AASPIRINS
A: acknowledge & assess
S: start where the client is
P: protect Life (preventing danger to self and others)
I: informed Consent
R: rule out
... [Show More] medical conditions, send to Dr. if medical
I: intoxication (don't treat if intoxicated)
N: non-judgmental
S: support self-determination
For "Best"/"Worst" or "MOST reasonable" questions
AREAFI
What to do "FIRST" or "NEXT":
A: Acknowledge/Assess feelings
R: Refer
E: Educate
A: Advocate
F: Facilitate
I: Intervene
Levels of cognition
knowledge (teaching facts, theories, etc)
comprehension
application
analysis
synthesis (creating something new)
evaluation (judging quality)
Maslow's Hierarchy of Needs
Physiological
Safety
Love/belonging
Esteem
Self-actualization
Types of groups
Shared problem, Counseling, Activity
self help, natural group, closed group, open group, structured, reference, crisis
Individual self-actualization occurs through...
- release of feelings that block social performance
- support from others
- orientation to reality and check out own reality with others
- reappraisal of self
Bowenian Family Therapy
change through understanding multigenerational dynamics
-driven to achieve balance of internal and external differentiation
Logotherapy
change through finding meaning in life, understanding purpose
Problem solving therapy (aka Task Centered)
change through supporting client to take actions to address problems; client defined problems
-Short term
-Good for lower functioning, schizophrenia, homeless
Dialectical Behavior theory
Aims to change behavioral, emotional, and thinking patterns associated with dysfunction
-teaches mindfulness, suicidal behavior, emotional regulation, interpersonal effectiveness
• Good for Borderline Personality Disorder
Narrative therapy
Change occurs by externalizing problem and creating a new narrative or story, which emphasizes the client's competencies and strengths.
-Problem separate of client, externalize the problem
Feminist Therapy
Change through recognizing disempowering social forces and empowering client.
-Good for eating disorders.
Emotional Triangulation
Network of relationship between 3 people. Stable until anxiety starts between dyad, then 3rd party is used to reduce anxiety.
structual family therapy
SW engages family in restructuring; boundaries are determined with Interpersonal, boundaries w/ outside world, hierarchal organization of the family
Interpersonal family structure
Family is defined. Promoted differentiation and autonomy
Boundaries of the outside world (Structural family therapy)
Defines family. Must be permeable enough to maintain well functioning open system
hierarchal organization (Structural family therapy)
in all families and cultures. Maintained generationally; parent-child roles, rights, obligations, etc.
Strategic Family Therapy
- Pretend technique
-1st order changes (superficial behavior changes)
-2nd order changes (systematic interaction patterns)
-Family homeostasis (preserve family organization and communication)
-Relabeling (change label attached to problem or person)
-Paradoxical directive (prescribe symptomatic behavior so client realize it can be controlled)
Suprasystem (systems theory)
An entity that is served by a number of component systems organized in interacting relationships
Throughput (system theory term)
Energy that is integrated into the system so it can be used by the system to accomplish its goals
Subsystem (systems theory)
A major component of a system made up of 2+ independent components that interact in order to attain their own purpose(s) and the purpose(s) of the system in which they are embedded
SOAP format (Assessment)
Subjective: How are they doing since last visit
Objective: Vitals, physical exam, lab results
Assessment: Tasks S & O into short assessment
Plan: Done after assessment; treatment plan
Mental Status Exam (MSE)
Appearance
Orientation (Time place events)
Speech (Slurred, pressed, slow)
Affect/Mood
Impulsivity (Potential of harm)
Judgement/Insight (Predict consequences)
Thought process (reality, thinking style)
Intellectual function/memory
Suicide Assessment (Danger to self)
- Hx of attempt/family hx
- Lives alone, no social support
- Psych disorders (depression, anxiety)
- Substance use/abuse
- Media & peer exposure
- Losses
- Firearms or lethal weapons
Suicide Protective Factors
- Social support, family connectedness
- Coping skills
-Access to clinical care/Treatment
- Religion & participation in religious activities
- Limited access to lethal methods
Risk Assessment (Suicide/Violence)
- Frequency, intensity & duration of suicidal or violent thoughts
- Access to available methods
- Availability/inability to control suicidal/violent thoughts
- Ability to not act on thoughts
- Factors making client feel better/worse
-Consequences of actions
- Deterrents to action
- Using drugs/alcohol
- Measures client uses to remain safe
Community Strength & Challenges
People, Partnerships, Facilities, Organizations, Policies, Regulations, Culture
Delusions
false beliefs, often of persecution or grandeur, that may accompany psychotic disorders
Endogenous depression
chemical imbalances in the brain rather than as a reaction to life events
Exogenous depression
depression caused by external events or psychosocial stressors
Folie a deux
shared delusion
Postmorbid
subsequent to the onset of an illness
Premorbid
before the onset of major symptoms
Psychotic
experiencing delusions or hallucinations
contraindicated
not recommended under these circumstances
AntiAnxiety & Panic Disorder
Ativan, Buspar, Klonopin, Valium, Xanax
ADHD/ADD Stimulants
Adderall, Concerta, Dexedrine, Ritalin
Antidepressants (SSRIs)
Celexa
Lexapro
Luvox
Paxil
Prozac
Zoloft
Antidepressants (Tricyclics)
Anafranil
Asendin
Elavil
Norpramin
Pamelor
Aventyl
Surmontil
Trofranil
Vivactil
Antidepressants (MAOI)
Nardil
Parnate
*Avoid alcohol & aged foods
Antidepressants (Others)
Effexor
Desyrel
Remeron
Serzone
Wellbutrin
Mood stabilizers (Anti-Manic/Bipolar)
Depakote
Lamictal
Lithium
Abilify
Antipsychotics (Schizoprenia & Mania)
Haldol
Clozaril- need blood work done
Thorazine
Seroquel
Risperdal
Zyprexa
Tardive dyskinesia (TD)
Abnormal, involuntary movement of tongue, jaw, lips, & face; twitching and snakelike movement of extremities as a result of a high dose of antipsychotics over time
Assessment of Violence (Danger to others)
-Youth under 13 y/o who commit crimes & escalating violence
-Aggression, associated w/ drugs, alcohol & risky behavior
-Delinquent peers & gangs
Assessment of violence (protective factors)
Programs, individual risk & environment
Target social context of change
Access to clinical care
Support system
Coping skills
Restrict access to lethal weapons
Social Work Values
1. service
2. social justice
3. dignity and worth of the person
4. importance of human relationships
5. integrity
6. competence
Ethical Problem Solving
-Identify ethical standards being compromised
-Determine if there is an ethical dilemma
-Weigh issues in light of SW values & ethics
-Suggest modifications
-Implement modifications
-Monitor for new dilemmas
Payment (SW Ethics)
Fees are fair, reasonable & commiserate w/ service. Bartering accepted only when it is acceptable in the local community
Lack of Decision Making (SW Ethics)
Act of behalf of client and safe guard against ill interest
Referrals (SW Ethics)
Refer for specialized knowledge
Termination (SW Ethics)
When services & relationships are no longer required or of interest
Commitment to clients (SW Ethics)
Promote wellbeing in client's interest; larger society or legal obligations may supersede loyalty to client
Self-determination (SW Ethics)
Respect and promote the right of clients and assist clients to identify goals and clarity
informed consent (SW Ethics)
An ethical principle that clients are told enough to enable them to choose whether they wish to participate; state purpose of service, risks, limits, costs, alternatives, right to refuse or withdraw consent, time frame of consent
Cultural Awareness
Understand culture and its function in human behavior and society
Conflict of Interest (SW Ethics)
Avoid interfering w/ exercising professional discretion and impartial judgement. No dual/multiple relationships
Privacy and Confidentiality (SW Ethics)
the responsibility we have to protect the privacy of patients and maintain the confidentiality of their medical information. Need consent for information release
Access to Records (SW Ethics)
Provide reasonable access to records
Sexual relationships & physical contact (SW Ethics)
None under any circumstances
Short Term Intervention
Psychodynamic
Crisis intervention
Cognitive behavioral therapy
case management
-Assessment
-Planning
-Linking
-Monitoring
-Advocacy
Evaluation (research)
-Quantitative info
-Improvements
-Symptom progress
-Qualitative info
Conflict resolution
1. Recognize existing potential conflict
2. Assess conflict
3. Select strategy
4. Intervention
Intervention escalation
-Decrease contact
-Decrease time between sessions
-Decrease formality of sessions
-Limit scope fo issued that can be discussed
-Use 3rd party mediator
Social Work Process
1. Engaging
2. Assessing
3. Planning
4. Intervening
5. Evaluating
6. Terminating
*Enhances mental emotional and action capabilities
Qualitative measurement
info that is not numerical (Open ended surveys, unstructured interviews, observations)
Quantitative measurement
collecting data involving numbers that can be statistically manipulated (number of clients, survey w/ a Likert scale)
Task Centered Practice
-quickly engage clients in problem-solving process&to maximize their responsibility for treatment outcomes
-focus on here and now
- client must be able to identify a precise psychosocial problem/solution confined to specific change in behavior or change of circumstances
- client must being willing to work on problem
establish relationship quickly
- termination begins almost immediately upon onset of treatment
Crisis intervention
- relieve the impact of stress with emotional and social resources
-return a clients to a previous level of functioning
-help strengthen mechanisms during the crisis period
-develop adapting coping strategies
-4-6 weeks; directive, high level activity/involvement
-local worker sets specific goals and task in order to increase a clients sense of mastery and control.
Phases of Intervention
-Engagement
-Assessment (Strengths and needs)
-Planning/Design intervention
-Intervention
-Evaluation
-Termination
Stages of Change Model
-precontemplation
-contemplation
-preparation
-action
-maintenance
-relapse
Change strategies
-modify systems (one on one or larger system)
-modify individual thoughts (change interpretation & statements)
-modify actions (behavior modification)
-advocacy (secure change)
-Mediator (negotiates)
-modify feedback (alter reinforcement)
Motivation Techniques
-identify problem or risk
-explain why change is important
-advocating change
-identify barriers
-best course of action
-setting goals
-taking steps to change
-preventing relapse
*empathy increases motivation & lowers resistance [Show Less]