I've always been confused about what all the initials mean after social worker's names. ACSW seems to be a popular one, but I never knew what that mean. So I spent some time learning about Indiana licensing and the NASW credentials. Here's what I understand:
An LSW (a licensed social worker) can be obtained on two levels in Indiana. There is the BSW, LSW, or the licensed bachelor of social work. The BSW, LSW social worker obtained their BSW from an accredited institution, then spent two years practicing before they were eligible to take the exam. The second level of LSW is the MSW, LSW, which is the master's level license. This social worker graduated with their MSW from an accredited institution and is eligible to take the LSW exam immediately after graduation.
The LCSW (a licensed clinical social worker) in Indiana is a MSW who has practiced for two years under supervision of an LCSW and during those years worked in a position that was at least 50% therapeutic practice.
Both levels of the LSW and the LCSW exam are offered through the ASWB, or the Association of Social Work Boards. The link to the exam is here: ASWB.
So what is with the ACSW? The ACSW stands for the Academy of Certified Social Workers. Well, NASW, or the National Association of Social Workers, offers credentials to NASW members in good standing. These are not licenses to practice in your state. The NASW has their own standards for obtaining the ACSW, which includes two years of postgraduate work supervised by another MSW and professional evaluations.
The NASW also offers certifications. There are currently seven certifications, which include the C-SWHC (Certified Social Worker in Health Care), the C-CATODSW (Certified Clinical Alcohol, Tobacco and Other Drugs Social Worker), AND THE C-CYFSW (Certified Children, Youth, and Family Social Worker). A link to the NASW credential website is here: NASW Credentialing.
Saturday, November 29, 2008
Thursday, November 27, 2008
Alfred Adler and Personality
Adler had a handful of theories about why we are the way we are. Major ones are inferiority, parenting styles, and birth order.
Adler believed that we all begin with feelings of inferiority as children, and strive to overcomes these feelings our entire lives. Some people are particularly driven to overcome these feelings and strive to be very successful and powerful. This theory would argue that our most powerful leaders (presidents, religious leaders) are driven by a need to be superior in order to negate their inferior feelings. If you think about it, one could analyze W. Bush by saying that he was driven by a need to become president to shake off the feeling that he was the least successful and dumbest of the Bush dynasty. And now he's the least popular president in the history of popularity polls. That can't be good for the inferiority complex.
Parenting styles refer to how parents protect their children from the world. If a parent shelters their child from even the knowledge of bad or dangerous things in the world, when the child grows up and discovers them, the child will regress and seek the same shelter they had with their parents. This could manifest in living with their parents and refusing to 'grow up' or finding a significant other to act as a surrogate parent. When parents do not shelter their children from any of the bad or dangerous things in the world the children grow up to distrust everyone and have difficulty forming healthy relationships. Adler recommends parents do not shelter their children from the bad in the world, but do protect them from danger.
Lastly, Adler has a lot to say about birth order. He believes that the oldest child originally believes they are the center of their parents' world, and when the second child is born, this theory is shattered. The oldest child resents the younger child, feels inferior, and competes for love and attention. The older child is also under pressure from the parents to be responsible for the younger child. This theory states that the oldest child will be the one with the most emotional problems. The youngest child is the child that is most doted on by the parents', so that child is most likely to grow up feeling inferior to others, believing they are not capable of taking care of themselves. According to Adler, the middle child is the one who will be the most emotionally stable. Coincidentally, Adler was a middle child.
Adapted from:
Robbins, S.P., Chatterjee, P., & Canda, E.R. (2006). Contemporary human behavior theory: A critical perspective for social work (2nd ed.). Boston: Pearson.
Adler believed that we all begin with feelings of inferiority as children, and strive to overcomes these feelings our entire lives. Some people are particularly driven to overcome these feelings and strive to be very successful and powerful. This theory would argue that our most powerful leaders (presidents, religious leaders) are driven by a need to be superior in order to negate their inferior feelings. If you think about it, one could analyze W. Bush by saying that he was driven by a need to become president to shake off the feeling that he was the least successful and dumbest of the Bush dynasty. And now he's the least popular president in the history of popularity polls. That can't be good for the inferiority complex.
Parenting styles refer to how parents protect their children from the world. If a parent shelters their child from even the knowledge of bad or dangerous things in the world, when the child grows up and discovers them, the child will regress and seek the same shelter they had with their parents. This could manifest in living with their parents and refusing to 'grow up' or finding a significant other to act as a surrogate parent. When parents do not shelter their children from any of the bad or dangerous things in the world the children grow up to distrust everyone and have difficulty forming healthy relationships. Adler recommends parents do not shelter their children from the bad in the world, but do protect them from danger.
Lastly, Adler has a lot to say about birth order. He believes that the oldest child originally believes they are the center of their parents' world, and when the second child is born, this theory is shattered. The oldest child resents the younger child, feels inferior, and competes for love and attention. The older child is also under pressure from the parents to be responsible for the younger child. This theory states that the oldest child will be the one with the most emotional problems. The youngest child is the child that is most doted on by the parents', so that child is most likely to grow up feeling inferior to others, believing they are not capable of taking care of themselves. According to Adler, the middle child is the one who will be the most emotionally stable. Coincidentally, Adler was a middle child.
Adapted from:
Robbins, S.P., Chatterjee, P., & Canda, E.R. (2006). Contemporary human behavior theory: A critical perspective for social work (2nd ed.). Boston: Pearson.
Wednesday, November 26, 2008
Freud and Personality
Well, it had to happen. We have to talk about Freud. We'll start with the Id, Ego, and Superego.
The id represents our basic human instincts. They are drives that want to be satisfied right now . The id is present at birth. Some of the basic drives it represents are food, attention, and sex.
The ego develops as the baby becomes a child. The ego strives to fulfill the needs of the id while staying within socially acceptable behavior. The child realizes that s/he cannot have everything all the time. "I really want that cookie, but if I just take it mom will be mad. I'll try asking politely."
The superego develops when the individual internalizes societal norms and buys into them. The superego can also be seen as our conscious.
The id and the superego are in constant battle... "I really want to take my coworker's Mt. Dew out of the fridge and eat it... but that would be stealing..." In a well balanced individual, the ego is able to negotiate between the id and the superego.
Sublimation is the term used for when one socially unacceptable drive is channeled into a socially acceptable one. The book that I'm working from uses sex as an example, saying that sexual urges are seen as socially inappropriate, so we turn to marriage, in which sex is socially appropriate. I prefer their other example, channeling aggressive or violent behaviors into competitive sports.
adapted from:
Macionis, J. (2008). Sociology (12th ed.) New Jersey: Pearson.
The id represents our basic human instincts. They are drives that want to be satisfied right now . The id is present at birth. Some of the basic drives it represents are food, attention, and sex.
The ego develops as the baby becomes a child. The ego strives to fulfill the needs of the id while staying within socially acceptable behavior. The child realizes that s/he cannot have everything all the time. "I really want that cookie, but if I just take it mom will be mad. I'll try asking politely."
The superego develops when the individual internalizes societal norms and buys into them. The superego can also be seen as our conscious.
The id and the superego are in constant battle... "I really want to take my coworker's Mt. Dew out of the fridge and eat it... but that would be stealing..." In a well balanced individual, the ego is able to negotiate between the id and the superego.
Sublimation is the term used for when one socially unacceptable drive is channeled into a socially acceptable one. The book that I'm working from uses sex as an example, saying that sexual urges are seen as socially inappropriate, so we turn to marriage, in which sex is socially appropriate. I prefer their other example, channeling aggressive or violent behaviors into competitive sports.
adapted from:
Macionis, J. (2008). Sociology (12th ed.) New Jersey: Pearson.
Tuesday, November 25, 2008
Basics of Family Therapy
Despite which technique or theory you use, typically the beginnings of family therapy will look the same. Usually, family therapy includes everyone who lives in the household, and sometimes extended family members. The therapist begins by establishing report with all the members. Greet the contact person first, and greet everyone, including children, individually. After everyone has settled, summarize the initial contact conversation and ask for input. Listen and reflect every point of view. When someone does not offer input in the initial conversation, ask for it directly. Establish a bond with every family member to reduce anxiety. You want to convey the message that you are not going to scapegoat anyone or jump to conclusions. Develop a hypothesis about the family; are there triangles? How do they benefit from the presenting problem? What is the cycle of the presenting problem? Is there a scapegoat? What are the boundaries like?
To minimize yelling, establish a rule that only one person may speak at a time. If emotions are becoming too volatile too early, change directions. Exploring strengths is always a good idea. Imagine a couple who entered therapy as a last resort to avoiding divorce. The wife is counting off a list of complaints about the husband, saying he's emotionally distant, ignores her, etc etc. The husband is becoming tense and annoyed hearing a reiteration of his failings. When the wife slows down, the therapist could say, 'I can see how that would be frustrating. I'm just curious; what do you think his strengths are in this family?' The wife switches directions and begins to talk about how good of a father he is, how he responds to his children's needs. First, the husband has probably heard his list of failures many times, but probably not heard his wife praise his parenting skills recently. The tension between the two deescalates. The strengths question and answer here could also be taken down the solution focused path and search for exceptions. But I'll come back to the solution focused technique in a later entry.
Adapted from:
Nichols, M. (2009). The essentials of family therapy (4th ed.) Boston: Pearson.
To minimize yelling, establish a rule that only one person may speak at a time. If emotions are becoming too volatile too early, change directions. Exploring strengths is always a good idea. Imagine a couple who entered therapy as a last resort to avoiding divorce. The wife is counting off a list of complaints about the husband, saying he's emotionally distant, ignores her, etc etc. The husband is becoming tense and annoyed hearing a reiteration of his failings. When the wife slows down, the therapist could say, 'I can see how that would be frustrating. I'm just curious; what do you think his strengths are in this family?' The wife switches directions and begins to talk about how good of a father he is, how he responds to his children's needs. First, the husband has probably heard his list of failures many times, but probably not heard his wife praise his parenting skills recently. The tension between the two deescalates. The strengths question and answer here could also be taken down the solution focused path and search for exceptions. But I'll come back to the solution focused technique in a later entry.
Adapted from:
Nichols, M. (2009). The essentials of family therapy (4th ed.) Boston: Pearson.
Sunday, November 23, 2008
Depression and Dysthymic Disorder
The criteria for the two disorders follow, directly from the DSM-IV TR. (emphasis added) An explanation follows at the end.
The criteria for Dysthymic Disorder is:
A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.
B. Presence, while depressed, of two (or more) of the following:
1. poor appetite or overeating
2. insomnia or hypersomnia
3. low energy or fatigue
4. low self-esteem
5. poor concentration or difficulty making decisions
6. feelings of hopelessness
C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time.
D. No Major Depressive Episode (see p. 356) has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission.
Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed episodes of Major Depressive Disorder, in which case both diagnoses may be given when the criteria are met for a Major Depressive Episode.
E. There has never been a Manic Episode (see p. 362), a Mixed Episode (see p. 365), or a Hypomanic Episode (see p. 368), and criteria have never been met for Cyclothymic Disorder.
F. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder.
G. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if:
* Early Onset: if onset is before age 21 years
* Late Onset: if onset is age 21 years or older
The criteria for a major depression episode is:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.
1. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).Note: In children and adolescents, can be irritable mood.
2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
3. significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.Note: In children, consider failure to make expected weight gains.
4. insomnia or hypersomnia nearly every day
5. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
6. fatigue or loss of energy nearly every day
7. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
8. diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
B. The symptoms do not meet criteria for a Mixed Episode (see p. 365).
# The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
D. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
So there is a very marked difference between Dysthymic Disorder and a Major Depression Episode. A huge difference is that in order to get the dysthymic diagnosis, one has to display the symptoms almost everyday for two years! For a major depression episode, the individual must show five symptoms nearly every day for two weeks. Personally, I think the time frame difference is a bit too much... two weeks for one and two years for another? I suppose if I wrote the book I'd lessen the time period for Dysthymic Disorder to maybe a year. But once again, the writers of the book did not ask me.
There are some other key points to remember here. When any mood change happens, be it depression, agitation, mania, etc., it is important to screen for substance use; both prescription and recreational. I had a therapist (who was a social worker) tell me that chronic marijuana use can mirror Dysthymic Disorder. I haven't seen the research on this, but it sounds plausible. And having experienced taking Topamax, I can say first hand that prescriptions can not only make you feel depressed but actually slow your psychomotor functioning. There are also medical conditions that would cause mood changes, such as hyper or hypothyrodism, brain tumors, even UTIs in the elderly. Lastly, when a patient presents with depressive symptoms it is imperative to screen for possible manic or hypomanic episodes.
The criteria for Dysthymic Disorder is:
A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.
B. Presence, while depressed, of two (or more) of the following:
1. poor appetite or overeating
2. insomnia or hypersomnia
3. low energy or fatigue
4. low self-esteem
5. poor concentration or difficulty making decisions
6. feelings of hopelessness
C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time.
D. No Major Depressive Episode (see p. 356) has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission.
Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed episodes of Major Depressive Disorder, in which case both diagnoses may be given when the criteria are met for a Major Depressive Episode.
E. There has never been a Manic Episode (see p. 362), a Mixed Episode (see p. 365), or a Hypomanic Episode (see p. 368), and criteria have never been met for Cyclothymic Disorder.
F. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder.
G. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if:
* Early Onset: if onset is before age 21 years
* Late Onset: if onset is age 21 years or older
The criteria for a major depression episode is:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.
1. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).Note: In children and adolescents, can be irritable mood.
2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
3. significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.Note: In children, consider failure to make expected weight gains.
4. insomnia or hypersomnia nearly every day
5. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
6. fatigue or loss of energy nearly every day
7. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
8. diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
B. The symptoms do not meet criteria for a Mixed Episode (see p. 365).
# The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
D. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
So there is a very marked difference between Dysthymic Disorder and a Major Depression Episode. A huge difference is that in order to get the dysthymic diagnosis, one has to display the symptoms almost everyday for two years! For a major depression episode, the individual must show five symptoms nearly every day for two weeks. Personally, I think the time frame difference is a bit too much... two weeks for one and two years for another? I suppose if I wrote the book I'd lessen the time period for Dysthymic Disorder to maybe a year. But once again, the writers of the book did not ask me.
There are some other key points to remember here. When any mood change happens, be it depression, agitation, mania, etc., it is important to screen for substance use; both prescription and recreational. I had a therapist (who was a social worker) tell me that chronic marijuana use can mirror Dysthymic Disorder. I haven't seen the research on this, but it sounds plausible. And having experienced taking Topamax, I can say first hand that prescriptions can not only make you feel depressed but actually slow your psychomotor functioning. There are also medical conditions that would cause mood changes, such as hyper or hypothyrodism, brain tumors, even UTIs in the elderly. Lastly, when a patient presents with depressive symptoms it is imperative to screen for possible manic or hypomanic episodes.
Friday, November 21, 2008
Bowen Family Systems Therapy
Key conceptions of Family Systems Therapy are Differentiation of Self, Emotional Triangles, Fusion, and Emotional Cutoff
Differentiation of Self is a term that refers to an individual's ability to think clearly and logically, even in the face of anxiety. Undifferentiated people react automatically with emotions. Undifferentiated people "... find it difficult to maintain their own autonomy, especially around anxious issues. Asked what they think, they said what they feel; asked what they believe, they echo what they've heard... Differentiated people are able to take stands on issues because they're able to think things through, decide what they believe, and then act on those beliefs." (p. 87)
How people become differentiated will be addressed soon.
Emotional triangles are when two people are locked in conflict and bring in a third party who then because fixed in the conflict. This forms a dysfunctional, three party relationship. The third party relieves some of the anxiety involved with the conflict, but also prevents the conflict from being resolved. An example of this could be a married couple who are having conflict and instead of dealing with the conflict, involve themselves with their child who acts as a distraction and someone to involve ("your father is so unemotional", "your mother spends too much money"). Emotional triangles can also form between a young married couple and a set of inlaws.
Emotional fusion is when two people become so over-involved in each others lives they lose their autonomy. Bowen, the man who originated this theory, first saw the concept of emotional fusion when working with young men with schizophrenia. He saw this concept between the men and their mothers, but after practicing in different fields, noticed this concept was in all types of families.
Emotional cutoff "The greater the emotional fusion between parents and children, the greater the likelihood of cutoff. Some people seek distance by moving away; others do so emotionally by avoiding personal conversations or insulating themselves with the presence of third parties." (p. 89) The book equates parents with kryptonite for some seemingly well adjusted adults.
Back to how a person ends up differentiated or undifferentiated. When a family is involved in fusion, the child most involved with the fusion becomes more undifferentiated and also experiences a high level of emotional anxiety. The child who is least involved in the fusion experiences the highest level of differentiation. THE REASON FOR THIS is because the child most involved in the fusion is forced to either "conform or rebel" (p. 89), emotionally while the child not involved in the fusion is able to learn to think for themselves.
Therapy
The goals of Family Systems Therapy are to help those involved realize the difference between thinking and feeling, lower anxiety, and to increase the realization of how the individual affects the family.
The therapy begins with the assessment of the families function and the relationships between the family members. Genograms are appropriate here.
Process questions are also the staple of Family Systems Therapy. Process questions are questions designed to move people towards differentiation. They help the person think logically and less emotionally about their problems and their involvement in them. An example exchange could be,
Therapist: "When your husband doesn't return your calls, what goes on inside you?"
Wife: "I get scared. And then I feel disrespected."
Therapist: "And how does that manifest?"
Wife: "I withdraw from him."
Therapist: "What are you trying to tell him when you do that?"
Wife: "That I'm hurt."
Therapist: "Does it work?"
The therapist is NEVER to take sides between couples. The therapist's job is not interfere with the content of the arguments, but to help the couple work on the process of their arguments. The therapist should work to keep those involved in therapy calm and rational, because when discussions become emotional, those involved are not able to think about their processes objectively.
Individual therapy with this theory involves helping the individual gain autonomy and to remove themselves from triangles.
Adapted from:
Nichols, M. (2009). The essentials of family therapy (4th ed.) Boston: Pearson.
Differentiation of Self is a term that refers to an individual's ability to think clearly and logically, even in the face of anxiety. Undifferentiated people react automatically with emotions. Undifferentiated people "... find it difficult to maintain their own autonomy, especially around anxious issues. Asked what they think, they said what they feel; asked what they believe, they echo what they've heard... Differentiated people are able to take stands on issues because they're able to think things through, decide what they believe, and then act on those beliefs." (p. 87)
How people become differentiated will be addressed soon.
Emotional triangles are when two people are locked in conflict and bring in a third party who then because fixed in the conflict. This forms a dysfunctional, three party relationship. The third party relieves some of the anxiety involved with the conflict, but also prevents the conflict from being resolved. An example of this could be a married couple who are having conflict and instead of dealing with the conflict, involve themselves with their child who acts as a distraction and someone to involve ("your father is so unemotional", "your mother spends too much money"). Emotional triangles can also form between a young married couple and a set of inlaws.
Emotional fusion is when two people become so over-involved in each others lives they lose their autonomy. Bowen, the man who originated this theory, first saw the concept of emotional fusion when working with young men with schizophrenia. He saw this concept between the men and their mothers, but after practicing in different fields, noticed this concept was in all types of families.
Emotional cutoff "The greater the emotional fusion between parents and children, the greater the likelihood of cutoff. Some people seek distance by moving away; others do so emotionally by avoiding personal conversations or insulating themselves with the presence of third parties." (p. 89) The book equates parents with kryptonite for some seemingly well adjusted adults.
Back to how a person ends up differentiated or undifferentiated. When a family is involved in fusion, the child most involved with the fusion becomes more undifferentiated and also experiences a high level of emotional anxiety. The child who is least involved in the fusion experiences the highest level of differentiation. THE REASON FOR THIS is because the child most involved in the fusion is forced to either "conform or rebel" (p. 89), emotionally while the child not involved in the fusion is able to learn to think for themselves.
Therapy
The goals of Family Systems Therapy are to help those involved realize the difference between thinking and feeling, lower anxiety, and to increase the realization of how the individual affects the family.
The therapy begins with the assessment of the families function and the relationships between the family members. Genograms are appropriate here.
Process questions are also the staple of Family Systems Therapy. Process questions are questions designed to move people towards differentiation. They help the person think logically and less emotionally about their problems and their involvement in them. An example exchange could be,
Therapist: "When your husband doesn't return your calls, what goes on inside you?"
Wife: "I get scared. And then I feel disrespected."
Therapist: "And how does that manifest?"
Wife: "I withdraw from him."
Therapist: "What are you trying to tell him when you do that?"
Wife: "That I'm hurt."
Therapist: "Does it work?"
The therapist is NEVER to take sides between couples. The therapist's job is not interfere with the content of the arguments, but to help the couple work on the process of their arguments. The therapist should work to keep those involved in therapy calm and rational, because when discussions become emotional, those involved are not able to think about their processes objectively.
Individual therapy with this theory involves helping the individual gain autonomy and to remove themselves from triangles.
Adapted from:
Nichols, M. (2009). The essentials of family therapy (4th ed.) Boston: Pearson.
Thursday, November 20, 2008
Substance Abuse and Substance Dependence
The DSM-IV TR criteria for substance ABUSE:
A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
B. The symptoms have never met the criteria for Substance Dependence for this class of substance.
The DSM-IV TR criteria for substance DEPENDENCE:
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
1. tolerance, as defined by either of the following:
a. a need for markedly increased amounts of the substance to achieve Intoxication or desired effect
b. markedly diminished effect with continued use of the same amount of the substance
2. Withdrawal, as manifested by either of the following:
a. the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)
b. the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms
3. the substance is often taken in larger amounts or over a longer period than was intended
4. there is a persistent desire or unsuccessful efforts to cut down or control substance use
5. a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects
6. important social, occupational, or recreational activities are given up or reduced because of substance use
7. the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)
Specify if:
With Physiological Dependence: evidence of tolerance or withdrawal (i.e., either Item 1 or 2 is present)
Without Physiological Dependence: no evidence of tolerance or withdrawal (i.e., neither Item 1 nor 2 is present)
To summarize, substance abuse is when a person uses a substance dangerously, or the use of the substance damages the person's home/work/school life. Substance dependence is more severe. The person does not have to be physiologically addicted to the substance if there is an intense psychological need for the substance. The person spends lots of time on the substance; thinking about it, trying to find it, using it, recovering from it, wanting to stop or cut back but being unable to.
A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
B. The symptoms have never met the criteria for Substance Dependence for this class of substance.
The DSM-IV TR criteria for substance DEPENDENCE:
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
1. tolerance, as defined by either of the following:
a. a need for markedly increased amounts of the substance to achieve Intoxication or desired effect
b. markedly diminished effect with continued use of the same amount of the substance
2. Withdrawal, as manifested by either of the following:
a. the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)
b. the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms
3. the substance is often taken in larger amounts or over a longer period than was intended
4. there is a persistent desire or unsuccessful efforts to cut down or control substance use
5. a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects
6. important social, occupational, or recreational activities are given up or reduced because of substance use
7. the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)
Specify if:
With Physiological Dependence: evidence of tolerance or withdrawal (i.e., either Item 1 or 2 is present)
Without Physiological Dependence: no evidence of tolerance or withdrawal (i.e., neither Item 1 nor 2 is present)
To summarize, substance abuse is when a person uses a substance dangerously, or the use of the substance damages the person's home/work/school life. Substance dependence is more severe. The person does not have to be physiologically addicted to the substance if there is an intense psychological need for the substance. The person spends lots of time on the substance; thinking about it, trying to find it, using it, recovering from it, wanting to stop or cut back but being unable to.
Management
Management
Theory X and Theory Y are theories that describe employee motivation. Theory X states that workers are only motivated by not getting in trouble. That is, workers are inherently lazy, do not want to work, and are not invested in their work or the company. Theory Y states that employees are motivated by doing good work. They enjoy working, and desire to be creative in their jobs. A manager in Theory X would act as an authoritarian boss, constantly prodding the workers to do their jobs. A manager in Theory Y would encourage ideas and value collaboration between management and employees.
Theory Z, which was developed after X and Y, is also known as the Japanese management approach. Theory Z can best be described as loyalty begetting loyalty. The company is loyal to the employee, providing long term employment, job security, promotion from within, and concern for the holistic needs of the employee and his/her family. In return, the employee has high job satisfaction and high production rates, and the employer sees low turnover. Examples of employers taking care of the employees holistic needs could include on-site daycare, (or crib in the cubicle- it happens!) exercise or meditation in the morning, and pets in the office place (I really wish I could bring my cat to work.)
Americans with disabilities act of 1990: this act prohibited discrimination in the workplace, in housing, and in public accommodations (the library, the mall, etc). The law states that employers must make ‘reasonable accommodations’ for employees with disabilities. Personally, I knew a man who had kidney failure and needed dialysis. The only time the clinic could run him was in the morning, so a reasonable accommodation in this case was to push his shifts back a few hours three times a week to accommodate dialysis. An example I have experienced that was very illegal was another dialysis patient being fired because the employer said he was driving up the cost of the business’s health insurance.
Kettner, P. M. (2002). Achieving excellence in the management of human service organizations. Boston: Allyn & Bacon.
Theory X and Theory Y are theories that describe employee motivation. Theory X states that workers are only motivated by not getting in trouble. That is, workers are inherently lazy, do not want to work, and are not invested in their work or the company. Theory Y states that employees are motivated by doing good work. They enjoy working, and desire to be creative in their jobs. A manager in Theory X would act as an authoritarian boss, constantly prodding the workers to do their jobs. A manager in Theory Y would encourage ideas and value collaboration between management and employees.
Theory Z, which was developed after X and Y, is also known as the Japanese management approach. Theory Z can best be described as loyalty begetting loyalty. The company is loyal to the employee, providing long term employment, job security, promotion from within, and concern for the holistic needs of the employee and his/her family. In return, the employee has high job satisfaction and high production rates, and the employer sees low turnover. Examples of employers taking care of the employees holistic needs could include on-site daycare, (or crib in the cubicle- it happens!) exercise or meditation in the morning, and pets in the office place (I really wish I could bring my cat to work.)
Americans with disabilities act of 1990: this act prohibited discrimination in the workplace, in housing, and in public accommodations (the library, the mall, etc). The law states that employers must make ‘reasonable accommodations’ for employees with disabilities. Personally, I knew a man who had kidney failure and needed dialysis. The only time the clinic could run him was in the morning, so a reasonable accommodation in this case was to push his shifts back a few hours three times a week to accommodate dialysis. An example I have experienced that was very illegal was another dialysis patient being fired because the employer said he was driving up the cost of the business’s health insurance.
Kettner, P. M. (2002). Achieving excellence in the management of human service organizations. Boston: Allyn & Bacon.
Tuesday, November 18, 2008
Systems Theory
Back to freshman year of the BSW!
A 'system' is a group of parts that together make up a whole of something. Like our organs and tissue are parts that make up our bodies. In the same way, individual people, families, and organizations together make systems.
A key part of systems is the boundary. Boundaries are the outside of the system. For example, one could see my husband and I as a system. Together we are a married couple. You could also expand this system to include any children we may have (we just have cats, but you get the idea) and us and our children would make up another system. Or you could go out even further to encompass our parents and our sisters and brothers. Systems can also include our schools, our places of work, our communities, etc.
A 'closed' system is a system that has impassible boundaries. Open systems have boundaries that are flexible. Systems can be too closed or too open. For example, a couple with children who allows random strangers to sleep in their home has created a system that is so open it is dangerous. A less extreme example could be boundaries between children and parents that are so loose they act more as peers than parents and children. A family system that is too closed leads to isolation.
Organizational systems can also be open or closed. Personally, I've observed a support group that ignored new and inquiring members. This system (the support group) was supposed to be open, but the members maintained a closed group.
The book I am working from cites ecological levels of systems.
"Microsystem: situations in which the person has face to face contact with influential others.
Examples: family, school, workplace, church...
mesosystem: relationships between microsystems; the connections between situations.
Examples: home-school, home-workplace, home-church...
Exosystem: settings in which the person does not participate but in which significant decisions are made affecting the person or others who interact directly with the person.
Examples: ... school board, local government...
Macrosystem: 'blueprints' for defining and organizing the institutional life of the society
Examples: ideology, social policy, shared assumptions about human nature..." p. 66
In a nutshell, intervention using the systems theory would take into account outside forces on the person. Family needs, the neighborhood, factories leaving the state, and the state of the economy all impact a person's employment status. A student who is not fed at home is not going to excel in school despite any in-school interventions that may be made.
Adapted from:
Ambrosino, R., Herrfernan, J., Shuttlesworth, G., & Amrosino R. Social work and social welfare: An introduction. (4th ed.) Belmont: Brooks/Cole.
A 'system' is a group of parts that together make up a whole of something. Like our organs and tissue are parts that make up our bodies. In the same way, individual people, families, and organizations together make systems.
A key part of systems is the boundary. Boundaries are the outside of the system. For example, one could see my husband and I as a system. Together we are a married couple. You could also expand this system to include any children we may have (we just have cats, but you get the idea) and us and our children would make up another system. Or you could go out even further to encompass our parents and our sisters and brothers. Systems can also include our schools, our places of work, our communities, etc.
A 'closed' system is a system that has impassible boundaries. Open systems have boundaries that are flexible. Systems can be too closed or too open. For example, a couple with children who allows random strangers to sleep in their home has created a system that is so open it is dangerous. A less extreme example could be boundaries between children and parents that are so loose they act more as peers than parents and children. A family system that is too closed leads to isolation.
Organizational systems can also be open or closed. Personally, I've observed a support group that ignored new and inquiring members. This system (the support group) was supposed to be open, but the members maintained a closed group.
The book I am working from cites ecological levels of systems.
"Microsystem: situations in which the person has face to face contact with influential others.
Examples: family, school, workplace, church...
mesosystem: relationships between microsystems; the connections between situations.
Examples: home-school, home-workplace, home-church...
Exosystem: settings in which the person does not participate but in which significant decisions are made affecting the person or others who interact directly with the person.
Examples: ... school board, local government...
Macrosystem: 'blueprints' for defining and organizing the institutional life of the society
Examples: ideology, social policy, shared assumptions about human nature..." p. 66
In a nutshell, intervention using the systems theory would take into account outside forces on the person. Family needs, the neighborhood, factories leaving the state, and the state of the economy all impact a person's employment status. A student who is not fed at home is not going to excel in school despite any in-school interventions that may be made.
Adapted from:
Ambrosino, R., Herrfernan, J., Shuttlesworth, G., & Amrosino R. Social work and social welfare: An introduction. (4th ed.) Belmont: Brooks/Cole.
DSM Layout
Because this is not the clinical exam, I imagine there is not a lot of in depth questions on less common mental illnesses. However, I feel that as a social worker, it is important to at least be familiar with the DSM and the more common diagnoses and their treatments.
There are five axises in the DSM-IV TR. The following is a direct quote out of the DSM-IV TR from page 27:
Axis I: Clinical Disorders and Other Conditions That May Be a Focus of Clinical Attention.
Axis II: Personality Disorders, Mental Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental Problems
Axis V: Global Assessment of Functioning
So, essentially, Axis I holds all the mental health diagnoses except personality disorders and mental retardation. Mental retardation does NOT include Pervasive Developmental Disorder (PDD) which is the umbrella for Autism and Aspergers. To further complicate things, other (what could be considered developmental disorders) disorders, such as Cerebral Palsy, are not considered mental health at all, but a 'General Medical Condition', so it would be coded under Axis III.
The reasoning is that personality disorders and mental retardation exist throughout the entire person. 'Pervasive', if you will. However, Pervasive Developmental Disorder is a 'clinical disorder'.
No, it doesn't make a whole lot of sense. But we didn't write the book, we just know how to use it. And this is how to use it.
The last Axis, the GAF, is a number scale of overall functioning. Many practitioners find it to be crap and don't use it at all because it is too subjective.
There are five axises in the DSM-IV TR. The following is a direct quote out of the DSM-IV TR from page 27:
Axis I: Clinical Disorders and Other Conditions That May Be a Focus of Clinical Attention.
Axis II: Personality Disorders, Mental Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental Problems
Axis V: Global Assessment of Functioning
So, essentially, Axis I holds all the mental health diagnoses except personality disorders and mental retardation. Mental retardation does NOT include Pervasive Developmental Disorder (PDD) which is the umbrella for Autism and Aspergers. To further complicate things, other (what could be considered developmental disorders) disorders, such as Cerebral Palsy, are not considered mental health at all, but a 'General Medical Condition', so it would be coded under Axis III.
The reasoning is that personality disorders and mental retardation exist throughout the entire person. 'Pervasive', if you will. However, Pervasive Developmental Disorder is a 'clinical disorder'.
No, it doesn't make a whole lot of sense. But we didn't write the book, we just know how to use it. And this is how to use it.
The last Axis, the GAF, is a number scale of overall functioning. Many practitioners find it to be crap and don't use it at all because it is too subjective.
Suicide Prevention
Behavioral warnings of suicidal ideation:
• A tendency toward isolation and social withdrawal
• Increasing substance abuse
• Expression of negative attitudes toward self
• Expression of hopelessness or helplessness
• Loss of interest in usual activities
• Giving away valued possessions
• Expression of a lack of future orientation: "It won't matter soon anyway."
• For someone who has been very depressed, when that depression begins to lift, the individual may be at INCREASED risk of suicide, as the individual will have the psychological energy to follow-through on suicidal ideation.
People with untreated severe mental illness are at risk of suicide. Possibly symptoms of mental illness may include:
• Extreme personality changes
• Loss of interest in activities that used to be enjoyable
• Significant loss or gain in appetite
• Difficulty falling asleep or wanting to sleep all day
• Fatigue or loss of energy
• Feelings of worthlessness or guilt
• Withdrawal from family and friends
• Neglect of personal appearance or hygiene
• Sadness, irritability, or indifference
• Having trouble concentrating
• Extreme anxiety or panic
• Drug or alcohol use or abuse
• Aggressive, destructive, or defiant behavior
• Poor school performance
• Hallucinations or unusual beliefs
College students who commit suicide often do not have effective coping mechanisms. Because of this, students are at the highest risk of suicide 48 hours after a triggering event. Triggering events are stressful events that the student cannot effectively cope with. Examples of triggering events are, but are not limited to: death of a friend or family member, failing school, family crisis, a break-up with a significant other, and fights with friends.
If you suspect someone may commit suicide, ask them. If they have, ask if they have a plan. The more specific the plan, the more likely they are to follow through. If they have a plan, find out if they have the means to execute the plan. If the plan is specific and the means are readily available and they have set the time: you MUST take the person to a mental health professional or the emergency room. If you are on the phone with them, call 911.
If the individual has a plan but you assess the threat to not be immediate, you must help the person seek help. Individuals overwhelmed with suicidal ideation are not capable of seeking help for themselves. Drive them to a mental health facility or walk them to a walk-in counselor. Reassure them that while the pain they are feeling is overwhelming, it can get better.
Adapted from:
National Alliance on Mental Illness
http://www.nami.org/Content/ContentGroups/Helpline1/Teenage_Suicide.htm
The Trevor Project
http://www.thetrevorproject.org/how_to_help_someone.aspx
• A tendency toward isolation and social withdrawal
• Increasing substance abuse
• Expression of negative attitudes toward self
• Expression of hopelessness or helplessness
• Loss of interest in usual activities
• Giving away valued possessions
• Expression of a lack of future orientation: "It won't matter soon anyway."
• For someone who has been very depressed, when that depression begins to lift, the individual may be at INCREASED risk of suicide, as the individual will have the psychological energy to follow-through on suicidal ideation.
People with untreated severe mental illness are at risk of suicide. Possibly symptoms of mental illness may include:
• Extreme personality changes
• Loss of interest in activities that used to be enjoyable
• Significant loss or gain in appetite
• Difficulty falling asleep or wanting to sleep all day
• Fatigue or loss of energy
• Feelings of worthlessness or guilt
• Withdrawal from family and friends
• Neglect of personal appearance or hygiene
• Sadness, irritability, or indifference
• Having trouble concentrating
• Extreme anxiety or panic
• Drug or alcohol use or abuse
• Aggressive, destructive, or defiant behavior
• Poor school performance
• Hallucinations or unusual beliefs
College students who commit suicide often do not have effective coping mechanisms. Because of this, students are at the highest risk of suicide 48 hours after a triggering event. Triggering events are stressful events that the student cannot effectively cope with. Examples of triggering events are, but are not limited to: death of a friend or family member, failing school, family crisis, a break-up with a significant other, and fights with friends.
If you suspect someone may commit suicide, ask them. If they have, ask if they have a plan. The more specific the plan, the more likely they are to follow through. If they have a plan, find out if they have the means to execute the plan. If the plan is specific and the means are readily available and they have set the time: you MUST take the person to a mental health professional or the emergency room. If you are on the phone with them, call 911.
If the individual has a plan but you assess the threat to not be immediate, you must help the person seek help. Individuals overwhelmed with suicidal ideation are not capable of seeking help for themselves. Drive them to a mental health facility or walk them to a walk-in counselor. Reassure them that while the pain they are feeling is overwhelming, it can get better.
Adapted from:
National Alliance on Mental Illness
http://www.nami.org/Content/ContentGroups/Helpline1/Teenage_Suicide.htm
The Trevor Project
http://www.thetrevorproject.org/how_to_help_someone.aspx
Monday, November 17, 2008
Piaget's Developmental Theory
Sensori-motor
Birth to 2 years
The child experience the world through their five senses. She learns to differentiate herself from objects. The child learns that things continue to exist even when they are not present. The child is 'egocentric', meaning the child is not capable of viewing the world from any point of view but their own.
Pre-operational
2 years to 7 years
Thinking is still egocentric. The child learns to use language to represent objects. The child understands rules, although not why the exist and do not see them as modifiable.
Concrete operational
7 years to 11 years
The child can think logically about objects and events. Can begin to understand different points of view. Understands why rules exist.
Formal operational
11 years and up
The child can think logically about the abstract. They can think about the hypothetical, the future, and ideological problems. They can form and test hypotheses.
Critics of Piaget believe that some children advance much faster to concrete and formal thought.
Adapted from:
Robbins, S.P., Chatterjee, P., & Canda, E.R. (2006). Contemporary human behavior theory: A critical perspective for social work (2nd ed.). Boston: Pearson.
Birth to 2 years
The child experience the world through their five senses. She learns to differentiate herself from objects. The child learns that things continue to exist even when they are not present. The child is 'egocentric', meaning the child is not capable of viewing the world from any point of view but their own.
Pre-operational
2 years to 7 years
Thinking is still egocentric. The child learns to use language to represent objects. The child understands rules, although not why the exist and do not see them as modifiable.
Concrete operational
7 years to 11 years
The child can think logically about objects and events. Can begin to understand different points of view. Understands why rules exist.
Formal operational
11 years and up
The child can think logically about the abstract. They can think about the hypothetical, the future, and ideological problems. They can form and test hypotheses.
Critics of Piaget believe that some children advance much faster to concrete and formal thought.
Adapted from:
Robbins, S.P., Chatterjee, P., & Canda, E.R. (2006). Contemporary human behavior theory: A critical perspective for social work (2nd ed.). Boston: Pearson.
Sunday, November 16, 2008
Erikson's Eight Developmental Stages
Erikson based this on Freud's theories of development. It has both psychological and social explanations for behavior. This theory is Eurocentric. The model is heavily influenced by Freud and there is no evidence he practiced outside of America/white society. Problems are defined as improper development and most likely due to external forces.
Infant (birth to 18 months)
Trust vs. Mistrust
learns to trust him/herself, others, and environment
Toddler (18 months to 3 years)
Autonomy vs. Shame and Doubt
learns to believe in him/herself
Preschool (3-5 years)
Initiative vs. Guilt
learns to take initiative in play rather than mimicking
'guilt' refers to Freud's Oedipal struggle
Latency State (6 to 12 years)
Industry vs. Inferiority
learns that he/she is capable and able to accomplish
Adolescence
Identity vs. Role Confusion
The teenager searches for themselves as an individual, separate from their environment
Young Adult
Intimacy vs. Isolation
The individual searches for meaningful relationships
Middle Adult
Generativity vs. Self absorption or Stagnation
search for meaning through intergenerational communication.
Late Adulthood
Integrity vs. Despair
Individual looks back with either feelings of accomplishment or dispair.
Adapted from:
Watson, S. (2005). Attachment Theory and Social Work. In M. Nash, R. Munford, and K. O'Donoghue, Social Work theories in action, 208-222. Philadelphia: Jessica Kingsley Publishers
Infant (birth to 18 months)
Trust vs. Mistrust
learns to trust him/herself, others, and environment
Toddler (18 months to 3 years)
Autonomy vs. Shame and Doubt
learns to believe in him/herself
Preschool (3-5 years)
Initiative vs. Guilt
learns to take initiative in play rather than mimicking
'guilt' refers to Freud's Oedipal struggle
Latency State (6 to 12 years)
Industry vs. Inferiority
learns that he/she is capable and able to accomplish
Adolescence
Identity vs. Role Confusion
The teenager searches for themselves as an individual, separate from their environment
Young Adult
Intimacy vs. Isolation
The individual searches for meaningful relationships
Middle Adult
Generativity vs. Self absorption or Stagnation
search for meaning through intergenerational communication.
Late Adulthood
Integrity vs. Despair
Individual looks back with either feelings of accomplishment or dispair.
Adapted from:
Watson, S. (2005). Attachment Theory and Social Work. In M. Nash, R. Munford, and K. O'Donoghue, Social Work theories in action, 208-222. Philadelphia: Jessica Kingsley Publishers
Juvenile Delinquency, Risk Factors, Protective Factors, and Interventions
A Juvenile Delinquent is a child between the ages of 7 and 12 who committs an act that would be considered a crime if committed by an adult. States can make their own laws regarding the age of responsiblity, but by common law the age i 7. In some states it is as old as 10.
A serious child delinquent i a child who has committed "one or more of the following acts: homicide, aggravated assault, robbery, rape, or serious arson."
Other child delinquents have committed a less serious, yet illegal act.
There are also children showing persistent disruptive behavior who have not committed a crime but have shown a pattern of behaviors such as truancy and incorrigibility that puts them at significant risk of offending.
Risk factors are not enough to create juvenile delinquency. Enough protective factors can counteract risk factors.
Individual risk factors : antisocial behaviors, aggression, late language development, lack of attachment to caregivers, hyperactivity, low intelligence, male gender
Family risk factors : divorce, teenage parents, abuse, family history of antisocial behavior, sibling delinquency, and family violence
School risk factors : lack of rule creation and enforcement, repeating grades, truancy, and problems with teachers
Environmental risk factors : rejection by peers, poverty, dangerous neighborhoods, access to weapons, and exposure to older delinquents, including while in juvenile detention
Protective factors : prosocial behavior in early development, such as sharing and helping, stable home environment, good relationship between child and parent(s), likes school
Best Practices: Primary Intervention
Conflict resolution training
parent training
home maker visits for at risk families
after school programs
mentor programs
Wraparound case management services that encompasses all areas of a child's support system
Multi systemic therapy: intensive home-based therapy
Boy Scouts/Girl Scouts (promotes leadership and ethics)
Big Brothers/Big Sisters (strengthens relationships)
Boys and Girls Club (promotes academic achievement and community)
Medications for severe emotional disorders
Best Practices: Secondary and Tertiary Interventions
Reducing contact with peers associated with delinquency and encouraging contact with prosocial peers
Early offender programs, specific to regional areas
Adapted from:
Anderson, J.; Barton, W.H.; Bealke, J.; Blackman, L.; Jarjoura, R.; Watkins, E.; Witesman, E.; Littlepage, L.;Wright, E.R. (2006). Evidence-based Practices in Prevention and Treatment for Children and Adolescents: A Report to the Early Intervention Planning Council. Indianapolis: Center for Urban Policy and the Environment.
Loeber, R., Farrington, D.P., and Petechuk, D. (2003). Child delinquency: Early intervention and prevention. Child delinquency bulleting series. Office of Juvenile Justice and Delinquency Prevention.
Wasserman, G.A., Keenan, K., Tremblay, R.E., Coie, J.D., Herrenkohl, T.I., Loeber, R., and Petechuk, D. (2003). Risk and protective factors of child delinquency. Child delinquency bulleting series. Office of Juvenile Justice and Delinquency Prevention.
A serious child delinquent i a child who has committed "one or more of the following acts: homicide, aggravated assault, robbery, rape, or serious arson."
Other child delinquents have committed a less serious, yet illegal act.
There are also children showing persistent disruptive behavior who have not committed a crime but have shown a pattern of behaviors such as truancy and incorrigibility that puts them at significant risk of offending.
Risk factors are not enough to create juvenile delinquency. Enough protective factors can counteract risk factors.
Individual risk factors : antisocial behaviors, aggression, late language development, lack of attachment to caregivers, hyperactivity, low intelligence, male gender
Family risk factors : divorce, teenage parents, abuse, family history of antisocial behavior, sibling delinquency, and family violence
School risk factors : lack of rule creation and enforcement, repeating grades, truancy, and problems with teachers
Environmental risk factors : rejection by peers, poverty, dangerous neighborhoods, access to weapons, and exposure to older delinquents, including while in juvenile detention
Protective factors : prosocial behavior in early development, such as sharing and helping, stable home environment, good relationship between child and parent(s), likes school
Best Practices: Primary Intervention
Conflict resolution training
parent training
home maker visits for at risk families
after school programs
mentor programs
Wraparound case management services that encompasses all areas of a child's support system
Multi systemic therapy: intensive home-based therapy
Boy Scouts/Girl Scouts (promotes leadership and ethics)
Big Brothers/Big Sisters (strengthens relationships)
Boys and Girls Club (promotes academic achievement and community)
Medications for severe emotional disorders
Best Practices: Secondary and Tertiary Interventions
Reducing contact with peers associated with delinquency and encouraging contact with prosocial peers
Early offender programs, specific to regional areas
Adapted from:
Anderson, J.; Barton, W.H.; Bealke, J.; Blackman, L.; Jarjoura, R.; Watkins, E.; Witesman, E.; Littlepage, L.;Wright, E.R. (2006). Evidence-based Practices in Prevention and Treatment for Children and Adolescents: A Report to the Early Intervention Planning Council. Indianapolis: Center for Urban Policy and the Environment.
Loeber, R., Farrington, D.P., and Petechuk, D. (2003). Child delinquency: Early intervention and prevention. Child delinquency bulleting series. Office of Juvenile Justice and Delinquency Prevention.
Wasserman, G.A., Keenan, K., Tremblay, R.E., Coie, J.D., Herrenkohl, T.I., Loeber, R., and Petechuk, D. (2003). Risk and protective factors of child delinquency. Child delinquency bulleting series. Office of Juvenile Justice and Delinquency Prevention.
Crisis Intervention in Children
Erikson believed that crisis was a part of development, and with support, crisis can be resolved and not lead to future problems. Children with many supports handle crisis most effectively.
Crisis Intervention is:
Appraisal focused; understanding the event
Problem focused; problem solving
Emotion focused; manage feelings
When working with a child who has experienced a crisis:
Adapted from:
Conceptualizations and General Principles of Crisis Counseling, Intervention, and Prevention. Handbook of crisis counseling, intervention, and prevention in the schools. 2nd ed. Mahwah, N.J. : L. Erlbaum Associates.
Crisis Intervention is:
Appraisal focused; understanding the event
Problem focused; problem solving
Emotion focused; manage feelings
When working with a child who has experienced a crisis:
- "begin counseling immediately" (p. 10)
- help the child understand what happened, "confront reality" (p. 10)
- help child mobilize any supports they may have
- look for other stresses to relieve
- do not give false reassurance or security
- "encourage self reliance" (p. 15)
Adapted from:
Conceptualizations and General Principles of Crisis Counseling, Intervention, and Prevention. Handbook of crisis counseling, intervention, and prevention in the schools. 2nd ed. Mahwah, N.J. : L. Erlbaum Associates.
Feminist Standpoint Theory
Feminist Standpoint Theory can be applied to individuals (in their environment), groups, and communities. The theory states that problems are created when the dominate group oppresses non dominate groups, and that oppression can be as passive as not realizing the realities of the non dominate group.
This theory originated with the idea that women understood women in society better than men, but has been expanded to include other oppressed populations such as people of color, gay and lesbian individuals, the elderly, children, and people in poverty.
According to Standpoint Theory, all theories that look at reality from a general standpoint are inherently looking at the realities of the dominant population.
If oppressed populations understand their world better than those from the outside, then appropriate societal change cannot be made for the oppressed population by the dominant population. Change must be lead by the oppressed group, because only they truly understand the reality of their situation.
Theory adapted from:
Robbins, S.P., Chatterjee, P., & Canda, E.R. (2006). Contemporary human behavior theory: A critical perspective for social work (2nd ed.). Boston: Pearson.
This theory originated with the idea that women understood women in society better than men, but has been expanded to include other oppressed populations such as people of color, gay and lesbian individuals, the elderly, children, and people in poverty.
According to Standpoint Theory, all theories that look at reality from a general standpoint are inherently looking at the realities of the dominant population.
If oppressed populations understand their world better than those from the outside, then appropriate societal change cannot be made for the oppressed population by the dominant population. Change must be lead by the oppressed group, because only they truly understand the reality of their situation.
Theory adapted from:
Robbins, S.P., Chatterjee, P., & Canda, E.R. (2006). Contemporary human behavior theory: A critical perspective for social work (2nd ed.). Boston: Pearson.
My Sources
Thanks for visiting my LSW study guide! When I registered to take the Exam (a whopping $175), they asked me if I would like to purchase their study guide for another $30. No thanks, I'm still spinning from that $175 fee and the possibility that if I do not pass it, I will have to pay it again! I thought, 'surely there is free study material on the internet... everything can be found on the internet!' I was so wrong.
I will be focusing primarily on human behavior and development theories and intervention models because this makes of the bulk of the test.
I will be citing the textbook my information came from, and making it clear when something is a direct quote. Study on!
I will be focusing primarily on human behavior and development theories and intervention models because this makes of the bulk of the test.
I will be citing the textbook my information came from, and making it clear when something is a direct quote. Study on!
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