Masters Social Work Exam Secrets
Content
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Reau the geneial success stiategies fiist, anu then pioceeu to the content sections. Each tip
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Top 2u Test Taking Tips ........................................................................................................................................ 4
ASWB Nasteis Exam ............................................................................................................................................... S
Piactice Test .......................................................................................................................................................... 9S
Piactice Questions............................................................................................................................................ 9S
Answeis anu Explanations ........................................................................................................................ 1S4
Seciet Key #1 - Time is Youi uieatest Enemy ........................................................................................ 1S7
Pace Youiself ................................................................................................................................................... 1S7
Seciet Key #2 - uuessing is not uuesswoik ............................................................................................. 1S7
Nonkeys Take the Test ............................................................................................................................... 1S7
$S Challenge .................................................................................................................................................... 1S8
Seciet Key #S - Piactice Smaitei, Not Baiuei ........................................................................................ 1S9
Success Stiategy ............................................................................................................................................. 1S9
Seciet Key #4 - Prepare, Don’t Procrastinate ......................................................................................... 1S9
Seciet Key #S - Test Youiself ......................................................................................................................... 16u
ueneial Stiategies .............................................................................................................................................. 16u
Special Repoit: What is Test Anxiety anu Bow to 0veicome It. .................................................... 166
Lack of Piepaiation ...................................................................................................................................... 166
Physical Signals .............................................................................................................................................. 167
Neivousness .................................................................................................................................................... 167
Stuuy Steps ....................................................................................................................................................... 169
Belpful Techniques ....................................................................................................................................... 17u
Special Repoit: Retaking the Test: What Aie Youi Chances at Impioving Youi Scoie. ....... 17S
Special Repoit: Auuitional Bonus Nateiial .............................................................................................. 177
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1. Caiefully follow all the test iegistiation pioceuuies
2. Know the test uiiections, uuiation, topics, question types, how many questions
S. Setup a flexible stuuy scheuule at least S-4 weeks befoie test uay
4. Stuuy uuiing the time of uay you aie most aleit, ielaxeu, anu stiess fiee
S. Naximize youi leaining style; visual leainei use visual stuuy aius, auuitoiy leainei
use auuitoiy stuuy aius
6. Focus on youi weakest knowleuge base
7. Finu a stuuy paitnei to ieview with anu help claiify questions
8. Piactice, piactice, piactice
9. Get a good night’s sleep; don’t try to cram the night before the test
1u. Eat a well balanceu meal
11. Know the exact physical location of the testing site; uiive the ioute to the site piioi
to test uay
12. Biing a set of eai plugs; the testing centei coulu be noisy
1S. Weai comfoitable, loose fitting, layeieu clothing to the testing centei; piepaie foi it
to be eithei colu oi hot uuiing the test
14. Biing at least 2 cuiient foims of IB to the testing centei
1S. Aiiive to the test eaily; be piepaieu to wait anu be patient
16. Eliminate the obviously wiong answei choices, then guess the fiist iemaining choice
17. Pace yourself; don’t rush, but keep working and move on if you get stuck
18. Naintain a positive attituue even if the test is going pooily
19. Keep youi fiist answei unless you aie positive it is wiong
2u. Check your work, don’t make a careless mistake
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Coie social woik values helu acioss the
boaiu by majoi social woik theoiists aie
as follows:
Woith of the inuiviuual
Right of inuiviuuals to access to
seivices
Right of inuiviuuals to fulfill
potential without iegaiu to class,
iace, genuei, oi sexual oiientation
Self ueteimination
Confiuentiality
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Coie social woik goals helu acioss the
boaiu by majoi social woik theoiists aie
to help clients:
Impiove social functioning
Resolve pioblems
Achieve uesiieu change
Neet self-uefineu goals
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The following aie majoi appioaches to
social woik piactice:
Psychosocial
Functional
Pioblem-solving
Behavioi mouification
Cognitive theiapy
Ciisis inteivention
Task centeieu anu competency-
baseu tieatment
Life mouel (ecological tieatment)
Family theiapy
Naiiative theiapy
Play theiapy
ueiiatiic social woik
Tiauma tieatment
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Thiee uiffeient ways to view how change
occuis in clients, as seen in the vaiieu
appioaches to social woik aie:
Psychological (e.g.,
psychouynamic, behavioial,
cognitive, etc.)
Spheie of change (e.g. inuiviuual,
couple, family, social system, etc.)
uoal of change (e.g. peisonality,
behavioial, social system, etc.)
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The uiffeient appioaches to social woik
have uiffeient aims foi assessment. Listeu
below aie uiffeient focuses that social
woik assessment can have:
Intiapsychic uynamics, stiengths,
anu pioblems
Inteipeisonal uynamics,
stiengths, anu pioblems
Enviionmental stiengths anu
pioblems
The inteiaction anu inteisection
of intiapsychic, inteipeisonal, anu
enviionmental factois.
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The appioach to social woik piactice will
affect the length of time neeueu to
accomplish goals. Extenueu peiious of
time foi tieatment aie neeueu foi those
appioaches that focus on peisonality
change. Shoitei-teim tieatment is calleu
foi in those appioaches that focus on
behavioial change, cognitive change, oi
pioblem solving. Examples aie ciisis
inteivention, task-centeieu tieatment,
cognitive, anu behavioial tieatment.
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The view of the tieatment ielationship
can be influenceu by the appioach to
social woik piactice. 0ne view of the
tieatment ielationship sees the
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theiapeutic ielationship as the main
channel foi piomoting change anu
pioviuing suppoit. Anothei view sees the
worker’s role as ally, teacher, or coach. In
this view, a heie-anu-now appioach is
taken. This can be seen in behavioial,
cognitive, oi ciisis inteivention mouels
foi piactice.
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The following aie some similaiities seen
among all appioaches to social woik
piactice:
The use of ielationship in some
way.
Some foim of assessment,
tieatment plan, anu goal-setting.
A means of evaluating tieatment.
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The theoietical base foi the psychosocial
appioach to social woik piactice is as
follows:
Psychoanalytic theoiy (Sigmunu
Fieuu)
Ego Psychology: psychoanalytic
base, with focus on ego functions
anu auaptation; uefense
mechanisms (Anna Fieuu);
auaptations to an aveiage
“expected” environment
(Baitmann); ego masteiy anu
uevelopment thiough the life
cycle (Eiikson);
sepaiation¡inuiviuuation
(Naigaiet Nahlei)
Social Science Theoiies: iole,
family anu small gioup, impact of
cultuie, communication theoiy,
systems theoiy
Biological theoiies: ecological,
homeostasis, behavioial genetics,
health, illness
The basic tenets of the psychosocial
appioach aie:
Psychosocial
Pioblem-solving
Ciisis inteivention
Task-centeieu casewoik
Planneu shoit-teim tieatment
Assumptions about human behavioi
The following aie the assumptions about
human behavioi that the psychosocial
appioach to piactice makes:
The inuiviuual always seen in the
context of enviionment,
inteiacting with social systems
(such as family), anu influenceu
by eailiei peisonal expeiiences.
Conscious, unconscious, iational,
anu iiiational motivations govein
inuiviuual behavioi.
Inuiviuuals can change anu giow
unuei fitting conuitions
thioughout the life cycle.
Change
In the psychosocial appioach to social
woik piactice, the following aie the
means thiough which change occuis:
Bevelopment of insight anu
iesolution of emotional conflicts.
Coiiective emotional expeiience
in ielationship with the woikei.
Changes in affective, cognitive, oi
behavioial patteins that inuuce
changes in inteipeisonal
ielationships.
Changes in the enviionment.
In the psychosocial appioach to piactice,
the motivations foi change aie as follows:
Bisequilibiium inuuces anxiety
anu ieleases eneigy to change.
Conscious anu unconscious neeus
anu wishes.
Relationship with the woikei (oi
gioup in gioup tieatment).
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
the psychosocial appioach is as follows:
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Ninuful use of the ielationship
can motivate anu cieate eneigy to
change.
Coiiective emotional expeiience.
Client and client’s needs are
cential. Self-uisclosuie by woikei
is useu puiposefully anu only foi
client’s benefit.
Some tiansfeience uynamics may
hampei tieatment, but geneially
they shoulu be seen anu useu as
potential vehicles foi piomoting
client self-unueistanuing anu
changing pioblematic
inteipeisonal patteins.
To ueal with possible
counteitiansfeience, woikei
shoulu be self awaie, seek
supeivision anu consultation to
ueciease counteitiansfeience
ieactions, anu use hei¡his own
theiapy foi uealing with
counteitiansfeience.
Woikei shoulu be awaie that s¡he
may be peiceiveu as moie
competent than the client anu as
the expert who is there to “fix” the
client’s problems. This can be
uisempoweiing to the client anu
woiks against a stiengths
peispective.
Assessment
Assessment in the psychosocial appioach
to social woik piactice:
Outlines client’s presenting
problem and client’s resources for
auuiessing it.
Beteimines if theie is an
appiopiiate match between
piesenting pioblem anu available
seivices.
Begins in fiist inteiview anu
continues thioughout tieatment.
Components incluue:
Bynamic: Beteimining how
uiffeient chaiacteiistics of client
and client’s important
ielationships inteiact to influence
his¡hei total functioning.
Etiological: Beteimining the
causative factois that piouuceu
the piesenting pioblem anu that
influence the client’s previous
attempts to ueal with it.
Clinical: articulation of the client’s
functioning (i.e., mental status,
coping stiategies¡style, if
peitinent a clinical uiagnosis).
Tieatment planning
In the psychosocial appioach to social
woik piactice, the following aie the
components of tieatment planning:
Bevelopment of a unique
tieatment plan baseu on the
client’s situation.
Client goals anu theii piacticality,
given the client’s abilities,
stiengths, anu weaknesses, as
well as availability of ielevant
seivices.
Tieatment plan is uiiecteu at
changing the inuiviuual, the
enviionment, oi the inteiaction
between the two.
Phases of tieatment
The phases of tieatment in the
psychosocial appioach aie as follows:
Engagement¡assessment
(applicant becomes client;
incieasing motivation; initial
iesistance; establishing woik
ielationship, assessment;
infoimeu consent ie:
confidentiality; client/worker’s
ioles, iights, iesponsibilities)
Contiacting¡goal setting
(client/worker’s mutual
unueistanuing ie: goals,
tieatment piocess, natuie of
ielationship¡ioles, intenueu time
of tieatment)
0ngoing tieatment¡inteiventions
(woiking towaiu impioving
pieviously agieeu upon pioblems;
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majoi focus: cuiient
functioning¡conscious
expeiience; uealing with ongoing
iesistance, tiansfeience,
counteitiansfeience)
Teimination (potential foi
giowth, ieiteiate majoi themes of
tieatment, expeiience feelings
about ielationship enuing)
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Theoietical base
The theoietical base foi the pioblem-
solving appioach to social woik piactice
is as follows:
Psychouynamic, with majoi
influence fiom Ego psychologists:
Eiik Eiikson (capacity foi change
thioughout life), Robeit White
(coping, auaptation, masteiy of
enviionment), Beinz Baitmann
(use of the conflict-fiee ego).
Social science theoiy: iole theoiy,
pioblem solving theoiy (}ohn
Bewey).
Assumptions about human behavioi
The following aie the assumptions that
the pioblem-solving appioach to social
woik piactice makes about human
behavioi:
Inuiviuuals aie engageu in life-
long pioblem-solving anu
auaptation to maintain, iebuilu, oi
achieve stability, even as
ciicumstances change.
The inuiviuual is vieweu as a
whole peison; the focus, howevei,
is on the peison in ielation to a
pioblem.
Inuiviuuals have oi can uevelop
the motivation anu ability to
change.
This peispective uoes not see the
inuiviuual as sick oi ueficient, but
insteau as in neeu of help to
iesolve life pioblems.
Each individual has a “reachable
moment” at a time of
uisequilibiium, at which point
s¡he can most successfully
mobilize motivation anu capacity
An individual’s cognitive
piocesses can be engageu to solve
pioblems, to achieve, anu to giow
emotionally
An inuiviuual has both
iational¡iiiational,
conscious¡unconscious piocesses,
but cognitive stiengths can
contiol iiiationality.
Change
In the pioblem-solving appioach to social
woik piactice, the following aie the
motivations foi change:
Bisequilibiium between ieality
anu what the client wants.
Conscious uesiie to achieve
change.
Positive expectations baseu on
new life possibilities.
The stiength of a suppoitive
ielationship anu positive
expectations of the woikei.
In the pioblem-solving appioach to social
woik piactice, the following aie the
means thiough which change occuis:
Impioveu pioblem-solving skills.
These may piouuce changeu in
peisonality oi impioveu
functioning, but these aie
seconuaiy to pioblem iesolution.
uiatification, encouiagement, anu
suppoit which iesult fiom
impiovement in the pioblem
situation. This and the worker’s
emotional suppoit inciease the
possibility of change.
Repetition anu piactice (uiilling)
of the pioblem-solving methou
incieases possibility foi
ieplication of effective stiategies
in new situations.
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Insight, iesolution of conflicts, anu
changes in feelings.
Pioblem iesolution conceining
changes in the inuiviuual, the
enviionment, anu¡oi the
inteiaction between the two.
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
the pioblem-solving appioach to social
woik piactice is as follows:
Ninuful anu continual use of the
suppoitive social woik
ielationship to motivate clients to
engage in pioblem iesolution.
The woikei is an expeit in
pioblem-solving methouology anu
guiues clients thiough steps of
pioblem iesolution. The
ielationship giows as woikei anu
client woik on pioblems jointly.
Woik is focuseu on piactical
pioblem solving, theiefoie
tiansfeience¡counteitiansfeience
aie less likely. These aie only
auuiesseu if inteifeiing with the
woik.
Assessment
Assessment in the pioblem-solving
appioach to social woik piactice is as
follows:
Focus fiist on iuentifying the
pioblem anu the aspects of the
peison¡enviionment that can be
involveu in pioblem solving.
Assess motivation, capacity, anu
oppoitunity (NC0) of the client to
iesolve the pioblem.
Incluue a statement of the
pioblem (objective facts anu
subjective iesponses to them),
piecipitating factois, anu piioi
effoits to iesolve it.
A combineu activity of woikei anu
client.
Tieatment planning
In the pioblem-solving appioach to social
woik piactice, the following aie the
components of tieatment planning:
Psychosocial: ueiiveu fiom an
evaluation of the pioblem anu the
client’s Motivation, capacity, and
oppoitunities (NC0).
Functional: the function of the
agency seives a bounuaiy of
seivice (i.e., auoption agency,
mental health seivice)
Inteiagency: using iesouices fiom
othei agencies in a netwoik of
seivices uesigneu to help the
client.
Phases of tieatment
The following aie the phases of tieatment
in the pioblem-solving appioach to social
woik piactice:
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involveu in tieatment: A &0(<%9
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Cleaily iuentify the pioblem anu
the client’s subjective response to
it.
Select a pait of the pioblem that
has possibility foi iesolution,
iuentify possible solutions, asses
theii achievability in light of NC0.
Engage client’s ego capacities.
Beteimine steps¡actions to be
taken by woikei anu client to
iesolve oi alleviate the pioblem.
Belp client caiiy out pioblem-
solving activities anu ueteimine
theii effectiveness.
Teimination.
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Theoietical base
The theoietical base foi the ciisis
inteivention appioach to social woik
piactice is as follows:
Psychouynamic, paiticulaily ego
psychology (Fieuu, Eiikson,
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Rapoport) and Lindemann’s work
on loss anu giief.
Intellectual uevelopment (Piaget)
Social Science: stiess theoiy,
family stiuctuie, iole theoiy
Assumptions about human behavioi
The ciisis inteivention appioach makes
following assumptions about human
behavioi:
The inuiviuual has a tenuency to a
natuial piogiessive giowth that
pievails ovei foices of iegiession.
Stiess uuiing a ciisis inuuces
uisequilibiium anu anxiety that
allow theiapeutic accessibility.
Ciisis can cieate oppoitunities to
uevelop new coping mechanisms
anu giowth oi can give iise to
uysfunctional behavioi.
Ciisis occuis when establisheu
coping skills uo not iesolve stiess
auequately. A ciisis inflicts an
aiiay of affective, cognitive, anu
behavioial tasks. A ciisis can
ieactivate olu pioblems.
An inuiviuual in ciisis is not ill,
but iathei is uealing with a
challenge that is a pait of the
human conuition. The ciisis
counseloi uoes not necessaiily
assume the piesence of a
pathological conuition oi BSN
uisoiuei.
An inuiviuual in ciisis is affecteu
by the past, but the piesent
situation is moie ielevant.
Change
The motivations foi change in the ciisis
inteivention appioach aie as follows:
Bisequilibiium causeu by a
stiessful event oi situation.
Eneigy, which is maue available
by anxiety about the situation.
A suppoitive ielationship.
In the ciisis inteivention appioach to
social woik piactice, the following aie the
means thiough which change occuis:
Challenging olu coping patteins
anu a ieoiganization of coping
skills.
uiowth, which occuis as the ego
uevelops a laigei iepeitoiie of
coping skills anu oiganizes them
into moie complex pattein.
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
the ciisis inteivention appioach to
piactice is as follows:
The ielationship iemains ieality
based in the face of the client’s
often intense attachment.
Regiession is uiscouiageu even as
the ciisis evokes a sense of
helplessness.
The worker’s role is based on
expeitise; it is authoiitative anu
uiiective.
The client is encouiageu to be
active, to be ieality oiienteu, anu
to woik towaiu finuing new
methous of coping with ciisis.
0se of the ielationship as a
coiiective expeiience is not
emphasizeu. Theie is a minimal
focus on tiansfeience¡
counteitiansfeience.
Assessment
The assessment piocess in the ciisis
inteivention appioach is as follows:
Exploiing the stiess piouucing
event/situation, the individual’s
iesponse to it, anu iesponses to
past ciises.
Chaiacteiistic signs, phases,
patteins of auaptation anu
malauaptation to ciisis (i.e. PTSB)
Because of neeu foi quick action,
highly focuseu assessment that
emphasizes cuiient state of
functioning, inteinal anu
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enviionmental suppoits anu
ueficits.
Phases of tieatment
The following aie the phases of tieatment
in the ciisis inteivention appioach to
piactice:
Iuentify events that biought on
the ciisis.
Piomote awaieness of impact of
ciisis, both cognitive anu
emotional.
Nanage affect leauing to tension
uischaige anu masteiy.
Seek iesouices in netwoiks
(inuiviuual, family, social) anu in
community.
Iuentify specific tasks associateu
with healthy iesolution of ciisis.
Tieatment skills oi techniques
The following tieatment skills oi
techniques aie useu in the ciisis
inteivention appioach:
Biief tieatment. Like the ciisis
itself, tieatment is time limiteu.
Piesent- anu futuie-oiienteu.
Tieatment can ueal with the past,
howevei, to iesolve olu conflicts if
they pievent woik on the piesent
ciisis.
0ses all psychosocial anu
pioblem-solving techniques, but
ieoiueis them; clinician is active,
uiiective, anu at times
authoiitative.
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The theoietical base of the behavioi
mouification appioach to social woik
piactice is as follows:
Eaily classical conuitioning
ieseaich (Pavlov)
Behavioi mouification theoiy—
opeiant conuitioning (Skinnei,
Thoinuike, Watson, Bollaiu &
Nillei, Thomas)
Social leaining theoiy—
obseiving, imitating, moueling
(Banuuia)
Assumptions about human behavioi
The assumptions that the behavioi
mouification appioach makes about
human behavioi aie as follows:
0ne can know a peison only
thiough the obseivable. Behavioi
can be explaineu by leaining
theoiy. Theoiy of the unconscious
is unnecessaiy.
A peison has leaineu,
uysfunctional behaviois iathei
than emotional illness. No
piesumptions about psychiatiic
illness.
0ne expiesses uysfunctional
behavioi in symptoms. Befinition
of symptoms: obseiveu inuiviuual
behaviois that aie labeleu as
ueviant oi pioblematic. 0nce the
symptoms aie iemoveu, theie aie
no iemaining unueilying
pioblems.
Bigh piioiity goes to ieseaich anu
empiiically baseu knowleuge.
Change
The behavioial mouification appioach
sees the following as the motivations foi
change:
Bisequilibiium
Anxiety
Conscious uesiie to eliminate a
symptom
Agieement to follow a behavioi
mouification piogiam
In the behavioial mouification appioach
to social woik piactice, the following aie
the means thiough which change occuis:
0peiant¡voluntaiy behavioi
which is 1) incieaseu by positive
oi negative ieinfoicement anu 2)
uecieaseu by withholuing
ieinfoicement oi punishing.
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Involuntaiy behavioi which is
incieaseu oi uecieaseu by
conuitioning.
Change uepenus upon
enviionmental conuitions oi
events that pieceue, aie
connecteu with, oi follow the
behavioi.
As a iesult of obseiving anu
imitating in a social context,
moueling occuis; this is not
leaineu by iewaiu anu
punishment.
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
the behavioial mouification appioach to
piactice is as follows:
The ielationship is waim,
empathic, anu facilitating.
The ielationship is not the focus
noi is it useu as pait of the
tieatment.
Tieatment planning
Tieatment planning in the behavioial
mouification piactice appioach is
uesciibeu below:
Piioiitize pioblems. Iuentify
maintaining conuitions foi
selecteu pioblems.
Engage client in establishing goals
foi change.
Establish baseline uata ie:
fiequency of behavioi.
Bevelop wiitten oi oial contiact.
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Theoietical base
The following is theoietical base foi the
cognitive theiapy appioach to social woik
piactice:
Albert Ellis’ rational-emotive
behavioi theiapy
Aaron Beck’s cognitive theory
Assumptions about human behavioi
The cognitive theiapy appioach makes
the following assumptions about human
behavioi:
Nental uistiess is causeu by the
malauaptive anu iigiu ways we
constiue events, not by the events
themselves.
Negative automatic thoughts aie
geneiateu by uysfunctional
beliefs. These beliefs aie set in
motion by activating events anu
they tiiggei emotional
consequences. Futuie events aie
inteipieteu thiough the filtei of
these belief systems.
Negative affect anu symptoms of
psychological uisoiueis follow
negative automatic thoughts,
biases, anu uistoitions.
Iiiational thinking caiiies the
foim of systematic uistoitions.
Change
The following aie the motivations foi
change in the cognitive theiapy piactice
appioach:
Bisequilibiium
Anxiety
Besiie to live without a symptom
Agieement to woik towaiu
changing thought patteins.
In the cognitive theiapy appioach to
social woik piactice, the following aie the
means thiough which change occuis:
Stiuctuieu sessions
Exploiing anu testing cognitive
uistoitions anu basic beliefs
Bomewoik between sessions
which allows client to piactice
changes in thinking in the natuial
enviionment.
Changes in feelings anu behaviois
in the futuie come about thiough
changes in the way the client
inteipiets events.
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Theiapeutic ielationship
The iole of the theiapeutic ielationship in
the cognitive theiapy appioach is as
follows:
Woikei is teachei, ally, coach
Woikei is active, uiiective,
uiuactic
Assessment
The assessment piocess in the cognitive
theiapy piactice appioach is as follows:
List the client’s cognitive
uistoitions (e.g., catastiophizing,
minimizing, negative pieuictions,
minu-ieauing, oveigeneialization,
peisonalization).
List the client’s negative
automatic thoughts anu
uysfunctional beliefs.
Tieatment planning
The tieatment planning piocess in the
cognitive theiapy appioach to piactice is
as follows:
Establish baseline uata measuiing
client’s negative automatic
thoughts, uistoitions, anu
uysfunctional beliefs. Bow often
uo these thoughts occui anu
unuei what ciicumstances.
Cieate taiget goals foi change anu
alteinative ways of thinking.
Agiee to contiact foi goals,
homewoik, anu time fiame of
tieatment.
Tieatment skills oi techniques
The following aie some tieatment
skills¡techniques useu in the cognitive
theiapy appioach:
Shoit teim tieatment
A focus on symptom ieuuction
0sing a iational appioach, focus
on conciete tasks in sessions anu
foi homewoik.
Pei Albeit Ellis—Be foicefully
confiontive in oiuei to ieveal
client’s thought system, get client
to see how that system uefeats
hei¡him, anu woik to change the
thoughts that make up that
system.
Pei Aaion Beck—A gentlei, moie
collaboiative appioach. Belp
client iestiuctuie inteipietations
of events. “What is the evidence
for this idea?” or “Is there another
way to look at this situation?”
Social skill builuing, gioup
theiapy, milieu tieatment.
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Theoietical base
The theoietical base of the task-centeieu
appioach to social woik piactice is as
follows:
Leaining theoiy
Cognitive anu behavioial theoiy
Bigh piioiity on ieseaich-baseu
piactice knowleuge
Assumptions about human behavioi
The task-centeieu appioach makes the
following assumptions about human
behavioi:
An inuiviuual is not influenceu
solely by inteinal¡unconscious
uiives, noi contiolleu solely by
enviionmental foices.
The client usually is able to
iuentify hei¡his own
pioblems¡goals.
The client is the piimaiy agent of
change anu is a consumei of
seivices.
The worker’s role is to help the
client achieve the changes that
s¡he ueciues upon anu is willing
to woik on.
Change
The motivations foi change accoiuing to
the task-centeieu appioach to piactice
aie as follows:
Tempoiaiy bieakuown in coping
influences client to seek help.
A conscious wish foi change.
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Stiengthening of self-esteem
thiough task completion.
In the task-centeieu appioach to social
woik piactice, the following aie the
means thiough which change occuis:
Claiification of pioblem¡pioblems
Steps taken to iesolve oi alleviate
pioblems.
Changes in enviionment.
Theiapeutic ielationship
The iole of the theiapeutic ielationship
accoiuing to the task-centeieu appioach
to piactice is as follows:
The ielationship is not an
objective in itself, but is a means
of augmenting anu suppoiting
pioblem solving. Tiansfeience¡
counteitiansfeience aspects aie
minimizeu.
Woikei expects that client will
woik on agieeu upon tasks anu
activities to iesolve pioblems, anu
also pioviues acceptance iespect
anu unueistanuing.
Collaboiative ielationship.
Worker seeks client’s input at all
stages. Client is consumei anu
woikei is the authoiity with
expeitise who woiks on the
client’s behalf.
Assessment
The piocess of assessment in the task-
centeieu piactice appioach is as follows:
Examination anu claiification of
pioblems aie piimaiy. The
pioblem must be one that
conceins the client anu is
amenable to tieatment.
The woikei anu client cieate a
iationale foi iesolution of the
pioblem anu note potential
tieatment benefits.
Tieatment planning
The tieatment planning piocess in the
task-centeieu appioach to piactice is as
follows:
A contiact must state agieement
on what will be woikeu on, the
worker’s and client’s willingness
to engage in the woik, anu the
limits of the tieatment (time, etc.).
The contiact can be foimal, oial,
oi wiitten; it is uynamic anu can
be ienegotiateu.
Both woikei anu client agiee on a
specific uefinition of the
pioblem¡s to be woikeu on anu
the changes sought in the piocess.
Expiesseu in both behavioial anu
measuiable teims.
Non-appiopiiate clients
The task-centeieu appioach to piactice
not appiopiiate foi the following clients:
Clients who aie inteiesteu in
existential issues, life goals,
anu¡oi uiscussion on stiessful
events.
Clients who aie unwilling oi
unable to use the stiuctuieu
appioach to tasks.
Clients who have pioblems that
aie not subject to iesolution oi
impiovement by pioblem-solving.
Clients who aie involuntaiy,
wheie tieatment is manuateu.
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The theoietical base to the systems
theoiy appioach to social woik piactice is
as follows:
This appioach is baseu on geneial
system theoiy applieu to social
woik tieatment.
Systems Theoiy is a fiamewoik
that a woikei can use with any of
the piactice appioaches in oiuei
to help the client establish anu
maintain a steauy state.
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Befinitions in systems theoiy:
Bounuaiy—oiganizational means
by which the paits of a system can
be uiffeientiateu fiom theii
enviionment anu which
uiffeientiates subsystems
0pen¡Closeu system—inuicates
whethei bounuaiy between a
system anu its enviionment is
open oi closeu.
Subsystem—subset of the entiie
system
Entiopy—ianuomness, chaos,
uisoiuei in a system. Causes a
system to lose eneigy fastei than
it cieates oi impoits it.
Bomeostasis—a system will make
changes in oiuei to maintain an
accustomeu balance.
Assumptions about human behavioi
The systems theoiy appioach makes the
following assumptions about human
behavioi:
Inuiviuuals have potential foi
giowth anu auaptation
thioughout life. They aie active,
pioblem solving anu puiposeful.
Inuiviuuals can be unueistoou as
open systems which inteiact with
othei living systems anu the
nonliving enviionment.
All systems aie inteiuepenuent.
Change in one system biings
about changes in the otheis.
Auuitionally, change in a
subsystem biings about changes
in othei subsystems.
Change
Changes in the inuiviuual, enviionment,
oi in the inteiaction between the
inuiviuual anu the enviionment aie
motivations foi change accoiuing to the
systems theoiy appioach to piactice.
Theiapeutic ielationship
The iole of the theiapeutic ielationship
accoiuing to the systems theoiy appioach
is as follows:
Bepenuing on the pioblem anu
taiget of change, the ielationship
may be suppoitive, facilitative,
collaboiative, oi auveisaiial. The
woikei may inteivene on behalf
of the client with inuiviuuals, the
social suppoit netwoik, oi the
laigei system.
The ielationship offeis feeuback
to the client anu to othei systems.
Assessment
Pioblems uo not belong to the inuiviuual,
but insteau belong to the inteiaction of
the behaviois oi social conuitions that
cieate uisequilibiium.
Tieatment planning
Tieatment planning in the systems theoiy
appioach is as follows:
Establishing specific goals, theii
piacticability, anu theii piioiity.
Taiget systems foi inteivention
aie iuentifieu in collaboiation
with the client.
Specific contiact is uevelopeu
with the client anu¡oi othei
systems that may be involveu in
change.
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The theoietical base foi the Ecological oi
Life Nouel appioach to social woik
piactice is as follows:
Ecology
Systems Theoiy
Stiess, coping, anu auaptation
theoiy
Psychouynamic, behavioial, anu
cognitive theoiy
This appioach follows a conceptual
fiamewoik that has its focus on the
inteiaction anu inteiuepenuence of
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people anu enviionments. It pioviues
seivice to inuiviuuals, families, anu
gioups within a community,
oiganizational, anu cultuial enviionment.
Assumptions about human behavioi
The Ecological oi Life Nouel appioach to
piactice makes the following assumptions
about human behavioi:
The inuiviuual is active,
puiposeful, anu pioblem solving.
S¡he has potential foi giowth anu
auaptation thioughout life.
Theie aie thiee aieas of life
expeiience in which pioblems
occui: life tiansitions,
enviionmental piessuies, anu¡oi
maladaptive lack of “fit” between
the inuiviuual anu a laigei entity
(the family, the community).
Each inuiviuual client system
uepenus upon oi is
inteiuepenuent with othei
systems.
Change
Notivation foi change in this appioach
stems fiom changes that the inuiviuual
wants in ielation to hei¡himself, the
enviionment, oi the inteiplay between
the two.
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
the Ecological¡Life mouel appioach is as
follows:
The worker’s relationship with
the client is baseu on mutuality,
tiust, anu authenticity.
Bepenuing on the goal of the
inteivention, the woikei¡client
ielationship may be suppoitive,
collaboiative, oi auveisaiial.
Murray Bowen’s family systems theory
Bowen’s theory focused on:
The iole of thinking veisus
feeling¡ieactivity in
ielationship¡family systems.
Role of emotional tiiangles. The
thiee-peison system oi tiiangle is
vieweu as the smallest stable
ielationship system anu foims
when a two-peison system
expeiiences tension.
ueneiationally iepeating family
issues. Paients tiansmit
emotional pioblems to a chilu.
(Ex: paients feai something
wiong with a chilu anu tieat chilu
as if something is wiong, inteipiet
child’s behavior as confirmation.)
0nuiffeientiateu family ego
mass—family’s lack of
sepaiateness, fixeu clustei of egos
of inuiviuual family membeis as if
all have a common ego bounuaiy
Emotional cutoff—way of
managing emotional issues with
family membeis (cutting off
emotional contact)
Consiueiation of thoughts anu
feelings of each inuiviuual family
membei as well as seeking to
unueistanu the family netwoik.
Hayley and Madanes’ Strategic Family
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This theiapy seeks to leain what function
the symptom seives in the family, i.e.,
what “payoff” is there for the system in
allowing the symptom to continue.
Pioblem-focuseu behavioial change,
emphasis of paiental powei anu
hieiaichical family ielationships, focus on
iole of symptoms as an attiibute of the
family’s organization.
Belplessness, incompetence, illness all
pioviue powei positions within the
family; chilu uses symptoms to change the
behavioi of paients.
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Milan School’s systemic family ther;?,
The Nilan School makes the assumption
that symptoms seive a puipose: to
maintain the family stiuctuie within
uysfunctional families. In this
unueistanuing, a family membei is
saciificeu to maintain the family
stiuctuie.
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This peispective uiaws on sociology, ego
concepts, anu communication theoiy to
foim iole theoiy concepts. Satii examineu
the roles of “rescuer” and “placatory” that
constiain ielationships anu inteiactions
in families. This peispective seeks to
inciease intimacy in the family anu
impiove self-esteem of family membeis
by using awaieness anu communication
of feelings. Emphasis on inuiviuual
giowth in oiuei to change family
membeis anu ueal with uevelopmental
uelays. Paiticulai impoitance is given to
maiital paitneis anu on changing veibal
anu non-veibal communication patteins
that lowei self-esteem.
Family System’s theory
Psychodynamic theory’s contributions to
Family System’s theory, via work of
Nathan Ackeiman, Bon }ackson, anu 0lga
Silveistein aie as follows:
Emphasizes multi-geneiational
family histoiy. Eailiei family
ielations anu patteins ueteimine
cuiient ones. Bistoiteu ielations
in chiluhoou leau to patteins of
miscommunication anu
behavioial pioblems.
Inteipeisonal anu intiapeisonal
conflict beneath appaient family
unity iesults in psychopathology.
Social iole functioning influenceu
by heieuity anu enviionment.
}ackson focuses on powei
ielationships. Be uevelopeu a
theory of “double-bind”
communication in families.
Bouble-binu communication
occuis when two conflicting
messages communicateu
simultaneously cieate¡maintain a
“no-win,” pathological symptom.
Sal Minuchin’s Structural family therapy
in ielation to its contiibutions to Family
Systems theoiy is as follows:
This theiapy seeks to stiengthen
bounuaiies when family
subsystems aie enmesheu, oi
seeks to inciease flexibility when
these systems aie oveily iigiu.
Ninuchin emphasizes that the
family stiuctuie shoulu be
hieiaichical anu that the paients
shoulu be at the top of the
hieiaichy.
Assumptions about human behavioi
The Family Systems Theoiy appioach to
piactice makes the following assumptions
about human behavioi:
Change in one pait of the family
system biings about change in
othei paits of the system.
The family pioviues the following
to its membeis: unity,
inuiviuuation, secuiity, comfoit,
nuituiance, waimth, affection,
anu iecipiocal neeu satisfaction.
Wheie family pathology is
piesent, the inuiviuual is socially
anu inuiviuually uisauvantageu.
Behavioial pioblems aie a
ieflection of communication
pioblems in the family system.
Tieatment focuses on the family
unity; changing family
inteiactions is the key to
behavioial change.
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Change
Bisequilibiium of the noimal family
homeostasis is the piimaiy motivation foi
change accoiuing to this peispective. The
family system is maue up of thiee
subsystems: the maiital ielationship, the
paient-chilu ielationship, anu the sibling
ielationship. Bysfunction that occuis in
any of these subsystems will likely cause
uysfunction in the otheis. The means foi
change in the Family Systems theoiy
appioach is the family as an inteiactional
system.
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
the Family Systems theoiy appioach to
social woik piactice is as follows:
The worker interacts in the “here
and now” with the family in
ielation to cuiient pioblems.
Woikei is a consultant to the
family.
The iole uiffeis accoiuing to school of
thought:
Stiuctuial—uysfunctional
inteiaction is actively challengeu
Stiategic anu Systemic—woikei is
veiy active
Nilan School—male¡female
clinicians aie co-theiapists; a
team obseives fiom behinu a one-
way miiioi, consults anu uiiects
theii co-theiapists with the clients
Psychouynamic—woikei
facilitates self-ieflection anu
unueistanuing of multi-
geneiational uynamics, conflicts
Satii—Woikei mouels caiing,
acceptance, love, compassion,
nuituiance in oiuei to help clients
face feais anu inciease openness
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Assessment:
Acknowleugement of uysfunction
in the family system.
Family hieiaichy: Who is in
chaige. Who has iesponsibility.
Who has authoiity. Who has
powei.
Evaluation of bounuaiies (aiounu
subsystems, between family anu
laigei enviionment)—aie they
peimeable oi impeimeable.
Flexible oi iigiu.
Bow uoes the symptom function
in the family system.
Tieatment planning:
Woikei cieates a mutually
satisfactoiy contiact with the
family to establish seivice
bounuaiies.
Bowenian family therapy’s goal is
uiffeientiation of the inuiviuual
fiom the stiong influence of the
family.
The following teims aie commonly useu
in Family Systems tieatment:
Bounuaiies: means of
oiganization thiough which
system paits can be uiffeientiateu
both fiom theii enviionment anu
fiom each othei. They piotect anu
impiove the uiffeientiation anu
integiity of the family, subsystem,
anu inuiviuual family membeis.
Collaboiative Theiapy: theiapy in
which sepaiate woikei sees each
spouse oi membei of the family
Complementaiy family
inteiaction: type of family
ielationship in which membeis
piesent opposite behaviois that
supply neeus oi lacks in the othei
family membei
Complementaiity of neeus:
ciiculai suppoit system of a
family, in which iecipiocity is
founu in meeting neeus; can be
auaptive oi malauaptive
Bouble-binu communication:
communication in which two
contiauictoiy messages aie
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conveyeu concuiiently, leauing to
a no-win situation
Family of oiigin: family into which
one is boin
Family of piocieation: the family
which one foims with a mate anu
one’s own children
Enmeshment: obscuiing of
bounuaiies in which
uiffeientiation of family
subsystems anu inuiviuual
autonomy aie lost. Similai to
Bowen’s “undifferentiated family
ego mass.” Characterized by
“mind reading” (partners speak
foi each othei, complete each
other’s sentences)
Bomeostasis: state of systemic
balance (of ielationships,
alliances, powei, authoiity)
Identified patient: “symptom
bearer” in the family
Nultiple family theiapy: Theiapy
in which thiee oi moie families
foim a gioup with one oi moie
clinicians to uiscuss common
pioblems. uioup suppoit is given
anu pioblems aie univeisalizeu.
Scapegoating: unconscious,
iiiational election of one family
membei foi a negative, uemeaneu,
oi outsiuei iole
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Theoietical base
The theoietical base foi the Naiiative
Theiapy appioach to social woik piactice
is as follows:
Biaws on the woik of Nichael
White of the Bulwich Centie in
Austialia.
0tilizes a vaiiety of inuiviuual anu
peisonality theoiies, as well as
social psychological appioaches.
Focuses on the stoiies people tell
about theii lives. These stoiies aie
inteipieteu thiough theii
subjective peisonal filteis.
Inteiventions aie uesigneu to
ieveal anu iefiame the way
clients stiuctuie theii peiceptions
of theii expeiiences.
Assumptions about human behavioi
The Naiiative Theiapy appioach to
piactice makes the following assumptions
about human behavioi:
Individuals’ behaviors come from
theii inteipietations of
expeiiences.
Subjective meanings influence
actions. Neanings ueiiveu fiom
inteipietations of expeiience
ueteimine specifics of action.
Naiiative theiapy is conceineu
with the telling anu ie-telling of
the preferred stories of people’s
lives, as well as the peifoimance
anu ie-peifoimance of these
stoiies.
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
the Naiiative theiapy appioach is as
follows:
Woikei is co-constiuctoi of new
naiiatives.
The ielationship is a paitneiship;
authoiity of theiapist is
minimizeu. Paitneiship uoes not
use techniques that iesult in
clients feeling coeiceu oi
manipulateu.
Relationship seeks anu is an agent
of client empoweiment. Woikei
offeis an optimistic, futuie-
oiienteu peispective that builus
on client’s abilities and strengths
in moving towaiu change.
Emphasizes client’s possibilities,
stiengths, anu iesouices.
Woikei guiues theiapeutic
conveisations to cieate new
possibilities, fiesh options, anu
oppoitunities to iefiame the
client’s realities.
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Assessment anu tieatment planning
Assessment:
Napping how the pioblem
influences the client’s life and
ielationships—how uoes the
pioblem affect the client(s).
Napping the influence of the
peison¡family in the life of the
pioblem—Clients stait to see
themselves as authois oi co-
authois of theii own stoiies.
Tieatment planning:
Togethei woikei anu client
establish cleai goals foi theii
woik.
Woikei anu client uiviue out anu
woik on small, specific, limiteu
goals.
The appioach avoius a meuical
(uisease) mouel that seeks
explanations foi pioblems oi
asciibes pathology to the family
system.
This theiapy builus on stiengths
anu abilities of families anu
inuiviuuals iathei than seeking
weaknesses anu ueficits.
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Chiluien aie typically iefeiieu to
tieatment foi symptoms oi behavioial
problems. The child’s underlying conflicts
ieveal themselves thiough play anu
veibally in fiee expiession. Play is the
child’s form of symbolic communication,
an emulation of the ieal woilu, anu the
child’s psychological reality. The
theoietical base foi the tieatment of
chiluien is founu in:
Noimal chilu uevelopment theoiy
Psychosocial uevelopment theoiy
(S. Fieuu, Anna Fieuu, Eiikson)
Attachment theoiy
0bject ielations theoiy
The following aie motivations foi change
in the chilu-tieatment (age ielateu
tieatment) appioach to piactice:
If chilu is in alteinative placement
(foster care, etc.), child’s behavior
may be seen as pioblematic by the
agency oi woikei anu tieatment
inteiventions may be sought.
Chilu is unhappy with peei
ielations, may be socially
immatuie.
0nsatisfactoiy school aujustment
(giaues, pioblems with authoiity)
Conflict with paients (stiuggle to
cope with uysfunctional family oi
problems in parents’ marriage)
Feelings of angei, unhappiness
Self-uestiuctive behaviois such as
cutting oi eating uisoiueis.
Theiapeutic ielationship
The iole of the theiapeutic ielationship
when tieating chiluien in social woik
piactice is as follows:
Woikei as theiapist—pioviues a
safe enviionment in which woikei
can follow child’s lead, show child
acceptance, cieate enviionment
foi fiee expiession
Woikei as auvocate
Woikei as case managei, caie
cooiuinatoi
Woikei as piotective seivice
woikei
Woikei as auoption anu fostei
caie specialist
Woikei as school guiuance
counseloi
Assessment anu tieatment planning
Assessment seeks to unueistanu the
child’s inner feelings anu conflicts, the
paient-chilu inteiaction, the family
uynamics anu inteiactions, anu piactical
uifficulties anu enviionmental pioblems.
Assessment will be sensitive to multi-
pioblem families anu will be cultuially
competent.
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Tieatment planning:
Builu on stiengths, focus on aieas
wheie functioning is pioblematic
(inuiviuual uifficulties, family
uysfunction, enviionmentally-
geneiateu ciises).
Suppoit auaptive behavioi
Set iealistic goals anu emphasize
the issues that uiiectly affect the
caie of the chilu.
Claiify the piojecteu length of
time of tieatment; ongoing
ieevaluation.
Builu ielationship thiough
management of conciete
pioblems.
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Theie aie seveial veisions of the social-
psychological aiea of community. 0ne is
the belief that people of a community aie
bounu togethei by an existing aiea of
inteiest. They feel connecteu baseu on
goals they shaie, neeus, values anu
activities that makeup the feeling of
community. Anothei is the belief that
theie is a peisonal-psychological
community within each inuiviuual. This
is the view fiom one peison that ieflects
what the community is like. Chiluien anu
lowei-class inuiviuuals tenu to view
community as having naiiow bounuaiies
than the miuule anu uppei class auults uo.
Anothei view is the cultuial-
anthiopological view of community,
which looks at community as a foim of
social living that is uefineu by attituues,
noims, customs, anu behaviois of those
living in the community.
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Theoietical base
The theoietical base of ueiiatiic Social
Woik is as follows:
Psychouynamic theoiy
Ego psychology
Family systems theoiy
Life-span uevelopment theoiy
(Wieck)
Continuity theoiy
Noimal aging anu uemogiaphics
of the aging population
Impact of chionic illness anu
physical¡cognitive limitations
Assumptions about human behavioi
ueiiatiic social woik makes the following
assumptions about human behavioi:
uiowth occuis thioughout the life
span, incluuing uuiing olu age.
Inuiviuuals aie inheiently
auaptive anu aie capable of
managing the uisiuptions,
uiscontinuities, anu losses that aie
chaiacteiistic of olu age.
0ui cultuie uemanus anu values
inuepenuence. This can piesent a
conflict with accepting the
incieasing neeu foi help in olu
age.
The younger generation’s caring
foi the oluei may be seen as iole
ieveisal anu may be challenging
to both geneiations. Bepenuency
in the ageu, howevei, has a
uiffeient meaning than
uepenuency in chiluhoou.
Suppoitive seivices aie piefeiable
to institutional caie whenevei
possible.
Ageist assumptions oi an
individual’s living in an
institutional setting aie not
ieasons to compiomise self-
ueteimination oi confiuentiality.
Inuiviuuals age in uiffeient ways.
Change
Notivations foi change incluue:
The neeu foi inuiviuuals to auapt
to longei peiious of olu age anu
ietiiement as life expectancy
incieases. With longei peiiou of
olu age comes incieaseu iisk foi
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chionic illness anu
physical¡cognitive limitations.
uieatei neeu foi multiple types of
social seivices, suppoiteu
housing, anu caie options.
Auult chiluien aie also affecteu by
their parents’ aging and may need
help uealing with the emotional
impact oi with caie planning.
Change occuis thiough:
Inuiviuual, couples, family
tieatment
Suppoit gioups oi gioup theiapy
Recieational piogiams
Euucation
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
ueiiatiic Social Woik is as follows:
Inuiviuual, couple, oi multi-
geneiational family theiapist
Case managei
Auvocate
Caie planning—woiking with
oluei auult anu¡oi hei¡his
chiluien to ueteimine level of caie
neeueu anu options
Social woikei foi institution—in
this iole woikei may expeiience
conflict in uefining who is client
anu whose neeus have pieceuence
(institution oi inuiviuual)
uuaiuian foi oluei auult who the
couit has ueclaieu mentally
incompetent oi conseivatoi foi
oluei auult who the couit has
ueclaieu incompetent to hanule
hei¡his own financial affaiis
Euucatoi
uioup theiapist oi leauei
Piogiam plannei
Assessment anu tieatment planning
Assessment is conceineu with:
Piesenting problem and client’s
iesouices foi iesolving it
When auult chiluien involveu,
inteigeneiational
uynamics¡iesouices, ielevance
anu impact of family histoiy on
piesent functioning
Piesence anu effect of chionic
illness anu physical¡cognitive
limitations
Bome safety
Neuications, theii influence on
functioning, anu negative siue
effects
Neeu foi suppoitive seivices oi
institutional caie
ABLs (activities of uaily living—
e.g., bathing, uiessing, etc.) anu
IABLs (instiumental activities of
uaily living—e.g., cooking,
uiiving)
Tieatment planning is conceineu with:
Inteiventions, solutions that offei
choice anu suppoit the oluei
adult’s highest level of functioning
Piomoting inuepenuence by
planning home mouifications
thiough home-safety assessment
anu planning foi assistive uevices
thiough assessing
physical¡cognitive limitations
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Physical abuse is extieme physical
uiscipline that exceeus noimative
community stanuaius.
Physical inuicatois aie biuises oi bioken
bones on an infant without an auequate
explanation oi that occui in unusual
places; laceiations; fiactuies; buins in
ouu patteins; heau injuiies; inteinal
injuiies; open soies; anu untieateu
wounus oi illnesses. Behavioial
inuicatois aie as follows:
Chilu may be oveily compliant,
passive, unuemanuing; oveily
aggiessive, uemanuing, hostile
Role ieveisal behavioi
Extiemely uepenuent behavioi ie:
paiental, emotional, physical
neeus
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Bevelopmental uelays
Sexual abuse is inappiopiiate sexual
contact, molestation, oi iape.
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Child neglect is failure of a child’s parent
oi caietakei, who has the iesouices, to
pioviue minimally auequate health caie,
nutiition, sheltei, euucation, supeivision,
affection, oi attention. Also, insufficient
encouiagement to attenu school with
consistency, exploitation by foicing to
woik too haiu oi long, oi exploie to
unwholesome oi uemoializing
ciicumstances. Inuicatois of chilu neglect
incluue abanuonment, absence of
sufficient auult supeivision, inauequate
clothing, pooi hygiene, lack of sufficient
meuical¡uental caie, inauequate
euucation, inauequate supeivision,
inauequate sheltei; consistent failuie,
unwillingness, oi inability to coiiect these
inuicatois.
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Theiapeutic ielationship
The woikei is to establish tiust anu a
woiking ielationship with the family anu
built paiental self esteem. Tieatment
issues incluue the paients confusing the
worker’s clinical role with the role of
chilu piotective seivices anu the paients
viewing the clinician as a hostile pait of
the legal system, iathei than as a tiusteu
helpei. Communication can be inhibiteu
by the peiception of coeicion, which can
also limit the treatment’s effectiveness.
Both paient anu chilu may become
unwilling to ieveal potentially uamaging
facts. Woikei shoulu openly uiscuss
manuateu iepoiting obligations anu
iesponsibility to infoim chilu piotective
seivices.
Tieatment planning
Tieatment planning foi
maltieateu¡tiaumatizeu chiluien is as
follows:
Piincipal goal is piotecting chilu
fiom fuithei haim anu halting any
fuithei abuse, neglect, oi sexual
exploitation immeuiately anu
conclusively. This may iequiie
tempoiaiy oi peimanent iemoval
of an offenuing caietakei oi
householu membei, oi iemoval of
the chilu fiom the home to a safe
place.
Seconuaiy goal is cieating
conuitions that insuie that abuse
oi neglect uoes not iecui aftei
supeivision¡tieatment is
teiminateu. Nay incluue
piosecution¡incaiceiation of
offenuing paity. Nay incluue
evaluation of non-offenuing
parent’s long-teim capacity anu
motivation to piotect the chilu.
0fficial agency can anu will use
legal authoiity to insuie
compliance with agency uiiectives
when necessaiy. Woikei shoulu
be aware that possibility of child’s
iemoval may be piimaiy concein
of paient anu may leau to panic,
uissembling, oi flight.
Treatment’s goal is to help
paients leain paienting¡ielational
skills that can change paiental
behavior and child’s responses
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Theoietical base
The tiauma victim expeiiences a thieat to
hei¡his physical integiity oi life. The
tiauma expeiience confionts a peison
with an extieme situation of feai anu
helplessness.
Tiauma may be chionic anu iepeateu oi
may take the foim of one event of shoit
uuiation.
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Nany of the symptoms ielateu to PTSB
anu uomestic violence aie self-piotective
attempts at coping with iealistic thieats.
Assumptions about human behavioi
Tiauma-Relateu social woik piactice
makes the following assumptions about
human behavioi:
Nost inuiviuuals expeiience the
woilu as a basically safe place in
which they aie woithy
paiticipants.
Tiauma can challenge oi ieveise
these assumptions about the
woilu anu oneself.
Resilience is uefineu as an innate
capacity to self-iegulate aftei
expeiiencing a stiessoi so
extieme as to be tiaumatic.
Resilience can be ueiiveu fiom
both inteinal anu enviionmental
iesouices.
Resilience can be moie uifficult to
achieve oi sustain when the
tiauma is moie seveie, is chionic,
anu¡oi when the peipetiatoi is
someone who shoulu be a
caietakei oi tiusteu piotectoi.
Change
The motivations foi change in Tiauma-
Relateu piactice aie:
Reality-baseu feai anu the neeu
foi piotection.
Symptoms incluuing uepiession,
anxiety, uissociation, low self-
esteem.
Theiapeutic ielationship
The iole of the theiapeutic ielationship in
Tiauma-Baseu social woik piactice is as
follows:
Foi clients with PTSB, the woikei
is a piotective piesence. The
woikei guiues the pace of
tieatment in oiuei to avoiu
floouing the client with too much
affect anu tiaumatic memoiies
that woulu piomote iegiession.
The woikei cieates an
emotionally safe theiapeutic
space in which to iemembei anu
piocess the tiauma.
Foi clients who have expeiienceu
uomestic violence, the woikei
may be theiapist, case managei,
couit-based victim’s advocate, or
biokei to obtain seivices.
Assessment
Assessment foi PTSB: evaluate the natuie
of the tiauma; the stiengths anu
limitations that pie-uate the tiauma; the
impact of trauma on the client’s
emotional life, self-esteem, anu
functioning; if client iemains at iisk anu
neeu foi self-piotective measuies.
Assessment foi uomestic violence:
evaluate if client is still at iisk anu if
piactical piotective measuies aie
iequiieu. Legal iepoiting not iequiieu foi
auult-auult uomestic violence, howevei, if
chiluien aie at iisk as witnesses oi
victims the woikei must make a iepoit to
chilu piotective seivices.
Tieatment planning
Foi PTSB: tieatments available incluue—
Psychouynamic theiapy
Bialectical Behavioial Theiapy (BBT)—
teaches skills to cope with intense
feelings, ieuuce symptoms of PTSB, anu
enhance iespect foi self anu quality of life
ENBR (Eye Novement Besensitization
anu Repiocessing)
uioup Theiapy (suppoit oi BBT)
Foi uomestic violence—
Bevelop a safety plan foi safe sheltei, etc.
to piotect victim fiom peipetiatoi.
Bo not assess oi tieat uomestic violence
in maiital oi family theiapy sessions as
this may inciease iisk to the victim,
inhibit ievealing the violence histoiy, anu
eniage the peipetiatoi.
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In social woik, clinical piactice:
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Seeks to impiove the inteinalizeu
negative effects of enviionmental
factois incluuing stiess fiom
health, vocational, family, anu
inteipeisonal pioblems.
The woikei inuiviuuals, couples,
anu families to change feelings,
attituues, anu coping behaviois
that hinuei optimal social
functioning.
Piactice is conuucteu in both
agencies anu piivate piactice.
Is uiffeientiateu fiom othei
piactice by its goal of helping
inuiviuuals change, facilitating
peisonal aujustment, tieating
emotional uisoiueis anu mental
illness, oi enhancing intiapsychic
oi inteipeisonal functioning.
Like all social woik piactice,
assessment is psychosocial,
focuseu on the peison-in-
enviionment, anu has the goal of
enhancing social functioning.
Theoietical appioaches
Psychosocial focuses on intiapsychic anu
inteipeisonal change. Pioblem Solving
seeks to solve uistinct pioblems, baseu on
psychosocial anu functional appioaches.
Behavioi Nouification symptom
ieuuction of pioblem behaviois, leaining
alteinative positive behaviois. Cognitive
Theiapy symptom ieuuction of negative
thoughts, uistoiteu thinking, anu
uysfunctional beliefs. Ciisis Inteivention
biief tieatment of ieactions to ciisis in
order to restore client’s equilibrium.
Family Theiapy tieats entiie family
system anu sees inuiviuual symptom
beaiei as inuicative of a pioblem in the
family as a whole. uioup Theiapy mouel
in which gioup membeis help anu aie
helpeu by otheis with similai pioblems,
ieceive valiuation foi theii own
expeiiences, anu test new social iuentities
anu ioles. Naiiative Theiapy the stoiies
clients tell about theii lives ieveal how
they constiuct peiceptions of theii
expeiiences. Woikei helps client
constiuct alteinative, moie affiiming
stoiies. Ecological oi Life Nouel focuses
on life tiansitions, enviionmental
piessuies, anu malauaptation between
inuiviuual anu family¡ enviionment.
Focuses on inteiaction anu
inteiuepenuence of people anu
enviionments. Task Centeieu Focuses on
completing tasks to stiengthen self-
esteem anu iestoie usual capacity foi
coping.
Assumptions
The assumptions of clinical piactice aie
that inuiviuual behavioi, giowth, anu
uevelopment aie biought about by a
complex inteiaction of psychological anu
enviionmental factois.
Knowleuge base
Theoiies of peisonality uevelopment
Systems Theoiy
Clinical Biagnosis (BSN-Iv-TR)
Significant influences aie socio-cultuial
factois incluuing ethnicity, immigiation
status, occupation, iace, genuei, sexual
oiientation, anu socioeconomic class.
Assessment
The assessment piocess is as follows:
Beteimine the piesenting
pioblem
Beteimine if theie is a match
between the pioblem anu
available seivices.
0ngoing uata collection anu
ieassessment to enhance
understanding of client’s
pioblems.
Worker’s role is to ask questions
anu ask foi elaboiation anu
description, observe client’s
behavioi¡affect, anu oiganize uata
to cieate a meaningful
psychosocial oi uiagnostic
assessment.
Souices of uata othei than client
incluue inteiviews with family
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membeis; home visits; contacts
with teacheis, cleigy, uoctois,
social agencies, anu fiienus.
Clinical uiagnosis—a piouuct of
the worker’s understanding of the
client’s problems based on the
uata collecteu. It categoiizes the
client’s functioning. Also includes
ielevant meuical illnesses oi
physical conuitions anu theii
influence on client’s emotional
life¡functioning.
D"'*%*>( %)(/;?(&%*0 /(<;%*"@')*?
The chaiacteiistics of the woikei anu the
neeus of the client that aie necessaiy to
establish a positive theiapeutic
ielationship aie as follows:
Worker’s characteristics - non-
possessive waimth anu concein,
genuineness, appiopiiate
empathy, nonjuugmental
acceptance, optimism iegaiuing
piospects foi change, objectivity,
piofessional competence, ability
to communicate with client, anu
self-awaieness. Self-uisclosuie
useu only puiposefully anu foi
client’s benefit.
Client neeus - hope anu couiage to
unueitake change piocess;
motivateu to change; tiust in
worker’s interest and skill; to be
uealt with as an inuiviuual anu not
a case, peisonality type, oi
categoiy; to expiess self; to make
one’s own choices; to change at
one’s own pace
Contiacting oi goal setting
The contiact is compatible with vaiious
mouels of social woik piactice anu is not
limiteu to an initial woiking agieement,
but is pait of the total tieatment piocess.
The contiact is helpful in facilitating the
client’s action in problem solving,
maintaining focus, anu continuing in
theiapy. The contiact is an explicit
agieement between the client anu the
woikei conceining taiget pioblems,
goals, anu stiategies of social woik
inteivention anu uistinguishing the ioles
anu tasks of the client anu the woikei.
The contiact incluues mutual agieement,
uiffeientiateu paiticipation, iecipiocal
accountability, explicitness, iealistic
agieement, anu flexibility. It is uifficult to
contiact with involuntaiy clients who uo
not acknowleuge¡iecognize pioblems,
who see the woikei as unhelpful, oi who
aie seveiely uistuibeu oi mentally
ietaiueu. The woikei shoulu
acknowleuge openly the uifficulty foi
both client¡woikei in manuateu
tieatment anu negotiate a contiact within
those iealities.
Impoitant teims in clinical social woik
piactice
Suppoiting¡Sustaining: Woikei
conveys confiuence in, inteiest in,
anu acceptance of client in oiuei
to decrease client’s feelings of
anxiety pooi self-esteem anu low
self confiuence. Woikei uses
inteiest, sympathetic listening,
acceptance of client, ieassuiance,
anu encouiagement.
Biiect influence: Woikei offeis
auvice, suggestions in oiuei to
influence client
Exploiation: Woikei continually
seeks to understand the client’s
view of self anu situation
Confiontation: Woikei challenges
client to ueal with inconsistencies
between hei¡his woius anu
actions, malauaptive behaviois, oi
iesistance to tieatment oi change
Claiification: Woikei questions,
iepeats, oi iephiases mateiial
client uiscusses. Woikei must use
sensitivity to client’s
uefensiveness.
Paitialization: Belping client to
bieak uown pioblems¡goals into
smallei, moie manageable
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elements in oiuei to ueciease
client’s sense of overwhelm and
increase client’s empowerment.
Bisciete elements of
pioblem¡goal can then be
piioiitizeu as moie manageable
oi moie impoitant.
0niveisalization: Noimalization of
pioblems; pioblems aie
piesenteu as a pait of the human
conuition in oiuei to help the
client see them as less
pathological.
Ventilation: Client’s airing of
feelings associateu with the
infoimation piesenteu about self
anu the situation. Nay alleviate
intensity of client’s feelings or
feeling that s¡he is alone with
them. Woikei may neeu to help
client uistinguish times when
ventilation is useful anu when it
may inciease intensity of feelings.
Cathaisis: The ielease of tension
oi anxiety thiough ieliving anu
intentionally examining eaily life,
iepiesseu, oi tiaumatic
expeiiences.
Inteipietation
Woikei offeis the psychouynamic
meaning of the client’s thoughts, feelings,
anu fantasies, paiticulaily about the
oiigins of pioblem behaviois.
Inteipietation seeks to impiove the
client’s insight and working through
uifficult mateiial by ueepening anu
expanding the client’s awareness.
Inteipietation may entail the following:
Exposing iepiesseu (unconscious)
oi suppiesseu (conscious)
infoimation.
Naking connections between the
piesent anu the past to help the
client see piesent uistoitions
moie cleaily.
Integiating infoimation fiom
uiffeient souices, so that the
client can gain a moie iealistic
peispective.
Inteipietation shoulu be useu
with clients who aie not
emotionally fiagile.
Resistance
In the psychouynamic unueistanuing,
iesistance is an unconscious uefense
against painful oi iepiesseu mateiial.
Resistance can be conveyeu thiough
silence, evasiveness, balking at worker’s
suggestions, oi by wanting to enu
tieatment piematuiely. The woikei ought
to iecognize anu unueistanu iesistance as
a chance to leain moie about the client
anu woik moie ueeply with the client to
help him¡hei face iesistance anu use it
effectively.
Tiansfeience anu counteitiansfeience
Transference is the client’s unconscious
ieuiiection of feelings foi anothei peison
towaiu the woikei in an attempt to
iesolve conflicts attacheu with that
ielationship oi ielationships. The woikei
shoulu help the client unueistanu
tiansfeience, how it ielates to
ielationships in hei¡his past, anu how it
may be contiibuting to piesent uifficulties
in ielationships. Counteitiansfeience is
the worker’s unconscious reuiiection of
feelings foi anothei peison oi
ielationship towaiu the client. The
woikei shoulu unueistanu hei¡his own
counteitiansfeience ieactions, be awaie
of theii piesence anu consequences, anu
use supeivision oi theiapy to gain gieatei
unueistanuing of them anu not impose
them on the client.
Teimination stage
H090=),<: Teimination offeis an
oppoitunity to iewoik pieviously
unfinisheu issues. Fiequently, eailiei
symptoms of the piesenting pioblem
iesuiface at this time. The woikei shoulu
not necessaiily use this ieemeigence as a
ieason to continue tieatment, but the
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woikei¡client shoulu woik uuiing the
teimination peiiou to stiengthen eailiei
gains.
Teimination offeis an oppoitunity foi
giowth in uealing with loss anu enuings.
The woikei shoulu acknowleuge,
veibalize, anu manage feelings about
enuings (such as angei, abanuonment,
sauness, etc.). Teimination can be an
oppoitunity to ieassess the meaning of
previous losses in the client’s life.
Teimination pioviues a chance to
evaluate tieatment anu the tieatment
ielationship. What goals weie met oi
unmet. What was effective oi ineffective.
Which client iesouices outsiue of
tieatment may continue aftei
teimination.
I3;,%(< ,+3, 3==0;, ,+0 3&&(%3;+ ,%
,0(/)93,)%9: The following factois will
affect how the client appioaches
teimination in Clinical Piactice:
The degree of the client’s
paiticipation in the tieatment
piocess.
The degree of the client’s success
anu satisfaction.
Eailiei losses the client may have
expeiienceu.
Nasteiy of the sepaiation-
inuiviuuation stage of
uevelopment in eaily life.
The ieason tieatment is enuing. If
woikei is leaving oi if enuing is
seen as against client’s wishes or
as a iejection, teimination may be
moie intense.
The timing of teimination—is it
occuiiing at a uifficult oi
favorable moment in the client’s
life.
Is teimination pait of a plan to
transfer client’s work to a new
woikei. If so, woikei anu client
shoulu use this time to put
togethei iueas about focus anu
goals foi next tieatment
ielationship.
Worker’s role: The woikei’s role in the
teimination piocess in Clinical Piactice is
as follows:
Plan sufficient time foi
teimination. In long-teim
tieatment this woulu be foui to
eight sessions.
Infoim the client if the woik is
enuing piematuiely.
Be aware of worker’s own
counteitiansfeience attituues anu
behaviois about teimination.
Continue to be sensitive,
obseivant, empathic, anu
responsive to the client’s response
to teimination.
Encourage client’s dealing with
the expeiience of teimination.
Confront client’s inappropriate,
uysfunctional coping with the
expeiience.
Promote the client’s believe in
hei¡his ability to caie foi self anu
uiiect hei¡his own life.
Piesent the possibility foi futuie
contact at times of uifficulty. uo
over the client’s resources
(inteinal anu enviionmental) that
client can uiaw on befoie making
uecision to ieentei tieatment.
M:HFGCF1N
The Biagnostic anu Statistical Nanual of
Nental Bisoiueis (BSN-Iv-TR) is a
manual which pioviues a common
language anu stanuaiu ciiteiia foi the
classification of mental uisoiueis. It is
also a classification system with peiiouic
ievisions. It incluues compiehensive
uesciiptions of the symptoms anu
manifestations of mental uisoiueis anu
associateu infoimation such as
pievalence. It uoes not uiscuss causation
(etiology). The BSN offeis specific ciiteiia
foi clinicians to uiagnose uisoiueis. The
BSN-Iv-TR is oiganizeu into a five-pait
“axis” system. The DSM also takes cultural
context, cultuial belief systems, anu
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cultuial uiffeiences between
client¡woikei into account anu incluues
Cultuie-Bounu Synuiomes. The BSN also
piesents a Befensive Functioning Scale,
which assesses the client’s defenses or
coping patteins at time of the evaluation
anu just pieceuing it.
Axis I
Axis I coveis Clinical Bisoiueis, such as
schizophienia oi moou uisoiueis. It is
possible to have moie than one Axis I
uiagnosis. 0thei examples of Axis I
uiagnoses incluue ABBB, Autism,
uisoiueis ielateu to substances
(meuication siue effects, substance
abuse), moou uisoiueis, anu eating
uisoiueis.
Axis II
Axis II coveis peisonality uisoiueis anu
intellectual uisabilities. It is possible to
have moie than one Axis II uiagnosis.
Axis III
Axis III Coveis physical uisoiueis anu
meuical conuitions (e.g., biain injuiy oi
othei physical uisoiuei which aggiavate
existing illnesses, cause symptoms similai
to mental uisoiueis, oi influence
tieatment options).
Axis Iv
Axis Iv coveis psychosocial anu
enviionmental pioblems that affect
uiagnosis, tieatment, anu piognosis (e.g.,
ueath in the family, lack of family suppoit,
lack of iesouices, etc.).
Axis v
Axis v is the ulobal Assessment of
Functioning, which is an evaluation of
cuiient functioning anu¡oi the highest
level of functioning in the past yeai. It
takes into account a person’s
psychological, social, anu occupational
functioning. Foi chiluien¡teens unuei the
age of 18 the Children’s Global
Assessment Scale is useu.
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Peivasive uevelopmental uisoiueis aie a
spectium of uisoiueis typifieu by
qualitative impaiiment in iecipiocal
social inteiaction; impaiiment with social
skills; anu steieotypeu behavioi, inteiest,
anu activities. The following aie peivasive
uevelopmental uisoiueis:
Autistic uisoiuei
Rett’s disorder
Chiluhoou uisintegiative uisoiuei
Asperger’s disorder
Autistic uisorder and Asperger’s disorder
Autistic uisoiuei has its onset befoie
thiee yeais of age. It is chaiacteiizeu by
uelays oi abnoimal functioning in: social
inteiaction, language foi social
communication, anu¡oi symbolic oi
imaginative play. In Autism, non-veibal
communication is not useu oi unueistoou
spontaneously. Theie is a lack of peei
ielationships oi iecipiocal inteipeisonal
shaiing anu a steieotypeu iepeitoiie of
activities anu inteiests. Those with
Asperger’s disorder exhibit social
impaiiment anu iestiicteu behaviois anu
inteiest, but have noimal language anu
cognitive uevelopment.
Rett’s disorder and childhood
uisintegiative uisoiuei
Those with Rett’s disorder have normal
uevelopment until five months. This is
followeu by a seveie ueteiioiation of
heau giowth anu hanu skills. Theie is
latei loss of social inteiaction, language
uevelopment anu psychomotoi capacity.
It almost exclusively affects females. In
chiluhoou uisintegiative uisoiuei, theie is
at least two yeais of noimal uevelopment.
This is followeu by ueteiioiation of
language skills anu social inteiaction, anu
an onset of steieotypeu behaviois anu
inteiests.
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2M!M ;@+ +*'/&?%*>( E();>*"/
+*'"/+(/'
Attention-ueficit hypeiactivity uisoiuei
(ABBB) - chaiacteiizeu by
inattentiveness anu oi¡hypeiactivity anu
impulsivity. Requiies symptoms
peisisting foi at least six months.
Symptoms incluue uifficulty staying
focuseu, easy uistiactibility, fiugeting,
acting “driven.” Symptoms not motivated
by angei oi wish to uisplease oi spite
otheis. Tieatment is by meuication
anu¡oi behavioi mouification.
Conuuct uisoiuei - peisistent pattein of
behavioi in which significant age-
appiopiiate iules oi societal noims aie
ignored, and others’ rights and property
aie violateu; aggiession anu uestiuction
of piopeity aie common.
0ppositional uefiant uisoiuei - Pattein of
negative, hostile, anu uefiant behavioi,
howevei, with less seiious violations of
the basic iights of otheis that chaiacteiize
conuuct uisoiueis. Behavioi is motivateu
by inteipeisonal ieactivity oi iesentful
powei stiuggle with auults.
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The following aie feeuing anu eating
uisoiueis of infancy oi eaily chiluhoou
aie:
Pica—peisistent eating of non-
foou substances such as paint,
haii, sanu, cloth, pebbles, etc.
Those with pica uo not show an
aveision to foou.
Rumination uisoiuei—
ieguigitation anu ie-chewing of
foou
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Tic uisoiueis aie chaiacteiizeu by iapiu,
iecuiient, steieotypeu motoi movements
or vocalizations. Those with Tourette’s
uisoiuei typically have multiple motoi
tics anu one oi moie vocal tics. Those
with chionic motoi oi vocal tic uisoiuei
have eithei motoi oi vocal tics. Tiansient
tic disorder is like Tourette’s, but is less
seveie, anu symptoms enu within 12
months.
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Encopiesis is the involuntaiy fecal soiling
in chiluien who have alieauy been toilet
tiaineu.
Enuiesis is the iepeateu voiuing of uiine
uuiing the uay oi night in beuuing oi
clothes. It occuis in those olu enough to
be expecteu to exeicise blauuei contiol.
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+*'"/+(/
Beliiium is a uistuibance in
consciousness oi cognition that uevelops
ovei a shoit peiiou of time. Is causeu by a
meuical conuition oi is substance ielateu.
Bementia is memoiy impaiiment with
multiple cognitive ueficits. Examples of
uementia incluue Alzheimeis, vasculai
uementia, uementia uue to BIv, anu
Parkinson’s. Amnestic disorder is
memoiy impaiiment without othei
cognitive impaiiments. It may be
substance inuuceu.
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Substance ielateu uisoiueis may be
causeu by abusing a uiug, by meuication
siue-effects, oi by exposuie to a toxin.
Substance uepenuence is a malauaptive
pattein of uiug use with incieaseu
toleiance, withuiawal symptoms,
compulsive use, oi behavioi pioblems.
Substance intoxication oi withuiawal is
the behavioial, psychological, anu
physiological symptoms uue to effects of
the substance. It will vaiy uepenuing on
type of substance.
Also piesent may be substance inuuceu
ueliiium, uementia, psychosis, moou
uisoiueis, anxiety uisoiuei, sexual
uysfunction, oi sleep uysfunction.
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Tieatment shoulu focus fiist on the
substance. Tieatment options incluue
outpatient oi inpatient; iesiuential oi uay
caie; gioup, inuiviuual, anu¡oi family
counseling; methauone maintenance (foi
opiates); uetoxification; self-help gioups;
oi a combination of theiapies anu
meuication
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Psychotic uisoiueis aie chaiacteiizeu by
psychotic symptoms uuiing an active
phase (uelusions, hallucinations,
uisoiganizeu speech, thought uisoiuei)
anu¡oi negative symptoms such as flat
affect, alogia, oi avolition. Psychotic
uisoiueis aie also chaiacteiizeu by
uecline fiom a pievious level of
functioning in woik, social ielations,
anu¡oi self caie.
Theie must be a continuous illness foi at
least six months with at least one month
of an active phase of psychotic symptoms.
0nset is typically in auolescence oi young
auulthoou.
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The types of schizophienia aie as follows:
Catatonic type - chaiacteiizeu by
stupoi, negativism, iigiuity,
mutism
Bisoiganizeu type - chaiacteiizeu
by incoheience, flat oi gieatly
inappiopiiate affect
Paianoiu type - chaiacteiizeu by
uelusions oi fiequent auuitoiy
hallucinations which aie often
peisecutoiy oi gianuiose
0nuiffeientiateu type -
chaiacteiizeu by piominent
uelusions, hallucinations,
incoheience, oi giossly
uisoiganizeu behavioi
Resiuual type - chaiacteiizeu by
absence of piominent psychotic
featuies
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Schizophienifoim uisoiuei: an illness of
less than six months uuiation, likely onset
pieceueu by tuimoil¡high stiess, iange of
pionoses anu chaiacteiizeu by absence of
blunteu oi flat affect.
Schizoaffective uisoiuei: chaiacteiizeu by
psychotic symptoms of schizophienia
concuiient with the piesence of eithei a
majoi uepiessive episoue, a manic
episoue, oi a mixeu episoue.
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+*'"/+(/
Belusional uisoiueis typifieu by the
piesence of a peisistent uelusion.
Ballucinations not piominent oi absent.
Belusion may be peisecutoiy type,
jealous type, eiotomanic type (that
someone is in love with uelusional
peison), somatic type (that one has
physical uefect oi uisease), oi gianuiose
type.
Biief psychotic uisoiuei suuuen onset
anu lasts less than one month
Shaieu psychotic uisoiuei is a uelusion
helu with anothei peison in a close
ielationship
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?',0)"%*0 +*'"/+(/'
The following aie tieatments foi
schizophienic anu othei psychotic
uisoiueis:
Antipsychotic meuication - This
must be consistently auministeieu
anu monitoieu foi iesponse anu
siue effects.
Inuiviuual psychotheiapy -
Suppoitive, little anxiety
inuucement, seeks to contain
psychotic symptoms, focuses on
iealistic goals to maintain highest
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level of functioning. uoal is to aiu
coping anu self-acceptance.
Family theiapy - Euucation anu
suppoit foi family membeis.
uioup theiapy - To help uevelop
social skills, to begin oi sustain
ielationships. Shoulu be piactical
anu suppoitive.
Nilieu Theiapy -
Bospital¡institutional tieatment
entailing theiapeutic combination
of staff, piogiam, social stiuctuie,
iespite, anu expectations of
ieasonable behavioi.
Social Netwoik Inteivention¡Case
Nanagement - Belp with housing,
income, social suppoit,
euucational¡vocational
oppoitunities, anu meuical caie.
Self-Belp uioups - Suppoit anu
euucation foi client anu family
membeis.
H""+ +*'"/+(/
Noou uisoiueis aie chaiacteiizeu by
peisistent abnoimal moou, which can be
eithei uepiesseu oi euphoiic. Symptoms
may be somatic, affective, cognitive,
anu¡oi behavioial. Noou uisoiueis cause
psychological uistiess anu impaiieu iole
functioning.
Tieatment
Antiuepiessants foi majoi uepiessive
uisoiuei anu uysthymia. Anti-psychotics
if accompanieu by psychotic featuies.
Noou stabilizeis if bipolai I, bipolai II, oi
cyclothymia. Consistent auministiation
anu monitoiing foi effectiveness anu siue
effects iequiieu.
Inteipeisonal¡psychouynamic theiapy.
Behavioial theiapy
Cognitive theiapy
uioup psychotheiapy
Self-help gioups
H;P"/ +(?/(''*>( +*'"/+(/ ;@+
+,'%),B*0 +*'"/+(/
Najoi uepiessive uisoiuei is
characterized by at least two week’s
uuiation of vegetative oi classic
symptoms such as significant weight
loss¡gain, insomnia¡sleeping too much,
motoi agitation¡low eneigy. Sauness,
feeling empty oi woithless, uifficulty
concentiating, uifficulty making uecisions.
ueneial loss of pleasuie¡inteiest.
Recuiient thoughts of ueath oi suiciue.
Bysthymic uisoiuei has similai symptoms
to majoi uepiessive uisoiuei, but less
seveie anu moie chionic. Buiation of at
least two yeais.
3*?"<;/ GO 3*?"<;/ GGO ;@+ 8,0<"%),B*0
+*'"/+(/'
Bipolai I was pieviously calleu manic-
uepiession. Requiies one oi moie manic
episoues. Nania is typifieu by peisistent
abnoimally elevateu oi iiiitable moou,
piessuieu speech, gianuiosity,
sleeplessness, anu¡oi excessive
pleasuiable anu high-iisk activity.
Bipolai II Chaiacteiizeu by majoi
uepiessive episoues with at least one
hypomanic episoue (less seveie
symptoms of mania).
Cyclothymic uisoiuei Chaiacteiizeu by
chionic, fluctuating moou with many
hypomanic anu many uepiessive
symptoms, howevei, not as seveie as
eithei bipolai I oi bipolai II.
2@I*(%, +*'"/+(/'
Panic uisoiuei—iecuiient biief but
intense feai in the foim of panic attacks
with physiological oi psychological
symptoms.
Phobia—feai of specific situations oi
objects
Social phobia—social anxiety uisoiuei.
Bispiopoitionate feai of embaiiassment
oi humiliation in social settings.
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0bsessive-compulsive uisoiuei (0CB)—
intiusive compulsive behaviois oi
iecuiiing thoughts which aie uistiessing
to the inuiviuual anu which aie time-
consuming anu inteifeie with hei¡his
ioutine oi functioning.
Post-tiaumatic stiess uisoiuei (PTSB)—
peisistently ie-expeiiencing a seveie
tiauma foi moie than one month.
Inuiviuual exhibits aiousal-anxiety
symptoms, anu avoiuance of things
associateu with the tiauma oi numbness.
Acute stiess uisoiuei—anxiety anu
uissociative symptoms uevelop within
one month of expeiiencing a tiauma.
ueneializeu anxiety uisoiuei—chionic
physiological anu cognitive symptoms of
uistiess, excessive woiiy lasting at least 6
months of uuiation.
Tieatment
Shoit-acting anti-anxiety meuications foi
episouic symptoms (panic attacks) anu
antiuepiessants foi longei teim use (ex.
0CB, social phobia)
Psychotheiapy such as suppoitive
theiapy, cognitive-behavioial theiapy
(systematic uesensitization), BBT
(Bialectical Behavioial Theiapy), ENBR
foi PTSB
uioup theiapy
Inpatient hospitalization (when a thieat
to self oi otheis)
:"B;%"A"/B +*'"/+(/'
All somatofoim uisoiueis aie maikeu by
multiple physical¡somatic symptoms that
cannot be explaineu meuically. Symptoms
impaii social oi woik functioning anu
cause uistiess.
Bouy uysmoiphic uisoiuei:
Pieoccupation with some
imagineu uefect in physical
appeaiance.
Conveision uisoiuei: Notoi oi
peiceptual symptoms suggesting
physical uisoiuei, but actually
ieflect emotional conflicts.
Bypochonuiiasis: uniealistically
inteipieting physical signs as
abnoimal anu pieoccupation with
seiious illness in oneself.
Somatization uisoiuei: multiple
anu iecuiiing somatic complaints
of seveial yeais.
Pain uisoiuei: pieoccupation with
pain that causes impaiieu
functioning anu which is causeu
by psychological factois
Tieatment
No uefinitive tieatment, but goal is eaily
uiagnosis in oiuei to ciicumvent
unnecessaiy meuical¡suigical
inteivention.
Attempt to move attention fiom
symptoms to pioblems of living.
Suppoitive Theiapy to help inuiviuual
cope with symptoms.
Long-teim ielationship with single
physician.
No meuication.
M*''"0*;%*>( +*'"/+(/'
These aie all chaiacteiizeu by a
uistuibance in the noimally integiative
functions of iuentity, memoiy,
consciousness, oi enviionmental
peiception.
Bissociative iuentity uisoiuei (pieviously
multiple peisonality uisoiuei): Two oi
moie peisonalities exist within one
peison. Each peisonality is uominant at a
paiticulai time.
Bissociative fugue: 0nexpecteu anu
suuuen tiavel fiom home, assumption of a
new iuentity anu inability to iecall
pievious iuentity.
Bissociative amnesia: Inability to iecall
impoitant peisonal uata, moie than
foigetfulness. Is not uue to oiganic causes
anu comes on suuuenly.
Bepeisonalization uisoiuei: Feeling
detached from one’s mental processes or
bouy, as if one is an obseivei.
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Tieatment
Tieatment is piimaiily uone via
psychotheiapy, with the goals of woiking
thiough unconscious conflict oi
iecoveiing tiaumatic memoiies, anu
integiating feeling states with memoiies
oi events.
2@"/(I*; @(/>"'; ;@+ E&<*B*; @(/>"';
Anoiexia neivosa is chaiacteiizeu by
extieme iestiiction of foou, the iiiational
feai of gaining weight, anu a uistoiteu
bouy image. Inuiviuuals often may suffei
fiom amenoiihea.
Bulimia neivosa is chaiacteiizeu by binge
eating followeu by puiging via self-
inuuceu
vomiting¡laxatives¡fasting¡vigoious
exeicise in oiuei to pievent weight gain.
It is maikeu by a peisistent ovei-concein
with bouy shape anu weight. At least two
binge eating episoues pei week foi thiee
months.
Tieatment
Psychophaimacology
Inuiviuual theiapy
Family theiapy
Neuical supeivision to monitoi weight,
vital signs, anu bloou values
Bospitalization when necessaiy foi close
behavioial anu meuical supeivision
D(/'"@;<*%, +*'"/+(/'
Peisonality uisoiueis aie chaiacteiizeu
by a long-teim anu inflexible pattein of
malauaptive peisonality tiaits. These
tiaits cause subjective uistiess anu¡oi
significant impaiiment in social oi woik
functioning. These uisoiueis aie believeu
to opeiate as coping anu uefensive
mechanisms uue to ego ueficits anu eaily
uevelopmental pioblems.
Clustei A peisonality uisoiueis
Paianoiu peisonality uisoiuei: peivasive
anu inappiopiiate inteipietation of
others’ actions as threatening or
uemeaning. Boes not cause psychotic
symptoms.
Schizoiu peisonality uisoiuei: lack of
concein foi social ielationships anu a
iestiicteu iange of emotional expeiience
anu expiession. Incapacity to foim
intimate social ielationships¡expeiience
affection foi otheis, anu lack of caiing
about others’ responses.
Schizotypal peisonality uisoiuei:
chaiacteiizeu by ueficits in inteipeisonal
connecteuness; peculiaiities in vaiious
thought, peiception, speech anu behavioi
patteins (i.e. magical thinking, iueas of
iefeience, iecuiient illusions).
Clustei B peisonality uisoiueis
Antisocial peisonality uisoiuei: a histoiy
of chionic iiiesponsible anu antisocial
behavioi, beginning in chiluhoou oi
adolescence. Violations of others’ rights
anu occupational failuie ovei seveial
yeais. Eaily lying¡stealing can leau to
acting out sexual behavioi, uiinking,
uiugs, anu latei failuie at woik anu home
anu auult violations of social noims.
Boiueiline peisonality uisoiuei:
instability in ielationships, moou, anu
self-image. 0npieuictable anu impulsive
acting-out, which can be self-uestiuctive.
Stiong moou shifts fiom noimal state to
iage. Chionic feai of being alone, uieau of
feeling emptiness. Nay have shoit-liveu
paianoiu oi uissociative symptoms.
Bistiionic peisonality uisoiuei: excessive
emotionality anu attention seeking.
Constant seeking of ieassuiance,
appioval, oi piaise. 0veily uiamatic anu
intense behavioi.
Naicissistic peisonality uisoiuei:
gianuiose sense of self-impoitance,
fantasies of unlimiteu success, chionic
exhibitionism, uifficulty uealing with
ciiticism, inuiffeience to otheis.
Relationship uifficulties—feeling entitleu,
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taking auvantage of¡exploiting otheis,
polaiizing otheis by iuealizing oi
uevaluing.
Clustei C peisonality uisoiueis
Avoiuant peisonality uisoiuei:
chaiacteiizeu by social uiscomfoit, feai of
ciiticism, timiuity, extieme sensitivity to
possibility of social iejection, feai of
social ielationships, uesiie foi closeness
but withuiawing socially, low self-esteem.
Bepenuent peisonality uisoiuei:
chaiacteiizeu by a peisistent pattein of
uepenuent anu submissive behavioi, a
lack of self-confiuence, anu an inability to
function inuepenuently.
0bsessive-compulsive peisonality
uisoiuei: chaiacteiizeu by a peisistent
pattein of peifectionism anu inflexibility.
Limiteu ability to uemonstiate positive
emotions. Peifectionism anu an ovei-
concein foi tiivial uetail. Bemanu otheis
comply. Pieoccupation with woik; tight
with money.
Tieatment
Intervention’s purpose is to alleviate
symptoms, ueciease social¡emotional
uisability, oi ueal with
inteipeisonal¡societal neeu foi symptom
management. Psychotheiapy is useu to
promote recognition of the client’s covert
uepenuence anu unexpiesseu feaifulness.
Woikei shoulu place impoitance on
awaieness of counteitiansfeience issues
because of tieatment-iesistant behaviois,
among otheis, such as mistiust of the
woikei, lack of bounuaiies, anu lack of
iecognition of the woikei as a peison.
Psychophaimacology is not geneially
useu.
D',0)"?);/B;0"<"-*0;< +/&-' A"/
'0)*L"?)/(@*; ;@+ ?',0)"%*0
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The following psychophaimacological
uiugs aie useu foi schizophienia anu
psychotic symptoms:
0lu antipsychotics—
! Baluol (Balopeiiuol)
! Thoiazine (Chloipiomazine)
! Nellaiil (Thioiiuazine)
! Stelazine (Tiifluopeiazine)
! Piolisin (Flophenazine)
! Navane (Thiothixene)
! Clozaiil (Clozapine)
Newei oi atypical
antipsychotics—
! Clozaiil
! Rispeiual
! Seioquel
! 0lanzapine (Zypiexa)
! Abilify
Siue effects anu othei ielevant factois
A majoi uiawback anu potential siue
effect foi the oluei antipsychotics (which
aie effective) is Taiuive Byskinesia. TB is
iiieveisible anu causes involuntaiy
movements of the face, tongue, mouth, oi
jaw. 0thei possible siue effects foi the
oluei antipsychotics incluue Paikinson-
like tiemoi oi muscle iigiuity; these aie
ieveisible anu can be counteiacteu with
Cogentin.
Among the newei antipsychotics, Clozaiil
iequiies fiequent bloou testing uue to the
iisk of agianulocytosis, a bloou uisoiuei
that uecieases white bloou cells anu
incieases the iisk of infection. Though
some atypical antipsychotics have much
less iisk of TB, they aie veiy expensive
anu can cause weight gain, affect bloou
sugai, anu affect the lipiu piofile.
M/&-' &'(+ A"/ E*?"<;/ +*'"/+(/
Bipolai uisoiuei is tieateu with moou
stabilizeis:
! #A !
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Lithium
Tegietol
Bepakote
Lamictal
Noou stabilizeis can cause weight gain.
Regulai bloou woik is necessaiy to
monitoi foi theiapeutic uiug levels anu
foi potential siue effects. Lithium can
cause kiuney oi thyioiu pioblems, anu
Tegietol anu Bepakote can cause
pioblems with livei function.
1/(;%B(@% "A &@*?"<;/ +(?/(''*"@
SSRIs (Selective Seiotonin Reuptake
Inhibitois):
Piozac
Zoloft
Paxil
Luvox
Celexa
Lexapio
Atypical Antiuepiessants:
Effexoi
Wellbutiin
Cymbalta
Tiicyclic Antiuepiessants
Imipiamine
Amitiiptyline
Elavil
NA0 Inhibitois
Naiuil
Painate
Naiplan
Siue effects anu othei ielevant factois
SSRIs have fewei siue effects than othei
antiuepiessants anu one cannot oveiuose
on SSRIs alone. SSRIs take seveial weeks
to be effective, aie expensive, can cause a
loss of libiuo, anu can lose effectiveness
aftei yeais of usage. In a few inuiviuuals,
SSRIs can cause agitation, suiciual
iueation, oi manic symptoms (in which
case piesciibei shoulu uiscontinue).
0f the Atypical Antiuepiessants,
Wellbutiin uoes not cause libiuo loss anu
is sometimes piesciibeu in combination
with an SSRI to countei sexual siue effects
oi to inciease the positive antiuepiessant
effect of the SSRI. Cymbalta is
iecommenueu foi uepiession linkeu with
somatic complaints.
Tiicyclic Antiuepiessants can cause siue
effects such as uiy mouth. These aie no
longei in common usage uue to caiuiac
monitoiing issues.
NA0 Inhibitois aie not in common usage
as they iequiie a special uiet to be safe.
M/&-' A"/ ;@I*(%,
Biugs useu foi anxiety aie
Benzouiazepines:
Ativan (Loiazapam)
Xanax
Klonopin
valium
Benzouiazepines aie effective, shoit
acting, anu quickly ielieve anxiety. They
shoulu be useu foi as shoit a time as
possible anu in conjunction with
appiopiiate theiapeutic inteivention
because of theii auuiction potential.
In the elueily, long teim-use of these
uiugs can cause psychotic symptoms that
can be ieveiseu by uiscontinuing theii
usage.
M/&-' &'(+ A"/ 2%%(@%*"@ M*'"/+(/'
Amphetamine-like:
Ritalin (shoit acting)
Long-Acting Ritalin
Conceita
Auueiall (shoit acting)
Auueiall XR (long acting)
These ielieve symptoms quickly anu
inuiviuuals can take them on selecteu
uays oi pait-uays if uesiieu. Potential foi
abuse, can suppiess appetite anu cause
weight loss, can cause eugy feelings like
too much caffeine. Can cause incieaseu
pulse iate.
! #B !
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Non-Amphetamine like:
Stiatteia - Is less appetite
suppiessing; weight loss is less of
a pioblem. Takes 2-4 weeks to be
effective anu must be taken eveiy
uay. Nust be monitoieu foi iaiely
occuiiing livei pioblem. Cannot
be abuseu.
Sigmund Freud’s theories
Topogiaphical Theoiy founu within the
Psychoanalytic Theoiy
0nconscious
Repiesseu fantasies anu expeiiences of
chiluhoou¡auolescence
Piimaiy piocess functioning—immeuiate
uischaige of mental eneigies
Inaccessibility to consciousness
Wish fulfillment—wishes aie the
motivation behinu uieams
Infantile—guiueu by pleasuie piinciple
Pieconscious
Accessibility to consciousness
Censoi which blocks the unconscious
0peiates accoiuing to ieality piinciple
Consciousness
Sensations fiom the outei woilu anu fiom
innei events such as thoughts, emotions,
memoiies
Reality piincipal functioning
Stiuctuial theoiy the Psychoanalytic
Theoiy
Iu is the souice of all motives, eneigies,
anu instincts. Cathexes of the iu aie
mobile, piess foi immeuiate anu iapiu
uischaige.
Ego is the iational, ieality-oiienteu
peisonality system.
Supeiego moial anu ethical stanuaius,
ambitions, anu ego iueals (conscience).
Seeks to inhibit iu impulses.
Peisonality uevelopment—infants aie
puie iu (uiiven by pleasuie piinciple). Iu
colliues with ieality, which leaus to ego
uevelopment. Ego builus piactical coping
stiategies, incluuing capacity to uelay
giatification. Ego is then goveineu by
ieality piinciple. Reality oiienteu thinking
is iefeiieu to as seconuaiy piocess
thought. Finally, the oeuipal complex
occuis in eaily chiluhoou. 0ut of that
piocess uevelops he supeiego.
Psychosexual Stages of Bevelopment
0ial stage: biith to 1.S yis,
giatification thiough
mouth¡uppei uigestive tiact
Anal Stage: 1.S-S yis, chilu gains
contiol ovei anal sphinctei, bowel
movements
Phallic Stage: S-S yis, giatification
in genital zone anu is sought
without concein foi otheis. Najoi
task is iesolution of oeuipal
complex anu leaus to
uevelopment of supeiego. This
begins about age 4 and the child’s
phallic stiiving is uiiecteu towaiu
opposite-sex paient anu in
competition with same-sex
paient. 0ut of feai anu love, the
chilu ienounces his uesiie foi
opposite sex paient anu iepiesses
hei¡his sexual uesiies. Chilu then
iuentifies with same-sex paient,
inteinalizes theii values, etc.,
which leaus to uevelopment of
supeiego anu ability to expeiience
guilt.
Latency stage: 6-1u yis,
sublimation of oeuipal stage,
expiession of sexual¡aggiessive
uiives in socially acceptable foims
uenital stage: 1u yis-auulthoou,
acceptance of one’s genitalia,
concern for others’ well-being
Auult peisonality types
0ial Peisonality: Infantile,
uemanuing, uepenuent behavioi;
pieoccupation with oial
giatification.
Anal Peisonality: Stinginess,
excessive focus on accumulating
anu collecting. Rigiuity in ioutines
! #C !
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anu foims, suspiciousness,
legalistic thinking.
Phallic Peisonality: Selfish sexual
exploitation of otheis, without
iegaiu to theii neeus oi conceins.
Anna Freud’s Defense Mechanisms
Befense mechanisms aie an unconscious
piocess in which the ego attempts to
expel anxiety-piovoking sexual anu
aggiessive impulses fiom consciousness.
Befense mechanisms aie attempts to
piotect the self fiom painful anxiety anu
aie useu univeisally. In themselves they
aie not an inuication of pathology, but
iathei an inuication of uistuibance when
theii cost outweighs theii piotective
value.
Impoitant teims
Compensation piotection against
feelings of infeiioiity anu
inauequacy stemming fiom ieal oi
imagineu peisonal uefects oi
weaknesses
Conveision somatic changes
conveyeu in symbolic bouy
language; psychic pain is felt in a
pait of the bouy
Benial avoiuance of awaieness of
some painful aspect of ieality
Bisplacement investing iepiesseu
feelings in a substitute object
Association altiuism; acquiiing
giatification thiough connection
with anu helping anothei peison
who is satisfying the same
instincts
Iuentification mannei by which
one becomes like anothei peison
in one oi moie iespects. Is a moie
elaboiate piocess than
intiojection.
Intiojection absoibing an iuea oi
image so that it becomes pait of
oneself.
Inveision (tuining against the
self) object of aggiessive uiive is
changeu fiom anothei to the self,
especially in uepiession anu
masochism.
Isolation of Affect Sepaiation of
iueas fiom the feelings oiiginally
associateu with them. Remaining
iuea is uepiiveu of motivational
foice; action is impeueu anu guilt
avoiueu.
Intellectualization Psychological
binuing of instinctual uiives in
intellectual activities, foi example
the adolescent’s preoccupation
with philosophy anu ieligion
Piojection Asciibing a painful iuea
oi impulse to the exteinal woilu.
Rationalization effoit to give a
logical explanation foi painful
unconscious mateiial to avoiu
guilt anu shame.
Reaction Foimation ieplacing in
conscious awaieness a painful
iuea oi feeling with its opposite.
Regiession withuiawal to an
eailiei phase of psychosexual
uevelopment
Repiession the act of obliteiating
mateiial fiom conscious
awaieness. Is capable of
masteiing poweiful impulses.
Reveisal Type of ieaction
foimation aimeu at piotection
fiom painful thoughts¡feelings
Splitting Seeing exteinal objects
as eithei all goou oi all bau.
Feelings may iapiuly shift fiom
one categoiy to the othei.
Sublimation ieuiiecting eneigies
of instinctual uiives to geneially
positive goals that aie moie
acceptable to the ego anu
supeiego.
Substitution tiauing of affect foi
anothei, i.e., iage masking feai
0nuoing iitualistically peifoiming
the opposite of an act one has
iecently caiiieu out in oiuei to
cancel out oi balance the evil that
may have been piesent in the act
! #D !
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Iuentification with the Aggiessoi
a child’s introjection of some
chaiacteiistic of an anxiety
evoking object anu assimilation of
an anxiety expeiience just liveu
thiough. In this, the chilu can
tiansfoim fiom the thieateneu
peison into the one making the
thieat.
Erikson’s psychosocial stages of
+(>(<"?B(@%
The inuiviuual uevelops aftei passing
thiough eight well-uefineu stages, each of
which uemonstiates a unique
combination of neeus anu vulneiabilities.
Each uevelopmental stage has its focus on
some aspect of giowth anu culminates in
an encountei oi ciisis. The outcome of the
encountei oi ciisis leaus to the
uevelopment of an impoitant human
quality.
The impact of the bioauei enviionment,
society, and its culture on the child’s
uevelopment aie taken into
consiueiation.
Psychosocial stage of Tiust vs. Nistiust
Biith to 1.S yis
Infants uevelop a sense of tiust in
self anu in otheis.
Psychological uangeis incluue a
stiong mistiust that latei
uevelops anu is ievealeu as
withuiawal when the inuiviuual is
at ouus with self anu otheis.
Psychosocial stage of autonomy vs. shame
anu uoubt
1.S to S yis—same ages as Freud’s
Anal Stage
In this phase, iapiu giowth in
musculai matuiation,
veibalization, anu the ability to
cooiuinate highly conflicting
action patteins is chaiacteiizeu by
tenuencies of holuing on anu
letting go.
The chilu begins expeiiencing an
autonomous will, which
contiibutes to the piocess of
iuentity builuing anu
uevelopment of the couiage to be
an inuepenuent inuiviuual.
Psychological uangeis incluue
immatuie obsessiveness anu
piociastination, iitualistic
iepetitions to gain powei, self-
insistent stubboinness,
compulsive meek compliance oi
self-iestiaint, anu the feai of a
loss of self-contiol.
Psychosocial stage of initiative vs. guilt
S-6 years (same ages as Freud’s
Phallic Stage)
Incuision into space by mobility,
into the unknown by cuiiosity,
anu into otheis by physical attack
anu aggiessive voice.
This stage frees the child’s
initiative anu sense of puipose foi
auult tasks.
Psychological uangeis incluue
hysteiical uenial oi self-
iestiiction, which impeue an
inuiviuual fiom actualizing innei
capacities.
Psychosocial stage of inuustiy vs.
infeiioiity
6-11 yrs (same as Freud’s Latency
Stage)
Neeu of chilu is to make things
well, to be a woikei, anu a
potential pioviuei.
Bevelopmental task is masteiy
ovei physical objects, self, social
tiansaction, iueas, anu concepts.
School anu peei gioups aie
necessaiy foi gaining anu testing
masteiy.
Psychological uangeis incluue a
sense of infeiioiity, incompetence,
self-iestiaint, anu confoimity.
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Psychosocial stage of iuentity vs. iuentity
uiffusion
Auolescence (same age iange as
Freud’s Genital Stage)
Ciucial task is to cieate an
iuentity, ieintegiation of vaiious
components of self into a whole
peison—a piocess of ego
synthesis.
Peei gioup is gieatly impoitant in
pioviuing suppoit, values, a
piimaiy iefeience gioup, anu an
aiena in which to expeiiment with
vaiious ioles.
Psychological uangeis incluue
extieme iuentity confusion,
feelings of estiangement,
excessive confoimity oi
iebelliousness, anu iuealism (a
uenial of ieality, neuiotic conflict,
oi uelinquency).
Psychosocial stage of intimacy vs.
isolation
Eaily auulthoou
Task is to entei ielationships with
otheis in an involveu, iecipiocal
mannei.
Failuie to achieve intimacy can
leau to highly steieotypeu
inteipeisonal ielationships anu
uistancing. Can also leau to a
willingness to ienounce, isolate,
anu uestioy otheis whose
piesence seems uangeious.
Psychosocial stage of geneiativity vs.
stagnation
Auulthoou
Key task is to uevelop concein foi
establishing anu guiuing the next
geneiation, anu the capacity foi
caiing, nuituiing, anu concein foi
otheis.
Psychological uangei is
stagnation. Stagnation incluues
caiing piimaiily foi oneself, an
aitificial intimacy with otheis, anu
self-inuulgence.
Psychosocial stage of integiity vs. uespaii
Latei auulthoou
Task is the acceptance of one’s
life, achievements, anu significant
ielationships as satisfactoiy anu
acceptable.
Psychological uangei is uespaii.
Bespaii is expiesseu in having the
sense that time is too shoit to
stait anothei life oi to test
alteinative ioaus to integiity.
Bespaii is accompanieu by self-
ciiticism, iegiet, anu feai of
impenuing ueath.
Piaget’s concepts and theories
Action anu 0peiation, Activity in
Bevelopment, anu Auaptation
Action is oveit behavioi.
0peiation is a paiticulai type of
action; may be inteinalizeu
thought.
Activity in Bevelopment: Chilu is
not a passive subject, but an active
contiibutoi to the constiuction of
hei¡his peisonality anu univeise.
The chilu acts on hei¡his
enviionment, mouifies it, anu is an
active paiticipant in the
constiuction of ieality.
Auaptation: Incluues
accommouation anu assimilation.
Accommouation entails auapting
to the chaiacteiistics of the object.
Assimilation is the incoipoiation
of exteinal ieality into the existing
mental oiganization.
Sensoiy-motoi stage
Biith-2 yis
Infant cannot evoke
iepiesentations of peisons oi
objects when they aie absent—
symbolic function.
Infant inteiacts with hei¡his
suiiounuings anu can focus on
objects othei than self. Infant
leains to pieuict events (uooi
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opening signals that someone will
appeai). Leains that objects
continue to exist when out of
sight. Leains a beginning sense of
causality.
Pie-0peiational Stage, Conciete
0peiational Stage, anu Foimal
0peiational Stage
Pie-0peiational Stage—2-7 yis
! Beveloping of symbolic
thought uiaws fiom sensoiy-
motoi thinking. Conceptual
ability not yet uevelopeu.
Conciete 0peiational Stage—7-11
yis
! Chilu gains capacity to oiuei
anu ielate expeiience to an
oiganizeu whole. Chilu can
now exploie seveial possible
solutions to a pioblem
without auopting one, as s¡he
is able to ietuin to hei¡his
oiiginal outlook.
Foimal 0peiational Stage—11-
auolescence
! Chilu¡youth can visualize
events anu concepts beyonu
the piesent anu is able to foim
theoiies.
! A systematic appioach to
pioblems ieplaces cognitive
ianuom behavioi.
! Chilu¡youth acquiies
objectivity anu awaieness of
ielative ielationships, the
ability to ieason by
hypothesis, anu the ielate
past, piesent, anu futuie.
Pavlov’s work in Learning Theory and
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Pavlov leaineu to link expeiimentally
manipulateu stimuli (oi conuitioneu
stimuli) to existing natuial, unconuitioneu
stimuli that eliciteu a fixeu, unconuitioneu
iesponse. Pavlov accomplisheu this by
intiouucing the conuitioneu iesponse just
piioi to the natuial, unconuitioneu
stimulus. }ust befoie giving a uog foou (an
autonomic stimulus foi salivation), Pavlov
sounueu a bell. The bell then became the
stimulus foi salivation, even in the
absence of foou being given. Nany
conuitioneu iesponses can be cieateu
thiough continuing ieinfoicement.
B.F. Skinner’s work in Learning Theory
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Empty 0iganism Concept—an
infant has the capacity foi action
built into hei¡his physical
makeup. Also has ieflexes anu
motivation that will set this
capacity in ianuom motion.
The Law of Effect goveins
uevelopment. Behavioi of
chiluien is shapeu laigely by
auults. Behaviois that iesult in
satisfying consequences aie likely
to be iepeateu unuei similai
ciicumstances. Balting oi
uiscontinuing behavioi is
accomplisheu by uenying
satisfying iewaius oi thiough
punishment.
Scheuules of Reinfoicement—
iathei than ieinfoicing eveiy
instance of a coiiect iesponse,
one can ieinfoice a fixeu
peicentage of coiiect iesponses,
oi space ieinfoicements
accoiuing some inteival of time.
Inteimittent ieinfoicement will
ieinfoice the uesiieu behavioi.
Skinnei was an opeiant theoiist.
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0peiant Behavioi is contiolleu by
consequences of that behavioi. Actions
pieceuing oi following the behavioi neeu
to be changeu. Responuent Behavioi is
behavioi which is biought out by a
specific stimulus. The inuiviuual must be
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uesensitizeu to the stimuli, foi example, in
the case of phobias.
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Floouing is a foim of uesensitization by
exposuie to anxiety piouucing stimulus at
full intensity foi piolongeu peiiou of time.
Is useu by behavioiist in tieating patients
who suffei fiom anxiety. Systematic
Besensitization is similai to floouing,
except much moie giauual. Patient is
piogiessively leu thiough images,
pictuies, anu¡oi events of the anxiety
piouucing situation anu is encouiageu to
uiscuss anu cope with the affect.
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values, beliefs, mouels of
behavioi, anu unueistanuings of
the natuie of the univeise must be
unueistoou within the cultuial
fiamewoik in which they appeai.
The outlines anu limitations of
noimality anu ueviance aie
ueteimineu by the uominant
cultuie.
Ethnic¡minoiity behavioial
noims anu expiessions of
emotional neeus may be uefineu
as abnoimal in that they uiffei
fiom those of the laigei, uominant
cultuie.
If unueistoou thiough a unique
cultuial context
behaviois¡attituues may be
peiceiveu uiffeiently. It is
impoitant foi a woikei to know
whethei a client fiom a paiticulai
ethnic gioup who uisplays
unoithouox behavioi is also
ueviant within hei¡his own
cultuie, as well as in hei¡his self-
assessment.
Impoitant teims
Accultuiation - The piocess of
leaining anu auopting the
uominant cultuie thiough
auaptation anu assimilation.
Ethnic Iuentity - A sense of
belonging to an iuentifiable gioup
anu having histoiical continuity,
in auuition to a sense of common
customs anu moies tiansmitteu
ovei geneiations.
Social Iuentity - The uominant
cultuie establishes ciiteiia foi
categoiizing inuiviuuals anu the
noimal anu oiuinaiy
chaiacteiistics believeu to be
natuial anu oiuinaiy foi membeis
of the society.
viitual Social Iuentity - The
attiibutes asciibeu to peisons
baseu on appeaiances, uialect,
social setting, anu mateiial
featuies.
Actual Social Iuentity -
Chaiacteiistics the peison
actually uemonstiates
Stigma - A chaiacteiistic that
makes an inuiviuual uiffeient
fiom the gioup anu is peiceiveu to
be an intensely uiscieuitable tiait.
Noimification - An attempt of the
stigmatizeu peison to piesent
hei¡himself as an oiuinaiy
peison.
Noimalization - Tieating the
stigmatizeu peison as if s¡he uoes
not have a stigma
0ppiesseu Ninoiities - In the 0S,
Black, Bispanic, Asian-Pacific, anu
Native Ameiicans aie most cleaily
set apait fiom othei
uisauvantageu gioups by theii
poweiful iacial, ethnic, anu
political consciousness. This
consciousness incieases self-
appieciation anu is expeiienceu
as iacial¡ethnic piiue. The
inuiviuuals who belong to these
gioups aie influenceu by issues
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uniquely associateu with gioup
membeiship.
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The following aie some basic
facts¡statistics uealing with chiluien in
poveity in the 0.S.:
Almost one in foui chiluien unuei
age six lives in poveity.
Ninoiity chiluien unuei age six
aie much moie likely than White
chiluien of the same age.
Nany of these chiluien in poveity
aie homeless oi aie in the chilu
welfaie system.
Fewei than one-thiiu of all pooi
chiluien below age six live solely
on welfaie.
Noie than half of chiluien in
poveity have at least one woiking
paient.
Chiluien of single motheis aie
moie likely to live in poveity.
Pooi chiluien have incieaseu iisk
of health impaiiment.
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Chiluien in fostei caie often go thiough
fiequent ielocations uue to iejection by
fostei families, changes in the family
situation, ietuining to biological families
anu latei ietuins to fostei caie, agency
pioceuuies, anu uecisions of the couit.
Auuitionally, many fostei chiluien
expeiience sexual anu physical abuse
within the fostei caie system.
Bue to fiequent changes in theii situation,
chiluien in fostei caie may change
schools multiple times, which can have an
auveise impact on theii acauemic
achievement.
Many youth “age out” of the foster care
system at age 18; this can abiuptly enu
the ielationships with fostei families anu
othei suppoitive stiuctuies.
Compaieu with chiluien iaiseu with theii
own families, chiluien who have been
thiough the fostei caie system have a
highei inciuence of behavioial pioblems,
incieaseu substance abuse, anu gieatei
piobability of enteiing the ciiminal
justice system.
Lawrence Kohlberg’s Theory of Moral
M(>(<"?B(@%
Build on Piaget’s moral
uevelopment ieseaich in which he
argues that children’s experiences
shape theii unueistanuing of
moial concepts (i.e. justice, iights,
equality, human welfaie) anu that
moial uevelopment is a piocess
that takes an extenueu peiiou.
Kohlbeig uistinguishes six stages
of moial ieasoning, each of which
ieveals a uiamatic change in the
moial peispective of the
inuiviuual.
Noial uevelopment is lineai (no
stage can be skippeu) anu takes
place thioughout the life span.
Piogiess between stages is
contingent upon the availability of
a iole mouel offeiing a mouel of
the piinciples of the next highei
level.
Stage 1
Stage one is the pie-conventional
oi piimitive level. The inuiviuual
peispective fiames moial
juugments, which aie conciete.
The fiamewoik of Stage 1 stiesses
iule following, because bieaking
iules may leau to punishment.
Reasoning of Stage 1 is ego-
centiic anu is not conceineu with
otheis.
Stage 2
Stage 2 emphasizes moial
iecipiocity. It has its focus on the
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piagmatic, instiumental value of
an action.
Inuiviuuals at this stage obseive
moial stanuaius because it is in
theii inteiest, but they aie able to
justify ietaliation as a foim of
justice.
Behavioi in this stage is focuseu
on following iules only when it is
in the person’s immediate
inteiest.
Stage 2 has a mutual contiactual
natuie, which makes iule-
following instiumental anu baseu
on exteinalities. Theie is,
howevei, an unueistanuing of
conventional moiality.
Stage S
Inuiviuuals in Stage S uefine
moiality in iefeience to what is
expecteu by those with whom
they have close ielationships.
Emphasis of this stage is on
steieotypic ioles (goou mothei,
fathei, sistei).
viitue is achieveu thiough
maintaining tiusting anu loyal
ielationships.
Stage 4
This stage shifts fiom basically
naiiow local noims anu iole
expectations to a laigei social
system peispective. Social
iesponsibilities anu obseivance of
laws aie key aspects of social
iesponsibility.
Inuiviuuals ieflect highei levels of
abstiaction in unueistanuing
laws’ significance.
Inuiviuuals at Stage 4 have a
sophisticateu unueistanuing of
the law anu only violate laws
when they conflict with social
uuties.
0bseivance of the law is seen as
necessaiy to maintain the
piotections that the legal system
pioviues to all.
Stage S
Stage S is chaiacteiizeu as the
post-conventional level.
Ethical ieasoning is shapeu on the
basis of geneial piinciples anu is
unueistoou in accoiuance with
unueilying iules anu noims.
Stage S iejects unifoim
application of iules anu noims.
The level of moial juugment is
iooteu in the ethical faiiness
piinciples fiom which moial laws
aie cieateu.
The peison at this level ciitically
evaluates laws anu juuges
whethei oi not they confoim to
piinciples of basic faiiness.
This level values human life anu
human welfaie aie piimaiy
piinciples of existence.
Carol Gilligan’s Morality of Care
Is the feminist iesponse to
Kohlberg’s moral development
theoiy. Kohlberg’s theory based
on ieseaich on males. uilligan
puipoits that a moiality of caie
reflects women’s experience more
accuiately than one emphasizing
justice anu iights.
Women’s morality reflects caring,
iesponsibility, anu nonviolence;
moiality of justice anu iights
emphasizes equality.
Anothei peispective is that these
two moialities give two uistinct
chaiges—to not tieat otheis
unfaiily (justice¡iights) anu not to
tuin away fiom someone in neeu
(caie). Caie stiesses
inteiconnecteuness anu
nuituiing. Emphasizing justice
stems fiom inuiviuualism.
Biffeiences in moial peispectives
aie explaineu by aspects of
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attachment. Nasculine—iequiies
inuiviuuation anu sepaiation fiom
the paient which leaus to
awaieness of powei uiffeiences
anu concein ovei inequity.
Feminine—continuing attachment
to paient, less awaieness of
inequalities, not piimaiily focuseu
on faiiness.
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values
The following aie values unueilying social
woik piactice with gioups:
Bignity anu woik of eveiy
inuiviuual.
All people have a iight anu a neeu
to iealize theii full potential.
Eveiy inuiviuual has basic iights
anu iesponsibilities.
The social woik gioup acts out
uemociatic values anu piomotes
shaieu uecision making.
Eveiy inuiviuual has the iight of
self-ueteimination in setting anu
achieving goals.
Positive change is maue possible
by honest, open, anu meaningful
inteiaction.
Auvantages
Nembeis can help otheis uealing
with the same issues anu can
iuentify with otheis in the same
situation.
Sometimes people can moie easily
accept help fiom peeis than fiom
piofessionals.
Thiough consensual valiuation,
membeis feel less violateu anu
moie ieassuieu as they uiscovei
that theii pioblems aie similai to
those of otheis.
uioups give oppoitunities to
membeis foi expeiimentation anu
testing new social iuentities¡ioles.
uioup piactice is not a
ieplacement foi inuiviuual
tieatment. uioup woik is an
essential tool foi many woikeis
anu can be the methou of choice
foi some pioblems.
uioup piactice can complement
othei piactice techniques.
Puiposes anu goals
uioup piactice takes a multiple-goals
peispective to solving inuiviuual anu
social pioblems anu is baseu on the
iecognition that gioup expeiiences have
many impoitant functions anu can be
uesigneu to achieve any oi all of the
following:
Pioviuing iestoiative, iemeuial, oi
iehabilitative expeiiences.
Belping pievent peisonal anu
social uistiess oi bieakuown.
Facilitating noimal giowth anu
uevelopment, especially uuiing
stiessful times uuiing the life-
cycle.
Achieving gieatei uegiee of self-
fulfillment anu peisonal
enhancement.
Belping inuiviuuals become
active, iesponsible paiticipants in
society thiough gioup
associations.
Types of social woik gioups
Euucational gioups, which focus
on helping membeis leain new
infoimation anu skills.
uiowth gioups, which pioviue
oppoitunities foi membeis to
uevelop ueepei awaieness of theii
own thoughts, feelings, anu
behavioi as well as uevelop theii
inuiviuual potentialities (i.e.
values claiification,
consciousness-iaising, etc.)
Theiapy gioups, which aie
uesigneu to help membeis change
theii behavioi by leaining to cope
anu impiove peisonal pioblems
anu to ueal with physical,
psychological, oi social tiauma.
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Socialization gioups, which help
membeis leain social skills anu
socially accepteu behaviois anu
help membeis function moie
effectively in the community.
Task gioups, which aie foimeu to
meet oiganizational, client, anu
community neeus anu functions.
Impoitance of ielationships
Establishing meaningful, effective,
ielationships is essential anu its
impoitance cannot be
oveiemphasizeu. The woikei will
foim multiple anu changing
ielationships with inuiviuual
gioup membeis, with sub-gioups,
anu with the gioup as a whole.
Theie aie multiple othei paities
who have a stake in members’
expeiiences, such as colleagues of
the woikei, agency
iepiesentatives, ielatives, fiienus,
anu otheis. The woikei will ielate
uiffeientially to all of these.
Contiacting woiking agieements
0nly if gioup membeis aie
involveu in claiifying anu setting
theii own peisonal anu common
gioup goals can they be expecteu
to be active paiticipants in theii
own behalf.
Woiking agieements consiuei not
only woikei-membei
ielationships, but also otheis with
a uiiect oi inuiiect stake in the
group’s process. Examples would
be agency sponsoiship,
collaboiating staff, iefeiial anu
funuing souices, families,
caietakeis, anu othei inteiesteu
paities in the public at laige.
Influencing gioup piocesses
The worker’s ability to recognize,
analyze, unueistanu, anu
influence gioup piocess is
necessaiy anu vital. The gioup is a
system of ielationships iathei
than a collection of inuiviuuals.
This system is foimeu thiough
associations with a unique anu
changing quality anu chaiactei
(this is known as gioup stiuctuies
anu piocesses).
Piocesses that the woikei will be
uealing with incluue
unueistanuing gioup stiuctuies,
value systems, gioup emotions,
uecision-making,
communication¡inteiaction, anu
gioup uevelopment (foimation,
movement, teimination).
Piocess of inuiviuualizing
The woikei must be piepaieu to
help inuiviuual membeis piofit
fiom theii expeiiences in anu
thiough the gioup.
0ltimately, what happens to
gioup membeis anu how they aie
influenced by the group’s
piocesses ueteimines the success
of any gioup expeiience, not how
the gioup itself functions as an
entity.
Exteinalizing
The woikei shoulu give attention to
helping membeis ielate beyonu the
gioup, to encouiaging active paiticipation
anu involvement with otheis in
incieasingly wiuei spheies of social
living. This shoulu occui even when the
gioup is ielatively autonomous.
Piogiamming
The woikei uses activities,
uiscussion topics, task-centeieu
activities, exeicises, anu games as
a pait of a planneu, conscious
piocess to auuiess inuiviuual anu
gioup neeus while achieving
gioup puiposes anu goals.
Piogiamming shoulu builu on the
neeus, inteiests, anu abilities of
gioup membeis anu shoulu not
! ?B !
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necessitate a seaich foi the
unusual, esoteiic, oi
melouiamatic.
Social woik skills useu in
implementing piogiams incluue
the following: initiating anu
mouifying piogiam plans to
iesponu to gioup inteiests, self-
uiiection anu iesponsibility,
uiawing cieatively upon piogiam
iesouices in the agency anu
enviionment, anu ueveloping
sequences of activities with
specific long-iange goals.
0sing piogiam activities is an
impoitant featuie of gioup
piactice.
J/"&? A"/B;%*"@
Key elements
The key elements of the gioup foimation
piocess aie as follows:
The woikei makes a cleai anu
uncomplicateu statement of
purpose, of both the members’
stakes in coming togethei anu the
agency’s (and others’) stakes in
seiving them.
Describing the worker’s part in as
simple teims as possible.
Reaching foi membei ieaction to
worker’s statement of purpose.
Identifying how the worker’s
statement connects to the
members’ expectations.
The woikei helps membeis uo the
woik necessaiy to uevelop a
woiking consensus about the
contiact.
Recognizing goals anu
motivations, both manifest anu
latent, stateu anu unstateu.
Re-contiacting as neeueu.
Worker’s role in contracting
Setting goals (contiacting)
Beteimining membeiship
Establishing initial gioup
stiuctuies anu foimats.
All thiee of these elements
iequiie skillful management by
the woikei.
Selecting membeis
Woikei explains ieasons foi
meeting with gioup applicants.
Worker elicits applicants’
ieactions to gioup paiticipation.
Worker assesses applicants’
situations by engaging them in
expiessing theii views of the
situation anu goals in joining the
gioup.
Woikei ueteimines
appiopiiateness of applicants foi
gioup, accepts theii iights to
iefuse membeiship, anu pioviues
oiientation upon acceptance into
the gioup.
Beteiogeneity vs. homogeneity
A gioup ought to have sufficient
homogeneity to pioviue stability
anu geneiate vitality.
uioups that focus on socialization
anu uevelopmental issues oi on
leaining new tasks aie moie likely
to be homogeneous.
uioups that focus on uisciplinaiy
issues oi ueviance aie moie likely
to be heteiogeneous.
Composition anu puiposes of
gioups aie ultimately influenceu
oi ueteimineu by agency goals.
8<"'(+ -/"&?'
Conveneu by woikeis.
Nembeis begin the expeiience
togethei, navigate it togethei, anu
enu it togethei at a pieueteimineu
time (set numbei of sessions).
Closeu gioups affoiu bettei
oppoitunities than open gioups
foi membeis to iuentify with each
otheis.
! ?C !
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uive gieatei stability to the
helping situation; stages of gioup
uevelopment piogiess moie
poweifully.
uieatei amount anu intensity of
commitment uue to same
paiticipants being counteu on foi
theii piesence.
6?(@ -/"&?'
0pen gioups allow paiticipants to
entei anu leave accoiuing to theii
choice.
A continuous gioup can exist,
uepenuing on fiequency anu iate
of membeiship changes.
Focus shifts somewhat fiom the
whole gioup piocess to inuiviuual
members’ processes.
With membeiship shifts,
oppoitunities to use gioup social
foices to help inuiviuuals may be
ieuuceu. uioup will be less
cohesive, less available as a
theiapeutic instiument.
Woikei is kept in a highly cential
position thioughout the life of the
gioup, as s¡he pioviues continuity
in an open stiuctuie.
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Shoit teim gioups aie foimeu
aiounu a paiticulai theme oi in
oiuei to ueal with a ciisis.
Limitations of time piecluue
woiking thiough complex neeus
oi auapting to a vaiiety of themes
oi issues.
The woikei is in the cential
position in a shoit teim gioup.
7"/B(+ -/"&?'
Belibeiately uevelopeu to suppoit
mutually agieeu-upon puiposes.
0iganization of gioup begins with
iealization of neeu foi gioup
seivices.
Puipose is establisheu by
iuentification of common neeus
among inuiviuuals in an agency oi
woikei caseloau.
Woikei guiueu in inteiventions
anu timing by unueistanuing of
inuiviuual anu inteipeisonal
behavioi ielateu to puipose.
It is auvisable to have scieening,
assessment, anu piepaiation of
gioup membeis.
Biffeient piactice iequiiements
foi voluntaiy anu non-voluntaiy
gioups as membeis will iesponu
uiffeiently to each.
3(-*@@*@- ?);'( "A -/"&? #"/=
Inteiventive skills
Woikei must tune into the neeus
anu conceins of the membeis.
Nembei cues may be subtle anu
uifficult to uetect.
Seeking membeis’ commitment to
paiticipate thiough engagement
with membeis.
Woikei must continually asses:
! members’ needs/concerns
! any ambivalence¡iesistance to
woik
! gioup piocesses
! emeiging gioup stiuctuies
! inuiviuual patteins of
inteiaction
Facilitate the group’s work.
Facilitating the group’s work
Piomote membei paiticipation
anu inteiaction.
Biing up ieal conceins in oiuei to
begin the woik.
Belp the gioup keep its focus.
Reinfoice obseivance of iules of
the gioup.
! ?D !
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Facilitate cohesiveness anu focus
the woik by iuentifying emeiging
themes.
Establish woikei iuentity in
relation to group’s readiness.
Listen empathically, suppoit
initial stiuctuie anu iules of the
gioup, anu evaluate initial gioup
achievements.
Suggest ongoing tasks oi themes
foi the subsequent meeting.
Stiess
Anxiety iegaiuing gaining
acceptance by the gioup.
Integiating gioup self-
ueteimination with an active
leaueiship iole.
Feai of cieating uepenuency anu
self-consciousness in gioup
membeis which woulu uetei
spontaneity.
Bifficulty obseiving anu ielating
to multiple inteiactions.
Uncertainty about worker’s own
iole.
H*++<( ?);'( "A -/"&? #"/=
Relatively cleai agieement of
puipose.
Nembeis aie engageu in gioup
tasks.
Nembeis allow woikei to
facilitate gioup effoits towaiu
achieving goals.
Inteiventive skills
Being able to juuge when woik is
being avoiueu.
Being able to ieach foi opposites,
ambiguities, anu what is
happening in the gioup when
goou anu bau feelings aie
expiesseu.
Suppoiting uiffeient ways in
which membeis help each othei.
Being able to paitialize laigei
pioblems into moie manageable
paits.
Being able to geneialize anu finu
connections between small pieces
of gioup expiession anu
expeiience.
Being able to facilitate puiposeful
communication that is investeu
with feelings.
Iuentifying anu communicating
the neeu to woik anu iecognizing
when woik is being accomplisheu
by the gioup.
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"A -/"&? #"/=
Powei anu contiol stage - consists
of limit setting, claiification, use of
the piogiam
Intimacy stage - consists of
hanuling tiansfeience, iivaliies,
uegiee of uncoveiing
Biffeientiation stages - consist of
claiification of uiffeiential anu
cohesive piocesses, gioup
autonomy
Sepaiation - consists of a focus on
evaluation, hanuling ambivalence,
incoipoiating new iesouices
1(/B*@;%*"@ "A -/"&? #"/=
uioup membeis may have
feelings of loss anu may uesiie to
minimize the painful feelings they
aie expeiiencing.
Nembeis may expeiience
ambivalence about enuing.
Woikei will:
! Examine hei¡his own feelings
about teimination.
! Focus the gioup on uiscussing
enuing.
! Belp inuiviuuals expiess theii
feelings of loss, ielief,
ambivalence, etc.
! @F !
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! Review achievements of the
gioup anu membeis.
! Belp membeis piepaie to
cope with next steps.
! Assess members’ and group’s
neeus foi continueu seivices.
! Belp membeis with tiansition
to othei seivices.
Nethous of foiestalling oi uealing with
teimination
Simple uenial - membei may
foiget enuing, act suipiiseu, oi
feel “tricked” by termination
Clusteiing - physically uiawing
togethei, also calleu supei-
cohesion
Regiession - ieaction can be
simple-to-complex. Eailiei
iesponses ieemeige, outbuists of
angei, iecuiience of pievious
conflicts, fantasies of wanting to
begin again, attempts to coeice
the leauei to iemain, etc.
Nihilistic flight - iejecting anu
iejection-piovoking behavioi
Reenactment anu ieview -
iecounting oi ieviewing eailiei
expeiiences in uetail oi actually
iepeating those expeiiences
Evaluation - assessing meaning
anu woith of foimei expeiiences
Positive flight - constiuctive
movement towaiu self-weaning.
Nembei finus new gioups, etc.
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1)("/, "A 'B;<< -/"&?'
This is a bioauly useu fiamewoik
foi unueistanuing small gioups.
In this fiamewoik, small gioups
aie living systems that consist of
inteiacting elements which
function as a whole.
In this fiamewoik, a social system
is a stiuctuie of ielationships oi a
set of patteineu inteiactions.
System concepts help maintain a
focus on the whole gioup, anu
explain how a gioup anu its sub-
gioups ielate functionally to
laigei enviionments.
This fiamewoik uesciibes how
inteiaction affects status, ioles,
gioup emotions, powei anu
values.
Social System Concepts
Bounuaiy maintenance:
maintaining gioup iuentities anu
sepaiateness
System linkages: two oi moie
elements combine to act as one
Equilibiium: maintaining a
balance of foices within the gioup
ueneial Systems Concepts
Steauy state: tenuency of an open
system to iemain constant but in
continuous exchange
Equifinality: final state of a system
that can be ieacheu fiom uiffeient
initial conuitions
Entiopy: tenuency of a system to
weai uown anu move towaiu
uisoiuei
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%)("/,R
Emphasizes the symbolic natuie
of people’s relationships with
otheis anu with the exteinal
woilu, veisus social system
analysis that emphasizes foim,
stiuctuies, anu functions.
uioup membeis play a pait in
ueteimining theii own actions by
iecognizing symbols anu
inteipieting meaning.
Buman action is accomplisheu
mainly thiough the piocess of
uefining anu inteipieting
situations in which people act.
The woikei uses such concepts to
explain how inuiviuuals inteiact
! @E !
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with otheis, anu to unueistanu
the iole of the inuiviuual as the
piimaiy iesouice in causing
change; the significance of social
ielationships; the impoitance of
self-concept, iuentification, anu
iole iuentity in gioup behavioi;
anu the meanings anu symbols
attiibuteu to gioup inteiactions.
J('%;<% "/*(@%;%*"@' ;@+ 7*(<+ 1)("/,
uestalt psychology playeu majoi
pait in uevelopment of gioup
uynamics. Contiasting with eailiei
psychologies that stiesseu
elementaiy sensations anu
associations, uestalt theoiists
vieweu expeiiences not in
isolation, but as peipetually
oiganizeu anu pait of a fielu
compiiseu of a system of co-
existing, inteiuepenuent factois.
uioup uynamics piouuceu a
plethoia of concepts anu
vaiiables: goal foimation,
cohesion, gioup iuentification anu
unifoimity, mutual uepenuency,
influences anu powei,
coopeiation anu competition, anu
piouuctivity.
uioup uynamics (oi gioup
piocess) pioviue a helpful
fiamewoik of caiefully uefineu
anu opeiationalizeu ielevant
gioup concepts.
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Inspired by J. L. Moreno’s work.
Both a geneial theoiy of human
ielations anu a specific set of
piactice techniques
(psychouiama, sociouiama, iole
playing).
Sociometiic test aie ueviseu to
measure the “affectivity” factor in
gioups.
Quality of inteipeisonal attiaction
in gioups is a poweiful foice in
iallying gioup membeis, cieating
feelings of belonging, anu making
gioups sensitive to membei
neeus.
8"-@*%*>( 8"@'*'%(@0, 1)("/, ;@+
3;<;@0( 1)("/,
Basic assumption of cognitive consistency
theoiy is that inuiviuuals neeu to oiganize
theii peiceptions in ways that aie
consistent anu comfoitable. Beliefs anu
attituues aie not ianuomly uistiibuteu
but iathei ieflect an unueilying coheient
system within the inuiviuual that goveins
conscious piocesses anu maintains
inteinal anu psychosocial consistency.
Accoiuing to balance theoiy, piocesses
aie balanceu when they aie consistent
with the individual’s believes and
peiceptions. Inconsistency causes
imbalance, tensions, anu stiess, anu leaus
to changing peiceptions anu juugments
which iestoie consistency anu balance.
The gioup woikei incoipoiates vaiying
iueas fiom these oiientations. Some
stiess the neeu foi the gioup to be self-
conscious, to stuuy its own piocesses,
emphasizing that cognition is appaient in
contiacting, builuing gioup
consciousness, pinpointing oi eliminating
obstacles, anu shaiing uata.
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%)("/,
Social exchange theoiists piopose
that membeis of gioups aie
motivateu to seek piofit in theii
inteiactions with otheis, i.e. to
maximize iewaius anu minimize
costs.
Analysis of inteiactions within
gioups is uone in teims of a seiies
of exchanges oi tiaueoffs gioup
membeis make with each othei.
! @G !
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The inuiviuual membei is the
piimaiy unit of analysis. Nany of
the coie concepts of this theoiy
aie meiely tiansfeiieu to the
gioup situation anu uo not fuithei
unueistanuing of gioup piocesses.
:%/&0%&/( *@ -/"&? #"/=
The patteineu inteiactions, netwoik of
ioles anu statuses, communications,
leaueiship, anu powei ielationships that
uistinguish a gioup at any point in time.
J/"&? ?/"?(/%*('
uioup piopeities aie attiibutes that
chaiacteiize a gioup at any point in time.
They incluue:
Foimal vs. infoimal stiuctuie
Piimaiy gioup (tight-knit family,
fiienuship, neighboi)
Seconuaiy ielationships (task centeieu)
0pen vs. closeu
Buiation of membeiship
Autonomy
Acceptance-iejection ties
Social uiffeientiation anu uegiees of
stiatification
Noiale, confoimity, cohesion, contagion,
etc.
2@;<,L*@- -/"&? ?/"0(''('
The majoi categoiies foi analyzing gioup
piocesses aie as follows:
Communication piocesses
Powei anu influence
Leaueiship
uioup noims anu values
uioup emotion
uioup uelibeiation anu pioblem
solving
J/"&? +(>(<"?B(@%
uioup piocesses that influence
the piogiess of a gioup, oi any of
its sub-gioups, ovei time. uioup
uevelopment typically involves
changing stiuctuies anu gioup
piopeities that altei the quality of
ielationships as gioups achieve
theii goals.
0nueistanuing gioup
uevelopment gives woikeis a
bluepiint foi inteiventions that
aid the group’s progression
towaiu attaining goals. A uangei
in using uevelopment mouels is in
the worker’s forcing the group to
fit the mouel, iathei than auapting
inteiventions foi what is
occuiiing in the gioup.
A complex set of piopeities,
stiuctuies, anu ongoing piocesses
influence gioup uevelopment.
Thiough piocesses that aie
iepeateu, fuseu with otheis,
mouifieu anu ieinfoiceu,
movement occuis.
Lineai stage mouels
The following aie the stages in the
uiffeient lineai stage mouels of gioup
uevelopment:
Tuckman’s Five stages:
! foim
! stoim
! noim
! peifoim
! aujouin
Boston Nouel (uailanu, }ones, &
Kolouny):
! Pieaffiliation
! Powei anu Contiol
! Intimacy
! Biffeientiation
! Sepaiation
Relational Nouel (feminist,
Schillei):
! Pieaffiliation
! Establishing a Relational
Base
! Nutuality & Inteipeisonal
Empathy
! Challenge & Change
! Sepaiation & Teimination
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Piimaiy focus - to influence a
wiue iange of small gioup
expeiiences, to facilitate
members’ identifying and
achieving of theii own goals, anu
to inciease social consciousness
anu social iesponsibility.
Assumes a iough unity between
involvement in social action anu
psychological health of the
inuiviuual. Eaily gioup woik was
conceineu with immigiant
socialization anu emphasizeu
piinciples of uemociatic uecision
making, in auuition to toleiance
foi uiffeience.
Nethouology - focus on
establishing positive ielationships
with gioups anu membeis, using
gioup piocesses in uoing with the
gioup iathei than foi the gioup,
iuentification of common neeus
anu gioup goals, stimulation of
uemociatic gioup paiticipation,
anu pioviuing authentic gioup
piogiams stemming fiom natuial
types of “group living.”
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-/"&? ?/;0%*0(
0ses a meuical mouel anu the
woikei is focuseu piimaiily on
inuiviuual change.
Stiuctuieu piogiam activities anu
exeicises.
Noie commonly founu in
oiganizations conceineu with
socialization, such as schools, anu
in those conceineu with
tieatment anu social contiol
(inpatient mental health
tieatment, etc.).
Piactice techniques in this mouel focus on
stages of tieatment.
Beginning stage - intake, gioup
selection, uiagnosis of each
membei, setting specific goals
Niuule stage - planneu
inteiventions. Woikei is cential
figuie anu uses uiiect means to
influence gioup anu membeis.
Woikei is spokespeison foi gioup
values anu emotions. Woikei
motivates anu stimulates
membeis to achieve goals.
Enuing stage - gioup membeis
have achieveu maximum gains.
Woikei helps clients ueal with
feeling about enuing. Evaluation
of woik, possible ienegotiation of
contiact.
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H"+(< "A -/"&? ?/;0%*0(
Woikei is not calleu a theiapist
but a meuiatoi anu paiticipates in
a netwoik of iecipiocal
ielationships. uoals aie uevelopeu
mutually thiough contiacting
piocess. The inteiaction anu
insight of gioup membeis is the
piimaiy foice foi change in what
is seen as a “mutual aid” society.
Worker’s task - help seaich foi
common giounu between gioup
membeis anu the social uemanus
they expeiience, help clients in
theii ielationships with theii own
social systems, uetect anu
challenge obstacles to clients’
woik, anu contiibute uata.
Phases of inteivention:
Tuning in¡piepaiation foi entiy -
woikei helps the gioup envision
futuie woik, but makes no
uiagnosis. Woikei is sensitive to
members’ feelings.
Beginnings - woikei engages
gioup in contiacting piocess;
gioup establishes cleai
expectations.
! @? !
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Niuule phase - seaiching foi
common giounu,
uiscoveiing¡challenging
obstacles, uata contiibution,
shaiing woik visions, uefining
limits¡iequiiements
Enuings - woikei sensitive to own
and members’ reactions and helps
membeis evaluate the expeiience
anu consiuei new beginnings
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-/"&? ?/;0%*0(
uioups of 8-1u membeis.
Inteiaction mainly thiough
uiscussion.
uioup membeis exploie feelings
anu behavioi anu inteipiet
unconscious piocesses.
The woikei uses inteipietation,
uieam analysis, fiee association,
tiansfeience ielations, anu
woiking thiough.
This appioach aims to help gioup
membeis ie-expeiience eaily
family ielationships, uncovei
ueep-iooteu feelings, anu gain
insight into the oiigins of faulty
psychological uevelopment.
Tavistick “Group as a Whole” G/"&?F
8(@%(/(+ H"+(<' A"/ ?/;0%*0( #*%)
-/"&?'
This approach derives from Bion’s
woik with Leaueiless uioups.
Bion uevelopeu analytic
appioaches that focuseu on the
gioup as a whole.
Latent gioup feelings aie
represented through the group’s
pievailing emotional states oi
“basic assumption cultures.”
uioups aie sometimes calleu S
gioups (Stuuy gioups).
Theiapist is iefeiieu to as a
consultant. The consultant uoes
not suggest an agenua, establishes
no iules¡pioceuuies, but iathei
acts as an obseivei. Najoi iole of
the consultant is to aleit membeis
to ongoing gioup piocesses anu to
encouiage stuuy of these
piocesses.
Consultant encouiages membeis
to exploie theii expeiiences as
gioup membeis thiough
inteiaction.
Irving Yalom’s “HereF;@+FNow” or
D/"0('' J/"&?'
Yalom stressed using clients’
immeuiate ieactions anu
discussing members’ affective
expeiiences in the gioup.
Relatively unstiuctuieu anu
spontaneous sessions.
uioups emphasize theiapeutic
activities, like impaiting
infoimation, oi instilling hope,
univeisality, anu altiuism.
The gioup can pioviue a
iehabilitative naiiative of piimaiy
family gioup uevelopment, offei
socializing techniques, pioviue
behavioi mouels to imitate, offei
inteipeisonal leaining, anu offei
an example of gioup cohesiveness
anu cathaisis.
Two inpatient gioup methous
baseu on the inteipeisonal
appioach aie the Inteiactional
Agenua gioup anu Focus uioups.
Moreno’s Psychodrama group therapy
Poweiful theiapy foi gioups that
uses spontaneous uiama
techniques to aiu in the ielease of
pent-up feelings, anu to pioviue
insight anu cathaisis to help
paiticipants uevelop new anu
moie effective behaviois.
Five piimaiy instiuments useu
aie the stage, the patient oi
piotagonist, the uiiectoi oi
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theiapist, the staff of theiapeutic
aiues oi auxiliaiy egos, anu the
auuience.
Can begin with a waim-up. 0ses
an assoitment of techniques such
as self-piesentations, inteiviews,
inteiaction in the iole of the self
anu otheis, soliloquies, iole
ieveisals, uoubling techniques,
auxiliaiy egos, miiioiing, multiple
uoubles, life ieheaisals, anu
exeicises.
3();>*"/;< -/"&? %)(/;?*('
Nain goals: to help gioup
membeis eliminate malauaptive
behaviois anu leain new
behaviois that aie moie effective.
Not focuseu on gaining insight
into the past, but iathei on
cuiient inteiactions with the
enviionment.
Among few ieseaich-baseu
appioaches.
Woikei utilizes uiiective
techniques, pioviuing
infoimation, anu teaching coping
skills anu methous of changing
behavioi.
Woikei aiianges stiuctuieu
activities. Piimaiy techniques
useu—iestiuctuiing, systematic
uesensitization, implosive
theiapies, asseition tiaining,
aveision techniques, opeiant-
conuitioning, self-help
ieinfoicement anu suppoit,
behavioial ieseaich, coaching,
moueling, feeuback, anu
pioceuuies foi challenging anu
changing conuitions.
J/"&? #"/= #*%) '(/*"&'<, B(@%;<<, *<<
0<*(@%'
Cleaily uefineu piogiams that use
psychosocial iehabilitation
appioaches (not
psychotheiapeutic).
Focus on making each gioup
session piouuctive anu iewaiuing
to gioup membeis.
Themes auuiesseu incluue uealing
with stigma, coping with
symptoms, aujusting to
meuication siue effects, uealing
with pioblems (family,
ielationships, housing,
employment, euucation, etc.),
ieal¡imagineu complaineu about
mental health tieatment
oiganizations.
Nany gioups in community-baseu
settings focus on helping
membeis leain social skills foi
inuiviuuals with limiteu oi
ineffective coping stiategies.
Nanuateu gioups in foiensic
settings aie highly stiuctuieu anu
focus on basic topics such as
iespect foi otheis, iesponsibility
for one’s behavior, or staying
focuseu.
J/"&?' A"/ 0)(B*0;< +(?(@+(@0,
The tieatment of choice foi
substance abuse.
uuiuelines foi these gioups
incluue maintaining
confidentiality, using “I”
statements, speaking uiiectly to
otheis, nevei speaking foi otheis,
awareness of one’s own thoughts
anu feelings, honesty about
thoughts anu feelings, taking
responsibility for one’s own
behavioi.
Types of gioups useu incluue
0iientation gioups that give
infoimation iegaiuing tieatment
philosophy¡piotocols.
Spiiitual gioups that incoipoiate
spiiituality into iecoveiy.
Relapse pievention gioups that
focus on unueistanuing anu
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uealing with behaviois anu
situations that tiiggei ielapse.
AA anu NA self- help gioups
utilize the piinciples anu
philosophies of 12-step piogiams.
Foi family anu fiienus, Nai-Anon
anu Al-Anon gioups pioviue
suppoit.
D;/(@% (+&0;%*"@ -/"&?'
These gioups aie useu in social
agencies, hospitals anu clinics.
0ften labeleu as Psychoeu gioups
oi Paient tiaining gioups.
0se a cognitive-behavioial
appioach to impiove the paient-
chilu ielationship.
0ften stiuctuieu to follow
manuals oi cuiiicula.
Focus is helping paients impiove
paient-chilu inteiactions, paient
attituues, anu chilu behaviois.
Abused women’s groups
Pioviue waim, accepting, caiing
enviionment in which membeis
can feel secuie.
Stiuctuieu foi consciousness
iaising, uispelling false
peiceptions, anu iesouice
infoimation.
Common themes these gioups
exploie incluue the use of powei
which ueiives fiom the fieeuom
to choose, the neeu foi safety, the
exploiation of iesouices, the iight
to piotection unuei the law, anu
the neeu foi mutual aiu.
Basic piinciples of these gioups:
iespect foi women, active
listening anu valiuation of
members’ stories, insuring self-
ueteimination anu
inuiviuualization, anu piomoting
gioup piogiams that membeis
can use to uemonstiate theii own
stiength anu achieve
empoweiment.
Foi post-gioup suppoit, gioups
typically seek to utilize natuial
suppoits in the community.
J/"&?' A"/ '?"&'( ;E&'(/'
Woik with this population is
typifieu by iesistance anu uenial.
Clients have uifficulty piocessing
guilu, shame, oi abanuonment
anxiety anu tenu to conveit these
feelings into angei.
These clients have uifficulties with
intimacy, tiust, mutuality, anu
stiuggle with feai of
abanuonment anu uiminisheu
self-woith.
Nanuatoiy gioup tieatment is
stiuctuieu. It is uesigneu to
challenge male bonuing that often
occuis in such gioups. Incluuing
spouses¡victims in these gioups is
quite contioveisial in clinical
liteiatuie.
J/"&?' A"/ '(I "AA(@+(/'
Typically, membeiship in these
gioups is oiueieu by the couit. No
assuiance of confiuentiality, as
woikeis may have to pioviue
iepoits to the couits, paiole
officeis, oi othei officials.
Clients typically ueny, test
woikeis, anu aie often iesistant.
In gioups with voluntaiy
membeiship, confiuentiality is
extiemely impoitant, as gioup
membeis often expiess extieme
feai of exposuie.
Piominent themes incluue uenial,
victim-blaming, blaming behavioi
on substances, blaming behavioi
on uncontiollable sex
uiives¡neeus.
Tieatment emphasizes the
impoitance of conscious contiol
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ovei uiives¡neeus, iegaiuless of
theii stiength oi if they aie
“natural.”
Cultuie of victimization stiongly
uiscouiageu.
J/"&?' A"/ 0)*<+/(@ "A ;<0")"<*0
A;B*<*('
Inuiviuuals who giow up with paients
who abuse alcohol anu¡oi uiugs often
leain to uistiust otheis as a suivival
stiategy. They become useu to living with
chaos anu unceitainty anu with shame
anu hopelessness. These inuiviuuals
commonly expeiience uenial, seciecy, anu
embaiiassment. They may have a geneial
sense of feaifulness, especially if they
faceu thieats of violence, anu tenu to have
iigiu iole attachment.
Tieatment in these gioups iequiies
caieful planning, piogiamming, anu
mutual aiu in the foim of alliances with
paiental figuies anu othei ielateu paities
in oiuei to cieate a healthy enviionment
that increases the individual’s safety and
ability to iely on self anu otheis.
J/"&?' A"/ '(I&;<<, ;E&'(+ 0)*<+/(@
uioup tieatment typically useu
with chilu victims of sexual abuse.
Woikei must pay paiticulai
attention to hei¡his own attituues
towaiu sexuality anu the sexual
abuse of chiluien.
Impoitant in these gioups aie
contiacting, consistent
attenuance, anu cleaily uefineu
iules anu expectations.
Clients may uisplay contiol issues
and may challenge the worker’s
authoiity.
Confiuentiality is not guaianteeu.
Teimination can be a paiticulaily
uifficult piocess.
Common themes that come up
incluue feai, angei, guilt,
uepiession, anxiety, inability to
tiust, uelayeu
uevelopmental¡socialization
skills.
Piogiamming can incluue ice
bieaking games, ait, bouy
uiawings, lettei wiiting, anu iole
playing.
8&<%&/(
Integiateu patteins of human behaviois
that incluue thought; communication,
actions; customs; beliefs; values; anu
institutions of a iacial, ethnic, ieligious, oi
social gioup.
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This iefeis to social gioups that aie not
easily subsumeu in the laigei cultuie.
These gioups uiffei by socioeconomic
status, genuei, sexual oiientation, age,
anu uiffeiential ability.
5%)@*0*%,
This is a gioup classification in
which membeis shaie a unique
social anu cultuial heiitage that is
passeu on fiom one geneiation to
the next.
Is not the same as iace, though the
two teims aie useu
inteichangeably at times
N;0(
This concept fiist appeaieu in the
English language just Suu yeais
ago. Theie is no biological
significance to iace, but it has
gieat social anu political
significance.
Race can be uefineu as a subgioup
that possesses a uefinite
combination of physical
chaiacteiistics of a genetic oiigin.
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S"/<+ >*(#
Woilu view is an integial concept
in assessment of clients’
expeiience. This can be uefineu as
a way that inuiviuuals peiceive
theii ielationship to natuie,
institutions, anu othei people anu
objects.
This compiises a psychological
oiientation to life as seen in how
inuiviuuals think, behave, make
uecisions, anu unueistanu
phenomena.
It pioviues ciucial infoimation in
the assessment of mental health
status, assisting in assessment
anu uiagnosis, anu in uesigning
tieatment piogiams.
8&<%&/;< 0"B?(%(@0( A"/ %)( *@+*>*+&;<
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The capability to function with
cultuial uiffeiences.
It incluues:
Awaieness anu acceptance of
uiffeiences.
Awareness of one’s own cultural
values.
0nueistanuing the uynamics of
uiffeience.
Bevelopment of cultuial
knowleuge.
Ability to auapt piactice skills to
fit the cultuial context of the
client’s structure, values, and
seivice.
It is an ongoing piocess that
iequiies continuing euucation,
awaieness, management of
tiansfeience¡counteitiansfeience
, anu continuous skill
uevelopment.
8&<%&/;< 0"B?(%(@0( A"/ %)( *@'%*%&%*"@
Piactice skills, attituues, policies, anu
stiuctuies that aie uniteu in a system, in
an agency, oi among piofessionals anu
allow that system, agency, oi gioup of
piofessionals to woik with cultuial
uiffeiences. It incluues:
values uiveisity - uiveise staff,
policies that acknowleuge anu
iespect uiffeiences, anu iegulai
initiation of cultuial self-
assessment.
Institutionalization - the
oiganization has integiateu
uiveisity into its stiuctuie,
policies, anu opeiations.
8&<%&/;< 0"B?(%(@0(
Communication
Communication in the context of cultuial
competence is uesciibeu below:
Inteipeisonal communication is
shapeu by both cultuie anu
context.
According to Hall’s Theory of
Communication, Bigh Context
communication styles aie useu in
Asian, Latino, Black, anu Native
Ameiican cultuies in the 0.S. In
this style, theie is a stiong
ieliance on contextual cues anu a
flexible sense of time. This style is
intuitive, anu in it social ioles
shape inteiactions,
communication is moie peisonal
anu affective, anu oial agieements
aie binuing.
According to Hall’s theory, low
context communication styles aie
useu moie in Noithein Euiopean,
white gioups in the 0.S. These
styles tenu to be foimal anu have
complex coues. They tenu to show
a uisiegaiu foi contextual coues
anu a ieliance on veibal
communication. In these styles
theie is an inflexible sense of time.
They aie highly pioceuuial,
ielationships aie functionally
baseu, anu lineai logic is useu.
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The clinician shoulu be awaie of
the potential foi cioss-cultuial
misunueistanuing anu that all
cultuies exhibit gieat uiveisity
within themselves.
Limitations
Some cultuial uiffeiences may be
uamaging oi unacceptable. The woikei
neeus to have a balanceu appioach to
assess cultuial noims within the context
of Ameiican piactices, noims, anu laws.
Theie aie illegal anu unacceptable
cultuial piactices, such as:
Chilu laboi
Bonoi killings
Piivate¡family vengeance
Slaveiy
Infanticiue
Female ciicumcision
Clitoiectomies
Infibulations
Wife oi seivant beating
Bigamy
Chilu maiiiage
Benial of meuical caie
Abanuonment of malfoimeu oi
uefective chiluien
Extieme uiscipline of chiluien
Knowleuge
The social woikei can uo the following to
acquiie moie knowleuge in oiuei to
become moie cultuially competent:
Reau applicable piactice oi
scientific piofessional liteiatuie.
Become familiai with the
liteiatuie of the ielevant gioup(s).
Iuentify anu consult with cultuial
biokeis.
0se of language anu communication
A woikei can use language anu
communication to become moie
cultuially competent by uoing the
following things:
Leain to speak the taiget
language.
0se inteipieteis appiopiiately.
Paiticipate in cultuial events of
the gioup(s).
Foim fiienuships with membeis
of uiffeient cultuial gioups than
one’s own.
Acquiie cultuial anu histoiical
infoimation about cultuial
gioups.
Leain about the institutional
baiiieis that limit access to
cultuial anu economic iesouices
foi vulneiable gioups.
uain an unueistanuing of the
socio-political system in the 0.S.
anu the implications foi majoiity
anu minoiity gioups.
Chaiacteiistics
The following aie some chaiacteiistics of
the cultuially competent social woikei:
With iegaiu foi inuiviuuality anu
confiuentiality, s¡he appioaches
clients in a iespectful, waim,
accepting, inteiesteu mannei.
S¡he unueistanus that opinions
anu expeiiences of both woikei
anu client aie affecteu by
steieotypes anu pievious
expeiience.
Is able to acknowleuge hei¡his
own socialization to beliefs,
attituues, biases, anu piejuuices
that may affect the woiking
ielationship.
Bisplays awaieness of cioss-
cultuial factois that may affect the
ielationship.
Able to communicate that cultuial
uiffeiences anu theii expiessions
aie legitimate
Is open to help fiom the client in
learning about client’s
backgiounu.
Infoimeu about life conuitions
fosteieu by poveity, iacism, anu
uisenfianchisement.
Is aware that client’s cultural
backgiounu may be peiipheial to
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the client’s situation and not
cential to it.
Stages of uevelopment foi oiganizations
The stages of uevelopment of cultuial
competency in oiganizations aie as
follows:
Cultuial uestiuctiveness
(uevaluing uiffeient cultuies anu
viewing them as infeiioi)
Cultuial incapacity (awaie of
neeu, feels incapable of pioviuing
seivices—immobility)
Cultural blindness (“colorblind,”
lack of iecognition between
cultuial gioups, uenial of
oppiession anu institutional
iacism)
Cultuial pie-competency (staiting
to iecognize neeus of uiffeient
gioups, seeking to ieciuit uiveise
staff anu incluue appiopiiate
tiaining)
Cultuial competency (auuiesses
uiveisity issues with staff anu
clients; staff is tiaineu anu
confiuent with a iange of
uiffeiences)
Cultuial pioficiency (Iueal; ability
to incoipoiate anu iesponu to
new cultuial gioups)
Neasuies
The measuies of cultuial competence aie
listeu below:
Recognizing effects of cultuial
uiffeiences on the helping
piocess.
Fully acknowledging one’s own
culture and its impact on one’s
thought anu action.
Compiehenuing the uynamics of
powei uiffeiences in social woik
piactice.
Compiehenuing the meaning of a
client’s behavior in its cultural
context.
Knowing when, wheie, anu how
to obtain necessaiy cultuial
infoimation.
3;//*(/' %" 0/"''F0&<%&/;< ?/;0%*0(
The following aie some baiiieis to cioss-
cultuial piactice:
Cultuial encapsulation
(ethnocentiism, coloi-blinuness,
false univeisals)
Language baiiieis (veibal, non-
veibal, bouy language, uialect)
Class-bounu values (ie: tieatment,
seivice ueliveiy, powei uynamics)
Cultuie-bounu values
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Stiesses
The following aie some of the stiesses
associateu with immigiation:
uaining entiy into anu
unueistanuing a foieign cultuie.
Bifficulties with language
acquisition.
Immigiants who aie euucateu
often cannot finu equivalent
employment.
Bistance fiom family, fiienus, anu
familiai suiiounuings.
Clinical issues
Some clinical issues associateu with
immigiation aie as follows:
Symptoms ielateu to stiess such
as uepiession, social isolation, etc.
Reason foi emigiating fiom home
countiy (i.e. iefugee.)
Bow immigiants use social
seivices is gieatly impacteu by
language anu woilu view.
Consiueiations when assessing neeus
The following aie aieas that a woikei
shoulu consiuei when assessing an
immigrant client’s needs:
Why anu how uiu client
immigiate.
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What social suppoits uoes the
client have.
(community¡ielatives)
Client’s education/literacy in
language of oiigin anu in English.
Economic anu housing iesouices
(incluuing numbei of people in
home, availability of utilities)
Employment histoiy, ability to
finu¡obtain woik.
Client’s ability to find and use
institutional¡goveinmental
suppoits.
Bealth status¡iesouices (pie anu
post-immigiation)
Social netwoiks (pie- anu post-
immigiation)
Life contiol—uegiee to which
s¡he expeiiences peisonal powei
anu the ability to make choices
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Piejuuice is bias oi juugment baseu on
value juugment, peisonal histoiy,
infeiences about otheis, anu application
of noimative juugments.
Bisciimination is the act of expiessing
piejuuice with immeuiate anu seiious
social anu economic consequences.
:%(/("%,?*@-
Amplifieu uistoiteu belief about an ethnic,
genuei, oi othei gioup in oiuei to justify
uisciiminatoiy conuuct.
6??/(''(+ B*@"/*%,
A gioup uiffeientiateu fiom otheis in
society because of physical oi cultuial
chaiacteiistics. The gioup ieceives
unequal tieatment anu views itself as an
object of collective uisciimination.
D/*>*<(-(
Auvantages oi benefits that the uominant
gioup has. These have been given
unintentionally, unconsciously, anu
automatically.
N;0*'B
ueneializations,
institutionalization, anu
assignment of values to ieal oi
imaginaiy uiffeiences between
inuiviuuals to justify piivilege,
aggiession, oi violence.
Societal patteins that have the
cumulative effect of inflicting
oppiessive oi othei negative
conuitions against iuentifiable
gioups baseu on iace oi ethnicity.
Is peivasive, ubiquitous, anu
institutionalizeu.
GB?<*0;%*"@' "A E*;' *@ )&B;@ '(/>*0(
0<*@*0;< #"/=
Bealth anu mental health seivices expiess
the iueology of the cultuie at laige
(uominant cultuie). This may cause haim
to clients oi ieinfoice cultuial
steieotypes.
Foi example:
Ninoiities anu women often
ieceive moie seveie uiagnoses
anu some uiagnoses aie
associateu with genuei.
Afiican-Ameiicans aie at gieatei
iisk foi involuntaiy commitment.
uays anu lesbians aie sometimes
tieateu with ethically
questionable techniques in
attempts to ieoiient theii
sexuality.
D/"E<(B;%*0 %/(;%B(@% B"+(<' #*%)
-;,' ;@+ <('E*;@'
The moial mouel foi tieatment is
ieligiously oiienteu anu views
homosexuality as sinful.
The meuical mouel in some foims
views homosexuality as a mental
illness.
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Repaiative oi conveision
psychotheiapy focuses on
changing a person’s sexual
oiientation to heteiosexual.
Tiauitional mental health
uisciplines view this type of
tieatment as unethical anu as
having no empiiical base.
D/;0%*0( *''&(' #)(@ #"/=*@- #*%)
-;,'O <('E*;@'O E*'(I&;<'O "/
%/;@'-(@+(/(+ *@+*>*+&;<'
Stigmatization anu violence
Inteinalizeu homophobia
Coming out
AIBS
Limiteu civil iights
0iientation vs. piefeience
(biology vs. choice)
2-(*'B
An attituue towaiu the capabilities anu
expeiiences of olu age which leaus to
uevaluation anu uisenfianchisement.
:%(/("%,?(' "A %)( (<+(/<,
Asexual
Rigiu
Impaiieu psychological
functioning
Incapable of change
:%/;%(-*0 ?/;0%*0( *''&(' #*%) "<+(/
;+&<%'
The following aie stiategic piactice issues
to be consiueieu when woiking with
oluei auults:
Role ieveisal (woikei often
youngei than client)
Physiological changes
vaiiation in physical anu mental
uecline
Clients often have expeiienceu
multiple losses
Clients aie often involuntaiy
Respect¡foimality can be
impoitant to client
Biffeiences in geneiational
peiceptions: socialization aiounu
pioblems, values, moies; anu
attituues towaiu ieceiving help,
chaiity, counseling
Two categoiies of oluei auults:
young-olu (6u-8u), olu-olu oi
fiail-olu (8u+)
8<*@*0;< 0"@'*+(/;%*"@' #*%) "<+(/
;+&<%'
The following aie some clinical
consiueiations the woikei shoulu make in
piactice with oluei auults:
Shoitei inteiviews, possibly moie
fiequent
vaiieu questioning styles
Woikei is moie active, uiiective,
anu uemonstiative
Bome visits may be piefeiieu to
office visits
Consiuei ioles anu attituues of
ielatives anu caietakeis
Awaieness of possibility foi abuse
oi exploitation
Access to social seivices oi othei
publicly funueu piogiams
Possible heaiing impaiiment anu
neeu to make iesponses shoitei,
louuei, anu slowei
Reminiscence is an impoitant
style of communication
2+B*@*'%/;%*"@
Neans of managing oiganizations
anu all of theii paits in oiuei to
maximize goals anu have the
oiganization succeeu anu giow
Biiecting all the activities of an
agency
0iganizing anu biinging togethei
all human anu technical iesouices
in order to meet the agency’s
goals
! A# !
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Notivating anu supeivising woik
peifoimeu by inuiviuuals anu
gioups in oiuei to meet agency
goals
Max Weber’s characteristics of a
E&/(;&0/;0,
Foimal hieiaichical stiuctuie.
Wiitten iules that uelineate
functions of the oiganization.
Spheies of
competence¡oiganization by
specialty
Impeisonal ielationships
Employment baseu on basis of
competence
Thoiough anu expeit tiaining.
8<;''*0;< H;@;-(B(@%K:0*(@%*A*0
H;@;-(B(@% %)("/, "A ;+B*@*'%/;%*"@
Employee is an appenuage of the
company. Well-uisciplineu, closely
supeiviseu woikeis achieve high
piouuctivity.
Woikeis most piouuctive when
they have little inuiviuual
uiscietion.
Piimaiy motivation foi all woik is
economic.
Piouuctivity linkeu to
compensation.
Authoiity is uistiibuteu thiough
the foimal, hieiaichical
oiganizational stiuctuie.
Foimal oiganizational stiuctuie
emphasizes piouuction,
compliance, anu efficiency.
Foi highest efficiency, woikeis
shoulu have specializeu, iepetitive
tasks that uo not call foi
inuiviuual juugment.
Mayo’s Human Relations theory of
;+B*@*'%/;%*"@
A peison must be vieweu
uiffeiently than an inuustiial
machine.
Noie than physical capacities,
woikplace social noims influence
piouuction.
Notivation is not solely economic
but is also emotional.
Employee paiticipation can
enhance motivation.
Infoimal oiganization anu peei
gioups aie impoitant in
influencing woikeis. Woik gioups
anu woikei involvement in task
uesign can inciease piouuction as
they inciease woikei moiale.
Nanagement shoulu consiuei the
woik gioup, social ielationships,
anu othei human factois when
planning.
2+B*@*'%/;%*>( 0);<<(@-(' &@*T&( %"
'"0*;< #(<A;/( "/-;@*L;%*"@'
Clinical seivices can be uifficult to
assess objectively.
Bifficult to evaluate pievention
piogiams as few techniques aie
able to measuie events that have
not occuiieu.
Staff tuinovei uue to low salaiy
anu buinout.
0ften uepenuent on political
enviionment foi funuing.
Can be uifficult to implement
systematization oi ioutine woik
uue to flexibility often iequiieu
when uealing with human
pioblems.
Structuralists’ (Etzioni and Drucker)
?(/'?(0%*>(' "@ ;+B*@*'%/;%*"@
A synthesis of the classical anu
human ielations schools of
thought
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Stiains between oiganizational
neeus anu peisonal neeus aie
pievalent. The two will always be
in conflict.
Theie is stiess among vaiious
levels within oiganizations.
Notivations aie both economic
anu non-economic (social).
0iganizational stiuctuies aie both
foimal anu infoimal.
:,'%(B' ?(/'?(0%*>( "@ ;+B*@*'%/;%*"@
QU;%LO U;)@R
0iganizations aie systems that
contain inteiacting,
inteiuepenuent paits.
0iganizations aie ielateu to othei
suiiounuing systems.
Najoi oiganizational piocesses
incluue input (eneigy, iesouices
to be acquiieu, such as clients oi
funus), thioughput (the woik that
is uone, such as counseling), anu
output (the iesults, such as clients
with impioveu psychosocial
functioning).
Systems can be open oi closeu (i.e.
moie oi less open to changes in
the enviionment)
D(/'?(0%*>( "@ ;+B*@*'%/;%*"@ "A %)(
M(0*'*"@FH;=*@- :0)""< QH;/0)O
:*B"@R
This school of thought is
conceineu with the piocess of
uecision making within an
oiganization anu the foices that
influence uecisions.
It uses the iuea of satisfying iathei
than maximizing objectives in
uecision making, such as seeking
acceptable iathei than maximum
achievement.
D/"-/;B (>;<&;%*"@
The steps in piogiam evaluation aie as
follows:
Beteimine what will be evaluateu.
Iuentify who will be the consumei
of the ieseaich.
Request the staff’s cooperation.
Inuicate what specific piogiam
objectives aie.
0utline objectives of evaluation.
Choose vaiiables.
Bevelop uesign of evaluation.
Apply evaluation uesign (conuuct
the evaluation)
Analyze anu inteipiet finuings.
Repoit iesults anu put them into
piactice.
86D
Community oiganization piactice
(C0P) highlights knowleuge about
social powei, social stiuctuie,
social change, anu social
enviionments.
C0P acknowleuges the iecipiocal
piocess between the inuiviuual
anu the social enviionment. It
seeks to influence anu change the
social enviionment as it is seen as
the souice anu likely solution foi
many pioblems.
In the view of C0P, social
pioblems iesult fiom stiuctuial
aiiangements iathei than fiom
peisonal inauequacies.
Consequently, iesouice anu social
powei ieallocation leaus to
changes in the community anu
eventually in inuiviuuals.
Tasks anu goals
The tasks anu goals of C0P aie as follows:
Change public oi piivate piioiities
in oiuei to give attention to
pioblems of inequality anu social
injustice.
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Piomote legislative change oi
public funuing allocation.
Influence public opinions of social
issues anu pioblems.
Impiove community
agencies¡institutions in oiuei to
satisfy neeus of the community
bettei.
Bevelop new ways to auuiess
community pioblems.
Bevelop new seivices anu
cooiuinate existing ones.
Impiove community access to
seivices.
Set up new piogiams anu seivices
in iesponse to new oi changing
neeus.
Bevelop the capacity of giassioots
citizen gioups to solve community
pioblems anu make claims on
public iesouices foi unuei-seiveu
communities.
Seek justice foi oppiesseu
minoiities.
values
The values of community oiganization
piactice aie as follows:
Woiking with, not foi clients, anu
in so uoing, enhancing theii
paiticipatoiy skills.
Beveloping leaueiship,
paiticulaily the ability to foiesee
anu act on pioblems.
Stiengthening communities in
oiuei that they aie bettei able to
ueal with futuie pioblems.
Reuistiibuting iesouices in oiuei
to enhance the iesouices of the
uisauvantageu.
Planning changes in systematic
anu scientific ways.
Rational pioblem-solving piocess:
stuuying the pioblem, uefining it,
consiueiing possible solutions,
cieating a plan, then
implementing anu evaluating the
plan.
Auvancing the inteiests of the
uisauvantageu in oiuei foi them
to have a voice in the piocess of
uistiibution of social iesouices.
Assumptions
The following assumptions unueilie
community oiganization piactice:
Nembeis of the community want
to impiove theii situation.
Nembeis of the community aie
able to uevelop the ability to
iesolve communal anu social
pioblems.
Rathei than having changes
imposeu on them, membeis must
paiticipate in change effoits.
A systems appioach, which
consiueis the total community, is
moie effective than imposing
piogiams on the community.
0ne goal of paiticipation in
community oiganization
initiatives involving social
woikeis is euucation in
uemociatic uecision-making anu
piomoting skills foi uemociatic
paiticipation.
The oiganizei enables membeis
to auuiess community pioblems
inuepenuently, in pait thiough
theii leaining analytic, stiategic,
anu inteipeisonal skills.
Factois useu to choose tactics
The following factois aie useu in
ueteimining which type of tactics will be
useu in community oiganization piactice:
The uegiee of uiffeiences oi
commonality in the goals between
the community gioup anu the
taiget system.
The ielative powei of the taiget
system anu the community gioup.
The ielationship of the
community gioup to the taiget
system.
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Collaboiative tactics
Tactics incluue pioblem solving,
joint action, euucation, anu milu
peisuasion.
Requiies a peiceiveu consensus in
goals, powei equality, ielatively
close ielationships, anu
coopeiation¡shaiing.
Campaign tactics
Tactics incluue haiu peisuasion,
political maneuveiing,
baigaining¡negotiation, anu milu
coeicion.
Requiies peiceiveu uiffeiences in
goals, inequality in powei, anu
inteimeuiate ielationships.
Contest tactics
Tactics incluue public conflict anu
piessuie.
Requiies public conflict,
uisagieement conceining goals,
unceitain powei, uistant oi
hostile ielationships.
Nouels
The uiffeient mouels of community
oiganization piactice aie listeu below:
Locality Bevelopment
Social Planning
Social Action
Social Refoim
J%;3:),' K070:%&/09, /%20:: Woiking in a
neighboihoou with the goal of impioving
the quality of community life thiough
bioau-spectium paiticipation at the local
level.
Is piocess-oiienteu with a puipose of
helping uiveise elements of the
community come togethei to iesolve
common pioblems anu impiove the
community.
Tactics useu incluue consensus anu
capacity builuing. As the oiganization
iesolves smallei pioblems, it facilitates
the solving of moie complex anu uifficult
pioblems.
The worker’s roles include enabler,
cooiuinatoi, euucatoi, anu biokei.
L%;)3: M:399)9* /%20:: Involves caieful,
rational study of a community’s social,
political, economic, anu population
chaiacteiistics in oiuei to pioviue a basis
foi iuentifying agieeu-upon pioblems anu
ueciuing on a iange of solutions.
uoveinment oiganizations can be
sponsois, paiticipants, anu iecipients of
infoimation fiom social planneis.
Focus on pioblem solving thiough fact
gatheiing, iational action, anu neeus
assessment.
Tactics may be consensus oi conflict.
The worker’s roles include researcher,
iepoitei, uata analyst, piogiam plannei,
piogiam implementei, anu facilitatoi.
L%;)3: >;,)%9 /%20:: This mouel iequiies
an easily iuentifiable taiget anu ielatively
cleai, explainable goals. Typically, the
taiget is a community institution that
contiols anu allocates funus, community
iesouices, anu powei anu clients aie
those who lack social anu economic
powei.
Assumption in this mouel is that uiffeient
gioups in the community have inteiests
that aie conflicting anu aie iiieconcilable.
In many cases, uiiect action is the only
way to convince those with powei to
ielinquish iesouices anu powei.
Tactics incluue conflict, confiontation,
contest, anu uiiect action.
The worker’s roles include that of
auvocate, activist, anu negotiatoi.
Social Refoim mouel: In collaboiating
with othei oiganizations foi the
disadvantaged, the worker’s role is to
uevelop coalitions of vaiious gioups to
piessuie foi change.
This mouel is a mixtuie of social action
anu social planning.
Stiategies incluue fact gatheiing,
publicity, lobbying, anu political piessuie.
Typically, this appioach is puisueu by
elites on behalf of uisauvantageu gioups.
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D"#(/
Powei is the ability to influence otheis in
intenueu ways.
Souices of powei aie:
Contiol of iecouises
Numbeis of people
Begiee of social oiganization
:"0*;< ?"<*0,
A collection of laws, iegulations, customs,
tiauitions, moies, folkways, values,
beliefs, iueologies, ioles, iole
expectations, occupations, oiganizations,
anu histoiy—all focusing on the
fulfillment of ciitical social functions.
N;%*"@;< ;??/";0) %" '"0*;< #(<A;/(
?"<*0, B;=*@-
This is an iuealizeu anu stiuctuieu
appioach. It incluues iuentifying anu
unueistanuing a social pioblem,
iuentifying alteinative solutions anu theii
consequences foi consumeis anu society,
anu iationally choosing the best
alteinatives. The iational appioach
minimizes iueological issues.
D"<*%*0;< ;??/";0) %" '"0*;< #(<A;/(
?"<*0, B;=*@-
This appioach iecognizes the impoitance
of compiomise, powei, competing
inteiests, anu paitial solutions. Those
who aie most affecteu by social policies
often have the least amount of political
powei to piomote change. Those who
have political powei aie often influenceu
by inteiests that aie seeking to piotect
theii own position. Policy makeis aie
often conceineu with ietaining piivilege
anu powei. Without aggiessive auvocacy,
the neeus of the uisauvantageu can
become maiginalizeu.
8"@A*+(@%*;<*%,
Social woik piivilege uoes not have the
same foice as that of attoineys anu cleigy.
0nlike cleigy anu attoineys, social
woikeis may be compelleu to testify in
couit unuei ceitain ciicumstances.
0iganizational policies shoulu ieflect the
expectation of confidentiality”
Recoius must be secuieu anu
lockeu.
Policies shoulu be in place that
insuie that iecoius not be left
wheie unauthoiizeu peisons aie
able to ieau them.
Computeiizeu iecoius shoulu be
secuieu with the same attention
given to wiitten iecoius (haiu
copies).
Agencies must pioviue spaces that
peimit piivate conveisations so
that conveisations about clients
can be helu wheie they cannot be
oveiheaiu.
G@A"/B(+ 0"@'(@%
A client may pioviue consent foi the
woikei to shaie infoimation with family
membeis, oi with othei piofessionals oi
agencies foi puiposes of iefeiial.
When the client pioviues this consent,
s¡he has ieason to expect that shaieu
infoimation is in hei¡his best inteiest,
anu uesigneu to impiove hei¡his
situation.
:%;%( B;@+;%(' %" /(?"/% 0)*<+ ;E&'(
Eveiy state in the 0.S. has laws
that manuate that social woikeis
iepoit the meie suspicion of chilu
abuse to the appiopiiate
authoiities.
A goou faith iepoit gives the
woikei immunity fiom civil oi
ciiminal liability if the iepoit is
not veiifieu as social woikeis
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cannot be founu liable foi
following the law.
Informing clients of the worker’s
uecision to make a iepoit is
ueteimineu situationally,
paiticulaily if theie is a concein of
the client’s violent reaction to self
oi otheis.
8"@0(/@' #)(@ /(?"/%*@- '(I&;< ;E&'(
Peipetiatois of these ciimes can be highly
motivateu to obtain ietiactions anu may
thieaten oi use violence to uo so. A majoi
concein in ueveloping immeuiate anu
long teim stiategies foi piotection anu
tieatment is the iole of the non-abusing
paient anu hei¡his ability to piotect the
chilu. The victim may be safei if the
woikei uoes not notify the family when
making the iepoit. uieat caie must be
taken by the woikei with these cases.
N(?"/%*@- %);% ; 0<*(@% *' ; +;@-(/ %"
'(<A "/ "%)(/'
The following aie the ciicumstances
unuei which a social woikei must iepoit
that a client is a uangei to self oi otheis:
The client’s mental state is such
that s¡he may uelibeiately oi
acciuentally cause haim to self.
The client makes a uiiect thieat to
haim anothei peison anu theie is
a ieasonable possibility that s¡he
can caiiy out the thieat.
Buty to wain: All mental health
piofessionals have a uuty to wain
inuiviuuals who aie thieateneu.
This piinciple was establisheu by
the Taiasoff Becision (N3(3<%== 7<4
O0*09,< %= P9)70(<),' %= $3:)=%(9)3Q
EDBA).
8"@A*+(@%*;<*%, *A ; '"0*;< #"/=(/ *'
'&(+ A"/ B;<?/;0%*0(
A woikei who is sueu foi malpiactice
may ieveal infoimation uiscusseu by
clients. The woikei shoulu aim to limit
the uiscussion of the content of clinical
uiscussions to those statements neeueu to
suppoit an effective uefense.
4*;E*<*%, A"/ '"0*;< #"/=(/'
Clients can sue social woikeis foi
malpiactice. The chain of liability extenus
fiom the inuiviuual woikei to supeivisoiy
peisonnel to the uiiectoi anu then to the
boaiu of uiiectois of a nonpiofit agency.
Nost agencies caiiy malpiactice
insuiance, which usually piotects
inuiviuual woikeis, howevei, woikeis
may also caiiy peisonal liability anu
malpiactice insuiance. Supeivisois can be
nameu as paities in a malpiactice suit as
they shaie vicaiious liability foi the
activities of theii supeivisees.
2<0")"< ;E&'(
Alcohol is the most available anu wiuely
useu substance. Piogiession of alcoholism
uepenuence often occuis ovei an
extenueu peiiou of time, unlike some
othei substances whose piogiession can
be quite iapiu. Because of this slow
piogiession, inuiviuuals can ueny theii
uepenuence anu hiue it fiom employeis
foi long peiious. Nost alcohol uepenuent
inuiviuuals have gainful employment, live
with families, anu aie given little
attention until theii uepenuence ciosses a
thiesholu, at which time the inuiviuual
fails in theii familial, social, oi
employment ioles. Nisuse of alcohol
iepiesents a uifficult uiagnostic pioblem
as it is a legal substance. Clients, theii
families, anu even clinicians can claim
that the client’s alcohol use is normative.
Aftei fiienus, family membeis, oi
employeis tiie of maintaining the fiction
that the individual’s alcohol use is
noimative, the alcoholic will be moie
motivateu to begin the piocess of
accepting tieatment.
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G@P&/*(' ;@+ *<<@(''(' 0;&'(+ E, &'( "A
'&E'%;@0('
The following aie possible injuiies oi
illnesses that often iesult fiom the use of
substances:
Physical uamage
Biain uamage
0iganic failuie
Fetal uamage when useu by
piegnant women
Biith of uiug exposeu babies who
iequiie intensive theiapy
thioughout chiluhoou
Alteiing of biain
chemistiy¡peimanent biain
uamage
Effects on uopamine in biain,
which uiiectly effects moou
!;/B +&( %" B(%)"+ "A ;+B*@*'%/;%*"@
"A *<<(-;< +/&-'
Boses can be unknown, which can leau to
uiug oveiuose anu ueath. 0sing
contaminateu neeules can cause staph
infections, Bepatitis, oi BIv¡AIBS.
Inhalants aie fiequently toxic anu can
cause biain uamage, heait uisease, anu
kiuney oi livei failuie.
!;/B /('&<%*@- A/"B E();>*"/' 0;&'(+
E, '&E'%;@0( &'(K;E&'(
Substances that aie illegally obtaineu aie
often associateu with minoi ciimes,
ciimes against family membeis anu the
community, anu piostitution. Alcohol is
associateu with uomestic violence, chilu
abuse, sexual misconuuct, anu seiious
auto acciuents. All substances piomote
behavioial pioblems that may make it
uifficult foi the inuiviuual to
obtain¡ietain employment, oi to sustain
noimal family ielationships.
9;/0"%*0'
Biugs useu meuicinally to ielieve pain.
They have a high potential foi abuse.
They cause ielaxation with an immeuiate
iush. Possible effects aie iestlessness,
nausea, euphoiia, uiowsiness, iespiiatoiy
uepiession, constiicteu pupils.
The following aie symptoms of oveiuose
of naicotics:
Slow, shallow bieathing
Clammy skin
Convulsions
Coma
Possible ueath
Withuiawal synuiome foi naicotics
incluues the following:
Wateiy eyes
Runny nose
Yawning
Ciamps
Loss of appetite
Iiiitability
Nausea
Tiemois
Panic
Chills
Sweating
The following aie inuications of possible
misuse of naicotics:
Scais (tiacks) causeu by injections
Constiicteu pupils
Loss of appetite
Sniffles
Wateiy eyes
Cough
Nausea
Lethaigy
Biowsiness
Nouuing
Syiinges, bent spoons, neeules,
etc.
Weight loss oi anoiexia
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M(?/('';@%'
Bepiessants aie uiugs useu meuicinally
to ielieve anxiety, iiiitability, oi tension.
They have a high potential foi abuse anu
uevelopment of toleiance. They piouuce a
state of intoxication similai to that of
alcohol. When combineu with alcohol,
theii effects inciease anu theii iisks aie
multiplieu.
The possible effects of uepiessants aie as
follows:
Sensoiy alteiation, ieuuction in
anxiety, intoxication
In small amounts, can cause
ielaxeu muscles anu calmness
In laigei amounts—sluiieu
speech, impaiieu juugment, loss of
motoi cooiuination
In veiy laige uoses—iespiiatoiy
uepiession, coma, ueath
Newboin babies of abuseis may
exhibit uepenuence, withuiawal
symptoms, behavioial pioblems,
anu biith uefects.
Symptoms of oveiuose of uepiessants
incluue:
Shallow iespiiation
Clammy skin
Bilateu pupils
Weak anu iapiu pulse
Coma
Beath
Withuiawal synuiome foi uepiessants
incluues the following:
Anxiety
Insomnia
Nuscle tiemois
Loss of appetite
Abiupt cessation oi a gieatly
ieuuceu uosage may cause
convulsions, ueliiium, oi ueath.
The following aie inuications of possible
misuse of uepiessants:
Behavioi similai to alcohol
intoxication (without the ouoi of
alcohol)
Staggeiing, stumbling, lack of
cooiuination
sluiieu speech
Falling asleep while at woik
Bifficulty concentiating
Bilateu pupils
:%*B&<;@%'
Stimulants aie uiugs useu to inciease
aleitness, ielieve fatigue, feel stiongei
anu moie uecisive, foi euphoiic effects, to
counteract the “down” feeling of
uepiessants oi alcohol.
The following aie possible effects of
stimulants:
Incieaseu heait iate
Incieaseu iespiiatoiy iate
Elevateu bloou piessuie
Bilateu pupils
Becieaseu appetite
With high uoses—
Rapiu oi iiiegulai heaitbeat
Loss of cooiuination
Collapse
Peispiiation
Bluiieu vision
Bizziness
Feelings of iestlessness, anxiety,
uelusions
Symptoms of oveiuose of stimulants
incluue:
Agitateu behavioi
Inciease in bouy tempeiatuie
Ballucinations
Convulsions
Possible ueath
Withuiawal synuiome foi stimulants
incluues:
Apathy
Long peiious of sleep
Iiiitability
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Bepiession
Bisoiientation
The following aie inuications of possible
misuse of stimulants:
Excessive activity, talkativeness,
iiiitability, aigumentativeness,
neivousness.
Incieaseu bloou piessuie oi pulse
iate, uilateu pupils
Long peiious without sleeping oi
eating
Euphoiia
!;<<&0*@"-(@'
Ballucinogens aie uiugs that cause
behavioial changes that aie often
multiple anu uiamatic. No known meuical
use, but some block sensation to pain anu
theii use may iesult in self-inflicteu
injuries. “Designer drugs,” which are
maue to imitate ceitain illegal uiugs, can
be many times stiongei than the uiugs
they imitate.
The following aie possible effects of
hallucinogens:
Rapiuly changing moou¡feelings,
immeuiately anu long aftei use.
Ballucinations, illusions,
uizziness, confusion, suspicion,
anxiety, loss of contiol.
Chionic use—uepiession, violent
behavioi, anxiety, uistoiteu
peiception of time.
Laige uoses—convulsions, coma,
heait¡lung failuie, iuptuieu bloou
vessels in the biain.
Belayeu effects—“flashbacks”
occuiiing long aftei use.
Besignei uiugs—possible
iiieveisible biain uamage.
Symptoms of oveiuose of hallucinogens
aie as follows:
Longei, moie intense episoues
Psychosis
Coma
Beath
The following aie inuications of possible
misuse of hallucinogens:
Extieme changes in behavioi anu
moou
Sitting¡ieclining in a tiance-like
state
Inuiviuual may appeai feaiful
Chills, iiiegulai bieathing,
sweating, tiembling hanus
Changes in sensitivity to light,
heaiing, touch, smell, anu time
Incieaseu bloou piessuie, heait
iate, bloou sugai
8;@@;E*'
Cannabis is the hemp plant fiom which
maiijuana (a tobacco like substance) anu
hashish (iesinous secietions of the
cannabis plant) aie piouuceu.
The possible effects of cannabis aie as
follows:
Euphoiia followeu by ielaxation
Impaiieu memoiy, concentiation,
anu knowleuge ietention
Loss of cooiuination
Incieaseu sense of taste, sight,
smell, heaiing
Iiiitation to lungs anu iespiiatoiy
system
Cancei
With stiongei uoses: fluctuating
emotions, fiagmentaiy thoughts,
uisoiienteu behavioi
Symptoms of oveiuose of cannabis
incluue:
Fatigue
Lack of cooiuination
Paianoia
Withuiawal synuiome foi cannabis
incluues:
Insomnia
Bypeiactivity
Sometimes uecieaseu appetite
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The following aie some inuications of
possible misuse of cannabis:
Animateu behavioi anu louu
talking, followeu by sleepiness.
Bilateu pupils
Blooushot eyes
Bistoitions in peiception
Ballucinations
Bistoitions in uepth anu time
peiception
Loss of cooiuination
2<0")"<
A liquiu uistilleu piouuct of
feimenteu fiuits, giains, anu
vegetables.
Can be useu as a solvent, an
antiseptic, anu a seuative.
Bas a high potential foi abuse.
Small to moueiate amounts taken
ovei extenueu peiious of time
have no negative effects anu may
have positive health iesults.
Possible effects of alcohol use incluue:
Intoxication
Sensoiy alteiation
Reuuction in anxiety
The following aie some symptoms of
oveiuose of alcohol use:
Staggeiing
0uoi of alcohol on bieath
Loss of cooiuination
Bilateu pupils
Sluiieu speech
Coma
Respiiatoiy failuie
Neive uamage
Livei uamage
Fetal alcohol synuiome (in babies
boin to alcohol abuseis)
Withuiawal synuiome foi alcohol
incluues:
Sweating
Tiemois
Alteieu peiception
Psychosis
Feai
Auuitoiy hallucinations
The following aie some inuications of
possible misuse of alcohol:
Confusion
Bisoiientation
Loss of motoi contiol
Convulsions
Shock
Shallow iespiiation
Involuntaiy uefecation
Biowsiness
Respiiatoiy uepiession
Possible ueath
:%(/"*+'
Steioius aie synthetic compounus closely
ielateu to the male sex hoimone,
testosteione, anu aie available legally anu
illegally. They have a moueiate potential
foi abuse, paiticulaily among young
males.
Possible effects of steioius incluue:
Inciease in bouy weight
Inciease in muscle mass anu
stiength
Impioveu athletic peifoimance
Impioveu physical enuuiance.
The following aie symptoms of oveiuose
of steioius:
Rapiu gains in weight anu muscle
Extiemely aggiessive behavioi
Seveie skin iashes
Impotence, ieuuceu sexual uiive
In female useis, uevelopment of
iiieveisible masculine tiaits
Withuiawal synuiome foi steioius
incluues:
Consiueiable weight loss
Bepiession
Behavioial changes
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Tiembling
The following aie inuications of possible
misuse of steioius:
Incieaseu aggiessiveness
Incieaseu combativeness
}aunuice
Puiple oi ieu spots on bouy
0nexplaineu uaikness of skin
0npleasant anu peisistent bieath
ouoi
Swelling of feet, lowei legs
1/(;%B(@% A"/ '&E'%;@0( ;E&'(
The components of tieatment foi
inuiviuuals with substance use uisoiueis
aie as follows:
An assessment phase
Tieatment of intoxication anu
withuiawal when necessaiy
Bevelopment of a tieatment
stiategy.
The thiee geneial tieatment stiategies
useu with inuiviuuals with substance
abuse uisoiueis aie:
Total abstinence (uiug-fiee)
Substitution, oi use of alteinative
meuications that inhibit the use of
illegal uiugs
Baim ieuuction
The following aie goals of substance
abuse tieatment:
Reuucing use anu effects of
substances
Abstinence
Reuucing the fiequency anu
seveiity of ielapse
Impiovement in psychological
anu social functioning
M:HFGCF1N 0/*%(/*; A"/ '&E'%;@0(
+(?(@+(@0(
S oi moie of the following in a 12-month
peiiou:
Toleiance—neeuing cleaily
incieasing amounts of the
substance to achieve uesiieu
effect; oi cleaily uiminisheu effect
with continueu use of the same
amount of the substance
Withuiawal—typical withuiawal
synuiome foi the substance; oi
the same oi a similai substance is
taken to ielieve¡avoiu withuiawal
symptoms
Substance taken in laigei
amounts than intenueu, oi ovei a
longei peiiou.
Peisistent uesiie oi unsuccessful
effoits to ieuuce oi contiol
substance use.
Person’s time is
uispiopoitionately ueuicateu to
acquiiing the substance, using it,
oi iecoveiing fiom its effects.
Significant occupational, social, oi
iecieational activities aie ieuuceu
oi given up because of substance
use.
Inuiviuual continues using
substance uespite awaieness of
having a lasting oi iepeating
physical oi psychological pioblem
likely causeu oi woiseneu by the
substance
M:HFGCF1N 0/*%(/*; A"/ '&E'%;@0(
;E&'(
1 oi moie in a 12-month peiiou:
Failing to fulfill majoi iole
obligations at woik school, oi
home uue to iecuiient substance
use.
Recuiient substance use in
settings in which it is physically
hazaiuous.
Recuiient substance-ielateu legal
pioblems.
Continuing use of substance in
spite of peisistent oi iecuiient
social oi inteipeisonal pioblems
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causeu oi woiseneu by the effects
of the substance.
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/(B*''*"@ A/"B '&E'%;@0(
;E&'(K+(?(@+(@0(
Foui sub-types of those in iemission on
the basis of whethei any of the ciiteiia foi
abuse¡uepenuence have been met anu
ovei what time fiame:
Full
Eaily paitial
Sustaineu
Sustaineu paitial
Remission categoiy also useu foi
inuiviuuals ieceiving agonist theiapy,
such as methauone maintenance, oi foi
inuiviuuals living in a contiolleu uiug-fiee
enviionment.
D),'*"<"-*0;< +(?(@+(@0(
If theie is eviuence of toleiance oi
withuiawal, the substance uepenuence is
specifieu as physiological. Without
eviuence of toleiance oi withuiawal, it
can be specifieu as without physiologic
uepenuence.
8<*@*0;< +*'"/+(/' A"&@+ #*%)
'&E'%;@0( ;E&'(
The following clinical uisoiueis aie
commonly founu in clients with substance
use uisoiueis:
Conuuct uisoiueis, paiticulaily
the aggiessive subtype
Bepiession
Bipolai uisoiuei
Schizophienia
Anxiety uisoiueis
Eating uisoiueis
Pathological gambling
Antisocial peisonality uisoiuei
PTSB
0thei peisonality uisoiueis
H(+*0;< ?/"E<(B' /(<;%(+ %" '&E'%;@0(
;E&'(
The following aie some meuical pioblems
that may be uiiectly ielateu to substance
use:
Caiuiac pioblems (acute cocaine
intoxication)
Respiiatoiy uepiession anu coma
(seveie opioiu oveiuose anu
alcohol abuse)
Bepatic ciiihosis (piolongeu
heavy uiinking)
Nalnutiition (fiom pooi self-caie)
Physical tiauma (iisk-taking
behavioi)
BIv infection (iisk-taking
behavioi)
Conuitions associateu with those
who auministei substances by
injection:
Bacteiial infections
BIv
hepatitis
7;0%"/' %);% 0"@%/*E&%( %" ;@+ ?/(+*0%
'&E'%;@0( ;E&'(
The following aie some factois that
contiibute to anu pieuict substance use:
Early or regular use of “gateway”
uiugs (alcohol, maiijuana,
nicotine)
Eaily aggiessive behavioi
Intia-familial uistuibances
Associating with substance-using
peeis
7;0%"/' %);% *@A<&(@0( +/&- "A 0)"*0(
The following aie factois that influence an
individual’s preference for a “drug of
choice”:
Cuiient fashion
Availability
Peei influences
Inuiviuual biological anu
psychological factois
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uenetic factois (especially with
alcoholism)
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'&E'%;@0( ;E&'( %/(;%B(@%
The following aie the objectives of clinical
management in tieatment foi clients with
substance abuse uisoiueis:
Establish anu maintain a
theiapeutic alliance.
Monitor the client’s clinical status.
Aiiange anu monitoi
seivices¡piogiams foi the client
anu family.
Assess the neeu foi continueu
seivices, monitoi theii
effectiveness.
Pioviue uiiect clinical social woik
seivices.
Remain aleit to states of
intoxication anu withuiawal.
Facilitate client’s following the
tieatment plan.
Pievent ielapse.
Pioviue euucation about
substance use uisoiueis.
Insuie availability of meuical caie.
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'&E'%;@0( &'( +*'"/+(/'
Phaimacologic tieatments aie useu foi
clients with substance use uisoiueis:
To tieat intoxication anu
withuiawal.
To ueciease ieinfoicing effects of
abuseu substances.
To uiscouiage the use of
substances by causing unpleasant
consequences thiough a uiug-
uiug inteiaction oi by paiiing
substance use with an unpleasant
uiug-inuuceu conuition.
Agonist substitution theiapy (i.e.
methauone).
Neuications to tieat clinical
conuitions.
D',0)"'"0*;< %/(;%B(@% A"/ '&E'%;@0(
&'( +*'"/+(/'
The following psychosocial tieatments
have been founu to be most effective foi
clients with substance use uisoiueis:
Cognitive behavioial theiapies
Behavioial theiapies
Psychouynamic¡inteipeisonal
theiapies
uioup anu family theiapies
Paiticipation in self-help gioups
1/(;%B(@% ?<;@ A"/ '&E'%;@0( ;E&'(
+*'"/+(/
The following aie the components of a
tieatment plan foi a client with a
substance use uisoiuei:
A stiategy to achieve abstinence
oi to ieuuce the effects oi use of
substances.
Effoits to inciease ongoing
compliance with the tieatment
piogiam, pievent ielapse, anu
enhance functioning.
Clinical management.
If necessaiy, auuitional
tieatments foi clients with
associateu conuitions.
!"'?*%;<*L;%*"@ A"/ '&E'%;@0( ;E&'(
+*'"/+(/'
Bospitalization is appiopiiate foi the
following types of client with substance
abuse uisoiueis:
Those with a uiug oveiuose who
can’t be adequately treated in
outpatient oi emeigency ioom
settings.
Those at iisk foi seveie oi
meuically complicateu
withuiawal.
Those with meuical conuitions
that make ambulatoiy
uetoxification unsafe.
Those with a uocumenteu iecoiu
of not engaging in oi benefitting
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fiom tieatment in a less
iestiictive setting.
Those with mental health
pioblems that woulu maikeuly
impaii theii ability to paiticipate
in, comply with, oi benefit fiom
tieatment. Also, those whose
associateu uisoiuei woulu on its
own iequiie hospital level caie.
Those who have not iesponueu to
less intensive tieatments anu
whose substance use uisoiuei
poses an ongoing thieat to theii
physical anu mental health. Also
those who exhibit behaviois that
constitute an acute uangei to self
oi otheis.
N('*+(@%*;< %/(;%B(@% A"/ '&E'%;@0(
;E&'( +*'"/+(/'
Resiuential tieatment is appiopiiate foi
those who uo not meet the clinical ciiteiia
foi hospitalization, but whose lives anu
social inteiactions focus piimaiily on
substance use, anu who uo not have
auequate social anu vocational skills anu
uiug-fiee social suppoits to maintain
abstinence in an outpatient setting.
6&%?;%*(@% %/(;%B(@% A"/ '&E'%;@0(
;E&'( +*'"/+(/'
0utpatient tieatment is appiopiiate foi
those whose clinical conuition oi
environmental circumstances don’t
iequiie a moie intensive level of caie.
H;@;-(B(@% "A ;<0")"< *@%"I*0;%*"@
;@+ #*%)+/;#;<
Clients who aie acutely intoxicateu neeu
to be monitoieu anu kept in a safe
enviionment. Within 4-12 houis aftei
stopping oi ieuucing alcohol use
symptoms of alcohol withuiawal typically
begin. These symptoms peak uuiing the
seconu uay of abstinence, anu settle
within 4-S uays. Theie can be seiious
complications of alcohol withuiawal
incluuing seizuies, hallucinations, anu
ueliiium. Foi clients with moueiate to
seveie withuiawal, tieatment incluues
meuical attention to ieuuce the physical
effects of withuiawal.
8"0;*@( &'( +*'"/+(/'
Tieatment setting
The following is the iecommenueu
tieatment setting foi most clients with
cocaine use uisoiueis:
Intensive outpatient tieatment
(meetings moie than twice¡wk).
vaiiety of tieatment moualities
useu simultaneously.
Focus of tieatment is the
maintenance of abstinence.
Nanagement of cocaine intoxication anu
withuiawal
Intoxication (by cocaine) can cause
hypeitension, tachycaiuia, seizuies, anu
paianoiu uelusions. 0sually only
suppoitive caie is iequiieu, but some
acutely agitateu clients may benefit fiom
seuation. Aftei stopping cocaine use,
ciaving anu uepiession aie common.
6?*"*+ &'( +*'"/+(/'
Phaimacological tieatments
Clients who have a histoiy of at least one
yeai of uepenuence on opioius,
maintenance on methauone oi LAAN (l-a-
acetylmethauol oi levomethauyl acetate)
can be appiopiiate. 0ne goal of tieatment
is to achieve a stable maintenance uose.
uoal of abstinence
Some clients will be able to attain
abstinence fiom all opioiu uiugs. Some
clients will iequiie long-teim
maintenance with opioiu agonists
(methauone oi LAAN). Abstinence can
nevei be achieveu foi some clients. In
these cases the goal of tieatment is
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ieuuction in moibiuity anu moitality
thiough ieuucing the effects of opioiu use.
Effective withuiawal tieatment stiategies
The following aie stiategies effective in
the tieatment of opioiu withuiawal:
Nethauone substitution with
giauual tapeiing.
Abiupt cessation of opioius, with
meuications to suppiess
symptoms of withuiawal.
Because the concuiient use of oi
withuiawal fiom othei substances
can complicate the tieatment of
opioiu withuiawal, monitoiing foi
the piesence of othei substances
is impeiative.
Clinical aspects that influence tieatment
The following aie clinical aspects that
may influence tieatment of opioiu use
uisoiueis:
Nental illness. Nany clients who
aie opioiu-uepenuent also have
mental illnesses that must be
iuentifieu anu tieateu alongsiue
the substance use uisoiueis.
Injection. 0sing opioius by
injection is linkeu with a high iisk
of meuical complications such as
bacteiial enuocaiuitis, hepatitis,
BIv infection, anu tubeiculosis.
Tieating piegnant women with
opioiu use uisoiueis is
complicateu by the incieaseu
iisks to the fetus anu the uigency
of minimizing the intake of
opioius. These iisks incluue low
biith weight, piematuiity,
neonatal abstinence synuiome,
stillbiith, anu suuuen infant ueath
synuiome.
N(<;?'( ?/(>(@%*"@
This is an appioach to tieatment that uses
cognitive behavioial techniques to help
clients uevelop gieatei self-contiol to
avoiu ielapse. Stiategies useu:
Biscussing ambivalence
Iuentifying emotional anu
enviionmental tiiggeis
Beveloping anu ieviewing specific
coping stiategies
Exploiing the uecision chain that
leaus to iesuming substance use
Leaining fiom biief ielapses
(slips) about tiiggeis that leau to
ielapse anu ueveloping effectual
techniques foi eaily inteivention.
:&E'%;@0( ;E&'( %/(;%B(@%
Notivational enhancement theiapy
This theiapy is baseu on cognitive
behavioial, client-centeieu, systems, anu
social-psychological peisuasion
techniques.
Is a biief tieatment mouality.
Incluues an empathic appioach in which
the woikei helps to motivate the client
thiough asking about the pios anu cons of
specific behaviois, thiough exploiing the
client’s goals anu ielateu inuecision about
ieaching those goals, anu thiough
listening ieflectively.
0peiant behavioial theiapy
This theiapy involves opeiant iewaiuing
oi punishing of clients foi uesiiable oi
unuesiiable behaviois, such as tieatment
compliance oi ielapse.
Rewaius may incluue voucheis oi othei
piizes awaiueu foi uiug-fiee testing oi
community ieinfoicement in which family
membeis oi peeis ieinfoice abstinence.
Contingency management theiapy
This is a behavioial tieatment which is
baseu on the use of pieueteimineu
consequences (both positive anu
negative) to iewaiu abstinence oi punish
uiug-ielateu behaviois.
Examples of negative consequences aie
notification of couits, employeis, oi
family membeis.
The effectiveness of this tieatment
iequiies the use of fiequent, ianuom,
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supeiviseu uiine monitoiing foi
substance use.
If negative contingencies aie baseu upon
the expecteu iesponse of otheis, the
woikei must obtain the wiitten infoimeu
consent of the client at the initiation of
the contiact.
Aveision theiapy
This involves combining substance use
with an unpleasant expeiience, such as a
milu electiic shock oi phaimacologically
inuuceu vomiting.
Is useu in specializeu facilities anu
contiolleu tiials have hau mixeu iesults.
Cue exposuie tieatment
This treatment is based on Pavlov’s
extinction paiauigm anu involves
exposuie of the inuiviuual to cues that
stimulate uiug ciaving, at the same time
pieventing actual uiug use anu the
expeiience of uiug-ielateu enfoicement.
Can also be combineu with ielaxation
techniques anu uiug iefusal tiaining to
ease the uisappeaiance of classically
conuitioneu ciaving.
Auvantages of gioup theiapy
Can be a suppoitive, theiapeutic, anu
euucational expeiience that helps
motivate anu sustain paiticipants.
uives clients oppoitunities to iuentify
with otheis.
Belps paiticipants unueistanu the impact
of substance use on theii lives.
Belps paiticipants to leain moie about
their own and others’ feelings and
ieactions.
Commonly iegaiueu as the piefeiieu
moue of psychotheiapeutic tieatment foi
substance-uepenuent clients.
Family inteiventions
When abstinence uisiupts a pieviously
well-establisheu malauaptive style of
family inteiaction anu family membeis
neeu help aujusting to a new set of
inuiviuual anu familial goals, attituues,
anu behaviois.
Family¡couple theiapy can be useful to
piomote psychological uiffeientiation of
inuiviuual family membeis, to pioviue a
foium foi the exchange of infoimation
anu iueas about the tieatment plan, to
uevelop behavioial management
contiacts foi continueu family suppoit,
anu to ieinfoice behaviois that pievent
ielapse anu enhance iecoveiy piospects.
Clinical iisks
Suiciue attempts anu completions aie
substantially highei with substance use
uisoiueis than in the geneial population,
with completeu suiciues S-4 times that in
the geneial population.
Incieaseu iisks foi homiciue anu othei
violence.
Impaiieu ieality testing, anxiety,
iiiitability, incieaseu aggiessiveness, anu
impaiieu impulse contiol.
N('(;/0)
Systematic stuuy auuing to oi veiifying
existing knowleuge that ielies on
systematic anu oiueily pioceuuies in the
seaich foi new knowleuge oi the
coiioboiation of existing knowleuge.
Theie aie stanuaiuizeu pioceuuies foi
collecting uata that aie uesciibeu in uetail
anu publisheu so that the ieseaich may be
ieplicateu by othei ieseaicheis.
Peei ieview thiough the publication
piocess is an impoitant featuie of
ieseaich.
Pioblem foimulation
Pioblem foimulation is the fiist step in
the ieseaich piocess. It is the methou that
ieseaicheis use to uevelop a statement
that can be opeiationalizeu. Pioblem
foimulation shoulu be woiueu in a way
that will allow measuiement.
Selecting a stuuy uesign
The following aie the ielevant factois that
go into selecting a stuuy uesign:
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Bow much inteivieweis must be
tiaineu.
Bow uata will be manageu anu
contiolleu.
Available ieseaich iesouices, such
as subjects, availability of existing
uata, anu quality of piofessional
ieseaicheis.
Auequacy of funuing.
Level of ceitainty iequiieu by
consumeis of ieseaich.
Involvement of human subjects
anu ethical issues ielateu to theii
involvement.
Time iequiieu¡available foi
ieseaich.
The following aie ethical issues¡conceins
involveu with selecting a stuuy uesign:
Reseaich must not leau to
haiming clients.
Benying an inteivention may
amount to haim.
Infoimeu consent.
Confiuentiality.
Nethouology
Nethouology consists of choosing
measuiement techniques, the setting in
which the ieseaich will be conuucteu, anu
the gioup¡population that will be stuuieu.
Steps
The following aie steps involveu in
ieseaich:
Pioblem foimulation
Nethouology
Collection of uata
Analysis of iesults
Bissemination of iesults
Concepts
Woius useu to oiganize expeiience.
Concepts aie peiceptions cieateu by
geneializing fiom specifics.
0peiationalizing a concept
Conuensing a concept to a set of
uiiections anu actions so that a stuuy can
piogiess in a systematic anu ieplicable
mannei.
An example of this woulu be
opeiationalizing the concept of
“succeeding on an exam” to “earning a
score of 75 or above.”
!,?"%)('*'
An asseition about a ielationship
between two oi moie vaiiables that can
be testeu with an outcome that can be
confiimeu, faileu to confiim, oi iefuteu.
Components of a hypothesis:
States theie is a ielationship
between two vaiiables.
Iuentifies the quality of that
ielationship in a testable way.
Shoulu be piecise about what is
iefeiieu to anu shoulu allow some
type of measuiement.
Avoius value juugments.
Is ielateu to a bouy of theoiy.
9&<< ),?"%)('*'
The Null hypothesis states that theie is no
significant ielationship between two
vaiiables. Stanuaiu ieseaich piactice is to
test a hypothesis against the Null
hypothesis.
C;/*;E<(
A tiait which eveiyone in the population
has in vaiying amounts oi types. Is the
opposite of a constant, which is a tiait
that uoes not vaiy with uiffeient people.
The uiffeient types of vaiiables aie as
follows:
Inuepenuent vaiiables aie
believeu to cause some vaiiation
in anothei vaiiable.
Bepenuent vaiiables have
vaiiation that must be explaineu.
Inteivening anu extianeous
vaiiables come between the
inuepenuent anu uepenuent
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vaiiables. This type of vaiiable
changes oi confuses the vaiiation
of the uepenuent vaiiable, which
was believeu to iesult fiom the
effects of the inuepenuent
vaiiable. Reseaicheis may not be
awaie of these vaiiables, oi may
be unable to contiol theii effects.
Piesence of these vaiiables can
leau to unceitainty iegaiuing the
meaning of the iesults obtaineu.
1)("/,
A set of ielateu hypotheses linkeu in a
way to explain some phenomena oi
pieuict some phenomena. Bypotheses
that test theoiies aie typically the basis of
ieseaich stuuies.
5I?<"/;%"/, '%&+,
This type of stuuy is useu to
exploie an aiea of knowleuge
about which little is known anu in
oiuei to gain familiaiity with ieal
life settings, pioblems, oi
phenomena.
Is useu to claiify concepts anu
uevelop hypotheses foi fuithei
ieseaich.
Is built on assessment of pie-
existing knowleuge, but is useu to
exploie new aieas.
Examples incluue systematic
ieview of ielateu liteiatuie,
suivey of expeits, analysis of case
mateiial, anu paiticipant
obseivation.
M('0/*?%*>( '%&+*('
These types of stuuies aie useu in
aieas wheie theie is moie
knowleuge than in exploiatoiy
stuuies.
Conceineu with veiifying facts;
aie caiefully uesigneu stuuies of
phenomena with systematic anu
well-uefineu pioceuuies.
Fiequently aie stuuies of a small
iepiesentative sample in oiuei to
uiaw infeiences about the
bioauei population. Caiefully
constiucteu samples of subjects to
be stuuieu in oiuei to avoiu bias.
Bypothesis may oi may not be
stateu in auvance.
These stuuies can be useu to
uepict the tiaits of a population oi
the ielationship among given
vaiiables.
Bata collection may be
accomplisheu thiough
obseivation, questionnaiies,
inteiview, stuuy of case mateiials,
oi testing of subjects.
5I?(/*B(@%;< '%&+*('
These stuuies aie the most iigoious anu
theii puipose is to test foi causality. They
always involve testing a pieuiction by
manipulating an inuepenuent vaiiable
anu measuiing the effect on a uepenuent
vaiiable. A iigoious stuuy of this type
ueteimines if a behavioi oi change in a
uepenuent vaiiable is causeu by an
inuepenuent vaiiable. The stuuy must be
conuucteu unuei contiolleu conuitions in
oiuei to eliminate the effect of othei
extianeous vaiiables anu alteinative
explanations foi the obseiveu
ielationship.
0ne must show the following to
ueteimine causality in an expeiimental
stuuy:
Concomitant vaiiation, oi that the
tieatment of the inuepenuent
vaiiable is associateu with
changes in the uepenuent
vaiiable.
That the change in the
inuepenuent vaiiable occuis
befoie the change in the
uepenuent vaiiable.
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Contiolling othei vaiiables that
may be piesent
Thieats to inteinal anu exteinal valiuity
Thieats aie alteinate opeiating vaiiables
which may influence the iesults of a stuuy
in unknown ways. Examples incluue:
Effects iesulting fiom the passage
of time, some may be moie
poweiful than the inteivention.
Neasuiement uecay—exhaustion
oi buinout of juuges oi obseiveis
Selection piocess bias
Noitality—loss of some of the
subjects fiom a sample
Bawthoine effect (Test-Taking
effect)—subjects may altei theii
behavioi simply as a iesult of
being stuuieu.
Placebo
7*(<+ (I?(/*B(@%
This is a type of expeiimental stuuy that
is conuucteu in a conciete, natuial
enviionment.
In this type of stuuy the ieseaichei tests a
hypothesis, but doesn’t have strict control
over participants’ exposure to the
expeiimental vaiiable.
4;E"/;%"/, (I?(/*B(@%'
A type of expeiimental stuuy in which
tests aie conuucteu unuei tightly
contiolleu laboiatoiy conuitions. The
conuitions aie aitificial (not conuucteu in
the real world and the researcher’s
conclusions may be suspect, even though
these expeiiments offei the most contiol
ovei the inuepenuent vaiiable.
8<;''*0;< 3(A"/(F2A%(/ 5I?(/*B(@%;<
;@+ 8"@%/"< J/"&? M('*-@ '%&+*(' #*%)
/;@+"B*L;%*"@
In this type of expeiimental stuuy, all
subjects aie ianuomly assigneu to
expeiimental anu contiol gioups. In this
way, the ieseaichei can assume that the
two gioups aie analogous at the
beginning of the stuuy. The ieseaichei
then auministeis the inuepenuent
vaiiable¡inteivention to the expeiimental
gioup, aftei which both gioups aie
measuieu.
Placebos aie often useu in this uesign
type to contiol foi the influence of testing.
5IF?"'% A;0%" ;@;<,'*' "/ 0"//(<;%*"@;<
;@;<,'*'
This type of expeiimental stuuy uses
statistical analysis of the uata to contiol
for a given variable’s effect.
The ieseaichei examines the ielationship
between the inuepenuent vaiiable anu
the uepenuent vaiiable unuei a vaiiety of
conuitions of a thiiu vaiiable.
Is conuucteu aftei uata collection is
completeu anu the ieseaichei seeks to
iule out alteinative explanations foi
changes.
C;<*+*%,
Bow well a stuuy actually measuies what
it intenus to.
N(<*;E*<*%,
Consistency in the measuiement of a
vaiiable.
Without ieliability, theie is no valiuity,
though ieliability uoes not guaiantee
valiuity.
Tests of ieliability aie as follows:
Test-Retest: A test is iepeateu to
the same paiticipants unuei the
same conuitions. Reliability is
highei with highei coiielation
between the initial anu ietest
scoies.
Split-Balf: ianuom place
assignments aie given to each
item in a test, which is then split
into two halves. Each half is
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scoieu sepaiately. Reliability is
measuieu thiough the uegiee of
coiielation between the two
scoies.
Alteinate Foims: the ieseaichei
auministeis compaiable measuies
of the same vaiiable to the same
subjects at appioximately the
same time. Reliability is measuieu
by the uegiee of coiielation
between the two scoies.
Intei-juuge Agieement: Nultiple
juuges aie tiaineu to obseive anu
scoie the same phenomenon in
the same way. Theii inuepenuent
measuies of the same obseiveu
phenomenon aie coiielateu.
Reliability is measuieu by the
uegiee of coiielation between the
scoies.
The following aie some methous foi
incieasing ieliability:
Stanuaiuizing auministiation of
the measuiement instiument.
Auuing auuitional items to cancel
out ianuom eiioi.
Statistically iuentifying anu
eliminating items which uo not
agiee with othei items.
8"@0&//(@% >;<*+*%,
The measuie useu in a stuuy is compaieu
with anothei instiument piesumeu to
measuie the same vaiiable. Concuiient
valiuity is inuicateu by a highei
coiielation between the iesults.
D/(+*0%*>( >;<*+*%,
A measuie useu in a stuuy is compaieu
with a pieuicteu futuie outcome.
8"@%(@% >;<*+*%,
Analysis by those consiueieu expeit in
the fielu stuuieu of an instiument. The
test has content valiuity if the expeits
juuge it to be a goou measuie of what is
being stuuieu. Also uesciibeu as face
valiuity.
8"@'%/&0% >;<*+*%,
The uegiee to which a measuie ielates to
othei vaiiables expecteu within a system
of theoietical ielationships.
9"B*@;< '0;<( "A B(;'&/(B(@%
This categoiy of measuiement has two oi
moie name categoiies, such as pass¡fail,
male¡female, oi vaiious colois.
Biffeience, but not uegiee of uiffeience is
shown by the categoiies. Few available
statistical pioceuuies as the
measuiement involve placing subjects in
categoiies anu counting them. This
categoiy is not highly sensitive in
ueteimining uiffeiences.
6/+*@;< '0;<( "A B(;'&/(B(@%
This categoiy of measuiement shows the
position of each subject with iespect to a
paiticulai chaiacteiistic. An example is
the oiuei in which subjects complete a
task. A numbei of non-paiametiic
statistics can be useu with oiuinal
measuiements.
G@%(/>;< '0;<( "A B(;'&/(B(@%
This categoiy of measuiement shows
oiuinal positions with equal inteivals
between scoies. (Examples: scoies on an
exam, height, oi weight) This categoiy
ianks uata anu also uses categoiies of
equal size. The most poweiful statistics
(those that moie accuiately measuie
uiffeiences with a small size sample) can
be useu with this categoiy.
N;%*" '0;<( "A B(;'&/(B(@%
This categoiy of measuiement is
compiiseu of an inteival scale with an
absolute zeio.
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:;B?<(
A pait of a laigei population that
iepiesents the total gioup fiom which it
is uiawn.
:&EP(0%
0ne element within the sample anu
population.
N(?/('(@%;%*>(@(''
The extent to which a sample accuiately
ieflects the chaiacteiistics of the gieatei
population fiom which it is uiawn.
D/"E;E*<*%, ';B?<*@-
This is a sample that peimits the
ieseaichei to inuicate that each element
of the population has a known piobability
of inclusion in the sample. This type of
sample is moie useful than a non-
piobability sample as it is moie piecise,
allows statistical infeiences about the
laigei population, anu assuies
iepiesentativeness. With this type of
sampling, the ieseaichei can estimate the
uegiee to which the sample may uiffei
fiom the total population, anu theiefoie
estimate how much the finuings may be in
error (this is expressed as “+ or –x%”).
Simple ianuom sample: subjects
aie uiawn ianuomly fiom a
known population anu each has
an equal piobability of inclusion
in the sample.
Stiatifieu ianuom sample: Aftei
subjects aie gioupeu into stiata of
inteiest (age, sex, ethnicity), they
aie then uiawn ianuomly fiom
each gioup.
Clustei ianuom sample: multiple-
stage sampling; successive
ianuom samples aie uiawn fiom
natuial gioups¡clusteis.
9"@F?/"E;E*<*%, ';B?<*@-
In this type of sampling, it is not possible
to specify the piobability that each
element of the population has an equal
chance of being incluueu.
Repiesentativeness is unceitain. Boes not
allow foi statistical infeience anu is less
piecise than a piobability sample.
Acciuental sample: uses the fiist
case encounteieu
Quota sample: incluues some
cases fiom each segment of a
population
Puiposive sample: intentionally
uiaws a sample fiom a pait of the
population assumeu to have
paiticulai knowleuge of what is
being stuuieu.
M('0/*?%*>( '%;%*'%*0'
Calculations that uepict some
chaiacteiistic of a gioup of sample. They
allow useis of ieseaich to summaiize
infoimation about the gioup anu make
useful compaiisons among two oi moie
gioups.
G@A(/(@%*;< '%;%*'%*0'
These calculations allow ieseaicheis to
geneialize fiom a sample to a laigei
population (fiom which the sample is
taken). They aie baseu on piobability
theoiy anu peimit finuings to be
inteipieteu.
92:S 8"+( "A 5%)*0'
Coie values of social woik
The following aie coie values of the social
woik piofession, accoiuing to the NASW
Coue of Ethics:
Seivice
Social justice
Bignity anu woith of the peison
Impoitance of human
ielationships
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Integiity
Competence
The puiposes of the NASW Coue of Ethics
aie as follows:
Iuentify coie values on which
social work’s mission is based.
Summaiize bioau ethical
piinciples that ieflect the
profession’s core values.
Establish a set of specific ethical
stanuaius that shoulu be useu to
guiue social woik piactice.
Pioviue ethical stanuaius to
which the geneial public can holu
the social woik piofession
accountable.
Socialize piactitioneis new to the
field to social work’s mission,
values, ethical piinciples, anu
ethical stanuaius.
Aiticulate stanuaius that the
piofession can use to assess
whethei social woikeis have
engageu in unethical conuuct.
Commitment to clients
Social workers’ primary responsibility is
to piomote the well-being of clients. In
geneial, client inteiests aie piimaiy.
However, social workers’ responsibility to
the laigei society oi specific legal
obligations may on limiteu occasions
supeiseue the loyalty oweu clients, anu
clients shoulu be so auviseu.
(see section 1.u1 of the Coue of Ethics)
Self-ueteimination
Social woikeis iespect anu piomote the
iight of clients to self-ueteimination anu
assist clients in theii effoits to iuentify
anu claiify theii goals. Social woikeis
may limit clients’ right to self-
ueteimination when, in the social
workers’ professional judgment, clients’
actions oi potential actions pose a
seiious, foieseeable, anu imminent iisk to
themselves oi otheis.
(see section 1.u2 of the Coue of Ethics)
Implications of infoimeu consent, pei the
NASW Coue of Ethics aie as follows:
Social woikeis shoulu use cleai,
unueistanuable language to
infoim clients of the puipose of
theii seivices, iisk ielateu to
those seivices, any limits to
seivices, ielevant costs,
reasonable alternatives, clients’
iight to iefuse oi withuiaw
consent, anu the time fiame
coveieu by the consent. Woikeis
shoulu pioviue clients an
oppoitunity to ask questions.
If clients aie not liteiate oi have
uifficulty unueistanuing the
language useu in the piactice
setting, the woikei shoulu take
steps to ensuie theii
compiehension (uetaileu veibal
explanation oi pioviuing an
inteipietei¡tianslatoi when
possible).
Foi clients lacking capacity to
pioviue infoimeu consent,
woikeis shoulu seek peimission
fiom an appiopiiate thiiu paity
while infoiming the client anu
seeking to ensuie that the thiiu
paity acts in a mannei consistent
with the client’s wishes and
inteiests.
When clients ieceive seivices
involuntaiily, woikeis shoulu
pioviue infoimation about the
natuie anu extent of seivices anu
about the extent of the client’s
iight to iefuse seivices.
Woikeis who pioviue seivices via
electionic meuia shoulu infoim
clients of the limitations anu iisks
associateu with such seivices.
Infoimeu consent shoulu be
obtaineu befoie auuio oi
viueotaping clients oi peimitting
obseivation by a thiiu paity.
(see section 1.uS of the Coue of
Ethics)
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Competence
Social woikeis shoulu pioviue
seivices anu iepiesent themselves
as competent only within the
bounuaiies of theii euucation,
tiaining, license, ceitification,
consultation ieceiveu, supeiviseu
expeiience, oi othei ielevant
piofessional expeiience.
Social woikeis shoulu pioviue
seivices in substantive aieas oi
use inteivention techniques oi
appioaches that aie new to them
only aftei engaging in appiopiiate
stuuy, tiaining, consultation, anu
supeivision fiom people who aie
competent in those inteiventions
oi techniques.
When geneially iecognizeu
stanuaius uo not exist with
iespect to an emeiging aiea of
piactice, social woikeis shoulu
exeicise caieful juugment anu
take iesponsible steps (incluuing
appiopiiate euucation, ieseaich,
tiaining, consultation, anu
supeivision) to ensuie the
competence of theii woik anu to
piotect clients fiom haim.
(see section 1.u4 of the Coue of
Ethics)
Cultuial Competence anu Social Biveisity
Social woikeis shoulu unueistanu
cultuie anu its function in human
behavioi anu society, iecognizing
the stiengths that exist in all
cultuies.
Social woikeis shoulu have a
knowledge base of their clients’
cultuies anu be able to
uemonstiate competence in the
piovision of seivices that aie
sensitive to clients’ culture and to
uiffeiences among people anu
cultuial gioups.
Social woikeis shoulu obtain
euucation about anu seek to
unueistanu the natuie of social
uiveisity anu oppiession with
iespect to iace, ethnicity, national
oiigin, coloi, sex, sexual
oiientation, age, maiital status,
political belief, ieligion anu
mental oi physical uisability.
(see section 1.uS of the Coue of
Ethics)
Conflicts of inteiest
Social woikeis shoulu be aleit to
anu avoiu conflicts of inteiest that
inteifeie with the exeicise of
piofessional uiscietion anu
impaitial juugment. Social
woikeis shoulu infoim clients
when a ieal oi potential conflict of
inteiest aiises anu take
ieasonable steps to iesolve the
issue in a mannei that makes the
clients’ interests primary and
protects clients’ interests to the
gieatest extent possible.
Occasionally, protecting clients’
inteiests may iequiie teimination
of the piofessional ielationship
with piopei iefeiial of the client.
Social woikeis shoulu not take
unfaii auvantage of any
piofessional ielationship oi
exploit otheis to fuithei theii
peisonal, political, oi business
inteiests.
(see section 1.u6 of the Coue of
Ethics)
Bual oi multiple ielationships
Social woikeis shoulu not engage in uual
oi multiple ielationships with clients oi
foimei clients in which theie is a iisk of
exploitation oi potential haim to the
client. In instances when uual oi multiple
ielationships aie unavoiuable, social
woikeis shoulu take steps to piotect
clients anu aie iesponsible foi setting
cleai, appiopiiate, anu cultuially sensitive
bounuaiies. (Bual oi multiple
ielationships occui when social woikeis
ielate to clients in moie than one
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ielationship, whethei piofessional, social,
oi business. Bual oi multiple
ielationships can occui simultaneously oi
consecutively.)
(see section 1.u6 of the Coue of Ethics)
Pioviuing seivices to people who have a
ielationship with each othei
When social woikeis pioviue seivices to
two oi moie people who have a
ielationship with each othei (foi example,
couples, family membeis), social woikeis
shoulu claiify with all paities which
inuiviuuals will be consiueieu clients anu
the nature of social workers’ professional
obligations to the vaiious inuiviuuals who
aie ieceiving seivices. Social woikeis
who anticipate a conflict of inteiest
among the inuiviuuals ieceiving seivices
oi who anticipate having to peifoim in
potentially conflicting ioles (foi example,
when a social woikei is askeu to testify in
a chilu custouy uispute oi uivoice
pioceeuings involving clients) shoulu
claiify theii iole with the paities involveu
anu take appiopiiate action to minimize
any conflict of inteiest.
(see section 1.u6 of the Coue of Ethics)
Clients’ right to privacy
Social workers should respect clients’
iight to piivacy. Social woikeis shoulu
not solicit piivate infoimation fiom
clients unless it is essential to pioviuing
seivice, oi conuucting social woik
evaluation, oi ieseaich. 0nce piivate
infoimation is shaieu, stanuaius of
confiuentiality apply.
(see section 1.u7 of the Coue of Ethics)
Ciicumstances in which social woikeis
may uisclose confiuential infoimation
Social woikeis may uisclose confiuential
infoimation when appiopiiate with a
valiu consent fiom a client, oi a peison
legally authoiizeu to consent on behalf of
a client.
Social woikeis shoulu piotect the
confiuentiality of all infoimation obtaineu
in the couise of piofessional seivice,
except foi compelling piofessional
ieasons. The geneial expectation that
social woikeis will keep infoimation
confiuential uoes not apply when
uisclosuie is necessaiy to pievent seiious,
foieseeable, anu imminent haim to a
client oi othei iuentifiable peison oi
when laws oi iegulations iequiie
disclosure without a client’s consent. In
all instances, social woikeis shoulu
uisclose the least amount of confiuential
infoimation necessaiy to achieve the
uesiieu puipose; only infoimation that is
uiiectly ielevant to the puipose foi which
the uisclosuie is maue shoulu be ievealeu.
(see section 1.u7 of the Coue of Ethics)
Social woikeis shoulu infoim clients, to
the extent possible, about the uisclosuie
of confiuential infoimation anu, when
feasible, befoie the uisclosuie is maue.
This applies whethei social woikeis
uisclose confiuential infoimation as a
iesult of a legal iequiiement oi baseu on
client consent.
Social woikeis shoulu uiscuss with clients
anu othei inteiesteu paities the natuie of
confidentiality and limitations of clients’
iight to confiuentiality. Social woikeis
shoulu ieview with clients ciicumstances
wheie confiuential infoimation may be
iequesteu anu wheie uisclosuie of
confiuential infoimation may be legally
iequiieu. This uiscussion shoulu occui as
soon as possible in the social woikei-
client ielationship anu as neeueu
thioughout the couise of the ielationship.
(see section 1.u7 of the Coue of Ethics)
Confiuentiality when woiking with
families, couples, oi gioups
When social woikeis pioviue counseling
seivices to families, couples, oi gioups,
social woikeis shoulu seek agieement
among the paities involveu conceining
each individual’s right to confidentiality
anu obligation to pieseive the
confiuentiality of infoimation shaieu by
otheis. Social woikeis shoulu infoim
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paiticipants in family, couples, oi gioup
counseling that social woikeis cannot
guaiantee that all paiticipants will honoi
such agieements.
Social woikeis shoulu infoim clients
involveu in family, couples, maiital, oi
group counseling of the social worker’s,
employer’s, and agency’s policy
concerning the social worker’s disclosure
of confiuential infoimation among the
paities involveu in counseling.
(see section 1.u7 of the Coue of Ethics)
Client access to iecoius
Social woikeis shoulu pioviue clients
with ieasonable access to iecoius
conceining the clients. Social woikeis
who are concerned that clients’ access to
theii iecoius coulu cause seiious
misunueistanuing oi haim to the client
shoulu pioviue assistance in inteipieting
the iecoius anu consultation with the
client iegaiuing the iecoius. Social
workers should limit clients’ access to
theii iecoius, oi poitions of theii iecoius,
only in exceptional ciicumstances when
theie is compelling eviuence that such
access woulu cause seiious haim to the
client. Both clients’ requests and the
iationale foi withholuing some oi all of
the iecoiu shoulu be uocumenteu in
clients’ files.
When pioviuing clients with access to
theii iecoius, social woikeis shoulu take
steps to piotect the confiuentiality of
othei inuiviuuals iuentifieu oi uiscusseu
in such iecoius.
(see section 1.u8 of the Coue of Ethics)
Sexual ielationships with cuiient clients
or with clients’ relatives
Social woikeis shoulu unuei no
ciicumstances engage in sexual activities
oi sexual contact with cuiient clients,
whethei such contact is consensual oi
foiceu.
Social woikeis shoulu not engage in
sexual activities oi sexual contact with
clients’ relatives or other individuals with
whom clients maintain a close peisonal
ielationship when theie is a iisk of
exploitation oi potential haim to the
client. Sexual activity oi sexual contact
with clients’ relatives or other individuals
with whom clients maintain a peisonal
ielationship has the potential to be
haimful to the client anu may make it
uifficult foi the social woikei anu the
client to maintain appiopiiate
piofessional bounuaiies. Social
woikeis—not their clients, their clients’
ielatives, oi otheis with whom the client
maintains a peisonal ielationship—
assume the full buiuen foi setting cleai,
appiopiiate, anu cultuially sensitive
bounuaiies.
(see section 1.u9 of the Coue of Ethics)
Sexual ielationships with foimei clients
Social woikeis shoulu not engage in
sexual activities oi sexual contact with
foimei clients because of the potential foi
haim to the client. If social woikeis
engage in conuuct contiaiy to this
piohibition oi claim that an exception to
this piohibition is waiianteu because of
extiaoiuinaiy ciicumstances, it is social
woikeis—not theii clients—who assume
the full buiuen of uemonstiating that the
foimei client has not been exploiteu,
coeiceu, oi manipulateu, intentionally oi
unintentionally.
(see section 1.u9 of the Coue of Ethics)
Pioviuing clinical seivices to inuiviuuals
with whom the woikei has a piioi sexual
ielationship
Social woikeis shoulu not pioviue clinical
seivices to inuiviuuals with whom they
have hau a piioi sexual ielationship.
Pioviuing clinical seivices to a foimei
sexual paitnei has the potential to be
haimful to the inuiviuual anu is likely to
make it uifficult foi the social woikei anu
inuiviuual to maintain appiopiiate
piofessional bounuaiies.
(see section 1.u9 of the Coue of Ethics)
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Physical contact between woikeis¡clients
Social woikeis shoulu not engage in
physical contact with clients when theie
is a possibility of psychological haim to
the client as a iesult of the contact (such
as ciauling oi caiessing clients). Social
woikeis who engage in appiopiiate
physical contact with clients aie
iesponsible foi setting cleai, appiopiiate,
anu cultuially sensitive bounuaiies that
govein such physical contact.
(see section 1.1u of the Coue of Ethics)
Beiogatoiy language
Social woikeis shoulu not use ueiogatoiy
language in theii wiitten oi veibal
communications to oi about clients. Social
woikeis shoulu use accuiate anu
iespectful language in all communications
to anu about clients.
(see section 1.12 of the Coue of Ethics)
Payment foi seivices
Social woikeis shoulu ensuie that
theii fees aie faii, ieasonable, anu
commensuiate with the seivice
peifoimeu. Consiueiation shoulu
be given to the client’s ability to
pay.
Social woikeis shoulu avoiu
accepting goous oi seivices fiom
clients as payment foi
piofessional seivices. Baiteiing
aiiangements, paiticulaily
involving seivices, cieate the
potential foi conflicts of inteiest,
exploitation, anu inappiopiiate
bounuaiies in social woikeis
ielationships with clients. Social
woikeis shoulu exploie anu may
paiticipate in baiteiing only in
veiy limiteu ciicumstances when
it can be uemonstiateu that such
aiiangements aie an accepteu
piactice among piofessionals in
the local community, consiueieu
to be essential foi the piovision of
seivices, negotiateu without
coeicion, anu enteieu into at the
client’s initiative anu with the
client’s informed consent. Social
woikeis who accept goous oi
seivices fiom clients as payment
foi piofessional seivices assume
the full buiuen of uemonstiating
that this aiiangement will not be
uetiimental to the client oi the
piofessional ielationship.
Social woikeis shoulu not solicit a
piivate fee oi othei iemuneiation
foi pioviuing seivices to clients
who aie entitleu to such available
services through the worker’s
employei oi agency.
(see section 1.1S of the Coue of Ethics)
Woiking with clients who lack uecision-
making capacity
When social woikeis act on behalf of
clients who lack the capacity to make
infoimeu uecisions, social woikeis shoulu
take ieasonable steps to safeguaiu the
inteiests anu iights of those clients.
(see section 1.14 of the Coue of Ethics)
Inteiiuption of seivices
Social woikeis shoulu make ieasonable
effoits to ensuie continuity of seivices in
the event that seivices aie inteiiupteu by
factois such as unavailability, ielocation,
illness, uisability, oi ueath.
(see section 1.1S of the Coue of Ethics)
Teimination of seivices
Social woikeis shoulu teiminate
seivices to clients, anu
piofessional ielationships with
them, when such seivices anu
ielationships aie no longei
iequiieu oi no longei seive the
clients’ needs oi inteiests.
Social woikeis in fee-foi-seivice
settings may teiminate seivices to
clients who aie not paying an
oveiuue balance if the financial
contiactual aiiangements have
been maue cleai to the client, if
the client uoes not pose an
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imminent uangei to self oi otheis,
anu if the clinical anu othei
consequences of the cuiient
nonpayment have been auuiesseu
anu uiscusseu with the client.
Social woikeis who anticipate the
teimination oi inteiiuption of
seivices to clients shoulu notify
clients piomptly anu seek the
tiansfei, iefeiial, oi continuation
of seivices in ielation to the
clients’ needs and preferences.
Social woikeis who aie leaving an
employment setting shoulu
infoim clients of all available
options foi the continuation of
seivice anu theii benefits anu
iisks.
(see section 1.16 of the Coue of Ethics)
Teiminating seivices with clients who aie
still in neeu of seivices
Social woikeis shoulu take ieasonable
steps to avoiu abanuoning clients who aie
still in neeu of seivices. Social woikeis
shoulu withuiaw seivices piecipitously
only unuei unusual ciicumstances, giving
caieful consiueiation to all factois in the
situation anu taking caie to minimize
possible auveise effects. Social woikeis
shoulu assist in making appiopiiate
aiiangements foi continuation of seivices
when necessaiy.
(see section 1.16 of the Coue of Ethics)
Ciicumstances in which teimination
shoulu not occui
Social woikeis shoulu not teiminate
seivices to puisue a social, financial, oi
sexual ielationship with a client.
(see section 1.16 of the Coue of Ethics)
Respect to colleagues
Social woikeis shoulu tieat
colleagues with iespect anu
iepiesent accuiately anu faiily the
qualifications, views, anu
obligations of colleagues.
Social woikeis shoulu avoiu
unwaiianteu negative ciiticism of
colleagues with clients oi with
othei piofessionals.
Social woikeis shoulu coopeiate
with social woik colleagues anu
with colleagues of othei
piofessions when it seives the
well-being of clients.
(see section 2.u1 of the Coue of Ethics)
Confiuentiality with colleagues
Social woikeis shoulu iespect
confiuential infoimation shaieu by
colleagues in the couise of theii
piofessional ielationships anu
tiansactions. Social woikeis shoulu
ensuie that such colleagues unueistanu
social workers’ obligation to iespect
confiuentiality anu any exceptions ielateu
to it.
(see section 2.u2 of the Coue of Ethics)
Inteiuisciplinaiy collaboiation
Social woikeis who aie membeis of an
inteiuisciplinaiy team shoulu paiticipate
in anu contiibute to uecisions that affect
the well-being of clients by uiawing on
the peispectives, values, anu expeiiences
of the social woik piofession.
Piofessional anu ethical obligations of the
inteiuisciplinaiy team as a whole anu of
its inuiviuual membeis shoulu be cleaily
establisheu.
Social woikeis foi whom a team uecision
iaises ethical conceins shoulu attempt to
iesolve the uisagieement thiough
appiopiiate channels. If the uisagieement
cannot be iesolveu social woikeis shoulu
puisue othei avenues to auuiess theii
conceins, consistent with client well-
being.
(see section 2.uS of the Coue of Ethics)
Bisputes involving colleagues
Social woikeis shoulu not take auvantage
of a uispute between a colleague anu
employei to obtain a position oi
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otherwise advance the social workers’
own inteiests.
Social woikeis shoulu not exploit clients
in uisputes with colleagues oi engage
clients in any inappiopiiate uiscussion of
conflicts between social woikeis anu
theii colleagues.
(see section 2.u4 of the Coue of Ethics)
Consultation
Social woikeis shoulu seek auvice
anu counsel of colleagues
whenevei such a consultation is in
the best inteiests of clients.
Social woikeis shoulu keep
informed of colleagues’ areas of
expeitise anu competencies.
Social woikeis shoulu seek
consultation only fiom colleagues
who have uemonstiateu
knowleuge anu competence
ielateu to the subject of the
consultation.
When consulting with colleagues
about clients, social woikeis
shoulu uisclose the least amount
of infoimation to achieve the
puiposes of the consultation.
(see section 2.uS of the Coue of Ethics)
Refeiial foi seivices
Social woikeis shoulu iefei
clients to othei piofessionals
when other professionals’
specializeu knowleuge oi
expeitise is neeueu to seive
clients fully, oi when social
woikeis believe they aie not
being effective oi making
ieasonable piogiess with clients
anu auuitional seivice is iequiieu.
Social woikeis who iefei clients
to othei piofessionals shoulu take
appiopiiate steps to facilitate an
oiueily tiansfei of iesponsibility.
Social woiks who iefei clients to
othei piofessionals shoulu
disclose, with clients’ consent, all
peitinent infoimation to the new
seivice pioviueis.
Social woikeis aie piohibiteu
fiom giving oi ieceiving payment
foi a iefeiial when no
piofessional seivice is pioviueu
by the iefeiiing social woikei.
(see section 2.u6 of the Coue of Ethics)
Sexual ielationships between colleagues
Social woikeis who function as
supeivisois oi euucatois shoulu not
engage in sexual activities oi contact with
cuiient supeivisees, stuuents, tiainees, oi
othei colleagues ovei whom they exeicise
piofessional authoiity.
Social woikeis shoulu avoiu engaging in
sexual ielationships with colleagues
wheie theie is potential foi a conflict of
inteiest. Social woikeis who become
involveu in, oi anticipate becoming
involveu in, a sexual ielationship with a
colleague have a uuty to tiansfei
piofessional iesponsibilities, when
necessaiy, in oiuei to avoiu a conflict of
inteiest.
(see section 2.u7 of the Coue of Ethics)
Impaiiment of colleagues
Social woikeis who have uiiect
knowledge of a social work colleague’s
impaiiment which is uue to peisonal
pioblems, psychosocial uistiess,
substance abuse, oi mental health
uifficulties, anu which inteifeies with
piactice effectiveness, shoulu consult
with that colleague anu assist the
colleague in taking iemeuial action.
Social woikeis who believe that a social
work colleague’s impairment interferes
with piactice effectiveness anu that the
colleague has not taken auequate steps to
auuiess the impaiiment shoulu take
action thiough appiopiiate channels
establisheu by employeis, agencies,
NASW, licensing anu iegulatoiy bouies,
anu othei piofessional oiganizations.
(see section 2.u9 of the Coue of Ethics)
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Incompetence of colleagues
Social woikeis who believe that a social
woik colleague’s incompetence should
consult with that colleague when feasible
anu assist the colleague in taking
iemeuial action.
Social woikeis who believe that a social
woik colleague is incompetent anu has
not taken auequate steps to auuiess the
incompetence shoulu take action thiough
appiopiiate channels establisheu by
employeis, agencies, NASW, licensing anu
iegulatoiy bouies, anu othei piofessional
oiganizations.
(see section 2.1u of the Coue of Ethics)
Repoiting unethical conuuct
Social woikeis shoulu take auequate
measuies to uiscouiage, pievent, expose,
anu coiiect the unethical conuuct of
colleagues.
Social woikeis shoulu be knowleuge
about establisheu policies anu pioceuuies
for handling concerns about colleagues’
unethical behavioi. Social woikeis shoulu
be familiai with national, state, anu local
pioceuuies foi hanuling ethics
complaints.
Social woikeis who believe that a
colleague has acteu unethically shoulu
seek iesolution by uiscussing theii
conceins with the colleague when feasible
anu when such uiscussion is likely to be
piouuctive.
Social woikeis shoulu uefenu anu assist
colleagues who aie unjustly chaigeu with
unethical conuuct.
(see section 2.11 of the Coue of Ethics)
Supeivision anu consultation
Social woikeis who pioviue supeivision
oi consultation shoulu have the necessaiy
knowleuge anu skill to supeivise oi
consult appiopiiately anu shoulu uo so
only within theii aieas of knowleuge anu
competence.
Social woikeis who pioviue supeivision
oi consultation aie iesponsible foi setting
cleai, appiopiiate, anu cultuially sensitive
bounuaiies.
Social woikeis shoulu not engage in any
uual oi multiple ielationships with
supeivisees in which theie is a iisk of
exploitation oi of potential haim to the
supeivisee.
Social woikeis who pioviue supeivision
should evaluate supervisees’ performance
in a mannei that is cleai anu iespectful.
(see section S.u1 of the Coue of Ethics)
Peifoimance evaluation
Social woikeis who have iesponsibility
foi evaluating the peifoimance of otheis
shoulu fulfill such iesponsibility in a faii
anu consiueiate mannei anu on the basis
of cleaily stateu ciiteiia.
(see section S.uS of the Coue of Ethics)
Client iecoius
Social woikeis shoulu take ieasonable
steps to ensuie that uocumentation in
iecoius is accuiate anu ieflects the
seivices pioviueu.
Social woikeis shoulu incluue sufficient
anu timely uocumentation in iecoius to
facilitate the ueliveiy of seivices anu to
ensuie continuity of seivices pioviueu to
clients in the futuie.
Social workers’ documentation should
piotect clients’ privacy to the extent that
is possible anu appiopiiate anu shoulu
incluue only infoimation that is uiiectly
ielevant to the ueliveiy of seivices.
Social woikeis shoulu stoie iecoius
following the teimination of seivice to
ensuie ieasonable futuie access. Recoius
shoulu be maintaineu foi the numbei of
yeais iequiieu by state statutes oi
ielevant contiacts.
(see section S.u4 of the Coue of Ethics)
Billing
Social woikeis shoulu establish anu
maintain billing piactices that accuiately
ieflect the natuie anu extent of seivices
pioviueu, anu specifically by whom the
seivice was pioviueu in the piactice
setting.
(see section S.uS of the Coue of Ethics)
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Resouice allocation foi clients
Social woikeis shoulu auvocate foi
iesouice allocation pioceuuies that aie
open and fair. When not all clients’ needs
can be met, an allocation pioceuuie
shoulu be uevelopeu that is
nonuisciiminatoiy anu baseu on
appiopiiate anu consistently applieu
piinciples.
(see section S.u7 of the Coue of Ethics)
Continuing euucation anu staff
uevelopment
Social woik auministiatois anu
supeivisois shoulu take ieasonable steps
to pioviue oi aiiange foi continuing
euucation anu staff uevelopment foi all
staff foi whom they aie iesponsible.
Continuing euucation anu staff
uevelopment shoulu auuiess cuiient
knowleuge anu emeiging uevelopments
ielateu to social woik piactice anu ethics.
(see section S.u8 of the Coue of Ethics)
Laboi-Nanagement uisputes
Social woikeis may engage in oiganizeu
action, incluuing the foimation of anu
paiticipation in laboi unions to impiove
seivices to clients anu woiking
conuitions.
The actions of social woikeis who aie
involveu in laboi-management uisputes,
job actions, oi laboi stiikes shoulu be
guided by the professions’ values, ethical
piinciples, anu ethical stanuaius.
Reasonable uiffeiences of opinion exist
among social woikeis conceining theii
piimaiy obligation as piofessionals
uuiing an actual oi thieateneu laboi
stiike oi job action. Social woikeis shoulu
caiefully examine ielevant issues anu
theii possible impact on clients befoie
ueciuing on a couise of action.
(see section S.1u of the Coue of Ethics)
Competence
Social woikeis shoulu accept
iesponsibility oi employment only on the
basis of existing competence oi the
intention to acquiie the necessaiy
competence.
Social woikeis shoulu stiive to become
anu iemain pioficient in piofessional
piactice anu the peifoimance of
piofessional functions. Social woikeis
shoulu ciitically examine, anu keep
cuiient with, emeiging knowleuge
ielevant to social woik. Social woikeis
shoulu ioutinely ieview piofessional
liteiatuie anu paiticipate in continuing
euucation ielevant to social woik piactice
anu social woik ethics.
Social woikeis shoulu base piactice on
iecognizeu knowleuge, incluuing
empiiically baseu knowleuge, ielevant to
social woik anu social woik ethics.
(see section 4.u1 of the Coue of Ethics)
Bisciimination
Social woikeis shoulu not piactice,
conuone, facilitate, oi collaboiate with
any foim of uisciimination on the basis of
iace, ethnicity, national oiigin, coloi, age,
ieligion, sex, sexual oiientation, maiital
status, political belief, oi mental oi
physical uisability.
(see section 4.u2 of the Coue of Ethics)
Piivate conuuct of social woikeis
Social woikeis shoulu not peimit theii
piivate conuuct to inteifeie with theii
ability to fulfill theii piofessional
iesponsibilities.
(see section 4.uS of the Coue of Ethics)
Bishonesty, fiauu, anu ueception
Social woikeis shoulu not paiticipate in,
conuone, oi be associateu with
uishonesty, fiauu, oi ueception.
(see section 4.u4 of the Coue of Ethics)
Impaiiment
Social woikeis shoulu not allow theii own
peisonal pioblems, psychosocial uistiess,
legal pioblems, substance abuse, oi
mental health uifficulties to inteifeie with
theii piofessional juugment anu
peifoimance oi to jeopaiuize the best
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inteiests of people foi whom they have a
piofessional iesponsibility.
Social woikeis whose peisonal pioblems,
psychosocial uistiess, legal pioblems,
substance abuse, oi mental health
uifficulties inteifeie with theii
piofessional juugment anu peifoimance
shoulu immeuiately seek consultation anu
take appiopiiate iemeuial action by
seeking piofessional help, making
aujustments in woikloau, teiminating
piactice, oi taking any othei steps
necessaiy to piotect clients anu otheis.
(see section 4.uS of the Coue of Ethics)
Nisiepiesentation
Social woikeis shoulu make cleai
uistinctions between statements maue
anu actions engageu in as a piivate
inuiviuual anu as a iepiesentative of the
social woik piofession, a piofessional
social woik oiganization, oi of the social
worker’s employing agency.
Social woikeis who speak on behalf of
piofessional social woik oiganizations
shoulu accuiately iepiesent the official
anu authoiizeu positions of the
oiganization.
Social woikeis shoulu ensuie that theii
iepiesentations to clients, agencies, anu
the public of piofessional qualifications,
cieuentials, euucation, competence,
affiliations, seivices pioviueu, oi iesults
to be achieveu aie accuiate. Social
woikeis shoulu claim only those ielevant
piofessional cieuentials they actually
possess anu take steps to coiiect any
inaccuiacies oi misiepiesentations of
theii cieuentials by otheis.
(see section 4.u6 of the Coue of Ethics)
Solicitations
Social woikeis shoulu not engage in
uninviteu solicitation of potential clients
who, because of theii ciicumstances, aie
vulneiable to unuue influence,
manipulation, oi coeicion.
Social woikeis shoulu not engage in
solicitation of testimonial enuoisements
(incluuing solicitation of consent to use a
client’s prioi statement as a testimonial
enuoisement) fiom cuiient clients oi
othei peisons who, because of theii
paiticulai ciicumstances aie vulneiable
to unuue influence.
(see section 4.u7 of the Coue of Ethics)
Acknowleuging cieuit
Social woikeis shoulu take iesponsibility
anu cieuit, incluuing authoiship cieuit,
only foi woik they have actually
peifoimeu anu to which they have
contiibuteu.
Social woikeis shoulu honestly
acknowleuge the woik of anu the
contiibutions maue by otheis.
(see section 4.u8 of the Coue of Ethics)
4(''(/ (<*-*E*<*%,
This concept asseits that welfaie
payments shoulu not be highei than the
lowest paying job in society anu ueiives
fiom Elizabethan Pooi Law. It suggests
that economic anu wage issues unueilie
the size of benefits anu the availability of
welfaie. Some believe it is a way to
contiol laboi anu maintain incentives foi
woikeis to accept low-paying oi
unuesiiable jobs that they might
otheiwise ieject.
G@0/(B(@%;< 0);@-(
Small changes built on each othei. An
example is the passing of Neuicaie,
followeu by the acceptance of Neuicaiu.
D&%;%*>( A;%)(/
The allegeu fathei of a chilu boin outsiue
of maiiiage.
:"0*"(0"@"B*0 '%;%&'
SES is ueteimineu by occupation,
euucation, anu income of the heau of a
householu.
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D/*B;/, ?/(>(@%*"@
Inteivention begun befoie any eviuence
of the onset of a pioblem (paient
euucation piogiams aie an example).
:(0"@+;/, ?/(>(@%*"@
Eaily uetection anu tieatment of a
pioblem.
1(/%*;/, ?/(>(@%*"@
Tieatment in the acute phase of a
pioblem.
H;*@'%/(;B*@- "/ @"/B;<*L;%*"@
Incluuing chiluien with special neeus in
iegulai classiooms, while continuing to
give them special seivices.
V&>(@*<( '%;%&' "AA(@'(
A ciime that has no equivalent in the
auult ciiminal coue that can only be
committeu by chiluien. Examples incluue
tiuancy, iunning away, etc.
8<*(@% ?"?&<;%*"@
The gioup seiveu by an agency oi all
clients seiveu by all fielus of social woik.
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1. You aie calleu to evaluate a 64-yeai-olu male with chionic obstiuctive pulmonaiy
uisease. Be lives in an assisteu living facility, anu was biought to the emeigency ioom by his
uaughtei. She hau taken him to lunch, anu became uistiesseu when he iefuseu to ietuin to
the facility. Be states he wants to live in his motoi home, as he iesents the loss of piivacy at
the facility. Bis uaughtei confiims he owns a woiking, fully self-containeu motoi home (i.e.,
stove, showei, iefiigeiatoi, etc). Be has auequate funus. Be plans to paik the motoi home in
a neaiby Kampgiounus of Ameiica (K0A) campgiounu, wheie all utilities can be hookeu up.
Be can have foou anu othei supplies ueliveieu. Bowevei, it is Novembei anu it is
unseasonably colu. The uoctoi confiims that the patient is pione to pneumonia, anu the
daughter states “he will die if he doesn’t return to the facility.” The patient refuses to
consiuei any othei living situation. In this situation, the social woikei shoulu:
a. Call the police anu have them take the patient back to the facility.
b. Call auult piotective seivices foi fuithei inteivention.
c. Allow the patient to move into his motoi home.
u. Place the patient on an involuntaiy holu foi suiciual behavioi.
2. A patient who is described as “oriented times four” (or “oriented x4”) is able to
uemonstiate awaieness of which of the following foui featuies:
a. Name, uate, city, anu season.
b. Age, cuiient yeai, location, anu situation.
c. Name, genuei, ethnicity, anu maiital status.
u. Peison, place, time, anu situation.
S. Befine the teims ieliability anu valiuity in evaluative testing.
a. A test is ieliable if it is easy to use, anu valiu if it is commonly useu.
b. A test is ieliable if it piouuces consistent iesults, anu valiu if it measuies what it
claims to measuie.
c. A test is ieliable if it incluues Likeit scale iesponse options, anu valiu if it has
been enuoiseu by majoi ieseaich institutions.
u. A test is ieliable if it measuies what it iepoits to measuie, anu valiu if it
piouuces consistent iesults.
4. Executive functioning bioauly iefeis to:
a. The skill anu capacity of a leauei to leau.
b. Bighei oiuei cognitive functions anu capacity.
c. Auministiative policy anu guiuelines.
u. A buieauciatic leaueiship style.
S. As a supeivisoi in a counseling clinic, you aie appioacheu by cleiical staff asking how
long they shoulu ietain patient counseling iecoius. The BEST answei you coulu give is:
a. 0ntil the client is no longei being seen.
b. 0ntil the patient uies.
c. 0ntil the statute of limitations expiies.
u. As long as possible, piefeiably inuefinitely.
! DA !
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6. You have been seeing a significantly uepiesseu client foi some months anu have been
caiefully keeping iecoius following each session. Recently the client became upset with you,
as he felt you have been ciitical of his life anu past uecisions. Buiing youi last session, the
client seemeu oveily suspicious anu even a bit paianoiu, uespite youi effoits to ieassuie
him anu iegain iappoit. The next uay, the client shows up without an appointment anu
uemanus to see youi clinical notes. Youi BEST iesponse woulu be to:
a. Tell the client to make an appointment to ieview his iecoius.
b. Tell the client his is not peimitteu to see youi piivate notes.
c. Immeuiately give the client a photocopy of his iecoius.
u. uive the client the oiiginal iecoiu, aftei you have maue a copy.
7. Iuentify the uiffeience between psychotheiapy anu counseling.
a. Psychotheiapy is geneially consiueieu to be long-teim in natuie, anu counseling
to be moie shoit-teim.
b. Psychotheiapy uses a specific systems appioach, while counseling is less bounu
by theoiy.
c. Theie is no uiffeience between the two teims.
u. The teim psychotheiapy may only be useu piopeily when iefeiiing to
psychoanalysis.
8. You have just hau youi fiist session with a 24-yeai-olu college stuuent. She is seeing you
following the bieak-up of a two-yeai ielationship, which occuiieu without waining about
six weeks prior to this visit. As she explained it, “He met someone else and just moved on.”
She has been having tiouble sleeping anu concentiating on hei stuuies since that time.
Touay she piesents as uysphoiic anu teaiful, but is affectively expiessive anu iesponsive to
humoi anu othei inteiactive stimuli. The univeisity she attenus is a consiueiable uistance
fiom hei family anu fiienus, leaving hei with limiteu suppoit uuiing this uifficult time. The
most appiopiiate uiagnosis woulu be:
a. Piimaiy insomnia.
b. Najoi uepiession.
c. Aujustment uisoiuei with uepiesseu moou.
u. Acute stiess uisoiuei.
9. You woik foi a majoi coipoiation as a counseloi. The available seivices aie bioau, anu
incluue family theiapy anu couples counseling. You weie sought out by a husbanu,
expeiiencing significant maiital uiscoiu. Be is employeu by the coipoiation, anu he took the
fiist steps to entei couples counseling. Aftei a few sessions, it becomes cleai that the wife
has tiaits of a seiious Axis II uisoiuei, anu ovei time you begin seeing hei exclusively. It has
been two months since youi last contact with the husbanu. Please iuentify youi piimaiy
client.
a. The husbanu.
b. The wife.
c. The coipoiation.
u. The couple.
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1u. What piimaiy conuition is tieateu by monoamine oxiuase inhibitois (NA0Is),
seiotonin-noiepinephiine ieuptake inhibitois (SNRIs), anu selective seiotonin ieuptake
inhibitois (SSRIs).
a. Attention ueficit uisoiueis.
b. Eating uisoiueis.
c. Sleep uisoiueis.
u. Bepiessive uisoiueis.
11. You aie calleu to evaluate the 4-yeai-olu chilu of a Southeast Asian family. The chilu has
been ill foi some uays, anu was biought to the emeigency ioom with a tempeiatuie of 1u2°
anu symptoms of a pulmonaiy viial infection. Buiing the meuical examination, the
physician noted numerous long, reddened welts on the child’s skin, with superficial
ecchymosis (bruising) and petechiae (minute hemorrhages) across the child’s chest,
suggestive of some foim of abuse. Thiough an inteipietei, he leaineu that a healing
“shaman” had repeatedly performed a “coin rubbing” procedure in an attempt to draw out
“bad wind” or “bad blood.” You view the child’s back, and also see these marks. A nurse
notes that “coin rubbing” to induce healing is common among traditional Vietnamese,
Chinese, Bmong, Cambouians, anu Laotians. She suggests that theie is no neeu to iepoit it
as abuse. You don’t want to alienate the family or cause them to avoid seeking health care.
As a social woikei youi best iesponse woulu be to:
a. Concui with the nuise, anu close the case.
b. Call a local Southeast Asian cultuial centei to leain moie.
c. Call chilu piotective seivices anu let them ueciue.
u. Call the police anu iequest an investigation.
12. You have been calleu to see the family caiegivei of a S2-yeai-olu uevelopmentally
uelayeu uepenuent auult with a hanupiint biuise on his aim. The caiegivei iepoits having
to iestiain the patient foicibly when the patient tiieu to leave the facility anu iun into busy
tiaffic. The physician iepoits that the patient has no othei olu biuises, anu you see no
eviuence of feai on the pait of the patient when inteiacting with the caiegivei. You iealize,
howevei, that a iepoit must be fileu, uue to the natuie anu ciicumstances suiiounuing the
injuiy. Aftei inteiviewing the caiegivei anu consulting with the physician, he tells you that
his nuise will be calling Auult Piotective Seivices, so you neeu not bothei. The piopei
iesponse is:
a. To thank the physician anu nuise foi saving you this buiuen.
b. To call APS later and make sure that they received the nurse’s report.
c. To call the caie facility’s licensing board and make a report there.
u. To call Auult Piotective Seivices youiself.
! DC !
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1S. You aie woiking with a 42-yeai-olu executive who is coping with the aftei-effects of a
business failuie anu subsequent peisonal bankiuptcy. Be is geneially coping well, but he
ieveals a past histoiy of alcoholism anu inuicates that he is stiuggling with a uesiie to
iesume uiinking. You encouiage him to follow with an Alcoholics Anonymous gioup, but he
iesponus that he thinks he can manage without such help. You have a peisonal uiinking
histoiy youiself, anu you iecognize the waining signs. You then consiuei ievealing youi
peisonal stoiy anu bolstei youi iecommenuation that he seek help, to uemonstiate the level
of youi peisonal unueistanuing anu empathy, anu to motivate him to take fuithei action.
The BEST couise of action woulu be:
a. To withholu this infoimation, because it involves peisonal uisclosuie by a
theiapist in a piofessional counseling ielationship.
b. To shaie youi stoiy, because it is entiiely relevant to the client’s specific
situation.
c. To shaie youi stoiy, because the consequences if the client ietuins to uiinking
aie potentially seveie.
u. To uisclose limiteu infoimation, being caieful not to ieveal too much about youi
own histoiy, in oiuei to motivate the client.
14. You aie hiieu by a piivate piactice theiapist who opeiates a couit-supeiviseu violent
offenuei tieatment piogiam. 0ne of youi iesponsibilities is to scieen new client iefeiials, to
ensuie that only low-iisk, fiist-time offenueis aie accepteu into the piogiam. In this
piocess, you aie to have each client sign a tieatment consent foim, which also incluues a
uetaileu consent foi ielease of infoimation. You note that insteau of the usual time anu
taiget limits, the foim allows information to be released at any time to “any law
enforcement agency,” “any spouse, ex-spouse, or significant other,” “any welfare or abuse
protection agency,” etc. You ask about the ethics of having clients sign this foim, anu you
are told, “It’s a hassle to tiy anu get specific infoimation ieleases, anu the safety of the
public is at stake. Use the form.” Your BEST response is to:
a. 0se the foim as uiiecteu.
b. Refuse to use the foim.
c. Call youi licensing boaiu anu uiscuss the foim.
u. Call law enfoicement anu uiscuss the foim.
1S. A stuuy attempts to measuie the efficacy of a new antiuepiessant meuication. A
“control” group of depression sufferers will receive only a placebo, while an “intervention”
gioup will ieceive the new meuication. In this study, the “null hypothesis” would state the
following:
a. The inteivention gioup will iepoit fewei symptoms of uepiession than the
contiol gioup.
b. The contiol gioup will iepoit fewei symptoms of uepiession than the
inteivention gioup.
c. Both the contiol gioup anu the inteivention gioup will iepoit fewei numbeis of
uepiessive symptoms.
u. Theie shall be no measuiable uiffeience in uepiession symptom iepoiting
between the contiol gioup anu the inteivention gioup.
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16. In statistical iesearch, a “Type I Error” (also called an “alpha error,” or a “false positive”)
iefeis to:
a. Failing to ieject the null hypothesis when the null hypothesis is false.
b. A failuie to ianuomize ieseaich paiticipants, theieby potentially intiouucing
bias.
c. Rejecting the null hypothesis when the null hypothesis is tiue.
u. Assuming a noimal statistical uistiibution when it is skeweu.
17. In statistical research, a “Type II Error” (also called a “beta error” or “false negative”)
iefeis to:
a. A failuie to ieject the null hypothesis when the null hypothesis is false.
b. Eiioneously selecting a statistical analysis mouel baseu upon invaliu
assumptions.
c. Rejecting the null hypothesis when the null hypothesis is tiue.
u. Naking an eiioi in mathematical calculations, upon which a finuing is baseu.
18. The term “deinstitutionalization” refers to:
a. Belping a client accommouate to a community living enviionment aftei having
been institutionalizeu foi an extenueu peiiou (usually, yeais).
b. Cieating a tieatment piogiam that seives the neeus of the client, as opposeu to
the neeus of the institution.
c. Changes in policy anu law that leu to the ielease of many mental health patients
who woulu have otheiwise iemaineu in institutional settings.
u. A philosophy of client-theiapist collaboiation in tieatment, as opposeu to
hieiaichical theiapist-uiiven tieatment.
19. Accoiuing to Bush et al (2uuS), what peicentage of people who successfully commit
suiciue have maue a piioi attempt.
a. 76%
b. 2S%
c. 49%
u. less than 1u%
2u. In terms of quality assurance in social work practice, what does the acronym “CQI”
iepiesent.
a. Ceitification of Quality Institute.
b. Communication Quality Inuex.
c. Commanu of Quality Inuicatois.
u. Continuous Quality Impiovement.
21. Iuentify the missing step in Albeit R. Robeits seven-stage ciisis inteivention mouel: 1)
assess lethality; 2) establish iappoit; S) __________; 4) ueal with feelings; S) exploie
alteinatives; 6) uevelop an action plan; 7) follow-up. The thiiu step is:
a. Evaluate iesouices.
b. Iuentify pioblems.
c. Enviionmental contiol.
u. Collateial contacts.
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22. Critical Incident Stress Debriefing” (CISD) refers to:
a. A quality impiovement plan foi ciisis counselois.
b. A methou for reducing stress in “first-responders.”
c. A communication-baseu stiess evaluation technique.
u. A way to iank the stiess inheient in vaiious encounteis.
2S. Accoiuing to }.W. Biisko (2uu9), the five key factois iequiieu foi a quality theiapeutic
ielationship between client anu clinician aie: 1) affective attunement; 2) mutual
affiimation; S) joint effoits to iesolve missteps; 4) __________; anu S) using vaiying types of
empathy. The fouith key factoi is:
a. 0se of humoi.
b. Accepting ciiticism.
c. Capacity to tiust.
u. uoal congiuence.
24. A woman uesciibes heiself as happily maiiieu, yet she occasionally engages in episouic
sexual contacts with othei men. When askeu what motivates hei episoues of infiuelity, she
pioviues a iathei vague initial response and finally states, “I guess I just don’t know.”
Accoiuing to Fieuu, what aiea of cognition is involveu in hei behavioi.
a. The subconscious minu.
b. The pieconscious minu.
c. The conscious minu.
u. The unconscious minu.
2S. Fieuu uesciibeu the concept of pain (whethei physical oi emotional) as aiising thiough
the psychic piocess of:
a. Repiession.
b. Intiojection.
c. Cathexis.
u. Fixation.
26. You meet with a client who has been stiuggling financially. It becomes appaient that he
must ieuuce his stanuaiu of living in oiuei to maintain financial solvency. Be theiefoie sells
his laige luxuiy automobile anu puichases a small but ieliable economy vehicle, iealizing
considerable savings. According to Heinz Hartmann’s “Ego Psychology” this kind of
accommouation is an example of:
a. Befensive functioning.
b. Alloplastic behavioi.
c. Integiative functioning.
u. Autoplastic behavioi.
27. According to “Object Relations Theory,” an infant’s separation and individuation from its
mothei shoulu laigely be complete by the time the infant is ageu:
a. 24 months.
b. Five months.
c. 14 months.
u. Nine months.
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28. Self-Psychology, as postulateu by Beinz Kohut, acknowleuges that peisonality is paitly
foimeu by social stiuctuie. A cohesive self is achieveu by incoipoiating the peiceptions anu
functions of healthy significant otheis anu objects into an inteinalizeu self stiuctuie
thiough a piocess calleu:
a. Empathic miiioiing.
b. Rappiochement.
c. Biffeientiation.
u. Tiansmuting inteinalization.
29. The piimaiy focus of uestalt Psychology, as founueu by Fieueiick Peils, is on:
a. The uevelopmental issues anu the past, as they influence the piesent.
b. The “here and now.”
c. Auaptation anu the futuie.
u. Noial uevelopment.
Su. According to Erik Erikson’s model of the Psychosocial Stages of Development,
inuiviuuals ovei the age of Su aie moving into the following stage:
a. Ego integiity veisus uespaii.
b. Intimacy veisus isolation.
c. Iuentity veisus iole confusion.
u. ueneiativity veisus stagnation.
S1. The capacity to unueistanu ueath is a uevelopmental piocess. Fiom ages 2-S, ueath is
not unueistoou as peimanent anu may be vieweu as sleep. Fiom ages S-9, death’s
peimanence may be iecognizeu, but some chiluien may not unueistanu it will happen to
them (exteinal symbols such as angels anu skeletons pieuominate). By age ten (but moie
often aiounu age seven, especially if loss of a pet oi loveu one has occuiieu), ueath is
unueistoou as peimanent, iiieveisible, anu inevitable. The two uevelopmental stages that
encompass these incieasingly elaboiate unueistanuings (in ascenuing oiuei), as iuentifieu
by Piaget, aie:
a. Foimal opeiational, conciete opeiational.
b. Pie-opeiational, foimal opeiational.
c. Pie-opeiational, conciete opeiational.
u. Sensoiimotoi, pie-opeiational.
S2. An eaily cognitive theoiist, who woikeu uiiectly with Fieuu, establisheu a theoietical
orientation that differed from Freud’s in three key features: 1) an individual’s personality is
best peiceiveu as a whole, iathei than as having hieiaichical segments oi paits; 2) social
ielationships uiive behavioi moie than sexual motivations; anu S) cuiient beliefs anu
thoughts play a fai gieatei iole in human behavioi than is suggesteu via psychoanalytic
theoiy, which is baseu laigely in the unconscious anu in past expeiiences anu beliefs. The
name of this theoiist is:
a. Lawience Kohlbeig.
b. Anna Fieuu.
c. Albeit Ellis.
u. Alfieu Aulei.
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SS. Which cognitive-behavioi appioach incoipoiates a theoiy of emotion known as the
“ABC Theory of Emotion”?
a. Ninufulness-baseu cognitive theiapy.
b. Rational emotive theiapy.
c. Functional analytic psychotheiapy.
u. Cognitive analytic theiapy.
S4. In woiking with a client, you become awaie that she peisistently behaves in ways to
please oi gain the appioval of otheis. While this is not always pioblematic, you uiscovei
that she is obsessed with wearing the “right” clothes, living in the “right” neighborhood, and
marrying the “right” peison. At piesent, hei finances aie in a shambles as she tiies
desperately to “keep up with the Joneses,” and her romantic life is suffering, as she only
puisues ielations that she believes otheis think aie optimum, iathei than juuging
ielationships on moie peisonally ielevant values, such as hei feelings foi them, baseline
compatibility, etc. Utilizing Kohlberg’s Theory of Moral Development, specify the Level and
Stage of moial uevelopment that applies to this inuiviuual:
a. Conventional Level, Stage S.
b. Pie-conventional Level, Stage 1.
c. Post-conventional Level, Stage 6.
u. Conventional Level, Stage 4.
SS. Name the foui kinus of ieinfoicement useu in 0peiant Conuitioning Theoiy, as
establisheu by B.F. Skinnei:
a. Positive ieinfoicement, conuitioneu stimulus, consequence iesponses, anu
negative ieinfoicement.
b. Negative ieinfoicement, punishment, conuitioneu iesponses, anu anteceuent
events.
c. Consequence iesponses, uepiivation iesponses, iewaius, time-out iesponses.
u. Positive ieinfoicement, negative ieinfoicement, punishment, anu extinction.
S6. Iuentify the foui steps (in the piopei oiuei) that Albeit Banuuia foimulateu to
opeiationalize Social Leaining Theoiy:
a. Attention, ietention, iepiouuction, motivation.
b. Attention, motivation, ietention, iepiouuction.
c. Notivation, ietention, iepiouuction, attention.
u. Repiouuction, motivation, attention, ietention.
S7. You have a client expeiiencing significant cognitive uissonance. She consiueis heiself as
a veiy piincipleu peison, anu holus heiself to veiy high stanuaius of conuuct. She veiy
openly condemns drinking, gambling, and other “vices,” yet she reveals that she has long
stiuggleu with a uesiie to gamble. Bei veiy vigoious uenunciations of gambling, even while
haiboiing a uesiie heiself, constitute the application of what uefense mechanism.
a. Piojection.
b. Rationalization.
c. Reaction foimation.
u. Substitution.
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S8. You have been contacteu by a couple to assist them with issues of maiital uiscoiu. They
have been maiiieu about six months. The wife piesents as vulneiable, teaiful, anu anxious,
anu the husbanu piesents as angiy anu oveiwhelmeu. The wife openly claims that “he has
never loved me,” and expresses anger that he married her without “the proper feelings.”
The husband responds that he has “done everything possible” to “prove” his love (to the
point of neai bankiuptcy anu jeopaiuizing his employment with fiequent absences), but
nothing is sufficient. Buiing the inteiview, you uiscovei that she has hau many shoit-teim
relationships in the past, that she has a history of suicide gestures and “fits of rage.” Further,
she fiequently uemanus a uivoice anu then begs him to stay, is ioutinely physically
assaultive, etc. The most likely uiagnosis is:
a. Inteimittent explosive uisoiuei.
b. Bistiionic peisonality uisoiuei.
c. Paianoiu peisonality uisoiuei.
u. Boiueiline peisonality uisoiuei.
S9. Bevelopmentally, a chilu that can walk inuepenuently both siueways anu backwaius,
climb staiis, thiow objects, jump with two feet, anu that knows seveial woius anu shoit
phiases woulu be appioximately:
a. 9-12 months olu.
b. 1S-17 months olu.
c. 18-19 months olu.
u. Two yeais olu.
4u. Identify the gender and typical age when the “Electra Complex” occurs:
a. Females, S-7 yeais of age.
b. Nales, S-6 yeais of age.
c. Females, 8-12 yeais of age.
u. Nales, 6-12 yeais of age.
41. A gioup of inuiviuuals with one oi moie chaiacteiistics (social, physical, ieligious, oi
cultuial) iuentifieu as being suboiuinately uistinct in a laigei societal context is iefeiieu to
as a:
a. Beteiogeneous gioup.
b. Ninoiity gioup.
c. Taiget gioup.
u. Bomogenous gioup.
42. All but one of the following aie National Association of Social Woikeis (NASW)
stanuaius foi cultuial competence:
a. Social woikeis shoulu enueavoi to seek out, employ, anu ietain employees who
pioviue uiveisity in the piofession.
b. Social woikeis shall enueavoi to iesouices anu seivices in the native language
of those they seive, incluuing the use of tianslateu mateiials anu inteipieteis.
c. Social woikeis shoulu uevelop the skills to woik with clients in cultuially
competent ways, anu with iespect foi uiveisity.
u. Social woikeis shoulu woik with uiveise clients only if they have hau specific
training in that client’s unique cultural backgrounu.
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4S. Cultuial competence in inuiviuual social woik piactice is best uefineu as:
a. The ability to woik well with uiveise gioups.
b. Receiving excellent tiaining in uiveisity.
c. The possession of a wiue-ianging knowleuge of many uiveise gioups.
u. The ability to iecognize steieotypes, piejuuiceu views, anu biases.
44. Basing one’s feelings, attitudes, and beliefs regarding a specific group of people upon
pieconceiveu iueas, iumois, anu infeiences is BEST uefineu as:
a. Bias.
b. Piejuuice.
c. Steieotyping.
u. Singling out.
4S. Basing the oppoitunities, options, anu benefits available to a specific gioup of people
baseu upon pieconceptions anu assumptions is BEST uefineu as:
a. Bigotiy.
b. Bisciimination.
c. Piejuuice.
u. Nisogyny.
46. Iuentify the foui most common minoiity classifications:
a. Ethnicity, genuei, sexual oiientation, cultuie.
b. Religion, iace, genuei, sexual oiientation.
c. Age, appeaiance, social stanuing, genuei.
u. Age, genuei, iace, sexual oiientation.
47. The belief that youi peisonal backgiounu (i.e., iace, cultuie, ieligion, etc) is supeiioi to
that of otheis is known as:
a. Steieotypy.
b. Racism.
c. Ethnocentiism.
u. Elitism.
48. Iuentify the five classifications of iace most commonly useu:
a. Asian, Black, Bispanic, Native Ameiican, White.
b. Asian, Black, Native Ameiican, Spanish, White.
c. Afiican, Asian, Inuian, Spanish, White.
u. Asian, Black, Nexican, Native Ameiican, White.
49. Piesenting symptoms that may appeai to ieflect fiom mental illness, but which actually
aiise fiom specific cultuial piactices, beliefs, oi values, aie iefeiieu to as:
a. Belief-baseu symptoms.
b. Iatiogenic symptoms.
c. Factitious synuiomes.
u. Cultuie-bounu synuiomes.
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Su. In obtaining an inteipietei foi a non–English-speaking client, youi best option woulu be
to select:
a. Anothei staff peison at the facility oi agency.
b. A piofessional inteipietei.
c. A fiienu of the client.
u. A ielative of the client.
S1. 0pon fiist meeting a client, a theiapist shoulu begin by taking the following steps (in the
oiuei listeu):
a. Summaiize legal anu ethical obligations, complete a counseling contiact, exploie
the client’s presenting pioblem, anu assess the client.
b. Complete a seivice contiact, summaiize legal anu ethical obligations.
c. Establish iappoit, summaiize legal anu ethical obligations, complete a seivice
contiact, anu assess the client.
u. Assess the client, summaiize legal anu ethical obligations, complete a seivice
contiact, anu establish a iappoit.
S2. A form of client assessment that focuses on a client’s social and relational functioning is
known as:
a. A genogiam.
b. A social status examination.
c. A social iesouice ieview.
u. A social assessment iepoit.
SS. A uiagiam that helps inuiviuual anu families to visually uepict the quality of inuiviuual
anu¡oi family ielationships with otheis, within a community, anu with impoitant iesouices
in theii lives (e.g., foou, sheltei, woik, school, health caie, etc) is calleu:
a. An eco-map.
b. A family uiagiam.
c. A genomap.
u. A ielational uiagiam.
S4. Assessing a client by means of a checklist oi questionnaiie is paiticulaily useful when:
a. The client doesn’t want to see the therapist.
b. The client is unsuie how to uesciibe the situation, oi if it is complex oi iisk
lauen anu the theiapist neeus to be thoiough.
c. The theiapist is too busy to see the client peisonally.
u. The theiapist wishes to avoiu a client inteiview.
SS. Iuentify the most commonly useu intelligence measuiement scale:
a. Wechslei-Bellevue Intelligence Scale.
b. Stanfoiu-Binet Intelligence Scale.
c. Binet-Simon Intelligence Scale.
u. Wechslei Auult Intelligence Scale.
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S6. The Biagnostic anu Statistical Nanual of Nental Bisoiueis (BSN), in its cuiient veision
(the BSN-Iv-TR), is useu to uiagnosis mental uisoiueis. It also allows foi the entiy of
ielateu factois thiough a multi-axial couing appioach. Name the piopei axis (in the
coiiesponuing oiuei) foi entiy of each of the following: a) the ulobal Assessment of
Functioning; b) ielevant physical uisoiueis; c) peisonality uisoiueis anu mental
ietaiuation; u) ielevant psychosocial factois; anu e) clinical uisoiueis:
a. Axis I; Axis III; Axis II; Axis Iv; anu Axis v.
b. Axis v; Axis III; Axis II; Axis Iv; anu Axis I.
c. Axis II; Axis Iv; Axis III; Axis v; anu Axis I.
u. Axis Iv; Axis III; Axis II; Axis v; anu Axis I.
S7. Inuicate the kinu of coues useu to iuentify conuitions that aie a focus of clinical
attention, but foi which insufficient infoimation exists to ueteimine if the issues can be
attiibuteu to a mental uisoiuei (oi which may, in fact, not be uue to a mental uisoiuei but
still iequiie clinical attention):
a. BSN coues.
b. uAF coues.
c. v Coues.
u. ICB Coues.
S8. The piocess by which a client anu theiapist ieview past goals, summaiize piogiess
maue, anu finalize plans to maintain anu continue past piogiess is calleu:
a. Closuie.
b. Wiap-up.
c. Finalization.
u. Teimination.
S9. A client with an intelligence quotient (IQ) of 76 shoulu be given a uiagnosis of:
a. Nilu mental ietaiuation.
b. Boiueiline intellectual functioning.
c. Noueiate mental ietaiuation.
u. Seveie mental ietaiuation.
6u. You aie seeing a 16-yeai-olu youth who has, foi the past yeai, been losing his tempei
fiequently, is iegulaily aigumentative with auults, often iefuses to follow uiiect iequests, is
easily annoyeu, anu ioutinely uses blaming to escape iesponsibility. Appioximately foui
months ago he was caught in a single episoue of shoplifting. The most appiopiiate uiagnosis
foi this youth is:
a. 0ppositional uefiant uisoiuei.
b. Conuuct uisoiuei.
c. Impulse-contiol uisoiuei.
u. Bisiuptive behavioi uisoiuei, not otheiwise specifieu.
61. Encopiesis is uefineu as:
a. The voluntaiy oi involuntaiy passage of stool in an inappiopiiate place by a
chilu ovei the age of foui.
b. The voluntaiy oi involuntaiy passage of stool in an inappiopiiate place by a
competent auult.
c. Belibeiate fecal incontinence only in a chilu ovei age foui.
u. Involuntaiy fecal incontinence only in a uevelopmentally uelayeu auult.
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62. The following ciiteiia aie all useu to uistinguish ueliiium fiom uementia, except one.
Select the paii that is not useu to uistinguish ueliiium fiom uementia:
a. Acute onset vs slow onset.
b. Biagnosis in patients unuei age 6S vs patients ovei age 6S.
c. Consciousness fluctuates bioauly vs ielatively stable symptoms.
u. ulobal cognitive impaiiments vs iuiosynciatic cognitive impaiiments.
6S. The following ciiteiia aie all useu to uistinguish substance abuse fiom substance
uepenuence except:
a. Symptoms of substance abuse aie usually less seveie than those of uepenuence.
b. The pioblematic effects of abuse aie usually limiteu to family, finances,
employment, anu legal issues (e.g., uiiving unuei the influence), while
uepenuence also involves significant physiological pioblems.
c. Substance abuse typically involves naicotics, while uepenuence typically
involves non-naicotic uiugs.
u. Abuse is typically limiteu to iecieational use, while uepenuence involves the
neeu foi incieasing uoses foi the uesiieu effect anu withuiawal symptoms of not
useu iegulaily.
64. Name the foui classic diagnostic “A’s” of schizophrenia:
a. Awaieness, ambivalence, autism, anu associations.
b. Agitation, awaieness, associations, anu autism.
c. Affect, anxiety, ambivalence, anu awaieness.
u. Affect, associations, ambivalence, anu autism.
6S. A S2-yeai-old man has been referred to see you for “family and work problems.” Two
months ago he lost his job as an executive in a majoi coipoiation, anu has not founu new
woik. 0n intake you uiscovei his uiinking has incieaseu, anu he iepoits feeling uepiesseu
most days. He can’t seem to enjoy doing anything, not even golf, which he used to love.
Rather, all he can seem to do is sleep and “sit around the house.” He feels useless, empty,
anu helpless to change his situation. Be has tiieu ieauing the want-aus, but he just can’t
seem to focus. He’s gained over 18 lbs. He then adds, “Sometimes I seem to hear voices,
telling me I’m just ‘no good,’ and that things will never get better. When that happens, I try
to plug my ears, but it doesn’t help. Only booze seems to get the voices to stop. Bo you think
I’m going crazy?” What is the client’s probable primary diagnosis?
a. Najoi uepiession.
b. Najoi uepiession with psychotic featuies.
c. Alcohol-inuuceu moou uisoiuei.
u. Alcohol-inuuceu psychotic uisoiuei, with hallucinations.
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66. You aie calleu to a hospital emeigency ioom to see a 26-yeai-olu univeisity stuuent. Be
came in claiming he was having a heait attack, but the meuical woik-up was entiiely
negative. You leain that he has been spenuing his nights sleeping in his cai outsiue the
emergency room, worried that he’s going to have a heart attack. He notes that at night his
chest begins to tighten, his heait staits iacing, his mouth goes uiy, anu his bieathing
becomes uifficult. Next, his palms become sweaty anu his hanus stait to tiemble anu tingle.
Then he feels dizzy, nauseous, and worries that he’s about to die. This is been going on for
about six weeks. His studies have suffered, and he’s becoming depressed and overwhelmeu.
Be has no substance abuse histoiy. Finally, he notes that his uau uieu of a heait attack at
about his same age. Bis most likely uiagnosis is:
a. Panic uisoiuei with agoiaphobia.
b. ueneializeu anxiety uisoiuei.
c. Acute stiess uisoiuei.
u. 0bsessive-compulsive uisoiuei.
67. You have been askeu to see a 1S-yeai-olu giil foi pioblems with bouy image anu eating.
Aftei speaking with hei, you uiscovei that she suffeis with an intense uesiie to lose weight,
feeling that this will help hei be moie attiactive to the opposite sex anu moie populai in hei
social circle. She is by no means obese or even “chubby” although she is not overly slender.
Bei paients iecently noteu an inciease in gioceiy costs, anu that foou seemeu to be
uisappeaiing aiounu the house inoiuinately quickly—often “junk” food and other quick
snacks. Finally, late one night, hei mothei passeu the bathioom anu heaiu the uaughtei
“purge” her foou. She confionteu hei anu uiscoveieu that the uaughtei hau been
“binge” eating and inducing vomiting for some weeks. Some mouest weight loss hau
occuiieu. The most appiopiiate uiagnosis woulu be:
a. Anoiexia neivosa, puiging type.
b. Anoiexia neivosa, iestiicting type.
c. Bulimia neivosa, puiging type.
u. Eating uisoiuei, not otheiwise specifieu.
68. You aie calleu to see a young black man in his miu-twenties. Two auult sisteis biought
him foi an uigent appointment. The young man is clean, neatly uiesseu in slacks, uiess
shoes, anu a tweeu spoit coat. Be is also calm, ielaxeu, anu without any signs of agitation.
The two sisteis, howevei, appeai uisheveleu, fiazzleu, anu almost histiionic. They bluit out
the he “has problems” and urge you to talk with him. Privately, he tells you that he is fine.
Latei, howevei, the lauies tell you he left home abiuptly anu tiaveleu cioss-countiy with no
destination. He didn’t sleep for three days (with them pursuing him), was spending money
excessively and writing checks he couldn’t cover. He ended up in a nationally famous
amusement paik at S:uu a.m. (having scaleu a fence), sitting on an empty iolleicoastei
“waiting for the ride to start.” When confronted, he admits all of this, but says he’s now
iesteu, anu uoing bettei. The most likely uiagnosis woulu be:
a. Biief psychotic uisoiuei.
b. Bipolai I, single manic episoue, in full iemission.
c. Bipolai I, single hypomanic episoue, in full iemission.
u. Cyclothymic uisoiuei.
! EFD !
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69. Peisonality uisoiueis aie peivasive anu enuuiing patteins of uysfunction. The BSN
pioviues foi the uiagnosis of ten specific peisonality uisoiueis, anu one categoiy foi
inueteiminate behaviois that appeai to chaiacteiistic of a peisonality uisoiuei. All aie
coueu on Axis II of the multiaxial BSN uiagnostic schema. These uisoiueis aie gioupeu into
thiee clusteis. Iuentify the clustei that uoes not piopeily uesciibe a peisonality uisoiuei
gioup:
a. Clustei A: Paianoiu, Schizoiu, anu Schizotypal Bisoiueis (also iefeiieu to as
“odd or eccentric behavior disorders”).
b. Clustei B: Impulsivity anu¡oi Affective Bysiegulation Bisoiueis (also iefeiieu to
as “dramatic, emotional, or erratic disorders”).
c. Cluster B: Violent and/or Explosive Disorders (also referred to as “aggressive
and intrusive conduct disorders”).
u. Cluster C: Anxiety and Compulsive Disorders (also referred to as “anxious or
feaiful disorders”).
7u. As a school counseloi, you aie scheuuleu to see a 9-yeai-olu boy iegaiuing uisiuptive
behavioi in the classioom. Rathei than begin with an office visit, you uiiectly obseive his
behavioi in the classioom. Theie you noteu the following: he seemeu to constantly fiuget
anu squiim in his seat; he talkeu nonstop; he was fiequently out of his seat, iunning,
touching, and playing with anything and everything he could reach. The teacher’s efforts to
quiet him appeaieu to be foigotten almost instantly. When an ait peiiou was begun, which
engageu most chiluien, he still hau uifficulty as he was easily uistiacteu anu seemeu to
switch constantly fiom one activity to anothei. Be appeaieu unable to slow uown long
enough to ieceive even simple anu cleai instiuctions. The few moments he was quiet, he
seemeu lost in uayuieaming, staiing out the classioom winuows. The most likely uiagnosis
foi this youngstei is:
a. Attention ueficit hypeiactivity uisoiuei (AB¡BB)
b. Conuuct uisoiuei.
c. 0bsessive compulsive uisoiuei.
u. 0ppositional uefiant uisoiuei.
71. The peispective fiom which a social woikei appioaches client inteiactions shoulu be
baseu upon a blenu of: 1) time anu iesouices available; 2) the tieatment mouality iequiieu
(inuiviuual, family, gioup); S) the issues to be auuiesseu; 4) the outcomes (goals) sought;
anu S) an appiopiiate theoietical fiamewoik. Taken togethei, this uefines the social
worker’s:
a. Theoietical oiientation.
b. Piactice fiamewoik.
c. Clinical appioach.
u. Nouel of inteiaction.
72. A practice framework that acknowledges and accounts for a client’s overall context in:
1) social setting (family, peeis, neighboihoou, etc); 2) social ielations quality (e.g., with
othei family membeis, fiienus, cowoikeis, etc); S) exteinal piessuies (woik, oiganizations,
etc); 4) cultuie; anu S) life-couise events (maiiiage, biiths, ietiiement, etc) is calleu a(n):
a. Ecosystems fiamewoik.
b. Cultuial fiamewoik.
c. Stiengths fiamewoik.
u. ueneialist fiamewoik.
! EEF !
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7S. A piactice fiamework that approaches a client’s issue or presenting problem from the
peispective of genuei, sex ioles, anu ielateu steieotyping anu uisciimination, along with the
influence that these elements may biing to beai on the issue oi piesenting pioblem, is
calleu a:
a. uenuei fiamewoik.
b. Roles fiamewoik.
c. Stiengths fiamewoik.
u. Feminist fiamewoik.
74. A practice framework that approaches a client’s issue or presenting problem with
paiticulai sensitivity anu attention to: cultuie, ethnicity, anu¡oi ieligion (oi othei similai
perspective that is integral to the client’s definition of self) is called a(n):
a. Cultuial fiamewoik.
b. Systems fiamewoik.
c. Ethnic-sensitive fiamewoik.
u. Stiengths fiamewoik.
7S. A theiapeutic appioach that views the client fiom a social context, that sees behavioi as
ueiiveu fiom unconscious uiives anu motivations, that views uisoiueis anu uysfunction as
emeiging fiom inteinal conflicts anu anxiety, anu that seeks to facilitate the conscious
awaieness of pieviously iepiesseu infoimation is calleu a:
a. Cognitive appioach.
b. Psychoanalytic appioach.
c. uestalt appioach.
u. Behavioi appioach.
76. If a client has uifficulty woiking with a paiticulai theiapist because the theiapist
ieminus hei of hei fathei, anu the theiapist is stiuggling to woik well with the client
because she has stiong tiaits ieminiscent of those of his ex-spouse, the client anu the
theiapist (iespectively) aie expeiiencing issues known as:
a. Inuiviuuation¡sepaiation conflicts.
b. Sepaiation¡inuiviuuation conflicts.
c. Tiansfeience¡counteitiansfeience conflicts.
u. Counteitiansfeience¡tiansfeience conflicts.
77. Collectively, the elements of engagement (builuing iappoit, tiust, etc), contiacting
(iuentifying goals anu iesponsibilities), tieatment piocesses, anu teimination (ieviewing
goals achieveu anu ways to inuepenuently fuithei piogiess, etc) aie known as:
a. The phases of tieatment.
b. The counseling piocess.
c. The theiapeutic piocess.
u. Collaboiative pioblem-solving.
! EEE !
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78. A theiapeutic appioach that views issues of uysfunction fiom the peispective of
behavioi (as opposeu to emotional anu mental pioblems), that uiscounts uelving into past
histoiy anu unconscious motivations in favoi of conuitioning, ieinfoicement, consequences,
anu conscious choice woulu best be iefeiieu to as a:
a. uestalt appioach.
b. Cognitive appioach.
c. Behavioial appioach.
u. Task-centeieu appioach.
79. A theiapeutic appioach that views thoughts anu cognition as uiiectly iesponsible foi
emotions anu behaviois, that sees the change of false beliefs anu misconceptions as the
piimaiy task, that is highly pioblem-focuseu anu goal-uiiecteu, anu that is oiienteu towaiu
the heie anu now (as opposeu to the past) is best uesciibeu as a:
a. Task-centeieu appioach.
b. Ciisis inteivention appioach.
c. uestalt appioach.
u. Cognitive appioach.
8u. Tieatment concepts anu techniques such as uieam analysis, exploiation of the past, fiee
association (saying anything that comes to minu in oiuei to exploie unconscious thoughts),
ventilation, sustainment (encouiagement, ieassuiance, etc), confiontation (to oveicome
“resistance”), and direct influence (advice and direction) are all associated with:
a. Behavioial mouification.
b. Psychoanalysis.
c. uestalt theiapy.
u. Cognitive theiapy.
81. Tieatment concepts anu techniques such as iuentification of taiget behaviois,
anteceuents, ieinfoiceis (positive anu negative), consequences, etc, along with tiacking
mechanisms (tally sheets, chaits, etc), jouinal-keeping iegaiuing specific occuiiences
(when, wheie, with whom, etc), anu ielateu feelings (incluuing intensity, fiequency, etc) aie
all associateu with:
a. Behavioial theiapy.
b. uestalt theiapy.
c. Psychoanalytic theiapy.
u. Cognitive theiapy.
82. Tieatment concepts anu techniques such as claiification (feeuback anu illumination of
misconceptions), explanation (education regarding misconceptions, thought “triggers” and
seconuaiy thoughts, beliefs, anu actions), inteipietation (insight uevelopment), paiauoxical
uiiection (having the client engage oi continue behaviois neeuing coiiection to enhance
awaieness anu inuuce a sense of contiol), ieflection (ieviewing), anu wiiting (uiagiamming
misconceptions anu analyzing thoughts, etc) aie all associateu with:
a. uestalt theiapy.
b. Psychoanalytic theiapy.
c. Cognitive theiapy.
u. Task-centeieu theiapy.
! EEG !
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>9' %,+0( (0&(%26;,)%9 %( (02)<,()86,)%9 )< <,();,:' &(%+)8),024 >:: ()*+,< (0<0(7024
8S. A theiapeutic appioach that teaches a phenomenological methou of awaieness, with a
focus on immeuiate peiceptions, feelings, anu actions as sepaiate fiom inteipieting anu
iecapitulating pieexisting attituues, anu wheie explanations anu inteipietations aie set
asiue in favoi of what is uiiectly peiceiveu anu felt is calleu:
a. Cognitive theiapy.
b. Psychoanalytic theiapy.
c. Task-centeieu theiapy.
u. uestalt theiapy.
84. A theiapeutic appioach that focuses solely on changing behaviois anu issues that the
client (as opposeu to the theiapist) believes to be pioblematic, anu that views behaviois as
fully conscious acts, anu that views inuiviuuals as fully able to contiol theii actions anu
make neeueu changes is calleu:
a. Ciisis inteivention.
b. Task-centeieu theiapy.
c. Psychoanalytic theiapy.
u. Cognitive theiapy.
8S. Treatment concepts and techniques such as “dialogue” (using the “empty chair”
technique – i.e., talking with an absent person to reveal inner conflicts), “enactment of
dreams,” “exaggeration” (dramatizing a physical or verbal action in order to enhance
awareness), “exposure of the obvious” (also to enhance client awareness), and “rehearsal”
(piacticing feelings, thoughts, anu behaviois in piepaiation foi change) aie useu to engage
and overcome barriers such as “confluence” (a preoccupation with false similarities while
ignoiing oi uenying uiffeiences), “introjection” (an over-iuentification anu integiation of
messages from others), “projection” (attributing one’s own dysfunctional personality traits
to others), and “retroflection” (doing to oneself what one wishes to do to another), which
aie all associateu with:
a. Task-centeieu theiapy.
b. Ciisis inteivention.
c. uestalt theiapy.
u. Behavioial theiapy.
86. A theiapeutic appioach that sees peiious of intense tiauma as optimal foi effecting
change, anu that seeks to equip clients with new anu¡oi moie effective coping skills to
manage tiaumatic situations is known as:
a. Cognitive theiapy.
b. Behavioial theiapy.
c. Task-centeieu theiapy.
u. Ciisis inteivention.
87. A theiapeutic appioach that views the family as a cential souice of stiength anu suppoit
foi inuiviuuals, that views the family as composeu of multiple subsystems (i.e., spousal,
paient-chilu, anu sibling subsystems), anu views that uysfunction anu conflict in any one
subsystem can penetiate anu affecting the othei subsystems is calleu:
a. Family theiapy.
b. Ciisis inteivention.
c. Systems theiapy.
u. Behavioial theiapy.
! EE# !
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88. A theiapeutic appioach that aiises fiom the belief that inuiviuual in similai situations
can iuentify with, comfoit, ieassuie, anu help one anothei is calleu:
a. uioup theiapy.
b. Conjoint theiapy.
c. Collective theiapy.
u. Systems theiapy.
89. The concepts of “preaffiliation” (becoming acquainted), “power and control” (setting the
roles), “intimacy” (developing cohesion), “differentiation” (independent opinion
expression), and “separation” (moving to closure and termination) are all stages in:
a. The lifecycle of a theiapeutic ielationship.
b. ueneial ielationship cycles.
c. uioup uevelopment.
u. Team cohesion.
9u. Tieatment concepts anu techniques laigely oiienteu aiounu immeuiate pioblem-
solving, stiess ieuuction, coping skill enhancement, suppoit system builuing, anu emotional
buffeiing aie piimaiily associateu with:
a. uiief theiapy.
b. Ciisis inteivention.
c. Task-centeieu theiapy.
u. Shoit-teim theiapy.
91. Specific treatment approaches, such as the “communications approach” (which sees
communication deficits as central to interpersonal dysfunction), the “structural approach”
(which views inteipeisonal inteiactions as central to dysfunction), the “social learning
approach” (focusing on improving interactive skills such as conflict resolution and
communication), and the “narrative approach” (using personal stories, ideas, thoughts, etc,
anu ievisions, to uiscovei anu implement new behavioi patteins) aie associateu with:
a. uioup theiapy.
b. Cognitive theiapy.
c. Behavioial theiapy.
u. Family theiapy.
92. All of the following aie kinus of gioup theiapy stiuctuies except one:
a. Natuial gioups (gioups which coalesce inuepenuently, anu seek a moueiatoi
only latei – such as a uivoice gioup).
b. Foimeu gioups (gioups foimeu aiounu a specific issue oi to achieve a ceitain
goal).
c. Foiceu gioups (gioups aiising fiom couit oiueis, insuiance manuates, oi othei
ciiteiia iequiiing attenuance).
u. Shoit-teim gioups (gioups oiienteu aiounu a ciisis situation |e.g.,
hospitalization of a loveu onej oi othei shoit-teim event, such as biith
piepaiation, etc).
! EE? !
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9S. The following five stage sequence is ieflective of a theiapeutic mouality: 1) a significant
stiessoi oi uisastious event; 2) an inciease in vulneiability anu anxiety (escalating when
coping skills are overwhelmed); 3) a “last straw” event that motivates help seeking; 4) a
peiiou of tuimoil anu confusion; anu S) the use of new coping skills, coupleu with
acceptance anu accommouation of change. The theiapeutic mouality is:
a. Cognitive theiapy.
b. Ciisis inteivention.
c. Behavioial theiapy.
u. Psychoanalytic theiapy.
94. Effective gioup leaueiship involves all but one of the following:
a. Reciuiting membeiship to ensuie a laige anu uiveise population, iueally
consisting of moie than 2u gioup membeis.
b. 0nconuitional positive iegaiu foi anu non-juugmental acceptance of gioup
membeis.
c. Pieseiving an effective, safe, anu nuituiing gioup enviionment (ensuiing
quality information is shared, dispelling myths, deflecting “ganging up,”
“pairing,” “scapegoating,” and clique [subgroup] development by some
membeis, etc).
u. Consciously using bouy language to facilitate communication anu openness.
9S. A theoietical appioach that believes that inuiviuuals, families, anu gioups aie all pait of
a greater whole, with “boundaries” (invisible lines of separation) between each, that change
in any one will iesult in change in the others, and that “entropy” describes the de-
oiganization of any oi all of these paits of the whole, but which notes that they tenu towaiu
“homeostatic balance” and resist entropy, is called:
a. Integiation theoiy.
b. uioup theoiy.
c. Bolistic theoiy.
u. Systems theoiy.
96. A theoietical appioach that focuses on the ielationship between living things anu theii
social and physical environment, and that sees “adaptation” as the process by which
inuiviuuals anu enviionments accommodate each other in seeking a “goodness of fit,” and
that views uysfunction as a failuie to coopeiate anu accommouate is calleu:
a. Systems theoiy.
b. Ecosystems theoiy.
c. Ecological theoiy.
u. Conseivation theoiy
! EE@ !
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97. A theiapeutic appioach that involves “field theory” (where everything that happens is
inteiielateu thiough a laigei netwoik of inteiactions, anu can only be fully unueistoou in
the context of the interrelatedness), “figure/ground formation” (which suggests that
whatevei is most impoitant in the heie anu now becomes figuial anu invites attention,
leaving everything else to drift into the background), exploration of “resistances,” the
processing of “introjects” (messages internalized in childhood), and the use of
“experiments” to increase awaieness anu giowth is calleu:
a. Existential theoiy.
b. Cognitive theoiy.
c. uestalt theoiy.
u. Systems theoiy.
98. A theiapeutic appioach that focuses on the multiuimensional aspects of the inuiviuual
(inteipeisonal, psychological, social, anu enviionmental), anu that engages the client in the
context of his oi hei peisonal histoiy, stiengths, weaknesses, iesouices, wants, anu neeus is
iefeiieu to as:
a. Cognitive theiapy.
b. Lifecouise theiapy.
c. Psychoanalytic theiapy.
u. Psychosocial theiapy.
99. A theiapeutic appioach that assumes clients to be competent to co-constiuct goals anu
stiategies (anu that iesistance is lowest when clients aie consciipteu in co-foimulating
inteiventions); that views that clients aie expeits iegaiuing theii own lives anu expeiience
meanings; that encourages change by “doing something differently”, even while recognizing
that only small steps need be taken (as change often “snowballs” and grows naturally); and
that suggests “if it isn’t broke, don’t fix it” and “if it didn’t work, try something different” is
calleu:
a. Solution-focuseu theiapy.
b. Cognitive theiapy.
c. Pioblem-oiienteu theiapy.
u. Systems theiapy.
1uu. A theiapeutic appioach that is useu piimaiily with the elueily anu with those
expeiiencing loss (e.g., uisability, beieavement, unemployment, etc), is often aujunctive to
othei theiapeutic inteiventions that focuses on impoitant suivivoi questions (What is the
meaning of life. Why go on. What have I accomplisheu. Bow well uiu I utilize life’s
oppoitunities. etc), anu that sees thiee key paths to meaning (cieativity, expeiiential values
|finuing beautyj, anu attituuinal values |a postuie towaiu positive copingj) is calleu:
a. uioup theiapy.
b. Logotheiapy.
c. Psychosocial theiapy.
u. Ciisis inteivention.
! EEA !
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1u1. A therapeutic approach that is based on “fundamental units of social intercourse” and
“fundamental units of social action” (called “strokes”), carried out through stimulus-
iesponse patteins (incluuing woius, tones, anu expressions) mediated by “ego states” (the
“parent” [concepts taught before age five], the “child” [feelings derived before age five], and
the “adult” [learned concepts from childhood onward]), and framed in the belief of
inuiviuual value, a capacity to think, anu the ability to change is calleu:
a. Social theiapy.
b. Psychosocial theiapy.
c. Cognitive theiapy.
u. Tiansactional analysis.
1u2. Theie aie two foims of conuitioning which can be useu to mouify behavioi. 0ne foim
of conuitioning is useu to tiain autonomic iesponses anu to associate a stimulus that
normally wouldn’t have any effect with a stimulus that woulu. The seconu foim of
conuitioning cieates an association between a behavioi anu a consequence (also calleu
“response-stimulus” conditioning). In the oiuei piesenteu heie, name these two foims of
conuitioning:
a. Autonomic conuitioning anu leaineu conuitioning.
b. Neuiological conuitioning anu cognitive conuitioning.
c. Classical conuitioning anu opeiant conuitioning.
u. Tiaineu conuitioning anu planneu conuitioning.
1uS. All of the following aie BSN ciiteiia foi substance uepenuence except:
a. 0sing multiple substances at the same time.
b. Toleiance (iequiiing incieaseu amounts to achieve intoxication), anu
withuiawal symptoms (hanu tiemois, sweating, etc).
c. 0sing gieatei quantities ovei longei peiious than intenueu, iepeateu effoits oi a
peisistent uesiie to ieuuce intake, anu continueu use uespite physical oi
psychological pioblems.
u. Bispiopoitionate ueuication to obtaining the substance, anu failing to attenu
employment, social, oi iecieational activities uue to use of the substance.
1u4. All of the following aie BSN ciiteiia foi substance abuse except:
a. Recuiient substance abuse in hazaiuous situations, anu having iecuiient legal
pioblems ielateu to substance abuse (e.g., uiiving unuei the influence aiiests,
etc).
b. Expeiiencing physiological withuiawal symptoms.
c. Continueu use uespite social anu inteipeisonal pioblems, anu failing to meet
majoi obligations at woik¡school oi home.
u. Not having been uiagnoseu with substance uepenuence.
! EEB !
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1uS. Assessment of a substance usei shoulu always incluue: 1) kinu of substance useu; 2)
fiequency anu quantity of use; S) typical level of intoxication; 4) withuiawal symptom
seveiity (if expeiienceu); S) uuiation of substance abuse (months oi yeais, etc); 6) moue of
use (oial, inhalation, neeules, etc); 7) any ielateu legal histoiy; 8) compiehensive histoiy of
any piioi tieatment (length, voluntaiy¡involuntaiy; type anu methous of tieatment,
successful oi unsuccessful piogiam completion). Thiee of the following shoulu also be
incluueu; inuicate which one is not applicable:
a. Family histoiy of substance abuse¡use.
b. Social histoiy.
c. Impact of use on uaily living.
u. Souices wheie substances weie obtaineu.
1u6. All but one of the following iepiesent tieatment moualities foi substance abuse:
a. Betoxification (iiuuing the bouy of toxins that have accumulateu fiom uiug use
– which may oi may not be meuically supeiviseu).
b. Phaimacologic tieatment (to ieuuce withuiawal symptoms oi to inuuce abusei
avoiuant-ieactions in an effoit to ieuuce futuie substance abuse).
c. Drug “affinity” testing to determine the level of addiction present.
u. Psychosocial tieatment (counseling anu behavioi mouification, gioup theiapy,
etc) to help establish new coping skills.
1u7. Cognitive-behavioial theiapy is the most commonly useu appioach to substance abuse
tieatment. Also useu, howevei, is behavioial theiapy, gioup anu family theiapy, anu all but
one of the following:
a. Psychouynamic theiapy
b. Psychoanalytic theiapies.
c. Self-help gioups.
u. Inteiventional theiapies.
1u8. The scope of substance abuse tieatment vaiies in accoiuance with numeious factois.
In paiticulai, inuiviuuals iequiiing a meuically supeiviseu uetoxification peiiou, inuiviuuals
who have oveiuoseu, inuiviuuals who hau ieceiveu unsuccessful tieatment in the past, anu
those with psychiatiic uisoiueis iequiie moie intensive inteiventions, potentially incluuing
hospitalization. 0theis may benefit fiom iesiuential tieatment piogiams that help them to
stay away fiom the uiug of abuse until they aie bettei able to asseit peisonal contiol.
Stuuies inuicate that the minimum time peiiou in a iesiuential piogiam to achieve bettei
long-teim outcomes is:
a. Su uays (one month).
b. 9u uays (thiee months).
c. 18u uays (six months).
u. S6S uays (12 months).
! EEC !
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1u9. Drugs of abuse may be grouped into “classes” such as: 1) alcohol (beer, wine, liquor);
2) cannabis (maiijuana, hashish); S) uepiessants (benzouiazepines, baibituiates), 4)
hallucinogens (LSB, mescaline¡peyote); S) naicotics (heioin, methauone, opium); anu 6)
stimulants (amphetamines, MDMA/“Ecstasy”). Please classify cocaine (and the freebaseu
form, crack cocaine) into the proper category, among one of these “classes”:
a. Bepiessant.
b. Ballucinogen.
c. Naicotic.
u. Stimulant.
11u. Nost anxiolytics aie a subclass of what uiug classification.
a. Ballucinogens.
b. Stimulants
c. Bepiessants.
u. Naicotics.
111. Communication is most bioauly uefineu as:
a. veibal expiessions between two oi moie inuiviuuals.
b. Bouy language (facial expiessions, gestuies, postuie, signals, etc) conveying
meaning between two oi moie inuiviuuals.
c. Wiitten expiessions shaieu between two oi moie inuiviuuals.
u. All of the above.
112. Significant client factois that may influence the communication piocess incluue: 1) age;
2) euucation; S) ethnicity; 4) cultuie (anu belief systems); S) ethnicity; 6) piimaiy language;
anu all but one of the following:
a. uiooming anu hygiene.
b. Emotional state.
c. Intellectual level.
u. uenuei.
11S. When exploring a client’s concerns, he begins to divulge important personal
infoimation about his maiital situation. At one point he seems to be having uifficulty finuing
auequate woius to expiess his emotions, feais, anu conceins. Aftei two oi thiee effoits to
expiess a paiticulaily sensitive issue, he seems unable to finu the woius to continue anu a
long pause ensues. At this junctuie you shoulu:
a. Attempt to fuithei the uiscussion by suggesting what he might have been tiying
to say.
b. Piess the client to continue so as not to lose the momentum of the conveisation.
c. Biscuss with him the uifficulty he is expeiiencing, anu encouiage him to take
moie time.
u. Ignoie the pause anu iemain quiet no mattei how long it takes.
! EED !
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114. You meet a client, anu uiscovei that she has limiteu English-speaking skills. You have
some ability to speak hei piimaiy language, but you aie not fluent. At this point you shoulu:
a. Teiminate the meeting immeuiately, until you can aiiange foi hei to see a social
woikei who speaks hei native language.
b. Revise the meeting to covei only veiy basic issues until othei aiiangements can
be maue.
c. Belay the meeting until you can finu an inteipietei befoie continuing.
u. Attempt to inteiview hei in hei own language.
11S. Asking the question “why” can be problematic because:
a. The client may feel the inquiiy is intiusive.
b. The question may seem confiontational.
c. The client may feel at fault foi a lack of claiity.
u. The client may feel you aie juuging oi challenging his iesponse.
116. When using “active” or “reflective” listening, “furthering responses” (short veibal oi
non-veibal cues to continue) can be useu to ease the conveisation along while helping the
client to feel fully heaiu. All but one of the following are examples of “furthering responses”:
a. “Okay” declarations.
b. Beau nouuing.
c. “Go on” inseitions.
u. “Um-hmm” or “yes” interjections.
117. The difference between “rephrasing” and “paraphrasing” what a client has said is:
a. Rephiasing is useu to coiiect what the client saiu wiong, while paiaphiasing is
useu to iepeat the same iuea back.
b. Rephiasing is useu to elaboiate on what the client saiu, while paiaphiasing is
useu to ieiteiate it.
c. Rephiasing is useu to emphasize what the client saiu, while paiaphiasing is useu
to show mutual unueistanuing.
u. Rephiasing is useu to claiify what the client saiu, while paiaphiasing is useu to
explain what the client saiu.
118. Active or “reflective” listening includes the use of attending non-veibal cues (sitting
foiwaiu, making goou eye contact, using content-appiopiiate affective expiessions, etc), as
well as all but one of the following:
a. Clarification (“Are you saying…?”).
b. Substitution (“What I would do is…”).
c. Encouragement (“Tell me more” and “Go on”).
u. Summarization (“What you’re saying is…”).
119. Leauing questions tenu to stifle communication, anu usually iesult in closeu-enueu
(“yes” or “no” short-answer) responses. All of the following are examples of “leading
questions” EXCEPT:
a. “You do know…[a certain fact]…don’t you?”
b. “Could you tell me more about…[a situation]…?”
c. “But sure you wouldn’t want to…[conclusion]…would you?”
u. “I think that…[decision]…would be best, don’t you?”
! EGF !
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12u. A question that contains multiple paits, potentially leaving a client confuseu oi uncleai
what the question was, oi at least unceitain which pait to answei fiist, is known as a:
a. Stackeu oi complex question.
b. Nanifolu question.
c. Nultipait question.
u. Fiagmenteu oi fiactuieu question.
121. When a client seems oveiwhelmeu oi unceitain how to shaie fuithei, it can help to
bieak uown the conceins at hanu into smallei, moie manageable paits. This communication
technique is known as:
a. Fiagmentation.
b. Sequestiation.
c. Bownsizing.
u. Paitialization.
122. The ielationship between a social woikei anu a client shoulu best be chaiacteiizeu as:
a. A fiienuship.
b. A peei ielationship.
c. A piofessional ielationship.
u. A collegial ielationship.
12S. A social woikei may be iequiieu to assume many ioles. These incluue: 1)
auministiatoi; 2) auvocate; S) biokei (iesouices anu linkages); 4) case managei (iesouice
anu seivice cooiuinatoi); S) counseloi; anu all but one of the following:
a. Euucatoi anu teachei.
b. Enfoicei anu iegulatoi.
c. Lobbyist anu politician.
u. Staff uevelopment cooiuinatoi.
124. The social woik piofession is ueuicateu to meeting basic human neeus anu enhancing
human well-being fiom a social context, incluuing societal anu enviionmental foices that
beai on pioblems in eveiyuay life. This is¡these aie the National Association of Social
Woikeis (NASW) social woik:
a. Cieeu.
b. uoals.
c. vision.
u. Piimaiy mission.
12S. Competence, inuiviuual uignity, integiity, quality human ielationships, seivice, anu
social justice aie:
a. Social work’s core values.
b. Piofessional guiuelines.
c. Theiapeutic ciiteiia.
u. Social work’s goals.
! EGE !
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126. If a social woikei witnesses, obtains eviuence, oi ieasonably suspects abuse (physical,
sexual, emotional, financial) of a chilu, uepenuent eluei, oi a uepenuent auult, oi has ieason
to believe that a client is a uangei to himself oi otheis, confiuentiality must be suspenueu
anu the issue iepoiteu to appiopiiate authoiities baseu upon the social woikei status as
a(n):
a. Evaluatoi.
b. Case managei.
c. Nanuateu iepoitei.
u. 0fficei of the state.
127. Buiing a seiies of home visits with an elueily, uementeu client you note that incieasing
numbers of persons appear to be living in the home. These include purported “relatives” as
well as the boyfiienu of a piivately hiieu in-home choie woikei. Buiing latei visits you note
a wiue-scieen television in the fiont ioom, anu a new cai in the uiiveway. You also note that
the client is no longei alloweu in the main house, anu has been moveu out of the mastei
beuioom anu into a small back ioom. Nost of hei clothes also seemeu to have uisappeaieu.
What piimaiy foim of abuse woulu you suspect in this situation.
a. Physical abuse.
b. Financial abuse.
c. Emotional abuse.
u. Sexual abuse.
128. Youi client is a maiiieu man who has piivately uiscloseu that he is bisexual. Be ieveals
a lengthy histoiy of sexual liaisons with othei men, anu most iecently has uiscloseu to you
that he is human immunoueficiency viius (BIv) positive (pei iepeateu confiimatoiy tests
via his piimaiy caie physician). Buiing multiple contacts you uiscovei that he has not
uiscloseu his BIv status to his spouse. When uiscussing issues of tiansmission, he
specifically notes that he uoes not use any baiiiei piotection uuiing sexual inteicouise.
0pon explaining the life-anu-death risk to his wife, he still maintains that he won’t change
this behavior. He first minimizes the risk, and then claims she would “suspect something” if
he staiteu using a piophylactic. Aftei lengthy counseling he iemains unwilling to
eithei ieveal his BIv status oi to use piotection. Accoiuing to iecent inteipietations of the
“Tarasoff Case” your duty now is to:
a. Continue this as a piioiity counseling topic.
b. Repoit the case to the Bepaitment of Public Bealth.
c. Contact the client’s physician to inform him of the problem.
u. Contact the client’s wife to inform her of the danger.
129. The Feueial Piivacy Act of 1974 (i.e., PL 9S-S79) iequiies that clients be infoimeu: 1)
when iecoius about them aie being maintaineu; 2) that they have a iight to access these
iecoius; S) that they have a iight to copies (pioviueu they beai the costs); anu 4) that the
iecoius will only be useu foi the puipose they weie cieateu unless they pioviue wiitten
ielease oi consent otheiwise. Exceptions incluue: 1) shaiing with agency employees on a
“need-to-know” basis; 2) legitimate research, if identifying information is removed; and all
but one of the following:
a. Pioviuing infoimation to goveinment agencies foi legitimate law-enfoicement
puiposes.
b. Responuing to a couit oiuei oi subpoena.
c. Publication in a ieputable piofessional jouinal.
u. Responuing to an emeigency to piotect anothei inuiviuual.
! EGG !
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1Su. In 1996, legislation was enacteu pioviuing Feueial piotection foi peisonal health
iecoius piivacy. The legislation applies to all health caie pioviueis, health caie
cleaiinghouses, anu health plan pioviueis. It sets limits on iecoius uisclosuie anu uses,
pioviues foi inuiviuual access to meuical iecoius, anu it establishes the iight to ieceive
notices of piivacy piactices. This legislation is calleu:
a. The Bealth Recoius Piivacy Act of 1996 (BRPA).
b. The Bealth Recoius Piivacy anu Accountability Act of 1996 (BRPAA).
c. The Bealth Insuiance Poitability anu Piivacy Act of 1996 (BIPPA)
u. The Bealth Insuiance Poitability anu Accountability Act of 1996 (BIPAA).
1S1. Malpractice liability generally runs from an agency’s Board of Directors, to the director,
supeivisoiy staff, anu then to the fiont-line social woikei. Employei anu supeivisoi liability
acciues unuei the legal theoiy of:
a. vicaiious liability.
b. Bieiaichical liability.
c. Substitute liability.
u. Pioxy liability.
1S2. Infoimation piotecteu by confiuentiality piinciples incluue(s):
a. Infoimation obtaineu uiiectly fiom a client.
b. Client infoimation obtaineu fiom a thiiu paity.
c. Wiitten iecoius anu obseivations iegaiuing a client.
u. All of the above.
1SS. Inuiviuuals bounu by the piinciples of confiuentiality incluue social woikeis, agency
auministiatois anu supeivisois, anu all but one of the following:
a. Agency volunteeis.
b. 0thei clients.
c. Agency cleiical staff.
u. Agency consultants.
1S4. Ceitain exceptions to confiuentiality exist. These incluue: 1) manuateu iepoiting
issues; 2) subpoenas oi othei couit oiueis; S) tieatment continuity (cioss-coveiage by
othei agency staff); anu all but one of the following:
a. Bisclosuies foi insuiance coveiage puiposes.
b. Disclosures at a client’s written request.
c. Bisclosuies to an employei pioviuing insuiance coveiage.
u. Bisclosuies iegaiuing a chilu (e.g., manuateu iepoiting, violations of the law,
etc).
1SS. An oiganization that is aiiangeu hieiaichically, with numeious uepaitments anu units
thiough which segments of specializeu seivices aie pioviueu, moving towaiu the
achievement of a common goal, is iefeiieu to as a(n):
a. Complex oiganization.
b. Bieiaichical oiganization.
c. Buieauciacy.
u. Institution.
! EG# !
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1S6. The chaiacteiistics of a buieauciacy incluue: 1) a hieiaichical stiuctuie of authoiity; 2)
ieciuitment of woikeis baseu upon piofessional qualifications; anu all but one of the
following:
a. A uivision of assignments baseu upon specializeu functions anu capacities.
b. Laigely inflexible opeiating iules anu pioceuuies applieu equally thioughout.
c. Cooiuination of iesponsibilities, activities, anu tasks to achieve a common goal.
u. Linkages to othei oiganizational entities shaiing a common stiuctuie.
1S7. The basic functions of auministiatois incluue: 1) monitoiing, ieviewing, auvising, anu
evaluating employees; 2) planning anu uelegation; anu all but one of the following:
a. Fiontline oiganizational seivices.
b. Auvocacy (both hoiizontally with uepaitmental staff, anu veitically between
othei uepaitments anu staff).
c. Conflict iesolution anu meuiation.
u. Planning anu uelegation.
1S8. An oiganization that is foimeu piimaiily foi non-commeicial puiposes, anu wheie its
employees anu membeis may not benefit peisonally as investois oi shaieholueis, is
iefeiieu to as a(n):
a. Closely helu coipoiation.
b. Chaiitable oiganization.
c. Seivice oiganization.
u. Nonpiofit oiganization.
1S9. A supervisor’s role involves: 1) to be a role model; 2) recruitment and orientation; 3)
uay-to-uay management; 4) staff tiaining, euucation, anu uevelopment; S) staff assessments
anu ieviews; anu all but 0NE of the following:
a. Auvocating foi staff anu piogiam neeus.
b. Allocating inteiuepaitmental opeiating funus.
c. Evaluating the piogiam foi ongoing impiovement.
u. Pioviuing suppoit anu counsel to staff.
14u. All of the following aie methous of piogiam evaluation EXCEPT one:
a. 0utcome evaluation.
b. Paiticipatoiy evaluation.
c. Recipiocal evaluation.
u. Piocess-oiienteu evaluation.
141. The following are all approaches to program “outcome evaluation” EXCEPT one:
a. The aggiegate evaluation appioach.
b. The uecision-oiienteu appioach.
c. The expeiimental evaluation appioach.
u. The peifoimance auuit appioach.
142. The following aie all approaches to program “participatory evaluation” EXCEPT one:
a. Clustei evaluations.
b. Action ieseaich.
c. Self evaluations.
u. Peei ieviews.
! EG? !
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14S. The following aie all compaiisons between consultation anu supeivision EXCEPT one:
a. Consultation is pioviueu by an outsiue expeit, while supeivision is pioviueu by
an inteinal staff leauei.
b. Consultants have bioau auministiative authoiity, while supeivisois have only
inteiuepaitmental authoiity.
c. Consultants pioviue auvice anu iecommenuations, while supeivisois tenu to
pioviue binuing uiiectives anu pioceuuies.
u. Consultation is episouic (as sought) anu voluntaiy, while supeivision is ongoing
anu manuatoiy.
144. A type of iecoiu-keeping that consoliuates anu iepoits all infoimation (incluuing
piogiess, inteiventions, anu conclusions) in an ongoing stoiy foim is calleu:
a. Besciiptive iecoiuing.
b. }ouinaling.
c. Naiiative iecoiuing.
u. Summaiy iecoiuing.
14S. A type of iecoiu-keeping that chionologically anu systematically iecoius client
infoimation (usually beginning with a fact-lauen face sheet, a statement of the piesenting
pioblem, goals, anu cuiient obstacles) is calleu:
a. 0utline iecoiuing.
b. Summaiy iecoiuing.
c. Contiguous iecoiuing.
u. Piocess iecoiuing.
146. Anothei type of iecoiu-keeping focuses on goals, anu is segmenteu into foui sections:
1) factual infoimation (a face sheet oi uatabase section); 2) the assessment anu expecteu
tieatment plan; S) the piogiess notes; anu 4) piogiess ieview entiies (usually at 6-12 week
inteivals). It is calleu:
a. Peison-oiienteu iecoiuing.
b. uoal-oiienteu iecoiuing.
c. Nanifolu iecoiuing.
u. Continuous ieview iecoiuing.
147. An auuitional type of iecoiu-keeping focuses largely on a client’s ongoing issues. It
contains foui components: 1) factual infoimation (a face sheet oi uatabase section); 2) a
checklist section pioviuing a iank-oiuei iostei of client issues; S) a iesolution plan (steps
foi iesolving the piimaiy issues); anu 4) piogiess notes summaiizing actions taken anu
iesults achieveu. This methou of iecoiu-keeping was boiioweu fiom the meuical aiena, anu
is modeled after the “SOAP” format (subjective, objective, assessment, and plan). In social
woik it is calleu:
a. Tiansactional iecoiuing.
b. Pioblem-oiienteu iecoiuing.
c. Summaiy iecoiuing.
u. S0AP iecoiuing.
! EG@ !
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148. The two majoi classifications of ieseaich aie:
a. Statistical anu uesciiptive.
b. Numeiical anu naiiative.
c. Quantitative anu qualitative.
u. Piagmatic anu theoietical.
149. Common foims of ieseaich uesigns incluue all but one of the following:
a. Besciiptive stuuies.
b. Expeiimental stuuies.
c. Exploiatoiy stuuies.
u. Statistical stuuies.
1Su. Pioblem iuentification, backgiounu infoimation, hypothesis foimulation,
opeiationalization (selecting a stuuy mouel anu uata collection), evaluation (uata analysis),
anu fuithei theoiization can be iefeiieu to as:
a. Stuuy uesign.
b. The ieseaich piocess.
c. Scientific investigation.
u. Knowleuge geneiation.
1S1. “Single system” research designs involve observing one client or system only (n=1)
befoie, uuiing, anu aftei an inteivention. Because of theii flexibility anu capacity to measuie
change ovei time, single system uesigns aie fiequently useu by piactitioneis to evaluate:
a. Theii piactice.
b. Bifficult clients.
c. Confoimation to policy.
u. Regulation auheience.
1S2. There are three types of single system research “case studies” or “pre-designs.” Identify
the answei, below, that is ERR0NE00SLY uesciibeu.
a. Changes in case stuuy (Besign B-C).
b. Inteivention only (Besign B).
c. 0bseivation only (Besign A).
u. Time seiies only (Besign A-B).
1SS. In an “A-B” single system research design, “A” indicates an initial phase without any
inteivention, and “B” refers to the intervention phase and requisite data collection. This
uesign is calleu:
a. The “intervention” single system design.
b. The “planned” single system design.
c. The “basic” single system design.
u. The “descriptive” single system uesign.
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1S4. 0thei single system uesigns incluue: 1) the A-B-A uesign – which miiiois the A-B
uesign, except that it auus a thiiu uata collection phase (aftei iemoval of the inteivention);
2) the A-B-A-B design (also called the “experimental replication design” – which involves
ieplication of the A-B design in the study’s second phase; and 3) the B-A-B uesign (also
known as the inteivention iepeat uesign) – which begins with an inteivention (iathei than
a baseline) phase. These thiee uesigns aie known as:
a. Complex single system uesigns.
b. Expeiimental single system uesigns.
c. 0peiational single system uesigns.
u. Exploiatoiy single system uesigns.
1SS. There are four categories of measurement. One is called the “nominal” category.
Nominal measurements are used when two or more “named” variables exist (e.g.,
male¡female, high¡meuium¡low, etc). All of the following aie also categoiies of
measuiement, except foi one. Iuentify the eiioneous entiy.
a. The “interval” category.
b. The “additive” categoiy.
c. The “ordinal” category.
u. The “ratio” category.
1S6. Theie aie foui tests of ieseaich valiuity (i.e., whethei you aie actually measuiing what
you intend to measure). One is “predictive validity,” which refers to the correlation of a
measuiement with an expecteu futuie outcome (e.g., high aptituue scoies shoulu pieuict
successful futuie peifoimance in the aptituue aiea). Thiee auuitional measuies of valiuity
aie listeu below, along with one entiy that is not a measuie of valiuity. Iuentify the
eiioneous entiy.
a. Concoiuant valiuity.
b. Content valiuity.
c. Concuiient valiuity.
u. Constiuct valiuity.
1S7. Theie aie foui majoi techniques foi valiuly sampling a population. 0ne is calleu
“simple random sampling,” which involves sampling in such a way that all membeis of a
given population have an equal chance of being selecteu. Thiee auuitional sampling
techniques aie listeu below, along with one entiy that is not a sampling technique. Iuentify
the eiioneous entiy.
a. Systemic sampling.
b. Clustei sampling.
c. Stiatifieu ianuom sampling.
u. Aggiegate sampling.
1S8. All but one of the following aie measuies of cential tenuency:
a. Neuian.
b. Nean.
c. Neiiuian.
u. Noue.
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1S9. All but one of the following aie measuies of vaiiability:
a. Range.
b. Intei-quaitile iange.
c. Quaitile iange.
u. Stanuaiu ueviation.
16u. The term “correlation” refers to the relationship of the sample variables to each other.
This relationship is expressed via a “correlation coefficient” (symbolized as “r”). A perfect
coiielation (wheie all measuiement points between two vaiiables coinciue) is statistically
iepiesenteu by the following coiielation coefficient value:
a. 1.u.
b. 9.9.
c. u.u.
u. u.S.
161. Five specific elements (1) a ieseaich hypothesis; 2) a null hypothesis; S) a test statistic;
4) a iejection iegion; anu S) a conclusion) collectively make up what is calleu a:
a. Theoietical constiuct.
b. Conceptual constiuct.
c. Statistical paiauigm.
u. Statistical test.
162. The teim iefeiiing to the thiesholu necessaiy to ueciue whethei an inteivention
produced an outcome, or whether it was the result of chance is “statistical significance.” The
actual value thiesholu inuicating ieasonable piobability that the inteivention piouuceu an
outcome is called the “level of significance.” An acceptable probability that the null
hypothesis will be incoiiectly iejecteu (a type I eiioi) is tiauitionally placeu at u.S. Wheie
gieatei ceitituue is iequiieu, it may be placeu at u.1. This thiesholu value is piopeily
referred to as a study’s:
a. Alpha value.
b. Beta value.
c. Kappa value.
u. 0mega value.
16S. Social seivice piogiams can be categoiizeu in thiee ways. Select the eiioneous entiy
fiom the foui categoiy options, below:
a. Exceptional eligibility piogiams.
b. Neans testeu piogiams.
c. 0niveisal piogiams.
u. Selective eligibility piogiams.
164. The social security program was enacted in 1935 to provide “old age survivors
benefits.” Individuals who are employed anu paying into the social secuiity system can eain
up to foui tax cieuits annually. To be eligible to ieceive social secuiity ietiiement benefits,
an inuiviuual must have eaineu a lifetime cieuit total of at least:
a. 8u cieuits.
b. 6u cieuits.
c. 4u cieuits.
u. 2u cieuits.
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16S. Publicly funueu uisability insuiance is available to inuiviuuals who become
unemployable uue to a peimanent oi chionic uisability. At a minimum, the uisability must
be expecteu to last foi a yeai oi moie, oi be expecteu to iesult in ueath. This piogiam is
auministeieu by:
a. Each state’s Department of Human Services.
b. The feueial Bepaitment of Bealth anu Buman Seivices.
c. The feueial Bisableu Peisons Piogiam.
u. The Social Secuiity Auministiation.
166. A social insuiance piogiam foi inuiviuuals sustaining employment-ielateu injuiies is:
a. The Employee Assistance Piogiam.
b. The State Compensation Piogiam.
c. The Worker’s Compensation Program.
u. The Worker’s Health Program.
167. The goveinment has established a “poverty line” threshold regarding income.
Inuiviuuals who fall below that thiesholu may be eligible foi means-testeu public
assistance. Eligible individuals include the “working poor,” as well as individuals who are
elueily, uisableu, anu¡oi blinu. Piimaiily funueu by the feueial goveinment, benefits aie
also supplementeu by the state. This piogiam is calleu:
a. The Inuigent anu Poveity Piogiam.
b. The Supplemental Secuiity Income piogiam.
c. The Income anu Poveity Assistance Piogiam.
u. The Secuiity anu Stability Income Piogiam.
168. In 1966 the program known as “Aid for Families with Dependent Children (AFDC)” was
ienameu anu ieviseu to be a tiansitional piogiam fiom welfaie to woik. The new name of
this piogiam is now:
a. Tiansitional Aiu to Woik Piogiam (TAW) piogiam.
b. Family Welfaie Resouice Tiansition (FWRT) piogiam.
c. Tempoiaiy Assistance foi Neeuy Families (TANF) piogiam.
u. Tiansitional Aiu foi Families anu Chiluien (TAFC) piogiam.
169. The feueial health insuiance piogiam foi the elueily is known as Neuicaie. Exclusively
foi inuiviuuals ovei the age of 6S oi the uisableu, oi inuiviuuals with enu-stage ienal
uisease (ESRB), this insuiance has two specific components:
a. Neuical insuiance anu hospital insuiance.
b. Physician insuiance anu hospital insuiance.
c. Neuical insuiance anu uiug coveiage.
u. Bospital insuiance anu uiug coveiage.
17u. 0nly one of the following foou assistance anu nutiition piogiams is not funueu by the
feueial goveinment. Iuentify the one locally funueu piogiam.
a. Elueily nutiition piogiam.
b. Foou stamps piogiam.
c. Women, Infants, anu Chiluien (WIC) piogiam.
u. Neals on Wheels piogiam.
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171. According to Freud’s Structural Theory of Personality Development, which part of the
peisonality woulu be uiiving the behavioi of a seiial iapist.
a. The Ego Iueal.
b. The Ego.
c. The Iu.
u. The Supeiego.
172. The concepts of “oral,” “anal,” “phallic,” “latency,” and “genital” hierarchically
iepiesent:
a. vaiious uiiving foices of the peisonality.
b. Psychosexual stages of uevelopment.
c. Teims inuicating stages of iepiession.
u. Facets of the peisonality.
17S. Eiikson pioposeu eight psychosocial stages of uevelopment. Each stage builus on the
othei, anu to successfully pass thiough any given stage, one must encountei anu oveicome a
“psychosocial crisis.” The crisis arises between two opposing personality features—one that
is in harmony with one’s personality and one that is not. Erikson called these two opposing
featuies:
a. The Iu anu Ego.
b. The Yin anu Yang.
c. Ego-Positive anu Ego-Negative.
u. Bystonic anu Syntonic.
174. Beinz Baitmann uevelopeu the theoiy of Ego Psychology to explain how inuiviuuals
use the Ego poition of peisonality to accommouate the exteinal enviionment (eithei
changing the self, oi acting upon the enviionment). Be pioposeu that the Ego has the
following numbei of majoi functions:
a. 12.
b. 24.
c. Eight.
u. S6.
17S. Hartmann’s theory of Ego Psychology drew from and built upon Freud’s
Psychoanalytic Theoiy. Bowevei, in explaining the oiigin anu functions of the Ego,
Baitmann paiteu ways with Fieuu in one significant aiea. Be believeu that the Iu anu the
Ego aie specifically piesent in:
a. Auults, following auequate uevelopment.
b. Chiluien, fiom biith foiwaiu.
c. Auolescents, uuiing pie-auult tiansitioning.
u. Latency-ageu chiluien, following auequate uevelopment.
176. Anothei human uevelopment theoiy posits that all inuiviuuals aie boin with a neeu to
uevelop a sense of self, a sense of otheis, anu to builu inteipeisonal ielationships. It
theoiizes that the sense of self anu otheis will affect all subsequent peisonal ielationships.
This theoiy is calleu:
a. Self-psychology.
b. Ego psychology.
c. Integiative Relations Theoiy.
u. 0bject Relations Theoiy.
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177. A uefense mechanism that seives to iepiess, uisconnect, oi uissociate feelings that
seem “dangerous” to psychic well-being is calleu:
a. Regiession.
b. Isolation.
c. Splitting.
u. Fiagmentation.
178. The theoiist most closely iuentifieu with 0bject Relations Theoiy is:
a. Naigaiet Nahlei.
b. Rene Spitz.
c. }ohn Bowlby.
u. Beinz Kohut.
179. During a child’s process of separation and individuation, there comes a point at which
the chilu iecognizes that his oi hei mothei still exists anu iemains available to him oi hei,
even if she is not uiiectly piesent. This cognitive iealization is a substage of the sepaiation-
inuiviuual stage of chilu uevelopment, anu it is known as the:
a. Rappiochement Substage.
b. The 0bject Constancy Substage.
c. The Biffeientiation Substage.
u. The Piacticing Substage.
18u. Accoiuing to Lawience Kohlbeig, the stage of uevelopment in which an inuiviuual fully
appieciates the neeu to confoim to social iules anu laws is:
a. The Conventional Level, stage 4.
b. The Pie-Conventional Level, stage 2.
c. The Post-Conventional Level, stage S.
u. The Conventional Level, stage S.
181. Responses to Pavlovian Classical Conuitioning aie leaineu in iesponse to an
environmental event (or “stimulus”). The response will either be voluntary or involuntary—
also known, iespectively, as:
a. Explicit oi inciuental iesponses.
b. Emitteu oi ieflexive iesponses.
c. Beteimineu oi spontaneous iesponses.
u. Immeuiate oi uelayeu iesponses.
182. A child described as “latency aged” will be between the ages of:
a. 12-16 yeais olu.
b. S-6 yeais olu.
c. 6-12 yeais olu.
u. 0nuei thiee yeais olu.
18S. In seeking to oveicome pioblems at the community level oi that affect society as a
whole, a social woikei is functioning as a(n):
a. Auvocate.
b. Biokei.
c. Euucatoi¡teachei.
u. Lobbyist oi politician.
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184. A “case manager” is someone who:
a. Facilitates staff uevelopment by means of case piesentations.
b. Teaches clients tools anu stiategies foi impioveu functioning.
c. Connects clients to neeueu iesouices anu seivices anu cooiuinates the ueliveiy
anu application of these iesouices anu seivices.
u. Implements agency oi oiganizational policies, seivices anu piogiams.
18S. You aie askeu to officiate at a funeial (i.e., intiouuce speakeis anu music, anu offei
closing iemaiks) foi a client who iecently uieu fiom a biain tumoi. You agiee, knowing that
the client hau few living ielatives anu fiienus who coulu pioviue this seivice. Some uays
aftei the funeial, a thank-you caiu aiiives. It contains a note of appieciation anu a $1uu.uu
bill. The BEST iesponse woulu be to:
a. uiaciously accept the money anu senu a ietuin note of thanks.
b. Bonate the funus to the local Biain Tumoi founuation, thanking them foi the
funus anu telling the family wheie they weie sent.
c. Retuin the money to the family with youi apologies anu explaining that agency
policy uoes not allow you to accept such a substantial gift.
u. Bieak the $1uu.uu bill anu sent $8u.uu back, thanking them foi the gift anu
explaining that youi agency has a $2u.uu limit on gifts.
186. The BEST souice foi the iules, guiuelines, anu bounuaiies that uefine a piofessional
ielationship between a social woikei anu his¡hei client is:
a. An agency policy anu pioceuuie manual.
b. A hanubook of clinical piactice.
c. The National Association of Social Woikeis (NASW) Coue of Ethics.
u. The social woik cieuentialing boaiu.
187. Aftei a theiapeutic ielationship has enueu, a client appioaches you to join in vaiious
family activities (biithuay celebiations, holiuay events, etc). In light of the fact that a past
piofessional ielationship existeu, yet acknowleuging that it has foimally enueu, the social
worker’s BEST iesponse woulu be to:
a. Attenu only small family gatheiings as a show of caie anu suppoit.
b. Accept any invitation that time will allow to show uncompiomising suppoit.
c. Attenu some events, anu invite the client out to otheis with you, so that the
activities don’t become one-siueu.
u. Cite the piofessional coue of ethics, anu claiify that even aftei a piofessional
ielationship enus, socializing is not peimitteu.
188. A client uevelops iomantic feelings foi you, anu iepeateuly makes oveituies anu
gestuies inuicating he¡she woulu like to become involveu. The BEST iesponse woulu be
to:
a. Refei the client to anothei piofessional piomptly, emphasizing the neeu the
client has to iemain focuseu on iesolving the impoitant pioblems involveu
without any uistiaction.
b. Talk about how much you wish things weie uiffeient, but cite the coue of ethics
as a baiiiei to becoming involveu.
u. Allow only a casually flirtatious relationship, making sure no legal “boundaries”
aie violateu.
u. Confiont the client anu uemanu that he¡she stop behaving inappiopiiately.
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189. If a client is to make a tieatment-oiienteu uecision, he¡she must be fully infoimeu
about the puipose, iisks, benefits, costs, anu buiuens that may be associateu with the
uecision. The client may neeu to be euucateu about ceitain ielateu featuies oi issues in
oiuei to make a meaningful uecision. While it may not be possible to foiesee eveiy
eventuality, the client must receive all information that a “reasonable person” would expect
in the given situation. This piocess of infoiming, euucating, anu ieviewing piioi to a
tieatment uecision is calleu:
a. Tieatment oiientation.
b. Infoimeu consent.
c. Patient euucation.
u. Legal uisclosuie.
19u. The NASW Coue of Ethics inuicates that a client’s ability to pay should be considered in
setting fees. This means that a social woikei may uo all of the following EXCEPT:
a. Beciease fees foi a neeuy peison alieauy ieceiving seivices.
b. Refei a potential to public piogiams piioi beginning seivices.
c. Libeially inciease fees foi a client who is paiticulaily well off.
u. Piouuce a sliuing-scale fee iate that sets ieasonable iates in auvance.
191. A uevelopmentally uelayeu auult is in neeu of a meuical pioceuuie oi tieatment with a
complex aiiay of possible buiuens anu benefits with any choice that may be maue. The
client is able to unueistanu many aspects of the pioceuuie, anu the immeuiate outcomes,
but he¡she may not be able to unueistanu the full iamifications of futuie eventualities both
with anu without ieceiving the pioceuuie oi tieatment. The best iesponse woulu be to:
a. Leave the client out of the uecision-making piocess entiiely.
b. Turn the entire issue over to an ethics committee and don’t remain involveu.
c. Tell the client just enough to make a uecision that you feel woulu be best.
u. Involve the client in eveiy aspect that he¡she can piopeily unueistanu, anu
allow his¡hei choices to govein wheie possible.
192. Social seivices may be paiu foi in numeious ways. The most obvious is by peisonal
contiibution (you pay foi what you ieceive). All of the following aie othei ways that social
seivices aie funueu, EXCEPT one:
a. Couit oiueieu funuing.
b. Employei funueu (uiiect pay).
c. uoveinment funueu (i.e., uiiect pay oi tax ielief).
u. Publicly funueu (non-piofit, public agencies).
19S. The tiansfei of seivices once peifoimeu by the goveinment to piivate entity pioviueis
is known as “privatization.” Under these circumstances, the pay sources becomes:
a. The piivate institution that assumes the seivice pioviuei iole.
b. The goveinment continues paying (but hopes the seivice will become cheapei to
pioviue).
c. Philanthiopic oiganizations that can affoiu to pay.
u. Peisonal contiibutions.
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194. Bousing assistance foi those with low income is pioviueu in all the following ways
EXCEPT:
a. Public housing (goveinment built anu owneu housing offeieu at ieuuceu ient
iates.
b. Subsidized housing (“Section 8” and other reduced rent and maintenance
piogiams via goveinment contiibutions).
c. Bome loan subsiuy piogiams.
u. Co-op housing (jointly owneu via the ientei anu the goveinment).
19S. A souice of foou foi low-income families is a feueially-funueu, state-auministeieu
piogiam that pioviues puichase vouchers or coupons based on a family’s size, income, and
iesouices (e.g., a selective eligibility, means-testeu piogiam) that is known as:
a. S&B gieen stamps.
b. Blue-book coupons.
c. Foou stamps.
u. Nutiition vouchei piogiam.
196. A feueially-funueu, state-auministeieu piogiam pioviuing foou anu assistance to
piegnant women, motheis of chiluien up to five months of age (if not bieast feeuing),
bieast-feeuing motheis up to 12 months aftei ueliveiy, anu chiluien up to five yeais of age
is calleu the:
a. Women, Infants, anu Chiluien (WIC) piogiam.
b. Women anu Chiluien Nutiition (WCN) piogiam.
c. Women anu Chiluien Foou (WCF) piogiam.
u. Women anu Chiluien Bealth (WCB) piogiam.
197. A locally funueu piogiam that pioviues ueliveiy of foou to low-income inuiviuuals who
aie unable to leave theii home is calleu:
a. Foou on the Nove.
b. Neals on Wheels.
c. Biive anu Bine.
u. Noveable Feast.
198. A feueially-funueu euucation piogiam that pioviues uisauvantageu chiluien with
supplemental compensating euucation is calleu the:
a. Eaily Euucation piogiam.
b. }ump Stait piogiam.
c. Beau Stait piogiam.
u. Nove 0n piogiam.
199. A feueially manuateu, state-auministeieu insuiance piogiam foi inuiviuuals who lose
a job uue to no fault of theii own, anu who aie actively seeking employment but who have
not been able to finu it, is calleu the:
a. 0nemployment Insuiance piogiam.
b. Employment Compensation piogiam.
c. Worker’s Compensation program.
u. 0nemployment Compensation piogiam.
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1 – C: Allow the patient to move into his motoi home. The patient has a plan sufficient to
meet his neeus foi foou, clothing, anu sheltei. Be has the legal iight to choose wheie he
wishes to live, even if otheis aie not comfoitable with his choice. Calling the police will not
help, as they cannot foice him to ietuin to the facility. Auult piotective seivices may have a
subsequent iole, if the patient begins to exhibit maikeu self-neglect oi cognitive changes,
but they cannot foice the patient eithei. Finally, the patient is not eligible foi an involuntaiy
holu, as he is not placing himself oi otheis in uangei baseu upon a uiagnosable mental
illness, intoxication, oi othei substance abuse. Caieful collateial planning, howevei, will be
impoitant (ensuiing the uaughtei visits anu checks in on him, etc) to tiy anu maximize his
potential foi success. Aftei coping with the haiuships of inuepenuent living, he may
willingly ietuin to assisteu living.
2 – D: A patient who is “oriented times four” is able to adequately identify: 1) himself
(peison); 2) his immeuiate location (place); S) geneial featuies of time (uay, month, yeai,
etc); anu 4) his geneial ciicumstances (situation; i.e., in a counseling office seeking help,
etc).
S – B: An evaluative test is ieliable if it piouuces consistent iesults (i.e., if the same test was
administered to the same subjects twice [i.e., “test-retest”], or to two similar groups with
similar results [i.e., “split half”], it would produce similar results), and it is valiu if it
measuies what is claims to measuie. Consequently, a test may be ieliable (consistently
piouucing similai iesults in test-ietest expeiiments) anu yet invaliu (failing to measuie
what it claims to measuie. Bowevei, a tiuly valiu test will always be ieliable. Intei-iatei
ieliability inuicates whethei the scoiing piocess can be accuiately caiiieu out by uiffeient
inuiviuuals using the same scoiing pioceuuie.
4 – B: Executive functioning iefeis to highei oiuei cognitive functioning. Specific examples
incluue: oiganization (attention, uecision-making, planning, sequencing, anu pioblem
solving), anu iegulation (initiation of action, self-contiol, anu self-iegulation). Lowei oiuei
cognitive measuies incluue: oiientation to place, iegistiation (iecall of new leaining
immeuiately oi within seconus, such as iepeating woius oi numbeis pioviueu), iecall
(shoit-teim anu long-teim memoiy), attention, anu calculation.
S – B: As long as possible, piefeiably inuefinitely. Recoius seive two puiposes: 1) to
maintain continuity between clinician-patient contacts; anu 2) to uocument quality caie. At
a minimum, records must be kept in accordance with your state’s statute of limitations.
Bowevei, you may not be legally piotecteu even then, anu ceitainly not aftei a patient’s
ueath (which coulu be constiueu, in some cases such as suiciue, as a failuie in quality caie).
Theiefoie, counseling iecoius shoulu be maintaineu as long as possible, anu the longei the
bettei.
6 – A: Tell the client to make an appointment to ieview his iecoius. Although laws
goveining patient access to psychiatiic iecoius vaiy wiuely, most states uo allow patients to
view these iecoius—although some limits aie alloweu in ceitain juiisuictions if the clinician
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has a compelling concein iegaiuing the welfaie of the patient. Regaiuless, all states allow
these records to be obtained by a patient’s attorney under subpoena. While the clinician
owns the psychiatiic iecoiu, the infoimation helu within that iecoiu is geneially vieweu as
belonging to the patient. Past ieseaich inuicates that patients typically cope well with this
infoimation. Even so, some infoimation may have a ueleteiious iatiogenic effect. At a
minimum, the clinician shoulu view the iecoiu in company with the patient, to explain,
claiify, ieassuie, anu otheiwise guiue the ieview piocess to a wholesome outcome. Become
thoioughly infoimeu of the laws in youi aiea goveining patient iecoius access.
7 – A: Psychotheiapy is geneially consiueieu to be moie long-teim (anu complex) in natuie,
anu potentially uepenuing moie on a specific theoietical oiientation, while counseling is
often seen as shoitei in uuiation anu oiienteu moie towaiu immeuiate pioblem-solving.
However, these terms are often used interchangeably. The term “counseling” has been
attiibuteu to Fiank Paisons, who useu it in his wiitings in 19u8. The ienowneu psychologist
Cail Rogeis auopteu the teim when the psychiatiic piofession iefuseu to allow him to call
himself a psychotheiapist. Some in the psychoanalytic fielu still feel the teim shoulu be
ieseiveu to those pioviuing foimal psychoanalysis, but this is not a wiuely shaieu view.
8 – C: Aujustment uisoiuei with uepiesseu moou. Ciiteiia foi this uisoiuei incluues a time-
limiteu natuie, usually beginning within thiee months of the stiessful event, anu lessening
within six months—eithei with iemoval of the stiessoi oi thiough new auaptation skills.
Adjustment disorder is a “sub-threshold disorder,” allowing for early classification of a
tempoiaiy conuition when the clinical pictuie iemains vague. While the patient uoes have
insomnia, it aiises fiom the stiessful loss anu not as an inuepenuent conuition. Nany of the
essential ciiteiia foi a majoi uepiession aie absent (weight loss, psychomotoi agitation,
blunteu affect, etc), although without successful tieatment this conuition coulu emeige. The
uiagnosis of acute stiess uisoiuei is not appiopiiate as the piecipitating event uiu not
involve thieateneu oi actual seiious injuiy oi ueath.
9 – B: The wife. Initially, youi iuentifieu client woulu be the husbanu. 0pon entiy of the wife
into the pictuie, youi iuentifieu client woulu be the couple, given that you weie woiking
with them both anu seeing them only jointly. Aftei the passage of time, howevei, anu upon
iuentification of issues iequiiing piimaiy woik with the wife, youi iuentifieu client woulu
be the wife. Iueally, you woulu have come to closuie with the husbanu moie foimally,
iuentifying specifically that youi focus hau shifteu fiom them as a couple to a piimaiy
enueavoi with the wife. Regaiuless, the infoimation now being enteieu in the clinical iecoiu
is exclusively that ielateu to the wife, anu the husbanu shoulu no longei be piivy to that
content. In keeping with this, youi iuentifieu client has become the wife.
1u – B: Nonoamine oxiuase inhibitois (NA0Is), seiotonin-noiepinephiine ieuptake
inhibitois (SNRIs), anu selective seiotonin ieuptake inhibitois (SSRIs) aie thiee classes of
meuications that aie useu piimaiily to tieat uepiessive uisoiueis.
11 – C: As a counseloi, you are mandated to report even “suspicions” of child abuse.
Theiefoie, you shoulu always call Chilu Piotective Seivices anu allow them to ueciue
whethei oi not a foimal investigation shoulu be unueitaken. It woulu be impoitant,
howevei, to also infoim them of the nurse’s prior experience, so that they may seek
appiopiiate uiiection anu avoiu unuue inteivention that coulu otheiwise uamage an
immigrant family’s willingness to seek health care for a child in the future.
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12 - B: In most (but not all) states you aie a manuateu iepoitei if you suspect Bepenuent
Auult abuse. Wheie iepoiting laws exist, you shoulu call Auult Piotective Seivices youiself,
anu submit the necessaiy wiitten iepoit unless they inuicate specifically that they uo not
wish to ieceive a uuplicate iepoit. While health caie pioviueis may occasionally offei help
of this natuie, it is not possible to uischaige youi manuateu iepoiting iequiiement in this
mannei. Wheie no laws foi Bepenuent Auult iepoiting exist, caie shoulu be taken not to
violate confiuentiality, anu appiopiiate consultation shoulu be obtaineu.
1S – A: Revelations of a peisonal natuie aie noimally uiscouiageu in a piofessional
theiapeutic ielationship. They have the potential to tuin the counseling expeiience into a
mutual shaiing piocess, iobbing the client of piopei attention. They can also cause the
client to uevalue the theiapist if any ievelation comes as an unwanteu suipiise. An
exception to this iule exists when the theiapeutic context is entiiely centeieu in the
infoimation to be ievealeu—i.e., in a uiug anu alcohol iehabilitation piogiam, wheie the
sole puipose of the counseling is to auuiess the issue being ievealeu (usually a gioup
setting, wheie self-uisclosuie is essential to the piocess). Bisclosuies shoulu not occui
eaily, befoie tiust is in place, anu the gioup leauei shoulu always cleaily unueistanu his oi
hei full intent anu goals befoie ievealing any peisonal infoimation.
14 – B: Refuse to use the foim. No client oi client population is beneath the ethical
stanuaius of the fielu. An appiopiiate infoimation ielease foim stipulates a limiteu peiiou
of time beyonu which the foim expiies, the specific kinu of infoimation to be ieleaseu, the
specific puipose foi which the infoimation is to be pioviueu, anu a specific inuiviuual oi
entity to whom¡which the infoimation will be pioviueu. While obtaining an infoimation
release is indeed a “hassle” it is the ethical standard of care in the field, and deviation from it
can open a piactitionei to legal liability. The fact that a given client, oi client population,
may be unawaie of this uoes not excuse the theiapist fiom using an ethically appiopiiate
foim in keeping with expecteu stanuaius of caie. Any limitations to confiuentiality—such as
manuatoiy iepoiting if a client expiesses intent to commit a ciime oi haim anothei—
belong on a tieatment consent foim, iathei than on an infoimation ielease foim.
1S – B: Theie shall be no measuiable uiffeience in uepiession symptom iepoiting between
the contiol gioup anu the inteivention gioup. The null hypothesis (often uesignateu as
“H
0
”) proposes that no relationship exists between two variables (often designated “x” and
“y”) other than that arising from chance alone. If a study’s results demonstrate no
uiffeience, then the null hypothesis is “accepted.” If differences emerge, then the study
“failed to reject the null hypothesis.” Statistical testing does not prove any hypotheses, but
insteau uispioves them via iejection.
16 – C: Rejecting the null hypothesis when the null hypothesis is tiue. A failuie to ianuomize
ieseaich paiticipants will potentially intiouuce bias, anu may pioviue giounus upon which
to invaliuate a stuuy, but it is not a type I eiioi. Assuming a noimal statistical uistiibution
when it is skeweu will violate the assumptions necessaiy to apply a piopei statistical mouel
to the analysis of uata.
17 – A: A failuie to ieject the null hypothesis when the null hypothesis is false. Invaliu
assumptions iegaiuing iaw uata (i.e., skeweu uata that was assumeu to follow a noimal, oi
“bell shaped” distribution) can lead to the selection of a statistical analysis model that will
piouuce inaccuiate output. Rejecting the null hypothesis when the null hypothesis is tiue is
a type I eiioi. Naking an eiioi in mathematical calculations is one way to intiouuce eiioi,
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but it is not a type II eiioi. This is less common in the computei age, wheie most
calculations have been automateu.
18 – C: Changes in policy anu law that leu to the ielease of many mental health patients who
woulu have otheiwise iemaineu in institutional settings. Involuntaiy hospital commitment
(i.e., in an asylum) became incieasingly common up to the 19Sus. Bowevei, the Community
Nental Bealth Act of 196S began to ieveise this tienu, as uiu the 1999 0S Supieme Couit
iuling in 0lmsteau vs LC. In 197u theie weie 41S,u66 beus in state anu county mental
hospitals, which fell to 119,uSS by 1988, anu to 6S,S26 by 1998. This eia has since come to
be called the era of “deinstitutionalization.” Sometimes over done, issues of homelessness
among the mentally ill, and “re-institutionalization” in the prison system have been noted.
19 – C: 0f successful suiciues, 49% of those stuuieu hau a piioi suiciue attempt histoiy. 0f
those pieviously seen by a mental health piofessional, 78% hau uenieu having any suiciual
iueation at theii last contact.
2u – D: CQI stands for “continuous quality improvement.” This is an outgrowth of the quality
assuiance (QA) piogiams of the 198us, anu is intenueu to symbolize the fact that quality
impiovement is a nevei-enuing piocess. Continuing euucation, pioblem iesolution
brainstorming, cause and effect “fishbone diagramming,” process flowcharts, improvement
storyboards, and implementation of the “plan, do, check, act” method of problem-solving
anu piocess impiovement aie all examples of CQI.
21 – B: “Identify problems” is the third step in the Roberts crisis intervention model.
22 – B: A method for reducing stress in “first-responders”. A “critical incident” is a traumatic
event fai outsiue noimal anu usual expeiiences. The CISB mouel staits with inviting fiist-
iesponueis (police, fiie, paiameuics, etc) involveu in an oveiwhelming event to meet –
iueally within the fiist 24 houis. The piocess begins with iequests of each paiticipant to
simply explain where they were and what they saw (no requests for “how you felt”). As it
unfolus, in a step-wise fashion, feelings aie giauually expiesseu in the noimal couise of
conveisation. It is cieuiteu with uiamatically ieuucing fiist-iesponuei buin-out anu
attiition.
2S – B: uoal congiuence, which, accoiuing to Biisko (2uu9), is the fouith of five key factois
iequiieu foi a quality theiapeutic ielationship between client anu clinician.
24 – B: The unconscious minu. Fieuu auuiesses thiee aieas of cognition: 1) the conscious
minu, of which inuiviuuals aie fully awaie; 2) the pieconscious minu, involving thoughts
anu feelings of which inuiviuuals may be immeuiately unawaie but which can be accesseu
easily if uesiieu; anu S) the unconscious minu, containing thoughts anu feelings of which all
inuiviuuals iemain entiiely unawaie. The goal of Psychoanalytic Theoiy is to auuiess this
aspect of the minu anu its iole anu influence on the conscious anu pieconscious minu, along
with the iesultant thoughts, emotions, anu behaviois.
2S – C: Cathexis. Cathexis iefeis to the attachment (whethei conscious oi unconscious), of
mental or emotional (“psychosexual”) energy (i.e., feelings and significance) to an idea,
object, image, oi, most commonly, a peison. Psychically, pain aiises fiom loss. Cathexes aie
“objective” when they are directed at the external world, and “narcissistic” when they have
meaning only foi the subject. Significant pain imposes a substantial naicissistic cathexis that
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tends to “empty the ego.” The result of prolonged pain is often “regression,” as the ego
becomes less able to serve its “anti-cathexis” role of imposing rationality and executive
functioning on a situation chaiacteiizeu by seveie pain (whethei physical oi emotional).
26 – B: Alloplastic behavioi. This is a foim of auaptation in which an inuiviuual changes
aspects of his enviionment in oiuei to bettei accommouate competing neeus oi uemanus.
Changes in oneself or one’s behavior (as opposed to the environment), in order to better
accommouate competing needs or demands is called “autoplastic behavior.”
27 – A: At or around 24 months. Margaret Mahler’s three stages of development are: 1) the
autistic stage; 2) the symbiotic stage; anu S) the sepaiation-inuiviuuation stage. The
sepaiation-inuiviuuation stage consists of foui sub-stages, the thiiu of which (the
iappiochement substage) is completeu sometime between 14-24 months of age. Then, the
infant enters the last substage (the “object constancy substage”), which is completed by the
infant sometime aftei 24 months of age.
28 – B: Tiansmuting inteinalization. Empathic miiioiing is the piocess by which the
mother demonstrates (“reflects”) care and understanding of the child, in turn helping the
chilu to uevelop a self-iuentity. Rappiochement is a teim fiom object ielations theoiy,
inuicating the neeu foi an infant to seek inuepenuence while still ietaining secuiity.
Biffeientiation is a substage in object ielations theoiy, wheie an infant begins to look at the
outsiue woilu, as opposeu to the inwaiu focus common to infants youngei than five months
of age.
29 – B: The present, “here and now.” Gestalt psychology seeks to unify and integrate the
personality, and to create “wholeness.” It sees individuals as empowered agents able to
contiol anu iegulate theii futuie by peisonal choice. A focus on the past anu its influence on
the piesent anu futuie is minimizeu (as compaieu with psychoanalytic theoiy).
Su – A: Ego integiity veisus uespaii. This is the last uevelopmental stage of life wheie one
ieconciles his oi hei ielationships with otheis, anu comes to accept his oi hei life
achievements (incluuing wheie uieams weie not met). Inuiviuuals unable to secuie
ielationship anu ego integiity will expeiience a sense of uespaii. Intimacy veisus isolation is
the young auult stage, chaiacteiizeu by builuing multiple impoitant ielationships. Iuentity
veisus iole confusion is the auolescent stage, wheie one foiges a sense of self anu his oi hei
place in society. ueneiativity veisus stagnation is the miu-life stage, most chaiacteiizeu by
leaining to caie about anu nuituie otheis, as opposeu to a naicissistic pieoccupation with
oneself. Eiikson was the fiist theoiist to auuiess human uevelopment acioss the entiie
lifespan.
S1 – C: Pie-opeiational, conciete opeiational. The sensoiimotoi stage encompasses biith to
two years of age, and children in this stage have only a “here and not here” understanding of
loss, at most. The foimal opeiational stage extenus fiom age 11 to age 1S, anu a chilu in this
stage is capable of hypothetical thinking, anu is thus ieauily able to unueistanu the essential
aspects ueath anu many of its moie philosophical anu existential concepts, as well.
S2 – B: Alfieu Aulei. Auleiian theoiy also incluues a biological view, laigely absent in
Psychoanalytic Theoiy, iecognizing that hoimonal changes, physical illness, chemical
imbalances, anu neuiological uisoiueis can uiamatically influence capacity anu behavioi. It
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is impoitant to note, howevei, that Aluei still locates false beliefs, iiiational thoughts, anu
misconceptions in the unconscious minu.
SS – B: Rational emotive theiapy (RET). Founueu by Albeit Ellis, iational emotive theiapy
utilizes the “ABC Theory of Emotion.” It states that an event (“A”), elicits thoughts and
beliefs (“B”), which directly result in specific behavioral consequences (“C”). Therefore,
analyzing one’s relevant thoughts and beliefs, and restructuring those that are dysfunctional
oi uistuibeu, will leau to incieasingly healthy anu functional iesponses.
S4 – A: Conventional Level, Stage S. The Theoiy of Noial Bevelopment was cieateu by
Lawrence Kohlberg, to extend and enhance Jean Piaget’s theory. Overall, Kohlberg felt that
the piocess of moial uevelopment was moie complex anu extenueu than that put foith by
Piaget.
SS – B: Positive ieinfoicement, negative ieinfoicement, punishment, anu extinction.
Positive ieinfoicement (the most poweiful of all) is the ABBITI0N of something pleasuiable
following a uesiiable behavioi. Negative ieinfoicement involves taking something away to
suppoit the behavioi (i.e., taking a bieak fiom an unpleasant task). Punishment involves
auuing something buiuensome when an unuesiiable behavioi occuis. Extinction is the
giauual withuiawal of a ieinfoicement until the taiget behavioi has been fully mouifieu
(i.e., ieuucing the bieak peiiou fiom a uifficult task if the classioom gets noisy).
S6 – A: Attention, ietention, iepiouuction, motivation. Banuuia anu his colleagues
uemonstiateu that consequences (ieinfoicement, punishment, etc) weie not always
necessaiy foi behavioial change oi othei leaining to take place. Simply obseiving someone
else’s activity could be sufficient. The four step pattern was as follows:
1. Attention -- the inuiviuual notices something in the enviionment. 2. Retention – he
iemembeis what was noticeu. S. Repiouuction – he copies what was noticeu. 4. Notivation
– the enviionment ueliveis a consequence (ieinfoicement oi punishment), that affects the
piobability that the behavioi will be iepeateu. Nost auveitising uses these piinciples: a
piouuct is piesenteu as socially uesiiable (attention). The au is iemembeieu (ietaineu), the
purchase is made (reproducing the ad’s direction to buy), and if social approval is
foithcoming then fuithei puichases will be maue.
S7 – C: Reaction foimation. A ieaction foimation is a uefense mechanism in which
unacceptable emotions anu impulses aie contiolleu (oi by which contiol is at least
attempteu) by exaggeiation of the uiiectly opposing tenuency. Anothei example woulu be
tieating someone you veiy much uislike in an oveily fiienuly mannei. 0i a woman
piofesses piofounu hatieu foi a man who left hei in oiuei to cope with the pain he causeu
when he uismisseu hei ueep love foi him. In this way, you attempt to both hiue anu cope
with youi tiue feelings.
S8 – B: Boiueiline peisonality uisoiuei. Inuiviuuals with this uiagnosis will exhibit: fiantic
effoits to avoiu ieal oi imagineu abanuonment; unstable anu intense inteipeisonal
ielationships (especially extiemes of iuealization anu uevaluation); an unstable sense of
self; extieme impulsivity (e.g., spenuing, sex, uiug use, ieckless uiiving, binge eating, etc);
iecuiiing suiciual behavioi (gestuies oi thieats, oi self-mutilating behavioi); affective
instability uue to ieactivity of moou; chionic feelings of emptiness; intense angei (e.g.,
fiequent uisplays of tempei, iecuiient physical fights); tiansient, stiess-ielateu paianoiu
iueation; oi seveie uissociative symptoms. Bowevei, as with all Axis II uisoiueis, this
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uiagnosis cannot piopeily be maue uuiing a fiist contact, but must be substantiateu ovei a
couise of clinical contacts sufficient to compel the uiagnosis to be maue (BSN-Iv-TR).
S9 – C: Appioximately 18-19 months olu. These skills anu capacities aie consistent with a
chilu between 18 anu 19 months of age.
4u – A: The “Electra Complex” is the female counterpart to the “Oedipus Complex” and
typically occuis between the ages of thiee anu seven.
41 – B: Ninoiity gioup. 0f significance, in the social sciences, a minoiity gioup neeu not be
smallei (in teims of population) than a uominant gioup. Rathei it is iuentifieu as such
because the uistinct iuentifying chaiacteiistic(s) put the gioup in a position of suboiuinate
status in a societal context.
42 – B: Although it is iueal foi social woikeis to ieceive specific tiaining iegaiuing each of
the inuiviuual minoiity populations they typically seive, they shoulu still ensuie that
someone fiom an unfamiliai backgiounu ieceives neeueu seivices even wheie no staff with
special tiaining in that backgiounu is available.
4S – A: The ability to woik well with uiveise gioups. Quality tiaining, wiue-ianging
knowleuge, anu the ability to iecognize steieotypes, piejuuices, anu biases aie all impoitant
contiibutois to cultuial competence; howevei, only when a social woikei also possesses the
capacity to piopeily apply this infoimation, can he oi she woik well with uiveise
populations.
44 – B: Piejuuice. Although the othei woius aie useful, they only uesciibe ceitain qualities
oi behaviois aiising fiom piejuuice.
4S – B: Bisciimination. Bigotiy is an intoleiance of othei iueas anu beliefs. Piejuuice is
accepting unconfiimeu infoimation that may be situationally oi inuiviuually unique, anu
assuming them to be valiu foi an entiie gioup oi class people. Nisogyny iefeis to a hatieu
oi uistiust of women.
46 – B: Age, genuei, iace (ethnicity), sexual oiientation.
47 – C: Ethnocentiism.
48 – A: Asian, Black, Bispanic, Native Ameiican, White.
49 – B: Cultuie-bounu synuiomes. Some appaient mental health symptoms may aiise fiom
ceitain cultuie-specific uictates of behavioi, moou, oi thought piocesses. Foi example,
talking with ghosts oi othei spiiits, seeing hallucinations oi visions, heaiing voices, etc, can
all be attiibuteu to ceitain cultuial anu¡oi ieligious gioups. In such situations, the
inuiviuual shoulu not ieceive a mental illness uiagnosis.
Su – B: A piofessional inteipietei. Selecting a ielative oi fiienu iisks violating client
confiuentiality, as uoes asking anothei staff peison to become involveu. Fuithei, non-
piofessional peisons may not have an auequate giasp of special teiminology neeueu to
piopeily auuiess meuical, legal, oi psychiatiic conceins. 0f note: wiitten woius aie
“translated,” while spoken words are “interpreted.”
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S1 – C: Establish a iappoit, summaiize legal anu ethical obligations, complete a seivice
contiact, anu assess the client. Establishing a iappoit usually incluues a ieview of the
client’s presenting problem, though it also includes fostering trust, showing empathy and
concein, anu uemonstiating a willingness to be non-juugmental about the piesenting issue.
Summaiizing legal anu ethical obligations incluues auuiessing manuatoiy iepoiting issues
anu client confiuentiality. A seivice contiact coveis mutual ioles anu expectations, majoi
goals, the anticipateu couise of tieatment, anu how to hanule issues of non-peifoimance.
Assessment should cover the client’s personal mental health history, medical history
(incluuing substance abuse), family histoiy, woik histoiy, anu social histoiy. It may also
include an evaluation of the client’s mood, safety, intellectual functioning, and emotional
stability.
S2 – B: A social assessment iepoit. This foim of client assessment may also be calleu a
“social history.”
SS – A: An eco-map (also called an “ecological map” or an ecogram, especially if it includes a
genogram). While a genogram is limited to “family tree” depictions, the eco-map is bioauly
constiucteu to incluue multiple othei impoitant ielationships to people, systems,
communities, extenueu family, iesouices, seivices, etc. It can exploie a iange of things, fiom
relationships to finances. Lines connecting the “client” (an individual or a family, at the
centei of the uiagiam) have uiiection aiiows to uepict influence flow (which may be
biuiiectional), stiength of the ielationship, anu quality of the ielationship (i.e., uominant,
poweiful, anu angiy woulu be uepicteu by the uiiection of the powei, a thick line woulu
inuicate a stiong connection, anu the line woulu be uiawn wavy oi ieu if the ielationship is
stiessful).
S4 – B: A stiuctuieu questionnaiie oi checklist can be paiticulaily helpful if a client is
having uifficulty exploiing, foimulating, oi uiscussing his situation oi conceins. The
uocument pioviues infoimation that piompts the client, anu theieby aius in opening up the
pioblem anu specific conceins. Questionnaiies anu checklists can also be paiticulaily
helpful if the situation being evaluateu is complex oi iisk lauen anu the theiapist neeus to
be paiticulaily thoiough (e.g., a suiciue assessment, etc).
SS – B: The Wechslei Auult Intelligence Scale (WAIS). This test was intiouuceu in 19SS as a
ieviseu upuate of the Wechslei-Bellevue Intelligence Scale of 19S9. Peihaps the next most
common scale useu is the Stanfoiu-Binet Intelligence Scale, fiist ieleaseu in 1916, which
was ueiiveu fiom the Fiench Binet-Simon Intelligence Scale of 19uS. The meuian scoie foi
the WAIS is 1uu, with a stanuaiu ueviation of 1S (i.e., scoies between 8S anu 11S), which
encompasses about 68% of all auults. It is auministeieu to inuiviuuals ovei the age of 16.
Inuiviuuals between the ages of 6-16 may be given the Wechslei Intelligence Scale foi
Chiluien (WISC).
S6 – B: Axis v; Axis III; Axis II; Axis Iv; anu Axis I. Clinicians shoulu assess clients on all five
axes to ensuie a thoiough evaluation.
S7 – C: v Coues. Nost of these coues, which weie boiioweu fiom the Inteinational
Classification of Bisease (ICB) manual, aie enteieu on Axis I (except foi v71.u9, which may
be enteieu on Axis I oi II when it is a focus of clinical attention, oi on Axis Iv when it is not).
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S8 – B: Teimination. This piocess can be unueitaken foi many ieasons: 1) when mutually
agieeu upon goals have been met; 2) when a client must move; S) following client-theiapist
conflicts; 4) upon iefeiial to a specialist; anu S) because of finance¡insuiance changes.
Effoits shoulu be maue foi this to be a positive expeiience.
S9 – B: Boiueiline intellectual functioning. IQ scoies fiom 71 to 84 qualify foi this uiagnosis.
6u – A: 0ppositional Befiant Bisoiuei. Bisiuptive Behavioi Bisoiuei, not otheiwise
specifieu (N0S) is an umbiella teim foi behavioi uistuibances that lack sufficient claiity foi
the assignment of a moie specific uiagnosis. Impulse-Contiol Bisoiuei is only appiopiiate
when a behavioi is compulsive in natuie. While angei may be a pait of that pictuie, it tenus
to be an oveiieaction to a piovocation; othei ielevant compulsions incluue gambling, skin-
picking, kleptomania, etc. The hallmaik of Conuuct Bisoiuei is uelibeiate ciuelty, anu
wanton uisiegaiu foi otheis iights anu piopeity. This client lacks any peivasive anu long-
stanuing eviuence in this iegaiu.
61 – A: The voluntaiy oi involuntaiy passage of stool in an inappiopiiate place by a chilu
ovei the age of foui (i.e., past toilet tiaining). This is a fiequently misuseu teim. It is most
fiequently applieu to chiluien anu uevelopmentally uelayeu auults. Auults with psychosis
may warrant use of the term, although the term “fecal incontinence” is more commonly
useu foi auults. A Biitish liteiatuie ieview founu only one use of the teim in an auult that
was not eithei psychotic oi mentally ietaiueu—a 19S2 case of a S6-yeai-olu uiagnoseu with
“infantile neurosis.” The most typical etiology is stool impaction (constipation)
compiomising sphinctei contiol anu allowing leakage into the unueiclothing. Bowevei,
emotional uisoiueis, anxiety, oi oppositional uefiant uisoiuei can sometimes unueilie the
behavioi. Inciuence of the conuition uiops steauily aftei age six.
62 – B: Beliiium is moie fiequently piesent in uementia patients than in patients without
uementia. This is because patients with uementia aie moie tenuously balanceu cognitively
than those without uementia, anu thus they succumb moie ieauily to the conuition. In
elueily uementia patients, a low-giaue fevei oi blauuei infection may be sufficient foi them
to lapse into delirium. Because health care providers often do not know the patient’s
baseline level of cognition, uementia fiequently masks ueliiium. Inueeu, a uiagnosis of
ueliiium is misseu moie than Su% of the time. Rapiu global ueteiioiation in cognition
(often, in houis to uays) is the hallmaik. Fevei, electiolyte imbalances (usually uue to
uehyuiation), anu meuication toxicity aie piecipitating factois. A meuical exam is theiefoie
necessaiy foi a piopei uiagnosis to be maue.
6S – C: Substance abuse typically involves naicotics, while uepenuence typically involves
non-naicotic uiugs. In geneial, naicotics aie moie auuictive than non-naicotic substances.
Even relatively “benign” substances of abuse, such as maiijuana, can piouuce uepenuence if
useu often enough, anu mounting clinical anu pieclinical eviuence suggests that a maiijuana
withuiawal synuiome also exists (howevei, it is not yet in the BSN). Common tieatment
meuications incluue: Antabuse (uisulfiiam; foi alcohol abuse); Revia (naltiexone; foi
alcohol anu naicotics); anu Tiexan (naltiexone; foi alcohol anu opioiu uepenuence).
64 – B: Affect, associations, ambivalence, anu autism. In 1911, Eugen Bleulei coineu the
teim schizophienia, anu uefineu it using his now-classic four “As:” Affect (blunted
emotional iesponse to stimuli); associations (loosening, uisoiueieu thought patteins),
ambivalence (an inability to make uecisions uue to pooi infoimation integiation anu
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piocessing), anu autism (a preoccupation with the self and one’s thoughts). Common
meuications foi tieatment: Cloiazil (clozapine), Baluol (halopeiiuol), Loxitane (loxapine),
Nellaiil (thioiiuazine), Piolixin (fluphenazine), Rispeiual (iispeiiuone), Stelazine
(tiifluopeiazine), Thoiazine (chloipiomazine), anu Zypiexa (olanzapine).
6S – B: Najoi uepiession with psychotic featuies. The piecipitating event was his job loss,
which led to depression. When the depression deepened he started “hearing voices,” and he
uiank to cope with the negative messages (anu to cope with his uepiession). Theiefoie,
while the alcohol use must be incluueu in his uiagnostic foimulation, it woulu not be his
piimaiy uiagnosis. 0f note, the uiagnosis of majoi uepiession with psychotic featuies is
misseu about 2S% of the time in an emeigency ioom, with only the uepiession typically
iuentifieu.
66 – A: Panic uisoiuei, with agoiaphobia. The symptoms of panic aie cleai, anu theie is a
specific feai (i.e., he is not suffeiing foi a geneializeu, nonspecific feai). The expansion of the
uiagnosis by acknowleuging the agoiaphobia is impoitant, as he was plainly feaiful of being
away fiom the hospital (sleeping theie at night) wheie he may not be able to obtain help—
which is the classic featuie of panic uisoiuei with agoiaphobia. Common tieatment
meuications: Celexa (citalopiam), Baluol (halopeiiuol), Klonopin (clonazepam), Libiium
(chloiuiazepoxiue), Paxil (paioxetine), valium (uiazepam), Tofianil (imipiamine), anu
Xanax (alpiazolam).
67 – B: Eating uisoiuei, N0S (not otheiwise specifieu). The uiagnosis coulu not be anoiexia
neivosa, as she has not lost substantial weight anu although of post-menaichal age, she has
not expeiienceu amenoiihea (much less foi thiee consecutive cycles). The uiagnosis coulu
not be bulimia neivosa, as hei behavioi has not peisisteu foi thiee oi moie months (so fai,
only on the oiuei of weeks). Theiefoie, the piopei uiagnosis is eating uisoiuei, N0S.
Bowevei, uncheckeu, ieceiving the uiagnosis of bulimia neivosa, puiging type, woulu only
be a mattei of time.
68 – B: Bipolai I, single manic episoue, in full iemission. Theie is no eviuence of fiank
psychosis, thus biief psychotic uisoiuei can be iuleu out. Bypomania uoes not appeai
appropriate, as the client’s behavior would likely have iesulteu in hospitalization hau
anyone been able to evaluate him uuiing his peiiou of mania. Cyclothymic uisoiuei uoes not
appear appropriate, as the client’s conduct exceeded the threshold severity for hypomania,
anu no infoimation is pioviueu iegaiuing uepiessive symptoms (though he may well have
them). Finally, the Bipolai I, single manic episoue is iuentifieu to be in full iemission, as the
client’s manic symptoms appear to have completely resolveu.
69 – C: Clustei B: violent anu¡oi Explosive Bisorders (also referred to as “aggressive and
intrusive conduct disorders”). These cluster descriptions have been provided by authors in
various academic sources, although they only loosely describe each cluster’s content.
Clustei A incluues: paianoiu, schizoiu, anu schizotypal peisonality uisoiueis. Clustei B
incluues: antisocial, boiueiline, histiionic, anu naicissistic peisonality uisoiueis. Finally
Clustei C incluues: 0bsessive¡Compulsive, Avoiuant, anu Bepenuent peisonality uisoiueis.
The auuitional categoiy foi inueteiminate behaviois that appeai to be chaiacteiistic of a
personality disorder is called: “personality disorder, NOS (not otherwise specified).”
Clusteis tenu to iun in families.
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7u – A: Attention ueficit hypeiactivity uisoiuei (AB¡BB). The teim ABB is no longei in use,
as it was excluueu fiom the last ievision of the BSN. Conuuct uisoiuei woulu not be
appiopiiate, as this chilu is not uelibeiately ciuel oi violent towaiu otheis. 0bsessive
compulsive uisoiuei uoes not fit, as the chilu is not fixateu on eithei iitualistic behavioi oi
things, pei se, but is simply chaotically busy. 0ppositional uefiant uisoiuei is not an
appiopiiate uiagnosis, as this chilu is not uelibeiately uncoopeiative oi aigumentative.
Caution is neeueu, howevei, in making the uiagnosis. The behavioi must not be situationally
uue to pioblems at home, anu it must have peisisteu foi six months oi longei. Fuithei, anu
most importantly, it must not be simple youthful exuberance or even a “high-energy”
peisonality. Rathei, the uiagnosis is piopeily maue when the behaviois aie extieme, anu
well out of step with othei peeis. Baving multiple involveu auults complete the Connoi
Rating Scales (i.e., paients, gianupaients, the teachei, a peuiatiician, etc) can ieuuce the
chance of inappiopiiately applying this buiuensome uiagnosis.
71 – B: Piactice fiamewoik. This fiamewoik may vaiy uepenuing upon the issues involveu,
iesouices, etc, anu thus multiple piactice fiamewoiks may be iequiieu to piopeily seive
the neeus of an agency anu its clients.
72 – A: Ecosystems fiamewoik. This piactice fiamewoik is laigely ueiiveu fiom Ecological
Systems Theory (also called “Development in Context” or “Human Ecology” theory). It
auuiesses five enviionmental systems, anu assumes bi-uiiectional influences within anu
between the systems. Bevelopeu by 0iie Bionfenbiennei, a uevelopmental psychologist, the
five systems aie: 1) the Niciosystem (family, peeis, neighboihoou, anu othei social
enviionments; 2) the Nesosystem (the connections between these enviionments; S) the
Exosystem (settings which inuiiectly affect uevelopment, such as paiental woik); 4) the
Naciosystem (the cultuial context); anu S) the Chionosystem (events anu tiansitions ovei
the life couise). Biology is also ielevant, thus the theoiy is sometimes called the “Bio-
Ecological Systems Theory.” The roles, norms, and rules of each system shape psychological
uevelopment thioughout life.
7S – B: Feminist fiamewoik. Although laigely useu only when woiking with female clients,
the fiamewoik can be extenueu to male clients, especially when the piesenting pioblem
involves sex iole issues, steieotypic expectations, anu¡oi ieveise iole genuei
uisciimination (female on male).
74 – C: Ethnic-sensitive fiamewoik. Bioauly constiuing this fiamewoik to incluue any anu
all majoi elements that a client uses to uefine anu iuentify the self (woik, exteinal
affiliations, histoiical context, etc), will allow this fiamewoik to be most effective. Thus, a
ietiieu militaiy man who iuentifies stiongly with his status as a past piisonei of wai uuiing
a paiticulai militaiy eia (e.g., a vietnam veteian, piisonei of wai, caieei soluiei, etc) woulu
benefit fiom a piactice appioach that is sensitive to anu acknowleuges this backgiounu in
the client’s life, relationships, anu psychological makeup.
7S – B: Psychoanalytic appioach. This appioach is built upon the concepts anu theoiy of
Sigmunu Fieuu anu otheis who have followeu him. The appioach is also sometimes calleu a
“psychodynamic” approach.
76 – C: Tiansfeience¡counteitiansfeience conflicts. Tiansfeience (client to theiapist) anu
counteitiansfeience (theiapist to client) incluue emotions, ieactions, uefenses, uesiies, anu
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feelings that come to beai on the ielationship anu¡oi the pioblem, whethei consciously oi
unconsciously.
77 – A: The phases of tieatment, as specific to psychoanalysis.
78 – C: Behavioral approach. Sometimes also simply called “behavior modification,” this
approach believes that as long as a problem can be “operationally defined” (in terms of the
specific change neeueu anu the consequences necessaiy to inuuce change) viitually eveiy
pioblem can be iesolveu by iesoiting to behavioial mouification techniques. This appioach
is most effective when the client voluntaiily unueitakes tieatment, but involuntaiy
tieatment can also be successful if piopei ieinfoicements anu¡oi consequences can be
integiateu into the change piocess. This appioach is baseu on piinciples of social leaining
theoiy, opeiant conuitioning, behavioial theoiy, anu classical (iesponuent) conuitioning
theoiy.
79 – B: Cognitive appioach. Consiueiable woik must be uone to seek out anu claiify a
client’s false beliefs and misconceptions that underlie problem behaviors and interpersonal
issues. This appioach has a significant euucational component, as the client must be taught
ways to iuentify these eiiant thoughts anu how to ciicumvent anu¡oi oveicome them using
new stiategies anu coping skills.
8u – B: Psychoanalysis.
81 – A: Behavioial theiapy, as foimulateu by }ohn Watson anu Ivan Pavlov (classical
conuitioning) anu B.F. Skinnei (opeiant conuitioning). Auuitional theiapist woik is uone in
analyzing client tally sheets, chaits, jouinal entiies, etc, in seaich of patteins anu insights
that woulu assist in iefining key insights in to behavioial anteceuents, anu impioving
selecteu ieinfoiceis anu consequences. Collateial woik must also be uone iegaiuing client-
theiapist contiact ievision anu consequences foi contiact agieement violation, etc.
82 – C: Cognitive theiapy.
8S – B: uestalt theiapy. Founueu by Fieueiick anu Lauia Peils, in the 194us.
84 – B: Task-centeieu theiapy. It is impoitant to note that, because this foim of theiapy is
client-uiiven, with the theiapist only assisting by means of facilitation, inuiviuuals who aie
not committeu to change woulu not be goou canuiuates foi this foim of theiapy. It is
geneially shoit-teim (6-12 sessions), anu involves open shaiing between both the client
and the therapist (i.e., no “hidden agendas”).
8S – C: uestalt theiapy.
86 – B: Ciisis intervention. The goal is not to produce a “cure” but to help clients more
auequately cope until the woist of the ciisis has passeu. 0nce the ciisis has passeu, the
client may well be in neeu of fuithei psychotheiapeutic inteivention.
87 – A: Family theiapy. This foim of theiapy is baseu laigely upon systems theoiy anu
communication theoiy.
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88 – A: uioup theiapy. It is impoitant to note, howevei, that gioup theiapy is typically an
adjunctive approach (sometimes called a “complementary therapy” or “complementaiy
intervention”), rather than an individual’s only source of treatment. The seven major types
of gioups aie: 1) euucational gioups; 2) giowth gioups (consciousness iaising); S) iemeuial
groups (or “psychotherapy groups” where issues, such as anger, are encounteieu); 4) self-
help gioups (such as Alcoholics Anonymous); S) socialization gioups (to impiove
interpersonal skills); 6) support groups (or “mutual sharing groups” for those with common
conceins, such as beieavement); anu 7) task gioups (focuseu on achieving specific goals,
such as job location, etc).
89 – C: uioup uevelopment. Buiing these stages, the social woikei neeus to: 1) facilitate
familiaiity anu elicit paiticipation; 2) claiify ioles; S) uevelop gioup cohesion; 4) suppoit
inuiviuual uifferences; and 5) foster independence. The use of a “Sociogram” (a chart or
uiagiam uepicting gioup membei ielationships) can aiu the social woikei in ievealing,
monitoiing, anu inteivening (if necessaiy) in gioup membei inteiactions anu bonuing.
9u – B: Ciisis inteivention. Because engagement is uuiing a ciisis expeiience, anu is
typically shoit-teim in natuie, the focus is less on assessment than on buffeiing, suppoit
system builuing, stiess ieuuction, etc.
91 – B: Family theiapy. This mouality also uses the “strategic family therapy approach,”
which focuses on the function of family iules anu behavioi patteins. The goal of the
theiapist is to uevise inteiventions which will elicit functional behavioial patteins, anu
ievise those family iules which uefeat oi impeue appiopiiate family ielationships anu
conuuct.
92 – C: Foiceu gioups. While some gioups aie foimeu of membeis unuei couit oiuei, theie
is no such gioup categoiy, noi woulu a gioup, itself, seek to foice attenuance.
9S – B: Ciisis inteivention. Inteiventions tenu to be pioblem-solving anu shoit-teim in
natuie, in keeping with the concept of a ciisis. The theiapist must have sufficient expeitise
in the ciisis issue (giief, suiciue, iape, etc) to be effective, but must also use caution to not
fostei uepenuency in the ielationship with the client, who may be sufficiently oveiwhelmeu
as to be unchaiacteiistically neeuy.
94 – A: Reciuiting membeiship to ensuie a laige anu uiveise population, iueally consisting
of moie than 2u gioup membeis. Nost theoiists inuicate that effective gioups shoulu not
have membeiships exceeuing 8-12. The youngei the gioup membeiship, the smallei the
iueal gioup (pieteens: S-4; teens: 6-8; young auults: 8-1u).
9S – D: Systems theory. The systems may be “open” (accepting of outside input) or “closed”
(resisting outside forces and input). Working with a system from a “horizontal approach” is
to limit the scope of inteivention to a specific community anu those things occuiiing within
it. In contrast, a “vertical approach” reaches well beyonu the iuentifieu community,
extenuing, foi example, to policies, piogiams, anu iesouices outsiue the community that can
be biought to beai in auuiessing community conceins.
96 – B: Ecosystems theory (also called the “Life Model Theory).” In diiect piactice, social
woikeis use ecosystems theoiy to help clients iecognize the uemanus of theii enviionment
anu then bettei accommouate. In community piactice, social woikeis use ecosystems
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theoiy to puisue community, policy, anu piogiam change in ways to make the enviionment
moie ieceptive to the inuiviuual.
97 – C: uestalt theoiy. In uestalt theoiy, gieat attention is given to the immeuiate
therapeutic encounter as an “experience” from which to gain awareness and increased
understanding of the “here and now,” which is considered to be a more reliable source of
unueistanuing than piocesses of cognitive inteipietation.
98 – D: Psychosocial therapy (also referred to as “bio-psycho-social therapy”). The earliest
pioponent of this foim of theiapy was Floience Bollis (196S), who was latei joineu by Naiy
Woods (who continued this work after Hollis’ death).
99 – A: Solution-focuseu theiapy. It oiiginateu at the Biief Family Theiapy Centei (BFTC) in
Nilwaukee, anu Steve ue Shazei was one of the piimaiy oiiginatois.
1uu – B: Logotheiapy. The oiiginatoi of this theiapeutic appioach was viktoi Emil Fiankl
(authoi of the best-selling book “Man’s Search for Meaning”).
1u1 – B: Tiansactional analysis (TA). The founuei of this theoiy was Eiic Beine, who
uevelopeu it uuiing the 19Sus. Tiansactional Analysis is the methou foi stuuying
inteiactions between inuiviuuals. Bepaiting fiom the Fieuuian uialogue appioach, TA
theiapists simply obseive communication piocesses (woius, bouy language, facial
expiessions), often in group settings, to explore a client’s transactions – in light of the fact
that complete communication impoitance is: actual woiu - 7%; woiu ueliveiy style (tone,
inflections, etc) - S8%; anu facial expiessions - SS%. Thiough such analyses, inteiactive
styles can be iuentifieu, anu changes maue (wheie neeueu) to enhance an inuiviuuals
inteipeisonal stiengths anu ultimate successes.
1u2 – C: Classical conuitioning anu opeiant conuitioning. Stimuli that inuuce a ieaction
without training are called “primary” or “unconditioned” stimuli (US). They include food,
pain, anu othei "haiuwiieu" oi "instinctive" stimuli. Stimuli that uo not inuuce a uesiie
ieaction until aftei conuitioning has occuiieu aie calleu seconuaiy oi conuitioneu stimuli.
1uS – A: 0sing multiple substances at the same time. Nost uepenuent useis will have
developed a “drug of choice” that is their primary problem. DMS criteria require three of the
remaining seven criteria for a diagnosis of “substance dependence.” A recovering substance
usei is most vulneiable to ielapse uuiing the fiist yeai aftei stopping the abuse.
Substance-ielateu uisoiueis (typically alcohol abuse) aie associateu with consiueiable
othei abuse, incluuing automobile acciuents, ciiminal activity, sexual misconuuct, uomestic
violence, anu chilu abuse.
1u4 – B: Physiological withuiawal symptoms woulu actually suggest substance uepenuence.
1uS – B: Souices wheie substances weie obtaineu. Theie is no iepoiting iequiiement foi
this, anu it is not geimane to the tieatment piocess.
1u6 – C: Drug “affinity” testing to determine the level of addiction present. There is no
laboratory test to determine an individual’s level of addiction – paiticulaily because much
of the auuictive expeiience is psychological anu not just physiological.
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1u7 – B: Psychoanalytic theiapies. ueneially, ueep seateu issues aie not uealt with in a
substance abuse tieatment piogiam. Nost focus on veiy piactical stiategies foi incieasing
awaieness anu bieaking the cycle of substance abuse ielapse (changing peeis, changing
aieas, becoming moie piouuctive anu attentive to life, impioving home ielationships, etc).
Because most auuictions aie chionic in natuie, inuiviuuals iequiie long-teim inteiventions.
Cost anu efficacy issues geneially move inuiviuuals into long-teim self-help iesouices, such
as Alcoholics Anonymous anu Naicotics Anonymous, etc.
1u8 – B: 9u uays (thiee months) is the minimum peiiou in a iesiuential tieatment piogiam
if the likelihoou of an enhanceu long-teim outcome is to be achieveu.
1u9 – B: Stimulant. In 1914, with the Baiiison Biug Act, cocaine was eiioneously classifieu,
in the eyes of the law, as a naicotic. This legal uesignation has nevei been ieviseu, thus,
identifying it as a narcotic would be “legally” correct. However, pharmaceutically anu
psychoactively, cocaine is a stimulant; thus, this woulu be the most coiiect answei, fiom an
abuse anu iehabilitation peispective.
11u – C: Bepiessants. Nost anxiolytics (anti-anxiety meuications) aie benzouiazepines,
which makes them uepiessants in theii action on the cential neivous system. Theie aie
exceptions, howevei, such as buspiione (BuSpai), which is a psychotiopic uiug that is a
seiotonin ieceptoi stimulant.
111 – B: All of the above. Communication, fiom the peispective of social woik, must be
bioauly uefineu, as all foims of communication will be impoitant in a theiapeutic context.
112 – A: Grooming and hygiene. While the client’s grooming and hygiene may indicate a
gieat ueal about the client anu his oi hei habits, financial status, mental anu physical health,
etc, these factois shoulu not have uiiect influence on the communication expeiience.
11S – C: Biscuss with him the uifficulty he is expeiiencing, anu encouiage him to take moie
time. “Sentence finishing” often substitutes the therapist’s thoughts in place of the clients,
which the client may then accept to ielieve the buiuen he is feeling. Piessing the client to
continue will often make the pioblem woise. Ignoiing the pioblem anu waiting inuefinitely
may leau to piematuie teimination.
114 – B: Revise the meeting to covei only veiy basic issues until bettei aiiangements can be
maue. Abiuptly teiminating a meeting may leave the client feeling iejecteu anu upset aftei
the effoits maue to attenu. Belaying the meeting can cause similai pioblems. Resoiting
to the use of youi limiteu language skills coulu leau to misunueistanuings anu unnecessaiy
confusion. Theiefoie, ievising the meeting to puisue only basic infoimation intake anu to
establish simple iappoit woulu be auvantageous.
11S – B: The client may feel you aie juuging oi challenging his iesponse. While many othei
problems may emerge from “why” questions, a sense of being judged is perhaps the most
significant among them. Often asking a client to “tell me more about that” serves the same
puipose, without the potential foi uisiupting the ielationship.
116 – A: “Okay” declarations. The word “okay” is often taken to mean, “I understand now,
there’s no need to continue.” Thus, other responses would be more likely to cause the client
to continue shaiing.
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117 – C: Rephiasing is useu to emphasize what the client saiu, while paiaphiasing is useu to
show mutual unueistanuing. Rephiasing changes only a few woius that fuithei emphasize
what the client has said (e.g. “the surgery hurt” to “so, the surgery was very painful”).
Paraphrasing, however, is virtually an unchanged restatement of the client’s words to
uemonstiate that she was heaiu.
118 – B: Substitution. Telling a client what you woulu uo not only tuins the conveisation
away fiom him anu his own thinking, but it closes off fuithei communication as the
authority figure “has spoken” and seemingly concluded that scenario.
119 – B: Not a leading question: “Could you tell me more about…” is an open-enueu, non-
leauing question that encouiages the client to continue anu to shaie moie.
12u – A: Stacked or complex question. For example, “Was the part that you didn’t
unueistanu wheie he tolu you to stop, oi wheie he askeu foi youi supeivisoi, oi wheie he
saiu that you coulu be liable foi that?” This question can easily leave a client confused and
unceitain how to iesponu. Feelings such as this can make the client less willing to
communicate.
121 – D: Partialization. For example, “Well, if we take these things one at a time, maybe we
can stait with…”
122 – C: A piofessional ielationship, which is necessaiy foi an effective bonu of tiust, anu to
facilitate essential uisclosuie necessaiy to achieve change.
12S – B: Enfoicei anu iegulatoi. Quality social woik is all about pioviuing insights anu
options. It is not about punitive accountability, enfoicement, oi policing. Assuming such
ioles will extinguish the tiust anu sustaining powei of the theiapeutic ielationship that
must pieuominate. While social woikeis may be calleu upon to pioviue piotective ioles in
investigating abuse, the law enfoicement anu the ciiminal justice system will mete out the
necessaiy consequences, not social woik staff, who must still iefiain fiom caustic ciitique
anu ieciimination.
124 – B: The NASW social woik piimaiy mission.
12S – A: Social work’s core values
126 – C: Nanuateu iepoitei. Again, this incluues even ieasonable suspicions of abuse – a
client who is ioutinely uiesseu impiopeily foi the weathei, has biuises, is malnouiisheu, is
abanuoneu alone when supeivision is neeueu, etc – must all be iepoiteu, along with fiank
eviuence of abuse.
127 – B: Financial abuse. This is also a foim of abuse that must be iepoiteu anu investigateu
by the piopei authoiities.
128 – D: Contact the client’s wife to inform her of the uangei. Accoiuing to iecent
inteipietations of the Taiasoff v. Regents of the 0niveisity of Califoinia case (1976,
Califoinia Supieme Couit iuling) confiuentiality, in this situation, may be bieecheu if: 1) the
BIv infection is known; 2) unpiotecteu sex (oi shaiing of neeules) is occuiiing; S) the
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behavioi is actually unsafe; 4) the client iefuses to mouify his behavioi even aftei being
counseleu iegaiuing the haim; anu S) if BIv tiansmission will likely occui.
129 – C: Publication in a ieputable piofessional jouinal. Regaiuless of the compelling natuie
of the infoimation, oi the goou it might uo otheis, iecoius cannot be ieleaseu foi
publication without consent fiom the inuiviuual. While PL 9S-S79 applies only to feueial
agencies anu settings, viitually all state anu local goveinment agencies have piomulgateu
these same piactices.
1Su – B: The Bealth Insuiance Poitability anu Accountability Act of 1996 (BIPAA)
1S1 – A: vicaiious liability. Although an agency may have liability insuiance, it is usually
iecommenueu that inuiviuual social woikeis caiiy theii own piivate coveiage. Agency
responsibility typically ends at the margins of the scope of the social worker’s employment
duties (unless agency staff knew in advance of an employee’s misconduct and took no
piotective action). Agency liability continues even off the piemises, to the uegiee the
employee’s scope of duties extends off the premises.
1S2 – B: All of the above. Any infoimation iegaiuing a client that comes to a social woikei
becomes subject to the iules of confiuentiality anu piivacy of the piofession.
1SS – B: 0thei clients. While othei clients ieceiving seivices at the agency may be askeu to
maintain confiuentiality (anu this iequest may even be foimalizeu in gioup settings) they
aie not piofessional bounu to ethical stanuaius as aie social woikeis anu suppoit staff
employeu by an agency.
1S4 – C: Bisclosuies to an employei pioviuing insuiance coveiage. Theie is no iequiiement
that infoimation be uiscloseu to an employei pioviuing coveiage, unless the employee has
pieviously stipulateu infoimation to be ieleaseu in consenting to coveiage anu seivices.
Payment foi coveiage by an employei uoes not, in anu of itself, entitle the employei to any
piivate client infoimation. Even unuei conuitions of subpoena, social woikeis may be able
to limit the scope of information shared, or even claim “privileged communication” status in
iesponse to oiueis to testify.
1SS – C: Buieauciacy.
1S6 – B: Linkages to othei oiganizational entities shaiing a common stiuctuie. This is not a
chaiacteiistic of a buieauciacy, although many buieauciacies uo shaie linkages anu have
close ties with othei buieauciatic oiganizations.
1S7 – A: Frontline organizational services. Services “in the trenches” are provided by
employee staff, not auministiatois.
1S8 – D: “Nonprofit” (or “not-foi-profit”) organization. Social service organizations tend to
fall in this categoiy, as they aie oiganizeu piimaiily to meet the neeus of inuiviuuals who
have few othei options oi iesouices. Because of the stiuctuie of the oiganization, anu its
iestiictions on membei anu employee investments, etc, ceitain tax benefits aie peimitteu
by the Inteinal Revenue Seivice.
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1S9 – B: Allocating inteiuepaitmental opeiating funus. Inteiuepaitmental funuing
allocation is something uone at the auministiative level, iathei than by supeivisoiy staff.
14u – C: Recipiocal evaluation is not a piogiam evaluation methou. 0utcome evaluation
focuses on enu-iesults aftei the piogiam is completeu. Paiticipatoiy evaluation is an
inuuctive, community-centeieu evaluative appioach. Piocess-oiienteu evaluation (also
called “formative evaluation”) analyzes a certain point in time under specifically selected
conuitions (e.g., at planning oi implementation point, etc) in oiuei to ueteimine if the
segment being evaluateu is functioning piopeily, which allows both stiengths anu
weaknesses to be iuentifieu.
141 – A: The “aggregate evaluation” approach is not a method of program “outcome
evaluation.” The “decision-oriented” approach utilizes agency uata, suiveys, inteiviews, anu
obseivations to iuentify which elements in a piogiam aie functioning well anu which neeu
improvement. The “experimental evaluation” approach is a very formal endeavor, wherein
iequisite inuepenuent vaiiables anu a uepenuent vaiiable aie uefineu anu then testing is
undertaken to examine causality. The “performance audits” approach uses an independent,
thiiu-paity evaluatoi to examine piogiam peifoimance stanuaius anu outcomes.
142 – D: “Peer reviews” is not a form of “participatory evaluation.” “Cluster evaluations” are
useu to examine seveial piogiam facets at one time. Baseu on pluialism, they allow multiple
programs to determine how to solve joint problems. “Action research” is an informal
methou of ieview conuucteu by inuiviuuals uiiectly affecteu by the issue being examineu.
“Self evaluations” are a method by which involved staff members evaluate a program.
14S – B: Consultants have bioau auministiative authoiity, while supeivisois have only
inteiuepaitmental authority. Consultants do not have “administrative authority,” but
function only in an auvisoiy capacity.
144 – C: Naiiative iecoiuing.
14S – B: Piocess iecoiuing. Face sheet infoimation is obtaineu at the time of client intake,
anu subsequent entiies aie maue aftei telephone conveisations, face-to-face contacts, etc.
This methou of iecoiu-keeping is time consuming, but it pioviues a paiticulaily complete
summaiy of inteiactions, goals, anu cuiient issues.
146 – A: Peison-oiienteu iecoiuing.
147 – B: Pioblem-oiienteu iecoiuing.
148 – C: Quantitative anu qualitative. Quantitative ieseaich consists of objective
expeiiments, suiveys, anu othei examinations that use iepiesentative numeiical uata in
uesciiptive oi infeiential analyses—useu piimaiily to test theoiies. Qualitative ieseaich
consists of subjective obseivations anu inteiviews using systematic inuuctive piocesses to
describe and define specific groups, individuals, or processes (for example, a “field
study”)—useu piimaiily to uevelop theoiies.
149 – B: Statistical stuuies. This is not a sepaiate foim oi categoiy of stuuy uesign. Statistics
can be useu in viitually any foim of stuuy, anu thus it cannot be uefineu as a categoiy of its
own. Besciiptive stuuies builu upon known infoimation in an attempt to fuithei extenu
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unueistanuings anu to pioviue new qualitative facts foi fuithei theoiization. These stuuies
iequiie moueiate iigoi anu contiol. Expeiimental stuuies use uepenuent vaiiables (the
vaiiables of inteiest) anu the manipulation of vaiious inuepenuent vaiiables to evaluate the
iesulting effects on the uepenuent vaiiables. They iequiie contiolleu conuitions anu the
ieuuction oi elimination of extianeous anu inteivening vaiiables. These kinus of stuuies
iequiie the highest iigoi anu contiol. Exploiatoiy stuuies aie useu in aieas anu subjects
wheie little oi nothing on the topic is known, oi to expanu existing knowleuge. These
stuuies iequiie low levels of iigoi anu contiol, allowing foi maximum flexibility in the
exploiation piocess.
1Su – B: The ieseaich piocess.
1S1 – A: Theii piactice. The evaluation piocess involves: 1) pioblem iuentification (calleu
the “target” of the research); 2) operationalization (selecting indices that represent the
pioblem that can be measuieu; S) ueteimining the “phase” (the time over which
measurement will occur), including a “baseline phase” (without intervention) and an
“intervention phase.” This may also include a “time series design,” where data is collected at
uisciete inteivals ovei the couise of the stuuy.
1S2 – B: Time seiies only (Besign A-B) is not one of the thiee. Besign A consists of
obseivation only, without any inteivention. Besign B is an inteivention only, without any
baseline measuiement. Besign B-C iefeis to an initial inteivention with uata iecoiueu (B),
followeu by a ieviseu inteivention anu ieneweu uata iecoiuing (C).
1SS – C: The “basic” single system design. This fundamental single system design is more
complex than single system case stuuy uesigns, as it incluues a planneu inteivention anu
foimal evaluation. Although it is flexible, easily opeiationalizeu, anu easily piouuces cleai
eviuence of change, etc, the piimaiy uiawback of this uesign is that it cannot uemonstiate
causation.
1S4 – B: Expeiimental single system uesigns. 0f fuithei note: 1) The A-B-A uesign, which
incluues uata collection aftei inteivention iemoval oi cessation, can moie fully establish
causality. Some ethical conceins aie noteu if a successful inteivention is iemoveu solely foi
stuuy puiposes, though it may be iestaiteu aftei conclusion of the stuuy. Because iesuming
an inteivention is not always possible this uesign is not iecommenueu foi piactice
evaluation. 2) The A-B-A-B uesign also faces the uilemma of tempoiaiily iemoving an
impoitant inteivention, potentially causing a client to uiop out. This stuuy uesign is also
paiticulaily time-consuming. S) The B-A-B uesign is paiticulaily useful foi situations wheie
a uelay in tieatment coulu be haimful oi unethical, such a ciisis situations.
1SS – B: The “additive” category. The ordinal category is used when a hierarchical
aiiangement exists, but the uistance between each position is not necessaiily equal (e.g.,
fiist, seconu, thiiu iunneis in a iace). The inteival categoiy can only be useu when both a
hieiaichical anu an equal-uistant ielationship between positions exists (e.g., a 1-1u scale).
The iatio categoiy is an inteival scale with an absolute zeio (a scoie of five is exactly one-
half of ten, etc).
1S6 – A: Concoiuant valiuity. Content valiuity iefeis to the uegiee to which a measuie
piopeily encompasses the full uomain of what is intenueu to be measuieu. Concuiient
valiuity iefeis to the uegiee to which a newly measuieu vaiiable coiielates with a
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measuiement of that same vaiiable by some othei means that has alieauy been valiuateu.
Constiuct valiuity iefeis to the uegiee to which infeiences can be maue fiom youi stuuy to
the theoiies upon which the stuuy was baseu.
1S7 – D: “Aggregate sampling”. “Cluster sampling” refers to a random sampling of groups,
aftei which all members of the selected group or “cluster” are then sampleu. “Stratified
random sampling” involves dividing a population into separate groups (or “strata”) such as
income, anu then simple ianuom sampling foi each of the stiata. “Systematic sampling” is a
pieueteimineu uesign oi sampling constiuct, such as choosing the fifth name on the top left
of each page in a phone book, etc.
1S8 – C: Neiiuian. Nean is the aiithmetic aveiage; meuian is the miu-point in a iange; anu
moue is the most common vaiiable value.
1S9 – C: Quaitile iange. The iange is the aiithmetic uiffeience between the highest anu
lowest value; the intei-quaitile iange is the aiithmetic uiffeience between the uppeimost
anu loweimost quaitiles (e.g., the 7S
th
quaitile anu the 2S
th
quaitile) anu is useu when two
sets of uata aie similai. The stanuaiu ueviation is a measuie of how tightly the samples aie
clusteieu aiounu the mean in a set of uata.
16u – A: 1.u. A coiielation coefficient of 1.u inuicates a peifect ielationship between two
vaiiables.
161 – D: Statistical test. The research hypothesis is symbolized as “H
A
,” the null hypothesis
is symbolized as “H
0
,” the test statistic is symbolized as “TS,” and the rejection region is
symbolized as “RR.”
162 – A: Alpha value.
16S – B: “Means tested programs”. Universal programs are open to everyone, without any
exclusion ciiteiia. Exceptional eligibility piogiams aie only available to ceitain gioups
with common needs, such as the Veteran’s Health Administration. Selective eligibility
programs are either “means tested” (including asset evaluation) or “income-tested” (looking
solely at financial income).
164 – C: 4u cieuits. Foi those boin befoie 196u, the ietiiement age foi maximum benefits is
6S. Foi those boin in oi aftei 196u, the age is 67.
16S – B: The Social Secuiity Auministiation, wheie the piogiam is iefeiieu to as Social
Secuiity Bisability (SSB).
166 – C: The Worker’s Compensation Program. To be eligible, the injuries sustained must
not have occuiieu thiough gioss negligence, willful misconuuct, oi intoxication.
167 – B: The Supplemental Secuiity Income piogiam.
168 – C: Tempoiaiy Assistance foi Neeuy Families (TANF) piogiam.
169 – A: Neuical insuiance anu hospital insuiance. The hospitalization coveiage poition is
known as Neuicaie Pait A, anu the meuical caie coveiage poition is known as Neuicaie
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Pait B. Expansions in iecent yeais have also iesulteu in Neuicaie Pait C (a combineu A & B
piogiam auministeieu by piivate health insuiance companies, BN0s, etc), anu Neuicaie
Pait B (piesciiption uiug coveiage).
17u – B: Neals on Wheels. Neals on Wheels is a locally funueu piogiam, not a feueially
funueu piogiam.
171 – C: The “Id.” It is the most primitive part of the personality, and the libido is its most
basic instinctual drive. The “Ego” is more rational, and mediates between individual wants
and environmental demands. As the Ego develops, the “Reality Principle” arises, introducing
compromise. The “Superego” incorporates ethical and moral constraints on behavior. It is
composed of two parts: 1) the “Conscience” (i.e., the “do not do” behaviors); and 2) the “Ego
Ideal” (regulating the “should do” behaviors). Development should be complete by about
age five, pei Fieuu.
172 – B: Psychosexual stages of uevelopment. The oial stage iepiesents that peiiou when
oial giatification is a piimaiy souice of fulfillment (fiom u-18 months of age). The anal
stage iefeis to the shift of attention to bowel contiol as a souice of accomplishment (18
months to thiee yeais). The phallic stage iefeis to the shift of attention fiom anus to
genitals (S-6 yeais of age). The latency stage iefeis to the peiiou of accommouation of
sexual uiges into socially acceptable behaviois (6-12 yeais of age). Finally, the genital stage
(fiom 12 to auulthoou) maiks the matuiing of genital inteiest into a piopei auult iole anu
feelings.
17S – B: Bystonic anu syntonic. Taking Stage 1 (tiust vs uistiust) as an example, one may be
naturally trusting or naturally distrusting. Regardless, one part of this stage “syntonic” (in
natural accord with one’s personality) and one part will be “dystonic” (not easily
accommodated in one’s natural personality). The “crisis” is coming to terms with both. One
must leain to be appiopiiately tiusting in key situations in oiuei to have fulfilling anu
meaningful ielationships. Yet one must not become so tiusting as to be vulneiable to abuse
in situations that shoulu not involve immeuiate tiust. 0pon iesolving this uichotomy, one
will be piepaieu to move on to the next uevelopmental stage.
174 – A: 12.
17S – B: All chiluien, as Baitmann believeu the Iu anu the Ego to be iuuimentaiily piesent
fiom biith foiwaiu. Be also believeu that the Ego has the capacity to function
inuepenuently, while Fieuu saw the Ego functioning as a meuiatoi (with the Iu) anu
ieceiving meuiation thiough the Supeiego.
176 – D: Object Relations Theory. Derived both from Freud’s Psychoanalytic Theory and
Hartmann’s Ego Psychology, it focuses on Ego organization during the first 3½ years of life,
when uiffeientiation between self anu otheis is emeiging.
177 – C: Splitting. Engaging this uefense mechanism can iesult in an inuiviuual losing touch
with his or her true feelings, resulting in a “fragmented self” in proportion to the frequency
anu uegiee to which the mechanism is utilizeu.
! E@@ !
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>9' %,+0( (0&(%26;,)%9 %( (02)<,()86,)%9 )< <,();,:' &(%+)8),024 >:: ()*+,< (0<0(7024
178 – A: Naigaiet Nahlei. Rene Spitz anu }ohn Bowlby also maue substantive contiibutions
to the uevelopment of this theoiy. Beinz Kohut, howevei, is not uiiectly associateu with this
theoiy oi its uevelopment.
179 – B: The 0bject Constancy Substage, as theoiizeu by Naigaiet Nahlei.
18u – A: The Conventional Level, stage 4, of moial uevelopment.
181 – B: Emitteu (voluntaiy) oi ieflexive (involuntaiy) iesponses.
182 – C: 6-12 yeais olu. A “latency-aged” child is one between the ages six anu twelve.
18S – B: Lobbyist oi politician, as effective change at this level typically iequiies enhanceu
policy oi legislation to align numeious inteiest gioups anu iesouices.
184 – C: Connects clients to neeueu iesouices anu seivices anu cooiuinates the ueliveiy anu
application of these iesouices anu seivices.
18S – B: Bonate the funus to the local Biain Tumoi founuation, thanking them foi the funus
anu telling the family wheie they weie sent. This allows the family to see youi giatituue,
even while making suie that the funus woulu be expenueu in a way that ieflects theii neeus,
as well.
186 – C: The NASW Coue of Ethics. While othei souices may be infoimative theie is no
substitute foi stuuying the NASW Coue of Ethics. Policy anu pioceuuie manuals anu clinical
piactice texts, in paiticulai, aie less likely to pioviue oveiaiching guiuelines of an ethical
natuie, anu insteau focus on piactical issues foi caiiying out specific job uuties.
187 – B: Cite the piofessional coue of ethics, anu claiify that even aftei a piofessional
ielationship enus, socializing is not peimitteu.
188 – A: Refei the client to anothei piofessional piomptly, emphasizing the neeu the client
has to iemain focuseu on iesolving the impoitant pioblems involveu without any
uistiaction. Feeuing the behavioi, allowing any level of inappiopiiate conuuct, anu
confionting the client will only uamage the impoitant piofessional ielationship that must
exist.
189 – B: Infoimeu consent.
19u – C: Libeially inciease fees foi a client who is paiticulaily well off. Client gouging
(chaiging iates outsiue of the usual anu customaiy iange) is nevei acceptable.
191 – B: Involve the client in eveiy aspect that he¡she can piopeily unueistanu, anu allow
his¡hei choices to govein wheie possible. Foi example, in situations wheie eithei a
magnetic iesonance imaging (NRI) scan oi a computeu tomogiaphy (CT) scan coulu
piouuce auequate imaging foi a iequisite test, let the client choose. No one may know,
except the client, that he¡she has issues with claustiophobia that woulu make an NRI scan
much moie buiuensome. Thus, asking the client woulu be essential to suppoiting his¡hei
iight to make inuepenuent uecisions.
! E@A !
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>9' %,+0( (0&(%26;,)%9 %( (02)<,()86,)%9 )< <,();,:' &(%+)8),024 >:: ()*+,< (0<0(7024
192 – A: Couit oiueieu funuing. Social seivices aie nevei funueu via couit oiuei (unless
fiom an estate oi by some methou of litigation—which falls under “personal contributions”
as they come fiom some piivate inuiviuual).
19S – B: The goveinment continues paying (but hopes the seivice will become cheapei to
pioviue). Piivatization is unueitaken in the hope that the seivice will be pioviueu less
expensively via the piivate sectoi, but the goveinment iemains the seivice payei. Issues of
accountability sometimes aiise once piivatization occuis.
194 – B: Co-op housing (jointly owneu via the ientei anu the goveinment). Theie aie no
“co-op” housing assistance programs based on public assistance.
19S – C: Foou Stamps.
196 – A: Women, Infants, anu Chiluien (WIC) piogiam.
197 – B: Neals on wheels.
198 – C: Beau Stait piogiam.
199 – A: 0nemployment Insuiance piogiam. The benefits aie time-limiteu anu iun out even
if employment cannot be founu.
! E@B !
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>9' %,+0( (0&(%26;,)%9 %( (02)<,()86,)%9 )< <,();,:' &(%+)8),024 >:: ()*+,< (0<0(7024
Weai a watch. At the beginning of the test, check the time (oi stait a chionometei on youi
watch to count the minutes), anu check the time aftei eveiy few questions to make suie you
are “on schedule.”
If you aie foiceu to speeu up, uo it efficiently. 0sually one oi moie answei choices can be
eliminateu without too much uifficulty. Above all, don’t panic. Don’t speed up and just
begin guessing at ianuom choices. By pacing youiself, anu continually monitoiing youi
piogiess against youi watch, you will always know exactly how fai aheau oi behinu you aie
with youi available time. If you find that you are one minute behind on the test, don’t skip
one question without spenuing any time on it, just to catch back up. Take 1S fewei seconus
on the next foui questions, anu aftei foui questions you'll have caught back up. 0nce you
catch back up, you can continue woiking each pioblem at youi noimal pace.
Furthermore, don’t dwell on the problems that you were rushed on. If a problem was taking
up too much time anu you maue a huiiieu guess, it must be uifficult. The uifficult questions
aie the ones you are most likely to miss anyway, so it isn’t a big loss. It is better to end with
moie time than you neeu than to iun out of time.
Lastly, sometimes it is beneficial to slow uown if you aie constantly getting aheau of time.
You aie always moie likely to catch a caieless mistake by woiking moie slowly than
quickly, anu among veiy high-scoiing test takeis (those who aie likely to have lots of time
left ovei), caieless eiiois affect the scoie moie than masteiy of mateiial.
You piobably know that guessing is a goou iuea. 0nlike othei stanuaiuizeu tests, theie is no
penalty foi getting a wiong answei. Even if you have no iuea about a question, you still
have a 2u-2S% chance of getting it iight.
Nost test takeis uo not unueistanu the impact that piopei guessing can have on theii scoie.
0nless you scoie extiemely high, guessing will significantly contiibute to youi final scoie.
What most test takers don’t realize is that to insure that 2u-2S% chance, you have to guess
ianuomly. If you put 2u monkeys in a ioom to take this test, assuming they answeieu once
pei question anu behaveu themselves, on aveiage they woulu get 2u-2S% of the questions
coiiect. Put 2u test takeis in the ioom, anu the aveiage will be much lowei among guesseu
questions. Why.
! E@C !
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1. The test writers intentionally write deceptive answer choices that “look” right. A test
takei has no iuea about a question, so he picks the “best looking” answer, which is
often wiong. The monkey has no idea what looks good and what doesn’t, so it will
consistently be iight about 2u-2S% of the time.
2. Test takeis will eliminate answei choices fiom the guessing pool baseu on a hunch oi
intuition. Simple but coiiect answeis often get excluueu, leaving a u% chance of
being coiiect. The monkey has no clue, anu often gets lucky with the best choice.
This is why the piocess of elimination enuoiseu by most test couises is flaweu anu
uetiimental to youi peifoimance. Test takers don’t guess; they make an ignoiant stab in the
uaik that is usually woise than ianuom.
Let me intiouuce one of the most valuable iueas of this couise—the $S challenge:
You only mark your “best guess” if you are willing to bet $5 on it.
5%6 %9:' 0:)/)93,0 ;+%);0< =(%/ *60<<)9* )= '%6 3(0 R)::)9* ,% 80, S@ %9 ),4
Why $S. Five uollais is an amount of money that is small yet not insignificant, anu can
ieally auu up fast (2u questions coulu cost you $1uu). Likewise, each answei choice on one
question of the test will have a small impact on youi oveiall scoie, but it can ieally auu up to
a lot of points in the enu.
The piocess of elimination IS valuable. The following shows youi chance of guessing it
iight:
If you eliminate
wiong answei
choices until only
this many iemain:
Chance of getting
it coiiect:
1 1uu%
2 Su%
S SS%
Bowevei, if you acciuentally eliminate the iight answei oi go on a hunch foi an incoiiect
answei, youi chances uiop uiamatically—to u%. By guessing among all the answei choices,
you aie u0ARANTEEB to have a shot at the iight answei.
That’s why the $5 test is so valuable. If you give up the auvantage anu safety of a puie
guess, it hau bettei be woith the iisk.
What we still haven’t covered is how to be sure that whatever guess you make is tiuly
random. Here’s the easiest way:
>:R3'< &);T ,+0 =)(<, 39<R0( ;+%);0 3/%9* ,+%<0 (0/3)9)9*4
! E@D !
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>9' %,+0( (0&(%26;,)%9 %( (02)<,()86,)%9 )< <,();,:' &(%+)8),024 >:: ()*+,< (0<0(7024
Such a technique means that you have ueciueu, E(A"/( ,"& '(( ; '*@-<( %('% T&('%*"@,
exactly how you aie going to guess, anu since the oiuei of choices tells you nothing about
which one is coiiect, this guessing technique is peifectly ianuom.
This section is not meant to scaie you away fiom making euucateu guesses oi eliminating
choices; you just neeu to uefine when a choice is woith eliminating. The $S test, along with
a pie-uefineu ianuom guessing stiategy, is the best way to make suie you ieap all of the
benefits of guessing.
Nany test takeis uelay the test piepaiation piocess because they uieau the awful amounts
of piactice time they think necessaiy to succeeu on the test. We have iefineu an effective
methou that will take you only a fiaction of the time.
There are a number of “obstacles” in the path to success. Among these aie answeiing
questions, finishing in time, anu masteiing test-taking stiategies. All must be executeu on
the uay of the test at peak peifoimance, oi youi scoie will suffei. The test is a mental
maiathon that has a laige impact on youi futuie.
}ust like a maiathon iunnei, it is impoitant to woik youi way up to the full challenge. So
fiist you just woiiy about questions, anu then time, anu finally stiategy:
1. Finu a goou souice foi piactice tests.
2. If you aie willing to make a laigei time investment, consiuei using moie than one
stuuy guiue. 0ften the different approaches of multiple authors will help you “get”
uifficult concepts.
S. Take a piactice test with no time constiaints, with all stuuy helps, “open book.”
Take youi time with questions anu focus on applying stiategies.
4. Take a piactice test with time constiaints, with all guiues, “open book.”
S. Take a final piactice test without open mateiial anu with time limits.
If you have time to take moie piactice tests, just iepeat step S. By giauually exposing
youiself to the full iigois of the test enviionment, you will conuition youi minu to the stiess
of test uay anu maximize youi success.
Let me state an obvious fact: if you take the test thiee times, you will piobably get thiee
uiffeient scoies. This is uue to the way you feel on test uay, the level of piepaieuness you
have, anu the veision of the test you see. Bespite the test wiiteis' claims to the contiaiy,
some veisions of the test WILL be easiei foi you than otheis.
! EAF !
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Since youi futuie uepenus so much on youi scoie, you shoulu maximize youi chances of
success. In order to maximize the likelihood of success, you’ve got to prepare in advance.
This means taking piactice tests anu spenuing time leaining the infoimation anu test taking
stiategies you will neeu to succeeu.
Nevei go take the actual test as a “practice” test, expecting that you can just take it again if
you neeu to. Take all the piactice tests you can on youi own, but when you go to take the
official test, be piepaieu, be focuseu, anu uo youi best the fiist time!
Eveiyone knows that time is money. Theie is no neeu to spenu too much of youi time oi
too little of youi time piepaiing foi the test. You shoulu only spenu as much of youi
piecious time piepaiing as is necessaiy foi you to get the scoie you neeu.
0nce you have taken a piactice test unuei ieal conuitions of time constiaints, then you will
know if you aie ieauy foi the test oi not.
If you have scoieu extiemely high the fiist time that you take the piactice test, then theie is
not much point in spenuing countless houis stuuying. You aie alieauy theie.
Benchmaik youi abilities by ietaking piactice tests anu seeing how much you have
impioveu. 0nce you consistently scoie high enough to guaiantee success, then you aie
ieauy.
If you have scoieu well below wheie you neeu, then knuckle uown anu begin stuuying in
eainest. Check youi impiovement iegulaily thiough the use of piactice tests unuei ieal
conuitions. Above all, don’t worry, panic, or give up. The key is perseverance!
Then, when you go to take the test, iemain confiuent anu iemembei how well you uiu on
the piactice tests. If you can scoie high enough on a piactice test, then you can uo the same
on the ieal thing.
The most impoitant thing you can uo is to ignoie youi feais anu jump into the test
immeuiately. Bo not be oveiwhelmeu by any stiange-sounuing teims. You have to jump
into the test like jumping into a pool—all at once is the easiest way.
H;=( D/(+*0%*"@'
As you ieau anu unueistanu the question, tiy to guess what the answei will be. Remembei
that seveial of the answei choices aie wiong, anu once you begin ieauing them, youi minu
will immeuiately become clutteieu with answei choices uesigneu to thiow you off. Youi
minu is typically the most focuseu immeuiately aftei you have ieau the question anu
! EAE !
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uigesteu its contents. If you can, tiy to pieuict what the coiiect answei will be. You may be
suipiiseu at what you can pieuict.
Quickly scan the choices anu see if youi pieuiction is in the listeu answei choices. If it is,
then you can be quite confident that you have the right answer. It still won’t hurt to check
the other answer choices, but most of the time, you’ve got it!
2@'#(/ %)( W&('%*"@
It may seem obvious to only pick answei choices that answei the question, but the test
writers can create some excellent answer choices that are wrong. Don’t pick an answer just
because it sounus iight, oi you believe it to be tiue. It N0ST answei the question. 0nce
you’ve made your selection, always go back and check it against the question and make sure
that you didn’t misread the question anu that the answei choice uoes answei the question
poseu.
3(@0)B;/=
Aftei you ieau the fiist answei choice, ueciue if you think it sounus coiiect oi not. If it
doesn’t, move on to the next answer choice. If it does, mentally mark that answer choice.
This doesn’t mean that you’ve definitely selected it as your answer choice, it just means that
it’s the best you’ve seen thus far. Go ahead and read the next choice. If the next choice is
worse than the one you’ve already selected, keep going to the next answer choice. If the
next choice is better than the choice you’ve already selected, mentally mark the new answei
choice as youi best guess.
The fiist answei choice that you select becomes youi stanuaiu. Eveiy othei answei choice
must be benchmaikeu against that stanuaiu. That choice is coiiect until pioven otheiwise
by anothei answei choice beating it out. Once you’ve decided that no other answer choice
seems as goou, uo one final check to ensuie that youi answei choice answeis the question
poseu.
C;<*+ G@A"/B;%*"@
Don’t discount any of the information provided in the question. Every piece of infoimation
may be necessaiy to ueteimine the coiiect answei. None of the infoimation in the question
is theie to thiow you off (while the answei choices will ceitainly have infoimation to thiow
you off). If two seemingly unrelated topics are discussed, don’t ignoie eithei. You can be
confident there is a relationship, or it wouldn’t be included in the question, and you are
piobably going to have to ueteimine what is that ielationship to finu the answei.
Avoid “Fact Traps”
Don’t get distracted by a choice that is factually tiue. Youi seaich is foi the answei that
answers the question. Stay focused and don’t fall for an answer that is true but iiielevant.
Always go back to the question and make sure you’re choosing an answer that actually
answeis the question anu is not just a tiue statement. An answei can be factually coiiect,
but it N0ST answei the question askeu. Auuitionally, two answeis can both be seemingly
coiiect, so be suie to ieau all of the answei choices, anu make suie that you get the one that
BEST answeis the question.
H*<= %)( W&('%*"@
Some of the questions may thiow you completely off. They might ueal with a subject you
! EAG !
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have not been exposed to, or one that you haven’t reviewed in years. While your lack of
knowleuge about the subject will be a hinuiance, the question itself can give you many clues
that will help you finu the coiiect answei. Reau the question caiefully anu look foi clues.
Watch paiticulaily foi aujectives anu nouns uesciibing uifficult teims oi woius that you
don’t recognize. Regaiuless of whethei you completely unueistanu a woiu oi not, ieplacing
it with a synonym, eithei pioviueu oi one you moie familiai with, may help you to
unueistanu what the questions aie asking. Rathei than wiacking youi minu about specific
uetaileu infoimation conceining a uifficult teim oi woiu, tiy to use mental substitutes that
aie easiei to unueistanu.
1)( 1/;? "A 7;B*<*;/*%,
Don’t just choose a word because you recognize it. On difficult questions, you may not
iecognize a numbei of woius in the answer choices. The test writers don’t put “make-
believe” words on the test, so don’t think that just because you only recognize all the woius
in one answei choice that that answei choice must be coiiect. If you only iecognize woius
in one answei choice, then focus on that one. Is it coiiect. Tiy youi best to ueteimine if it
is correct. If it is, that’s great. If not, eliminate it. Each woiu anu answei choice you
eliminate incieases youi chances of getting the question coiiect, even if you then have to
guess among the unfamiliai choices.
5<*B*@;%( 2@'#(/'
Eliminate choices as soon as you iealize they aie wiong. But be caieful! Nake suie you
consider all of the possible answer choices. Just because one appears right, doesn’t mean
that the next one won’t be even better! The test writers will usually put more than one good
answer choice for every question, so read all of them. Don’t worry if you are stuck between
two that seem iight. By getting uown to just two iemaining possible choices, youi ouus aie
now Su¡Su. Rathei than wasting too much time, play the ouus. You aie guessing, but
guessing wisely because you’ve been able to knock out some of the answer choices that you
know aie wiong. If you aie eliminating choices anu iealize that the last answei choice you
are left with is also obviously wrong, don’t panic. Start over and consider each choice again.
Theie may easily be something that you misseu the fiist time anu will iealize on the seconu
pass.
1"&-) W&('%*"@'
If you aie stumpeu on a pioblem or it appears too hard or too difficult, don’t waste time.
Nove on! Remembei though, if you can quickly check foi obviously incoiiect answei
choices, youi chances of guessing coiiectly aie gieatly impioveu. Befoie you completely
give up, at least tiy to knock out a couple of possible answeis. Eliminate what you can anu
then guess at the iemaining answei choices befoie moving on.
3/;*@'%"/B
If you get stuck on a uifficult question, spenu a few seconus quickly biainstoiming. Run
thiough the complete list of possible answei choices. Look at each choice anu ask youiself,
"Coulu this answei the question satisfactoiily." uo thiough each answei choice anu
consiuei it inuepenuently of the otheis. By systematically going thiough all possibilities,
you may finu something that you woulu otheiwise oveilook. Remembei though that when
you get stuck, it’s important to try to keep moving.
! EA# !
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N(;+ 8;/(A&<<,
Understand the problem. Read the question and answer choices carefully. Don’t miss the
question because you misieau the teims. You have plenty of time to ieau each question
thoioughly anu make suie you unueistanu what is being askeu. Yet a happy meuium must
be attained, so don’t waste too much time. You must read carefully, but efficiently.
7;0( C;<&(
When in uoubt, use common sense. Always accept the situation in the pioblem at face
value. Don’t read too much into it. These problems will not require you to make huge leaps
of logic. The test writers aren’t trying to throw you off with a cheap trick. If you have to go
beyonu cieativity anu make a leap of logic in oiuei to have an answei choice answei the
question, then you should look at the other answer choices. Don’t overcomplicate the
pioblem by cieating theoietical ielationships oi explanations that will waip time oi space.
These are normal problems rooted in reality. It’s just that the applicable relationship or
explanation may not be ieauily appaient anu you have to figuie things out. 0se youi
common sense to interpret anything that isn’t clear.
D/(A*I('
If you'ie having tiouble with a woiu in the question oi answei choices, tiy uissecting it.
Take auvantage of eveiy clue that the woiu might incluue. Piefixes anu suffixes can be a
huge help. 0sually they allow you to ueteimine a basic meaning. Pie- means befoie, post-
means aftei, pio - is positive, ue- is negative. Fiom these piefixes anu suffixes, you can get
an iuea of the geneial meaning of the woiu anu tiy to put it into context. Bewaie though of
any tiaps. }ust because con- is the opposite of pio-, doesn’t necessarily mean congress is the
opposite of piogiess!
!(+-( D)/;'('
Watch out foi ciitical heuge phiases, leu off with woius such as “likely,” “may,” “can,”
“sometimes,” “often,” “almost,” “mostly,” “usually,” “geneially,” “iaiely,” and “sometimes.”
Question wiiteis inseit these heuge phiases to covei eveiy possibility. 0ften an answei
choice will be wiong simply because it leaves no ioom foi exception. 0nless the situation
calls foi them, avoiu answei choices that have uefinitive words like “exactly,” and “always.”
:#*%0)E;0= S"/+'
Stay alert for “switchbacks.” These aie the woius anu phiases fiequently useu to aleit you
to shifts in thought. The most common switchback word is “but.” 0theis incluue
“although,” “howevei,” “neveitheless,” “on the othei hanu,” “even though,” “while,” “in spite
of,” “uespite,” and “iegaiuless of.”
9(# G@A"/B;%*"@
Coiiect answei choices will iaiely have completely new infoimation incluueu. Answei
choices typically aie stiaightfoiwaiu ieflections of the mateiial askeu about anu will
uiiectly ielate to the question. If a new piece of infoimation is incluueu in an answei choice
that uoesn't even seem to ielate to the topic being askeu about, then that answei choice is
likely incoiiect. All of the infoimation neeueu to answei the question is usually pioviueu
foi you in the question. You shoulu not have to make guesses that aie unsuppoiteu oi
choose answei choices that iequiie unknown infoimation that cannot be ieasoneu fiom
what is given.
! EA? !
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On technical questions, don’t get lost on the technical terms. Don’t spend too much time on
any one question. If you don’t know what a term means, then odds are you aren’t going to
get much fuithei since you don’t have a dictionary. You shoulu be able to immeuiately
iecognize whethei oi not you know a teim. If you don’t, work with the othei clues that you
have—the othei answei choices anu teims pioviueu—but don’t waste too much time trying
to figuie out a uifficult teim that you don’t know.
8"@%(I%&;< 8<&('
Look foi contextual clues. An answei can be iight but not the coiiect answei. The
contextual clues will help you finu the answei that is most iight anu is coiiect. 0nueistanu
the context in which a phiase oi statement is maue. This will help you make impoitant
uistinctions.
Don’t Panic
Panicking will not answei any questions foi you; therefore, it isn’t helpful. When you first
see the question, if youi minu goes blank, take a ueep bieath. Foice youiself to
mechanically go thiough the steps of solving the pioblem using the stiategies you've
leaineu.
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Don’t get clock fever. It’s easy to be overwhelmed when you’re looking at a page full of
questions, youi minu is full of ianuom thoughts anu feeling confuseu, anu the clock is
ticking uown fastei than you woulu like. Calm uown anu maintain the pace that you have
set foi youiself. As long as you aie on tiack by monitoiing youi pace, you aie guaianteeu to
have enough time foi youiself. When you get to the last few minutes of the test, it may seem
like you won’t have enough time left, but if you only have as many questions as you should
have left at that point, then you’re right on track!
2@'#(/ :(<(0%*"@
The best way to pick an answei choice is to eliminate all of those that aie wiong, until only
one is left anu confiim that is the coiiect answei. Sometimes though, an answei choice may
immeuiately look iight. Be caieful! Take a seconu to make suie that the othei choices aie
not equally obvious. Don’t make a hasty mistake. There aie only two times that you shoulu
stop befoie checking othei answeis. Fiist is when you aie positive that the answei choice
you have selecteu is coiiect. Seconu is when time is almost out anu you have to make a
quick guess!
8)(0= ."&/ S"/=
Since you will piobably not know eveiy teim listeu anu the answei to eveiy question, it is
important that you get credit for the ones that you do know. Don’t miss any questions
thiough caieless mistakes. If at all possible, tiy to take a seconu to look back ovei youi
answer selection and make sure you’ve selected the correct answer choice and haven’t
made a costly careless mistake (such as marking an answer choice that you didn’t mean to
maik). The time it takes foi this quick uouble check shoulu moie than pay foi itself in
caught mistakes.
3(#;/( "A M*/(0%<, W&"%(+ 2@'#(/'
Sometimes an answei choice will iepeat woiu foi woiu a poition of the question oi
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iefeience section. Bowevei, bewaie of such exact uuplication. It may be a tiap! Noie than
likely, the coiiect choice will paiaphiase oi summaiize a point, iathei than being exactly
the same woiuing.
:<;@-
Scientific sounding answers are better than slang ones. An answer choice that begins “To
compare the outcomes…” is much more likely to be correct than one that begins “Because
some people insisted…”
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Avoiu wilu answeis that thiow out highly contioveisial iueas that aie pioclaimeu as
established fact. An answer choice that states the “process should used in certain situations,
if…” is much more likely to be correct than one that states the “process should be
discontinued completely.” The first is a calm rational statement and doesn’t even make a
definitive, uncompromising stance, using a hedge word “if” to provide wiggle room, whereas
the seconu choice is a iauical iuea anu fai moie extieme.
2@'#(/ 8)"*0( 7;B*<*('
When you have two oi moie answei choices that aie uiiect opposites oi paiallels, one of
them is usually the correct answer. For instance, if one answer choice states “x increases”
anu another answer choice states “x decreases” or “y increases,” then those two or three
answei choices aie veiy similai in constiuction anu fall into the same family of answei
choices. A family of answei choices consists of two oi thiee answei choices, veiy similai in
constiuction, but often with uiiectly opposite meanings. 0sually the coiiect answei choice
will be in that family of answer choices. The “odd man out” or answer choice that doesn’t
seem to fit the paiallel constiuction of the othei answei choices is moie likely to be
incoiiect.
! EAA !
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The veiy natuie of tests cateis to some level of anxiety, neivousness, oi tension, just as
we feel foi any impoitant event that occuis in oui lives. A little bit of anxiety oi
neivousness can be a goou thing. It helps us with motivation, anu makes achievement
just that much sweetei. Bowevei, too much anxiety can be a pioblem, especially if it
hinueis oui ability to function anu peifoim.
“Test anxiety,” is the teim that iefeis to the emotional ieactions that some test-takeis
expeiience when faceu with a test oi exam. Baving a feai of testing anu exams is baseu
upon a iational feai, since the test-taker’s performance can shape the course of an
acauemic caieei. Neveitheless, expeiiencing excessive feai of examinations will only
inteifeie with the test-takei’s ability to perform anu chance to be successful.
Theie aie a laige vaiiety of causes that can contiibute to the uevelopment anu sensation
of test anxiety. These incluue, but aie not limiteu to, lack of piepaiation anu woiiying
about issues suiiounuing the test.
Lack of piepaiation can be iuentifieu by the following behaviois oi situations:
Not scheuuling enough time to stuuy, anu theiefoie ciamming the night befoie the test
oi exam
Nanaging time pooily, to cieate the sensation that theie is not enough time to uo
eveiything
Failing to oiganize the text infoimation in auvance, so that the stuuy mateiial consists of
the entiie text anu not simply the peitinent infoimation
Pooi oveiall stuuying habits
Woiiying, on the othei hanu, can be ielateu to both the test takei, oi many othei factois
aiounu him¡hei that will be affecteu by the iesults of the test. These incluue woiiying
about:
Pievious peifoimances on similai exams, oi exams in geneial
Bow fiienus anu othei stuuents aie achieving
The negative consequences that will iesult fiom a pooi giaue oi failuie
Theie aie thiee piimaiy elements to test anxiety. Physical components, which involve
the same typical bouily ieactions as those to acute anxiety (to be uiscusseu below).
Emotional factois have to uo with feai oi panic. Nental oi cognitive issues conceining
attention spans anu memoiy abilities.
! EAB !
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Theie aie many uiffeient symptoms of test anxiety, anu these aie not limiteu to mental
anu emotional stiain. Fiequently theie aie a iange of physical signals that will let a test
takei know that he¡she is suffeiing fiom test anxiety. These bouily changes can incluue
the following:
Peispiiing
Sweaty palms
Wet, tiembling hanus
Nausea
Biy mouth
A knot in the stomach
Beauache
Faintness
Nuscle tension
Aching shoulueis, back anu neck
Rapiu heait beat
Feeling too hot¡colu
To iecognize the sensation of test anxiety, a test-takei shoulu monitoi him¡heiself foi
the following sensations:
The physical uistiess symptoms as listeu above
Emotional sensitivity, expiessing emotional feelings such as the neeu to ciy oi laugh too
much, oi a sensation of angei oi helplessness
A uecieaseu ability to think, causing the test-takei to blank out oi have iacing thoughts
that aie haiu to oiganize oi contiol.
Though most stuuents will feel some level of anxiety when faceu with a test oi exam, the
majoiity can cope with that anxiety anu maintain it at a manageable level. Bowevei,
those who cannot aie faceu with a veiy ieal anu veiy seiious conuition, which can anu
shoulu be contiolleu foi the immeasuiable benefit of this suffeiei.
Natuially, these sensations leau to negative iesults foi the testing expeiience. The most
common effects of test anxiety have to uo with neivousness anu mental blocking.
Neivousness can appeai in seveial uiffeient levels:
The test-taker’s difficulty, or even inability to read and understand the questions on the
test
The uifficulty oi inability to oiganize thoughts to a coheient foim
The uifficulty oi inability to iecall key woius anu concepts ielating to the testing
questions (especially essays)
The ieceipt of pooi giaues on a test, though the test mateiial was well known by the test
takei
! EAC !
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Conveisely, a peison may also expeiience mental blocking, which involves:
Blanking out on test questions
0nly iemembeiing the coiiect answeis to the questions when the test has alieauy
finisheu.
Foitunately foi test anxiety suffeieis, beating these feelings, to a laige uegiee, has to uo
with piopei piepaiation. When a test takei has a feeling of piepaieuness, then anxiety
will be uiamatically lesseneu.
The fiist step to iesolving anxiety issues is to uistinguish which of the two types of
anxiety aie being suffeieu. If the anxiety is a uiiect iesult of a lack of piepaiation, this
shoulu be consiueieu a noimal ieaction, anu the anxiety level (as opposeu to the test
results) shouldn’t be anything to worry about. Howevei, if, when auequately piepaieu,
the test-takei still panics, blanks out, oi seems to oveiieact, this is not a fully iational
ieaction. While this can be consiueieu noimal too, theie aie many ways to combat anu
oveicome these effects.
Remembei that anxiety cannot be entiiely eliminateu, howevei, theie aie ways to
minimize it, to make the anxiety easiei to manage. Piepaiation is one of the best ways
to minimize test anxiety. Theiefoie the following techniques aie wise in oiuei to best
fight off any anxiety that may want to builu.
To begin with, tiy to avoiu ciamming befoie a test, whenevei it is possible. By tiying to
memorize an entire term’s worth of information in one day, you’ll be shocking your
system, anu not giving youiself a veiy goou chance to absoib the infoimation. This is an
easy path to anxiety, so foi those who suffei fiom test anxiety, ciamming shoulu not
even be consiueieu an option.
Insteau of ciamming, woik thioughout the semestei to combine all of the mateiial
which is piesenteu thioughout the semestei, anu woik on it giauually as the couise
goes by, making suie to mastei the main concepts fiist, leaving minoi uetails foi a week
oi so befoie the test.
To stuuy foi the upcoming exam, be suie to pose questions that may be on the
examination, to gauge the ability to answei them by integiating the iueas fiom youi
texts, notes anu lectuies, as well as any supplementaiy ieauings.
If it is tiuly impossible to covei all of the infoimation that was coveieu in that paiticulai
teim, concentiate on the most impoitant poitions, that can be coveieu veiy well. Leain
these concepts as best as possible, so that when the test comes, a goal can be maue to
use these concepts as piesentations of youi knowleuge.
In auuition to stuuy habits, changes in attituue aie ciitical to beating a stiuggle with test
anxiety. In fact, an impiovement of the peispective ovei the entiie test-taking
expeiience can actually help a test takei to enjoy stuuying anu theiefoie impiove the
oveiall expeiience. Be ceitain not to oveiemphasize the significance of the giaue - know
that the iesult of the test is neithei a ieflection of self woith, noi is it a measuie of
intelligence; one grade will not predict a person’s future success.
! EAD !
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To impiove an oveiall testing outlook, the following steps shoulu be tiieu:
Keeping in minu that the most ieasonable expectation foi taking a test is to expect to tiy
to uemonstiate as much of what you know as you possibly can.
Reminuing ouiselves that a test is only one test; this is not the only one, anu theie will
be otheis.
The thought of thinking of oneself in an iiiational, all-oi-nothing teim shoulu be
avoiueu at all costs.
A reward should be designated for after the test, so there’s something to look forward
to. Whethei it be going to a movie, going out to eat, oi simply visiting fiienus, scheuule
it in auvance, anu uo it no mattei what iesult is expecteu on the exam.
Test-takeis shoulu also keep in minu that the basics aie some of the most impoitant
things, even beyonu anti-anxiety techniques anu stuuying. Nevei neglect the basic
social, emotional anu biological neeus, in oiuei to tiy to absoib infoimation. In oiuei to
best achieve, these thiee factois must be helu as just as impoitant as the stuuying itself.
Remembei the following impoitant steps foi stuuying:
Naintain healthy nutiition anu exeicise habits. Continue both youi iecieational
activities anu social pass times. These both contiibute to youi physical anu emotional
well being.
Be ceitain to get a goou amount of sleep, especially the night befoie the test, because
when you’re overtired you are not able to perform to the best of your best ability.
Keep the stuuying pace to a moueiate level by taking bieaks when they aie neeueu, anu
vaiying the woik whenevei possible, to keep the minu fiesh insteau of getting boieu.
When enough stuuying has been uone that all the mateiial that can be leaineu has been
leaineu, anu the test takei is piepaieu foi the test, stop stuuying anu uo something
ielaxing such as listening to music, watching a movie, oi taking a waim bubble bath.
Theie aie also many othei techniques to minimize the uneasiness oi appiehension that
is expeiienceu along with test anxiety befoie, uuiing, oi even aftei the examination. In
fact, theie aie a gieat ueal of things that can be uone to stop anxiety fiom inteifeiing
with lifestyle anu peifoimance. Again, iemembei that anxiety will not be eliminateu
entirely, and it shouldn’t be. Otherwise that “up” feeling for exams would not exist, and
most of us uepenu on that sensation to peifoim bettei than usual. Bowevei, this anxiety
has to be at a level that is manageable.
0f couise, as we have just uiscusseu, being piepaieu foi the exam is half the battle iight
away. Attenuing all classes, finuing out what knowleuge will be expecteu on the exam,
anu knowing the exam scheuules aie easy steps to loweiing anxiety. Keeping up with
woik will iemove the neeu to ciam, anu efficient stuuy habits will eliminate wasteu
time. Stuuying shoulu be uone in an iueal location foi concentiation, so that it is simple
to become inteiesteu in the mateiial anu give it complete attention. A methou such as
SQSR (Suivey, Question, Reau, Recite, Review) is a wonueiful key to follow to make suie
! EBF !
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that the stuuy habits aie as effective as possible, especially in the case of leaining fiom a
textbook. Flashcaius aie gieat techniques foi memoiization. Leaining to take goou
notes will mean that notes will be full of useful infoimation, so that less sifting will neeu
to be uone to seek out what is peitinent foi stuuying. Reviewing notes aftei class anu
then again on occasion will keep the infoimation fiesh in the minu. Fiom notes that
have been taken summaiy sheets anu outlines can be maue foi simplei ieviewing.
A stuuy gioup can also be a veiy motivational anu helpful place to stuuy, as theie will be
a shaiing of iueas, all of the minus can woik togethei, to make suie that eveiyone
unueistanus, anu the stuuying will be maue moie inteiesting because it will be a social
occasion.
Basically, though, as long as the test-takei iemains oiganizeu anu self confiuent, with
efficient stuuy habits, less time will neeu to be spent stuuying, anu highei giaues will be
achieveu.
To become self confiuent, theie aie many useful steps. The fiist of these is “self talk.” It
has been shown thiough extensive ieseaich, that self-talk foi stuuents who suffei fiom
test anxiety, shoulu be well monitoieu, in oiuei to make suie that it contiibutes to self
confiuence as opposeu to sinking the stuuent. Fiequently the self talk of test-anxious
stuuents is negative oi self-uefeating, thinking that eveiyone else is smaitei anu fastei,
that they always mess up, and that if they don’t do well, they’ll fail the entire course. It
is impoitant to uecieasing anxiety that awaieness is maue of self talk. Tiy wiiting any
negative self thoughts anu then uisputing them with a positive statement insteau. Begin
self-encouiagement as though it was a fiienu speaking. Repeat positive statements to
help iepiogiam the minu to believing in successes insteau of failuies.
0thei extiemely helpful techniques incluue:
Self-visualization of uoing well anu ieaching goals
While aiming for an “A” level of understanding, don’t try to “overprotect” by setting your
expectations lowei. This will only convince the minu to stop stuuying in oiuei to meet
the lowei expectations.
Don’t make comparisons with the results or habits of other students. These are
inuiviuual factois, anu uiffeient things woik foi uiffeient people, causing uiffeient
iesults.
Stiive to become an expeit in leaining what woiks well, anu what can be uone in oiuei
to impiove. Consiuei collecting this uata in a jouinal.
Cieate iewaius foi aftei stuuying insteau of uoing things befoie stuuying that will only
tuin into avoiuance behaviois.
Nake a piactice of ielaxing - by using methous such as piogiessive ielaxation, self-
hypnosis, guiueu imageiy, etc - in oiuei to make ielaxation an automatic sensation.
Woik on cieating a state of ielaxeu concentiation so that concentiating will take on the
focus of the minu, so that none will be wasteu on woiiying.
Take goou caie of the physical self by eating well anu getting enough sleep.
Plan in time foi exeicise anu stick to this plan.
! EBE !
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Beyonu these techniques, theie aie othei methous to be useu befoie, uuiing anu aftei
the test that will help the test-takei peifoim well in auuition to oveicoming anxiety.
Befoie the exam comes the acauemic piepaiation. This involves establishing a stuuy
scheuule anu beginning at least one week befoie the actual uate of the test. By uoing
this, the anxiety of not having enough time to stuuy foi the test will be automatically
eliminateu. Noieovei, this will make the stuuying a much moie effective expeiience,
ensuiing that the leaining will be an easiei piocess. This ielieves much unuue piessuie
on the test-takei.
Summaiy sheets, note caius, anu flash caius with the main concepts anu examples of
these main concepts shoulu be piepaieu in auvance of the actual stuuying time. A topic
shoulu never be eliminated from this process. By omitting a topic because it isn’t
expecteu to be on the test is only setting up the test-takei foi anxiety shoulu it actually
appeai on the exam. 0tilize the couise syllabus foi laying out the topics that shoulu be
stuuieu. Caiefully go ovei the notes that weie maue in class, paying special attention to
any of the issues that the piofessoi took special caie to emphasize while lectuiing in
class. In the textbooks, use the chaptei ieview, oi if possible, the chaptei tests, to begin
youi ieview.
It may even be possible to ask the instiuctoi what infoimation will be coveieu on the
exam, oi what the foimat of the exam will be (foi example, multiple choice, essay, fiee
foim, tiue-false). Auuitionally, see if it is possible to finu out how many questions will
be on the test. If a ieview sheet oi sample test has been offeieu by the piofessoi, make
goou use of it, above anything else, foi the piepaiation foi the test. Anothei gieat
iesouice foi getting to know the examination is ieviewing tests fiom pievious
semesteis. 0se these tests to ieview, anu aim to achieve a 1uu% scoie on each of the
possible topics. With a few exceptions, the goal that you set foi youiself is the highest
one that you will ieach.
Take all of the questions that weie assigneu as homewoik, anu iewoik them to any
othei possible couise mateiial. The moie pioblems iewoikeu, the moie skill anu
confiuence will foim as a iesult. When foiming the solution to a pioblem, wiite out each
of the steps. Don’t simply uo heau woik. By uoing as many steps on papei as possible,
much claiification anu theiefoie confiuence will be foimeu. Bo this with as many
homewoik pioblems as possible, befoie checking the answeis. By checking the answei
aftei each pioblem, a ieinfoicement will exist, that will not be on the exam. Stuuy
situations shoulu be as exam-like as possible, to piime the test-taker’s system for the
expeiience. By waiting to check the answeis at the enu, a psychological auvantage will
be foimeu, to ueciease the stiess factoi.
Anothei fantastic ieason foi not ciamming is the avoiuance of confusion in concepts,
especially when it comes to mathematics. 8-1u houis of stuuy will become one hunuieu
peicent moie effective if it is spieau out ovei a week oi at least seveial uays, insteau of
uoing it all in one sitting. Recognize that the human biain iequiies time in oiuei to
assimilate new mateiial, so fiequent bieaks anu a span of stuuy time ovei seveial uays
will be much moie beneficial.
! EBG !
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Additionally, don’t stuuy iight up until the point of the exam. Stuuying shoulu stop a
minimum of one houi befoie the exam begins. This allows the biain to iest anu put
things in theii piopei oiuei. This will also pioviue the time to become as ielaxeu as
possible when going into the examination ioom. The test-takei will also have time to
eat well anu eat sensibly. Know that the biain neeus foou as much as the iest of the
bouy. With enough foou anu enough sleep, as well as a ielaxeu attituue, the bouy anu
the minu aie piimeu foi success.
Avoiu any anxious classmates who aie talking about the exam. These stuuents only
spieau anxiety, anu aie not woith shaiing the anxious sentimentalities.
Befoie the test also involves cieating a positive attituue, so mental piepaiation shoulu
also be a point of concentiation. Theie aie many keys to cieating a positive attituue.
Shoulu feais become iushing in, make a visualization of taking the exam, uoing well, anu
seeing an A wiitten on the papei. Wiite out a list of affiimations that will biing a feeling
of confidence, such as “I am doing well in my English class,” “I studied well and know
my material,” “I enjoy this class.” Even if the affirmations aren’t believed at first, it
senus a positive message to the subconscious which will iesult in an alteiation of the
oveiall belief system, which is the system that cieates ieality.
If a sensation of panic begins, woik with the feai anu imagine the veiy woist! Woik
thiough the entiie scenaiio of not passing the test, failing the entiie couise, anu
uiopping out of school, followeu by not getting a job, anu pushing a shopping cait
through the dark alley where you’ll live. This will place things into perspective! Then,
piactice ueep bieathing anu cieate a visualization of the opposite situation - achieving
an “A” on the exam, passing the entire course, receiving the degree at a graduation
ceiemony.
0n the uay of the test, theie aie many things to be uone to ensuie the best iesults, as
well as the most calm outlook. The following stages aie suggesteu in oiuei to maximize
test-taking potential:
Begin the examination uay with a moueiate bieakfast, anu avoiu any coffee oi
beveiages with caffeine if the test takei is pione to jitteis. Even people who aie useu to
managing caffeine can feel jitteiy oi light-heaueu when it is taken on a test uay.
Attempt to uo something that is ielaxing befoie the examination begins. As last minute
ciamming clouus the masteiing of oveiall concepts, it is bettei to use this time to cieate
a calming outlook.
Be ceitain to aiiive at the test location well in auvance, in oiuei to pioviue time to select
a location that is away fiom uoois, winuows anu othei uistiactions, as well as giving
enough time to ielax befoie the test begins.
Keep away fiom anxiety geneiating classmates who will upset the sensation of stability
anu ielaxation that is being attempteu befoie the exam.
Shoulu the waiting peiiou befoie the exam begins cause anxiety, cieate a self-uistiaction
by ieauing a light magazine oi something else that is ielaxing anu simple.
Buiing the exam itself, ieau the entiie exam fiom beginning to enu, anu finu out how
much time shoulu be allotteu to each inuiviuual pioblem. 0nce wiiting the exam,
shoulu moie time be taken foi a pioblem, it shoulu be abanuoneu, in oiuei to begin
! EB# !
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anothei pioblem. If theie is time at the enu, the unfinisheu pioblem can always be
ietuineu to anu completeu.
Reau the instiuctions veiy caiefully - twice - so that unpleasant surprises won’t follow
uuiing oi aftei the exam has enueu.
When wiiting the exam, pietenu that the situation is actually simply the completion of
homewoik within a libiaiy, oi at home. This will assist in foiming a ielaxeu
atmospheie, anu will allow the biain extia focus foi the complex thinking function.
Begin the exam with all of the questions with which the most confiuence is felt. This will
builu the confiuence level iegaiuing the entiie exam anu will begin a quality
momentum. This will also cieate encouiagement foi tiying the pioblems wheie
unceitainty iesiues.
Going with the “gut instinct” is always the way to go when solving a problem. Second
guessing shoulu be avoiueu at all costs. Bave confiuence in the ability to uo well.
Foi essay questions, cieate an outline in auvance that will keep the minu oiganizeu anu
make ceitain that all of the points aie iemembeieu. Foi multiple choice, ieau eveiy
answei, even if the coiiect one has been spotteu - a bettei one may exist.
Continue at a pace that is ieasonable anu not iusheu, in oiuei to be able to woik
caiefully. Pioviue enough time to go ovei the answeis at the enu, to check foi small
eiiois that can be coiiecteu.
Shoulu a feeling of panic begin, bieathe ueeply, anu think of the feeling of the bouy
ieleasing sanu thiough its poies. visualize a calm, peaceful place, anu incluue all of the
sights, sounus anu sensations of this image. Continue the ueep bieathing, anu take a few
minutes to continue this with closeu eyes. When all is well again, ietuin to the test.
If a “blanking” occurs for a certain question, skip it anu move on to the next question.
Theie will be time to ietuin to the othei question latei. uet eveiything uone that can be
uone, fiist, to guaiantee all the giaues that can be compileu, anu to builu all of the
confiuence possible. Then ietuin to the weakei questions to builu the maiks fiom
theie.
Remember, one’s own reality can be created, so as long as the belief is there, success
will follow. And remember: anxiety can happen later, right now, there’s an exam to be
wiitten!
Aftei the examination is complete, whethei theie is a feeling foi a goou giaue oi a bau
grade, don’t dwell on the exam, and be certain to follow through on the reward that was
promised…and enjoy it! Don’t dwell on any mistakes that have been made, as there is
nothing that can be uone at this point anyway.
Additionally, don’t begin to study for the next test right away. Do something relaxing for
a while, anu let the minu ielax anu piepaie itself to begin absoibing infoimation again.
! EB? !
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Fiom the iesults of the exam - both the giaue anu the entiie expeiience, be ceitain to
leain fiom what has gone on. Peifect stuuying habits anu woik some moie on
confiuence in oiuei to make the next examination expeiience even bettei than the last
one.
Leain to avoiu places wheie openings occuiieu foi laziness, piociastination anu uay
uieaming.
0se the time between this exam anu the next one to bettei leain to ielax, even leaining
to ielax on cue, so that any anxiety can be contiolleu uuiing the next exam. Leain how
to ielax the bouy. Slouch in youi chaii if that helps. Tighten anu then ielax all of the
uiffeient muscle gioups, one gioup at a time, beginning with the feet anu then woiking
all the way up to the neck anu face. This will ultimately ielax the muscles moie than
they weie to begin with. Leain how to bieathe ueeply anu comfoitably, anu focus on
this bieathing going in anu out as a ielaxing thought. With eveiy exhale, iepeat the
word “relax.”
As common as test anxiety is, it is veiy possible to oveicome it. Nake youiself one of the
test-takeis who oveicome this fiustiating hinuiance.
! EB@ !
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Aftei going thiough the expeiience of taking a majoi test, many test takeis feel that once
is enough. The test usually comes during a period of transition in the test taker’s life,
anu taking the test is only one of a seiies of impoitant events. With so many
uistiactions anu conflicting iecommenuations, it may be uifficult foi a test takei to
iationally ueteimine whethei oi not he shoulu ietake the test aftei viewing his scoies.
The impoitance of the test usually only auus to the buiuen of the ietake uecision.
However, don’t be swayed by emotion. There a few simple questions that you can ask
youiself to guiue you as you tiy to ueteimine whethei a ietake woulu impiove youi
scoie:
1. What went wrong? Why wasn’t your score what you expected?
Can you point to a single factoi oi pioblem that you feel causeu the low scoie. Weie
you sick on test uay. Was theie an emotional upheaval in youi life that causeu a
uistiaction. Weie you late foi the test oi not able to use the full time allotment. If you
can point to any of these specific, inuiviuual pioblems, then a ietake shoulu uefinitely be
consiueieu.
2. Is theie enough time to impiove.
Nany pioblems that may show up in youi scoie iepoit may take a lot of time foi
impiovement. A ueficiency in a paiticulai math skill may iequiie weeks oi months of
tutoiing anu stuuying to impiove. If you have enough time to impiove an iuentifieu
weakness, then a ietake shoulu uefinitely be consiueieu.
S. Bow will auuitional scoies be useu. Will a scoie aveiage, highest scoie, oi most
iecent scoie be useu.
Biffeient test scoies may be hanuleu completely uiffeiently. If you’ve taken the test
multiple times, sometimes youi highest scoie is useu, sometimes youi aveiage scoie is
computeu anu useu, anu sometimes youi most iecent scoie is useu. Nake suie you
unueistanu what methou will be useu to evaluate youi scoies, anu use that to help you
ueteimine whethei a ietake shoulu be consiueieu.
4. Aie my piactice test scoies significantly highei than my actual test scoie.
If you have taken a lot of piactice tests anu aie consistently scoiing at a much highei
level than youi actual test score, then you should consider a retake. However, if you’ve
taken five piactice tests anu only one of youi scoies was highei than youi actual test
scoie, oi if youi piactice test scoies weie only slightly highei than youi actual test
scoie, then it is unlikely that you will significantly inciease youi scoie.
! EBA !
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S. Bo I neeu peifect scoies oi will I be able to live with this scoie. Will this scoie still
allow me to follow my uieams.
What kinu of scoie is acceptable to you. Is youi cuiient score “good enough?” Do you
have to have a certain score in order to pursue the future of your dreams? If you won’t
be happy with your current score, and there’s no way that you could live with it, then
you should consider a retake. However, don’t get your hopes up. If you aie looking foi
significant improvement, that may or may not be possible. But if you won’t be happy
otheiwise, it is at least woith the effoit.
Remembei that theie aie othei consiueiations. To achieve youi uieam, it is likely that
youi giaues may also be taken into account. A gieat test scoie is usually not the only
thing necessary to succeed. Make sure that you aren’t overemphasizing the importance
of a high test scoie.
Fuitheimoie, a ietake uoes not always iesult in a highei scoie. Some test takeis will
scoie lowei on a ietake, iathei than highei. 0ne stuuy shows that one-fouith of test
takeis will achieve a significant impiovement in test scoie, while one-sixth of test takeis
will actually show a ueciease. While this shows that most test takeis will impiove, the
majoiity will only impiove theii scoies a little anu a ietake may not be woith the test
taker’s effort.
Finally, if a test is taken only once anu is consiueieu in the auueu context of goou giaues
on the pait of a test takei, the peison ieviewing the giaues anu scoies may be tempteu
to assume that the test takei just hau a bau uay while taking the test, anu may uiscount
the low test scoie in favoi of the high giaues. But if the test is ietaken anu the scoies
aie appioximately the same, then the valiuity of the low scoies aie only confiimeu.
Therefore, a retake could actually hurt a test taker by definitely bracketing a test taker’s
scoie ability to a limiteu iange.
! EBB !
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