What's goes into a biopsychosocial assessment?

What's goes into a biopsychosocial assessment? Simple: biology, psychology, social/cultural, um, -ology. Here's a page from Palomar College social work-slash-psych class that lays it all out.

From the page:

 The biopsychosocial (BPS) framework is an approach that emphasizes the importance of a systemic view of the individual and an integration of biological, psychological, and sociocultural factors on human development and functioning. The biopsychosocial interview, an assessment typically conducted by therapists and counselors at the beginning of therapy, assesses for biological, psychological and social factors that can be contributing to a problem or problems with a client. It's considered a holistic assessment, looking at a client on all different levels. The biopsychosocial interview is utilized because problems usually don't exist in a vacuum--they all influence each other in different ways. It's not enough just to look at a person; you have to look at his or her environment as well.

Also on the page is a link to this biopsychosocial assessment form which, if you haven't encountered them in the field or classroom, will give you a better sense of a thorough BPS exam than all the descriptions you can find.

How might this appear on the ASWB exam? It might not. Nor may the mental status exam, which is detailed further down the linked page.

If you were an exam writer, how would you include either BPS or MSE into a question?

ASWB Exam Prep: The Mental Status Examination

Let's see how well you know  your way around the Mental Status Examination (MSE). First, here's what an MSE is:

The Mental Status Exam is analogous to the physical exam: it is a series of observations and examinations at one point in time. Focused questions and observations can reveal "normal" or pathological findings. Although our observations occur in the context of an interview and may therefore be ordered differently for each patient, the report of our findings is ordered and "paints a picture" of a patient's appearance, thinking, emotion and cognition.

 Simple enough. There are some tricky details and vocabulary within the MSE that may show up on the ASWB exam. Taking this quiz should get you all-the-more ready for MSE questions on the social work licensing exam.

1. What characteristic might be described by one of these: Hesitant, expansive, rambling, halting, stuttering, lilting, jerky, forgetful. 

2. What are auditory, visual, and olfactory hallucinations?

3. What is an overvalued idea.

4. Define flight of ideas.

5. What is alexithymia?

Have answers? Are the right ones? Answer key below--scroll down...

Bonus concepts: echopraxia, catalepsy, waxy flexibility and paratonia -- click through for definitions.

Remember, the real ASWB exam doesn't quiz like this. Questions tend to be longer form vignettes. Try practice tests like those from SWTP to prepare for the full-length, 170-question ASWB exam. Generally, the more practice, the readier you'll be.

Good luck!






















Definitions via Wikipedia.

1. Flow of speech.

2. Auditory hallucinations involve hearing (e.g., voices); visual involve seeing (e.g., shadows); olfactory involve smelling (e.g., something burning or rotten).

3. An overvalued idea is an emotionally charged belief that may be held with sufficient conviction to make believer emotionally charged or aggressive but that fails to possess all three characteristics of delusion—most importantly, incongruity with cultural norms.

4. Flight of ideas describes excessive speech at a rapid rate that involves causal association between ideas. Links between ideas may involve usage of puns or rhymes. It is typical of mania, classically seen in bipolar disorder.

5. Alexithymic individuals may be unable to describe their subjective mood state.

KSA of the Day: The Concept of Attachment and Bonding

Attachment and bonding may or may not come up on the social work licensing exam. But they'll come up every day you're a living and breathing social worker (and person). Preparing for the exam is a good excuse to gain a better, deeper understanding of the thinking and theorizing on the subject.

What springs to mind when you hear "attachment and bonding"? How about John Bowlby? How about Mary Ainsworth? How about Harlow's monkey?

Let's start with the monkey.

Harlow's monkey gets milk from a fake wire monkey, but clings to the cozier fake cloth monkey. Attachment and bonding!

Attachment theory can't be summed up quite as quickly. But how's this: Attachment theory posits that attachment isn't a byproduct of other psychological drives, but an essential drive in and of itself. Attachment is so crucial that the quality of early attachments affects the way a person relates to others for their entire lifetime. Attachment researchers have identified several typical patterns of attachment between infants and caregivers--some secure and some insecure--and witnessed their longterm stickiness. Young children with a certain attachment pattern grow into adults with that same attachment pattern.

But don't just take it from this blog. Read up. Here are some places to get smart and smarter about attachment:

• Attachment Theory (Wikipedia)
• Attachment Theory (Simply Psychology)
• Attachment Styles (verywell.com)

That should do it to get your prepared for attachment and bonding questions on the ASWB exam.
Stay cozy and good luck!

Motivational Interviewing and the ASWB Exam

Motivational interviewing comes up in regular social work practice all the time, even if people don't always refer to what they're doing as motivational interview. Same goes for the ASWB exam. Knowing motivational interviewing basics will help you in your practice and help you pass the test. So get learning!. Here are some basics via Wikipedia:

Motivational interviewing (MI) refers to a counseling approach in part developed by clinical psychologists Professor William R Miller, Ph.D. and Professor Stephen Rollnick, Ph.D. Motivational Interviewing is a method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior.[2] MI is a goal-oriented, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with non-directive counseling, it's more focused and goal-directed. It departs from traditional Rogerian client-centered therapy through this use of direction, in which therapists attempt to influence clients to consider making changes, rather than non-directively explore themselves. The examination and resolution of ambivalence is a central purpose, and the counselor is intentionally directive in pursuing this goal.

A few key points in MI (also via Wikipedia):

1. Motivation to change is elicited from the client, and is not imposed from outside forces.
2. It is the client's task, not the counselor's, to articulate and resolve the client's ambivalence.
3. Direct persuasion is not an effective method for resolving ambivalence.
4. The counseling style is generally quiet and elicits information from the client.
5. The counselor is directive, in that they help the client to examine and resolve ambivalence.
6. Readiness to change is not a trait of the client, but a fluctuating result of interpersonal interaction.
7. The therapeutic relationship resembles a partnership or companionship.

Sound familiar?

Here's MI summed up in a 17 minute video:



For more motivational interviewing wisdom from around the web, try:

• MotivationalInterviewing.org
• MotivationalInterviewing.net
• Motivational Interviewing as a Counseling Style (NCBI)

Happy studying. Happy exam-passing!

Jean Piaget for Social Work Exam Preppers

Celebrate Jean Piaget's August 9th birthday by brushing up on his theories.  Here are some links and a video to help you out:

• Article at Simply Psychology
• Stages at About.com
• More at Wikipedia

(Again, don't overstudy. If this shows up on your social work exam at all, it'll likely amount to one question at most.)

Freud's Theory of Psychosexual Development

Continuing with the best, most ASWB-exam relevant, parts of the CounsellingResource collection, here's Freud's Theory of Psychosexual Development delivered in under ten minutes.



Here's Simply Psychology tackling the same.

Erikson's Stages of Psychosocial Development

Another from the CounsellingResources collection, Erikson's Psychosocial Stages of Development:



Here's the same info via Wikipedia.

Five Stages of Grief

From the CounsellingResource YouTube channel, here's a quick primer on Elisabeth Kubler-Ross and the Five Stages of Grief.

ASWB Clinical Exam Content Outline

Removed at the request of the ASWB. Find the complete outline at aswb.org.

KSA of the Day: Effects of Diversity

Clinical KSA of the Day:  EFFECTS OF DIVERSITY.  Here's a source to get exam-ready on the topic:  The NASW's Diversity and Equality page. 

KSA of the Day: Human Behavior in the Environment

Clinical KSA of the Day:  HUMAN BEHAVIOR IN THE ENVIRONMENT.  Some links:  The Person in Environment (PIE) theory; Psychological defense mechanisms; The dynamics of sexual abuse; The effects of trauma on behavior. If you're the overstudying type, you could bury yourself in this section--and in the entire outline--for a long, long while.  (Note: Don't overstudy!)

KSA of the Day: Human Development in the Life Cycle

KSA of the day (from the clinical section of the ASWB Content Outline @ aswb.org).  Reading this can bring on a wave of anxiety.  But it seems harder than it is.  Much of what you'll be tested on takes common sense social work instinct that you've likely had in place for years.  First section: HUMAN DEVELOPMENT IN THE LIFE CYCLE.

For brushing up, here's a PowerPoint summarizing several developmental theories, courtesy of Dr. A.M. Gonzalez.

Family Therapy and the ASWB Exam

There's lots to know about family therapy in order to do it well. It order to test about family therapy, you need to know lots less.  Here are some helpful family therapy summaries on the web:

• Clinical Map of Family Therapy Models (Scribd)
• Family Therapy (Wikipedia)
• Family Therapy - Therapist Profiles

Attachment Theory

To celebrate John Bowlby's birthday (February 26th), why not take a moment to review Attachment Theory? Here's some help on the web:

• Simply Psycholgy
• Wikipedia
• About.com

And here's video from the Counselling Resource YouTube channel (ad skipable):

Getting familiar with the Mental Status Exam

If you've done intakes in a social work setting, great--it's as if you've been studying for the exam while you worked. Lots of ASWB exam items cover the very questions that social workers face at first contact with clients. Where best to refer?  How best to treat?   And, of course, what's going on with this person?  That is, what emerges when you do a Mental Status Exam?

A working knowledge of the Mental Status Exam, and the terms it contains, gives you a leg up come exam day.  Here are a few links that'll walk you through the basics:

• How to Do a Mental Status Exam
• Wikpedia MSE
• MSE at UCSD