exam 1 Flashcards
After Dianne made the 911 call, what happened?
Dianne said she did not need help and that she was just overreacting
911: If you do need help give me a number from 1-5 and said 3
In chapter 1, was Dianne allowed to tell her hosts”good-bye”?
No, she was not able to say bye to her hosts. John was waiting outside the bathroom door. Which he told Dianne to grab her purse right after she came out.
Which John had no intention of answering any of Dianne’s questions
In Chapter 1, what was the reason John wanting to go home from the party?
“You happened”
Dianne supposedly humiliated him in front of his friends. For the simple reason that she was supposedly flirting with Scott.
-excuse: she was also drunk.
In chapter 1, between the episodes of verbally and physically abusing Dianne , what did John do ?
John was in the living room watching TV.
Specifically, sport channel; football.
In chapter 2, how did Dianne’s friend react?
“Oh honey, what has he done to you?”
That it wasn’t his fault because he was may stressed over the fact he lost his job and start his retirement early.
In chapter 3, how did John react when Dianne returned to to her store to begin the morning duties
- Regretful of what he has done.
- Begged her to get him another chance that he was never going to do it again . (Forgiveness)That he cannot believe what he had done
- Reasoning that Dianne the right to be scared of him.
In chapter 3, when John saw the bruises he caused , how did he react?
He saw the bruises and avoided to look at them. He just pretended that they didn’t existed and kept taking.
In chapter 3, how did the minister at the local church react after Dianne told him what happen?
The minister told her that she had to make some changes to save her marriage, and pray.
Then said that a divorce(“not good in gods eyes”) was only possible if there was an adultery.
In chapter 4, what title had Dianne won?
Mrs. Arizona
In chapter 4, when did the verbal abuse from John?
2 weeks after they were married.
After Dianne dropped Derek at the airport to go see his father for the summer.
In chapter 1 and 4, how long did Dianne and John date before they got married?
They dated for 4 months.
In chapter 4, Dianne’s father began to make plans for a big fishing trip on John’s boat. What did her father say to her regarding getting married to John?
You better hurry up and marry him before he finds out what you’re really like and dumps you.
In chapter 5, Dianne told John she wanted to get an annulment, how did he react?
Stood quiet and stared at Dianne. He was violent and aggressive when he said “If you leave me, I’ll kill you!”
- he threw his coffee at Dianne’s face. Then hit the side of her face with the mug.
In chapter 6, how is perversion different from fulfilling “normal” sexual needs above abnormal sexual demands?
It’s another way in which the abuser can degrade his victim because he is not satisfied
In chapter 6, what two things happen when the victim refuses to take part in the above Abnormal sexual demands?
Tension building phrase and explosion phase.
LECTURE 1
Chapter 10 and 11
When would a case manager use confrontation with a client?
- Client says something but doesn’t follow through, body language contradicts what they said, or behavior is contradictory.
- Client has a perception you disagree with
- The client has unrealistic expectation for you or him/herself
- The client asks for help, but doesn’t follow through with suggestions
- Client says they have certain values, but behavior doesn’t match
What are the four parts of a complete I- Message for confrontation?
- Your concerns/feelings/ observations about the situation
- A non-blaming description of what you have seen or heard, of the behavior
- The tangible outcome for you as a result, or the possible consequences for the client
- An invitation to collaborate on a solution
ex.
(1) I think what concerns me is (2) you being late for the last four appointments has (3) caused a lot of scrambling on my part to catch up the rest of the day. (4) Can we look at what is happening here?”
What are the rules for confrontation?
- be matter of the fact (details)
- be tentative
- take full responsibility for your observations
- always collaborate (together figure out a situation)
- don’t accuse the other person
- don’t confront because you are angry
- don’t be judgemental
- don’t give the client a solution
Why would a case manager ask permission to share ideas?
Leaves the client in charge of his/ her solution and free to reject the offer of ideas
Ask feedback from the client
Best to have more than 1 feedbacks so the client can have a choice.
What are some common reasons clients may be angry?
-Client is angry about something the agency has done, you said or did
So the client feels exhausted,overwhelmed,confused, and in need of attention
View anger as a clue to underlying issues or problems that need to be resolved
Why is disarming anger important
YOU, the professional , are expected to use techniques that move the relationship beyond the anger
- Eliminates any obstacle to true understanding
- Shows clients you respect their messages
- Enables you to understand their problem
- Allows you to practice empathy
- Focuses work on solving the problem
What is a common mistake case managers make with clients who are openly angry?
Clients will give you no trouble , follow all your suggestions, be appreciative, and never criticize or be resistive.
Many clients sound angrier than they mean to be. Taking anger personally is a major mistake when dealing with an angry client.
It’s not about YOU and how you feel . It’s ALWAYS ABOUT THE CLIENT and your responsibility to the clients.
What should you avoid doing when disarming anger?
DO NOT become defensive( when you defend yourself, it makes them ANGIER)
DO NOT become sarcastic
DO NOT act SUPERIOR
DO NOT grill the client ( avoid asking numerous questions, one after the other in a doubtful tone of voice)
How do you manage the angry outbursts from a client out of control?
Secure the safety of everyone Remain matter of fact (stick to the subject Remain calm , use relaxed movements Use an even tone of voice Use reflective listening
Lecture 2
Ch7,8,& 9
How would clients react when the case manager displays an attitude of superiority?
Clients get the sense the cm talking down to them and harms the relationship
Which two aspects of reflective listening is considered empathic and the most useful kind of response?
The content of what the client has said
The feelings that underlie what the client said
Important as empathetic are the feelings
What is an example of correct responses in listening to content?
So you decided .. Or so in other words
Repeating the facts back to the client
How can responding to content help the client?
By repeating the facts back to the client, the client can begin to integrate what happened to them and assist in their healing process.
When a case manager says to their client “ I understand how you feel, but…” What is about to happen?
Tends to negate the clients real feelings and push the workers perspective instead
What is the purpose of reflective listening?
- Let’s clients know you have heard their concern and feelings accurately
- Allows you to correct misperceptions
- Shows that you accept where your client currently is at the moment
What is an empathic response?
A single sentence that includes the clients feelings
- The ability to hear accurately the underlying feelings and emotions that the client is expressing when they speak.
- From a facial expression, body language, tone of voice, mood and choice of words
- Listening for the feeling and determining the degree of feeling
Why construct a single statement to respond to your client’s feelings?
Practices empathy and acknowledges client’s feelings
Because if you add more it distracts the client and moves them away from their central concern .
What does your instructor state regarding “could you tell me…? “And “would you…?”
Instructor disagrees with the author of the book and aids these are actually “closed questions” because they can be answered with a “yes or no” answer.
Tend to bog sessions down and should avoid these types of questions and ask more specific open questions.
What questions make clients feel uncomfortable and [why do they have this effect?]
“Why” question make clients uncomfortable.
Because they don’t want to questioned so much
[NEED MORE INFO]
Assumptions
Lecture 3
Just notes
Do male case managers normally work in the field of domestic violence ?
NO!but rarely
Are the majority of perpetrators males or females? Are the majority of victims women or female children?
Majority of perpetrators are men.
Victims are women and female children (BOTH)
What suggestion are given for working in women’s programs for domestic violence ?
Women are SEEN no so much as victims , but more as survivors
Since the women clients have been the victims of abuse of power and control these AGENCIES and the workers within them seek to put the women in control , to value her desires and perspective , and to give her control over the process of her therapy and her legal decisions
What was discussed in your lecture on Rape and Domestic Violence regarding batterers in general?
- Batterers tend to minimize the abuse, or deny it all together , and believe they will not suffer any legal or economic consequences.
- do not act violently
Why are victims of rape or domestic violence reluctant to seek help
- People assume that rape was women’s fault because of her dress or demeanor or the places she went
- in some cultures the woman is considered damaged as a result
The above May be reinforced by religious leaders and others in their immediate culture
She FEARS involvement with the criminal justice system
What is the escalation pattern of abuse (aka the cycle of violence, the Battering Cycle)?
- Early in the relationship, abuse is often hard to spot. As the abuser takes more and more independence away from the victim , he typically does so under the notion that he is doing it out of love and concern for her.
-TENSION BEGINS TO BUILD in the relationship until an ACUTE EPISODe occurs. These episodes generally increase in violence the longer the relationship lasts
-there generally follows a DE- escalation process in which the batterer apologies profusely, offers, to get help. He insists that she is the only one who understands him and that he cannot go on without her, and promises the behavior will never be repeated.
Psychological damage
The victim are responding to the entire history of abuse basis not just one incident , leading to feeling helpless ,hopeless, depressed , acute fear , constant anxiety.
Problem when leaving
heighten ris of homocide
Leaves and returns to her abuser
“”””"”NOTES”””””
What are some problems a women faces when she tries to leave the batterer?
Hope for change Isolation Societal denial Barricades to leaving Dangers in leaving Economic autonomy
What state passed the nation’s first stalking statue in response to the often- deadly consequences of stalking passed?
California in 1991
What should you do when conducting in interview with a battered victim in the hospital?
- Conduct the interview with women in private
- Do not ask her if she wants the significant other present in the interview room, while they are present
- Be warm to the significant other you are asking to leave, and say you want to speak with him after you complete the interview
- When speaking to the significant other, DO NOT even glance at the victim to see what she might want
What do you take into consideration when assessing the batterer’s lethality?
If he is likely to harm victim, you must inform both the police and the intended victim.
- threats to KILL
- plans/ fantasy that includes killing
- access to weapons
- insists that victim belongs to him and no one else can have her
-batterer is virtually isolated except from his victim
-separation causes great rage
-Has easy access to victim
-has history of violence
Sudden change in risk taking in which batterer appears to have no concern for the consequences of his behavior or for himself
What are some issues with domestic violence in later life?
Married for some years before the abuse began
Concerned that there is a mental health or physical problem with batterer, not want to leave when he is ill
Feel vulnerable: batterer threatened to kill her, her friends, her children, pets
Problems with hearing, seeing, walking may prevent victim from gleaving
Fears losing financial security
What was discussed regarding violence against Latinas?
- Latina women are often the foundation of their families. They are expected to be dutiful mothers, wives, and daughters, putting their needs last
- Women are expected to take partners for life, and usually they defer to their husband although in family matters they often have an equal say. Patriarchal families are not uncommon
- Many Latina women believe that if their partner is abusive it is gods will. The woman is expected to follow catholic doctrine and to be traditional and conservative in her religious beliefs. Seeking help may be seen as public act of disrespect and an act against god.
- Latina women may be ignored by men because they are women
What was discussed regarding teen dating and violence?
Teenagers have fewer resources to which to turn to, such as being unaware of the programs for battered women
Peer pressure can prevent her from leaving the relationship
The possessive nature of the abuse and the jealous reactions of her boyfriend, coupled by his dominance, are often interpreted by a teenage girl as positive signs that her boyfriend has made a loving commitment to her
Battering often occurs when teenage victims insist that their partners wears a condom or abstain from sexual activity
Many of the teenage males who abuse teenage girls come from homes in which their male role models abuse females
How are elderly women affected by rape?
Suffer more physical pain than a younger women
Preexisting medical problems may be worsen by assault
Most sexual assault of elderly women occur in their own home, often in association with burglary
CMs need to assess the support available ( family, friends, religious organizations , senior center,etc) along with assessing the senior’s cognitive ability
In the decision to prosecute or not, is it strictly up to the victim if she is the victim of rape? How about if she is a victim of domestic violence?
Rape : YES!
Domestic violence : there may be laws that make it mandatory for police to prosecute whether the woman wants it or not. Taking the responsibility for prosecution away from the victim is done to protect her from further abuse.
Lecture 4
Ch 14,&15
What do you include in the section: Previous Treatment?
When
With whom
Where
And for what
What do you write under “Disposition”?
The name of the person to whom you refer the client for intake, and the date of the intake appointment.
What is the purpose of the verification letter?
To confirm the appointment for an initial intake
Hopefully cut down on missed appointments
Because agency doesn’t get paid for missed appointments
What is the purpose of the first interview?
Identify client's strengths Identify client's weakness Current problems that caused client to seek help now Potential problems A sense of who the client is
Task listen and communicate that you have obtained an accurate understanding of the client opinion about themselves and their problem
Create a professional understanding of the above and what services you can provide the client
Begin establishing rapport with the client
How do you prepare for the first interview?
Review Initial Inquiry information
If a former client, review past records, past medical difficulties, medications
What suggestions are made regarding a case manager’s office?
Your office: No personal picture, a comfortable chair for client, and an environment where both of you can talk in a normal voice, not feel crowded.
What suggestion’s are given for meeting the client?
Go to the waiting room to meet your client
Introduce yourself
Mentally note their reactions to you and your office
Show interest in what they say
Make sure they signed an informed consent form
If asked about your credentials, answer but don’t give out personal details
Describe the agency and it’s purpose
Confirm payment arrangements, that they know about confidentiality and it’s limits, and that they signed HIPAA forms
Is it alright to take notes during your interview with the client?
Yes.
Reflect back feelings , paraphrase content
What is meant by the phrase “presenting problem”?
Why they are seeking services now as opposed to last week, the extent the problem is interfering with their ability to function, whether they have a support system, and what services they want
What is suggested for the case manager to do as the client leaves?
Stand up to indicate session is over
Walk the client back to waiting room
“Door-Knob Sydrome” (ie. husband beating , “we’ll talk about it next time”) they tell you something of great significance just as they are leaving
If the client is a danger to themselves or others, do not allow them to leave agency until proper arrangement are made
Maintain confidentiality: do not discuss client’s name, next appointment , or anything else related to the client where other clients can overhear the discussion
give them a card with time and date appointment on it
What is the “door-knob syndrome” and what should you do if you encounter this?
(ie. husband beating , “we’ll talk about it next time”)
they tell you something of great significance just as they are leaving
Just stop them and say that you’ll continue the conversation later
Lecture 5
Ch24
Why are contact notes needed?
Legal purpose: need to show that the service you are being paid for is actually given to the client
Administrative purpose: documents activities on behalf of client and all related contacts so CM are not relying on memory.
Notes focus on client, not the CM
What are the four parts your contact notes should always contain?
- The focus of the inteview (why did they come in)
- CM’s assessment mood
- Any resolution that takes place
- The reason for the next contact or follow-up
3 & 4 can be switched
Examples are in the notes
How do you label the contact notes?
Left-hand margin, plAce:
- Date
- The type of contact in parentheses
Ex. 9/15/14 (office)
- collateral contact ( someone other than the client)
- office
- phone
- site visit
- group( parenting, grieving,AA, etc)
- home visit
What are the types of contacts for a contact note?
- collateral contact ( someone other than the client)
- office
- phone
- site visit
- group( parenting, grieving,AA, etc)
- home visit
When do you use quotations in a contact note?
Place only the client’s exact words in quotation marks
How do you describe a person with a disability for your case files?
Person first
- identify the client first rather than the disability
Disability
Write “disability” rather than “handicapped
Wheelchair:
- “she uses a wheelchair. “ rather than “she is wheelchair-bound”
Blind
-Refer to total loss of vision
-other terms: partial sight, visual impairment
Deaf
-Refers to total loss of hearing
-other terms : partial hearing, hearing impairment
Nonverbal
“ a client who cannot speak” rather then “mute”
Congenital disability
- a disability that has existed since BIRTH
LEARNING DISABILITY (understand writing, speaking, reading MENTAL DISORDER
What government requirements must you keep in mind while filling out the various forms in your client’s case file?
Use BLACK INK
Never use a pencil or correction fluid
All notes must be legible
The client must be identified by name on each page
Sign and date every note
If client is in ongoing service, every note must end with the next schedule service date
Draw diagonal lines through blank spaces
How do you correct a mistake in a contact note?
Draw a line through the error Write the word " error " above the line Write the correction next to the word "error" Sign or initial the line Date your signature or initials
