Objective Personality Tests

Minnesota MultiPhasic Personality Inventory (MMPI)

Projective Personality Tests

Adults: Rorschach and Thematic Apperception Test (TAT)
Children: Child Apperception Test (CAT), House-Tree-Person, and the Kinetic Family Drawings

Piaget's Stages

Sensorimotor (0-2yr)
Preoperational (2-7yr)
Concrete Operations (7-11yr)
Formal Operations (11+yrs)

Preconscious

Thoughts and feelings which can be brought into consciousness easily

Reframing

Relabeling a family's description of behavior to make it more amenable to therapeutic change

Sexual Pain Disorder

Dysparunia
Vaginismus

Superego

Conscience

Unconscious

Thoughts, feelings, desires, and memories of which we are unaware

Accommodation

Adapting to the events of the environment

Antipsychotic Meds

Thorazine
Haldol
Clozaril
Mellaril
Prolixin
Navane
Stelazine
Seroquel
Resperdal
Zyprexa

Assimilation

The integration of external elements into the evolving structure of the organism

Case manager

Person at the HMO, PPO, or insurance company that manages the benefits and the providers

Common Side Effects of Meds

Dry mouth
Blurred vision
Weight gain
Constipation
Sexual dysfunction (decreased libido)
Sedation
Dizziness
Movement disorders (pacing, grimacing, rigidity, tremors)

Denial

Primitive defense; inability to acknowledge true significance of thought, feelings, wishes, behavior, or external reality factors which are consciously intolerable

Dependent variable

Clinical condition (depression, anxiety, etc)

Devaluation

Defense mechanism frequently used by persons with narcissistic personality organization which is the consequence of omnipotence; split of primitive idealization

Displacement

Directing an impulse, wish, or feeling toward a person or situation not its real object, thus permitting expression in a less threatening situation

Ethical Decision Making

Understanding legal duties
Understanding values/ethics of Social Work
Identifying legal and ethical implications
Logical ethical decision making process

Hollis Typology of Categories of Interventions---Direct: Client-Social Worker Communication

EGO SUPPORTIVE
1. Sustainment
2. Direct influence
3. Exploration, description, ventilation

EGO MODIFYING
4. Person in situation reflection, including self evaluation
5. Pattern-dynamic reflection
6. Developmental reflection

Hollis Typology of Categories of Interventions---Indirect: Environment Interventions

EGO SUSTAINING
1. Resource development or provider of services
2. Interpreter of or mediator between client and environment
3. Intervene in the environment

Idealization

Overestimation of admired aspect or attribute of another

Identification

Universal mechanism whereby a person patterns self after significant other

Independent variable

Treatment intervention

Intervening variable

Generally will be "meds" on test

Isolation of Affect

Unacceptable impulse, idea, or act is separated from its original memory source, thereby removing original emotional charge

Mood Stabilizers (anti-depressants)

Elavil
Celexa
Wellbutrin
Remeron
Norpramin
Effexor
Prozac
Serazone
Tofranil (imipramine)
Zoloft
Lithium (adults) Depakote (adolescents): used with Bipolar manic phase, sometimes in conjunction with an anti-depressant

OCD Meds

SSRI Anti-depressants, particularly Zoloft and Paxil

Other Therapeutic Communication Skills

Empathy
Centering
Confronting
Reframing
Advising
Educating
Focusing
Reviewing
Reflecting
Interpreting

POS

Point of Service; usually refers to a type of managed care contract

1. Disregards logical connections between ideas
2. Permits contradictions to exist simultaneously
3. Lacks concept of time
4. Wishes are represented as fulfillment

Projection

Primitive defense; attributing one's own disowned attitudes, wishes, or feelings to an external object

Reaction formation

Person adopts affects, ideas, attitudes, or behaviors which are opposite of those he harbors consciously or unconsciously

Reality testing

Accurate perception of external environment and internal world

Regression

Partial or symbolic return to more infantile patterns of reacting or thinking; can be in service to the ego

Roleplaying

Acting out the parts of important characters to dramatize feelings and practice new ways of relating

Scapegoat

A member of the family, usually the identified patient, who is the object of displaced conflict or criticism

Schemata

Action sequence and behavior patterns; organization and adaptation

Secondary Process Thinking

1. Follows reality principle
2. Postpones gratification
3. Replaces wish fulfillment with appropriate action on the environment
4. Goal directed

Sedatives (Anti-anxiety agents)

Xanax
Librium
BuSpar
Ativan
Valium (Diazapam)
Klonapin (Benzodiazine)
Inderal
Restoril

Self Awareness and Self Understanding

Understanding the influence of family of origin
Understanding the influence of current situational factors
Assessing one's self esteem
Assessing one's acceptance of others
Assessing one's assertiveness
Assessing readiness for social work practice

Splitting

Defensive mechanism of borderline personality organization which manifests as self or others being seen as all good or all bad.

Stimulant (ADHD) Meds

Ritalin
Dexidrine
Cylert

Talking and Listening Basic Interpersonal Skills

Voice and speech
Body language
Listening: hearing, observing, encouraging and remembering
Active listening

General Systems Theory

Based on the concept of a system as interacting parts contained within a boundary (family system unit)

Homeostasis

Steady state order necessary for movement

Feedback

When output from systems is put back into the system

General Systems Theory: Implications for Practice

1. Problems are defined in transactional terms
2. The unit of attention includes the relevant related systems
3. Humans are active, purposeful, goal-seeking organisms whose development and functioning are outcomes of transactions between their genetic potential and their environment

Adaptedness

Goodness of fit with the environment; this is a continuous process

Stress

Environmental demand perceived as challenge and associated with positive feelings or discrepency between demand and capacity for coping with it associated negative feelings

Coping

Psychological, physiological and behavioral response that is set in motion as result of the experience of emotional stress.

Fixation

A point of development where there is a failure to resolve conflict

Psychoanalytic Treatment Goal

To resolve intrapsychic conflict; treatment involves dealing with the repressed material in the unconscious using clarification, confrontation, interpretation, and working through

Psychoanalytic Theory

Individual is viewed as a product of his past

Ego Psychology (Erikson)

Ego Psychology Treatment

Geared to enhancing the effective and efficient functioning of the ego in managing internal and external stress

Object Relations Theory (Mahler)

A development of a consolidated sense of self as the result of separation and individuation of the self from the love object (mother).

Object Relations Substages

Attachment
Separation
Individuation
Object Constancy

Object Relations Treatment

Geared to enhancing the self-object differentiation

Moral Development Theory (Kohlberg)

Parallels cognitive development in that the child cannot achieve higher levels of moral reasoning until achieving higher levels of cognitive reasoning; can have cognitive without moral, but cannot have moral without cognitive

Pre-conventional

Moral reasoning based on avoiding punishment and to serve one's own needs

Conventional

Moral reasoning based on the need to look good in one's own eyes and the eyes of others

Post-conventional

Stages of Death and Dying (Kubler-Ross)

Denial
Anger
Bargaining
Depression
Acceptance

Social Role Theory (Basic Themes)

1. Certain behaviors are prescribed relative to our position in that system.
2. Every role involves both our own expectations and abilities as well as the expectations of others
3. Social functioning may be seen as the sum of roles performed by the human system
4. The concept of role, role functioning, role expectations, and role transactions may be used to increase the knowledge base for the assessment of the problem situation

Role Ambiguity

Role expectations are unclear

Role Conflict

2 or more opposing views on role definition

Role reversal

Roles are opposite to that which previously existed

Talking and Listening Basic Interpersonal Skills

Voice and speech
Body language
Listening: hearing, observing, encouraging and remembering
Active listening

General Systems Theory

Based on the concept of a system as interacting parts contained within a boundary (family system unit)

Locus of control

the extent to which an individual believes that life events are under his own control (internal locus of control) or under the control of external forces (external locus of control)

Social Authority or Power

Coercive: power from control of punishments
Reward: power from control of rewards
Expert: power from superior ability or knowledge
Legitimate: power from having legitimate authority

Three Basic Assumptions of Communication Theory

1. One cannot NOT communicate
2. All human communication is multi-leveled
3. The message sent is not necessarily the message received

Contradictory communication

Offering 2 or more contradictory messages on the same communication level

Incongruent communication

Offering 2 or more contradictory messages on different communication levels

Ambiguous communication

Verbal and nonverbal communication do not give the receiver adequate information upon which to formulate an adequate response

Paradoxical communication

Giving one message and acting out another

Stimulus-response dilemma

Communication based on the premise that one is simply being reactive to the other therefore is not fully responsible for the communication

Overload at the content level

Too much information provided at one time or the information sent cannot be responded to appropriately because of the split content

Problem Solving Approach (Perlman) MAIN MODEL OF THE SOCIAL WORK PROFESSION

Based on the assumption that all human living is a problem-solving process. An inability to cope is due to some lack of motivation, capacity or opportunity to solve problems in an appropriate way. Treatment is reality based.

Treatment Actions in the Problem Solving Approach

1. To release, energize and give direction to the client's motivation.
2. To release and then repeatedly exercise the client's mental, emotion and action capacities for coping with his problem and/or himself in connection with it
3. To make accessible to the client the opportunities and resources necessary to the solution of the problem

Problem Solving Approach Looks at the 4 P's in the process of change

Person
Problem
Place (agency)
Process (therapeutic relationship)

Psychosocial Approach (Hollis)

People are seen in the context of interactions or transactions with the external world. A formal medical, psychological and social history are obtained, and the diagnosis is based on this history.

Psychosocial Treatment

Differentiated according to needs of clients and results in a modification of the person, environment, or both, and of the exchange between them. Uses all developmental theories and integrates various aspects of all relevant treatment modalities.

Crisis Intervention (Golan)

Process of actively influencing the psychosocial functioning of individuals during a period of disequilibrium. A state of crisis is time limited (usually 6-8 weeks). Brief intervention during a crisis usually provides maximum therapeutic effect. Social Worker is active rather quickly

Crisis

An upset in a steady state. Crisis is defined by the client. Feelings of hopelessness may be present and ego patterns may be more open to influence and correction.

Goals of Crisis Intervention

1. Relieve impact of stress with emotional/social resources
2. Return to previous level of functioning
3. Help people strengthen coping mechanisms during the crisis period and develop adaptive coping strategies

Brief and Planned Short Term Treatment

Restricts duration to 8-12 sessions
Uses interventions from learning theory and behavioral modification to promote completion of a well-defined task
Primary aim is to quickly engage clients in the problem-solving process and maximize their responsibility for treatment outcome

Task-Centered Treatment

Offers a pragmatic approach in which the problem is partialized into clearly delineated tasks to be addressed consecutively.
Client must be able to acknowledge a precise psychosocial problem, the solution to which is either a specific change in behavior or a change of circumstances.
Assessment focuses on helping client identify the problem that is of primary concern; circumstances surrounding the problem are explored and specific tasks evolve from this process.
1. Assessment
2. Set goals
3. Define tasks

Time-limited Psychotherapy

Addresses the client's emotional reactions to a strictly time-limited process that makes optimal use of the role of the "doctor-patient" relationship. Uses a non-negotiable time-limited contract.

Behavioral Approaches

1. Goal is to modify behavior
2. Focus is on observable behavior

Respondent or Classical Conditioning (Pavlov)

Learning occurs as a result of pairing a stimulus with an involuntary response so that the stimulus eventually elicits the conditioned response

Operant Conditioning (Skinner)

Antecedent events precede behaviors which, in turn, are followed by consequences. Consequences which increase the occurences of the behavior are referred to as reinforcing; consequences which decrease the occurence of the behavior are referred to as punishing.

Systematic desensitization

Anxiety-producing stimulus is paired with relaxing response so that eventually anxiety-producing stimulus produces a relaxation response.

In vivo desensitization

Pairing and movement through hierarchy takes place in "real" setting

Aversion Therapy

Any treatment aimed at reducing the attractiveness of a stimulus or a behavior by repeatedly pairing it with aversive stimulation of a real or imagined nature

Sensate focus

An in vivo desensitization and communication-enhancement procedure used in sex therapy that involves the couple providing each other with pleasurable sensory stimulation through a structured body message (pleasuring)

Positive reinforcement

The worker praises, gives tokens, or otherwise rewards positive behaviors

Negative reinforcement

Behavior increases because negative (aversive) stimulus is removed

Fading

A procedure for gradually changing one stimulus controlling a behavior to another stimulus

Cognitive Approach

Human functioning is seen as the product of reciprocal interaction between personal and environmental variables.
Emphasis is placed on cognitive skills from problem solving.
What a client says to himself influences his behavior and feelings.
Certain thoughts cause certain behaviors and certain behaviors cause certain thoughts.

Cognitive Treatment

1. Gaining understanding of, and communicating from, the client's system of meanings.
2. Initially accepting the "internal validity" of the client's personal views and understanding what maintains them.
3. Gradually facilitating the client's ability to consider other possible meanings by putting the same facts or situations into other conceptual or emotional frameworks
4. Building client awareness of the possible inaccuracies of their cognitive appraisals
5. Focusing the attention on client's expectations and interpretations of events.
6. Helping the client construct alternatives, more adaptive meanings, expectations, and self instructions
7. Providing experiences that give evidence to support changed views and counter old ones (task assignments and behavioral experiments)

Rational Emotive Therapy (RET)

A cognitively-oriented therapy in which the therapist seeks to change the client's irrational beliefs by argument, persuasion, and rational re-evaluation, and by teaching the client to counter self-defeating thinking with new, non-distressing self statements.

Gestalt

Experiences are not isolated but are part of a perceptual system of interdependent factors

Gestalt Treatment

Experiential
Here and now
Often used with groups as well as individuals

Family Therapy

Views the family as a system of interacting parts in which change in any part affects the functioning of the whole. The family is the unit of attention for diagnosis and treatment. Social roles and interpersonal interaction are the focus. Real behaviors and communication that affect the current life situation are emphasized

Goal of Family Therapy

To interrupt the circular feedback of pathological communication and behaviors, then replace it with a new pattern that will sustain itself without the dysfunctional aspects of the original pattern

Issues in Family Therapy

Establishing a contract with the family
Examining alliances and groupings within the family
Where the power resides
Relationship of each family member to problem
How does the family relate to outside world
Family history as related to interaction in current behavior
Communication patterns: complementarity, symmetrical
Family rules that regulate patterns of interaction
Meaning of presenting symptom in current family homeostasis
Flexibility of structure and accessibility of alternative action patterns
Family's development stage
Sources of external stress and support
Family homeostasis

Interventions in Family Therapy

Define family stages and tasks
Address emotional cutoff
De-triangulation
Coaching
Redefine family rules
Genogram
Restructuring roles

Structural Family Therapy (Minuchin)

Stresses the importance of family organization for the functioning of the group and the well-being of its members.

Family Structure

The invisible set of functional demands organizing interaction among family members.

Multi-generational Approach (Bowen)

Pathology in current family relationships is seen as unfinished business in family of origin relationships. Problems are fusion among family members and inadequate individuation

Goal of Multi-Generational Approach

To increase differentiation of individuals within the family and avoid the need for triangulation

Strategic Family Therapy (Haley/Palo Alto Group)

Presenting problem is viewed as a symptom of and a response to current dysfunction in family interaction.

Goal of Strategic Family Therapy

To solve the particular problem that is presented. The symptom is regarded as a communicative act that is part of a repetitive sequence of behaviors among family members, serving a function in the interactional network.

What does Strategic Family Therapy focus on?

Problem resolution by altering the feedback cycle that maintains the symptomatic behavior

What is the worker's task in Strategic Family Therapy?

To formulate the problem in solvable, behavioral terms and to design an intervention plan to change the dysfunctional family pattern.

Psychodrama

A treatment approach in which roles are enacted in a group context. Members of the group recreate their problems in living and devote themselves to the role dilemmas of each member.

Group Psychotherapy

Treatment of patients with mental illness: uncovering procedures, the achievement of insight into unconscious motivations, and other intrapsychic processes.

Stages of Group Development

Pre-affiliation (Forming): development of trust
Power and control (Storming): struggle for individual autonomy and group identification
Intimacy (Norming): utilizing self in service of the group
Differentiation (Performing): acceptance of each other as distinct individuals
Separation/termination (Adjourning): independence

Factors in Group Cohesion

Group size: optimal 5-10
Homogeneity: similarity of group members
Participation in goal and norm setting for group
Interdependence: dependent on one another for achievement of common goals
External threat: increases cohesiveness
Member stability: frequent changes in membership decreases cohesiveness

Contra-indications for group treatment

Client in crisis
Compulsive need for attention
Actively psychotic
Paranoid
Suicidal

Primary Prevention

To prevent: aimed at reducing the prevalence of a problem by reducing the incidence of new cases; creating environments that promote mental health

Secondary Prevention

To treat symptoms: reduce prevalence by reducing the duration through early detection and intervention

Tertiary Prevention

To reduce disability in chronic problems: reduce duration of problem by reducing negative after effects

Neuron

A specialized cell that is directly involved in mental processes and behavior

One way to classify the many different types of Neurons is?

In terms of their functions as either sensory (afferent) neurons, interneurons, or motor (efferent Neurons)

What are Kholberg's 3 stages of Moral Development?

Level I - Preconventional Morality 4-10 years

Level II - Conventional Morality 10-13 years

Level III - Postconventional Morality - Adolescence to adulthood, not reached by most adults

Kholberg's Preconventional Morality

Level I - 4-10 years

Stage I:
- punishment-obedience orientation
- moral judgment is based on desire to avoid punishment

Stage 2:
- instrumental-relativist orientation
- moral judgment is based on desire to satisfy own needs

Kholberg's Conventional Morality

Level II - 10-13 years

Stage 3:
- good boy/nice girl orientation
- moral judgment is based on desire to avoid dislike or disapproval by others

Stage 4:
- law and order orientation
- moral judgment is based on desire to avoid censure by a legitimate authority

Kholberg's Postconventional Morality

Level III - adolescence to adulthood

Stage 5:
- legalistic orientation
- moral judgment is based on maintaining the respect of equals and the community, maintianing social order, and obeying democratically-determined laws

Stage 6:
- universal ethical principles orientation
- moral judgments are based only on individual's own conscience

What are the 6 stages of Kholberg's model of moral development?

Stage 1 - punishment/obedience - avoid punishment

Stage 2 - instrumental/relativist - satisfy own needs

Stage 3 - good boy/nice girl - avoid dislike or disapproval by others

Stage 4 - law and order - avoid censure by a legitimate authority

Stage 5 - legalistic - maintaining respect, social order, obeying democratically determined laws

Stage 6 - universal ethical principles - own conscience is only determinant

Core values of the social work profession

-service
-social justice
-dignity and worth of the person
-importance of human relationships
-integrity
-competence

value:
service

ethical principle:
social workers' primary goal is to help people in need and to address social problems

value:
social justice

ethical principle:
social workers challenge social injustice

value:
dignity and worth of the person

ethical principle:
social workers respect the inherent dignity and worth of the person

value:
importance of human relationships

ethical principle:
social workers recognize the central importance of human relationships

value:
integrity

ethical principle:
social workers behave in a trustworthy manner

value:
competence

ethical principle:
social workers practice within their areas of competence and develop and enhance their professional expertise