LMSW_ Apgar

In the DSM-5, the multiaxial system was: A. Eliminated completely B. Expanded to include additional areas C. Reduced to only those of clinical priority D. Not changed form the DSM-IV-TR

A. Eliminated completely The APA developed the original Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952 to create a uniform way to define mental health disorders. The APA first introduced the multiaxial system in the third edition (DSM-III, published in 1980), which suggested, but did not require, that social workers report diagnostic information on the five distinct axes. This tradition continued with only modest changes in the DSM-IV (1994) and DSM-IV-TR (2000). Axis I listed the primary or principal diagnoses that needed immediate attention; this included recording of clinical disorders as well as "Other Conditions That May Be a Focus of Clinical Attention" (e.g life stressors, impairments in functioning). Axis II contained pervasive psychological issues such as Personality Disorder, personality traits, and Mental Retardation (now Intellectual Disability Disorder) that shaped responses to Axis I disorders. Axis III was intended to cue reporting of medical or neurological problems that were relevant to the individual's current or past psychiatric problems. Axis IV required social workers to indicate which of nine categories of psychosocial or environmental stressors influenced client conceptualization or care (e.g recent divorce, death or partner, job loss). Finally, Axis V included the opportunity to provide a Global Assessment of Functioning (GAF) rating, a number up to 100 intended to indicate overall level of distress or impairment. Concerns of all the multiaxial system included the degree to which Axes I and II were mutually exclusive and distinct; lack of clear boundaries between medical and mental health disorders; inconsistent use of Axis IV for clinical and research purposes; and poor psychometric properties and clinical utility of the GAF. As Axes I, II, and III have been eliminated, social workers can simply list any disorders or conditions previously coded on these three axes together and in order of clinical priority of focus. Because many billing systems already used this system, this does not result in meaningful changes in terms of third- party billing. This change removers the distinction of previous clinical disorders, Personality Disorders, and Intellectual Disability Disorders. Social workers previously listed psychosocial and contextual factors the affect clients and are relevant to conceptualization on Axis IV. This included notation regarding concerns in the nine key areas: primary support group, social environment, education, occupation, housing, economic, access to health care, legal system/ crime, and other. Beginning with the DSM-5, social workers are advised to make a separate notation regarding contextual information, rather than including it in axial notation. However, there is not guidance regarding how or where to do so. Initially developed as the Health-Sickness Rating Scale, the GAF was introduced as Axis V. Over time, this single number scale came to be used to assist in payers' determination of medical necessity for treatment and on determining eligibility for disability compensation. The discontinued use of the GAF in the DSM-5 suggests that social workers use the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) as a measure of disability. The GAF scale was removed from the DSM-5 because of perceived lack of reliability and poor clinical utility.

What is the MOST important factor in the development of an effective helping relationship? A. Social worker's training and experience in working with similar client problems B. Client's willingness to view a social worker as a resource for change C. Nonverbal and verbal communication between a social worker and client D. Agency policies that clearly articulate the roles of both social worker and client

C. Nonverbal and verbal communication between a social worker and client The helping relationship between a social worker and client is expressed through interaction. This interaction is commonly thought of in terms of verbal communication, which is natural, because the majority of treatment involves talking. However, nonverbal communication is also very important. Body posture, gestures, facial expressions, eye movements, and other reactions often express feelings and attitudes more clearly than do spoken words.

A client is admitted to an impatient setting for substance abuse detoxification. The social worker learns that the client is addicted to a prescription medication with a very short half-life. Based upon this information the social worker can predict that the withdrawal symptoms will likely: A. Increase significantly over time, peaking weeks or months after initial detox. B. Be life-threatening, needing careful medical monitoring to ensure health and safety C. Occur quickly after admission, causing the desire to use again to happen immediately D. Consist of psychological, rather than physical, effects which require psychopharmacology intervention

C. Occur quickly after admission, causing the desire to use again to happen immediately Indicators of substance abuse require social workers to understand the way in which substances produce physiological and psychological changes in the body. The half-life of a drug is the time it takes for the amount currently in the body to be reduced by half. It does not matter what the current amount is- the time it takes for it to be reduced by half will always be the same for a particular drug. For most drugs, the half-life cannot be measured accurately and can only be a rough estimate as it varies from client to client. But, half-life is still a helpful concept, because if a drug has a short half-life (24 hours or less) it means that it is more difficult to come off of it. If a drug has a long half-life, withdrawal is naturally slower and usually easier to tolerate. Drugs with a short half-life are designed for fast action. They are made to hit the body quickly, so they can provide relief with speed. Long-acting drugs tens to maintain their effects for a long period of time, though the first dose takes longer to take effect. Due to their quick effect, drugs with short half-life tend to be popular with people who have addictions. They tend to deliver huge changes in a very short time period. For drug users who want a big high in a hurry, these medications are tailor-made. Withdrawal symptoms come quickly, drawing clients back into addiction. Withdrawal discomfort contributes substantially to the risk of relapse. Client who feel ill immediately are desperate for relief, and they might get that release by going back to drugs. If withdrawal discomfort can lead right back to drug use, it is imperative that an addiction treatment program sooth discomfort. Often, the best way to provide relief is to provide client accustomed to short half-life drugs with medications in the same class that have a longer half-life. For example, alcohol is a sedating drug with a very short half-life. Chronic users who attempt to withdrawal may experience a variety of life-threatening symptoms, including seizures. Switching to a long half-life sedating drug can help the brain to adjust to the lack of drugs without plunging a client into a state of medical emergeyc.

During acculturation, which of the following statements describes the responsibilities of those in the dominant and nondominant cultures? A. Individuals in both the majority and minority have an equal responsibility to change in order to work together cooperatively. B. Individuals in majority groups must teach those in the minority about their customs and traditions. C. Individuals in the minority must advocate for inclusion to ensure equal access to societal rewards by those in the majority. D Individuals in the minority must decide which majority practices they will follow for integration to occur.

A. Individuals in both the majority and minority have an equal responsibility to change in order to work together cooperatively. Acculturation is defined as a mutual and dynamic process of cultural change that occurs when two or more cultures come into contact. Acculturation requires the mutual accommodation of aspects of each culture (or cultures), although it is acknowledged that nondominant or minority groups often experience a greater change than dominant groups (the majority). However, the aim is change in both the dominant and nondominant groups to achieve interpersonal and intergroup relational outcomes that are the product of both groups' orientations. Underlying acculturation strategies have two main goals: the desire to preserve heritage and culture and the facilitation of productive interaction between cultural groups. Thus, acculturation must be a process of mutual accommodation. Unfortunately, the role of majority groups is often not acknowledged or is downplayed, leaving the integration. Change in both those in the majority and minority is crucial for achieving true multicultruralism.

A social worker has an involuntary client who has been court- ordered to receive counseling. Since intake, the client has expressed her belief that meeting with the social worker will not be helpful and has repeatedly threatened not to come in the future. During the next session, the social worker stops the client when she is complaining and says, "You are correct that talking with me does not appear to be helpful and I don't think that you should come next week." The social worker's statement is an example of a: A. Paradoxical directive B. Cognitive distortion C. Double bind D. Manifest message

A. Paradoxical directive Social workers often find themselves providing services to those who did not choose to receive them and need methods aimed at working with involuntary clients. While there are many interpretations that may be helpful, the use of paradoxical interventions can assist with the resistance that often accompanies these circumstances. Paradoxical interventions or directives involve prescribing they very symptom that client wants to resolve. It is a complex concept often equated with reverse psychology. It is asking for something in order to achieve the opposite result. The underlying principle is that clients engage in behaviors for a reason, which is typically to meet a need (rebellion, attention, a cry for help, etc). In prescribing the symptom, social workers help clients to understand this need and determines how much control (if any) that have over the symptom. By choosing to manifest the symptom, they may recognize they can create it and therefore have the power to stop or change it. It helps clients be in control of their behavior and experiences. Paradoxical interventions are often used with families or part of a strategic family therapy. A cognitive distortion is an exaggerated or irrational thought that is believed to perpetuate the effects of psychopathological states. It is the focus of what cognitive behavior and other therapeutic approaches try to change. A double bind is a dilemma in communication in which a client receives tow or more conflicting messages whereby a successful response to one message results in a failed response to the other. Thus, a client is automatically wrong regardless of his or her action. Manifest content is the concrete words or terms in a communication. Thus, a manifest message is that which is taken literally without analyzing is hidden or underlying meaning.

Upon intake, a social worker learns that a client has been successfully managing her Bipolar Disorder for several years. The client is MOST likely using which of the following interventions? A. Psychopharmacology B. Individual psychotherapy C. Support group counseling D. Peer recovery

A. Psychopharmacology Psychopharmacology is the prescription of psychotropic medications to affect brain chemical associated with mood and behavior. Psychotropic drugs are prescribed to treat a variety of mental health problems, including Bipolar Disorder (BD) and Schizophrenia. Usually psychotropic medications are prescribed by psychiatrists, though other physicians and professionals may be able to prescribe the in certain jurisdictions. Doctors often treat the manic symptoms associated with BD with one set of drugs and use other drugs to treat depression. Certain drugs are also used for "maintenance" of a steady mood over time. A number of medications are used to treat BD. The types of medications prescribed are based on particular symptoms and can include combinations of mood stabilizers (such as lithium), antispychotics, antidepressants, and antianxiety medications.

Echolalia is associated with which of the following DSM-5 diagnoses? A. Catatonia B. Autism Spectrum Disorder C. Bipolar Disorder D. Major Depression

B. Autism Spectrum Disorder Echolalia is the repetition of phrases, words, or parts of words. Echolia may be a sign of Autism Spectrum Disorder (ASD). Almost all toddlers go through a stage in which they "parrot" words and phrases that they overhear. Mimicry is an efficient way to experiment with different sounds and practice emerging social language skills. This is a normal and a critical stage in language development. However, these behaviors past early childhood can be considered atypical. Some communication problems that can be used in assisting to make a diagnosis of ASD are pedantic speech or unusually formal language (child speaks like an adult or "little professor"), echolalia (immediate or delayed), "jargon" or gibberish (mature jargoning after developmental age of 24 months), pronoun reversal (e.g "You" for "I"; not just mixing up gender pronouns), and referring to self by own name (does not use "I"). Other criteria for ASD must also be met in order to make a proper diagnosis. In DSM-5, Catatonia may be diagnosed as a specifier for Depressive Disorders, Bipolar Disorder (BD), and Psychotic Disorders; as a separate specified diagnosis. The major characteristic of catatonia is stupor. Stupor is a condition in which a client lacks critical cognitive functioning and is unresponsive to stimuli other than pain. Under DSM-5, three of the 12 characteristic symptoms of Catatonia must be presented. One of those symptoms is echolalia. BD and Majro Depressive Disorder are not characterized by communication deficits or problems.

Which statement is NOT true about the distinction between grief and depression? A. Painful feelings caused by grief come in waves while mood and ideation, which are almost constantly negative, are associated with depression. B. Feelings of worthlessness, suicidal ideas, and impairment of overall function are symptoms of grief rather than depression. C. When grief and depression coexist, grief is more severe and prolonged that grief without depression. D. In grief, self- esteem is usually preserved while corrosive feelings of worthlessness and self- loathing are more common when depressed.

B. Feelings of worthlessness, suicidal ideas, and impairment of overall function are symptoms of grief rather than depression. Major Depressive Disorder is a medical illness that causes persistent feelings of sadness and loss of interest in previously enjoyed activities. Using the fourth edition text revision of the DSM (DSM-IV-TR), social workers refrained from diagnosing major depression in individuals within the first 2 months following the death of a loved one in what has been referred to as the "bereavement exclusion". By advising social workers not to diagnose depression in recently bereaved individuals, the DSM-IV-TR bereavement exclusion suggested that grief somehow protected someone from major depression. For some clients, death of loved ones can precipitate major depression, as can other stressors. The bereavement exclusion was removed from the DSM-5, forcing social workers to have to differentiate between typical behavior and a diagnosable mental disorder. While the grieving process is unique to each client, it can contain some of the same features of depression like intense sadness and withdrawal from customary activities. However, grief and depression are also different in important aspects.

A client uses racist language when describing an incident that occurred at work resulting in his termination. The social worker is helping the client locate another job as outlined in his service plan. While the comments are not related to the reasons why he was fired, they are deeply troubling and offensive to the social worker. The social worker feels that the client is ethnocentric and discriminates against others. In this situation, the social worker should: A. Modify the client's service plan to include increasing his knowledge about other cultures B. Process feelings with a supervisor while continuing to work with the client on locating employment C. Ask that the client be transferred to another social worker in the agency as it is impossible for the social worker to be objective in assisting the client D. Explore the underlying basis for the client's discriminatory attitudes

B. Process feelings with a supervisor while continuing to work with the client on locating employment Professional objectivity means that social worker communication should not be burdened with emotional investment. If a client feels judged, he or she will not speak frankly. A social worker cannot tell a client what he or she should feel or do. A client will change his or her feelings or actions when motivated to do so. In this case scenario, the client's racist language and feelings do not related to the presenting problem or service goals. Thus, while the comments are disturbing to the social worker, they should not interfere with the delivery of needed services. The social worker should not modify the client's service plan as the goals in the plan are dictated by assessment findings about current client difficulties. The case scenario clearly states that the discriminatory comments are not related to the firing, which is the presenting problem. Transferring the client is also not appropriate as it does not assist him. The social worker cannot let his or her own emotional reactions to views of the client interfere with treatment. Lastly, there is no justification for exploring the discriminatory attitudes of the client in more depth as they are not germane to the problem or service being provided. It is important for the social worker to discuss his or her feelings with a supervisor so that they can be resolved in a manner that does not interfere with professional objectivity. The core of the helping process is the relationship between a social worker and client. If the client feels judged by the social worker, he may not be open to assistance.

A client with Anorexia Nervosa, who believes her eating habits are normal, takes pride in her excessive exercise, and does not want to change, views her disorder as: A. Ego alien B. Ego-dystonic C. Ego-syntonic D. Egocentric

C. Ego-syntonic Psychodynamic theories explain the origin of the personality. Freud proposed that personalities have three components- the id, ego, and superego. The ego is the component that manages the conflict between the id and the constrains of the real world. Ego-syntonic refers to instincts or ideas that are acceptable to the self and are compatible with one's values and ways of thinking. They are consistent with one's fundamental personality and beliefs. Ego-dystonic refers to thoughts, impulses, and behaviors that are felt to be repugnant, distressing, unacceptable, or inconsistent with one's self- concept. For a person who is a thief, stealing would be considered ego-syntonic, meaning that it comes naturally; there is unlikely to be any conflict about the act of stealing, and there is little or no guilt, as a result. For most people, stealing would be ego-dystonic. One of the problems in working with certain psychiatric disorders in a therapeutic setting is the extent to which the disorder is experienced by the client as ego-syntonic or ego-dystonic. Social workers who work with certain eating disorders encounter the problem of clients who believe that their eating behavior is perfectly normal (e.g ego-syntonic). Anorexia Nervosa is just such an example. This is an eating disorder that is characterized by extremely low body weight and body image distortion with an obsessive fear of gaining weight. Clients who have this condition typically have poor insight and often refuse to accept that their weight is dangerously low even when it could be deadly. In other words, their body and their eating behavior is "normal", or ego-syntonic, in that they feel that there is nothing the matter with how they eat and live. The task for social workers involved in treating this disorder is, essentially, to make something that is eog-sytnoic for the client something that is ego-dystonic instead, so that there might be some leverage in bringing about meaningful and necessary emotional, physical, and behavioral change. Clients who experience the behaviors associated with the eating disorder as problematic and incongruent with how they see themselves view their eating disorder as ego-dystonic; this view is typically endorsed by Bulimia Nervosa and Binge Eating Disorders. As a result, clients often want help because they are frustrated with unsuccessful weight loss attempts and are ashamed of their binge eating/ purging behaviors. This desire for help leads to an improved therapeutic alliance and motivation to change. In contrast, clients with eating disorders who experience their behaviors as congruent with their personality and have a certain amount of pride in the ability to diet and exercise to extremes view the eating disorder as ego-syntonic. This ego-syntonic view is most often seen in Anorexia Nervosa. In most cases, when the eating disorder is experienced as ego-syntonic, there will be little or not motiavation to change the behaviors, which results in high levels of treatment resistance that increase with time. Ego alien is another term used to refer to ego-dystonic behavior. Egocentric is having little or no regard for others' interests, beliefs, or attitudes (e.g being self-centered).

A client who is discriminated against due to his or her national origin and/or culture is being judged based on: A. Nondominant ancestry B. Race C. Ethnicity D. Minority Status

C. Ethnicity The traditional definition of race and ethnicity is related to biological and sociological factors, respectively. Race refers to physical characteristics, such as skin, hair, or eye color. Ethnicity refers to cultural factors, including nationality, regional culture, ancestry, and language. Thus, race is usually judged by appearance while ethnicity is determined based on membership in social and cultural groups. Since ethnicity is about the learned cultural behaviors celebrated throughout regions around the world, it can be altered or mimicked through choice and beliefs. In addition, it is possible to have more than one ethnicity at a given time, but race is considered unchanging or fixed throughout the life course.

Which of the following is a dynamic risk factor for predicting the likelihood that perpetrators of sexual assault will reoffend? A. History of antisocial behavior B. Prior criminal history C. Use of force in prior assaults D. Abuse of substances

D. Abuse of Substances Static risk factors are those that cannot be changed- characteristics of the offense (such as use of force), history of antisocial behavior (sexual or otherwise), age at first offense, gender of victims, and prior criminal history. Static risk variables are relatively easy to identify, as they can be gathered from archival data, such as existing records. Though may assessment are based on static, historical risk factors, they have been criticized for neglecting dynamic (changeable) risk factors. After all, if a client's risk is completely determined by historical, unchangeable factors, there is no reason to provide rehabilitative treatment. Psychotherapy cannot change a client's history; it can only affect variables that are amenable to change. Although age is considered a dynamic risk factor, the most useful dynamic risk factors are those amenable to deliberate interventions (.e.g, substance abuse, unemployment).

Personality Disorders are MOST often diagnosed during: A. Middle childhood B. Puberty C. Infancy D. Adulthood

D. Adulthood Personality Disorders are defined as deeply ingrained and enduring attitude and behavioral patterns that deviate markedly from the culturally expected range. They are not secondary to other mental illnesses or attributable to gross brain damage or disease, although they may precede and coexist with other disorders. Disorders of personality tend to appear in late childhood or adolescence and continue to manifest into adulthood. However, while most Personality Disorders can be diagnosed prior to adulthood, few are, as there is a belief that adolescent personality problems are transient. There are also concerns about the negative effects of labeling. Thus, the diagnosis of Personality Disorder is likely to occur during adulthood. There is also evidence that the symptoms of Personalty Disorder do not remain stagnant, but actually change in magnitude and scope over time.

Which of the following behaviors is NOT an indicator that a client is resistant or lacks readiness to fully participate in services? A. Engaging in small talk about irrelevant topics B. Regularly missing or being late for appointments C. Limiting the amount of information revealed about the problem D. Asking in detail about confidentiality practices and procedures

D. Asking in detail about confidentiality practices and procedures. Social workers should not assume that clients are ready or have the sills needed to make changes in their lives. Clients may be oppositional, reactionary, noncompliant, and/or unmotivated. These attitudes or behaviors are often referred to as resistance. There are indicators that a social worker should use as evidence that a client may be resistant or not ready/able to fully participate in services. These indicators include engaging in small talk with a social worker about irrelevant topics. not keeping appointments, and limiting the amount of information communicated to a social worker. Additional indicators of resistance include: * Silence/ minimal talking during sessions * Engaging in intellectual talk by using technical terms/ abstract concepts or asking questions of a social worker that are not related to client issues or problems * Being preoccupied with past events instead of current issues * Discounting, censuring, or editing thoughts when asked about them by a social worker * False promising * Flattering a social worker in an attempt to "soften" him or her so that the client will not be pushed to act * Payment delays or refusals

When intense subgroup attraction interferes with group functioning, the social worker should employ all of these strategies EXCEPT: A. Examining whether the group as a whole is sufficiently attractive to members B. Engaging in exercises that separate subgroup members C. Promoting norms that emphasize group cohesion D. Dismissing subgroup members from the larger group

D. Dismissing subgroup members from the larger group In some situations, social workers may actively encourage members to form subgroups, particularly in groups that are too large and cumbersome for detailed work to be accomplished. For example, subgroup formation if often useful in large task groups such as committees, delegate councils, and some teams. Members are assigned to a particular subgroup to work on a specific task or subtask. The results of the subgroup's work are then brought back to the larger group for consideration and action. Regardless of whether social workers actively encourage subgroup formation, they occur naturally because not everyone in a group interacts with all members equally. The formation of intense subgroup attraction, however, can be a problem for group functioning. Subgroup members may substitute their own goals and methods of attaining them for the goals of the larger group. They can disrupt the group by communicating among themselves while others are speaking. Subgroup members may fail to listen to members who are not a part of the subgroup. Ultimately, intense and consistent subgroup formation can negatively affect the performance of the group as a whole. When intense subgroup attraction appears to be interacting with the group as a whole, a number of steps can be taken, including examining whether the group as a whole is sufficiently attractive to members, engaging in exercises that separate subgroup members, and promoting the development of norms that emphasize the importance of members listening to and respecting each other. Terminating or dismissing group members is not a strategy to address the problem; it excluded group participants rather than engages them.

A social worker has just implemented a new agency practice to resolve an existing ethical issue. According to the principles of ethical problem solving, the social worker should NEXT: A. Ensure that the new practice is formally incorporated in agency documents and trainings B. Examine the key social values and principles that support the new procedure C. Explore if other practices need to be updated to incorporate new trends in the fied D. Monitor the procedure to see if the problem is resolved and any new concerns emerge

D. Monitor the procedure to see if the problem is resolved and any new concerns emerge While all the response choices may occur and be useful on a practical level, the question asks for the response choice which occurs next according to the principles of ethical problem solving. There are six sequential steps in ethical problem solving: (1) identifying the ethical standards, as defined by the professional code of ethics, that are being compromised; (2) determining whether an ethical issue or dilemma exists; (3) weighing ethical issues in light of the social work values and principles as defined by the professional code of ethics; (4) suggesting modifications in light of prioritized ethical values and principles; (5) implementing modifications in light of prioritized ethical values and principles; and (6) monitoring for new ethical issues and dilemmas. As the new practice has just been implemented (step 5), the social worker should monitor the situation to determine if the problem has been rectified and any new ethical issues emerge (step 6).

Couples counseling for those who are currently in battering relationships should: A. Accompany concurrent individual counseling of both parties to enhance effectiveness B. Occur only if there is assurance that no violence will occur after the onset of treatment C. Commence only after reporting requirements under "duty to warn" legislation are made clear D. Not be selected as a therapeutic intervention due to safety concerns

D. Not be selected as a therapeutic intervention due to safety concerns Couples intervention/ treatment is not a viable therapeutic tool for use in violent relationships. Violent relationships are those in which physical or sexual assaults occur, threats of violence occur, and/ or partners live in environments of fear caused by their partners. Couples counseling is inappropriate even when both parties requires it and/ or want to maintain their relationship. Treating a couple together before violence is addressed and stopped can endanger victims, lend credibility to the misunderstanding that partners are responsible for violence inflicted upon them, minimize the attention on the violence by focusing on couple interactions, and increase the isolation of victims by reinforcing fears about speaking freely. Ending violence in relationships is primary and dependent solely on batterers' motivation and commitment to do so.

A 24-year-old client wants to move out of her family home and live with several friends. The social worker has concerns as the family provides a lot of financial and emotional support to the client. In addition, the friends are having problems paying the rent and have received an eviction notice. Though the client reports that her financial support toward the bills will address the issue, the social worker strongly believes that the client is making a poor choice. In this situation, the social worker should FIRST: A Acknowledge that the client has the right to make this decision B. Determine the main reason that the client wants to move C. Suggest that the client further discuss her decision with her family D. Assess whether the client is being financially exploited by her friends

A. Acknowledge that the client has the right to make this decision Social workers respect and promote the rights of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients' right to self-determination only when, in their professional judgement, a clients' actions or potential actions pose serious, foreseeable, and imminent risk to themselves or others.

A social worker is assisting a community to develop a program to treat adolescent drug addiction. Neighborhood citizens are very concern as several youth have died due to overdose in the last few weeks. In order to ensure that services are developed using the principles of social justice, the social worker should: A. Advocate for community members to have decision-making power in the planning process B. Use evidence- based practices as the foundation for treatment of this hard-to-serve population C. Integrate substance use and mental health treatment due to the prevalence of co-occurrence of these disorders D. Gain support from community leaders to increase the likelihood of successful implementation

A. Advocate for community members to have decision-making power in the planning process Social work is a practical profession aimed at helping people address their problem and matching them with the resources they need to lead healthy and productive lives. Ensuring that community resources reflect problems identified and solutions created by local citizens is essential. This underpinning of this approach can be summarized int two words: social justice. Social justice is the view that everyone deserves equal economic, political, and social rights and opportunities. Social workers aim to open the doors of access and opportunity for everyone, particularly those in greatest need. Central to social justice is the empowerment of clients. Empowerment is the giving of or sharing of power with others. Community organization and social planning are built on the principles of social justice with members who have complete decision-making power.

Upon intake, a client tells a social worker that she cannot wait "to be told how to fix the problem." The client's statement is BEST representative of role: A. Ambigiuity B. Reverals C. Conflict D. Complementarity

A. Ambiguity Problems can arise when a client is not clear on a social worker's role. Initial clarification should be made during engagement and should be discussed during the therapeutic process if the role of a social worker changes. Role is a behavior prescribed for an individual occupying a designated status. Social role theory has some important terms that relate to role issues: Role ambiguity is a lack of role clarity Role Reversal is when two or more individual switch roles Role conflict is an incompatibility with role expectations Role complementarity occurs when a role is carried out in an expected way People generally like to give advice. A danger is that clients may expect social workers to fulfill this inappropriate role. Social workers must correct role ambiguity so clients see them as consultants, advocates, case manager, catalysts, mediators, brokers, and so on- not advice givers.

A client meets with a social worker as he has been estranged from his parents and feels an emotional loss at not having a relationship with them. He reports that he would like to contact the and does not know why it has been so long since they talked. In order to discuss the available options, the social worker should FIRST: A. Ask the client about his family history and relationships before the split occurred B. Obtain more information about the last contact that the client had with his family C. Discuss the feelings of grief that have resulted from his family breakup D. Help the client contact his parents with the goal of meeting to discuss the situation

A. Ask the client about his family history and relationships before the split occurred The problem-solving approach is based on the belief that an inability to cope with a problem is due to some lack of motivation, capacity, or opportunity to solve problems in an appropriate way. Clients' problem- solving capacities or resources are maladaptive or impaired. The goal of the problem-solving process is to enhance client mental, emotional, and action capacities for coping with problems and/ or making accessible the opportunities and resources necessary to generate solutions to problems. A social worker engages in the problem-solving process vai the following steps- engaging, assessing, planning, interviewing, evaluating, and terminating.

A client seeing a social worker for weekly counseling for her anxiety feels that her symptoms are worsening. She would like to be voluntarily hospitalized to address her problem, but has been told by her insurance company that inpatient services will not be covered since appropriate services can be delivered in the community. In order to formulate a treatment pan, the social worker should: A. Assess her current symptoms so an appropriate level of care can be established B. Obtain a listing of the criteria for medical necessity form the insurance carrier C. Contact the inpatient program to see if charity care funding is available D. Explain the medical necessity requirement for inpatient hospitalization

A. Assess her current symptoms so an appropriate level of care can be established The problem-solving process drives the methods used to develop an intervention plan. The steps precede planning include engagement and assessment, which are both essential to ensuring that a social worker and client have created a therapeutic alliance and collected the information needed to begin planning, the third stage. In planning, a social worker and client should 1. Define the problem (in a well-defined, clear, and data-driven format) 2. Examine the causes of the problem and how it relates to other positive or negative aspects of a client's life 3. Generate possible solutions that will impact on the problem 4. Identify the driving and restraining forces related to implementation of each of the possible solutions 5. Rate the driving and restraining forces related to consistency and potency 6. Prioritize solutions based on these ratings 7. Develop SMART objectives- Specific, Measurable, Achievable, Relevant, and Time-specific-related to the chosen solutions 8. Create strategies and activities related to the objectives

A client has been seeing a social worker to deal with the grief associated with the recent death of his elderly mother. The client lived with his mother for his entire life and was her primary caregiver just prior to her passing. The client informs the social worker that he has recently been diagnosed with cancer and will begin treatment immediately. The social worker should respond to this disclosure by: A. Assessing whether current goals need to be altered given a change in his physical well-being B. Adjusting his appointments in order to work around needed medical appointments C. Mobilizing the client's natural support network to assist him during treatment D. Reassuring him that there are many effective medical treatments for cancer

A. Assessing whether current goals need to be altered given a change in his physical well-being Assessment is a vital component of the therapeutic process. It begins after engagement and drives planning or the creation of contracts. Social workers must consider biological, psychological, and social factors when identifying the root causes of problems. Diagnostic information should always be shared with clients and used to facilitate the establishment of intervention plans. Assessment is continual and must incorporate information that is discovered during the entire problem-solving process.

Upon intake, a client who professes to be "health conscious" reports that she smokes cigarettes. When asked by the social worker if she is aware of the health risks associated with smoking, the client states that "the reports are filled with misinformation and the hazards are not that great". The client's assertion MOST likely results from: A. Cognitive dissonance B. Metacommunication C. Displacement D. Intellecturalization

A. Cognitive dissonance Psychologist Leon Festinger (1957) proposed a theory of cognitive dissonance centered on how people try to reach internal consistency. Clients have an inner need to ensure that their beliefs and behaviors are consistent. Inconsistent or conflicting beliefs lead to disharmony, which clients strive to avoid. As the experience of dissonance is unpleasant, clients are motivated to reduce or eliminate it and achieve consonance (e.g agreement). For example, clients who smoke might continue to do so, even though they know it is bad for their health. They might decide that they value smoking more than their health, deeming the behavior "worth it" in terms of risks versus rewards. Another way to deal with this dissonance is to minimize the potential drawbacks. Smokers might convince themselves that the negative health effects have been overstated. They might also rationalize health concerns by telling themselves that they cannot avoid every possible risk out there. Lastly, smokers might try to convince themselves that if they do stop smoking then they will gain weight, which also presents health risks. By using such explanations, smokers are able to reduce the dissonance and continue the behavior. There are three key strategies to reduce beliefs or minimize cognitive dissonance: (1) focus on more supportive beliefs that outweigh the dissonant belief or behavior, (2) reduce the importance of the conflicting beliefs, and (3) change the conflicting belief so that it is consistent with other beliefs or behaviors. Metacommunication is the context within which to interpret the content of a message (such as nonverbal communication, body language, tone, etc). Displacement and intellectualization are both defense mechanisms. Displacement is directing an impulse or feeling toward a less threatening target and intellectualization is focusing on the facts and logic to avoid uncomfortable emotions.

A social worker is promoting a social policy that will make treatment readily available to an underserved group. Given opposition from several special interest groups, it is unlikely that the policy will be adopted as currently proposed. The social worker invites leaders from each of these groups to work on an amended policy, agreeing to incorporate elements of their competing proposals if they support the collaborative plan. The social worker is using which technique to influence social policy? A. Cooptation B. Advocacy C. Planning' D. Mobilization

A. Cooptation Often social workers who want to influence social policy need to address resistance to change. Forming strong ties to potentially influential people who are ambivalent about a change can be helpful as there is the opportunity to coopt them. This cooptation increases the probability that the change will occur. In addition, creating strong ties to potentially influential individuals who disapprove of a change outright can also be effective. Often when they are asked to be part of coming up with an acceptable solution, resistance is reduced as they are less likely to disagree with something that they have been part of creating. Cooptation is the process by which a group subsumes or assimilates another (usually smaller or weaker) with the ogal of gaining support by adopting views or ideals of the group(s) subsumed.

Which of the following is TRUE about child sexual abuse? A. Perpetrators are male in the majority of reported cases of sexual abuse. B. Sexual abuse is a cultural or socioeconomic problem. C. Most victims do not know their perpetrators prior to the sexual abuse first occurring. D. Victims of sexual abuse will have physical signs of their abuse.

A. Perpetrators are male in the majority of reported cases of sexual abuse. Male perpetrators tend to be the majority of reported cases of abuse. However, women are also capable of child sexual assault. Reports of female perpetrators are on the rise, and female offenders have been reported in cases of abuse involving both male and female children. Sexual abuse is not a problem plaguing only certain families or people with a certain level of family income and education. Sexual abuse crosses all socioeconomic, neighborhood, race, and class barriers. It happens in large and small families; in cities and in rural areas; in wealthy and lower income neighborhoods; and in homes, schools, churches, and businesses. The people most likely to abuse children are the ones with the most opportunity, most access, and most trust. Abusers can be parents, stepparents, uncles, aunts, siblings, babysitters, tutors, and family friends. Most reported cases of child molestation involve a child and a known perpetrator. Frequently, an absence of physical evidence is used as support that a perpetrator must be innocent of an alleged sexual assault. However, abnormal genital findings are rare, even in cases where abuse has been factually proven by other forms of evidence. Many acts leave no physical trace. Injuries resulting from sexual abuse tend to heal very quickly, and many times exams of child victims do not take place on the same day as the alleged act of abuse. .

In recent weeks, a school social worker has developed a reasonable suspicion that a teenage student is being physically abused at home. When asking the child about the injuries, she reports child protective services has already interviewed her and found that "everything is fine". She states that she frequently gets injured in sports and that accounts for the cuts, scrapes, and bruises. In this situation, the social worker should: A. Report the suspicion immediately to the abuse hotline B. Monitor the situation to see if the signs continue when she is not engaged in sports C. Document the conversation in the student record D. Speak to a supervisor to determine if a report is still needed since child protective services has already investigated the allegations

A. Report the suspicion immediately to the abuse hotline Mandated reports are individuals required by law to report suspicions of child abuse or neglect. Since social workers work with children and families in a variety of settings and roles, it makes sense that the law in all states requires social workers to report their suspicions of child abuse and neglect. Although some social work settings- such as school, hospitals, and mental health clinics- are more likely than others, like nursing homes, to yield suspicions of child maltreatment, all social workers regardless of setting are mandated reporters of suspected child abuse and neglect. Social workers should report suspected child abuse or neglect even when they believe that it has already been investigated. Victims may be fearful about making their perpetrators angry and may be intentionally misinforming social workers about child protective service involvement. Reports should also not be delayed for any reasons, such as consulting with a supervisor. Documenting in clients' files may be useful, but it does not replace or fulfill the duty to report suspected abuse.

Trauma bonding helps to explain whey victims of abuse: A. Stay in relationships with their perpetrators B. Benefit from providing mutual support to one another C. Are likely to be abusers themselves D. Experience long-term psychological issues

A. Stay in relationships with their perpetrators Trauma bonding is when a client wants to go back to or stays with a person who has caused him or her pain, with the irrational thinking that the person who caused the pain can take it away. Trauma bonding is similar to Stockholm Syndrome, in which a victim sympathizes with the abuser.. Exploitive relationships can create trauma bonds- chains that link a client to someone who is dangerous to him or her. They occur in situations of incredible intensity or importance where there is an exploitation of trust or power. Trauma bonds are characterized by betrayal that is so purposeful and self-serving it moves to the realm of trauma. Trauma bonds create chains of trust that link a client to someone who is exploitive, dangerous, abusive, and/or toxic. A client in a trauma bond feels very confused about his or her relationship, yet is unable to break free from it. Trauma bond relationships are manipulative and exploitive. Sometimes relationships that start out as intimate and lifelong can move into trauma bonds.

Positive regard is BEST defined as: A. Unconditional acceptance of clients' actions and feelings B. Acknowledgement of clients' strengths in assessments C. Constant reinforcement of clients' progress toward change D. Use of language that is free of pejorative terms

A. Unconditional acceptance of clients' actions and feelings Unconditional positive regard was used by humanistic psychologist Carl Rogers in client- centered therapy. Practicing unconditional positive regard means accepting and respecting clients without judgement or evaluation. It refers to acceptance of others whether they are liked or not. Unconditional positive regard can be misunderstood as being nice, pleasant, or agreeable with others; however, unconditional positive regard is not an action toward others. Rahter, it is a feeling or mindset.

A social worker learns from a client that his wife's company is going to open a corporate site in a neighboring town that will dramatically increase property values in that area. The social worker tells this information to a colleague who is struggling financially and looking to invest in order to improve his situation. The social worker does not reveal the source of the information. In this situation, the social worker's actions are: A. Unethical, since the social worker used client information for a personal interest B. Ethical, since the social worker protected the confidentiality of the ciient C. Unethical, since the social worker cannot ensure that the colleague's investment will grow D. Ethical, since the social worker assisted a colleague and did not personally benefit from the information

A. Unethical, since the social worker used client information for a personal interest The 2008 NASW Code of Ethics includes numerous standards that relate to professional boundaries. First, social workers should not take unfair advantage of any professional relationship or exploit others to further their personal, religious, political, or business interests. They should also be alert to and avoid conflicts of interests that interfere with the exercise of professional discretion and impartial judgement. As in relationships with clients, social workers should not engage in dual or multiple relationships with colleagues in which there is a risk of exploitation or potential harm.

Upon intake, a client reports that she would like to end her marriage but is prohibited in her religion. Her relationship with her husband had deteriorated over the years and he has told her that he is unwilling to change the situation. She feels "torn" between respecting her religious doctrine and her strong desire to eave her husband due to her unhappiness. She begins to cry and stays, "Maybe I am just a bad person and supposed to live my whole life in misery." After reflecting the client's unhappy feelings, the social worker should NEXT: A. Use universalization to reassure the client that many people in her situation would feel this way B. Suggest that the client ask her husband is he would be willing to attend the next session as a way of determining if he is truly not willing to change C. Ask about the reasons that the client feels that she is being punished D. Help the client to identify and weight all costs and benefits of leaving the marriage to assist in her decision making

A. Use universalization to reassure the client that many people in her situation would feel this way Religion provides people with meaning to their lives and helps guide them in their everyday moral choices. Religion has connected the races and societies of the world. It has given meaning to lives that may seem otherwise hopeless. Religion has provided for a universal language and culture among those who believe in a higher power. The spirit or being who is worshiped and praised may not be the same, but the practices are usually similar and serve the same purpose- to give direction, insight, courage, and a divine connection. Spirituality and/or religious beliefs have a profound impact on behaviors and attitudes. Thus, social workers must find out about these beliefs and asses their impact in contributing to and/ or solving presenting problems. Test-Taking Strategies Applied: The question contains a qualifying word- NEXT. The order in which the response choices are to occur is critical. When a question asks about the sequencing of actions by a social worker, it is helpful to recall the stage of the problem-solving process. This case scenario is occurring "upon intake", indicating that the social worker is meeting with the client on or close to the first session. Thus, the social worker is still engaging or building a therapeutic alliance with the client. Finding out more about the client's self-image and helping her to analyze her decision more carefully may be helpful, but these are incorrect responses as dealing with her feelings must occur first. Universalization is a supportive intervention used to reassure and encourage clients. It places a client's experience in the context of other individuals who are experiencing the same or similar challenges, and seeks to help a client grasp that his or her feelings and experiences are not uncommon given the circumstances. Universalization "normalizes" a client's experience in an attempt to help avert natural feelings of "being alone", or, in this case scenario, help the client to see that she is not being punished or a bad person for having these feelings. The woman is the client, so having her husband come to the next session is not appropriate as the social worker is not engaged in couples counseling.

A client is discharged from the hospital with a medication that must be taken four times a day. Which of the following abbreviations will appear on the client's medication order? A. qid B. prn c. bid d. qh

A. qid These are common abbreviations that appear on medication orders. Qid indicates that a medication is to be taken four times a day. Prn is used for medications that are to be administered as needed. Bid indicates that a medication is to be taken twice daily. Qh appears when medications are taken every hour.

Universalism as a basis of social allocation is BEST defined as: A. Resources that adequately meet all existing needs of clients B. Benefits made available to an entire population as a basic right C. Services that are consistently provided regardless of geographic locale D. Distribution of assistance that disproportionately benefits those in power

B. Benefits made available to an entire population as a basic right A critical aspect of social policy analysis is determining the social allocation methodology. Social allocation concerns who shall benefit and the manner in which entitlement is defined. Attempts to develop principles of eligibility traditionally begin with the distinction between universalism and selectivity. Universalism denotes benefits made available to an entire population as a basic right. Examples are Social Security for those who are elderly and public education for youth. Contrarily, selectivity denotes benefits made available based on individual need, usually determined by a test of income. Examples include public assistance and public housing. Universalism, consistent with institutional welfare practice, takes the approach that needs are a part of everyday life and that welfare should be provided as a public service. Institutional social work focuses on giving each person equal opportunity to be supported, whatever his or her circumstances may be.

A client is discouraged as her siblings have received many academic awards and she is a very poor student. The client works hard to get the lead in the high school play in order to earn the praises of others. The client is using the defense mechanism of: A. Sublimation B. Compensation C. Substitution D. Conversion

B. Compensation Clients use defense mechanisms to mange internal conflicts. Defense Mechanisms are automatic, involuntary, usually unconscious psychological activities aimed at reducing anxiety. Compensation occurs when clients overachieve in one area to compensate for failures in anther. For example, clients with poor family lives may direct their energy into excelling above and beyond what is required at work. Compensation can manifest itself in a few different ways. Overcompensation occurs when people overachieve in one area to make up for shortcomings in another aspect of life. Undercompensation, on the other hand, can happen when people deal with such shortcomings by becoming overly dependent on others. Sublimation is the transformation of unwanted impulses into something less harmful. When faced with the dissonance of uncomfortable thoughts, psychic energy is created. Sublimation channels this energy away from destructive acts and into something that is socially acceptable and/ or creatively effective. Substitution is the replacement of an unattainable to unacceptable goal, emotion, or object by a more attainable or acceptable one. Conversion results in a physical symptom emerging from a repressed urge, anxiety, or internal conflict.

A hospital social worker is working with a client who has suffered a traumatic brain injury that has damaged his cerebellum. The social worker would expect this impairment to affect his: A. Problem-solving abilities B. Coordination and balance C. Feelings and emotions D. Breathing and heart rate

B. Coordination and balance When doing assessment and intervention planning, social workers need to know basic medical terminology. Central to this knowledge is understanding how the brain works. The brain is the most complex part of the human body and is the seat of intelligence, interpreter of the senses, initiator of body movement, and controller of behavior. The cerebrum fills up most of the skill. It is involved in remembering, problem solving, thinking, and feeling. It also controls movement. The cerebellum sits at the back of the head, under the cerebrum. The cerebellum receives information from the sensory systems, the spinal cord, and other parts of the brain and then regulates motor movements. The cerebellum coordinates voluntary movements such as posture, balance, coordination and speech, resulting in smooth and balanced muscular activity. It is also important for learning motor behaviors. It controls coordination and balance. The brainstem sits beneath the cerebrum in front of the cerebellum. It connect the brain to the spinal cord and controls automatic functions such as breathing, digestion, heart rate, and blood pressure.

A social worker is contacted by a former client who received follow-up services from another agency after termination.. The former client reports that his confidentiality was breached by the agency's staff and recommends that the social worker no refer to this agency in the future. In order to best assist, the social worker should: A. Inform the agency director about the incident so that no referrals are made in the future B. Educate the client about methods for filing licensing and other complaints C Ask the client if he would like to meet to discuss the situation further D. Contact the follow-up agency staff to see if they are aware of the allegations

B. Educate the client about methods of filing licensing and other complaints Clients often need assistance with advocacy skills, including those which protect their rights to confidentiality of all information obtained in the course of professional service. Empowerment of a client is essential in all advocacy efforts. Providing education and support to clients while they try to change policies and/ or serveries helps ensure that clients have the knowledge and assistance needed.

A hospital social worker will be working with a woman who is getting a percutaneous endoscopic gastrostomy (PEG) tube. Based on this information, it is likely that the needs of the client will focus on: A. Improving mobility for maximum ambulation and independence B. Ensuring sufficient specialized liquid nutrition for ongoing sustenance C. Enhancing cardiopulmonary functioning to increase oxygen intake D. Monitoring urine output to guarantee waste is being eliminated from the body

B. Ensuring sufficient specialized liquid nutrition for ongoing sustenance Social workers need to know basic medical terminology even if they are not based in hospitals. This knowledge will help understand health problems experienced by clients and appropriate interventions to address them. If a client is having ongoing and serious trouble swallowing and con't get enough food or liquids by mouth, a feeding tube may be put directly into the stomach through the abdominal skin. This procedure is called a percutaneous endoscopic gastrostomy (PEG).. PEG allows nutrition, fluids, and/ or medications to be put directly inot the stomach, bypassing the mouth and esophagus. Clients who have difficulty swallowing, problems with their appetite, or an inability to take adequate nutrition through the mouth can benefit from this procedure. Specialized liquid nutrition as well as fluids, is given through the PEG tube. If the PEG tube is placed because of swallowing difficulty (e.g, after a stroke), there will be restrictions on oral intake. A few PEG clients may continue to eat or drink after the procedure so it is important for a client to discuss restrictions with his or her physician. PEG tube placement is one of the most common endoscopic procedures performed today, and more than 100,000 are performed annually in the United States.

Ecomaps are BEST defined as visual tools to: A. Understand where natural resources are scarce and conservation must occur B. Explore clients' relationships with other people and entities in their environments C. Guide environmental justice advocacy efforts on the micro, mezzo, and macro levels D. Show sources of power within all types of environmental systems

B. Explore clients' relationships with other people and entities in their environments An ecomap helps visualize the social and personal relationships of clients within their environments or ecosystems. With a client at the center, it is a map of everything that may affect him or her including interactions with family, friends, business associates, religious communities, and any other social or educational groups or clubs. Ecomaps were developed in 1975 by Dr. Ann Hartman who is also credited with creating the genogram. Ecomaps not only document the connections between family members and the outside world, but they also provide a way to visualize the quality of those connections either as positive and nurturing or negative wrought with conflict and stress. Connections can also be considered strong or weak. An ecomap can be a powerful tool for discovering possible sources of depression and anxiety, as well as uncovering hidden support systems in friends, neighbors, clubs, professional agencies, charities, and churches. An ecomap is sometimes also referred to as an ecogram.

Asking clients closed- ended, instead of open- ended, questions assists social workers with: A. Ensuring that clients are in charge of the helping process B. Focusing the social work interview C. Learning how client experiences have been perceived D. Using positive regard in the problem-solving approach

B. Focusing the social work interview There a different methods used to facilitate communication, including using varying types of questions to obtain the information necessary for understanding a client's difficulties and adaptive capabilities. A good approach is to ask questions initially that are somewhat general and then work toward more specific questions that focus on greater detail. This deductive trajectory from the general to the specific is helpful not only in the first few interviews, but also in later interviews when a client is actively engaged in working toward solutions to a problem. Open- ended questions are quite general and allow clients wide latitude to talk about themselves and their situations. By using minimal prompts and little structure, open-ended questions provoke clients to take the initiative to discuss what they think is important. Closed-ended questions offer a more limited range of answers and encourage clients to provide more definitive answers to specific topics. Specific questions are intended to focus the interview in greater detail on important subjects regarding the client's thoughts, feelings, behaviors, or details of a situation or event. These questions are intended to fill in the gaps of a general narrative about especially important events. The details of a client's problems and experiences may be critical to understand exactly what has been going on. A directive style introduces more structure into the interview, uses more closed questions that limit response options, and is more purposeful to the task at hand.

A client is referred to a social worker by her employer due to many absences. She is a single mother with three small children. Financial troubles have resulted in her home being placed in foreclosure. She has had many different jobs int he last few years with few lasting more than several months. In order to best assist this client, the social worker should FIRST: A. Develop strategies to address issues that led to the work absences B. Help the client to identify her underlying problems C. Ascertain the clients earnings and expenses to find existing financial gaps D. Determine is she qualifies for subsidized housing assistance

B. Help the client to identify her underlying problems Often clients have multiple problems. Problem identification must include methods of involving clients in identifying problems targeted for intervention. Problems should always be considered using person-in-environment perspectives and strengths-based approaches. It is essential that social workers, through the problem-solving process, view clients as experts in their lives. Clients should be asked about what they would like to see changed and clients' definitions of problems should be accepted. Clients should be asked about what will be different when their problems are solved. Social workers should listen carefully for, and work hard to respect, the direction in which clients want to go with their lives (their goals) and the words they use to express these directions. Clients should be asked about the paths that they would like to make desired changes. Clients' perspectives should be respected and clients' inner resources (strengths) should be maximized as part of treatment.

During an assessment, a client admits to regularly using drugs. When asked about attempts to seek treatment, the client states that he is fearful of being "dope sick". Based on this statement, the client is MOST likely using: A. Cocaine B. Heroin C. Marijuana D. Stimulants

B. Heroin Social workers must know indicators of substance abuse and other addictions, as well as signs of withdrawal. When a client describes himself or herself as "dope sick", it refers to a severe set of symptoms related to drug withdrawal. This term most often refers to withdrawal from heroin and other opiate drugs, including prescription narcotics (opioids). However, less commonly, it may also refer to methamphetamine, cocaine, or other drug withdrawals. When a client is "dope sick", eh or she very often feel death is imminent. The duration of use, frequency of use, and other individual factors dictate how severe the symptoms will be and how long they will last. If a client enters a detox program, the symptoms can often be managed and mitigated by monitoring vital statistics, and using other drugs to help with withdrawal symptoms. Opioid withdrawal includes both physical and mental issues- anxiety and depression, severe mood swings, anger, irritability, restlessness, lethargy (feeling extremely tired and sluggish), nausea and vomiting, drug cravings, profuse sweating and/ or chills, insomnia, muscle aches and pains, diarrhea, and so on.

Which Personality Disorder is MOST closely associated with attention-seeking behavior? A. Schizoid B. Histrionic C. Obsessive- Compulsive D. Narcissistic

B. Histrionic There are three types of recognized Personality Disorders: odd-eccentric, dramatic, and anxious- fearful. Cluster A Personality Disorders are characterized by odd, eccentric thinking or behavior. They include Paranoid Personality Disorder, Schizoid Personality Disorder, and Schizotypal Personality Disorder. Cluster B Personality Disorders are characterized by dramatic, overly emotional, or unpredictable thinking or behavior. They include Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder, and Narcissistic Personality Disorder. Cluster C Personality Disorders are characterized by anxious, fearful thinking or behavior. They include Avoidant Personality Disorder, Dependent Personality Disorder, and Obsessive-Compulsive Personality Disorder. Histrionic Personality Disorder is characterized by: * Constantly seeking attention * Excessively emotional, dramatic, or sexually provocative actions to gain attention * Speaking dramatically with strong opinions, but few facts or details to back them up * Being easily influenced by others * Having shallow, rapidly changing emotions * Showing excessive concern with physical appearance * Thinking relationships with others are closer than they really are

Crisis intervention for clients who have just experienced trauma or violence is NOT focused on: A. Instilling hope that equilibrium and mastery of their current circumstances will occur B. Implementing strategies to prevent further incidents from occurring in the future C. Providing education about the events that occurred and the supports available to assist D. Meeting immediate needs to ensure safety and further adverse outcomes

B. Implementing strategies to prevent further incidents from occurring in the future Social workers must understand the indicators of psychosocial stress in order to provide effective treatment when there is a perceived threat to health and safety. The aim of crisis intervention should be the humane, competent, and compassionate care of all affected. The goal should be to prevent adverse health outcomes and to enhance the well-being of individuals and communities. In particular, it is vital to use all appropriate endeavors to prevent the development of chronic and disabling problems, such as Posttraumatic Stress Disorder, depression, alcohol/substance abuse, and relationship difficulties. A number of factors help to facilitate positive outcomes and prevention when clients encounter traumatic or other threatening situations. First, it is crucial to recognize clients' strengths as well as the suffering they have experienced. While survivors' suffering must be acknowledged, and compassion and empathy conveyed to them, it is also important that those who care for them believe in and support their capacity to master this experience. Second, information and education to help clients understand what has happened should be an integral part of the support and care systems. Third, many clients need to tell the story of their experience, to give testimony both to externalize it and obtain emotional release, and to gain understanding and support from others. Supportive networks are critical and should be retained, reinforced, and rebuilt. These networks help people in the ongoing recovery process, both through the exchange of resources and practical assistance and through the emotional support they provide to deal with the disaster of its aftermath.

Hypomania can be characterized as: A. Extreme manic episode with psychotic features B. Inflation in mood that does not result in significant impairment in work or family/ social life. C.. Elevated mood that is subtle and not noticeable to family D. Any manic episode that does not meet the diagnostic criteria for a mental disorder

B. Inflation in mood that mode that does not result in significant impairment in work or family/ social life. Hypomania is a condition similar to mania, but less severe. The symptoms are elevated mood, increased activity, decreased need for sleep, grandiosity, racing thoughts, and so on. Hypmanic episodes differ from mania as they do not cause significant distress or impair client's work or family/ social life in an obvious way while manic episodes do. There are never any psychotic features present in hypomanic episodes. Other symptoms inlude: 1. Inflated self-esteem or gandiosity 2. More talkative than usual or pressure to keep talkig 3. Destructibility (e.g, attention too easily drawn to unimportant or irrelevant external stimuli) 4. Increase in goal-directed activity (either socially, at work, or school, or sexually) or psychomotor agitation. 5. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g, the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments) Hypomatic episodes are associated with a change in functioning that is uncharacteristic. This change in functioning and in mood is not subtle- the change is directly noticeable by others (usually friends of family members). Hypomania can be difficult to diagnose because it may masquerade as mere happiness. It is important to diagnose hypomania because, as an expression of Bipolar Disorder, ti can cycle into depression and carry an increased risk of suicide.

A client who is making substantial progress in treatment learns that her insurance has authorized only two more sessions. The social worker and client feel that additional therapy is needed in order to achieve stated treatment goals. In order to BEST assist the client, the social worker should: A. Identify the most critical topics to be discussed so they can be covered in the remaining sessions B. Inform the client of the insurance company's appeal process while providing support through the process C. Provide the insurance company with information on additional problems experienced by the client and services needed in order to justify continued payment D. Set an affordable fee that the client can pay privately once the insurance company stops paying

B. Inform the client of the insurance company's appeal process while providing support through the process Social workers in managed care settings should be particularly careful about the ways in which they terminate services. If clients' insurance companies refuse to authorize services or an extension of services, social workers should be sure to advise clients of their right to appeal decisions and offer to assist clients with appeal processes. Empowerment of clients through the provision of education and support, is essential to advocacy for policies, services, and resources that meet clients' needs.

During an assessment, a social worker MOST likely obtains a family history from a client in order to: A. Assist the client to see how problems can be multigenerational B. Learn how the client's problems emerged and are influenced by his or her larger system C. Reveal any past trauma that may have inhibited optimal functioning D. Identify informal supports that can be helpful in addressing issues or problems

B. Learn how the client's problems emerged and are influenced by his or her larger system Understanding a client's family history is an important part of the assessment process. A client is part of a larger family system. Thus, gaining a better understanding of the experiences of other family members may prove useful in understanding influences on a client throughout his or her life course. There are no set questions that must be included in a family history; often, they relate to the problem or issue experienced by a client at the time. However, they may include identifying family members': * Ethnic backgrounds (including immigration) and traditions * Biological ties (adoption, blended family structures, foster children) * Occupations and educational levels * Unusual life events or achievements * Psychological and social histories, as well as current well-being * Past and present substance use behaviors * Relationships with other family members * Roles within the immediate and larger family unit * Losses such as those from death, divorce, or physical separation * Past and present significant problems, including those due to medical, financial, and other issues * Values related to economic status, educational attainment, and employment * Coping skills or defense mechanisms Finding out what adults and/ or children get the most attention or recognition and which get the least may also be useful.

Negative entropy in a system occurs when order is: A. Decreased or eliminated B. Maintained or increased C. Directed at maladaptive purposes D. Non controlled in any way

B. Maintained or increased In systems theory, entropy has been used to describe a force or tendency that is present in all systems. All systems tend to "run down", and to progress to a stage of reduced coherence and eventually completely random order. They tend to consume all the energy that they have available and eventually stop functioning or "fall apart". Families can be considered as systems. If there is an insufficient amount of social energy of the appropriate kind (some call this love) exchanged, there is likely to be some sort of breakdown in their ordered relationship, and the bond between them could weaken. Communities are also systems. Oppression, injustice, violence, malnutrition, and poverty all prevent people from working together in harmony, thereby causing entropy. The reverse tendency, which has been called negative entropy, maintains or increases the order or harmony within systems. Examples of energy or influence that can act as negative entropy are food, affection, education, medicine, or anything else that helps sustain or improve well-being.

Using the DSM-5, symptoms of Borderline Personality Disorder include all of the following EXCEPT: A. Marked impulsivity B. Obsessive tendencies C. Suicidal ideation D. Affective instability

B. Obsessive tendencies Using the DSM-5, the diagnostic criteria for Borderline Personality Disorder (BPD) requires clients to have five of nine characteristics to be diagnosed. Clients who partially, but incompletely, meet his criteria set may be considered to have borderline personality traits or features. Although not fulfilling criteria for the full disorder, such as formulation may nonetheless be useful in guiding treatment decisions. BPD is characterized as a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsiviity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1. Frantic efforts to avoid real or imagined abandonment 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation 3. Identity disturbance: markedly and persistently unstable self-image or sense of self 4. Impulsivity in at least two areas that are potentially self-damaging (e.g, spending, sex, substance abuse, reckless driving, binge eating) 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 6. Affective instability due to a marked reactivity of mood (e.g, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) 7. Chronic feelings of emptiness 8. Inappropriate, intense anger or difficulty controlling anger (e.g, frequent displays of temper, constant anger, recurrent physical fights) 9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

A school social worker is contacted by the parents of a 12-year-old boy as they would like to see his educational records based on the belief that they contain inaccurate information about his academic achievements. Under federal law, these records are: A. Public information, making them accessible to any party for justified purposes B. Open to inspection and review by the parents at any time C. Available to the parents only if the assent of the child is obtained prior to their release D. Strictly confidential, only to be released to the parents if ordered by a court

B. Open to inspection and review by the parents at any time Social welfare legislation has an important impact on many areas of social work practice, including confidentiality. The Family Educational Rights and Privacy Act (FERPA) is a federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S Department of Education. FERPA gives parents certain rights with respect to their children's education records. These rights transfer to the student when he or she reaches the age of 18 or attends at school beyond the high school level. Students to whom the rights have transferred are "eligible students". Parents or eligible students have the right to inspect and review the students' education records maintained by schools. Schools are not required to provide copies of records unless, for reasons such as great distance, it is impossible for parents or eligible students to review the records. Schools may charge a fee for copies. Parents or eligible students also have the right to request that schools correct records which they believe to be inaccurate or misleading. If a school decides not to amend a record, the parent or eligible student then has the right to a formal hearing. After a hearing, if the school still decides not to amend the record, the parent or eligible student has the right to place a statement with the record setting forth his or her view about the contested information. Generally, schools must have written permission for the parent or eligible student in order to release any information from a student's education record. However, FERPA allows schools to disclose those recrods, without consent, to certain parties or under certain conditions.

A client who was not selected valedictorian of her high school class describes herself "as a failure". Her grade point average was one of the highest in the graduating class, but she states that she is "a loser". This client is MOST likely using the cognitive distortion of: A. Jumping to conclusions B. Polarized thinking C. Catastrophizing D. Blaming

B. Polarized thinking Cognitive distortions, which were first theorized by Aaron Beck, are simply what the mind convinces clients of something that is not really true. These inaccurate thoughts are usually used to reinforce negative thinking or emotions- telling clients things that sound rational and accurate, but really serve only to keep them feeling bad about themselves. For instance, a client might tell himself or herself, "I always fail when I try to do something new; I therefore fail at everything I try." This is an example of "black-or-white" (or polarized) thinking. The client in only seeing things in absolutes- that if he or she fails at one thing, he or she must fail at all things. Cognitive distortions are at the core of what many social workers using cognitive behavioral techniques try to help a client learn to change. By learning to correctly identify these negative though patterns, a client can then answer the negative thinking back, and refute it. By refuting the negative thinking over and over again, it will slowly diminish over time and be automatically replaced by more rational, balanced thinking, There are many cognitive distortions. Jumping to conclusions is when clients know how others feel and why they act as they do without being told. For example, a client may conclude that someone is reacting negatively toward him or her, but doesn't actually bother to find out if it is correct. Another example is a client may anticipate that things will turn out badly, and will feel convinced that the predication is already an established fact. In polarized thinking, things are either "black or white". It is either perfection or failure- three is no middle ground. Clients place people or situations in "either/or" categories, with no shades of gray or allowing for the complexity of most people and situations. If a client's performance falls short of perfect, it is seen as total failure. Catastrophic is when clients expect disaster to strike no matter what. This is also referred to as "magnifying or minimizing". Clients hear about a problem and use "what if" questions (e.g, "What if tragedy strikes?", "What if it happens to me?"). For example, a client might exaggerate the importance of insignificant events (such as a mistake or someone else's achievement), or inappropriate shrink the magnitude of significant events until they appear tiny (e.g, a client's own desirable qualities or someone else's imperfections). Blaming is holding other people responsible for pain or blaming oneself for every problem.

A decision about whether a social worker must disclose privileged information without a client's consent is NOT legally influenced by: A. Relevant statutes B. Professional experience C. Judicial opinion D. Sate and federal regulations

B. Professional experience Attorney-client interactions were the first to gain the right of privileged communication. Over time, other groups of professionals sought legislation to provide them with this right. It is important for social workers to understand the distinction between confidentiality and privileged communication. Confidentiality refers to the professional norm that information offered by or pertaining to clients will not be shared with third parties. Privilege refers to the disclosure of confidential information in court of during other legal proceedings. A significant court decision for social workers concerning privileged communications was the landmark case of Jaffe v. Redmond (1996) in which the U.S Supreme Court rules taht the clients of clinical social workers have the right to privileged communication in federal courts. In this case, a police officer sought counseling from a social worker after the officer killed a man involved in a fight. The social worker objected to a court order to disclose clinical notes she made during counseling sessions with the officer, arguing that the psychotherapists- client privilege protected the contents of the conversation. In its decision, the Supreme Court concluded that participants in therapy must be able to predict with some degree of certainty whether particular discussion will be protected. Disclosure of privileged information may be permissible when a client threatens to commit suicide, has been abused or neglected, is impaired and may pose a threat to the public, and so on. Whether a social worker must disclose privileged information without a client's consent is often a matter of dispute and subject to relevant statutes, regulations, and judicial opinion.

During the sixth session, a client becomes angry as she feels that a social worker is judging her behavior. She leaves abruptly, sending a written request several days later for a copy of her record. In the request, the client states that she will not be returning for services. The social worker does not feel that the information in the record would be harmful to the client, but is concerned about the abrupt termination. The social worker should: A. Tell the client that she can receive a copy only if she meets with the social worker again B. Provide a copy with an offer to assist with interpreting the information if needed C. Refuse to release the information as the client did not terminate appropriately D. Refer the client to her insurance company for all relevant service information

B. Provide a copy with an offer to assist with interpreting the information if needed Social workers should provide clients with reasonable access to records. Social workers who are concerned that clients' access to their records could cause serious misunderstanding or harm should provide assistance in interpreting the records and consultation regarding the records. Social workers should limit clients' access to their records, or portions of their records, only in exceptional circumstances where there is compelling evidence that such access would cause serious harm. Both clients' requests and the rational for withholding some or all of the record should be documented in clients' file.

A social worker who has been helping a client for more than a year to deal more effectively with unconscious conflicts, including understanding how adverse childhood experiences have impacted on adult functioning, is MOST likely engaged in: A. Dialectic behavioral therapy B. Psychoanalysis C. Task-centered treatment D. Crisis intervention

B. Psychoanalysis Short-term interventions or brief therapy focuses on resolving a specific problem within a minimal amount of time to achieve specific goals. Treatments like dialectic behavioral, task-centered, crisis intervention, cognitive behavioral, and solution-focused are all short-term. Brief treatments are generally aimed at motivating a client to perform a particular action (e.g, to enter treatment, change a behavior, think differently about a situation), whereas long-term therapies are used to address larger concerns (e.g, altering personality characteristics, addressing long-standing problems). Long-term therapies can be very effective for clients with complex mental disorders. While there are some short-term psychoanalysis models, most are long in duration. Psychoanalysis helps clients understand themselves more fully and involves uncovering- and learning to deal more effectively with- unconscious conflicts. It may also assist clients to understand how certain types of adverse childhood experiences interfere with adult functioning.

A social worker who was recently hired as an executive director of a large mental health agency notices that the racial composition of the administration does not reflect that of the overall organizational staff. There are few individuals of color in leadership positions. In this situation, the social worker should FIRST: A. Encourage minority staff to apply for supervisory positions in the future B. Review the hiring process and practices of the agency C. Raise the concern at the next executive staff meeting D. Implement a program to attract and develop qualified job candidates of color

B. Review the hiring process and practices of the agency Institutionalized discrimination or institutional racism is a patter of giving negative treatment to a group of people based on the attribute, such as race. It leads to inequality, explaining why some people face unequal treatment to occupy unequal status. In hiring, research suggests that people hire people who tend to act and look exactly like themselves. This it is difficult to embrace, celebrate, and hire a racially diverse pool of applicants without diverse leadership from the onset. Structural and institutional racism is subtle. It is rooted in the operations of organizations but can be detected. If an organizational structure disproportionately comprises those in the majority, dominant group, there appears to be an institutional racism problem. This discrimination perpetuates itself when those in charge of the hiring are constantly looking for the "right fit", and the "right fit" tends to always look like the rest of those who have already been hired. This bias process lead to homogeneity of those in power.

A client is upset because a boy whom she recently kissed broke up with her. The client states that she does not understand why the breakup occurred as the kiss indicated that he had strong feelings toward her. The social worker explains that kissing may not have the same meaning for the boy. The social worker's statement is rooted in which theoretical perspective? A. Self- psychology B. Symbolic interaction C. Operant conditioning D. Object relations

B. Symbolic interaciton Clients' communication is often covert- with is meaning not readily evident. Social workers must have techniques that explore the underlying meaning of communication. Symbolic interactionism is an approach that focuses on interpreting the meanings that clients develop through their interaction with others. The central theme of symbolic interacitonism is that human life is lived in the symbolic domain. Symbols are cultually derived social objects having shared meanings that are created and maintained in social interaction. Through language and communication, symbols provide the means by which reality is constructed. Reality is primarily a social product and is dependent on symbolic interactions for its existence. Even the physical environment is relevant to human conduct mainly as it is interpreted through symbolic systems. Symbolic interactionism is based on three basic premises" (1) Human act toward things on a basis of the meanings that things have for them; (2) the meanings of things derive from social interaction; and (3) these meanings are dependent on, and modified by, an interpretive process of the people who interact with one another. Meanings depend on a degree of consensual response between two or more people. If most of those who use it agree, the meaning of a symbol is clear; if consensus is low, the meaning is ambiguous, and communication is problematic. Within a culture, a general consensus prevails on the meanings associated with various words or symbols. The interpretive process entails the cognitive ability to take the perspective of another. It is a critical process in communication because it enables people to interpret one another's responses, thereby bringing about greater consensus on the meanings of the symbols uses. The determination of meanings also depends on negotiation- that is, on mutual adjustments and accommodations of those who are interacting. Defining a situation is not a static process. An initial definition, based on past experiences or cultural expectations, may be revised in the course of interaction. Self- psychology aims to help clients develop greater senses of self- cohesion by meeting self-object needs. Operant conditioning explains that behaviors are more or less likely to occur based on their consequences, with reinforcement making them more likely and punishment less likely for reoccurrence. Object relations helps to understand how lifelong relationship skills are rooted in early attachment with caregivers.

Which theory of prejudice explains hiring a worker of a minority group at a lower wage? A. Scapegoating B. Authoritarian personality C. Exploitation D. Normative

C- Exploitation Exploitation is treating someone badly in order to benefit from his or her resources or work. It is when someone uses a situation to gain unfair advantage. Exploitation is more common when there is a power differential between parties due to social status, abilities, income, education, job position, and so on. There is no explanation of why prejudice exists, but several approaches taken together offer insight. Exploitation theory is based on using others unfairly for economic advantage. When an individual who is a minority is hired at a lower wage, it perpetuates the power differential between those in the majority and those in the minority, as well as unfairly exploits based on an individual attribute or characteristic. Scapegoating theory explains putting blame on others for one's own failings, such as an unsuccessful applicant assuming that an individual who is a minority got "her or her" job. Authoritarian personality theory posits that child- rearing can lead to developing intolerance as an adult. This rigid personality type dislikes people who are different. Normative theory explains prejudice through peer and social influences that encourage tolerance or intolerance.

Social workers who use a humanistic approach: A. Promote scientific inquiry based in sound qualitative research methods B. Value the study of animals as knowledge generated can be applied to human behavior C. Acknowledge that people are basically good and have free will to make themselves better D. View objective reality as more important than subjective perception and understanding

C. Acknowledge that people are basically good and have free will to make themselves better A humanistic approach studies the whole client and the uniqueness of each individual. Sometimes the humanistic approach is called phenomenological. This means that personality is studied from the point of view of a client's subjective experience. Humanism rejected the assumptions of the behavioral perspective that is characterized as deterministic, focused on reinforcement of stimulus- response behavior, and heavily dependent on animal research. Humanistic psychology also rejected the psychodynamic approach because it, too, is deterministic, with unconscious irrational and instinctive forces determining human though and behavior. Both behaviorism and psychoanalysis are regarded as dehumanizing by humanists. A humanistic approach begins with the existential assumption that clients have free will. A further assumption is that clients are basically good and have an innate need to make themselves and the world better. The humanistic approach emphasizes the personal worth of a client, the centrality of human values, and the creative, active nature of human being. The approach is optimistic and focuses on human capacity to overcome hardship, pain, and despair. Humanists argue that objective reality is less important than a client's subjective perception and understanding of the world. Thus, little value is placed on scientific research like experiments. Humanism also reject the study of animals it does not consider the unquie properties of human beings. Humanism views human beings as fundamentally different from other animals, mainly because human are conscious being capable of through, reason, and language.

A client is experiencing severe financial hardship and working outside the home will greatly enhance the financial well-being of her family. She refuses to seek employment, citing the need to stay home and care for her small child as the reason. This decision will likely result in the eviction of her family in the near future. To effectively serve this client, the social worker must: A. Locate affordable housing options in case the client needs to move quickly B. Help the client to see the urgency of her situation C. Acknowledge the effects of values on the client's attitudes and behaviors D. Explore with the client employment opportunities that may be done at home

C. Acknowledge the effects of values on the client's attitudes and behaviors Values are linked to both behaviors and attitudes. For example, extrinsic values- such as wealth or preservation of public image- tend to influence levels of personal well-being. In general, the esteem of others or pursuit of material goods seem to dive people toward their pursuit through more inherently rewarding motivations and self-direction values seem to provide more self-satisfaction. It is common to see people segmented into distinct groups or dichotomies based on their values. People who hold strong traditional values are more likely to observe national holidays and customs. Stronger achievement values are associated with stress-related behaviors (such as taking on too many commitments). Aspects of our society may constrain people from expressing the intrinsic values they hold. Education, the media, and social pressures are likely to influence the kinds of values seen as relevant to particular situation. Given the relationship between values and actions, it is important for a social worker to look at what influences values and how they develop and change over time.

A social work organizes and joins a group of community members for a "sit in" at a government building. This demonstration, which is against the law, aims to put political pressure on official to act on pending legislation. The strategy employed is known as: A. Community advocacy B. Indirect casework C. Civil disobedience D. Social planning

C. Civil disobedience Influencing social policy often requires mobilizing those who either traditionally have little power in society- the poor, minorities, or people with disabilities, for example- and/or groups that feel their concerns are being ignored. By working together, members of these groups can exercise power collectively because of their numbers, using the media, their votes, boycotts, and other types of social, political, and economic pressure to convince those in power to rethink their positions. There are many techniques to draw attention to social problem.s Civil disobedience is a particular kind of action in which group members intentionally break a law. They might do so because they are protesting a law, want to make a strong statement about an issue, and/ or desire a particular action to be taken. Civil disobedience is effective as a strategy only if those who practice it are willing to accept the consequences of their actions, and face arrest, trial, and possible punishment. Otherwise, they are simply lawbreakers, and their protest loses is moral force. Often an act of civil disobedience involves a protest or a "sit-in", which occurs when a group occupies a space in order to make a moral point, to assert its right to use the space, or to spur desired action. The act becomes civil disobedience if the group is trespassing on the space it occupies. Test-Taking Strategies Applied: Selecting the correct answer requires social workers to be familiar with the terms listed as response choices. While the case scenario described is associated with advocacy for legislative change, community advocacy, as well as the other response choices, are not the best answers as the question is looking for a specific "strategy". Civil disobedience is a tool or method in which law breaking is used to draw attention to or urge action. Community advocacy is a broad social mandate and most advocacy techniques are not rule violating, such as the one described. Indirect casework may be considered as those administrative and other tasks associated with assisting clients such as travel, waiting in court, preparing monthly reports or a court report, reading documents, and attending meetings. This is a macro activity, but not associated with the actions mentioned in the question. Social planning is a process through which needs or problems become known. Meeting those needs or solving those problems involve generating and evaluating alternative solutions before choosing the one that is best. Planning also involves evaluating the effectiveness of the implementation effort. These steps are not mentioned in the case scenario.

A social work administrator agrees to meet with a group of employees who are concerned about the impact of an agency policy on client services. After expressing appreciation to the employees for raising the issue, the social worker should NEXT: A. Explain the reasons why the policy was originally implemented B. Identify alternatives which can address the concerns raised C. Determine the nature and length of the employees' distress D. Obtain information from clients on the issue to see whether they view it as a concern

C. Determine the nature and length of the employees' distress. Agency policy and functioning has a profound influence on service delivery and the ability of social workers to practice ethically and effectively. Social work takes place in a wide variety of settings, including, but not limited to, private practices, public sector, organizations (government), schools, hospitals, correctional facilities, and private nonprofit agencies. Macro-level problem-solving mirrors the steps taken when working with individual clients. The problem-solving process starts with engaging and assessing, respectively, before moving to planning, intervening, evaluating, and finally terminating. Central to assessment is understanding the problem, including its contributing causes and magnitude. Driving and restraining forces for change must be understood before alternative solutions are generated.

Upon intake, a social worker learns that a client needs to be referred to another agency for nutrition assistance. After verifying the need for the service, the social worker should NEXT: A. Assist the client to gather all financial documents needed for an eligibility determination B. Contact nutrition assistance programs to see if there are any openings C. Determine which agencies, if any, already provides other services to the client D. Educate the client about the importance of healthy eating in maintaining good health

C. Determine which agencies, if any, already provides other services to the client There are important steps in helping clients with the utilization of available community resources. Sometimes, they may need to be referred for services. When making referrals, social workers must engage in the following steps: Step 1: Identify the Need or Purpose for the Referral Social workers often find that the client needs require specialized knowledge or cannot be met by their agencies. Step 2: Research Resources When making a referral, it is critical that social workers refer to competent providers, those with expertise in the problems that clients are experiencing. In addition, if clients are already receiving services from agencies, it may be advisable to see if there are available services provided by these agencies in order to avoid additional coordination and fragmentation for clients. Step 3: Discuss and Select Options Clients' rights to self-determination should be paramount. Step 4: Plan for Initial Contact Social workers may wan to work with a client to prepare for the initial meeting. Preparation may include helping clients to understand what to expect. Step 5: Make Initial Contact Social workers may be asked to assist with providing transportation and/ or support for clients to access new providers. Step 6: Follow-Up to See If Need Was Met Social workers should always follow-up to ensure that there was not a break in service and that new providers are meeting clients' needs.

Which is NOT an appropriate reason for a social worker to conduct a needs assessment? A. Detection of barriers preventing service or resource access B. Identification of clients impacted by problems that require services or resources C. Documentation of critical needs identified by service agencies D. Recognition of an ongoing social problem

C. Documentation of critical needs identified by service agencies Social workers are often called upon to assist with developing or navigating service networks, as well as creating community resources where they are lacking. Needs assessments are concerned with discovering the characteristics and extent of a particular social situation to determine the most appropriate response. There are a number of different reasons for conducting a needs assessment including to determine: * whether services exist in the community * whether there are enough clients * who uses existing services * the existence of an ongoing social problem A key ethical issue with needs assessment is ensuring that the needs documented are expressed by those in a community affected by a problem, rather than the needs that an agency would like to see met. Recommendations should not be based on the services that an agency feels are important and wants to provide. Agencies sometimes have their own "agendas" that may be different form the "true" needs of a community.

A social worker leans hat his daughter's boyfriend has made an appointment to see him at his agency to discuss problems that the youth is having at home. The social worker contacts the boyfriend by phone and learns that fighting with his parents has become destructive. The boyfriend states that he trusts the social worker who has interacted with the boy and his parents for several months. In this situation, the social worker should: A. Arrange to see the boy at the agency immediately to assess whether he is in danger B. Offer suggestions that may be helpful before telling him that being served by the agency would pose a conflict C. Explain prohibitions about meeting with the boy while providing names and contact information of other clinicians who can help D. Recommend that the boy meet with the social worker's supervisor so that a determination can be made about how to best assist

C. Explain prohibitions about meeting with the boy while providing names and contact information of other clinicians who can help Social workers must ensure that they do not engage in dual or multiple relationships that may impact on the treatment of clients. Social workers should be alert to and avoid conflicts of interests that interfere with the exercise of professional discretion and impartial judgement. Social workers should inform client when a real or potential conflict of interest arises and take reasonable steps to resolve the issue in a manner that makes clients' interests primary and protects clients' interests to the greatest extent possible. Test-Taking Strategies Applied: This question requires knowledge about the need to avoid conflicts of interests. In this case scenario, the social worker has a personal relationship with the boy that precludes serving him. Offering suggests about courses of action would not be appropriate as the social worker does not know the root cause of the problem, and therefore, cannot offer advice. Additionally, having the boy meet with the supervisor would not be advisable as it is also a conflict and requires the boy to waste time explaining his situation to someone who will not be treating him. While the case scenario describes the fighting as "destructive", there is no indication that the boy is in danger. The boy should understand the reasons that the social worker cannot meet with him and freely choose from a listing of multiple appropriate providers. A suggestion by the social worker as to which one may be best may unduly influence the boy's decision.

A social worker is hired by an organization to increase employee recruitment and retention due to a problem with staff turnover. Immediately upon starting, the social worker is pressured by the administrators to "get something in place". The BEST response for the social worker is to: A. Ask the administrator to identify what would be helpful B. Begin implementing some strategies that can b built upon incrementally over time C. Explain the pitfalls of not spending time understanding the root cause of the problem D. Inquire about getting assistance in designing a strategy that will be acceptable to all employees

C. Explain the pitfalls of not spending time understanding the root cause of the problem Clients may have a hard time achieving their goals if barriers exist within their larger environment (such as work or school) o in their communities. In addition, if organizational and/or community factors have contributed to client distress, they must be changed to prevent them from affecting others in the same way. Social workers must not only assist with individual problems, but also must make system-level changes to achieve broader outcomes. The problem-solving process can be used with organizations and communities. With these larger units of intervention, it includes: 1. Acknowledging the problem 2. Analyzing/ defining the problem 3. Generating possible solutions- "brainstorming" 4. Evaluating each option 5. Implementing the option of choice 6. Evaluating the outcome Thus, a social worker uses the same process of engagement, assessment, planning, intervention, evaluation, and termination in planning interventions with organizations and communities.

A social worker is a field supervisor for a student in an agency. As her internship ends, the student confides to the social worker that she thinks that she could benefit from counseling to assist with some unresolved issues. The student would like to receive those services at the agency, preferably from the social worker. In this situation, the social worker should: A. Explore the reasons for the request as a method of professional development for the student B. Make an appointment for the student to see another social worker in the agency C. Inform the student that her request would violate professional boundaries and provide contact information for several other counseling agencies D. Agree to see the student for counseling after she completes all the requirements for her internship

C. Inform the student that her request would violate professional boundaries and provide contact information for several other counseling agencies. Many ethical standards speak to the professional boundaries that social workers should maintain with clients. Social workers must ensure that they do not engage in dual or multiple relationships that may impact on the treatment of clients. Social workers should be alert to and avoid conflicts of interest that interfere with the exercise of professional discretion and impartial judgement. Social workers should avoid potential or real conflicts of interest. Dual relationships can be simultaneous or consecutive.

A social worker completes a sexual history with an adolescent client. The social worker asks about the number of partners that she has had and the methods, if any, that she is using to prevent pregnancy and sexually transmitted diseases. The social worker then puts the sexual history in the client's file. The social worker's supervisor would consider this sexual history to be inappropriate because it: A. Included protected health information about sexually transmitted diseases B. Was placed in an adolescent client's file instead of stored separately C. Lacked important information about the gender of her partners and sexual practices D. Should have been completed by another professional who is licensed in this area

C. Lacked important information about the gender of her partners and sexual practices Some clients may not be comfortable talking about their sexual history, sex partners, or sexual practices. It is critical that social workers try to put clients at ease and let them know that taking a sexual history may be an important part of the assessment process. A history is usually obtained through a face-to-face interview, but can also be gotten from a pencil-and-paper document. A sexual history is a source of information that is available to social workers to assist with identifying the root of clients' problems. Questions included in a sexual history may vary depending upon client issues. However, they should involve collecting information about the "5 Ps": (1) partners (number, gender, risk factors, and length of relationships); (2) practices (risk behaviors, oral/vaginal/anal intercourse, satisfaction with practices, desire/arousal/orgasm); (3) protection from sexually transmitted diseases (STDs; condom use); (4) past history of STDs; and (5) prevention of pregnancy (if desired)/ reproductive history. If clients are experiencing dissatisfaction of dysfunction, social workers will need to understand the reasons for dissatisfaction and/ or dysfunction. Medical explanations must be ruled out before psychological factors are considered as causes. A systems perspective should be used to understand issues in this area. For example, a medical/ biological condition that decreases satisfaction or causes dysfunction may heavily impact on psychological and social functioning. In addition, a psychological or social issue can lead to a lack of desire, inability to become aroused, or failure to attain orgasm. Alcohol and/or drug use should also be considered related to concerns about desire, arousal, or organism because they can cause decreased interest or abilities in these areas.

A client is upset about the breakup of his marriage. He feels distraught and does not think that he will ever have another intimate relationship. In this situation, the social worker can BEST demonstrate empathy by: A. Discussing similar events in the social worker's life that have been resolved successfully B. Telling the client that many people in this situation feel similarly C. Listening attentively while looking at the client as he describes his feelings D. Helping the client to find ways to cope with his emotions during this difficult tie

C. Listening attentively while looking at the client as he describes his feelings. There are many methods that social workers use to facilitate communication with clients. Central to the formation of a therapeutic alliance is displaying empathy. Empathy is distinguished from sympathy as the latter denotes pity or feeling bad for a client, whereas the former means that a social worker understands the ideas expressed, as well as the feelings of a client. To be empathic, a social worker must accurately perceive a client's situation, perspective, and feelings as well as communicate this understanding in a helpful (therapeutic) way. In order to facilitate change through the problem-solving process, a social worker must use various verbal and nonverbal communication techniques to assist clients to understand their behavior and feelings. In addition, to ensure clients are honest and forthcoming during this process, social workers must build trusting relationships with clients. These relationships develop through effective verbal and nonverbal communication. Social workers must be adept at using both forms of communication successfully, as well as understanding them, because verbal and nonverbal cues will be used by clients throughout the problem-solving process. Insight into their meaning will produce a higher degree of sensitivity to clients' experiences and a deeper understanding of their problems. There are many verbal and nonverbal communication methods, including: Active listening, in which social workers are sitting up straight and leaning toward clients in a relaxed and open manner, can involve commenting on clients' statements, asking open-ended questions, and making statements that show listening is occurring. Silence by social workers show acceptance of clients' feelings and promotes introspection or time to think about what has been learned. Reframing by social workers show clients that there are different perspectives and ideas that can help to change negative thinking patterns and promote change. Test-Taking Strategies Applied: The question contains a qualifying work-BEST. While telling the client that his feelings are typical in this situation and helping him cope with his emotions will be helpful, the correct answer is the one that "can BEST demonstrate empathy". Central to empathy is understanding a client's situation and the feelings expressed. Showing a client that his or her experiences and perceptions are important can be achieved with nonverbal communication techniques like active listening and eye contact/ posture. The incorrect response choices focus on the social worker intervening by "discussing", "telling", or "helping". Often empathy is established by more passive actions such as listening, attending, and suspending value judgments. Most therapeutic situations require little to no self-disclosure by a social worker and any self-disclosure must be thoroughly evaluated in supervision before it is used as it can be an indication of a professional boundary violation.

A school social worker receives a referral for a fifth-grade girls who is having trouble getting along with classmates. This behavior may result in her being placed in a resource room with one-on-one instruction. The nature of the problem is BEST understood by: A. Reviewing her past academic records B. Determining whether similar behavior is occurring in the home C. Observing classroom interaction between the girl and her peers D. Interviewing the child to find out her thoughts about being moved

C. Observing classroom interaction between the girl and her peers Although most information that social workers obtain when doing assessments comes from interviews or records, direct observation can produce a lot of valuable information about interaction patterns. When functioning as observers, social workers can assume many roles, including acting as complete observers when those who are being watched are not aware of the observations. In order to accurately assess problem, social workers often triangulate, gathering relevant information from different sources.

Which of the following statements BEST supports the need for mental health parity? A. Mental health treatment should be done by those with specialized education and experience. B. Mental health clinicians should be compensated commensurate with other health care professionals. C. Physical and mental health are not distinct as one is not possible without the other. D. Mental health screening is essential to detect psychological issues that may negatively impact on quality of life.

C. Physical and mental health are not distinct as one is not possible without the other The concept of mental health parity generally refers to legal provisions that further the aim of achieving coverage in health insurance plans for the treatment of mental health conditions that is equivalent to the coverage provided for physical conditions. Just as there are many types of physical illness, mental illness is varied and can affect people at all stages of life. In fact, nearly all people will be affected by mental health or Substance Use Disorders themselves or in their families at some point during their life courses. Mental health parity acknowledged that mental illness is treatable and most who experience it recover and live happy, productive lives. However, treatment must be available to achieve optimum behavioral health. Physical health and mental health cannot be viewed as separate and distinct. One is not possible without the other. Almost all states have passed some form of mental health parity legislation; however, most of these laws are limited in scope. Only a few states have parity requirements that apply to all mental health and Substance Abuse Disorders. Federal legislation, the Mental Health Parity and Addiction Equality Act of 2008 (MHPAEA), requires group health plans and health insurance issuers to ensure that financial requirements (e.g, co-pays, deductibles) and treatment limitations (e.g, visit limits) applicable to mental health and substance use treatment benefits are no more restrictive than the predominant requirements or limitations applies to substantially all medical/ surgical benefits.

A social worker who retired more than a year ago from private practice runs into a former client whom she has not seen in years. The former client received grief counseling from the social worker for several years after her mother died. The former client also recently retired and suggests that the social worker join a local group for retirees to which she belongs. The social worker, who has been looking for ways to stay active, agrees to attend the next meeting. The social worker's actions are: A. Justified as she has not served the client for years. B. Unprofessional because the social worker is using the former client for her own gain C. Problematic as she is knowingly creating a conflict of interest or dual relationship D. Acceptable because the interaction will be in a group context and not intimate in nature

C. Problematic as she is knowingly creating a conflict of interest or dual relationship Social workers must ensure that they do not engage in dual or multiple relationships with current or former clients. In addition, social workers should be alert to and avoid conflicts of interest. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. Dual or multiple relationships occur when social workers relate to clients in more than one relationship, whether it is professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively.

A couple in their mid-50s makes an appointment to see a social worker due to recent sexual dysfunction. During the first session, they report that they have recently had a lot of changes due to their children entering college. The husband reports decreased sexual desire that has made physical intercourse difficult. In this situation, the social worker should FIRST: A. Explore how having their children leave the house has affected their relationship B. Determine when changes in their sexual activities first began C. Refer the couple for physical examination to rule out medical etiology D. Arrange to meet with each spouse separately to find out if other issues exist

C. Refer the couple for physical examination to rule out medical etiology Sexual Dysfunctions are problems associated with sexual desire or response. Many issues can be classified as Sexual Dysfunctions. For example, for men, problems may include erectile dysfunction and premature or delayed ejaculation. For women, problems may refer to pain during sexual intercourse. Issues may be caused by psychological factors,, physical conditions or a combination of both. It is essential that a medical examination be the first step in treating Sexual Dysfunctions in order to identify medications or medical conditions that are the cause of the problems. Many of the symptoms can be addressed medically. However, Sexual Dysfunctions can also be due to childhood sexual abuse, depression, anxiety, stressful life events, and/ or other psychological issues. Treatment may also be needed to assist with coping with the signs and symptoms; these include, but are not limited to: * Premature or delayed ejaculation in men * Erectile Disorder (not being able to get or keep an erection) * Pain during sex * Lack or loss of sexual desire * Difficulty having an orgasm * Vaginal dryness

A social worker is supervising a student intern and would like to ensure that the intern considers the social work core values in all agency decision making. The BEST method for the student to learn about these values is to: A. Read the agency policies and procedures manual B. Speak to employees of the agency about their experiences C. Review the professional code of ethics D. Receive regular supervision to discuss client issues and progress

C. Review the professional code of ethics The mission of social work is rooted in a set of professional core values which are service, social justice, dignity and worth of the person, importance of human relationships. integrity, and competence. These values guide social workers' conduct via standards, which are statements to the general public about what is expected. Professional standards are outlined in the 2008 NASW Code of Ethics and used in guiding decision making, especially when here is a lack of clarity or conflicts arise.

A client who was hospitalized for hallucinations is being discharged with medication to address these symptoms. The client is MOST likely being prescribed: A. Paxil (paroxetine) B. Tegretol (carbamazepine) C. Risperdal (risperidone) D. Klonopin (clonazepam)

C. Risperdal (risperdone) Social workers must have knowledge of psychotropic medications as psychopharmacology is the treatment of choice for some mental disorders. Antipsychotic medicines are used primarily to manage psychosis. The work "psychosis" is used to describe conditions that affect the mind, and in which there has been some loss of contact with reality, often including delusions (false, fixed beliefs) or hallucinations (hearing or seeing things that are not really there). It can be a symptom of a physical condition, drug use, or a mental disorder such as Schizophrenia. Test- Taking Strategies Applied: The question contains a qualifying word- MOST. While the client may be prescribed any of the medications for other symptoms, the correct answer must be a medication that addresses the symptoms mentioned- hallucinations. Risperdal is the only antipsychotic mediation listed. Paxil is an antidepressant used to address signs of sadness, lethargy, hopelessness, and so on. Tegretol is a mood stabilizer, often used for treatment of Bipolar Disorder. Klonopin is an antianxiety drug, which is prescribed for nervousness and panic disorders. While social workers are not expected to know every psychotropic medication, they should be familiar with popular medications within each category as there is usually a question or two on every examination that requires such knowledge.

A social work supervisor finds that a supervisee is having trouble advocating for the needs of clients when participating in interdisciplinary team meetings. The supervisee states that he often feels intimidated speaking in front of other members of the team and bringing up his concerns. In order to best assist the supervisee, the social worker should: A. Accompany the supervisee to future team meetings to provide support B. Explain the importance of representing the client's perspective in team meetings C. Role play team meetings with the supervisee to strengthen his assertiveness skills D. Clarify the social worker's role within the team so he understands his unique contribution

C. Role play team meetings with the supervisee to strengthen his assertiveness skills Role playing is a teaching strategy that offers several advantages. 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 supervisees or client are not passive recipients and understanding of different perspective. In role playing, participation helps embed concepts. Role playing gives clarity to information that may be abstract or difficult to understand. The use of role playing emphasizes personal concerns, problems, behavior, and active participation. Role playing improves interpersonal and communication skills and enhances communication.

A social worker who was recently hired by a large agency sees the services are delivered in a very bueaucratic manner with employees at the lowest organizational levels having their tasks overseen by supervisors who, in turn, are overseen by managers. There is also a strong expectation that workers perform tasks according to specific procedures designed to maximize levels of service. This agency is MOST likely operating according to the principle of: A. Human relations theory B. System theory C. Scientific management theory D. Contingency theory

C. Scientific management theory Social workers work in a myriad of organizational settings, which may adopt varying management approaches or principles. Classic scientific management theory involves creating multiple levels of workers to improve productivity. Employees at the lowest levels find their tasks overseen by supervisors who, in turn, are overseen by managers. At every level, employees are expected to perform tasks according to specific procedures designed to maximize productivity. Rules must be followed exactly. Classic scientific management theory has several shortcomings. While some components of the theory, such as designing procedures for completing a task and keeping personal issues out of business, help an organization achieve the job at hand, employee feelings and opinions are not taken into account. Thus, the agency may not grow or may experience high levels of employee turnover as employees fail to develop a relationship with the organization and leave in search for a more satisfying job. Human relations theory focuses more on the individuals in a workplace than the rules, procedures, an processes. Instead of directives coming directly from management, employees and managers interact with on another to help make decisions. The focus of this style is creating fulfilled, productive workers and helping them invest in their companies. Systems theory in management helps manager look at organizations from a broader perspective. Systems theory has brought a new perspective for managers to interpret patterns and events in their organizations. In the past, managers typically focused on one part of an organization and then moved attention to another. Now, more managers are recognizing the various parts of their organizations, and, in particular, the interactions of these parts. Contingency theory is based on the belief that there is no best way to organize, lead, or make decisions in organizations. Instead, the optimal course of action is contingent (dependent) upon internal and external situations. Such a flexible approach ensures that organizations can handle uncertainties in the environment effectively and efficiently.

Which criterion does not need to be met for social workers to be able to terminate clients for nonpayment of fees? A. The clinical and other consequences of the nonpayment have been discussed with clients. B. The financial contractual arrangements have been made clear to clients, preferably in writing. C. Social workers have used sliding scales to make fees affordable for clients. D. Clients do not pose imminent danger to self or others.

C. Social workers have used sliding scales to make fees affordable for clients. According to the NASW Code of Ethics, 2008-1.16 Termination of Services, before social workers begin termination of services for nonpayment of fees, the following criteria should be met: * The financial contractual arrangements have been made clear to clients, preferably in wirting * Clients do not pose an imminent danger to self or others * The clinical and other consequences of nonpayment (e.g disruption of treatment/ interruption of services) have been discussed with clients. When setting fees, social workers should ensure that they are fair, reasonable, and commensurate with the services performed (NASW Code of Ethics, 2008- 1.13 Payment of Services). Consideration should be given to clients' ability to pay. However, social workers do not need to institute sliding scales or set fees based on clients' incomes.

A client who attributes his illness to the "evil eye" is likely going to seek intervention through: A. Medication administraiton B Educational group work C. Spiritual rituals D. Medical Treatment

C. Spiritual rituals Spirituality and/ or religious beliefs are important considerations to the selection of treatment modalities as they have a strong influence on client behavior and attitudes. Historically, mental illness was thought to be caused by evil spirits, the "evil eye". In much of the world, it still is. The range of "normal" behavior varies by cultures as well. The "evil eye" is essentially a specific type of magical curse and has its roots in superstition. Any bad event from which there is not an obvious cause might be blamed on a curse. Curses, including the "evil eye", are an answer to why bad things happen to good people. The best way to deal with the "evil eye" is to avoid it in the first place. The method varies by culture, geographic region, and personal preference. Once a person has been afflicted by the "evil eye", there are a variety of ways to have it removed. Often those who believe they have been harmed by the "evil eye" will seek out shamans, witch doctors, psychics, or other spiritual healers to remove the curse- often for a fee. In working with these populations, social workers should be aware of common folk beliefs and practices.

A social worker is using a single-subject design to assess the impact of an intervention on client functioning. Prior to implementing the intervention, it is essential that the baseline measurements are: A. Decreasing B. Increasing C. Stable D. Variable

C. Stable Social workers who use single-subject designs to evaluate practice find it both a powerful and satisfying research method. One reason for this is that single-subject designs provide feedback quickly about the effects of the treatment conditions. Social workers know relatively soon whether the treatment is working or not working. Day-to-day changes can be observed firsthand, quickly, and in individual clients. If daily changes to the treatment are necessary, they can be made. Seldom do social workers have available scientific evaluation procedures that do this. In contrast to the single-subject approach, a large sample statistical approach may take weeks or months of testing, calculating means, then performing statistical analysis, and so on, and unfortunately, often nothing may be known about the effects of the treatment conditions until the final statistical analysis is complete. Because the baseline serves as a point from which the treatment effects are judged, it is important that a stable baseline be established. There is no set number of days or sessions that define baseline stability. Instead, a criterion of stability must be established with some clients taking a little time to establish stability and others taking much longer. Without stability, it will be impossible to discern if changes in functioning would have occurred naturally without the intervention.

When children are not emancipated, their ability to legally consent to treatment may depend on all of the following EXCEPT: A. Their age B. The services requested C. Their service utilization history D. The state in which they are seeking assistance

C. The service utilization history The ability of children to legally consent to their own treatment depends on: *Their age * The services requested *The state in which assistance is sought If children have been legally emancipated (either due to maturity or automatically because they are parents themselves), they are able to consent for treatment. Otherwise, the age of majority at which an individual is deemed to be sufficiently mature to make adult decisions is 18 years of age in most states. However, some states have statutes that increase the age to 19, 20, or 21. In addition, certain treatment requests, including for mental health treatment, can be made by minors in a number of states. For example, in one state, a minor who is 16 years or older has the same capacity as an adult to consent to consultation, diagnosis, and treatment of a mental or emotional disorder. Discretion is given to the health care provider concerning notice to the parent, guardian, or custodian of the minor. In another, any minor who is 12 years or older may request and receive counseling services or psychotherapy for up to five sessions on an outpatient basis without the consent of the parent or guardian, but the parent or guardian will not be responsible for the costs of the services.

Absent client consent to release records or a recognized legal exception, what ethical duty do social workers have with regard to releasing client information? A. Social workers must release information only if subpoenaed to do so.. B. Social workers must provide only material that they feel will directly benefit clients. C. Social workers must keep all records confidential while clients are living. D. Social workers must claim privilege on behalf of clients.

D Social workers must claim privilege on behalf of clients. Absent client consent to release records or a recognized legal exception, social workers have a duty to claim privilege on behalf of their clients before releasing any information. The NASW Code of Ethics, 2008- 1.07(f), states that social workers should protect the confidentiality of clients during legal proceedings to the extent permitted by law. Subpoenas may be issues by judges, clerks of the court, or attorneys. Social workers should not assume that attorney subpoenas requesting client records have legal authority requiring the release of records unless they are accompanied by court orders signed by judges- not judges' clerks. Acceptance of subpoenas does not mean social workers consent to complying with them. Objections to subpoenas can be made with "Motions to Quash", which is a legal procedure to block or modify subpoenas. Judges review the legal issues and determine if the client records or information should be disclosed. Social workers are mandated to keep information confidential unless told by clients to release it or due to legal exceptions. They cannot release confidential information even when they think doing so will directly benefit clients. Confidentiality extends past client death. Thus, deceased clients have the same rights to confidentiality as those who are living.

A client confides to a social worker that she feels overwhelmed as she does not know where to begin addressing her many problems. She recently lost her job and has increasing demands being placed on her by her aging parents. Which of the following statements by the social worker will BEST convey empathy to the client? A. "We need to figure out together which problem is most pressing so we can come up with some strategies to help make things better." B. "It is a pity that you are experiencing so many problems at the same time, but we can work together to make your situation better." C. "Perhaps your job loss can be viewed as a positive as you will now have more time to meet the demands placed on your by your parents." D. "Feeling overwhelmed is understandable given the issues that you have mentioned and your acknowledgment of these feelings is important."

D. "Feeling overwhelmed is understandable given the issues that you have mentioned and your acknowledgment of these feelings is important." Empathy is defined as the act of perceiving, understanding, experiencing and responding to the emotional state and ideas of another person. It is understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner. Empathy is sensing others' feelings and perspectives. Empathy is not the same as sympathy. Sympathy is a feeling or an expression of pity or sorrow for the distress of another; an expression of compassion or commiseration. Sympathy can sometimes be perceived as denoting a paternalistic attitude, thereby being disempowering. Clients do not need sympathy or sorrow, but instead someone to listen to them and validate their emotions in a caring manner.

A social worker attends a new-employee orientation that reviews the mission of the agency and its programs. It is designed to assist employees in the work with clients. The supervisor documents attendance in the social worker's personnel file. Which function of supervision is represented by the supervisor's action? A. Supportive B. Bureaucratic C. Educational D. Administrative

D. Administrative There is a common agreement about the function of supervision. They included administrative, educational, and supportive responsibilities as follows: Administrative- the promotion and maintenance of good standards of work, coordination of practice with policies of administration, as the assurance of an efficient and smooth-running office. Educational- the educational development of each social worker in a manner calculated to inspire the full realization of her or his possibilities and usefulness. Supportive- the maintenance of harmonious working relationship and the cultivation of positive interactions among colleagues.

An example of cultural blindness in social work practice is: A. Viewing the needs of all clients, not just those in the dominant culture, as equally important B. Identifying cultural norms that have impacted on clients' presenting problems C. Advocating for the rights of all clients regardless of culture, race, and/ or ethnicity D. Applying helping approaches universally to all clients without considering cultural diversity

D. Applying helping approaches universally to all clients without considering cultural diversity Cultural blindness is a point on the cultural proficiency continuum that is characterized by a well-intentioned desire to be unbiased. The continuum begins with cultural destructiveness and progresses to cultural incapacity, cultural blindness, cultural precompetence, and cultural competence, respectively, before ultimately reaching cultural proficiency. The hallmark of cultural blindness is that all people are the same and that color or culture should make no difference. This attitude leads to ethnocentrism in the delivery of services. Ethnocentric helping approaches and other dominant- culture attitudes and values are deemed universally applicable, with little regard for the relevancy to minority populations. Cultural blindness, like views that promote assimilation, degrades the unique strengths and capabilities of diverse groups. Examples of cultural blindness include exhibiting little motivation to learn more about diverse groups or pretending not to notice the race or other diversity characteristics of a client. Cultural blindness leads to the incapacity to comprehend how specific situations may be seen differently by clients belonging to other cultures. There is a strict alignment with the viewpoints, outlooks, and morals of social workers' own societies or cultures.

A client reports that she was recently fired from her job based upon her religious beliefs. She is intimidated by the thought of taking action against her former employer as she does not believe that she will be successful in fighting the bias against her. She feels depressed and hopeless. In formulating treatment goals, the social worker should: A. Identify whether antidepressant medications may be needed B. Determine the impacts of her current emotional state C. Compete a suicide risk assessment D. Assist the client in fighting the discriminatory practices of the agency

D. Assist the client in fighting the discriminatory practices of the agency The effects of discrimination can be seen on both the micro and macro levels. Exposure to discrimination is linked to anxiety and depression, as well as other mental health and behavioral problems. In addition, clients may experience physical effects such as diabetes, obesity, and high blood pressure. These health problems may be caused by not maintaining healthy behaviors (e.g, physical activity) or engaging in unhealthy ones (e.g, smoking and alcohol or drug abuse). On a macro level, discrimination also restricts access to resources and systems needed for good health, education, employment, social support, and participation in sports, cultural, and civic activities. Discrimination and intolerance can also create a climate of despondence, apprehension, and fear within a community. The social and economic effects of discrimination on one generation may flow on to effect future generations, which can lead to cycles of poverty and disadvantage for future generations. Test-Taking Strategies Applied: The question is essentially asking about the desired intervention for a client who has been adversely affected by discrimination. When clients have been victims of discrimination, social workers mus work to empower them. The correct answer is the only one that is linked to empowerment or eradicating the root cause of the problem. In addition, identifying the need for antidepressants and/ or determining the client's current emotional state are assessment tasks that would occur prior to the formulation of treatment planning. The social worker will certainly address the negative impacts of discrimination, but finding ways to support the client in fighting the discrimination is essential. The correct answer is also the only one which indirectly helps others, who are adversely affected by discriminatory practice of this employer, not just the individual client. Selecting a response choice that focuses on the root cause of a problem rather than just addressing its effects, is optimal. There is no indication that the client is suicidal, so completing a risk assessment is not warranted. Suicide screening is also not a treatment goal in the case scenario.

A social worker observes a steady decline in a client's mobility as he has refused to get a needed hip replacement. The doctor has assured the client that the surgery is low risk and will greatly enhance his quality of life. In order to best assist the client, the social worker should: A. Urge the client to get the surgery based upon the doctor's advice B. Speak to the client's family so that they can assist in helping the client change his mind C. Provide the client with materials that clearly articulate the benefits of having the procedure D. Assist the client to prioritize his concerns about having the surgery

D. Assist the client to prioritize his concerns about having the surgery Social workers must always respect and promote the right of clients to self-determination. When clients are faced with difficult choices, social workers must assist clients to identify and clarify their goals. Social workers may limit clients' self-determination only when clients' actions or potential actions pose a serious foreseeable and imminent risk to themselves or others. In order for clients to provide informed consent, they must be provided with clear and understandable language related to services to to provided, risks, benefits, alternatives, and so on.

A client reports that he was recently in a serious accident at work that has resulted in limitations in his mobility. In this situation, a social worker should FIRST: A. Assist with making a workers' compensation claim to help the client pay for medical expenses and lost wages B. Refer the client to vocational rehabilitation services to determine whether modifications are needed to his home and work environment C. Discuss the psychological impacts of trauma and disability that will need to be addressed in order for the client to make a full recovery D. Conduct a biopsychosocial assessment to determine the impact of the client's physical changes on his other life domains.

D. Conduct a biopsychococial assessment to determine the impact of the client's physical changes on his other life domains. Social workers view client problems using a systems perspective. A system is a whole comprising component parts that work together. Systems theory views human behavior through larger contexts. It illustrates that clients are members of families, communities, and broader society. Thus, a change to an individual client brings about adjustments in these larger structures. Contrarily, family, community, and societal modifications impact on individual client functioning. Systems theory also recognizes an individual client has his or her own system- with physiological, psychological, social, spiritual, and cultural components. If there is a change in one domain, it is likely to affect the others. In this case scenario, the client has had a physiological change resulting from an accident at work. The social worker may ultimately take one of the actions described in the incorrect response choices, bu the or she must initially determine the impact that this decline in mobility has had on client well-being in all other areas. A complete assessment must be done to determine the client's short- and- long term needs in each life domain. These needs would then require prioritization so that those that necessitate immedicat attention are addressed first.

A family comes to see a social worker as their relationships have become strained. The teenage has a group of good friends, but never brings them home and spends most of his time in his room. The parents engage in destructive patterns of fighting that usually result in them no speaking to each other. The family is experiencing financial difficulties due to underemployment and the son threatens to leave the house if "things do not get better." In order to best assist, the social worker should: A. Model effective communication strategies that can be used by family members B. Begin individual counseling with the son to assist him with dealing with the stress in the household C. Help the parents look for additional work to alleviate their financial demands D. Determine the outcomes desired by the family to assist them with prioritizing their concerns

D. Determine the outcomes desired by the family to assist them in prioritizing their concerns Family theories provide theoretical and therapeutic bases for family-related situations. A family systems approach argues that in order to understand a family system, a social worker must look at the family as a whole, rather than focusing on its members. In this case scenario, there are many problems mentioned that may or may not stem from the same underlying issue(s). The social worker can "best assist" by determining more specifically the expectations of the family members with regard to treatment outcomes. If all members are not focused on achieving the same results, it will be less likely that change will occur. It is unclear in the case scenario if they all view the problem, and desired outcomes, consistently. Modeling good communication would be helpful, but does not address the underlying issues that need to be identified and prioritized in order for the intervention to be effective.

A client in his early 20s meets with a social worker to discuss his decision to have predictive testing for Huntington's disease, which occurs later in life. It is not curable, but he think it will be useful in making decisions about getting married and starting a family. He states that he does not want anyone to have to care for him so he would not get married or have children if it is found that he will eventually develop the disease. In order to best assist the client, the social worker should: A. Discourage him from undergoing testing because marrying and having children are important life tasks B. Ask him about his risk factors so that a better recommendation about testing can be made C. Encourage testing so that he can make informed choices now and in the future D. Discuss the implications of the testing for him and his family

D. Discuss the implications of the testing for him and his family Bioethics is the analysis and study of moral, legal, social, and ethical considerations involving the biological and medical sciences. Social workers involved in genetic counseling and reproductive health face difficult ethical issues concerning the use of technology for genetic selection and engineering, in vitro fertilization, surrogate motherhood, and abortion. Social workers in neonatal intensive care units understand the ethical implications of decisions to use technology to sustain the lives of remarkably premature and low-birth-weight infants. Most recently, a handful of social workers associated with health care programs involved in cloning and stem cell research have had to wrestle with a host of widely publicized and daunting bio ethical issues. In addition, social workers involved in organ transplantation programs at major medical centers participate in ethical decisions and debates concerning the allocation of scarce hearts, kidneys, and livers, as well as the selection of candidates for artificial organs. Oncology social workers, along with other social workers involved with terminally ill patients, participate in ethical decision concerning the termination of life support, the limits of aggressive medical treatment, and other end-of-life decisions.

A child who is receiving services for a child protection agency due to physical abuse is referred to a school social worker because of bullying behavior. In the last month, the child has hit several of his peers while in school. The child is MOST likely using which defense mechanism? A. Compensation B. Incorporation C. Rationaliztion D. Displacement

D. Displacement Clients use defense mechanisms to manage internal conflicts. Defense mechanisms are automatic, involuntary, usually unconscious psychological activities aimed at reducing anxiety. Displacement involves taking out frustrations, feelings, and impulses on less threatening people or objects. Displaced aggression is a common example of this defense mechanism. Rather than express anger in ways that could lead to negative consequences (such as arguing with a boss or an abuser), anger is expressed toward a person or object that poses no threat (such as a spouse, children, or pet). Compensation is excelling in one area to make up for deficiencies in another (e.g a person who stutters becomes an expressive writer). Incorporation occurs when the psychic representation of a person, or parts of a person, is/ are figuratively ingested (e.g a child models a superhero's behaviors or adopts aspects of his or her personality in order to feel stronger and more confident). Rationalization happens when controversial behaviors or feelings are justified and explained in seemingly rational or logical manners so that they are made consciously tolerable or even superior (e.g thinking that cheating on a test is acceptable when the material is known as a good grade would be obtained even without the unethical act).

A client who is a member of an American Indian tribe states that he is "two-spirited" during an assessment. This information likely means that he: A. Recognizes the impact of elders, including deceased relatives, on his life circumstances B. Views the good and bad in his own decisions and actions, as well as those of others C. Has encountered difficulties assimilating into broader society due to ethnic differences D. Identifies both masculine and feminine parts of his sexual, gender, and/ or spiritual identity

D. Identifies both masculine and feminine parts of his sexual, gender, and/or spiritual identity The term "two-spirited" refers to a person who has both a masculine and a feminine spirit, and is used by some American Indian, Native American, Alaska Native, and/or Indigenous people (also referred to as First Nations people) to describe their sexual, gender, and/or spiritual identity. An an umbrella term, it encompass same-sex attraction and a wide variety of gender variance, including people who might be described in Western culture as gay, lesbian, bisexual, transgender, gender queer, cross-dressers, or who have multiple gender identities. Two-spirited can also include relationships that would be considered poly.

A female social worker is part of a multidisciplinary team working with a Muslin male client. When interacting with the client, the social worker should be aware that physical touch is generally: A. Prohibited in all public and nonpublic interactions unless occurring between spouses B. Limited to handshaking if occurring between members of the opposite gender C. Encouraged to demonstrate empathy and compassion in all formal and informal relationships D. Not accepted between members of the opposite gender unless they are nonpublic interaction between close family members

D. Not accepted between members of the opposite gender unless they are nonpublic interaction between close family members There are diverse styles of communicating. Nonverbal gestures and greetings vary across countries, cultures, and religions. What is seen as acceptable for one is not necessarily acceptable for another. Muslims have strict cultural rules about touching. Men and women cannot touch even causally, in public. You will not see couples, even those who are married, walking down the street holding hands. Muslims not shaking hands with those of the opposite gender is a simple example of a cultural and religious difference that is easy to respect and accommodate. If it important to point out the Muslims do not distinguish in this matter between Muslim and non-Muslim people, and the issue is the same for Muslim women as it is for men. Islam prohibits nonessential touching and physical contact with a person of the opposite gender, with the exception of certain immediate family members, as a sign of modesty, humility, and chastity. In addition, it is a form of respect toward other peons by acknowledging no one has the right to touch them except for their nearest and dearest. It is also important to note that this practice is not unique to this cultural group and can be seen in others. When working with a Muslim client, the need for essential touch should be discussed, if applicable, and permission should be granted. For example, if a member of the opposite gender was to faint or experience a seizure, a person may be required to do whatever possible to help, including touching, if appropriate. However, every Muslim is responsible for his or her own actions, and is free to choose the degree to which he is she implements the various tenets of the religion. For this reason, social workers may meet Muslims who are more than happy to shake the hands of members of the opposite gender; however, the number of Muslims who refrain from doing so is significant and an awareness of the issue is vital when interacting with Muslims, both formally and informally.

Within social work practice, action research is distinguished from other scientific methods due to the: A. Mandate that investigation occur as urgent injustice is currently occurring B. Commitment of resources to take action on the finding in order to realize change C. Focus on social problems that have been identified as needing immediate attention D. Processes of collaborative problem solving and inquiry occurring simultaneously

D. Processes of collaborative problem solving a inquiry occurring simultaneously Action research is a technique to influence social policy through an interactive inquiry process that balances collaborative problem-solving actions with data-driven collaborative analysis or research. Its aim is to guide change in order to solve an immediate problem. Action research challenges traditional social science by moving beyond reflective knowledge by outside experts through sampling; to an active moment-to-moment theorizing, data collecting, and inquiry occurring in the midst of emergent structure. It is seen as "action science"- rather than "reflective science". Action research involves actively participating in a change situation often via an existing organization, while simultaneously conducting research.

Self-actualization is BEST defined as: A. Practicing mindfulness and staying in the moment by concentrating on tasks at hand B. Monitoring progress toward goal attainment C. Understanding the consequences of one's actions when engaging in maladaptive behavior D. Realizing one's potential through personal growth and peak experiences

D. Realizing one's potential through personal growth and peak experiences "Self-actualization" represents a concept derived from humanistic theory by Abraham Maslow. Self-actualization represents growth of an individual toward fulfillment of the highest needs; those for meaning in life.. It focuses on the achievement of one's full potential through creativity, independence, spontaneity, and a grasp of the real world. Maslow created a psychological hierarchy of needs that reflect a pattern of growth depicted in a direct pyramid order of assertion- toward self-actualization. Maslow identified some of the key characteristics of self-actualized people: * Acceptance of realism: Self- actualized people have realistic perceptions of themselves, others, and the world around them. * Problem- centering: Self-actualized individuals are concerned with solving problems outside of themselves, including helping others, and finding solutions to problems in the external world. These people are often motivated by a sense of personal responsibility and ethics. * Spontaneity: Self-actualized people are spontaneous in their internal thoughts and outward behavior. While they can conform to rules and social expectations, they also tend to be open and unconventional. * Autonomy and solitude: Self- actualized people need independence and privacy. While they enjoy the company of others, these individuals need time to focus on developing their own individual potential. * Continued freshness of appreciation: Self-actualized people tend to view the world with a continual sense of appreciation, wonder, and awe. Even simple experiences continue to be a source of inspiration and pleasure.

A social worker receives a request for "all mental health records" of a client. The social worker maintains psychotherapy notes of sessions in a separate locked location. After reviewing all of the records and notes, the client signs a single authorization releasing all mental health information. Based on this consent, the social worker should: A. Provide copies of both the record and psychotherapy notes B. Advise the client that the decision is poor and no information should be sent C. Send a summary of diagnoses, treatment dates, and fees collected D. Release only the information in the record and not the psychotherapy notes

D. Release only the information in the record and not the psychotherapy notes The Health Information Portability and Accountability Act (HIPAA) affords psychotherapy notes more confidentiality protection in certain circumstances. The term "psychotherapy notes" is specifically defined in the HIPAA medical privacy regulations as the "notes a mental health provider documenting or analyzing the conversation during a counseling session" that are maintained separately for the client record. Social workers should understand that a general consent or authorization to release all mental health information in the record is not sufficient to disclose separately maintained psychotherapy notes. If a clinical social worker possesses separate therapy notes, they may be released only if a second, separate signed authorization is provided by the client. If a separate authorization from the client to release "psychotherapy notes" is not provided, the separate notes should be withheld when responding to a request for records. A social worker should not make the decision that information should not be sent unless there is a compelling professional reason why such a disclosure may be harmful to the client, which is not indicated in this case scenario. In addition, sending only a summary of diagnoses, treatment dates, and fees collected is not honoring the client's authorization that all mental health information be released.

A client is very concerned about information that has been shared with a social worker over the years being "used against her". The client is trying to be appointed guardian of her elderly father by the court despite the objections of her siblings. In this situation, the social worker should: A. Advise the client to work out the disagreement with her siblings amiably so they can provide mutual support to one another during this difficult time B. Suggest that the client speak to a lawyer to better understand what is admissible in such proceedings C. Ask the client what has been revealed that causes her concern so that the social worker can better understand why she is fearful D. Review confidentiality procedures and their limits in order to alleviate the client's concerns

D. Review confidentiality procedures and their limits in order to alleviate the client's concerns Social workers should review, with clients, circumstances where confidentiality information may be required and where disclosure of confidential information may be legally required (NASW Code of Ethics, 2008- 1.07 Privacy and Confidentiality). This discussion should occur as soon as possible in a social worker- client relationship and as needed throughout the course of the relationship.

When doing treatment planning, a social worker asks a client, "If you woke up tomorrow and the change you want had happened, how would you know? What would be different?" These questions aim to: A. Help define the roles of the client and social worker in the planned change process B. Identify which interventions or techniques are best suited to address the problem C. Develop an evaluation strategy for monitoring progress D. Specify the concrete, observable goal which will be the focus of treatment

D. Specify the concrete, observable goal which will be the focus of treatment The participation of clients in the process of identifying what is important to them now and in the future, and acting upon these priorities, is paramount. Clients' participation in the intervention process will reduce resistance, increase motivation to change, and ensure sustainability of progress made. In order to involve clients, social worker must continually listen, learn about, and facilitate opportunities with clients whom they are serving. Methods should be used to enhance client involvement during intervention planning in each aspect of constructing a contract. The goals of intervention and means used to achieve these goal are incorporated in a contractual agreement between a client and social worker. The contract (also called an intervention of service plan) may be informal or written. The contract specifies problem(s) to be worked on; the goals to reduce the problem(s); client and social worker roles int he process; the interventions or techniques to be employed; the means of monitoring progress; stipulations for renegotiating the contract; and the time, place, fee, and frequency of meetings.

During a session, a couple is told by a social worker to enact a problem so the social worker can observe interaction patterns and confront maladaptive behaviors. This social worker is MOST likely using which type of family therapy? A. Behavioral B. Bowenian C. Strategic D. Structural

D. Structural Structural family therapy, developed by Salvador Minuchin, is a strengths- based, outcome-oriented treatment modality based on ecosystemic principles. The social worker focuses on what is taking place among family members, rather than on individual psyches. Family structure consists of recurrent patterns of interaction that its members develop over time as they accommodate to each other. A well-functioning family is not defined by the absence of stress or conflict, but by how effectively it handles them as it responds to the developing needs of its members and the changing conditions in its environment. The job of the social worker is to locate and mobilize underutilized strengths, helping the family outgrow constraining patterns of interaction that impede the actualization of its own resources. Families are organized into subsystems with boundaries regulating the contact family members have with each other. Enactment, in which family members are encouraged to deal directly with each other in session, permits the social worker to observe and modify their interactions. Enactments are seen as in-session dialogues. Behavioral family therapy approaches center on reinforcing desired behavior to improve communication within a family, rather then focusing on negative acts. This method operates on the theory that actions are learned responses acquired from past experiences. Social workers using this type of counseling encourage families to focus on the present and not dwell on the past. Families might learn ways to use positive reinforcement to achieve conflict resolutions. A Bowenian- trained social worker is interested in focusing on the intergenerational transmission process. Improvement in overall functioning will ultimately reduce a family member's symptomology. Eight major theoretical constructs are essential to understanding Bowen's approach- differentiation, emotional system, multigenerational transmission, emotional triangle, nuclear family, projection process, sibling position, and social regression. Strategic family therapy is active, directive, and task-centered. It is more interested in creating change in behavior than change in understanding.

The PRIMARY criterion for selecting an intervention modality should be that it is: A. Applied consistently to ensure reliability of service provision B. Sanctioned and monitored by agency administration to ensure quality C. Approved by third-party payers so that reimbursement for services will occur D. Supported by research and professional values for treating the presenting problem

D. Supported by research and professional values for treating the presenting problem Social workers should always use evidence-based interventions whenever possible. Available research and clinical expertise should be used as criteria for selecting intervention modalities. Evidence-based social work practice combines research knowledge, professional/clinical expertise, social work values, and client preferences/circumstances. It is a dynamic and fluid process whereby social workers seek, interpret, use, and evaluate the best available information in an effort to make the best-practice decisions. Decisions are based on the use of many sources, ranging from systematic reviews and meta-analysis to less rigorous research designs. Social workers often use "evidence-based practice" to refer to programs that have a proven track record. However, it takes a long time for a program or intervention to be "evidence-based". Thus, most interventions in social work need more empirically supported research in order to accurately apply the term. "Evidence-informed practice" may be more appropriate. Some questions guide the selection of intervention modalities: * How will the recommended modality assist with the achievement of the treatment goal and will it help get the outcomes desired? * How does the recommended treatment modality promote client strengths, capabilities, and interests? * What are the risks and benefits associated with the recommended modality? * Is there research or evidence to support the sue of this modality for this target problem? * Is this modality appropriate and tested on those with the same or similar cultural background as the client? * What training and experience does a social worker have with the recommended modality? * Is the recommended modality evidence-based or consistent with available research? If not, Why? * Was the recommended modality discussed with and selected by a client? * Will the sue of the recommended modality be assessed periodically? When? How?

Which is NOT true of diagnosing Schizophrenia using the DSM-5? A. Symptoms must have been present for 6 months. B. Clients must exhibit at least tow of the specified symptoms. C. Symptoms must be active for at least 1 month. D. The predominant symptoms should define the subtype.

D. The predominant symptoms should define the subypte Schizophrenia is characterized by delusions, hallucinations, disorganized speech and behavior, and other symptoms that cause social or occupational dysfunction. For a Schizophrenia diagnosis using the DSM-5, symptoms must have been present for 6 months and include at least 1 month of active symptoms. DSM-5 raises the symptoms threshold, requiring that an individual exhibit at least two of the specified symptoms. (In the DSM's previous edition, the threshold was one). Additionally, the diagnostic criteria no longer identify subyptes. Subytpes had been defined by the predominant symptoms at the time of evaluation. Bu these were not helpful because clients' symptoms often changed from one subtype to another and presented overlapping symptoms, which blurred distinctions among the five subtypes and decreased their validity. Some of the subtypes are now specifiers to help provide further detail in diagnosis. For example, Catatonia (marked by motor immobility and stupor) can be sued as a specifier for Schizophrenia Spectrum and Other Psychotic Disorders such as Schizoaffective Disorder. This specifier can also be used with other disorders such as Bipolar Disorder and Major Depressive Disorder.

Reversal methods in single-subject research designs are unethical when: A. Baseline measurements have not occurred to determine clients' functioning prior to treatment B. Costs of treatments are very expensive given clients' financial situation C. Alternative treatments are available to clients to address presenting problems D. Withdrawal of treatment could result in clients' risk of harm

D. Withdrawal of treatment could result in clients' risk of harm Social workers use singe-subject designs to determine whether an intervention has had an intended impact. Single-subject designs involve collecting data through repeated, systematic measurement. A client's behavior will be measured before anything is changed to gather a baseline measurement (denoted by an "A") and then an intervention will be introduced to see if change occurs (denoted by a "B"). For example, if a social worker was going to assist a client to stop smoking, then a few weeks may be spent measuring how much the client smokes before an intervention begins. If the intervention had a positive effect and smoking behavior is reduced, the intervention will continue, but if it has no effect or a negative effect, then it will not. A common type of single-subject design is known as a reversal method. In these designs, after a period of intervention, the intervention is removed and a client is returned to a baseline condition. This is desirable as a social worker can see if the new behavioral pattern could continue without the intervention. One type of reversal method is the ABA design. This method starts with a baseline period followed by an intervention and then returns to baseline. A problem with reversal designs is that it could be considered unethical to return a client back to a preintervention state (by withdrawing the intervention) if the intervention is working and his or her behavior could be harmful without it.