LCSW Exam (Apgar Terms)

Learning theory- Social/Situational

(Bandura)—learning is obtained between people and their environment and their interactions and observations in social contexts. Social workers establish opportunities for conversation and participation to occur.

Learning theory- Humanistic

(Maslow)—learning is viewed as a person's activities aimed at reaching his or her full potential, and the focus of learning is in meeting cognitive and other needs. Social workers aim to develop the whole person.

Learning theory- Behaviorist

(Pavlov, Skinner)—learning is viewed through change in behavior and the stimuli in the external environment are the focus of learning. Social workers aim to change the external environment in order to bring about desired change.

Learning theory- Cognitive

(Piaget)—learning is viewed through internal mental processes (including insight, information processing, memory, and perception) and the focus of learning is internal cognitive structures. Social workers aim to develop opportunities to foster capacity and skills to improve learning.

self- concept

(or self-image) how one sees him or herself

Three Types of Supervision

(understand benefits and challenges) Individual, Peer Group, Facilitated Group

Guidelines for Interventions for Abuse

- According to most literature on domestic violence, traditional marital/couples therapy is not appropriate in addressing abuse in the family. It puts victims in greater danger of further abuse. - Medical needs and safety are priorities. Note: Consider domestic violence in the context of Maslow's hierarchy of needs. - aIn working with a victim of abuse, trust is a major issue in establishing a therapeutic alliance.

Some common tests

- Achievement/Aptitude tests: typically used in education, measure how much clients know (have achieved) in a certain subject or subjects, or have ability (aptitude) to learn - Intelligence tests: measure intelligence (IQ) - Job/Occupational tests: match interests with careers - Personality tests: measure basic personality traits/characteristics - Neuropsychological tests: assess and measure cognitive functioning (e.g., how a particular problem with the brain affects recall, concentration, etc.) - Specialized clinical tests: investigates areas of clinical interest, such as anxiety, depression, Posttraumatic Stress Disorder, and so on.

Methods that can be helpful in working with involuntary clients

- Acknowledging clients' circumstances and understanding how they came about given clients' histories - Listening to clients' experiences in order to try to understand how they feel about intervention - Engaging in clear communication because involuntary clients struggle to understand what is happening to them - Making clear what the purpose of the intervention is, what clients have control over and what they do not, what is going to happen next, and what the likely consequences will be if they do not participate - Assisting at an appropriate pace as progress may be slow - Building trust, even on the smallest scale, by consistently being honest and up-front about the situation and why a social worker is involved - Giving clients practical assistance when needed to help them fight for their rights - Paying attention to what is positive in clients' behavior and celebrating achievements - Showing empathy and viewing clients as more than the problems that brought them into services

indicators of traumatic stress

- Addictive behaviors related to drugs, alcohol, sex, shopping, and gambling - An inability to tolerate conflicts with others or intense feelings - A belief of being bad, worthless, without value or importance - Dichotomous "all or nothing" thinking - Chronic and repeated suicidal thoughts/feelings - Poor attachment - Dissociation - Eating disorders—anorexia, bulimia, and obesity - Self-blame - Intense anxiety and repeated panic attacks - Depression - Self-harm, self-mutilation, self-injury, or self-destruction - Unexplained, but intense, fears of people, places, or things

Effects of sexual abuse

- Aversive feelings about sex; overvaluing sex; sexual identity problems; and/or hypersexual behaviors - Feelings of shame and guilt or feeling responsible for the abuse, which are reflected in self-destructive behaviors (such as substance abuse, self-mutilation, suicidal ideation and gestures, and acts that aim to provoke punishment) - Lack of trust, unwillingness to invest in others; involvement in exploitive relationships; angry and acting-out behaviors -Perceived vulnerability and victimization; phobias; sleep and eating problems

Effects of psychological abuse and neglect

- Avoid eye contact and experience deep loneliness, anxiety, and/or despair - Have a flat and superficial way of relating, with little empathy toward others - Have a lowered capacity to engage appropriately with others - Engage in bullying, disruptive, or aggressive behaviors toward others -Engage in self-harming and/or self-destructive behaviors (i.e., cutting, physical aggression, reckless behavior showing a disregard for self and safety, drug taking)

Methods for Measurable Objectives

- Criteria: What behavior must be exhibited, how often, over what period of time, and under what conditions to demonstrate achievement of the goal? - Method for evaluation: How will progress be measured? - Schedule for evaluation: When, how often, and on what dates or intervals of time will progress be measured?

Assumptions of family systems approach

- Each family is more than a sum of its members. - Each family is unique, due to the infinite variations in personal characteristics and cultural and ideological styles. - A healthy family has flexibility, consistent structure, and effective exchange of information. The family is an interactional system whose component parts have constantly shifting boundaries and varying degrees of resistance to change. - Families must fulfill a variety of functions for each member, both collectively and individually, if each member is to grow and develop. - Families strive for a sense of balance or homeostasis. - Negative feedback loops are those patterns of interaction that maintain stability or constancy while minimizing change. Negative feedback loops help to maintain homeostasis. Positive feedback loops, in contrast, are patterns of interaction that facilitate change or movement toward either growth or dissolution. - Families are seen as being goal oriented. The concept of equifinality refers to the ability of the family system to accomplish the same goals through different routes. - The concept of hierarchies describes how families organize themselves into various smaller units or subsystems that are comprised by the larger family system. When the members or tasks associated with each subsystem become blurred with those of other subsystems, families have been viewed as having difficulties. For example, when a child becomes involved in marital issues, difficulties often emerge that require intervention. - Boundaries occur at every level of the system and between subsystems. Boundaries influence the movement of people and the flow of information into and out of the system. Some families have very open boundaries where members and others are allowed to freely come and go without much restriction; in other families, there are tight restrictions on where family members can go and who may be brought into the family system. Boundaries also regulate the flow of information in a family. In more closed families, the rules strictly regulate what information may be discussed and with whom. In contrast, information may flow more freely in families that have more permeable boundaries. - The concept of interdependence is critical in the study of family systems. Individual family members and the subsystems comprised by the family system are mutually influenced by and are mutually dependent upon one another. What happens to one family member, or what one family member does, influences other family members.

Elements of Trauma Informed Care

- Environment of Care - Staff appearance - Organizational Understanding - Treatment Considerations

Factors affecting group cohesion include:

- Group size - Homogeneity: similarity of group members - Participation in goal and norm setting for group - Interdependence: dependent on one another for achievement of common goals - Member stability: frequent change in membership results in less cohesiveness

Benefits of Self-Care

- Identify and manage the general challenges that hard-working professionals face such as the potential for stress and burnout or interpersonal difficulties - Become aware of personal vulnerabilities such as the potential for retraumatization (if trauma history exists), vicarious or secondary traumatization (if working with individuals who report their own traumatic experiences), and compassion fatigue (which can be developed from a combination of burnout and vicarious traumatization) - Achieve balance in life by maintaining and enhancing the attention paid to different domains of life in a way that meets personal needs

Groups help through:

- Instillation of hope - Universality - Altruism - Interpersonal learning - Self-understanding and insight

Change Strategies

- Modify systems: The decision to help a client on a one-to-one basis or in the context of a larger system must take into consideration a client's preferences and previous experiences, as well as the degree to which a client's problem is a response to forces within the larger system and whether change can be readily attained by a change in the larger system. - Modify individual thoughts: A social worker may teach how to problem solve, alter his or her self-concepts by modifying self-defeating statements, and/or make interpretations to increase a client's understanding about the relationship between events in his or her life. - Modify individual actions: A social worker may use behavior modification techniques, such as reinforcement, punishment, modeling, role playing, and/or task assignments. Modeling and role modeling are very effective methods for teaching. They should be used whenever possible. - Thoughts can be modified by feedback from others and behaviors can be modified through the actions of others in a system (by altering reinforcements). - A social worker can also advocate for a client and seek to secure a change in a system on his or her behalf. - A social worker can be a mediator by helping a client and another individual or system to negotiate with each other so that each may attain their respective goals.

classic model of cultural, racial, and ethnic identity development

- Preencounter: At this point, the client may not be consciously aware of his or her culture, race, or ethnicity and how it may affect his or her life. - Encounter: A client has an encounter that provokes thought about the role of cultural, racial, and ethnic identification in his or her life. This may be a negative or positive experience related to culture, race, and ethnicity. For minorities, this experience is often a negative one in which they experience discrimination for the first time. - Immersion-Emersion: After an encounter that forces a client to confront cultural, racial, and ethnic identity, a period of exploration follows. A client may search for information and will also learn through interaction with others from the same cultural, racial, or ethnic groups. - Internalization and Commitment: At this point, a client has developed a secure sense of identity and is comfortable socializing both within and outside the group with which he or she identifies.

Methods to identify strengths

- Seeking exceptions—determining when the problem does not exist or occur (locations, times, and contexts); - Scaling the problem—identifying the severity of the problem on a scale from 1 to 10 according to the client; - Scaling motivation—estimating the degree to which client feels hopeful about resolution; and/or - Miracle question—having the client determine what would be different if problem did not exist.

Core Values of Social Work

- Service - Social justice - Dignity and worth of the person - Importance of human relationships - Integrity - Competence

self-motivating techniques

- Visualizing his or her goals, including using visual images on the refrigerator or in a place that will remind a client of the desired aim - Reminding himself or herself of why change is needed - Making up a contract with himself or herself of steps that will be taken toward reaching the desired end result - Rewarding himself or herself when progress is made on the goals - Taking a break to do something that is liked or be with a friend to stay encouraged - Being around positive people who will encourage and not create barriers to change - Educating himself or herself about steps that will assist in the change effort - Breaking down goals into achievable steps - Forgiving himself or herself when setbacks in progress occur - Conceptualizing a new reality or what life will be like when change happens

Goals of Treatment for Substance Disorders

1. Abstinence from substances 2. Maximizing life functioning 3. Preventing or reducing the frequency and severity of relapse

4 types of ethical and legal categories

1. Actions that are compatible with both legal and ethical standards in social work (legal and ethical) 2. Actions that are neither legal nor ethical in social work according to prevailing standards (not legal and not ethical) 3. Actions that are legal, but not ethical according to prevailing standards (legal, but not ethical) 4. Actions that are ethical, but not legal according to standards and laws (ethical, but not legal)

Types of Parenting

1. Authoritarian Parenting Children are expected to follow the strict rules established by the parents. Failure to follow such rules usually results in punishment. Authoritarian parents fail to explain the reasoning behind these rules. Authoritarian parenting styles generally lead to those who are obedient and proficient, but are lower in happiness, social competence, and self-esteem. 2. Authoritative Parenting Like authoritarian parents, those with an authoritative parenting style establish rules and guidelines that their children are expected to follow. However, this parenting style is much more democratic. Authoritative parents are responsive to their children and willing to listen to questions. When children fail to meet the expectations, these parents are more nurturing and forgiving rather than punishing. Authoritative parenting styles generally tend to result in those who are happy, capable, and successful. 3. Permissive Parenting Permissive parents have very few demands on their children. These parents rarely discipline their children and are generally nurturing and communicative with their children, often taking on the status of a friend more than that of a parent. Permissive parenting often results in children who rank low in happiness and self-regulation, experiencing problems with authority and tending to perform poorly in school. 4. Uninvolved Parenting An uninvolved parenting style is characterized by few demands, low responsiveness, and little communication. Although these parents fulfill basic needs, they are generally detached from their children's lives. Those who have experienced uninvolved parenting styles rank lowest across all life domains. They tend to lack self-control, have low self-esteem, and are less competent than their peers.

Personality Theories (5 types)

1. Biological Biological theories suggest that genetics are responsible for personality. Research on heritability suggests that there is a link between genetics and personality traits. 2. Behavioral Behavioral theories suggest that personality is a result of interaction between the individual and the environment. Behavioral theorists study observable and measurable behaviors, rejecting theories that take internal thoughts and feelings into account. 3. Psychodynamic Psychodynamic theories emphasize the influence of the unconscious mind and childhood experiences on personality. 4. Humanist Humanist theories emphasize the importance of free will and individual experience in the development of personality. Humanist theorists emphasized the concept of self-actualization, which is an innate need for personal growth that motivates behavior. 5. Trait Trait theories posit that the personality is made up of a number of broad traits. A trait is basically a relatively stable characteristic that causes an individual to behave in certain ways.

Attachment theory

1. Bowlby defined attachment as a lasting psychological connectedness between human beings that can be understood within an evolutionarycontext in which a caregiver provides safety and security for a child. Bowlby suggests that children come into the world biologically preprogrammed to form attachments with others, because this will help them to survive. They initially form only one primary attachment (monotropy) and this attachment figure acts as a secure base for exploring the world. Disrupting this attachment process can have severe consequences because the critical period for developing attachment is within the first 5 years of life. 2. There is another major theory of attachment that suggests attachment is a set of learned behaviors. The basis for the learning of attachments is the provision of food. A child will initially form an attachment to whoever feeds it. This child learns to associate the feeder (usually the mother) with the comfort of being fed and, through the process of classical conditioning, comes to find contact with the mother comforting. The child also finds that certain behaviors (i.e., crying, smiling) bring desirable responses from others and through the process of operant conditioning learns to repeat these behaviors in order to get the things he or she wants. These theories are, however, criticized because there are cultural influences that may impact on attachment and the ways in which children interact with caregivers.

Strategies of Planning

1. Defining the problem (in a well-defined, clear, and data-driven format) 2. Examining the causes of the problem and how it relates to other positive/negative aspects of a client's life 3. Generating possible solutions that will impact on the problem 4. Identifying the driving and restraining forces related to implementation of each of the possible solutions 5. Rating the driving and restraining forces related to consistency and potency 6. Prioritizing these solutions based on these ratings 7. Developing SMART objectives—Specific, Measurable, Achievable, Relevant, and Time-specific—related to the chosen solutions 8. Creating strategies and activities related to the objectives

Essential Steps in Ethical Problem Solving

1. Identify ethical standards, as defined by the professional code of ethics, that are being compromised (always go to the NASW Code of Ethics. First—do not rely on supervisor or coworkers) 2. Determine whether there is an ethical issue or dilemma 3. Weigh ethical issues in light of key social work values and principles as defined by the NASW Code of Ethics 4. Suggest modifications in light of the prioritized ethical values and principles that are central to the dilemma 5. Implement modifications in light of prioritized ethical values and principles 6. Monitor for new ethical issues or dilemmas

8 causes of groupthink:

1. Illusion of invulnerability—excessive optimism is created that encourages taking extreme risks. 2. Collective rationalization—members discount warnings and do not reconsider their assumptions. 3. Belief in inherent morality—members believe in the rightness of their cause and ignore the ethical or moral consequences of their decisions. 4. Stereotyped views of those "on the out"—negative views of the "enemy" make conflict seem unnecessary. 5. Direct pressure on dissenters—members are under pressure not to express arguments against any of the group's views. 6. Self-censorship—doubts and deviations from the perceived group consensus are not expressed. 7. Illusion of unanimity—the majority view and judgments are assumed to be unanimous. 8. Self-appointed "mindguards"—members protect the group and the leader from information that is problematic or contradictory to the group's cohesiveness, views, and/or decisions.

Stages of Spiritual Development

1. Individuals are unwilling to accept a will greater than their own. 2. Individuals have blind faith in authority figures and see the world as divided simply into good and evil and right and wrong. 3. Scientific skepticism and questioning are critical, because an individual does not accept things on faith, but only if convinced logically. 4. The individual starts enjoying the mystery and beauty of nature and existence. Basic principles of all models move from the "egocentric," which are associated particularly with childhood, to "conformist," and eventually to "integration" or "universal."

6 levels of cognition

1. Knowledge: rote memorization, recognition, or recall of facts 2. Comprehension: understanding what the facts mean 3. Application: correct use of the facts, rules, or ideas 4. Analysis: breaking down information into component parts 5. Synthesis: combination of facts, ideas, or information to make a new whole 6. Evaluation: judging or forming an opinion about the information or situation

Steps of Crisis Plan

1. Plan and conduct a thorough biopsychosocial and lethality/imminent danger assessment 2. Make psychological contact and rapidly establish the collaborative relationship 3. Identify the major problems, including crisis precipitants 4. Encourage an exploration of feelings and emotions 5. Generate and explore alternatives and new coping strategies 6. Restore functioning through implementation of an action plan 7. Plan follow-up and "booster" sessions

Operant Techniques (4 types)

1. Positive reinforcement: Increases probability that behavior will occur—praising, giving tokens, or otherwise rewarding positive behavior. 2. Negative reinforcement: Behavior increases because a negative (aversive) stimulus is removed (i.e., remove shock). 3. Positive punishment: Presentation of undesirable stimulus following a behavior for the purpose of decreasing or eliminating that behavior (i.e., hitting, shocking). 4. Negative punishment: Removal of a desirable stimulus following a behavior for the purpose of decreasing or eliminating that behavior (i.e., removing something positive, such as a token or dessert).

Two schools of thought on crime prevention

1. Pro-punishment- punishment is the means to preventing 2. Positivist (pro-treatment)- philosophy suggests that some instances of criminal behavior are determined by factors, such as mental illness, that offenders find difficult to control. Therefore, treatment becomes a means of preventing future criminal behaviors. Social work has historically been strongly associated with the positivist school of thought of crime prevention. Social work must recognize its professional obligation both to the offender and to the community (from a public safety perspective) and participate in the process of developing crime reduction policies that reflect social work's commitment to both the offender and the community.

Two classes of behavioral development

1. Respondent: involuntary behavior (anxiety, sexual response) that is automatically elicited by certain behavior. A stimulus elicits a response. 2. Operant: voluntary behavior (walking, talking) that is controlled by its consequences in the environment.

Stages of Treatment for Substance Disorders

1. Stabilization: Focus is on establishing abstinence, accepting a substance abuse problem, and committing oneself to making changes 2. Rehabilitation/habilitation: Focus is on remaining substance-free by establishing a stable lifestyle, developing coping and living skills, increasing supports, and grieving loss of substance use 3. Maintenance: Focus is on stabilizing gains made in treatment, relapse prevention, and termination

Management of conflict

1. The recognition of an existing or potential conflict 2. An assessment of the conflict situation 3. The selection of an appropriate strategy 4. Intervention When previous attempts to resolve a conflict have only escalated the conflict, a useful technique is to structure the interactions between the parties. Structuring techniques include: 1. Decreasing the amount of contact between the parties in the early stages of conflict resolution 2. Decreasing the amount of time between problem-solving sessions 3. Decreasing the formality of problem-solving sessions 4. Limiting the scope of the issues that can be discussed 5. Using a third-party mediator

Roles of an Observer

1. complete participant (living the experience as a participant) 2. participant as observer (interacting with those who are participating), 3. observer as participant (limited relationship with others participating—primarily observer) 4. complete observer(removed from activity—observer only).

5 factors that influence behavior

1. individual characteristics 2. interpersonal factors 3. institutional factors 4. community factors 5. public policy

three-stage model for adolescent cultural and ethnic identity development

1. unexamined cultural, racial, and ethnic identity, is characterized by a lack of exploration of culture, race, and ethnicity and cultural, racial, and ethnic differences—they are rather taken for granted without much critical thinking. This is usually the stage reserved for childhood when cultural, racial, and ethnic ideas provided by parents, the community, or the media are easily accepted. Children at this stage tend not to be interested in culture, race, or ethnicity and are generally ready to take on the opinions of others. 2. cultural, racial, and ethnic identity search and is characterized by the exploration and questioning of culture, race, and ethnicity in order to learn more about them and to understand the implications of belonging. During this stage, there is questioning of where beliefs come from and why they are held. For some, this stage may arise from a turning point in their lives or from a growing awareness of other cultures, races, and ethnicities. It can also be a very emotional time. 3. cultural, racial, and ethnic identity achievement. Ideally, people at this stage have a clear sense of their cultural, racial, and ethnic identity and are able to successfully navigate it in the contemporary world, which is undoubtedly very interconnected and intercultural. The acceptance of cultural, racial, and ethnic identity may play a significant role in important life decisions and choices, influencing attitudes and behavior. This usually leads to an increase in self-confidence and positive psychological development.

Crisis Intervention Theories

A "crisis" is an acute disruption of psychological homeostasis in which a client's usual coping mechanisms fail and there is evidence of distress and functional impairment. A crisis does not need to be precipitated by a major life event. The goals are to alleviate stress and mobilize coping skills, psychological capabilities, and social resources. The goals of crisis intervention are to (a) relieve the impact of stress with emotional and social resources, (b) return a client to a previous level of functioning (regain equilibrium), (c) help strengthen coping mechanisms during the crisis period, and (d) develop adaptive coping strategies. Crisis intervention focuses on the here and now, is time limited (most crises last from 4 to 6 weeks), is directive, and requires high levels of activity and involvement from a social worker. A social worker sets specific goals and tasks in order to increase a client's sense of mastery and control.

Token economy (specific behavioral terms)

A client receives tokens as reinforcement for performing specified behaviors. The tokens function as currency within the environment and can be exchanged for desired goods, services, or privileges.

Rational emotive therapy (RET) (specific behavioral terms)

A cognitively oriented therapy in which a social worker seeks to change a client's irrational beliefs by argument, persuasion, and rational reevaluation and by teaching a client to counter self-defeating thinking with new, nondistressing self-statements.

Contract

A contract can be a written, oral, or even implied agreement, although the more specific a contract, the more likely it is to prevent misunderstandings. A contract should delineate the problems or concerns to be addressed, goals and objectives of the intervention, activities that a client will undertake, tasks to be performed by a social worker, expected duration of the intervention, schedule of time and place for meetings, and/or identification of other persons, agencies, or organizations expected to assist with the change process.

Program Evaluation

A cost-benefit analysis determines the financial costs of operating a program as compared with the fiscal benefits of its outcomes. A cost-benefit ratio is generated to determine whether, and the extent to which, the costs exceed the benefits. Program decisions can be made to eliminate or modify the program (by reducing program expenditures) based upon the findings. A cost-effectiveness analysis is similar to a cost-benefit analysis, but distinct. It considers the benefits that are not measured in monetary terms, such as illnesses prevented and/or lives saved. It does not produce a cost-benefit ratio, but may focus on the most financially efficient way to achieve a defined outcome or the cost for producing a specific nonmonetary outcome. An outcomes assessment is the process of determining whether a program has achieved its intended goal(s). It involves collecting evidence through assessment, analyzing the data, and then using the findings to make programmatic changes if needed. It is an iterative process with continual feedback loops.

Gender role

A gender role is a theoretical construct that refers to a set of social and behavioral norms that, within a specific culture, are widely considered to be socially appropriate for individuals of a specific sex.

Controversy of cognitive development

A major controversy in cognitive development has been "nature and nurture," that is, the question of whether cognitive development is mainly determined by a client's innate qualities ("nature"), or by his or her personal experiences ("nurture"). However, it is now recognized by most experts that this is a false dichotomy: There is overwhelming evidence from biological and behavioral sciences that, from the earliest points in development, gene activity interacts with events and experiences in the environment.

Mental Status Exam

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 process, thought content, perception, cognition, insight, and judgment. A mental status examination is a necessary part of any client assessment no matter what the presenting problem. It should be documented in the record either in list form or in narrative form. The following client functions should be included: 1. Appearance—facial expression, grooming, dress, gait, and so on 2. Orientation—awareness of time and place, events, and so on 3. Speech pattern—slurred, pressured, slow, flat tone, calm, and so on 4. Affect/mood—mood as evidenced in both behavior and client's statements (sad, jittery, manic, placid, etc.) 5. Impulsive/potential for harm—impulse control with special attention to potential suicidality and/or harm to others 6. Judgment/insight—ability to predict the consequences of her or his behavior, to make "sensible" decisions, to recognize her or his contribution to her or his problem 7. Thought processes/reality testing—thinking style and ability to know reality, including the difference between stimuli that are coming from inside herself or himself and those that are coming from outside herself or himself (statements about delusions, hallucinations, and conclusions about whether or not a client is psychotic would appear here) 8. Intellectual functioning/memory—level of intelligence and of recent and remote memory functions

mission statement, goals, objectives and outcomes

A mission statement is a general, concise statement outlining the purpose guiding the practices of an organization. Outcomes eventually flow from the mission statements of an agency. Goals are broad, general statements of what the program intends to accomplish. Goals describe broad outcomes and concepts expressed in general terms (e.g., clear communication, problem-solving skills). Goals should provide a framework for determining the more specific objectives of a program and should be consistent with the mission of the agency. A single goal may have many specific subordinate objectives. Objectives are brief, clear statements that describe the desired outcomes. They are distinguished from goals by the level of specificity. Goals express intended outcomes in general terms and objectives express them in specific terms. Outcomes may be knowledge, abilities (skills), and/or attitudes (values, dispositions) that have been obtained. Outcomes are achieved results.

Risk factors of abusers

A past history of violent behavior is the best predictor of future violence Risk factors include: 1. History of owning weapons and using them against others 2. Criminal history; repetitive antisocial behavior 3. Drug and alcohol use (substance use is associated with the most violent crimes) 4. Psychiatric disorder with coexisting substance abuse 5. Certain psychiatric symptoms such as psychosis, intense suspiciousness, anger, and/or unhappiness 6. Personality Disorders (Borderline and Antisocial Personality Disorders) 7. History of impulsivity; low frustration tolerance; recklessness; inability to tolerate criticism; entitlement 8. Angry affect without empathy for others—high anger scores associated with increased chance of violence 9. Environmental stressors: lower socioeconomic status or poverty; job termination

Role theories

A role is defined as the collection of expectations that accompany a particular social position. Each of these roles carries its own expectations about appropriate behavior, speech, attire, and so on. Role ambiguity: lack of clarity of role Role complementarity: the role is carried out in an expected way (i.e., parent-child; social worker-client) Role discomplementarity: the role expectations of others differ from one's own Role reversal: when two or more individuals switch roles Role conflict: incompatible or conflicting expectations When assessing, social workers view problems as differences between clients' behaviors and the expectations of others with regard to roles.

Symptoms of Addiction

A social worker should be aware of the signs and symptoms of addiction, as well as withdrawal. For example, use of cocaine can be associated with dilated pupils, hyperactivity, restlessness, perspiration, anxiety, and impaired judgment. Delirium tremens (DTs) is a symptom associated with alcohol withdrawal that includes hallucinations, rapid respiration, temperature abnormalities, and body tremors. Wernicke's encephalopathy and Korsakoff's syndrome are disorders associated with chronic abuse of alcohol. They are caused by a thiamine (vitamin B1) deficiency resulting from the chronic consumption of alcohol. A person with Korsakoff's syndrome has memory problems. Treatment is administration of thiamine.

System Theory

A system is a whole comprising component parts that work together. Applied to social work, systems theory views human behavior through larger contexts, such as members of families, communities, and broader society. The founding and central principle is the examination of homeostasis and mechanisms that it affects Important to this theory is the concept that when one thing changes within a system, the whole system is affected. Applications to Social Work 1. Social workers need to understand interactions between the micro, mezzo, and macro levels. 2. Problems at one part of a system may be manifested at another. 3. Ecomaps and genograms can help to understand system dynamics. 4. Understanding "person-in-environment" is essential to identifying barriers or opportunities for change. 5. Problems and change are viewed within larger contexts.

Flooding (specific behavioral terms)

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

Individual Psychology

Adler believed that the main motivations for human behavior are not sexual or aggressive urges, but striving for perfection. He pointed out that children naturally feel weak and inadequate in comparison to adults. This normal feeling of inferiority drives them to adapt, develop skills, and master challenges. Adler used the term "compensation" to refer to the attempt to shed normal feelings of inferiority. However, some people suffer from an exaggerated sense of inferiority-inferiority. Such people overcompensate, which means that, rather than try to master challenges, they try to cover up their sense of inferiority by focusing on outward signs of superiority such as status, wealth, and power. Healthy individuals have a broad social concern and want to contribute to the welfare of others. Unhealthy people are those who are overwhelmed by feelings of inferiority. The aim of therapy is to develop a more adaptive lifestyle by overcoming feelings of inferiority and self-centeredness and to contribute more toward the welfare of others.

Common Prescription Medications

Advair Diskus is a prescription used to treat asthma and chronic obstructive pulmonary disease (COPD). Crestor is a lipid-lowering agent taken orally. Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) for oral administration. Diovan is used to treat heart disease or heart failure. Hydrocodone/acetaminophen is the most popular painkiller used to treat moderate to severe pain. Hydrocodone, a narcotic analgesic, relieves pain through the central nervous system, and it also is used to stop or prevent coughing. This drug can become habit-forming when used over an extended period of time. Levothyroxine sodium is used to treat hypothyroidism, a condition where the thyroid gland does not produce enough of the thyroid hormone. This drug also is used to treat thyroid cancer and to help shrink an enlarged thyroid gland. Lantus is a sterile solution of insulin glargine for use as a subcutaneous injection for diabetes. Lisinopril (which used to be sold under the brand names Zestril and Prinivil) is a high blood pressure medication. Its main function is to block chemicals in the body that trigger the tightening of blood vessels. Lisinopril also is used to help treat heart failure. Lyrica is used to control seizures, as well as treat nerve pain and fibromyalgia. Metoprolol, the generic version of Lopressor, is used to treat high blood pressure and also helps reduce the risk of repeated heart attacks. Metoprolol also treats heart failure and heart pain or angina. Nexium is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid. Simvastatin (generic form of Zocor) is prescribed to treat high cholesterol and is typically recommended in conjunction with diet changes. This drug is believed to have a variety of benefits including helping to prevent heart attacks and strokes. Synthroid is a prescription, man-made thyroid hormone that is used to treat hypothyroidism. Ventolin solution is used in inhalers for asthma. Vyvanse is used to treat hyperactivity and impulse control disorders.

Role in the Problem-Solving Process

Advocate In the advocate role, social workers champion the rights of others with the goal of empowering the client system being served. Social workers have a particular responsibility to advocate on behalf of those disempowered by society. Broker In the role of broker, social workers are responsible for identifying, locating, and linking client systems to needed resources in a timely fashion. Social workers are concerned with the quality, quantity, and accessibility of services. Change Agent A change agent participates as part of a group or organization seeking to improve or restructure some aspect of service provision. A change agent, working with others, uses the problem-solving model to identify the problem, solicit input, and plan for change. A change agent acts in a coordinated manner to achieve planned change at multiple levels that helps to shift the focus of institutional resources to meet identified goals. Counselor The role of the counselor focuses on improving social functioning. Social workers help client systems articulate their needs, clarify their problems, explore resolution strategies, and apply intervention strategies to develop and expand the capacities of client systems to deal with problems more effectively. A key function of this role is to empower clients by affirming their personal strengths and their capacities to deal with problems more effectively. Mediator When dispute resolution is needed in order to accomplish goals, social workers will carry out the role of mediator. Social workers intervene in disputes between parties to help them find compromises, reconcile differences, and reach mutually satisfying agreements. The mediator takes a neutral stance among the involved parties. The primary role of social workers is to act as a resource—assuming various roles depending upon the nature of client problems.

Acceptance

An acknowledgment of "what is." Acceptance does not pass judgment on a circumstance and allows clients to let go of frustration and disappointment, stress and anxiety, regret and false hopes. Acceptance is the practice of recognizing the limits of one's control. Acceptance is not giving up or excusing other people's behavior and allowing it to continue. Acceptance is not about giving in to circumstances that are unhealthy or uncomfortable. The main thing that gets in the way of acceptance is wanting to be in control.

Systematic desensitization (specific behavioral terms)

An anxiety-inhibiting response cannot occur at the same time as the anxiety response. Anxiety-producing stimulus is paired with relaxation-producing response so that eventually an anxiety-producing stimulus produces a relaxation response. At each step a client's reaction of fear or dread is overcome by pleasant feelings engendered as the new behavior is reinforced by receiving a reward. The reward could be a compliment, a gift, or relaxation.

Behavioral- OPERANT CONDITIONING (B. F. Skinner)

Antecedent events or stimuli precede behaviors, which, in turn, are followed by consequences. Consequences that increase the occurrence of the behavior are referred to as reinforcing consequences; consequences that decrease the occurrence of the behavior are referred to as punishing consequences. Reinforcement aims to increase behavior frequency, whereas punishment aims to decrease it. Antecedent → Response/Behavior → Consequence

Aversion therapy (specific behavioral terms)

Any treatment aimed at reducing the attractiveness of a stimulus or a behavior by repeated pairing of it with an aversive stimulus. An example of this is treating alcoholism with Antabuse.

Information

Anything people perceive from their environments or from within themselves. People act in response to information.

Cognitive dissonance

Arises when a person has to choose between two contradictory attitudes and beliefs. The most dissonance arises when two options are equally attractive. Three ways to reduce dissonance are to (a) reduce the importance of conflicting beliefs, (b) acquire new beliefs that change the balance, or (c) remove the conflicting attitude or behavior. This theory is relevant when making decisions or solving problems.

Assertiveness Training

Assertiveness training is when procedures are used to teach clients how to express their positive and negative feelings and to stand up for their rights in ways that will not alienate others. Assertiveness training typically begins with clients thinking about areas in their life in which they have difficulty asserting themselves. The next stage usually involves role plays designed to help clients practice clearer and more direct forms of communicating with others. Feedback is provided to improve responses, and the role play is repeated. Clients are asked to practice assertive techniques in everyday life. Assertiveness training promotes the use of "I" statements as a way to help clients express their feelings.

Steps in Cognitive Restructuring

Assist clients in: 1. Accepting that their self-statements, assumptions, and beliefs determine or govern their emotional reaction to life's events 2. Identifying dysfunctional beliefs and patterns of thoughts that underlie their problems 3. Identifying situations that evoke dysfunctional cognitions 4. Substituting functional self-statements in place of self-defeating thoughts 5. Rewarding themselves for successful coping efforts

Couples Interventions and Treatment Approaches

Behavior modification—Successful couples counseling methods will address and attempt to modify any dysfunctional behavior so that couples can change the way each individual behaves with the other. Insight-oriented psychotherapy—A good deal of time is spent studying interactions between individuals in order to develop a hypothesis concerning what caused individuals to react to each other in the way they do. Gottman Method, which is based on the notion that healthy relationships are ones in which individuals know each other's stresses and worries, share fondness and admiration, maintain a sense of positiveness, manage conflicts, trust one another, and are committed to one another. In addition, when developing an alliance with the couple as a unit, a social worker can reframe individual problems in relationship terms and support each person's sense of himself or herself as being part of a unit, as well as a separate individual.

Biofeedback (specific behavioral terms)

Behavior training program that teaches a person how to control certain functions such as heart rate, blood pressure, temperature, and muscular tension. Biofeedback is often used for Attention-Deficit/Hyperactivity Disorder (ADHD) and Anxiety Disorders.

Behavioral Development

Behavioral theories suggest that personality is a result of interaction between the individual and the environment. Behavioral theorists study observable and measurable behaviors, rejecting theories that take internal thoughts and feelings into account. These theories represent the systematic application of principles of learning to the analysis and treatment of behaviors. Behaviors determine feelings. Thus, changing behaviors will also change or eliminate undesired feelings. The goal is to modify behavior. Best-known applications of behavior modification are sexual dysfunctions, phobic disorders, compulsive behaviors (i.e., overeating, smoking), and training of persons with Intellectual Disabilities and/or Autism Spectrum Disorder.

Models of Explaining Substance Abuse

Biopsychosocial model: There are a wide variety of reasons why people start and continue using substances. This model provides the most comprehensive explanation for the complex nature of substance abuse disorders. It incorporates hereditary predisposition, emotional and psychological problems, social influences, and environmental problems. Medical model: Addiction is considered a chronic, progressive, relapsing, and potentially fatal medical disease. - Genetic causes: Inherited vulnerability to addiction, particularly alcoholism - Brain reward mechanisms: Substances act on parts of the brain that reinforce continued use by producing pleasurable feelings - Altered brain chemistry: Habitual use of substances alters brain chemistry and continued use of substances is required to avoid feeling discomfort from a brain imbalance Self-medication model: Substances relieve symptoms of a psychiatric disorder and continued use is reinforced by relief of symptoms. Family and environmental model: Explanation for substance abuse can be found in family and environmental factors such as behaviors shaped by family and peers, personality factors, physical and sexual abuse, disorganized communities, and school factors. Social model: Drug use is learned and reinforced from others who serve as role models. A potential substance abuser shares the same values and activities as those who use substances. There are no controls that prevent use of substances. Social, economic, and political factors, such as racism, poverty, sexism, and so on, contribute to the cause.

Techniques in an Interview

Clarification—reformulate problem in a client's words to make sure that the social worker is on the same wavelength Confrontation—calling attention to something Interpretation—pulling together patterns of behavior to get a new understanding Reframing and relabeling—stating problem in a different way so a client can see possible solutions Summarization—identifying key ideas and themes regarding client problems to provide focus and continuity to an interview Universalization—the generalization or normalization of behavior

Rorschach Inkblot Test

Client responses to inkblots are used to assess perceptual reactions and other psychological functioning. It is one of the most widely used projective tests.

Self-Monitoring Techniques

Clients are encouraged to pay attention to any subtle shift in feelings. Clients frequently keep thought or emotion logs that include three components: (a) disturbing emotional states, (b) the exact behaviors engaged in at the time of the emotional states, and (c) thoughts that occurred when the emotions emerged. In cognitive behavioral therapy (CBT), homework is often done between sessions to record these encounters. This homework involves client self-monitoring, which is central to this approach.

Rational Choice

Clients are rational and goal directed and human interaction involves exchange of social resources such as love, approval, information, money, and physical labor. Clients have self-interest and try to maximize rewards and minimize costs. Power comes from unequal resources in exchanges.

Conflict

Clients try to advance their own interests over the interests of others as they compete for scarce resources. Power is unequally divided and some social groups dominate others. Members of nondominant groups become alienated from society. Social change is driven by conflict.

Follow-up

Clients who tell social workers during follow-up about new problems that have arisen should be seen for assessment.Social workers who have already assisted clients resolve issues are often the first ones to which clients disclose new problems which have emerged. The standard of practice is that social workers must involve clients and their families (when appropriate) in making their own decisions about follow-up services or aftercare. Involvement must include, at a minimum, discussion of client and family preferences (when appropriate).

Co-occurring Disorders

Co-occurring disorders and conditions are present when there are two or more disorders occurring at the same time. For example, clients may have one or more disorders relating to the use of alcohol and/or other drugs, as well as one or more mental disorders. In order for a disorder or condition to be co-occurring, it must be independent and not symptomatology resulting from the other disorder(s)/condition(s).

Cognitive Development

Cognitive development focuses on development in terms of information processing, conceptual resources, perceptual skill, language lea

Intradisciplinary teams

Composed exclusively of social workers who may have different levels of training and skill within the profession. Intradisciplinary teams are often referred to as unidisciplinary. An interdisciplinary approach differs from a multidisciplinary one due to its holistic nature. Professionals in an interdisciplinary team are charged with working together and a treatment plan is usually developed by the entire group.

Consultation

Consultation is the utilization of an "expert" in a specific area to assist with developing a solution to the issue. Consultation is usually time limited and the advice of the consultant can be used by a social worker in the problem-solving process. When seeking consultation, social workers need to get the permission of clients if any identifying or specific information will be shared. In addition, social workers should only disclose information that is absolutely necessary when interacting with consultants. Four things are critical in consultation: 1. Defining the purpose of the consultation 2. Specifying the consultant's role 3. Clarifying the nature of the problem 4. Outlining the consultation process

Partializing Techniques

During the problem-solving process, a social worker may need to assist a client to break down problems or goals into less overwhelming and more manageable components. This is known as partialization and aims to break complex issues into simpler ones. Partialization is useful because it may assist a social worker and a client to identify the goals that are easier to achieve first, enabling a client to see results more quickly and gain some success in making harder changes. Behavioral objectives are the smaller, observable, and measurable intermediate steps that lead to broader long-term goals. There are several important elements of behavioral objectives: 1. Good behavioral objectives are client-oriented and place the emphasis upon what a client will need to do in order for change to occur. 2. Good behavioral objectives are clear and understandable and contain a clearly stated verb that describes a definite action or behavior. 3. Good behavioral objectives are observable and describe an action that results in observable products. 4. Good behavioral objectives contain the behavior targeted for change, conditions under which a behavior will be performed, and the criteria for determining when the acceptable performance of the behavior occurs.

Humanistic Perspective

Each client is unique and is responsible for the choices he or she makes. Clients have the capacity to change themselves because human behavior is driven by a desire for growth, personal meaning, and competence. Behaving in ways that are not consistent with the true self causes clients anxiety.

Ego Psychology

Ego psychology focuses on the rational, conscious processes of the ego. Ego psychology is based on an assessment of a client as presented in the present (here and now). Treatment focuses on the ego functioning of a client, because healthy behavior is under the control of the ego. It addresses: - Behavior in varying situations Reality testing: perception of a situation - Self Psychology - Coping abilities: ego strengths - Capacity for relating to others The goal is to maintain and enhance the ego's control and management of stress and its effects.

Delirium, Dementia and Depression

Elderly clients are at high risk for depression, as well as cognitive disorders, the latter of which can be chronic (as in dementia) or acute (as in delirium). Some patients have both affective (mood) and cognitive disorders. Clarifying the diagnosis is the first step to effective treatment, but this can be particularly difficult because elderly clients often have medical comorbidities that can contribute to cognitive and affective changes.

Emotional Development

Emotional milestones are often harder to pinpoint than signs of physical development. This area emphasizes many skills that increase self-awareness and self-regulation. Social skills and emotional development are reflected in the ability to pay attention, make transitions from one activity to another, and cooperate with others.

Empathic Communication

Empathic understanding involves being nonjudgmental, accepting, and genuine. - Establishes rapport with clients—empathic communication is one means of bridging the gap between a social worker and client - Starts where a client is and stays attuned to a client throughout the encounter (being perceptive to changes in frame of mind) - Increases the level at which clients explore themselves and their problems - Responds to a client's nonverbal messages (a social worker can observe body language and make explicit a client's feelings) - Decreases defensiveness and engages a client in processing and testing new information - Defuses anger that represents obstacles to progress

Nonverbal communications

Facial expression, body language, and posture can be potent forms of communication.

Information processing block

Failure to perceive and evaluate potentially useful new information.

Family crisis

Family crises are disruptions in families' usual patterns of functioning. Families in crisis find that their usual ways of coping or problem solving do not work; as a result, they feel vulnerable, anxious, and overwhelmed. Family members may have difficulty thinking clearly, dwell on meaningless activities, express hostility or numbness, be impulsive or dependent, and/or feel incompetent. Families are thrust into crises when more than one of the following occurs: They experience a stress-producing situation - They have difficulty coping - They show chronic difficulty meeting basic family responsibilities - They lack sources of support

Existential Theory

Focus on the acceptance of the client's fundamental autonomy, freedom of choice, and the social worker's commitment to the concept of client self-determination

Existential Theory

Focuses on a person as a unique being, as well as the choices they can currently make empowering them to take responsibility for their well-being (self-determination)

Formal and informal power

Formal power is received in accordance with position in an organization and the authority associated with that position. Conversely, informal power stems from the relationships built and respect earned from coworkers. Formal Power Formal power may refer to position in the organizational hierarchy, corporate structure, or even job function. A chief executive officer, for example, has decision-making power in many areas. Informal Power The most powerful person in an organizational unit is not necessarily a supervisor. Instead, persons with the most influence, who can lead others to achieve goals or accomplish tasks, may have the greatest influence. Formal power is necessary to achieve goals. Informal power can be equally useful. Workers may be more apt to accept criticism or take direction when they receive guidance from a colleague that is respected and trusted. It is often easier to get employee "buy-in" when suggestions come from those with informal power.

Grieving process

Grieving can be thought of as a developmental process with phases which focus on reacting (focusing on safety, trust, and survival), reconstructing (focusing on validation and understanding), and reorienting (focusing on self-reinvention), though the process is not always linear.

Group Work

Group work is a method of working with two or more people for personal growth, the enhancement of social functioning, and/or for the achievement of socially desirable goals. When individual problems arise, they should be directed to the group for possible solutions as the group is the agent of change. Social workers must remind group members that confidentiality cannot be guaranteed—though seeing an agreement among group members concerning preserving the confidentiality of information shared should be an initial goal of any group process. Contraindications for group: client who is in crisis; suicidal; compulsively needy for attention; actively psychotic; and/or paranoid Types of Groups: Open Versus Closed Open groups are those in which new members can join at any time. Closed groups are those in which all members begin the group at the same time. Short-Term Versus Long-Term Some groups have a very short duration, whereas others meet for a longer duration. A social worker takes on different roles throughout the group process, which has a beginning, middle, and end. Beginning A social worker identifies the purpose of the group and his or her role. This stage is characterized as a time to convene, to organize, and to set a plan. Members are likely to remain distant or removed until they have had time to develop relationships. Middle Almost all of the group's work will occur during this stage. Relationships are strengthened as a group so that the tasks can be worked on. Group leaders are usually less involved. End The group reviews its accomplishments. Feelings associated with the termination of the group are addressed.

Phobias

Haphephobia- fear of being touched Acrophobia- fear of heights Algophobia- fear of pain Agoraphobia- fear of leaving home or going to unfamiliar places

Leadership vs. Management

However, there is agreement that successful organizations need both good leadership and management. Some suggest that leadership can be viewed as a subset of management because a leadership role is inherent in a management position. Leadership is related to being focused on the future, dealing with uncertainty and instability, and prospectively considering the ways in which organizational operations need to change. Leadership also includes initiating, sustaining, and helping to maintain a certain amount of momentum through the change process. Leaders must be attentive to and help to balance stability and change. Management, on the other hand, focuses on efficiency, effectiveness, and planning.

Social Behavioral

Human behavior is learned when clients interact with the environment through association, reinforcement, and imitation. All human problems can be formulated as undesirable behavior and can be changed through techniques such as classical and operant conditioning.

Developmental

Human development occurs in defined, age-related stages that build upon one another and are distinct. Human development is a complex interaction of biological, psychological, and social factors.

Id, Ego and Superego

Id: A reservoir of instinctual energy that contains biological urges such as impulses toward survival, sex, and aggression. The id is unconscious and operates according to the pleasure principle, the drive to achieve pleasure and avoid pain. Ego: The component that manages the conflict between the id and the constraints of the real world. Some parts of the ego are unconscious, whereas others are preconscious or conscious. The ego operates according to the reality principle—the awareness that gratification of impulses has to be delayed in order to accommodate the demands of the real world. The ego's role is to prevent the id from gratifying its impulses in socially inappropriate ways. Ego-Syntonic/Ego-Dystonic: Syntonic = behaviors "insync" with the ego (no guilt) Dystonic = behavior "dis-n-sync" with the ego (guilt) The ego's job is to determine the best course of action based on information from the id, reality, and the superego. When the ego is comfortable with its conclusions and behaviors, a client is said to be ego-syntonic. However, if a client is bothered by some of his or her behaviors, he or she would be egodystonic (ego alien). Ego strength is the ability of the ego to effectively deal with the demands of the id, the superego, and reality. Superego: The moral component of personality. It contains all the moral standards learned from parents and society. The superego forces the ego to conform not only to reality, but also to its ideals of morality. Hence, the superego causes clients to feel guilty when they go against society's rules.

Objectives in stages of cognitive development

Ideally, in order for a client to learn, there should be objectives at each of these levels. Clients may have goals to learn in any of three domains of development: 1. Cognitive: mental skills (knowledge) 2. Affective: growth in feelings or emotional areas (attitude or self) 3. Psychomotor: manual or physical skills (skills)

Steps of Intervention Planning

In engagement, a social worker should be actively involved with a client in determining why treatment was sought; what has precipitated the desire to change now; the parameters of the helping relationship, including defining the roles of a social worker and client; and the expectations for treatment (what will occur and when it will happen). Client involvement is essential in determining what is important to a client now and in the future. In assessment, a client is the source of providing essential information upon which to define the problem and solutions, as well as identifying collateral contacts from which gaps in data can be collected. In planning, an understanding of the problem is developed. Goals are developed from this understanding in order to provide a direction to help or assist. Specific action plans are developed and agreed upon in order to specify who will do what, what resources will be needed and how they will be used, and timelines for implementation and review. In intervention, a client must be actively involved in mobilizing his or her support network to realize continued progress and sustainable change. A client must bring to the attention of a social worker issues that arise which may threaten goal attainment. Progress, based upon client reports, must be tracked and plans/timelines adjusted accordingly. In evaluation, subjective reports of a client, in conjunction with objective indicators of progress, should be used to determine when goals or objectives have been met and whether new goals or objectives should be set. Client self-monitoring is a good way to involve a client so he or she can see and track progress himself or herself. In termination, a client should reflect on what has been achieved and anticipate what supports are in place if problems arise again. Although this is the last phase of the problem-solving process, it still requires active involvement by both a social worker and client.

Assent and Consent

In order to obtain informed consent, social workers must use clear and understandable language related to service purpose, risks, limits due to third-party payers, time frame, and right of refusal or withdrawal. If the client lacks capacity or is a minor informed consent must be obtained by a responsible third party and assent must be obtained from the client. Consent is the agreement of clients or their authorized representatives, who have legal authority to make decisions for them, to participate in treatment. Assent is a term used to express willingness to participate in treatment by clients who are too young to give consent or have been deemed by the courts as incapable of making legal decisions. Assent by itself is not sufficient. If assent is given, social workers must still obtain consent from clients' parents or guardians. Court-mandated services do not require clients' consent, but clients should be advised at the onset what they have control over and what they do not in these situations. In some states, children can access limited services without parental consent, but the terms still have distinct meanings.

Strategic Family Therapy

In strategic family therapy, a social worker initiates what happens during therapy, designs a specific approach for each person's presenting problem, and takes responsibility for directly influencing people. It has roots in structural family therapy and is built on communication theory. It is active, brief, directive, and task-centered. Strategic family therapy is more interested in creating change in behavior than change in understanding. Strategic family therapy is based on the assumption that families are flexible enough to modify solutions that do not work and adjust or develop. There is the assumption that all problems have multiple origins; a presenting problem is viewed as a symptom of and a response to current dysfunction in family interactions. Concepts/Techniques - Pretend technique—encourage family members to "pretend" and encourage voluntary control of behavior - First-order changes—superficial behavioral changes within a system that do not change the structure of the system - Second-order changes—changes to the systematic interaction pattern so the system is reorganized and functions more effectively - Family homeostasis—families tend to preserve familiar organization and communication patterns; resistant to change - Relabeling—changing the label attached to a person or problem from negative to positive so the situation can be perceived differently; it is hoped that new responses will evolve - Paradoxical directive or instruction—prescribe the symptomatic behavior so a client realizes he or she can control it; uses the strength of the resistance to change in order to move a client toward goals

Readiness for Termination

In termination, a social worker and client (a) evaluate the degree to which a client's goals have been attained, (b) acknowledge and address issues related to the ending of the relationship, and (c) plan for subsequent steps a client may take relevant to the problem that do not involve a social worker (such as seeking out new services, if necessary).

Methods to Assess Reliability and Validity in Research

Interrater or Interobserver Reliability Assesses the degree to which different raters/observers give consistent estimates of the same phenomenon. Test-Retest Reliability Assesses the consistency of a measure from one time to another. Parallel Forms Reliability Assesses the consistency of the results of two tests constructed in the same way from the same content domain. Internal Consistency Reliability Assesses the consistency of results across items within a test. Validity is the degree to which what is being measured is what is claimed to be measured. It attempts to minimize systematic errors that may yield reliable results but do not actually assess the constructs of interest. There are different means to assess validity. Face Validity Examines whether the assessments "on their face" measure the constructs. Content Validity Examines whether all of the relevant content domains are covered. Criterion-Related Validity (including predictive, concurrent, convergent, and discriminant validities) Examines whether constructs perform as anticipated in relation to other theoretical constructs. - Predictive validity assesses whether constructs predict what they should theoretically be able to predict. - Concurrent validity assesses whether constructs distinguish between groups that should be able to be distinguished. - Discriminant validity assesses the degree to which constructs are different from (diverge away from) other constructs to which they should be dissimilar.

Behavioral- RESPONDENT OR CLASSICAL CONDITIONING (Pavlov)

Learning occurs as a result of pairing previously neutral (conditioned) stimulus with an unconditioned (involuntary) stimulus so that the conditioned stimulus eventually elicits the response normally elicited by the unconditioned stimulus. Unconditioned Stimulus → Unconditioned Response Unconditioned Stimulus + Conditioned Stimulus → Unconditioned Response Conditioned Stimulus → Conditioned Response

Learning theory

Learning theory is a conceptual framework describing how information is absorbed, processed, and retained during learning. Cognitive, emotional, and environmental influences, as well as prior experience, all play a part in how understanding, or a worldview, is acquired or changed, as well as how knowledge and skills are retained.

Manifest and Latent Content

Manifest content is the concrete words or terms contained in a communication, whereas latent content is that which is not visible, the underlying meaning of words or terms.

Signs of Drug Use

Marijuana: glassy, red eyes; loud talking, inappropriate laughter followed by sleepiness; loss of interest, motivation; weight gain or loss Cocaine: dilated pupils; hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; may go long periods of time without eating or sleeping; weight loss; dry mouth and nose Heroin: contracted pupils; no response of pupils to light; needle marks; sleeping at unusual times; sweating; vomiting; coughing, sniffling; twitching; loss of appetite

level of care determinations

Medical necessity is a criterion used to determine whether treatments and services are justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care. Payment for services, as well as whether levels of care are justified, uses medical necessity to assess whether treatment and service requests are "reasonable and necessary" given clients' diagnoses and/or presenting problems.

Features of Bipolar

Melancholic- loss of pleasure in almost all activities or lack of reactivity to usually pleasant stimuli and, in some cases, decreased appetite and weight loss Atypical- mood reactivity, hypersomnia, increase appetite, feelings of rejections, and/or heaving feeling in arms or legs Catatonia- marked psychomotor disturbance involving extreme inactivity or excessive motor activity

Modeling (specific behavioral terms)

Method of instruction that involves an individual (the model) demonstrating the behavior to be acquired by a client.

Shaping (specific behavioral terms)

Method used to train a new behavior by prompting and reinforcing successive approximations of the desired behavior.

Genetic testing

Minimally, a social worker must understand the types of genetic conditions, including single gene disorders, chromosome anomalies, and multifactorial disorders, and the effect of harmful environmental toxins on development. Furthermore, an understanding of the patterns of inheritance between generations (autosomal dominant, autosomal recessive, and X-linked recessive) is essential in working with families.

Social planning

Models of social planning in social work practice include those that are based on community participation. Rather than planning "for" communities, social workers as planners engage "with" community members. Social planning does not merely examine sociological problems that exist, but also includes the physical and economic factors that relate to societal issues.

Motivation

Motivation is a state of readiness or eagerness to change, which may fluctuate from one time or situation to another. The role of a social worker is to create an atmosphere that is conducive to change and to increase a client's intrinsic motivation, so that change arises from within rather than being imposed from without. Empathy is a factor that increases motivation, lowers resistance, and fosters greater long-term behavioral change.

Object Relations Theory

Object relations theory, which was a focus of Margaret Mahler's work, is centered on relationships with others. According to this theory, lifelong relationship skills are strongly rooted in early attachments with parents, especially mothers.

Double bind

Offering two contradictory messages and prohibiting the recipient from noticing the contradiction.

Common Feedback Methods

One-on-One Feedback An individual delivering feedback to another, face-to-face, is probably the most common form. Such feedback needs to be delivered sensitively and according to the principles of the profession. Intragroup Feedback Individuals in a group provide feedback to the group and/or to one or more individuals within the group. If the feedback is directed to the performance of the group, it can be particularly effective. Group-to-Group Feedback This might take place between two groups that are working together. The feedback may go in one direction or both. The feedback might be directed at particular individuals or at the group as a whole. Consultative Feedback An individual or group serves as a formal or informal consultant to another (usually to a group, but occasionally to an individual). The individual or group receiving the feedback may be more apt to accept and consider the feedback, given the expertise of the consultative entity, but has no obligation to do so. 360° Feedback This method involves feedback from all directions—supervisors, peers, subordinates, the community, and so forth. The idea is that the feedback reflects multiple viewpoints and gives a complete picture. All models of feedback in social work practice should be supportive, use a strengths perspective (emphasizing the positives), not "attack," and focus on actions needed for change.

Stages of community-based decision making

Orientation stage—Community members may meet for the first time and start to get to know each other. Conflict stage—Disputes, little fights, and arguments may occur. These conflicts are eventually worked out. Emergence stage—Community members begin to see and agree on a course of action. Reinforcement stage—Community members finally make a decision and justify why it was correct. Community members are far more likely to buy into policy that has been created with their participation. Their support over time will lead to permanent change.

In vivo desensitization (specific behavioral terms)

Pairing and movement through a hierarchy of anxiety, from least to most anxiety-provoking situations; takes place in "real" setting.

Permanency Planning

Permanency planning is an approach to child welfare that is based on the belief that children need permanence to thrive. Child protection services should focus on getting children into, and maintaining, permanent homes.

Phases of Trauma Informed Care

Phase 1: Safety and Stabilization This initial stage is focused on establishing safety and stability, which must occur for trauma treatment to proceed. For many trauma survivors, basic needs, as described in Maslow's hierarchy of needs, are not being met. In this phase, social work interventions include case management to obtain housing, health services, transportation, and other critical supports. Crisis intervention models aimed at developing safety plans and establishing equilibrium or stability are also used. Phase 2: Mourning and Remembrance The second stage is when survivors acknowledge and speak about what happened and are ready to integrate experiences into a larger life context. This process allows emotional space in which the future can be constructed. Addressing what is and is not remembered is the focus of creating healing stories about the trauma experienced. Psychoeducation can be a very important component of addressing questions about the trauma experience and its effects. Trauma always results in a loss of some kind. Grief for what was, for what never was, and/or for what could have been must be addressed. Phase 3: Reconnection and Reintegration The third stage is marked by a commitment to move forward in life, searching for ways to use the trauma experience for empowerment. Trauma survivors may engage in new activities and/or relationships. A client moves from surviving into a new identity marked by an understanding of his or her history of trauma. Therapeutic strategies include integration of self-care strategies into everyday life and developing deepening resilience.

Cycles of Violence

Phase I: Tension building Phase II:Battering incident—shortest period of the cycle, lasts a brief time Phase III:"Loving-contrition" (absence of tension or "honeymoon" phase)—batterer offers profuse apologies; assures attacks will never happen again and declares love and caring

Stages of Group Development

Preaffiliation—development of trust (known as forming) Power and control—struggles for individual autonomy and group identification (known as storming) Intimacy—utilizing self in service of the group (known as norming) Differentiation—acceptance of each other as distinct individuals (known as performing) Separation/termination—independence (known as adjourning)

Primary, Secondary, and Tertiary Prevention Strategies

Primary Prevention The goal is to protect people from developing a disease, experiencing an injury, or engaging in a behavior in the first place. Examples: - Immunizations against disease - Education promoting the use of automobile passenger restraints and bicycle helmets - Screenings for the general public to identify risk factors for illness - Controlling hazards in the workplace and home - Regular exercise and good nutrition - Counseling about the dangers of tobacco and other drugs Since successful primary prevention helps avoid the disease, injury, or behavior and its associated suffering, cost, and burden, it is typically considered the most cost-effective. Secondary Prevention Secondary prevention occurs after a disease, injury, or illness has occurred. It aims to slow the progression or limit the long-term impacts. It is often implemented when asymptomatic, but risk factors are present. Secondary prevention also may focus on preventing reinjury. Examples: - Telling those with heart conditions to take daily, low-dose aspirin - Screenings for those with risk factors for illness - Modifying work assignments for injured workers Tertiary Prevention Tertiary Prevention Tertiary prevention focuses on managing complicated, long-term diseases, injuries, or illnesses. The goal is to prevent further deterioration and maximize quality of life because disease is now established and primary prevention activities have been unsuccessful. However, early detection through secondary prevention may have minimized the impact of the disease. Examples: - Pain management groups - Rehabilitation programs - Support groups

Roles in Healthy Families

Provision of Resources: The provision of resources is an instrumental role that fulfills the most basic needs of the family unit: having money, food, clothing, and shelter. Emotional Support: Supporting other family members is primarily an affective role and includes providing comfort and support. Life Skills Development: One of the functions of families is the physical, emotional, educational, and social development of children. This role ensures that life skills development of members occurs. Family System Management: Decision making, handling finances, and maintaining appropriate boundaries and behavioral standards are critical to maintaining a healthy family dynamic. Intimate Relationship Maintenance: Intimate relationships, including sexual ones, are critical between partners and couples. Ensuring that quality intimate relationships are maintained is essential to meeting the emotional needs of partners and spouses. - The Family Hero, often the oldest child, devotes his or her time and attention to minimizing or masking problems. By overachieving and being successful in school or work, the Family Hero tries to make up for a dysfunctional home life. - The Scapegoat is defiant, hostile, and angry, and gets in trouble at school or work. His or her behavior turns the focus away from dysfunction in the family. - The Mascot tries to get people to laugh as a way of improving the atmosphere and drawing attention away from the dysfunctional household. -The Lost Child becomes a loner or is very shy. He or she draws away from interactions with family members and becomes invisible in order to avoid adding to the dysfunction or stain.

Psychodynamic theories

Psychodynamic theories explain the origin of the personality. Although many different psychodynamic theories exist, they all emphasize unconscious motives and desires, as well as the importance of childhood experiences in shaping personality. Psychodynamic approaches aim to help clients review emotions, thoughts, early life experiences, and beliefs in order to gain insight into their lives and their present-day problems. Recognizing recurring patterns helps clients see the ways in which they avoid distress and/or develop defense mechanisms as methods of coping so that they can take steps to change these patterns. ccording to psychodynamic theory, behavior is influenced by unconscious thought; vulnerable or painful feelings are resolved by the use of defense mechanisms.

Psychotherapies

Psychotherapy aims to treat clients with mental disorders or problems by helping them understand their illness or situation. Social workers use verbal techniques to teach clients strategies to deal with stress, unhealthy thoughts, and dysfunctional behaviors. Psychotherapy helps clients manage their symptoms better and function optimally in everyday life. For example, cognitive behavioral therapy (CBT), a blend of cognitive and behavioral therapy, is used for depression, anxiety, and other disorders. Dialectical behavior therapy (DBT), a form of CBT developed by Marsha Linehan, was developed to treat people with suicidal thoughts and actions. It is now also used to treat people with Borderline Personality Disorder.

experimental, quasi-experimental, and pre-experimental

Randomized experiments, also called "experimental," are the most rigorous. When randomization of subjects or groups is neither practical nor feasible, quasi-experimental approaches can be used. Quasi-experimental research uses intervention and comparison groups, but assignment to the groups is nonrandom. Pre-experimental studies contain intervention groups only and lack comparison/control groups, making them the weakest.

Anger Management Techniques

Relaxation Exercises - Deep breathing - Meditation or repeating calming words/phrases - Guided imagery - Yoga - Stretching or physical exercise Assisting clients to practice these techniques regularly will result in using them automatically in tense situations. Cognitive Techniques - Replacing destructive thoughts, such as "This is the end of the world" with healthy ones like "This is frustrating, but it will pass" - Focusing on goals as a way of finding solutions to problems - Using logic to get a more balanced perspective - Not using an "all or nothing" approach - Putting situations into perspective Communication Skills - Slowing down speech to avoid saying something not meant or that one will regret - Listening to what others are saying - Thinking about what to say before speaking - Avoiding defensiveness - Using humor to lighten the situation Environmental Change - Walking away or leaving situation - Avoiding people or situations in the future that evoke anger - Not starting conversations or entering situations that may cause anger when tired or rushed

Reliability and Validity in Research Terms

Reliability (dependability, stability, consistency, predictability): Can you get the same answer repeatedly? Validity (accuracy): Is what is believed to be measured actually being measured or is it something else? External validity: Can the results be generalized? Internal validity: Is there confidence in cause/effect?

Time out (specific behavioral terms)

Removal of something desirable—negative punishment technique.

Echolalia

Repeating noises and phrases. It is associated with Catatonia, Autism Spectrum Disorder, Schizophrenia, and other disorders. It is a behavior that is part of normal language development. The stage in which it will be most prominent begins around 18 months as a child masters producing language/speech, is able to imitate words and begin to imitate phrases spoken by others Echolalia peaks at 24-30 months of age, and disappears by the time a child turns 3. Echolalia can be associated with various development problems, but in the absence of other diagnostic signs it should not be a sign of pathology or concerns

Information processing

Responses to information that are mediated through one's perception and evaluation of knowledge received.

Role-Modeling

Role modeling emphasizes the importance of learning from observing and imitating and has been used successfully in helping clients acquire new skills, including those associated with assertiveness. Role modeling works well when it is combined with role play and reinforcement to produce lasting change. Live modeling refers to watching a real person perform the desired behavior. Symbolic modeling includes filmed or videotaped models demonstrating the desired behavior. Self-modeling is another form of symbolic modeling in which clients are videotaped performing the target behavior. In participant modeling, an individual models anxiety-evoking behaviors for a client and then prompts the client to engage in the behavior. In covert modeling, clients are asked to use their imagination, visualizing a particular behavior as another describes the imaginary situation in detail.

Role Play

Role playing in social work practice may be seen between supervisor and supervisee or social worker and client. In all instances, role playing usually raises interest in a topic as clients are not passive recipients in the learning process. In addition, role playing teaches empathy and understanding of different perspectives as clients take on the role of another, learning and acting as that individual would in the specified setting. In role playing, participation helps embed concepts. Role playing gives clarity to information that may be abstract or difficult to understand. Role playing activities can be divided into four stages: 1. Preparation and explanation of the activity 2. Preparation of the activity 3. Role playing 4. Discussion or debriefing after the role play activity

Difference between screening and assessment

Screening is a process for evaluating the possible presence of a particular problem. The outcome is normally a simple yes or no. Assessment is a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis.

Single-Subject Research

Single-subject research aims to determine whether an intervention has the intended impact on a client, or on many clients who form a group. The most common single-subject research is pre- and post-test or single-case study (AB) in which there is a comparison of behavior before treatment (baseline; denoted by an "A") and behavior after the start of treatment (intervention; denoted by a "B"). The reversal or multiple baseline (ABA or ABAB) is also commonly used. In single-subject research, a client is used as his or her own control. The focus differs from experimental research, which looks at the average effect of an intervention between groups of people. Single-subject research is ideal for studying the behavioral change a client exhibits as a result of some treatment. When done correctly and carefully, single-subject research can show a causal effect between the intervention and the outcome. The flexibility, simplicity, and low cost of single-subject research are also beneficial. It can be more flexible and easier to plan because it is usually smaller in scale than experimental research.

Social Constructionist

Social reality is created when clients, in social interaction, develop a common understanding of their world. Clients are influenced by social processes that are grounded in customs, as well as cultural and historical contexts.

Interdisciplinary teams

Social workers often work together with others from various professions. Interdisciplinary teams are often seen as advantageous to clients because they do not have the burden of navigating multiple service systems and communicating to multiple professionals involved in their care. Interdisciplinary teams can also be cost effective and can increase positive outcomes.

Ethics Audit

Social workers should create, implement, and evaluate policies that minimize risk for clients, workers, and practice settings. One critical feature of implementing a comprehensive risk management strategy is conducting a comprehensive ethics audit. An ethics audit entails examining risks through the following steps: 1. Appointing a committee or task force of concerned and informed staff and colleagues 2. Gathering information from agency documents, interviews with staff and clients, accreditation reports, and other sources to assess risks associated with client rights; confidentiality and privacy; informed consent; service delivery; boundary issues; conflicts of interest; documentation; client records; supervision; staff development and training; consultation; client referral; fraud; termination of services; professional impairment; misconduct, or incompetence; and so on 3. Reviewing all collected information Determining whether there is no risk, minimal risk, moderate risk, or high risk in each area 4. Preparing action plans to address each risk, paying particular attention to policies that need to be created to prevent risk in the future and steps needed to mitigate existing risk Monitoring policy implementation and progress made toward reducing existing risk, as well as ensuring that procedures adhere to social work's core ethical principles

The Family Life Cycle

Stage 1: Family of origin experiences: - Maintaining relationships with parents, siblings, and peers - Completing education - Developing the foundations of a family life Stage 2: Leaving home - Differentiating self from family of origin and parents and developing adult-to-adult relationships with parents - Developing intimate peer relationships - Beginning work, developing work identity, and financial independence Stage 3: Premarriage stage - Selecting partners - Developing a relationship - Deciding to establish own home with someone Stage 4: Childless couple stage - Developing a way to live together both practically and emotionally - Adjusting relationships with families of origin and peers to include partner Stage 5: Family with young children - Realigning family system to make space for children - Adopting and developing parenting roles - Realigning relationships with families of origin to include parenting and grandparenting roles - Facilitating children to develop peer relationships Stage 6: Family with adolescents - Adjusting parent-child relationships to allow adolescents more autonomy - Adjusting family relationships to focus on midlife relationship and career issues - Taking on responsibility of caring for families of origin Stage 7: Launching children - Resolving midlife issues - Negotiating adult-to-adult relationships with children - Adjusting to living as a couple again - Adjusting to including in-laws and grandchildren within the family circle - Dealing with disabilities and death in the family of origin Stage 8: Later family life - Coping with physiological decline in self and others - Adjusting to children taking a more central role in family maintenance - Valuing the wisdom and experience of the elderly - Dealing with loss of spouse and peers Preparing for death, life review, and reminiscence

Theories of Couples Development

Stage 1: Romance: - Much of this stage consists of conversations and dates to learn more about the other partner. - The focus of this stage is attachment. - symbiotic or mutualistic relationships—often putting the needs of others before their own. Stage 2: Power Struggle - As the coupled individuals begin to notice differences and annoyances that were once overlooked, there can be greater separation and loss of romance resulting from self-expression. This stage differs as individuals focus on differences rather than similarities, which was the hallmark of the initial romantic stage. - Differentiation, or seeing oneself as distinct within a relationship, must be managed so that these new feelings do not result in breakups as the illusion of "being one" fades. - To "survive" this stage, individuals must acknowledge differences, learn to share power, forfeit fantasies of complete harmony, and accept partners without the need to change them. Stage 3: Stability - There is acceptance that partners are different from one another and power struggles to minimize these differences are avoided. - Margaret Mahler described "practicing" as a subphase of separation-individuation in infant development. Practicing occurs when toddlers begin to explore on their own, but still see themselves as part of their mothers/caregivers. The stability stage of couples development mirrors this subphase as partners learn to live independent lives while still identifying as and seeing the value of being part of an intimate relationship. - "rapprochement," also relates to the stability stage of couples development. Often, partners who have been successful in achieving a well-defined sense of self in relationships will have crises that will threaten their identities or separateness. They may rely more heavily on companionship and intimacy, seeking more comfort and support from each other. Thus, the stability stage is a time when there is still some back and forth between intimacy and independence with the ultimate goal being intimacy that does not sacrifice separateness. Stage 4: Commitment - Partners acknowledge that they want to be with each other and that the good outweighs the bad. Stage 5: Co-creation - The foundation of the relationship is no longer personal need, but the appreciation and love of the other and the support and respect for mutual growth.

Methods to Assess The Availability of Community Resources

Step 1: Clarifying the Need or Purpose for the Referral Step 2: Researching Resources Step 3: Discussing and Selecting Options Step 4: Planning for Initial Contact Step 5: Initial Contact Step 6: Follow-Up to See If Need Was Met

Stress Management Techniques

Stress is a psychological and/or physical reaction to life events, with most people experiencing it regularly in their own lives. The first step in stress management is for clients to monitor their stress levels and identify their stress triggers. These can be major life events, but also those associated with day-to-day life, such as job pressures, relationship problems, or financial difficulties. Positive life events, such as getting a job promotion, getting married, or having children, also can be stressful. The second step in stress management is to assist clients in identifying what aspects of a situation they can control. Clients can make these changes, as well as benefit from stress-reduction techniques, such as deep breathing, exercise, massage, tai chi, or yoga, to manage those aspects of a situation that cannot be altered. Maintaining a healthy lifestyle is essential to helping manage stress.

Substance and Non-substance Abuse Disorders

Substance Use Disorder in Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) combines the DSM-IV categories of Substance Abuse and Substance Dependence into a single disorder measured on a continuum from mild to severe. Each specific substance (other than caffeine, which cannot be diagnosed as a Substance Use Disorder) is addressed as a separate use disorder (Alcohol Use Disorder, Stimulant Use Disorder, etc.). Mild Substance Use Disorder in DSM-5 requires two to three symptoms from a list of 11. Drug craving is added to the list, and problems with law enforcement is eliminated because of cultural considerations that make the criteria difficult to apply. Essentially, people can become addicted, dependent, or compulsively obsessed with any activity, substance, object, or behavior that gives pleasure. These activities, substances, objects, or behaviors produce beta-endorphins in the brain, producing a "high," leading to an addictive cycle. Those who are addicted will become obsessed with an activity, substance, object, or behavior and will seek it out, often to the detriment of work or interpersonal relationships. They will compulsively engage in the activity even if they do not want to do so. Cessation of the activity results in withdrawal symptoms of irritability, craving, and restlessness. Those with addictions do not appear to have control as to when, how long, or how much they will continue the activity, use of the substance or object, or behavior (loss of control). Individuals with addictive behaviors deny problems resulting from the addiction, even though others can see the negative effects. They usually have low self-esteem because there are psychological factors associated with other addictions as well.

Signs of Abuse

Suspicious injury (not consistent with history of injury, unusual locations, various stages of healing, bites, repeated minor injuries, delay in seeking treatment, and old scars or new injuries from weapons) Somatic complaints without a specific diagnosis (such as chronic pain—head, abdomen, pelvis, back, or neck) Behavioral presentation (crying, minimizing, no emotional expression, anxious or angry, defensive, fearful eye contact) Controlling/coercive behavior of partner (partner hovers, overly concerned, won't leave client unattended, client defers to partner, fear of speaking in front of partner, or disagreeing with him or her)

Systems

Systems are made up of interrelated parts; each part impacts all other parts, as well as the system as a whole. The dynamic interactions within, between, and among systems produce both stability and change.

Beck Depression Inventory

The Beck Depression Inventory (BDI) is a 21-item test, presented in multiple-choice formats, that assesses the presence and degree of depression in adolescents and adults.

Malingering

The DSM-5 defines malingering as intentionally falsely or grossly exaggerating physical or psychological problems. Motivation for malingering is usually external, such as avoiding work/military, obtaining reward (financial resources, medications, etc.), avoiding legal action, and so on. On the other hand, malingering also may be an adaptive response such as an inmate with mental illness trying to obtain relatively sparse and difficult-to-obtain mental health resources in prison. Three categories of malingering are: - Pure malingering (feigning a nonexistent disorder) - Partial malingering (consciously exaggerating real symptoms) - False imputation (ascribing real symptoms to a cause a client knows is unrelated to the symptoms)

Differences in the DSM-5

The DSM-5 deleted a separate section for "Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence" and now lists them in other chapters. The DSM-5 replaces the Not Otherwise Specified (NOS) categories with two options: Other Specified Disorder and Unspecified Disorder. 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. The DSM-5 has discarded the multiaxial system of diagnosis (formerly Axis I, Axis II, Axis III) and combines the first three axes outlined in past editions of the DSM into one axis with all mental and other medical diagnoses. It has replaced Axis IV with significant psychosocial and contextual features and dropped Axis V (Global Assessment of Functioning, known as GAF). The World Health Organization's Disability Assessment Schedule 2.0 (WHODAS 2.0) is added to Section III, Emerging Measures and Models, under Assessment Measures.

The Minnesota Multiphasic Personality Inventory

The Minnesota Multiphasic Personality Inventory (MMPI) is an objective verbal inventory designed as a personality test for the assessment of psychopathology consisting of 550 statements, 16 of which are repeated. The Minnesota Multiphasic Personality Inventory (MMPI) has the following clinical scales: hypochondriasis, indicating stress over physical health; depression, indicating hopelessness; hysteria, indicating anxiety and tension; psychopathic, indicating aggression, acting out, and rebellion; masculinity-femininity, indicating gender identity; paranoia, indicating disturbed thinking; psychasthenia, indicating worrying; schizophrenia, indicating orientation to reality; hypomania, indicating energy; and social introversion, indicating being withdrawn.

Myers-Briggs Type Indicator

The Myers-Briggs Type Indicator (MBTI) is a forced-choice, self-report inventory that attempts to classify individuals along four theoretically independent dimensions. The first dimension is a general attitude toward the world, either extraverted (E) or introverted (I). The second dimension, perception, is divided between sensation (S) and intuition (N). The third dimension is that of processing. Once information is received, it is processed in either a thinking (T) or feeling (F) style. The final dimension is judging (J) versus perceiving (P).

Person-in-Environment (PIE) Theory

The PIE perspective highlights the importance of understanding individual behavior in light of the environmental contexts in which a client lives and acts. The perspective has historical roots in the social work profession. The PIE classification system was developed as an alternative to the commonly used disease and moral models (i.e., Diagnostic and Statistical Manual of Mental Disorders [DSM], International Statistical Classification of Diseases and Related Health Problems [ICD], civil or penal codes) to implement social work philosophy and area of expertise. PIE is client-centered, rather than agency-centered.

Stanford-Binet Intelligence Scale

The Stanford-Binet Intelligence Scale is designed for the testing of cognitive abilities. It provides verbal, performance, and full scale scores for children and adults.

Thematic Apperception Test

The Thematic Apperception Test (TAT) is another widely used projective test. It consists of a series of pictures of ambiguous scenes. Clients are asked to make up stories or fantasies concerning what is happening, has happened, and is going to happen in the scenes, along with a description of their thoughts and feelings. The TAT provides information on a client's perceptions and imagination for use in the understanding of a client's current needs, motives, emotions, and conflicts, both conscious and unconscious. Its use in clinical assessment is generally part of a larger battery of tests and interview data.

Wechsler Intelligence Scale

The Wechsler Intelligence Scale (WISC) is designed as a measure of a child's intellectual and cognitive ability. It has four index scales and a full scale score.

Active listening

The active part in the listening process can be achieved by showing interest in clients' words. Once clients notice that social workers are understanding what is said and really taking an interest, communication will be more open. Active listening establishes trust and respect, so clients will feel comfortable confiding in social workers. Thus, it helps build a therapeutic alliance. Active listening can also include speaking by using mirroring techniques to paraphrase and reflect back to clients what they have just said.

Process of Engagement

The beginning of the problem-solving process includes activities of a social worker and a client to be helped that are directed at (a) becoming engaged with each other (engagement), (b) assessing a client's situation in order to select appropriate goals and the means of attaining them (assessment), and (c) planning how to employ these means (planning). During engagement, the limits to confidentiality must be explicitly stated at the beginning of this stage. Social workers must also explain their roles and how they can assist clients in addressing their problems.

Context

The circumstances surrounding human exchanges of information.

three different levels of awareness

The conscious contains all the information that a client is paying attention to at any given time. The preconscious contains all the information outside of a client's attention but readily available if needed—thoughts and feelings that can be brought into consciousness easily. The unconscious contains thoughts, feelings, desires, and memories of which clients have no awareness but that influence every aspect of their day-to-day lives.

Metacommunication

The context within which to interpret the content of the message (i.e., nonverbal communication, body language, vocalizations).

Aim Inhibition (defense mechanism)

The individual accepts a modified form of their original goal. AKA substitution

Race

The meaning of race is not fixed; it is related to a particular social, historical, and geographic context. The way races are classified has changed in the public mind over time; for example, at one time racial classifications were based on ethnicity or nationality, religion, or minority language groups. Today, society classifies people into different races primarily based on skin color.

Mindfulness

The practice of paying close attention to what is being experienced in the present, both inside the body and mind and in the external world. It is a conscious effort to be with whatever is going on right now, without judging or criticizing what we find. In each moment, mindfulness invites being awake, aware, and accepting of ourselves. The practice of mindfulness is integral to efforts to reduce stress and to increase capacity to cope. Mindfulness can stand alone as a treatment tool or may be incorporated with other treatment modalities. Most settings where social workers practice would be conducive to mindfulness practice.

Case Management

The primary goal of social work case management is to optimize client functioning and well-being by providing and coordinating high-quality services, in the most effective and efficient manner possible, to individuals with multiple complex needs (NASW Standards for Social Work Case Management, 2013). Five case management activities are (a) assessment, (b) planning, (c) linking, (d) monitoring, and (e) advocacy. Fragmentation presents one of the biggest service delivery challenges for clients and those who are assisting them, such as social workers. Clients can fall through the cracks because the connections between services are either absent or problematic, or needed services are missing altogether.

Strengths Perspective

The strengths perspective is based on the assumption that clients have the capacity to grow, change, and adapt (humanistic approach). Clients also have the knowledge that is important in defining and solving their problems (clients or families are experts about their own lives and situations); they are resilient and survive and thrive despite difficulties.

Case Presentations

There is no universal format for a case presentation in social work practice. However, there are some standard elements, including: - Identifying data (demographics, cultural considerations) - History of the presenting problem (family history) - Significant medical/psychiatric history (diagnoses) - Significant personal and/or social history (legal issues, academic/work problems, crisis/safety concerns) - Presenting problem (assessment, mental status, diagnosis) Impressions and summary (interview findings) - Recommendations (treatment plan/intervention strategies, goals, theoretical models used)

Basic conditions of the therapeutic process

There must be trust with a social worker. There must be recognition that the therapeutic process is a joint exploration. There must be listening on both sides. A social worker must behave in a manner that makes it easier for a client to speak freely by listening attentively, by accepting what is said in a nonjudgmental manner, and by giving occasional support or encouragement. A social worker may be encouraging by simply repeating reflectively or paraphrasing what a client has said.

Self Psychology

This approach defines the self as the central organizing and motivating force in personality. As a result of receiving empathic responses from early caretakers (self-objects), a child's needs are met and the child develops a strong sense of selfhood. "Empathic failures" by caretakers result in a lack of self-cohesion. The objective of self psychology is to help a client develop a greater sense of self-cohesion. Through therapeutic regression, a client reexperiences frustrated self-object needs. Three self-object needs are: Mirroring: behavior validates the child's sense of a perfect self Idealization: child borrows strength from others and identifies with someone more capable Twinship/Twinning: child needs an alter ego for a sense of belonging Ego Psychology According to Kohut, caregivers are not always responsive, which leads to poor self-cohesion. It is essential that children receive mirroring that confirms children's sense of greatness and perfection, idealizing of others through which children take in strength and calmness, and twinship or alter-ego that provides children with a sense of being human and a likeness to others.

Structural Family Therapy

This approach stresses the importance of family organization for the functioning of the group and the well-being of its members. A social worker "joins" (engages) the family in an effort to restructure it. Family structure is defined as the invisible set of functional demands organizing interaction among family members. Boundaries and rules determining who does what, where, and when are crucial in three ways. 1. Interpersonal boundaries define individual family members and promote their differentiation and autonomous, yet interdependent, functioning. Dysfunctional families tend to be characterized by either a pattern of rigid enmeshment or disengagement. 2. Boundaries with the outside world define the family unit, but boundaries must be permeable enough to maintain a well-functioning open system, allowing contact and reciprocal exchanges with the social world. 3. Hierarchical organization in families of all cultures is maintained by generational boundaries, the rules differentiating parent and child roles, rights, and obligations. Restructuring is based on observing and manipulating interactions within therapy sessions, often by enactments of situations as a way to understand and diagnose the structure and provide an opportunity for restructuring.

Maslow's hierarchy of needs

This five-stage model can be divided into basic (or deficiency) needs (i.e., physiological, safety, social, and esteem) and growth needs (self-actualization). Deficiency needs—also known as D-Needs Growth needs—also known as "being needs" or B-Needs Deficiency Needs - Physiological - Safety - Social - Esteem Maslow called these needs "deficiency needs" because he felt that these needs arise due to deprivation. The satisfaction of these needs helps to "avoid" unpleasant feelings or consequence. Growth Needs - Self-actualization These needs fall on the highest level of Maslow's pyramid. They come from a place of growth rather than from a place of "lacking."

Psychoeducation Methods

This model allows a social worker to provide clients with information necessary to make informed decisions that will allow them to reach their respective goals. In addition to focusing on clients' education, it also provides support and coping skills development.

continuous quality improvement systems

Today, many agencies are developing systems that move beyond compliance monitoring. These systems attempt to gather and assess a range of information on quality, and they work to implement needed improvements on an ongoing basis. As a way of differentiating these efforts from traditional compliance monitoring, the new approaches are often called continuous quality improvement systems. These systems require that agencies adopt the following steps: Step 1: Adopting outcomes and standards Step 2: Incorporating quality assurance standards and processes throughout their work Step 3: Gathering data and information Step 4: Analyzing data and information Step 5: Using analyses and information to make improvements Funders and accreditors support and encourage the move toward continuous quality improvement processes. This new approach improves upon compliance monitoring in three ways. First, quality improvement programs are broader in scope, assessing practice and outcomes, as well as compliance. Second, they attempt to use data, information, and results to effect positive changes in policy and practice, along with compliance with federal, state, and agency requirements. Third, these programs engage a broad range of internal and external partners in the quality improvement process, including top managers, staff at all levels, clients, and other stakeholders.

Parallel Process (transference and counter transference)

Transference and countertransference within supervisory relationships can be a parallel process of what is occurring between a social worker and a client. The transference occurs when a social worker recreates, within a supervisory relationship, a presenting problem and emotions occurring in a therapeutic relationship. Countertransference occurs when a supervisor responds to a social worker in the same manner that a social worker responds to a client. Thus, a supervisory interaction replays, or is parallel with, a social worker-client interaction. In essence, the processes at work in the relationship between a social worker and a client are reflected in the relationship between a social worker and his or her supervisor.

Traumatic experience

Traumatic experiences often involve a threat to life or safety, but any situation that leaves a client feeling overwhelmed and alone can be traumatic, even if it does not involve physical harm. It is not the objective facts that determine whether an event is traumatic, but a subjective emotional experience of the event. An event will most likely lead to emotional or psychological trauma if: - It happened unexpectedly - There was not preparation for it - There is a feeling of having been powerless to prevent it - It happens repeatedly - Someone was intentionally cruel - It happened in childhood

SOAP format

Treatment plans are often developed and progress is often assessed based upon objective and subjective data gathered by a social worker. S (Subjective): The subjective component is a client's report of how he or she has been doing since the last visit and/or what brought a client into treatment. O (Objective): In health care, the objective component includes vital signs (temperature, blood pressure, pulse, and respiration), documentation of any physical examinations, and results of laboratory tests. In other settings, this section may include other objective indicators of problems such as disorientation, failing school, legal issues, and so forth. A (Assessment): A social worker pulls together the objective and subjective findings and consolidates them into a short assessment. P (Plan): The plan includes what will be done as a consequence of the assessment. Lastly, in evaluation, subjective reports of a client, in conjunction with objective indicators of progress, should be used to determine when goals or objectives have been met and whether new goals or objectives should be set. Client self-monitoring (subjective data) is a good way to involve a client so he or she can see and track progress himself or herself.

Psychodynamic

Unconscious, as well as conscious, mental activity serves as the motivating force in human behavior. Early childhood experiences are central and clients may become overwhelmed by internal or external demands. Defense mechanisms are used to avoid becoming overwhelmed.

Terms/Values that may inhibit the therapeutic relationship

Universalism—There is one acceptable norm or standard for everyone versus there are other valid standards that have been developed by people that they have determined to be most useful to them. Dichotomous "either-or" thinking; differences are inferior, wrong, bad versus differences are just different and coexist. Heightened ability/value on separating, categorizing, numbering, "left-brain" versus "right-brain" or "whole picture." Mental activity is highly valued to the exclusion of physical and spiritual experiences. Persons are studied in isolation, not as part of a group or interrelated with their environment. High value on control, constraint, restraint versus value on flexibility, emotion/feelings, expressiveness, spirituality. What cannot be controlled and definitively defined is deemed nonexistent, unimportant, unscientific, or deviant/inferior. Reality is defined with the assumption of objectivity; subjective reality is viewed as invalid because it cannot be consistently replicated by many people. Measure of self comes from outside, and is only in contrast to others versus value comes from within—you are worthwhile because you were born, and you strive to live a life that is in harmony with others and the environment. Worth is measured by ac cumulation of wealth or status (outside measures)—therefore, one can only feel good if one is better than someone else, or accumulates more than someone else, or has a higher status. Power is defined as "power over" others, mastery over environment versus "power through" or in harmony with others; by sharing power, power can be expanded, and each becomes more powerful.

Bowenian Family Therapy

Unlike other models of family therapy, the goal of this approach is not symptom reduction. Rather, a Bowenian-trained social worker is interested in improving the intergenerational transmission process. Thus, the focus within this approach is consistent whether a social worker is working with an individual, a couple, or the entire family. It is assumed that improvement in overall functioning will ultimately reduce a family member's symptomatology. 1. Differentiation is the core concept of this approach. The more differentiated, the more a client can be an individual while in emotional contact with the family. This allows a client to think through a situation without being drawn to act by either internal or external emotional pressures. 2. Emotional fusion is the counterpart of differentiation and refers to the tendency for family members to share an emotional response. This is the result of poor interpersonal boundaries between family members. In a fused family, there is little room for emotional autonomy. If a member makes a move toward autonomy, it is experienced as abandonment by other members of the family. 3. Multigenerational transmission stresses the connection of current generations to past generations as a natural process. Multigenerational transmission gives the present a context in history. This context can focus a social worker on the differentiation in the system and on the transmission process. 4. An emotional triangle is the network of relationships among three people. Bowen's theory states that a relationship can remain stable until anxiety is introduced. However, when anxiety is introduced into the dyad, a third party is recruited into a triangle to reduce the overall anxiety. It is almost impossible for two people to interact without triangulation. 5. The nuclear family is the most basic unit in society and there is a concern over the degree to which emotional fusion can occur in a family system. Clients forming relationships outside of the nuclear family tend to pick mates with the same level of differentiation. 6. Family projection process describes the primary way parents transmit their emotional problems to children. The projection process can impair child functioning and increase vulnerability to clinical symptoms. 7. Sibling position is a factor in determining personality. Where a client is in birth order has an influence on how he or she relates to parents and siblings. Birth order determines the triangles that clients grow up in. 8. Societal regression, in contrast to progression, is manifested by problems such as the depletion of natural resources. Bowen's theory can be used to explain societal anxieties and social problems, because Bowen viewed society as a family—an emotional system complete with its own multigenerational transmission, chronic anxiety, emotional triangles, cutoffs, projection processes, and fusion/differentiation struggles.

Antianxiety Drugs

Used for the treatment of Anxiety Disorders Ativan (lorazepam) Buspar (buspirone) Klonopin (clonazepam) Valium (diazepam) Xanax (alprazolam) Benzodiazepines are a class of drugs primarily used for treating anxiety, but they also are effective in treating several other conditions. There is a high abuse potential of these drugs and they can be dangerous when combined with alcohol or illicit substances. It is critical to look for signs of impaired motor or other functioning.

Stimulants

Used for the treatment of Attention-Deficit/Hyperactivity Disorder Adderall (amphetamine, mixed salts) Concerta (methylphenidate, long acting) Dexedrine (dextroamphetamine) Dexedrine Spansules (dextroamphetamine, long acting) Metadate (methylphenidate, long acting) Ritalin (methylphenidate)

Antimanic Agents (Mood Stabilizers)

Used for the treatment of Bipolar Disorder Depakene (valproic acid, divalproex sodium), Depakote sprinkles Lamictal (lamotrigine) Lithium (lithium carbonate), Eskalith, Lithobid Tegretol (carbamazepine), Carbotrol Topamax (topiramate) There is a small difference between toxic and therapeutic levels (narrow therapeutic index) that necessitates periodic checks of blood levels of lithium. Also, there is a need for periodic checks of thyroid and kidney functions, because lithium can affect the functioning of these organs.

Antidepressants

Used for the treatment of Depressive Disorders Selective Serotonin Reuptake Inhibitors (SSRIs) Celexa (citalopram) Lexapro (escitalopram) Luvox (fluvoxamine) Paxil (paroxetine) Prozac (fluoxetine) Zoloft (sertraline) Tricyclics Anafranil (clomipramine) Asendin (amoxapine) Elavil (amitriptyline) Norpramin (desipramine) Pamelor (nortriptyline) Sinequan (doxepin) Surmontil (trimipramine) Tofranil (imipramine) Vivactil (protriptyline) Monoamine Oxidase Inhibitors (MAOIs) Nardil (phenelzine) Parnate (tranylcypromine) There are dietary restrictions of foods that contain high levels of tyramine (generally food that has been aged). Foods to avoid may include beer, ale, wine (particularly Chianti), cheese (except cottage and cream cheese), smoked or pickled fish (herring), beef or chicken liver, summer (dry) sausage, fava or broad bean pods (Italian green beans), and yeast vitamin supplements (brewer's yeast). Others Desyrel (trazodone) Effexor (venlafaxine) Remeron (mirtazapine) Serzone (nefazodone) Wellbutrin (bupropion)

Antipsychotics Medications

Used for the treatment of Schizophrenia and mania Typical Haldol (haloperidol) Haldol Decanoate (long-acting injectable) Loxitane (loxapine) Mellaril (thioridazine) Moban (molindone) Navane (thiothixene) Prolixin (fluphenazine) Serentil (mesoridazine) Stelazine (trifluoperazine) Thorazine (chlorpromazine) Trilafon (perphenazine) Atypical Abilify (aripiprazole) Clozaril (clozapine) Geodon (ziprasidone) Risperdal (risperidone) Seroquel (quetiapine) Zyprexa (olanzapine) With Clozaril, there is an increased risk of agranulocytosis that requires blood monitoring.

Wernicke's encephalopathy and Korsakoff's syndrome

Wernicke's encephalopathy and Korsakoff's syndrome (sometimes called "Wet Brain") are disorders associated with chronic abuse of alcohol. They are caused by a thiamine (vitamin B1) deficiency resulting from the chronic consumption of alcohol. Korsakoff's syndrome or Korsakoff's psychosis tends to develop as Wernicke's symptoms go away. dWernicke's encephalopathy causes brain damage in lower parts of the brain called the thalamus and hypothalamus. Korsakoff's psychosis results from permanent damage to areas of the brain involved with memory. Symptoms of Wernicke's encephalopathy include confusion and loss of mental activity that can progress to coma and death, loss of muscle coordination that can cause leg tremor, and/or vision changes such as abnormal eye movements. Symptoms of Korsakoff's syndrome include inability to form new memories or even seeing or hearing things that are not really there.

Extinction (specific behavioral terms)

Withholding a reinforcer that normally follows a behavior. Behavior that fails to produce reinforcement will eventually cease.

mandated network arrangements and selforganizing networks

Within each of these forms, there may be a lead organization or a model in which all organizations share decision-making power. The former is often associated with a centralized structure, whereas the latter is more indicative of a decentralized one. Networks can also have strong and weak arrangements in which the parameters of integration may or may not be highly regulated.

Devaluation (defense mechanism)

a defense mechanism frequently used by persons with Borderline Personality Disorder in which a person attributes exaggerated negative qualities to self or another. It is the split of primitive idealization.

Projective Identification (defense mechanism)

a form of projection utilized by persons with Borderline Personality Disorder—unconsciously perceiving others' behavior as a reflection of one's own identity.

Symbolization (defense mechanism)

a mental representation stands for some other thing, class of things, or attribute. This mechanism underlies dream formation and some other symptoms (such as conversion reactions, obsessions, compulsions) with a link between the latent meaning of the symptom and the symbol; usually unconscious.

Social work assessment

a more comprehensive process that may utilize the results from educational and psychological tests, but can also involve interviewing a client and/or family, reviewing a client's history, checking existing records, and consulting with previous or concurrent providers.

Undoing (defense mechanism)

a person uses words or actions to symbolically reverse or negate unacceptable thoughts, feelings, or actions (i.e., a person compulsively washing hands to deal with obsessive thoughts).

Dissociation (defense mechanism)

a process that enables a person to split mental functions in a manner that allows him or her to express forbidden or unconscious impulses without taking responsibility for the action, either because he or she is unable to remember the disowned behavior, or because it is not experienced as his or her own (i.e., pathologically expressed as fugue states, amnesia, or dissociative neurosis, or normally expressed as daydreaming).

Pluralism

a society in which diverse members maintain their own traditions while cooperatively working together and seeing others' traits as valuable (cultural pluralism—respecting and encouraging cultural difference)

Psychodrama

a treatment approach in which roles are enacted in a group context. Members of the group re-create their problems and devote themselves to the role dilemmas of each member.

Tardive dyskinesia

abnormal, involuntary movements of the tongue, lips, jaw, and face, as well as twitching and snakelike movement of the extremities and occasionally the trunk may result from taking high doses of antipsychotic medications over a long period of time. Symptoms may persist indefinitely after discontinuation of these medications. Thus, antipsychotic use should be closely monitored and prescribed at low doses if possible.

Coordination

achieved through the integration of services in which services are combined and provided simultaneously. Such an approach is often used with mental health and substance use interventions in which they are combined within a primary treatment relationship or service setting. Another method of coordination is wrap-around services in which multiple providers and services may overlap in some ways, but are not combined to the same degree as integrated services. In addition, "round tables" or interdisciplinary team approaches also are useful in ensuring that all professionals are brought together to stay informed of total client care and work together to avoid fragmentation and/or duplication.

Three components of supervision

administrative, educational, and supportive. Administrative supervision aims to ensure that a social worker is accountable to the public as well as to his or her organization's policies. The major responsibility is to make sure that the work is performed in an acceptable manner. Educational supervision establishes a learning alliance between a supervisor and a social worker with the aim of teaching new skills or refining existing ones. Supportive supervision is focused on increasing performance by decreasing job-related stress that interferes with functioning.

Empowerment

aims to ensure a sense of control over well-being and that change is possible. A social worker can help to empower individuals, groups, communities, and institutions. On an individual level, social workers can engage in a process with a client aimed at strengthening his or her self-worth by making a change in life that is based on his or her desires (self-determination). To facilitate empowerment, a social worker should: 1. Establish a relationship aimed at meeting a client's needs and wishes such as access to social services and benefits or to other sources of information 2. Educate a client to improve his or her skills, thereby increasing the ability for self-help 3. Help a client to secure resources, such as those from other organizations or agencies, as well as natural support networks, to meet needs 5. Unite a client with others who are experiencing the same issues when needed to enable social and political action

Task-centered approach

aims to quickly engage clients in the problem-solving process and to maximize their responsibility for treatment outcomes. The focus is on the "here and now." The problem is partialized into clearly delineated tasks to be addressed consecutively (assessment leads to goals, which lead to tasks). Termination, in this modality, begins almost immediately upon the onset of treatment. Assessment focuses on helping a client identify the primary problem and explore the circumstances surrounding the problem. Specific tasks are expected to evolve from this process. Consideration is given to how a client would ideally like to see the problem resolved.

Sexual identity

also may be very different to their sexual orientation. Sexual identity is about the way people present their sexual preferences. People may have private sexual identities which may be different to their public identities. Even private sexual identities can differ from sexual orientation or attractions. Many people who experience same-sex attraction and/or have sexual contact with others of the same sex do not see themselves as homosexual or bisexual.

Fixation

an inability to progress normally from one stage into another. When the child becomes an adult, the fixation shows up as a tendency to focus on the needs that were overgratified or overfrustrated.

Ethnocentrism

an orientation that holds one's own culture, ethnic, or racial group as superior to others

Social exchange theory

based on the idea of totaling potential benefits and losses to determine behavior. People make decisions about relationships based on the amount of rewards they receive from them. A client remains in an abusive relationship because the high cost of leaving lowers the attractiveness (outweighs the benefits) of the best alternative. A client will leave when the best alternative promises a better life (rewards outweigh the costs).

Defense mechanisms

behaviors that protect people from anxiety. Defense mechanisms are automatic, involuntary, and usually unconscious psychological activities to exclude unacceptable thoughts, urges, threats, and impulses from awareness for fear of disapproval, punishment, or other negative outcomes. Defense mechanisms are sometimes confused with coping strategies, which are voluntary.

Compassion fatigue

best defined as a syndrome consisting of a combination of the symptoms of secondary trauma and burnout. It usually represents the overall experience of emotional and physical fatigue that social workers can experience due to the prevalent use of empathy when treating clients who are distraught and experiencing emotional pain. Social workers also encounter bureaucratic hurdles that exacerbate agency stress and upset the balance between practice and administrative demands. Much like burnout, compassion fatigue tends to occur cumulatively over time, whereas secondary trauma may have a more immediate onset. Social workers may develop empathy or compassion fatigue as they repeatedly see little or no improvement in client situations. Social workers who treat victims of trauma can find that secondary trauma may contribute to overall compassion fatigue. However, social workers who do not treat those who have experienced trauma may experience compassion fatigue without experiencing secondary trauma.

Disorientation

confusion with regard to person, time, or place

Turning Against Self (defense mechanism)

defense to deflect hostile aggression or other unacceptable impulses from another to self.

Splitting (defense mechanism)

defensive mechanism associated with Borderline Personality Disorder in which a person perceives self and others as "all good" or "all bad." Splitting serves to protect the good objects. A person cannot integrate the good and bad in people.

Countertransference

defined as redirection of a social worker's feelings toward a client, or more generally, as a social worker's emotional entanglement with a client. A social worker's recognition of his or her own countertransference is nearly as critical as understanding a client's transference. Not only does this help a social worker regulate his or her emotions in the therapeutic relationship, but it also gives a social worker valuable insight into what a client is attempting to elicit in him or her.

Endogenous depression

depression caused by a biochemical imbalance rather than a psychosocial stressor or external factors

Exogenous depression

depression caused by external events or psychosocial stressors

Conflict theory

derived from the works of Karl Marx, posits that society is fragmented into groups that compete for social and economic resources. Social order is maintained by consensus among those with the greatest political, economic, and social resources. According to conflict theory, inequality exists because those in control of a disproportionate share of society's resources actively defend their advantages. Conflict theorists challenge the status quo, encourage social change, and believe rich and powerful people force social order on the poor and the weak.

Decompensation (defense mechanism)

deterioration of existing defenses.

Psychoanalytic Theory

developed by Sigmund Freud, a client is seen as the product of his past and treatment involves dealing with the repressed material in the unconscious. According to psychoanalytic theory, personalities arise because of attempts to resolve conflicts between unconscious sexual and aggressive impulses and societal demands to restrain these impulses.

Oedipus complex

developed during the phallic stage. The Oedipus complex refers to a male child's sexual desire for his mother and hostility toward his father, whom he considers to be a rival for his mother's love. Freud thought that a male child who sees a naked girl for the first time believes that her penis has been cut off. The child fears that his own father will do the same to him for desiring his mother—a fear called castration anxiety. Because of this fear, the child represses his longing for his mother and begins to identify with his father. The child's acceptance of his father's authority results in the emergence of the superego.

Genograms

diagrams of family relationships beyond a family tree allowing a social worker and client to visualize hereditary patterns and psychological factors. They include annotations about the medical history and major personality traits of each family member. Genograms help uncover intergenerational patterns of behavior, marriage choices, family alliances and conflicts, the existence of family secrets, and other information that will shed light on a family's present situation.

Displacement (defense mechanism)

directing an impulse, wish, or feeling toward a person or situation that is not its real object, thus permitting expression in a less threatening situation (i.e., a man angry at his boss kicks his dog).

Dissociation

disturbance or change in the usually integrative functions of memory, identity, perception, or consciousness (often seen in clients with a history of trauma)

Hypomanic

elevated, expansive, or irritable mood that is less severe than full-blown manic symptoms (not severe enough to interfere with functioning and not accompanied by psychotic symptoms)

Acting Out (defense mechanism)

emotional conflict is dealt with through actions rather than feelings (i.e., instead of talking about feeling neglected, a person will get into trouble to get attention).

Compensation (defense mechanism)

enables one to make up for real or fancied deficiencies (i.e., a person who stutters becomes a very expressive writer; a short man assumes a cocky, overbearing manner).

Psychotic

experiencing delusions or hallucinations

Dynamic risk factor

factors that can be changed by interventions such as change in living situation, treatment of psychiatric symptoms, abstaining from drug and alcohol use, access to weapons, and so on. Each client presents with a unique set of risk factors that require an individualized plan.

Static risk factors

factors that cannot be changed by interventions such as past history of violent behavior or demographic information.

Delusion

false, fixed belief despite evidence to the contrary (believing something that is not true)

Community organizing

focused on harnessing the collective power of communities to tackle issues of shared concern. It challenges government, corporations, and other power-holding institutions in an effort to tip the power balance more in favor of communities. Community organization enhances participatory skills of local citizens by working with and not for them, thus developing leadership with particular emphasis on the ability to conceptualize and act on problems.

Cognitive behavioral therapy (CBT)

hands-on, practical approach to problem solving. Its goal is to change patterns of thinking or behavior that are responsible for clients' difficulties, and so change the way they feel. CBT works by changing clients' attitudes and their behavior by focusing on the thoughts, images, beliefs, and attitudes that are held (cognitive processes) and how this relates to behavior, as a way of dealing with emotional problem

Co-optation

has many meanings, but may be used as a strategy to influence social policy as leaders will try to quiet dissention or disturbances not only by dealing with immediate grievances, but by making efforts to channel the energies and angers of dissenters into more legitimate and less disruptive activities. When coopting, incentives are offered and other efforts are made aimed at complacency.

Hallucinations

hearing, seeing, smelling, or feeling something that is not real (auditory most common)

Identification (defense mechanism)

imitating central figure in one's life (act like boss, dress like parents, etc.) (identify as someone better to be better)

Independent and Dependent Variables

independent variables (or those that are believed to be causes) and dependent variables (which are the impacts or results). In many studies, the independent variable is the treatment provided and the dependent variable is the target behavior that is trying to be changed.

Psychological tests

instruments used to measure an assortment of mental abilities and characteristics, such as personality, achievement, intelligence, and neurological functioning. They often take the form of questionnaires. They may be written, verbal, or pictorial tests (like the famous Rorschach test that uses inkblot images). The tests may also be referred to as scales, surveys, screens, checklists, assessments, measures, inventories, and so on.

Qualitative research

involves collecting information through unstructured interviews, observation, and/or focus groups. Data can be collected from a single individual at a time or multiple people in group settings. Qualitative data collection methods are usually very time consuming, so they are confined to smaller samples than usually found in quantitative approaches.

Communication theory

involves the ways in which information is transmitted; the effects of information on human systems; how people receive information from their own feelings, thoughts, memories, physical sensations, and environments; how they evaluate this information; and how they subsequently act in response to the information.

Repression (defense mechanism)

key mechanism; expressed clinically by amnesia or symptomatic forgetting serving to banish unacceptable ideas, fantasies, affects, or impulses from consciousness.

Inhibition (defense mechanism)

loss of motivation to engage in (usually pleasurable) activity avoided because it might stir up conflict over forbidden impulses (i.e., writing, learning, or work blocks or social shyness).

Introjection (defense mechanism)

loved or hated external objects are symbolically absorbed within self (converse of projection) (i.e., in severe depression, unconscious unacceptable hatred is turned toward self).

Quantitative research

mainly collects data through the input of responses to research instruments containing questions (i.e., such as questionnaires). Information can be input either by the respondents themselves (e.g., online or mail survey) or social workers can input data (e.g., phone surveys or interviews). Methods for distributing surveys are via postal mail, phone, website, or in person. However, newer technologies have created additional delivery options, including through wireless devices such as smartphones.

Identification With the Aggressor (defense mechanism)

mastering anxiety by identifying with a powerful aggressor (such as an abusing parent) to counteract feelings of helplessness and to feel powerful oneself. Usually involves behaving like the aggressor (i.e., abusing others after one has been abused oneself).

Congruence in communication

matching of awareness and experience with communication. It is essential that a client is able to express himself or herself and that this communication is reflective of his or her feelings. Congruence is essential for the vitality of a relationship and to facilitate true helping as part of the problem-solving process.

Educational tests

measure cognitive (thinking) abilities and academic achievement. These measurements provide a profile of strengths and weaknesses that accurately identify areas for academic remediation and insight into the best learning strategies. They provide details into the learning process that will provide clients, family members, and school staff the best learning strategies. Educational assessments provide the necessary documentation for the legal purposes of establishing the presence of disabilities, but they do not guarantee that their findings will be accepted by schools and/or accommodations provided. Reaching decisions to have educational testing is often arrived at after a period of struggle, distress, and different efforts at improving the educational process with limited success.

Contraindicated

not recommended or safe to use (a medication or treatment that is contraindicated would not be prescribed because it could have serious consequences)

Summative evaluations

occur at the end of services and provide an overall description of their effectiveness. Summative evaluation examines outcomes to determine whether objectives were met. Summative evaluations enable decisions to be made regarding future service directions that cannot be made during implementation. Impact evaluations and cost-benefit analyses are types of summative evaluations.

Group polarization

occurs during group decision making when discussion strengthens a dominant point of view and results in a shift to a more extreme position than any of the members would adopt on their own. These more extreme decisions are toward greater risk if individuals' initial tendencies are to be risky and toward greater caution if individuals' initial tendencies are to be cautious.

Cultural identity

often defined as the identity of a group or culture of an individual who is influenced by his or her self-identification with that group or culture. Certain ethnic and racial identities may also bestow privilege.

Formative evaluations

ongoing processes that allow for feedback to be implemented during service delivery. These types of evaluations allow social workers to make changes as needed to help achieve program goals. Needs assessments can be viewed as one type of formative evaluation.

Idealization (defense mechanism)

overestimation of an admired aspect or attribute of another.

Parallel Process

overidentification with the client and their issues

Regression (defense mechanism)

partial or symbolic return to more infantile patterns of reacting or thinking. Can be in service to ego (i.e., as dependency during illness).

Reaction Formation (defense mechanism)

person adopts affects, ideas, attitudes, or behaviors that are opposites of those he or she harbors consciously or unconsciously (i.e., excessive moral zeal masking strong, but repressed asocial impulses or being excessively sweet to mask unconscious anger).

Sublimation (defense mechanism)

potentially maladaptive feelings or behaviors are diverted into socially acceptable, adaptive channels (i.e., a person who has angry feelings channels them into athletics).

Stages of change

precontemplation stage, in which he or she is not even considering changing or is in denial about the need to change. Contemplation is the first time that there is some movement toward change because a client, while ambivalent about changing, may weigh the benefits versus costs (i.e., time, expense, effort) of change. In preparation, a client may indicate a willingness to experiment with small changes, whereas the action stage is characterized by definitive change behaviors.

Projection (defense mechanism)

primitive defense; attributing one's disowned attitudes, wishes, feelings, and urges to some external object or person.

Denial (defense mechanism)

primitive defense; inability to acknowledge true significance of thoughts, feelings, wishes, behavior, or external reality factors that are consciously intolerable.

Incorporation (defense mechanism)

primitive mechanism in which psychic representation of a person is (or parts of a person are) figuratively ingested.

Premorbid

prior to the onset of an illness

Sexual orientation

refers to an individual's pattern of physical and emotional arousal toward other persons. People do not choose their sexual orientation—it is simply part of who they are.

Globalization

refers to an interconnectedness of persons across the world. The current globalization of the economy requires that social workers broaden their horizons and view many domestic social justice issues within a global framework.

harm reduction model

refers to any program, policy, or intervention that seeks to reduce or minimize the adverse health and social consequences associated with substance use without requiring a client to discontinue use. This definition recognizes that many substance users are unwilling or unable to abstain from use at any given time and that there is a need to provide them with options that minimize the harm that continued drug use causes to themselves, to others, and to the community. In addition, clients who use substances may prefer to use informal and nonclinical methods to reduce their consumption or reduce the risks associated with use. Harm reduction is practical, feasible, effective, safe, and cost-effective. Harm reduction acknowledges the significance of ANY positive change that clients make in their lives; these interventions are designed to "meet clients where they are" currently.

Transference

refers to redirection of a client's feelings for a significant person to a social worker. Transference was first described by Sigmund Freud, who acknowledged its importance for a better understanding of a client's feelings. Transference is often manifested as an erotic attraction toward a social worker, but can be seen in many other forms such as rage, hatred, mistrust, parentification, extreme dependence, or even placing a social worker in an esteemed status.

Sexual behavior

refers to sexual contacts or actions. It is important to realize that people's sexual orientation may not fit perfectly with their sexual behavior (what they do sexually). There are many factors that shape or determine sexual behavior and sexual orientation is only one of those factors. Sexual behavior can be influenced by peer pressure, family expectations, cultural expectations, religious beliefs, and so on.

Ethnicity

refers to the idea that one is a member of a particular cultural, national, or racial group that may share culture, religion, race, language, or place of origin. Two people can share the same race but have different ethnicities.

Secondary trauma

relates to the behaviors and emotions that result from knowledge about traumatizing events experienced by clients and the stress resulting from helping or wanting to help them. Secondary trauma results from engaging in empathic relationships with clients who have had traumatic experiences and witnessing the effects of those experiences. The symptoms of secondary trauma mirror those experienced by the primary victim of trauma, including, but not limited to, insomnia, chronic irritability or angry outbursts, fatigue, difficulty concentrating, and/or avoidance.

Paraphrasing and clarifying

rephrase what clients are saying in order to join together information. Clarification uses questioning, paraphrasing, and restating to ensure full understanding of clients' ideas and thoughts.

Conversion (defense mechanism)

repressed urge is expressed as a disturbance of body function, usually of the sensory, voluntary nervous system (as pain, deafness, blindness, paralysis, convulsions, tics).

Psychosocial stress

results when there is a perceived threat (real or imagined). Examples of psychosocial stress include threats to social status, social esteem, respect, and/or acceptance within a group; threats to self-worth; or threats that are perceived as uncontrollable. Psychosocial stress can be caused by upsetting events, such as natural disasters, sudden health problems or death, and/or breakups or divorce. Stress may manifest itself in many different ways, such as high blood pressure, sweating, rapid heart rate, dizziness, and/or feelings of irritability or sadness.

Translational research

set of methods that essentially focuses on moving research fingers from the lab or "basic" studies into practical use. The translational aspect of this type of work comes from the emphasis on utilizing findings from highly-controlled, rigorous, studied in ways that directly impact populations in need of improved/modified models Two areas of translation: 1. Process of applying discoveries generated during research in the lab, and in pre-clinicial studies, to the development of trials and studies in humans 2. Concerns research aimed at enhancing the adoption of best practices in the community

Folie à deux

shared delusion

Reflecting or validating

show empathetic understanding of clients' problems. These techniques can also assist clients in understanding negative thought patterns.

Reframing

shows clients that there are different perspectives and ideas that can help to change negative thinking patterns and promote change.

Burnout

state of physical, emotional, psychological, and/or spiritual exhaustion. It can be manifested by cynicism or a lack of satisfaction in working with clients to resolve their problems. Burnout is characterized by emotional fatigue and feeling inadequate due to not being able to change clients' life circumstances. Many factors can contribute to burnout, including client, organizational, and/or contextual variables.

Stratification

structured inequality of entire categories of people who have unequal access to social rewards (e.g., ethnic stratification, social stratification)

Postmorbid

subsequent to the onset of an illness

differential diagnosis

systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible.

Organic brain syndrome

term used to describe physical disorders that impair mental function. The most common symptoms are confusion; impairment of memory, judgment, and intellectual function; and agitation. Disorders that cause injury or damage to the brain and contribute to organic brain syndrome include, but are not limited to, alcoholism, Alzheimer's disease, Fetal Alcohol Spectrum Disorders (FASDs), Parkinson's disease, and stroke.

Ego strength

the ability of the ego to effectively deal with the demands of the id, the superego, and reality. It is a basis for resilience and helps maintain emotional stability by coping with internal and external stress. Traits usually considered to be indicators of positive ego strengths include tolerance of pain associated with loss, disappointment, shame, or guilt; forgiveness of others, with feelings of compassion rather than anger; persistence and perseverance in the pursuit of goals; and/or openness, flexibility, and creativity in learning to adapt. Those with positive ego strength are less likely to have psychiatric crises.

positive regard

the ability to view a client as being worthy of caring about and as someone who has strengths and achievement potential. It is built on respect and is usually communicated nonverbally.

case to cause advocacy

the integration of individual clients's challenges with social action and reform efforts. The primary mission of social work is to enhance well-being of humans, and social workers do this by ensuring that they are working on a macro level to improve client's lives. the relationship between micro and macro practice.

Rationalization (defense mechanism)

third line of defense; not unconscious. Giving believable explanation for irrational behavior; motivated by unacceptable unconscious wishes or by defenses used to cope with such wishes.

Isolation of Affect (defense mechanism)

unacceptable impulse, idea, or act is separated from its original memory source, thereby removing the original emotional charge associated with it.

Substitution (defense mechanism)

unattainable or unacceptable goal, emotion, or object is replaced by one more attainable or acceptable.

Somatization

unconscious process by which psychological distress is expressed as physical symptoms. Somatic symptoms often occur as reactions to stressful situations and are not considered abnormal if they occur sporadically. However, some clients experience continuing somatic symptoms and even seek medical care for them.

Inferential statistics

used to answer research questions or test models or hypotheses. In many cases, the conclusions from inferential statistics extend beyond the immediate data. For instance, inferential statistics determine the probability that an observed difference between groups is a dependable one or one that might have happened by chance.

descriptive statistics

used to describe the basic features of the data. They provide simple summaries about the sample and the measures. Together with simple graphics analysis, they form the basis of virtually every quantitative analysis of data. Descriptive statistics describe what the data shows.

Gender identity

usually conforms to anatomic sex in both heterosexual and homosexual individuals. However, individuals who identify as transgender feel themselves to be of a gender different from their biological sex; their gender identity does not match their anatomic or chromosomal sex. Sexual orientation and gender identity are distinct with those who are transgender exhibiting the same full range of possible sexual orientations and interests of those who are not transgender.

Silence

very effective when faced with a client who is experiencing a high degree of emotion, because the silence indicates acceptance of these feelings. On the other hand, silence on the part of a client can indicate a reluctance to discuss a subject. A social worker should probe further with a client who is silent for an unusually long period of time.˙

Three learning styles

visual (uses visual objects such as graphs and charts to learn), auditory (retains information through hearing and speaking), and kinesthetic (likes to use hands-on approaches to acquire knowledge).

Groupthink

when a group makes faulty decisions because of group pressures. Groups affected by groupthink ignore alternatives and tend to take irrational actions that dehumanize other groups. A group is especially vulnerable to group-think when its members are similar in background, when the group is insulated from outside opinions, and when there are no clear rules for decision making.

Gender fluidity

when gender expression shifts between masculine and feminine, can be displayed in dress, expression, and self-description.

Intellectualization (defense mechanism)

where the person avoids uncomfortable emotions by focusing on facts and logic. Emotional aspects are completely ignored as being irrelevant. Jargon is often used as a device of intellectualization. By using complex terminology, the focus is placed on the words rather than the emotions.