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LCSW Exam > Direct and Indirect Practice/Psychotherapy and Clinical Practice > Flashcards

Direct and Indirect Practice/Psychotherapy and Clinical Practice Flashcards

1
Q

micro practice: assertiveness training

A

-form of CBT often used to promote positive self esteem by helping clients become more aware of personal rights and be able to verbally express/assert self in positive way
-assertive vs aggressive vs passive vs passive aggressive

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2
Q

micro practice: role modeling

A

-example of socially appropriate behavior for given set of circumstances
-modeling examples of coping skills
-Robert Merton credited with this concept

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3
Q

micro practice: limit setting

A

-set reasonable boundaries/rules to know what to expect
-help to establish safety and more open to learning
-help with connection to predictable consequences of behavior

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4
Q

micro practice: developing treatment plans with clients;

A

collaborative and interactive; client’s priorities and perspectives, integrate strengths into plan and objectives

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5
Q

micro practice: couples intervention and treatment approaches

A

-CBT
-problem solving
-communication theory
-transactional analysis
-family life education
-grief counseling
-psychoeducation
-role play
-can also give homework if applicable
-set clear limits of neutrality; avoid identifying with one partner or another
-sometimes 1 or both also need individual counseling

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6
Q

micro practice: interventions with groups; Yalom’s 11 therapeutic (curative) factors of groups

A
  1. instillation of hope
  2. universality
  3. information giving
  4. altruism
  5. corrective recapitulation of primary family
  6. improved social skills
  7. imitative behavior
  8. interpersonal learning
  9. group cohesiveness
  10. catharsis
  11. existential factors
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7
Q

micro practice: approaches used in consultation

A

-interactional helping process
-consultant has greater knowledge/experience, consultee needs that knowledge for a problem
-giving and taking of help
-code of ethics; seek appropriate consultation for ethical dilemmas

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8
Q

micro practice: case recording covers

A

-presenting problem
-history
-current goals/objectives
-progress over the course of services

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9
Q

micro practice: for case recording, need to accurately reflect available information

A

about whats happening, clinical assumptions/interpretations/research thats been considered, reasoning/decision making processes that impact services delivery

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10
Q

micro practice: tools that support evaluation may included

A

-initial assessments
-genograms
-ecomaps
-social histories
-service/treatment plans
-transfer/discharge summaries

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11
Q

micro practice: evaluation of practice looks at

A

-fidelity
-service/treatment plan reviews
-process evals
-outcomes evals
-client satisfaction surveys
-case studies
-cost analysis
-single system design

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12
Q

Use of CBT techniques

A

-cognition is the mediator of psychological distress/dysfunction
-combines cognitive and behavioral
-effective for range of clients/populations/issues
-practitioners role is of a teacher/guide to teach client about the relationships between thoughts, behaviors, affect and psychological distress

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13
Q

cognitive techniques

A

help client identify irrational/faulty logic in thought patterns and to reframe them with rational/logical ones; change from negative emotional reactions and sometimes self destructive behavior to understanding and coping with thoughts in behaviorally appropriate ways

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14
Q

most recognized models of CBT

A
  1. Beck’s cognitive therapy
  2. Meichenbaum’s CBT
  3. Ellis’s Rational Emotive Behavioral Therapy
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15
Q

assessment phase of CBT

A

identify specific thoughts and beliefs in relationship to problem

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16
Q

intervention phase of CBT

A

identify and dispute irrational beliefs, use other interventions as appropriate; goal to replace maladaptive thinking and increase emotional/behavioral function

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17
Q

micro practice: client’s role in problem solving process

A

empower client’s to solve problems with individual or environmental change; client initially needs to learn elements of problem solving; role for them to implement steps and make changes
-wellness recovery action plan (WRAP); self designed prevention and wellness process that anyone can use to get well and stay well

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18
Q

advanced directives

A

-legal way to indicate person has given legal rights/decision making to another if they become incapacitated
-pair with living will; decisions about end of life

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19
Q

ecological/life systems model: theory

A

focuses on the interrelatedness between people and their environment; developed from quality of life issues and concern for the environment
-emphasizes adaptation of person to environment, as well as degree of fit to person and environment
-holistic/transactional model, avoids dehumanizing language; person and environment involved in circular ongoing relationship in which both are acted upon and influenced by others
-problems arise as consequences of maladaptive transactions between individual and environment

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20
Q

ecological/life systems model: aim of intervention

A

make environment more responsive to needs, release individuals adaptive potential by altering transactions between client and environment; focus of intervention is interface between client and clients environment

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21
Q

ecological/life systems model: terms- adaptiveness

A

goodness of fit with environment, adaptive balance with environment, continuous process

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22
Q

ecological/life systems model: terms- niche

A

status occupied by individual/group within a given social system; associated with power and oppression

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23
Q

ecological/life systems model: terms- habitat

A

individuals physical and social setting within a cultural context

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24
Q

ecological/life systems model: terms- positive stress

A

environmental demand perceived as challenge and associated with positive feelings

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25
Q

ecological/life systems model: terms- negative stress

A

discrepancy between demand and capacity for coping with it and associated with negative feelings

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26
Q

ecological/life systems model: terms- coping

A

response set in motion as result of experience of emotional stress, effective coping patterns lead to elimination of stress

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27
Q

functional approach model of treatment

A

-based on growth with the center of change residing in the client
-emphasis on releasing clients power for choice/growth
-helping rather than treating

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28
Q

functional approach model of treatment: principles

A

-time phase (beginning, middle, end)
-use of structure
-de-emphasize the diagnosis
-function of agency
-use of relationship

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29
Q

planned short term or task centered treatment:

A

restricting duration of treatment at outset; empirically developed system that offers pragmatic approach to problem solving; partialize problem into clearly delineated tasks to be addressed consecutively; client must be willing to work on problem

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30
Q

planned short term or task centered treatment: primary aim

A

quickly engage clients in problem solving process and maximize responsibility for treatment outcome
-needs to identify precise problem and solution confined to a specific change in behavior/circumstances
-assessment focuses on helping the client identify the primary problem and explore the circumstances around the problem
-consider how client wants to see problem resolved

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31
Q

Problem Solving Approach treatment model: assumptions

A

-human living is a problem solving process, ego is the mechanism for solving problems
-translates ego psychology into principles of helping action
-inability to cope with problem due to lack of motivation/capacities/resources are impaired/maladaptive
-reality based relationship with SW

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32
Q

Problem Solving Approach treatment model: goals of action

A

-to release/energize/direct motivation by minimizing disabling anxiety/fears, promote support and safety, free ego energies for higher investment in task at hand
-to release and exercise clients mental/emotional/action capacities with problem and self in connection with it
-make accessible to the client the opportunities/resources needed to problem solution

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33
Q

Problem Solving Approach treatment model: 4 Ps

A

person
problem
place (agency)
process (therapeutic relationship)

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34
Q

models of treatment: psychosocial approach (diagnostic school)

A

-approach considers client in context of interactions/transactions with the external world
-formal BPS history obtained
-based diagnosis on BPS history
-differentiate treatment according to clients needs and results in modification of person/environment/both and exchanges between them (incorporates systems)

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35
Q

psychodynamic models: psychoanalytic (Freud)- general

A

-man seen as product of the past, treatment deals with repressed material in the subconscious
-id/ego/superego are stable structures in anatomy of personality

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36
Q

psychodynamic models: psychoanalytic (Freud)- 3 personality structures

A

id, ego, superego

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37
Q

psychodynamic models: psychoanalytic (Freud)- id

A

unconscious source of motives/drives, pleasure principle, immediate gratification

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38
Q

psychodynamic models: psychoanalytic (Freud)- ego

A

emerges at about 6 months old, logic/reason, reality principle, mediates between id/superego/reality

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39
Q

psychodynamic models: psychoanalytic (Freud)- superego

A

incorporates parental and societal values and standards into personality, develops age 4-5

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40
Q

psychodynamic models: psychoanalytic (Freud)- unresolved conflict is

A

basis for psychopathology; need to go back into past and resolve conflict

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41
Q

psychodynamic models: psychoanalytic (Freud)- psychic distress (anxiety) caused by

A

inability of ego to reconcile id/superego/reality which causes conflict

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42
Q

psychodynamic models: psychoanalytic (Freud)- fixation

A

failure to resolve conflict at any developmental stage

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43
Q

psychodynamic models: psychoanalytic (Freud)- determinism

A

function of mind/order of ideas not random, related to prior experiences and events

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44
Q

psychodynamic models: psychoanalytic (Freud)- structural model of the mind

A

mind has 3 layers of mental activity; conscious, preconscious, unconscious

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45
Q

psychodynamic models: psychoanalytic (Freud)- dynamic principle

A

attempts to understand the individual in terms of conflicts between id/ego/superego

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46
Q

psychodynamic models: psychoanalytic (Freud)- genetic principle

A

early years of childhood important part of personality development

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47
Q

psychodynamic models: psychoanalytic (Freud)- stages of psychosexual development

A

oral
anal
phallic
latency
genital

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48
Q

psychodynamic models: psychoanalytic (Freud)- psychosexual stages use

A

libidinal energy invested in different organ at each stage

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49
Q

psychodynamic models: psychoanalytic (Freud)- cathexis

A

investment of (libidinal) energy

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50
Q

psychodynamic models: psychoanalytic (Freud)- processes involved

A

clarification
confrontation
interpretation
working through goal to resolve intrapsychic conflict

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51
Q

psychodynamic models: psychoanalytic (Freud)- primary technique

A

analysis (dreams, transference, resistance, free association)

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52
Q

psychodynamic models: ego psych (Anna Freud, Erik Erikson)- focus on

A

the rational, conscious processes of the ego

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53
Q

psychodynamic models: ego psych (Anna Freud, Erik Erikson) personality is

A

open system where it can develop through life cycle (Erikson)/fixed in childhood (Freud)

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54
Q

psychodynamic models: ego psych (Anna Freud, Erik Erikson))- assessment of person in

A

here and now, present

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55
Q

psychodynamic models: ego psych (Anna Freud, Erik Erikson)- treatment looks at ____ ______

A

ego function (ego controls healthy behavior); behavior in relation to situation, reality testing, coping abilities, capacity for relating to SW

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56
Q

psychodynamic models: ego psych (Anna Freud, Erik Erikson)- ego support

A

support function of ego (strengths, defenses, reality testing)

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57
Q

psychodynamic models: ego psych (Anna Freud, Erik Erikson)- ego defensive function

A

unconscious, involved in resolving conflicts

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58
Q

psychodynamic models: ego psych (Anna Freud, Erik Erikson)- ego autonomous function

A

conscious, conflict free, adaptive function

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59
Q

psychodynamic models: ego psych (Anna Freud, Erik Erikson)- goal

A

to maintain and enhance ego’s control/management of reality stress and its effects

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60
Q

psychodynamic models: individual psychology (Alfred Adler)- holistic theory of what development

A

personality/psychotherapy

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61
Q

psychodynamic models: individual psychology (Alfred Adler)- individuals strive for what

A

perfection; individuals have single motivation behind all behavior, always drawn to future to reach fulfillment, perfection

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62
Q

psychodynamic models: individual psychology (Alfred Adler)- feelings of inferiority

A

when kids experience a sense of perceived/real weakness, develops feelings of inferiority they deal with either adaptively or maladaptively

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63
Q

psychodynamic models: individual psychology (Alfred Adler)- lifestyle

A

way individuals live/cope with lives, style determined early in life by different factors (birth order, nurture vs neglect from parents)

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64
Q

psychodynamic models: individual psychology (Alfred Adler)- social interest or community feelings

A

healthy individuals have social concern and want to contribute to the welfare of others; unhealthy people who are overwhelmed by feelings of inferiority overcompensate by striving for power over others and become self-centered

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65
Q

psychodynamic models: individual psychology (Alfred Adler)- goal of therapy

A

to develop more adaptive lifestyle by overcoming feelings of inferiority and self-centeredness and contribute to welfare of others

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66
Q

psychodynamic models: Self Psychology (Heinz Kohut)- defines ____ as central organizing/motivating force in personality

A

self

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67
Q

psychodynamic models: individual psychology (Alfred Adler)- early caregivers are

A

self-objects

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68
Q

psychodynamic models: individual psychology (Alfred Adler)- as result from receiving empathy from self-objects

A

needs are met and develops strong sense of self-hood; empathic failures by caretakers result in self-disorder/lack of self cohesion

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69
Q

psychodynamic models: individual psychology (Alfred Adler)- goal

A

help increase sense of self-cohesion

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70
Q

psychodynamic models: individual psychology (Alfred Adler)- techniques of therapy

A

therapeutic regression, patient re-experiences frustrated self object needs

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71
Q

psychodynamic models: individual psychology (Alfred Adler)- self object needs; mirroring

A

validates childs sense of perfect self

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72
Q

psychodynamic models: individual psychology (Alfred Adler)- self object needs; idealization

A

child borrows strength from others, identify with someone more capable

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73
Q

psychodynamic models: individual psychology (Alfred Adler)- self object needs; twinship/twinning

A

needs an alter ego for sense of belonging/humanness

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74
Q

humanistic/existential models: Rogerian/Person Centered- general

A

-nondirective, client centered
-believes humans are basically good, single motivation for actualizing to achieve full potential, need to be organized/unified for growth

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75
Q

humanistic/existential models: Rogerian/Person Centered- incongruity between concept of self and experience

A

causes anxiety, maladaptive behavior; anxiety dealt with by denying/selective perception/distorting external info

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76
Q

humanistic/existential models: Rogerian/Person Centered- in right therapeutic environment, client achieves

A

congruence between self and experiences and move toward potential

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77
Q

humanistic/existential models: Rogerian/Person Centered- core condition in therapy

A

unconditional positive regard, accurate empathy, therapist genuineness/congruence

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78
Q

humanistic/existential models: Rogerian/Person Centered- conditions needed from client

A

incongruence (aware and want to do something about it), clients perceptions of therapists conditions (can recognize and accept therapists efforts to reach them), clients self-exploration

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79
Q

humanistic/existential models: Rogerian/Person Centered- basic activities of self exploratoin

A
  1. self disclosure
  2. exploration of self
  3. self awareness
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80
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- seek increased awareness through

A

dramatization of split off parts of self; dramatization is key (psychodrama, role play, empty chair)

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81
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- process oriented approach focusing on

A

Awareness, wholeness, contact, self regulation; integration of mind/body/thoughts/actions central to approach

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82
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- pay attention to patterns involving

A

Layers of organismic function (thought, feeling, activity); formation of patterns part of lawfulness of nature

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83
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- organism has drive to pull self together, done by

A

Expanding consciousness by putting person in touch with current, immediate needs

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84
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- emphasis on fully _____ whats unfolding in the ______

A

Experiencing, present/here and now

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85
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- therapist deals with

A

What’s observed and helps client be more aware of experiences, grow through experiential learning, develop good contact skills, take responsibility for thoughts/feelings/actions

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86
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- contraindicated for clients who have

A

Problems with self-control

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87
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- pay attention to

A

The obvious

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88
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- doesn’t believe in

A

Repression

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89
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- group process/workshop

A

Therapy sessions (briefly) are part of total living experience

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90
Q

humanistic/existential models: Gestalt Therapy (Fritz Perl)- directed awareness

A

Everything dealt with in the here and now

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91
Q

Humanistic/existential models: transactional analysis (Eric Berne)- each person has 3 ego states

A

Parent, adult, child

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92
Q

Humanistic/existential models: transactional analysis (Eric Berne)- interactions between people are transactions between

A

Certain ego states of each person

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93
Q

Humanistic/existential models: transactional analysis (Eric Berne)- each child writes a life script based on

A

Who’s ok; script acted out through the individual’s life unless they recognize and change it

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94
Q

Humanistic/existential models: transactional analysis (Eric Berne)- 4 life positions

A
  1. I’m ok, you’re ok
  2. I’m not ok, you’re not ok
  3. I’m ok, you’re not ok
  4. I’m not ok, you’re ok
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95
Q

Humanistic/existential models: transactional analysis (Eric Berne)- game analysis

A

Client made aware of habitual defective interactions through psychodrama/direct confrontation

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96
Q

Humanistic/existential models: transactional analysis (Eric Berne)- script treatment

A

Social worker clarifies client’s life script and gives counter injunction to bring reversal

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97
Q

Humanistic/existential models: transactional analysis (Eric Berne)- strokes

A

Physical contacts between people, lets people know they’re ok and valued

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98
Q

Humanistic/existential models: transactional analysis (Eric Berne)- contracting

A

Change defined by treatment contract that’s made between adult and adult ego states; client and therapist also make agreement of goals/methods of treatment

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99
Q

Postmodern Model based on

A

Premise that truth isn’t absolute; arose in reaction to modernism, movement committed to using scientific inquiry in search for universal laws/truths that would explain all-natural phenomenon

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100
Q

Postmodern Model: Narrative Therapy- no objective reality, people ____ knowledge of themselves based on _____

A

Construct; conversation and social interaction

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101
Q

Postmodern Model: Narrative Therapy- meaning/interpretations of experiences involves

A

Telling a story that makes sense

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102
Q

Postmodern Model: Narrative Therapy- stories created incorporate

A

Sociocultural influences and personal interactions

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103
Q

Postmodern Model: Narrative Therapy- use stories to organize

A

World and lives

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104
Q

Postmodern Model: Narrative Therapy- goal

A

To help clients deconstruct their story lines (understand the stories they organize life around) and change stories to discover new realities/truths

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105
Q

Postmodern Model: Narrative Therapy- approach is

A

Collaborative, client is expert on their own life

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106
Q

Postmodern Model: Narrative Therapy- externalizing the problem

A

Separating client from the problem

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107
Q

Postmodern Model: Narrative Therapy- problem saturated stories

A

Stories client has co-constructed in interactions with others

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108
Q

Postmodern Model: Narrative Therapy- mapping the problem’s domain

A

Effect of problem overtime and domains of problem

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109
Q

Postmodern Model: Narrative Therapy- unique outcomes

A

Uncovering new truths/strengths

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110
Q

Postmodern Model: Narrative Therapy- spreading the news

A

Letting others know when experiencing positive change, public acknowledgement of success

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111
Q

Behavior Modification: Sociobehavioral School- theories represent

A

Systematic application of principles of learning to the analysis and treatment of behaviors

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112
Q

Behavior Modification: Sociobehavioral School- behaviors determine

A

Feelings; changing behavi0rs will also change/eliminate undesired feelings

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113
Q

Behavior Modification: Sociobehavioral School- goal

A

To modify behavior; focus on observable behavior-all behavior that is pertinent (thought and affect, motor function)

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114
Q

Behavior Modification: Sociobehavioral School- intervention focused on

A

Target symptom, problem behavior, environmental condition; not on personality

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115
Q

Behavior Modification: Sociobehavioral School- respondent behavior

A

Involuntary behavior that is elicited by certain behavior (stimulus  response)

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116
Q

Behavior Modification: Sociobehavioral School- operant behavior

A

Voluntary behavior controlled by consequences in the environment

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117
Q

Behavior Modification: Sociobehavioral School- symptoms of problematic behavior are no different from other behavioral responses

A

-involve respondent/operant/both behavior
-learned through conditioning
-obey same laws of learning/conditioning as “normal” behavior
-amenable to change through applying what’s known about learning/behavioral modification

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118
Q

Behavior Modification: Sociobehavioral School- most behaviorists try to change _____ behaviors

A

Specific; specify behaviors that define the problem, these become the targets of change

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119
Q

Behavior Modification: Behavior Paradigms; respondent/classical conditioning

A

Stimulus response approach to behavior-responding to neutral stimulus in same way as an unconditioned stimulus; doesn’t invoke new behaviors-connection of existing responses to new stimulus, invokes involuntary responses

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120
Q

Behavior Modification: Behavior Paradigms; respondent/classical conditioning- learning occurs as result of pairing

A

Previously neutral (conditioned) stimulus with and unconditioned (involuntary) stimulus so conditioned stimulus eventually as same response as unconditioned

unconditioned stimulus  unconditioned response
unconditioned stimulus + conditioned stimulus  unconditioned response
conditioned stimulus  conditioned response

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121
Q

Behavior Modification: Behavior Paradigms; operant conditioning- behavior has effect/operates on

A

Environment

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122
Q

Behavior Modification: Behavior Paradigms; operant conditioning- antecedent events/stimuli precede behaviors, which are followed by

A

Consequences

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123
Q

Behavior Modification: Behavior Paradigms; operant conditioning- reinforcing consequences

A

Those that increase occurrence of behavior; a kid eats veggies to get dessert

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124
Q

Behavior Modification: Behavior Paradigms; operant conditioning- punishing consequences

A

Those that decrease occurrence of behavior; employee finishes work to avoid getting fired

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125
Q

Behavior Modification: Behavior Paradigms; operant conditioning- ABC model

A

Antecedentresponse (behavior)consequence

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126
Q

Behavior Modification: Behavior Paradigms; operant conditioning- positive reinforcement

A

Increase probability that behavior will occur

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127
Q

Behavior Modification: Behavior Paradigms; operant conditioning- negative reinforcement

A

Behavior increase because aversive stimulus removed (i.e. removed shock)

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128
Q

Behavior Modification: Behavior Paradigms; operant conditioning- positive punishment

A

Presentation of undesirable stimulus following behavior to decrease it (hitting, shaking)

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129
Q

Behavior Modification: Behavior Paradigms; operant conditioning- negative punishment

A

Removal of desired stimulus following behavior to decrease it (remove something positive such as dessert)

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130
Q

Behavior Modification: Behavior Paradigms; operant conditioning- reinforcement does what to behavior

A

Increases frequency

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131
Q

Behavior Modification: Behavior Paradigms; operant conditioning- punishment does what to behavior

A

Decreases frequency

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132
Q

Behavior Modification: Behavior Paradigms; operant conditioning- chain

A

Exists when one performance produces conditions that make next one possible

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133
Q

Behavior Modification: Behavior Paradigms; operant conditioning- fading

A

Procedure for gradually changing 1 stimulus controlling behavior to make another stimulus

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134
Q

Behavior Modification: Behavior Paradigms; operant conditioning- extinction

A

Withholding a reinforcer that normally follows a behavior with consequence decline in that behavior; behavior fails to produce reinforcement that will eventually stop

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135
Q

Behavior Modification: Behavior Paradigms; operant conditioning- prescriptions

A

Telling and expecting a client specifically how to behave in situations

136
Q

Behavior Modification: Behavior Paradigms; modeling/observational learning

A

Learn by observing others

137
Q

specific behavioral procedures: systematic desensitization

A

pair anxiety producing stimulus with relaxing one, eventually anxiety stimulus produces relaxation response, provide reward each time relaxation response occurs

138
Q

specific behavioral procedures: in vivo desensitization

A

pairing and moving through anxiety hierarchy, real setting

139
Q

specific behavioral procedures: aversion therapy

A

any treatment aimed at reducing attractiveness of stimulus/behavior by pairing it with aversive stimulation (**treat alcoholism with Antabuse)

140
Q

specific behavioral procedures: shaping

A

method to train new behavior by prompting and reinforcing successive approximation of desired behavior

141
Q

specific behavioral procedures: flooding

A

anxiety extinguished by prolonged imaginal/in vivo exposure to high intensity of feared stimuli

142
Q

specific behavioral procedures: modeling

A

method of instruction that involves and individual demonstrating behavior

143
Q

specific behavioral procedures: assertiveness training

A

procedure to teach people how to express feelings and stand up for self

144
Q

specific behavioral procedures: contingency contract

A

agreement between 2+ people that specifies behavior change to take place and consequences if not honored

145
Q

specific behavioral procedures: Rational Emotive Therapy (RET)

A

cognitive oriented, change clients irrational beliefs and teach client to reframe thinking

146
Q

specific behavioral procedures: sensate focus

A

in vivo desensitization; communication enhancement procedure used in sex therapy (for exam: Masters and Johnson); couple provides each other with pleasurable sensory stimulation through structured body massage, pair pleasure/relaxation with graded sexual contact

147
Q

specific behavioral procedures: squeeze technique

A

procedure for delaying ejaculation

148
Q

specific behavioral procedures: self-instructional training

A

cognitive behavioral modality; client learns to covertly emit task related self instructions that guide behavior and help reduce anxiety and increase problem solving

149
Q

specific behavioral procedures: time out

A

removal of the opportunity to obtain positive reinforcement

150
Q

specific behavioral procedures: token economy

A

intervention environment in which tokens are given as reinforcement which can be exchanged for goods/services/privileges

151
Q

behavioral approach to autism

A

-helps to decrease unwanted behaviors and reinforce wanted, applied behavior analysis
-speech therapy to help with communication
-OT/PT
-public schools required to provide free/appropriate education from ages 3-21

152
Q

substance abuse treatment risk factors

A

-demographic(male, inner city/rural with low SES, lack of employment opportunities)
-family (family use, dysfunction/trauma; for exam-family history of alcoholism is strongest predictor for having alcohol problem)
-social (peers use, social/cultural norms, expect positive effects from use, available/accessible)
-genetic
-psychiatric (low self-esteem/distress tolerance, MH issues, loss of control)
-behavioral (use of other substances, conduct disorder/antisocial, impulsivity, aggressive behavior, poor interpersonal relationships

153
Q

causes of substance abuse

A

-BPS perspective
-medical/biological model; addiction is chronic, progressive, relapsing, potentially fatal disease (brain reward mechanisms-drugs act on parts of brain and reinforce continued use by producing pleasurable feelings)
-altered brain chemistry (dependence)
-self medication
-family/environmental model
-clinical model-use linked to emotional problems
-social model-learned and reinforced from peers/sociocultural

154
Q

substance use assessment instruments: AUDIT

A

alcohol use diagnosis identity test; screen for alcohol problems, cross cultural, age, gender validation, structured interview or self report

155
Q

substance use assessment instruments: CAGE AID

A

(0 for no, 1 for yes, score of 2+ indicates clinically significant)
-ever felt need to CUT down use?
-have people ANNOYED you by criticizing use?
-have you felt GUILTY about use?
-have you used 1st thing in the morning to steady nerves/for hangover (EYE OPENER)

156
Q

substance use assessment instruments: TWEAK test for pregnant women

A

-tolerance (2 points if she says 5+ drinks)
-worried friends/family about use (2 points)
-eye opening-use in the morning (1 point)
-amnesia/blacking out (1 point)
-k-cut down, anyone said you should (1 point)

157
Q

substance use assessment instruments: Michigan Alcoholism Screening Test (MAST)

A

24 yes/no questions, score 5+ indicates problems

158
Q

for clients with long term addiction, refer them to _____ first

A

drug and alcohol treatment before starting therapy

159
Q

substance use assessment parameters (ASAM)

A

-acute intoxication/withdrawal potential
-biomedical conditions/complications
-emotional/behavioral conditions (psych eval)
-treatment acceptance/resistance
-relapse potential/continued use potential
-recovery/living environment

160
Q

for substance use assessment, need comprehensive, multidimensional assessment that looks at

A

-standard medical history and physical exam
-substance use history
-family/social history
-mental health history
-collateral reports
-lab tests

161
Q

substance use treatment: select ____ restrictive setting

A

least; use ASAM guidelines

162
Q

goals of substance use treatment

A
  1. abstinence
  2. maximize life function
  3. prevent/decrease frequency and severity of relapse
163
Q

Korsakoff’s syndrome

A

memory problems from thiamine deficiency from alcohol use, under memory impairment in DSM

164
Q

Korsakoff’s syndrome and Wernicke’s encephalopathy associated with

A

chronic alcohol abuse, B1/thiamine deficiency

165
Q

symptoms of alcohol withdrawal delirium (DTs)

A

delirium, hallucinations, agitation, autonomic hyperactivity

166
Q

stages of substance use treatment

A
  1. stabilization-abstinence, acceptance
  2. rehab/habilitation-staying sober by establishing stable lifestyle, developing skills
  3. maintenance-stabilizing gains, relapse prevention
167
Q

detox from what substances may be needed

A

CNS depressants (alcohol, barbiturates, benzos), opiates

168
Q

cocaine intoxicatoin

A

high feeling, euphoria, hyperactivity, restlessness, impaired judgement, tachycardia, dilated pupils, perspirations/chills, nausea/vomiting, muscle weakness

169
Q

treatment modalities for substance use: biologically based

A

meds that discourage use/suppress withdrawal symptoms, address MH conditions
-Antabuse (aversion therapy)
-MAT-methadone, naltrexone

170
Q

treatment modalities for substance use: psychosocial/psychological interventions

A

modify maladaptive feelings, attitude, behaviors; self help groups, behavior modification

171
Q

critical components of effective treatment for substance abuse

A

assessment
match treatment to client’s individual needs
comprehensive services
relapse prevention
accountability

172
Q

substance abuse treatment approaches: minnesota model of residential chemical dependency treatment

A

BPS disease model of addiction, abstinence primary treatment goal, uses AA as relapse prevention, recovery tool

173
Q

substance abuse treatment approaches: drug free OP treatment

A

uses different counseling approaches, skills training, education and supports without meds to address needs of individual to be sober

174
Q

substance abuse treatment approaches: methadone maintenance/opioid substitution

A

MAT, benefits people who haven’t benefitted from other treatment approaches, reduce relapse/criminal activity

175
Q

substance abuse treatment approaches: therapeutic community residential treatment

A

for those with psychosocial adjustment problems and require structured resocialization

176
Q

relapse prevention: Marlatt and Gordon-

A

-empirically based, CBT approach, social learning theories
-emphasizes self management and self control
-focus is to teach how to anticipate/cope with relapse process
-approach reframes relapse as a way to learn new coping skills to benefit recovery
-view relapse as a process, identify triggers and warning signs of relapse to find ways to cope and maintain recovery
-high risk situations–negative emotional states, interpersonal conflict, social pressure
-abstinent violation effect (AVE)-can’t cope with high risk situation and relapse, experience sense of decreased self efficacy thats attributed to failure of internal/global factors rather than lack of adequate coping skills to deal with (combo of this and substance use increases risk for full relapse)
-successful coping of relapse more likely when its attributed to external factors

177
Q

relapse prevention: Gorski Developmental Model of Recovery (DMR)

A

-based on disease model of addiction and BPS approach to treatment
-6 stages: transition, stabilization, early/middle/late recovery, maintenance (each has own behaviors, recovery tasks, relapse risks)
-PAW (post acute withdrawal)-BPS symptoms that occur after withdrawal (7-14 days); decreased cognitive function, memory problems, problems regulating emotions, coordination/balance, difficulty managing stress

178
Q

nature of dual diagnosis disorders

A

-experiences more severe distress/impairment
-more difficult to assess, treat, manage
-conditions interact and exacerbate the other
-symptoms of one can mimic/mask the other
-often more resistant to treatment and have more denial, increase relapse risk
-cycles of stabilization and acute decompensation from substances, more psychosocial problems
-need both MH and DA treatment, often fall through the cracks

179
Q

dual diagnosis: indicators that support/confirm presence of psychiatric illness

A

-clients history indicates onset of psych disorder prior to substance use
-nature/severity of symptoms and problems differ from those with just substance abuse
-continues to experience psych symptoms after period of time (2-4 weeks), long enough for DA symptoms to clear
-family history of MH
-history of multiple treatment failures in DA/MH treatment
-positive treatment response to psychotropic meds

180
Q

dual diagnosis: special treatment considerations

A

-severity of MH can impact how patients process info
-traditional DA treatment methods (confrontation, group work) not well tolerated and can worsen MH symptoms
-patients are management problem and can disrupt routines of programs
-many DA programs don’t have medical resources (psychiatrists) to treat MH
-dual diagnosis clients need integrated program combining MH/DA

181
Q

dual diagnosis: for exam, while meds are standard care in treatment, best answer for some questions may be

A

use of alternative treatment options; nonpsychoactive drugs, support/self help groups, individual therapy

182
Q

dual diagnosis: principles of care

A

-acceptance of all clients
-accessibility
-integration of MH/DA in 1 setting
-continuity of care
-individualized treatment
-comprehensiveness
-emphasis on quality of care
-responsible implementation
-optimism and recovery

183
Q

suicide risk factors

A

-depression/other MH or DA issues
-prior attempt
-family history of MH or suicide
-family violence
-firearms in the house
-incarceration
-exposure to suicidal behavior
-women attempt 3-4x more than men, but 4x as many men die (men use more violent methods)
-2nd leading cause of death for ages 15-34
-older adults disproportionately likely to die by suicide
-American Indians and Alaska natives have higher rates of suicide, followed by nonhispanic whites; Hispanics lowest rate, black people 2nd lowest

184
Q

suicide risk factors for nonfatal attempts

A

estimated 11 nonfatal attempts for every suicide death; most suicide attempts are expressions of extreme distress, not harmless bid for attention, most just want the pain to end

185
Q

suicide prevention

A

-treatment for MH/DA issues
-cognitive therapy
-DBT counseling
-clozapine approved for suicide prevention
-improve primary cares ability to identify SI

186
Q

assessing suicide risk

A

-previous attempt best predictor of future attempt (also medical seriousness of that attempt)
-white male over 65 or under 30
-single, separated/divorced, widowed
-lives alone, lacks support
-presences of MH/DA, medical condition
-family history of suicide
-severe hopelessness, losses
-presence of firearms/access
-adolescents-impulsive, antisocial behavior, family violence
-recent psychiatric hospital discharge (new meds may have given energy to implement suicide plan)

187
Q

suicide protective factors

A

-effective and appropriate clinical care for MH, DA, medical conditions
-access to clinical interventions and support
-restricted access to lethal methods
-family and community support
-learned skills in problem solving, conflict resolution
-cultural/religious beliefs that discourage suicide and support self preservation
-absence of MH/DA issues
-presence of dependent kids

188
Q

behavioral warning signs of suicide

A

-giving away belongings
-taking care of legal stuff (making a will)
-dramatic increase in mood (boost from deciding to end life)
-verbalize threats to commit suicide or feelings of despair/hopelessness
-plan/intent
-visits medical provider
-asks about donating body to science
-engaged in high risk behavior
-symptoms of severe depression

189
Q

assessing lethality of suicide

A

-risk and protective factors
-MH/DA
-social supports and deterrents to taking action
-assessment of plan (frequency/intensity/duration of thoughts, accessibility/access to methods, ability/inability to control SI, ability not to act on thoughts, what helps/makes things worse, consequences of acting on thoughts, deterrents to acting, rehearsal/thinking of funeral), what do they need to maintain safety
**even if assessed as at risk, may still need insurance approval for medical necessity (danger to self/others, unable to care for self)

190
Q

assessing risk of violence- 2 important factors to keep in mind when assessing

A

circumstances of evaluation (structured approach), length of time over which clinician is making a prediction (limited to brief time-few months)

191
Q

assessing risk of violence- risk factors

A

-*past history of violent behavior is best indicator of future behavior (most violent act they’ve perpetrated, each prior act increases chances of future violence)
-history of violent suicide attempts
-history of using weapons against others (own/have access to weapons)
-criminal history (repetitive antisocial behavior)
-substance use (alcohol, stimulants associated with disinhibition)
-psych disorders with co-existing substance use
-certain psych symptoms (psychosis, depression, brain injury and illness, borderline and antisocial personality disorders)
-history of impulsivity, decreased frustration tolerance, recklessness, entitlement, inability to tolerate criticism
-angry affect without empathy for others
-military history and conduct during enlistment
-frequent job terminations
-18-24 years old
-men 10x more likely (similar rates for gender in MH populations)
-lower SES/poverty
-low IQ, intellectual disability, low education level
-take all threats seriously and evaluate level of danger, elicit info on potential grudge list, assess for SI

192
Q

practical strategies for risk of violence

A

-interventions to address static (past history of violence, demographic info) and dynamic (things that can be changed; living situation, MH/DA treatment, access to weapons) risk factors

193
Q

interventions to reduce risk of violence

A

pharmacotherapy, DA treatment, psychosocial interventions, removal of weapons, increase level of supervision, using appropriate risk assessment tool and obtaining detailed history of past violence

194
Q

youth violence: early onset risk factors (ages 6-11)

A

-general offenses
-substance use
-being male
-aggression, antisocial behavior/attitudes/beliefs
-hyperactivity
-exposure to violence
-medical/physical issues, low IQ
-low SES/poverty
-antisocial parents
-poor parent/child relations
-broken home
-abuse/neglect from parents
-poor school attitude
-weak social ties with peers
-antisocial peers

195
Q

youth violence: late onset (12-14)

A

-general offenses
-psych condition (restless, difficulty concentrating, risk taking)
-aggression
-male
-physical violence, antisocial behaviors/beliefs/behavior
-crimes against persons
-low IQ
-substance use
-poor parent/child relations
-low parental involvement
-antisocial parents
-broken home
-low SES/poverty
-abusive parents
-family conflict
-poor attitude/school performance
-weak social ties
-antisocial/delinquent peers
-gang membership
-neighborhood crimes/drugs
-neighborhood disorganization

196
Q

youth violence: protective factors (age at onset not known)

A

-intolerant attitude toward deviance
-high IQ
-being female
-positive social orientation
-perceived sanctions for transgressions
-warm, supportive relationship with parents or other adults
-parents positive evaluation of peers
-parental monitoring
-commitment to school
-recognition for involvement in conventional activities
-friends who engage in conventional behavior

197
Q

youth violence: pathways to violence

A

-2 general onset trajectories; before puberty and adolescence
-youths who become violent before 13 commit more crimes, more serious crimes, for longer times; pattern of escalating violence through childhood, sometimes into adulthood
-most youth violence starts in adolescence and ends with transition into adulthood
-more highly aggressive kids or kids with behavioral disorders don’t become serious offenders
-serious violence part of lifestyle that involved drugs, guns, precocious sex and risky behaviors
-difference in patterns of serious violence by age of onset and rates of individual offending; need different intervention

198
Q

youth violence: prevention

A

-components that address individual risks and environmental conditions-need both for most effective program
-most programs are ineffective, some even cause harm
-target change in social context in schools more effective than changing individual attitudes/beliefs
-involvement with delinquent peers and gang members are most powerful predictors of youth violence, hard to address with effective interventions
-quality of implementation impacts program efficacy

199
Q

Working with older adults: most effective strategies for working with at risk older adults

A

-team approach
-social services
-health/MH services
-criminal justice system

200
Q

Working with older adults: general guidelines

A

-need to improve personal sensitivity to aging process as experienced by the elderly
-be aware of own feelings/attitudes/stereotypes of elderly
-awareness of how belonging to particular cohort of elderly population impacts development and reaction to a helping relationship
-recognize there’s great variability among elderly-focus on development rather than age
-recognize how aging progress is affected by age and gender

201
Q

Working with older adults: relationship building

A

-modify clinical process to accommodate cognition impairments, lower energy levels
-modify physical settings
-use more active and structured stance, solicit input/feedback by paraphrasing/prompting ?
-may need to do more outreach, work hard to overcome reluctance/resistance they feel about needing help
-warm, supportive, nonconfrontational approach, provide structure and direction
-there and then focus
-transference/countertransference issues—remind them of child/grandchild, may be reminded of own grandparent

202
Q

Working with older adults: interventions; indirect

A

-intervene with informal helpers
-info and referral to local/state/federal programs
-healthcare service to live independently
-homecare
-day treatment
-outpatient and inpatient services
-family services (respite, adult day care, visiting, emergency response, phone reassurance)
-case management

203
Q

Working with older adults: direct interventions

A

-techniques to stimulate life review and reminiscence
-sensory training and remotivation
-reality orientation (mild dementia) and validation intervention (severe dementia)
-group work

204
Q

Working with older adults: special considerations

A

-issues of autonomy/self-determination (placement issues)
-late life depression, suicide risk
-substance abuse
-need for guardian if elderly person is incompetent

205
Q

Brief therapy

A

-systematic, focused process relies on assessment, client engagement and rapid implementation of change strategies
-6-20 sessions
-goal to provide tools to change basic attitudes/behaviors and to handle underlying problems
-focus on the present
-problem/solution focused
-clearly defined goals related to specific change/behavior
-approaches understandable to client and clinician
-produce immediate results
-easily influenced by personality/counseling style of counselor
-rapid establishment of strong working relationship
-therapy style highly active, empathetic and at times directive
-patient responsible for change
-early in process focus on enhancing clients sense of self-efficacy and hope of change
-talk about termination from the beginning
-outcomes are measurable

206
Q

family therapy: general info

A

-treat family as a unified whole, system of interacting parts where change to 1 part impacts whole system
-family is unit of attention for diagnosis/treatment
-focus on social roles and interpersonal interaction
-emphasis on real behaviors and communication that impact the current life situation
-goal to interrupt the circular pattern of pathological communication/behaviors and replace with new pattern without dysfunction

207
Q

family therapy: issues

A

-establishing contract with family
-examine alliances/groupings in family
-identify where power resides
-relationship of each family member to the problem
-how family relates to the outside world
-influence of family history to current interactions
-communication patterns
-family rules that regulate interaction patterns
-meaning of presenting problem in maintaining homeostasis
-flexibility of structure and accessibility to alternative action patterns
-family’s developmental stage
-sources of external stress/support
-family homeostasis

208
Q

family therapy: interventions

A

-define family stages and tasks-explain normal development/life cycle and relate to current problems
-use genogram

209
Q

family therapy: interventions- emotional cutoff

A

enmeshed member tries to break off all emotional ties, SW helps re-establish contact and learn successful ways to disengage

210
Q

family therapy: interventions- triangulation

A

how family uses others to talk for them, teach direct communication

211
Q

family therapy: interventions- coaching

A

guide family members in differentiation of self

212
Q

family therapy: interventions- family rules

A

explicit definition of rules family is guided by; restructure roles; shift interactions during session, assign HW, define interactional patterns, sculpting/psychodrama

213
Q

family therapy approaches: multigenerational/intergenerational approach

A

-pathology in current family relationships seen as unfinished business in family of origin relationships
-problems result of fusion due to inadequate individuation
-resolve tension by triangulating a 3rd party into interaction; helps to lessen difficulties in dyad, use 3rd person to talk through with no direct communication
-therapist coaches effective communication
-goal of therapy-increase differentiation of individuals, decrease triangulation

214
Q

family therapy approaches: structural family therapy

A

-importance of family organization for function and well-being of members
-SW joins with family in effort to restructure it
-family structure-invisible set of function demands organizing interaction among family
-boundaries and rules determine who does what/when/where
-interpersonal boundaries define individual family members and promote differentiation and autonomous/independent function
-boundaries with outside world define the family unit, must be permeable enough to maintain well functioning open system allowing contact and reciprocal exchanges
-hierarchical organization in families maintained by generational boundaries, rules differentiating, parent/child roles, rights and obligations
-enactment of situations during session

215
Q

family therapy approaches: communication/interaction family therapy

A

-experiential therapy, uses communication theory to examine dysfunctional patterns
-make explicit the implicit family rules
-SW develops working alliance with family, uses in vivo therapeutic experiences to teach family about their dysfunction, helps family overcome fear of change
-family roles based on communication patterns (placater, blamer, leveler, distractor)

216
Q

family therapy approaches: strategic family therapy

A

-assume that all problems have multiple origins
-view presenting problem as symptoms of and response to current dysfunction in interactions
-goal is to solve presenting problem
-symptoms regarded as communicative act thats part of repetitive sequence of behavior among family, serving a function in interactional network
-therapy focuses on problem resolution-alter feedback cycle that maintains problem behavior
-workers task is to formulate problem in solvable, behavioral terms and design intervention plan to change dysfunctional family patterns
-techniques of reliability, reframing, directives and paradoxical instructions used to achieve specific behaviorally defined objectives
-relabeling-alter meaning of behavior/redefine the situation so perceived meaning of behavior is less negative
-paradoxical instruction-prescribe the symptomatic behavior so client can control it, uses strength of the resistance to change in order to move toward goals

217
Q

family therapy approaches: psychodynamic approach

A

-integrates ideas from psychoanalytic and object relations with family systems
-family dynamics are reflection of interactions between intrapsychic factors and social, cultural, environmental factors
-SW tries to develop empathic working alliance to help achieve more harmony between individual and family needs

218
Q

family therapy approaches: behavioral family therapy approach

A

-based on social learning theory and exchange theory
-behavior is learning and maintained by contingencies in individuals social environment
-goal-teach more effective ways of dealing with each other by changing consequences of behavior/altering reinforcements

219
Q

group work: social group work

A

-dates back to settlement movement
-goal is to help individual maximize social function
-SW helps individual change environment/behavior through interpersonal interactions
-emphasis on conscious components
-group helps each other change/learn about social roles they want to hold
-common goal; SW and group agree to purpose/structure/function of group
-group major helping agent; common social tasks observed, management of self to cope, emphasis on socially functional behaviors
-individual self-actualization occurs; release of feelings, support from others, orientation to reality/check reality with others, reappraisal of self
-emphasis on social function rather than illness/pathology
-psychodrama can be used

220
Q

group psychotherapy

A

-members gain more knowledge and insight into selves to make changes through interactions with others
-focus of treatment is pathology/illness

221
Q

group psychotherapy: stages of group development

A

James Garland-preaffiliation, power and control, intimacy, differentiation, separation/termination
Bruce Tuckman-forming, storming, norming, preforming, adjourning

222
Q

group psychotherapy: curative universal factors/how groups help (Yalom)

A

-instillation of hope
-universality
-altruism
-interpersonal learning
-self understanding and insight
-existential learning

223
Q

group psychotherapy: factors in group cohesion

A

group size (5-10)
homogeneity
participation in goal/norm setting
interdependence
external threat increases cohesion
member stability

224
Q

group psychotherapy: group contraindications

A

crisis, SI, compulsive need for attention, psychosis, paranoia

225
Q

group polarization

A

process during group decision making when discussion strengthens dominant POV and results in shift to more extreme position than anyone would have on their own

226
Q

groupthink

A

high group cohesion and loyalty to group can undermine decision making to maintain the “we-ness” they ignore alternatives; to counteract, SW puts positive value on open inquiry

227
Q

crisis intervention

A

-state of crisis is time limited
-brief intervention during crisis usually provides max therapeutic effect
-goals-alleviate stress, mobilize psych capabilities/social resources
-crisis is an upset in steady state, decreases capacity of effective function and decision making
-ego patterns may be more open to influence and connection
-goals-relieve impact of stress with resources, help person regain equilibrium, help increase coping during crisis and for long term

228
Q

social role theory: role

A

behavior prescribed for an individual with a designated status

229
Q

social role theory: role behavior

A

how the status occupant should act toward an individual with who his status rights and obligations put him in contact; basic script for behavior, learned in process of socialization

230
Q

social role theory: status

A

implies relationship to another person, set of rights/obligations that regulate transactions with individuals of other statuses

231
Q

social role theory: social and individiaul determinants of role behavior

A

persons needs/ideas of mutual obligations and expectations that have been invested in the particular status he undertakes, compatibility/conflicts between persons conception of obligations and expectations and those help by person with whom in a reciprocal relationship

232
Q

social role theory: role ambiguity

A

role for which no place has been made in social system, lacks regularized expectations

233
Q

social role theory: role complemntarity

A

exists when reciprocal role of role partner carried out in expected way

234
Q

social role theory: role discomplementarity

A

when different roles conflict or when role expectations assigned by another differ from ones own

235
Q

social role theory: role reversal

A

roles opposite to whats appropriate

236
Q

social role theory: failure in role complementarity

A

cognitive discrepancy, discrepancy of roles, discrepancy in cultural value

237
Q

social role theory: role allocation

A

-ascribed-automatically by age, sex, etc
-achieved-by occupation
-adopted-satisfy some need of the individual
-assumed-lets pretend

238
Q

social role theory: explicit roles

A

conscious and exposed to observation

239
Q

social role theory: implicit roles

A

unconscious (acting like a dependent child)

240
Q

social role theory: prescription

A

behavior that should be performed (SW prescribes behavior, strain if not congruent)

241
Q

social role theory: sanctioning

A

behavior with intent to modify anothers behavior, usually toward conformity

242
Q

social role theory: locus of control

A

extent to which individual believes life events under his own control (internal) or control of outside forces (external)

243
Q

bases of social power: coercive

A

power from control of punishments

244
Q

bases of social power: reward

A

power from control of rewards

245
Q

bases of social power: expert

A

power from superior ability/knowledge

246
Q

bases of social power: referent

A

power from acceptance as standard for self-evaluation, attracted to/identify with person with power

247
Q

bases of social power legitimate

A

power from having legit authority

248
Q

bases of social power: informational

A

content of message leads to new cognitions

249
Q

resilience

A

-ability to bounce back
-everyone bor with innate capactiy, responsive environment fosters those traits (social competence, autonomy, problem solving, sense of purpose)
-protective factors-caring relationships, high/realistic expectations that can rise to challenge, opportunities to participate and contribute
-resilience emerges once effects of adversity buffered by having basic needs
-resilience can be learned; create opportunities to have basic needs met

250
Q

definitions of collaboratoin

A

-learned skill that can be improved
-important vehicle for improving services for clients
-1 plan for client with many people owning/taking responsibility for it
-collaborative teams more likely to develop new/innovative problem solving
-professional commitment to working with other professionals to deal with services related issues
-improve professoinal skills from fostering partnerships and empowering clients to become effective team members

251
Q

communication; considerations for SW interview

A

-SW has responsibility for achieving purpose of interview
-interview designed to serve interest of client
-plan and focus actions to further purpose; purpose may vary
-concern of interview is specific
-all communication interactive/interrelational
-verbal and nonverbal

252
Q

Communication Theory

A

-invokes the way info transmitted, effects of info on human system, how people receive info, how they evaluate it, and how they respond

253
Q

Communication Theory: information

A

anything people perceive from environment or from within self

254
Q

Communication Theory: information processing

A

responses to info that are mediated through perception/evaluation of information received

255
Q

Communication Theory: feedback

A

how behavior affects internal state/surrounding, perceive what follows actions and evaluate perceptions as feedback

256
Q

Communication Theory: relationships

A

defined by the messages implicit and explicit in communication
-symmetrical-2 have equal power
-complementary-1 up/1 down position, unequal power

257
Q

Communication Theory: double bind

A

offering 2 contradictory messages and prohibiting recipient from noticing contradiction

258
Q

Communication Theory: paradox

A

prescribing the symptom, symptom no longer serves purpose and can disappear

259
Q

Communication Theory: nonverbal communications

A

facial expression, gesture, posture, tone of voice

260
Q

Communication Theory: metacommunication

A

context within which to interpret content of message

261
Q

Communication Theory: context

A

circumstances surrounding information exchanges

262
Q

Communication Theory: rules for info processing

A

rules by which potentially available info perceived/evaluated

263
Q

Communication Theory: info processing block

A

fail to perceive/evaluate potentially useful new info

264
Q

Communication Theory: metacomplementary relationship

A

1 person lets other have control/forces to take it

265
Q

Communication Theory: symmetrical escalation

A

power struggle, trying to be 1 up at the same tim

266
Q

verbal barriers to communication

A

-using should’s to make client feel judged and resist change
-giving premature advice
-using logical arguments/lecturing
-judging/blaming can harm relationship
-making glib interpretations of behavior
-talking to client using jargon and defining them by diagnosis
-providing premature reassurance or without genuine basis
-sarcasm
-defensive response when provoked by client
-inappropriate use of questions
-ill timed/frequent interruptions
-domineering/authoritarian behaviors from SW
-SW must provide structure/direction
-use of cliches/phrases
-avoid fishing for clinically irrelevant info

267
Q

code of ethics states should only elicit how much information

A

minimum information necessary for providing services

268
Q

axioms of communicatoin

A

-can’t NOT communicate
-every communication has a context and relationship aspect such that the latter classifies the former and is a metacommunication
-nature of relationship contingent on punctuation of communicational sequences between people (make meaning out of pauses)
-all communication exchanges are symmetrical/complementary, depending on whether they’re based on equality or difference

269
Q

research

A

-limit the amount you study; goal to know few things well, discover answers to questions through applying scientific procedure
-research always starts with some kind of problem

270
Q

types of research studies

A

-exploratory/formative: purpose to gain familiarity with phenomenon/achieve new insights into it, to formulate more precise research problem/develop hypothesis
-descriptive: purpose to accurately describe characteristics of something
-correlation: purpose to determine the way things are associated (correlation doesn’t equal causation)
-testing causal hypotheses-purpose to test hypothesis about causal relationship between variables

271
Q

experimental studies

A

-experimental; manipulate and control at least 1 independent variable to observe impact on dependent (most effective way to test hypothesis that 1 variable causally influences another)
-nonexperimental; doesn’t allow you to rule out in advance the possibility that the effect was created by some other factor thats correlated with presumed causal factor
-IV is the one manipulated/controlled, DV is one affected

272
Q

common research designs

A

-experimental group design; comparison of control to experimental groups (experimental group gets treatment; compare groups before and after treatment)
-pre-post (AB) design; compare a variable before/pre treatment (baseline, A) to after/post treatment (B), hard to rule out alternative causes of change
-single subject designs-experimental study of 1 person (ABA reversal design; baseline, treatment, withdrawal of treatment-does DV return to baseline)

273
Q

**in some cases, unethical to withdrawal treatment if

A

patient at risk of harm; in crisis would not delay treatment to obtain baseline data

274
Q

reliability

A

can you get the same answer repeatedly, are measures obtained true measures of what you’re measuring; dependability, stability, consistency, predictability, accuracy

275
Q

validity

A

are you measure what you think you’re measuring or something else; validity of measuring instrument is extent to which different in scores reflect the true difference

276
Q

external validity

A

can results be generalized to other settings/group/times, etc

277
Q

internal validity

A

did experimental treatment make difference in this instance

278
Q

content validity

A

How well an instrument covers all relevant parts of construct it aims to measure; how well the test represents the construct

279
Q

construct validity

A

How well a test measures the intended concept; are test measures actually measuring depression

280
Q

predictive validity

A

to what degree does variation in test score predict variation on other measure; does IQ predict academic success

281
Q

face validity

A

How suitable the content of a test seems to be on the surface, more informal and subjective assessment

282
Q

statistic

A

-collection of theory/methods applies for purpose of understanding data
-descriptive stats; describes the data
-inferential stats; generalizations made about a population by studying a sample (tests include ANOVA, ttest, chi square)
-nominal-classifies objects into categories based upon some defined characteristic (race, sex, color); classifies without order, categories are mutually exclusive
-ordinal-logical ordering of categories (ordering cities by population), have logical order and are scaled according to number of particular characteristics they have
-interval; difference varies between various levels of the categories on any part of the scale reflect equal differences of the characteristic measured (equal interval)
-ratio; equal different in characteristics represented by equal difference in the number assigned to categories (equal intervals), 0 reflects absence of characteristic (speed, weight, length)

283
Q

random sampling and assignment
**true experiments must have

A

-in random sampling; each individual within population has equal chance of being selected for study, and all members of a sample selected independently of one another
-random assignment; individual selected for study assigned to experimental/control groups according to chance

284
Q

measures of central tendency

A

mode-most frequent score
median-point below which half of scores lie; often best measure of central tendency in highly skewed distribution
mean-average of scores, strongly affected by extreme scores, varies less from sample to sample if sample drawn from same population

285
Q

bias in research
bias in sampling
bias in assignment
bias in test administration

A

-results from collection of evidence in such a way that 1 alternative answer to a question is favored over another
-when 1 subject is more likely to be selected than another
-when subject not equally likely to be assigned to experimental/control group
-when different experimenters administer the test differently

286
Q

null hypothesis; level of significance

A

-statement of no difference/relationship between variables or control/experimental groups
-probability that difference is due to chance,

287
Q

types of research

A

-pure (basic) vs applied research; pure-human phenomena to understand them as an end in itself, knowledge for the sake of knowledge/applied-conducted to do something better/more efficient
-both important
-weakness of SW applied research-wide gap between those who develop new approaches to practice and those who do efficacy research
-developmental research; goal to build intervention technology, begins with examining existing research regarding methods that have been used to deal with problems, gather data on intervention implementation and outcomes, helps improve the interventions and design experiments to move closer to outcome

288
Q

stages of research process

A
  1. problem formulation (operational definition, determine problem that research should help solve, specification of hypothesis, statement of assumptions, relate problem formulation to a theory)
  2. research measurement design (decide how data will be collected ensuring reliability and validity of content/concurrent/predictive/construct, use of each instrument, how data will be coded and analyzed, qualitative vs quantitative data)
  3. data analysis (analyze coded data, inferential stats-determine what the relationship is likely to be among variables, research terms; t test-test of statistical significant difference between means, chi square-test of statistical significance that measures different between observed frequency and expected frequency due to chance, random error-assessed by instrument reliability)
289
Q

macro SW practice

A

-concerned with practice in domains of communities, organizations, political arena
-need to have at least basic understanding of macro as a clinical SW
-grew out of churches and ethnic benevolent associations, settlement houses
-embraced wide range of social movements

290
Q

community organization

A

-intervention primarily centered on organizing/planning/development/change
-individuals/groups/organizations engage in planned action to influence social problems
-emphasis on social and environmental factors, prevention, concern with social reform

291
Q

community organization: community definition/dimensions/functions

A

-community occurs when people come together around commonalities, shared interest
-community is combination of social units/systems that perform the major locality relevant social functions (exchange of goods/services, socialization, social control, social participation, mutual support)

292
Q

community organization: community theories-systems theory

A

communities set boundaries but are open systems that require exchange and interaction internal/external (horizontal/vertical)
-bond within community, bridge community to external
-change in one part equal change in another

293
Q

community organization: community theories- human ecology theory

A

-communities are interdependent
-how people integrate with their environment where they have to compete and cooperate
-competition, centralization, concentration, segregation, succession

294
Q

community organization: community theories- human behavior theories

A

-relationships with systems at all levels and how they engage, SW macro direct practice to interact with community, communities have culture, collective identity

295
Q

community organization: community theories- power and politices

A

-power dependency theory, conflict theory, resource mobilization theory
-reliance on external powers for resources, impacts power dynamics
-collective identity/efficacy of community, tied with ability to band together for a change

296
Q

community organization: community theories- strength/empowerment perspectives

A

strengths/assets of community

297
Q

community organization: community theories- social networking theory and social capital

A

-ability to come together and use social ties to make change, how social cpaital can be used to influence change

298
Q

community organization: definition

A

collective human effort centered on mobilization, planning/advocating for resources to address community identified issues
-build and maintain organization base (organizers organize organizations)
-planning includes fact gathering, assessing, form strategies
-advocating includes pressuring and bargaining

299
Q

community organization: common characteristics

A

-focusses on social/communal rather than psychological needs of individual community members, strives to develop resources that respond to needs of community
-build on assets/capacities
-enhance participatory skills of individuals by working with them not for them (democratic participation)
-develop leadership of locals (empowerment and human capital development)
-strengthen community to deal with future problems better (capacity building, build social capital)
-advance interests of disadvantaged/marginalized so they can engage (equity)

300
Q

community organization: assumptions

A

-community members can develop capacity to solve problems
-members want to improve their situations
-members must participate in change efforts, not have change imposed
-systems approach most effective
-democratic participation
-members gain from organization skills in addressing problems they aren’t dealing with themselves

301
Q

community organization: approach

A

-community intervention uses systematic, rational, planned, problem solving approach
-define problem and assess its dimensions, community assessment, engage community
-consider/develop priorities, develop goals/strategies with an action plan, raise awareness of issue, increase community buy in
-create/implement community interventions, mobilize resources
-evaluation of plan and outcomes
-revise plan for renewed action, termination of intervention

302
Q

models of community intervention: locality development

A

community work aimed at improving the quality of community life through participation of many people at the local level; democratic procedures, participation of all, majority rule determining decisions, consensus building/collaboration, seeks to build on all community assets

303
Q

models of community intervention: social planning

A

emphasizes rational study of a community problem as basis of determining solution
-relies on community/experts to develop programs and services; educated, advocate, campaign strategies
-primary prevention; prevent a problem before it happens, reduce incidence of new cases
-secondary prevention; to treat symptoms and decrease prevalence by reducing duration through early detection and intervention, prevent recurrence/exacerbation of already identified problem
-tertiary prevention; reduce disability in chronic problems, reduce duration of problems by decreasing negative after affects

304
Q

models of community intervention: social action

A

can only solve problem by taking direct action against those in power, develop coalitions to change

305
Q

models of community intervention: asset based community development (ABCD)

A

focused on identifying, mapping, mobilizing 3 building blocks for collective efficacy, strength and empowerment model
-gifts/capacities of individuals in community, capacities of local associations, resources of institutions located in the community

306
Q

models of community intervention: community building

A

approach for rebuilding low income/distress community, core principles for effective community building
-improvements that reinforce values and build social/human capital
-community drive with broad resident involvement
-comprehensive, strategic, entrepreneurial
-asset based
-tailed to neighborhood scale and conditions
-collaboratively linked to broader society to enhance outside opportunities
-consciously change institutional barriers to racism

307
Q

SW/Human Services Management

A

-goal to enhance service resources/service efficacy
-focused goal attainment and organizational maintenance activities
-political process that’s concern with when/why/how/to whom services are allocated

308
Q

organizational theories: bureaucratic theory

A

hierarchical organizational structure in which positions are defined in terms of tech knowledge and competency and require high degree of specializatoin
-largely closed systems, often insular
-more focus on efficacy and maximizing efficiency

309
Q

organizational theories: scientific management theory

A

employ hierarchical management framework and uses approaches to optimize efficiency and productivity through applying scientifically based principles
-standard of job performance
-employees motivated by economic self interest and punishments for poor performance (Theory X-managers believe staff dislikes work and avoid it, so systems of incentives/sanctions use to reward/punish staff)

310
Q

organizational theories: human relations theory

A

emphasize the importance of cohesive work groups, participatory leadership, and open communication
-theory Y-managers view work as natural human process and assume employees are self directed (more likely to lead an effective organization)

311
Q

organizational theories: management by objectives

A

purpose of management is to establish/direct what the organization is to accomplish, the goals must be central focus
-focus on outcomes first and then work backward to identify goals and build structure
-driving force in strategic planning process

312
Q

organizational theories: structural function theories

A

focus on application of goals/power/centralization
-utilize information relations, interdependence, adaptation, participation
-assumes bureaucratization is an ever changing process
-organizations take on a life of their own, organization goals displaced by goals of individual
-organization as organism

313
Q

organizational theories: systems theories

A

synthesize structural/function and human relations approaches
-bureaucracies viewed as social systems with subsystems whose functions are management, adaptation, maintenance
-shift to open system management theory and practice

314
Q

organizational theories: contingent theory

A

organizations are systems interrelated with environment, changes in environment require organizational change to remain effective
-many ways to organize, depends on stability of environment

315
Q

organizational theories: theory Z

A

aimed at increase employee loyalty to company by providing job for life and focus on staff well being on and off job
-quality oriented management style

316
Q

organizational theories: organization concepts

A

-power, politics, economics
-culture of organization
-diversity
-pursuing and managing excellence
-sense making-social learning theory helps understand how we make sense of our environment and process info
-organizational learning-open systems and exchange of info

317
Q

organizational theories: theories of motivation- need hierarchy theory

A

Maslow’s hierarchy of needs; physiological, safety, belonging, esteem, self actualization

318
Q

organizational theories: theories of motivation- ERG theory

A

Alderfer reduced basic needs to 3; existence, relatedness, growth (ERG)

319
Q

organizational theories: theories of motivation- needs for achievment, power, and affiliation

A

nACH, nPOW, nAFF; intreact as motivators in organizational setting

320
Q

organizational theories: theories of motivation- 2 factor theory

A

2 types of needs identified by Herzberg
-lower level needs; physiological, safety, belongingness; have little impact on job satisfaction, but produce dissatisfaction when not met

321
Q

organizational theories: theories of motivation- equity theory

A

employees compare ratio of their inputs to outcomes to ratios of coworkers

322
Q

organizational theories: theories of motivation- goal setting theory

A

individuals are motivated to achieve goals they’ve consciously decided to pursue

323
Q

organizational theories: theories of motivation- expectancy theory

A

individuals will be motivated when they perceive that successful performance and valued rewards are contingent on high level of effort

324
Q

organizational theories: theories of motivation- reinforcement theory

A

applies principles of operant conditioning to organization settings, predicts when behaviors are followed by reinforcement they will be likely to occur again

325
Q

organizational theories: current trends

A

-greater diversity in US population; people live longer and with greater chronic illnesses/conditions
-growing economic disparity in US, growing concern with racial/ethnic disparity in US
-less economic resources/public funding
-commercialization of nonprofit/human services sector, competition from private sector
-declined in welfare state
-renewed focus on rehab/re-entry in criminal justice system
-orgs need to be more business like
-new organization, management systems that address need for new admin/management approaches
-greater accountability (financial and impact), better systems of management, evaluation, evidence based practice

326
Q

Human Service Management Competencies: Executive Leadership (domain I)

A

-establish, promote, anchor the vision, philosophy, goals, objectives, values of an organization
-possess interpersonal skills that support viability/positive function of an organization
-have analytical/critical thinking skills that promote organizational growth
-model appropriate professional behavior, encourages others to be professional
-manage diversity, cross cultural understanding
-develops/manages internal/external stakeholder relationships
-initiates and facilitates innovative change processes
-advocate for public policy change/social justice at national, state, local levels
-demonstrate effective interpersonal/communication skills
-encourage active involvement of all staff/stakeholders in decision making
-plans, promotes, models life congruent learning

327
Q

Human Service Management Competencies: Resource Management (domain II)

A

-effectively manage HR
-manage/oversee budget/other financial resources to support organizations mission/goals and ongoing program improvement
-establish/maintain internal controls to ensure transparency/protection/accountable for use of resources
-manages IT

328
Q

Human Service Management Competencies: strategic management (domain III)

A

-fundraising
-marketing and PR
-designs and develops effective programs
-manages risk/legal affairs
-ensure strategic planning

329
Q

Human Service Management Competencies: community collaboration (domain IV)

A

builds relationships with other agencies/groups in community

330
Q

Key Administrative and Management Function: ethical practice (NASW code)

A

-3.07 administration; advocate for resources to meet clients needs, take reasonable steps to meet clients needs/staff supervision
-6.01 social welfare; promote general welfare of society
-6.02 public participation; shape social policies/institutions
-6.04 social and political action; engage to help ensure all have equal access to basic needs, expand choice/opportunity for all, promote conditions that encourage respect for all and doesn’t discriminate

331
Q

Key Administrative and Management Function: general

A

-communication and interpersonal relationships
-culturally responsive management practices
-collaboration; building partnerships, alliances, coalitions
-governance; knowledge/understanding of policies that govern operation
-leadership
-management/leadership tasks and conflict resolution, interpersonal methods (persuasion, super-ordinate goals, bargaining, problem solving, structuring the interaction, organizational redesign)
-planning (SWOT analysis-strengths and weaknesses internal, opportunities and threats external)
-program development and organizational management; sense of informal vs formal aspects of service delivery
-program evaluation (effort, impact, effectiveness, efficiency, quality)
-financial development and management

332
Q

signs of financially healthy nonprofits

A
  1. resources to ensure stable programming from year to year
  2. ready source of internal cash or access to cash if needed
  3. committed to income based, not expense based budgeting
  4. have positive cash fund balance at the end of the year
  5. if deficit for year, have accumulated surpluses which are greater than current years deficit
  6. established, or plan to, operating reserve to finance stability of organization
333
Q

budgeting and resource allocation

A

-budgeting techniques; zero base (starts year with 0 budget allocation), program planning budget system (each item on budget must be something that carries stated objective), cost effectiveness and cost benefit analysis, management by objectives (need to all be aimed at achieving specified goal)
-staff development

334
Q

public/community relations and marketing

A

-knowledge and understanding of the community and ability to work collaboratively and do outreach
-PR tasks include education, outreach, advocacy
-IT
-public policy and advocacy; social welfare policy, policy analysis, issues

335
Q

policy practice competencies

A

-understand human rights/social justice and welfare are mediated by policy
-understand role in policy development/implementation within practice setting
-recognize and understand different things that affect social policy
-knowledge of policy formulation, analysis, implementation, evaluation

336
Q

supervision

A

-practice in which authorized staff person assigned direction, coordination, guidance, development, evaluation of performance of staff, goal to provide effective/efficient delivery of client services
-administrative
-educational
-supportive
-**if problem situation arises, first discuss privately with supervisee to get their perception of the problem and determine how to address it
-evaluation is an ongoing process; errors include halo effect (base all on 1 outstanding aspect), leniency bias (hesitation to be honest about negative performance), central tendency error (rate all work as average), recency error (only consider most recent performance), contrast error (standard of comparison is supervisor or poorly performing group), negativity effect (total performance biased by deficiency in 1 area)
-group supervision

337
Q

problem solving process (*keep general format in mind for solving problems)

A
  1. acknowledge the problem
  2. analyze/define the problem
  3. generate possible solutions (brainstorm)
  4. evaluate each option
  5. implement option of choice
  6. evaluate outcome

LCSW Exam (9 decks)

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