ASWB LCSW Exam Prep

Theories

Are general explanations supported by evidence obtained through the scientific method.

Psychoanalytic Theory

Sigmund Freud

Client is a product of his past

Treatment involves dealing with repressed material in the unconscious

Personalities arise because of attempts to resolve conflicts between the unconscious sexual and aggressive impulses and social demands to restrain these impulses

3 Levels of Awareness

Preconscious, Conscious, Unconscious

Preconscious (3 Levels of Awareness)

Info outside of the client's attention but available and easy to bring to consciousness.

Conscious (3 Levels of Awareness)

Info the client is paying attention to at any given time.

Unconscious (3 Levels of Awareness)

Thoughts, feelings, desires and memories of which a client has no awareness but that influences every aspect of their day-to-day lives.

3 Components of Personalities

Id, Ego, Superego

Id (3 Components of Personalities)

Instinctual energy, biological urges, impulses toward survival, sex and aggression.

Unconscious.

Pleasure principle - the drive to achieve pleasure and avoid pain.

Ego (3 Components of Personalities)

Manages conflict between Id and the real world.

Has unconscious, preconscious or conscious parts.

Reality principle - the awareness that gratification of impulses has to be delayed in order to accommodate the demands of the real world.

Role is to prevent the Id from gratifying its impulses in socially inappropriate ways.

Ego-Syntonic/Ego-Dystonic:

Syntonic - behaviors "insync" with ego (no guilt)

Dystonic - behaviors "dis n sync" with ego (guilty)

Determine best course of action based on info from id, reality, and the superego.

Inability to reconcile the demands of the Id, reality and superego produces conflict that leads to a state of psychic distress known as anxiety.

Ego strength - ability to deal with demands of id, reality and superego.

Superego (3 Components of Personalities)

The moral component of personality, learned from parents and society, causes clients to feel guilty.

Psychosexual Stages of Development

Freud believed there to be five stages of psychosexual development: Oral, Anal, Phallic, Latent and Genital. At each of these stages, pleasure is focused on a particular part of the body. Too much or too little pleasure in any one of these stages caused a fixation which would lead to personality or psychological disorders. For example, too much pleasure in the phallic stage could lead to obsessive masturbation and sexual dysfunction as an adult.

Oral (Stage of Development)

Birth-12 months

Pleasure centers on mouth; sucking, biting, chewing.

If not satisfied result is excessive smoking, overeating, or dependence on others.

Anal (Stage of Development)

Age 2 (during toilet training)

Pleasure centers on Bowel movements.

If not satisfied result is an overly controlling (anal-retentive) personality or an easily angered (anal-expulsive) personality.

Phallic (Stage of Development)

Age 3 to 5

Pleasure centers on Genitals.

If not satisfied result is Guilt or anxiety about sex.

Latency (Stage of Development)

Age 5 to Puberty

Pleasure centers on Sexuality is latent, or dormant, during this period.

No fixations at this stage.

Genital (Stage of Development)

Begins at puberty

Pleasure centers on The genitals; sexual urges return.

No fixations at this stage.

Fixation

Is an inability to progress normally from one stage into another.

Oedipus complex

A male child's sexual desire for his mother and hostility toward his father.

Castration anxiety

Fear of penis being cut off, child accepts father and authority results in superego.

Primary techniques used in psychoanalytic psychotherapy

analysis of dreams, resistances, transferences, and free associations

Individual Psychology

Alfred Adler's view that people are motivated by purposes and goals and that perfection, not pleasure, is thus the key motivator in human life.

Compensation

Attempt to shed normal feelings of inferiority.

Inferiority

Overcompensate, try to cover up their sense of inferiority by focusing on outward signs of superiority such as status, wealth and power.

Aim of Individual Psychology (Alfred Adler)

To develop a more adaptive lifestyle by overcoming feelings of inferiority and self centeredness and to contribute more toward the welfare of others.

Self Psychology

Based on central organizing and motivating force in personality, three self object needs: mirroring, idealization, twinship/Twinning

Mirroring (3 self object needs)

Validates the child's sense of a perfect self.

Idealization (3 self object needs)

Child borrows strength from others and identifies with someone more capable.

Twinship/Twinning (3 self object needs)

Child needs an alter ego for a sense of belonging.

Ego Psychology

Based on an assessment of a client as presented in the present (here and now) focuses on the rational, conscious processes of the ego. The goal is to maintain and enhance the ego's control and management of stress and its effects.

Psychosocial Stages of Development

Erik Erikson

Focus on how children socialize and how this affects their sense of self.

8 Stages of Psychosocial Development (Erik Erikson)

Trust vs. Mistrust

Autonomy vs. Shame and Doubt

Initiative vs. Guilt

Industry vs. Inferiority

Identity vs. Role Confusion

Intimacy vs. Isolation

Generativity vs. Stagnation

Ego Integrity vs. Despair

Trust vs. Mistrust (8 Stages of Psychosocial Development)

Birth to 1 year

Trust based upon consistency of caregiver.

Autonomy vs. Shame and Doubt (8 Stages of Psychosocial Development)

Age 1 to 3

Child asserts their independence, walks away from caregiver, picks likes and dislikes.

Initiative vs. Guilt (8 Stages of Psychosocial Development)

Age 3 to 6

Child asserts self more frequently.

Industry vs. Inferiority (8 Stages of Psychosocial Development)

Age 6 to Puberty

Child develops a sense of pride in their accomplishments.

Identity vs. Role Confusion (8 Stages of Psychosocial Development)

Adolescence

Transition from childhood to adulthood.

Child begins to look at the future in terms of career, relationships, families, housing etc.

Intimacy vs. Isolation (8 Stages of Psychosocial Development)

Young Adulthood

Child begins to share themselves intimately with others and explores relationships.

Generativity vs. Stagnation (8 Stages of Psychosocial Development)

Middle Adulthood

Child establishes career, settles down begins family develops a sense of being a part of the bigger picture.

Ego Integrity vs. Despair (8 Stages of Psychosocial Development)

Senior Citizens

Slow down, explore life as a retired person.

Object Relations Theory

Margaret Mahler

Lifelong relationship skills are strongly rooted in early attachments with parents, especially mothers.

Objects refer to people, parts of people, or physical items that symbolically represent either a person or part of a person.

Normal Autism (Phases of Object Relations)

0-1 month

Infant is detached and self-absorbed.

Spends most time sleeping.

Normal Symbiotic (Phases of Object Relations)

1-5 months

Child is aware of mother.

No individuality, the child and mother are one.

Separation/Individuation (Phases of Object Relations)

Subphase Differentiation/Hatching

5-9 months

Aware of difference between self and mother.

Increased alertness and interest in the world.

Child uses mother as a point of orientation.

Practicing (Phases of Object Relations)

9-15 months

Crawl and walk freely.

Child explores and becomes more distant from the mother.

Experiences self still as one with mother.

Rapprochement (Phases of Object Relations)

15-24 months

Child becomes once again close to mother.

Awareness of phsycial mobility = psychic separateness from mother.

Toddler is tentative, wants mother in sight.

Object Constancy (Phases of Object Relations)

24-38 months

Child understands mother has a separate identity and is truly a separate individual.

Cognitive Development

study of how children acquire the ability to learn, think, reason, communicate, and remember

Sensorimotor (Stage of Cognitive Development)

0-2 yrs; the stage during which infants know the world mostly in terms of their sensory impressions and motor activities. Touching, smelling, and listening to learn

Preoperational (Stage of Cognitive Development)

2-7 yrs; symbolic thought, egocentrism, irreversibility, centration, conservation, transductive thought, collective monologue, theory of mind, animism, artificialism

Concrete Operations (Stage of Cognitive Development)

7-11 yrs; conceive how objects change, an reverse think, can decenter to think from other perspective

Formal Operations (Stage of Cognitive Development)

11+ yrs; characterized by the ability to perform hypothetical reasoning beyond the here and now

Attachment Theory

theory based on John Bowlby's work that posits that children are biologically predisposed to develop attachments to caregivers as a means of increasing the chances of their own survival

Maslow's Hierarchy of Needs

Physiological, Safety, Social (love and belonging), Esteem, Self actualization

Think order of prioritizing problems or issues with a client

5 Stages of Grief

Denial and isolation

Anger

Bargaining

Depression

Acceptance

Person-In-Environment (PIE) Theory

A perspective that recognizes the complexity of interactions between people and their environment, and promotes the notion that people both shape and are shaped by their environment.

Defense Mechanisms

Are automatic, involuntary, usually unconscious psychological activities to exclude unacceptable thoughts, urges, threats, and impulses from awareness for fear of disapproval, punishment, or other negative outcomes. Are sometimes confused with coping strategies, which are voluntary.

Serves as an important protective function. Protect the ego.

Acting Out, Splitting etc.

What would a client be doing or saying while using a defense mechanism?

Family Life Cycle

1. Family of Origin Experiences

2. Leaving Home

3. Premarriage stage

4. Childless couple stage

5. Family with young children

6. Family with adolescents

7. Launching children

8. Late Family LIfe

Authoritarian Parenting

strict rules, punishment

Leads to obedient and proficient, lower happiness social competence and self esteem

Authoritative Parenting

rules and guidelines

Responsive to children and listen to questions. More nurturing and forgiving rather than punishing.

Leads to happy capable and successful children.

Permissive Parenting

Very few demands, rarely discipline generally nurturing and communicative (friend status more than parent)

Leads to children who rank low in happiness and self regulation, experience problems with authority and perform poorly in school

Uninvolved Parenting

Few demands, low responsiveness, little communication. Fulfill basic needs generally detached from their children's lives.

Lead to children ranking lowest across all domains, lack self-control have low self-esteem and less competent than peers

Circular Questioning

Is a technique that can be used to explore differences between the family members.

Alcohol Withdrawal

Includes Seizures

Honeymoon phase of Domestic Violence

Borderline Personality disorder (Male/Female), major defense mechanisms

Men exhibit different patterns of impulse-related disorders

Projective identificaction

Paraphilias behaviors DSM 5

Classical conditioning

Operant conditioning

negative reinforcement

Extinction

Geriatric Depression Inventory

Minnesota Multiphasic Personality Inventory

Beck Anxiety Inventory

CAGE

Problem-solving

Physical Symptom

FIRST rule out any medical basis

Treatment for Addictions

Group therapy since the group process breaks down the individual client's denial and rationalizations

Clarifying Techniques

Involuntary

Right to refuse treatment.

Right to refuse to give permission to the hospital to contact his family.

Right to keep the record of his admission confidential.

Does not have the right to leave the hospital regardless of his condition.

Confrontation

Reflection

Clarification

Partialization

Malpractice Suit

right to disclose client information to the court to defend against a malpractice lawsuit

Boundaries (Code of Ethics)

Dual Relationship (Code of Ethics)

Occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Can occur simultaneously or consecutively.

Mandated Reporting

Social Work Core Values

Service

Social Justice

Dignity and Worth of the Person

Importance of Human Relationships

Integrity

Competence

Service

Primary goal is to help people in need and to address social problems. Volunteer (pro bono service).

Social Justice

Challenge social injustice.

Pursue social change, on issues of poverty, unemployment, discrimination and other forms of social injustices.

Dignity and Worth of the Person

Respect the inherent dignity and worth of the person.

Mindful of individual differences and cultural and ethnic diversity.

Promote clients' self-determination.

Importance of Human Relationships

Recognize the central importance of human relationships.

Engage people as partners in the helping process.

Integrity

Behave in a trustworthy manner.

Act honestly, responsibly and promote ethical practices.

Competence

Practice within their areas of competence and develop and enhance their professional expertise.

Ethical Standards

Ethical Responsibility to Clients

Ethical Responsibility to Colleagues

Ethical Responsibilities in practice settings

Ethical Responsibilities as professionals

Ethical Responsibilities to the social work profession

Ethical Responsibilities to the broader society

Ethical Responsibility to Clients

Commitment to Clients - Clients' interests are primary except when limited by legal or larger society.

Self-Determination - Assist client to identify and clarify their goals. Right to self-determination can be limited when in the social workers' professional judgement the clients' actions or potential actions pose a serious, foreseeable and imminent risk to themselves or others.

Informed Consent - Inform Client of the purpose of the services, risks, limits (due to a third-party payer), relevant costs, reasonable alternatives, client rights to refuse and withdraw consent and the time frame covered by the consent. Allow questions.

Provide detailed verbal explanation or arrange for a qualified interpreter or translator whenever possible.

Protect client interest when they lack ability to provide informed consent by seeking permission from appropriate third-party, ensure action is in the interest and wishes of the client.

When involuntary, provide info about the nature and extent of services and the extent of clients' right to refuse service.

Inform limitations and risks associated with using electronic media such as computers telephones radio television etc.

Should obtain clients' informed consent before audiotaping or videotaping clients or permitting observation of services to clients by a third party.

Competence - provide services within ones education and training.

Cultural Competence and Social Diversity - Should understand culture and its function in human behavior and society. Recognize strengths in all cultures. Should have a knowledge base of their clients' cultures.

Conflicts of Interest - Inform clients when a real or potential conflict of interest arises. Some cases protecting clients' interests may require termination of the professional relationship with proper referral of the client.

Should not take unfair advantage of any professional relationship or exploit others to further their personal, religious, political, or business interests.

Should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client.

When serving people who have a relationship with each other SW should clarify which individual will be considered the client and the nature of the SW's obligation to the various individuals.

When a SW is asked to testify in a child custody dispute or divorce proceedings involving clients should clarify their role with the parties involved and take appropriate action to minimize any conflict of interest.

Privacy and Confidentiality - Only seek information that is essential to providing service conduct evaluations or research.

Confidentiality does not apply when disclosing to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. SW should disclose the least amount of confidential information necessary to achieve the desired purpose. Only info directly relevant to the purpose for which the disclosure is made should be revealed. SW should inform clients, to the extent possible, about the disclosure of confidential information and the potential consequences, when feasible before the disclosure is made. This applies both to legal requirement or client consent.

Discuss with client the nature of confidentiality and limitations of clients' right to confidentiality. Review circumstances where confidential information may be requested and where disclosure may be legally required. This should occur ASAP in the SW-Client relationship and as needed throughout the relationship.

Inform that SW cannot guarantee that all participants in group/family will honor confidential agreements.

Should not discuss confidential information in public or semipublic areas such as hallways, waiting rooms, elevators and restaurants. Protect confidentiality as allowed my law.

If it is to cause harm SW should request the court withdraw the order or limit the order as narrowly as possible.

Take precautions when using computers, electronics etc. Trasfer and dispose of cleints recors in a manner consistent with state statutes. protect confidentiality in the event of a death termination etc.

Access to Records - Provide reasonable access of records to clients. Provide assistance in interpreting the reocrds and consultation with the client regarding the records. Limit access only when it could cause serious arm to the client. Request and rationale for withholding should be documented.

Sexual Relationships - Under no circumstances engage in sexual activities or sexual contact with current clients, former clients, their relatives or other individuals with whom the clients maintain a close personal relationship with, whether such contact is consensual or forced. SW assume the full burden for setting clear, appropriate, and culturally sensitive boundaries. SW should not provide services to individuals with whom they have had a prior sexual relationship.

Physical Contact - Should not engage in physical contact with clients when there is a possibility of psychological harm. SW who engage in appropriate physical contact with clients are responsible for setting clear, appropriate and culturally sensitive boundaries that govern such physical contact.

Sexual Harassment - Should not sexually harass clients including sexual advances, sexual solicitation, requests for sexual favors, and other verbal or physical conduct of a sexual nature.

Derogatory Language - Use accurate and respectful language in all communications to and about clients.

Payment for Services - Ensure fees are fair, reasonable and commensurate with services performed. Consideration should be given to clients' ability to pay.

Avoid accepting goods or services from clients as payment for services. Bartering arrangements, particularly involving services, creat the potential for conflict of interest, exploitation, and inappropriate boundaries in SW-client relationships. Only when an accepted practice among professionals in the community. Should not solicit a private fee to clients who are entitled to such available service through the SW employer or agency.

Clients who Lack Decision-Making Capacity - Act on behalf of clients to safeguard the interests and rights.

Interruption of Services - Make reasonable efforts to ensure continuity of services in the event that services are interrupted by factors such as unavailability, relocation, illness disability or death.

Termination of Services - Terminate services when services are no longer required or no longer serve the clients' needs or interests.

Take steps to avoid abandoning clients who are still in need of services. Should assist in making appropriate arrangements for continuation of services when necessary.

In fee-for-service settings may terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to the client, if the client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed with the client.

Should not terminate to Pursue a relationship with the client.

Notify client promptly of termination or interruption and seek transfer, referral or continuation of services as needed.

When leaving a work setting should inform clients of appropriate options for the continuation of services and the benefits and risks of the options.

Ethical Responsibility to Colleagues

Respect

Confidentiality

Interdisciplinary Collaboration

Disputes Involving Colleagues - Do not take advantage of a dispute between colleague and an employer to obtain a positive or advance.

Consultation - Should seek the advice and counsel of colleagues whenever such consultation is in the best interest of clients.

Referral for Services - Refer when not qualified or not being effective. Facilitate orderly transfer of responsibilities. Prohibited from giving or receiving payment for a referral.

Sexual Relationships - Should not engage in sexual activity or contact with supervisees, students, trainees or other colleagues over whom they exercise professional authority. Avoid engaging in sexual relationships with colleagues when there is potential for a conflict of interest.

Sexual Harassment - Should not sexually harass supervisees, students, trainees or colleagues. Includes sexual advances, sexual solicitation, request for sexual favors, and other verbal or physical conduct of a sexual nature.

Impairment of Colleagues - With direct knowledge of a colleagues impairment due to personal problems, psychosocial distress, substance abuse, or mental health difficulties and that interferes with practice effectiveness should consult with that colleague when feasible and assist the colleague in taking remedial action.

If it interferes with practice effectiveness and that the colleague has not taken adequate steps to address the impairment should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies and other professional organizations.

Incompetence of Colleagues - Consult with that colleague when feasible and assist the colleague in taking remedial action.

If incompetent and has not taken adequate steps to address it take action through appropriate channels.

Unethical Conduct of Colleagues - Discourage, prevent, expose and correct the unethical conduct of colleagues.

Be knowledgeable about polices and procedures for handling concerns. Take action as appropriate.

Ethical Responsibilities in practice settings

Supervision and Consultation - Should not engage in any dual or multiple relationships with supervisees in which there is a risk of exploitation or harm. Evaluate performance in a manner that is fair and respectful.

Education and Training - Evaluate in a fair and respectful manner. Inform clients of services being provided by students. Set boundaries no dual relationships.

Performance Evaluation - Fair and considerate manner

Client Records - accurate and reflects services provided

sufficient and timely documentation

protect client privacy

store records following termination maintained by the number of years required by state statutes.

Billing - Establish and maintain billing practices.

Client Transfer - Carefully consider client's need before agreeing to provide services.

Administration - Advocate within and outside their agencies for resources for clients needs.

Advocate for resource allocation procedures that are open and fair.

Continuing Education and Staff

Development - provide continuing education and staff development

Commitments to Employers - improve agency policies and procedures

not allow agency to interfere with their ethical practice of social work

prevent and eliminate discrimination

Labor-Management Disputes - SW can enage in organized action including labor unions to improve services and working conditions

Ethical Responsibilities as professionals

Competence -

Discrimination -

Private Conduct - Should not permit their private conduct to interfere with their ability to fulfill their responsibilities.

Dishonesty, Fraud, and Deception -

Impairment - Should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, mental health interfere with their professional judgement. Immediately seek consultation and take appropriate remedial action.

Misrepresentation - Make clear distinctions between statements made and actions engaged in as a private individual and as a representative of the social work profession.

Solicitations - Should not engage in uninvited solicitation of potential clients. Should not engage in solicitation of testimonial endorsements including consent of use of testimonial.

Acknowledging Credit - Take credit only for work they have done.

Ethical Responsibilities to the social work profession

Integrity of the Profession - Teach, research consultation service legislative testimony etc.

Evaluation and Research - monitor and evaluate policies right to withdraw from research