LCSW Note Cards/From Study Guide

The basic tenants of program evaluation Client outcomes are of primary importance
 Splitting  Is most often used by clients with DX of borderline personality disorderSplitting:  defense mechanism, in which a person perceives self and others as “all good” or “all bad”.  A person cannot integrate the good and bad in people.
 Cognitive Behavioral Therapy (CBT)  This type of therapy uses concepts and techniques from behaviorism, social learning theory, and task-centered treatment, and tends to be comparatively short term.  This treatment is usually limited and specific in goals, and focuses on the client’s presenting problem.
 CBT History Cognitive-Behavioral Therapy (CBT) is a general classification of psychotherapy, and several approaches to CBT fall within this classification, including Rational Emotive Behavior Therapy, Cognitive Therapy, Rational Behavior Therapy, Rational Living Therapy, Schema Focused Therapy, and Dialectical Behavior Therapy.  Each approach has its own developmental history.
Ellis and CBT Ellis developed and popularized the ABC model of emotions, and later modified the model to the A-B-C-D-E approach.  In the 1990’s Ellis renamed his approach Rational Emotive Behavior Therapy.
Aaron Beck In the 1960’s, Aaron Beck, M.D. developed his approach called Cognitive Therapy.  Beck’s approach became known for its effective treatment of depression.
 Maxie Maultsby Also in the 1960’s Maxie C. Maultsby, Jr., M.D. (a student of Ellis’) developed Rational Behavior Therapy.   Maultsby’s contributions were numerous, including his emphasis on client rational self-counseling skills and therapeutic homework.  Maultsby’s contributions included his concept of “thought shorthand”, to which he refers as “attitudes”, Rational Emotive Imagery, Rational Self-Analysis, and the Five Criteria for Rational Behavior.
David Burns David Burns, M.D. popularized CBT with his 1980’s best-selling book, Feeling Good.
Psychoanalytic Approach to therapy Psychoanalysis was founded by Sigmund Freud (1916-1917).  Freud believed that people could be cured by making conscious their unconscious thoughts and motivations, thus gaining “insight”.The aim of psychoanalysis therapy is to release repressed emotions and experiences, i.e. make the unconscious conscious. Psychoanalysis is commonly used to treat depression and anxiety disorders.
 Psychoanalysis Assumptions · Psychoanalytic psychologists see psychological problems as rooted in the unconscious mind.· Manifest symptoms are caused by latent (hidden) disturbances.· Typical causes include unresolved issues during development or repressed trauma.· Treatment focuses on bringing the repressed conflict to consciousness, where the client can deal with it. 
 Okay; I just liked this picture.
 Scapegoat When problems occur, people do not like to blame themselves. They will thus actively seek scapegoats onto whom we can displace our aggression. These may be out-groupindividuals or even entire groups. Like bullies, we will often pick on powerless people who cannot easily resist.Scapegoating increases when people are frustrated and seeking an outlet for their anger.Once cast as a scapegoat it can be difficult to shake off the classification
 When is family therapy impossible?  It is impossible to work in family therapy when members are deceitful.  Boundary violations, myths, secrets, and resistant clients may all exit in a dysfunctional family, but they do not prevent successful treatment with family therapy.
 Social Phobia (6 months) website for this…..
 Cognitive Behavioral  Directive/focused on the client’s presenting problem is using this therapeutic model.
 Object Relations (developed in a paper by Karl Abraham (1927), however Melanie Klein is largely credited with developing the modern theory, particularly with the mother as the principal object.)  Object Relations Theory is a theory of relationships between people, in particular within a family and especially between the mother and her child. A basic tenet is that we are driven to form relationships with others and that failure to form successful early relationships leads to later problems. It is also concerned with the relation between the subject and their internalized objects, as well as with external objects. Thus we have a relationship with the internal mother as well as an external one.
 ExistentialExistential continued…. Existential psychotherapy is a philosophical method of therapy that operates on the belief that inner conflict within a person is due to that individual’s confrontation with the givens of existence.[1] These givens, as noted by Irvin D. Yalom, are: the inevitability of death, freedom and its attendant responsibility, existential isolation (referring to Phenomenology), and finally meaninglessness. These four givens, also referred to as ultimate concerns, form the body of existential psychotherapy and compose the framework in which a therapist conceptualizes a client’s problem in order to develop a method of treatment. In the British School of Existential therapy (Cooper, 2003), these givens are seen as predictable tensions and paradoxes of the four dimensions of human existence, the physical, social, personal and spiritual realms (Umwelt, Mitwelt, Eigenwelt and Uberwelt).
Paradoxical intent Viktor Frankl was a Holocaust survivor, a renowned psychiatrist, and the founder of a branch of psychotherapy called logotherapy. Logotherapy’s core assumption is that man is primarily motivated towards meaning (vs. pleasure, power, etc.), and that meaning can be found even in suffering. Accordingly, Frankl characterizes pathological behavior as that which prevents one from experiencing meaning.One of Frankl’s more interesting observations is that paranoid behavior can sometimes be self-prophesying. Frankl observed that, “fear brings about that which one is afraid of, and that hyper-intention makes impossible what one wishes.” In other words, the act of trying to directly control a fear or compulsion triggers a type of anticipatory anxiety which actually has the effect of bolstering the fear or compulsion. To dispel this sort of neurotic behavior, Frankl devised a technique called “paradoxical intention,” which is an unconscious stepping out of the paranoid behavior at hand. (ex. Instead of constant fear of lack of sleep, stay awake and flip/flop your thinking…embrace it….reverse psychology)
Primary purpose of evaluating the effectiveness of social work treatment in an agency. Weigh treatment outcomes in its evaluation of effectiveness
A breach of ethical conduct may exist when a social worker…. Exchanges sessions for babysitting by the client:Bartering arrangements can result in boundary problems and conflict-of-interest issues, particularly when they involve the provision of services in exchange for treatment.
 During a utilization review phone call, a social worker is asked to provide specific details of the sexual abuse incidents the client experienced.  The social worker should FIRST Review the release of information with the client before providing information.  You must always use judgment in accordance with social work principles and ethics to make decisions of this kind.  Utilization review processes may require the provision of certain treatment details, but other details may need to be withheld for the good of the client.  A decision such as this should be reviewed with the client, and the social worker should be prepared to support the client in any choice that is made.
When a client refuses to release information a social worker should FIRST Address the item of self-determination and acknowledgement of the client’s right to confidentiality.
Unethical practices Receiving a portion of the treatment fees for the referral of a client to another practitioner
Unethical practices Acting as a paid consultant to an agency on which the social worker serves as a board member is a clear conflict of interest.
Safety of a client Ethically – safety is always the first area of concern to address when it is jeopardized.

It is unethical to accept any type of gift from a client – “Explain that accepting gifts would be a violation of social work ethics

In mandating reporting of abuse – regardless of circumstances under which the disclosure of abuse takes place you must report it immediately.  (Ex. If it’s a 15 year old perpetrator on a mother’s child not in therapy WITH YOU, you cannot tell the mom – breach of confidentiality of your 15 year old client….BUT YOU MUST TELL AUTHORITIES….

If a client asks you to give a note to her friend who you also see in counseling – simply decline to accept the note.  Acknowledging anything may violate confidentiality of the fact you just acknowledged that her friend is in counseling with you!

In your work you must be self-aware, identify and resolve ethical dilemmas through consultation with your supervisor (not your client, and you do not “wait and see” – DISCUSS WITH YOUR SUPERVISOR)

Dual relationships are a very real part of social work practice, and social workers need to understand when such dual relationship cannot be managed with a client relationship.  REFER ON!

If your client exposes drug use, or if a parent of a child you are serving expects drug use and they ask for testing or any type of thoughts….REMEMBER CONFIDENTIALITY.  YOU CANNOT TALK ABOUT YOUR CLIENT’S DRUG USE TO PARENTS, FOSTER CARE PARENTS, ETC…

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