LMSW

Provisional Diagnosis

- A provisional diagnosis is appropriate when a social worker doesn't yet have enough information to draw a diagnostic conclusion. Sometimes the client's symptoms may be accounted for by a variety of different diagnoses. - When it's not yet clear whether the client's symptoms are the result of a mental health issue--rather than substance abuse--it's appropriate to make a provisional diagnosis. - The length of time a person needs to have symptoms present to qualify for a diagnosis varies with each diagnosis. - The diagnosis should not be dependent upon the client's insurance plan. - If a client doesn't meet the criteria for a diagnosis, the diagnosis should not be given as provisional.

Parenting Styles

- Authoritarian and authoritative parents will correct inappropriate behavior. - Permissive parents may not correct the behavior, but they show warmth and love to the child. - An uninvolved parent is emotionally detached from the child, and therefore doesn't care much about the child's behavior. This best describes the reactions of the couple in this scenario. The clients in this example pay no attention to their child, so they are best described as uninvolved. - A permissive parent has trouble setting appropriate boundaries for a child, but gives the child a lot of love and attention. These parents do not appear to notice their child. - An authoritative parent is a warm, loving parent who sets reasonable boundaries. These parents do not set any boundaries. - An authoritarian parent sets harsh, sometimes unrealistic limits on a child's behavior. These parents have set no limits.

Obsessive Compulsive Disorder:

- Best treatment is exposure therapy- rewards are often a part of this therapy since a system of rewards may help change the behavior - is an anxiety disorder in which people act on obsessive thoughts to relieve their anxiety. Their behavior is not necessarily harmful.

Bipolar I and Bipolar II

- Bipolar I: must include at least one manic episode in addition to depression. - Bipolar II includes hypomanic episodes and severe depression. It does not include any full-blown manic episodes. - Clients with bipolar disorder tend to benefit from having a regular schedule. - Helping clients establish a daily routine and regular sleep patterns can decrease their symptoms. - Since clients with bipolar disorder benefit from having regular sleep and a predictable daily schedule, encouraging the client to track his symptoms and activities can help to decrease his symptoms.

Mandated:

- Child protective services will only have access to the client's records if she chooses to sign a release of information or if her records were subpoenaed to court. - It is correct to help the client see that she is not being forced to attend, but instead to be aware of the consequences of choosing to discontinue services.

Chronic pain is an issue that social workers frequently address.

- Clients need to know the potential consequences of long-term dependence on medication, including addiction. Social workers can teach client skills to help manage their pain and improve their quality of life while living with chronic pain. Social workers can also provide education on the link between mental health and physical health - It is correct to provide the client with education on the link between mental and physical well-being and to assist him in learning about new ways in which he can deal with his pain. - It's inappropriate to ask the physician to prescribe more narcotics, especially since the purpose of the referral was to help the client learn new ways to manage his chronic pain.

Eating Disorders

- Clients with eating disorders often need a multi-dimensional approach to treatment. Social workers can assist them with changing their distorted thoughts and unhealthy behaviors. Doctors can monitor a client's weight and health status. A client with an eating disorder should have a full physical to determine the state of their health in order to assist with determining the best course of treatment. Sometimes clients may need a medical hospitalization to stabilize them or they may require an inpatient psychiatric hospitalization to help manage their symptoms. - It's likely that the client's eating disorder and self-esteem issues are related and the social worker would need to treat the eating disorder in order to improve the client's self-esteem. - It is important to get a release of information to coordinate care with the primary care physician. Once the client's health status has been established, the social worker can determine what services will be most effective.

College Students and Depression

- College students are at high risk of depression. They also are at risk of suicide. Depression is common among college students. Although college students may struggle to adjust to college life and being away from home, if they are experiencing these symptoms they are likely depressed. If lack of sleep is a problem, it may be a symptom of depression.

Denial

- Denial is the refusal to accept reality. This woman is able to acknowledge that her husband left her. With denial, she might say she is certain her husband is going to change his mind and won't leave her.

Displacement

- Displacement involves redirecting thoughts, impulses, and feelings meant for one person and taking them out upon another person or object. If this woman were displacing her feelings, she might argue with someone not involved in the situation, such as a boss or friend.

Family Members and Addiction

- Efforts often enable a person to continue their substance use - The work with family members often revolves around helping them learn how to set limits and keep healthy boundaries, so that they do not continue to enable the substance abuse problems. - Adult children of alcoholics often have difficulty with self-esteem. They typically become either irresponsible or hyper-responsible and may be loyal to people who abuse them. The characteristics of adult children of alcoholics typically include harsh self-judgment, difficulty with intimate relationships, a martyr's attitude toward other people's problems, a fear of authority and angry people, and undue allegiance to people undeserving of loyalty.

Contact outside of treatment

- Establishing a rigid rule that clients can only have contact with the social worker during appointments can be damaging to the therapeutic relationship, and ignores the fact that clients may have crises or questions that require contact outside of normal treatment times. - Not allowing contact in between sessions may frustrate clients, cause them to be upset with the social worker during appointments, and actually increase burnout. - Not allowing any contact between appointments can be damaging to therapeutic rapport, whereas allowing a certain amount of contact can contribute to the therapeutic relationship. - Social workers should find a balance between allowing clients too much contact outside of treatment and not having any contact at all. An appropriate amount of contact can actually foster independence. - Establishing a rigid rule can be damaging to the therapeutic relationship, since clients may have valid reasons for contacting the social worker between appointments.

Asian Cultures

- For many Asian cultures, family is very important; Asian clients typically prefer to keep their problems within the family. Therefore, it can be helpful for social workers to provide brief, solution-focused interventions rather than traditional therapy. - It would be important to include the client's family if he so chooses, and to help him gain support from them as necessary. - There is not any evidence stating that Asian cultures prefer medication over therapy. - It is important to respect the client's right to privacy and his desire to keep the problems within the family. Keeping treatment brief will support the client in this effort.

Treatment to a child and testifying in court:

- If a social worker is asked to provide treatment for a child, but is likely to be subpoenaed to discuss recommendations about the child's living situation, this potential conflict of interest should be discussed in advance with the family. A social worker providing treatment should not offer to be an expert witness. Because of the potential conflict of interest, the social worker shouldn't volunteer to take on both roles. - The code of ethics is clear that social workers should make clients aware of potential conflicts of interest, including when a therapist may be asked to testify about a child's living situation. - The social worker doesn't have enough information to say what is in the child's best interest at the time of the assessment, and if subsequently providing treatment, should not offer to testify on the father's behalf - if the social worker is hired to treat the client, the social worker should not focus on gathering evidence during treatment sessions.

ADHD

- In order for people to meet the diagnostic criteria for ADHD, some symptoms must have been present prior to age twelve. To meet ADHD criteria, she needs impairment in at least one area, such as school, social activities, or work but she does not need impairment in all three or specifically at work. Although adult ADHD may present somewhat differently, adults still have difficulty with concentration and attention.

Intellectualization

- Intellectualization is overemphasizing thinking when faced with an unacceptable impulse. This client is using intellectualization by focusing on the financial aspect of her divorce, ignoring emotions she'd prefer not to acknowledge.

Latino Cultures

- Latino culture often relies heavily on the concept of machismo for men and marianismo for women. Ideal characteristics for men include pride, honor, courage, and leadership; for women, self-sacrifice and subordination. - Married Latinas tend to defer to their husbands to make important decisions, especially when dealing with children and authority figures. - Since Latino men tend to be the head of the household, it's likely the father would handle this issue. - Grandmothers don't tend to make the decisions in most Latino families. - Generally, it is the father who is head of the household in a Latino family and therefore the best choice to deal with this situation.

Treatment Plans

- Need to be clear on how progress will be measured (there may be times when objective evidence is needed in addition to subjective statements from the client) - Client's reports are purely subjective, client's self-reports are based on subjective data about the client's feelings and cannot be measured by others. Since a client's reports on feelings cannot be verified by others, this documentation is subjective rather than objective. - A test to measure a client's understanding of anxiety, initially and later is objective

Couples:

- Protect confidentiality of both parties including when a divorce or separation occurs - court proceedings can become complicated, and social workers should seek legal consultation. If only one party has authorized release of the records, the social worker should maintain confidentiality for both parties, and seek legal counsel. - The social worker should seek legal consultation to find out how to proceed, given the obligation to maintain confidentiality for both parties.

Reaction formation

- Reaction formation involves converting unwanted thoughts and feelings into their opposite. If this client were demonstrating reaction formation, she would be voicing pleasure or relief about the pending divorce.

Adoption:

- Research shows that children who are adopted can often benefit from ongoing contact with their birth family, as long as the birth family can be supportive of the adoption. - If both families are supportive, an arrangement to ensure ongoing contact can be beneficial to adopted children. - Not all children struggle to attach to the new family. If the birth parents are supportive, the child may not have this issue. - Although children can benefit from being asked for their input, leaving the choice up to the child may be stressful for the child. The child's priority may be to please others rather than to decide what's healthiest for him. - Since not all birth families will be supportive of the adoption, contact will sometimes be inappropriate. The adoptive family will need to supervise the child to try to avoid undesired contact.

Culture and parenting practices

- Since cultural issues may impact how parents expect a child to behave, how they perceive a child's role in the family and how they believe discipline should be handled, social workers should inquire about the parents' culture to learn about its possible influence on their parenting practices. - If the social worker asks about the family's culture in a respectful and direct manner, such questions are not likely to offend. - It's important for social workers to inquire about the possible impact of people's culture on their parenting.

Sleep Disorders

- Sleep disorders can lead to problems that can mimic depression. It is important to rule out physical health problems when people are chronically exhausted. Recommending he discuss a sleep study with his physician could be helpful in determining if he has a condition, such as sleep apnea, that is causing his symptoms. - The correct first course is to talk to his physician to rule out physical health problems and sleep disorders. - A psychiatrist should not be the first option. It is important to rule out physical health issues first.

Code of Ethics

- Social workers are directed to keep client information confidential unless there is an imminent risk and clear, intended victims. In this case, according to current law, since the client does not disclose specific victims, confidentiality must be maintained. - Dual relationships are unethical when they're sexual in nature or exploit the client in some fashion. o Even if a dual relationship is present, there may be circumstances in which a social worker can maintain a professional relationship with a client. Especially in rural areas, where a dual relationship is unavoidable and does not harm the client. - states that social workers need to confront colleagues who may be distressed or experiencing problems that might interfere with their work. - The Social Work Code of Ethics clearly states that social workers need to make appropriate referrals when clients present with issues that are outside of a social worker's area of expertise. - When social workers take on positions in the community, it's important to clarify roles. If the social worker takes on the youth leader role, it's important that youth, parents, and other staff understand that the social worker is acting as a private citizen and not providing client services. o The social worker can work with the youth group as long it's clear what role the social worker is taking on.

Thyroid Problems

- Thyroid problems have been linked to depression. Since the client reports a history of thyroid problems, it is important to recommend she have her thyroid levels tested prior to beginning mental health services as she may be experiencing a medical issue contributing to her depression. - It is important to address any physical health issues before establishing goals and objectives. It is important to rule out physical health issues before treating her mental health issues.

Women and Substance Abuse

- Typically use less alcohol than men - drink less often - less likely to develop alcohol related problems - once they do become addicted the associated problems, physical and interpersonal, tend to progress more quickly and become more severe than with men - more likely to feel stigmatized by their alcoholism and less likely to seek treatment or reveal alcoholism to a therapist - Self-esteem problems and depression are risk factors that the social worker should keep in mind when creating programs to address substance use. - Risk factors for substance abuse in women include depression, peer pressure, and low self-esteem.

Interpreters

- Use of a child as an interpreter may alter family power relationships and prevent adults from sharing important or embarrassing details - Child are the least appropriate - Relatives may also impose their own views and hide important or embarrassing details - An untrained interpreter may miss important clues

PTSD in Soliders

- Virtual reality therapy: allows clinicians to simulate the combat environment and expose soldiers to lifelike scenarios, thereby helping reduce their anxiety and symptoms of PTSD. Virtual reality therapy, which seems to reduce the stigma surrounding treatment, has been shown to be effective in reducing symptoms of PTSD for combat soldiers. - There is conflicting research about whether or not hypnotherapy is helpful for symptoms of PTSD. - Sand tray therapy is most commonly used with children, since they're less likely to be able to verbalize their experiences. - There's conflicting research about the benefits of psychoanalysis and PTSD. For soldiers who have develop symptoms due to combat experience, exploring their childhood or their unconscious desires hasn't proven helpful.

Speech

- When a client's speech is frenzied, loud, and difficult to interrupt, it indicates pressured speech. can be a sign of mania but it can also indicate other disorders, such as schizophrenia. Pressured speech is loud, rapid, frenzied, and can be difficult to interrupt. - Circumstantial speech involves unnecessary details before getting to the point but is not necessarily loud or rapid. - Tangential speech lacks focus but is not necessarily rapid.

Chronic pain and depression are frequent co-morbid conditions.

- When depression increases, pain can increase and increased pain can make depression worse. Social workers can help people manage their pain better by managing their mental health symptoms. Cognitive-behavioral therapy is often helpful in teaching new skills to manage chronic pain. Other pain management strategies--not listed in the answers here--may also be useful.

Terminal Diagnosis:

- When people are given a terminal diagnosis, maintaining hope and optimism can reduce their depression and anxiety and lead to better outcomes. - Since this family reports they're praying for a miracle, they understand the illness has a poor prognosis and therefore aren't in denial. - Since there are cases in which people survive after a terminal diagnosis, it's for the social worker to help the family remain optimistic. - It's more helpful to encourage the family to remain hopeful, rather than reminding the teenager that her cancer is terminal. - The fact that this family are praying for a miracle indicates they already understand the cancer is terminal.

young children and PTSD

- Young children who aren't able to verbalize their anxiety will often engage in traumatic play if they are experiencing symptoms of PTSD. Traumatic play is often repetitive and involves replaying and acting out the trauma. - Since this child is only four years old and has experienced a trauma, it's important to know how much of her play centers on the fire. Trauma-themed play can be a symptom of PTSD.

HIPAA privacy regulations

- allow clients to review their records. They can propose amendments to the record if they so wish. - It is appropriate to discuss the client's concerns, including any amendments he would like to make. - The client may not have the opportunity to talk to the people who receive the records. Inaccurate records may be damaging to him, even if he offers a verbal explanation of any discrepancies - The record can be amended after it has been signed. - The client has a right to his own records and he can provide input into any amendments he would like to see made. - According to federal law (HIPAA), in order to release substance abuse information, a client needs to specifically state that it can be released. Otherwise, all substance abuse information has to be kept confidential. o Since the client has only signed a release about general diagnostic information, it's only acceptable to share information about the generalized anxiety disorder.

Sensory Disorders

- can cause children to exhibit a wide array of behaviors that can interfere with school and social functioning. Sensory problems can cause children to struggle with noises, tactile issues, and physical coordination. A referral to an occupational therapist can help determine if some behavioral issues may be caused by sensory issues. - An occupational therapist can provide further evaluation to help determine if the child has sensory issues that may be contributing to the behavioral issues.

School refusal

- can stem from a variety of problems. Anxiety is a common reason kids stay home. However, keeping a child at home is likely to worsen the child's anxiety, not relieve it. When parents allow children to stay home from school, it can create more problems for the child--as well as legal problems for the parents. - The longer the child avoids school the more difficult it could be for her to return. The social worker will likely be most successful in treating the child's anxiety with exposure to school, not continued avoidance. - Not sending the child to school is illegal. Although these parents are well-intentioned in their attempts to reduce their daughter's anxiety, they are likely going to make her anxiety worse in the long-term if they do not make her attend school.

Informed Consent

- clients have a right to know about a social worker's training, expertise, and education - It is important to answer these sorts of questions honestly and factually to assist clients in making decisions about their treatment.

The DSM-5 chapter, "Disruptive, Impulse-Control, and Conduct Disorders"

- collects conditions involving problems in the self-control of emotions and behaviors, particularly those in which people are unable to resist performing acts harmful to themselves or others. - Impulse-specific disorders from the chapter include kleptomania and pyromania. Disruptive and conduct-specific disorders include oppositional defiant disorder, conduct disorder, and antisocial personality disorder, among others.

Erikson's Psychosocial Theory

- describes how people navigate the life cycle by resolving specific issues at specific stages. The goal of the adolescent stage, which Erikson labels Identity versus Role Confusion, is to gain independence and forge an identity. When adolescents attempt to delay taking on adult responsibilities, they experience Role Confusion. - Initiative versus guilt is a stage children experience between the ages of three and five. - Competence is an issue for children ages six to twelve and involves learning new skills. - Erikson's theory discusses isolation as the time between 18 and 35 when people seek intimate relationships with a romantic partner.

Psychomotor agitation

- describes people who exhibit increased motor activity that does not serve any purpose. Pacing and handwringing are common examples. Psychomotor agitation sometimes accompanies schizophrenia or bipolar disorder. The client may be able to concentrate on the discussion despite the need to move around.

Culture-specific syndromes

- don't neatly conform to Western categorization of mental illness, and are only found within certain ethnic populations. Examples include ataque de nervios dhat syndrome, khyâl cap, kufungisisa, maladi moun, shenjing shuairuo, susto, and taijin kyofusho. . - Taijin kyofusho is a culturally distinctive phobia, found in Japan, that refers to an intense fear that one's body, its parts or its functions, displease, embarrass, or are offensive to other people. - Shenjing shuairuo, which is found in primarily in China, , refers to physical or mental fatigue and excitability--something akin to a "nervous breakdown." - Taijin kyofusho involves an anxious shame about one's body, shenjing shuairuo is a mixed symptom episode.

Victims of child Abuse

- greater risk for substance abuse and often become physical abusers themselves - may be developed memory problems to help cope with the trauma - may have suffered physical damage affecting their cognition - often ashamed to answer questions about their past even when their memories are relatively intact

Cognitive behavioral therapy

- is based on a combination of behavioral theory, cognitive theory, and social learning theory. CBT recognizes that people learn behavior when it's modeled for them by others, and that their thoughts and expectations can play a major role in determining behavior. The therapy helps people change maladaptive behavior and identify and replace cognitive distortions.

Family systems theory

- is based on the assumption that people cannot be understood as separate individuals but only as part of their family; cognitive-behavior therapy focuses on people's thoughts and behaviors rather than their family relationships.

Personal Centered Approach

- is based on the idea that clients will find their own solutions and will get what they need out of treatment. The social worker provides the client with unconditional positive regard and acceptance, and the client uses the therapeutic relationship to work through their own issues. - Person-centered therapy, as described by Carl Rogers, helps build trust and a therapeutic relationship based on unconditional positive regard, genuineness, and empathy.

Conflict theory

- is based on the idea that groups and individuals try to advance their own interests over the interests of others, who may feel oppressed as a result; it's not a central part of cognitive-behavior therapy.

Avoidant personality disorder

- is characterized by a long-standing fear of rejection and sense of inadequacy. People with avoidant personality disorder do not recognize their fears are irrational. They often lack social relationships and may have occupational problems. the client avoids social interactions and situations where she may feel rejected.

Humanistic Approach

- social workers help clients improve their self-concept and encourage feelings of self-worth, so they can work through their problems and recognize their full potential. With journaling and talking about feelings front-and-center, the intervention is most likely a humanistic approach.

Social learning theory

- states that people learn behavior by watching others. CBT recognizes that people can learn behavior when it is modeled for them by others. Also, a person's thoughts influences a person's behavior so a person's expectations can play a major role in determining behavior.

Antisocial personality disorder

- tends to peak in the late teenage years through the early twenties. People with antisocial personality disorder tend to improve around the age of thirty-five and many people in their forties and fifties report being in remission. - Consequences often have little to no impact on whether or not people change their behaviors when they have antisocial personality disorder. - Although personality disorders tend to be long-lasting, symptoms can certainly improve over time. - Antisocial personality disorder can be very difficult to treat. Direct confrontation can be effective, but not always when a professional is confronting the antisocial behaviors. Peer group interventions can sometimes be more helpful in motivating a person to change. - Family therapy isn't usually effective with people with antisocial personality disorder. - A humanistic approach isn't likely to be effective for a person with antisocial personality disorder. - Cognitive behavioral therapy isn't usually effective with antisocial personality disorder. - Allowing peers to directly confront a person's antisocial behaviors can be the most effective tool in creating change.

Death

- young children cannot grasp the finality of death and don't understand that death is permanent - The sudden, violent death of a loved one--especially a child--can lead to severe depression. Auditory and visual hallucinations are not uncommon in cases depression that follow a traumatic loss. - Complicated grief is not included in the dsm 5 - Since young children have a limited understanding of the finality of death, at this child's age it is developmentally appropriate to have magical thinking.

Maslow's Hierarchy of needs:

1. Physiological 2. Safety 3. Love/belonging 4. Esteem 5. Self-actualization According to Abraham Maslow's Hierarchy of Needs, humans are motivated to satisfy a variety of needs, in succession from lower to higher, starting with basic physiological needs and progressing toward a need for transcendence. The satisfaction of the higher needs--for knowledge, for beauty, for self-actualization--depends on whether the lower needs--for safety, for love, for esteem--have already been met.

elders

80 and up encourage independence- provide physical, mental and social activities support end of life decisions- provide info, resources and so on assist a person in self care- promote med safety, provide safety grips, ram

Bowen model of family therapy

: helps each family member learn that it's okay to have separate thoughts and feelings while remaining connected to the family. - Goal of treatment: help avoid unhealthy triangles. Each person learns to tolerate the anxiety that accompanies feelings of closeness or distance - learn to be independent in healthy ways and not try to rescue one another from pain. Both husband and wife would learn to trust that their partner can handle negative emotions.

Miracle Question

A miracle question asks clients to imagine their issues have been resolved overnight, what would be different, and what might have happened to bring this about.

Transference Intervention

A transference interpretation helps clients acknowledge how much the past is affecting their present behavior, by showing how their feelings about the therapist repeat or mimic feelings toward important figures in the past. error

Evaluating Abstract Thinking Abilities:

Asking clients how two objects are alike or how they are similar is a way to assess their abstract thinking abilities--their capacity to grasp intangibles and respond to questions that don't have right or wrong answers. Offering a proverb to decipher is another strategy. - Since this question has multiple answers and requires a level of abstract thought, it's an appropriate question to ask to assess abstract thinking ability. - If the question is concrete or has a concrete answer, it doesn't test abstract thinking abilities.

ASPIRINS ask what is the BEST (or MOST reasonable) course of action

Assess Start where the pt is at Protect Life (of the individual and community...this one is about determining/preventing danger to self and others) Informed Consent Rule Out Medical Issue Intoxicated Do Not Treat Non-Judgmental (open minded social workyness) Self-Determination

Antabuse

Aversion therapy has been used successfully to treat alcohol abuse, nicotine addiction, and other maladaptive behaviors. An alcoholic who takes Antabuse and continues to drink will experience various unpleasant symptoms, including nausea, vomiting, vertigo, and chest pain, and may thereby be conditioned to avoid alcohol entirely. However, long-term compliance over several years is often required, and the dropout rate with Antabuse treatment is notoriously high.

Bed wetting

Bed-wetting is twice as common in boys than girls, and a diagnosis of nocturnal enuresis is appropriate starting at age five. bed-wetting is more common in children with ADHD

Boundary Crossings

Boundary crossings are the deviations from usual practice, as when social workers disclose facts about themselves, ask clients for advice on specific matters, or have multiple chance encounters socially. Boundary crossings are often unavoidable, especially in rural areas, are not considered unethical, and can often have positive effects, as when a therapist treats a client's fear of driving by riding along with the client in a car.

Attachment

Children with a history of abuse and neglect may struggle with attachment disorders. In particular, adopted children, especially those who may have been placed in foster care, have most likely experienced disruptions to their attachments, and may struggle to attach securely to new caregivers. As a result, they may exhibit behavioral issues and have difficulty regulating their emotions. It is important to educate caregivers about the nature of attachment and impart strategies to help these children securely attach. The more the adoptive parents learn about attachment issues, the more likely they are to find appropriate ways of intervening in her behaviors. Although the child may have inherited some biologically-based mental health issues, it's important to address the attachment issues first. Until there's stability in the child's environment, including a secure attachment to her caregivers, the child's mental health issues will be difficult to assess.

Confidentiality

Confidentiality is greatly protected in social work - There must be a serious risk of death or harm or suspicion of child abuse or neglect in order to break confidentiality. This situation does not meet any of those criteria. - It is important for the client to be aware of the potential risks of breaking the rules, so it would appropriate to discuss this with her. This approach maintains confidentiality.

Defense Mechanisms

Defense mechanisms help people avoid uncomfortable thoughts, feelings, and impulses. The closest fit here is intellectualization, which involves a "flight into reason"--a focus on solving practical problems without addressing feelings.

Developmentally disabled clients

Developmentally disabled clients do not typically respond well to group-therapy interactions. Since parents and/or siblings are typically caregivers for developmentally disabled clients, a family-centered approach is generally the best approach to the various challenges and interpersonal issues that arise.

E-therapy problems

Duty to warn can be problematic in e-therapy, because the social worker can never be entirely sure of the client's real name or geographic location. It may also be hard for therapists to assess a client's potential for violence or self-harm, since the client's body language may be harder to gauge, or absent, and the vocal cues absent or more difficult to read.

Exposure Therapy

Exposure therapy involves putting clients face to face with their fears, and is typically preceded by training in relaxation.

FAREAFI what to do first or what to do next

Feelings Assess Refer Educate Advocate Facilitate Intervene

Freud

Freud's theory states that there are three parts to the psyche, the id, ego, and superego. Put simply, the id consists of primitive drives; the ego seeks pleasure in realistic ways and mediates between id and superego; the superego acts as moral compass. - The superego is the psyche's moral compass--our conscience. Stealing without regard to morality demonstrates a lack of superego development. - The ego operates according to the reality principle, seeking long-term benefit. Since immediate gratification is the goal here, a lack of superego development is the issue. - The id is comprised of instinctual drives, acting according to the pleasure principle--"What I want, now." This client's id is at work when he steals without thought to morality or consequences.

sex offenders and treatment plans

In fact, the recidivism rate for sex offenders is lower than that for burglary, robbery, or drug crimes, most sex crimes are committed by people known to the victim, and treatment greatly reduces the rate of recidivism.

Arab Cultures

In many Arab cultures, mental health issues are described in terms of physical health. Symptoms of depression or anxiety are often reported as physical aches and pains rather than emotional ones.

Objective measure of client commitment to goals

It's helpful for social workers to have objective data about their clients' progress or lack of progress, as well as their clients' subjective reports of their feelings and behaviors. The basic difference between objective and subjective data is that objective data are verifiable by a third party, whereas subjective data are internal. subjective is feelings and internal states objective must be observable by outside parties

Principal Diagnosis

Many clients have co-morbid conditions that may warrant more than one diagnosis. The principal diagnosis should be the one for which the client is currently seeking treatment.

Tips for parents and tv

Parents often do not monitor what their children are viewing on television or video games and it can lead to serious behavioral issues. Young children cannot tell the difference between reality and fantasy. It is important to address this with parents so they can help promote healthy development. It is important to explain to the child's mother that his behaviors are not likely to improve unless his exposure to violence is decreased.

Behaviorist cognitive humanistic social/situational

Pavlov, skinner Piaget maslow bandura

Lithium

People taking Lithium require frequent lab work to test their blood levels for possible toxicity. Other medications, dehydration, and other medical issues can interfere with Lithium levels so frequent checks are important. Clients need to be educated on the importance of getting their lab work done on time. Lithium does not interfere with cholesterol.

Suicidality

People who fantasize about suicide in order to get even with others can benefit from learning how to be assertive with the people in their lives. It may also be valuable for this client to learn problem-solving skills to help her cope with her feelings. - This client would most likely benefit from learning assertiveness skills to empower her. Problem-solving skills could help her identify new ways to deal with her feelings. Suicide is a persistent issue for African-American youth, males in particular. Many African-Americans condemn suicide on religious grounds and view it as something only non-African-Americans do. While education in this area can be helpful, interventions that focus on the self-destructive behaviors that can lead to suicide, rather than the suicide risk itself, are more likely to find support among African-American families.

Schizoid personality disorder and schizotypal personality disorder are closely related

People with either disorder tend to avoid close relationships and express little emotion, but people with schizotypal personality disorder display odd or irrational thought processes, such as believing in telepathy or magical powers. - People with schizotypal personality disorder do not enjoy close relationships. - Schizoid personality disorder does not include hallucinations or delusions. - Schizotypal personality disorder is differentiated from schizoid personality disorder on the basis of a person's connection with day-to-day reality. People with schizotypal personality disorder display bizarre beliefs and odd behavior.

Older clients

Reality orientation is not helpful for clients with advanced dementia, and antipsychotic drugs should only be used in older clients as a last resort. The best response is to engage the client on her level by letting her talk about her husband. Antipsychotics were not developed for dementia patients, and some have been shown to elevate the risk of stroke in older people. Since the hallucination did not frighten the client or result in dangerous behavior, there is no reason to put her on antipsychotic medication. One of the guiding principles of social work is to "start where the client is." In this case, the client is clearly thinking about her husband, and the social worker can best support her by allowing her to talk freely. Reality orientation is not recommended for people with dementia because each time they are reminded of an unpleasant reality, they grieve as if they were hearing it for the first time. Changing the subject doesn't give the client a chance to talk about her late husband, a topic that is clearly important to her.

Medication resistant to schizophrenia

Research has shown that white Europeans with schizophrenia are nearly twice as likely to be treatment-resistant--unresponsive to antipsychotic drugs--than non-white Europeans. In general, schizophrenia in white Europeans has a longer duration than in other ethnicities.

Asian Americans

Research on Asian-American immigrants and their children shows that while Asian-Americans have lower rates of mental illness than Caucasians, they are less likely to seek treatment, which can pose a challenge for social workers in the community. Of particular concern is domestic violence among recent immigrants, whose efforts to adapt and find employment often challenge traditional gender roles (especially when wives have to work outside the home) and may lead to violent disputes over household duties.

Middle age (40-60)

Research on middle age has challenged stereotypes about midlife crises, menopausal distress, the empty-nest syndrome, and cognitive decline. Not all men go through midlife crises, not all women experience menopause as a time of high stress, the empty nest is often experienced as liberating, and cognitive functioning is typically higher in middle age than young adulthood. The typical stress of middle age is "overload"--juggling the demands of work and family--to which women in midlife are especially vulnerable.

antidepressants

SSRIS: celexa, lexapro, Luvox, paxil, prozac, Zoloft, Slavic, Effexor, trazodone, bupropion

Special Population: Sex Offenders

Sex offender treatment often requires a specialized approach that aims to protect the community from additional antisocial acts. Sex offenders are often mandated by the legal system or child protective system to receive treatment. Denial is very common. A group approach to treatment is often effective at challenging the denial and helping clients learn new skills to prevent them from reoffending. - In treating sex offenders, little emphasis is placed on the therapeutic relationship. Many sex offenders use relationships for their own gain, not to develop healthy connections. - Non-directive and supportive counseling doesn't tend to be effective with sex offenders. Clients may never acknowledge their behavior or choose to work on difficult issues. More directive work in groups is the preferred approach. - Group therapy is usually the preferred treatment method with sex offenders. Group members can typically hold one another accountable and address denial better than a social worker can in a one-on-one situation.

Social Work Supervisory positions

Social Work Supervisory positions - Administrative: focuses on how the agency's policies and organizational structure impact a social worker's performance. Reviews how an agency's policies and the agency's organizational structure impact a social worker's job. - Educational: discussing a social worker's treatment interventions - Supportive: reducing a social worker's job stress Clinical supervisors have the responsibility to offer recommendations to a supervisee that encourage ethical conduct. If a supervisor is negligent or does not make appropriate recommendations, the supervisor can be held liable. - A supervisor can be held liable if supervision is deemed inadequate or inappropriate. - A clinical supervisor doesn't need to be the agency supervisor in order to be held liable. - Even if a clinical supervisor doesn't have direct client contact, the supervisor can be held liable for improper supervision. - Supervisors can be held liable by a client, an agency or by the supervisee.

Charts

Social workers should keep inactive files safely locked away for the duration required by state law, at minimum. Records should be inaccessible to reception staff, other social workers, and other office personnel. When a social worker is in private practice, it's appropriate to keep inactive files locked up, inaccessible to other office staff.

Transgender Clients

Social workers working with transgender teenagers and their families should provide support to both the teenager and the family, helping them evaluate the pros and cons of making a social transition to the other gender, and leaving the final decision to the teenager. - Many transgendered teenagers make successful social transitions before adulthood. - Since the decision is ultimately the teenager's, the social worker's role is to educate the teenager and the family about the benefits and risks of making the transition. - Although it may increase conflict, the social worker shouldn't automatically discourage this teen from making the social change, which could have benefits as well. - The social worker should not simply begin to work with the teen on transitioning without first discussing the pros and cons of transitioning with the teen and family.

BPD

Splitting is a common feature of borderline personality disorder. Often, people with BPD see others as either all good or all bad. The social worker should recommend that the client talk to the group leader directly about her concerns; indirect communication is not likely to be helpful.

Skinner's operant conditioning theory

States that people's behaviors are shaped by either reinforcement or punishment - Negative reinforcement: the removal of a negative condition or adverse stimulus, creating a sense of relief, which strengths behavior. Rewarding the behavior is not a negative reinforcement. - Positive reinforcement: when a behavior is rewarded. - Classical conditioning: pairing a neutral stimulus with a behavior. PAVLOV

Irritable bowel Syndrome:

Studies have shown that most people with irritable bowel syndrome suffer from anxiety, though it's often unclear whether the anxiety led to the bowel problems or vice versa. - People with irritable bowel syndrome are more likely to have an anxiety disorder. - Most people with irritable bowel syndrome tend to worry about a variety of issues, such as money, health, and family.

Alcohol Abuse

Studies of alcoholism have shown that different ethnic groups have different metabolic reactions to alcohol; that sons of alcoholic fathers are more likely to become alcoholics than daughters; and that children of alcoholics adopted into non-alcoholic families are three to four times more likely to become alcoholic than the general population, all of which strongly support a genetic theory of alcoholism.

Advocacy and NASW

The NASW Code of Ethics states that social workers should engage in social and political action that ensures equal access to resources, and advocate for changes in policy and legislation. - restrictive or unequal laws must be fought against -Whenever possible, social workers should seek to change discriminatory laws.

HIPPA and Lawsuits

Under HIPAA, a therapist's psychotherapy notes are excluded from the provision that clients have the right to all their health information; but such notes do not include counseling start and stop times, notes on diagnosis, treatment modalities, symptoms, prognosis, and progress to date, all of which the client is entitled to see and copy. When needed to defend a lawsuit, psychotherapy notes may be disclosed without a client's consent. error

Chance meetings between clinicians and clients often happen, especially in small towns or academic settings.

When encountering a client in public, social workers should take their cues from the client, rather than ignore the client or initiate contact. It is widely recommended to discuss this early in therapy to avoid confusion. Subsequent discussion of an encounter, in a therapy session, is appropriate, and can be helpful.

Folie à deux

a psychotic disorder, refers to a shared delusion, not a reaction to a real event.

Solution focused therapy

a short-term practice aimed at making concrete changes.

13-18

ability to understand abstract ideas, higher math concepts, develop moral philosophies, including rights and privileges and move toward a more mature sense of themselves and their purpose challenges authority, concerned about appearance

Paradoxical intervention

actually prescribes the symptoms that clients are seeking help with. In this case, telling the couple not to communicate at all is a paradoxical intervention.

Psychodynamic psychotherapy

addresses unconscious and internal processes that motivate behavior; cognitive-behavior therapy is based on conscious thoughts.

sexual development

age 2- know their own gender age 5/6- modest and private about dressing and bathing, aware of marriage, age 8-12- sex play occurs because of curiosity become more self-conscious and often feel uncomfortable dressing in front of others masturbation increase, questions about sex age 12/13- dating, making out occurs age 13-19- increase increase in romantic and sexual relationships, most have sex by 20 adult: 50 menopause, by 25 mens testicles slow testosterone production

older adults

age 65-79 encourage person to talk about feelings of loss, grief and achievements -provide info, materials, to make med use and home safe - support for coping with any impairments - encourage social activity with peers as a volunteer and so on

young adults

ages 21-39 support person in making health care decisions encourage healthy and safe habits at work and home recognize commitments to family, career and community (time and $)

contemplation

ambivalence, conflicted emotion

Cognitive restructuring

an aspect of cognitive therapy--involves replacing overly negative thoughts with more realistic thoughts. It can help people with a variety of conditions, including anxiety and depression.

anti anxiety

anxiety and panic disorders Ativan, lorazepam, buspar, klonopin, clonazepam, valium, diazepam and Nana's high abuse potential

Cluster C

anxious and fearful avoidant, dependent and obsessive compulsive Cluster C--the "fearful" cluster--includes dependent, obsessive-compulsive, avoidant personality disorder

Benzodiazepines

are tranquilizers often used to treat anxiety and can be used as muscle relaxers. Valium and Xanax are benzodiazepines, tranquilizers often used to treat anxiety.

Rational Emotive Behavior Therapy

as stated by its founder, Albert Ellis, is that "People are not disturbed by things but by their view of things." A precursor of Cognitive Behavior Therapy, REBT aims to help people identify and discard their irrational beliefs so they can better manage their behavior and overcome mental distress. Rational Emotive Behavior Therapy focuses on how clients' false beliefs affect their behavior--in this instance, on the possibility the client feels his wife is deliberately irritating him.

Person Centered therapy

based on the writings of Carl Rogers, proposes several core conditions for growth in psychotherapy including therapist genuineness, unconditional positive regard, and accurate empathy.

refugee

basic survival needs

Antimanic agnets (mood stabilizers)

bipolar depakote, lamictal, lithium, topamax, small diff b/w therapeutic and toxic levels

heroin

contracted pupils, no response of pupils to light. needle marks, sleeping at unusual times, sweating, vomiting, coughing, sniffing, twitching, loss of appetite

Narrative theory

deals with the stories people tell about themselves, a process assumed to begin in adolescence. Narrative theory, the basis for narrative therapy, assumes people form an identity by creating an evolving story of the self, starting in adolescence.

precontemplation

denial, ignorance of the problem

stages of grief

denial- shock with feeling replaced by not happening anger- someone or something to blame bargaining: negotiate with ones self or higher power to attempt to change what occurred depression: sadness and loneliness reflect on loss acceptance: at peace with what happened

Psychomotor retardation

describes a person moving and speaking very slowly.

agoraphobia

diagnosed when client's experience intense fear of being in situations from which escape might be difficult.

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

Illness anxiety disorder

disorder involves preoccupation with having or acquiring a serious illness and is more. IBS is more likely to be found in people who suffer from GAD.

Social (pragmatic) communication

disorder is diagnosed when speech difficulties are specific to certain situations--not following the rules for conversation and storytelling, for example.

Cluster B

dramatic emotional and erratic antisocial, borderline, narcissistic, histrionic Cluster B--the "dramatic" cluster--includes borderline, histrionic, narcissistic, and antisocial personality disorder

Erik Erikson,

ego strengths are qualities that animate people during the eight stages of life. The Psychosocial Inventory of Ego Strengths (PIES) was developed as a self-report measure of Erikson's eight ego strengths.

Beck's theory of depression

emphasizes the effects of peer rejection, parental criticism, loss of a parent, and other negative events of childhood.

Mindfulness

entails focusing on what is happening in the moment. - The social worker is recommending that this woman change how she thinks, which represents a focus on cognition, not behavior. - The social worker is recommending this woman change her negative thoughts to more realistic thoughts--an example of cognitive restructuring

preparation

experimenting with small changes, collecting information about change

Psychoanalysis

explores a person's childhood and their unconscious drives and motives.

Family System

extent to which individuals problems are related to family issues. must look at the family as a whole rather than focusing on its members

relapse

feelings of frustration and failure

acute med problem

focus on med eval first

victim of DV

focus on medical and safety issues

Cognitive therapy

focuses on changing a person's irrational and distorted thoughts.

Behavior Therapy

focuses on changing behaviors through the use of rewards and punishments. Little emphasis is placed on the underlying reason for the behavior or the thoughts that accompany the behavior. When kids exhibit behavior problems, a behavior therapist often works with the parents to teach them how to effectively use rewards and punishments. - Helping the parents use rewards and consequences to make following the rules more likely for the child would be a goal of behavior therapy.

Object relations therapy

focuses on how clients' early experience of their mothers is reflected in the therapeutic relationship.

Jungian Therapy

focuses on increasing a person's awareness of unconscious processes, with a particular focus on dreams, archetypes, and myth.

Kohlberg's theory

focuses on the development of moral reasoning, starting in childhood and continuing throughout an individual's lifetime.

psychoanalytic

freud- cat seen as the product of their past and treatment involves dealign with repressed material in the unconscious

universalization

generalization or normalization of behavior

marijuana

glassy, red eyes, loud talking, inappropriate laughter, followed by sleepiness, loss of interest, motivation, weight gain or loss

Adolescent depression

has some features similar to adult depression, but adolescents sometimes complain more of being "bored" than sad, and may present as more irritable than sad. Many of the symptoms of depression can mimic other disorders, such as ADHD. However, this scenario describes a child who has lost interest in spending time with friends, which would be more indicative of a low-grade depression. Since his symptoms have lasted over a two years, he meets the criteria for persistent depressive disorder.

ACT therapy

helps clients learn how to accept uncomfortable emotions, identify values, and take value-directed action.

Interpersonal therapy

in which the therapist engages the client on a deep emotional level, is typically used in treating depression.

Common anti-anxiety medications

include Klonopin, Ativan, Xanax, and Buspar.

Risk factors for domestic homicide against women

include the woman's attempts to break off the relationship, the abuser's drug use, lack of education, and/or unemployment, the woman's failure to report prior assaults, and having a child in the home who is not the partner's biological offspring. However, the period of greatest risk, for both battering and homicide, is during pregnancy or shortly after giving birth.

An effective case presentation

includes a demographic description of the client, the presenting problem, the goal of treatment, any legal, ethical, or safety issues, the treatment plan, the interventions being employed, what stage of treatment the client is in, and the provisional diagnosis--which is always subject to change. - The client's final diagnosis is liable to change during the treatment, as symptoms change. - It's critical to address any legal or ethical issues involved in the treatment. - Defining the goals of the treatment, including what constitutes a successful outcome, is part of any case presentation.

The willingness of sexually abused children and adolescents to reveal the abuse depends on several factors

including the duration of the sexually abusive relationship, the degree of coercion involved, the number of instances of abuse, and, chiefly, the closeness of the relationship between the perpetrator and the victim.

Strategic family therapy

initiates what happens during therapy, designs a specific approach for each person's presenting problem and takes responsibility for directly influencing people.

Adjustment Disorder

involves emotional or behavioral symptoms related to stress which do not meet the criteria for another diagnosis, such as an anxiety or depressive disorder.

CBT

involves helping people change irrational thoughts and behaviors, with less emphasis on talking about feelings.

Motivational Interviewing

is a collaborative, goal-oriented, non-confrontational approach to various mental health issues, especially substance abuse. It assumes that motivation to change must be elicited from the client, not imposed by outside forces, and that it is the client's task, not the counselor's, to identify and resolve the conflicts standing in the way of progress. - Since the agreed-upon purpose of the treatment is to treat the client's substance abuse, this paradoxical question--a recognized technique in Motivational Interviewing--is designed to heighten the client's awareness of why he came to treatment and his lack of progress. - motivates clients to come up with their own reason for change

Erotomania

is a delusional disorder in which a person feels that someone, usually of higher status, is in love with them.

PIE

is a holistic approach that simultaneously addresses clients' social roles, their relation to their physical and social environments, their mental health, and their physical health. Among its principles are the commonalities that exist among social workers in various countries, and the importance of social and environmental change.

Conversion disorder

is a mental health condition in which a person has physical symptoms that cannot be explained by medical evaluation. These symptoms almost always occur following a stressful experience. People with conversion disorders are not making up their symptoms; the physical symptoms are a way to cope with unwanted thoughts or feelings. - Ie. This woman's swallowing prevents her from being able talk about her childhood sexual abuse. Conversion disorder is the most likely of the offered diagnoses.

Flooding

is a method of treating phobias that exposes the client to a feared stimuli until the client is able to relax. As in systematic sensitization, clients face phobias head-on, without the gradual build to worst-case situations.

Partializing

is a way to help clients break down a lot of information into smaller units. By breaking down lots of problems into smaller steps, social workers can assist clients with developing strategies to address them one at a time. Partializing would help the client determine which problem to begin addressing

Acute Stress disorder

is diagnosed after a perceived life or injury-threatening event.

Cyclothymia

is diagnosed when a person experiences hypomania and mild depression.

A language disorder

is diagnosed when people have difficulty with "acquisition and use of language...due to deficits in comprehension or production" and are below expected age level.

persistent depressive disorder (dysthymia)

low-grade depression, loss of interest in usual activities, decreased grades, and irritability, all point to a diagnosis of

maintenance

maintaining a new behavior, avoiding temptation

Substance Use DSM Specifiers

mild: 2-3 symptoms moderate: 4-5 symptoms severe: 6 or more symptoms

Cluster A

odd and eccentric schizoid, paranoid, schizotypal Cluster A--the "eccentric" cluster--includes paranoid, schizoid, and schizotypal personality disorder;

psychosexual stages of development

oral: birth-12 sucking anal: age 2 bowl move's phallic: 3-5 genitals latency: 5- puberty: sexuality genital: begins at puberty: the genitals: sexual urges

Carl Rogers' theory of self-actualization

posits the lasting effects of conditional vs. unconditional love during childhood.

stages of change

pre contemplation: clit is unaware, unable and or unwilling to change contemplation: ambivalent or uncertain regarding behavior change, behaviors unpredictable

interpretation

puling together patterns of behavior to get a new understanding

interpretation

pulling together patterns of behavior to get a new understanding

task centered

quickly engage at in the problem solving process and maximize their responsibility for tx outcomes. time limits due to time constraints, here and now, immediate results, problem partialized into clear tasks

Malingering

refers to the practice of creating symptoms for personal gain. There is no evidence this woman is lying or trying to obtain benefit from her symptoms.

clarification

reformulate problem in the clts words to make sure that you are on the same wavelength

Acute stress disorder

similar to PTSD, is diagnosed when symptoms occur within one month of a traumatic event.

Treatment Priorities

social workers ideally collaborate with clients, their families, and/or legal services to determine a hierarchy of problems and concerns. If clients present with multiple problems, task-centered therapy usually deals with no more than three at a time, to avoid loss of focus and direction. When clients are involuntary, and appear resistant to change, the best approach is to focus on the problem for which the client was mandated.

reframing and relabeling

stating the problem in a different way so a cat can see possible solutions

Antipsychotic medications

such as Risperdal, Seroquel, and Abilify are most commonly used for treating schizophrenia.

action

taking direct action toward achieving a goal

Bowenian Family theory

the goal of this approach is not symptom reduction

Approaches to treating addiction

the medical model, which regards substance abuse as a disease; the psychodynamic model, which emphasizes the abuser's internal conflicts that need to be resolved to eliminate the self-medicating behavior; the moral model, which considers drug abuse an anti-social choice and stresses the need for willpower to overcome the temptations of drug abuse. ; and the social model and, which focuses on substance abuse as the result of exposure to other users, peer pressure, relationship pressure, and advertising. The biopsychosocial model of addiction combines aspects of all these approaches.

Rape victims

typically experience a variety of symptoms after the attack, including guilt, shame, anxiety, depression, and anger. Though there's a significant risk of long-term PTSD, the initial distress generally peaks in about three weeks, finally easing two or three months post-assault. Male partners of rape victims may show symptoms often seen in female partners of war veterans: isolation, anger, and a feeling of powerlessness. Survivors of rape may have to struggle with their partners' reactions as well as their own. Male partners of rape victims often experience symptoms comparable to those suffered by the female partners of war veterans--including a feeling of powerlessness that can lead to rage

People with autism spectrum disorder (ASD)

typically show inappropriate social skills, but standardized tests are usually not sensitive enough to assess the depth and significance of these deficits in high-functioning students. Observing their behavior with peers and during an interview are two useful approaches. Another method is to show the student photographs of the person doing the assessment, and then ask the student to conduct an interview based on those photographs. Students with autism have difficulty with this task, since it entails a degree of empathy and organization beyond their capacities. - People with ASD often score high on intelligence tests. - Students with social cognitive deficits have a hard time with this task, which requires a degree of empathy and organization typically lacking in cases of ASD. - While this test can identify students with severe impairments, high-functioning students with ASD may perform on an average level or better.

antipsychotics

used for schizophrenia and mania halodol, clozaril, ability, risperdal, seroquel, zyprexa

panic attacks

usually come out of the blue and are not triggered by a specific fear or memory

autism spectrum disorder

which can be characterized by difficulty with appropriate social interaction and repetitive patterns of interest or behavior.

Gestalt Therapy

which focuses on being "in the moment," is a non-goal-oriented treatment heavily reliant on the client's subjective experience.

Unspecified bipolar and related disorder

would be the appropriate diagnosis only if the client had symptoms that didn't meet the criteria for another type of bipolar disorder. This client seems to meet the diagnostic criteria for bipolar II.