Monday, August 27, 2012

Behavioral Theory (Behaviorism)

We practice with human beings in their social environments, so this comment from the founding father of Behaviorism speaks volumes about the causes of human behavior and thought, as well as methods we can employ to assist them in changing those very things that challenge them:

Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select -- doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors. --John Watson, 1930

Behavioral theory is based on the belief that behaviors can be measured, trained, and changed. This theory of learning is based upon the idea that all behaviors are acquired through conditioning. Conditioning occurs through interaction with the environment. Behaviorists believe that our responses to environmental stimuli shapes our behaviors. There are two major types of conditioning that produce behavior: Operant conditioning and Classical (Pavlovian or Respondent) Conditioning.

Operant conditioning

(AKA instrumental conditioning) A method of learning that occurs through rewards and punishments for behavior. Through operant conditioning, an association is made between a behavior and a consequence for that behavior. Coined by behaviorist B.F. Skinner, he believed that internal thoughts and motivations could not be used to explain behavior. Skinner used the term operant to refer to any "active behavior that operates upon the environment to generate consequences" (1953). In other words, Skinner's theory explained how we acquire the range of learned behaviors we exhibit each and every day (Learning Theory). Examples include: children completing homework to earn a reward from a parent or teacher, or employees finishing projects to receive praise or promotions. Removal of a desirable outcome or the use of punishment can be used to decrease or prevent undesirable behaviors. For example, the loss of recess privileges or additional homework as punishment may lead to a decrease in disruptive behaviors.

Reinforcement
is any event that strengthens or increases the behavior it follows:

Positive reinforcers are favorable outcomes that are presented or added after the behavior, such as praise or a direct reward.
Negative reinforcers involve the removal of an unfavorable outcome after the display of a behavior.

Punishment
on the other hand, is the presentation of an adverse outcome that causes a decrease in the behavior it follows.

Positive punishment, sometimes referred to as punishment by application, involves the presentation of an unfavorable event or outcome in order to weaken the response it follows, such as “time out.”.
Negative punishment, also known as punishment by removal, occurs when an favorable event or outcome is removed after a behavior occurs, such as the denial of recess time.

Classical conditioning

Although operant conditioning plays the largest role in discussions of behavioral mechanisms, classical conditioning (or Pavlovian conditioning or respondent conditioning) is a technique used in behavioral training in which a naturally occurring stimulus is paired with a response, then substituted with different stimulus. Eventually, the new stimulus comes to evoke the response. The two elements are then known as the conditioned stimulus and the conditioned response. Pavlov's experiments, the dog was presented with a stimulus such as a light or a sound, and then food was placed in the dog's mouth. After a few repetitions of this sequence, the light or sound by itself caused the dog to salivate.^[19]

The Little Albert Experiment (Classical conditioning by Watson)

classical conditioning

Neutral Stimulus: The white rat
Unconditioned Stimulus: The loud noise
Unconditioned Response: Fear
Conditioned Stimulus: The white rat
Conditioned Response: Fear

Family Therapy

The family is a psychological unit, in which changes in one member affect other members and the family's functioning. Family therapy is geared toward helping individual members become aware of their defensive reactions and to communicate more openly with each other; it usually focuses on present problems and their practical solutions. Families are also self-regulating and tend toward homeostasis, though returning to it may bring about additional challenges. A family is a multi-generational network, that employs its cultural beliefs. Family therapy is inappropriate in circumstances where domestic/family violence, destructive behavior, or abuse between members is present.

Types of family therapy:

Family Systems (Bowen)
Experiential (Satir, Whitaker)
- Experiential therapists are interested in altering the overt and covert messages between family members that affect their body, mind and feelings in order to promote congruence and to validate each person’s inherent self-worth. Change and growth occurs through an existential encounter with a therapist who is intentionally “real” and authentic with clients without pretense
Narrative (Epston, White)
- People use stories to make sense of their experience and to establish their identity as a social and political constructs based on local knowledge. Narrative therapists avoid marginalizing their clients by positioning themselves as a co-editor of their reality with the idea that “the person is not the problem, but the problem is the problem.”
Strategic (Haley, Madanes)
- Symptoms of dysfunction are purposeful in maintaining homeostasis in the family hierarchy as it transitions through various stages in the family life cycle.
Structural (Minuchin)
- Family problems arise from maladaptive boundaries and subsystems that are created within the overall family system of rules and rituals that governs their interactions.
Solution-Focused (de Shazer)
- The inevitable onset of constant change leads to negative interpretations of the past and language that shapes the meaning of an individual’s situation, diminishing their hope and causing them to overlook their own strengths and resources.
Psychodynamic (Scharff)
- By applying the strategies of Freudian psychoanalysis to the family system therapists can gain insight into the interlocking psychopathologies of the family members and seek to improve complementarity. Individuals choose relationships that attempt to heal insecure attachments from childhood. Negative patterns established by their parents (object) are projected onto their partners.
Communications Model (Jackson, Haley)
- All people are born into a primary survival triad between themselves and their parents where they adopt survival stances to protect their self-worth from threats communicated by words and behaviors of their family members.
Feminist (Bern)
- Complications from social and political disparity between genders are identified as underlying causes of conflict within a family system. Therapists are encouraged to be aware of these influences in order to avoid perpetuating hidden oppression, biases and cultural stereotypes and to model an egalitarian perspective of healthy family relationships.

Test-taking strategies and tips

If you have a disability (physical, mental or attention challenges?), you may be able to request extra time in which to finish the exam.
Use the Code of Ethics as a lens through which you view the questions.
Look at the situation presented in each question as part of the Social Work Intervention Model / Problem-Solving Method, deciding which tasks must happen before others in the process.
Answer all questions. Leave none blank.
Practice breathing exercises to reduce anxiety
Flag questions to review later, but do it judiciously; save time at the end of the test period to go back..
Take breaks to clear your mind, refocus, get some exercise, and reduce anxiety
Positive Thoughts - see it in your mind's eye - FTW!

Read one social worker's experience of taking the exam and passing it

If by some chance you do not pass the first time, make sure to get a copy of the diagnostic information from the failed test, which will outline the areas on which an exam review should focus.
Notes from the author of www.socialworkexamhelp.com/study-tips.html

take your time, use all the time allowed
decide who the client is and consider what's in the client's best interest
what's the process in social work? use this as the main lens!

More study tips from the LCSW Study Group

Wednesday, August 15, 2012

License Exam: Multi-axial Diagnosis

MULTIAXIAL DIAGNOSIS

In the DSM-IV-TR system, an individual is diagnosed on five different domains, or "axes." In a single axis system, an individual would be diagnosed in just one domain (for example, a clinical disorder, such as major depressive disorder, would be assigned). This, however, conveys very limited information on what can be a very complex clinical picture. The multi-axial system in DSM-IV-TR was developed in part in order to capture more of the complexity surrounding psychiatric conditions. In the DSM-IV-TR, each axis can convey important information about both the symptoms experienced by the individual and the context surrounding those symptoms.

Axis I: Clinical Disorders

Major psychiatric disorders are diagnosed on Axis I. When you think of a "psychiatric diagnosis," these are the kinds of disorders that probably come to mind. For example, major depressive disorder andposttraumatic stress disorder are diagnosed on Axis I. Disorders of learning, such as reading or arithmetic disorders, and developmental disabilities, such asautistic disorder, are also diagnosed on Axis I. Axis I tends to be reserved for major disorders that are thought to be somewhat episodic (i.e., they typically have a clear onset and periods of remission or recovery). But, this is not true of all Axis I disorders (e.g., autistic disorder is not an episodic condition).

Axis II: Personality Disorders or Mental Retardation

Axis II also includes some conditions that we might consider "psychiatric disorders," but these are thought to be longer-standing conditions that are typically present before age 18. The personality disorders are longstanding, pervasive patterns of thinking and behavior that usually appear before the age of 18 but are typically diagnosed after 18 (when the personality is considered more fully formed). These disorders are not thought of as episodic; they are considered stable and chronic (although there is some recent research suggesting otherwise). Mental retardation (or MR) is also a long-standing condition (it must be present before the age of 18) that is stable over time. MR refers to significantly below average intellectual functioning combined with deficits in adaptive behavior. One rationale for the diagnosis of personality disorders and MR on Axis II is that these are chronic conditions that should be separated from Axis I conditions in order to allow them to be highlighted, since they convey important additional diagnostic information. There is some controversy, however, about whether personality disorders are truly qualitatively different than Axis I clinical disorders, and whether they should remain on Axis II.

Axis III: Medical or Physical Conditions

Axis III is reserved for medical or physical conditions that may affect or be affected by mental health issues. For example, if someone has cancer, and their illness and treatment are affecting their mental health, that would be important information to be conveyed in the diagnosis. So, the cancer diagnosis would be included on Axis III. Alternatively, someone might have a medical condition that is impacted by their mental health. For example, someone with diabetes might not comply with their medical treatment regimen if they have a psychiatric disorder that causes impulsive or erratic behavior. Diagnosing the medical illness on Axis III might alert a clinician of a potential problem.

Axis IV: Contributing Environmental or Psychosocial Factors

Often, a psychiatric diagnosis happens in the context of major environmental or social stressors. For example, job loss, divorce, financial problems, or homelessness may contribute to the development or maintenance of a mental health condition (alternatively, a psychiatric disorder can contribute to the development of these stressors). These important contextual factors are coded on Axis IV.

Axis V: Global Assessment of Functioning

The last axis, Axis V, is reserved for the global assessment of functioning, or GAF. The GAF is a number between 0 and 100 which is meant to indicate level of functioning, or a person's ability to engage in adaptive daily living. Lower scores indicate lower functioning, with a score of zero indicating that a person is incapable or maintaining their own safety or basic hygiene, or is an imminent threat to the safety or welfare of others. Scores near 100 indicate superior functioning.

_Sources:

_{American Psychiatric Association.
Diagnostic and statistical manual of mental disorders, 4th ed, text
revision.Washington, DC, Author, 2000.}
_{Bernstein, DP, Iscan, C, Maser, J, Board of Directors, Association for
Research in Personality Disorder, & Board of Directors, International
Society for the Study of Personality Disorders. "Opinions of personality
disorder experts regarding the DSM-IV Personality Disorders classification
system." Journal of Personality Disorders, 21:536-551, 2007.}

Monday, August 13, 2012

License Exam: Differential Diagnosis Decision Trees

DSM Decision Trees for Differential Diagnosis

The purpose of these decision trees is to aid the clinician in understanding the organization and hierarchical structure of the DSM-IV Classification. Each decision tree starts with a set of clinical features. When one of these features is a prominent part of the presenting clinical picture, the clinician can follow the series of questions to rule in or rule out various disorders. Note that the questions are only approximations of the diagnostic criteria and are not meant to replace them.

The Psychotic Disorders decision tree is the only one that contains disorders that are mutually exclusive (i.e., only one disorder from that section can be diagnosed in a given individual for a particular episode). For the other decision trees, it is important to refer to the individual criteria sets to determine when more than one diagnosis may apply.

Contents

I. Differential Diagnosis of Mental Disorders Due to a General Medical Condition

II. Differential Diagnosis of Substance-Induced Disorders

III. Differential Diagnosis of Psychotic Disorders

IV. Differential Diagnosis of Mood Disorders

V. Differential Diagnosis of Anxiety Disorders

VI. Differential Diagnosis of Somatoform Disorders

Monday, August 6, 2012

License Exam: Community Practice

Community Practice

SWOT Analysis from Community Toolbox

Friday, August 3, 2012

License Exam resource: Wikipedia Psychology Portal

Psychology

Basic psychology

Applied psychology

Methodologies

Orientations

Eminent
psychologists

Lists

Wednesday, August 1, 2012

NASW Social Work Code of Ethics (English and Spanish)

Code of Ethics (English and Spanish)

Preamble

The primary mission of the social work profession is to enhance human wellbeing and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty. A historic and defining feature of social work is the profession’s focus on individual wellbeing in a social context and the wellbeing of society. Fundamental to social work is attention to the environmental forces that create, contribute to, and address problems in living.

Social workers promote social justice and social change with and on behalf of clients. “Clients” is used inclusively to refer to individuals, families, groups, organizations, and communities. Social workers are sensitive to cultural and ethnic diversity and strive to end discrimination, oppression, poverty, and other forms of social injustice. These activities may be in the form of direct practice, community organizing, supervision, consultation administration, advocacy, social and political action, policy development and implementation, education, and research and evaluation. Social workers seek to enhance the capacity of people to address their own needs. Social workers also seek to promote the responsiveness of organizations, communities, and other social institutions to individuals’ needs and social problems.

The mission of the social work profession is rooted in a set of core values. These core values, embraced by social workers throughout the profession’s history, are the foundation of social work’s unique purpose and perspective:

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

This constellation of core values reflects what is unique to the social work profession. Core values, and the principles that flow from them, must be balanced within the context and complexity of the human experience.

Ethical Principles

The following broad ethical principles are based on social work’s core values of service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. These principles set forth ideals to which all social workers should aspire.

Value: Service

Ethical Principle: Social workers’ primary goal is to help people in need and to address social problems.
Social workers elevate service to others above selfinterest. Social workers draw on their knowledge, values, and skills to help people in need and to address social problems. Social workers are encouraged to volunteer some portion of their professional skills with no expectation of significant financial return (pro bono service).

Value: Social Justice

Ethical Principle: Social workers challenge social injustice.
Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers’ social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice. These activities seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity. Social workers strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people.

Value: Dignity and Worth of the Person

Ethical Principle: Social workers respect the inherent dignity and worth of the person.
Social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Social workers promote clients’ socially responsible selfdetermination. Social workers seek to enhance clients’ capacity and opportunity to change and to address their own needs. Social workers are cognizant of their dual responsibility to clients and to the broader society. They seek to resolve conflicts between clients’ interests and the broader society’s interests in a socially responsible manner consistent with the values, ethical principles, and ethical standards of the profession.

Value: Importance of Human Relationships

Ethical Principle: Social workers recognize the central importance of human relationships.
Social workers understand that relationships between and among people are an important vehicle for change. Social workers engage people as partners in the helping process. Social workers seek to strengthen relationships among people in a purposeful effort to promote, restore, maintain, and enhance the wellbeing of individuals, families, social groups, organizations, and communities.

Value: Integrity

Ethical Principle: Social workers behave in a trustworthy manner.
Social workers are continually aware of the profession’s mission, values, ethical principles, and ethical standards and practice in a manner consistent with them. Social workers act honestly and responsibly and promote ethical practices on the part of the organizations with which they are affiliated.

Value: Competence

Ethical Principle: Social workers practice within their areas of competence and develop and enhance their professional expertise.
Social workers continually strive to increase their professional knowledge and skills and to apply them in practice. Social workers should aspire to contribute to the knowledge base of the profession.

Purpose of the NASW Code of Ethics

Professional ethics are at the core of social work. The profession has an obligation to articulate its basic values, ethical principles, and ethical standards. The NASW Code of Ethics sets forth these values, principles, and standards to guide social workers’ conduct. The Code is relevant to all social workers and social work students, regardless of their professional functions, the settings in which they work, or the populations they serve.
The NASW Code of Ethics serves six purposes:

The Code identifies core values on which social work’s mission is 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 to the field to social work’s mission, values, ethical principles, and ethical standards.
The Code articulates standards that the social work profession itself can use to assess whether social workers have engaged in unethical conduct. NASW has formal procedures to adjudicate ethics complaints filed against its members.* In subscribing to this Code, social workers are required to cooperate in its implementation, participate in NASW adjudication proceedings, and abide by any NASW disciplinary rulings or sanctions based on it.

The Code offers a set of values, principles, and standards to guide decision making and conduct when ethical issues arise. It does not provide a set of rules that prescribe how social workers should act in all situations. Specific applications of theCode must take into account the context in which it is being considered and the possibility of conflicts among the Code‘svalues, principles, and standards. Ethical responsibilities flow from all human relationships, from the personal and familial to the social and professional.

Further, the NASW Code of Ethics does not specify which values, principles, and standards are most important and ought to outweigh others in instances when they conflict. Reasonable differences of opinion can and do exist among social workers with respect to the ways in which values, ethical principles, and ethical standards should be rank ordered when they conflict. Ethical decision making in a given situation must apply the informed judgment of the individual social worker and should also consider how the issues would be judged in a peer review process where the ethical standards of the profession would be applied.

Ethical decision making is a process. There are many instances in social work where simple answers are not available to resolve complex ethical issues. Social workers should take into consideration all the values, principles, and standards in this Code that are relevant to any situation in which ethical judgment is warranted. Social workers’ decisions and actions should be consistent with the spirit as well as the letter of this Code.

In addition to this Code, there are many other sources of information about ethical thinking that may be useful. Social workers should consider ethical theory and principles generally, social work theory and research, laws, regulations, agency policies, and other relevant codes of ethics, recognizing that among codes of ethics social workers should consider theNASW Code of Ethics as their primary source. Social workers also should be aware of the impact on ethical decision making of their clients’ and their own personal values and cultural and religious beliefs and practices. They should be aware of any conflicts between personal and professional values and deal with them responsibly. For additional guidance social workers should consult the relevant literature on professional ethics and ethical decision making and seek appropriate consultation when faced with ethical dilemmas. This may involve consultation with an agencybased or social work organization’s ethics committee, a regulatory body, knowledgeable colleagues, supervisors, or legal counsel.

Instances may arise when social workers’ ethical obligations conflict with agency policies or relevant laws or regulations. When such conflicts occur, social workers must make a responsible effort to resolve the conflict in a manner that is consistent with the values, principles, and standards expressed in this Code. If a reasonable resolution of the conflict does not appear possible, social workers should seek proper consultation before making a decision.

The NASW Code of Ethics is to be used by NASW and by individuals, agencies, organizations, and bodies (such as licensing and regulatory boards, professional liability insurance providers, courts of law, agency boards of directors, government agencies, and other professional groups) that choose to adopt it or use it as a frame of reference. Violation of standards in this Code does not automatically imply legal liability or violation of the law. Such determination can only be made in the context of legal and judicial proceedings. Alleged violations of the Code would be subject to a peer review process. Such processes are generally separate from legal or administrative procedures and insulated from legal review or proceedings to allow the profession to counsel and discipline its own members.

A code of ethics cannot guarantee ethical behavior. Moreover, a code of ethics cannot resolve all ethical issues or disputes or capture the richness and complexity involved in striving to make responsible choices within a moral community. Rather, a code of ethics sets forth values, ethical principles, and ethical standards to which professionals aspire and by which their actions can be judged. Social workers’ ethical behavior should result from their personal commitment to engage in ethical practice. The NASW Code of Ethics reflects the commitment of all social workers to uphold the profession’s values and to act ethically. Principles and standards must be applied by individuals of good character who discern moral questions and, in good faith, seek to make reliable ethical judgments.

Pages