291 terms

Social Work License (MSW Exam)

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Piaget
(Adaptations, Assimilation and Accommodation)
0-1 Sensory-Motor
2-4 Preoperational Period
5-7 "
8-12 Concrete Operations period
13-18 formal Operations period
19-21
21 +
50 +
Freud (Libido)
0-1 Oral
2-4 Anal
Oedipal/Phallic
8-12 Latency
13-18 Genital
19-21 "
21+ "
50 + "
Erickson
(Stage conflict)
0-1 Trust vs. Mistrust (stage #1)
2-4 Autonomy vs. Shame & Doubt (stage #2)
5-7 Initiative vs. Guilt (stage #3)
8-12 Industry vs. Inferiority (stage #4)
13-18 Identity vs. Role Diffusion, confusion (stage #5)
19-21 Intimacy Vs. Isolation (stage #6)
21 + Generativity vs. Stagnation (stage #7)
50 + Integrity vs. Despair (stage #8)
Trust vs. Mistrust (stage 1) 0-1
During infancy (0-1) the child is dependent on mother for food and care. As the child incorporates or takes in through sucking and swallowing; there is a receptivity to what is being offered. The mother is responsible for coordinating the child's experience of getting and hers of giving. At the latter part of this stage the child's eyes begin to focus and incorporation becomes more active as the child bites to "hold onto" things. If the mother provides a predictable environment in which the child's needs are met, a sense of basic trust will develop. This sense of trust implies not only sameness and continuity from the caretaker, but also self-trust in one's capacity to cope with urges. According to Erickson, it is the quality rather than the quantity of maternal care that is critical at this stage. Successful resolution will lead to a lasting ego quality of hope, an enduring belief that wishes can be fulfilled. Unsuccessful resolution will lead to a sense of mistrust in other people and the environment.
Autonomy vs. Shame and Doubt (stage 2) 2-3
During early childhood (2-3) the child learns a sense of autonomy through retention and elimination of urine and feces. As the child's muscles mature to the point that bodily wastes can be retained or expelled at will, the child experiments with two simultaneous social modalities "holding on" and "letting go." Parents must be firm and tolerant so that the child can gradually learn bowel and bladder control and a "sense of self-control without loss of self esteem." From this emerges a sense of autonomy and pride, and the lasting ego quality of WILL POWER, the determination to use free choice and self-restraint. Unsuccessful resolution of this stage will lead to lifelong feelings of shame and doubt.
Initiative vs. Guilt (stage 3) 3-5
During the play age (3-5), increased locomotor mastery (walking and running) gives the child a wider radius of goals. In addition, language skills add to the ability to imagine "so many things he cannot avoid frightening himself with what he himself has created and thought up." The Oedipal wishes and the ambivalent feelings that accompany them must be repressed in order to temporarily mask the initiative toward the opposite sex parent. While this initiative is a prerequisite for masculine and feminine behaviors later in life, it is now repressed of necessity-in order to avoid the guilt that would accompany knowledge of incestuous thoughts. Parents assist the child in learning appropriate roles, including gender roles, as the child diverts the sexual drive into acceptable activities. At this point conscience, or superego, becomes established to govern the initiative. Proper resolution of this stage leads to a lasting ego quality of purpose, the courage to pursue goals. Unsuccessful resolution leads to feeling of shame.
Industry vs. Inferiority (stage 4) 6-12
The child now enters the school age (6-12) and is enmeshed in the "world" of school and opportunities for new types of mastery. As children develop their abilities in new skills and tasks, they desire recognition gained from producing things. Through this, they develop a sense of industry and a lasting ego quality of competence. Unsuccessful resolution of this stage leads to life long feelings of inferiority and inadequacy.
Identity vs. Role Confusion (stage 5) 12-18
As the child approaches adolescence (12-18 or so), physical and hormonal changes mark the beginning of puberty. Rapid growth and physical genital maturity disrupt the earlier continuity of childhood. This stage is perhaps the most important for Erikson, as the adolescent must now forge a lasting ego identity through aligning his or her basic dries, endowments, and opportunities. A sense of ego identity is "the accrued confidence that ones ability to maintain inner sameness and continuity...is matched by the sameness and continuity of ones meaning for others. Thus, self-esteem grows to be a conviction that one is learning effective steps toward a tangible future, that one is developing a defined personality within a social reality which one understands. As the adolescent struggles to integrate past and future views of self and begins to define new appropriate sex roles, an identity crisis may emerge from this confusion. New expectations from parents may add to this stress. Tolerance, understanding, and guidance in the home can assist the adolescent in achieving an integrated identity. Unsuccessful resolution can result in either role confusion or identity diffusion, a state in which the individual is left with strong doubts about who he or she "is." This may lead to delinquency, psychotic incidents, or over-identification with others. Youths who emerge with a strong sense of identity and individuality gain a lasting ego quality of fidelity or freely pledges loyalties.
Intimacy vs. Isolation (stage 6) (early to late 20s)
Young adulthood (early to late 20s) brings an end to the years of childhood and youth. It is now time for choosing a career, socializing with the opposite sex, and eventually marriage and raising a family. Interpersonal intimacy is the task of this stage, encompassing both psychological and sexual intimacy. Failure to achieve intimacy leads to isolation, an inability to develop intimate and meaningful relationship. The person who cannot be intimate will likely be self-absorbed. Proper resolution of this stage leads to a lasting ego quality of love, or mutuality of devotion.
Generativity vs. Stagnation (stage 7) (late 20s-50s)
During adulthood (last 20s-50s), maturity geniality (in the Freudian sense) leads to procreation and establishing guidance for the next generation. those who do not apply this to their own offspring must sublimate and find outlets in altruistic activities. According to Erikson, simply wanting or having children is insufficient for completion of this stage. Rather, an active role and a "belief in the species" leads to efforts to make the world a better place for future generations. Unsuccessful resolution of this stage results in a sense of stagnation or self-indulgence that reflection interpersonal impoverishment. Successful resolution of this stage can be seen in the lasting ego quality of care, or concern for others.
Integrity vs. Despair (after 50)
Late adulthood (after 50) is a period of retrospective reflection about one's own life and acceptance of the eventual end of life. If, at the end of the life cycle, one can accept responsibility for past choices and find meaning and contentment in the road that was traveled, a sense of integrity is achieved. Unsuccessful resolution of this stage leads to a sense of despair. This may be exhibited as disgust and anger at external sources but is an indication of self-contempt. The lasting ego quality that emerges from proper resolution of this stage is wisdom.
Sensorimotor (0-2 yrs) (Stage 1)
Reflex activity (0-1 months) Learns to suck / tracks moving object but ignores its disappearance.

Primary circular reactions (1-4 months) Repetitive movements; opesn and closes fist; moves thumb to mouth; moves hand and watches it. Looks at spot where object disappeared.

Secondary circular reactions (4-8 months) Imitates own sounds if made by someone else; repeats movements that have an effect. Searches for a partly concealed object.

Coordination of secondary schemes (8-12 months) Imitates new sounds; moves objects that are in the way. Searches for an object in the last place it was found.

Tertiary circular reactions (12-18 months) Drops objects to see effect; reaches a toy by pulling an extension of it. Searches for and finds objects that are hidden while watching.

Invention through mental combinations (18-24 months) Can evoke memories not linked to perception; experiments are done internally. Searches for and finds objects that are hidden out of sight. Object constancy is complete.
Peroperational (2-7 yrs) (Stage 2)
Preconceptual (age 2-4) Language; symbolic thought; pretend play; conscious of self as an object. Can mentally visualize things that are not present.

Intuitive (age 4-7) Centers on one thing at a time; thinking is confined to momentary perceptions.
Concrete Operations (7-11 yrs) (Stage 3)
Reasoning and logical thought begin; is able to perform reverse operations mentally; exhibits conversation, seriation, classification; transitivity; centers on more than one thing at a time; remembers changes that have taken place.
Formal operations (11-15 yrs) (Stage 4)
Hypothetical deductive reasoning; combinational thought
Kohlberg's stages of MORAL Development
Level #1 Pre-conventional - controls are external. Rewards and punishments.
1. Punishment/obedience: Decisions concerning what is good/bad are made to avoid punishment
2. Naive Instructional Hedonism: Rules are obeyed in order to receive rewards. Often favors are exchanged.

Level #2 Conventional (role conformity) The opinions of others become important. Behavior is governed by conforming to social expectations.
3. Good boy/girl morality: Good behavior is considered to be what pleases others. There is a strong desire to please and gain the approval of others.
4. Authority-Maintaining Morality: The belief in law and order is strong. Behavior conforms to law and higher authority. Social Order is important.

Level #3 Post-conventional Moral decisions are finally internally controlled. MOrality involves high lever principals beyond law and even beyond self-interest.
5. Morality of Contract: Laws are considered necessary. HOwever, they are subject to rational thought and interpretation. Community welfare is important.
6. Morality of individual Principles & Conscience: Behavior is based on internal ethical principles. Decisions are made according to what is right rather than what is written into law.
Maslow's theory of Self-Actualization
Self-actualization means that there is a natural inherent tendency of people to express their innate potentials for love. What is needed for SA to proceed successfully is a nurturing environment that provides adequate sustenance and social support, as well as a personal commitment to growth. SA is like the process of an oak growing from a seed into a full tree. The acorn seed already has within it the potential for the full oak, but adequate sunlight, water, nutrient, and other environmental supports are necessary for growth to occur.
Maslow's theory of Self-Transcendence
AS self-actualization continues to its fullest potential, it carries one beyond self-preoccupation, narcissism, and finally ego-focused self-identity; self-actualization then becomes self-transcendence. Self-transcendence is not a denial or abandonment of the self. Rather, it is a completion and fulfillment of the self in communion with other beings and the Ground of Being, that is, the ultimate and sacred being or reality, that some call God.
Maslow's Hierarchy of Needs
6. Top: Self-transcendence (needs: peak experiences, unitive consciousness)
5. Self-actualization needs: Altruistic love, beauty, creativity, justice.
4. Esteem needs
3. Belongingness and love needs
2. Safety needs
1. Physiological needs
Awareness
The crisis worker attempts to bring conscious awareness warded off, denied, shunted, and repressed feelings, thoughts, and behaviors that freeze the client's ability to act in response to the crisis.
Catharsis
The crisis worker provides a safe and accepting environment for clients to ventilate, air, expose, and bring forth feelings, thoughts, and behaviors generated by the crisis that may be perceived by clients as socially unacceptable or too psychologically hurtful to be shared. There are two primary reasons for promoting
Validation
The crisis worker attempts to validate that the clients' reactions are appropriate, normal, customary, and expressed within a culturally acceptable limits given the kind,type,and duration of the crisis provides these are not harmful psychologically, physically, or morally to self or others.
Expansion
The crisis worker engages in activities to broaden, open-up, and increase clients' tunnel vision, restricted affect, perception, and interpretation of the crisis so that other affective and cognitive views and behavioral options may be considered.
Focus
The crisis worker attempts to qualify, narrow, and downsize clients' all encompassing, catastrophic, interpretations and perceptions of the crisis event in to more specific, realistic, manageable components and options.
Guidance
The crisis worker provides information, referral, and direction in regards to clients obtaining assistance from specific external support systems to help generate coping skills and problem solving abilities.
Mobilization
The crisis worker attempts to activate and marshal both the internal resources of the client and to find and use external support systems to help generate coping skills and problem solving abilities.
Ordering
The crisis worker methodically helps client classify and categorize problems so as to prioritize and sequentially attack the crisis in a logical and linear manner.
Protection
The crisis worker safeguards clients from engaging in harmful, destructive, detrimental, and unsafe feelings, behaviors, and thoughts that may be psychologically or physically injurious or lethal to themselves or others.
Crisis Intervention Strategy
Awareness
Catharsis
Validation
Expansion
Focus
Guidance
Mobilization
Ordering
Protection
RULES of the ROAD
Step #1: Defining the Problem
Step #2: Ensuring Safety
Step #3: Providing Support
Step #4: Examining Alternatives
Step #5: Making Plans
Step #6: Obtaining Commitment
Rules of the Road - Step #1 Defining the Problem
1. Communicate caring attitude
2. Establish contact
3. Explore meaning of crisis
Rules of the Road - Step #2 Defining the Problem
1. Use directive, closed end questions
2. Determining degree of lethality
3. Take immediate action to ensure safety of oneself, the client, or significant others.
4. Reinforce the client's proactive, safe behavior
5. Make owning statements about your responsibilities
6. Use the Triage Severity Scale as a basis of making decisions on client disposition
Rules of the Road - Step #3 Defining the Problem
1. Make very clear owning statements that the client really does count for something
2. Positively reinforce even the most minimal client movement
3. Searching for external supports is critical in providing continuing help to get through the crisis
Rules of the Road - Step #4 Defining the Problem
1. Use situational support mechanism
2. Use previously successful coping mechanisms
3. Use environmental resources
4. Generate positive and constructive thinking patterns
5. Reinforcing taking action
Rules of the Road - Step #5 Defining the Problem
1. Emphasize short-term goals
2. Make concrete plans
Rules of the Road - Step #6 Defining the Problem
1. review plan
2. establish responsibility
Core Listening Skills
Restatement
Reflection
Owning Statements
Summary recapitulation
Open ended and closed questions
Monitoring nonverbal cues
Levels of Intervention
Direct Intervention
Collaborative Intervention
Indirect Intervention
Listening
Step #1 Define the Problem: empathy, genuinness, and acceptance or positive regard. SW must perceive the problem as client sees. it.
Step #2 Ensuring Client Safety: continually keep client safety at the forefront of all crisis intervention procedures. We definite client safety simply as minimizing the physical and psycho-logical danger to self and others.....
Step #3 Providing Support: communicating tot he client that the worker is a person who cares about teh client. assure the client that "here is one person who realy cares about you"
Core Listening Skills: Restatement
Restatement take the client's own thoughts and words about what the content of the event is and feeds them back to the client from the crisis worker.
Core Listening Skills: Reflection
Reflection of feelings seeks to understand and uncover client feelings. MOst often phrased in the form of a guess or a hypothesis, reflections are set in a conditional sense so the client is free to except or reflect the proposed feeling hypothesized by the crisis worker.
Core Listening Skills: Owning statements
Owning statements are typically "I" statements that indicate the crisis worker's state of being in regard to what is happening in real time.
Core Listening Skills: Summary recapitulation
Summary recapitulation attempts to summarize the content of the client's current affective, behavioral, and cognitive functioning. It encapsulates what the client has, is, or will feel, do or think about the problem. It clarifies for both he client and the crisis worker what the current state of events is that surround the crisis.
Core Listening Skills: Open ended and closed questions
used to gather information regarding clients' affective, behavioral, and cognitive reactions to the crisis.
Core Listening Skills: Monitoring nonverbal cues
involves attending to voice pitch and tone, rate of speech, body movements and so on. These often help in the assessment of clients' reaction as these are being experiences in the current situation
Levels of Intervention: Direct Intervention
Crisis worker functions as a manager and instructs clients and to a degree promotes dependency on crisis workers. Much of the time direct interventions will begin with "I".... example: "I (crisis worker) want/need you to.....
Levels of Intervention: Collaborative Intervention
Crisis worker partners with client, helping clients to organize resources and activate coping-skills to resolve the crisis. The pronoun "we" is used or implied: "Together we can work through this problem" and "you and I will be in this together"
Levels of Intervention: Indirect Intervention
Crisis worker acts as a sounding board. Clients are capable of generating solutions with minimal assistance. The pronoun "you" is used often: "What are you feeling"; "Are there other ways you can think about the situation", and "What can you do to resolve the situation."
Acting
Step#4: examining alternatives
exploring a wide array of appropriate choices available to the client.
1. situational supports
2. coping mechanisms
3. Positive and construction thinking patterns
Step#5: Making Plans
a plan should identify additional persons, groups, and other referral resources that can be contactd for immediate sup-port, and provide coping mechanisms -- something concrete and positive for the client to do now, definite action steps that the client can own and comprehend.
Step#6: Obtaining Commitment
the issues of control and autonomy apply equally to the process of obtaining an appropriate commitment
Dynamics of Addiction
Defense Mechanisms
Denial
Displacement
Fantasy
Projection
Rationalization
Intellectualization
Minimizing
Reaction Formation
Regression
Repression
Enabling and Codependency
Suppression
Dissociation
Repression
Escape to Therapy
Intellectualization
Displacement
Reaction Formation
Passive Aggression
Hypochondriasis
Children in Alcoholic Families
Scapegoat
Hero
Lost Child
Family Mascot
Family Rules in Alcoholic Families
Don't Talk/ Don't have Problems
Don't Trust
Don't Feel
Don't Behave Differently
Don't Blame Chemical Dependency
Do Behave as I want
Do be better and more responsible
Don't have fun
Denial
a normal adaptive process for self-protection, but within the alcoholic it becomes rigid and maladaptive. Denial is the emotional refusal to acknowledge a person, situation, condition, or event the way it actually is.
Displacement
the venting of hostility on a person or object, neither of which deserves it.
Fantasy
fantasy is used to escape from a variety of threatening circumstances and emotions.
Projection
often attribute motives within themselves to significant others. Sensitivity, suspiciousness, and hostility toward others are outward manifestations of the distancing, estrangement, and lack of communication that characterize the alcoholic.
Rationalization
Alcoholics make all kinds of excuses to support their addiction and their felt inadequacies of acting and behaving.
Intellectualization
they speak in generalizations or theoretical terms in an impersonal manner and thereby remove themselves from hurtful feelings.
Minimizing
Alcoholics play down the seriousness of the situation
Reaction Formation
occurs as a defense against perceived threat and is one of the most harmful defense mechanisms because it distances dependents from their true feelings.
Regression
often immature and narcissistic, with resulting behavior similar to that of emotional prepubescence. The behavior is intended to manipulate, control, and get one's way. Temper tantrums, sulking, and pouting are all common forms of regression.
Repression
deal with threatening and hurtful events by burying them in unconscious memory. When sober, alcoholics repress the dependency needs and angry feeling s that accompany them, and they remember nothing of the personality behavior change that occur when they are intoxicated.
Codependency
**has to do with one's relationship to the chemical dependent.
the person has some as yet unsubstantiated "disease," "addiction;" or "syndrome" of codependency that probably originated in and was "caught" from a dysfunctional family of origin. Perhaps most insidious is the notion that once "caught" codependents must admit to their low self-esteem, their enmeshment and powerlessness in a pathological relationship, their in-ability to withstand rejection, and their avoidance of issues.
Enabler
Either out of fear of retribution by a union, threat of legal action, or misplaced compassion, an employer may back off confronting an employee about substance abuse.

**has to do with one's BEHAVIOR toward a chemical dependent.
Alcoholics can me enablers feel like they are doing them a favor by:
1. doing the individual's work
2. "covering" for poor work performance
3. Accepting excuses or making special arrangements
4. Overlooking frequent absenteeism or tardiness
5. Overlooking evidence of chemical abuse
suppression
codependents may suppress the problems that addict brings tot he family by maintaining a "stiff upper lip" and not allowing their emotions to surface. This is a defense of quiet desperation and is based on the hope that some miraculous change will occur in the dependent.
Dissociation
For those who dissociate themselves from the problem and repress it their perception of events is drastically altered by putting the problem aside. means distancing the problem emotionally and sometimes geographically....
Escape to Therapy
Seeking therapeutic assistance may be another form of escape for codependents.
Passive Aggression
overspending, implying the threat of suicide, being late, forgetting, starting arguments and then leaving, ....the co-dependent keeps everyone ina state of uproar
Hypochondriasis
converts anger into physical complaints. This is an extremely effective punishment of others because no matter how much consolation they receive, codependents obtain attention by this defense mechanism, and they don't give it up with-out a struggle.
Scapegoat
troubled child of al alcoholic family. Acting-out child is the one who comes to the attention of school administrators, police, and social services. have poor self-images and attempt to enhance themselves by rebellious, attention-seeking behavior. Acting-out children use unacceptable forms of behavior to say "care about me" or "I can't cope" socially, these children generally gravitate towards peers who have equally low self-esteem and are prone to engage in delinquent behavior. They fill correctional facilities, mental health institution, and chemical dependency unites in hospitals. they enable the addiction by becoming another stressor that can serve as an excuse for the substance abuse and by focusing the family's anger and energy away from the addict and onto themselves.
Hero
oldest child most likely -- very sophisticated child or family hero. little adult. takes care of the alcoholic, the spouse and the other children. The responsible child enables the alcoholic by giving her or him mmore time to drink.
Lost child
middle or younger child -- follows directions, handles whatever has to be handled, and adjusts to the circumstances, however dysfunctional they may be. The lost child outwardly appears to be more flexible, spontaneous and some what more selfish than others in the home. They don't feel, question, get upset, or at in anyway to draw attention to themselves. they enable by not being a 'bother'...doesn't take leadership roles and is generally a loner...
family mascot
youngest child --- placates and comforts everybody int he family and makes them feel better. by making tastily members feel better, he or she can divert attention from the problem and it will subside or go away.
1. the mascot may act the clown and distract the family through humorous antics. life of the party but have few close friends....trouble with teachers.
2. assume a role of sympathetic counselor to the rest of the family. highly sensitive to the needs of others, this child may be the apologist for the family's behavior and attempt to apply psychological balm to the emotional wounds other members of the family suffer.
FACTS on alcoholism
1. runs in families. Rarely is a case seen in isolation. There may be generational skips, but alcoholism is invariably found in the extended family of the alcoholic
2. Children of alcoholics run a higher risk of developing alcoholism than do children in the mainstream of the population.
3. Children of alcoholics tend to marry alcoholics....
Characteristics of Caretakers at Risk
Immaturity - young or insecure adults may have a difficult time understanding a child's behavior and needs. Their own need to be cared for is so great that they may be unable to take care of the needs of the child.

Lack of parenting skills -adults who have had poor models for family relationships may have a far more difficult time providing a healthy environment for their children.

Unrealistic expectations - Adults who do not relate well to other adults may expect children to satisfy their needs for love, protection, self-esteem, and sexual gratification.

Isolation - adults who have no support system, who are isolated geographically or emotionally from family and friends, may take out their frustration on children.

Substance abuse -- problems with drug or alcohol abuse limit the ability of adults to care properly for children.

Mental illness or developmental delay -

Poor impulse control -

Significant and major disruptions of a normal life -

An accumulation of small stressors -
Characteristics of Children At-Risk
A child whose care may pose particular difficulties:
handicapped physically or mentally
colicky or illness prone
hyperactive
demanding, unusual need for attention
infant with feeding difficulties
premature child
exceptionally bright child
previously abused child

A child who is perceived as difficult:
child of wrong gender - child is not the gender for which the parent had strongly hoped.
child is seen as bad, ugly, stupid, or willful, even if the appearance or behavior appears normal to others.
child whose conception or birth caused particular problems for the parent
child who has physical/personality characteristics similar to a person who has caused the caretaker pain or distress
physical indicators of physical abuse
face, lips and mouth
torso, back buttocks, thighs
various stages of healing
clustered, forming rectangular patterns, reflecting shape of article used to inflict (ex. electric cord, belt buckle)
several different surface areas
regularly appear after absence, weekend or vacation
Unexplained burns:
cigar, cigarette burns, especially on soles of feet, palms, back or buttocks
immersion burnes (sock-like, glove-like, doughnut shaped on buttocks or genitalia)
patterns like electric burner, iron, etc.
rope burns on arms, legs, neck or torso
infected burns, indicating delay in seeking treatment
Internal INjuries
Unexplained fractures/dislocations
Unexplained lacerations or abrasions
Head injuries
Other factors to consider when assessing injuries
Behavioral/emotional indicators and effects of physical abuse
obvious attempts to hide bruises or injuries
inappropriate clothing relative to weather (long-sleeved shirts or dresses in hot weather)
excessive school absenteeism
fearful of parents or adults
appears frightened and apprehensive of caretakers
apprehensive when other children cry
behavioral extremes
extremely aggressive, oppositional, demanding, rageful
arriving early at school and leaving late
academic and behavioral difficulties at school
cognitive and intellectual impairment
deficits in speech and language
hyperactivity, impulsivity, low frustration tolerance
lack of basic trust in others
depression, low self-esteem, destructive behavior, suicidal tendencies, consistently tired and unable to stay awake
missing PE or complaining that physical activity causes pain or discomfort
physical neglect
underweight, poor growth pattern
consistent hunger, poor hygiene, inappropriate dress
consistent lack of supervision, especially in dangerous activities or for long periods
wasting of subcutaneous tissue
unattended physical problems or medical needs
abandonment
abdominal distention
bald patches on the scalp
behavior/emotional indicators and effects of physical neglect
serious height and weight abnormalities
developmental lags (i.e. toilet training, motor skills, socialization, language development)
non-organic failure to thrive: delayed developmentally, listless, apathetic, depressed, non-responsive, fatigued
frequent absences from school (i.e. staying home to take care of other children or parents)
reports of being left alone, unsupervised or abandoned
anti-social tendencies, delinquency, alcohol or drug abuse, streetwise
chronically dirty
frequent inappropriate dress for the weather conditions
sexual abuse
diffictuly in walking or sitting
torn, stained or bloody underclothing
bruises, bleeding or lacerations in external genitalia, vaginal or anal areas
pain on urination
vaginal/penile discharge
vaginal/penile swelling
veneral disease
poor sphincter tone
pregnancy
semen about genitals or on undergarments
swollen or red cervix, vulva, perineum or anus
behavioral emotional indicators and effects of sexual abuse
simulation of sexual activity with younger or same age children
excessive masturbation
seductive behavior and sexual acting out towards adults, promiscuity, prostitution
knowledge of sexual matters inappropriate to age or developmental level
lacks of trust, particularly with significant others
poor peer relationships, social withdrawal
extreme fear of particular person or place
sudden drop in academic performance
non-participation in school and social activities
unwillingness to undress for physical education class at school
inability to concentrate in school
arriving early at school and leaving late
feelings of depression, guilt, shame, withdrwaal, suicidal feelings and gestures
overly compliant behavior
behavioral regression, infantile behavior, enuresis, encopresis
physical systems with no organic base
nightmare, wont's sleep alone
over and under eating
emotional abuse
speech disorders
lags in physical developmnt
failure to thrive
hyperactive/disruptive behavior
sallow, empty facial appearance
anxiety and unrealistic fears
sleep problems, nightmares
developmental lags
conduct and academic problems at school
poor relationships with peers
behavioral extremes -- aggressive/passive, inappropriately adult-like/infantile, immature, childish
oppositional, defiant of authority/overly compliant
over-controlled, rigid/overly impulsive
depressed, withdrawn, isolated
apathetic, aloof indifferent
habit disorder such as biting, rocking, head banging, or thumb sucking in an older child
Child Welfare work: Targets of Intervention
a substitute parent that does for the disadvantaged, dependent child what the effective family does for the advantaged child.
child welfare services
supportive services: education, casework counseling, family therapy
Supplementary services
day-care, and parenting functions while the child remains in the home
substitute care services
replace the naturla parent(s) permanently or temporarily. respite care (giving parents under stress a "break" from parenting, foster care and adoptions
Child protective services
focus of intervention and the role of the social worker
child protective service functions
-- reporting
-- investigation
-- intervention
-- termination
current trends in child protective services
HIGH volume of reports and a simultaneous reduction in funding for services, child protective services have become more of a means of identifying cases of maltreatment and less an agent for training and rehabilitating abusive/neglecting families. Family treatment is also in increasingly a multidisciplinary undertaking, including such professional as teachers, doctors, members of the legal profession, child care providers and mental health workers. Many communities have set up multidisciplinary teams that attempt to identify maltreatment, intervene with maltreating families, develop policies and programs and provide community education and consultation services to child protective
Characteristics of abusive families
unfulfilled needs for nurturance and dependence
isolation and fear of relationships
lack of support systems
marital problems
life crisis
inability to care for or protect a child
the special child
lack of nurturing child-rearing practices
(assessing client contexts) ADDRESSING
A - age and generational influences
D - Developmental and acquired disabilities
R - Religion and spiritual orientation
E - Ethnicity and race
S - Socioeconomic status
S - sexual orientation
I - indigenous heritage
N - national origin
G - Gender
(assessing client contexts) RESPECTFUL
R - religious and spiritual identity
E - ethnic, cultural, and racial background sexual identity
P - psychological maturity
E - economic class standing and background chronological-developmental challenges threat to well-being and trauma
F - family history, values, and dynamics
U - unique physical characteristics
L - location of residence and language differences
Purpose of the Social Work Interview
1. information ( to make a social study)
2. Diagnostic (to arrive at an appraisal)
3. Therapeutic (to effect change)
A Comparison of Theoretical Viewpoints in Family Therapy (pg. 59)
Psychodynamic - Unresolved conflicts form past continue to attach themselves to situation. Past; early internalized family conflicts lead to interpersonal conflicts family. (Psychoanalytic).

Experiential - Egalitarian; active facilitator providing family with new experiences through the therapeutic encounter. free choice; self-determination; growth of the self; maturity achieved by overcoming impasses in process of gaining personal fulfillment.

Transgenerational - coach; direct by non-confrontational; detriagulated from family fusion. Aids family in developing relational fairness. emotional attachments to ones family of origin need to be resolved.

Structural - symptoms in an individual are rooted in the context of family transactions, and family structuring must occur before symptoms are relieved. Active; stage director manipulates family structure to change dysfunctional sets.

Strategic - active; manipulative problem-focused; prescriptive; paradoxical. reluctant communication patterns offer clues to family rules and possible dysfunction; a symptom represents a stratgy for controlling an relationship while claiming it to be involuntary.

Milan - dysfunctional families are caught up in destructive "games" and are guided by belief systems that do not fit the realities of their lives.

Cognitive-Behavioral - personal functioning is determined by the reciprocal interaction of behavior and its controlling social conditions.

Social Constructionist - people use language to subjectively construct their views of reality and provide the basis for how they create "stories" about themselves.
Therapeutic techniques and goals in family therapy (pg. 61)
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Psychoanalytic therapy
Key figures: Sigmund Freud. A theory of personality development, a philsophy of human nature, and a method of psychotherapy, it focuses on unconscious factors that motivate behavior. Attention is given to the events of the first 6 years of life as determinants of the later development of personality.
Alderian therapy
Alfred Adler: Following adler, rudolf dreikurs is credited with popularizing this approach in the US. a growth model, it stresses taking responsibilities, creating ones own destiny, and finding meaning an d goals ti give life direction. Key concepts are used in most other current therapies.
Existential therapy
Viktor Frankl, Rollo May, and Irvin Yalom. It reacts against the tendency to view therapy as a system of well defined techniques. Instead, it stresses building therapy on the basic conditions of human existence, such as choice, the freedom and responsibility to shape one's life, and self-determination. It focuses on the quality of the person to person therapeutic relationship.
Person-centered therapy
Carl Rogers. This approach was developed during the 1940s as a non-directive reaction against psycho-analysis. Based on a subjective view of human experiencing, it places faith in and gives responsibility to the client in dealing with problems.
Gestalt therapy
Fritz and Laura Perls. An experiential therapy stressing awareness and integration, it grew as a reaction against analytic therapy. It integrates the functioning of body and mind.
Reality Therapy
William Glasser. A short term approach focusing on the present, it stresses a person's strengths. Clients learn more realistic behavior and thus achieve success.
Behavior therapy
Arnold Lazarus and Albert Bandura. It applies the principals of learning to the resolution of specific behavior disorders. results are subject to continuous experimentation. This technique is always in the process of refinement.
Cognitive Behavior Therapy
Albert Ellis founded ration emotive behavior therapy, a highly didactic, cognitive, action-oriented model of therapy that stresses the role of thinking and belief systems as the root of personal problems. A.T. Beck founded cognitive therapy
Feminist Therapy
Grew out of efforts of many women. Central concept is the concern for the psychological oppression of women. Focusing on the constrain imposed by the sociopolitical status to which women have been relegated, this approach explores women's identity development, self-concept, goals and aspirations, and emotional well-being.
Family Systems Therapy
A number of significant figures have been pioneers of the family systems approach. This systematic approach is based on the assumptions that the key to changing the individual is understanding and working with the family.
Therapeutic relationship (pg. 65)
Psychoanalytic therapy - the analyst remains anonymous, and clients develop projections toward him or her. Focus is on reducing the resistances that develop in working with transference and on establishing more rational control. long-term analysis, engaged in free association to uncover conflicts and gain insights by talking.

Alderian therapy - emphasis is on join responsibility, on mutually determining goals, on mutual trust and respect, and on equality.

Existential therapy - therapist's main takss are to accurately grasp clients' being in the wold and to establish a personal and authentic encounter with them. RELATIONSHIP is critically important.

person-centered therapy - relationship is of primary importance. the qualities of the therapist including genuineness, warmth, accurate empathy, respect and non-judgmentalness-and communication of these attitudes to client-are stressed.

gestalt therapy - therapist's main function is to create a good relationship with the client. Therapists are then able to engage clients in an evaluation of all their relationship with respect to what they want and how effective they are in getting this. therapists find out what clients want, ask what they are choosing to do, invite them to evaluate present behavior, help them to make plans for change, get them to make a commitment.

Behavior therapy - the therapist is active and directive and functions as a teacher or trainer in helping client learn more effective behavior. Clients must be active in the process and experiment with new behaviors.

cognitive-behavior therapy -
Techniques of Therapy (pg. 66)
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Application of Approaches (pg. 68)
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ID
Unconscious
EGO
Conscious
Super-Ego
Society Rules
Calendar of Psychic events
causality
Phases
Oral
Anal
Phallic (oedipian, electra)
Conflicts
Latency
Genital
Clinical Social Work
restoration or enhancement of social functioning. Two sets or paths: one general theory of personality or personality development: a confluence of the connections among an individual's biological equipment, quality of nurturance experience, live opportunities or modes to deal with object relations as well as the functions accompanying those relations.
Theory of Causation
Basically psychoanalysis is a psychology of conflict. The functioning of the mind is the expression of conflicting forces. Some of these forces are conscious; other, major ones unconscious. As a method of therapy, psychoanalysis emphasizes the importance of biological animal and social being. A fundamental principle that regulates the mind but relates to events in the body is the pleasure principle by which human psychology is governed by a tendency to seek pleasure and to avoid pain. This principle is dominant in the first few years or existence.
Fixation
Unconscious attachment to a stage or phase
Mechanisms of psychotherapy
Treatment process has four phases:
opening phase
development of transference (analysis of transference help client to understand how he misperceives and misresponds to the present in terms of the past)
working through
resolutions of the transference
Anna Freud
Ego defense mechanisms (i.e. repression, projection, reaction formation) serve to ward off anxiety stemming from external thurst, id impulse and/or super-ego demands.
Hartman
talks about the autonomous ego which grows and matures as a result of experience. such functions include perception, motor equipment, intelligence, judgment, impulse control, self and body image, and though processes
Reality ego
evolves by maturing and freeing itself form the instinctual drives, leading to adaption. Ego naturation becomes both an instructional and learning process. The individual's sense of confidence, mastry and augonomy in overcoming difficult situations insures and strengthens his coping mechanisms
Erikson
Sequence of phases of psychological development, extending to a full life cycle. He outlined how in each phase a specific task must be solved; the solution of each phase depends on the successful or unsuccessful solution of the previous phase.
Present status
Emphasizes adaptation to external reality. Knowledge of object relations role performance, interpersonal and transactional relationship.
Implications for Treatment
Ego assessment: Defensive structure, ability to cope with stress, anxiety, frustration-tolerance, reality-testing, and super-ego development determines differential diagnosis.
Present psychosocial assessment
Essentially a system theory approach -- the person situation gestalt or configuration -- Human being "in the context of his/her interactions or transactions with external world."
Duty to Warn (pg. 73)
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Common Transition Points through the Life Cycle
Married Couple -- Commitment to each other
Childbearing family - Developing parent roles
Preschool children - Accepting child's personality
School children - accepting adolescence (social and sexual role changes)
Teenagers (experimenting with independence of late teens)
Launching children - accepting child's independent adult role
Middle-aged parents - letting go-facing each other again
aging family members - accepting old age
Dislocation in the family life cycle requiring additional steps to re-stabilize and proceed developmentally (pg. 75)
1. The decision to divorce
2. Planning the breakup the system
3. separation
4. the divorce
5. post-divorce family custodial single parent
6. noncustodial single parent
Remarried family formation: A developmental outline
1. entering the new relationship
2. conceptualizing and planning new marriage and family
3. remarriage and reconstitution of family
Group Therapy (pg. 77)
Stages:
1. preaffiliation -- forming group dynamics
2. power and control - storming group dynamics
3. intimacy - norming
4. differentiation - performing
5. separation - adjourning
self actualization needs
education programs
volunteer opportunities
esteem needs
support groups
psychosocial counseling
mental health centers
social needs
recreational and social
groups
senior centers
home visitors
safety and security needs
emergency response system
adult family homes
congregate care facilities
senior housing
continuing care retirement
communities
wellness clinics
telephone contact
survival needs
home delivered meals
senior discounts
mobile meals
transportation
homemaker
home health
personal care
medical care
Organizing to promote community change (pg. 80)
community organizing is based on the principle of like-minded people joining together to promote change.
Important concepts:
- individuals and organizations identify a common goal
- like-minded individuals and organizations consolidate themselves to have a more effective voice in the community
- all individual members of the community are welcome to participate in the effort including politicians, business leaders, citizens, and others.
- organizations and agencies are welcome to form a network of the concerned. This network includes schools, financial institutions, social service organizations, political organizations, nonprofit organizations, and others.
- the combined efforts of many voices has the power to facilitate change.
- basic to the work is organizing as a team and gathering information to understand the community with its needs
- basic to the work is developing an action plan
Model of Client Empowerment
education and train those in need, to organize, establish their agenda, and work for their own cause by organizing campaigns, networking with government and business leaders, proposing legislation, and participating in the political, economic, and social processes of the community
community organization
efforts to assist a community to increase its capacity to solve problems and achieve its own goals. Empowerment is a term that is applied to individuals, groups or communities that experience increased ability to control their environments. The term community is used broadly to refer geographic areas (neighborhoods), group identifications (minority communities), and special interested (disability, etc.)
Advocacy
the advocate takes action for an individual or group, representing their wishes, and acting as their agent. Advocacy presumes the inability of the client (individual or community) to act on their own. The advocate acts only by authorization of some client, and must represent the client's wishes.
strategies of community organization
locality development -
social planning - done at the community level to solve community problems and meet community-wide service needs.
social action - lack of sufficient power to get needs met and problems solved. The organizer works with grass-roots community groups to help them develop political power to assert heir needs to public officials, business leaders.
Needs Assessment
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Asset Mapping
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Community Collaborations
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Boundary Management: Coalitions, Professional Associations, and Networks
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Marketing
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Publics
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Product
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Place
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Price
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Promotion Marketing and Collaboration
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Public Relations
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Code of Ethics
- The code identifies core values on which social work's mission based.
- The code summarizes broad ethical principles that reflect the profession's core values and establishes a set of specific ethical standards that should be used to guide social work practice.
- The code is designed to help social workers identify relevant considerations when professional obligations conflict or ethical uncertainties arise.
- The Code provides ethical standards to which the general public can hold the social work profession accountable.
- The Code socializes practitioners new tot he field to social work's mission, values, ethical principles, and ethical standards.
Service
social worker's primary goal is to help people in need and to address social problems.
Social Justice
social workers challenge social injustice.
Dignity and Worth of the Person
social workers respect the inherent dignity and worth of the person.
Importance of Human Relationships
social workers recognize the central importance of human relationships.
Integrity
social workers behave in a trustworthy manner
Competence
social workers practice within their areas of competence and develop and enhance their professional expertise
social workers ethical responsibilities to clients
commitment to clients
self-determination
informed consent
competencies
cultural competence and social diversity
conflicts of interest
privacy and confidentiality
access to records
sexual relationships
physical contact
sexual harassment
derogatory language
payment for services
clients who lack decision-making capacity
interruption of services
termination of services
Negligence/Malpractice
four legal criteria that must be shown by a preponderance of the evidence:
1. duty -- can be established by a relationship or by statutory law. It refers to the fiduciary responsibility to care for the welfare of another person(s) over which a supervisor has direct control and knows, or should know, of their actions.
2. Breach -- based on a violation of the preceding duty where specific actions or inactions occurred that were both foreseeable and unreasonable given that fiduciary responsibility.
3. Causation -- breach of duty was a direct and/or proximate cause of injuries incurred by a client or patient.
4. Damage -- demonstrable physical, financial, or emotional injury (including pain and suffering) must have occurred as a result of the foregoing three criteria.
Types of Research Designs
Qualitative and quantitative
Qualitative Research
unstructured data - not numbers
exploratory
can't be generalized
ex. focus group, unstructured/ semi-structured interviews
Quantitative Research
uses structured data numbers
exploratory, descriptive or explanatory
may be generalized depending on design
ex. survey, pre/post test
Survey Design
cross-sectional, one point in time
descriptive, can't support causality
can show that things correlate (are related)
issue: to what degree does the sample represent the population?
if the sample was selected randomly - we can determine the probability that it is representative
Pre-experimental Design
pre-test post-test
ex. did who student get into fewer fights after attending the anger management course
can show the # of fights decreased but not why the numbers of fights changed
Experimental Designs
can explain and address causality because these CONTROL for alternative explanations of the outcome
- single subject designs
- quasi-experimental designs
- experimental designs
experimental design (variables)
Independent variable -- the presumed cause. The variable that is manipulated.

Dependent variable -- the presumed effect. It changes based on the level the independent variable
Single-Subject
subject as their own control

issue: external validity
if the treatment worked for samy can we say that it will also work for simone?

solution: replicate replicate, replicate
Quasi-experimental Design
uses a comparison group to control for other explanations of the change in the subjects

comparison group - a group which is similar to the participants but receive no service or a different service

Issue: threats to internal validity. How alike or different are the experimental group and the comparison group.
Experimental Design
- uses a control group to control for other explanations of the change in the subjects
- control group is created by random assignment to the treatment or non treatment group
- random assignment does not guarantee that both groups are ON AVERAGE the same if the groups are small (under 25)
- ethical issue; withholding treatment can be an issue
Analysis - choosing a method
type of research question
level of measurement
number of groups
sample size
assumptions of the tests that we are interested in
Mean
average score, need interval or ration data

an average that is calculated by adding up all the scores and dividing by the number of scores
Median
1/2 the scores above 1/2, need ordinal, interval or ration data. use in place of the mean when there are outliers (e.g. income)
Mode
The most common score. Can use with nominal, ordinal, interval ration data.
Ethics and research
voluntary
informed consent (who, why, what, parental consent for less than 18 yr)
do no harm
protection of sensitive information
- confidentiality (I won't tell what you said.)
- anonymity (I won't be able to connect you with what you said.)
Frequency
the number of times that a given score is produced. That number is called its frequency.
Frequency distribution
a summary of the array of all scores produced from lowest to highest
Histogram
a bar graph showing the frequency of all or grouped scores in a distribution.
Modality
refers to the number of distinguishable peaks in a distribution. BIMODAL means that there are two peaks.
Normal Distribution
a distribution which graphically produces a symmetrical bell shaped curve, with frequencies greatest in the cent and less frequent at the extremes. It is sometimes called a Normal Curve.
Percentile Rank
a number which gives the precent of cases scoring at or below that score.
Quartile
divides the number of cases into four equal parts. The 1st quartile is up to 25%, the 2nd quartile is 26% to 50%, the 3rd is 51% to 75%, and the 4th is 76% to 100%
Skewness
this term describes the shape of the distribution curve, where positive skewness means that scores tend to be clustered in the higher ranges, and negative skewness means that they tend to fall in the lower ranges.
Range of Scores
largest score minus the smallest score; the area in between the highest and lowest scores. range between 1 and 10 is 9
Deviation
the distance of a score from the mean of all scores is called its deviation
Variance
this refers to the mean of the squared deviations. difference between each score and every other score
Standard Variation
refers to an average of all the deviation from the mean; average variability
Z-score
standardized score which has been transformed to represent how far it lies from the mean (set at zero)
Normal Curve
a theoretical distribution of a total population expressed as a graph that is symmetrical (not skewed and is unimodal) the scores fall proportionately under the curve according to the following %'s:
68% - fall within 1 standard deviation of the mean
95% fall within 2 SDs of the mean
99% fall wihin 3 SDs of the mean
Inferential Statistics
refers to statistical procedures for making inferences about a population from a sample
Population
everyone, all cases.
Sample
any subset of a population. a RANDOM SAMPLE is one that has been drawn from a population using a table of random numbers....
Probabiuty
the probability of an event occurring in the number of different ways an event can occur divided by the total number of possible events.
Hypothesis
a statistically testable statement of belif that something is true.
Type I Error
rejecting the hypothesis when indeed it is true
Type II Error
accepting the hypothesis when indeed it is false
Degrees of Freedom
when estimating a population from a sample, you subtract 1 from the sample size. the number is called (dt) degrees of freedom
t- Test
a statistical procedure for determining the significance of the variation of a scare from the mean
Correlation
a coefficient of correlation is a number that describes how events are related.

Positive correlation -- means that as one thing increases in frequency or strength, another also increases.

negative correlation -- means that as one thing increases, another decreases.
Multiple Regression
predicts the relationships and interactions among more than one independent variable and one dependent variable.
Analysis of Variance
abbreviated ANLOVA this statistical test determines the significance of the differences among the means of three or more samples
CHI - Square
non-parametric statitic that tests for the significance of the difference between observed and expected frequencies in a categorical set of data
Reliabiuty
a variable should vary due to real differences,not because of measurement "noise" -- a reliable measurement has little "error variance" mostly "true variable."
Error Variance
measurement noise caused by factors such as use of poorly constructed measurement instrument, respondent tiredness or disinterest, problems in the testing environment, cultural or language confusions, etc.
Alpha Reliability
procedure for assessing error variance by examining the relationship among responses to items in a measurement instrument. (also called INTERNAL consistency reliabuity) it assumes that if the items are measuring the same variable, they should be highly correlated.
Consistent Reliability
it assumes that if items are measuring hte same variable, they should be highly correlated
Split-Half Reliability
this method for assessing reliability assume that the top half of the items in a measurement instrument should be highly correlated with the lower half
Test-Retest Reliability
method for determining reliability, assumes that there should be consistency between different administrations of the same measurement instrument. scores should be highly correlated.
Validity
the extent to which a measurement instrument actually measures what is intended to. (concurrent, face, predictive, construct validity)
Level of Measurement
type of data that has been gathered (nominal, ordinal, interval)
Affect
the instantaneous, observable expression of emtion. Moods are symptoms; affects are signs
Alexithymia
a mood in which the patient has a constricted emotional life, diminished ability to fantasize, and a virtual inability to articulate emotions. describes the absence of emotion...
Alogia
an impoverishment in thinking that is inferred from observing speech and language behavior.
Ambivalence
having two strongly opposite ideas or feelings at the same time, which renders the individual virtually unable to respond or decide.
Amnesia
a pathological loss of memory
two types:
anterograde: for events occuring after a significant point in time
retrograde: events occuring before a significant point in time.
Anhedonia
a mood in which there is a pervasive inability to perceive and experience pleasure in actions and events that are normally pleasurable or satisfying for the individual or most individuals.
Anorexia
loss of appetitie
Anxiety
can refere to a symptom or a syndrome. A symptom, anxiety is a mood of inner tension, restlessness, uneasiness, or apprehension. as a syndrome, anxiety combines this (internal) moc with (external) physiologic signs, such as tremor, heart-pounding, hyper-vigilance, dilated pupils, and agitation. Anxiety is pathological only wen it chronically interferes with a person's functioning, Wheras anxiety implies the absence of a consciously recognized, external threat, fear implies that such threat exists. Anxiety focused on an up-coming event is called anticipatory anxiety -- free-floating anxiety.
Ataxia
a partial or complete loss of coordination of voluntary muscular movement
Autistic thinking
thought derived from fantasy. The person defines his environment based on internal fantasies instead of on external realities. an individual's being preoccupied with his own private world; social withdrawal into one's inner world usually results.
Avolition
the inability to initiate and persist in goal-directed activities.
Blocking
when a person's train of thought abruptly and unexpectedly stops.
Catatonia
extreme psychomotor agitation or retardation. Patients seem driven even when motionless; some appear frantic, others fanatical
Catalepsy
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Cataplexy
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Clanging
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Clouding of consciousness
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Circumstantiality
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Coma
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Compulsions
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Conversion symptom
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Concrete Thinking
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Confabulation
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Craving
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Deja Vu
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Delusions
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Depersonalization
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Derailment
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Derealization
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Disorientation
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Dissociation
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Distractibility
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Echolalia
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Echopraxia
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Ego-dystonic
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Ego-syntonic
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Flight of Ideas
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Folie A deux
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Fugue
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Gender Dysphoria
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Guilt
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Hallucinations
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Hallucinosis
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Hypersomnia
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Ideas of reference
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Illogical thinking
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Illusions
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Incoherence
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Insomnia
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Looseness of associations
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Magical thinking
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Mood
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Mood-congruent psychotic features
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Mood-incongruent psychotic features
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Mutism
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Neologism
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Obsessions
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overvalued
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panic attacks
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paranoia
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paranoid
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paranoid style
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perseveration
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phobia
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posturing
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Poverty of content of speech
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poverty of speech
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pressured speech
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psychomotor
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psychomotor agitation
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psychosis
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reality testing
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schneiderian first-rank symptoms
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shame
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stereotypy
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stupor
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tangentiality
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thought disorder
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tic
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vegetative
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word salad
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