Assessment in Social Work Practice

Ego Dystonic

(A.k.a. ego alien.) Descriptive of impulses, behaviors, wishes, etc., that are unacceptable to the ego, or to the person's ideal conception of self.

Warm-Up Period

A brief period of "small talk" that may be used at the beginning of an interview to help a client feel more comfortable before he/she begins self-disclosing. Is most appropriate to use when a client appears resistant or defensive and is also useful with many adolescent clients.

Defensiveness ("Faking Good")

A conscious effort by a client to convince a clinician that he/she is better off than is really the case.

Malingering ( "FAKING BAD")

A conscious effort by a client to present him/herself as being worse off than is really the case. Clients who "fake bad" during assessments are usually motivated by a specific external incentive for wanting to come off as more disturbed or less able than they actually are.

Coping Strategy Vs. Ego Defense Mechanism

A coping strategy is a deliberate and conscious effort to solve a problem or handle personal distress, while an ego defense mechanism is an habitual, unconscious maneuver used to avoid facing a problem.

Person-In-Environment (PIE) System

A diagnostic taxonomy used to describe, classify, and code problems in adult social functioning. Problems are grouped into four factors: factor I, problems in social role functioning; factor II, problems in the environment; factor III, mental health problems; and factor IV, physical health problems.

Reciprocal Empathic Responding

A form of empathic responding used to build trust and understanding. At the reciprocal level, the social worker's verbal and nonverbal responses convey understanding, but are more or less interchangeable with the client's basic messages: They accurately reflect factual aspects of the client's messages and his/her surface feelings.

Empathic Communication

A helping skill that involves first, empathic recognition of the client's feelings, and then, demonstrating through accurate reflection of those feelings one's understanding of the client's inner experiencing.

Flat Affect (Blunting)

A muted or apathetic response to stimuli that would normally evoke a stronger response (e.g., the client discusses a traumatic life event in a detached, matter-of-fact way). May indicate a mental disorder (e.g., depression or schizophrenia), substance use, or a medication side-effect.

Social Functioning

A person's motivation, capacity, and opportunity to (a) meet his/her basic needs (including performing tasks necessary for daily living such as obtaining food, shelter, and transportation) and (b) perform his/her major social roles as defined by his/her community and culture. Information about a client's need-meeting activities and social role performance provides valuable information about his/her current level of social functioning, including strengths and deficits.

Paraphrase

A selective restatement of the main idea of a client's message that resembles his/her message but is not identical to it. A paraphrase emphasizes the literal meaning of the client's message (the content rather than affect) and is expressed in fewer words than the client has used.

Reframing (Redefining)

A technique used to help clients change the negative meaning they give to an event, behavior, or life experience through gently persuading them that it can be viewed in a different and more positive light. For example, the social worker may offer a new perspective, encourage a client to come up with a new perspective, or redefine a problem behavior as a positive behavior that has been taken to an extreme.

Orientation (Disorientation)

An accurate awareness of person, place, time, situation, familiar objects, and other people. Marked disorientation may be associated with severe mental illness, substance intoxication, or a pathological brain syndrome (e.g., delirium).

Starting Where The Client Is

Entails focusing on a client's priorities, including his/her primary concerns (what he/she considers important or wants to talk about) and current emotional state.

Beck Depression Inventory-II

Measure of the depth of a person's depression (the severity of his/her complaints, symptoms, and concerns). May be used with individuals age 13 and older with at least an 8th-grade reading level.

Reflection (of Content and Feeling)

An active listening skill that involves restating or repeating something a client has just said with an emphasis on the part of the message that is most helpful. Its key purpose is to build understanding. In reflecting content, a social worker considers what elements of a client's message are most likely to promote achievement of the interview's goals and then uses that content in the reflection; a simple reflection of content will then repeat, verbatim, a key word or phrase from the client's message. In reflecting feeling, a social worker expresses the emotional component of the client's message: Rather than responding to only the client's words, the worker also infers from those words, other verbal cues, and nonverbal cues what the client is feeling about the information being disclosed.

Motivational Interviewing

An approach developed specifically for clients who are ambivalent about changing their behaviors that combines the transtheoretical (stages of change) model with client-centered therapy and self-efficacy. The goal is to increase a client's intrinsic motivation to change so that change and the reasons for change come from the client rather than being imposed by a therapist, a spouse, employer, etc.

Strengths Perspective

An approach that requires attention to a client's (or community's) strengths and resources during assessment and intervention and serves as a counterbalance to the focus on problems, deficiencies, and pathology that characterizes many commonly used practice theories and models.

Genogram

An assessment tool used to obtain and record information about a client's family patterns and history. Provides a schematic diagram of the family system describing at least three generations of family relationships, geographical locations, and significant life events.

Antecedent

An event or other stimulus that precedes a behavior and is thought to influence it.

Anhedonia

An inability to feel joy or express many pleasurable emotions.

Role Performance

An individual's actual behavior while performing a social role. A person's role performance may be consistent with his/her role conception but not conform to others' role expectations.

Role Conception

An individual's own beliefs and assumptions about how he/she is supposed to behave in a particular social role. What an individual expects of him/herself may not conform to the role expectations defined by others and the wider society.

Doorknob Communication

Any client disclosure of important or difficult information just as a session is about to end. Some experts believe this behavior reflects an unconscious effort by the client to prolong an interview or set up the therapist for an accusation of indifference. Schulman believes that it reflects either information important to the client that the client has been uncomfortable discussing earlier in the session or important information that the client did raise earlier in the session but that the social worker overlooked.

Vineland Adaptive Behavior Scales (Vineland-II)

Appropriate for individuals from birth to age 90 and designed to evaluate personal and social skills of individuals with intellectual disability, autism spectrum disorder, ADHD, brain injury, or major neurocognitive disorders (i.e., dementia), and for assisting in the development of educational and treatment plans.

Dual Perspective Worksheet

Assessment tool used to depict the location of supports and barriers or problems that affect a client's interactions with his/her social environment. Allows you and the client to identify areas of strength that might be resources for change and areas that need to be changed. Also helps you determine whether your intervention should target elements of the client's nurturing environment, sustaining environment, or both.

Life History Grid

Assessment tool used to graphically depict significant events in a client's life and the development of significant problems over time. Allows you to organize and depict data related to various periods in a client's life.

Life Cycle Matrix

Assessment tool used to graphically depict the developmental stage of all individuals in a household.

Social Network Grid

Assessment tool used to identify a client's potential social supports with an emphasis on his/her perceptions and beliefs about them. Results can be used to help the client use his/her social supports more effectively.

Role Expectations

Beliefs held by relevant others (family, cultural models, society, etc.) regarding how a person in a particular social role should behave. A person's patterned behaviors are often influenced by his/her various social roles.

Ecosystem

Concept pertaining to the physical and biological environment and the interaction of all components. Ecosystems theory is used to describe and analyze people and other living systems and their transactions.

Rapport

Consists of a sense of trust between a social worker and client, a comfortable atmosphere, and a mutual understanding of the purpose of an interview. Many experts believe that rapport must start to develop in the first face-to-face interview because a client's sense of trust and comfort are vital for facilitating a productive assessment.

Presenting Problem

Consists of the perceived symptoms and overt issues or difficulties that, according to the client, constitute the problem for which he/she has sought help. May not be the actual problem, or the problem that needs attention (i.e., may be a distortion of the actual problem or a matter that the client feels safer disclosing or a client and his/her family may misunderstand the problem or not understand it fully). Nevertheless, a social worker should "start where the client is" during assessment and focus initially on eliciting the presenting problem.

Emotion-Focused Coping Vs. Problem-Focused Coping

Emotion-focused coping is used to reduce one's emotional response to stress, while problem-focused coping is used to deal directly with the source of stress. Usually a person must deal with his/her emotional reactions before moving on to problem-solving, but emotion-focused and task-focused coping often occur simultaneously.

Ego Syntonic

Descriptive of values, feelings, behaviors, ideas, etc., that are consistent with a person's ego or sense of self; they feel real and acceptable to the consciousness.

Mental Status Exam

Evaluation of a client's current mental functioning. Most MSEs include evaluation of behavioral and cognitive aspects. Information is collected through observation and questioning. Using a mental status exam can help a social worker recognize key symptoms and when to refer clients for psychiatric evaluations and evaluations of medical problems (including neurological problems) that affect psychological functioning.

Confabulation

Fabrication of experiences or situations in order to fill in and cover up gaps in memory.

Viral Loads and CD4 Counts (HIV/AIDS)

HIV viral load is the number of copies of the human immunodeficiency virus in a person's blood and other parts of his/her body. Keeping the viral load low can reduce complications of HIV disease and extend a person's life. The CD4 count measures the number of CD4 cells in a sample of blood and is a good indicator of how strong a person's immune system is. The CD4 count is also useful for identifying the stage of a person's HIV disease. Keeping the CD4 count high can reduce complications of HIV disease and extend a person's life. (CD4 cells, also called T-helper cells, are a type of white blood cell that fights infection.)

Functional Analysis

In behavioral assessments, an assessment of the environmental variables (i.e., antecedents and consequences) that control a behavior.

Fact-Gathering Interview

Interview conducted when a client first contacts an agency; involves gathering predetermined and specific information from the client.

Open-Ended Questions

Interview questions that define a topic area but allow a client to respond in whatever way he/she chooses. Effective for encouraging a client to self-disclose or expand on personal information and, thus, tend to elicit valuable data.

Closed-Ended Questions

Interview questions that elicit responses that provide either factual information or a simple "yes" or "no." Used primarily in the latter portion of an interview to obtain missing factual data.

Direct Assessment of Suicide

Involves questioning a client directly about his/her intent to commit suicide with an emphasis on three indicators that directly suggest an elevated and more imminent risk of a suicide attempt - intent, plan, and means. Risk to life is highest when a client has both a concrete, lethal suicide plan and the means available to carry it out.

Mutuality

Mutual efforts by the social worker and a client to work on the problem. Establishing mutuality with a client requires the worker to both adopt a posture of professional competence and convey that he/she and the client are equal partners in the helping relationship who are both responsible for what happens in the helping process.

Self-Monitoring (Behavior Therapy)

Observational technique in which a client is asked to record information about the frequency and conditions surrounding a target behavior; the client may also be instructed to keep a journal of other important information such as his/her feelings and thoughts before, during, and after each occurrence of the behavior. Results provide detailed information about the behavior and the variables that influence it so that an appropriate intervention strategy can be developed and the effects of the intervention can be evaluated.

Person-In-Environment Theory

PIE theory assumes that human problems have their roots in both individual and situational factors and that understanding and treating human problems requires a dual focus on the individual and environmental forces.

Tardive Dyskinesia

Potentially irreversible extrapyramidal side-effect associated with long-term use of a first-generation (traditional) antipsychotic drug. Symptoms include rhythmical, stereotyped movements of the muscles of the face, limbs, and trunk (similar to Huntington's chorea). In some cases, symptoms are alleviated by a GABA agonist or by gradual withdrawal of the drug.

Intake Procedures

Procedures used by social agencies to make initial contacts with clients productive and helpful. The social worker emphasizes obtaining preliminary information from the client in order to determine whether he/she can work with the client or should refer the client to a more suitable agency or professional.

Social Assessment Reports

Professional reports that describe the social aspects of a client's functioning and his/her situation (i.e., social history) with a particular focus on the match or lack of match between a client's needs and the resources available to meet his/her needs. Used by social workers to communicate to other professionals (e.g., interdisciplinary teams, doctors, psychologists, school personnel, judges) relevant social information about a client (or family) and are particularly useful when decisions are being made about the type of service or program that would be most appropriate for a client and/or when attempting to facilitate a client's adjustment to a new environment (e.g., foster home, nursing home).

Dual Perspective

Proposes that the social environment includes two sets of influences: The nurturing environment is composed of individuals with whom a person interacts frequently and sometimes in an intimate way, and the sustaining environment includes individuals a person encounters in the wider community and broader society. Ideally, a person is accepted, respected, and supported in both environments. Turn

Rapid Assessment Instruments (RAIS)

Relatively short, self-administered, and easily scored instruments useful for demonstrating that a client's condition warrants treatment because of its effects on his/her functioning. Examples include the SF-36 Health Survey and SF-12 Health Survey.

Projective Personality Tests

Relatively unstructured personality tests (e.g., Rorschach, TAT) in which the stimuli are ambiguous and the responses required are open-ended. Their development and use are based on the "projective hypothesis," which proposes that a person's interpretation of ambiguous stimuli provides information about his/her personality traits, needs, feelings, conflicts, etc.

Conners 3

Scales used to evaluate behaviors and other concerns in youth ages 8 to 18. In contrast to its predecessor (Conners' Rating Scales-Revised), offers a more thorough assessment of ADHD and addresses comorbid disorders, such as oppositional defiant disorder and conduct disorder. The Conners 3 includes parent rating scales (Conners 3-P), teacher rating scales (Conners 3-T), and self-report rating scales (Conners 3-SR).

Millon Clinical Multiaxial Inventory (MCMI-III)

Self-report inventory used to assess lasting personality traits and acute clinical states. Is appropriate for individuals age 18 and over with at least an 8th-grade reading comprehension level. For adolescents (ages 13 to 19) whose reading ability is at or above the 6th-grade level, the MACI is available.

Minnesota Multiphasic Personality Inventory (MMPI-2)

Self-report personality test that reports an examinee's performance in terms of clinical scales and validity scales. Although originally intended as a tool for deriving psychiatric diagnoses, is now more commonly interpreted in terms of score profiles to derive information about an examinee's personality characteristics. For adolescents (ages 14 to 18), the MMPI-A is available.

Role Theory

Set of concepts that define how the behaviors of individuals are influenced by the different social positions they hold and the expectations that accompany those positions.

Instrumental Activities of Daily Living

Skills beyond basic self-care that evaluate how individuals function in their homes, workplaces, and social environments.

Basic Activities of Daily Living

Skills needed in typical daily self-care (e.g., bathing, dressing, feeding, toileting).

Role Demands

The knowledge, skills, physical and mental abilities, and other personal attributes an individual must have in order to successfully perform a given social role.

Informational Interview

Social work interview used to obtain data for a social history in order to facilitate appropriate decisions about the kinds of services the social worker or agency should offer a client. Rather than collecting comprehensive information about a client's life history, the worker focuses on obtaining background information related to the problem, including objective facts and subjective feelings and attitudes.

Activities of Daily Living (ADLs)

Social workers refer to the ability or inability to perform activities of daily living (ADLs) as a measurement of a person's functional status. ADL criteria are useful for clients with physical disabilities, clients who are elderly, and clients who have chronic diseases or serious mental disorders (e.g., schizophrenia).

Enactment

Technique used to create a situation in which you can observe clients' interactions directly. Generally entails asking clients to recreate a past conflict in your presence but can also involve having clients role-play contrived situations to find out how they interact when engaged in common activities such as planning, parenting, and decision-making.

Client-Focused Measures

Techniques developed specifically for a particular client and used to assess the extent of his/her problem, follow his/her progress during treatment, and determine when intervention can be terminated. Include individualized rating scales, goal attainment scales, and client logs.

HAART (Highly Active Antiretroviral Therapy)

Term used to describe a medication regimen taken by patients with HIV/AIDS that includes combination of anti-HIV drugs from at least two of the main classes. This combination helps combat new resistant strains of the virus that emerge as HIV makes copies of itself and also decreases the rate of opportunistic infections.

Empathy

The ability to perceive, understand, and experience the emotional state of another person (Barker, 1987). Empathic responding is used throughout the helping process to develop rapport, maintain a working relationship, and enable social workers to move toward confronting a client's problematic issues. Fundamental to empathic responding is reflecting an understanding and acceptance of not only the client's overtly expressed feelings but also his/her underlying emotions. Can be conveyed through verbal and nonverbal communication.

Problem System

The client, other people, and elements in the environment that interact to produce and/or maintain the client's problem situation. Consists of three systems that interact to produce and maintain human problems: the intrapersonal system (biophysical, emotional, psychological); the interpersonal system (family, other relationships); and the environmental system (support system, resources).

Reliability

The degree of accuracy (repeatability, consistency) of a test.

Validity

The usefulness of a test - i.e., the extent to which a test measures what it purports to measure.

Appropriate Affect

This is present when a person is in touch with his/her emotions and can express them as he/she feels them in response to specific emotional or situational stimuli (e.g., the person cries when discussing sad material).

Self-Report Inventories And Checklists

Tools used to assess and diagnose specific client problems, determine the need for further assessment in specific areas, and facilitate treatment planning, monitoring, and outcome assessment. A useful alternative to longer psychological tests when the presence or severity of one problem, condition, or symptom is of particular concern. Are easy to administer and allow a social worker to learn a client's own perception of his/her problem; however, are susceptible to response sets on the part of the client, yield limited information, and must be supplemented with data from other sources.

Primary Gain and Secondary Gain

Two mechanisms used to explain the development of symptoms: With primary gain, the symptom keeps an internal conflict or need out of conscious awareness; with secondary gain, the symptom helps the individual avoid a noxious activity or obtain otherwise unavailable support from the environment

Case Formulations

Used to describe what the client and his/her situation are like, to explain why they are the way they are, and to provide a basis for intervention planning. Concerned with not only naming the client's problem but also understanding the problem within the context of the client's life. The categories used to organize information for case formulations usually include (a) symptoms and problems, (b) precipitating stressors or events, (c) predisposing life events or stressors, and (d) a mechanism that links the first three categories together and offers an explanation of the precipitants and maintaining influences of the client's problems.

Neuropsychological Tests

Used when brain degeneration or damage is suspected and to determine the nature of the impairment produced by brain pathology.

Disengagement Vs. Enmeshment

With disengagement, boundaries are too rigid, not allowing adequate communication between subsystems; and with enmeshment, boundaries are overly diffuse, allowing too much communication with other subsystems. In contrast, healthy boundaries are optimally permeable: They protect the integrity of a subsystem while also allowing interaction between subsystems and can adapt to the changing needs of the family system.