LCSW Exam Flashcards
Tarasoff Law
Duty to notify victim/police if someone has a plan of harm
Length of crisis state
2 days to 6 weeks
Maturational Crisis
Precipitated by normal stress during the course of life (marriage, birth, retirement)
Situational Crisis
Precipitated by a sudden traumatic event that is unexpected (death, job loss, illness)
Substance Use Disorder
- The person must have at least two of the following for a given substance within the same 12-month period:
o Taking the substance in larger amounts or for longer than you meant to
o Wanting to cut down or stop using the substance but not managing to
o Spending a lot of time getting, using, or recovering from the use of the substance
o Cravings and urges to use the substance
o Not managing to do what you should at work, home, or school because of substance use
o Continuing to use, even when it causes problems in relationships
o Giving up important social, occupational, or recreational activities because of substance use
o Using substances again and again, even when it puts you in danger
o Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
o Needing more of the substance to get the effect you want (tolerance)
o Development of withdrawal symptoms which can be relieved by taking more of the substance
Signs of alcohol intoxication
inappropriate sexual or aggressive behaviors; impaired judgment; slurred speech; emotional lability; incoordination; unsteady gait; involuntary, rhythmic movement of the eyes; impaired attention or memory; stupor; coma
Signs of alcohol withdrawal
sweating; tachycardia; hand tremor; insomnia; nausea or vomiting; transient illusions or hallucinations; anxiety; psychomotor agitation; grand mal seizures; delirium tremens (DTs)
Wernicke-Korsakoff syndrome
a chronic memory disorder caused by severe defiency of thiamine (Vitamin B1). The individual may attempt to compensate for memory loss by fabricating memories. It can cause hallucinations and can also lead to personality changes. The prognosis is generally poor.
Wernicke Encephalopathy
an acute, life-threatening but reversible condition that requires emergency treatment. Results from severe acute deficiency of thiamine. May experience confusion, loss of muscle coordination (leg tremors) and vision changes (abnormal eye movements, double vision, eyelid drooping). Prognosis is good if treated accordingly.
Signs of amphetamines/cocaine intoxication
euphoria, anxiety, hyperactivity; grandiosity, confusion, anger, paranoia, auditory hallucinations, tachycardia, elevated or lowered blood pressure, dilated pupils, perspiration or chills, nausea or vomiting, weight loss, psychomotor agitation, muscular weakness, confusion, seizures
Signs of amphetamines/cocaine withdrawal
dysphoric mood, fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor agitation, or retardation
Signs of caffiene intoxication
restlessness, nervousness, excitement, insomnia, flushed face, diuresis, GI disturbance, muscle twitches, rambling flow of thought and speech, tachycardia or arrhythmia, periods of inexhaustibility, psychomotor agitation
Signs of caffiene withdrawal
headache (most common), changes in mood (such as depression and anxiety), difficulty concentrating, fatigue, increased appetite
Signs of cannabis intoxication
impaired motor coordination, euphoria, anxiety, sensation of slowed time, impaired judgment, social withdrawal, conjunctival injection (redness of the eyes), increased appetite, dry mouth, tachycardia
Signs of cannabis withdrawal
irritability, anger or aggression, nervousness or anxiety, sleep difficulty, decreased appetite or weight loss, restlessness, depressed mood, stomach pain, shakiness/tremors, sweating, fever, chills, and/or headache
Signs of hallucinogen intoxication
perceptual changes, anxiety, depression, ideas of reference, paranoid ideation, pupillary dilation, tachycardia, sweating, palpitations, blurred vision, tremors, incoordination
Signs of hallucinogen withdrawal
o Hallucinogen Persisting Perception Disorder (Flashbacks): following the cessation of use, the reexperiencing of one or more of the perceptual symptoms that were experienced while intoxicated with the hallucinogen; this reexperiencing causes significant distress or impairment in social, occupation, or other important areas of functioning.
Signs of opioids intoxication
initial euphoria followed by apathy or dysphoria, pupillary constriction, drowsiness or coma, slurred speech, impairment of attention and memory
Signs of opioids withdrawal
dysphoric mood, nausea or vomiting, muscle aches, lacrimation or rhinorrhea (runny eyes and nose), pupillary dilation, diarrhea, yawning, fever, insomnia
Early Full Remission
none of the criteria for substance use disorder except cravings are met for at least 3 months but less than 12 months
Sustained Full Remission
none of the criteria for substance use disorder except cravings have been met for at least a 12 month period or longer
CAGE Questionnaire
o The CAGE questionnaire is a quick screening tool used to assess for alcohol problems specifically. This screener helps determine whether a person drinks in excess and may benefit from alcohol treatment.
Naltrexone
blocks the euphoric effects and feelings of intoxication (alcohol). Can be used for opioid use disorder as well (pill form for alcohol, injectable for opioids).
Disulfiram (Antabuse)
works by creating an unpleasant reaction to alcohol. Use of this requires medical supervision
Acamprosate
can reduce the desire to drink alcohol by stabilizing chemical signaling in the brain that could otherwise be disrupted during withdrawal from alcohol
Methadone
Used for opioid dependence. Most often used. It works by reducing cravings and withdrawal and blunts or blocks the effects of opioids.
Buprenorphine
suppresses and reduces cravings for opioids
Pre-Contemplation Stage (Motivational Interviewing)
client is not yet thinking about change
Contemplation (Motivational Interviewing)
the client is thinking about and talking about change. They are considering whether to work towards change
Preparation (Motivational Interviewing)
The client is actively planning out steps to take to make change happen during this stage.
Action (Motivational Interviewing)
client is taking positive steps to put the plan from the previous stage in place
Maintenance (Motivational Interviewing)
the client is maintaining the change that has been made
Harm Reduction
an intervention that aims to reduce the negative effects of alcohol and drug use. Acknowledges that despite prevention and abstinence efforts, some clients will continue to engage in alcohol and drug use. Includes things like:
Limiting the number of days you drink per week
Limiting the number of drinks, you consume in one sitting
Having a designated driver
Utilizing needle exchange sites
Utilizing injection sites
Contingency Management
a type of behavioral therapy that uses incentives to help clients abstain from drugs and alcohol. Clients are encouraged to engage in sobriety and engage in behaviors supporting sobriety. As goals are achieved and behaviors are modified, clients receive rewards
Stages of Grief
DABDA – Denial, Anger, Bargaining, Depression, Acceptance
Paranoid Personality Disorder
non-delusional paranoia, unjustified doubts; misreading harmless remarks or events; quick reactions of anger, holding grudges, expectation of being exploited; unjustified questions re: fidelity of partner
Schizoid Personality Disorder
detachment from social relationships; preference for being alone; restricted range of affect; lack of close friends; flat affect; emotionally cold; lack of desire for relationships; lack of sexual desire; indifference to opinion of others; lack of pleasure in activities
Schizotypal
inappropriate or constricted affect; irrational beliefs; magical thinking; ideas of reference; extreme social anxiety; unusual perceptual experiences (illusions); lack of close friends; paranoid ideation, eccentric appearance
Histrionic Personality Disorder
constant demands for approval/praise; exaggeration of emotion; discomfort when not the center of attention; sexual seductiveness; use of physical appearance to draw attention; content of speech lacking detail; suggestibility; rapidly shifting and shallow expression of emotions; belief that relationships are more intimate than they really are; view of themselves as glamorous and impressive
Narcisstic Personality Disorder
sense of entitlement; believe rules don’t apply to them; using others for personal gain; grandiosity; belief that they are special/unique; need for excessive admiration; lack of empathy; envious of others and belief that others are envious of them; fantasies of success/power/love; arrogance
Borderline Personality Disorder
unstable relationships; alternation between idealization and devaluation; feelings of emptiness; mood reactivity; angry outbursts followed by guilt/shame; impulsivity that is self-damaging; avoidance of abandonment (real or perceived); suicidal threats; self-mutilating behaviors; identity disturbance; transient paranoia or dissociation
Antisocial Personality Disorder
frequent physical fights or assaults; irresponsibility; deceitfulness; reckless disregard for safety; impulsive behavior; lack of remorse; disregard and violates the rights of others
Avoidant Personality Disorder
fear of being ridiculed; social inhibition; poor self-image; preoccupation with being criticized or rejected in social situations; avoidance of new activities; reluctance to take personal risks; restraint in intimate relationships; desire for social relationships; feelings of loneliness
Dependent Personality Disorder
need for excessive advice/reassurance; need for others to assume responsibility; difficulty doing things independently; lack of self-confidence; going to great lengths to be nurtured/supported; feelings of helplessness; moving from one relationship to the next to receive care and support; difficulty disagreeing with others; need for approval; preoccupation with being left to take care of oneself
Obsessive Compulsive Personality Disorder
preoccupation with details, rules, lists or organization; perfectionism; stubbornness; insistence that others do things “their way”; overly conservative with money; excessive devotion to work or productivity; reluctance to delegate to others; inflexibility around morals, ethics, values etc. difficulty throwing things out (even when useless or lacking in sentimental value)
Freud’s Psychosexual Development Theory
Psyche includes: Id (a human’s basic, instinctual drives, pleasure seeking); Ego (attempts to mediate between Id and reality); and Superego (reflects the internalization of cultural rules usually learned from parents).
Oral Stage
(birth – 1 year) – an infant’s primary interaction with the world is through the mouth.
Anal Stage
(1-3 years) – primary focus of the libido was on controlling bladder and bowel movements. Toilet training is a primary issue with children and parents. Too much pressure can result in an excessive need for order or cleanliness later in life (anal retentive) while too little pressure from parents can lead to messy or destructive behavior later in life (anal expulsive)
Phallic Stage
(3-6 years)- primary focus of the id’s energy is on the genitals. Children become aware of their gender identity.
Latent Stage
(6-puberty) – sexual feelings are dormant. Children develop social skills, values and relationships with peers and adults outside the family.
Genital Stage
(puberty-adult) – the onset of puberty causes the libido to become active once again. During this stage, people develop a strong interest in the opposite sex. If development has been successful up to this point, the individual will continue to develop into a well-balanced person.
Piaget’s Developmental Theory
o Based on premise people actively construct higher levels of knowledge. Motivation for cognitive development occurs when there is a state of ‘disequilibrium’ brought on by a discrepancy between the person’s current understanding of the world and reality. Equilibrium is achieved through a combination of assimilation (incorporation of new information into existing schemas) and accommodation (modification of existing schemas), which both lead to (adaptation).
Sensorimotor Stage
(birth to 2 years) – infants and young children learn primarily through sensory input and action. 3 achievements during this stage: 1) object permanence, 2) causality, 3) symbolic thought
Preoperational Stage
(2-7 years) – symbolic function – which allows the child to learn through the use of mental images, language, and other symbols that represent objects that aren’t present. Children during this stage engage in symbolic play and can solve problems mentally.
Concrete Operational Stage
(7 to 11 years) – children are capable of performing mental operations using logic and abstract thinking. Classify and problem solve in more sophisticated ways.
Formal Operational Stage
(11 years plus) – Adolescent or young adult is able to think abstractly, hypothetically, and in a relativistic way. Egocentrism.
Erikson’s Developmental Theory
Based on Freud’s emphasis on unconscious motivation. Greater emphasis on the ego. Each of the 8 stages involves a psychosocial task that is to be mastered. If not mastered, the person continues to develop, but the ego is damaged and subsequent stages will be affected. We give the person until the very END of the age range to have resolved the conflict.
Trust vs. Mistrust
(0-18 months) – Basic trust develops in the context of the relationship between the infant and caregiver, forms the foundation for all other stages.
Autonomy vs. Self Doubt
18 months - 3 years
Initiative vs. Guilt
(3-6 years)
Industry vs. Inferiority
6-12 years
Identity vs. Role Confusion
12-18 years
Intimacy vs. Isolation
18-40 years
Generativity vs. Stagnation
40-65 years
Ego Integrity vs. Despair
65- death
Mahler Stages of Development
o According to Mahler, the Object Relations theory refers to the way a child’s Ego becomes organized over the first 3 ½ years of life. During this time, the child struggles between the self and others. The theory focuses on the reciprocal relationship between a mother and her infant and its effect on the infant’s development of sense of self that occurs in three stages. Individuals are born with the drive to develop a sense of self and others along with the motivation to build interpersonal relationships.
Autistic Stage
(newborn -1 month) -infant is focused purely on himself; unresponsive to external stimuli.
Symbiotic Stage
(1-5 months) – begins to perceive the ‘need-satisfying object’ – the mothers ego functions for the infant. Infant begins to understand that the mother is a separate being from themselves.
Separation-Individuation Stage
5-24 plus months) – during separation, the infant begins to develop and understanding of the boundaries of self, and they start to see their mother as a separate individual. Begins to develop a sense of self.
Differentiation Substage
5-9 months) -attention shifts from being inwardly focused to outwardly focused
Practicing Substage
(9-14 months) – continues to separate from their caretaker, their autonomous ego functions become more apparent.
Rapprochment Substage
(14-24 months) – begins to want to act independently. Move away from their mother but come back to ensure she’s there.
Object Constancy Substage
after 24 months) - infant internalizes their mother and begins to understand that their mother still exists for them despite her absence
Trauma Informed Therapy
Trauma treatments do not begin while the trauma is still actively occurring. Safety must be established first. Treatment focuses on clients gaining back control and empowerment in their lives.
TF-CBT
trauma focused CBT. Treatment for children and adolescents. Involves the child parents/caregivers with individual sessions for both the child and parents as well as join parent/child sessions. Relatively short-term treatment. 3 stages: stabilization, trauma narrative, integration and consolidation.
Prolonged exposure therapy
evidence-based treatment for PTSD.
CBT
behavioral change occurs by learning to modify dysfunctional thought patterns. Includes: Negative cognitive triad (view of self, view of world, view of prospects of future), automatic thoughts, schemas, reframing, cognitive restructuring, thought record
DBT
Behavioral therapy that aims to change behavioral, emotional and cognitive patterns associated with dysfunction by helping clients improve their emotional and cognitive regulation. Evidence based for borderline personality. Also used for chronic SI/self-injury, eating disorders and SUD. Learning how to cope with uncomfortable thoughts/feelings. “Coaching calls.” Modules include mindfulness, distress tolerance, interpersonal effectiveness, emotion regulation.
Rational Emotive Behavior Therapy
short term, present focused therapy that helps clients identify and replace self-defeating rigid thought patterns, beliefs, and unhealthy behaviors that interfere with their life goals with healthier thoughts and behaviors. Teaches unconditional self-acceptance. Tools include cognitive reframing, visualizations, self-help tools and homework assignments.
Exposure Therapy
used to treat anxiety disorders. Can be used within CBT. Systematic desensitization is used to treat phobias. Prolonged exposure therapy is evidenced based for PTSD.
Attachment Theory
secure attachment, preoccupied/anxious attachment, dismissive/avoidant attachment, fearful/avoidant attachment
Structural Family Therapy
change occurs through remodeling the family’s organization (structure); enmeshed boundaries; disengaged boundaries, family map
Strategic Family Systems
action-oriented directives and paradoxical interventions given by the therapist. The therapist takes an active and directive role to facilitate change, particularly around patterns of communication. Interventions include positioning, restraining, paradoxical directives.
Bowen Family Systems Theory
change occurs through understanding multigenerational dynamics. Genograms.
Systems Theory
observes and analyzes all the systems that contribute to a person’s behavior and wellbeing. Social workers focus on strengthening those systems, which can include improving and creating more supportive systems through connection to community resources.
Psychodynamic Theory
change occurs though insight and understanding of early, unresolved issues.
Client/Person Centered Therapy
Change occurs by creating conditions for the client to grow through the therapeutic relationship with the presence of three essential components: congruence/genuineness, unconditional positive regard, and empathy. Non-directive therapy, congruence, unconditional positive regard, empathy, self-actualization, locus of control.
Solution Focused Therapy
brief, goal directed therapy focused on a client’s strengths and resources. “Miracle Question”
Task Centered/Problem Solving Therapy
a short-term therapy that elicits change through supporting clients to take actions that address the problems in their lives
Gestalt Therapy
change occurs through increased awareness of the here and now experience. Empty chair technique.
Narrative Therapy
a respectful and non-blaming approach to both individual and community work. It views the clients as the experts in their own lives.
Logotherapy
change occurs through finding meaning in life and helping the client gain a sense of purpose.
Feminist Theory
change through recognizing disempowering social forces and empowering clients. Eating disorders.
Termination
Ethical responsibility to advocate for more sessions if insurance is trying to terminate. Ethical duty to transfer/refer clients if therapist is leaving.
Tardive Dyskinesia
a possible side effect of long-term use of antipsychotic medications to treat schizophrenia. Tardive Dyskinesia causes involuntary movements of the tongue and lips, face, trunk, and extremities. There are a number of treatment options for this side effect, including two FDA approved drugs, Ingrezza (Valbenazine) and Zenazine (Tetrabenazine) as well as anticholinergics, or muscle relaxers.
Rationalization
Plausible reasons justify an action or opinion. Helps the person cope with disappointments by blaming external circumstances.
Repression
Refuses to let unacceptable impulses into conscious awareness.
Denial
Distorts/refuses to accept reality. Uncommon in children because they are unable to distinguish between fantasy and reality.
Projection
Places unacceptable feelings from the person feeling them onto another person. Projection is a two-way street.
Displacement
Affect is transferred from one object to another. Has 3 parties/situations involved.
Projective Identification
Takes projection a step further, with the person who has been projected onto believing the projection.
Intellectualization
Content is separated from repressed affect.
Asceticism
Characterized by rigor and self-denial.
Sublimation
Displace unacceptable instincts for constructive and socially acceptable behaviors.
Introjection/Internalization
Introjection is the internalization of outside events or characteristics of other people.
Identification
A process by which qualities of an external object are absorbed into one’s personality
Reaction Formation
A process by which unacceptable impulses are expressed as their opposites.
Undoing
A process by which we avoid being punished for undesirable thoughts or actions.
Randomized Controlled Trial
experimental design that measures the effect of an intervention by randomly assigning participants to either the experimental/intervention group or a control group. Difficult to do in SW practice due to ethics concerns.
Quasi Experimental Design
resembles a randomized controlled trial but does not involve the random assignment to a control group vs. experimental group. Instead, it allows the researcher to control the assignment to the treatment and control groups using some criteria other than random assignment. Commonly used in field research where random assignment is difficult or not possible.
Single Subject Design
research where the subject serves as their own control, rather than using another individual/group
Retrospective Design
participants are asked to retrospect and try to remember what they were like at an earlier point in time
Cross-sectional Design
researchers collect data at a single point in time from participants of different ages
Longitudinal Design
the same people are measured at different agesC
Cross-sectional design
combination of cross sectional and longitudinal designs. At the first point, groups of people from several different ages are measured. If the design were to stop there, it would be a simple cross-sectional design, but these groups are then followed over time, incorporating the longitudinal aspect.
Correlation
mutual relationship between two variables that are related; a change in one variable is associated with a change in the other variable
Inter-rater reliability
the degree to which different people give similar scores for the same observations; refers to the consistency of a measure
Construct validity
the degree to which an instrument measures the characteristic being investigated
Internal validity
the confidence that can be placed in the cause- and effect relationship in a study
External validity
the extent to which an effect in research can be generalized to other populations, settings, and treatment variables.
Concurrent validity
the extent to which the results of a particular test, or measurement, correspond to those of a previously established measurement for the same construct. You want to make sure the test accurately measures what it is supposed to measure.
Predictive validity
this involves testing a group of subjects for a certain construct, and then comparing them with results obtained at some point in the future.
