Application of theoretical concepts Flashcards

Question

Aging and the challenges?

Answer 1

- Stressing over loss of jobs due to retirement, reduction of independence, decrease of ability to perform daily activities, loss of friends and relatives due to death, uncertainty of importance, impending loss of their own lives. - Stress due to unfinished business- goals. - Depression is common and higher risk of suicide. - Integrity Vs. Despair- Erick Erikson

Answer 2

- The honeymoon period (closeness, falling in love, bonding over similarities). - Passionate, nurturing, and selflessly strive to please the other (Difference minimized). - Challenge of this stage, each individual's idealistic views toward the other person and the relationship.

Answer 3

- Couples address their difference and find ways to resolve conflict. - Negotiating differences and supporting each other's needs when the couple doesn't agree is an important challenge. - There is an ongoing process of defining the self and managing the anxiety of intimacy and separation or loss resulting from self-expression. - Enmeshment can also occur by becoming hostile and dependent. - When the couple cannot separate and resolve difference, conflict escalates into constant arguing and bickering. - Breakups are common during this stage.

Answer 4

- Couples explore independence, nurture outside relationship, and develop self-esteem and competence separate from the relationship. - Characterized by the redirection of a person's attention, time, activities away from the partner and towards self. - Difficulties of this stage include- controlling each other's individual interests/ activities.

Answer 5

- Reestablishing intimacy. - Partners are able to show openness and vulnerability and seek to comfort and support one another. - Sex life usually deepens during this stage.

Answer 6

- Couples embraces intimacy, recognizes that they can come together and be stronger than each member is alone. - Constancy is the hallmark of this stage. - Able to value and respect the separateness of other. - Experience the wholeness and intimacy that comes from the ability to trust and from the knowledge that one is loved. - Foundation of the relationship is the appreciation and love of the other and support and respect for mutual growth.

Answer 7

- The notion that ppl do not exit in a vacuum. - The essential elements of the social structure created w/in a family do more to shape a person's life - Family system theory is a philosophy that looks at interaction of members in the family system rather than individual etiology (cause or manner of causation of a disease or condition) to account for causes of behaviors.

Answer 8

- Homeostasis refers to maintaining balance and, in a sense, what is normal for a particular family. - A systems attempt to maintain the status quo - Is comfortable in maintaining at its present level even if one considers the family to be extremely dysfunctional. - A change in the family system means that the family must readjust to accommodate that change. - Changes perceived to be positive can have stressful consequences on the family system.

Answer 9

- External boundary- separates the family “inside” from the neighborhood and community surrounding. Boundary can range from being fluid to extremely rigid. The nature of the external boundary will impact the functioning of that family system. - Family subsystems- includes internal boundaries such as siblings groups, family members of the same sex, or of the same generation. The communication and interaction of the subsystems will trigger changes in the larger family system. - Alignments- Are similar to subsystems but may occur across subsystems. And often serve to carry out developmental tasks or to meet emotional needs of the system. - Roles- all family members have roles w/in the family. While some roles may not be individually functional, the roles, rigid or fluid are a part of the overall functioning of the family system. - Rules- Family members establish rules that dictate how family members relate to the external environment and each other. Can be implied or implicit, such as the ‘unwritten rule”, that you do not talk about the mental illness of an aunt or uncle. Can be explicit and clearly delineated, such as a parent’s conscious decision to never argue in front of the children. - Power distribution- The ability to make decisions and resolve conflicts is instrumental in the functioning of a family. Family members have certain patterns of power and influence w/in the family, which create order when critical family decisions require action. - Communication- All behavior is communicative. Body language, eye contact and even silence portray a message. Communication is a critical element of the family system

Answer 10

- Independence- This phases starts when a young adult starts out on his or her own. The primary task of this stage is the differentiation of the young adult from his or her family of origin and the establishment of intimate peer relationship. - Coupling- selecting a partner and adjusting to the life as a couple is an important part of this stage. A great challenge for many in this phase is the negotiating of family origins issues into the new family system. In a functional relationship, both partners will understand the importance of their own family of origin issues and will create new family system based on a joint agreement. - Parenting (Infants- Adolescent)- Families with children spend much of the family life cycle in this state. Parenting infants and young children; parenting school aged children; parenting adolescents. Regardless of the uniqueness of this stage relates to meeting the needs of each child as his or her developmental age. Parents are in a specific phase in which much of their time, energy, and resources are focused on nurturing and supporting the growth of their children. - Launching Adult children- This stage commonly referred to as the Empty nest. Parents in this stage focus on re-establishing the marital relationship as well as career needs and goals. - Retirement/ Senior years- This family life cycle is often marked with the addition of members into the family system whether they are spouses of grown children or grandchildren. This stage also marks the time when the family prepares to lose members (spouses, friends, and siblings)

Answer 11

- Family life cycles, and even the issues encountered by families, can vary greatly depending on cultural and ethnic differences. For example- the number of “three generational” families in Mexican-American culture is significantly more prevalent than that of Anglo-Americans. It is always important to consider the unique nature of each family.

Answer 12

- Events such as marriage, birth of a child, and divorce. Moving into a new home, which typically involves packing and changing schools is a normal life crisis. Leaving a job and accepting a new position also results in a normal crisis. Death of a loved one is considered a normal life crisis. Grief is not a disease; it is a normal part of losing a loved one. Grief is a long, difficult process, but in time becomes more manageable.

Answer 13

- Stressful life events can contribute to illness. - Death of a spouse or child - Divorce - Marital separation - Detention in jail or other institution - Death of an immediate family member - Major personal injury or illness - Marriage - Being fired from work - Marital reconciliation - Retirement

Answer 14

- Major change in health or behavior of family member - Pregnancy of spouse/ partner - Sexual difficulties - Gaining a new family member - Major business readjustment - Major change in financial state (significant increase or decrease in income) - Death of a close friend - Changing to a different type of work - Major change in the number of argument with spouse (i.e. increase or decrease) - Taking on a significant mortgage

Answer 15

- Foreclosure on a mortgage or loan - Major change in responsibility at work - Son or daughter leaving home - In-law troubles - Outstanding personal achievement - Partner beginning or ceasing work outside of the home - Beginning or ceasing formal schooling - Major change in living conditions (e.g. new house, renovating) - Revision of personal habits (e.g. dress, exercise) - Troubles with the boss

Answer 16

- Change in residence - Changing to a new school - Major change in usual type and/or amount of recreation - Major change in church or spiritual activities - Major change in social activities (e.g. number of social events) - Taking on a small loan (e.g. car, home remodel) - Major change in sleeping habits - Major change in number of family get-together (i.e. increase or decrease) - Major change in eating habits (e.g. a lot more or less food intake) - Holiday or vacation - Minor violations of the law (e.g. traffic or parking infringement)

Answer 17

- Disbelief - emotional numbing - nightmares and other sleep disturbances - anger, moodiness, irritability - forgetfulness - flashbacks - survivor guilt - hypervigilance - loss of hope - social withdrawal - increased use of alcohol and drugs - isolation from others

Answer 18

- People first begin to recognize that there is a threat. - Next, these individuals discover that the stress and trauma of the event cannot be dealt with using existing coping skills. - Ppl then begin to experience fear, confusion, and stress. - Those facing a crisis begin to exhibit symptoms of distress and discomfort. - Finally, ppl enter a state of imbalance where crisis situation seems insurmountable.

Answer 19

- Are expectations of behavior in the presence of others and are often governed by social and cultural norms. - If a person's behavior in a social role is reinforced, self-image is likely to be enhanced. - If behavior in the social role is punished or negatively viewed, self image may suffer.

Answer 20

- Usually the result of family services organizations removing children from their biological parents due to abuse, neglect, drugs, problems with the law, severe emotional and behavioral problems, and parents' inability to care for their children. - Children are usually placed in foster care, residential facilities or with other relatives. - Some research findings indicate that displaced children experience psychological and emotional risks, disruptive emotional bonds with parents, poor school adjustment, decreased academic achievement, higher levels of suspensions from school, rage, grief, sadness, and despair.

Answer 21

- Of a child can result in significant, long-lasting problems, including: mental health problems, behavioral problems, substance abuse, relationship difficulties, increased likelihood of developing Reactive attachment disorder- RAD. - RAD- individuals are unable to form normal and needed emotional bonds with caregiver or others. - Adults who are abused as children are more likely to abuse their own children- perpetuation the cycle of abuse. - Typical perpetrators- child's parents, or primary caregiver. - Children of an economically disadvantaged, young, single parent are most at risk to be abused. - Other factors that contribute to child abuse- family stress, social isolation, medical problems of the child, family violence, alcohol and drug abuse, parental personality (eg. low tolerance or low empathy), and crises

Answer 22

- Obvious effects- welts, broken bones, burns, and internal injuries. Hand mark or belt mark. - Wearing inappropriate clothes. - Some injuries may result in permanent physical and mental damage and sometimes results in death. - Children can exhibit fear, withdrawal, anxiety, anger, behavioral problems, aggression, poor social skills, and poor problem solving skills. - The most common perpetrator of physical abuse of a child under 14 is the female parent. - SW's, and other mental health wrkrs, teachers, healthcare professionals, and doctors are required by law in all states to report child abuse.

Answer 23

- Can result in significant emotional/psychological and behavioral problems for a child being abuse and often times the child will became a perpetrator him/herself, sexually abusing other children. - Perpetrators are usually men and known by their victims. - Life-long problems with intimacy, self-image, sexual acting out, aggression, withdrawal, phobias, sleep disorders, and eating disorders may require professional help to overcome. - Sexual abuse may result in physical injuries and the transmission of STD.

Answer 24

- Trouble walking or sitting - sexual inappropriateness - avoidance of a specific person w/o reason - running away from home - reluctance to change clothing in front of others - sexually transmitted diseases or pregnancy under the age of 14

Answer 25

- slower than normal physical development as a result of malnourishment - delayed mental development due to lack of stimulation - illnesses and medical problems that are a result of lack of medical attention - poor school performance due to frequent absences - poor social skills and lack of friends resulting from the child's dirty and unkempt appearance and lack of proper clothing - emotional problems resulting from the aforementioned problems - lack of parental supervision and improper living conditions - death as a result of starvation and exposure

Answer 26

- poor self esteem - insecurity and anxiety - relationship problems - inability to trust or predict the future - delays in speech and language skills - fearfulness, withdrawal, distrust, anxiousness to please - involvement in criminal behavior - substance abuse

Answer 27

- Is typically inflicted by family members and occurs in a variety of forms including verbal, emotional and physical, the wrongful taking of assets or exploitation, and neglect (the most commonly reported form of abuse). - Factors that may contribute to abuse include poverty, substance addictions, and difficulty holding down a job. - Middle- aged caretakers may become abusive in response to the challenge of juggling work, care of dependent children and care of an elderly parent. - Elder abuse occur in nursing homes and other institutional settings. - SW's should report elder abuse to police or adult protective services.

Answer 28

- argumentative, non-compliant or resistive with care - hostile, verbally abusive, aggressive/combative behavior - cognitive impairment - mute - manipulative or intrusive - history of substance abuse - incontinence

Answer 29

- alcohol/ drug abuse, untreated mental illness - financial problems - excessive absenteeism - poorly trained - family problems - power conflicts - role reversal: looking for the elder to fill caregiver needs

Answer 30

- elder needs cannot be met by the service provider - frequent "reorganizations" poor communication between administration and staff - high personnel turnover, insufficiently paid staff, high overtime demands laced on the paid caregivers - crowding of vulnerable adults - inadequate or uniformed response to abuse when initially reported - inconsistent and unclear expectations of caregiver, lack of adequate training for caregivers, absence of clear role definitions for caregivers

Answer 31

- unexplained bruises or welts - multiple bruises in various stages of healing - unexplained fractures, abrasions, and lacerations - low self-esteem or loss of self-determination - withdrawn, passive, fearful - reports or suspicions of sexual abuse - social isolation - malnourishment or dehydration - unkempt appearance - lack of glasses, dentures, or hearing aides, if needed - failure to keep medical appointments - inappropriate or soiled clothes - disappearance of possessions - forced to sell house or change one's will - overcharged for home repair - inadequate living environment - forced to sign over control of finances - no money for food or clothes

Answer 32

Characteristics that link to different forms of abuse: - In most cases, the perpetrator is known to the victim - Most sexual abusers are male and their victims are female. the perpetrator seek out or exploit opportunities to have unsupervised contact with potential victims. They "groom" the potential victim by spending time with them, buying gifts or doing special favors. - Physical or emotional abuse or neglect is more likely to be unplanned and influenced by features of the care environment. - Perpetrators of financial abuse are often opportunistic, but some cases are predatory, seeking out vulnerable people and situations in which theft is not likely to be discovered or hard to prove.

Answer 33

- Is an individual's ability to adapt to adverse conditions (such as disasters). - Individuals have developed coping skills that allow them to effectively navigate around or through crises. - A resilient person have an optimistic attitude and positive emotions and are able to balance negative emotions with positive ones.

Answer 34

- Resilience is a process, not a trait. - Factors are: the ability to make realistic plans and taking steps to follow through with them; a positive self- concept and confidence in one's strength and abilities; communication and problem-solving skills; the ability to manage strong impulses and feelings; supportive and caring relationships both within and outside the family

Answer 35

- Maintain good relationships with family members, friends, and others - Avoid seeing crises or stressful events as unbearable problems - Accept circumstances that cannot be changed - Develop realistic goals and move towards them - Take decisive actions in adverse situations - Look for opportunities of self-discovery after a struggle with loss - Develop self-confidence - Keep a long-term perspective and consider stressful event in a broader context - Maintain a hopeful outlook, expecting good things and visualizing what is desired - Take care of one's mind and body, exercising regularly, paying attention to one's needs and feelings.

Answer 36

Provides the basis for treatment of individuals, group, and families confronted with stressful events that exceed their coping abilities.

Answer 37

- Hazardous event- an "upset in a steady state (state of equilibrium) that poses an obstacle, usually important to the fulfillment of important life goals or to vital need satisfaction, and the individual (of family) cannot overcome through usual methods of problem solving." (Caplan in Hepworth, Rooney, and Larsen, 1997) - A crisis is generally defined as short-term and overwhelming.

Answer 38

- Situational, which is a stressful event (e.g. seeing someone decapitated) - Maturational, which is a developmentally-based crisis (e.g. starting school) - Crisis due to cultural values or societal factors (e.g. homosexuality in a heterosexually- oriented society)

Answer 39

- To reduce the impact of the crisis situation in the present (reduce symptoms) - To assist the individual in more effectively responding to the impact of the stressful event via the mobilization of the individual's internal (psychological) and external (e.g. social, financial) resources - Restoration to at least pre-crisis level of functioning

Answer 40

- It is typically initiated by a hazardous event. - The homeostatic balance of the individual is disrupted, leaving him in a vulnerable state. - The individual attempts to regain his balance first by use of his usual problem-solving methods then attempts to develop and use new coping strategies. - A precipitating factor that sends the person into an active state of crisis, comprised of disequilibrium and personal disorganization. - The stressful initial and subsequent events are experienced as a threat (to innate needs, autonomy, or sense of well-being), a loss (of someone or something), or as a challenge (to the survival or growth of the individual). - If the crisis is experience as a threat, the Clt's anxiety tends to escalate. As a loss, the Clt often manifests depression, a sense of deprivation or mourning. As a challenge, the Clt many express moderate anxiety, hope, and positive expectation.

Answer 41

- A crisis in not pathology; it is a situation that causes a person to feel great internal struggles. - Sometimes stirs up unresolved conflicts from the past, which results in an inappropriate reaction or overreaction. - Fixation at a stage or the failure to pass through a specific phase can reveal the basis that individual's inability to deal with the crisis situation. - Active state of crisis and disequilibrium is time-limited, typically lasting between 4 and 6 weeks. - Inadequate help during the active stance may result in the development of inadequate maladaptive behavior or coping patterns. - If basis needs are met, such as physical resources necessary for life, then the individual can handle most situations. Food and shelter are important basic needs. Other needs include a sense of personal identity, a mutually supportive and close relationship with at least one other person, membership and acceptance in at least one group and one or more roles that promote a sense of self-respect and dignity. And financial security.

Answer 42

- The individual experience a crisis or precipitating (cause or situation to happen suddenly, unexpectedly, prematurely) event. - The individual expresses increased tension and shock, possible denial of the crisis situation, and failure of customary coping skills. - The individual experience sharply escalating tension, varying levels of depression, and feelings of being overwhelmed, confused, helpless or hopeless. - The individual attempts to use different means of coping; maladaptive, which may result in emotional collapse or suicide, or they are adaptive, which results in the Clt regaining a new equilibrium at the same level of higher than the pre-crisis level of functioning.

Answer 43

Phase I- Formulation of problem/ crisis identification (often completed in first interview) The SW elicits the Clt's reaction to what happened and the role the Clt and others played in the event. The SW determines the nature and duration of the vulnerable state (e.g. early and later efforts to cope, including previous assistance received or sought). The SW assesses the present or active state of the crisis, evaluate the Clt's current life circumstances, develops a contract of joint activities including goals and related tasks, and establishes a specific, concrete, working plan of activities.

Answer 44

Phase II- Implementation phase (first to fourth interviews) SW gather all necessary information from the Clt including obtaining additional background data relevant to the Clt's current life situation and the crisis event. The SW identifies current and pre-crisis past themes. The SW intervenes to bring about a behavior change, learns how the Clt has coped in the past and outcome of previous coping efforts. The SW and Clt develop specific action-oriented tasks to achieve short-term goals.

Answer 45

Phase III- (last interview or two) The SW and Clt make the decision to terminate treatment. If no agreement was made, the SW recommends less frequent meetings and discusses a termination plan with the Clt. In the last meeting or two, the SW reviews progress including key themes and affective issues. The SW also summarizes tasks completed to date, goals reached, and work yet to be completed. The SW discusses the Ctl's future goals and objectives. The SW communicates that treatment is the crisis situation is completed, while at the same time letting the Clt know that additional services are available in the future, if needed.

Answer 46

He suggested that SW do: 1. Conduct a thorough biopsychosocial and imminent danger assessment 2. Rapidly establish rapport with the Clt. 3. Identify the major problems or crisis precipitants. 4. Deal with the Clt's feelings and emotions. 5. Generate and explore alternatives or new coping strategies. 6. Restore functioning through implementation of an action plan. 7. Plan a follow-up time to meet with the Clt.

Answer 47

- Philosophy of Karl Marx and Max Weber - Society actually is held together through conflict rather than function. - It is argued that groups w/in society are born from conflict rather than playing a specific functional role. - Social relationship as viewed through the Conflict theory model, are about power and exploitation. - There is an ever present economic value placed on relationships as one tries to improve his or her own status at the expense of another person. - It is also believed that groups in power, for example, the wealthy, place rules and laws to further perpetuate and reinforce their status. Other groups, e.g. labor unions, the poor, create an uprising that is "the conflict" that results in social change. - Conflict theory does not have to relate only to social change, it can also relate to conflicts around ideologies and philosophy.

Answer 48

- Teaching Clts the skills to successfully resolve conflicts is a necessary life skill. Core principles: - Listen actively: active listening includes not only what the person is saying but intonation (rise and fall of voice) and body language. - Think before reacting: reacting quickly causes damage to the relationship. There is a need for considering potential outcomes before reacting. - Attack the problem NOT the other person: When emotions are high it is difficult to not attack the other person. What is the underlying reason for the emotion? - Accept responsibility: Acceptance for the individual's part in the conflict. - Use direct communication: Focus on "I" messages to express wants, needs or concerns. Avoid the use of "you" messages. - Look for common interests: What is important about the conflict to all parties? - Focus on the future: What do the parties want to do differently?

Answer 49

- What does each party really want or need? - What does each individual think the other side really wants or need? - What could satisfy the interests of the other side? - Of all the alternatives, which is the best and most realistic option? - Identify and list as many possible options to resolve the issue. - Prioritize each option - Estimate the cost of not resolving the conflict - If the person cannot get everything he wants, what can the person live with in order to obtain a resolution now?

Answer 50

Types of trauma and violence: - Sexual abuse or assault includes unwanted or coercive sexual contact, sexual exploitation or exposure to inappropriate sexual material or environment. - Physical abuse or assault is actual or attempted physical behavior that causes serious physical injury or death - Emotional abuse or psychological maltreatment includes verbal abuse, emotional abuse and excessive demands or expectations that cause an individual to experience conduct, cognitive, affective, or other mental disturbances. This type of abuse can also include acts of omission such as intentional social deprivation or neglect. - Neglect is failure to provide an individual with basic needs, medical or mental health treatment, or prescribed medications. Neglect can also occur when exposing someone to dangerous environments, abandoning a person or expelling someone from home. - An unintended injury or accident from a serious accident, illness or medical procedure that causes extremely painful or life-threatening event may also be traumatic. - Victim or witness to community violence involves exposure to extreme violence in a community, such as gang-related violence, interracial violence, police and citizen altercations, and other forms of destructive individual and group violence. - Victim or witness to domestic violence involves exposure to a pattern of abusive behavior in a relationship that is used by one partner to maintain power and control over another intimate partner. The abusive behavior can include physical, emotional, sexual, or economic actions or threats. - Historical trauma is the cumulative emotional and psychological wounding as a result of group trauma that has been transmitted across generations

Answer 51

Types of trauma and violence: - School violence is the violence that occurs in the school setting, which includes school shootings, bullying, interpersonal violence among classmates, and student suicide. - Bullying is defined as unwanted, aggressive behavior among school-aged children that involves real or perceived power imbalance and the behaviors are repeated over time. Consequences of bullying include mental health issues, substance use and suicide. - Natural and manmade disasters resulting from a major accident, manmade or natural event can result in trauma. - Forced displacement is a type of trauma that occurs when people face political persecution and are forced to move to a new home (e.g. Native Americans who were historically displaced from their homes, refugees fleeing violence or political upheaval). - War, terrorism, or political violence. - Military trauma: the impact of deployment by the military members or family can be traumatic - Traumatic grief or separation may include death of a partner or sibling, homicide or suicide, death of a close friend or other family member, which is experienced as traumatic. - System- induced trauma and re-traumatization results when systems that are designed to help individuals and families actually cause trauma (e.g. child removal from a home, sibling separation, multiple foster placements in a short period of time, seclusion and restraint).

Answer 52

- Individuals may experience the same event but their responses may be significantly different. - Traumatic response is shaped by a number of factors including genetics, previous life experiences, and support systems. - Survivors need to be respected, informed, connected and hopeful regarding their own recovery. - There is a interrelation between trauma and symptoms of substance abuse, eating disorders, depression and anxiety. - It is important to work in a collaborative manner with survivors, family and friends of the survivor, and other human services agencies. - The SW's interaction should empower survivors and consumers.

Answer 53

Proposed by SAMSHA- The Substance Abuse and Mental Health Services Administration 1. Safety: Individuals feel physically and psychologically safe. Interpersonal relationships promote a sense of safety. 2. Trustworthiness and transparency: Organizational decisions are conducted with transparency and trust among staff and Clts. 3. Peer support and mutual self-help: This principle is a key vehicle to building trust, establishing safety and empowerment. 4. Collaboration and mutuality: Power difference between staff and Clts are minimized. There is a recognition that healing occurs in meaningful sharing of power and decision-making. 5. Empowerment: Individual strengths are recognized and validated and new skills are developed. 6. Voice and choice: A recognition that every individual's experience is unique and requires an individualized approach. 7. Resilience and strength based: A belief in the resilience and ability to individuals, organizations and communities to heal and promote recovery. 8. Inclusiveness and shared purpose: Everyone has a role to play in a trauma-informed approach. 9. Cultural, historical and gender issues: The organization actively moves past stereotypes and biases, offers gender responsive services, values traditional cultural connections and recognizes and addresses historical trauma. 10. Change process: The process in conscious, intentional and ongoing, constantly responding to new knowledge and developments.

Answer 54

- Addiction and Trauma Recovery Integration Model (ATRIUM): brings together peer support, psychosocial education, interpersonal skills training, meditation, creative expression, spirituality and community action to support survivors in addressing and healing from trauma. - Essence of Being Real: This goal is to promote relationships rather than focusing on the trauma. It s a peer-to-peer approach intended to address the effects of trauma, which is particularly helpful for survivor groups, first responders and frontline service providers and agency staff. - Risking Connection: Emphasizes empowerment, connection and collaboration. It addresses issues such as understanding how trauma hurts, using relationship and connection as a treatment tool, working with dissociation and self-awareness, and transforming vicarious traumatization. - Sanctuary Model: Assists children who have experienced interpersonal violence, abuse, and trauma. It is intended for residential treatment settings for children, public schools, domestic violence shelters, homeless shelters, group homes, and outpatient and community- based settings. The intention is to create a healing environment that improves efficacy in the treatment of traumatized children, reduces restraints and other coercive practice, and improves staff morale and retention. - Seeking Safety: Consists of therapy for trauma, PTSD, and substance abuse and can be used in a variety of settings. It focuses on ideals to counteract the loss of ideals in both PTSD and substance abuse, plus knowledge of cognitive, behavioral, interpersonal and CM interventions. - Trauma, Addiction, Mental Health and Recovery (TAMAR): Is a structured, manualized 10- week intervention combining psycho-educational approaches with expressive therapies. The focus is on the symptoms of trauma, current functioning, symptom appraisal and management, impact of early chaotic relationship on healthcare needs, development of coping skills, preventive education regarding sexually transmitted diseases and sexuality, as well as help in dealing with role loss and parenting issues. - Trauma Affect Regulation: Guide for Education and Therapy (TARGET): Is an educational and therapeutic approach for the prevention and treatment of complex PTSD. It provides practical skills that can be used by trauma survivors and family members to de-escalate and regulate extreme emotion, manage intrusive trauma memories experienced in daily life, and restore the capacity for information processing and memory. - Trauma Recovery and Empowerment Model (TREM & M-TREM): Is intended for trauma survivors, particularly those with exposure to physical or sexual violence. The model is gender specific. It can be used in mental health, substance abuse, co-occurring disorders, and criminal justice settings.

Answer 55

- Implications for SW practice include identifying risk factors and taking safety precautions. - SW should ask direct questions, such as, "Has any adult used physical force or threatened another adult in the home? Who used physical force or threatened whom?" - Indicators of domestic violence may include- physical/ sexual assault, child abuse, injuries, evidence of intimidation, emotional abuse, isolation, threats and stalking. - Safety is the primary concern for the Clt. As such, the SW should assist the Clt and children in getting to a safe place immediately. - Risk factors for women include depression, anxiety, PTSD, and substance abuse. Children esp. boys who witness violence between parents or caregivers are more likely to perpetrate (carry out/ commit) domestic violence as adults. - It is not uncommon for individuals to stay in the abusive relationship for reasons such as emotional or economic dependency; guilt associated with breaking up a family; the belief that violence is an inevitable and legitimate part of a close relationship; social and physical isolation from others who could provide support; commitment to the partner; embarrassment to tell others; a hope that things will get better; and fear that the perpetrator will respond with increased violence. - Domestic violence is often associated with drinking.

Answer 56

Domestic violence can arise in response to conflict that a couple experiences where the motivation is to gain control in the situation rather than to control the relationship in general. Either party may perpetrate this kind of violence in the heat of conflict. - Cycle of Abuse- Four phase model: Phase I- Tension Building is a phase in which the breakdown in communication occurs, after which the victim becomes fearful and experience the need to calm down the abuser. Phase II- Incident is a term used to describe the verbal, emotional and/or physical abuse that occurs. This stage involves feelings of deep anger, blaming and sometimes threats and intimidation. Phase III- Reconciliation: is the the phase where the 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 aka "the honeymoon phase". Used to describe the phase in which the incident is forgiven and in one's mind no abuse is taking place.

Answer 57

- Another type of trauma and violence of vulnerable population.

Answer 58

- Runaway and homeless youths - Foreign nationals - Children and adults who are coerced or forced into sexual or labor services, and children who are used in various forms of pornography. - Victims of trauma, sexual assault, domestic violence, social discrimination, and war. - Individuals living in poverty - Individuals who have previously been sexually abused by parents, step-parents, boyfriends, or older siblings. - There appears to be on single profile for victims of trafficking according to the Department of Health and Human Services, Administration for Children and Families, Office on Trafficking in Persons (OTTP), and Department of Justice Attorney General.

Answer 59

- The person appears disconnected from family, friends and community. - If a child/ adolescent, has stopped attending school; has engaged in commercial sex acts, chronic runaway/homeless youth, excess amount of cash in their possession, hotel keys/ key cards, lying about age/ false ID, sexually explicit profiles on social networking sites. - Has had a sudden or dramatic change in behavior - Appears to b e disoriented or confused, or shows signs of emotional abuse - Has bruises in various stages of healing or other signs of physical abuse - Has untreated sexually transmitted diseases - Is fearful, timid or submissive - Is unable to access food, water, sleep, or medical care - Defers to another person who accompanies him/her and seems to be in control of the situation; the person appears to be coached on what to say. - Ties to protect pimp/ trafficker from authorities - Lacks official identification documents - Has tattoos/ branding on the neck and or lower back. - Avoids eye contact, social interactions, and authority figures. - Has unsuitable and unstable living situations; living at place of employment. - Is not allowed to go into public alone. - Resides somewhere with abnormal or unusual security measures.

Answer 60

- They have many needs including safety, medical care, counseling, social services and legal services. - SW's are in a position to id victims of trafficking and link them with the services. - The trauma of trafficking can lead to lifelong emotional problems that affect many aspects of an individual's life functioning.

Answer 61

- A "physical or psychological craving for a drug" (Macionis, 2005). - Drug use is often a contributing factor in domestic violence cases. - Drug addictions are costly, draining the family budget or leading the addicted individual to commit criminal acts as a means of securing the funds necessary to support the addiction. - Individuals who are addicted to drugs may be unable to maintain employment. - Individuals with substance addictions are often in denial about the magnitude of their problem. - Co-dependent- other family members who may engage in behavior that maintains the addiction. Their behavior may include, covering up for the substance abuser's problem behavior and even providing the abuser with substances to keep the peace. - Children of substance abusers often have difficulty trusting others and are frequently thrust into the role of caretaker of the addicted parent. Commonly these children drop out of school and engage in delinquent behavior leading to issues with the legal system. Oftentimes they develop drug addictions themselves.

Answer 62

- Disease Model: Addiction is a pathological (compulsive/ obsessive) condition characterized by signs or symptoms, which are exhibited by most individuals. The model views the addition process as chronic and progressive. - The Moral Model: The individual has a defective spirit and weakness of character. A person who possesses moral strength would have the strength to stop addiction. The model has little sympathy for the people what have chronic addictions. Temperance Model: The individual is powerless against the addiction; abstinence is the only salvation. If the person with an addiction believes in a higher power, they possess the strength to resist the use of alcohol. Genetic Theories: Rates of addiction are higher among relatives than the general population.

Answer 63

Personality Theory: Addiction is the result of an addictive personality characterized by high levels of impulsiveness, aggression, emotionality, agitation, frustration, ineffectual coping mechanism to stress, and a need to be in complete control but feels powerless and hopeless. Psychodynamic Theory: Problem drinking is associated with ungratified needs and how the individual learned to satisfy those needs in childhood. Humanistic Experience- Individuals use alcohol to satisfy a need for power. Intoxication is accompanied by thoughts of increased social and personal power. The exposure Model: Based on the assumption that the introduction of a substance into the body on a regular basis will inevitably lead to addiction. The substance causes metabolic adjustments requiring continued and increasing dosages of the substance in order to avoid withdrawal.

Answer 64

Behavioral/ Learning Theory: Excessive use of substances is a learned behavior. Substance provide individuals with immediate reinforcement in the form of reduced anxiety, improved mood, and avoidance of withdrawal symptoms. The role of the environment is significant as is the process of socializing and observing behaviors of role models. Tension- Reduction Hypothesis: Substances reduce anxiety, fear and other states of tension. The reduction of tension then leads to addiction through negative reinforcement. Cognitive Theory: Addiction results from the belief that substances use will reduce tension or will act as a euphoriant. Sociocultural Theories: Social and cultural factors determine levels of alcohol consumption. In the US, alcohol use is generally considered a normative and socially acceptable behavior. Biopsychosocial Models: Addition involves the interaction between biophysical, psychological and sociocultural factors.

Answer 65

- The current focus is on neurobiology and brain research which id the pleasure center of the brain reinforcing the addiction. - Addiction, once thought to be only substances (alcohol, drugs), have expanded to pornography, gambling, hoarding, and excessiveness in eating, shopping and the use of electronic devices. - There are no treatment practice that is effective with all addiction. There is evidence that certain treatment strategies are effective with certain types of addictions. - One of the strengths of the mental health system, including SW, is that there are multiple services and types of treatments available for addiction. - When making an accurate assessment and recommending treatment strategies, SWs need to consider the following Clt factors: Needs, History, Personal resources, Motivation level, Supportive system.

Answer 66

- Individuals with chronic issues are able to hide their gambling behavior for a while from family and others. As the addiction become more problematic, the individual's life begins to unravel. - Spending increased time, money, and conversation around gambling. - Claiming the ability to stop at any time, but unable to do so. - When not engaged in gambling, the individual is restless and irritable. - Continuing to gamble despite negative consequences. - Salaries and savings disappear and the individual often borrows money from others. - Attempting to gamble himself/herself out of financial difficulties. - Persistently lies about their gambling, despite feeling helpless against gambling. - Missing social obligations and other responsibilities. - Key relationships in the person's life start to suffer.

Answer 67

- For most ppl, there is a healthy relationship with food because it's a source to promote life. For others, food becomes an uncontrollable craving that leads to excessive consumption resulting in physical, emotional, and social consequences. Food, drug and alcohol addictions are similar in that the individual has uncontrollable cravings that lead to excessive behavior, in this case, eating. Typically these foods are salty, sugary or carbohydrate rich foods. - An inability to control cravings or the amount of food consumed. - Trying many different weight loss programs while still excessively consuming food. - Engaging in purging behavior (vomiting, laxative use) to avoid weight gain. - Avoiding social interactions because individual lacks control of his/her eating. - Stealing food from others - Obsessing over food and how the food is being prepared or served. - Feeling ashamed about weight. - Feeling depressed or sad about weight or self-image. - Eating as a reward for doing a job well. - Eating when not hungry. - Becoming anxious or irritable when eating certain food, when not eating, or if there does not seem to be enough food.

Answer 68

- Key factor is that the addict feels desperate to have his or her sexual outlet regardless of the consequences. The individual cares more about the act of sex than the other individual involved. A sexual addiction most often manifests in one of the following ways: substituting sex for love or pursing different, varied, or extreme sexual activities that are focused on the sex acts, rather than any type of connection between two people. - Sex dominates the individual's life to the exclusion of other activities. An inability to contain sexual urges and respect the boundaries of others involved in the sexual act. - The individual engages in phone and computer sex, use of prostitutes, pornography, or exhibitionism. - The individual has multiple partners or cheats on partners. - The person practices unsafe sexual practices. - In extreme cases, the person engages in criminal activities ( stalking, rape, incest, or child molestation). - The individual feels guilt and shame. - The individual has a pattern of recurrent failure to resist impulses to engage in extreme acts of lewd sex. - The individual makes several attempts to stop, reduce, or control behavior.

Answer 69

- Excessive use of the Internet, which interferes with functioning in other areas of life such as relationships, education, work, physical health and emotional well-being. - An individual repeatedly goes online to avoid real work responsibilities or difficulties and this avoidance results in even more problems in his or her life. - Addictions to video games, pornography, Facebook/social network sites, online gambling, or online entertainment. - Frequent feelings of guilt after speeding too much time online. - Great difficulty avoiding the internet for recreational us for consecutive days. - Often losing track of time when online. - Strong feelings or frustration or tension when unable to go online. - Unreasonable justification for unhealthy levels of use. - Downplaying the negative effects of excessive internet use. - Loss of interest and participation in hobbies or activities that were once enjoyed - Feeling calm, content, or happy only when online. - Preoccupation with going online when engaged in other activities (i.e. neglecting other important responsibilities, and decreased time spent with family and friends) - Experiencing negative mood when not on the internet - Headaches, neck aches, back problems - Irregular, unhealthy eating habits - Tired, dry and/or red eyes - Occasional marathon internet sessions lasting all day or all night - Multiple attempts to reduce internet use with little or no success - Relationship problems and frequent arguments stemming from one partner spending too much time online - Deceiving others about the amount of time spent on the internet.

Answer 70

- Each family member copes with the addicted family member's behavior in his/her own way. - Unfortunately, most of the coping strategies are dysfunctional and adversely affect the health and well-being of each family member. Potential effects on the family. - Family Rules: Are learned over time and provide stability and safety. When addiction occurs, the family rules adapt to the dynamics of the addiction. Initially family members may minimize or deny that their family member is getting into serious difficulty with drugs or alcohol. As severity increases, family members will spend more time and energy around the addicted person and ignore their own needs. They will avoid confrontation. Slowly the family rules being to change. - Emotional Effects: Includes: Stress- (family members are forced to confront the consequences of the addiction, unpredictability of the person's behavior); Guilt- (family members feeling responsible for the family member's addiction leading to enabling behavior and/or social withdrawal from friends); Anger- (No matter how family member try, the person continues using substances; being overwhelmed with the damage the behavior is causing the family, all leading to anger); Denial and shame- (Stigma attached to addiction, the reality that a loved one is addicted leading to painful feelings of shame.) Children may stay away from home because of the addict's behavior They may feel deprived of emotional and physical support by the addicted parent. They develop the inability to trust others.

Answer 71

- Is to resolve relationships distress and restore overall functioning.

Answer 72

- Attempts to uncover unresolved childhood conflicts with parental figures and early development and their impact on the current interpersonal relationship. - Introjection- which is how the infant processes versions of how the love object (mother or primary caretaker). - Core of this model deals with the process of becoming a separate distinct person from caregiver-child interactions during childhood.

Answer 73

- Is based on the premise that marriage becomes a closed system that inhibits growth through mutual unconscious interactions between partners. - There is a complementary personality fit between couples that is unconscious and fulfills certain needs. - The "mothering figure" is the central motivation for selection and attachment of a mate. - There is a supposition (uncertain belief) is that a partner finds "lost parts" of the self in other partner. - The therapy values affect, silence, body language, fantasy, dreams, and transference as necessary for reaching the unconscious in order to develop insight. - The SW creates a neutral and impartial environment to understand the distortions and internalized conflicts that each partner brings to the relationship that is dysfunctional. And is seen as the agent of change

Answer 74

- Fosters the ability of the couple to communicate important feelings. - Proposes that dysfunction originates from the person's incapability to recognize and validate sensitivities and problems in the relationship. - The two major categories of problems are: (1) dysfunction brought into the relationship from early childhood trauma and experiences (2) the person's reaction to difficulties and sense that he is un-deserving because of shame and guilt.

Answer 75

- Seeks to improve relationships between a couple by increasing the frequency of positive exchanges and decreasing the frequency of negative and punishing interactions. - The model includes the influence of the environment on the relationship as well as the histories of the partners. - The SW assesses both the strengths and weaknesses of the relationship - The belief is that when certain behaviors are reinforced (positively or negatively) they will be linked to the individuals sense of relationship satisfaction. - Skills taught include: expressing themselves in clear behavioral terms, improved communication skills, establishing a means to share power and decision making, improved problem solving skills.

Answer 76

- Focuses on the functioning of the couple. - The couple's negative interactions are believed to be repetitious, which causes the problems in the relationship. - Integrative behavioral SW's help couples improve behavior exchanges, communication, and problem solving skills. - Therapy is individualized, flexible, and based on specific problems in the relationship. - The basic assumptions are: talking about how a partner feels and thinks about problems is sometimes necessary before the partner can accept them. Most partners can learn ways to alter the negative emotional responses they have to problems as well as their partner. Most partners can learn new ways to resolve problems and the emotions that come with them. Couples who succeed in learning new skills can be happy and content.

Answer 77

- Focus on the need to understand the couple's emotional and behavioral dysfunction and how it relates to inappropriate information processing. - Emotional states have an innate (in born; natural) adaptive potential and therapy seeks to discover the negative types of thinking that drive the negative behavior that causes relationship difficulties. - The SW educates and increases awareness about perceptions, assumptions, and standards of interaction between the couple. - Common cognitive distortions with couples are: arbitrary (based on random choice or personal whim, rather than any reason or system) inference- conclusions made in the absence of substantiating evidence, overgeneralization, magnification and minimization a situation is perceived in greater or lesser light than is appropriate, dichotomous (exhibiting or characterized by dichotomy-a division or contrast between two things that are or are represented as being opposed or entirely different) thinking- black or white thinking, labeling and mislabeling, tunnel vision, biased explanation- suspicious thinking; spouse holds a negative alternative motive behind his or her intent, mind reading, selective abstraction- information taken out of context and highlighting specific details while ignoring other information, personalization- external events are attributed to oneself when insufficient evidence exists to render a conclusion.

Answer 78

- Views emotions and cognition (thinking) as interdependent and that emotion drives interpersonal expression. - Has origins in Emotion and Attachment theory. - Relationship distress is believed to be a result of unexpressed and unacknowledged emotional needs. - The basic principles are: relationships are attachment bonds; Partners are seen as coping well, given their current circumstances; Rigid interaction patterns create and reflect absorbing emotional states; Emotions are the target and agent of change; Change involves a new experience of the self. - In 8- 20 short- term sessions, the SW helps couples acknowledge, assess, and express emotions related to the distress in the relationship and then helps the couple to find the underlying emotions that are keeping them stuck in the rigid positions and negative interactions.

Answer 79

- Views a couple's relationship difficulties as a in inability to coupe with environmental or personal life changes. The goal is to facilitate a solution to the presenting problem in the most efficient and ethical manner. - Despite relationship dissatisfaction, the couple will resist change to maintaining the status quo. - Focusing on strengths rather than weaknesses is the key to success. - Pathologizing (regard or treat (someone or something) as psychologically abnormal or unhealthy) is considered to be counterproductive.

Answer 80

- Moving from who is to blame to what can be done - Relationship maintenance - Encouraging conversations outside of therapy that are not happening.

Answer 81

- According to Toseland and Rivas (1995), as a "goal- directed activity with small groups of people aimed at meeting socio-emotional needs and accomplishing tasks... directed to individual members of a group and as a whole within a system of service delivery"

Answer 82

Pappell and Rothman (1980) ID three: - Social Goal Model- originated in settlement houses and neighborhood centers. This goal is to raise social consciousness, social responsibility, informed citizenry and to encourage political and social action. The group leader acts as a role model and enabler. - Remedial Model- is used in clinical outpatient and inpatient settings. The goal of this model is to restore or rehabilitate individuals exhibiting dysfunctional behavior. The group leader is a change agent (facilitate improvement) and utilizes assessment and interventions to assist group members to achieve their treatment goals. - Reciprocal Model- can be used in clinical inpatient and outpatient settings and in neighborhood and community centers. The purpose is to provide mutual aid to group members in achieving optimum adaptation and socialization. The group worker functions as a mediator between members, group, and society to assist all concerned in getting their needs met.

Answer 83

Toseland and Rivas, 1995 - Typically involve formal agendas and/or rules. The goal is to accomplish a specific task. The roles of members may be assigned and communication focuses on the task as hand. It is important that the members of task groups have the requisite interest, knowledge base, and skills to achieve the purpose of the group. Meetings may be private or open, and there is low self-disclosure. The standard for success is the accomplishment of the task.

Answer 84

Toseland and Rivas, 1995 - May have procedures that are formal or informal. The goal is to increase the ability of members to meet their socio-emotional needs. The role of group members naturally evolve through the interaction of members over time. Open communication is encouraged among group members and members are expected to increasingly self-disclose over time. Group members are expected to maintain confidentiality within and outside of the group. The standard for success is the achievement of individual and group goals.

Answer 85

- Support Groups- are comprised of members with a common problem or set of circumstances (e.g. a group for single fathers) who provide each other with assistance in dealing effectively with their situation. - Educational Groups- helps members learn specific information and skills that will be personally beneficial (e.g. a group to educate adolescents about AIDS). - Growth Groups- provide group members with personal opportunities as opposed to remediation (e.g. marriage enrichment group). - Therapy Groups- Provide members with remediation and/or rehabilitation (e.g. a group for adults molested as children). - Socialization Groups- assist members in negotiating developmental stages and adapting to changes in roles or environment (e.g. a group for new immigrants).

Answer 86

- An alteration in the social order of a society, that can be driven by forces such as culture, religion, economics, technology, science, and politics. Social change can occur in social institutions, nature, social behavior, or social relations. Theorists have presented ideas about how social change happens naturally, as well as when an organization or entity intervenes to make change happen.

Answer 87

- The most notable theorist was Karl Marx, who believed that social organization was determined largely by economic factors and that social movements or revolutions were the result of tensions in society. Identified in clusters: - Theories of Functionalism- are used to describe the linear models of social change that re associated with the Theory of order and stability or Equilibrium theory. It is proposed that social change happens in an effort to restore equilibrium for the survival of the system. - Conflict Theories- recognize the inherent strains in social structures that result in inequality, which is the source of conflict. Conflict may be caused by cultural clashes, unregulated events such as terrorism, economic conditions, random violence, and other conflicts that result in movements that create change. Interpretive Theories- define social change not in terms of events, but in terms of how one interprets those events. These interpretations are defined and shaped by the meanings that the events have for the individuals which are frequently influenced by culture. Those meanings vary form one individual to the next. The interpretation then affects future actions and relationships. Interpretive theorists view society as an ongoing process of human interaction rather than a structure or an entity.

Answer 88

- With an attempt to influence social change through the Settlement Movement, which assisted immigrants with living and employment needs. - Attention was focused on poor working conditions, economic reform and obtaining basic services for people in need.

Answer 89

- The goal of SW is "to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty. A historic and defining feature of SW is the profession's focus on the individual well-being in a social context and the well-being of society". (NASW, 2008, revised 2017)

Answer 90

- Social services programs and polices, government, and non-profit agencies. Significant social programs such as SS, Medicare, MA, civil rights, anti-poverty programs, veteran's services, and many others were developed through the the process of social planning by the federal government. - Relied on research, existing theories about services, and successful programs that had been created by local jurisdictions, states and foreign government. - Not-for profit agencies, community groups, and local planning councils engage in planning to respond to community needs and to improve the quality of life in communities. - Social planning in community settings may also be referred to as neighborhood planning. - Social planning is considered by some a model of community organization, along with community development and social action. Is considered to be separate and distinct from clinical practice, although clinical SWs may be involved in agency level planning. Planning involves gathering information, "diagnosing" the problem, and formulating a treatment plan that is appropriate for the situation.

Answer 91

- A controversial concept in social change. - Many decisions that are made on a policy level are made by the "haves" of society, which usually include the powerful and the wealthy. The "have-nots" are those who are poor, disenfranchised (deprive (someone) of a right or privilege, marginalized ((of a person, group, or concept) treated as insignificant or peripheral. and discriminated against, and are typically the Clts whom the profession of SW serves. - SW have a desire and a responsibility to include Clt systems in macro practice, yet that inclusion needs to be honest and genuine. - Grassroots (the public, esp. the voters, and those who provide the basic support for a political movement or social change) social change efforts involve citizens who are aware of the unmet needs of their community. These citizens need to be heard and have their input seriously considered. - Real citizen participation can result in social change and policy formulation that truly meets the needs of the community. The vulnerable and disenfranchised Clts who have not been involved in the solutions to their problems may feel powerless. SWs, as social change agents, must become facilitators of action rather than perpetuators of the status quo.

Answer 92

- Is best described as the norms, values, codes of conduct, traditions, informal and formal laws, and cultural practices that have existed for years and form the framework of a society. - Racism, sexism, ageism, etc., demonstrate the impact that social institutions have on a society in an attempt to control certain segments of the population. An example of this impact, the effects of social institutions on the raising incidence of suicide among homosexual youth. - Social institutions (S.I) affect other members of the population in similar ways. any individual or group that is different from the norm may be affected in negative ways. S.I were established to support society and maintain stability, but sometimes that structure becomes hurtful to to those citizens who function outside of the "norm". SW have the responsibility to work with social institutions to educate the public and change those practices that are destructive.

Answer 93

- The family- is the social institution whose function is to nurture and protect children, and is a significant factor in an individual's development. If a homosexual youth feels unsupported in his or her family, or fears rejection if his or her sexual orientation is exposed, this could lead to consideration of suicide. If the youth comes form an abusive or dysfunctional family, the risk increases. - The Religion- is the social institution that has a great impact on the lives of those who subscribe to religious beliefs and participate in religious practices. Many religions condemn homosexual behavior and consider it to be sinful, immoral, and evil according to their belief systems. For homosexual youth who remain active in their faith, they may face an internal conflict without the help of their religious leader. This difficult religious dilemma has resulted in cases of suicide as a way out. School- is a social institution that can be a hostile environment for gay and lesbian youth. School is mandatory for most children and youth, and verbal harassment and physical abuse by other students often goes unpunished. Many schools are not allowed to educate students on the subject or sexuality and many do not know how to deal with gay and lesbian issues in the school setting. Social demands to be heterosexual in a school setting conflict with the internal orientation of homosexual youth. Often these youths become isolated, withdrawn, alienated, and depressed and may turn to suicide. Bullying of a homosexual youth has resulted in an increased rate of teen suicides.

Answer 94

- Social Youth Organizations- are social institutions that are designed to provide recreation and support for young people, may instead result feel unwelcoming to homosexual youth. These organizations may not have programs that offer support for their orientation and often have policies that forbid the hiring of gay or lesbian staff, who could be good role models for the youth. The myths that pedophiles are gay still remain prevalent even in the evidence that the overwhelming majority are heterosexual. - Health Professionals- can contribute of homosexual youth suicide when they fail to adequately provide mental and physical health services to the youth and their families. Even mental health counselors and therapists may fail to work with the homosexual youth from the youth's perspective and may not open aline of communication that can provide a safe therapeutic environment. This experience may weaken the youth's self-esteem and reinforce society's intolerance of homosexuality, again possibly leading to suicidal thoughts and actions. - The Juvenile Justice System can be especially destructive to homosexual youths. Gay youth who are in custody have little choice in what happens to them. They may be placed in foster homes that are similar to the home from which they came. In may states, gay and lesbian adults are not allowed to become foster parents or adoptive parents, once again denying gay youth good role models. Group homes may not provide the protection and understanding that gay youth need and the youth can be discriminated against and abused by other group home residents.

Answer 95

- Since families are the foundation of society, family life education is instrumental in providing people with information, resources, experiences, and skills intended to improve, strengthen and enrich family life. Family life education also is important in helping families cope with crises, normal life transitions, personal growth, and adjustments to an extended chronic condition of a family member. - Since SWs are trained to view individuals in their social environment, they are especially valuable in providing resources, involving other family members and support systems, and assisting family members in accessing community resources. Family life education programs are available to new immigrants adjusting to their new country, prostitutes needing parenting skills, mothers attempting to regain custody of their children, and prisoners dealing with self-esteem issues, communication and parenting. - The National Council on Family Relations has sponsored a U.S., program to certify family life educators, providing training and certification in ten areas of family life education. They also promote ways in which policymakers can support strengthening families, including research, dissemination (the action or fact of spreading something, especially information, widely) of information in the media, strengthening community mental health organizations, viewing policy decisions through a family impact lens, encouraging organizations and businesses to support family life education and other policy considerations. - The National Resource Center for Permanency and Family Connections has identified numerous organizations and publications directed toward family life education. Many states have established models of practice, strategies plans, and programs to meet the needs of their constituents. SW's play an important role in family life education in direct practice with families, group work, education of the public, policy formulation, research, and other micro, mezzo, and macro SW practice settings.

Answer 96

Community organization refers to work with larger entities, such as citizen groups and directors of organizations in order to: 1. to find solutions to social problems 2. to develop specific qualities in community members, including proactive behavior, self-directness, and cooperativeness 3. to bring about needed changes in the quality of community relationships as well as in the way decision-making power is distributed (Dunham, 1970) Community organization involves planning (identifying problem areas, diagnosing causes, and formulating solutions); organizing (developing the constituencies and devising the strategies necessary to bring about change); and; action (implementation of the selected strategies).

Answer 97

- The community is the CT - Communities may need assistance in learning how best to meet their needs - In the context of a democracy, ppl need to learn the skills that will enable them to work collaboratively with others to eradicate social problems. - The lives of human beings can be enriched by achieving a better balance bw resources available for social welfare and the social welfare needs of community members - The community needs to be understood and accepted as it is. - It is essential to fully involve all elements of the population. - Community organization involves work with various intracommunity entities. - The different elements of a community are interdependent.

Answer 98

Locality development: is the process of utilizing community members to create change. The focus is on building a cohesive community through education, participation, and leadership. This process creates a strong community infrastructure that will be able to respond to its needs. Social Planning- involves studying a problem situation in a targeted community proposing a plan. Foci of planning are coordination of social services, rational problem- solving, research, system analysis, and development of expertise and leadership. Social action- is the use of power and control techniques to bring about change. Many areas of significant social change have been accomplished by aggressive social action (e.g. woman's suffrage, civil rights, social protests, etc.) Social reform- is the process of working with other agencies to create change. SW can be instrumental in rearranging social institutions or changing institutional policies in order to achieve social justice or eliminate structural inequities.

Answer 99

- Poverty (financially disadvantaged population) Roughly 36 million individuals in the U.S., including one-fifth of all children, live in poverty. Numerically there are more Caucasians who are financially disadvantaged, members of many minority groups are over-represented among the financially disadvantaged. Single women with children, are more apt to live in poverty. They are often malnourished and subsequently more susceptible to disease and unable to obtain health insurance. They are more apt to live in hazardous environment and less apt to complete high school, resulting in difficulty securing employment with adequate income. - Suicide- Is the tenth leading cause of death in the U.S. Characteristics associated with suicidal behavior include: 1. a mental disorder, in particular a mood disorder or schizophrenia; 2. alcoholism and substance abuse; 3. certain psychological characteristics including apathy, indifference to treatment, low social involvement, hopelessness, poor pain tolerance, and poor health; 4. inadequate social support; 5. unemployment or retirement; 6. the presence of stressful environment events (e.g. loss of a loved one); 7. being a male; 8. a previous suicide attempt; 9. being gay, lesbian, bisexual, or transgender; 10. family history of suicide; 11. family violence, including physical or sexual abuse; 12. access to firearm; 13. incarceration. - Aging- Some resist the aging process, while others accept it, welcoming retirement and the slower pace of life. The elderly are faced with many challenges as they age, including the death of peers and the physical limitations associated with health issues, such as memory, hearing, and vision problems. Depression often results from these challenges. Over 55% of the elderly suffer from depression, but the elderly are commonly misdiagnosed with Alzheimer's or as having other forms of dementia. - Death- Is typically prolonged with sorrow and grieving. Grieving is considered a normal response to the loss of a loved one rather than a mental disorder, such as one of the depressive disorders. Elizabeth Kubler- Ross: 5 Stages of Dying- D.A.B.D.A Stage 1: Denial- the individual disbelieves that he/she is dying. This stage may be identified as a state of shock that gradually remits (cancel or refrain from exacting or inflicting (a debt or punishment). Stage 2: Anger- this stage is marked by rage and resentment towards others or God and is marked with frustration. Individuals may find it difficult to relate to the dying person. Stage 3: Bargaining- efforts to strike a deal with fate, God, or with others. Stage 4: Depression- deep sadness develops as the dying person becomes increasingly weak and uncomfortable. Fear of death may occur and the individual, as well as significant others, feel a sense of tremendous loss. Stage 5: Acceptance- the individual is often void of feeling. The dying person's struggle against death ends.

Answer 100

The impact of any loss depends on the meaning associated with the loss and is highly individualized. Primary Losses- pertain to personal losses, objects, or jobs. Secondary losses- are harder to recognize and frequently associated with the impact or meaning of the loss. Ex. loss of comfort, companionship, activity, income, an important opportunity, or community connection. Grief- is a natural response to loss. How the individual responds depends on personality, coping skills, life experience, faith, and the nature of the loss. There is no normal time for grieving. Grief may be chronic, delayed, exaggerated (so overwhelmed with grief that they develop major psychiatric disorders), or masked (manifests physical symptoms that may not appear to be related to the loss.) Emotional symptoms- associated with grief and loss are: disbelief, sadness, guilt, anger, fear, relief, anxiety, feelings of loneliness and isolation, or becoming overwhelmed with the loss. Persistent maladaptive thoughts may trigger feelings that can lead to depression or anxiety. Disbelief is often the initial cognitive reaction to the news of a death, especially if the death was sudden. Disbelief is frequently transitory (not permanent), however, if disbelief persists it can turn into denial. Other cognitive responses include confusion, difficulty organizing thoughts, and preoccupation with the deceased. Physical symptoms may include fatigue, sleep disturbance, muscle aches and pains, GI upset, altered appetite, absent-mindedness, and lowered immunity.

Answer 101

- Accepting the reality of the loss. It is important to work through the pain of grief. Ppl can hinder the mourning process by avoiding painful thoughts, using thought stopping strategies, or entertain only pleasant thoughts of the deceased. They may avoid reminders of the deceased. Substances may be used to desensitize the individual's painful thoughts. - Adjusting to an environment where the deceased is no longer present. Taking on new roles and learning new coping skills. - Emotionally relocating the deceased and moving on with life. The individual moves from a relationship with the deceased to an ongoing relationship with memories of the deceased. This allows for the individual to continue with their own lives after the loss.

Answer 102

- SW values and ethics emphasizes the importance of having sensitivity to the many aspects of diversity that are inherent in working with CTs in a global society. - The NASW Code of Ethics (2008) states: 1. SWs should understand culture and its function in human behavior and society, recognizing that strengths that exist in all cultures. 2. SWs should have a knowledge base of their CT's cultures and be able to demonstrate competence in the provision of services that are sensitive to CTs' cultures and to differences among ppl and cultural groups. - One of the strengths of the SW profession ,which enables SW to provide culturally sensitive services, is the profession's long history of advocating for and responding to ppl's differences and the impact of social injustice on their lives. SW should use the SW skills of empathy, caring, and strengths- based assessment and treatment. - Ethnographic approach- study of culture. Culture is viewed as fluid, evolving, heterogeneous (diverse in character or content) and conflictual rather than as static, fixed, cohesive, and unified. Goal of using an ethnographic approach is for the SW to understand the CT's experiences as he or she has felt, lived, and known the experiences (Goldstein, 1994).

Answer 103

1. Attitude of SW - Self-awareness is essential. Acknowledging one's own biases, beliefs, values, limitations, and counter-transference is relation to diverse populations is an initial step that the SW must take. - SW should consider the CTs as individuals first, then as members of a group. No assumptions should be made based on the group they identify with. - SW should understand the differences that exist w/in and across all groups and recognize the strengths of each group and each individual w/in the group. SW should not prejudge which area of culture is relevant or not, instead clarify that with the CT. - The therapeutic relationship can be viewed as a two-way learning encounter for both SW and CT. It may take time to establish trust with a CT from another culture or group. - SW should attempt to understand the CT's distressing experience, as well as the impact of oppression and discrimination in the CT's daily life. - SW should seek to understand beliefs and behaviors of the CT's culture that are in conflict with the laws of the culture in which the CT presently resides. The SW should help the CT understand the laws. - SW should respect the CT's privacy and confidentiality and make every effort to ensure truly informed consent. - A SW cannot refuse to work with a CT solely because of the CT's race, ethnicity, sexual orientation or disability. However, if a SW believes that he/she cannot be effective for a particular reason, the SW should seek supervision and consider referring the CT to another SW. If there are value differences but the SW chooses to work with the CT, the SW must respect the CT's choices.

Answer 104

2. Knowledge - SWs should continually read books and professional journals, attend continuing education workshops, and consult with other professionals in an attempt to understand the many issues and complexities of diverse populations. - Attending activities of diverse population is also a good way to better understand cultural and social values of the various groups. - The SW should ask the CT for clarification of cultural beliefs, values, and behaviors that the SW does not understand. - Since language may be a barrier, the SW should make an effort to learn as much as possible about the CT's native language and utilize an interpreter, if necessary. Even if the SW speaks the same language there can be cultural and regional language differences that the CT can clarity for the SW. - The SW should determine the CT's level of traditional or assimilated acculturation based on the CT's evaluation.

Answer 105

3. Skills of the SW - The art of SW involves skillfully engaging the CT as a partner in the therapeutic process. - The SW should let the CT know that he/she has clinical expertise and some knowledge about the CT's culture but the CT will need to educate the SW further about his/her culture. - Using culturally sensitive language, the SW should introduce the idea to the CT in the first session that he/she will be the cultural guide. - Knowing that the therapeutic relationship is the most important factor in helping the CT, the SW should focus on developing that relationship by using many of the basic principles and skills of SW practice. - In some cases it is beneficial to match the CT with a SW of similar background, but this is not always possible or necessary. The SW can acknowledge the differences b/w him /herself and the CT and discuss with CT any past experiences that the CT may have had which may contribute to negative transference. - Therapy styles may need to be modified when working with a diverse CTs. For example, if a CT comes from a culture that discourages confrontation and speaking one's mind, assertiveness training may not be the best tool to teach the CT. - The SW should make sure that the CT agrees with the treatment goals and the goals do not conflict with the CT's belief and values. - In the first interview the SW should offer specific recommendations to the CT that can be immediately helpful. - The SW should utilize the CT's cultural resources (e.g. family members, cultural network) in treatment planning. - The SW should be attuned to variation in non-verbal behavior, (e.g. lack of eye contact) and not misinterpret that behavior or diagnose pathology.

Answer 106

Is one of the ways in which SW can ascertain the "meaning" of a CT's cultural experiences. This action allows SW to depart from the traditional technique of listening for the underlying "feelings" associated with the CT's words to listening for the underlying "cultural meanings". Communication techniques used in ethnographic interviewing include restating and incorporating terms and phrases used by the CT rather than rephrasing and reframing. This way the CT can prioritize his concerns and needs rather than the SW. CTs can be encouraged to tell stories about their cultural experiences using their own words and phrases rather than trying to translate their experience by using words that they believe will be better to understood by the SW. The use of language is an important consideration in interviewing, as CT may express themselves in terms that are not familiar to the SW.

Answer 107

- Is a family assessment tool that is intended to individualize culturally diverse family. Developed by Elaine Congress. - The culturagram examines areas which is an important part of meeting the needs of a CT: Reasons for relocation, Legal status, Time in community, Language spoken at home and in the 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.

Answer 108

1. Nurturing System: consists of the individual's family, intimate friends, and the immediate community. 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. 2. Sustaining system: consists of the institution of the larger society. Is one in which that same individual receives his education, is employed, and is involved in the economic and political world. Dual perspective concept- wherein 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. SWs interacting with minority CTs, it is important for him/her to recognize the daily challenges that CT face while living in both systems. Although every CT is an individual, with his or her own unique qualities, individuals from racially and culturally diverse backgrounds may share a common identity with the group and share traits of their dominant culture.

Answer 109

- Traditional Adaptation is identified as behavior, values, and beliefs of individuals of a diverse group that are distinct from those of the majority group. In the case of traditional adaptation, extended families tend to be strong and there is an expectation that the children will marry wi/in the ethnic group. Members of the traditional minority group exhibit strong ethnic identity. - Marginal Adaptation occurs when individuals do not adhere closely to the values and behaviors of either their ethnic group or the larger society, often resulting in cultural conflict. - Assimilation occurs when individuals learn to value the norms of the Sustaining system and to devalue the norms of their ethnic group. The term "assimilation" can be confusing because Piaget used the same word with regard to Cognitive development but these are two different concept. Bicultural adaptation occurs when individuals integrate the norms, values, and beliefs of their ethnic group and of the larger society. An individual should be allowed to be fully bicultural, rather than be expected assimilate into the dominant culture.

Answer 110

African- Americans Kinship (blood relationship) relations are important, with grandparents being very involved in raising young children. Male and female roles are egalitarian (relating to believing in the principle that all ppl are equal and deserve equal rights and opportunity) and often women work outside of the home. Children are expected to respect and obey their elders. There is a deep sense of mutual responsibility among members. Spirituality and church membership are important. The leading cause of death among young African- Americans ages 10-24 is homicide. Asian- Americans There is great importance placed on family honor. Elders are revered. Families have structured roles for members. Consideration is given to what is best for everyone rather than what is best for the individual. Open conflicts are discouraged. They are generally reluctant to share private matters with strangers. Individuals are not likely to seek treatment for mental illness, as mental illness is seen as bringing shame on the family. Seeking treatment for physical symptoms is more acceptable, so individuals may seek help for physical problems. It is for individuals to observe cultural proprieties before beginning a serious discussion of issues. The treatment of choice would be direct, structured, short-term, problems- solving approach. They may avoid eye contact and can be reluctant to directly express emotions. Caucasians (US and Canada) Change is valued over tradition. Male and female roles are egalitarian and role reversal often occurs. There is a strong sense of individualism and self-help. Orientation is toward the future; youth is revered. Value is placed on work, activity, and competition. Communication is direct, open and honest. There is a belief in personal control over the environment, rather than fate. Hispanics/ Latinos Families are largely patriarchal, with clearly defined roles for males and females. Major decisions are made by the parents. The welfare of the family is more important than the welfare of the individual, stressing interdependence rather than independence. Their native language is important. Individuals are expected to refrain from discussing personal problems with outsiders. Spirituality, religion, and church attendance are important, as is the view that control over life's events is external. Native American People Elders are held in high regard. Generosity is a value. Rigid gender roles exist. The belief is held that tribes are responsible for raising children. Trust is placed in tribal decision before decisions of other outsider of the tribe. Great importance is placed on tribal customs and rituals. Individuals listen rather than talk. Native Americans have a spiritual and holistic approach to life. The treatment of choice would include a non-directive, collaborative approach utilizing the network of tribal elders and traditional healers w/in the culture. The SW may need to model self-disclosure and verbal expression.

Answer 111

- Coming Out Process- Robbins, Chatterjee, and Canada (1998) acknowledging to self and others that one is gay or lesbian. - Coming Out Process stages: 1. Identity confusion 2. Recognition of gay or lesbian identity 3. Exploration and experimentation relative to gay and 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 - Loved ones can constitute significant support system or can become an overwhelming obstacle to the CT. - If the CT's sexual orientation is identified as the reason for therapy, he/she may be dealing with issues of coming out, homophobia, discrimination, or relationships with family members and friends who do not know that he/she is gay or lesbian. Therapy should relate to the stage of coming out and should foster the CT's self-esteem. Treatment can focus on such things a problem solving, social skills, and assertiveness.

Answer 112

- A person who believes that his/her physical body does not represent his/her true sex. - Transgender tend to deal with issues related to gender while lesbian gay, bisexual, and transsexual people generally deal with issues of sexual orientation. - Transsexual person- of, relating to, or being a person whose gender identity is opposite the sex the person had or was identified as having at birth NOTE: Transsexual people may or may not undergo surgery and hormone therapy to obtain a physical appearance typical of the gender they identify as. - Individuals can be heterosexual, homosexual, bisexual or non- sexual (not involving sex or sexual activity). - Cross dressers, who previously were referred to as "transvestities", usually have no gender identity conflict internally but occasionally prefer to dress in the clothing of the opposite sex. -Sexual orientation refers to how sexual desires are directed; in other words, how the individual actually behaves sexually. - Gender identity refers to the individual's sense of self as a man or a woman.

Answer 113

- Is a process, not an event that affects psychological, social and emotional, and physical change. - Psychological change include: choosing a new name or nickname, using a different se to pronouns, altering objects and clothing to better represent gender identity, adopting mannerisms consistent with the new gender role, and "coming out". - Physical changes may include hormone replacement therapy, surgical procedure, permanent hair reduction, changing one's speaking or singing voice through voice training. Some individuals choose sex reassignment therapy while others do not. - The emotional strain of dealing with stigma and experiencing transphobia pushes many transgender ppl to seek treatment to improve their quality of life, for depression and anxiety. - SW should also address related family issues. - Many transgender face discrimination at work or accessing work, public accommodations and healthcare which potentially increases the financial burden on the CT.

Answer 114

- Gay/ lesbian- men (typically referred to as gay) and women (typically referred to as lesbian) who are attracted to the same sex. - Bisexual- refers to an individual's attraction to both men and women. - Pansexual- an individual's attraction to or association with members of all biological sexes and gender identities. The term is based upon the individual, not the sex and can be used for either males or females. - Transgender- an individual's gender identity as male or female, not based upon sex assignment at birth. Individuals may also ID bi-gender. - Transsexual- refers to the desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with one's anatomical sex, and a desire to have surgery or hormonal treatment to make one's body congruent with one's preferred sex. - Intersex- refer to ambiguous (open to more that one interpretation; double meaning) sexual anatomy, also referred to hermaphrodite (a person or animal having both male and female sex organs or other sexual characteristics, either abnormally or (in the case of some organisms) as the natural condition.). - Genderqueer and Intergender- are catch- all terms for gender identities other than man and woman; individual may self- identify as being both man/woman, as being neither man nor woman, or feeling completely outside the gender binary.

Answer 115

- Women are more likely to seek mental health services than men and are more likely than men to be diagnosed with a psychogenic (having a psychological origin or cause rather than a physical one) mood disorder when a medical condition actually underlies the symptoms (e.g. diagnosed w/ psychogenic depression when they actually have a hormone imbalance.) - Some psychiatric diagnoses are associated with gender (e.g. more women are diagnosed as Borderline Personalty Disorder and more men Narcissistic Personality Disorder). - Women are viewed as being subordinate in almost every aspect of society. Their issues are often ignored or minimized by medical, legal, and social institutions. - Women still receive lower pay than men for the same jobs, with the problem being more severe for women of color. - Women are 2x likely as men to be underinsured and women represent two-thirds of all MA recipients. - The number of women living with AIDS in the US continues to increase; the largest increase of new HIV cases is among women. - Minority women have lower levels of education and higher levels of poverty and unemployment. - Women face discrimination in healthcare, esp economically disadvantaged women, minority women, and women with HIV/AIDS.

Answer 116

- Helping clarify the nature of inequality between genders. - Further promoting women's right's, issues, and interests. - Examining the history of feminism in areas such as reproduction rights, sexual objectification, languages, literature, films, art, interpretation of history, treatment of women, social status, oppression and other related areas.

Answer 117

- Traditionally, religion and spirituality have been viewed as one, or at least closely related to one another. - Spirituality can be seen as a path to the understanding of the meaning of life, an immaterial reality or the discovery of one's personal being. - The practices can include contemplation, prayer, or meditation that leads to an individual's connection with him/herself, other individuals, with nature, the human community, the cosmos, or some other spiritual belief. - With the decline of membership in organized religions and growing secularism (the principle of separation of the state form religious institutions) in the western world, spirituality is now being seen as a border context. - Secular spirituality is considered a less structured, more personalized, and more pluralistic outlook than that of organized religions. - Spirituality can be viewed as: - 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. - SWs need to be respectful of the diversity of CTs' belief systems and, if appropriate, utilize those beliefs in treatment.

Answer 118

- According to Macionis (2005), Disability is "a physical or mental condition that limits everyday activities". - The 1990 Americans with Disability Act (ADA) outlawed discrimination against individuals with disability in the area of employment and public accommodations. - When a disabled person seeks SW services, the SW should not automatically assume that the disability is the focus of treatment. SW should acknowledge the disability, when appropriate, and ask the CT what he or she hopes to address in the treatment process. - Treatment issues may include grieving losses, discrimination, social relationships, developing independent living skills, barriers to normal functioning, and rehabilitation. - The CT support system should also be included in appropriate. - Hearing impaired CT should receive the assistance of an interpreter while receiving services from the SW. If this is the case, the SW should talk to the CT, not the interpreter.

Answer 119

- Personal (gender, race, age, coping skills, and past experience) - Social and family relationship and social support - Socioeconomic status; culture, political, social and physical environment - ADL's- including work, school, and recreation - Goals of the individual. - Emotional reactions to chronic illness and disability include grief (normal reaction to loss), fear and anxiety (often associated with future perceptions of what was desired) - Anger (loss associated with the condition, being a victim and blaming others for their condition), frustration - Depression (feelings of hopelessness, helplessness, apathy, discouragement, dejection) - Guilt (self-criticism and blame) - The same reactions can also occur in family members if they feel they are involved in some way with the individual's condition. Thy may also feel anger and resentment toward the person with the illness or disability. - Chronic illness and disability also affects individuals differently across the lifespan. In childhood there is an increase in behavioral and emotional disorders. The condition may impact the child's normal development in regard to trusting others, sense of autonomy, and nurturing by a consistent and loving caregiver. Family overprotectiveness can interfere with normal activities that further isolate the individual from social interactions, as well as the child's emotional expression. - During adolescence, perceptions of and interactions with peers may be impacted by the illness or disability. There may be delays in independence and emancipation from parents. Any alteration in physical appearance can impact the adolescent's self-concept and body image. Protective actions of family members may create barriers to the adolescent's individual identity development, decrease self-esteem and self confidence. - During young adulthood, physical limitations may inhibit the individual's efforts o build intimate relationships or maintain already established ones. If the individual has children, childcare issues may be a source of stress. - During middle adulthood, chronic illness and disability can interfere with occupational functioning and potentially early retirement. It has a significant impact on the financial well-being of the individual's family and may create difficulties with the disabled individual's self-esteem, identity, and self- concept. Role alterations and associated responsibilities also change. - Chronic illness and disability in older adults imposes cognitive and physical limitations in addition to the normal aging process. Spouses of similar age who are providing care may also suffer from physical limitations making caregiving difficult. The person suffering from the illness or disability may need to give up his/her lifestyle and move to another environment. There may be additional expenses that are associated with the illness or disability that places strain on limited budgets. - The effects of chronic illness and disability has both emotional (anger, sadness, shock, denial, guilt, anxiety, and depression) and economic impact on families. Expectation for the future may lead to anger, resentment or disappointment. Family members may become advocate for the disabled person for necessary services, health care, etc. Due to the need for extra care, family members may become exhausted as well as emotional strain bw family members. - CT and family education are an integral part of adapting to chronic illness and disability. An individual's and family understanding of the condition and treatments are basic components of self-determination and responsible care. It is also imperative tht CT and family members understand how to optimize CT potential, which is not only related to maintenance treatment but preventive treatment to mitigate further health conditions and disability.

Answer 120

- Four disease stages: Acute infection; Asymptomatic; Symptomatic, or chronic; AIDS (Acquired Immune Deficiency Syndrome) - Once diagnosed there is a long period of emotional and psychological adjustment with the individual experiencing denial, anger, depression, and hopelessness. - Individuals is most at risk for psychiatric diagnosis of Adjustment Disorder, anxiety, and depression. - HIV positive and AIDS CTs face several losses: loss of support from their social group, loss of physical 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. - Mental health should deal with the here and now and learning new ways of coping and problem solving. - SW's need to help engage in lifestyle changes, such as exercise, proper nutrition, compliance with a medication regime, and avoidance of risky sexual behavior. - Cognitive- behavioral therapy may be beneficial treatment strategy. Support groups and psychotherapy groups may also be very helpful. - Crisis intervention may be necessary when the CT reaches the final stage of the disease process. - There is increased risk of suicide.

Answer 121

- There are many factors to consider when dealing with this unique population, including "military culture". - Military combat veterans may have a "warrior mentality" that they may feel is not understood by the non-military public. Soldiers view themselves as part of a brotherhood of support. - The increased number of women serving in the military has also resulted in problems not encountered previously. - The increase in PTSD and TBI- Traumatic Brain Injury cases has risen dramatically. - Military sexual trauma reports has increased, chronicling victimization of both women and men. - SWs are dealing with vets and their family members. Spouses experience changes in their lives when the vet is deployed and again when he/she returns. Children also faces a variety of reactions and often experience secondary PTSD. - Vets may face other issues related to re-integration; that life has gone on without them and feel left out, lost, and disoriented. - Vets frequently experience sleep issues, anxiety, numbness, hyper-vigilance, substance abuse, and the desire to return to active duty. - Marital difficulties are common among military personnel. - SW interventions strategies that are helpful: acknowledging that you do not understand what the vet has experienced; Be patient; Be cognizant of coping mechanisms used by the vet; Encourage the vet to tell his/her story; Avoid insensitively worded questions such as "Did you see any dead bodies?"; Provide information and help obtaining government and community resources for the vet and family. - Effective Therapeutic interventions- Cognitive Behavioral therapy; Solution focused Brief therapy; Acceptance and Commitment Therapy (ACT); Narrative Therapy; Family and Cognitive Therapy; Eye movement Desensitization and Reprocessing (EMDR)

Answer 122

- The NASW code of Ethics prohibit discrimination of CTs based on "immigration status". - The NASW Standards for Cultural Competence in SW practice requires SWs 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 diverse CTs" ... and to "be aware of the effect of social policies and programs on diverse CT populations, advocating for and with CT's whenever appropriate" (NASW, 2001). - Residents of the US have rights to benefits and services that are defined in federal law, regardless of their immigrations status. - In some cases, there may be a legal requirement that SW must disclose CT info, in these situations, the NASW Code of Ethics creates an expectation that CTs be fully informed, in their own language, prior to the release of information.

Answer 123

- To guarantee that the human service and education needs to all children are met regardless of their own 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 efforts to remove penalties on the children of undocumented immigrants based on their parents's actions. - To protect all immigrants from family violence, including the undocumented, with provisions to protect women form 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 (NASW, 2009).

Answer 124

- Institutional racism (policies, practices or procedures embedded in bureaucratic structures that systematically lead to unequal outcomes for people of color.), discrimination, social injustice, and economic inequities still exist in our society despite the legal and social efforts to eradicate these problems. - Women's salaries are still lower than men's for the same job. - Minority groups are still disproportionately involved in the correctional system- more often arrested, convicted and incarcerated than Caucasian individuals. - Minority group members are disproportionately economically disadvantaged. - Minority groups representation in business, administrative positions, decision- making positions, and other leadership roles is not equivalent with the percentage of the general population. - Housing issues, wages, types of jobs, education, and financial matters are all areas where minority populations are still struggling to be competitive with Caucasian persons.

Answer 125

- One of its major ethical issues, stating that "SWs pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. SWs' social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice. These activities seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity. SWs strive to ensure access to needed information, services and resources; equality of opportunity; and meaningful participation in decision making for all people".

Answer 126

- (e.g. racism, sexism, and ageism) has contributed a continued lack of social and economic justice. In society, there exists multiple aspects diversity, which are dynamic and intersect with one another. - Societies have defined norms, the purpose of which is to maintain power and control over others who are less powerful. - Individuals' life experience are effected by their ethnicity, gender, socio-economic class, age, sexual orientation, physical and emotional abilities and physical characteristics. - The defined norm in the US is "male, white, heterosexual, youthful, able-bodied, wealthy, and Christian". People have preconceived or unconscious biases against those who do not fit the norm, thus leading to discrimination. - Racism- is the belief that races have distinct characteristics that are hereditary and cultural and some of these characteristics endow certain races with an intrinsic (belonging to the essential nature or constitution of a thing) superiority over others. Racism is usually directed toward people of color. It carries attitudes and behaviors that range from dislike to outward discriminatory behaviors such as avoidance, aggression, and violence. Or language and micro aggressions. - Sexism- in a patriarchal system, if fueled by the belief of male dominance and female inferiority. The traditional family order consists of relationships in which the man is the head of the household and woman who step outside this role threaten the rules of patriarchy and can be expected to be feared and hated by men and women who find security in the power of men. - Heterosexism and Homophobia- are discriminatory terms referring to one's sexual orientation. Heterosexism- is a belief that the only acceptable and valid sexual relationships are heterosexual and carries with it assumptions, expectations, and values (e.g. individuals will marry someone of the opposite sex; only heterosexual relationships portrayed in the media are seen as positive). Heterosexism may create conflict in the ability to have a positive sexual identity for gay, lesbian, bisexual and transgender individuals. Homophobia- is defined as an irrational fear of individuals who love and sexually desire individuals of the same sex. Homophobia can be manifested in dislike and avoidance of homosexuals, but can also result in discrimination and acts of violence. Violent criminal acts committed against an individual can be enhanced to a "hate crime" if the victim is homosexual. - Ageism- prejudice and discrimination against a certain age group and is usually directed toward elderly individuals. - Ableism- is a prejudice or discrimination against individuals who have physical, intellectual, or emotional disabilities. It can be detrimental to school- age children and young adults when it results in bullying, harassment, and physical altercations. And can continue to have negative consequences to adults, especially in employment discrimination, the correctional system and social discrimination. - Classism refers to the prejudice against groups of people who share a social position that is deemed less than acceptable in terms of society's norms. Classism can refer to an individual's socio-economic class, social position in society, political beliefs and cultural characteristics. (e.g. a person who believes himself superior to poor or disadvantage person). - Fatism- is a term used to describe an individual's physical characteristics. Being overweight can engender criticism by others and overweight individuals are often shunned, rejected, ridiculed and deemed incapable of controlling their eating habits.

Answer 127

- Consists of the state and government agencies and processes that control crime and penalize the offenders. - The components consists of law enforcement, courts, prosecutors and defense attorneys, sentencing, and corrections. - SW provide direct services for victims, ranging from victims' rights to treatment for trauma and grief.

Answer 128

- Affects youths who enter the juvenile correctional system. - In an effort to reduce criminal acts in the public school system, polices have been initiated that have increased the likelihood of youth being referred to the criminal system for offense that previously were handled w/in the school system. - "Zero tolerance" policies for drugs, weapons, assaults, and other disciplinary acts results with more students being charged with crimes and entering "the system". - Once a young person is charged with a crime he/she is more likely to be arrested for repeated offense, sometimes resulting in profiling, a practice that over- identifies minority individuals. - Poverty is a factor because economically disadvantaged parents are typically unable to afford the fees associated with getting the child out of the system more quickly.

Answer 129

- The increased use of technology which has been recently addressed as it pertains to the practice of SW. - It refers to the ways in which societies and individual citizens have been brought closer together, through trade, new ways of communicating, integration of societies and economics, and National and international policies. - Have a social impact on the lives of ppl, their work, their families, and the societies in which they live. - SWs are impacted in the service of micro, meso, and macro practice, including policy- making advocacy.

Application of theoretical concepts Flashcards

LMSW exam