LMSW

What to do first

Feelings- acknowledge client's feelings

Assessment- collect info

Refer

Educate- teach skills

Facilitate- use empathy, positive regard, genuineness to enable clients to make their own changes

Intervene- "Therapy"

Communication Skills

Non-Verbal Prompt

Minimal Prompts

Paraphrase

Reflexive Listening

Accurate Empathy

Summarization

Ethnic Note: Convey Acceptance with/without Approval

Motivational Interviewing 5 Steps

1. Use empathy to establish a connection

2. Note discrepancies between clients' behavior and their goals

3. Avoid Arguments- stay out of power struggles

4. Roll with Resistance- Acknowledge clients' reluctance to change

5. Support Self-Efficacy- Acknowledge that clients are in charge of their own lives

Contact Phase:

Problem Identification and Definition

-Problem as the client sees it

-Problem as defined by significant systems with which the client system is in interaction

-Problem as the worker sees it

-Problem-for-work (place of beginning together)

Abreaction

Psychoanalytic term for reliving an experience in order to purge it's emotional distress

Aichmophobia

A specific phobia that focuses on the fear of sharp objects

Amenorrhea

Most commonly diagnosed when a woman misses three or more periods in a row.

Anamnesis

Remembering past events. A clients medical or psychiatric history

Process of memory

Antecedent Behavior

Stimulus that elicits a behavior. What happens just prior to the behavior you are observing

Classical Conditioning

A form of learning in which existing responses are attached to new stimuli by paring those stimuli with those that naturally elicit the response. Also can be thought of as stimulus response in that the same as respondent stimulus elicits a response

Complementary

Relational form denoting a complementary functioning together such as dominant submission pattern. These functional roles are not always healthy

Conscious Use Of Self

Necessitates a high level of self-awareness. Process of knowingly using the relationship in a manner that is a positive experience for the client

Contingency

Relationship, usually casual, between two events in which one is usually followed by another

Contingency Contract/ Management

Specifying which behaviors are expected and what reinforcers will follow

Cooptation

A community organizer's strategy for minimizing anticipated opposition by absorbing or including the opponent in the group membership

Defense Mechanism

Narcissistic Type

Immature Type

Neurotic Type

Mature Type

Narcissistic Defenses

Unconscious Projection

Denial

Distortion

Immature Defense Mechanisms

Acting Out

Blocking

Hypochondriasis

Introjection

Projection

Somatization

Neurotic Defense Mechanisms

Controlling

Displacement

Dissociation

Intellectualization

Isolation

Rationalization

Reaction Formation

Repression

Mature Defense Mechanisms

Altruism

Anticipation

Humor

Sublimation

Suppression

Delirium

Acute confusion and other cognitive deficits. It is not a disease, but rather a syndrome and caused by something outside the brain, such as an infection in the urinary tract or a reaction to benzos or anesthesia

Dementia

A serious loss of cognitive ability. Gradual and progressive in Alzheimer's and vascular dementia or immediate as a result of brain injury

Double Bind

Interaction in which one person demands a response to a message containing mutually contradictory signals while the other person is unable to either to comment on the incongruity or escape from the situation.

Example: a very angry parent demanding the truth from a vulnerable child

Dynamic Equilibrium

Refers to interplay of forces in an open system which may give the appearance of being at rest, but is forever changing

Ex: Family System

Ego-Dystonic

Ideas, impulses, behaviors that are incompatible/unacceptable to the ego

Ego-Syntonic

The person's characteristics are compatible with the person's self-image and therefore are not easily seen as problems. The person's ideas or impulses are acceptibility to the ego and compatible with the ego's principles

Equifinality

a particular end state may be reached from different means

Extinction

A term in "classical conditioning" repeated presentation of the conditioned stimulus w/o the conditioned stimulus and the resulting gradual decrease in the conditioned response

In "Operant Conditioning" occurs when reinforcement is withheld following performance of a previously reinforced response

Gestalt Therapy

The natural course of a biological and psychological development of the organism, entails a full awareness of physical sensations and psychological needs. Concerned primarily with perceptual processes

Individuation

A process of differentiation, having for its goal of the development of the individual personality; development of the psychological individual as a differentiated being from the general collective psychology. Identified with Jungian Therapy

Negative Reinforcement

Any behavior which increases the probability of a response by terminating or withdrawing an unpleasant stimulus. Always increases the likelihood of the future occurrence of the behavior it follows

Operant Conditioning

A type of learning in which responses are modified by their consequences. The correct response is reinforced and more likely to occur again. Reinforcement increases the like likelihood of future occurrences of the reinforced response. Punishment and extinction decreases the likelihood of the future occurrences of symptoms

Paradoxical Intention

A therapeutic strategy in which the client is instructed to engage in or magnify the behaviors of concern. A therapeutic practice sometimes known as prescribing the symptoms

Partialization

Cutting down of a complex problem to such size and specificity as to make it manageable for discussion and work-over by the client at a given time

Positive Reinforcement

A stimulus which follows a behavior and increases the likelihood of the occurence of the behavior which it follows

Pseudomutuality

An artificial closeness in some families which fosters dependence and loss of self-identity

Reactive Attachment Disorder

Severe and unusual disorder in children. A failure to form normal attachments with caregivers. Inhibited type shoes an extreme lack of attachment. Disinhibited type shows extreme attachment to everyone including strangers

Stimulus Control

Arranging the environment in such a way that a given response is either more or less likely

Strategic Family Therapy

An approach to family therapy associated with Don Jackson and Jay Haley which employs such strategies as paradox in order to force changes in behavior. Important concept is meaning of symptoms and the power of the therapist

Structural Family Therapy

An approach to family therapy associated with Minuchin which emphasizes the importance of the nuclear family and seeks to change pathological alliances and splits the family. This approach also emphasizes maintaining proper roles and boundaries in the family

Synergy

The ability of a social system to generate more energy than it needs to function

Transference

Displacement by the client onto the worker of feelings or attitudes. They may be positive or negative

Countertransference

The worker's unrealistic and inappropriate feelings toward the client

Anti Depressants

MAOIs

Tricyclic antidepressants

Selective Serotonin Re-uptake Inhibitors

Other Drugs

Drugs for Bipolar Disorder

MAOI

Monoamine Oxidase Inhibitors (antidepressant)

Marplan

Nardil

Parnate

MAOI Common Side Effects

CNS: Dizziness, headache, drowsiness, sleep distruabances, weakness, fatigue, tremors

Autonomic: Blurred vison, glaucoma, urinary rentenion

GI: Dry mouth, constipation

Other: Edema, weight gain, anogromasia, ejaculatory disturbances

Tricyclics

Antidepressant

1. Tofranil, Janimine, Presamine, SK_Pramine (Imipramine)

2. Elvail, Amitid, Endep, Amiril (Amitriptyline)

3. Norpamine, Pertofrane (Despramine)

4. Sinequan, Adpin (Doxepin)

5. Aventyl, Pamelor (Nortriptyline)

6. Vivactil (Protriptyline)

7. Surmontil (Trimipramine Maleate)

8. Asendin (Amoxapine)

9. Anafril (Clomipramine)

Tricyclic Common Side Effects

CNS: confusion, disturbed concentration, disorientation, delusions, excitement anxiety, restlessness, insomnia, nightmares, dizziness, weakness, headache, fatigue

Autonomic: Dry mouth, blurred vision, constipation

Cardio: Hypo- and Hyper- tenson, tachycardia, palpitations, stroke

GI: Nausea, epigastric distess, vomiting, anorexia, diarrhea

Other: Lethality of overdose, drowsiness, alpecia (hair loss), weight gain or loss

SSRI

Selective Serotonin Re-Uptake Inhibitors

1. Prozac (Fluoxetine)

2. Paxil (Paroexetine)

3. Zoloft (Sertraline)

4. Luvox (Fluvoxamine)

5. Celexa (Citalopram)

6. Lexapro (Escitalopram)

SSRI Common Side Effects

CNS: Headache, nausea, insomia, drowsiness, anxiety, tremor, fatigue, sedation, abnormal dreams, sexual dysfunction

GI: Nausea, diarrhea, dry mouth, anorexia, constipation, abdominal pain, vomiting

Respitory: Upper respitory tract infection, flu-like symptoms, cough

Antidepressants fomr Biploar disorder

mood stablizers:

1. Lithium

2. Depakote (Anti convulsant)

3. Tegretol (Anti convulsant)

4. Lamictal

5. Trileptal

6. Topomax

7. Neurotonin

Antidepressants for bipolar disorder common side effects

CNS: Fine hand tremor, drowsiness, muscular weakness, uncoordination, slurred speech, dizziness, vertigo, restlessness, confusion

Autonomic: blurred vision, dry mouth

GI: Nausea, diarrhea, vomiting, anorexia

Other: General discomfort, dehydration, thirtst, weight loss/gain, swelling of ankles/wrists

Antipsychotics: Major Tranquilizers

typical:

1. Thorazine (Chloropramizine)

2. Mellaril (Thioridazine)

3. Prolixin (Fluphenazine)

4. Trilafon (Perphenazine)

5. Stelazine (Trifluoperazine)

6. Haldol (Haloperidol)

7. Navane (Thiothixene)

8. Loxitane (Succinate)

9. Pehnergan (Promethazine)

10. Moban (Molindone)

Antipsychotic (Typical) side effects

CNS: drosisness, neck spasm, proturion of the tounge, agitation, jitteriness, insomina, Pseudoparkinsonism (mask like faces, drooling, shuffing gait)

GI; jaundice, nauesa, consitpation

GI: Pripism, Uriniary retention, impotence

Endocrine: Lactation, amenorhhea, hyper/hypo glycemia, false preg test

Other: dry mouth, wieght gain, blurred vision

TARTIVE DYSKINESIA - starts with small tounge tremors, facial tics and abmormal jaw movements. Can progress into rolling of tounge, licking lips, and smacking, pouting and chewing and sucking motions. Later can develop into spasmodic moveents of hands, feet, arms, legs, neck, and shoulders- except with newer antipsychotics

Antipsychotics Atypical Major Tranquilizers

1. Clozaril (Clozapine) (side effect- agrunulocytosis- clumping of white blood cells)

2. Risperdol (Risperdone)

3. Zyprexa (Olanzapine)

4. Seroquil (Quetiapine) (Side effect- cataracts)

5. Geodon (Ziprasidone)

6. Abilify (Aripiprazole)

7. Invega Sustenna (Paliperidone)

Antiparkinson Medications

Artine (trihexyhenidyl)

Cogentin (benstropine mesylate)

Benedryl (Trihexphenidyl)

Symmetrel (Amantadine)

Parlodel

Antiparinson Side Effects

CNS: Weakness, confusion, disorientation, memory impairment, nervouness, depression, listlessness, numbness of fingers

GI: consitpation, dry mouth, nausea, vomiting

Ophthalmic: blurred vision, dialtated pupils

Anxiety Agents

Benzodiazepine

Beta Blockers

Azapirones

Antianxiety: Benzodiazepine

1. Valium (Diazepam)

2. Serax (Oxzepam)

3. Librium (Chlorodiazeposide)

4. Atarax, Vistaril (Hydroxyzine)

5. Xanax (Alprazolam)

6. Buspar (Buspirone)

7. Tranxene (Clorazepate)

8. Ativan (Lorazepam)

9. Klonopine (Anti-convulsant)

10. Inderol (beta- blocker)

Antianxiety: Beta Blockers

1. Inderol

2. Corgard

3. Lopressor

4. Tenormin

Antianxiety: Axapirones

1. Buspar (Buspirone)

Cerebral Stimulants: Hyperactivity (Paradozical Effect)

1. Benzedrine (Amphetamine Sulfate)

2. Dexedrine (Dexo-amphetamine)

3. Ritilin (Amphetamine- Methyphenidate)

4. Cylert (Pemoline)

5. Adderall (Mixed Salts- Dextroamphetamine and Ampthetamine)

6. Stratera (Non-stimulant)

Drugs for Substance abuse

1. Antibus (Alcohol antagonist)

2. Campral- for absense from alcohol

3. Trexan (Naltrexone-Opioidantagonist) (blocks alcohol receptors)

4. Revia

5. Suboxone (Bupreophine) for detox heroin and other drugs

Motivational Interviewing 5 Steps

1. use empathy to establish a connection

2.Note discrepancies between clients' behavior and their goals

3. Avoid arguements- stay out of power struggles

4. Roll with resistance- acknowledge clients' reluctance to change

5. Support self-efficacy- acknowledge that clients are in charge of their own lives

Psychosocial

(Hollis and Turner)

- Person in the Environment

- Psychodynamic perspective

-Primarily Ego psychology

-Levels of personality

Id- innate drives

Superego- controls the drives

Ego- Mature Processing

-Conscious v Unconscious

-Defense Mechanisms

-Every person has some level of pathology

-Role of the Social Worker: ventalization of feelings and emotions is therapeutic. Insight oriented approach: Insight into the conflict between the conscious and the unconscious

- Social History: birth till now

Social Learning Theory

-Recipocal Determination

-Expectancy of Reinforcement

-Modeling (vicarious learning)

Cognitive Theory

-Overt behavior

-Covert behavior (rules, beliefs, perceptions, attributions)

-Behavior is learned through reinforcement and modeling

Structural Family Therapy

Minuchin

Symptoms are rooted in the context of the family transaction patterns, and family restructuring must occure before symptoms are relieved

Heirarchy, boundary, subsystem, alignment, colaition

Goals of Structural Family Therapy

Strengthen parental subsystem, Realign coalitions, establish boundaries

Interventions of Structural Family Therapy

Joining, action preceeds understanding, change interaction patterns, enactments, unbalancing

Strategic/ Communication Family Therapy

Haley, Madanes, Wetzlawick, MRI

Redundant communication patterns offer clues to family rules and dysfunction; symptoms represents strategy for controlling relationships

Goals of Strategic/ Communication Family Therapy

Symptom relief, resolution of presenting problem,

Interventions of Strategic/Communication Family Therapy

Paradoxical interventions, prescribing the symptom, therapeutic double binds, directives, pretend techniques, relabeling

Experiental Family Therapy

Satir

Self concept, Communication, Family Rules, Growth of Self

Goals of Experiential Family Therapy

Relieve family pain, genuineness, learning to express one's sense of being

Interventions of Experiential Family Therapy

Sculpting, Acceptance, Communication skills, self discovery and disclosure from therapist

Humanistic Family Therapy

Whitaker

Growth as an interpersonal process, therapy as an encounter

Goals of Humanistic Family Therapy

Simutaneous sense of togetherness and healthy separation, Interpersonal competence

Interventions of Humanistic Family Therapy

Use of self, modeling, confrontation, cotherapy

Behavioral/Cognitive Family Therapy

Patterson, Stuart, Liberman

Personal functioning is determined by the reciprocal interaction of behavior and is controlling social conditions

Goals of Behavioral/Cognitive Family Therapy

Modification of behavioral consequences between persons to eliminate maladaptive behavior and symptoms

Interventions of Behavioral/Cognitive Family Therapy

Reinforcement of desired behaviors, skills training, contingency contracting, positive reciprocity between marital partners, parents and children

Solution Focused Therapy

-Dont need to know the cause to intervene

-Change takes place when clients focus on their goals and understand what they have to do to get there

-Solution focused (hope) v. problem focused (despair)

Solution Focused Therapy

Clients are experts on their problems, therefore:

1. Describe the problem

2. Develop goals

3. Ask the Miracle Question: "If a miracle occured and you could have any result, what would be different about your life?"

4. Exploring the Exception: "At the time when the problem did not occur, what was life like?"

5. Supportive feedback to the clients and summarization

Social Goals Model: Task Oriented Group Purpose

Social Consciousness and social responsibilty

Task Oriented Group: Role of Social Workers

Enabler

Task Oriented Group: Types of activity

Wide range of activities and tasks, including those of community organization

Task Oriented Group: Theory Base

Eclectic Theory Base

Remedial Model: Process Group- Purpose

To remedy social dysfunctioning by specific behavioral change

Process Group- Role of Worker

Change Agent

Process Group- Types of activities

Use of direct and indirect means of influence, including extra-group means

Process Group- Theory Base

Social role theory, cognitive behavioral theory, group dynamics

Reciprocal Model: Process Group- Purpose

To achieve a mutual aid system, initially no specific goals

Process Group- Role of Worker

Mediator or resource person

Process Group- Types of activity

Engagment of group members of process of interpersonal relations

Process Group- Theory base

Systems theory and field theory

Addiction

physiological- normal life continures

Addiction

-Stimulants (cocaine and methaphetimine)

-Opiates (morphine, heroin, oxy/hydro codone)

-Benzos (valum, xanax)

Alcohol- associated with WERNICKE'S ENCEPHALOPATHY (characterized by movement, memory, and other neurological probems)

Chemical Dependence

psychological (pot and Lsd)

lifestyle, the need for drugs replaces the need for people. Having drugs available becomes a preoccupation

Themes in 12 Step Programs

- Admitting Powerlessness

- Seeking Help from a higher power

- Prayer or meditation for help

- Making a moral inventory

- Confessing Wrongs

- Asking other for forgiveness

- Making amends

- Carrying the message to others