Overview Of Theories:lcsw Exam

Front 1

Sigmund Freud is most known for

Back 1

Psychoanalytic Theory of Personality

Hint 1

Seeks to relieve the person of neurosis; uses free association and dream analysis to uncover repressed conflicts that are re-lived on an emotional and intellectual level; long term, multiple times a week. Continues until a mature understanding is achieved and integrated into personality.

Front 2

Important Dimensions of Freud's Theory

Back 2

1. Levels of Consciousness
2. Structure of Personality
3. Psychosexual Stages of Child Development

Front 3

Levels of Consciousness Include

Back 3

Conscious
Preconscious
Unconscious

Hint 3

Conscious: mental activities of which we are fully aware

Preconscious: feelings, thoughts, and ideas which we are not currently aware but can bring awareness to relatively easily

Unconscious: feelings, thoughts, memories, and desires of which we are unaware

Front 4

What methods did Freud use to bring the unconscious conflicts to the awareness of patients?

Back 4

Free Association
Dream Analysis
(experimented with hypnosis)

Front 5

According to Freud, what is included in the Structure of Personality?

Back 5

1. Instincts:
life instinct (eros)
death instinct (thanatos)


2. Personality:
Id
Ego
Superego

Hint 5

1. Instincts: inborn factors that give force and direction to psychological activity
a. life instinct: constructive, loving, and altruistic acts
b. death instinct: destructive, hateful, and agressive acts

2. Personality:
Id- only part present at birth; operates on pleasure principle; seeks immediate gratification; no regard for anything or anyone else; cathexis occurs when the id invests libidinal energy into an image of an object that has the capacity to fill a need

ego- gives power to go beyond being able to keep an image of need gratifying object in the mind to actually getting needs met; operates on reality principle; seeks to gain gratification in acceptable manner; defenses designed to keep anxiety level manageable by keeping anxiety-producing impulses out of the conscious; defenses can be adaptive; maintain stability of personality by keeping from overwhelm by anxiety and stress

Superego- arises out of the ego; develop beliefs about what is good and bad; takes over position of parents (observes, judges, rewards and punishes)

Front 6

What are the two aspects of the Superego that were identified by Freud?

Back 6

1. The Conscience

2. The Ego Ideal

Hint 6

1. Conscience: contains "should nots", things for which one has been punished

2. Ego Ideal: contains "the shoulds", positive moral teachings. Rewards include feelings of self righteousness and pride. Punishments include feelings of guilt and shame. How the ego negotiates between needs of id and morals of superego, and realities of world determines individual behavior.

Front 7

Name the Psychosexual Stages of Development and the ages in which they occur?

Back 7

Stage 1: Oral (birth-1year)

Stage 2: Anal (2-3)

Stage 3: Phallic (3-6)

Stage 4: Latency Period (6-11)

Stage 5: Genital (12-adulthood)

Hint 7

Oral Stage (birth-1) : breast or substitute is object of cathexis; need to take in nourishment and to breathe; sucking when not eating reveals need for satisfaction; results in erotic pleasure; way of investigating world; initial ability to tell what is me and what is not me

Anal (2-3): teaching the child control over bowel and urinary function; erotic pleasure is anus and sphincter muscles

Phallic (3-6): sources of erotic pleasure are penis, clitoris and vulva; pleasure from self stimulation with a love object; Oedipus Complex and Electra Complex; resolution when child represses feelings for opposite sex parent and begins to identify with same sex parent

Latency (6-11): sexual feelings continue to be repressed; stop masturbating out of fear of castration and loss of parental love; defensive rejection of sex; "Infantile Amnesia" for sexual urges of earlier stages; focus on work and play with same sex; superego maintains parental standards; failure to negotiate stage may lead to discomfort with opposite sex, avoidance of intimacy, or aggressive, emotionally detached sexual activity

Genital (12- adulthood): develop primary and secondary sex traits; normal focus on opposite sex; Intercourse is primary erotic activity; when expression of sexuality is limited to marriage may develop defense of sublimation (sports, art, music, service in place of sexual activity)

Front 8

Alfred Adler developed

Back 8

Individual Psychology

Front 9

Name Alfred Adler's theories?

Back 9

1. Personality Development



2. Methods of Psychoanalysis

Hint 9

1. Personality Development: begin in state of inadequacy or inferiority; basic drive toward self-actualization or superiority; individual is seen in relation to environment not composed of id, ego, superego; primary indicator of wellness is successful function in groups; birth order impact on personality; self image or "fiction" influences how children interpret and respond to life events

2. Method: therapist task is to help pt identify dysfunctional patterns and develop more positive self image and life goals; therapist assesses pt's drive toward perfection, activity and interest in contributing to good of society; therapy is non-authoritarian, equal pt-therapist interaction; empathy is therapeutic goal, focus is on daily life experience

Front 10

John B. Watson developed

Back 10

Behaviorism

Hint 10

Objective way of analyzing behavior.

Front 11

Using Behaviorism what did John Watson condition "Little Albert" to fear and how?

Back 11

"Little Albert" was conditioned to fear a white rat and then generalize that fear to a white rabbit using behavioral techniques.

Hint 11

Watson concluded that the child had no fear of the rat or the rabbit until he was behaviorally conditioned, therefore, parents can shape child's behavior through stimulus-response conditioning.

Front 12

What was the conclusion following the "Little Albert" experiment?

Back 12

Parents could shape child's behavior through stimulus-response conditioning.

Front 13

Through the Behaviorism school of thought, what did Watson emphasize?

Back 13

He emphasized observable behavior of individuals rather than their emotional or mental state, which could not be observed.

Front 14

Who developed Classical or Response Conditioning?

Back 14

Ivan Pavlov

Front 15

What terms are associated with Classical Conditioning?

Back 15

Unconditioned Stimulus
Unconditioned Response
Conditioned Stimulus
Conditioned Response

Front 16

Define Unconditioned Stimulus and give an example.

Back 16

A stimulus that innately evokes a response in the organism.

Hint 16

Example, the meat powder that was presented to dogs that resulted in unconditioned or innate response of salivation.

Front 17

Define Unconditioned Response and give an example.

Back 17

An innate response to a stimulus.

Hint 17

Example, the salivation of Pavlov's dogs when presented with the unconditioned stimulus of the meat powder.

Front 18

Define Conditioned Stimulus and give an example.

Back 18

A stimulus that does not innately evoke a response in an organism but the organism learns to respond to because it has been paired with an unconditioned stimulus in the past.

Hint 18

Example, Pavlov's dogs learned to respond to the ringing of a bell because the bell had been repeatedly paired with the presentation of the meat powder.

Front 19

Define Conditioned Response and give an example.

Back 19

The organism's learned response to a conditioned stimulus.

Hint 19

Example, Pavlov's dogs' learned response to the ringing of the bell was salivation.

Front 20

What was Jean Piaget interested in and what theory did he develop from this interest?

Back 20

Piaget pioneered Cognitive Development Theory. He was interested in children's changing cognitive abilities via the qualitative interviews with children.

Front 21

What were the two ways that Piaget said children learn?

Back 21

1. Assimilation

2. Accomodation

Hint 21

Assimilation is a way of learning where a person incorporates aspects of the environment into an existing thought structure.

Accomodation is another way of learning which refers to modifying current thought structure to incorporate a new, perceived feature of the environment.

Front 22

List Piaget's Stage Model which represents the development of children's cognitive abilities.

Back 22

Stage 1: Sensorimotor (birth-2)


Substage 1: Impulsive and Reflexive action

Substage 2: Primary Circular Action

Substage 3: Practicing Secondary Circular or Repetitive Actions for their Consequences

Substage 4: Coordinating Secondary Schemes

Substage 5: Tertiary Circular Actions/Continuation of Experimentation with more variable

Substage 6: Invention through Mental Combinations

Stage 2: Preoperational (2-7) thoughts are egocentric

Stage 3: Concrete Options7-11 able to reason about concrete aspects of environment and understands conservation

Stage 4: Formal Operations 11-adulthood, if achieved at all; able to reason about things in abstract

Hint 22

Sensorimotor: This stage has 6 substages which are precursor to intelligence.


1. Impulsive and Reflexive Actions are actions taken for their own sake.

2. Primary Circulare Action is repetitive actions that are combined over time (looking at and touching a stuffed animal).

3. Practicing Secondary Circular or Repetitive Actions for their Consequences (pushing a bowl repeatedly off the high chair to be picked up by parent).

4. Coordinating Secondary Schemes and applying to new situations: child experiments with goal-directed behavior (taking lid off a box to get toy inside)

5. Tertiary Circular Actions/Continuation of Experimentation with More Variability: child shows increased flexibility and creativity in previously acquired behaviors and skills (dropping toys and other objects to observe effect).

6. Invention through Mental Combinations: child increasingly performs experiments internally and object permanence is fully developed; now understands that object does not stop existing when out of sight.

Front 23

Leo Vigotsky was known for his work with what population?

Back 23

He worked with children using the Child Development Theory.

Front 24

Vignotsky believed that children learn best in what type of environment?

Back 24

A supportive environment where they can identify what needs to be done, rather than someone telling them.

Hint 24

Application of his theories are seen in classrooms where there is social interaction, group conversation, and oral and written expression.

Front 25

Kurt Lewin was known for his work in?

Back 25

Social Psychology, Organizational Management, and Applied Psychology
Addressed prejudice through sensitivity training
Nature and Nurture shape individuals
Force Field Analysis
Leadership Climates: Authoritarian, Democratic, Laissez-faire

Front 26

What did Anna Freud identify?

Back 26

Defense Mechanisms

Front 27

Name the ego defense mechanisms

Back 27

Compensation, Conversion, Denial, Displacement, Identification, Isolation of Affect, Intellectualization, Projection, Rationalization, Reaction Formation, Regression, Repression, Sublimation, Substitution and Undoing

Front 28

Define Compensation

Back 28

the seeking of success in one area of life as a substitute for success in another area of life that has been limited because of personal or environmental barriers.

Front 29

Define Conversion

Back 29

the transformation of anxiety into a physical dysfunction, such as paralysis or blindness, which does not have a physiological basis.

Front 30

Define Denial

Back 30

a refusal to acknowledge an aspect of reality, including one's experience, because to do so would result in overwhelming anxiety.

Front 31

Define Displacement

Back 31

shifting of negative feelings one has about a person or situation onto a different person or situation

Front 32

Define Identification

Back 32

anxiety is handled through identifying with the person or thing producing the anxiety

Hint 32

ex. identifying with a kidnapper

Front 33

Define Isolation of Affect

Back 33

painful feelings are separated from the incident that triggered them initially

Hint 33

ex. a rape victim telling story without emotion

Front 34

Define Intellectualization

Back 34

reasoning is used to block difficult feelings; involves removing one's emotions from a stressful event

Front 35

Define Projection

Back 35

negative characteristics are denied and instead seen as being characteristics of someone else

Front 36

Define Rationalization

Back 36

person substitutes a more socially acceptable, logical reason for an action rather than identifying the real motivation

Front 37

Define Reaction Formation

Back 37

adopting a behavior that is the antithesis of the instinctual urge

Hint 37

ex. acting as if one has sympathies for oppressed group when actually has prejudice against group

Front 38

Define Regression

Back 38

reverting to more primitive modes of coping associated with earlier and safer developmental periods

Front 39

Define Repression

Back 39

unconscious pushing of anxiety-producing thoughts and issues out of conscious and into the unconscious

Hint 39

Sigmund Freud is accurately credited with identifying this defense mechanism, although Anna also addressed this in her work

Front 40

Define Sublimation

Back 40

intolerable drives or desires are diverted into activities that are acceptable

Front 41

Define Sublimation

Back 41

a mechanism by which intolerable drives or desires are diverted into activities that are acceptable

Front 42

Define Undoing

Back 42

a mechanism by which an individual engages in repetitious ritual in an attempt to reverse an unacceptable action previously taken

Front 43

Acting Out

Back 43

exhibiting observable behavior rather than by merely feeling or reflecting

Hint 43

directly related to stress and emotional conflict/ often used by children and adolescents

Front 44

Affiliation

Back 44

shared emotional conflict or stress for the purpose of eliciting support or help

Hint 44

Could be positive such as church or exercise groups or negative such as gang activity.

Front 45

Aim Inhibition

Back 45

individual places a limit on their instinctual demands and accepts a modified fulfillment of goals or desires

Hint 45

A person who wants to go to med school, but becomes a pharmacist instead.

Front 46

Altruism

Back 46

person deals with their emotional conflict or stress by selflessly dedicating their life to meeting others' needs

Hint 46

The person receives vicarious gratification.

Front 47

Anticipation

Back 47

person deals with anxiety by "practicing" their emotional reaction to a future event and considering responses or solutions that they may utilize

Front 48

Autistic Fantasy (or Fantasy)

Back 48

Daydreaming excessively as a substitute for real action.

Front 49

Avoidance

Back 49

refusal to participate in activities or encounter situations or objects that represent unconscious, aggressive or sexual impulses and the possible punishment for those impulses

Hint 49

Dynamic Theorists consider avoidance a major defense used by people with phobias.

Front 50

Deflection

Back 50

a group member who redirects attention away from themselves and onto another group member

Front 51

Devaluation

Back 51

Attributing negative qualities about themselves to others

Hint 51

Often used by bullies.

Front 52

Dissociation

Back 52

compartmentalizing or separating of activities or thoughts from the main portion of one's consciousness

Hint 52

individuals who lead "two" lives(often addicts)

Front 53

Fixation

Back 53

interruption of normal personality development at a stage short of mature independence

Front 54

Help-Rejecting Complaining

Back 54

an individual deals with their emotional conflict or stress by asking for help and then rejecting the help that is given

Hint 54

Requests are often disguised hostility which are then expressed by refusing the requested suggestions or advice.

Front 55

Humor

Back 55

deals with their own emotional conflict or stress by pointing out amusing aspects of the stress

Front 56

Idealization

Back 56

over-estimating the desirable qualities and under estimating the limitations of something that is important to the person

Front 57

Identification

Back 57

both the unconscious and the conscious modeling of another person's behavior or style

Front 58

Incorporation

Back 58

a child, through the process of observation, assimilates into their ego and superego the values, attitudes, and preferences of parenting

Hint 58

one of the earliest mechanisms used in the development process

Front 59

Introjection

Back 59

unconsciously incorporating ideas, attributes, or mental images into one's own personality

Front 60

Isolation

Back 60

person is able to split off emotional components from a thought or experience

Hint 60

commonly used in OCD

Front 61

Omnipotence

Back 61

dealing with his or her own emotional stress by feeling or acting in a superior manner

Front 62

Passive Aggression

Back 62

expresses aggression toward another person in an indirect and unassertive manner, which, in turn, gives the agitator the opportunity to avoid the emotional stress related to dealing with person's reaction

Front 63

Projection Identification

Back 63

falsely attributes to another person one's own unacceptable impulses, thoughts or feelings; person consciously recognizes attributes that are projected and considers them justifiable reactions to the person on whom they are projecting; the projector feels at one with the other person

Hint 63

a very primitive form of relating; for the receiver it is far more disturbing and more difficult to deal with than projection

Front 64

Resistance

Back 64

prevents the bringing of repressed feelings or information to conscious awareness, sparing the anxiety that would come from those memories or insights

Front 65

Restitution

Back 65

relieving stress or guilt by doing something to make up for what one considers a behavior error committed against another individual

Front 66

Self-Assertion

Back 66

a healthy way of dealing with emotional conflict or stress by expressing feelings and thoughts directly and in a non-coercive or non-manipulative matter

Front 67

Somatization

Back 67

experiencing physical symptoms of sympathetic and parasympathetic systems as the result of emotional conflict or stress

Front 68

Splitting

Back 68

relating to significant others, person may "split" the significant other into 2 parts, good and bad, in an effort to cope with painful feelings associated with that person

Front 69

Suppression

Back 69

conscious and intentional exclusion of data from consciousness

Hint 69

refusing to think about something that is temporarily interfering with current functioning

Front 70

Symbolization

Back 70

a way of turning emotional conflicts into symbols, which can be viewed as displacements of deeper desires

Hint 70

ex. interpreting a specific dream as a symbol of a deeper feeling or desire

Front 71

What school of psychology was Abraham Maslow associated with and what concept did he develop?

Back 71

He was associated with the Humanistic school of psychology, and developed Maslow's hierarchy of needs

Hint 71

Others associated with Humanistic psychology are Carl Rogers, Fritz Perls and Eric Berne. Maslow also borrowed ideas from mentors Harry Harlow, Alfred Adler, Ruth Benedict and Max Wertheimer.

Front 72

What did Maslow see as the hierarchy of human needs?

Back 72

Physiological Needs

Safety Needs

Belonging and Love Needs

Esteem Needs

Self-Actualization

Hint 72

Physiological:
oxygen,water, food, sleep, sex

Safety:
protection, security, structure, predictability

Belonging and Love:
affection, identification with a group, friendship, intimacy

Esteem:
respect, recognition, appreciation

Self-actualization:
developing full potential

Front 73

According to Maslow, how does positive self-esteem occur?

Back 73

Positive self-esteem occurs when an individuals' social experiences result in recognition, feelings of adequacy, and acceptance.

Hint 73

Basic needs must be met before higher needs. Maslow believed that only 1-2% of population reached self-actualization.

Front 74

Who was Rene Spitz associated with and what was he interested in studying?

Back 74

Rene Spitz was part of the psychoanalytic movement in America. He was interested in ego development of the child and relationship between mother and child.

Front 75

What did Rene Spitz observe in hospital settings and orphanages?

Back 75

He observed emotional deficiencies that had a significant effect on the children's psycho-emotional development. He called this "hospitalism" or "Anaclitic depression".

Front 76

Name three significant principles in the psychological development in children that Rene Spitz identified.

Back 76

The Smiling Response
Stranger Anxiety
Semantic Communication

Front 77

What was the focus of Erik Erikson's Ego Psychology?

Back 77

He focused on adult development and the ability of individuals to solve problems and effectively negotiate society.

Hint 77

Built on Freudian Theory; thought that Freud neglected characteristics and development of healthy personalities

Front 78

How did Erikson describe the healthy personality?

Back 78

"actively masters the environment, show a certain unity of personality, and is able to perceive the world and self correctly

Hint 78

He believed (unlike Freud) that development occurs over the lifespan; later experiences could alter, but not entirely change what had been achieved in prior stages either in a positive or negative direction.

Front 79

How many psychosocial stages did Erikson identify and what did they correspond to?

Back 79

He identified 5 childhood stages and 3 stages of adulthood. The childhood stages correspond to Freud's psychosexual stages.

Front 80

Name Erikson's 8 Psychosocial Stages and the ages in which they occur.

Back 80

Stage 1: Trust vs. Mistrust (birth-1)

Stage 2:
Autonomy vs Shame & Doubt
(2-3)

Stage 3: Initiative vs Guilt
(3-5)

Stage 4: Industry vs Inferiority
(6-11)

Stage 5:
Indentity vs Identity Diffusion or
(Role or Identity Confusion)
(12-18)

Stage 6: Intimacy vs Isolation
(early adulthood 19-mid 30s)

Stage 7: Generativity vs Stagnation/Self Absorption
(middle age: mid 30's to 50's)

Stage 8: Integrity vs Despair
(old age: 60's and beyond)

Front 81

Describe Trust vs Mistrust.

Back 81

Stage 1: quality of infants relationship with mother; determines the level of trust the individual develops in himself and in others (ages birth-1 year)

Front 82

Describe Autonomy vs Shame and Doubt.

Back 82

Stage 2: (2-3 years of age); sense of power over independence as they gain control over elimination system; parents need to provide balance; punitive or rigid parenting may result in compulsivity and stinginess with time and resources in adulthood;

Front 83

Describe Initiative vs Guilt

Back 83

Stage 3: (ages 3-5 years)
growing ability with language, locomotion, and managing environment; initiative is acheived through empathic parenting otherwise sense of guilt develops

Front 84

Describe Industry vs Inferiority

Back 84

Stage 4: (ages 6-11) need to engage in worthwhile activities that are seen through to completion; adult assistance and positive reinforcement important

Front 85

Describe Identity vs Identity Diffusion

Back 85

Stage 5: (12-18 years)
identity confusion can occur at any age; synthesis of earlier life experience, growing sense of purpose; neg outcome may be adult acting like adolescent due to stunted emotional growth

Front 86

Describe Intimacy vs Isolation.

Back 86

Stage 6: (ages 19-mid 30's)
able to develop healthy relationships and take appropriate emotional risks with opposite sex; or become self absorbed and isolated (avoid intimacy).

Front 87

Describe Generativity vs Stagnation/ Self Absorption

Back 87

Stage 7: (ages mid 30's- 50's)
desire to have children and prepare the next generation to take over

Front 88

Describe Integrity vs Despair

Back 88

Stage 8:
(old age 60's and beyond)
sense that life has been worthwhile and lived in harmony with values, sense of having been true to self, not fear death; or despair that there is not time to create different life, continue to fear death

Front 89

How did Erikson build on Freud's theory?

Back 89

He added characteristics of healthy personalities.

Front 90

According to Margaret Mahler (Separation-Individuation Process), what is the definition of Object Relations?

Back 90

Object Relations is the process by which an infant struggles, over the first few years, to differentiate between self and non-self (other).

Front 91

List the stages in Mahler's stage based developmental theory.

Back 91

Stage One: Normal Autism
(ages birth-1 month)

Stage 2: Symbiosis
(1-4 months)

Stage 3:
Separation-Individuation
(4-8 months thru 36 months)
Substages:
1. Differentiation from Mother/Hatching (4-8 months)
2. Practicing (8-15 months)
3. Rapprochement
(15-24 months)
4. Achievement of Individuality
(24-36 months thru 4 years)

Hint 91

Abandoned Stage 1 after further research.

Failure to navigate Rapprochement may lead to Narcissistic or Borderline Personality Disorder.

Front 92

According to B.F. Skinner, what is Operant Conditioning?

Back 92

Operant Conditioning is behavior that has been reinforced will be repeated. Deals with the modification of voluntary behavior through consequences.

Hint 92

differs from Pavlov who worked with conditioning of behavior so that it occurs under new antecedent behavior.

Front 93

What are the four types of Operant Conditioning?

Back 93

Positive Reinforcement
Negative Reinforcement
Punishment
Extinction

Hint 93

Positive and Negative Reinforcement Strengthen Behavior.

Punishment and Extinction Weaken Behavior.

Antecedent(stimuli)----------------
Response(behavior)----------------
Consequence

Front 94

Name Lawrence Kohlberg's 3 general levels of
Moral Development.

Back 94

level 1: Preconventional Morality (individual perspective)

Level 2: Conventional Morality
(individual conforms to expectations of society)

Level 3:
Post Conventional Morality
(identification of moral principles)

Hint 94

Most people never reach
level 3.

Front 95

Define John Bowlby's concept of Attachment Theory.

Back 95

The nature of our attachments with our caregivers is the blueprint for future relationships.

Front 96

What is Separation Anxiety?

Back 96

Part of Attachment Theory, occurs between 6 and 8 months of age, separation anxiety is when a baby is distressed when separated from the primary caregiver.

Front 97

According to Attachment Theory, what is Stranger Anxiety?

Back 97

Stranger Anxiety happens around 8 months old. The baby is distressed by seeing a stranger's face as opposed to the face of a familiar person, such as the mother.

Front 98

Describe the phases a child goes through with a prolonged separation from the primary cargiver.

Back 98

1. Protest Phase- anger

2. Despair/Depression- usually crying

3. Detachment-through repression (healthy adaptation)

4. Anaclitic Depression-type of depression seen in children who initially have a supportive and caring mother but then are removed from her care.

Hint 98

Anaclitic Depression seen in children who have been hospitalized or in orphanages.

Front 99

Define the characteristics of attachment as described by Bowlbey.

Back 99

1. Proximity Maintenance: the desire to be near people to whom we are attached

2. Safe Haven: returning to the attachment figure for comfort and safety when feeling afraid or threatened.

3. Secure Base: point of security (usually the mom) from which the child can explore surroundings without fear of abandonment.

4. Separation Distress: anxiety that occurs in the absence of attachment figure.

Front 100

Who was the Person In The Environment System (PIE) developed for and why?

Back 100

Developed by James Karl and Karen Wandrei. PIE was developed specifically for Social Workers to give an assessment system to examine the social functioning of adult clients.

Front 101

PIE creates uniform statements about_____.

Back 101

Uniform statements are created about social, environmental, mental and physical health problems, and current strengths.

Hint 101

Bio-psycho-social Assessment

Front 102

How does PIE delineate problems?

Back 102

It delineates problems in terms of duration, severity, and the client's ability to cope or problem solve, and current strengths.

Hint 102

Strengths based system

Not diagnostic/cause and effect
.

Front 103

What are the four factors needed to provide a total picture of client's issues according to PIE?

Back 103

Factor I:
Social functioning: problems, type, severity, duration, coping ability

Factor II:
Environmental Problems: severity, duration

Factor III:
Mental Health Problems:
Axis I and/or II diagnoses and conditions listed in the most recent addition of the DSM-IV

Factor IV:
Physical Health Problems: correlates with Axis III in the DSM-IV-TR

Hint 103

All factors are needed to provide a total picture of client's issues.
REFERENCE Page 38 in study guide for example

Front 104

Who developed PIE?

Back 104

James Karl and Karen Wandrei developed PIE in the 1990s.

Front 105

Childhood physical development includes

Back 105

growth and motor development

Hint 105

Physical and mental disabilities impact continued development and functioning.

Front 106

Childhood cognitive and intellectual development includes

Back 106

learning, remembering, using symbols, and problem solving

Front 107

Childhood language development includes

Back 107

competence of using correct sounds (phonology)

encoding messages (semantics)

understanding the way words are combined (syntax)

using language in different contexts (pragmatics)

Hint 107

Some childhood psychopathology is first noticed during language development such as autism.

Front 108

What are the general social and emotional development patterns?

Back 108

Newborns do not express fear

around 8-12 months begin to show fear of perceived threats

Beginning in preschool through adulthood the capacity for empathy and understanding social rules is developed.

Front 109

What can self-image in children be based on?

Back 109

Self-image can be based on genetic factors, parental training, modeling of others, social and cultural experiences, and other environmental factors.

Front 110

Describe sexual development.

Back 110

Inquisitiveness is natural; parents who normalize and explain have children who grow up with healthier attitudes toward sex; parents who over react may cause children to be confused and secretive; parents should educate themselves if same sex attraction is an issue

Front 111

List the milestones of average human development.

Back 111

Birth-2
Responds to faces and bright objects

2 months
Appearance of social smile; follows moving objects w/ eyes

4 months
Recognizes familiar objects; coos; enjoys people more

6 months
Teething begins; turns over

7 months
Picks things up

8 months
Sits alone; strangter anxiety

9 months
Crawls

10 months
Pays attention; plays

11 months
Stands with support

12 months
Leafs through books looking at pictures

10-12 months
Walks with support; shows a greater variety of emotion

15 months
Walks alone; can name some familiar things

18 months
runs

2 years
Can speak in short sentences

6 years
Well-developed speech; well-developed ability to use imagination

Front 112

Roughly what ages does adolescent development take place?

Back 112

12-18 years are the ages of typical adolescent development

Front 113

What is Positive Youth Development?

Back 113

The efforts of communities, schools, government agencies, and adults to create supportive communities for young people, and to encourage youth to contribute in a positive way to the larger community.

Front 114

What is the typical sequence of sexual maturation in adolescence?

Back 114

Bodies change and begin to go through puberty as early as age 10; sexual feels happen as the body changes; interest in opposite or same sex occurs; the desire to date or be social becomes more important.

Hint 114

This may be influenced by physical size, intellect, disability, and/or genetics.

Front 115

What risks do adolescents who struggle with gender identity, are gay or lesbian or who question their sexual identity face?

Back 115

The teens are at high risk for depression, emotional problems and suicide.

Front 116

What does adult social development consist of?

Back 116

Adults' focus on dating, career choice, mating, producing children, and forming a new home and family life.

Front 117

Describe the experiential learning model that David Kolb designed.

Back 117

Doing: active experimentation

Watching: reflective observation

Feeling: concrete experience

Thinking: abstract conceptualization

Hint 117

Adults' learn and grow emotionally, cognitively, and spiritually. Usually through, formal or self-instruction, guidance and mentoring, trial and error, and sometimes therapy.

Front 118

Children from what type of family structure are at the most risk for being physically abused?

Back 118

Economically disadvantaged, young, single parents are the most likely to abuse their children.

Front 119

Describe the profile of a typical sexual perpetrator

Back 119

male, is familiar to the child, and has been abused himself as a child

Front 120

What are some signs of sexual abuse?

Back 120

trouble walking or sitting; sexually inappropriate behavior; avoidance of a specific person w/o apparent reason; running away; reluctant to change in front of others; sexually transmitted disease; pregnant before age 14

Front 121

List and describe the four phases of the cycle of abuse as it relates to Domestic Violence

Back 121

Phase I: Tension Building
breakdown in communication; after the victim becomes fearful and experiences the need to calm the abuser down

Phase II: Incident
the verbal, emotional and/or physical abuse that occurs; involves feelings of deep anger, blaming, and sometimes threats and intimidation

Phase III: Reconciliation
abuser apologizes, gives excuses, blames the victim and denies the abuse or says that it was not as bad as the victim reports

Phase IV: Calm
incident is forgiven and in one's mind no abuse is taking place; sometimes called "the honeymoon phase"

Hint 121

Many stay in abusive relationship b/c of emotional or financial dependence; guilt about breaking up the family; believe violence is part of relationships; isolation from outside support system; commitment to partner; embarrassment; hope; fear of increased violence

Front 122

Define addiction.

Back 122

Addiction is the "physical or psychological craving for a drug".

Hint 122

Often involved in domestic abuse

Front 123

What is the current research focus on addiction?

Back 123

neurobiology and brain reasearch which identifies the pleasure center of the brain as reinforcing the addiction.

Front 124

In order to make an accurate assessment and recommend the best course of treatment what should Social Workers consider?

Back 124

SW should consider:
Needs
History
Personal Resources
Motivation Level
Support System

Front 125

What are the classes of substances identified in the DSM-IV-TR?

Back 125

Alcohol
Inhalants
Amphetamines
Opioids
Cannabis
Phencyclidine (PCP)
Cocaine
Sedatives/hypnotics/anxiolytic
Hallucinogens

Hint 125

Nicotine is listed in DSM
Caffeine is not listed even though it is known to be addictive.

Front 126

Define Substance Dependence.

Back 126

Substance Dependence causes physiological signs and symptoms of tolerance and withdrawal.

Front 127

What is tolerance?

Back 127

gradually increasing the amount of substance to produce the desired effect previously attained

Front 128

Define Substance Abuse.

Back 128

Abuse is a maladaptive pattern of substance use that leads to clinically significant impairment or distress within a 12 month period. No symptoms of tolerance or withdrawal.

Front 129

Who constitutes the largest segment of the poor?

Back 129

Children

Hint 129

1/5th of all children live in poverty

Front 130

What are the poor more at risk for than the rest of the population?

Back 130

malnourishment which leads to disease; unable to obtain healthcare; hazardous living environments; less likely to complete High School resulting in inability to obtain secure employment which provides adequate income

Hint 130

Cycle of Poverty

Front 131

Who is more likely to live in poverty?

Back 131

Single women with children are more likely to live in poverty.

Hint 131

Also more likely to by physically abusive to their children under age 14.

Front 132

What is the 10th leading cause of death in the US?

Back 132

suicide

Hint 132

11 attempts for every 1 that succeeds

Front 133

What are some characteristics associated with suicidal behavior?

Back 133

1. mental disorder, particularly mood disorder or Schizophrenia
2. substance abuse
3. certain psychological traits such as apathy, indifference to tx, low social involvement, hopelessness, poor pain tolerance, and poor health
4. inadequate social support
5. unemployment or retirement
6. stressful life events
7. being male
8. previous attempt
9. being gay, lesbian or transgender
10. family history
11. family violence, including physical or sexual
12. access to firearms
13. incarceration

Hint 133

Prevention is most likely to succeed if early intervention for s/s of depression, etc followed by tx and education.

Front 134

What percentage of the elderly suffer from depression and what are they commonly misdiagnosed with?

Back 134

55% suffer from depression; most likely to be misdiagnosed with alzheimer's or dementia

Front 135

What are Elizabeth Kubler-Ross's stages of dying?

Back 135

Stage 1: Denial
disbelief
shock that gradually remits

Stage 2: Anger
Rage and resentment toward others or G-d
Difficulty relating to dying person

Stage 3: Bargaining
Try to strike a deal with fate, G-d or others

Stage 4: Depression
Deep sadness as dying person becomes more weak and uncomfortable
Fear of Death may occur
Sense of tremendous loss

Stage 5: Acceptance
Void of feeling
Dying person's struggle against death ends

Hint 135

this is foundation for grief process; does not happen in order

Front 136

What does the NASW state in regards to Cultural Competence and Social Diversity?

Back 136

1. Social Workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.

2. Social workers should have a knowledge base of their clients' cultures and be able to demonstrate competence in the provision of services that are sensitive to clients' cultures and to differences among people and cultural groups.

3. Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sexual orientation, age, marital status, political beliefs, religion, and mental or physical disability.

Hint 136

In all cases, social workers should use the social work skills of empathy, caring,and strengths-based assessment and treatment.

Front 137

Describe the Ethnographic Approach.

Back 137

Culture is viewed as fluid, evolving, heterogeneous,and conflictual rather thatn as static, fixed, cohesive, and unified. Derived from the field of anthropology.

Hint 137

The client becomes the cultural guide for the social worker.

Front 138

What is the goal of using the Ethnographic Approach?

Back 138

The goal is for the sw to understand the client's experiences as he or she has felt, lived, and known the experience. To understand the client's frame of reference.

Front 139

What are the 3 broad categories related to Culturally Competent Social Work?

Back 139

1. Attitude of Social Worker
2. Knowledge
3. Skills of the Social Worker

Hint 139

should be applied to any client when working on the micro, meso, or macro level

Front 140

Describe the important aspects of the Attitude of the Social Worker.

Back 140

1. Self Awareness
2. Consider the client as individual first and then as member of group
3. understand the difference within and across all groups and recognize the strengths of each group and each individual in group
4. therapeutic relationship can be viewed as a two-way learning for sw and client
5. attempt to understand client's distressing experience, as well as the impact of oppression and discrimination in the client's daily life
6. seek to understand beliefs and behaviors of the client's culture that are in conflict that are in conflict with the laws of the culture in which the client presently resides
7. respect the client's privacy and confidentiality and make every effort to ensure truly informed consent
8. sw cannot refuse to work with a client solely because of the client's race, ethnicity, sexual orientation, or disability. if a sw has a valur difference with the client but chooses to work with them anyway the sw must respect the client's choices

Hint 140

Must be able to apply basic principles of sw practice to all persons, including recognizing and building upon their strengths.

Front 141

What knowledge base are sw's expected to have?

Back 141

1. should continually read books and professional journals, attend workshops and use consultation in an attempt to understand many issues of cultural diverse clt's
2. attend activities of divers populations
3. ask client for information and clarification about beliefs, values, and behaviors that the sw does not understand
4.make an effort to learn as much as possible about the client's native language and use an interpreter if necessary

Front 142

Discuss the importance of SW Skills

Back 142

1. engage the client as partner in therapeutic process
2. let the client know that he or she has clinical expertise and some knowledge about client's culture, but that client is expert on culture
3. use culturally sensitive language when explaining in the first sentence that the client will be cultural guide
4. focus on developing therapeutic relationship by using basic principles of social work practice
5. sometimes beneficial to match client with sw of similar background, but not always possible. in such cases discuss openly with client any past negative experiences that are leading to transference
6. therapy styles may need to be modified when working with diverse clients
7. make sure client agrees with tx and tx does not conflict with client's belief system
8. first interview sw should offer suggestions that may be immediately helpful
9.utilize client's cultural resources when tx planning
10.be attuned to variations in non-verbal behavior and not misinterpret for pathology

Front 143

What is Ethnographic Interviewing?

Back 143

This allows the sw to depart for the traditional technique of listening for the underlying "feelings" associated with the client's words to listening for the underlying "cultural meaning". Restate and incorporate terms and phrases used by client rather than rephrasing and reframing the terms and phrases. Do not assume that you understand every word spoken and ask the client to clarify terms or statments as they relate to client's culture.

Hint 143

This way the client prioritizes needs and concerns rather than the social worker doing it for them.

Front 144

What is a cultural assessment tool?

Back 144

Elaine Congress developed a Culturagram which is a family assessment tool that is intended to individualize culturally diverse families.

Front 145

Name the 10 areas which are examined when using a Culturagram.

Back 145

Reasons for relocation
Legal status
Time in community
Language spoken in home and in community
Health beliefs
Crisis events
Holidays and special events
Contact with cultural and religious institutions
Values about education and work
Values about family including structure, power, myths and rules

Hint 145

see page 54 in study guide for questions in a cultural evaluation

Front 146

What information does a cultural evaluation provide for the social worker?

Back 146

It gives information about the client's cultural beliefs, values, behaviors, and support system.

Hint 146

see p. 54 in study guide for list of questions

Front 147

Theorists like Leon Chestang assert that everyone is part of what two systems?

Back 147

The Nurturing System and the Sustaining System

Front 148

Describe the Nurturing System.

Back 148

The Nurturing System consists of the individual's family, intimate friends, and the immediate community.

Hint 148

The nurturing system is one in which a person is viewed and treated as a unique individual who is loved for who he is by his family, friends and neighborhood acquaintances in his immediate environment.

Front 149

Describe the Sustaining System.

Back 149

The Sustaining System consists of institutions of the larger society.

Hint 149

The sustaining system is one in which that same individual receives his education, is employed, and is involved int the economic and political world.

Front 150

What is the "dual perspective" concept that Chestang describes?

Back 150

Dual perspective is where an individual must constantly shift between the safe culture of loved ones and the dominant culture of the larger society, evaluating what kind of behavior is expected in each.

Hint 150

It is important for the social worker to recognize the daily challenges that clients face while living in the Nurturing and Sustaining Systems.

Front 151

What might cultural norms influence?

Back 151

Cultural norms may influence how the client understands his own issues and may affect how they view and utilize social services.

Front 152

Describe the different forms of adaptation that Bicultural Identity can take.

Back 152

Traditional Adaptation:
exhibit strong ethnic identity

Marginal Adaptation:
often results in cultural conflict

Assimilation:
learn to value norms of Sustaining System and devalue norms of their ethnic group

Bicultural Adaptation:
individuals INTEGRATE the norms, values, and beliefs of their ethnic group and of larger society

Hint 152

see pages 56-58 in study guide for details on ethnic groups

Front 153

What stages are in the coming out process?

Back 153

1. Identity Confusion
2. Recognition of gay or lesbian identity
3. Exploration and experimentation relative to gay or lesbian identity
4. Disclosure of identity to others
5. Acceptance of gay or lesbian identity
6. withdrawal from the heterosexual world
7. Pride in identity
8. Increased disclosure to others
9. Re-involvement in heterosexual world
10. Broadening focus beyond gay or lesbian sexual orientation

Hint 153

Important note: the client may be in a different place of acceptance than the process of family members; loved ones may need time to adjust; therapy should be related to the stage of coming out if that is what the presenting issue is; tx should focus on problem solving, social skills, and assertiveness

Front 154

What is Transgender?

Back 154

Can be heterosexual, bisexual, homosexual, or non-sexual; believes that his or her physical body does not represent his or her true sex; current tx is to view transgender individual's in terms of social and political ramifications rather than as dysfunctional; sw's should address related family issues

Hint 154

Sexual orientation is completely different from gender identity. Gender identity refers to the individual's sense of self as a man or a woman. Cross dresser's usually do not have gender identity issues they just like to dress in clothing of the opposite sex.

Front 155

List and define terminology used to identify non-heterosexual sexuality, sexuality, sexual anatomy, or gender identity.

Back 155

Gay/Lesbian:
attracted to the same sex

Bisexual:
attraction to both men and women

Pansexual:
attraction that is based upon the individual, not the sex

Transgender:
refers to gender identity as male or female

Transsexual:
Desire to live and be accepted as a member of the opposite sex; generally with a desire to change one's body through surgery or hormone therapy

Intersex:
ambiguous sexual anatomy, also referred to as hermaphrodite

Genderqueer and Intergender:
catch-all terms for gender identities other than man and woman

Front 156

How has the Feminist Theory contributed to the field of Women's Issues?

Back 156

helping to clarify the nature of inequality between gender

further promoting women's rights, issues and interest

examining the history of feminism in areas such as reproductive rights, sexual objectification, language, literature, films, art, interpretation of history, treatment of women, social status, oppression and other related areas

Front 157

What are some ways in which spirituality can be viewed?

Back 157

an orientation in life

a source of inspiration

universal connectedness, expressed in energy, cause and effect, and mystical theories

a spiritual path in the search for meaning in life, which can include organized religion or other forms of spirituality

Hint 157

sw's need to be respectful of the diversity of client's belief system and if appropriate utilize those beliefs in treatment

Front 158

What types of problems are the elderly faced with?

Back 158

series of losses: retirement, independence, ability to perform daily activities, loss of friends and relatives to death, loss of importance, and impending loss of own life

Unfinished business:
depression is common and higher risk of suicide
(integrity vs. despair)

Hint 158

may experience side effects from medication; may not get the attention they need or may feel guilty because someone else has to care for them

Front 159

What is included in the multi-modal approach that social workers need to take when working with the elderly?

Back 159

addressing physical, psychological, and social needs; tx includes case management, coordination of services, referral services and mental health services; individual therapy includes helping the person to grieve their losses, setting realistic expectations, preserving as much autonomy as possible, and finding meaning in life; therapy should have a structured/gentle approach with therapist taking an active role

Hint 159

sw's offer support, validation,a nd explore options for services; work with family members and caregivers; crisis intervention and referral for adult protective services may be necessary

Front 160

How does Macionis define a disability?

Back 160

A disability is a physical or mental condition that limits everyday activities.

Hint 160

about 49.7 million Americans of all ages have a disability; about two-thirds of those have a severe disability

Front 161

Name the four disease stages that individuals with HIV face.

Back 161

1. Acute infection
2. Asymptomatic
3. Symptomatic or Chronic
4. AIDS (Acquired Immune Deficiency Syndrome)

Hint 161

Once diagnosed there is a long period of emotional and psychological adjustment with the individual experiencing denial, anger, depression, and hopelessness.

Front 162

During the period after being diagnosed with HIV, individuals generally go through a long phase of emotional and psychological adjustment. What psychiatric diagnosis are they most at risk for during this phase?

Back 162

Adjustment Disorder
Anxiety
Depression

Front 163

What losses may be faced by HIV and AIDS clients?

Back 163

loss of support from their social group; loss of phsysical functioning; loss of financial security; possible loss of jobs; loss of self-esteem; loss of life goals; and possible impending loss of their own lives

Front 164

What should mental health tx focus on when working with HIV and AIDS clients?

Back 164

focus should be on helping the client deal with the here and now and learning new ways of coping and problem solving

Hint 164

SW's need to help HIV and AIDS clients engage in lifestyle changes

Front 165

What are some tx strategies which may be beneficial to HIV and AIDS clients?

Back 165

CBT
Support Groups
Psychotherapy Groups
Crisis Intervention as needed
(especially in final stage)

Hint 165

increased risk of suicide with this population

Front 166

Name some factors to consider when working with military veterans returning home from deployment.

Back 166

"military culture" and "warrior mentality": soldiers view themselves as part of a brotherhood of support

Hint 166

returning veterans find themselves lost when trying to reintegrate into society. Women returning home have resulted in issues not previously seen.

Front 167

What types of injuries and psychological issues are returning veterans dealing with today?

Back 167

more head and limb injuries
Increase in: PTSD; TBI (traumatic brain injury); sexual trauma, for both men and women

Hint 167

due to better body armor their are less casualties, but more trauma to head and limbs; families are requiring services as well and children are experiencing secondary PTSD and other issues

Front 168

Describe some other issues faced due to re-integration.

Back 168

sleep issues; anxiety; numbness; hyper-vigilance; substance abuse; desire to return to active duty; marital difficulties are common

Front 169

What social work strategies are helpful with veterans?

Back 169

Acknowledge that you do not understand what the veteran has experienced

Be patient

Be cognizant of coping mechanisms used by the veteran

Encourage the veteran to tell his or her story

Avoid insensitively worded questions such as "Did you kill anyone?", "Did you see anyone killed?", and "Did you see any dead bodies?"

Provide information and help obtaining government and community resources for the veteran and family

Front 170

List some therapeutic interventions that have been effective with veterans.

Back 170

CBT
Solution Focused Brief Therapy
Acceptance and Commitment Therapy (ACT)
Narrative Therapy
Family and Couples Therapy
EMDR

Front 171

What is the NASW Standard for Cultural Competence in Social Work Practice?

Back 171

requires social workers to "be knowledgeable about and skillful in the use of services available in the community and broader society and be able to make appropriate referrals for their divers clients"...and to "be aware of the effect of social policies and programs on diverse client populations, advocating for and with clients whenever appropriate.

Hint 171

NASW code of ethics was amended in 2008 to prohibit discrimination of clients based on "immigration status".

Front 172

Name the NASW policies regarding immigrants that support specific goals related to undocumented individuals and their families.

Back 172

To guarantee that the human service and education needs of all children are met regardless of their or their parents' legal status

To ensure access to emergency health and mental healthcare for all immigrants

To ensure appropriate immigration-related services to undocumented minors in foster care, and, if they are eligible, adjustment of their status before they leave foster care

To provide for efforts to remove penalties on the children of undocumented immigrants based on their parents' actions

To protect all immigrants from family violence, including the undocumented, with provisions to protect women from gender-specific forms of violence.

To oppose mandatory reporting of immigration status by health, mental health, social service, education, policy, and other public service providers.

Front 173

Who has rights to benefits and services in the US as defined by federal law?

Back 173

All RESIDENTS of the US regardless of immigration status.

Hint 173

If SW have a case where they must disclose client information, the NASW code of ethics creates an expectation that these clients be fully informed in their own language, prior to the release of information.

Front 174

Describe what the NASW code of ethics identifies as Social Justice.

Back 174

Social Justice is one of the major ethical issues identified by NASW, stating, "Social workers pursue social change; particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers' social change efforts are focused primarily on the issues of poverty, unemployment, discrimination, a nd other forms of social injustice. Social workers strive to ensure access to needed information, services and resources; equality of opportunity and meaningful participation in decision making for all people."

Hint 174

these activities seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity

Front 175

What are Social Workers' ethical responsibilities to broader society as defined by the NASW?

Back 175

1. Promote the general welfare of society. Advocate for living conditions conducive to the fulfillment of basic human needs and should promote social, economic, political, and cultural values, and institutions that are compatible with the realization of social justice.

2. Facilitate informed public participation in shaping social policies and institutions.

3. Provide appropriate professional services in public emergencies to the greatest extent possible.

4. Engage in social and political action that seeks to ensure that all people have equal access to the resources, employment services, and opportunities they require to meet their basic human needs and to develop fully.

5. Act to expand choice and opportunity for all people, with special regard for vulnerable, disadvantaged, oppressed, and exploited people and groups.

6. Promote conditions that encourage rewpect for cultural and social diversity with the US and globally. Promote policies and practices that demonstrate respect for difference, support the expansion of cultural knowledge and resources, advocate for programs and institutions that demonstrate cultural competence, and promote policies that safeguard the rights of and confirm equity and social justice for all people.

7. Social workers should act to prevent and eliminate domination of, exploitation of and discrimination against any person, group, or class on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, or mental or physical disability

Hint 175

Be aware of the impact of the political arena on practice and advocate for changes in policy and legislation to improve social conditions in order to meet basic human needs and promote social justice.

Organizations, agencies, institutions and businesses that exhibit and promote cultural competence will integrate diversity into their policies, procedures, hiring practices, and training. Social workers and members of diverse populations must participate in political office, administrative positions, program planning, policy-making, and serving on boards of directors in order to achieve social and economic justice.

Front 176

What does Assessment refer to?

Back 176

Assessment is the process of arriving at tentative conclusions about the nature of client's situation, including problems and resources. This is the basis for treatment planning. Should be an ongoing process.

Hint 176

Mary Richmond was one fo the first to concentrate on assessment and diagnosis.

Front 177

What aspects of the client's internal and external experience should the assessment focus on?

Back 177

Internal:
Biophysical functioning
Use and abuse of substances
Cognitive and preceptual functioning
Emotional functioning
Mental disorders
Behavioral functioning
Motivation
Degree of acculturation
Language fluency
Problem Solving Skills

External:
Health and safety factors
Social Support Systems
Environmental needs of adults and children
Cultural norms
Educational support and needs
Precipitating events that brought the client to seek social work services

Front 178

What are the areas that the client's self report should focus on?

Back 178

Problem area: identified from client's point of view; be careful if psychiatrically unstable

Strengths: need to be identified; may need direction from sw to identify own strengths

Support System: resiliency may be determined by having at least one significant individual in client's life

Attitude: positive (hope that things will get better) or negative (defeatist or persecutory)

Level of Motivation

Use of Resources: personal and environmental (ex. problem solving skills, faith or spirituality, cultural values, cognitive abilities, and dependence on his or her support system

Danger to Self or Others: if yes then take immediate action

Front 179

What should observation based data include?

Back 179

Appearance: note any condition relevant to understanding client (ex. body weight, physical disabilities, health, facial affect, grooming, etc)

Health concerns: observe in addition to reading medical record; look for self care, cognitive ability, emotional functioning, and social skills; also look for possible substance use/abuse

Life Skills: indicative of functioning (strength or limitation); depending on age note mobility, money management, cleanliness, personal hygiene, communication skills, organizational skills, social skills, problem-solving skills, self care, and work skills

Front 180

When to refer for additional evaluation.

Back 180

After subjective and objective assessment, the sw may decide to refer for additional evaluation such as formal psychological testing, psych eval, vocational testing, or med eval

Hint 180

may need to refer to another professional or agency. explain why to client and facilitate process. follow up with individual to whom the client was referred and use that info to complete assessment,

Front 181

Assessment of Problem Areas and Strengths

Back 181

Biopsychosocial Model: how the body's functioning may contribute to current problem

Psychological: emotions, thinking processes and behaviors

Social: role of environment, culture, socioeconomic status, poverty, and spirituality in the clt's health

NEXT: identify current level of functioning, strengths and weaknesses, mental health status, needs

Front 182

Medical Model

Back 182

focuses on pathology or what is "wrong" with client

Hint 182

social workers explore strengths, resiliency and positive life function in addition to problem area

Front 183

Strengths Perspective

Back 183

strengths are essential in healing process; incorporating them will aid in empowering clt to reach desired goals

Hint 183

what is wrong with the clt often reinforces the powerlessness of the clt in current situation

Front 184

Strengths Perspective of Assessment

Back 184

Empowers clt to solve own problems

Examines possible alternatives

Teaches competencies

Creates more equity between the client and social worker

builds self confidence

helps clts to see that problems are influenced by multiple factors, are interactive, and are ever changing

Front 185

Social History

Back 185

focus on strengths of client as well as problem areas; should include info from multiple sources

Front 186

Identify presenting problem

Back 186

Why clt was referred to agency or setting; reason from viewpoint of agency, clt and family

Front 187

Referral Problem

Back 187

the primary reason for seeking help; the problem that needs to be address FIRST

Hint 187

may be differing opinions about primary problem; all perspectives should be stated in social history

Front 188

Gathering Data via interviewing and observation

Back 188

begins in intake

topics include: problem areas, strengths, support system, attitude of clt, clt motivaation, clt's resources, danger to self and others, appearance, health and life skills

Front 189

Records

Back 189

both current and past; need to have clt release to obtain info from outside sources

Hint 189

Compliance with HIPPA

Front 190

Assessment Instruments

Back 190

any tests or asssessments that have been given to the clt are necessary pieces of info for the formulation of a diagnosis and treatment plan

Hint 190

90% of errors are dx

Front 191

Suicide Risk

Back 191

requires timely assessment; "no harm" contract for ideation without plan; admit to hospital if ideation with plan

Hint 191

involuntary commital requires emergency services and significant others

Front 192

Specific Domains of Mental Status Exams

Back 192

Appearance: age, height, weight, grooming

Attitude: cooperative, uncooperative, hostile, guarded, suspicious

Behavior: observation of level of activity, abnormal movements, eye contact, gait

Mood: described by clt in own words; internal emotional state

Affect: the emotion conveyed by the clt's nonverbal behavior; evaluated by appropriateness, intensity, range, reactivity and mobility (subject to CULTURAL
INFLUENCES)

Speech: production rather than content; include ability to name objects, produce specific words in a set time and repeat short sentences

Thought Process: quantity, rate and form (coherent or logical); can't be directly observed only inferred from clt's speech; flight of ideaas, poverty of speech, perseveration; a formal thought disorder may be exhibited by thought blocking; loosening of associations, tangential thinking, derailment, circumstantial

Thought content: delusions, obsessions, phobias, over valued ideas, and preoccupation; abnormalities measured by open ended conversational type questions; delusions (paranoid, grandiose, erotomanic, jealousy, reference); thought withdrawal, Insertion, broadcasting

Perception: sensory experience; main distortion is hallucination (auditory, visual, tactile, gustatory, olfactory); distortion of sense of time, depersonalization, derealization

Cognition: level of alertness, orientation, attention, memory, language and executive function

Insight: the individual's understaqnding of his or her problems and tx options; on a continuum

Judgement: ability to make sound, reasoned and responsible decisions

Hint 192

Abnormal movements or tremors may include: tics, catatonia, repetitive purposeless movements, odd mannerisms, restlessness, psychomotor agitation, or retardation

Mood states: neutral, euthymic (normal), depressed or dysphoric, euphoric, angry, anxious, indifferent (apathetic), anhedonic (inability to experience pleasure)

Types of Affect: full range, restricted, blunted, flat, labile, congruent, incongruent, exaggerated, or dramatic

Front 193

Documentation

Back 193

SOAP notes:
subjective observation
objective data
assessment
plan

BIRP notes:
Behavior of clt
Intervention of sw on behalf of that documented behavior
Response to intervention
Plan

Front 194

DSM Classification:

Back 194

Axis I: Clinical Disorders
Other conditions that might be the focus of tx (V codes)

Axis II: Personality Disorders (V codes)
Mental Retardation
Borderline Intellectual Functioning (V code)

Axis III: General Medical Condition or current medical conditions that have potential relevance to the understanding and management of the disorders on Axis I or II

Axis IV: Psychosocial and Environmental Problems

Axis V: GAF
sw's judgement of overall functioning

Front 195

Specifiers

Back 195

Mild
Moderate
Severe
In Partial Remission
In Full Remission
Prior History

Front 196

Mental Retardation

Back 196

Mild IQ 50-70

Moderate IQ 35-55

Severe IQ 20-40

Profound IQ less than 25

Hint 196

Teachable

Trainable

Total Care

Institutionalization

Front 197

Learning Disorders

Back 197

Reading Disorder
Math Disorder
Disorder of Written Expression

Hint 197

significantly impair person's ability to perform activities of dailing living or in academic area

Front 198

Motor Skills Disorder

Back 198

Developmental Coordination Disorder: only motor skills disorder in the DSM

Hint 198

not the result of medical condition or PDD

Front 199

Communication Disorders

Back 199

Expressive Language
Receptive Language
Mixed Receptive-Expressive
Phonological
Stuttering

Front 200

PDD

Back 200

serious impairment in social interaction skills, communications skills, or stereotypical behavior or interest; frequently involve mental retardation

Hint 200

Rhett's disorder: primarily girls; after post birth normal development; decrease in head grown, loss of mother skills, social engagement and language development

Autistic Disorder: significant impairment in communication, social interaction, restricted range of interest (respirdone to tx irritability; no single tx)

Childhood Disintegrative Disorder: significant loss of skills after seemingly normal development for the first 2 yrs of life (no medication unless for depression or to decrease anxious behavior; behavior therapy programs; rewards to reinforce desirable behavior)

Asperger's: impairment in social interaction that is both severe and sustained; nonfunctional repetitive/stereotypical behavior, interest, activity in the absense of significant delay in language, cognition or self help skills; has adaptive behavior that does not include social involvement and interest in environment (psych meds for specific behaviors; hyperactive, inattention and impulsive may use psychostimulents, clonidine, trycyclics, or Strattera/ for irritibility and aggression may use mood stabilizer, beta blockers, clonidine, naltrexone, or neuroleptics/ tricyclics or SSRIs for compulsions, obsessions, ritualistic behavior/ for anxiety try SSRIs or tricyclics; behavior mod, educational intervention, individual psychotherapy to help learn social skills, detect social cues, deal with emotions around dx

Front 201

ADD/ADHD/ and Disruptive Behavior Disorders

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ADD/ADHD
combined type
predominantly inattentive type
predominantly Hyperactive-Impulsive type (tx focus on meds such as stimulents or Strattera, tricyclics effective in some adults; therapies include individual psychotherapy, behavior mod, social skills; psychotherapy and meds preferred for adults

Conduct Disorder:
Before 10 yrs called Childhood-Onset type/ onset at 10 or later called Adolescent-Onset
(more common in males; females tend to runaway more)
pattern of violating the rules and norms of society and the rights of others in a variety of settings (may have aggression with animals or people, destruction, dishonesty, truancy, stealing, runaway); meds used only if Axis I
disorder present; tx is difficut due to nature of behavior CBT and support for family most effective, tx rarely brief

Oppositional Defiant Disorder: present for at least 6 months; negative, hostile, defiant; dx when does not meet criteria for Conduct Disorder (or Antisocial if over 18); behavior not due to mood disorder; more common in males before puberty/ females after puberty; meds not currently recommended; Behavior Mod through parent training, parent training may be more effective than family therapy

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Feeding and Eating Disorders

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Pica: persistent eating of at least 1 nonfood item for a at least 1 month; no standard tx, Behavior Mod

Rumination Disorder: repetitive regurgitation and rechewind of food over at least 1 month; onset preced by period of normal functioning; tx based on cause of behavior/ Behavior Mod may extinguish behavior

Feeding Disorder of Infancy or Early Childhood: failure to eat a sufficient quantity of food with failure to gain or maintain weight; must occur over at least 1 month period; not the result of medical or mental disorder or inabillity to access food

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Tic Disorders

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Tourette's: multiple motor tics and minimum of one vocal tic over the cours of the disorder; must occur multiple times per day almost every day or intermittently for more than 12 months; no more than 3 consecutive months that are considered "tic free"

Chronic Motor or Vocal Tic Disorder: single or multiple motor tics or vocal tics over more than 1-yr period and occur repeatedly in a day, on most days, or occur intermittently with a max of 3 tic free consecutive months

Transient Tic Disorder: single or multiple motor and/or vocal tics occuring repetitively over a day's time, on most days, for a minimum of 4 weeks and a max of 12 consecutive months; not previously met other criteria

Hint 203

no specific meds; antipsychotic meds and anti-hypertensive med to decrease tics

Habit Reversal Training (HRT) to increase tic awareness and develop competing response; based on presencce of premonitory urge (or sensation) just before tic/ replace with alternate response

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Elimination Disorders

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Encopresis: at least 4 yrs old; one event each month over at least 3 months and not directly related to substance or medical condition; may be voluntary or involuntary; tx to prevent constipation and encourage good bowel habits; therapy may be needed to reduce shame, guilt or loss of self esteem

Enuresis: at least 5 yrs old occuring at least 2x a week for over at least 3 consecutive months or must result in significant distress or impairment; may be voluntary or involuntary; tx focus on behavior; meds may be desmopressin acetate (DDAVP); most important reason to treat is minimize embarrassment and anxiety and frustration of child and parent/ help child feel not alone by talking with someone/ Behavioral Approach

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Separation Anxiety

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evident for a minimum of 4 weeks and onset before age 18; developmentally normal in infants and toddlers to approx 3-5 yrs; r/o panic disorder with agoraphobia first; meds include Prozac (fluoxetine)/only SSRI approved by FDA for those younger than 18 yrs, used when functional impairment is moderate to severe; CBT/ focus on skill building, recognizing anxious feelings re physical reaction, thoughts in anxious situations, plan how to cope adaptively; younger children use play therapy; children's success praised highly by therapist and parent

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Selective Mutism

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persistent failure to speak in certain situations with a demonstrated ability to talk as evidenced by doing so in other situations; lasts minimum of 1 month and cannot be during first month of school; slightly more common in females; some cases treat with meds such as Prozac/more successful in younger children/reduces sx in about 3/4 of children; Behavior Mod techniques using positive reward for speech and withheld when silent, stimulus fading involves finding motivating "stimulus" for child to speak in mute situations/a trusted parent is often good "stimulus"/ particularly effective when paired with positive reinforcement techniques

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Reactive Attachment Disorder of Early Childhood

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disturbance in ability to relate in most social situations; onset before age 5

Two Types:
Inhibited type- failure to initiate and respond to social interaction in a manner consistent with the individeual's developemental level
Disinhibited Type- indiscriminate sociability (lack of boundaries)

Meds not indicated unless other Axis I disorder; no standard tx

Hint 207

Typically evidence of abuse, neglect and frequenjt changes of caregivers; dx fairly uncommon

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Stereotypic Movement Disorders

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repetitive, nonfunctional motor behavior, such as body rocking, head banging and biting oneself; disrupts individual's life and has potential to cause physical injury; not result of compulsion, tic or PDD; must continue for minimum of 4 weeks; Prozac, Zoloft and Luvox (SSRIs) or Anafranil (tricyclic) may help; goal of tx is to ensure safety, as well as improve ability to function, surroundings modified as necessary, aim to reduce stress that may trigger movements, relaxation techniques to help resist urges

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Delirium, Dementia, Amnestic and Other Cognitive Disorders

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significant decline in cognition caused by either the direct effects of a sustance or toxin, or a medical condition, or both; substance or medical condition is provided as part of dx

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Delirium

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disturbance in the level of consciousness; onset over a brief time; often clears when condition relents

1. Due to General Medical Condition
2. Substance Induced Delirium
3. Due to Multiple Etiology
4. Delirium NOS (Indeterminate Etiology

Hint 210

Tx is finding etiology and treating underlying cause

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Dementia

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impairment in a number of cognitive abilities, including memory and often becomes progressively worse over time

1. Dementia of Alzheimer's Type
2. Vascular Dementia
3. Dementia Due to Other General Medical Conditions
4. Substance-Induced Persisting Dementia
5. Dementia Due to Multiple Etiologies
6. Dementia NOS (Indeterminate Etiology)

Hint 211

cannot be cured; med may improve mental function, mood and behavior; meds include Aricept, Reminyl, Exelon and Namenda/ Antidepressants for depression/Anxiety, agitation, and hallucinations may be treated with antipsychotics; goal of tx is to keep person safe/make adjustments to home, use calendars for memory, maintain good nutrition and sleep; nursing home may be necessary

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Amnestic Disorder

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impairment in memory solely

1. Due to General Medical Condition
2. Substance-Induced Persisting Amnestic Disorder
3. Amnestic Disorder NOS (indeterminate etiology)

Hint 212

no tx proven; many recover slowly over time; sometimes recover past memories; generally recover from transient global amnesia w/o tx

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Cognitive Disorders NOS

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do not meet criteria for for specified disorders, but impair cognitive function

Front 214

Mental Disorders Due to General Medical Condition

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involve sx that appear to have resulted directly from physiological changes associated with medical condition

3 Criteria:
a. good evidence that problem is directly related to medical condition
b. does not meet criteria for other mental disorder that can cause observed sx
c. sx occurred in absence of delirium; meds are specified to underlying etiology of given mental disorder

Hint 214

Catatonic Disorder
Personality Change
Mental Disorder NOS
Delirium
Dementia
Amnestic Disorder
Psychotic Disorder
Mood Disorder
Anxiety Disorder
Sexual Dysfunction
Sleep Disorder

(all followed by phrase: Due to General Medical Condition)

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Separation Anxiety

Back 215

evident for a minimum of 4 weeks and onset before age 18; developmentally normal in infants and toddlers to approx 3-5 yrs; r/o panic disorder with agoraphobia first; meds include Prozac (fluoxetine)/only SSRI approved by FDA for those younger than 18 yrs, used when functional impairment is moderate to severe; CBT/ focus on skill building, recognizing anxious feelings re physical reaction, thoughts in anxious situations, plan how to cope adaptively; younger children use play therapy; children's success praised highly by therapist and parent

Front 216

Selective Mutism

Back 216

persistent failure to speak in certain situations with a demonstrated ability to talk as evidenced by doing so in other situations; lasts minimum of 1 month and cannot be during first month of school; slightly more common in females; some cases treat with meds such as Prozac/more successful in younger children/reduces sx in about 3/4 of children; Behavior Mod techniques using positive reward for speech and withheld when silent, stimulus fading involves finding motivating "stimulus" for child to speak in mute situations/a trusted parent is often good "stimulus"/ particularly effective when paired with positive reinforcement techniques

Front 217

Reactive Attachment Disorder of Early Childhood

Back 217

disturbance in ability to relate in most social situations; onset before age 5

Two Types:
Inhibited type- failure to initiate and respond to social interaction in a manner consistent with the individeual's developemental level
Disinhibited Type- indiscriminate sociability (lack of boundaries)

Meds not indicated unless other Axis I disorder; no standard tx

Hint 217

Typically evidence of abuse, neglect and frequenjt changes of caregivers; dx fairly uncommon

Front 218

Stereotypic Movement Disorders

Back 218

repetitive, nonfunctional motor behavior, such as body rocking, head banging and biting oneself; disrupts individual's life and has potential to cause physical injury; not result of compulsion, tic or PDD; must continue for minimum of 4 weeks; Prozac, Zoloft and Luvox (SSRIs) or Anafranil (tricyclic) may help; goal of tx is to ensure safety, as well as improve ability to function, surroundings modified as necessary, aim to reduce stress that may trigger movements, relaxation techniques to help resist urges

Front 219

Delirium, Dementia, Amnestic and Other Cognitive Disorders

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significant decline in cognition caused by either the direct effects of a sustance or toxin, or a medical condition, or both; substance or medical condition is provided as part of dx

Front 220

Schizophrenia

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Positive Symptoms: hallucination (a perception w/o an accompanying external reality)delusions, disorganized speech, inappropriate affect, disorganized behavior

negative symptoms:
flat or blunted affect; avolition, alogia, decrease in the amount of speech or poverty of content of speech, anhedonia

Hint 220

avolition: loss of willpower or decisiveness

alogia: speech disturbance involving poverty of speech (speech that contains little or no meaningful information)

anhedonia: loss of ability to experience pleasure

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3 Phases of Schizophrenia

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1. Prodromal: decline in role functioning and precedes active phase (full blown criteria not yet met)

2. Active Phase: full-blown sx (ex. delusions, hallucinations, severly disorganized speech)

3. Residual Phase: follows active phase; psychotic sx have improved but impairment continues

Hint 221

continuous signs of disorder for minimum 6 months to receive dx; mood disorder during active phase have to be relatively brief/ otherwise Pchizoaffective Disorder or Mood Disorder with Psychotic Features should by r/o; active phase lasts at least 1 month unless tx has decreased sx

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Subtypes of Schizophrenia

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1. Paranoid Type: prominent delusions; typically of persecutory or grandiose type or audityory; other sx not prominent

2. Disorganized Type: disorganized speech ad behavior as well as flat or inappropriate affect

3. Catatonic Type: minimum of 2 of the following
a. motor immobility: catalepsy or stupor
b. excessive purposeless movement (unrelated to external stimuli)
c. negativism or mutism
d. peculiar voluntary movement
e. echolalia or echopraxia

4. Undifferentiated Type: does not meet other criteria

5. Residual Type: minimum of one full blown episode; continues to have impairment but in the absence of prominent psychotic sx

Hint 222

catalepsy- rigid maintenance of posture over extended period of time

stupor- unresponsive, immobile, mutism

negativism- resistance to instruction, rigid posturing or resistance to being moved

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Med Management and Tx for Schizophrenia

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meds: combo of antipsychotic, antidepressant, and anti-anxiety depending on type of sx

Treatment: wrap around services including social skills,
education, independent living assistance, case management, and med compliance; group therapy helpful when reality based, solution focused, task centered; family therapy decreases relapse rates; community and support groups helpful

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Schizophreniform Disorder

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Differs from Schizophrenia in 2 ways: may not experience impairment in social or occupational functioning; sx of disorder are minimum 1 month and less than 6 months; continues beyond 6 months change to Schizophrenia

Hint 224

meds and tx similar to Schizophrenia

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Schizoaffective Disorder

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major depressive, manic or mixed episode in combo with sx of Schizophrenia; delusions or hallucinations during 2 week period when prominent mood sx not present; mood sx need to be prominent part

Hint 225

tx antipsychotics and individual therapy; problem solving approach

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Delusional Disorder

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minimum one non-bizarre delusion and evident for minimum 1 month; may be accompanied by tactile or olfactory hallucinations if related to delusion; psychosocial function apart from delusion is normal; concurrent mood episode brief

Hint 226

Subtypes:
Erotomanic
Grandiose
Jealous
Persecutory
Somatic
Mixed
Unspecified

meds are only marginally effective; some antipsychotics help delusions temporarily; Individual therapy most helpful/ client therapist relationship most important

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Brief Psychotic Disorder

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Schizophrenic sx; evident at least 1 day, no more than 1 month; specify with marked stressors or w/o marked stressors

Hint 227

with postpartum onset-sx appear 4 weeks postpartum

if specific stressor, remove stressor, brief hospitalization and/or antipsychotics may be necessary

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Shared Psychotic Disorder
(Folie a Deux)

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delusion in and individual closely involved with another individual who has prominent delusion

Hint 228

Benzos can help alleviate intense sx after removal from primary person; therapy focus on individual