Lmsw Prep Direct Practice Theories

Front 1

Systems/Ecological Theory

Back 1

* People are composed of subsystems and interact with systems in the environment
*Emphasizes the current situation & current history
*Has boundaries
*Changes to one part in the system results in changes in other parts of the system.
*Focus is on interactions rather than dysfunction, pathology, or problems.

Front 2

Biopsychosocial Assessment

Back 2

*All behavior is the product of the interplay between biology, psychological, and social environment.
*Odd or unusual behavior (out of context to the culture) may signal unusual bio, psycho, social experiences.
*Therefore, we compare normal human development principles to our clients.

Front 3

FAREAFI

Back 3

1. Feelings-acknowledge client's feelings
2. Assessment-collect information
3. Refer-to the most helpful services/providers
4. Educate-teach new skills
5. Advocate-influence others on client's behalf
6. Facilitate-use empathy, positive regard, genuineness to enable client's to make their own changes.
7. Intervene-*Therapy

Front 4

Communication Skills

Back 4

*Non-verbal prompt (nod)
*Minimal Prompts ("uh huh")
*Paraphrase (I'm mad as hell-"You're mad as hell")
*Reflective Listening-reflects emotion
*Accurate empathy
*Summarization-("Let me see if I've got this right")
*Ethnic Note-convey acceptance with/without approval...we validate people as human beings.

Front 5

Motivational Interviewing 5 Steps

Back 5

1. Use empathy to establish a connection
2. Note discrepancies between client's behavior & goals
3 Avoid arguments-stay out of power struggles
4. Roll with resistance-acknowledge client's reluctance to change.
5. Support self-efficacy-acknowledge that clients are in charge of their own lives.

Front 6

Problem Solving Model

Back 6

1. Problem identification and definition
2. Goal Identification
3. Preliminary Contract
4. Exploration & Investigation
5. Assessment & Evaluation
6. Formulation of a Plan of action
7. Prognosis
8. Carrying out the plan

Front 7

Making a Referral

Back 7

*Helps clients get needed services
*Clients generally know best what they need
*Are appropriate only when your agency cannot meet the need.
*Make sure it fits clients needs
*Address clients misgivings
*Write down info for client: person's name, contact, statement of purpose etc.
*ONLY finished when clients are getting the services they need.

Front 8

Psychosocial (Hollis and Turner)
*Person in Environment*

Back 8

*Psychodynamic perspective
*Primarily ego psychology (id, ego, superego)
*Conscious vs. Unconscious (conflict between id & superego).
*Defense Mechanisms
*Every person has a pathology
*Role of the SW=Ventilation of feelings & emotions is therapeutic, insight into conflict between conscious & subconscious.
*Social History-from birth to present

Front 9

Behavioral (Skinner, Thomas, Gambrill)

Back 9

-Classical Conditioning
-Operant Conditioning
-Social Learning Theory

*Derives from learning theory
*Behavior is learned & can be unlearned
*Past history not important other than learning hx
*Antecendent/Consequences important
*Action oriented
*Change Environment

Front 10

Cognitive Theory

Back 10

-Overt Behavior
-Covert Behavior
*Behavior is determined by our cognitions
*Life is NOT controlled by unconscious forces
*Self-talk about an event determines our feelings about it
*Great emphasis on rational thinking
*Irrational thinking is destructive
*Emotions and motives are NOT unconscious
*Treatment focuses on disputing the client's self-defeating & irrational beliefs
*Action oriented
*ABC's of Personality
-A. Activating event
-B. Belief
C. Consequences

Front 11

CBT (Beck & Ellis)

Back 11

Merges cognitive & behavioral theories.
*Short term
*Skill building
*Thoughts/Emotions/Behaviors all interconnected

Front 12

Task Centered (Reid & Epstein)

Back 12

*Breaks down task into manageable parts
*Tasks are large enough to be important but small enough to be achievable/successful
*Focuses on short-term treatment
*Problem ranges=family & interpersonal relations, carrying out social roles, decision-making, emotional distress reactive to situational problems.

Front 13

Existential Theory

Back 13

*Focuses on human beings in their existence.
*Focuses on life themes rather than techniques
*Self awareness is primary to looking beyond personal problems, issues...
*Emphasis on honest and intimate relationships with others.
*Example-Gestalt Therapy.

Front 14

Feminist Theory

Back 14

*Focuses on the role of society in creating males & females, i.e. gender roles, power differences...
*Differences in moral decision making, differing in abuse and violence.
*Sociological perceptive & considers cultural issues
*Techniques focus in gender power awareness.

Front 15

Family Preservation Models

Back 15

*Focuses on reducing risk of child placement out of home.
*Short term
*Intense
*Assumption (ideally)-clients are best cared for by their families

Front 16

Family Therapy

Back 16

*Treatment for the whole family
*Clarifies roles & behaviors of family members.
*Various techniques-primarily behavioral

Front 17

Family Therapy Models

Back 17

Structural
Strategic/Communication
Experiential/Humanistic
Behavioral/Cognitive

Front 18

Structural Family Model
(Minuchin)

Back 18

*Symptoms in an individual are rooted in the context of family transaction patterns, and family restructuring must occur before symptoms are relieved. Hierarchy boundary, subsystem, alignment, coalition.
*Goals-Strengthen parental subsystem, realign coalitions, establish boundaries
*Interventions-Joining, action precedes understanding, change interaction patterns, enactments, unbalancing, structure, strengthen etc...

Front 19

Strategic/Communication
(Haley)

Back 19

*Redundant communication patterns offer clues to family rules & dysfunction; symptom represents strategy for controlling relationships.
*Goals-symptom relief; resolution of presenting problems.
*Interventions-Paradoxical interventions, prescribing the symptom, therapeutic double binds, directives, pretend techniques, relabeling.

Front 20

Experiential/Humanistic
(Satir)

Back 20

*Self-concept, communication, family rules, growth of self, growth as an interpersonal process.
*Goals-relieve family pain, genuineness, learning to express one's sens of being, simultaneous sense of togetherness & healthy.
*Interventions-Sculpting, acceptance, communication skills, use of self, modeling, confrontation, cotherapy

Front 21

Behavioral/Cognitive
(Patterson, Stuart, Liberman)

Back 21

*Personal functioning is determined by the reciprocal interaction of behavior and its controlling social conditions.
*Goals-Modification of behavioral consequences between persons to eliminate maladaptive behavior & symptoms.
*Interventions-Reinforcement of desired behaviors; skills training, contingency contracting (if you do...you'll get...), positive reciprocity between marital partners, parents & children.

Front 22

Solution Focused Therapy

Back 22

*You don't have to know the cause of a problem to effectively intervene.
*Change takes place when clients focus on their goals and understand what they have to do to get there.
*Hope vs. despair (problem-focused)
*The clients are the experts about their problems, therefore;
1. Describe the problem
2. Develop goals
3. Asking the miracle question
4. Exploring the exception
5. Supportive feedback to the clients and summarization.

Front 23

Group Roles

Back 23

*Scapegoat-Any person who innocently bears the blame for others.
*Deviant member-One whose behavior deviates from the general norm of the group. Can range from mild to extremely inappropriate.
*Internal Leader-Indigenous leader (derives authority from the group members). may shift from one member to another.
*Gatekeeper-One who feels a strong sense of urgency about a particular issue. Guards the gate through which the group must pass for the work to deepen.
*Defensive Member-Denies existence of problems or accepting responsibility for one's own part in the problem or taking any help from group members after a problem has been raised.
*Quiet member-remains noticeably quiet over a period of time.
*Loquacious member-Talkative.

Front 24

Models of Social Work Group Practice

Back 24

*Social-Goals Model
*Remedial Model
*Reciprocal Model

Front 25

Social-Goals Model

Back 25

*Purpose-social consciousness and social responsibility
*Role of worker-Enabler
*Types of Activity-wide range of activities & tasks including those of community organization
*Task focused..ex. planning a party: I reserved the room can you handle the party? (when party is over, group is over).

Front 26

Remedial Model

Back 26

*Purpose: To remedy social dysfunctioning by specific behavioral change.
*Role of worker: Change Agent
*Types of Activity: Use of direct and indirect means of influence, including extra-group means..ex: therapy/intervention group...therapists helps each member with their issue (think therapy=remedy).

Front 27

Reciprocal Model

Back 27

*Purpose: To achieve a mutual aid system; initially, no specific goals.
*Role of Worker: mediator or resource person
*Types of Activity: Engagement of group members of process of interpersonal relations ex: people help each other...12 step groups (reciprocal=give & take) Typically the worker doesn't even go to meetings...you just make sure they have what they need.

Front 28

Child Abuse-Physical Abuse

Back 28

Injury by hitting, slapping, burning, etc. Single episode or repeated..trauma can vary in severity. (Application of force)
Examples
-Central patterns of injuries
-Injuries suggesting a defensive posture
-Inconsistent injuries
-Multiple injuries in stages of healing
-Substantial delay between injury-treatment
-Vague complaint-frequent visits to care
-Alcohol or drug usage
-Injury during woman's pregnancy

Front 29

Sexual Abuse

Back 29

Wide range of actions:
-Fondling
-Intercourse
-Exploitation
-Porn
Can be once or recurrent

Front 30

Emotional Abuse

Back 30

Act of omission (not saying I love you)
Habitual interactions-name calling, blaming, rejecting, ignoring, corrupting

Front 31

Neglect

Back 31

Failure to provide:
-Physical
-Educational, or
-Emotional needs,
-Endangerment

Front 32

Affects of Abuse on Children

Back 32

*Lots of trust issues...every child believe mom & dad have all the right answers & believes everything they say...so when they're abused, they think "If I can't trust my parents...who can I trust?"
*Feel worthless & damaged. They are egocentric by nature, therefore it's their fault. Plus they believe what they're told (i.e. "you're no good") :(
*They do not learn how to regulate their emotions. They fail to learn when & where its ok to cry, be afraid, angry etc. They don't know when expressing their emotions will be ok...

Front 33

Sexually Abused Clients

Back 33

*Demonstrate sexual behavior that is unusual or inappropriate for their ages and setting.
*Dissociation
*Child/Adult who is embarrassed or guilty about their bodies
*Adult with close, secretive relationship with child
*Parent who is extremely protective of the child-even with responsible adults.

Front 34

A Model for Interviewing Children

Back 34

*Allow sufficient time to obtain info
*Discuss confidentiality & your obligation to report
*Conduct a nonbiased, noncoercive, and nonrepetitive interview
*Ask open ended questions, prompts...avoid leading questions
*Avoid giving the child other people's info
*Listen to everything and follow up
*Use art, match the child's words, use "I'm confused, tell me about that".

Front 35

Substance Use

Back 35

The ingestion of a substance (alcohol or a drug, legal or illegal) with any regularity (once or repeatedly over a lifetime) that results in little or no significant life consequences.

Front 36

Substance Abuse

Back 36

The use of drugs (legal or illegal) with some regularity or pattern that results in a person experiencing a pattern of negative life consequences.
DSM IV:
-failure to fulfill major role obligations (not going to work)
-physically hazardous situations (driving a car)
-recurrent substance-use-related legal problems (DUI)
-persistent or recurrent social or interpersonal problems caused by the substance (wife/family hates it).

Front 37

Chemical Dependency or Addiction

Back 37

Recurrent or chronic use (often daily), that results in a psychological (CD) and/or physiological (Addiction) "need" (real or felt) for the drug as a matter of survival, causing severe and/or chronic negative life consequences. Their life is fully encompassed by the obsession to use drugs and live the accompanying lifestyle.

Front 38

Addiction

Back 38

physiological effects of certain drugs-characterized by withdrawal smptoms

Front 39

Tolerance

Back 39

a progressive immunity to the effects of the drug

Front 40

Withdrawal Symptoms

Back 40

after the body creates a tolerance for a drug (usually heroin, alcohol, benzodiazepine) and a consequent need decreased levels of the drug may result in physical pain and adverse symptoms such as convulsions and death.

Front 41

Addiction vs. Chemical Dependence

Back 41

Addiction (tolerance & withdrawal)
-stimulants (cocaine, meth)
-Opiate (morphine, heroin, oxy/hydro-codone)
-Benzodiazepines (valium, xanax)
-Alcohol-associated with Wernicke's Encephalopathy (characterized by movement, memory & other neurological problems).

Chemical Dependence (psychological dependence)
-Marijuana & LSD

Front 42

Abuse vs. Dependence

Back 42

*Both contain negative life consequences
*Both clients may look similarly to the casual observer
**Abuse can be episodic or continual, but "normal" life continues (can usually keep a job and "manage" the abuse)
**Dependency is a lifestyle. The need for the drugs replaces the need for people. Having drugs available becomes a preoccupation (can't manage anything...everything else is secondary).

Front 43

ADHD

Back 43

Combination of HD & ADD...impulsivity in at least 2 settings (home, school, outdoor play etc.)
Disorder affects friendships, school work, confidence, self-image etc.

Front 44

ADD

Back 44

Inattention issues-persistent pattern of inattention (sits still and watches tv but can't really concentrate on the show)

Front 45

HD

Back 45

Hyperactivity issues-excessive physical movement (concentrates on the tv but is doing cartwheels while watching).

Front 46

Records

Back 46

*Case notes can be changed as you write; however, after they are finished and signed, they are finished and unchangeable.
*The change-in-process requires a **single line through the wrong information** and the addition of correct information with your initials above the "change"
*Using white-out, erasing, or scribbling over the information appears to be intentionally covering up information.
*If subpoena from lawyer you have to show up w/the records but you don't have to produce them.
*If subpoena from the court (judge) you have to bring/show everything.