Tuesday, October 11, 2016

Social Work Exam Quiz: DSM Time Frames

Here's another quiz that will test the depths of your DSM knowledge. For each of the following fill in the blank--what is the proper time frame according to DSM-5?

1. Encopresis (repeated passage of feces into inappropriate places). Chronological age is at least ___ years (or equivalent developmental level).

2. Binge-Eating Disorder. Beinge eating occurs, on average, at least once a week for ___ months.

3. Disruptive Mood Dysregulation Disorder (severe, recurrent temper outbursts). Primary criteria have been present for ___ months or more. Age of onset is before ___ years.

4. Insomnia Disorder. The sleep difficulty occurs at least ___ nights a week and has been present for at least ___ months.

5. Manic Episode (in Bipolar I). Decreased need for sleep (e.g., feels rested after only ___ hours of sleep).

6. Brief Psychotic Disorder. Duration of episode is at least ___ day(s) but less that ___ month(s).

7. Schizophreniform Disorder. Symptoms are present for at least ___ month(s), but less than ___ months.

8. Schizophrenia. Continuous signs of the disturbance persist for at least ___ months.

9. Cannabis Use Disorder. "In early remission" if criteria have not been met for at least ___ month(s) but for less than ___ months. "In sustained remission" if criteria have not been met for ___ month(s) or longer.

How'd you do? Answers in comments.

These aren't depths that will necessarily be plumbed on the ASWB exam, but if you know this stuff, you can safely say, "DSM questions? Bring 'em on. I'm ready."

And if you're looking for real, exam-style DSM questions to practice on (along with all the other types of questions), check out SWTP practice tests. Tell 'em "Pass the ASWB Exam" sent you!

Thursday, September 29, 2016

Quick Quiz: Panic Disorder Symptoms

What are they symptoms of panic disorder? That's what we're asking you. A diagnosis of panic disorder requires "Recurrent unexpected panic attacks (an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur." A list of 13 symptoms follows.

Your task, should you choose to accept it. Name as many of those 13 symptoms as you can. To get you started (but also limit you by taking away an answer you may have thought of), the first one is filled in.

1. Palpitations, pounding heart, or accelerated heart rate.

How'd you do? Here's a rating scale (an arbitrary one):

1-3 Not bad
4-7 Pretty amazing
8-12 Incredible!

The complete list is in comments.

What is Selective Mutism?

Selective mutism is an anxiety disorder diagnosed when a client has difficulty speaking in certain settings (e.g., at school). The DSM criteria for the disorder are as follows:
A. Consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., at school) despite speaking in other situations.
B. The disturbance interferes with educational or occupational achievement or with social communication.
C. The duration of the disturbance is at least 1 month (not limited to the first month of school) 
D. The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation. 
E. The disturbance is not better explained by a communication disorder (e.g., childhood-onset fluency disorder) and does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder.
And that's that. The disorder is most common in children five and under. Knowing the above criteria should allow you to easily identify the correct answer in any social work licensing exam on the topic!

For more reading about selective mutism, try selectivemutismcenter.org, AnxietyBC, & Medline Plus.

Friday, September 23, 2016

KSA of the Day: Techniques for Stress Management

Here's an ASWB exam content outline item that may come in handy before and after you sit for the social work licensing exam: Techniques for Stress Management.

Social workers experience all manner of stressors, even in ideal work situations. Burnout, secondary trauma, and collapsing self-care are common. Figuring out how to manage your own stress--by making changes to what you face and how you face it--is a great first step in being able to help clients with stress management. And knowing some (widely accepted, empirically validated) techniques to lessen stress may have the additional benefit of getting you through a question or two on the test!

To get started with the "how you face it" solutions, here's a list from the Mayo Clinic.
  • Autogenic Relaxation
  • Progressive Muscle Relaxation
  • Visualization
  • Deep breathing
  • Hypnosis
  • Massage
  • Meditation
  • Tai chi
  • Yoga
  • Biofeedback
  • Music and art therapy 
 Most of these you may have encountered or tried. But what's that first one refer to again?
Autogenic relaxation. Autogenic means something that comes from within you. In this relaxation technique, you use both visual imagery and body awareness to reduce stress.
You repeat words or suggestions in your mind to relax and reduce muscle tension. For example, you may imagine a peaceful setting and then focus on controlled, relaxing breathing, slowing your heart rate, or feeling different physical sensations, such as relaxing each arm or leg one by one.
Ah, okay, thanks Mayo Clinic! Here's another list from the NIH
  • Autogenic Training
  • Biofeedback-Assisted Relaxation
  • Deep Breathing or Breathing Exercises
  • Guided Imagery
  • Progressive Relaxation
  • Self-Hypnosis
The NIH page takes a look at the research about relaxation's effects on various conditions. E.g., anxiety:
Studies have shown relaxation techniques may reduce anxiety in people with ongoing health problems such as heart disease or inflammatory bowel disease, and in those who are having medical procedures such as breast biopsies or dental treatment. Relaxation techniques have also been shown to be useful for older adults with anxiety.
On the other hand, relaxation techniques may not be the best way to help people with generalized anxiety disorder. Generalized anxiety disorder is a mental health condition, lasting for months or longer, in which a person is often worried or anxious about many things and finds it hard to control the anxiety. Studies indicate that long-term results are better in people with generalized anxiety disorder who receive a type of psychotherapy called cognitive-behavioral therapy than in those who are taught relaxation techniques.
Important to note: social work's systems/holistic/biopsychosocial/macro view will often point a different direction. Instead of sharing techniques to reduce the effects of stress, social workers should find ways to help clients advocate to reduce the stressors themselves. Don't be too surprised if a question tries to lure you in with appealing distractors like autogenic relaxation when the real, BEST answer is to make changes around, not within, the client.

Hope that helps. Good luck with the exam!

Friday, September 16, 2016

KSA of the Day: Client Self-Determination

We've been hopping around in the ASWB's KSA outline for a while now. Let's jump down to the bottom today, into the Value Issues section, part C of Professional Values and Ethics, which makes up 18% of the exam. The nice thing about these KSA items is this: you probably already know your way around professional values and ethics in social work. And if you don't, or want to get refreshed on social work values and ethics, there's just one, simple place to turn: the NASW Code of Ethics.

Take this KSA: Client Self-Determination. It's in the code a couple of times. First in the Ethical Principles, up top:

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 self-determination. 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.

Want it more spelled out? The code is ready to do just that, in 1.02, Self-Determination:

Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients’ right to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.

Social workers don't have to agree with everything their clients believe and do. Gently exploring pros and cons is one thing, but imposing values and judgments on clients is another.

How might this show up on the social work licensing exam? Take a look at this free practice question from SWTP to get an idea. If a client isn't planning to do harm to self or others--imminent harm--social workers are to back off. Clients get to choose how to live their lives. Sometimes it's hard to watch, but that's all part of being an ethical social worker.

For more about client self-determination, take a look at these Eye on Ethics columns from Social Work Today: Making Difficult Decisions and The Challenge of Paternalism in Social Work. But really all you have to do is read the above section of the Code of Ethics, and you're up to speed!

Good luck on the exam!

Wednesday, September 7, 2016

Social Work Exam Quiz: Name That Psychotherapy II

Here's a second installment in our Name That Psychotherapy series. The first quiz is here.
We've grabbed some descriptions (or description fragments) from Wikipedia's long list of psychotherapies and left you to match the descriptions with one of the listed therapy approaches. Today's task: Name that psychotherapy

1. _________________, a therapy in which subjects confront their fears and discontinue their escape response.

2. _________________ is focused helping people change patterns of behavior that are not helpful, such as self-harm, suicidal ideation, and substance abuse.

3. _________________ seeks to help people identify their values and the skills and knowledge they have to live these values, while challenging dominant discourses that it claims shape people's lives in destructive ways.

4. _________________ asserts that a person's development is determined by often forgotten events in early childhood rather than by inherited traits alone.

5. _________________ suggests that the way people relate to others and situations in their adult lives is shaped by family experiences during infancy.

Maybe the (fairly vague) descriptions are enough for you. If so, wow! If not, here's a list of ten possibilities to weed through. The right answers are in there.

Cognitive behavioral therapy (CBT)
Object-relations psychotherapy
Systematic desensitization
Dialectical behavioral therapy (DBT)
Play therapy
Narrative therapy
Existential psychotherapy

Answers in comments!

Monday, August 8, 2016

KSA of the Day: Risk Factors Related to Suicide

Here's an item on the ASWB exam outline that's good to have a deep understanding of whether or not you're prepping for the social work licensing exam: Risk factors related to suicide.

This is knowledge that can be tested for in all different manner of licensing exam questions. The ASWB exam focuses on safety above just about all else. Correctly identifying suicide risk is a vital first step in keeping clients safe. This is material worth knowing.

As you're reviewing risk factors for suicide, it's good to take note of these words from the American Foundation for Suicide Prevention:
There’s no single cause for suicide. Suicide most often occurs when stressors exceed current coping abilities of someone suffering from a mental health condition. Depression is the most common condition associated with suicide, and it is often undiagnosed or untreated. Conditions like depression, anxiety and substance problems, especially when unaddressed, increase risk for suicide. Yet it’s important to note that most people who actively manage their mental health conditions lead fulfilling lives.
This intro is followed by a good list of risk factors. As usual, the internet has the answers to your exam-prep questions well answered. We won't waste time writing lists from scratch, but instead point you to a few valuable sites to get up to speed on this KSA. Here you go:
There are plenty more good lists just a web search away. But these'll get you the knowledge you need on the test--and in practice. Use them well. Good luck!