LCSW (DSM-IV-TR) Flashcards

Terms Definitions
What is listed on Axis I
Clinical Disorders and other Conditions that many be a focus of clinical attention
What is listed on Axis II
Personality Disorders and mental retardation
What is listed on Axis III
General medical conditions
What is listed on Axis IV
Psychosocial and environmental problems
What is listed on Axis V
Global Assessment of Functioning
What is the Principal Diagnoses
The reason for the visit, the justification for the service / treatment to be given.
What is the diagnostic criteria for mental retardation
Age of onset must be before the age of 18, IQ below 70
What is the IQ range for mild mental retardation
50-55
What is the IQ range for moderate mental retardation
35 - 55
What is the IQ range for severe mental retardation
20 - 35
What is Borderline Intellectual Functioning
people have IQ's ranging from 71- 75
What is the diagnostic criteria for Autistic Disorder
some symptoms present before the age of 3, marked lack of awareness of the existence of others, lack of interest in social play or lack of seeking comfort during times of distress.
Differential Diagnoses for Autism
Schizophrenia with childhood onset. Symptoms usually develop after years of normal or near normal functioning.
Rett's Disorder
Only occurs in girls. Deceleration in head growth.
Asperger's Disorder
No delay in language, cognitive development. More prominent in males than females. Able to work.
What are some assessment considerations for child you suspect are living with Autism
Refer the child for pediatric and neurological evaluations and laboratory studies. Record medical info on Axis III. Review developmental, medical records. Refer child to speech and hearing evaluations.
What are some treatment options for children living with Autism
Educational programs focused on ADL's. Shaping and discrimination training. No unstructured play therapy - not helpful.
What is the diagnostic criteria for ADHD
A disturbance for at least 6 months. Must have of these symptoms; careless mistakes, not seeming to listen, often losing and forgetting things, easily distracted, fidgeting.
Conduct Disorder
A persistent pattern of conduct that violates the basic rights of others and major age appropriate norms or rules. aggression toward people of animals, destruction of property, theft.
Treatment for Conduct Disorder
Best for pre-adolescents. Parent management training , parents establish riles, negotiate compromises construct treatment contracts and offer awards. Functional Family Therapy - focuses on improving communication.
Oppositional Defiant Disorder
A recurrent pattern of negativistic, defiant, and hostile behaviors toward authority figures persisting for at least 6 months. Often loses temper, argues with adults, actively defies or challenges the rules or requests, deliberately annoys people, blames others
Pica
Eating non-nutritional substances for at least 1 month.
Rumination Disorder
Regurgitation and rechewing of food.
Feeding Disorder of Infancy of Early Childhood (aka, failure to thrive)
Persistent failure to eat adequately, along with significant failure to gain weight or significant weight loss.
Assessment Considerations when work with disorders found in Childhood
1. Refer child to a physician for medical evals to rule out the possibility that a general medical condition is responsible for the symptoms. 2. Obtain developmental medical, social, psychiatric, family histories, and a history of the problem. 3. Assess possible co-disorders (i.e. sleep disorders and behavioral problems). 4. Family assessments
Tic Disorders
A sudden, rapid, recurrent, non-rhythmic, stereotyped motor movement or vocalization.
Tourette's Disorder
Multiple motor and one or more vocal tics. Common associated features include obsessions and compulsions, social discomfort and depression.
Assessment considerations for Tic Disorders
The Conners Parents Questionnaire - to rate the effects of the disturbance on clients day to day life, interview teachers
Enuresis - Elimination Disorder
Voiding urine - treatment bell and and method is effective
Encopresis - Elimination Disorder
Passing feces into inappropriate places at least 1 time per month for at least 3 months - treatment includes behavioral education / positive reinforcement
What is a Mental Disorder
A syndrome or pattern that is associated with distress, disability and / or marked increased risk of suffering death, pain, disability or an important loss of freedom
Define Delirium
A disturbance in consciousness with reduced ability to focus, sustain or shift attention. A change in cognition, symptoms develop over a short period of time (hours or days).
Define Dementia
A slow progressive decline in cognitive functioning, memory impairment
What is Amnestic Disorder
Amnestic disorders mental disorders characterized by acquired impairment in the ability to learn and recall new information, sometimes accompanied by inability to recall previously learned information, and not coupled to dementia or delirium. The disorders are subclassified on the basis of etiology as amnestic disorder due to a general medical condition, substance-induced persisting amnestic disorder, and amnestic disorder not otherwise specified.
Polysubstance Dependence
Polysubstance dependence is a diagnosis given for a behavioral pattern exhibited by an individual who has been using a minimum of three psychoactive substances within a twelve month period without the use of one outweighing the other. These substances do not include caffeine or nicotine. [1]

A person with polysubstance dependence is psychologically addicted to being in an intoxicated state, but because no single drug predominates, the person does not develop symptoms of physical dependence (tolerance, physical withdrawal upon cessation, etc.) in relation to any of the abused substances.

When coding Polysubstance Dependence in a DSM-IV-TR multiaxial diagnosis, "304.80 Polysubstance Dependence" is accompanied by a list of the substances abused (e.g. "305.00 Alcohol Abuse", "305.60 Cocaine Abuse"); there is no diagnostic label for "Polysubstance Abuse".
Schizophrenia
Ill for at least 6 months, must have at least 2 of 5 symptoms 1. Delusions 2. Hallucinations 3. Disorganized behavior 4. Disorganized Speech 5. Negative Symptoms
Positive Symptoms
Positive symptoms are those that most individuals do not normally experience but are present in people with schizophrenia. They can include delusions, disordered thoughts and speech, and tactile, auditory, visual, olfactory and gustatory hallucinations, typically regarded as manifestations of psychosis. Hallucinations are also typically related to the content of the delusional theme. Positive symptoms generally respond well to medication.
Negative Symptoms
Negative symptoms are deficits of normal emotional responses or of other thought processes, and respond less well to medication. They commonly include flat or blunted affect and emotion, poverty of speech (alogia), inability to experience pleasure (anhedonia), lack of desire to form relationships (asociality), and lack of motivation (avolition). Research suggests that negative symptoms contribute more to poor quality of life, functional disability, and the burden on others than do positive symptoms. People with prominent negative symptoms often have a history of poor adjustment before the onset of illness, and response to medication is often limited.
Paranoid type
Where delusions and hallucinations are present but thought disorder, disorganized behavior, and affective flattening are absent.
Disorganized type
Where thought disorder and flat affect are present together.
Catatonic type
The subject may be almost immobile or exhibit agitated, purposeless movement. Symptoms can include catatonic stupor and waxy flexibility
Undifferentiated type
Psychotic symptoms are present but the criteria for paranoid, disorganized, or catatonic types have not been met.
Residual type
Where positive symptoms are present at a low intensity only.
Differential Schizophrenia
Psychotic symptoms may be present in several other mental disorders, including bipolar disorder, borderline personality disorder, drug intoxication and drug-induced psychosis. Delusions ("non-bizarre") are also present in delusional disorder, and social withdrawal in social anxiety disorder, avoidant personality disorder and schizotypal personality disorder. Schizophrenia is complicated with obsessive-compulsive disorder (OCD) considerably more often than could be explained by pure chance, although it can be difficult to distinguish obsessions that occur in OCD from the delusions of schizophrenia.
Rule Out Medical Causes for Schizophrenia
A more general medical and neurological examination may be needed to rule out medical illnesses which may rarely produce psychotic schizophrenia-like symptoms,[61] such as metabolic disturbance, systemic infection, syphilis, HIV infection, epilepsy, and brain lesions. It may be necessary to rule out a delirium, which can be distinguished by visual hallucinations, acute onset and fluctuating level of consciousness, and indicates an underlying medical illness. Investigations are not generally repeated for relapse unless there is a specific medical indication or possible adverse effects from antipsychotic medication.
Delusional Disorder
A psychiatric diagnosis denoting a psychotic mental disorder that is characterized by holding one or more non-bizarre delusions in the absence of any other significant psychopathology. Non-bizarre delusions are fixed beliefs that are certainly and definitely false, but that could possibly be plausible, for example, someone who thinks he or she is under police surveillance. For the diagnosis to be made, auditory and visual hallucinations cannot be prominent, though olfactory or tactile hallucinations related to the content of the delusion may be present.
Schizophreniform Disorder
A mental disorder diagnosed when symptoms of schizophrenia are present for a significant portion of the time within a one-month period, but signs of disruption are not present for the full six months required for the diagnosis of schizophrenia.
Schizoaffective Disorder
A psychiatric diagnosis that describes a mental disorder characterized by recurring episodes of elevated or depressed mood, or of simultaneously elevated and depressed mood, that alternate with, or occur together with, distortions in perception.
Brief Psychotic Disorder
Less then 1 month. A period of psychosis whose duration is generally shorter, non re-occurring, and not better accounted for by another condition.
Psychotic Disorder Not Otherwised Specified (NOS)
Psychotic symptoms that do not meet the criteria for any specific psychotic disorder.
When providing treatment to a child with oppositional defiant disorder a social worker should.
engage the child's teacher in order to reinforce the generalization of interpersonal problem solving skills which are learned in therapy sessions
Your client, a 42 year old man, has just presented information that leads you to a reasonable suspicion that he is engaging in physical child abuse. You should...
comment on the pro-social purpose of child abuse reports and ask the client if he would like to make the report himself immediately in your presence
Your 12 year old client has ADHD. In order to help the client anticipate and prepare for challenging situations, cope with arousal in a challenging situation, and cool down after a challenging situation you should
teach him self-instructional statements
You are using cognitive restructuring to treat a 40 year old client's symptoms of a generalized anxiety disorder. Which of the following interventions should you use first?
initiate self-monitoring strategies by teaching the client to identify automatic negative and self critical thoughts - Self-monitoring and identification of a client's own automatic thoughts is part of an individualized assessment process which precedes change oriented intervention in any treatment approach, including cognitive behavioral therapy.
Jennifer, age 11, experiences discrete episodes of intense anxiety which peak within ten minutes and tend to dissipate over the next half hour to forty-five minutes. These episodes occur whenever the teacher asks Jennifer to speak in class. She does not w
phobic anxiety- because the anxiety episodes are precipitated by a specific stimulus situation, that is, being called upon to speak by the teacher.
If you were using the classic dialectic behavioral therapy model with a borderline personality disorder client, you would provide and/or arrange for the client to receive...
an eclectic combination of interventions involving weekly group and individuals sessions over a 1 year period
An 11 year old client with conduct disorder has been physically abused and lacks a sense of empathy for others whom he has abused. He also lacks a sense of safety and security and is socially isolated. In order to help the child develop a greater sense of
help the client become conscious of, and verbalize, what it was like to be victimized himself. People with conduct disorder, antisocial personality disorder, and others who are abusive and exploitive toward others often lack a sense of empathy because they are not in touch with their own affective experience. This is often the result of dissociation used as a defense against the pain of their own earlier victimization.
Your client ventilates her emotions freely during sessions with you, to the point where she feels embarrassed. The first thing you should do is...
paraphrase her comments in a way that directs attention away from affect and more to factual aspects of the situation until she is ready for greater self-revelation.
In assessing your adolescent client's developing sense of identity, you should determine...
how well the client is adapting to social demands to begin making adult role choices - is most directly relevant to adolescent identity formation
whether or not the client has a sense of time perspective, a sense that there will be a future and that he will be there in the future, is considered what stage?
a sense of time perspective is established during infancy at the stage of basic trust.
You have been helping a substance dependent client overcome compulsive behavior that is not directly related to the substance use. His substance dependence has been characterized by denial and avoidance, but recently he has been considering either reducin
discuss substance use in a general way and help the client understand the effects and consequences of the substances he is using. This stage of change is referred to as "contemplation." The client is beginning to wonder why he or she engages in a harmful habit and what its payoff might be. The client is not yet planning to take action. Moving too fast will threaten the therapeutic relationship. This is a phase of tentative exploration of the issues in a general way.
The Tarasoff "Duty to Warn" requires that you warn the appropriate individuals whenever you determine that your psychotherapy client...
presents a serious danger of violence to another person
Vascular dementia
Vascular dementia develops as a result of multiple small strokes. Some cognitive functioning is lost with each stroke, then mental status stabilizes until the next small stroke.
Dementia of the Alzheimer's type
involves a more or less steady progressive deterioration in cognitive functioning, recommend that family members maintain social contact but keep visits short and limited in number so that the individual doesn't feel overwhelmed.
Delirium and a primary degenerative dementia
delirium involves disorientation and a clouding of consciousness, often with incoherence.
Amnestic disorder and Parkinson's disease
amnestic disorder involves memory loss with no other cognitive disturbance.
Reactive Attachment Disorder
markedly disturbed and developmentally inappropriate social relatedness in most contexts, the disturbance is not accounted for solely by developmental delay and does not meet the criteria for pervasive developmental disorder, onset before five years of age, a history of significant neglect, an implicit lack of identifiable, preferred attachment figure.
Phobias
involved marked and persistent fear that is excessive or unreasonable and, if the anxious individual is an adult, recognized by the individual as being excessive or unreasonable.
"Honest Labeling" response
It clearly and simply identifies the client's behavior as the therapist sees it. "You're accepting a lot of my advice without question, but I sense that you disagree..."
Psychodynamic psychotherapy, especially when using a Self Psychology approach
involves a genuine, empathic relationship in which the therapist provides reconstructive opportunities with an adequate selfobject. The course of therapy involves an "understanding phase" in which the therapist's efforts are aimed at grasping, through empathy, the affective experience of the client. Efforts are made to communicate this experience to the client. This is followed by an "explaining phase" in which the therapist uses empathic understanding to interpret the affects and behaviors that result from empathic failures. Underlying reasons for the client's experience may be interpreted.
When conducting a diagnostic workup of a client whose primary language is different than your own, you should temper your diagnostic impressions with an awareness that...
Flow of thought may reflect indicators of cognitive disturbances in the absence of true cognitive disturbances. Individuals speaking in a non-dominant language, or secondary language, are more likely to express incoherent sounds, be less fluent, have extended silences or hesitations, and speak slowly. Be cautious about drawing inferences about cognitive impairments based on such observations alone.
Rationalization
involves thinking up logical, socially approved reasons for one's past, present or proposed behavior. These reasons are not always reasonable and, therefore, are often inconsistent with one another.
Intellectualization
a defense mechanism in which an affective charge is compartmentalized through logic-tight arguments.
Displacement
involves discharging pent up feelings, usually by hostility, on objects less dangerous than those to which the feelings were originally directed.
Reaction formation
involves development of attitudes and behavior patterns which are opposite of dangerous and unpleasant impulses and desires.
You should avoid this line of questioning in order to protect your client's privacy
The NASW Code of Ethics prohibits solicitation of private information unless it is essential to providing services or conducting research.
Behavioral specification
a three point assessment procedure in which a client specifies particular behaviors which define a problem, establishes a baseline of the specify those behaviors which define a problem for the client, and specify conditions associated with the emergence of the problem behavior - specified behaviors prior to intervention, and specifies the antecedents and consequences associated with emission of the problem behavior.
You should only use a diagnosis of adjustment disorder with depressed mood for a client in crisis if the symptoms were...
either caused or triggered by a stressor - An adjustment disorder may be diagnosed whenever emotional or behavioral symptoms develop "in response to an identifiable stressor." This could involve symptoms that are either caused or triggered by the stressor.
In order to reduce the likelihood of developing PTSD you and the client should use a crisis intervention approach in which you...
Research has found that a therapist can reduce the likelihood of developing PTSD following a trauma by using a crisis intervention approach that focuses on disclosing the traumatic events, exploring troubling reactions, identifying coping strategies, developing a plan of action, and providing referrals for supportive services such as medical care and self-help groups.
Symptoms of personality disorders
are inflexible and ego syntonic. If your client saw his suspiciousness and aggressiveness as being excessive, that would indicate neither inflexibility nor an ego syntonic quality. Such a person might have paranoid personality traits, but not the diagnosable syndrome of a personality disorder. paranoid personality disorder can co-occur with prodromal paranoid schizophrenia if the paranoid symptoms have been pervasive and persistent throughout childhood.
The most efficacious psychosocial treatments for conduct disorder, as identified in research
involve parent training. In such programs parents learn to appropriately establish rules and limits, implement consequences, and reward positive behaviors. Many will need help learning effective communication with the child and problem solving and negotiation strategies. These skills are then applied in a graduated way, first dealing with simple problems and then moving on to more difficult problems.
treatment of anxiety disorders
relaxation training
treatment of obsessive compulsive disorder
exposure and response prevention
treatment of serious and persistent mental illness
Wellness Recovery Action Plan
Shenjing shuairuo
a culture bound syndrome listed in an appendix of the DSM, and is included in the Chinese Classification of Mental Disorders. It is often compared to "neurasthenia," a condition long recognized in western cultures as well. Shenjing shuairuo, as well as neurasthenia, are characterized by fatigue, in addition to a variety of somatic complaints such as dizziness, headaches, pains, and gastrointestinal problems.
In order to avoid conflict among the case managers, you and the other case managers should...
identify a primary case manager who has the authority to arbitrate such conflicts. This approach allows each agency to continue providing case management services to assist the client in accessing and coordinating services that are specifically related to that agency's area of responsibility and expertise.
Assertive Community Treatment (ACT)
is a model of comprehensive, community-based treatment, rehabilitation, and support developed out of the work of Marx, Stein, and Test in the late 1960's. Part of its successful dissemination results from the well documented efficacy of the model, however many who claim to use the ACT model borrow some features but not others. A high fidelity, robust replication of the model means that you are using most, if not all, of its features, including the fact that Marx, Test and Stein used relatively small client to staff ratios in order to achieve their efficacious results.
Stages of Change
client is beginning to plan to take action, you should help the client clarify goals and objectives because the actions that he chooses will depend on the goals and objectives he wants to achieve with those actions. Focusing on substance use in a general way is more appropriate for the client who is in a "pre-contemplation" or "contemplation" phase of change when denial and avoidance are more prevalent and the client is not yet ready to benefit from very much personalized confrontation.
Enmeshed (Groups)
enmeshed group members are overly sensitive to one another's actions
Closed system (Groups)
closed system is one with limited influence from the external environment.
Non-cohesive group
group members fail to attend meetings regularly, do not listen to other members or accept their opinions, and are usually unwilling to change their minds to take on the views of others.
Hypochondriasis
a preoccupation with the fear of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily symptoms or bodily functions.
Histrionic
histrionic refers to a pattern of excessive emotionality and attention seeking
Conversion symptoms
are unexplained deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition.
Your client complains of an appetite disturbance, insomnia, and low energy with a sense of fatigue. If your client also feels sad, and if these symptoms are not due to a medical condition, your client probably has a...
dysthymia, major depression, or bipolar disorder
Your 25 year old client is experiencing clouded conscious with difficulty focusing and shifting attention. His symptoms developed over a short period of time and tend to fluctuate during the course of the day. Your client...
has a medical condition. Delirium is a disturbance of consciousness with reduced ability to focus, sustain, or shift attention, which develops over a short period of time and tends to fluctuate during the course of the day. Delirium is due to either a medical condition or use of certain substances.
Pre-contemplative phase of change.
At this stage the community standard of practice is to present the client with general information about substance use and its consequences, rather than confronting the client with his or her own dysfunctional behavior.
A cognitive restructuring approach
Identify the client's misinterpretations which lead to the anxiety. You and the client need to identify the client's misinterpretations which lead to the anxiety so that they can then be tested and corrected.
Family therapy
Emphasize immediate here and now interaction during sessions. especially when it involves sessions with the whole family group, emphasizes immediate here and now interaction during sessions. The therapist observes communication patterns, describes and clarifies them, and teaches alternative ways of communicating. In some forms of family therapy the therapist might explore with the family the meaning of their communication patterns as they emerge during sessions.
Which of the following symptoms, commonly caused by diabetes, should you be particularly sensitive to when conducting your psychosocial assessment?
Depression and irritability
Under the "Unprofessional Conduct" provisions of the LCSW license law, an LCSW's license can be revoked or suspended for "Administering to himself or herself any controlled substance or using any of the dangerous drugs specified in Sec. 421
using alcohol in a manner that is dangerous or injurious to yourself
Psychodynamic therapy is based on the assumption that individuals have a limited amount of psychic energy.
When that energy is bound up, or fixated, on issues from the past, there is that much less energy to apply to problem solving in the client's here and now reality. Resolving fixations frees up that energy to deal with today's opportunities and challenges.
SUDS Scale
SUDS is a Subjective Units of Distress scale in which a client rates their anxiety from 0 or 1, the lowest level of anxiety they have ever experienced, to 10, the highest level of anxiety they have ever experienced. A score of 5 is half way between these two extremes.
Structural Family Therapy
Homework assignments are used in structural family therapy to evaluate structure, flexibility, and resonance, and to teach new patterns of communicating and relating.
Bowenian multigenerational therapy
Bowenian multigenerational therapy that locates the best differentiated family member, known as the "leader," and then focuses therapy sessions on work with that individual.
When developing a treatment plan with your client with a schizoid personality disorder, you should emphasize...
Treatment for symptoms of personality disorder is generally not very effective, and people with personality disorders usually do not seek treatment for their symptoms because they are ego syntonic. Therefore, therapy usually focuses on resolving specific problems which may have arisen because of the symptoms, and helping with situational needs that the client is unable to meet because of the symptoms.
Echolalia
refers to repeating the speech of another person.
Perseveration
refers to repeating a single word or phrase over and over.
Clanging
is a speech pattern characterized by rhyming.
Neologisms
are words made up by an individual which are not readily understood by others.
Synesthesias
has sensory experiences associated with one modality when another modality is stimulated, such as hearing the color blue - are commonly caused by substance use, but can also be caused by general medical conditions.
Hwa-byung
Korean - suppressed anger has caused insomnia, fatigue and gastric distress
Koro
the penis will recede into the body and possibly cause death - which leads to sudden and intense anxiety. The belief is found in south and east Asia.
Shen-kui
excessive semen loss from frequent intercourse or masturbation has led to insomnia, fatigue, frequent dreams and impotence - a Chinese folk belief. Note that many culture-bound syndromes involve insomnia and fatigue.
When addressing relationship issues in family therapy, "role conception" refers to...
how a person in a position thinks others expect him to behave in that position
Triadic arrangements
You are working with a family in which communications reveal an oppressor-victim-rescuer pattern. This family is best described as...
Gestalt therapy
offers the client a process of self-discovery. It seeks to bring unconsciously held "unfinished business" (aspects of ourselves which we leave in the background) to consciousness. As the client becomes more self-aware, his or her own natural capacity for self-integration takes ownership of, and organizes, information brought to consciousness for a renewed sense of wholeness.
Ego integrity versus Despair
Ego integrity refers to a sense of wholeness (integrity) in one's life. This comes about through accepting responsibility for one's own thoughts, feelings, desires, decisions and actions. Despair is the result of he extent to which the client has a sense of unified wholeness in his or her life - self-fragmentation, a disowning of one's life experience through projection, displacement, rationalization and other defenses.
Intimacy versus isolation
client's sense of closeness to friends and family is more directly related to one's sense of intimacy versus isolation.
Initiative versus Guilt
enjoyment of the pursuit of goals is more directly related to one's sense of initiative versus guilt.
self-alienation
a humanistic existential therapy concept related to self-fragmentation and a lack of self-acceptance. This concept also applies to a person, not a family relationship pattern.
Describe obsessive compulsive qualities
client's persistent, pervasive circumstantiality - Circumstantiality involves thought and speech which becomes diverted from the main point by incidental detail. People with obsessive compulsive personality traits, including people with obsessive compulsive personality disorder, often engage in circumstantiality in their pursuit of excessive orderliness and perfectionism.
narcissism
narcissism involves grandiosity, a need for admiration, and a lack of empathy. It is not particularly related to circumstantiality.
schizotypal qualities
schizotypal qualities involve acute discomfort in close relationships, cognitive or perceptual distortions, and behavior eccentricities, not circumstantiality.
schizotypal personality traits
Schizotypal personality traits are characterized by cognitive and perceptual distortions which might include a disturbed sense of reality, dissociative experiences, ideas of reference or influence, and magical thinking. Disturbed sense of reality is to be distinguished from impaired reality testing in which the person loses the ability to accurately describe external events.
antisocial personality traits
antisocial personality traits involve exploitive and hurtful relationships with other people. It is more about behavior than it is about experience of reality.
reactive attachment disorder
reactive attachment disorder involves a disturbance in a young child's ability to bond, or form attachments, with others due to pathogenic caretaking. It is true that pathogenic caretaking, especially if it involves traumatic assaults, can lead to a sense of dissociation which can take the form of a disturbed sense of reality, but this feature is more characteristic of schizotypal personality traits.
3 year old client has achieved a developmentally appropriate status
whether or not the child shows rejection, ambivalence and negativity when limits are set- This developmental milestone involves developing a sense of autonomy, and to be able to exercise autonomy without a dysfunctional sense of shame and self-doubt. The child needs to be able to show rejection, ambivalence and negativity when limits are set as a way of experiencing the boundaries of one's separateness from those who set limits.
child's development between the ages of 3 and 6 years
whether or not the child engages in exploring with curiosity, asking questions, and examining the environment
developmental milestones of the first year of life
whether or not the child is able to want things that aren't immediately available and experience hope
developmental milestones of adolescence
adolescence that a young person is expected to be able to try on temporary identities and use a peer group as a frame of reference for identity.
minor consent law (Family Code Sec. 6929)
requires only that the treatment be related to a drug or alcohol related problem. requires that your treatment include the involvement of the minor's parent or guardian because it is no longer inappropriate. allows you to provide treatment related to an alcohol or drug related problem to a minor age 12 or older without either parent's consent if it would be inappropriate to involve the parents in the treatment.
Why would it be best to focus on a specific, immediate problem rather than a general, long term issue with such a client?
This is probably the kind of problem the client is interested in. Most individuals who seek help from a mental health professional, regardless of their diagnosis, are seeking help for specific, immediate problems. This fact is the basis for the development of crisis intervention and short term psychotherapy approaches.
your 9 year old client's cognitive development is age appropriate if your client is able to
Assume the perspective of another person. Prior to the age of seven a child\rquote s cognitive development is characterized by egocentrism, the inability to take another person's perspective. By about the age of seven most children have developed the capacity for perspectivism. Now able to see things from another's perspective, the child is capable of empathic understanding.
selfobject
In self psychology, a psychodynamic theory, the selfobject is the way in which a person might experience another person as part of one's self, an extension of oneself, so to speak.
cognitive dissonance
cognitive dissonance refers to the tendency of individuals to seek consistency among their beliefs and opinions. When there is an inconsistency between attitudes or behaviors (dissonance), something must change to eliminate the dissonance. In the case of a discrepancy between attitudes and behavior, it is most likely that the attitude will change to accommodate the behavior. These issues are not specifically related to a person's attempt to exert control over others.
narcissism
narcissism is only one form of difficulty people have when they try to exert control over others as if the other person were an extension of oneself.
idioms of distress
idioms of distress are the ways in which culture influences how people express or communicate their feelings of distress.
assimilation and accommodation
Assimilation and accommodation refer to a social system's way of relating to the social environment. Specifically, these qualities refer to the extent to which the social system influences its environment to change (assimilation from the environment's perspective), and to what extent the environment influences the social system to change (accommodation from the environment's perspective).
too much heterogeneity
Too much heterogeneity means too many differences between group members, usually with regard to personality traits, psychological sophistication, culture, motivation for treatment, or diagnosis. Too many differences can lead to the kind of conflict described in the question.
too much homogeneity
too much homogeneity, or sameness among members, tends to lead to boredom and lack of stimulation but not this kind of conflict which is very stimulating.
When assessing your therapy group's degree of integration, you should be paying attention to which of the following features?
Role expectations and norms are the means by which a group maintains its integration, that is, shapes behavior in the group and maintains its patterns of communication.
Magnification
Magnification involves overvaluing the significance of something. In the case of this question the significance of the therapist's suggestions is being overvalued.
personalization
personalization involves erroneously assuming responsibility for external problems where little or no responsibility exists.
catastrophic thinking
catastrophic thinking involves the prediction of worst case scenarios while ignoring more likely outcomes. Catastrophic thinking would be a correct answer if the question stated that your client believes he will commit suicide or be hospitalized for failing to understand or properly carry out your suggestions.
arbitrary inference
selective abstraction involves using "mental filters" when drawing a conclusion from a small, selected portion of the available information. It is similar to sampling error in research.
Parasomnias
are sleep disturbances such as sleepwalking that involve abnormal events during sleep.
General neglect
is distinguished from severe neglect. General neglect means negligent failure to provide adequate food, clothing, shelter, medical care or supervision.
severe neglect
failure to protect the child from severe malnutrition constitutes severe neglect which is distinguished from general neglect.
Training in Community Living (TCL) model of case management services
The TCL model emphasizes advocacy, brokering services, and other forms of direct, practical assistance. The model does not oppose the use of supportive clinical interventions to reduce symptoms, but this is not a focus. When TCL case managers use specific clinical interventions, it is usually to teach social skills directly related to the client’s participation in services or social support networks.
Enmeshed
is a term used by Minuchin in his structural family therapy to refer to families whose members have diffuse boundaries and excessive reactivity and dependency between members. Members of these families characteristically lack a sense of self as separate from their family as a whole.
Disengaged
Disengaged families typically have very rigid boundaries and members tend to act independently of one another. Members of these families lack a sense of togetherness and social connection. Minuchin proposed that the ideal family falls in the middle of this spectrum.
Resonant
resonant refers to family members being responsive to one another's communications and behaviors. Healthy relationships, as well as enmeshed relationships, could be properly described as resonant.
Mary Ainsworth has described three typical attachment styles through her "strange situation" experiments which involved a mother watching her child play.
After another brief period of time, the mother would return and the stranger would exit. When children behave in the manner described in this question, the attachment style was defined as "avoidant." Avoidant infants freely explore the environment both in low stress situations and during the exit of and reunion with their caretaker. These infants display little distress in relation to separation from their caretaker and will ignore the caretaker upon reunion.
securely attached infants
demonstrated both exploration and attachment in low stress situations, distress at the departure of a primary caretaker and entrance of the stranger, and a restoration of exploration and attachment upon reunion with the primary caretaker.
Resistant/ambivalent Infants
resistant or ambivalent infants tend to need to remain in close proximity with their caretaker in low stress situations. These infants are less likely than securely attached infants to explore the environment freely. They will demonstrate distress at the exit of a caretaker and fail to be calmed by reuniting with their caretaker.
disorganized attached infants
category of "disorganized" infant attachment refers to infants who do not display an organized or systematic strategy of attachment to their primary caretakers.
"Forced choice" confrontations
Forced choice situations are good occasions for supportive confrontation with substance abusing clients who are not yet committed to taking action on overcoming their problem. These are situations in which the client can recognize that if he or she doesn't get help, something important will be lost, such as a relationship, a job, or housing. These situations arise naturally in the lives of substance abusers. Often the therapist's role will be to help the individual frame the situation as a "forced choice" between continuing to suffer the undesirable consequences, or work on abstinence and recovery.
Triangulation
a dysfunctional strategy used by members of a family to avoid dealing with conflict in a subsystem such as the marital relationship. This strategy involves diverting the energy of the conflict to a third member of the family. There are two types of triangulation. The first, exemplified by the vignette, is termed "detour protect." This type involves two family members joining together to protect another family member. Typically, the intensity of the effort to protect appears excessive or outright unnecessary. The other type of triangulation termed "detour attack," involves two family members joining together against another family member who is seen as a common enemy. These coalitions can be formed between the mother and father or across generational boundaries.
distraction and displacement
are ego defense mechanisms, aspects of personality, which may contribute to triangulation in family dynamics, but are not a matter of family dynamics per se.
Clients diagnosed with borderline personality disorder
present as extremely unstable, particularly with respect to interpersonal relationships, self-image, and affect. Borderline clients will often demonstrate an inability to understand that when they leave a person, that person will continue to exist. As a result, they become overwhelmed by their fear of abandonment and will tend to cling to people in moments of separation while, in contrast, they may push people away as they get too close.
authoritarian parents
Authoritarian parents are highly demanding but lack responsiveness. These parents create well-structured environments with clear rules for their children. However, they fail to provide explanations for their rules or take into consideration the child's response to their rules. Rules are expected to be obeyed without debate.
permissive parents
permissive parents are low on demandingness and highly responsive. These parents tend to be very lenient and nondirective, allowing the child to create structure in his/her environment.
authoritative parents
authoritative parents are highly demanding and highly responsive. These parents provide clear rules for their children but offer explanation and consider the child's perspective. Research has demonstrated that in relation to these four parenting styles, children of authoritative parents tend to become the most well adjusted adults.
uninvolved parents
uninvolved parents are low on demandingness and responsiveness. This parenting style has proven to be the most damaging to the child's growth.
initial stage of group development
known as the orientation stage, group members resist self-exploration and self-disclosure and, instead, seek comfort and mutual support. A sense of similarities leads to a sense of mutual identification which relieves anxiety.
Private events
Private events are thoughts, perceptions, evaluations and self-statements that mediate the effects of stimulus conditions and, therefore, influence the way people choose to respond to those conditions.
domestic violence reporting law
domestic violence reporting law only requires a report when the abuse comes to the health care practitioner's attention because he or she provides medical services for a physical condition which he or she reasonably suspects is a wound or other physical injury that was inflicted by the patient's own act, or by another where the injury was caused by means of a deadly weapon. does include social workers as a health practitioner.
Thematic Apperception Test (TAT)
Thematic Apperception Test (TAT) the client tells stories about a series of cards portraying family and social situations. The test reveals personality traits and themes.
Humanistic existential approaches to psychotherapy
Humanistic existential approaches to psychotherapy view the primary locus of change as being within the client. The quality of the therapeutic relationship releases the client's own natural healing and problem solving capacities.
Cognitive Therapy - the brainstorming technique
When using the brainstorming technique, the therapist initially engages the client in developing a list of alternative beliefs without considering the validity or practicality of the alternatives. The list should include whatever comes to mind. Then the client is engaged in considering potential consequences of changing the schema (or core belief) in question.
abduction
Welfare and Institutions Code Sec. 15610.06 states that “abduction" means the removal from the state and the restraint from returning to this state of any elder or dependent adult who does not have the capacity to consent to the removal from this state or of any conservatee without the consent of the conservator or the court.
false imprisonment
being held in a location against one's will is addressed in the elder adult abuse reporting act as false imprisonment or other form of isolation.
isolation
preventing an elder from receiving mail or phone calls constitutes isolation, not abduction.
mental suffering
threats may be a form of mental suffering, not abduction, and only if they cause fear, agitation, confusion, severe depression or other forms of serious emotional distress. It is not a matter of reportable mental suffering if the “threat" to place an elder in a nursing home is being communicated because a caretaker believes that such placement is what the elder needs for proper care.
the oral aggressive personality
the oral aggressive personality is a biting, sarcastic, scornful personality pattern resulting from a fixation at the later phase of the oral stage when teeth come in and biting becomes a major source of pleasure.
oral dependent personality
oral dependent personality is a passive, overly dependent, unenterprising personality pattern resulting from a fixation at the earlier phase of the oral stage if a child has repeated anxiety over whether food will be given or withheld.
"oral pre-operational" personality
"oral pre-operational" personality is not a behavioral science concept. It is a mix of Freud's "oral stage" concept of psychosexual development with Piaget's "pre-operational" stage of cognitive development.
life history grid
Presents a graphic means of eliciting the life history of an client during an initial interview. The grid summarizes chronological facts about the client, and is useful for both the social agency and the client.
life cycle matrix
is used to graphically depict the developmental stage of all clients in the household.
genograms - family
sociograms - social life
are used to obtain and record information about a client's family patters and history. This tool provides a schematic diagram of the family system describing at least three generations of family relations.
ecomap
is sued to help a client acquire a better understanding of her social context so that she can learn effective ways for changing it. Circles are used ti represent diff factos, spouse, kids, school, work, social workers, agencies, ect. look at the way energy flows between the various circles.
dual perspective worksheet
a person's nurturing environment is composed of people with whom a person interacts frequently and sometimes in an intimate way. the sustaining environment included the people a person encounters in the wider community and broader society
social network grid
collecting info about key people in the client social networks
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