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LSW Test


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3 Primary Duties re: Ethics
Duty to Protect Best Interest of Client
Duty to Honest Disclosure
Duty to Provide Treatment
Aptitude and Achievement Test
The Peabody Individual Achievement Test
The Wide Range Achievement Test (WRAT)
Emotional barriers that protect and enhance the integrity of individuals, subsystems and families
Mental activities of which we are fully aware
The psychological isolation that results from overly rigid boundaries around individuals and subsystems in a family
A conflict created when a person receives contradictory messages in an important relationship, and cannot leave or comment
Mediator between id and superego (between internal and external reality)
Minuchin's term for loss of autonomy due to a blurring of psychological boundaries
Erikson's Stages
Trust v Mistrust (0-18mo)
Autonomy v Shame/Doubt (18-36mo)
Initiative v Guilt (3-6yr)
Industry v Inferiority (6-11yr)
Identity v Role Confusion (Adolescence)
Intimacy v Isolation (Early Adulthood)
Generativity v Stagnation (Middle Adulthood)
Integrity v Despair (Late Adulthood)
Social Justice
Dignity and Worth of Person
Importance of Human Relationships
Family Drawing
An experiential therapy technique where family members are asked to draw their ideas about how the family is organized
Family myths
Beliefs of all family members based on a distortion of reality that help shape the family rules
Family rules
Expectations of how family members are expected to behave
Freuds Stages
Oral (0-18mo)
Anal (18-36mo)
Phallic (3-6yr)
Latency (6-11yr)
Genital (11-19yr)
A schematic diagram of the family system
squares = men
circles = women
horizonatal lines = marriages
vertical lines = children
Identified Patient
The symptom bearer as identifed by the family
Intelligence Tests
Weschler Adult Intelligence Scale (WAIS) (16+)
Weschler Intelligence Scale for Children (WISC) (5-15)
Weschler Preschool and Primary Scale of Intelligence (WIPPSI) (4-6 1/2)
Accepting and accommodating to families in order to win confidence and avoid resistence
Primitive drives and instinctual needs
Mahler's Stages
Normal Autism (0-2mo)
Normal Symbiosis (2-6mo)
Hatching (6-9mo)
Practicing (9-18mo)
Rapproachment (15-36mo)
Object Constancy (36+mo)
Neuropsychological Tests
Bender Gestalt Visual Motor Test (5-adult)
Orgasmic Disorders
Female Orgasmic Disorder
Male Orgasmic Disorder
Premature Ejaculation
A self-contradictory statement
Paradoxical directive
A technique used in strategic therapy whereby the therapist directs family members to continue their symptomatic behavior. If they conform, they admit control and expose secondary gain. If they rebel, they give up their symptoms
Parentified Child
A child who has been allocated power to take care of younger siblings; adaptive when done deliberately in large or single family homes, maladaptive when it results from unplanned withdrawal of parental responsibility
Objective Personality Tests
Minnesota MultiPhasic Personality Inventory (MMPI)
Projective Personality Tests
Adults: Rorschach and Thematic Apperception Test (TAT)
Children: Child Apperception Test (CAT), House-Tree-Person, and the Kinetic Family Drawings
Piaget's Stages
Sensorimotor (0-2yr)
Preoperational (2-7yr)
Concrete Operations (7-11yr)
Formal Operations (11+yrs)
Thoughts and feelings which can be brought into consciousness easily
Relabeling a family's description of behavior to make it more amenable to therapeutic change
Sexual Arousal Disorders
Female Sexual Arousal Disorder
Male Erectile Disorder
Sexual Desire Disorders
Hypoactive Sexual Desire Disorder
Sexual Aversion Disorder
Sexual Pain Disorder
Thoughts, feelings, desires, and memories of which we are unaware
Adapting to the events of the environment
Antipsychotic Meds
The integration of external elements into the evolving structure of the organism
Case manager
Person at the HMO, PPO, or insurance company that manages the benefits and the providers
Common Side Effects of Meds
Dry mouth
Blurred vision
Weight gain
Sexual dysfunction (decreased libido)
Movement disorders (pacing, grimacing, rigidity, tremors)
Primitive defense; inability to acknowledge true significance of thought, feelings, wishes, behavior, or external reality factors which are consciously intolerable
Dependent variable
Clinical condition (depression, anxiety, etc)
Defense mechanism frequently used by persons with narcissistic personality organization which is the consequence of omnipotence; split of primitive idealization
Directing an impulse, wish, or feeling toward a person or situation not its real object, thus permitting expression in a less threatening situation
Ethical Decision Making
Understanding legal duties
Understanding values/ethics of Social Work
Identifying legal and ethical implications
Logical ethical decision making process
Health Maintenance Organization
Hollis Typology of Categories of Interventions---Direct: Client-Social Worker Communication
1. Sustainment
2. Direct influence
3. Exploration, description, ventilation

4. Person in situation reflection, including self evaluation
5. Pattern-dynamic reflection
6. Developmental reflection
Hollis Typology of Categories of Interventions---Indirect: Environment Interventions
1. Resource development or provider of services
2. Interpreter of or mediator between client and environment
3. Intervene in the environment
Overestimation of admired aspect or attribute of another
Universal mechanism whereby a person patterns self after significant other
Independent variable
Treatment intervention
Intervening variable
Generally will be "meds" on test
Isolation of Affect
Unacceptable impulse, idea, or act is separated from its original memory source, thereby removing original emotional charge
Medically necessary
Condition must be determined to be "medically necessary" in order for there to be reimbursement
Mood Stabilizers (anti-depressants)
Tofranil (imipramine)
Lithium (adults) Depakote (adolescents): used with Bipolar manic phase, sometimes in conjunction with an anti-depressant
Non-network provider
Out of network provider; usually reimbursed at a lower rate but fewer accountability requirements
OCD Meds
SSRI Anti-depressants, particularly Zoloft and Paxil
Other Therapeutic Communication Skills
Point of Service; usually refers to a type of managed care contract
Preferred Provider Organization
Approval to provide service; based on a determination of "medical necessity" by case manager
Primary Care Physician
The physician who serves as the gatekeeper; all non-routine care must come through the PCP
Primary Process Thinking
1. Disregards logical connections between ideas
2. Permits contradictions to exist simultaneously
3. Lacks concept of time
4. Wishes are represented as fulfillment
Primitive defense; attributing one's own disowned attitudes, wishes, or feelings to an external object
Reaction formation
Person adopts affects, ideas, attitudes, or behaviors which are opposite of those he harbors consciously or unconsciously
Reality testing
Accurate perception of external environment and internal world
Partial or symbolic return to more infantile patterns of reacting or thinking; can be in service to the ego
Acting out the parts of important characters to dramatize feelings and practice new ways of relating
A member of the family, usually the identified patient, who is the object of displaced conflict or criticism
Action sequence and behavior patterns; organization and adaptation
Secondary Process Thinking
1. Follows reality principle
2. Postpones gratification
3. Replaces wish fulfillment with appropriate action on the environment
4. Goal directed
Sedatives (Anti-anxiety agents)
Valium (Diazapam)
Klonapin (Benzodiazine)
Self Awareness and Self Understanding
Understanding the influence of family of origin
Understanding the influence of current situational factors
Assessing one's self esteem
Assessing one's acceptance of others
Assessing one's assertiveness
Assessing readiness for social work practice
Defensive mechanism of borderline personality organization which manifests as self or others being seen as all good or all bad.
Stimulant (ADHD) Meds
Talking and Listening Basic Interpersonal Skills
Voice and speech
Body language
Listening: hearing, observing, encouraging and remembering
Active listening
General Systems Theory
Based on the concept of a system as interacting parts contained within a boundary (family system unit)
Steady state order necessary for movement
When output from systems is put back into the system
General Systems Theory: Implications for Practice
1. Problems are defined in transactional terms
2. The unit of attention includes the relevant related systems
3. Humans are active, purposeful, goal-seeking organisms whose development and functioning are outcomes of transactions between their genetic potential and their environment
Goodness of fit with the environment; this is a continuous process
Environmental demand perceived as challenge and associated with positive feelings or discrepency between demand and capacity for coping with it associated negative feelings
Psychological, physiological and behavioral response that is set in motion as result of the experience of emotional stress.
A point of development where there is a failure to resolve conflict
Psychoanalytic Treatment Goal
To resolve intrapsychic conflict; treatment involves dealing with the repressed material in the unconscious using clarification, confrontation, interpretation, and working through
Psychoanalytic Theory
Individual is viewed as a product of his past
Ego Psychology (Erikson)
Personality develops as a result of interaction with and mastery of the social environment with a progressive development throughout the life cycle.
Ego Psychology Treatment
Geared to enhancing the effective and efficient functioning of the ego in managing internal and external stress
Object Relations Theory (Mahler)
A development of a consolidated sense of self as the result of separation and individuation of the self from the love object (mother).
Object Relations Substages
Object Constancy
Object Relations Treatment
Geared to enhancing the self-object differentiation
Moral Development Theory (Kohlberg)
Parallels cognitive development in that the child cannot achieve higher levels of moral reasoning until achieving higher levels of cognitive reasoning; can have cognitive without moral, but cannot have moral without cognitive
Moral reasoning based on avoiding punishment and to serve one's own needs
Moral reasoning based on the need to look good in one's own eyes and the eyes of others
Belief in greater moral principles and a sense of personal commitment to doing what is right, regardless of individual needs.
Stages of Death and Dying (Kubler-Ross)
Social Role Theory (Basic Themes)
1. Certain behaviors are prescribed relative to our position in that system.
2. Every role involves both our own expectations and abilities as well as the expectations of others
3. Social functioning may be seen as the sum of roles performed by the human system
4. The concept of role, role functioning, role expectations, and role transactions may be used to increase the knowledge base for the assessment of the problem situation
Role Ambiguity
Role expectations are unclear
Role Conflict
2 or more opposing views on role definition
Role reversal
Roles are opposite to that which previously existed
Locus of control
the extent to which an individual believes that life events are under his own control (internal locus of control) or under the control of external forces (external locus of control)
Social Authority or Power
Coercive: power from control of punishments
Reward: power from control of rewards
Expert: power from superior ability or knowledge
Legitimate: power from having legitimate authority
Three Basic Assumptions of Communication Theory
1. One cannot NOT communicate
2. All human communication is multi-leveled
3. The message sent is not necessarily the message received
Contradictory communication
Offering 2 or more contradictory messages on the same communication level
Incongruent communication
Offering 2 or more contradictory messages on different communication levels
Ambiguous communication
Verbal and nonverbal communication do not give the receiver adequate information upon which to formulate an adequate response
Paradoxical communication
Giving one message and acting out another
Stimulus-response dilemma
Communication based on the premise that one is simply being reactive to the other therefore is not fully responsible for the communication
Overload at the content level
Too much information provided at one time or the information sent cannot be responded to appropriately because of the split content
Based on the assumption that all human living is a problem-solving process. An inability to cope is due to some lack of motivation, capacity or opportunity to solve problems in an appropriate way. Treatment is reality based.
Treatment Actions in the Problem Solving Approach
1. To release, energize and give direction to the client's motivation.
2. To release and then repeatedly exercise the client's mental, emotion and action capacities for coping with his problem and/or himself in connection with it
3. To make accessible to the client the opportunities and resources necessary to the solution of the problem
Problem Solving Approach Looks at the 4 P's in the process of change
Place (agency)
Process (therapeutic relationship)
Psychosocial Approach (Hollis)
People are seen in the context of interactions or transactions with the external world. A formal medical, psychological and social history are obtained, and the diagnosis is based on this history.
Psychosocial Treatment
Differentiated according to needs of clients and results in a modification of the person, environment, or both, and of the exchange between them. Uses all developmental theories and integrates various aspects of all relevant treatment modalities.
Crisis Intervention (Golan)
Process of actively influencing the psychosocial functioning of individuals during a period of disequilibrium. A state of crisis is time limited (usually 6-8 weeks). Brief intervention during a crisis usually provides maximum therapeutic effect. Social Worker is active rather quickly
An upset in a steady state. Crisis is defined by the client. Feelings of hopelessness may be present and ego patterns may be more open to influence and correction.
Goals of Crisis Intervention
1. Relieve impact of stress with emotional/social resources
2. Return to previous level of functioning
3. Help people strengthen coping mechanisms during the crisis period and develop adaptive coping strategies
Brief and Planned Short Term Treatment
Restricts duration to 8-12 sessions
Uses interventions from learning theory and behavioral modification to promote completion of a well-defined task
Primary aim is to quickly engage clients in the problem-solving process and maximize their responsibility for treatment outcome
Task-Centered Treatment
Offers a pragmatic approach in which the problem is partialized into clearly delineated tasks to be addressed consecutively.
Client must be able to acknowledge a precise psychosocial problem, the solution to which is either a specific change in behavior or a change of circumstances.
Assessment focuses on helping client identify the problem that is of primary concern; circumstances surrounding the problem are explored and specific tasks evolve from this process.
1. Assessment
2. Set goals
3. Define tasks
Time-limited Psychotherapy
Addresses the client's emotional reactions to a strictly time-limited process that makes optimal use of the role of the "doctor-patient" relationship. Uses a non-negotiable time-limited contract.
Behavioral Approaches
1. Goal is to modify behavior
2. Focus is on observable behavior
Respondent or Classical Conditioning (Pavlov)
Learning occurs as a result of pairing a stimulus with an involuntary response so that the stimulus eventually elicits the conditioned response
Operant Conditioning (Skinner)
Antecedent events precede behaviors which, in turn, are followed by consequences. Consequences which increase the occurences of the behavior are referred to as reinforcing; consequences which decrease the occurence of the behavior are referred to as punishing.
Systematic desensitization
Anxiety-producing stimulus is paired with relaxing response so that eventually anxiety-producing stimulus produces a relaxation response.
In vivo desensitization
Pairing and movement through hierarchy takes place in "real" setting
Aversion Therapy
Any treatment aimed at reducing the attractiveness of a stimulus or a behavior by repeatedly pairing it with aversive stimulation of a real or imagined nature
Sensate focus
An in vivo desensitization and communication-enhancement procedure used in sex therapy that involves the couple providing each other with pleasurable sensory stimulation through a structured body message (pleasuring)
Squeeze technique
A procedure for delaying ejaculation
Positive reinforcement
The worker praises, gives tokens, or otherwise rewards positive behaviors
Negative reinforcement
Behavior increases because negative (aversive) stimulus is removed
A procedure for gradually changing one stimulus controlling a behavior to another stimulus
Cognitive Approach
Human functioning is seen as the product of reciprocal interaction between personal and environmental variables.
Emphasis is placed on cognitive skills from problem solving.
What a client says to himself influences his behavior and feelings.
Certain thoughts cause certain behaviors and certain behaviors cause certain thoughts.
Cognitive Treatment
1. Gaining understanding of, and communicating from, the client's system of meanings.
2. Initially accepting the "internal validity" of the client's personal views and understanding what maintains them.
3. Gradually facilitating the client's ability to consider other possible meanings by putting the same facts or situations into other conceptual or emotional frameworks
4. Building client awareness of the possible inaccuracies of their cognitive appraisals
5. Focusing the attention on client's expectations and interpretations of events.
6. Helping the client construct alternatives, more adaptive meanings, expectations, and self instructions
7. Providing experiences that give evidence to support changed views and counter old ones (task assignments and behavioral experiments)
Rational Emotive Therapy (RET)
A cognitively-oriented therapy in which the therapist seeks to change the client's irrational beliefs by argument, persuasion, and rational re-evaluation, and by teaching the client to counter self-defeating thinking with new, non-distressing self statements.
Experiences are not isolated but are part of a perceptual system of interdependent factors
Gestalt Treatment
Here and now
Often used with groups as well as individuals
Family Therapy
Views the family as a system of interacting parts in which change in any part affects the functioning of the whole. The family is the unit of attention for diagnosis and treatment. Social roles and interpersonal interaction are the focus. Real behaviors and communication that affect the current life situation are emphasized
Goal of Family Therapy
To interrupt the circular feedback of pathological communication and behaviors, then replace it with a new pattern that will sustain itself without the dysfunctional aspects of the original pattern
Issues in Family Therapy
Establishing a contract with the family
Examining alliances and groupings within the family
Where the power resides
Relationship of each family member to problem
How does the family relate to outside world
Family history as related to interaction in current behavior
Communication patterns: complementarity, symmetrical
Family rules that regulate patterns of interaction
Meaning of presenting symptom in current family homeostasis
Flexibility of structure and accessibility of alternative action patterns
Family's development stage
Sources of external stress and support
Family homeostasis
Interventions in Family Therapy
Define family stages and tasks
Address emotional cutoff
Redefine family rules
Restructuring roles
Structural Family Therapy (Minuchin)
Stresses the importance of family organization for the functioning of the group and the well-being of its members.
Family Structure
The invisible set of functional demands organizing interaction among family members.
Multi-generational Approach (Bowen)
Pathology in current family relationships is seen as unfinished business in family of origin relationships. Problems are fusion among family members and inadequate individuation
Goal of Multi-Generational Approach
To increase differentiation of individuals within the family and avoid the need for triangulation
Strategic Family Therapy (Haley/Palo Alto Group)
Presenting problem is viewed as a symptom of and a response to current dysfunction in family interaction.
Goal of Strategic Family Therapy
To solve the particular problem that is presented. The symptom is regarded as a communicative act that is part of a repetitive sequence of behaviors among family members, serving a function in the interactional network.
What does Strategic Family Therapy focus on?
Problem resolution by altering the feedback cycle that maintains the symptomatic behavior
What is the worker's task in Strategic Family Therapy?
To formulate the problem in solvable, behavioral terms and to design an intervention plan to change the dysfunctional family pattern.
A treatment approach in which roles are enacted in a group context. Members of the group recreate their problems in living and devote themselves to the role dilemmas of each member.
Group Psychotherapy
Treatment of patients with mental illness: uncovering procedures, the achievement of insight into unconscious motivations, and other intrapsychic processes.
Stages of Group Development
Pre-affiliation (Forming): development of trust
Power and control (Storming): struggle for individual autonomy and group identification
Intimacy (Norming): utilizing self in service of the group
Differentiation (Performing): acceptance of each other as distinct individuals
Separation/termination (Adjourning): independence
Factors in Group Cohesion
Group size: optimal 5-10
Homogeneity: similarity of group members
Participation in goal and norm setting for group
Interdependence: dependent on one another for achievement of common goals
External threat: increases cohesiveness
Member stability: frequent changes in membership decreases cohesiveness
Contra-indications for group treatment
Client in crisis
Compulsive need for attention
Actively psychotic
Primary Prevention
To prevent: aimed at reducing the prevalence of a problem by reducing the incidence of new cases; creating environments that promote mental health
Secondary Prevention
To treat symptoms: reduce prevalence by reducing the duration through early detection and intervention
Tertiary Prevention
To reduce disability in chronic problems: reduce duration of problem by reducing negative after effects

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