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153 Cards in this Set
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Ethics |
1) if client states plan to commit suicide
2) If client threatens to cause serious harm to another person, with a plan and access to carry out threat 3) If Client is suing the Therapist 4) if Court-order by judge to testify in court |
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Ethics
Informed Consent |
must have written form or agreement by client to enter treatment
form must include the associated risks vs. benefits associated with treatment client has right to leave treatment clear outline of cost of service (co-pays) and time frame of sessions what circumstances that will limit confidentiality |
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Ethics
Client right to self-determination |
Client has a right to make own decisions
Social worker should educate clients on pros and cons of their decision but the client choose what is best |
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Under what circumstance do you NOT respect "right to self-determination"
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1) Client has active delusions, Hallucinations
2)Client is intoxicated 3) Client has potential to pose serious harm to themselves or others |
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ETHICS
What does it mean by avoid "Dual Relationships" |
Social Worker should not provide individual therapy sessions to two or more people who have a relationship with each other. Ex: cannot provide individual therapy to Wife and Mother-In-Law.
Provide REFERRALS-at least 3 names of social workers |
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Ethics
What does it mean by "No Bartering" |
it is unethical to exchange social work services for goods
ex: client cannot paint your office in place of paying co-pay fees |
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Ethics
Tarasoff Decision refers an ethical obligation to... |
Duty to Warn: The supreme court established a legal duty of social workers to inform and warn a threatened victim of any harm his/her client may cause.
Client must present serious danger to another, if client threatens physical violence, victim must be identifiable( know address, relationship to client, and access to victim) |
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In Vivo Desensitization
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Behavioral Therapy
-used for clients with anxiety/phobias Theory: client has a fear of object or situation, creates fear response (anxiety, panic attacks), the response has been conditioned, client avoids fear. Goal: Confronting the fear, gradually helps to unlearn fear Process: client creates list of object/situations that cause fear response (panic attack) in order of intensity( least fearful to most fearful) In real setting gradually check things off the list: confronting fear |
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Aversion Therapy
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- Behavioral Therapy
- Client exposed to a stimulus while being subjected to some form of discomfort. Over time client learns to associate stimulus with uncomfortable feeling/experience -way to stop specific behavior -used to treat alcoholism |
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Biofeedback
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-Behavioral therapy
- teaches client to control certain functions such as heart rate, blood pressure, migraines -commonly used for ADHD, Anxiety -use relaxation techniques, mediation, mindfulness, deep breathing - |
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DSM IV
Axis I |
Clinical Disorder
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DSM IV
Axis II |
Personality Disorder and Mental retardation
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DSM IV
Axis III |
General Medical Conditions
*help Clinician understand the complete picture, factors in the significance of medical condition on client's functioning and mental health |
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AXIS IV
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List all Psychosocial stressors
-deaths -recent divorce child neglect/sexual abuse -employment problems -access to health care -legal problems -Education problems -Homelessness |
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Axis V
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GAF Score
100= perfect functioning 50 to 41= client has serious symptoms, suicidal thoughts, addictive behaviors, serious social, school or work impairment in functioning 0= not enough information |
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What three things should you rule out before making a diagnosis?
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1) Is it caused by medical condition- request for blood work, doctor evaluation
2) is it caused by substance abuse/ substance withdrawal? |
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Personality Disorders
what age? what axis? what do you rule out |
-Appears on Axis II
-Do not need medication/treated with psychotherapy -must be 18 years old -no delusions/no hallucinations |
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Schizoid Personality Disorder
What cluster? |
-Cluster A
-introvert (keeping to themselves) -withdrawn -cold/distant -fearful of closeness/intimacy with other |
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Paranoid Personality Disorder
What Cluster? |
Cluster A
-do not trust others -thinks actions of others are deliberately harming or threatening -Aggressive outburst -unforgiving |
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Alfred Adler
What is the underlying belief? |
personality is developed in childhood
-Children feel that they are inferior (less than/weaker) which could be real or perceived -impacts personality as adults and ability to live and cope with their lives Adults overcompensate( strive to over-power others) and become very self centered= maladaptive behaviors |
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What is the goal of Adlerian Therapy?
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1) Self-awareness: allows clients to look at how they interpret their experience and re-frame (change negative thoughts/assumptions to more realistic)
2) Encourage client to engage in social activities leads to decrease feelings of inferiority |
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Psychoanalytic Therapy
ID |
Id: Unconscious
-seeks immediate gratification -pleasure principle -impulsive |
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Psychoanalytic Therapy
EGO |
-represents logic and reasoning
-mediates between ID (impulses) and Superego (morals/values) |
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Psychoanalytic Therapy
SUPEREGO |
incorporates values from parents
society values morals "conscience" |
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Psychoanalytic Therapy
Ego dystonic |
Dys- "diss"= Guilt
when one feels guilty with his/her behavior |
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Psychoanalytic Therapy
EGO Syntonic |
when one feels comfortable with his/her behavior
* the goal of psychoanalytic therapy |
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Techniques used in Psychoanalytic Therapy
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1) Free Association: client are encourage to speak freely about anything that comes to mind
2) Resistance: any area client has difficulty talking about or changes topic will mean their underlying issues 3) Transference 4) interpretation of dreams |
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Goal of Psychoanalytic Therapy
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1)gain understanding of how childhood experiences affect adult behavior
2) Educating client on how mind process things= more aware of their actions 3) Ego Strength- no unresolved conflict, ability to cope with internal and external stress |
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Transference
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When client transfers feelings onto therapist which could be due to conflict in past relationships or childhood issues
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How do you address Transference
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1) identify when it occurs in session
2) address/explore with client the meaning 3) reveal/ analysis how it may be connected to unresolved conflict with childhood figures * Insight= changed behavior |
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Counter-transference
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unconscious
feelings or reactions the therapist may have towards a client -feeling are due to therapist unresolved conflict from past or present relationships |
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Person Centered Therapy
Who developed it? whats the underlying beliefs |
-Carl Rogers
Belief: all human have self actualizing tendency( to move forward, grow and reach fullest potential) -Emphasis the importance of client seeking assistance, controlling their destiny -client has ability to process their experience and learn from them |
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Goal of Person-Centered Therapy?
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-Create a supportive environment for client
-Increase clients self esteem -Client should feel more comfortable expressing themselves w/o fear of rejection -Client understands how negative view of self affects behavior -develop cohesive sense of self |
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Three conditions must be present in Person-Centered Therapy: Therapist must have these w/ client
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1) Unconditional Positive Regard: acceptance and support no matter what client experiences
2) Genuineness/ Congruence: openness/genuine 3) Empathic Understanding (active listening/ reflection) |
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Task Centered Treatment
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-based on idea: people are capable of solving their own problems
-focus on breaking down the problem into small task that client can accomplish |
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What is the process for Task Centered Treatment
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1) Assess (whats the problem) client defines the problem
2) Set goals ( how will be resolve the problem) 3) Define tasks- tasks are developed by client/SW (Action steps) choose time frame and monitor the progression 4) Termination: Goals are reached |
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Enuresis
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-Childhood/adolescent disorder
-urinating in clothing or in bed -could be due to stress -could be sue to medical condition - could be a defense mechanism- regression |
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Encopresis
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-feces in inappropriate places such as in underwear or floor
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ADHD
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-failure to remain attentive in at least two different settings or situations (home and school- same behavior)
-Girls most likely to be inattentive -Boys most likely to be hyperactive |
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Conduct Disorder
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- Under age 18
-Violates the rights of others - shows little to no respect for parent or law or feelings of others -must show repetitive/persistent pattern of behavior -Destructive behavior (fire setting, vandalism) -Aggressive behavior ( fighting, bully, cruelty to animals) - No affection or bond/empathy with others |
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Oppositional Defiant Disorder
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at least 6 months of behavior
-moody, easily frustrated - deliberately annoys ppl -does not follow adult requests or follow rules by adults -Frequently looses temper |
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Reactive Attachment Disorder
What are the Characteristics |
present before or by age 5
-when infants/children don't establish bonds with parents -detached, unresponsive to parents -calm when left alone -no interest in play with toys -too friendly with strangers -shun everyone |
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Risk factors for developing an alcohol problem
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-family history of alcoholism
-depression, anxiety anti-social personality impulse behaviors (conduct disorder) -family dysfunction (poor parenting) family trauma (death, divorce) Males |
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Korasakoff Syndrome
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medical condition due to chronic alcohol abuse
-Vitamin B1 deficiency - severe memory loss - making up stories due to gaps in memory |
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Austism
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-4-5 more frequent in males
- social impairment + communication problems (non-verbal, use signing in place of speech) -develops before age 3 -many range from moderate to severely retarded |
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Aspergers
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-only social impairment
- more common in boys -repetitive patterns of behavior |
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Kolhberg Theory of Moral Development
What is level 1? What ages? |
Pre-conventional
Age: before 9 Elementary school |
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Kohlberg Theory of Moral Development
What is stage 1? What is stage 2? |
Stage 1: Obedience/Punishment
children see rules as fixed and absolute, and obey to avoid punishment Stage 2: Individualism/Exchange "whats in it for me?" starts to negotiate, only conform to rules for reward |
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Kohlberg Theory of Moral Development
Stage 3? Stage 4? |
Stage 3: "good girl/ good boy"
obey rules to gain approval from others. concerned with living up to social expectations and roles. Stage 4: Maintaining Social Contract focus on maintaining law and order, respecting authority |
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Kohlberg Theory of Moral Development
Stage 5? Stage 6? |
Stage 5: Social Contract
concerned with individual rights, believe that members of society should agree on rules (democracy) Stage 6: Universal principles based on universal ethics concerned for larger universal issues |
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Freud Psychosexual Stages
Oral Stage |
Age: birth to 1 year
infants learn the world through mouth. sucking, tasting provides pleasure problems at this stage: oral fixation ex: (thumb sucking, smoking, overeating) |
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Freud Psychosexual Stages
Anal Stage |
Age: 1 to 3 yrs
focus is controlling bladder/bowel movements and toilet training. Problems at this stage: Too much pressure -> OCD, excessive need for cleanliness or order Not Enough Pressure---> messy, destructive behaviors later in life |
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Freud Psychosexual Stages
Phallic Stage |
Age: 3 to 6
genitals provide pleasure, ID (impulses) Oedipal Complex: boy has sexual attraction to mother Super-Ego( mediator) develops, boy/girl acts like same-sex parent and repress sexual feelings |
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Freud Psychosexual Stages
Latent Stage |
Age 6 to 11
before puberty focus on play and interacting with same-sex peers |
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Freud Psychosexual Stages
Genital stage |
starts at puberty
genitals=pleasure sexual urges are back and directed towards opposite sex. |
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If an HIV Client discloses they are having unprotected sex, what do you do?
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HIV Decisions- No legal duty to warn
Discuss with client safe sex practices and urge to practice urge Client to disclose his/her situation to their partner |
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Ethics
If a Client ask to have copy of treatment records, what do you do? |
Code of Ethics: SW must provide client with reasonable access to his/her records
1) First explore and discuss reason for requesting records 2) Follow law/jurisdiction of clinic/area |
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Histrionic Personality Disorder?
What Cluster? |
-attention seeking behavior
- wants to be center of attention in any group setting -inappropriate sexually/provocative behavior for attention -easily influenced by others -Low self Esteem -need immediate gratification -more likely in females |
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Ethics
What are your ethical responsibilities to colleagues? |
refer to colleague when the colleague possesses specialized knowledge or training in area that would BETTER help client
-You could accept client but it is your responsibility to become COMPETENT in that area -avoid relationships wit colleagues/no conflict of interest |
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Ethics
What are your ethical responsibility to society? |
1) promote & support conditions that facilitate cultural and social diversity
2) participate in charity work (for free) |
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Agoraphobia
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Disorder, fearful of places that prevent ready escape or would cause particular embarrassment are AVOIDED or cause great distress (panic attack)
ex: fear of riding in a car, riding in elevator |
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OCD
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disorder where avoid things/place that trigger compulsive rituals.
Obsessions: thoughts or actions that serve to neutralize anxiety Compulsions: repetitive actions help to alleviate anxiety -Both have rigid rules (ex: washing with specific soap 10X on each hand) |
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PTSD
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Duration: symptoms must be 1 to 3 months
anxiety as a result from exposure to traumatic event -Cause serious impairment in daily life activities or functioning ex: war, rape, battery, tragic accidents, hurricanes, floods, fires |
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what are symptoms of PTSD?
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-intrusive daytime memories/flashbacks
-repetitive nightmares/trouble sleeping -panic attacks -avoid situations that are anyway reminiscent of traumatic event |
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Narcissistic Personality Disorder
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"They are the most important person in the world"
-exaggerates acheivements/talents to view themselves as "expert" - fantasies of unlimited success -Feelings of entitlement, exploiting others -Lack of empathy -Seeks constant attention |
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Borderline Personality
What Cluster? |
-Cluster B
-Pattern of unstable relationships -frantic effort to avoid abandonment - at times self destructive -view people as "all bad" or "all good" -Sudden dramatic shifts in view of other (from idealizing to hating) -Frequent mood swings |
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With Borderline Personality?
what must therapist establish with this type of client? |
Therapist should develop strict boundaries in the 1st session.
watch out for self-destructive behaviors (cutting, intentionally burning w/ cigarette, suicide attempts) |
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Anti-Social Personality Disorder
*Think of PJ |
-failure to follow rules/law
-history of legal troubles -lack of remorse, rationalizing hurting others/stealing from others -no respect for others/lack of empathy -irresponsible (history of unemployment) -excessively opinionated/self assured |
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Schizotypal
What Cluster? |
Cluster A
-Difficulty establishing close relationships -odd beliefs, magical thinking -bizarre fantasies -odd speech |
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Benzodiazepines are used to treat which disorders?
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anxiety disorders
- also used to induce sleep |
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Schizophrenia
What is the DSM IV criteria? |
-must have symptoms for at least 6 months
-Must have active psychotic symptoms( delusions/hallucinations) -impaired thinking/ "thought disorder" -disorganized speech -affective flattening- inappropriate response to events /no emotional response -Alogia- inability to speak -Avolition- lack of motivation, lack of drive to pursue goals |
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What are the most common treatment options for Schizophrenia?
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1) Anti-psychotic drugs- used to treat agitation, hallucinations, delusions, disorganized thinking , paranoid behavior
2) Ego supportive therapy |
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Tardive Dyskinesia
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A side effect of Anti-psychotic medications
-abnormal involuntary movements of tongue, lips jaw, twitching of the face -occurs after many months or years of taking anti-psychotic medications |
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Thorazine(chlorpromazine)
Prolixin (fluephenazine) Haldol (haloperidol) |
medications used to treat schizophrenia or anti-psychotic medications
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Injectable medications are useful for what type of client?
What are anti-psychotics available in injectable forms? |
-Used for clients who are non-compliant with oral medications
examples: Haldol D (decanoate) , Prolixin D, |
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What are common Bi-polar medications?
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1)Lithium
2) Tegretol 3) Depakote |
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Lithium
What are the side effects? |
* used to treat anxiety disorders
Side Effects: kidney/ thyroid problems -needs frequent blood work to monitor health -weight gain -increased need to urinate -dehydration (client should drink a lot of water) |
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What is a Paradoxical Effect?
What medications have this effect |
Paradoxical Effect are medications that have opposite effect to the one effected
Ritalin, Adderall (amphetamine) are stimulants but they help to calm down person with ADHD |
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What is the standard of care when treating hyperactivity in children?
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-Medication
-prescribe stimulants because they help to calm down children with hyperactivity. Examples: Ritalin |
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what are the signs of alcohol withdrawal?
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-Tremors
-Anxiety -Seizures |
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What are signs of Cocaine Use?
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-Dilated Pupils
-Talkative -Hyperactive -Restlessness - |
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For questions that ask what should the SW do FIRST?
*remember this accro |
F: Feelings of the client be acknowledged first above all. Begin building rapport.
A: Assess R: Refer E: Educate A: Advocate F: Facilitate I: Intervene |
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Folie a Deux
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Shared Delusion. a person may develop a delusional system as a result of a close relationship with a person who already has an established delusional system
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What age group has the highest suicide rate?
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Age 65 plus
highest rate white men over 85 years old |
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How does sexual orientation effect suicide?
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Gay and Lesbian youth are more likely to commit suicide than other youth.
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Research Question
What is Reliability? |
-measures how consistent
-Can you get the same answer repeatedly? |
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Research Question
What is Validity? |
How accurate
- "Are we measuring what we think we are measuring or something else?" |
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External Validity?
Internal Validity? Content Validity? |
External Validity: can the results be applied to other populations or to other groups
Internal Validity: |
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Research Question:
Independant Variable Dependant Variable |
IV: The variable that is being controlled, what causes the results or presumed effect
DV: The outcome Example: |
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Type of clients that are Not recommended for Group Therapy?
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-Clients in Crisis
-Suicidal clients - Borderline Personality (Constant need for attention) -Actively Psychotic( having hallucinations/delusions) -Paranoid |
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Term to Know:
Contraindicated |
Means not safe, not useful, not recommended
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Term to Know:
Incongruity |
"Out of Place"
"Does not Fit in" "In conflict with" Ex: A well groomed women with a messy apartment |
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What is the Referral Process?
What should you keep in mind? |
1) What is the need or purpose
2) research resources 3) discussing and selecting options with client 4) Plan for 1st contact (initial contact) 5) Initial contact between client and referal source 6) Follow up with client to see if need was met * Always keep in mind clients right to self determination |
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Elder Abuse
What are the types of Abuse? |
Abuse to a person 60 years old or older
Types of Abuse: 1) Physical Abuse 2) Sexual Abuse 3) Emotional/Psychological- threats, verbal/nonverbal, intimidation 4) Neglect: caregiver fails to provide basic needs 5) Financial Abuse: unauthorized use of older person's resources: money, credit card, pension 6) Self-Abuse: older person threatening his/her welfare |
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What are some behavioral warning signs of child sexual abuse?
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1) regression to infant behaviors EX: bed wetting
2) Fears/ anxiety 3) Knowing sexual information inappropriate for age 4) Delinquent behavior: EX: running away, absences from school 5) problems relating to peers, School difficulty |
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Forms of Abuse?
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1)Physical Abuse: physical injury
2) Child Neglect; failing to meet child basic needs Examples: lack of food, shelter, proper supervision, no doctor visits, excessive absences from school 3) Sexual Abuse: exposing or subjecting a child to sexual contact, forcing sex or sexual acts on a child 4) Emotional Abuse: psychological, verbal, mental injury |
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In an initial Session, a social worker should?
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1) Explain the social worker role
2) explain confidentiality and limits 3) client has right to refuse treatment (Client self Determination) 4) build rapport with client 5) find out clients view of the problem |
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Hypomania
What disorder is it related to? |
Bi-polar
Hypomania: less severe form of mania May feel very good, highly productive person may not perceive behavior as a problem BUT those who know client notice change -Not severe enough to interfere with functioning |
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Children with Mania are more likely to have what symptoms?
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-more irritable
-destructive tantrums -children have fast mood swings between mania (elevated mood) and depression. |
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Dystonia, a side effect of which type of drug?
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Side Effect of Antipsychotic drugs
-Dystonia- sudden and painful muscle stiffness, Muscle spasms Ex: Valium has this side effect |
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Terms to Know:
Somatic |
Related to body
think physical symptoms |
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Terms to Know:
Premorbid |
before the start of an illness
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Group Polarization
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-when decisions or opinion of people in a group become more extreme than actual private belief
-Could be good or bad extreme EX: A group of fairly cautious people when placed in together were ask to make a decision. They make a much MORE cautious decision then they would have if asked individual and not in a group. |
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Group Think
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person will set aside own personal beliefs and take group's opinion
-prefer to keep the peace -people tend to agree with the group to avoid rejection or fear to disrupt group harmony -Leads to poor decision making (need different opinions to make decisions) |
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What is Therapist role in group psychotherapy?
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- The facilitator- helps each member change their behavior through interpersonal experience( interacting with group members)
- SW should allow the group to come to resolutions and resolve conflicts -Modeling "adaptive" behaviors to group -If group members challenge leader- "Its ok" remain consistent allow group to deal with conflict together |
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Things to keep in mind working with Asian/ Pacific Islanders
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-Hierarchial Family Structure
-High respect for elders -Elders are Decision- Makers -Usually seek help from within family -Strict rules and roles -Father is head of household, wife has very low status *Common to complain of Somatic concerns- emotional problems expressed through physical complaint (headaches, body pain) |
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Things to keep in mind with working with HIspanic/Latino clients
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-Roman Catholic
-Extended family system (godparents, informal adopted children) -Male have greater power and authority (Machismo) -Shame when seeking mental health assistance -Excessive emotionality when in crisis |
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Native American/Alaskan Natives
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-Respect for Elders
-Tradition of Oral Story Telling -Avoid eye contact as sign of respect -use traditional healing (medicine man, shaman or spiritual leaders as natural healers) - |
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What are common reason Native American clients seek treatment
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*High Suicide
Alcoholism Family problems Adjustment issues |
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Common reasons Asian/Pacific Islanders seek help
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-Family Conflict
-Dissociative Disorders -PTSD |
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Ethnocentrism
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belief that your own culture, race or ethnic group is more important than others
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Institutionalized Discrimination
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Government or organizations that have laws or policies and operate in a way that fail to meet the needs of certain races or exclude certain races.
Ex: Achievement gap in education in low income areas Stop and Frisk, targets racial profiling |
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What is the goal of group therapy?
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-Instillation of Hope: seeing people who are coping or recovering gives HOPE to those at beginning stage of the process
-Universality: "Not in this Alone" -Altruism: group members are able to share their strengths and help other boost SELF-ESTEEM -Existential Learning: working in a group helps group members accept responsibility for actions/choices, ability to accept difficult realities (death, divorce etc.) -Interpersonal Learning: Improve relationship skills, improve ability to relate to other |
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Stages of Group Development
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1. Preaffiliation or "forming:"
-Group members have anxiety, mixed feelings about group, seek GUIDANCE/LEADERSHIP from group leader 2.Power and Control or "Storming" -competition and conflict among group members -group concerned with authority of leader 3. Intimacy or "Norming" -group members develop a BOND -Develop trust and structure -More openness, more COHESION 4. Differentiation or "Performing" -express individual differences -improved group skills in analyzing and working through problems -open exchange of feedback -more mature, productive 5. Separation or "Adjourning" Termination |
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Indicators of physical abuse
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-bruises
-burns -bite marks -whiplash (Shaken Baby Syndrome) Fractures |
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Indicators of Child Neglect
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-lack of adequate medical/dental care
-poor personal hygiene -child is dirty - not dressed appropriate for weather -left home alone -unsanitary environment/living conditions -Fire hazards -Children fend for own nutritional needs |
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If a Client express attraction to Social Worker, what should be done?
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1) validate client without acting
2) explore with client the underlying reason for attraction/feelings 3) Document Discussion 4) speak to supervisor and get feedback |
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Ethics
Social Worker witness co-worker "slacking" under-performing with client due to stress (personal problems, substance abuse, psychosocial distress) what do you do? |
1st: talk/approach to colleague about witnessed behavior
2nd: promote self-care and encourage to seek help 3rd: if colleague IGNORES: report it (supervisor, agency, NASW) |
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Somatoform Disorders
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-presence of physical symptoms without medical reason for symptoms
-Emotional problems in the form of physical symptoms Symptoms: -pain -headache -sexual problems (erectile dysfunction) -diarrhea -nausea *Not faking |
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Defense Mechanism
Reaction Formation |
-When experience situation too painful or threatening- turn it into opposite
EX: person experiences a sudden loss of family member and is laughing and demonstrate happy mood. |
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Malingering
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faking a mental or physical illness in an effort to avoid an unpleasant consequence or to achieve goal or reward.
EX: Faking psychosis to avoid jail time |
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Defense Mechanism
Denial |
-Hiding feelings
-do not acknowledge the problem -conscious |
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Defense Mechanism
Sublimation |
-Turning bad behaviors/thoughts into positive activities
-healthy redirection of an emotion Ex: Taking an kickboxing class, instead of taking out anger on friends |
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Displacement
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-taking out anger, feelings, impluses on another person INSTEAD of real person you have an issue with.
-Place unwanted/unpleasant feelings onto someone less threatening or innocent bystander |
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Defense Mechanism
Splitting *relates to which disorder? |
*Borderline Personality
-People are "all good" or "all bad" Ex: " She's a great therapist".....Next session "She's horrible therapist" |
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Defense Mechanism
Isolation of Affect |
Show no emotions when confronted with difficult events
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Projection
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-taking your emotions and placing it onto others
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Defense Mechanism
Repression |
Forgetting what happened or details of what happened
-removing painful thought from memory |
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Defense Mechanism
Introjection |
-to identify characteristics of a person and incorporate then into one's own self
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Defense Mechanism
Undoing |
taking back one's unwanted behaviors through praise and gifts
EX: making up for yelling at your kids, you buy them toys |
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Defense Mechanism
Regression |
going back to earlier developmental stage or Infant-like state
Ex: " 9 year old bed wetting after mother bring homes newborn." |
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Major Depression
Duration? |
Duration: symptoms must be present for 2 week period
*must cause impairment in functioning or Activities for daily living (ADLS) (changes in social life, work, school) - Depressed mood -loss of interest in activities (nearly all day or daily) |
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Key symptoms of Depression
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-no interest or pleasure in activities
-weight gain/ weight loss -loss of energy (always tired) -sleep a lot or insomnia -no appetite -thoughts of death with or without plan -difficulty concentrating |
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Depression in Children or Adolescents
Duration? Symptoms? |
-Duration: Dysthmic Disorder (long term depression) Child/adolescents have symptoms for at least 1 year
-Symptoms: -irriable mood -Fail to make expected weight gain (underweight for age/height) -*high suicide for Teens |
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Exogenous Depression
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Caused by external events (outside factors)
Psychosocial stressors: Trauma, poverty, death of parent |
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Endogenous Depression
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Due to internal reason, such as biochemical imbalance
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SSRI's are used to treat...
Name a few |
Depression
-Anti-depressants -2nd generation Common SSRI: Prozac Zoloft Paxil |
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Sensate Focus
What type of intervention? |
-Behavioral intervention
-used for couples/ sex therapy -used to desensitize couples that have performance anxiety -couples provide each other with pleasurable message for sensory stimulation then paired with gradual sexual contact |
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Termination
What is social worker role? |
- Social Worker and client look if goals have been accomplished
-Evaluate ( have symptoms decreased?, client stable? *always look at client's baseline vs. present to determine termination Review with client, steps or skills learned to use if presented with similar problem |
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Social Work Technique
Reframing |
-stating a problem in a different way so client can see possible solutions
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Rational Emotive Behavior Therapy
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-uses a confrontational approach/ Short-term
-Structured -Looks at changing negative thoughts and improve coping skills ABC's A--> What started things off, looks at situation circumstance B--> Triggers- how the event triggers one's thoughts, negative self-talk C--> create reaction-poor coping, fear, anxiety, phobia depression |
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What is a paradoxical Directive?
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when social worker tells client to continue acting in destructive/maladaptive ways with goal of bringing awareness and change.
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Social Work Intervention
Confrontation |
-only used with an established client ( client who is engaged)
*Never aggressive -point out to client recent behaviors or use of defense mechanism (denial, rationalizing bad behaviors) Point out resistance in treatment ( missed appointments, frequent lateness, avoiding, incomplete homework assignments) |
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Social Work Techniques
Partialization |
Taking a clients overwelming thoughts and statements and breaking it down into smaller more manageable parts.
-Prioritizing clients problems (SAFETY 1st) |
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Mandated reporter
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Social Workers are responsible for reporting any instance of abuse that he/she SUSPECTS.
-Child Abuse (physical, sexual, neglect) -Elder Abuse |
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Social Work Process
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1) Engagement: Why is client here? client view of the problem? explain SW role, Confidentiality limits, Client right to self- determination, non-judgemental stance
2) Assessment: what are client's strengths/weaknesses, stressors, historical reasons for having problems in life, history of mental health?, Family history 3) Planning: Client an worker come up with plan to solve problem 4) Evaluation: have the goals been accomplished? is client ready to end services? how do you measure goals? (better behavior, stable in community, housing, medication compliance, symptoms decreased) 5) Termination client reaches goal and no longer needs service |
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MASLOW Hierarchy of Needs
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MOST IMPORTANT
1) Physiological need/SAFETY: - food, shelter, basic needs to survive 2) Safety needs: -needs to be safe from danger or harm -need stable environment -needs predictability THEN 3) Love and Belonging -need to be assured -need unconditional acceptance 4) Ego/Esteem -need to feel satisfied, valued, respect for self and others *Important for teens/adolescents 5) Self Actualization( LIFE GOAL of Adulthood) -on-going process -dealing with what the worlds is not how it should be -to be content with life choices |
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Bi- Polar Disorder
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Mood disorder
-must have mania and depression symptoms -causes severe impairment in normal activities and relationships -standard of treatment =MEDICATION |
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Manic Symptoms
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-begins suddenly, intensify over few days
-rapid shift in mood from overly happy to anger -elevated mood (not normal self/mood) -no sleep but full of energy -loud/rapid speech -changes topic quickly when speaking - |
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Most common type of Dementia
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60-70% of case are Alzheimers Disease
-progressive -changes in brain -affects memory, social and intellectual ability -Affects daily functioning |
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According to John Bowlby what age is does child have Separation Anxiety?
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12 months/ 1 year
-"normal" behavior and age after that Problem |
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At what age do infants begin spoken communication?
If there is a speech delay should.... |
18 to 24 months typical toddler begins spoken language.
Speech delay *refer to get hearing testing *refer for medical evaluation |
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Working with Domestic Violence Client, Social Worker should
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1) get history and Develop a Safety plan for client experience abuse
2) refer to battered women's shelter, attorney 3) Build trust with client (non-judgmental stance, validate feelings) 4) empower client to obtain economic, social, work support outside of abusive relationship |
