Csw Flashcards

Ethnicity

refers to the idea that one is a member of a particular cultural, national, or racial group that may share culture, religion, race, language, or place of origin. Two people can share the same race but have different ethnicities.

race

Today, society classifies people into different races primarily based on skin color. at one time racial classifications were based on ethnicity or nationality, religion, or minority language groups.

Cultural identity

is often defined as the identity of a group or culture of an individual who is influenced by his or her self-identification with that group or culture.

are general explanations that are supported by evidence obtained through the scientific method.

Theory

theory may explain human behavior by describing how humans interact with each other or react to certain stimuli.

Developing competencies in this domain enhances a person's mental health, success in work, and ability to achieve in life tasks.

Erik Erikson's stages of psychosocial development

was interested in how children socialize and how this affects their sense of self. He saw personality as developing throughout the life course and looked at identity crises as the focal point for each stage of human development.

According to Erikson,

there are eight distinct stages, with two possible outcomes.

Trust Versus Mistrust

From birth to 1 year of age, children begin to learn the ability to trust others based upon the consistency of their caregiver( s). If trust develops successfully, the child gains confidence and security in the world around him or her and is able to feel secure even when threatened. Unsuccessful completion of this stage can result in an inability to trust, and therefore a sense of fear about the inconsistent world. It may result in anxiety, heightened insecurities, and feelings of mistrust in the world around them.

Autonomy Versus Shame and Doubt

Between the ages of 1 and 3, children begin to assert their independence by walking away from their mother, picking which toy to play with, and making choices about what they like to wear, to eat, and so on. If children in this stage are encouraged and supported in their increased independence, they become more confident and secure in their own ability to survive in the world. If children are criticized, overly controlled, or not given the opportunity to assert themselves, they begin to feel inadequate in their ability to survive, and may then become overly dependent upon others while lacking self-esteem and feeling a sense of shame or doubt in their own abilities.

Initiative Versus Guilt

Around age 3 and continuing to age 6, children assert themselves more frequently. They begin to plan activities, make up games, and initiate activities with others. If given this opportunity, children develop a sense of initiative, and feel secure in their ability to lead others and make decisions. Conversely, if this tendency is squelched, either through criticism or control, children develop a sense of guilt. They may feel like nuisances to others and will therefore remain followers, lacking self-initiative.

Industry Versus Inferiority

From age 6 to puberty, children begin to develop a sense of pride in their accomplishments. They initiate projects, see them through to completion, and feel good about what they have achieved. If children are encouraged and reinforced for their initiative, they begin to feel industrious and feel confident in their ability to achieve goals. If this initiative is not encouraged but instead 49restricted, children begin to feel inferior, doubting their abilities, and failing to reach their potential.

Identity Versus Role Confusion

During adolescence, the transition from childhood to adulthood is most important. Children are becoming more independent, and begin to look at the future in terms of career, relationships, families, housing, and so on. During this period, they explore possibilities and begin to form their own identities based upon the outcome of their explorations. This sense of who they are can be hindered, which results in a sense of confusion (" I don't know what I want to be when I grow up") about themselves and their role in the world.

Intimacy Versus Isolation

The sixth of Erikson's eight stages of development. Adults seek someone with whom to share their lives in an enduring and self-sacrificing commitment. Without such commitment, they risk profound loneliness and isolation.

Generativity Versus Stagnation

Erikson's seventh stage of psychosocial development, in which the middle-aged adult develops a concern with establishing, guiding, and influencing the next generation or else experiences stagnation (a sense of inactivity or lifelessness) During middle adulthood, individuals establish careers, settle down within relationships, begin families, and develop a sense of being a part of the bigger picture. They give back to society through raising children, being productive at work, and becoming involved in community activities and organizations. By failing to achieve these objectives, individuals become stagnant and feel unproductive.

Ego Integrity Versus Despair

eighth and final stage of Erikson's model of development in which the goal is to develop a sense of wholeness that comes from having lived a full life and the ability to let go of regrets, the final completion of the ego

Emotional Development

This area emphasizes many skills that increase self-awareness and self-regulation. Social skills and emotional development are reflected in the ability to pay attention, make transitions from one activity to another, and cooperate with others.

Cognitive Development (Piaget)

focuses on development in terms of information processing, conceptual resources, perceptual skill, language learning, and other aspects of brain development. It is the emergence of the ability to think and understand.

Cognitive Development: six levels of cognition:

1. Knowledge: rote memorization, recognition, or recall of facts 2. Comprehension: understanding what the facts mean 3. Application: correct use of the facts, rules, or ideas 51 4. Analysis: breaking down information into component parts 5. Synthesis: combination of facts, ideas, or information to make a new whole 6. Evaluation: judging or forming an opinion about the information or situation

Positive reinforcement:

Increasing behaviors by presenting positive stimuli, such as food. A positive reinforcer is any stimulus that, when presented after a response, strengthens the response.

Negative reinforcement:

Increasing behaviors by stopping or reducing negative stimuli, such as shock. A negative reinforcer is any stimulus that, when removed after a response, strengthens the response. (Note: negative reinforcement is not punishment.)

Positive punishment:

the administration of a stimulus to decrease the probability of a behavior's recurring

Negative punishment:

Removal of a desirable stimulus following a behavior for the purpose of decreasing or eliminating that behavior (i.e., removing something positive, such as a token or dessert).

Clients may have goals to learn in any of three domains of development:

Cognitive: mental skills (knowledge) 2. Affective: growth in feelings or emotional areas (attitude or self) 3. Psychomotor: manual or physical skills (skills)

Jean Piaget

Four stage theory of cognitive development: 1. sensorimotor, 2. preoperational, 3. concrete operational, and 4. formal operational. He said that the two basic processes work in tandem to achieve cognitive growth-assimilation and accomodation. was a developmental psychologist best known for his theory of cognitive development. His stages address the acquisition of knowledge and how humans come to gradually acquire it. Piaget's theory holds that children learn though interaction with the environment and others.

Piaget

also developed a theory of moral development, but the work by Lawrence Kohlberg is best known in this area. He agreed with Piaget's theory of moral development in principle, but wanted to develop the ideas further.

Lawrence Kohlberg's Theory of Moral Development

6 stages of moral development under three levels. Kohlberg believed that moral development parallels cognitive development.

Kohlberg's theory

holds that moral reasoning, which is the basis for ethical behavior, has six identifiable developmental constructive stagesâeach more adequate at responding to moral dilemmas than the last.

Preconventional

Kohlberg's stage of moral development in which rewards and punishments dominate moral thinking

conventional morality

second level of Kohlberg's stages of moral development in which the child's behavior is governed by conforming to the society's norms of behavior, early adolescence

postconventional morality

third level of Kohlberg's stages of moral development in which the person's behavior is governed by moral principles that have been decided on by the individual and that may be in disagreement with accepted social norms, adult

Learning Theory

is a conceptual framework describing how information is absorbed, processed, and retained during learning. Cognitive, emotional, and environmental influences, as well as prior experience, all play a part in how understanding, or a worldview, is acquired or changed, as well as how knowledge and skills are retained.

Behaviorist (Pavlov, Skinner)

learning is viewed through change in behavior and the stimuli in the external environment are the locus of learning. Social workers aim to change the external environment in order to bring about desired change.

Cognitive (Piaget)

learning is viewed through internal mental processes (including insight, information processing, memory, and perception) and the locus of learning is internal cognitive structures. Social workers aim to develop opportunities to foster capacity and skills to improve learning.

Humanistic (Maslow, Rogers)

learning is viewed as a person's activities aimed at reaching his or her full potential, and the locus of learning is in meeting cognitive and other needs. Social workers aim to develop the whole person.

learning is obtained between people and their environment and their interactions and observations in social contexts. Social workers establish opportunities for conversation and participation to occur.

Behavioral theories

suggest that personality is a result of interaction between the individual and the environment. These theories represent the systematic application of principles of learning to the analysis and treatment of behaviors. Behaviors determine feelings. Thus, changing behaviors will also change or eliminate undesired feelings. The goal is to modify behavior.

Behavioral theorists

study observable and measurable behaviors, rejecting theories that take internal thoughts and feelings into account. The focus is on observable behaviorâa target symptom, a problem behavior, or an environmental condition, rather than on the personality of a client.

Respondent Conditioning

involuntary behavior (anxiety, sexual response) that is automatically elicited by certain behavior. A stimulus elicits a response.

operant conditioning

voluntary behavior (walking, talking) that is controlled by its consequences in the environment.

RESPONDENT OR CLASSICAL CONDITIONING

learning occurs as a result of pairing previously neutral (conditioned) stimulus with an unconditioned (involuntary) stimulus so that the conditioned stimulus eventually elicits the response normally elicited by the unconditioned response (Pavlov)

OPERANT CONDITIONING

(B. F. Skinner): Antecedent events or stimuli precede behaviors, which, in turn, are followed by consequences. Consequences that increase the occurrence of the behavior are referred to as reinforcing consequences; consequences that decrease the occurrence of the behavior are referred to as punishing consequences. Reinforcement aims to increase behavior frequency, whereas punishment aims to decrease it.

Aversion therapy:

Any treatment aimed at reducing the attractiveness of a stimulus or a behavior by repeated pairing of it with an aversive stimulus. An example of this is treating alcoholism with Antabuse.

Antabuse

A drug that, when combined with alcohol, causes violent nausea; it is used to control a person's drinking.

Biofeedback:

Behavior training program that teaches a person how to control certain functions such as heart rate, blood pressure, temperature, and muscular tension. Biofeedback is often used for Attention-Deficit/ Hyperactivity Disorder (ADHD) and Anxiety Disorders.

Extinction (operant conditioning)

Withholding a reinforcer that normally follows a behavior. Behavior that fails to produce reinforcement will eventually cease. To ignore the behaviors

Flooding/exposure therapy

A treatment procedure in which a client's anxiety is extinguished by prolonged real or imagined exposure to high-intensity feared stimuli.

In Vivo Desensitization (Behavioral therapy)

Pairing and movement through a hierarchy of anxiety, from least to most anxiety provoking situations; takes place in "real" setting.

modeling therapy

Method of instruction that involves an individual (the model) demonstrating the behavior to be acquired by a client.

Rational emotive therapy (RET):

cognitively oriented therapy in which a social worker seeks to change a client's irrational beliefs by argument, persuasion, and rational reevaluation and by teaching a client to counter self-defeating thinking with new, nondistressing self-statements.

Time out

Removal of something desirableânegative punishment technique.

Token economy

an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats.

Human growth, development, and learning

become progressively complex over time and are influenced through a variety of experiences and interactions.

Child development

refers to the physical, mental, and socioemotional changes that occur between birth and the end of adolescence, as a child progresses from dependency to increasing autonomy.

Sexuality in infants and toddlers

Children are sexual even before birth. Males can have erections while still in the uterus, and some boys are born with an erection. Infants touch and rub their genitals because it provides pleasure. Little boys and girls can experience orgasm from masturbation, although boys will not ejaculate until puberty. By about age 2, children know their own gender. They are aware of differences in the genitals of males and females and in how males and females urinate.

Sexuality in children (age 3-7)

Preschool children are interested in everything about their world, including sexuality. They may practice urinating in different positions. They are highly affectionate and enjoy hugging other children and adults. They begin to be more social and may imitate adult social and sexual behaviors, such as holding hands and kissing. Many young children play "doctor" during this stage, looking at other children's genitals and showing theirs. This is normal curiosity. By age 5 or 6, most children become more modest and private about dressing and bathing. Children of this age are aware of marriage and understand living together, based on their family experience. They may role play about being married or having a partner while they "play house." Most young children talk about marrying and/ or living with a person they love when they get older. Most sex play at this age happens because of curiosity.

Sexuality in preadolescent youth (age 8-12)â

Puberty, the time when the body matures, begins between the ages of 9 and 12 for most children. 63Girls begin to grow breast buds and pubic hair as early as 9 or 10. Boys' development of the penis and testicles usually begins between 10 and 11. Children become more self-conscious about their bodies at this age and often feel uncomfortable undressing in front of others, even a same-sex parent. Masturbation increases during these years. Preadolescent boys and girls do not usually have much sexual experience, but they often have many questions. They usually have heard about sexual intercourse, homosexuality, rape, and incest, and they want to know more about all these things. The idea of actually having sexual intercourse, however, is unpleasant to most preadolescent boys and girls. Same-gender sexual behavior can occur at this age. Boys and girls tend to play with friends of the same gender and are likely to explore sexuality with them. Same-gender sexual behavior is unrelated to a child's sexual orientation.

Sexuality in adolescent youth (age 13-19)

Once youth have reached puberty and beyond, they experience increased interest in romantic and sexual relationships and in genital sex behaviors. As youth mature, they experience strong emotional attachments to romantic partners and find it natural to express their feelings within sexual relationships. There is no way to predict how a particular particular teenager will act sexually. Overall, most adolescents explore relationships with one another, fall in and out of love, and participate in sexual intercourse before the age of 20.

Adult sexuality

Adult men also experience some changes in their sexuality, but not at such a predictable time as with menopause in women. Men's testicles slow testosterone production after age 25 or so. Erections may occur more slowly once testosterone production slows. At around age 50, women experience menopause, which affects their sexuality in that their ovaries no longer release eggs and their bodies no longer produce estrogen. They may experience several physical changes. Vaginal walls become thinner and vaginal intercourse may be painful because there is less vaginal lubrication and the entrance to the vagina becomes smaller.

Theories of Spiritual Development throughout Lifespan

Individuals are unwilling to accept a will greater than their own.

Cultural, racial, and ethnic identities

are passed from one generation to the next through customs, traditions, language, religious practice, and cultural values. Current events, mainstream media, and popular literature also influence cultural, racial, and ethnic identities.

The first stage, unexamined cultural, racial, and ethnic identity,

is characterized by a lack of exploration of culture, race, and ethnicity and cultural, racial, and ethnic differencesâthey are rather taken for granted without much critical thinking. This is usually the stage reserved for childhood when cultural, racial, and ethnic ideas provided by parents, the community, or the media are easily accepted. Children at this stage tend not to be interested in culture, race, or ethnicity and are generally ready to take on the opinions of others.

The second stage of the model is referred to as the cultural, racial, and ethnic identity search

is characterized by the exploration and questioning of culture, race, and ethnicity in order to learn more about them and to understand the implications of belonging. During this stage, there is questioning of where beliefs come from and why they are held. For some, this stage may arise from a turning point in their lives or from a growing awareness of other cultures, races, and ethnicities. It can also be a very emotional time.

the third stage of the model is cultural, racial, and ethnic identity achievement.

Ideally, people at this stage have a clear sense of their cultural, racial, and ethnic identity and are able to successfully navigate it in the contemporary world, which is undoubtedly very interconnected and intercultural. The acceptance of cultural, racial, and ethnic identity may play a significant role in important life decisions and choices, influencing attitudes and behavior. This usually leads to an increase in self-confidence and positive psychological development.

Classic Model of Cultural, Racial and Ethnic Identity Development

refers to identity statuses rather than stages, because stages imply a linear progression of steps that may not occur for all.

Preencounter:

At this point, the client may not be consciously aware of his or her culture, race, or ethnicity and how it may affect his or her life.

Encounter:

client has an encounter that provokes thought about the role of cultural, racial, and ethnic identification in his or her life. This may be a negative or positive experience related to culture, race, and ethnicity. For minorities, this experience is often a negative one in which they experience discrimination for the first time.

Immersion-Emersion:

After an encounter that forces a client to confront cultural, racial, and ethnic identity, a period of exploration follows. A client may search for information and will also learn through interaction with others from the same cultural, racial, or ethnic groups.

Internalization and Commitment:

At this point, a client has developed a secure sense of identity and is comfortable socializing both within and outside the group with which he or she identifies.

Maslow's hierarchy of needs

implies that clients are motivated to meet certain needs. When one need is fulfilled, a client seeks to fulfill the next one, and so on. This hierarchy is often depicted as a pyramid. This five stage model can be divided into basic (or deficiency) needs (i.e., physiological, safety, social, and esteem) and growth needs (self-actualization).

Deficiency Needs (Maslow)

also known as D-Needs. Physiological Safety Social Esteem. Maslow called these needs "deficiency needs" because he felt that these needs arise due to deprivation. The satisfaction of these needs helps to "avoid" unpleasant feelings or consequence.

Growth Needs (Maslow)

Once basic needs are met, their is a need to know and understand things, to appreciate beauty, or to grow and develop in appreciation of others, which can be satisfied completely. In fact, the more people are able to meet their growth needs, the greater their motivation might become to learn more. The three high-level needs are: 1. self-actualization2. beauty3. knowledge & understanding

Physiological needs:

These needs maintain the physical organism. These are biological needs such as food, water, oxygen, and constant body temperature. If a person is deprived of these needs, he or she will die.

Safety Needs (Maslow)

There is a need to feel safe from harm, danger, or threat of destruction. Clients need regularity and some predictability.

Friendship, intimacy, affection, and love are neededâfrom one's work group, family, friends, or romantic relationships.

Esteem Needs (Maslow)

People need a stable, firmly based level of self-respect and respect from others.

Self-actualization needs

There is a need to be oneself, to act consistently with whom one is. Self-actualization is an ongoing process. It involves developing potential, becoming, and being what one is capable of being.

On the examination, Maslow's hierarchy of needs

is often not explicitly asked about, but it can be applied when asked about the order of prioritizing problems or issues with a client.

Attachment Theory (Bowlby)

originated with the seminal work of John Bowlby. Bowlby defined attachment as a lasting psychological connectedness between human beings that can be understood within an evolutionary context in which a care-giver provides safety and security for a child. Bowlby suggests that children come into the world biologically preprogrammed to form attachments with others, because this will help them to survive.

Monotropy (Bowlby)

this attachment figure acts as a secure base for exploring the world. Disrupting this attachment process can have severe consequences because the critical period for developing attachment is within the first 5 years of life.

There is another major theory of attachment

that suggests attachment is a set of learned behaviors.

The purpose of biopsychosocial assessments

is to gather information on functional capacity or everyday competenceâthe ability of older adults to care for themselves, manage their affairs, and live independent, quality lives in their communities. Assessments may also include diagnostic medical and physical evaluations.

The Impact of Aging Parents on Adult Children

Clients may want help in areas such as communication (i.e., understanding requests for assistance/ resistance of their parents), self-care (i.e., developing coping skills and attending to their own needs), and/ or resource identification (i.e., finding services to assist in meeting child/ parent needs).

Gerontology

study of the aging process

Personality Theories

theories attempt to explain both personality characteristics and the way these characteristics develop and impact behavior/ functioning. Theories that have this aim can be categorized as biological, behavioral, psychodynamic, humanist, or trait focused.

Biological Theory

theories suggest that genetics are responsible for personality. Research on heritability suggests that there is a link between genetics and personality traits.

Behavioral Theory

theories suggest that personality is a result of interaction between the individual and the environment. Behavioral theorists study observable and measurable behaviors, rejecting theories that take internal thoughts and feelings into account.

psychodynamic theory

theories emphasize the influence of the unconscious mind and childhood experiences on personality.

Humanist Theory

Humanist theories emphasize the importance of free will and individual experience in the development of personality. Humanist theorists emphasized the concept of self-actualization, which is an innate need for personal growth that motivates behavior.

Trait Theory

Trait theories posit that the personality is made up of a number of broad traits. A trait is basically a relatively stable characteristic that causes an individual to behave in certain ways.

Conflict theory,

derived from the works of Karl Marx, posits that society is fragmented into groups that compete for social and economic resources.

According to conflict theory,

inequality exists because those in control of a disproportionate share of society's resources actively defend their advantages. The masses are bound by coercion by those in power. This perspective emphasizes social control, not consensus and conformity. Groups and individuals advance their own interests, struggling over control of societal resources.

Conflict theorists

challenge the status quo, encourage social change, and believe rich and powerful people force social order on the poor and the weak. Conflict theorists note that unequal groups usually have conflicting values and agendas, causing them to compete against one another. This constant competition between groups forms the basis for the ever-changing nature of society.

Self-image

is how a client defines himself or herself, which is often tied to physical description (i.e., tall, thin), social roles (i.e., mother, student), personal traits (i.e., worthy, generous), and/ or existential beliefs (i.e., one with the world, a spiritual being). It is how a client sees himself or herself.

Body image

is the way one perceives and relates to his or her body, and how one thinks he or she is seen.

Factors associated with positive body image:

Acceptance and appreciation of natural body shape and body differences Self-worth not tied to appearance Confidence in and comfort with body An unreasonable amount of time is not spent worrying about food, weight, or calories Judgment of others is not made related to their body weight, shape, and/ or eating or exercise habits Knowing physical appearance says very little about character and value as a person

Factors of negative body image:

Distorted perception of shape or body parts, unlike what they really are Believing only other people are attractive and that body size or shape is a sign of personal failure Feeling body doesn't measure up to family, social, or media ideals Ashamed, self-conscious, and anxious about body Uncomfortable and awkward in body Constant negative thoughts about body and comparisons to others

Some possible effects of a negative body image:

Emotional distress Low self-esteem Unhealthy dieting habits Anxiety Depression Eating disorders Social withdrawal or isolation

PARENTING SKILLS AND CAPACITIES

Although there are very few actual cause-and-effect links between specific actions of parents and later behavior of children, there are four distinct parenting styles that seem to impact behavior later in life.

Authoritarian Parenting

Children are expected to follow the strict rules established by the parents. Failure to follow such rules usually results in punishment. Authoritarian parents fail to explain the reasoning behind these rules. Authoritarian parenting styles generally lead to those who are obedient and proficient, but are lower in happiness, social competence, and self-esteem.

authoritative parenting style

Like authoritarian parents, those with an authoritative parenting style establish rules and guidelines that their children are expected to follow. However, this parenting style is much more democratic. Authoritative parents are responsive to their children and willing to listen to questions. When children fail to meet the expectations, these parents are more nurturing and forgiving rather than punishing. Authoritative parenting styles generally tend to result in those who are happy, capable, and successful.

permissive parenting style

Permissive parents have very few demands on their children. These parents rarely discipline their children and are generally nurturing and communicative with their children, often taking on the status of a friend more than that of a parent. Permissive parenting often results in children who rank low in happiness and self-regulation, experiencing problems with authority and tending to perform poorly in school.

uninvolved parenting style

An uninvolved parenting style is characterized by few demands, low responsiveness, and little communication. Although these parents fulfill basic needs, they are generally detached from their children's lives. Those who have experienced uninvolved parenting styles rank lowest across all life domains. They tend to lack self-control, have low self-esteem, and are less competent than their peers.

Feminist Theory

analyzes the status of women and men in society with the purpose of using that knowledge to better women's lives.

Feminist theorists

question the differences between women and men, including how race, class, ethnicity, sexuality, nationality, and age intersect with gender. Themes that are studied include discrimination, objectification (especially sexual objectification), oppression, stereotyping, and so on. Feminist theory is used in the fields of social work, sociology, economics, education, and others.

Feminism

is a political, cultural, or economic movement aimed at establishing equal rights and legal protection for women.

out-of-home placement

is generally viewed as an intervention that only occurs when there is a health or safety risk in the home. Individuals who are placed outside of their homes often experience significant life problems. children who are removed from their homes due to abuse and/ or neglect typically are higher users of mental health or other social services than before they were placed away from their parents. These children often report a high level of stress, which may manifest in substance abuse, chronic aggressive or destructive behavior, suicidal ideation or acting out, and/ or patterns of runaway behavior. Academic problems are also common among these children.

BASIC PRINCIPLES OF HUMAN GENETICS

Social workers in all settings must educate themselves about the process of genetic inheritance and understand the primary reasons that clients seek genetic testing and counseling.

THE FAMILY LIFE CYCLE

The emotional and intellectual stages from childhood to retirement as a member of a family

Stage 1: Family of origin experiences

Main tasks Maintaining relationships with parents, siblings, and peers Completing education Developing the foundations of a family life

stage 2: leaving home (family life cycle)

Main tasks Differentiating self from family of origin and parents and developing adult-to-adult relationships with parents Developing intimate peer relationships Beginning work, developing work identity, and financial independence

stage 3: premarriage stage (family life cycle)

Main tasks Selecting partners Developing a relationship Deciding to establish own home with someone

stage 4: childless couple stage (family life cycle)

Developing a way to live together both practically and emotionally Adjusting relationships with families of origin and peers to include partner

Stage 5: Family with young children (family life cycle)

Main tasks Realigning family system to make space for children Adopting and developing parenting roles Realigning relationships with families of origin to include parenting and grandparenting roles Facilitating children to develop peer relationships

Stage 6: Family with adolescents (family life cycle)

Adjusting parent-child relationships to allow adolescents more autonomy Adjusting family relationships to focus on midlife relationship and career issues Taking on responsibility of caring for families of origin

stage 7: launching children (family life cycle)

Resolving midlife issues Negotiating adult-to-adult relationships with children Adjusting to living as a couple again Adjusting to including in-laws and grandchildren within the family circle Dealing with disabilities and death in the family of origin

stage 8: later family life (family life cycle)

Coping with physiological decline in self and others Adjusting to children taking a more central role in family maintenance Valuing the wisdom and experience of the elderly Dealing with loss of spouse and peers Preparing for death, life review, and reminiscence

Family life cycle theory

suggests that successful transitioning may also help to prevent disease and emotional or stress-related disorders.

Family dynamics

are the patterns of relating or interactions between family members. Each family system and its dynamics are unique, although there are some common patterns. All families have some helpful and some unhelpful dynamics.

Family dynamics often

have a strong influence on the way individuals see themselves, others, and the world, and influence their relationships, their behaviors, and their well-being.

Healthy functioning is characterized by:

Treating each family member as an individual Having regular routines and structure Being connected to extended family, friends, and the community Having realistic expectations Spending quality time, which is characterized by fun, relaxed, and conflict-free interactions Ensuring that members take care of their own needs and not just the family needs Helping one another through example and direct assistance

Theories of Couples Development

there are some predictable stages that characterize intimate relationships. Couples interactions follow a developmental model, much like those that explain individual growth throughout the life course.

Stage 1: Romance (couple development)

The first stage of couples development begins when individuals are introduced and learn that they have common interests and are attracted to one another. Much of this stage consists of conversations and dates to learn more about the other partner. The focus of this stage is attachment. Like early stages of child development, the infancy of couples development is filled with passion, nurturing, and selfless attention to the needs of others. Differences are minimized and partners place few demands on each other. This romantic bond is the foundation that is critical to the health of the relationship in the future. In this first stage, members engage in symbiotic or mutualistic relationshipsâoften putting the needs of others before their own.

Stage 2: Power Struggle (couple development)

As the coupled individuals begin to notice differences and annoyances that were once overlooked, there can be greater separation and loss of romance resulting from self-expression. This stage differs as individuals focus on differences rather than similarities, which was the hallmark of the initial romantic stage. 83 Time away from each other is often needed for the partners, and the bliss associated with the initial stage of couples development dissolves. Differentiation, or seeing oneself as distinct within a relationship, must be managed so that these new feelings do not result in breakups as the illusion of "being one" fades. Critical effort must be made to balance the desire for self-discovery with the desire for intimacy. To "survive" this stage, individuals must acknowledge differences, learn to share power, forfeit fantasies of complete harmony, and accept partners without the need to change them.

Stage 3: Stability (couple development)

This stage in couples development is characterized by the redirection of personal attention, time, and activities away from partners and toward one's self. Individuals focus on personal needs in a manner that is respectful of others. Autonomy and individuality are key. Relationships are seen as more mature as disagreements can occur with both parties "winning." There is acceptance that partners are different from one another, and power struggles to minimize these differences are avoided.

Margaret Mahler described practicing

as a subphase of separation-individuation in infant development. Practicing occurs when toddlers begin to explore on their own but still see themselves as part of their mothers/ caregivers. The stability stage of couples development mirrors this subphase as partners learn to live independent lives while still identifying as and seeing the value of being part of an intimate relationship.

Another subphase of separation-individuation identified by Mahler,

"rapprochement," also relates to the stability stage of couples development. Often, partners who have been successful in achieving a well-defined sense of self in relationships will have crises that will threaten their identities or separateness. They may rely more heavily on companionship and intimacy, seeking more comfort and support from each other. Thus, the stability stage is a time when there is still some back and forth between intimacy and independence with the ultimate goal being intimacy that does not sacrifice separateness.

Stage 4: Commitment

While the commitment stage of couples development is when marriage is ideal, it often occurs earlier in the romance stage, perhaps explaining the high rates of divorce caused by the inability to resolve power struggles. Individuals who have stabilized are able to embrace the reality that both partners are human, resulting in shortcomings in all relationships. Partners acknowledge that they want to be with each other and that the good outweighs the bad. Although much work has been done in building relationships, there is still more needed to effectively function in the next and last stage of couplehood.

Stage 5: Co-Creation

Constancy is the hallmark of this last stage. Just like children who are able to internalize and maintain images of their mothers/ caregivers and use them to soothe in stressful moments, couples in this stage are able to do something similar. Each partner is able to value and respect the separateness of 84the other. The foundation of the relationship is no longer personal need, but the appreciation and love of the other and the support and respect for mutual growth. Often, couples in this stage work on projects together, such as businesses, charities, and/ or families. This stage aims to make a contribution beyond the relationship itself. Like Erik Erikson's stage of psychosocial functioning in middle adulthood, which focuses on the crisis of generativity versus stagnation, this stage of couples development development aims to create or nurture things that are enduring, often by creating positive change that benefits other people. Success leads to feelings of usefulness and accomplishment.

THE IMPACT OF PHYSICAL AND MENTAL ILLNESS ON FAMILY DYNAMICS

The impact of mental illness on family dynamics also can be profound. Mental illness of a family member affects all aspects of family functioning, including physical, financial, and emotional well-being. These impacts often depend upon the relationship of family members to a person with a mental illness. This can cause problems and tension within the family, as well as isolation and loss of meaningful relationships with those who are not supportive of the illness. Family members may be bewildered, frightened, and exhausted. Family members may become angry. If the illness is not stable, families go from crisis to crisis, feeling that they have no control over what is happening.

Defense mechanisms

are behaviors that protect people from anxiety. Defense mechanisms are automatic, involuntary, usually unconscious psychological activities to exclude unacceptable thoughts, urges, threats, and impulses from awareness for fear of disapproval, punishment, or other negative outcomes. Defense mechanisms are sometimes confused with coping strategies, which are voluntary.

Acting Out

emotional conflict is dealt with through actions rather than feelings (i.e., instead of talking about feeling neglected, a person will get into trouble to get attention).

Compensation

enables one to make up for real or fancied deficiencies (i.e., a person who stutters becomes a very expressive writer; a short man assumes a cocky, overbearing manner).

Conversion

repressed urge is expressed disguised as a disturbance of body function, usually of the sensory, voluntary nervous system (as pain, deafness, blindness, paralysis, convulsions, tics).

decompensation stage

deterioration of existing defenses.

Denial

primitive defense; inability to acknowledge true significance of thoughts, feelings, wishes, behavior, or external reality factors that are consciously intolerable.

Devaluation

defense mechanism frequently used by persons with borderline personality organization in which a person attributes exaggerated negative qualities to self or another. It is the split of primitive idealization.

Dissociation

a process that enables a person to split mental functions in a manner that allows him or her to express forbidden or unconscious impulses without taking responsibility for the action, either because he or she is unable to remember the disowned behavior, or because it is not experienced as his or her own (i.e., pathologically expressed as fugue states, amnesia, or dissociative neurosis, or normally expressed as daydreaming).

Displacement

directing an impulse, wish, or feeling toward a person or situation that is not its real object, thus permitting expression in a less threatening situation (i.e., a man angry at his boss kicks his dog).

Idealization

overestimation of an admired aspect or attribute of another.

Identification

universal mechanism whereby a person patterns himself or herself after a significant other. Plays a major role in personality development, especially superego development.

Identification With the Aggressor

mastering anxiety by identifying with a powerful aggressor (such as an abusing parent) to counteract feelings of helplessness and to feel powerful oneself. Usually involves behaving like the aggressor (i.e., abusing others after one has been abused oneself).

Incorporation

primitive mechanism in which psychic representation of a person is (or parts of a person are) figuratively ingested.

Inhibition

loss of motivation to engage in (usually pleasurable) activity avoided because it might stir up conflict over forbidden impulses (i.e., writing, learning, or work blocks or social shyness).

Introjection: Defense Mechanism

loved or hated external objects are symbolically absorbed within self (converse of projection; i.e., in severe depression, unconscious unacceptable hatred is turned toward self).

Intellectualization Defense Mechanism

- An attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual process of logic, reasoning and analysis.

Isolation of affect (defense mechanism)

unacceptable impulse, idea, or act is separated from its original memory source, thereby removing the original emotional charge associated with it.

Projection

primitive defense; attributing one's disowned attitudes, wishes, feelings, and urges to some external object or person.

Projective Identification

a form of projection utilized by persons with borderline personality disorderâunconsciously perceiving others' behavior as a reflection of one's own identity.

Rationalization (defense mechanism)

third line of defense; not unconscious. Giving believable explanation for irrational behavior; motivated by unacceptable unconscious wishes or by defenses used to cope with such wishes.

reaction formation (defense mechanism)

person adopts affects, ideas, attitudes, or behaviors that are opposites of those he or she harbors consciously or unconsciously (i.e., excessive moral zeal masking strong, but repressed asocial impulses or being excessively sweet to mask unconscious anger).

Regression

psychoanalytic defense mechanism in which an individual faced with anxiety retreats to a more infantile psychosexual stage, where some psychic energy remains fixated.

Repression (defense mechanism)

key mechanism; expressed clinically by amnesia or symptomatic forgetting serving to banish unacceptable ideas, fantasies, affects, or impulses from consciousness.

Splitting

defensive mechanism associated with borderline personality disorder in which a person perceives self and others as "all good" or "all bad." Splitting serves to protect the good objects. A person cannot integrate the good and bad in people.

sublimation (defense mechanism)

potentially maladaptive feelings or behaviors are diverted into socially acceptable, adaptive channels (i.e., a person who has angry feelings channels them into athletics).

Substitution

unattainable or unacceptable goal, emotion, or object is replaced by one more attainable or acceptable.

Symbolization

a mental representation stands for some other thing, class of things, or attribute. This mechanism underlies dream formation and some other symptoms (such as conversion reactions, obsessions, compulsions) with a link between the latent meaning of the symptom and the symbol; usually unconscious.

Turning Against Self

defense to deflect hostile aggression or other unacceptable impulses from another to self.

Undoing: Defense Mechanism

a person uses words or actions to symbolically reverse or negate unacceptable thoughts, feelings, or actions (i.e., a person compulsively washing hands to deal with obsessive thoughts).

ADDICTION THEORIES AND CONCEPTS: Family

Parents, siblings, and/ or spouse use substances; family dysfunction (i.e., inconsistent discipline, poor parenting skills, lack of positive family rituals and routine); family trauma (i.e., death, divorce)

Peers use drugs and alcohol; social or cultural norms condone use of substances; expectations about positive effects of drugs and alcohol; drugs and alcohol are available and accessible

ADDICTION THEORIES AND CONCEPTS: Psychiatric:

Depression, anxiety, low self-esteem, low tolerance for stress; other mental health disorders; feelings of desperation; loss of control over one's life

ADDICTION THEORIES AND CONCEPTS: Behavioral:

Use of other substances; aggressive behavior in childhood; impulsivity and risk-taking; rebelliousness; school-based academic or behavioral problems; poor interpersonal relationships

Biopsychosocial model:

There are a wide variety of reasons why people start and continue using substances. This model provides the most comprehensive explanation for the complex nature of substance abuse disorders. It incorporates hereditary predisposition, emotional and psychological problems, social influences, and environmental problems.

Medical Model of Addiction

Addiction is considered a chronic, progressive, relapsing, and potentially fatal medical disease. Genetic causes: Inherited vulnerability to addiction, particularly alcoholism Brain reward mechanisms: Substances act on parts of the brain that reinforce continued use by producing pleasurable feelings Altered brain chemistry: Habitual use of substances alters brain chemistry and continued use of substances is required to avoid feeling discomfort from a brain imbalance

Self-medication model:

Substances relieve symptoms of a psychiatric disorder and continued use is reinforced by relief of symptoms.

Family and environmental model:

Explanation for substance abuse can be found in family and environmental factors such as behaviors shaped by family and peers, personality factors, physical and sexual abuse, disorganized communities, and school factors.

Drug use is learned and reinforced from others who serve as role models. A potential substance abuser shares the same values and activities as those who use substances. There are no controls that prevent use of substances. Social, economic, and political factors, such as racism, poverty, sexism, and so on, contribute to the cause.

substance use disorder criteria

Disorder in Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) combines the DSM-IV categories of Substance Abuse and Substance Dependence into a single disorder measured on a 90continuum from mild to severe. Each specific substance (other than caffeine, which cannot be diagnosed as a substance use disorder) is addressed as a separate use disorder (Alcohol Use Disorder, Stimulant Use Disorder, etc.). Mild Substance Use Disorder in DSM-5 requires two to three symptoms from a list of 11. Drug craving is added to the list, and problems with law enforcement is eliminated because of cultural considerations that make the criteria difficult to apply.

Gambling Disorder is the sole condition in a new category on behavioral addictions. Its inclusion here reflects research findings that Gambling Disorder is similar to Substance-Related Disorders in clinical expression, brain origin, comorbidity, physiology, and treatment.

Goals of Treatment Substance Disorder

1. Abstinence from substances 2. Maximizing life functioning 3. Preventing or reducing the frequency and severity of relapse

Harm Reduction Model

refers to any program, policy, or intervention that seeks to reduce or minimize the adverse health and social consequences associated with substance use without requiring a client to discontinue use. This definition recognizes that many substance users are unwilling or unable to abstain from use at any given time and that there is a need to provide them with options that minimize the harm that continued drug use causes to themselves, to others, and to the community.

Stages of Treatment: substance abuse disorder

Stabilization: Focus is on establishing abstinence, accepting a substance abuse problem, and committing oneself to making changes 2. Rehabilitation/ habilitation: Focus is on remaining substance-free by establishing a stable lifestyle, developing coping and living skills, increasing supports, and grieving loss of substance use 91 3. Maintenance: Focus is on stabilizing gains made in treatment, relapse prevention, and termination

use of cocaine can be associated with

dilated pupils, hyperactivity, restlessness, perspiration, anxiety, and impaired judgment.

Delirium tremens (DTs)

is a symptom associated with alcohol withdrawal that includes hallucinations, rapid respiration, temperature abnormalities, and body tremors.

Wernicke's encephalopathy and Korsakoff's syndrome

are disorders associated with chronic abuse of alcohol. They are caused by a thiamine (vitamin B1) deficiency resulting from the chronic consumption of alcohol. A person with Korsakoff's syndrome has memory problems. Treatment is administration of thiamine.

Medication-assisted treatment interventions

assist with interfering with the symptoms associated with use. For example, methadone, a synthetic narcotic, can be legally prescribed. A client uses it to detox from opiates or on a daily basis as a substitute for heroin. Antabuse is a medication that produces highly unpleasant side effects (flushing, nausea, vomiting, hypotension, and anxiety) if a client drinks alcohol; it is a form of "aversion therapy." Naltrexone is a drug used to reduce cravings for alcohol; it also blocks the effects of opioids.

Psychosocial or psychological interventions

modify maladaptive feelings, attitudes, and behaviors through individual, group, marital, or family therapy. These therapeutic interventions also examine the roles that are adopted within families in which substance abuse occurs; for example, the "family hero," "scapegoat," "lost child," or "mascot" (a family member who alleviates pain in the family by joking around).

Behavioral therapies: substance abuse disorder

ameliorate or extinguish undesirable behaviors and encourage desired ones through behavior modification.

Self-help groups (Alcoholics Anonymous, Narcotics Anonymous) is

provide mutual support and encouragement while becoming abstinent or in remaining abstinent. Twelve-step groups are utilized throughout all phases of treatment. After completing formal treatment, the recovering person can continue attendance indefinitely as a means of maintaining sobriety.

SYSTEMS AND ECOLOGICAL PERSPECTIVES AND THEORIES

A system is a whole comprising component parts that work together. Applied to social work, systems theory views human behavior through larger contexts, such as members of families, communities, and broader society. Important to this theory is the concept that when one thing changes within a system, the whole system is affected. Systems tend toward equilibrium and can have closed or open boundaries.

Closed system

Uses up its energy and dies

Differentiation

Becoming specialized in structure and function

Entropy

Closed, disorganized, stagnant; using up available energy

Equifinality

Arriving at the same end from different beginnings

Homeostasis

A tendency to maintain a balanced or constant internal state; the regulation of any aspect of body chemistry, such as blood glucose, around a particular level

Input

Obtaining resources from the environment that are necessary to attain the goals of the system

Negative entropy (systems theory)

Exchange of energy and resources between systems that promote growth and transformation

Open Systems Theory

A system with cross-boundary exchange

output

A product of the system that exports to the environment

Subsystem

A major component of a system made up of two or more interdependent components that interact in order to attain their own purpose( s) and the purpose( s) of the system in which they are embedded

Suprasystem (systems theory)

An entity that is served by a number of component systems organized in interacting relationships

Throughput

Energy that is integrated into the system system so it can be used by the system to accomplish its goals

ROLE THEORIES

A role is defined as the collection of expectations that accompany a particular social position. Clients have multiple roles in their lives; in different contexts or with different people, such as being students, friends, employees, spouses, or parents. Each of these roles carries its own expectations about appropriate behavior, speech, attire, and so on. What might be rewarded in one role would be unacceptable for another

Role theory examines

how these roles influence a wide array of psychological outcomes, including behavior, attitudes, cognitions, and social interaction. There are some important terms used in role theory.

Role ambiguity:

lack of clarity of role

Role complementarity:

the role is carried out in an expected way (i.e., parent-child; social worker-client)

Role discomplementarity:

role expectations of others differs from one's own

role reversal

when two or more individuals switch roles

Role conflict:

incompatible or conflicting expectations

THEORIES OF GROUP DEVELOPMENT AND FUNCTIONING

Humans are small group beings. Group work is a method of social work that helps individuals to enhance their social functioning through purposeful group experiences, as well as to cope more effectively with their personal, group, or community problems. In group work, individuals help each other in order to influence and change personal, group, organizational, and community problems. A social worker focuses on helping each member change his or her environment or behavior through interpersonal experience. Members help each other change or learn social roles in the particular positions held or desired in the social environment.

A therapeutic group provides

provides a unique microcosm in which members, through the process of interacting with each other, gain more knowledge and insight into themselves for the purpose of making changes in their lives. The 94goal of the group may be a major or minor change in personality structure or changing a specific emotional or behavioral problem.

Individual self-actualization occurs through:

Release of feelings that block social performance Support from others (not being alone) Orientation to reality and check out own reality with others Reappraisal of self

Some types of groups include:

Groups centered on a shared problem Counseling groups Activity groups Action groups Self-help groups Natural groups Closed versus open groups Structured groups Crisis groups Reference groups (similar values)

Psychodrama Groups

is a treatment approach in which roles are enacted in a group context. Members of the group re-create their problems and devote themselves to the role dilemmas of each member.

The stages of group development are:

1. Preaffiliationâdevelopment of trust (known as forming) 2. Power and controlâstruggles for individual autonomy and group identification (known as storming) 3. Intimacyâutilizing self in service of the group (known as norming) 4. Differentiationâacceptance of each other as distinct individuals (known as performing) 5. Separation/ terminationâindependence (known as adjourning)

Groups help through:

Instillation of hope Universality Altruism Interpersonal learning Self-understanding and insight

Factors affecting group cohesion include:

Group size Homogeneity: similarity of group members Participation in goal and norm setting for group Interdependence: dependent on one another for achievement of common goals Member stability: frequent change in membership results in less cohesiveness

Groupthink

is when a group makes faulty decisions because of group pressures. Groups affected by groupthink ignore alternatives and tend to take irrational actions that dehumanize other groups. A group is especially vulnerable to group-think when its members are similar in background, when the group is insulated from outside opinions, and when there are no clear rules for decision making.

illusion of invulnerability (groupthink)

excessive optimism is created that encourages taking extreme risks.

Collective rationalization (Irving Janis's Groupthink)

members discount warnings and do not reconsider their assumptions.

belief in the inherent morality of the group

members believe in the rightness of their cause and ignore the ethical or moral consequences of their decisions.

Stereotyped views of those "on the out"-groupthink

negative views of the "enemy" make conflict seem unnecessary.

Direct pressure on dissentersâ groupthink

members are under pressure not to express arguments against any of the group's views.

self-censorship (groupthink)

doubts and deviations from the perceived group consensus are not expressed.

illusion of unanimity (groupthink)

the majority view and judgments are assumed to be unanimous.

Self-appointed "mindguards"â groupthink

members protect the group and the leader from information that is problematic or contradictory to the group's cohesiveness, views, and/ or decisions.

Group polarization

occurs during group decision making when discussion strengthens a dominant point of view and results in a shift to a more extreme position than any of the members would adopt on their own. These more extreme decisions are toward greater risk if individuals' initial tendencies are to be risky and toward greater caution if individuals' initial tendencies are to be cautious.

Community development is ultimately about getting community members working together in collective action to tackle problems that many individuals may be experiencing or to help in achieving a shared dream that many individuals will benefit from.

INTERPERSONAL RELATIONSHIPS

The contacts a person has with many different people

Family systems theory

searches for the causes of behavior, not in the individual alone, but in the interactions among the members of a group. The basic rationale is that all parts of the family are interrelated. Further, the family has properties of its own that can be known only by looking at the relationships and interactions among all members.

The family systems approach is based on several basic assumptions:

Each family is more than a sum of its members. Each family is unique, due to the infinite variations in personal characteristics and cultural and ideological styles. A healthy family has flexibility, consistent structure, and effective exchange of information. The family is an interactional system whose component parts have constantly shifting boundaries and varying degrees of resistance to change. Families must fulfill a variety of functions for each member, both collectively and individually, if each member is to grow and develop. Families strive for a sense of balance or homeostasis.

Negative feedback loops

are those patterns of interaction that maintain stability or constancy while minimizing change.

Positive feedback loops,

in contrast, are patterns of interaction that facilitate change or movement toward either growth or dissolution.

The concept of hierarchies

describes how families organize themselves into various smaller units or subsystems that are comprised by the larger family system. When the members or tasks associated with each subsystem become blurred with those of other subsystems, families have been viewed as having difficulties. For example, when a child becomes involved in marital issues, difficulties often emerge that require intervention.

Boundaries occur

at every level of the system and between subsystems. Boundaries influence the movement of people and the flow of information into and out of the system. Some families have very open boundaries where members and others are allowed to freely come and go without much restriction; in other families, there are tight restrictions on where family members can go and who may be brought into the family system. Boundaries also regulate the flow of information in a family. In more closed families, the rules strictly regulate what information may be discussed and with whom. In contrast, information may flow more freely in families that have more permeable boundaries.

The concept of interdependence is critical

in the study of family systems. Individual family members and the subsystems comprised by the family system are mutually influenced by and are mutually dependent upon one another. What happens to one family member, or what one family member does, influences other family members.

Genograms

are diagrams of family relationships beyond a family tree allowing a social worker and client to visualize hereditary patterns and psychological factors. They include annotations about the medical history and major personality traits of each family member. Genograms help uncover intergenerational patterns of behavior, marriage choices, family alliances and conflicts, the existence of family secrets, and other information that will shed light on a family's present situation.

Family life education aims to strengthen individual and family life through a family perspective. Social workers are well suited to work with a client within the family context, which is essential for such a model. Much of family life education is delivered through parenting classes, premarriage education, marriage enrichment programs, and/ or family financial planning courses. All of these activities focus on improving a client's quality of life individually and, equally as important, within his or her family unit. Social workers use a strengths perspective, as well as their knowledge of human development, systems and social role theories, and ecological or "person-in-environment (PIE)" influences, when engaging in family life education.

STRENGTHS-BASED AND RESILIENCE THEORIES

The strengths perspective is based on the assumption that clients have the capacity to grow, change, and adapt (humanistic approach). Clients also have the knowledge that is important in defining and solving their problems (clients or families are experts about their own lives and situations); they are resilient and survive and thrive despite difficulties.

Strengths Perspective

focuses on understanding clients (or families) on the basis of their strengths and resources (internal and external) and mobilizing the resources to improve their situations.

Methods to enhance strengths include:

Collaboration and partnership between a social worker and client Creating opportunities for learning or displaying competencies Environmental modificationâenvironment is both a resource and a target of intervention

Emotional and psychological trauma

is the result of extraordinarily stressful events that destroy a sense of security, making a client feel helpless and vulnerable in a dangerous world.

Traumatic experience

often involve a threat to life or safety, but any situation that leaves a client feeling overwhelmed and alone can be traumatic, even if it does not involve physical harm. It is not the objective facts that determine whether an event is traumatic, but a subjective emotional experience of the event.

An event will most likely lead to emotional or psychological trauma if:

It happened unexpectedly There was not preparation for it There is a feeling of having been powerless to prevent it It happens repeatedly Someone was intentionally cruel It happened in childhood

A "crisis"

is an acute disruption of psychological homeostasis in which a client's usual coping mechanisms fail and there is evidence of distress and functional impairment.

1. Plan and conduct a thorough biopsychosocial-spiritual-cultural and lethality/ imminent danger assessment (Crisis)

A social worker must conduct a biopsychosocial-spiritual-cultural assessment covering a client's environmental supports and stressors, medical needs and medications, current use of drugs and alcohol, and internal and external coping methods and resources. Assessing lethality is first and foremost.

2. Make psychological contact and rapidly establish the collaborative relationship

In a crisis, a social worker must do this quickly, generally as part of assessment.

3. Identify the major problems, including crisis precipitants

A social worker should determine from a client why things have "come to a head." There is usually a "last straw," but a social worker should also find out what other problems a client is concerned about. It can also be useful to prioritize the problems in terms of which problems a client wants to work on first.

4. Encourage an exploration of feelings and emotions

A social worker should validate a client's feelings and emotions and let him or her vent about the crisis. The use of active listening skills, paraphrasing, and probing questions is essential. A social worker should also challenge maladaptive beliefs.

5. Generate and explore alternatives and new coping strategies

A social worker and a client must come up with a plan for what will help improve the current situation. Brainstorming possibilities and finding out what has been helpful in the past are critical.

6. Restore functioning through implementation of an action plan

This stage represents a shift from a crisis to a resolution. A client and a worker will begin to take the steps negotiated in the previous stage. This is also where a client will begin to make meaning of the crisis event.

7. Plan follow-up

Follow-up can take many forms as it can involve phone or in-person visits at specific intervals. A postcrisis evaluation may look at a client's current functioning and assess a client's progress.

PERSON-IN-ENVIRONMENT (PIE) THEORY

The PIE perspective highlights the importance of understanding individual behavior in light of the environmental contexts in which a client lives and acts. The perspective has historical roots in the social work profession. PIE is client-centered, rather than agency-centered.

Communication Theory

involves the ways in which information is transmitted; the effects of information on human systems; how people receive information from their own feelings, thoughts, memories, physical sensations, and environments; how they evaluate this information; and how they subsequently act in response to the information. Effective communication skills are one of the most crucial components of a social worker's job.

Silence

is very effective when faced with a client who is experiencing a high degree of emotion, 104because the silence indicates acceptance of these feelings.

Acceptance

An acknowledgment of "what is." Acceptance does not pass judgment on a circumstance and allows clients to let go of frustration and disappointment, stress and anxiety, regret and false hopes. Acceptance is the practice of recognizing the limits of one's control. Acceptance is not giving up or excusing other people's behavior behavior and allowing it to continue. Acceptance is not about giving in to circumstances that are unhealthy or uncomfortable. The main thing that gets in the way of acceptance is wanting to be in control.

cognitive dissonance theory

Arises when a person has to choose between two contradictory attitudes and beliefs. The most dissonance arises when two options are equally attractive. Three ways to reduce dissonance are to (a) reduce the importance of conflicting beliefs, (b) acquire new beliefs that change the balance, or (c) remove the conflicting attitude or behavior. This theory is relevant when making decisions or solving problems.

Context

The circumstances surrounding human exchanges of information.

double bind communication

Offering two contradictory messages and prohibiting the recipient from noticing the contradiction.

Echolalia

Repeating noises and phrases. It is associated with Catatonia, Autism Spectrum Disorder, Schizophrenia, and other disorders.

information processing theory

Responses to information that are mediated through one's perception and evaluation of knowledge received.

Information processing block

Failure to perceive and evaluate potentially useful new information.

Metacommunication

The context within which to interpret the content of the message (i.e., nonverbal communication, body language, vocalizations).

Nonverbal communications

Facial expression, body language, and posture can be potent forms of communication.

In communication, there are two types of content, manifest and latent.

Manifest content is the concrete words or terms contained in a communication, 106whereas latent content is that which is not visible, the underlying meaning of words or terms.

Psychodynamic theories

explain the origin of the personality. Although many different psychodynamic theories exist, they all emphasize unconscious motives and desires, as well as the importance of childhood experiences in shaping personality.

Psychoanalytic Theory

A theory developed by Freud that attempts to explain personality, motivation, and mental disorders by focusing on unconscious determinants of behavior

Freud believed that behavior and personality derive from the constant and unique interaction of conflicting psychological forces that operate at three different levels of awareness:

the preconscious, the conscious, and the unconscious.

conscious

awake, alert, aware of one's surroundings

preconscious

in Freud's theory, the level of consciousness in which thoughts and feelings are not conscious but are readily retrieveable to consciousness

unconscious

according to Freud, a reservoir of mostly unacceptable thoughts, wishes, feelings, and memories. According to contemporary psychologists, information processing of which we are unaware.

Id:

reservoir of instinctual energy that contains biological urges such as impulses toward survival, sex, and aggression. The id is unconscious and operates according to the pleasure principle, the drive to achieve pleasure and avoid pain.

Ego:

The component that manages the conflict between the id and the constraints of the real world. Some parts of the ego are unconscious, whereas others are preconscious or conscious. The ego operates according to the reality principle the awareness that gratification of impulses has to be delayed in order to accommodate the demands of the real world. The ego's role is to prevent the id from gratifying its impulses in socially inappropriate ways.

Ego-Syntonic/ Ego-Dystonic:

Syntonic = behaviors "in-sync" with ego (no guilt)Dystonic = behaviors "dis-in-sync" with ego (guilt)The ego's job is to determine the best course of action based on information from the id, reality, and the superego. When the ego is comfortable with its conclusion ps and behaviors, one is said to be ego-syntonic. However, if one is bothered by some of his/her behaviors, one would be ego-Dystonic (ego alien)

Ego strength (Psychoanalytic Theory)

The ability of the ego to effectively deal with the demands of the id, the superego and reality-helps to maintain emotional stability and cope with internal and external stress

Superego (Freud)

The moral component of personality. It contains all the moral standards learned from parents and society. The superego forces the ego to conform not only to reality, but also to its ideals of morality. Hence, the superego causes clients to feel guilty when they go against society's rules.

psychosexual stages of development

Freud believed that personality solidifies during childhood, largely before age 5. He proposed five stages of psychosexual development: the oral stage, the anal stage, the phallic stage, the latency stage, and the genital stage. He believed that at each stage of development, children gain sexual gratification or sensual pleasure from a particular part of their bodies. Each stage has special conflicts, and children's ways of managing these conflicts influence their personalities.

Fixation

is 108an inability to progress normally from one stage into another. When the child becomes an adult, the fixation shows up as a tendency to focus on the needs that were overgratified or overfrustrated.

Oedipus Complex (Freud)

a boy's sexual desires toward his mother and feelings of jealousy and hatred for the rival father

Castration Anxiety (Phallic Stage)

fear that father will castrate him if his desire for mom is discovered

oral stage

Freud's first stage of personality development, from birth to about age 2, during which the instincts of infants are focused on the mouth as the primary pleasure center.

Anal Stage (Freud)

1-3 years. The libido now becomes focused on the anus and the child derives great pleasure from defecating. The child is now fully aware that they are a person in their own right and that their wishes can bring them into conflict with the demands of the outside world (i.e. their ego has developed).

phallic stage

Freud's third stage of personality development, from about age 4 through age 7, during which children obtain gratification primarily from the genitals.

latency stage

the fourth psychosexual stage, in which the primary focus is on the further development of intellectual, creative, interpersonal, and athletic skills

genital stage

Freud's last stage of personality development, from the onset of puberty through adulthood, during which the sexual conflicts of childhood resurface (at puberty) and are often resolved during adolescence).

Individual Psychology (Adler)

Adler believed the main motivations for human behavior are not sexual or aggressive urges, but striving for perfection. The aim of this therapy is to develop a more adaptive lifestyle by overcoming feelings of inferiority and self centeredness and to contribute more toward the welfare of others. Compensation- the attempt to shed normal feelings of inferiority.

Self Psychology (Kohut)

Empathy creates a strong sense of self; lack of empathy creates a lack of self cohesion ... through regression, client experiences frustrated self-object needs

Mirroring: (self psychology)

behavior validates the child's sense of a perfect self

Idealization: (self psychology)

child borrows strength from others and identifies with someone more capable

twinship/twinning (self psychology)

child needs an alter ego for a sense of belonging

Ego Psychology

focuses on the rational, conscious processes of the ego. Ego psychology is based on an assessment of a client as presented in the present (here and now). Treatment focuses on the ego functioning of a client, because healthy behavior is under the control of the ego. It addresses: Behavior in varying situations Reality testing: perception of a situation 110 Coping abilities: ego strengths Capacity for relating to others The goal is to maintain and enhance the ego's control and management of stress and its effects.

Object Relations Theory

According to this theory, lifelong relationship skills are strongly rooted in early attachments with parents, especially mothers. Objects refer to people, parts of people, or physical items that symbolically represent either a person or part of a person. Object relations, then, are relationships to those people or items.

THE DYNAMICS AND EFFECTS OF LOSS, SEPARATION, AND GRIEF

Elisabeth KÃ¼bler-Ross outlined what has been the traditional five stages of grief. She originally developed this model based on her observations of people suffering from terminal illness. She later expanded her theory to apply to any form of personal loss, such as the death of a loved one, the loss of a job or income, major rejection, the end of a relationship or divorce, drug addiction, incarceration, the onset of a disease or chronic illness, and/ or an infertility diagnosis, as well as many tragedies and disasters (and even minor losses).

Denial and isolation stage

Shock is replaced with the feeling of "this can't be happening to me."

anger stage of grief

The emotional confusion that results from this loss may lead to anger and finding someone or something to blameâ" why me?"

bargaining stage

People look for ways to buy time, making promises and negotiating with their God, doctors, nurses or others for more time and for relief from pain and sufferingKubler-Ross Stages of Grief

Depression stage

Stage four of the grieving process when the grieving person is sad and depressed

Acceptance (stage of grief)

The person faces the reality of the loss and experiences closure.

static risk factors

Factors that cannot be changed by interventions such as past history of violent behavior or demographic information

Dynamic risk factors:

Attributes of the offender that can be altered through intervention, including level of education, employment skills, addiction issues, and cognitive thinking abilities, among others.

Is the most common practice, and happens directly with an individual client or family.

Macro system

A large system that includes organizations and communities

is social work with groups and communities

sexual orientation

an enduring sexual attraction toward members of either one's own sex (homosexual orientation) or the other sex (heterosexual orientation)

sexual behavior

What you think, say, and do about sex

sexual identity

which of the various categories of sexuality one identifies with

dysphoria,

sense of great unhappiness or dissatisfaction

Ethnocentrism

Belief in the superiority of one's nation or ethnic group.

Stratification

the uneven distribution of resources and privileges among participants in a group or culture

Pluralism

A state in which people of all races and ethnicities are distinct but have equal social standing

gender roles

expectations regarding the proper behavior, attitudes, and activities of males and females

Gender role theories

Those explanations of delinquent and criminal behaviour that focus on the role that gender plays in the lives and behaviours of both females and males.

gender fluidity

a flexible range of gender expression, which can change day-to-day and allows for less restrictive and stereotypical gender expectations

One of the 5 AP World themes is focused on ______ structure/systems. Includes development of family groups, gender roles and relations, ethnic and racial constructions and economic class.

Mental Status Exam (MSE)

A formal assessment of cognitive functions such as intelligence, thought processes, and capacity for insight.

differential diagnosis

a list of potential diagnoses compiled early in the assessment of the patient

comorbid

refers to the presence of two or more unrelated disease conditions at the same time in the same person

Contraindicated

not recommended under these circumstances

Delusion

A false belief or opinion

Disoriented

confused as to time or place; out of touch

Dissociation

a split in consciousness, which allows some thoughts and behaviors to occur simultaneously with others

endogenous depression

depression that appears to be produced from within (perhaps by chemical imbalances in the brain), rather than as a reaction to life events

Exogenous depression

caused by external events of psychosocial stressors

Folie a deux

Shared delusion. A person may develop delusional system as a result of close relationship with person who already has established system.

Hallucinations

false sensory experiences, such as seeing something in the absence of an external visual stimulus

hypomanic episode

less severe and less disruptive version of a manic episode that is one of the criteria for several mood disorders

Postmorbid

subsequent to the onset of an illness

Premorbid

referring to the period of time prior to a patient's illness

psychotic disorder

a psychological disorder in which a person loses contact with reality, experiencing irrational ideas and distorted perceptions

Euphoria

A feeling of great happiness or well-being

somatization disorder

a psychological disorder involving combinations of multiple physical complaints with no medical explanation

somatic symptoms

symptoms involving physical problems and/or concerns about medical symptoms

Co-occurring disorders

A client with a mental disorder and a substance abuse problem

aphasia

impairment of language, usually caused by left hemisphere damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing understanding).

Agnosia

the inability to recognize familiar objects.

Prosopagnosia

inability to recognize faces

Acalculia

acquired inability to perform calculations

Dysarthria

slurred speech

tinnitus

ringing in the ears

organic brain syndrome

Disturbance of attention, memory, intellect, and orientation; may have delusions or hallucinations.

fight or flight response

an emotional and physiological reaction to an emergency that increases readiness for action

psychotropic medications

drugs that mainly affect the brain and reduce many symptoms of mental dysfunctioning

tardive dyskinesia

involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors

Typical Antipsychotics

A class of older drugs to treat schizophrenia and related psychotic disorders primarily by reducing excess levels of dopamine in the brain.

atypical antipsychotics

Antipsychotics that do not have significant side effects common to older antipsychotics

antimanic drugs

used to treat bipolar disorder and include lithium and certain anticonvulsant drugs

Antidepressants

a class of psychotropic medications used for the treatment of depression

Benzodiazepines

drugs that lower anxiety and reduce stress

Stimulants

...

precomtemplation stage

when individuals are not yet genuinely thinking about changing

comtemplation stage

Uncertain of behavioral changes. Client is willing to look at pros and cons, but is not committed to working towards change.

preparation stage

stage of change in which people are getting ready to make a change within the coming month

action stage

Stage of change in which people are actively changing a negative behavior or adopting a new, healthy behavior

maintenance stage

In the client-agency relationship, the day-to-day interaction that, when successful, may go on for years.

Relapse Stage

Clients need renewed commitment and motivation b/c they have lost interest or become discouraged

ego strength

ability of the ego to effectively deal with the demands of the id. Ego and supergo, those with little ego strength may feel torn between competing depends while those with too much can become rigid. It helps to maintain emotional stability by coping with internal and external stress.

Unspecified Disorder

category is used when the clinician is unable to specify the reason or does not want to include the specific explanation (ex. unspecified ADHD)

Other specified disorder

allows SW to specify reason that criteria for a specific disorder is not met

agoraphobia

An abnormal fear of open or public places

Trichotillomania

a disorder characterized by the repeated pulling out of one's own hair

Excoriation Disorder

Recurrent skin picking resulting in skin lesions

Elimination Disorders

enuresis and encopresis

enuresis

bed wetting

Encopresis

a childhood disorder characterized by repeated defecating in inappropriate places, such as one's clothing

Hypersomnolence Disorder

Characterized by excessive sleepiness in spite of sleeping at least seven hours with at least one of the following: recurrent daytime sleep episodes, prolonged sleep for more than nine hours that is non-restorative, or difficulty being fully awake after abrupt awakening. Occurs at least three times a week for at least three months. Specifiers: with mental comorbidity, with medical condition, and with another sleep disorder. Additional specifiers: acute, subacute, and persistent. Severity is specified based on the frequency of difficulty maintaining daytime alertness: mild moderate and severe.

kleptomania

a continual urge to steal regardless of economic motive

pyromania

a compulsion to set things on fire

delirium

an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech.

schizoid personality disorder

a psychological disorder characterized by little interest or involvement in close relationships, even those with family members

schizotypal personality disorder

a psychological disorder characterized by several traits that cause problems interpersonally, including constricted or inappropriate affect; magical or paranoid thinking; and odd beliefs, speech, behavior, appearance, and perceptions

histrionic personality disorder

a personality disorder characterized by excessive emotionality and preoccupation with being the center of attention; emotional shallowness; overly dramatic behavior

paraphilic disorders

deviations in sexual behavior such as pedophilia, exhibitionism, fetishism, voyeurism, and so on

voyeuristic disorder

the practice of observing, to become aroused, an unsuspecting individual undressing or naked

Objective Data

information that is seen, heard, felt, or smelled by an observer; signs

subjective data

things a person tells you about that you cannot observe through your senses; symptoms

SOAP format

subjective, objective, assessment, plan

research design

specifies which research questions must be answered, how and when the data will be gathered, and how the data will be analyzed. It is the blueprint.

research data

Data used for the purpose of answering a proposed question or testing a hypothesis.

experimental research design

used to answer scientific questions by testing a hypothesis through the use of a series of carefully controlled steps

quasi-experimental design

Research method similar to an experimental design except that it makes use of naturally occurring groups rather than randomly assigning subjects to groups.

Pre-experimental designs

designs that offer little or no control over extraneous factors

single subject design

A wide variety of research designs that use a form of experimental reasoning called baseline logic to demonstrate the effects of the independent variable on the behavior of individual subjects.

randomized experiment

a study in which the investigator assigns the treatments to the experimental units at random

internal validity

extent to which we can draw cause-and-effect inferences from a study

external validity

extent to which we can generalize findings to real-world settings

Qualitative Research

informal research methods, including observation, following social media sites, in-depth interviews, focus groups, and projective techniques

Quantitative Research

structured responses that can be statistically tested to confirm insights and hypotheses generated via qualitative research or secondary data

descriptive statistics

numerical data used to measure and describe characteristics of groups. Includes measures of central tendency and measures of variation.

inferential statistics

numerical data that allow one to generalize- to infer from sample data the probability of something being true of a population

Reliability and Validity

two factors that make up a good psychological test

Reliablility

consistency of measurement

Validity

The ability of a test to measure what it is intended to measure

psychotherapy

treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth

implicit

implied

explicit

definite, clearly stated

Universalization

the generalization or normalization of behavior

clarification

(n.) the act of making clear or understandable, an explanation

Confrontation stage

Introjects are interpreted and exposed

interpretation

in psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight

Reframing and relabeling

stating problem in a different way so a client can see possible solutions

active listening

empathetic listening in which the listener echoes, restates, and clarifies. A feature of Rogers' client-centered therapy

Silence in communication

demonstrates acceptance and allows the client to compose their thoughts and provide further information

Questioning Techniques

Verbal and non-verbal prompting; restatement; reflective listening statements; active listening; wait time

Pharaphrasing

A counselor's response that restates the ocntent of hte clients precious statment

Reframing

the process of redefining events and experiences from a different point of view

Congruence

Agreement, harmony, or correspondence

Role Modeling

a process by which we imitate the behavior of another person we admire who is in a particular role

Live modeling

watching a real person perform the desired behavior

symbolic modeling

Social Learning Technique: Presentation of desired behaviors via audio or videotape, through written materials, or by observing another

participant modeling

technique in which a model demonstrates the desired behavior in a step-by-step, gradual process while the client is encouraged to imitate the model

covert modeling

clients are asked to use their imagination, visualizing a particular behavior as another describes the imaginary situation in detail.

harm reduction approach

a response to high-risk behaviours that focuses on reducing the harm such behaviours have on people's lives

brief interventions

During a crisis usually provide maximum therapeutic effect.

Partialization

Treating an individual's problems as not being connected with the purpose of pursuing separate solutions aimed at specific areas. This allows for prioritizing problems, treatment of problems needing immediate attention, and simplifying treatment to a more manageable level.

assertiveness training

a set of methods for helping clients learn to express their feelings and stand up for their rights in social situations

Task Centered Approach

Aims to quickly engage client in the problem-solving process and to maximize their responsibility for treatment outcomes

Psychoeducation

learning skills that improve daily functioning

Group work

a process that seeks to stimulate and support more adaptive personal functioning and social skills of individuals through structured group interaction

Contraindications for groups

Clients who are in crisis; suicidal; compulsive needed for attention; activity psychotic; and paranoid

open group

has a fluctuating number and new members are always accepted

Close group

Are those that all members join at the same time.

Strategic Family Therapy

Jay HaleyEmphasizes change techniques over theory. Influenced by Milton EricksonTherapist is very directive, especially useful with change-resistant familiesTechniques: Take charge role, directies, paradoxical directives, ordeals, out-positioning, reframing

Pretend Technique (Strategic Family Therapy)

Encourage family members to pretend and encourage voluntary control of behavior

First-order Changes (Strategic Family Therapy)

Superficial behavioral changes within a system that do not change the structure of the system

Second-order changes (Strategic Family Therapy)

Changes to the systematic interaction pattern so the system is reorganized and functions more effectively

family homeostasis

Tendency of families to resist change in order to maintain a steady state.

Relabeling (Strategic Family Therapy)

Changing the label attached to a person or problem from negative to positive so the situation can be perceived differently; it is hoped that new responses will evolve

Paradoxical directive or instruction (Strategic Family Therapy)

Prescribe the symptomatic behavior so a client realizes he or she can control it; uses the strength of resistance to change in order to move client toward goals

Structure family therapy

Stress the importance of family organization for the functioning of the group and the wellbeing's of it's members. Boundaries and rules determining what, where, and when are critical in three ways.

Interpersonal boundaries

Define individual family members and promote their differentiation and autonomous, yet interdependent, functioning (dysfunctional = rigid enmeshment or disengagement)

Boundaries (Structural Family Therapy)

2. Outside World: define family unit, boundaries must be permeable enough to maintain functioning open system allowing for contact and reciprocal changes

hierarchical organization

In family of all cultural is maintained by generalization boundaries, the rules, differentiating parents and child roles, rights and obligations.

restructuring

Is based on observing and manipulating interaction within therapy sessions, often by enacting of situations as a way to understand and diagnose the structure and provide an opportunity for reconstructing

Bowenian Family Therapy

Bowen's theory and therapeutic model is based on the family's emotional system, the differentiation of self within one's family, and the multi-generational transmission of emotions and family patterns.

Emotional triangle (Bowenian Family Therapy)

The network of relationships among 3 people- when anxiety is introduced with 2 people, a third party is recruited to reduce overall anxiety

Emotional Fusion

(Bowen) When family members share an emotional response due to lack of boundaries or emotional autonomy. Movement away from the family is experienced as abandonment.

Nuclear Family Emotional System

An unstable, fused family's way of coping with stress, typically resulting in marital conflict, dysfunction in a spouse, or psychological impairment of a child; their pattern is likely to mimic the patterns of past generations and to be repeated in future generations.

family projection process (Bowen)

undifferentiated parents project tensions and anxiety onto the most susceptible /sensitive child/ This causes triangulation, the child become symptomatic and the parents focus on the child, rather than on themselves.

Sibling position (Bowenian Family Therapy)

- a factor in determining personality; birth order has an influence on how he/she relates to parents and siblings

Societal regression (Bowenian Family Therapy)

Bowen views society as a family with multi generational transmission, chronic anxiety, emotional triangles, cutoffs, projection processes, and fusion/differentiation strugglesmanifest by problems such as depletion of natural resources, contrast to progression

insight-oriented psychotherapy

face-to-face discussion of life problems and associated feelings

Gottman Method Couples Therapy

based on notion that healthy relationships are ones in which individuals know each other's stresses&worries, share fondness&admiration, maintain a sense of positiveness manage conflicts, trust one another&are committed to one another;focuses on conflicting verbal communication in order to increase intimacy, respect&affection;removes barriers that create a feeling of stagnancy in conflicting situations&created a heightened sense of empathy&understanding within relationships

Mindfulness

Being alert, mentally present, and cognitively flexible while going through life's everyday activities and tasks.

case presentation

episodes in which healthcare professionals meet to share information and evaluate the progress of a patient

Criteria

a principle or standard by which something may be judged or decided

primary prevention

Actions that change overall background conditions to prevent some unwanted event or circumstance, such as injury, disease, or abuse.

secondary prevention

-focuses on early identification of individuals or communities experiencing illness, providing treatment, and conducting activities that are geared to prevent worsening health status-examples: communicable disease screening and case finding; early detection and treatment of diabetes; exercise programs for older adult clients who are frail

tertiary prevention

-aims to prevent the long-term consequences of a chronic illness or disability and to support optimal functioning-examples: prevention of pressure ulcers as complication of a spinal cord injury; promoting independence for the client who has traumatic brain injury

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