Theoretical Approaches
Define Psychosocial
Focuses on intrapsychic and interpersonal change. Based on psychoanalytic theory, ego psychology, role, and systems theory.
The beginning stage is broken into 3 sections. What are they?
Assessment, establishing a positive therapeutic relationship, and contracting or goal setting.
Give at least 4 interventions a worker could utilize during the middle stage.
Supporting or sustaining, direct influence, exploration, reflection & respond, confrontation, clarification, interpretation, partialization, univeralization, ventilation, and catharsis.
A client comes to you with issues, during your sessions you are able to work through these issues. As a result, you begin the termination process. But the client begins to show the initial issues again. What should you do?
Continue the termination process. The initial symptoms of presenting problem reemerge at time of termination. This is not a reason to continue treatment, but should be worked on within the termination period to consolidate earlier gains made.
The most important consideration in choosing a goal with a client is
The client. The NASW Code of Ethics and the professional mandate for social workers holds the professional mandate for social worker holds the client's right to self-determination, the social worker's obligation to support that right, as a primary practice obligation.
Define Problem-Solving
To solve discrete problems, based on psychosocial and functional approaches
What characteristics should the work have when establishing a positive therapeutic relationship?
non possessive warmth and concern, genuineness, appropriate empathy, nonjudgmental acceptance, optimism about possibilities of change, objectivity regarding the situation, professional knowledge
Catharsis is an intervention that can be used by the worker in the Middle Stage. Define catharsis.
reliving and consciously examining repressed, early life, or traumatic experiences in treatment to achieve abreaction, the release of tension or anxiety that was caused by the conflict and its repression.
Describe Defensive Reactions
Client may deny or devalue the work and the worker to deny feelings about losing something of value. The client may act out feelings of tension, anxiety, depression through self-defeating behavior (e.g., lateness, explosiveness, premature ending).
A client's capacity to enter a social work relationship cannot usually be determined by which of the following:
1. emotional and personality make up
2. age
3. judgment
4.intelligence
Age. Age will more accurately reveal how the person may enter into a relationship, based on developmental expectations, rather than whether they are capable of a relationship.
Describe the difference between behavior modification and cognitive therapy.
Behavior Modification: for symptom reduction of problem behaviors and learning alternative positive behaviors.
Cognitive therapy: for symptom reduction of negative thoughts, distorted thinking, and dysfunctional beliefs.
Define Goal Setting
An explicit agreement between the worker and client regarding target problems, goals, and strategies of social work intervention, and differentiating the roles and tasks of the client and the worker.
What are the three special considerations in treatment?
Resistance, transference, and countertransference
You should plan adequate time for termination. When terminating long-term treatment how many sessions would you have?
4-8 sessions
A criterion that is not a measure of a client's motivation is
1. the level of discomfort
2. the level of hope
3. ego strength
4. the ability to see himself or herself as able to change
Ego Strength will influence motivation
Define ecological or life model
focuses on life transitions, environmental pressures, and the maladaptive fit between individual and family or the larger environment. Focuses on the interaction and interdependence of people and environments.
Goal Setting includes 6 areas. These areas are...
Mutual Agreement, differentiated participation, reciprocal accountability, explicitness, realistic agreement, and flexibility.
Describe the difference between transference and countertransference.
Transference: Client's unconscious attempts to recapitulate with the worker the conflicts attached to a relationship experienced with significant persons in the past. Help the client to understand the dynamics of the transference and how it relates to past relationships and present difficulties.
Countertransference: The therapist's unconscious distorted perceptions and responses to the client based on emotional conflicts regarding a significant person from the worker's past. Use supervisory help or therapy to understand and not impose on the client.
When evaluation treatment and treatment relationships. What questions would you consider?
What treatment goals were met? Not met? What was effective within the treatment that facilitated growth? What did not work effectively? What facilitated meeting treatment goals from the client's resources outside treatment and which may continue as resources beyond termination.
The most appropriate technique to use with a new client who is decompensating is
1. confrontation
2. ego support
3. ventilation
4. operant conditioning
Ego Support. There is a minimal relationship with a new client. The social worker may not have a complete psychosocial assessment. They should appeal to the client's strengths in order to provide safety for the decompensating client and to support his highest level of functioning.
Explain the difference between group and narrative therapy.
Group Therapy: A practice model in which group members can help and be helped by others with similar problems, get validation for their own experiences, and test new social identities and roles.
Narrative Therapy: USes the stories that people tell about their lives to reveal how they structure perceptions of their experiences. Therapists co-constructs alternative, more affirming stories with the client.
How should a social work create a goal with a resistant client?
Interpretation is used with clients who are not emotionally fragile. The worker suggests the psychodynamic meaning of the client's thoughts, feelings and fantasies, especially about the origins of problem behaviors. Aims at enhancing the client's insight and working through conflictual material by deepening and extending the client's conscious understanding Interpretation may involve 3 areas. What are those 3 areas?
1. Uncovering repressed/suppressed material
2. Connecting the present to the past so the client can see present disotrations more clearly.
3. Integrating material from various sources so the client gains a more realistic perspective on his/her situation.
There are 7 factors to that affect the client's treatment ending. List at least 4 factors.
1. Degree of client's involvement in treatment.
2. Degree of success and satisfaction.
3. The client's earlier losses.
4. Mastery of early life separation-individuation stage of development.
5. Reason for ending: May be more intense if worker leaves and ending is perceived as against the client's wishes or as a rejection or narcissistic injury to self-esteem.
6. Timing: Is ending occuring a a difficult or a propitious moment in the client's life?
7. Is termination with one worker part of a transfer plan to begin with a new worker? In this case, the evaluation phase of work should be used to formulate ideas about the focus and goals for the next treatment relationship.
In the social worker relationship, the social worker should be careful not to act on
1. A transference reaction
2. a worker-client relationship
3. a countertransference reaction
4.the client's desire to change the contract and add new goals.
A countertransference reaction