whole andre responsibility to share talents to benefit whole, sharing central

obligation to family, group rather than individual, male has greater power. Often speak Spanish in an expressive manner when talking english more reserveduarded. Wish to improve life circumstances on micro and macro level, dignity of self, respect elders, proud of heritage

sexual orientation- do not choose, simply part of who they are.

sexual behavior - sexual contacts and actions. Can be influenced by others, family and culture expectations,

sexual identity - way people present their sexual preferences

Transgender - gender identity does not typically associated with their assigned sex at birth. This thought can change even when very young. Sexual identity does not match their external characteristics

Transitioning - live the gender desired and sometimes take hormones and have surgeries. They are finally matching outside and inside as a long period

attraction that cross many pansexual or queer
unsure about orientation are curious/questioning
no attraction - a sexual

gender fluidity - go back and forth in dress or description

21 item test, multiple choice; assesses the presence and degree of depression in adolescents and adults

personality test, 550 statements, 16 repeated

(MBTI) classify 4 independent dimensions
-introvert-extrovert
-sensation or intuition
-thinking or feeling
- judging or perceiving

Rorschach - ink blots

Stanford - Binet Intelligence Scale - cognitive abilities, both adult and children

Thematic Apperception Test -series of pictures shows imagination and perceptions

Wechsler Intelligence Scale - measure a child's intellectual and cognitive ability

Delirium - altered level of conscious, lethargy/hyperactivity, impaired attention, acute, does respond to treatment, memory immediately affected, disorganized irritable, aggressive and earful

Dementia - deterioration over time, progression slow but stable., recent impaired, impoverished thinking, impaired ADL's, fairly stable, labile, apathetic, irritable, more impaired as disease progresses

Depression - chronic, responds to treatment, selective impairment, may voice hopelessness and self depreciation, stability varies, flat , unresponsive or sad, maybe irritable, may neglect self care

Achievement and Aptitude - how much they have achieved and their ability yo learn

Intelligence - IQ

job/occupational test - matches interested and careers

personality test - personality traits and characteristic's

Neuro Psych Testing - measures cognitive functioning
specialized Clinical Tests - anxiety, depression, PTSD and so on

realize - the wide spread impact on trauma, and potential paths for recovery

recognize - signs and symptoms of trauma

Respond- integrating knowledge about trauma into SW procedures

Seek - actively resist re-traumatization

facing problems by seeking help,
sharing problem with SW,
Persevering under difficult situation, resourceful,
meeting family and financial obligations, understand actions of others,
function under stress,
considering other course of action

seeking exceptions -determining the problem does not exist or occur,

scaling the problem -1-10 scale

scaling motivation - what degree does the client hopeful about resolution

scaling motivation - how hopeful about resolution,

miracle question

limiting information,
silence/minimal talking,
small talk,
false promising,
delayed payment,
missing appointments

pre-contemplation - unaware or unwilling to change. Lack of Motivation/Resistance

contemplation - to consider

preparation - preparing to change

maintenance -ability to maintain new behavior

Ego Strength - the ability to effectively deal with the demands of the (ID -Super Ego - Reality). based on resilience and helps maintain emotional stability by coping with internal and external stress. Positive Ego Strength are less likely to have psych crisis

deleted section Children's disorders are moved into other sections

NO longer MR now developmental disability

Autism incorporates: aspergers, Pervasive development and Disintegrative Disorder

NOS eliminated= Now two options are Other Specified Disorder or Unspecified Disorder

Dropped Axis 1,2,3

Axis 5 was replaced significant psychosocial and contextual features

Dropped Axis V - dropped GAF

WHODAS added addedEmerging Measures and Models, under assessment measures

cannabis - new
Tobacco related disorder - new
gambling - new

oppositional Defiant D isorder-There are 3 types.

conduct disorder- behavior that violates the rights of others or society. 3 moths symptoms, 1 symptom 6 months

intermittent explosive disorder-

kleptomania.-stealing

post morbid - subsequent to the onset of an illness

Pre morbid - prior to the onset of the illness
Folie a deux - shared delusion

Malingering - intentionally falsely aggerated symptoms

Somatization - psychological distress turns into physical distress which could lead to over using the medical system(persistant considerable distress and disability)

differental dx - systematic diagonistic method used to idenify the presence where mutliple alternatives are possible

endogenous - depression caused by bio chemical imbalance

exogenous - depression due to external events

***A social worker must use a systems approach in assessment of clients mental health

Atypical Antipsychotics - Abilify, Seroquel and Zyprexa

Typical Antipsychotics - haldol ( injectible available) , Thorazine, clozaril ( must have blood monitoring), geodon, risperdal

*****Tardive Dyskinesia ( abnormal involuntary movements movements which normally selts from taking high doses of anti psychotics. Anti psychotics must be monitored. This goes away but can stay forever if nto treated

Mood Stabilizers - depakote, lithium (need blood levels as well as monitering thyroid and kidney), Lamictal, topomax

Anti depressents:
SSRIs - celexa, lexapro, Paxil, Luvox, prozac, Zoloft

TRicyclics - Elavil, etc

MAOIs - NARDIL AND PARNATE ( need to avoid foods that contain high levels of tyramine, food that has been aged)

Others - trazodone, Effexor, remeron, Wellbutrin

Anti-anxiety - Benzo's, high abuse potential, look for impaired motor functioning. Ativan, Buspar, KLonopin, Valium, Xanax

Stimulants for ADHD
Adderall ( mixed salts)
Concerta ( long acting)
Metadate ( long acting)
Ritalin
Dexedrine

Qualitative Research - collecting information in unstructured manner

Quantitive research collects data thru responses, distributing surveys

secondary data - information that has been collected for other purposes

existing data - data, concern due to reliability

data analysis cleaning, checking accuracy, entering into computer

descriptive statistics - used to describe the basic features of data

Descriptive statistics - describe what data knows

Inferential statistics - used to answer research questions or test models

Formative Evaluation - looks at how the work gets done and satisfaction of employees

Outcome Assessment - defined differences made

reliability - can you get the sama answer repeatedly

validity - is what believes to be measured actually being measured or something else

external validity - can the results be generalized

internal validity is their confidence in cause/effect

engagement - why treatment was sought by sw and client/ expectations for treatment. Client involvement is essentiality

assessment - client is the source of providing essential information and defining collateral contacts

Planning - develop a common understanding of the clients preferred lifestyle. Goals are developing order to specify-who will do what, resources used, and timeline

-define problem
-examining the cause of problem
-possible solutions
-identify driving and restraining forces for
=implication
=Rating
-Prioritizing
-SMART objectives - specific, measurable, ----achievable, relevant, Time specific
-Strategies and Activities

=========================================

intervention - client actively involved
progress must be tracked thru clients eyes. Adjustments can be made throughout

evaluation - subjective reports of clients, goals met and wether new goals should be in place

termination - client reflects on what has been achieved, supports in place if problem starts again

incorporates a greater cultural sensitivity
the cultural Formulation interview guide included o help SW assess cultural factors influencing clients perspective

micro intervention - therapy, case management, education of crisis intervention

macro intervention - advocacy and organizing

evidence based - select if possible

data collection - intervention plan is driven by collection of this information as a part of assessment

Based on an understanding of the vulnerabilities and triggers in psychiatric patients who have histories that include violence and victimization.

safety and stabilization - basic needs not being met, repeat behaviors experienced, SW interventions: obtain housing, health services, transportation, , developing safety plan, create coping skills

mourning remembrance - acknowledge and speak about what happened. Ready to integrate experiences in large life context Grieve for what was, psychoeducation

reconnection and reintegration - commitment to move forward, self care strategies, deepening resilience

psychological contact rapidly establishing the collaborative relationship

Idenify major prooblems

Encourage exploration of feelings and emotions

generate and explore alternatives and new coping

restore functioning - active plan

plan fu and booster sessions

ADHD must appear by 12 y/o

Schiphrenia - disturbance for 6 months and 2 active symptoms, Subtypes were deleted

Schizoaffective - requires mood disorder as well

CAtatonia - requires 3 of 12 symptoms. Maybe be a specifier for other dx

Bi-Polar - new specifier "with mixed features"

Bi-Polar 1 - mixed episode will meet all criteria for mania and depression

Bi-Polar 2 - MDD with hypomania for at least 4 consecutive days

New DMDD ( childhood bi-polar) dx up to 18 y/o

MDD 2 week time period

Persistant Depressive Disorder ( was dysthymia)

Prementrual Dysphoric Disorder ( new). Past year 5 of specifed symptoms must occur week before period

Social Anxiety - 6 months or longer, distress and impairment

Delusions - can be w/o AH/VH. Functioning isn't always affected

Brief psychotic - 1 day - 1 month

Schizophrenform - ?

schizophrenia - symptoms for 6 months, 1 month of active symptoms.

schizoaffective - schizophrenia paired with another mood disorders

catatonia - 3 of 12 Could be a specifier of dx

Sexual disfuntion - 6 months or more exact severity criteria

Substance abuse disorder- this is the disorder is now the only one ( used to be broken up into 2) with the specific substance

Comorbid - existing at the same time

contraindicated - medication or treatment not recommended or safe to use

delusion - false, fixed belief that is not true
disorientation confusion with person, time, place

Disassociation - disturbance or change in memory ( seen in clients with trauma background)

Endogenous depression - caused by chemical imbalance

Exogenous Depression - caused by external events

Folie a deux - shared delusions

Hallucinations - usually AH seeing, hearing, smelling, feeling something that is not there

Hypomanic - elevated, expansive, irritable mood less severe than mania, sometimes doesn't effect functioning

Postmorbid - subsequent to onset of illness

Premorbid - prior to onset of illness

Psychotic - experiencing delusions or hallucinations

goal, identifying changes, whaat changes need to be made, , change strategies needed to reach goal, timeline for completing these actions

Important to create a contract or service agreement written or oral to address problems or concerns, interventions, activities. Identify people or agencies to help with process

Uses a three phase model for choosing appropriate treatment

1. safety and stabilization - establishing safety and stabilization
-basic needs not being met, due to trauma many times -in dangerous relationships or SIB, SI or risky behaviors
-SW helps to obtain housing, health services, transportation and supports
-need to safety plan and change coping into non harmful and learn positive

2. Mourning and Remembrance
- talk about what happened and ready to work
-psycho-education
- grief for what was and what was never needs to be discussed
3. Reconnection and Reintegration
- commitment to move forward
- learning self care and deepening resilience
- environment for treatment needs to be: soothing, attire professional, respect and on-time. Open stance, constantly address trauma status, respect cultures, avoid triggers
*** need to be aware of immigration laws, social and political issues

-Plan and conduct biopsychosocial and imminent danger assessment
-establish collaborative relationship
-identify problems
-Encourage explore feelings and emotions
-Explore new coping skills
-Generate new strategies and coping
-Restore functioning thru action plan
-Plan follow up and booster sessions

Code of Ethics Provides Guidance

- Terminate when no longer required or serve clients needs

- Assist making appropriate arrangements for continuation of services when necessary

- SW can terminate if client is not paying and client is not danger to self, discussed with client

- SW should not terminate to pursue social, financial or sexual relationship with client

- SW need to notify when services will be interrupted and seek transfer or help client with needs

- SW leaving must notify and seek transfer in re: to clients needs and preferences

- SW should inform client of options for service and benefits and risks

- Unethical to treat a client when not necessary

- SW should make effort to ensure continuity of care

- SW must include family when appropriate in making their own decisions about follow up. A meeting is needed

-SW are often responsible for coordination of clients follow up services

-Clients at risk need follow up assessments after discharge

Formative Evaluation - ongoing process

Summative Evaluation -occurs at the end of service/ outcome

Standards in Evaluation Process:

-must have written consent
-right to withdraw
- access to supportive services
- avoid conflict off interest

SOAP format ( often used in healthcare)

s - subjective - facts perceived by client

o - objective - facts of clients situation

a - assessment - pulls together subjective and objective and creates assessment

p -plan - what will be done after assessment

Research Design is a blueprint
identify problem
review literature associated with problem
specify research question
explain how data will be attained
describe methods to find out if true or false

experimental - randomized, most rigorous

quasi experimental - intervention and comparison groups. Non random

pre-experimental - intervention groups only, weakest

single subject - does it have intended impact on client. Used to study behavioral changes

Most common are:
pre-and post test or single case study (AB)
baseline (A)
intervention (B)

internal validity -casual inferences can be made about the intervention and behavior

external validity - general population

some cases would be unethical to withdraw treatment if puts client at risk.

In crisis, treatment would not be delayed in an effort to obtain baseline data.

4 ways to assess reliability:
interrater/interobserver reliability - consistent estimates of same thing

test- retest reliability - measure from one time to another

parallel forms of reliability - assess consistency of two test constructed the same

internal consistency Reliability - assess consistency of results within a test

Validity - what measured is what is claimed to be measured

most important is relationship with client and social worker
must have trust
listening on both sides
reflecting
paraphrasing
constructively assist

Engagement - building rapport, creating goals ( can see resistance and SW will need to explore)
Assessment - assess situation in order to select goals
Planning - how to employ goals

Advocate -goal of empowering client system; responsibility to advocate on behalf of those that can't

Broker - identifying, linking client systems, choosing service option an assist

Change Agent - part of group/org seeking to improve or restructure some aspect of service. Uses problem solving to identify problem. Acts in a coordinated manner. to help focus on the goals created.

Counselor - focuses on social functioning. Key function is to empower by pointing out strengths capacities to deal with problems more effectively

Mediator -intervene to help find compromise, reconcile differences and reach agreement. Meditator stays neutral

PRIMARY GOAL OF A SOCIAL WORKER IS TO ACT AS A RESOURCE, PLAYING DIFFERENT ROLES DEPENDING ON NEED.

1. recognize indirect and direct communicating styles
2. Sensitivity to non verbal cues
3. Generate a wide variety of verbal and nonverbal responses and strategies
4. use culturally appropriate language
5. identify own style and recognize limitations and strengths
6. identify and reduce barriers to engagement of those from different cultures

suspicious injury
somatic complaints
behavioral presentation
controlling/ coversive behavior of partner

phase 1 tension building
phase 2 battering incident
phase3 honeymoon stage/assures never happen again

Batterers - self centered, entitled, experience trauma in the past, , victims are possessions

Stay: thinks behavior will change, lack of supports, doesn't think anyone will believe, threatens will take children away or other things, more dangerous to leave, cant afford to be on own. Clients leave when reward is better than staying

active listening- sitting forward, asking questions, open ended statements

silence by sw - acceptance of feelings and promotes time to think. Effective when emotions are high

questioning - open and closed formats to get information in non - judgment way

reflecting /validating - empathize, can assist with negative thought patterns

paraphrasing and clarifying-rephrase in order to join with client. Clarifying is when paraphrase to understand clients needs

reframing- showing a different perspective to change negative into positive

facial expressions- desirable and appropriate gestures, direct eye contact

postures or gestures- arm gestures and movements

-ask verbally or non-verbally if an intervention should be altered

-feedback can be verbal or non-verbal. Look at behaviors of client or verbally ask

-clients need to provide consent if the client is working with a consultant

- ask for feedback, best learning can be from those who will be critical. Talk about feedback in supervision

-Feedback is critical at key decision points ( transferring or closing cases)

-Be careful to guard against influencing, sw has more power than client

-Confidentiality should be respected

-Always be clear why feedback important

-Document feedback

-Feedback will be different depending on when it is asked for. Ask a couple different times to see if responses different

- Method for feedback can be different depending on the person. Ask close ended questions and/or open if additional information needs to be captured

one on one feedback - giving feedback to another, usually face to face

intra-group feedback - individuals give feedback to group and/or one or more individuals

group to group feedback-btw 2 groups. Could be group to group or one member of one group to another group

consultative feedback - consultant ( 1 or more pp) gives feedback. Person more apt to accept because it's coming from a professional

360 feedback - feedback reflects multiple view points and give complete picture. Should be supportive and coming from a strengths perspective

universalization -the generalization or normalization of behavior

clarification - reformulate problem in clients words to make sure SW is on the same wave length

Confrontation - calling attention to something

Interpretation - pulling together patterns and behaviors to get a new understanding

Reframing, Relabeling - stating problem in a different way so a client can see possible solutions

summarization - bring important points together to give SW and Client awareness of progress made. Gives Sense that Sw and client understands each other, can provide closure, organize unrelated materials. it is not ok for family members to interpret or provide services SW cannot. If using interrupter SW must face the pt and not get opinions from interrupter

Maslow's theory that human needs:
- physiological
- safety
- social
- esteem
- self-actualization

this helps find where intervention should start. whats the priority. Medical and substance use need to be addressed first

Steps taken:

engagement - why change sought, what caused desire to change and define the role of SW

Assessment - define problems and solutions, also define collateral contacts

PLanning -Create Action Plan, what reasources and how used

Intervention - issues that might threaten attainment need to address. Track and plan and if need be adjust

Evaluation - use subjective and objective to determine if goals were met or new ones need to be created

Termination - goals achieved and idenify supports if needed in future

micro -helping client solve their problems, can access from other sources

mezzo - apply to larger group, make connection btw mezzo and micro

macro -aim at helping not only indivdual butothers expweriencing same difficulties on broader leave;

EAPIET
engaging
assessing
planning
intervention
evaluation
termination

motivational approach and help identify what can be worked on.

if person is symptomatic - need to help think of a time when things were better and how can get better
create motivation to change and increase client motivation.Empathy is a must.

Techniques:
-identify problem
-why is change important
-advocate
-identify barriers
-best course of action
-setting goals
-taking steps towards change
-preventing relapse

-acknowledge
-listen
-Engage
-Purpose of Intervention
-Assisting
-Building Trust
-Practical Assistance
-Paying Attention
-Empathy

Explanation,Preparation, Role Playing, Debriefing

symbolic - filmed demonstrating desired behavior

self -clients are video taped

participant - SW shows the behavior and client engages in behavior

covert - imagination and visualize behavior

recognition, assessment, strategy, intervention

if it doesn't work, decrease contact btw parties, decrease time btw problem solving sessions, decrease formality, limiting scope of issue, use mediator

healthful ways to control and express anger, such as journaling, exercising, speak slowly focusing on goals, putting things in perscpective, listen, and keeping a sense of humor, walkign away if need be if evokes anger.

Examining rishs by taking follwoing steps
-appointing a commitee of concerned people
-gathering infromation
- reviewing collected info
- determining risk level
-preparing action plans
-monitoring progress made

Risk Management is an ongoing process and will need to be adjusted if need be when audits are done. Stradgies already in palce

Psychotherapy - therapy and medication
DBT - Marsha Linehan for BPD and SI
CBT - used for depression and anxiety
Psychodynamic - explain origin of personality, unconscious, as importance of childhood memories. Painful memories are resolved by using defense mechanisms

conscious - pay attention to at any given time

preconscious -information outside of clients attention

unconscious - thoughts and feelings client doesn't have awareness of

Fixation happens when hard to transition from one stage to another

Castration Anxiety is fear that he will have penis cut off by father due to his desire for mother.

Oral stage: Birth to 18 months. The mouth - result fixation smoking, overeating, dependence on others

· Anal stage: 18 months to 3 years. The anus. Results of fixation controlling, easily angered

· Phallic stage: 3 to 6 years. genitals. Results on fixation is guilt or anxiety about sex. Opedius OCmplex ( desire mtoher and hostility towards father)

· Latency: 7 to puberty. Sexual urges are submerged. No fixations

· Genital: Adolescence. sexual urges return, genitals. No fixations

individual psychology, birth order, main motivation for behavior are not sexual or aggressive urges, but striving for perfection

§ Compensation - attempt to shed normal feelings of inadequacy

§ Overcompensate - exaggerated sense of inferiority which they try to cover up

a better sense of self-cohesion through therapeutic regression.

Self object needs:
· Mirroring - validates childs sense of self

· Idealization -idenifies with someone more capable

· Twinning/twin ship - needs alter ego for belonging

· The rational, conscious process and In the here and Now.

· Treatment focuses on enhancement of ego functioning

· Behavior in relation to a situation

· Reality testing

· Coping abilities/ ego strengths

· Capacity for relating to others

Attachment with early stages of the mother

Stages of the separation-individuation process

· Autistic phase (birth-1 month). Infant is detached and self absorbed

· Symbiotic phase (1-5 months) - child is now aware of mother but no sense of self.

· Differentiation phase (5-9 months) - increased alertness and interest in the outside world.

· Practicing phase ( 9-15 months) - infants ability to crawl, becomes more distant from mother

· Rapprochement phase (15-24 months) - infant becomes once again close w/ mother and to be in sight in order for mom to read toddlers feelings

· Object constancy (24-38 months ) when child understands mother separate.

a therapeutic approach that teaches clients to question the automatic beliefs, assumptions, and predictions that often lead to negative emotions and to replace negative thinking with more realistic and positive beliefs

ensure sense of control that change is possible.

To facilitate:
-meet client where they are
-educate to improve skills to increase ability to self help
- Help client to secure resources
- unite client with others dealing with the same

Change stradegies, modifying systems, teach how to problem solve, behaviorial techniques, thoughts, individual actions(modeling and role modeling), feedback from others, SW advocate

Group is agent of change, confidentiality can not be guaranteed, can be issues if someone has SI or is needy
-Beginning states purpose ,
-Middle all of the work happens during this phase
-End reviews accomplishments

Types
open vs. Closed - open new pp can join at any time, closed is closed
Short Term vs. Long Term

must understand background and issues with functioning
awareness of the impact of diversity
understand family of origin, family structure
goal is to interrupt the circular pattern

- establish contract
- alliance
- where does the power reside
- determine relationship each member has to problem
- how family relates to outside world
- assessing interactions and influence of family history
- communication patterns
- identifying rules
- presententing symptoms
- flexibility of structure
- find out about external supports

Triggering emotional trauma and not repairing
inability yo bond or reconnect after damage is done
Lack skills and knowledge how to repair

Treatment techniques:
• Behavior modification - modify the behaviors so they can make changes

• Insight oriented psychotherapy - studying interactions to understand why couples interact the way they do

• Gottman method - healthy relationships know each others stresses and worries, fondness, manage conflicts, trust and are committed. Method focuses verbal communications o increase intimacy, respect and affection. Remove barriers

· Pretend - encourage voluntary control
· First order changes - super facial behavioral changes that do not change the structure of the system
· Second order changes - system is re-org and functions more effectively
· Family hemostasis - persevere familiar communication and org; resistant to change
· Relabeling - change label attached to the person or problem from negative to positive
· Paradoxical direction or instruction - explain so the person can control it in order to move client towards goal

Provision of resources - most basic needs; food, shelter etc

emotional support - supporting, providing comfort and support

life skills development -development of physical, emotional, educational and social

family system management - boundaries and behavioral standards

intimate relationship-intimate relationships are essential for emotional needs of partner

family hero - masking problems, the family hero tries to make up dysfunctional home life

scape goat - gets in trouble and behavior turns the focus away from dysfunction in the family

mascot - tries to get people to laugh to draw attention away from dysfunctional home life

lost child - loner and very shy. Becomes invisible to avoid adding to chaos

Therapist initiates whats happening in therapy
active, brief and task centered. Change in Behavior rather than change the understanding. Presenting problem is a symptom and response to issue. Work on altering feedback cycle

pretend - encourage family members to control behavior

first order change - superficial behavioral changes that
do not change the structure of the system

second order change - system is reorganized and functions more effectively

family homeostasis - resistant to change

re-labeling- changing label of person/problem from negative to positive

paradoxical directive or instruction-explain behavior so a client realizes he/she can control it. Use strength to move a client towards goal

treatment in which therapist joins the family in an effort to restructure it.

-interpersonal boundaries rather than emeshment

-Boundaries with the outside world define the family unit but enough to maintain a well functioning open system

-Hierarchical organization-maintain generational boundaries, parent vs. child. Roles, rights and obligations.

improvement of overall functioning will ultimately reduce a family members symptomatology

1. Differentiation - The more the individual can be self while in contact with family the easier it is to make changes without external and internal pressures

2. Emotional fusion - family members share an emotional response. Result of poor boundariesIt someone tries to become independent fear of abandonment happens

3. Multigenerational transmission gives present context in history

4. Emotional triangle - relationship btw 3 pp. Relationship can maintain stability until anxiety is introduced.

5. Nuclear family is the most basic unit. Clients forming relationships tend to pick mates with the same level of Differentiation.

6. Family projection process - parents transmit emotional problems to children

7. Sibling Position factor in determining personality. Birth order determines the way children and parents interact

8. Societal regression - viewed society like a family, system with own generational issues

community org - collective power to tackle areas of concern. focus on power, mobilizing power on problem and mobilizing resources

social planning - community decides goals and strategies retaliating to issues. SW can facilitate planning through all stages

criteria -what behavior must be exhibited under what conditions to achieve goal
method for evaluation
schedule for evaluation
benchmarks
objectives break down goals which are steps towards the final desired outcome

Primary Prevention - most cost effective, protect from behavior in first place i.e. good nutrition and exercise

Secondary Prevention - occurs after, aims to slow progression also focus on preventing re-injury i.e modifying work assignments

Tertiary Prevention -managing complicated long term diseases. Prevent further deterioration and maximize quality of life. pain management

meetings uneventful, no new ground broken, :
evaluate if goals attained, baseline?
acknowledge issues in termination, cope with feelings
plan next steps

-summarized broad ethical standards
-is the moral compass for social work professions
-holds the social work profession accountable
advocate for change in order to meet basic human needs and promote social justice
-

help advocate with third party
advocacy is one of the most important things for a sw to do
advocating to change the factors that create and contribute to problems
Sometimes Sw will need to bring in a 3rd party to have their needs met when resources aren't available
when clients treated unfairly the SW should try to strength the clients own skills. SW can locate for clients

must have a work environment that supports ethical practice and committed to standards and good quality services
Sw should never be at risk for not upholding ethical standards
clients should always been informed
Storage of records and confidentiality must be established
Critical to have quality supervision

Optimize client function and well being by providing and coordinating high quality service in the effect and efficient manner
Coordinating services improves outcome

integration of services -coordination is achieved through combined services at the same time

warp around service- multiple providers and services over lap but not as much as integration of services

disciplinary team approaches - all professionals are brought together to stay informed of client care and avoid duplication

5 case management activities
assessment
planning
linking
monitoring
advocacy

Most important objective is to improve outcome of service delivery, accountable to client and the public at large.

Areas to include in SW evaluation:
-establish relationship with client
-Knowledge and skills
-Adhere to agency objectives
-use supervision
-staff and community relationships
-NASW Ethics
-Cultural Competence

benefit analysis - costs of operating program. Do costs exceed benefit

cost - effectiveness Analysis -the benefits are not measured by monetary terms

Outcome Assessment - achieved intended goal. Using finding to make changes if needed. Continual feedback loops

-Eliminating services
-Adding Services
-Acquiring more adequate resources
-Targeting different groups of participants to receive services

Evaluation findings - opportunities to make programs betterIndicate need for improvement

Program Evaluation - Findings should be viewed with excitement about the possibilities of developing an even stronger set of services and improving efforts

individual - professional enhancement, more time to explore, less exposure to poor practices. Although can be, intimidating, time consuming, no input from others, no chance to compare with others

Peer Group - each member can offer and receive ideas, shared influence, avoids getting stuck with bad supervisor, personal growth from group, peer support. Although, group members might not take on their responsibilities, respect and trust necessary, groups remains closed, competition, defensiveness, limited time available for each member

Facilitated Group - learn from practice example, giving feedback, role play, less expensive and time consuming, growth via group dynamics. Although, supervisors anxiety can be barrier, supervisor must be skilled, less time for each person, needs to have a high level of trust

Establishes a learning alliance between a supervisor and social worker with the aim of teaching new skills or refining existing ones.

demographics
Assessments
Service Plans
Discharge Plan
Releases
Correspondence

Client notes and Clients files separate
Professional notes
Develop universal so everyone can understand
If needed create drafts and work on later, others can review
Document unmet needs

identifying data
presenting problem
medical/psych history
presenting problem
impression and summary
recommendation

Critical in consultation ( using an expert)
defining
specifying
clarifying
outlining

Provide Peer support:
Allow work to be assigned across multiple professionals
Full goals by ensuring all aspects of client care delivered
create cross-fertilization of skills btw professionals
facilitate decision making to all aspects of client care
streamline work through sharing of info

Guidelines for Collaboration:
clearly articulate goals
understand the roles of professionals
seek and establish common proud
acknowledge the differences
address conflict with teams
establish and maintain collegial relationships

Interdisciplinary Teams comprised only of SW from potentially from other disciplines

Puts power in the community, partnerships with diverse groups, decision making with community. Go through stages:

Orientation stage - community member meet for the first time and get to know each other.

Conflict stage - arguments and disputes might occur. the conflicts resolve

emergence stage - begin to see and agree on course of action

reinforcement stage - community members make decisions and justify why correct

mission statement - concise outline of what is to be accomplished.

Goal -should provide framework the more specific objectives of program and be consistent with mission statement

Objectives - statement that describe the desired outcomes

Outcomes - Achieved results

Formal -postion in org chart. CEO has the most power and makes the decisions. It is obvious bc of titles and functions. Needed to achieve goals

informal - Person with the most influence who can lead others to goals or accomplishment tasks, have greatest influence. Someone can lead without official authority. Sometimes the most experience or most respected. It's easy to get employee buy in if coming from someone they respect

-Always go to code of ethics first - do not rely on supervisors and co-workers
-Determine if there is an ethical dilemma
weigh ethical issues in light of key SW vales and principles outlines in NASW- Code of Ethic
-Suggest Modifications
-Implement Modifications
-Monitor for new Ethical Issues and Dilemma's

client can refuse and withdraw consent at any time
some self disclosure can be harmless and useful. However, can blur the lines and boundaries need to be maintained. Sometimes SW shares for own benefit. Can ask supervisor first if it's necessary and makes sense. Important to understand why disclosure in order to maintain appropriate relationship

A legal document in which an individual gives written instructions expressing his or her wishes regarding health care in the event that person can no longer make those decisions.

Written doctors orders for someone whose death may occur soon. Explains desired medical care. Documents kept in medical records.

universalism-there is only one acceptable norm or standard

dichotomous- "either or" thinking

heightened- persons studied in isolation, not as a part of the group or environment

High value on control, constraint, restraint- objective not considering subjective

power- "power over"others. not sharing power

-outline perimeters of the team, frequency of contact, communication, positions
-understand and define roles
-understand values of each member
-agreed methods of decision making
-determine needs fo resolving conflict

transference - Person unconsciously and inappropriately displaces those emotional reactions onto social worker

Countertransference -redirection of SW feelings towards client

Only 150 questions will actually be counted in your score

Answer

Pass or Fail

to wait 90 days to retake it

4

tests will be about 2 years behind in latest research

on your understanding of the core essentials

knowledge, skills, and abilities

always base this on necessarily your clinical judgement

"what did I study related to this question?" or "Which KSA is being tested?"

"what would i do in this situation" because you will be drawing on your practice experience rather than the existing knowledge

a particular situation or scenario.

there is only one right answer and it is based on the KSAs.

the details of the vignette

focus on the content being tested

the correct ones

"least, most, first, not, best, next"

that you are focusing on what is important.

interrelated concepts that are organized in a way that explain aspects of everyday life.

in which a theory is operationalized.

that is usually broader and at a higher level of abstraction

Theory, model or perspective

the paradigm the question states. For example, "what theory is used in..." or "what practice", or "what model"

INFORMATION BASED ON YOUR PAST EXPERIENCES

clues for the answer

last sentence of the question

"provide, explore, engage, ignore or wait"

what a therapist will do or should do

that the SW is relying on the client

means that a SW is not taking critical information into account

what to do First or Next- ex: a SW should always assess health and safety needs first before relationship needs

ENGAGEMENT, ASSESSMENT, PLANNING, INTERVENTION, EVALUATION, AND TERMINATION

why is the client there, why they are seeking services now, the role of the SW, what to expect in treatment, listen to client, explain limits of confidentiality

stage of problem-solving they are in

the PROBLEM-SOLVING STAGE they are in

"when developing rapport" to indicate engagement, "when gathering information on the problem" to indicate Assessment or "when developing the contract" to indicate Planning, "when implementing skills" to indicate Intervention, "when assessing whether ct has reached their goals" to indicate evaluation, "when discussing next steps after reaching goals" to indicate termination

then it is usually relevant in the answers. For example, Imaginary friends in childhood are an extension of pretend play and part of Piaget's preoperational stage.

their RIGHT TO SELF DETERMINATION

ALWAYS GO WITH THE CLIENT

offer's advice

It should ALWAYS be about the clients right to self determination and removing barriers

themsevles

it is to ensure that the client is getting quality care not treatment and is NOT about adhering to policies

for the agency

clients are a harm to self or others

write down key words, stages, hints, etc

the responses yet

which of the KSA's is being tested

they will be essential in selecting the correct answers from the incorrect ones.

to determine how the important concepts related the KSA are relevant to the question.

If more than one response choice appears to be viable, go back and read the question again- looking only at the remaining viable responses. This will take several tries.

read the question and the answers that are left.

"Tell the client to x,y,z", The exception is "tell me HOW you..."

A word or a catch phrase does not make an answer correct. Ask yourself whether the answer would still be as appealing without the buzzword.

all the required clinical criteria are present.

clinical issues to be addressed as part of an intervention or treatment.

psychotherapy, unless the question is explicitly stating that. Use a more generalist approach

Do not pick a solution if the question is not asking for one

explicitly states this in the question

are unconscious mechanisms which are activated in times of anxiety, stress, and distress without any choice or conscious intentionality. They are a necessary tool of protection and in moderate use contribute to successful adaptation. Defense mechanisms are a part of normal functioning, but they can be considered as pathological in some instances.

includes conscious strategies that enable clients to attain realistic goals by using available resources and past experiences while acting within society's rules of conduct. While defense mechanisms are unconscious processes whereas coping methods are conscious, in reality, sometimes clients exhibit rational coping simultaneously with unconscious defenses.

that indicates that there may be more than one distinction between answers. However, the correct response choice is the one which contains the most fundamental or important difference.

drive to the testing center so you know how to get there. Arrive early so you are not rushed. Take your time reviewing the tutorial on the computer so you aren't rushed.

Help the client understand the likelihood of her children having the disease. Human genetics is the study of inheritance. It is important for social workers to have knowledge about the benefits, limitations, and risks. Social workers can help the clients weigh the pros and cons of the test and discuss the social and emotional aspects of testing. The social worker in this situation can educate the client that every person carries two copies of most genes and a carrier is a person who has a change in one copy of the gene. The carrier does not have the genetic disease but can pass the gene to the child. If both parents carry the abnormal gene, there is a 25% chance the child will have the disease and a 50% that their child will be a carrier of the disease. There is also a 25% chance that the child will not get the abnormal gene and so will not have the disease nor be a carrier. If only one parent is a carrier then the child has a 50% chance of being a carrier but almost no chance that they will have the disease. It would not be appropriate to meet with the husband because the client has not stated a desire for that. No medical issues have been raised so a referral to a doctor is also not necessary. While the client is upset and anxious, her feelings may result from not understanding how gene testing works.

Inferiority- Erik Erikson maintained that personality develops in predetermined order. He was interested in how children socialize and how this affects their sense of self. He saw personality as developing throughout the life course and looked at the identity crises as the focal point of each stage of human development. Industry and Inferiority occur during childhood between the ages of 6 and 11 and is the 4th stage of psychosocial development. The question contains a qualifying word- MOST. In order to select the correct answer, it is necessary to recall Erikson's stages of psychosocial development. The incorrect answers reflect problems associated with other psychosocial crises throughout the life course. When age is included in a question, it is usually CRITICAL to selecting the correct answer. It is also says Psychosocial Problem which Erikson is associated with!

Authoritarian- There are 4 major parenting styles which reflect skills and capabilities of clients. Permissive parenting, sometimes referred to as indulgent parenting has very few demands. Authoritative parenting establishes rules and guidelines that children are expected to follow. However, this parenting is democratic and parents are responsive to children and willing to listen. AUTHORITARIAN parenting , children are expected to follow strict rules established by the parents. Failure to follow such rules usually results in punishment. Authoritarian parents do not explain reasoning. The Uninvolved parenting style is characterized by few demands, low responsiveness and little communication. While these parents fill basic needs, they are generally detached and can be even neglectful.

is based on the assumption that abnormal behavior is the result of physical problems and should be treated medically.

Temporary state which can be reversed at any time. Death is just one life event or crisis which impacts families. When deaths of family members occur, children go through a series of stages in trying to understand its meaning. For example, preschool children usually see death as reversible, temporary, and impersonal. Watching cartoon characters on television miraculously rise up whole again after having been crushed or blown apart tends to reinforce this notion. If the age of a client is mentioned in a case scenario, it is usually relevant in selecting the correct response choice. The age is a useful hint of where a client is in the life course and what might be expected with regard to his or her cognitive, emotional, and/or social development. This case scenario requires knowledge about the complex concepts associated with death as well as child development.

Irreversibility or finality, the understanding that the dead cannot come back to life
Universality or applicability, the understanding that all living things (and only living things) die
Personal mortality, the understanding that death applies to oneself
Inevitability, the understanding that all living things must die eventually
Cessation or nonfunctionality, the understanding that bodily and mental functions cease after death
Causality, the understanding that death is ultimately caused by a breakdown of bodily functions
Unpredictability, the understanding that the timing of (natural) death is not known in advance
Piaget's cognitive developmental stages indicate that these death concepts cannot really be understood by someone until age 7 years at the absolute earliest.

Shaping-Shaping refers to the reinforcement of behaviors that approximate or come close to desired new behaviors. The steps involved are often called successive approximations because they successively approximate or get closer and closer to desired behaviors. This technique works well for phobias and anxiety-related disorders as the process of shaping can involve the creation of a hierarchy ranging from the least feared situation to the most feared situation. Rewards to greater incremental exposure are provided as a means to confront fears.The question requires recall knowledge about behavioral techniques. Shaping is used when it may be, or has been, difficult to achieve a goal or demonstrate a behavior. Shaping allows the goal or behavior to be achieved in steps, each reinforced positively. After a client achieves each successive step of the behavior or goal, a reward is received and the next one is presented until the desired end result is reached. If there is difficulty in a client reaching the steps, they should be broken down into smaller increments.

classical and operant conditioning.

refers to the pairing of naturally occurring stimulus-response chains with other stimuli in order to produce a similar response. For example, whenever you come home wearing a baseball cap, you take your child to the park to play. So, whenever your child sees you come home with a baseball cap, he is excited because he has associated your baseball cap with a trip to the park. (Association)

is recognition that behaviors have antecedents and consequences—and are increased or decreased by reinforcement or punishment, respectively. Whenever a child goes to bed on time, her parent reads her a bedtime story. The story reading is a positive reinforcement used to increase target behavior (going to bed on time). (reduce or increase bxs)

is the process of learning to voluntarily influence physiological processes by making changes in cognition. It provides a visible and experiential demonstration of the mind-body connection. Biofeedback is also a therapeutic tool to facilitate learning self-regulation of autonomic functions for improving health. Ex- wearing a headband that monitors your brain activity while you meditate. It uses sounds to let you know when your mind is calm and when it's active to help you learn to control your stress response.

is learning by observing or imitating. There are different types of modeling techniques to assist learners.

is a form of behavior therapy based on the principles of respondent conditioning. It is sometimes referred to as exposure therapy or prolonged exposure therapy. As a psychotherapeutic technique, it is used to treat phobia and Anxiety Disorders including Posttraumatic Stress Disorder. It works by exposing clients to their painful memories, with the goal of reintegrating their repressed emotions with their current awareness.

Help the client understand the effects of internalized homophobia on his feelings. Many people who are lesbian, gay, bisexual, transgender, queer, or intersex (LQBTQI) develop an internalized homophobia that can contribute to problems with self-acceptance, anxiety, depression, difficulty forming intimate relationships, and being open about what sexual orientation or gender identity one actually has. In the case scenario, the distress experienced by the client is an issue which can result from oppression and discrimination. It is critical for the client to understand that his lack of self-worth comes from societal problems and should not be associated with his sexual feelings or preferences. Treatment is directed toward decreasing shame over the homosexual orientation and integrating the client's social role and personal identity. Suicide risk would have been assessed earlier, and nothing in the case scenario indicates the presence of new signs or feelings. Exploring familial relationships is an assessment task which would have happened prior to planning. Lastly, role modeling can be effective, but it does not help address the feelings which are the basis of the client's concerns.

Globalization- Interaction of people, organizations, and governments is the process of globalization. The process is determined by trade between the nations, investments in their businesses, and data gathered through information technology and has some effects on the cultural, environmental, political, and economic development of the countries. Globalization can have both negative and positive effects on quality of life. Cultural convergence means bringing together different cultural groups, which results in these cultures becoming more alike in terms of technology, sports, language, and even politics.
Globalization and culture are interdependent. The question contains a qualifying word—MOST—even though it is not capitalized. Though some of the incorrect responses can lead to cultural convergence, globalization is the greatest or most significant contributor. Globalization causes the greatest interaction between people, which results in cultural convergence.

Role conflict: From the structural perspective, roles are the culturally defined norms—rights, duties, expectations, and standards for behavior—associated with a given social position. In other words, social position is seen as influencing behaviors. In addition, statuses such as gender, ethnicity, sexual orientation, and social class also shape roles. Social workers must be aware of social role theory and view problems as emerging from interactions between clients and their environments. Person-in-environment perspectives are sensitive to role conflicts experienced by clients.
In the case scenario, the client is facing conflicting demands and expectations—as a mother, wife, professional, and so on. The client is the woman and the problem should not be viewed as a family issue. Family problems are best resolved by family therapy in which the interactions of members are the focus of intervention. Cultural bias involves a prejudice or highlighted distinction in viewpoint that suggests a preference of one culture over another.The client recognizes the views of her husband's family and does not appear to see her views as superior. However, she is unhappy due to the conflict that exists between the fulfillment of the various roles. Social injustice is an unfair practice that results in violation of human rights. Her problem is a personal one and not an indicator of social injustice.

The actual enactment of role behavior, however, may not correspond to the role expectations. In countries with strong normative expectations for women to be full-time mothers, single mothers and low-income mothers often have to violate these role expectations and have been criticized as less competent mothers as a result.

success in carrying out a role, can vary depending on social contexts and resources.

Abusive-Family systems theory considers the nature of relationships to be bidirectional, and moves away from seeking blame of one person for the dynamic of the relationship. The exception to this theory is within abusive relationships, where the responsibility and blame lay clearly with the perpetrator of the abuse. This is a recall question about family dynamics and functioning. Social workers must understand family systems theory, as well as the dynamics of abuse. Victims should never be seen as contributing to or responsible for their abuse. As the question asks about "blame for the dynamics" resting with specific individuals as opposed to resulting from the action of all parties, a belief contrary to a family systems approach, the correct answer must involve abuse of one person by another.

views issues and problems within a circular fashion, using what is described as a systemic perspective; this means that the event and the problem exist within the context of the relationship, where each influences the other. Family systems theory aims to assess these patterns of interactions and look at why things may be happening instead of why they happened. Family systems theory considers the nature of relationships to be bidirectional, and moves away from seeking blame of one person for the dynamic of the relationship. The exception to this theory is within abusive relationships.

their behavior would be viewed through the lens of their family (parent-child) behaviors and family systems rather than looking at young persons in isolation.

There is no blame associated with polygamy.

"family affair" that must be understood and treated within the marital system rather than from an individual perspective. Social workers use marital therapy to understand the relational dynamics that led to and/or sustain affairs. They shy away from blame and focus on issues of intimacy, communication, expectations, agreements, and conflict management in the marriage.

Defense mechanism in which a repressed urge is expressed by disturbance of a body function. Conversion is a defense mechanism which occurs when cognitive tensions manifest themselves in physical symptoms. The symptom may be symbolic and dramatic and often acts as a communication about the situation. Extreme symptoms may include paralysis, blindness, deafness, becoming mute, or having a seizure. Lesser symptoms include tiredness, headaches, and twitches. For example, a client's arm becomes suddenly paralyzed after he or she has been threatening to hit someone else. Conversion is different from psychosomatic disorders where real health changes are seen (such as the appearance of ulcers). It also is more than malingering, where conscious exaggeration of reported symptoms is used to gain attention. With time, symptoms will go away, especially if clients' stress is reduced, such as by taking them away from the initial, anxiety-provoking situations. This is a recall question on the defense mechanisms. It is not necessary to memorize the definitions of the defense mechanisms, but their names should be familiar. The correct answer could have been obtained simply by recognizing that conversion was a defense mechanism.
Often questions on defense mechanisms include case scenarios which describe clients' behavior. Thus, social workers must be able to distinguish between the defense mechanisms based on client verbalizations and actions using the situational contexts as clues.

are psychological mechanisms aimed at reducing anxiety. They were first discussed by Sigmund Freud as part of his psychoanalytic theory and further developed by his daughter, Anna Freud. Often unconscious, defense mechanisms are used to protect clients from psychological pain or anxiety. While such mechanisms may be helpful in the short term, alleviating suffering that might otherwise incapacitate, they can easily become a substitute for addressing the underlying cause and so lead to additional problems. The solution, therefore, is to address the underlying causes of the pain these mechanisms are used to defray.

Differentiating roles and boundaries for the husband and wife in the relationship. Clients engaged in enmeshed interpersonal relationships are nearly always the last to know. Often social workers work with adult children who are recovering from the pain and confusion caused by enmeshed relationships with parents. In order to select the correct answer, social workers must first diagnose the problem. The feelings and behaviors of the couple are indicative of enmeshment. Once the cause of the problem is known, the question can be simplified to picking out the treatment focus when working with enmeshed relationships. The wife is not the client as the couple sought treatment, so focusing on the wife's self-worth will not address the problem. Finding out more about past intimate relationships is an assessment—not a treatment—task. Understanding each other's feelings will not help each person develop boundaries and differentiate from one another, which is the root of the issue.

Neglecting other relationships because of an obsession or concern about one relationship. Happiness is contingent upon a relationship. Self-esteem is contingent upon a relationship. Excessive anxiety, fear, or a compulsion to fix the problem whenever there is a disagreement in a relationship. Feeling of loneliness that overwhelms when not with the other person—often creating irrational desires to reconnect. Symbiotic emotional connections which result in an individual becoming angry, upset, or depressed when another person is angry, upset, or depressed. Strong desire to fix another person's situation and change his/her state of mind. When relationships are enmeshed, they are no longer able to grow. Social workers must work to establish healthy boundaries and respect for autonomous choices. This process can be painful for clients.

Cultural sensitivity. Cultural sensitivity refers to a set of skills used in social work practice that facilitates learning about and understanding clients whose cultural background may not be the same. Social workers must operate with the awareness that cultural differences exist between them and clients without assigning these differences a value. These differences are positive—not better or worse, right or wrong. Being culturally sensitive does not mean being an expert in each culture's values. It simply means a willingness to ask honest questions, seek understanding, and demonstrate empathy rather than judging. It also means that, when knowingly entering spaces in which there will be cultural differences at play, social workers should do a bit of homework beforehand and avoid jumping to conclusions. The most important thing when being culturally sensitive is remembering to ground interactions in the understanding that clients' background, experiences, and values naturally vary from those of social workers. These differences should lead to understanding and empathy, rather than judgment. This is a recall question which relies on social workers understanding the effect of culture, race, and ethnicity on behaviors, attitudes, and identity. In the case scenario, the social worker is demonstrating respect and not assuming that the client would like to be called by his or her first name. Such action is an example of cultural sensitivity. Ethnocentrism is viewing others' cultures solely by the values and standards of one's own culture. The social worker is doing the opposite in the case scenario.

A descriptive features specifier is used for those who meet the full criteria, but also present with limited prosocial emotions. All of the response choices are accurate with regard to the diagnosis of Conduct Disorder according to the DSM-5. However, the descriptive features specifier for those with limited "prosocial emotion," such as empathy and guilt, was not available in the DSM-IV. It was added in the DSM-5.

Replaced with "Other Specified" and "Unspecified" diagnoses. An important clinical tool in the DSM-5 is the revised diagnoses of "Other Specified" and "Unspecified" mental disorders. Replacing the "Not Otherwise Specified" categories, these diagnoses give social workers more flexibility. The first allows a social worker to specify the reason that the criteria for a specific disorder are not met, whereas the second allows a social worker the option to forgo specification.

A 13-year-old girl physically and emotionally taking care of her father who was permanently injured in an accident. A role reversal is when two individuals switch roles. The 13-year-old girl has become the caregiver for her father, who is dependent due to his permanent injury. This is a role reversal because a parent would usually be meeting the physical and emotional needs of a child. The other response choices are all role issues, but none contain a reversal in a parent-child relationship.

Sexual arousal must result from cross-dressing. Transvestic Disorder identifies people who are sexually aroused by dressing as the opposite sex, but who experience significant distress or impairment in their lives, socially or occupationally, because of their behavior. The DSM-IV limited this behavior to heterosexual males. The DSM-5 has no such restriction, opening the diagnosis to women or gay men who have this sexual interest.

Delirium. A mental status examination is a structured way of observing and describing a client's current state of mind, under the domains of appearance, attitude, behavior, mood and affect, speech, thought processes, thought content, perception, cognition, insight, and judgment. It is NOT a psychiatric evaluation aimed at diagnosing disorders. Many disorders or conditions cause delirium, such as alcohol/drug abuse or withdrawal and infections. Delirium involves a quick change between mental states (e.g., from lethargy to agitation and back to lethargy). Symptoms that can be detected by a mental status examination include changes in alertness (usually more alert in the morning, less alert at night), awareness, orientation to time or place, memory, recall, and mood (personality changes).

Leave it up to the client to determine the extent to which the coworker attends or participates in sessions. Cultural competence involves working in conjunction with natural, informal support and helping networks (i.e., neighborhoods, coworkers, churches, spiritual leaders, healers). The coworker is probably a member of the client's support network and can be useful in the problem-solving process. It is the client's decision of whether information can be shared. The social worker should use the coworker as a valuable source of information about the problem as the coworker is a collateral source.

Negative reinforcement. Negative reinforcement is the removal of an aversive (negative) stimulus with the goal of increasing the targeted behavior. In the case vignette, the husband says that he will do more around the house (targeted behavior) if the wife stops (removes) the nagging (negative stimulus).

Clarify what will happen in treatment and the responsibilities of both the client and social worker with regard to change. Social work roles in the problem-solving process include consultant, advocate, case manager, catalyst, broker, mediator, facilitator, instructor, mobilizer, resource allocator, and so forth.
Problems can arise when a client is not clear about a social worker's role. Initial clarification should be made during engagement and should be discussed during the therapeutic process if the role of a social worker changes. The social worker in this case vignette must address this situation immediately and should not ignore the comment. In addition, the social worker should not make this a therapeutic issue and question the client further about it because it may simply result from a lack of understanding on the client's part.

Mixed method. Evaluation methods can be classified as either qualitative or quantitative. In qualitative evaluations, data are collected through observations and/or interviews. Findings are generated via identification of themes in the language used and content contained in the communication observed or generated. The focus groups employed by the social worker are qualitative in nature.
Contrarily, quantitative evaluations are conducted by making numerical comparisons and statistical inferences. The social worker's comparison of the number of clients rehospitalized versus the number who were not is a quantitative approach. Since both qualitative and quantitative methods are being used, the social worker is using a mixed method approach to evaluation.

Legal problems associated with gambling. Legal involvement was removed as a diagnostic criterion from the Substance-Related and Addictive Disorders category of the DSM-5.

Minimizing risk to self and others. The mission of the social work profession is rooted in a set of core values. These core values are the foundation of social work's unique purpose and perspective. The values stated in the preamble of the NASW Code of Ethics are service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence.

service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence.

Get others to laugh as a way of drawing attention away from family problems. The "Mascot" tries to get others to laugh as a way of improving the atmosphere and drawing attention away from the dysfunctional household.

One culture incorporating elements, such as attitudes, beliefs, or behaviors, of another culture into its own ways. Acculturation is a process in which members of one cultural group adopt the beliefs and behaviors of another. Although acculturation is usually in the direction of a minority group adopting habits and language patterns of the majority, acculturation can be reciprocal with the majority also adopting patterns typical of the minority group.

Social workers cannot guarantee to group members that information disclosed in groups will be kept confidential because it may be disclosed by other members. When social workers engage in group work, they should seek agreement among group members concerning preserving the confidentiality of information shared. However, social workers should inform members that they cannot guarantee that all group members will honor such agreements. Group members do not have the same legal obligations that social workers do to keep information private and protected. However, social workers engaged in group work should use the same professional standards with regard to their own conduct.

Partializing action steps so clients can make incremental progress toward change. Partialization is a good technique to assist clients in breaking down problems or goals into less overwhelming and more manageable components. However, it does not happen during ENGAGEMENT, but rather planning and/or intervention. The remaining response choices do occur during engagement and are useful for helping alleviate the fears of resistant clients.

Unethical because the social worker cannot terminate services for this reason. Social workers should not terminate services to pursue a social, financial, or sexual relationship with a client.

Limit certain foods high in tyramine. Nardil is a monoamine oxidase inhibitor (MAOI), and there are dietary restrictions of foods that contain high levels of tyramine (generally food that has been aged), including cheeses, cured meats, and yeast extract spreads.

Physical symptoms associated with alcohol withdrawal. Delirium tremens are caused by alcohol withdrawal. The prescription of benzodiazepines is the treatment of choice to minimize their impacts. The main symptoms of delirium tremens are nightmares, agitation, confusion, disorientation, visual and auditory hallucinations, fever, sweating, and rapid respiration.