Psychotherapy /Clinical interventions /Case Management Flashcards
Formative Evaluation
&
Summative Evaluation
Formative Evaluation
-Ongoing
-Examine process of delivering services
-Allows SWs to make changes as needed
Summative Evaluation
-Occurs at end
-Examine outcomes
-Determine if objectives were met
Congruent Communication
Communication of individual matches their feelings
EX:
hugging person who is sad
Yelling at person when upset
Interview Techniques
Clarification
Confrontation
Interpretation
Clarification -Restating problem in client’s words to make sure SW is on the same page
Confrontation - Calling attention to something
Interpretation - Pulling together patterns of behavior to get a new understanding
Interview Techniques
Reframing/Relabeling
Summarization
Universalization
Reframing/Relabeling - stating problem in different way
Summarization - identify ideas/themes on client problems
Universalization - generalize/normalize behvior
Problem Solving Process - 6 Steps
Engagement - engage with group/client
Assessment - assessment of strengths and needs
Planning - understanding of problem
Intervention - aimed at making change
Evaluation - when goals/objectives have been met
Termination - progress should be reviewed & supports needed for future should be indentified
6 Stages of Change
Precontemplation - denial of problem
Conteplation - conflicted emotion
Preparation - experimenting w. small changes
Action - taking direct action
Maintenance - maintaining new behavior
Relapse - feelings of frustration/failure
Role Modeling Techniques
Symbolic Modeling
Self Modeling
Live Modeling
Participant Modeling
Covert Modeling
Symbolic Modeling - Actor videotaped preforming desired behavior
Self Modeling - Client videotaped preforming desired behaviors
Live Modeling - Watching a person in real life perform desired behavior
Participant Modeling - Person models anxiety-evoking behavior & prompts client to engage in the behavior
Covert Modeling -
Client visualizes particular behavior
while another person describes an imaginary situation
Crisis Intervention
-Does not need to follow a major life event - can be the “last straw”
-Focuses on here/now
-Time limited
Goals:
-Relieve stress with resources
-Return client to previous level of functioning
-Help strengthen/develop coping mechanisms
Anger Management Techniques
Relaxation exercises
**Cognitive techniques **
-replacing destructive thoughts with healthy ones
EX - “this is the end of the world” to “Thi is frustrating, but will pass”
Communication Skills
-listening to others
-thinking before speaking
Environmental Change
-walking away/leaving situation
Stress Management Techniques
- Client monitors their stress levels & identify their stress triggers
- Assist client in identifying what parts of situation they can control
Cognitive Behavioral Therapy
CBT
- Treats Depression/Anxiety
-Goal = Change patterns of thinking/behavior that are responsible for client’s problems
-Time limited - Goal oriented - Problem focused
Combination of Psychotherapy and Behavioral therapy
Dialectical Behavior Therapy
DBT
-Treats suicide & BPD
-People who feel emotions intensely
-Goal = Help client accept difficult feeings & understand that these feelings are unhealthy/disruptive
- Looking for Balance
Psychoanalytic Theory
3 Levels of Awareness:
Concious
Preconcious
Unconcious
**Concious **- info client is paying attention to
**Preconcious **- info outside of client’s attention - but thoughts/feelings/memories readily available if needed
Unconcious - thoughts/feelings/memories client has no awareness of - but influence their day to day
Psychoanalytic Theory
ID
Ego
Superego
—-Picture Iceberg - Bottom to top
**ID **
(Devil on shoulder)
-Unconcious
-Biological urges - survival/sex/agression
-Pleasure Principle
EX - “I want it NOW!”
Ego
-Concious/preconcious/unconcious
-Rationality
-Reality Principle
-Makes sure that IDs wants are acceptable in real world
EX - “Let’s make a compromise”
Superego
(Angel on shoulder)
-Preconcious/Unconcious
-Morals - sense of right and wrong
-Feel guilt when breaking rules
-Learned from parents/society
EX - “It’s not right to do that”
Psychoanalytic Theory
Ego-Syntonic
Ego-Dystonic
Ego Strength
Ego-Syntonic - behaviors “insync” w. ego (no guilt)
Ego-Dystonic - behaviors “dis-n-sync” w. ego (guilt)
Ego Strength - ability of Ego to manage the demands of the ID, Superego, and reality
-Helps maintain emotional stability & cope w. stress
Psychoanalytic Theory
Pleasure Principle
Reality Principle
Pleasure Principle
-ID
-Achieve pleasure - Avoid pain
Reality Principle
-Ego
-Impulses must be delayed in order to be socially appropriate in real world
Psychosexual Stages of Development
Our -Ass- Play- Loves- Genitals
Oral
Anal
Phallic
Latency
Genital
Oral
birth - 1
Source - Mouth - sucking/chewing/biting
Result - smoking, overeating, dependence on others
Anal
1- 3
potty training
Source - bowel movements
Result - controling or easily tempered
Phallic
3 - 6
Source - Genitals
Result - guilt/anxiety about sex
Latency
6 - 12
Source - sexuality is dormant
Result - no fixations
Genital
puberty 12 - 18
Source - genitals - sexual urges return
Result - no fixtions
Psychosexual Development
Oedipus Complex
Castration Anxiety
**Oedipus Complex **
-Phallic stage
-Male child’s sexual desire for mother
and hostility toward dad
-Dad = Rival for mother’s love
Castration Anxiety
-Child fears father will cut off penis for desiring mother
-Because of this fear - child represses longing for mother
and begins to identify with dad
-This is the emergence of Superego
Partialization
break down complex issues into simpler ones
Assertiveness Training
-Role play
-Use of “I” statements
-Self observation
-Assuming personal responsibility
Task Centered Approaches
-Quickly engage clients in problem solving process
-Focus = “here & now”
-Assessment - leads to goals - leads to tasks
Group Work
-Group = vehicle of change
-individual problems should be directed to the group for solutions
NO-NOs
client in crisis
suicidial
needy for attention
actively psychotic/paranoid
Family Therapy
Instrumental Functions
Affective Functions
Instrumental Functions- physical resources
EX - food/clothing/shelter
Affective Functions - emotional support to family members
Roles in Families
Family Hero
Scapegoat
Mascot
Lost Child
Family Hero - often oldest child
makes up for dysfunction by overachieving in school/work
Scapegoat - defiant/hostile/angry
gets in trouble at school/work
behavior turns focus away from family
Mascot - gets people to laugh - to improve atmosphere and draw attention away from dysfunctional household
Lost Child - shy/loner
draws away from family
becomes invisible - to avoid adding dysfunction
Strategic Family Therapy
-Task Centered
-Interested in change in behavior - not change in understanding
Permanency Planning
Children need permancence to thrive
first goal = get children back into original homes
Prevention Strategies
Primary
Secondary
Tertiary
**Primary **
-Protect people from disease/injury/engaging in a behavior
EX:
exercise
education on tobacco/drug use
screenings
**Secondary **
-Occurs after disease/injury/illness
-Aims to slow progression
EX:
modified work assignmnets for injured workers
screenings
telling those w. heart condition to take daily aspirin
Tertiary
-Focus = manage disease/injury/illness
-Goal = prevent further deterioration/maximize quality of life
EX:
Pain management
Support groups
rehab programs
Psychotherapy
&
Behavioral Therapy
**Psychotherapy **
-Personal meaning placed on things
-Thinking patterns begin in childhood
Behavioral Therapy
-Relationship between problems, behaviors, thoughts
Psychodynamic/
Psychoanalytic
Approaches
- Unconcious motives/desires
- Childhood experiences shape personality
-Treatment = dealing with repressed material in unconscious
Object Relations Theory
-Relationship of Mom/Infant plays a critical role in
infant growth/development
-Relationships to people and items
Self Psychology
3 self object needs:
Mirroring
Idealization
Twinship/Twinning
Mirroring
-Behavior validates child’s sense of self
Idealization
-Identifies w. someone more capable
Twinship/Twinning
-Child needs alter ego for sense of belonging
Program Evaluation:
Cost Benefit Analysis
Cost Effective Analysis
Outcome Assessment
**Cost Benefit Analysis **
Financial cost of program & financial benefit of outcomes
—Cost Beneift Ratio - does cost exceed benefit?
Cost Effective Analysis
Similiar to cost benefit analysis
Benefit/outcome not measured in money
EX - illness prevented - lives saved
Outcome Assessment
Has program achieved intended goals
Use findings to make changes
3 components of Supervision:
Administrative Supervision
Educational Supervision
Supportive Supervision
Administrative Supervision
-Holds SW accountable to public/organization’s policies
Educational Supervision
-Learning relationship
-Teaches new skills
Supportive Supervision
-Increasing preformance - by decreasing job related stress
Co-optation
-Strategy to influence social policy
-Leaders try to quiet disagreement/disturbances through incentives
EX - hush money
Referring Client’s for Services - 6 Steps
1. Clarify need/purpose of referral
2. Researching resources
3. Discussing/selecting options
4. Planning for initial contact
5. Initial Contact
6. Follow up - See if need was met
Program Objectives/Outcomes:
Mission Statement
Goal
Objective
Outcomes
Mission Statement
-Purpose of organization
Goal
-What program intends to accomplish
Objective
-Desired outcome
Outcomes
-Achieved results
EX - knowledge, skills, attitudes
Q
Which is NOT true when an agency uses the services of a consultant?
a. The agency retains formal authority over agency practices, whereas a consultant has informal authority based on skills and knowledge.
b.The agency must get consent for releases of information when sharing client information with a consultant.
c.The agency is mandated to follow a consultant’s recommendations.
d.The agency must use a consultant who has demonstrated knowledge, expertise, and competence.
The agency is mandated to follow a consultant’s recommendations.
Q
Which of the following is the BEST definition of empowerment?
Obtaining resources to assist in improving a client’s financial and social status
Building skills and obtaining resources that will assist a client in controlling and making changes, if desired, in his or her own well-being
Meeting basic needs in a client’s life to facilitate growth toward self-actualization
Creating alliances or power networks that can be used by a client to increase his or her social standing
Building skills and obtaining resources that will assist a client in controlling and making changes, if desired, in his or her own well-being
Question
Group therapy is not appropriate for all of the following client groups EXCEPT those who are:
A.Actively in crisis
B.Paranoid or psychotic
C.Compulsively in need of attention
D.Isolated from others
Isolated from others
Q
A client enters a social worker’s office and is outraged at an interaction that has just taken place with another agency staff member. The client is indignant and demands that the social worker “do something.” In this situation, the social worker should FIRST:
A.Explain to the client that it would be best for the client to address the issue directly with the staff member
B.Get the staff member so that the client can speak to him or her and resolve the issue immediately
C.Tell the client to go to the agency director who is in a position to take action
D.Listen to the client’s account of the situation
Listen to the client’s account of the situation
Q
A teenager is having problems initiating conversation with peers. In order to BEST assist the teenager, the social worker should:
Ask the teenager to keep a journal documenting thoughts that can be used in later conversations with peers
Explore with the teenager the underlying reasons for his or her problems with peer relationships
Assess whether there are other social deficits that may result in appropriate diagnosis
Engage in a role play with the teenager so that he or she can practice needed communication skills
Engage in a role play with the teenager so that he or she can practice needed communication skills
Q
When working with an involuntary, court-mandated client, it is useful for a social worker to FIRST do which of the following to address resistance?
A.Show the client a copy of the court order so that he or she can understand the reasons for treatment
B.Make sure that the client sees all reports given to the court to build trust between the client and social worker
C.Include some of the client’s own goals in the service plan in addition to those that must be addressed as mandated by the court
D.Acknowledge the client’s circumstances and lack of choice in receiving services
Acknowledge the client’s circumstances and lack of choice in receiving services
Q
A mother and teenage child yell at each other almost the entire time of a session. The mother says that she is upset with her daughter’s choice in boyfriend, her grades in school, her inappropriate dress, and her lack of help around the house. The daughter says that she is angry as her mother does not listen to her, does not respect her privacy, does not give her any “space,” and speaks to the daughter’s friends in a demeaning manner. In order to BEST assist with helping them resolve their conflicts, the social worker should:
A.Work with the mother and child to prioritize their concerns
B.Focus on both the mother’s and child’s strengths and skills
C.Suggest that the mother and child increase the amount of time that they spend with one another to facilitate the problem-solving process
D.Acknowledge the level of conflict and discord between the mother and child
Work with the mother and child to prioritize their concerns
Question
Which of the following is NOT congruent communication?
A.Ignoring nonverbal cues that indicate anger
B.Smiling at a person who is being annoying
C.Hugging a person in pain
D.Yelling at an individual when upset
Smiling at a person who is being annoying
Q
A client who has repeatedly stated that she hates her sister tells a social worker that she has just asked her sister to be the maid of honor in her wedding. The social worker points out that this action appears contradictory to her feelings about her sister. This statement by the social worker is known as a:
A.Clarification
B.Generalization
C.Paradoxical instruction
D.Confrontation
Confrontation
**
Question
All of the following are true about crisis intervention EXCEPT:**
A.It is time limited.
B.It focuses on the “here and now.”
C.It must follow a major life event.
D.It involves a high level of intervention and activity by the social worker.
It must follow a major life event.
Q
A social worker finds that a client has poor interpersonal skills. The BEST intervention that a social worker can use to address these issues is:
Engaging the client in a psychoeducational group aimed at providing information about communication skills
Modeling appropriate verbal and nonverbal communication skills
Conducting intensive psychotherapy aimed at addressing the communication deficits
Providing the client with individual instruction on appropriate interpersonal skills
Modeling appropriate verbal and nonverbal communication skills
Q
Upon coming in for an intake interview, a couple reports that they have not had sexual intercourse for more than a year due to the husband’s inability to sustain an erection. He reports that he has had a lot of stress at work and feels overwhelmed by the pressures placed upon him. In order to best diagnose the reasons for the husband’s sexual dysfunction, a social worker should FIRST:
A.Ask the husband to provide more information about his job stress
B.Determine if the physiological changes in the husband occurred at about the same time as his overwhelming feelings
C.Recommend that the husband see a physician to see if there are any medical problems
D.Explore whether the couple is having any other problems in the relationship
Recommend that the husband see a physician to see if there are any medical problems
Q
During an initial session, a client complains that she feels like a failure because she is getting divorced and could not “save her marriage.” She ends by asking whether she is wrong to feel this way. In order to facilitate the therapeutic alliance, the social work should:
A.Explore with her why she thinks that the divorce is causing her to feel this way
B.Find out more about her past relationships
C.Tell her that such feelings are commonly felt in this situation
D.Explain that she will have a lot of time to work through these feelings in the coming weeks
Tell her that such feelings are commonly felt in this situation
Q
What is the immediate goal of social work services for a client in crisis?
A.To assist the client to return to the previous level of functioning
B.To provide the client with strategies to prevent future crises from occurring
C.To determine whether the emotional stressors have caused the client to be a danger to self or others
D.To develop a long-term strategy to assist the client in dealing with the impacts of the trauma caused by the crisis
To assist the client to return to the previous level of functioning
Q
Which of the following target populations would BEST have their needs fulfilled by participation in a psychoeducational group?
A.Older adults with high blood pressure who need to learn about healthy eating methods
B.Teens who need peer support to address issues of addiction
C.Mothers who feel isolated and want to meet other mothers in their area
D.Couples who have experienced loss and are having trouble coping
Older adults with high blood pressure who need to learn about healthy eating methods
Q
Which of the following is NOT an aim of case management?
A.To avoid duplication and gaps in treatment in care
B.To coordinate and monitor multiple services to ensure efficient and effective utilization
C.To treat emotional or mental dysfunction in order to maximize wellbeing
D.To link to services as needed to optimize functioning
To treat emotional or mental dysfunction in order to maximize wellbeing
Q
A client barges into a social worker’s office yelling in a loud and hostile manner. The MOST effective method for the social worker to address the situation is to:
A.Tell the client that it is not possible to speak now, but his or her concerns can be discussed during a scheduled appointment
B.Listen to the client’s concerns and provide other methods to reach the social worker in the future if problems arise
C.Contact agency security immediately to remove the client in order not to reinforce the behavior
D.Instruct the client on appropriate tone and voice volume when interacting with others
Listen to the client’s concerns and provide other methods to reach the social worker in the future if problems arise
Q
Which of the following is NOT an appropriate task for a social worker facilitating a group?
A.Modeling methods for the group in dealing with dilemmas or situations
B.Identifying assumptions made by, or unconscious communication used by, the group
C.Opening up new avenues of exploration to the group
D.Providing solutions to problems that are raised by the group
Providing solutions to problems that are raised by the group
Question
Which of the following is NOT essential for implementing a strengths-based intervention?
A.Opportunities are created so that clients can learn or display competencies.
B.There is collaboration and partnership with the client.
C.There is an assumption that clients can change and adapt.
D.The inner psychological struggles that clients are experiencing must be a focus of treatment.
The inner psychological struggles that clients are experiencing must be a focus of treatment.
Q
Federal law requires health care facilities that receive Medicare and Medicaid reimbursements to do all of the following with regard to advance directives EXCEPT:
A.Inform clients of their rights to have advance directives that will allow them to make decisions regarding their health care
B.Use a portion of their revenues to assist clients with the costs associated with creating advance directives
C.Ask clients if they have advance directives and document their responses
D.Provide education about advance directives
Use a portion of their revenues to assist clients with the costs associated with creating advance directives
Q
Which of the following is true of BOTH networking in business and networking in social work practice?
A.It aims to educate about the problems experienced by others and thereby helps to effect system changes.
B.It aims to attract more individuals to organizations so that these entities can prosper.
C.It is beneficial for clients as it keeps the costs down through sharing of resources.
D.It creates a community and builds alliances around a common interest or goal.
It creates a community and builds alliances around a common interest or goal.
Question
Which of the following is the MOST important benefit of community participation in social work practice?
A.It puts the decision-making power partly or wholly with community members.
B.It shows the media that individuals want to get involved when there is a good cause.
C.It informs community members about the work that needs to be done to make change.
D.It divides the workload so that it can be distributed across a larger group.
It puts the decision-making power partly or wholly with community members.
Q
A client needs to access services from another organization. In order to BEST assist this client, a social worker should:
A.Let the client identify and contact agencies independently to avoid interfering with the client’s right to self-determination
B.Refer the client to an agency that the social worker has a relationship with to ensure an easy transition
C.Work with the client to evaluate options and select an agency that the client thinks will best meet his or her needs
D.Contact the client’s insurance company to see which agencies are participating providers
Work with the client to evaluate options and select an agency that the client thinks will best meet his or her needs
Q
An agency that employs social workers has detailed job descriptions that delineate the best way to perform functions, closely supervises its employees, and ties employee pay increases to behaviors that promote the goals of the organization. This agency is MOST likely using which of the following approaches to manage its workers?
A.Scientific management
B.Human relations
C.Systems
D.Contingency
Scientific management
A scientific management approach finds the one “best way” to perform each task; carefully matches each worker to each task; closely supervises workers, using reward and punishment as motivators; and manages and controls behavior.
Scientific management
-finds the one “best way” to perform each task
-carefully matches each worker to each task
-closely supervises workers
Q
Which of the following is NOT an objective of social work supervision?
A.To increase the social worker’s capacity to work more effectively
B.To assist the social worker in resolving conflicts or problems
C.To assure the delivery of the most effective and efficient client services
D.To ensure consistent treatment of clients
To ensure consistent treatment of clients
Question
Which of the following is NOT an example of client advocacy?
A.Working with legislators to craft a bill that would fill a service gap
B.Speaking to an agency board of directors to change a policy that negatively impacts on clients
C.Writing a press release for a local paper about a growing community need
D.Providing community members with a listing of service agencies that can assist them in meeting their needs
Providing community members with a listing of service agencies that can assist them in meeting their needs
Q
Members of a community are concerned about rising crime rates, drug problems, and high unemployment in their neighborhood. When engaging in community organizing with this group, the social worker should FIRST:
A.Tell community members about strategies that have worked well to address these issues in other locations
B.Work with the citizens to prioritize their concerns
C.Contact local legislators to make them aware of the problems
D.Identify an individual who can lead the other community members in taking action
Work with the citizens to prioritize their concerns
Q
As required by law, Individual Educational Plans (IEPs) for children with disabilities must be reviewed and revised by schools at least:
A.Daily
B.Yearly
C.Monthly
D.Weekly
Yearly
