LCSW/LMSW FREE Practice Question: Suicidal Clients

Posted by Bethany Vanderbilt

September 13, 2017 at 9:37 AM

As you all know, September is Suicide Prevention Month, and here at TDC, we are using the month as a platform to begin conversations around this often-taboo topic. If you’re studying for your licensure exam, whether a social work exam OR a MFT exam, you’ve probably found that this topic is front and center. There’s a good reason for that: at some point in our professional lives we will almost certainly work with at least one client who wants to end his or her life. Our state boards and licensing organizations want to ensure that as competent professionals we can recognize the signs and symptoms of potential suicide, assess for it accurately, and take the necessary steps to help our client’s stay safe.

Our study systems help prepare you for this topic in a number of ways: we provide concrete information on danger to self and others, risk factors, signs, behaviors, how to evaluate the level of risk, and a spectrum of interventions that will be reflected on the exam. We also provide numerous practice questions with rationales that help you think about this topic from all angles.

Let’s get into a practice question that looks at this topic:

SAMPLE QUESTION: 

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A 66-year-old man is referred to a social worker by his adult daughter. During the initial assessment, the man reports poor sleep, decreased appetite, and increased feelings of agitation and restlessness after being laid off from his job. He goes on to tell the social worker that “things just seem to keep going downhill since my wife died a year ago.” What action should the social worker take FIRST:

A. Refer the client to an MD to rule out any medical issues

B. Teach the client relaxation skills to help him sleep

C. Ask the client if he’s having any thoughts of suicide or self harm

D. Normalize the client’s feelings of grief and loss

So, what would we do here? Try to help him with concrete issues? Address the potential for medical problems? Leave your answer in the comments below and be sure to tune in tomorrow for the answer and a discussion of the rationale.

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Topics: MFT, Exam Prep, LCSW Exam Prep, Suicide Prevention

MFT Success Story!

Posted by Heidi Tobe

September 11, 2017 at 8:54 AM

Last month we shared Yves Domond's successful journey using the Therapist Development Center to pass his master's level social work exam after failing the exam four previous times. This month we are excited to share our interview with Caroline Moreno who recently PASSED her marriage and family therapy exam to become a Licensed Marriage and Family Therapist!

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Caroline Moreno graduated in 2014 from California Baptist University. She's had a passion for helping people as far back as she can remember. Caroline shares that her journey to getting licensed "has been a very interesting one to say the least." She is glad that despite some bumps in the road she was able to follow through with this process and make her dream of becoming a LMFT come true!

TDC: How did you find the Therapist Development Center?

Caroline: I heard about Therapist Development Center back when I was in grad school. Then a couple years later, once I was ready to take my exams, my co-workers at the time were using the program and shared how helpful it was.

TDC: Had you taken the exam before? 

Caroline: I had taken the test once before. The first time I took the exam I definitely let anxiety get the best of me. Not only was I anxious about taking the test, working full time did not make it any easier to study. It was difficult to incorporate studying into my personal life.

TDC: What did you like about the Therapist Development Center’s approach?

Caroline: What I liked about Therapist Development Center’s approach was how user friendly it was. Like I had mentioned before, when you work full time it can make it difficult to study. With TDC you can set up your own schedule and figure out how long you need to study. Another thing that I liked about the program was that they do not overwhelm you with a bunch of study material. The material is very specific and the lectures that go along with it make it easier to comprehend the concepts. The best part about TDC is even if you do not pass the exam the first time, they will restart your program at no charge. They truly work with you to ensure that you will pass.

TDC: Did you use any other prep materials?

Caroline: I personally did not use any other prep materials, but I had friends that did. When looking at their material even I became overwhelmed for them. They were sent packets of papers and books with no direction. Most of them complained that they had no idea where to start because they were sent so much material.

TDC: How long did you study with TDC materials and what did your studying look like?

Caroline: It took me about 4 to 5 month to study because I decided to go at my own pace. After contacting TDC and telling them that I would be retaking my clinical exam they recommended that I go over the whole program. I am going to be honest, I did not want to go through all the material, but I am glad that I did. I studied about 3-4 days out of the week. I utilized my city library to study because I found that there were fewer distractions. I really focused on areas that I felt were my weak points. I listened to the lectures more than once until I felt comfortable with the concept. Even though I was focused on studying, I made sure to incorporate self-care into my routine. For me that was hanging out with friends and family, going to concerts, and doing whatever I found fun. This helped because when I felt myself burning out, doing something fun was a refresher and made it easier to go back to studying.

TDC: Did you utilize coaching at all? If so, tell us about that experience and how it impacted your studying.

Caroline: I had a great experience with the coaches at TDC. Whenever I had a question, a coach would contact me in a timely manner and give me a detailed answer. The coaches are encouraging and I truly felt like they were genuinely there to help me pass.

TDC: How did you feel while taking the exam after using TDC materials?

Caroline: Before entering into the testing center, I parked my car and took a couple of minutes to myself. I listened to one of my favorite songs that motivated me (Eminem-Lose Yourself), said a quick prayer, and told myself “You got this.” This helped me get my anxiety out. Once I was inside taking the test I felt confident, because I knew that I knew the material. There were times where I started to second guess myself, but I remembered what TDC said about feeling like you will be failing the test, and being comfortable about being uncertain. This helped because you normalize the feeling before taking the test. The exam is truly a marathon. By the time I reached question 100 my brain was tired, but once I got up and took my break I was refreshed and ready to pass the test!

TDC: What do you think made the difference to help you pass this time?

Caroline: My mindset definitely was the difference between me passing and the previous time I took it. The first time I took the exam I had a lot going on personally. I had just been laid off, my Mom had a major surgery, and I just felt pressured to take the test. I went in telling myself "I am not going to pass" because I did not feel ready. The second time around I made sure that I was mentally and emotionally ready to take the test. I had a job that was supportive of me studying and my friends and family were understanding of the process. I made sure that I was going to take the exam on my own time and kept a positive attitude.

TDC: What were the best and hardest parts of the licensing journey?

Caroline: The best part of the licensing journey is the experience. You learn so much being an intern and working with different environments and people. When you finally get licensed it is like a weight is lifted. It is also a surreal feeling because you start to think back to all of the sacrifices you have made to get to that point and realize that everything was worth it. Even though sometimes being an intern can be a stressful journey, I know that every little step made me a stronger therapist. I am just grateful that I also had some fantastic people that helped me on the way.

TDC: How is your life and career different now that you've passed?

Caroline: Now that I am licensed I feel like the sky is the limit! Being licensed allows me to be a little more independent, which is always exciting. Since I am newly licensed I cannot wait to see what the future has in store for me!

TDC: Do you have any advice for people studying for this exam?

Caroline: My advice for people studying for this test is RELAX! There are going to be times when you feel overwhelmed, but do not forget to live your life. Do not let this exam take over. If you set up a realistic schedule of when you can study and follow through with it you will be fine. Surround yourself with positive people and think positively going in. You can do whatever you set your mind to. Good Luck!

TDC: Anything else you'd like to add?

Caroline: Everyone’s experience is different when studying/taking the exam. Find a routine that works for you and never compare yourself to someone else. You will PASS the test if you study at your own pace and in your own way. TDC is there to help you do so!

We at TDC are so excited for Caroline! Whether you’re studying for the first or the tenth time, we encourage you to sign up for TDC today and join the thousands of social workers and marriage and family therapists who have successfully passed their licensing exams using TDC. To read more about social workers who have successfully used TDC to pass their licensing exams, click here. To read more about marriage and family therapists who have successfully used TDC to pass their licensing exams, click here.

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Topics: MFT, Exam Prep

BBS Board Meeting Update

Posted by Robin Gluck

August 28, 2017 at 11:17 AM

On Friday I drove up to Sacramento to attend the BBS board meeting. My goal was twofold: to gather information on matters of importance to MFTs and Social Workers, and to ask a few questions specific to the concerns we’ve heard regarding the MFT Clinical exam. Thankfully, both goals were achieved and I want to share with you what I learned and discuss how this information impacts you.

 

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First, some positive developments:

1. The BBS passed legislation that will allow English as a Second Language (ESL) test-takers to request accommodations for time-and-a-half. This process will begin in October. To qualify for this accommodation, the BBS will require you to show proof of one of the following:

a. A Test of English as a Foreign Language, Internet Based Test (TOEFL-iBT) certification score of 85 or below; or

b. Documentation from a qualifying Master’s degree program showing they granted additional examination time or other allowance due to English as a second language; or

c. Documentation of a foreign qualifying Master’s degree that was presented primarily in a language other than English

Retrieved from: http://www.bbs.ca.gov/pdf/regulation/2016/1805_isr.pdf

2. The BBS, alongside licensing agencies throughout the country, recognize the need to improve mobility and are developing processes to make interstate mobility easier for MFTs and Social Workers. The Pathway to Mobility Committee will take charge of this and develop standards. Among the big changes for MFTs is the CA Clinical Exam being accepted in other states (already true for Oregon) and CA accepting the National Exam for those licensed elsewhere!

3. The BBS is hoping to launch their new and improved website in September. This site will make it easier for licensees to navigate, renew licenses, access forms, etc.

Now let’s talk about the MFT Clinical Exam. To be completely honest, I deleted a few drafts before settling on how to present what is clearly a sensitive subject that elicits many emotions. I am acutely aware, based on feedback from recent test-takers and reading threads on various social media sites, there is a lot of anxiety and anger regarding this exam. And while I do not want to minimize or dismiss people’s concerns and feelings, I am worried that some reactions may be more harmful than helpful. After sharing what was presented at the meeting, I will discuss strategies for moving from a place of feeling like a victim to feeling empowered.

The Office of Professional Examination Services (OPES) shared with the board how they develop their exams and addressed concerns regarding the significant drop in the pass rate in the first two quarters of 2017. While the pass rate in the last two quarters of 2016 was in the low 70% range, it dropped to around the low 50% range in the first two quarters this year. Several people, including me, voiced concerns about the exam, including the drop in scores and complaints we’ve heard about awkward wording and time constraints. OPES and the board listened to the feedback while affirming their belief in the integrity of the exam, acknowledging that drops like this can happen. They are paying close attention to these numbers and noted that data for the current quarter shows the pass rate is continuing to rise. Pass rates in this cycle are expected to be more on par with scores prior to the previous two quarters. While this exam will continue to be administered in California, OPES and Board members heard the concerns that were voice and stated that the conversation is not over.

When I coach people, a key goal of mine is to shift thinking away from feeling like a victim of this test to feeling strong and in control. Feeling empowered will naturally contribute to greater levels of confidence, lower levels of anxiety, and oftentimes greater cognitive functioning as you prepare for and take the exam. So, let’s talk about some strategies to move from victimization to empowerment:

1. Join a professional association and become an active participant (CAMFT, NASW, CALPCC). These agencies exist to advocate for their members and the profession as a whole. Representatives of these agencies will frequently present to the board, advocate for the positions of their members, and help advance their members’ concerns. If you are not a member already, consider joining today!

2. Attend board meetings (or write letters). The most direct way to address concerns and push for change is to communicate directly with the people in charge. When the board convenes, they usually provide an opportunity for the public to participate and ask questions. At the meeting on Friday, several people spoke up about the exam and their concerns. This is exactly how the ESL accommodation came about. Your voice matters, so make sure you are heard!

3. Help with the occupational analysis. Every 3-7 years, the board conducts an occupational analysis—and we are due for one this year. OPES develops and sends surveys to clinicians to understand trends in the field. The results of this survey are used to develop the examination outline. The most recent survey was conducted in 2012 and the response rate was a meager 10-15%. This is a fairly small sample size. If more therapists complete this survey, the examination outline will likely provide a better reflection of trends in our profession. While this survey is conducted for licensed MFTs and not interns (associates), even as interns you can encourage colleagues to complete the survey.

4. Help with exam development. Exam questions are developed by Subject Matter Experts (SMEs). The BBS is frequently recruiting individuals to participate in developing exam questions. You do not have to be licensed for long to do this and if you are not yet licensed, you can again encourage colleagues you respect and trust to participate in the process. Imagine how much better it would feel to have people you know and trust be involved in this process.

5. Focus on your studies and uplifting activities/people. When Amanda Rowan created TDC, she wanted to ensure our program was strengths-based. TDC is designed to help you build your knowledge, clinical skills, and become more confident test-takers without feeling overwhelmed. Pay attention to how you are being affected by your studies—are you studying the right amount, or too much? Do you have a healthy balance between your studies and other aspects of your life? Who do you talk with about your exam prep and how to do you feel after talking with them? Is your supervisor aware you are preparing for the exam and helping you do so? Are you on social media and if so how do you feel after reading different threads? Would stepping away from the collective anxiety on social media be healthier for you for a time? Over the next few days, ask yourself these questions. If you find that your actions are helping lift you up and feel more confident, awesome, keep doing them! If you find certain activities are causing you to feel anxious or angry, pause and consider focusing your attention elsewhere.

These exams are hard, but they are doable. Although you do have to work hard, you do not have to suffer. We have worked with thousands of successful test-takers and are here to support you! If you are struggling, please reach out to your coach. We are here to help you PASS WITH CONFIDENCE!

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Topics: MFT, Exam Prep

Answer and Rationale for MFT Question on Duty to Warn

Posted by Robin Gluck

August 26, 2017 at 11:59 AM

On Friday we posted the following question on our Tarasoff duty, and today we have the answer and rationale for you!

A 24-year-old woman is mandated to therapy by her probation officer for anger management. The therapist has been meeting with the client for 4 months and is nearing termination. Over the course of treatment, the woman slowly opened up to the therapist about her life, including her past involvement with gang violence and drug use. In session, she shares that her boyfriend has been very possessive and threatened to hurt a guy he thought she was flirting with. She confesses that he has a gun, has been in jail for assault in the past, and already researched where the man lives. What actions should the therapist take to address the legal and ethical issues presented in this situation?

a. Inform police of the threat and attempt to contact the intended victim.

b. Encourage client to report the boyfriend’s plan to the police and develop a safety plan.

c. Inform client that we must share this information with her probation officer since she is mandated to treatment and could be an accessory to a crime.

d. Inform client she must report the boyfriend’s plan to the police and assess client’s personal safety.

In this question we are provided with information that is alarming.  There is a clear risk of danger presented by the boyfriend: he has a history of violence, has a weapon, and found where the potential victim resides. And yet, our duty to protect is not triggered. In fact, we cannot notify the police or potential victim without breaching confidentiality.  Let’s look at the answer.

Answer:

The best answer to this question is B.  Answer A would be correct if the client was the potential perpetrator of violence (in fact, this is exactly what we do when our duty to protect is triggered under Tarasoff).  Answer C is incorrect as well since we are not required to report this information to the client’s probation officer and it is outside our scope of practice to determine whether this would constitute accessory to a crime.  Answer D is very similar to B, but rather than encouraging the client to make a report, it has the therapist forcing the client’s hand. Therapists cannot force clients to make reports; it is ultimately the client's decision.  Answer B best addresses how we would handle this situation both legally and ethically. Legally, we would maintain confidentiality. Ethically, we would encourage the client to report the danger to police, but would not force them to do so. Additionally, we would safety plan with the client to manage their personal safety around this situation.

In moments like these it's also a good idea to seek legal consultation to ensure you know what your legal obligations are. If you have a supervisor, this would be a situation you would want to consult with them on as well.

Which answer did you choose?  Does the rationale fit with your understanding of Tarasoff and how you would work in the clinical setting? Or did you learn something new with this scenario?  If you have any further questions feel free to check in with a TDC coach. We are here to support you all along the way. And if you came up with the same answer-great job! You are on the right track to getting licensed.

Still haven’t signed up for an exam preparation program? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

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Topics: MFT, Exam Prep

Free MFT Practice Question: Duty to Warn

Posted by Robin Gluck

August 25, 2017 at 11:30 AM

This week our practice question explores Tarasoff and our duty to protect. Oftentimes, people struggle with questions on this topic because the subject itself feels a bit abstract. Many clinicians have read case law and studied Tarasoff in graduate school, but have not encountered these situations in clinical practice. And while it is an intimidating prospect, the likelihood of our duties being triggered under Tarasoff is thankfully low. However, the BBS still wants to ensure you know what to do in the unlikely event you find yourself in this situation.

The most common question I receive regarding Tarasoff is, “What am I required to do if the potential perpetrator of violence is someone other than my client?” Many clinicians believe our duty to protect is triggered regardless of our relationship to the potential perpetrator, but that is not true. Our duty to protect is only triggered if we can reasonably determine that someone is a danger to others. To do this, a therapist must properly assess the level of risk by taking into account risk factors such as history of violence, affect, language, etc. We cannot accurately assess someone if we do not have a relationship with them and the law takes this into account. Tarasoff is only triggered when it is our client who is the potential danger.

With this in mind, let’s look at the question:

A 24-year-old woman is mandated to therapy by her probation officer for anger management. The therapist has been meeting with the client for 4 months and is nearing termination. Over the course of treatment, the woman slowly opened up to the therapist about her life, including her past involvement with gang violence and drug use. In session, she shares that her boyfriend has been very possessive and threatened to hurt a guy he thought she was flirting with. She confesses that he has a gun, has been in jail for assault in the past, and already researched where the man lives. What actions should the therapist take to address the legal and ethical issues presented in this situation?

a. Inform police of the threat and attempt to contact the intended victim.

b. Encourage client to report the boyfriend’s plan to the police and develop a safety plan.

c. Inform client that we must share this information with her probation officer since she is mandated to treatment and could be an accessory to a crime.

d. Inform client she must report the boyfriend’s plan to the police and assess client’s personal safety.

The answer and rationale will be posted at noon PST tomorrow! We encourage you to post an answer in the comments section below (you can also post your reasoning behind your answer choice!). Then check back in tomorrow for the correct answer and rationale explaining why the correct answer is correct and why the other answers are not correct.

Haven't signed up for an exam prep program yet? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

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Topics: MFT, Exam Prep, Practice Questions

Answer and Rationale for MFT Practice Question on Suicidal Clients

Posted by Robin Gluck

August 14, 2017 at 10:22 AM

On Friday we posted the following question on suicidal clients, and today we have the answer and rationale for you!

Jill, an 18-year-old college student who is living at home, has been meeting with a therapist on a weekly basis for several months. She was referred for therapy after receiving medical treatment for alcohol poisoning. Jill reports feeling alone, lacking direction, and does not believe the future has much to offer her. She cut back on drinking after her experience with alcohol poisoning, but continues to smoke marijuana on a regular basis and has experimented with other drugs. In session, she shares that her boyfriend broke up with her over the weekend and now that she is completely alone, she wants to go to sleep and not wake up. How should the therapist manage the legal and ethical issues presented in this case?

a. Determine if she has a plan and means to commit suicide before taking other steps

b. Inform parents of risk because client lives with them and is a danger to self

c. Initiate involuntary hospitalization due to stated suicidal ideation and substance use

d. Validate client’s feelings of helplessness and help her identify healthier coping strategies

This question provides you with some information about risk factors, but the clinical picture is incomplete and until you gather more information it will be hard to determine the most appropriate intervention. The BBS is not only testing that you know when to intervene, but is also testing that you will take reasonable, measured steps based on the level of risk and not overreact. Breaking confidentiality or initiating hospitalization prematurely could rupture the therapeutic relationship and cause greater harm than help to the client. Remember, our legal and ethical responsibilities are to assess and manage our client’s safety and overall well-being. With this in mind, let’s review our answer choices.

Answer:

The best answer to this question is A. The client has expressed suicidal ideation, but has not indicated a plan or means to carry out a plan. Before we decide what level of intervention is appropriate, we would need to assess the level of risk. Based on the information provided, it’s not clear if breaking confidentiality is necessary, or if it’s even appropriate to involve the parents, so we would hold off on B. We are not required to break confidentiality, but may choose to do so only if we believe it is necessary and would be beneficial. Answer C may be tempting as well because of the risk linked to substance abuse, feelings of hopelessness and suicidal ideation. Again, this would be a jump without assessing plan and means. Answer D is not strong because validating the client’s feelings of helplessness and identifying healthier coping strategies does not directly address the suicidal ideation and potential danger to self and would fall short of fulfilling our legal and ethical obligations.

Which answer did you choose? Does the rationale fit with your understanding of danger to self and how you would work in the clinical setting? Or did you learn something new with this scenario? If you have any further questions feel free to check in with a TDC coach. We are here to support you all along the way. And if you came up with the same answer-great job! You are right on the right track to getting licensed.

Still haven’t signed up for an exam preparation program? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

 

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Topics: MFT

DSM 5 Changes: Autism Spectrum Disorder

Posted by Heidi Tobe

August 7, 2017 at 12:00 PM

Last month we introduced our monthly DSM 5 blog and discussed the removal of the multiaxial system between the DSM-IV-TR and the DSM 5. This month we’ve decided to take on one of the most talked about changes to the DSM 5: the new Autism Spectrum Disorder diagnosis. This DSM 5 diagnosis represents one of the major shifts between the DSM-IV-TR and the DSM 5. The DSM 5’s Autism Spectrum Disorder diagnosis encompasses four separate DSM-IV-TR diagnoses that were previously under the category of Pervasive Developmental Disorders: Asperger’s Disorder, Childhood Disintegrative Disorder, Autism Disorder, and Pervasive Developmental Disorder NOS. These four disorders no longer exist independently and are all captured within the Autism Spectrum Disorder diagnosis. For the purposes of the exam, these changes make it a bit simpler as there are no longer four separate diagnoses to differentiate between. The change was made in hopes of greater reliability and consistency in the diagnosis of Autism Spectrum Disorder and with general agreement that these four conditions all fall within one condition with varying levels of severity.

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For a DSM 5 diagnosis of Autism Spectrum Disorder there must be deficits in BOTH social communication/interaction as well as restricted/repetitive patterns, with the severity in each of the areas being specified based on the levels of support required. For the first category, you must see a persistent deficiency in social communication and interaction. For example, you may notice a child who has abnormal social engagement. They may lack eye contact, have little interest in receiving or exchanging non verbal communication, or have a lack ability to understand the emotions or affect of others. This can impact their ability to play with friends and is therefore often observed and diagnosed when children enter school for the first time.

The second area is a restricted/repetitive pattern of behavior, interests, or activities. This can include motor movements such as clapping, or echolalia (repeating what someone says). You may observe inflexibility in functioning, in which the child experiences distress when their schedule is changed or interrupted. Hypo OR hypersensitivity to external stimuli can also be present, in which a child could either be indifferent to pain, temperature, etc., or they could be highly sensitive to touch, sound, etc.

For a diagnosis of Autism Spectrum Disorder, criteria for BOTH of these categories must be met. For individuals who have deficits in the social use of language, but do not show restricted interests or repetitive behavior, the diagnosis of Social Communication Disorder would be used (Social Communication Disorder is a new diagnosis in the DSM 5). This diagnosis does not fall within Autism Spectrum Disorder, but is a Communication Disorder. 

Even before these changes were officially rolled out in the DSM 5, they were the cause of much conversation and controversy. There was concern that lumping these diagnoses together could result in less services and coverage for individuals who were higher functioning (namely those with a previous diagnosis of Asperger's Disorder). For those of you working within this population, what has your experience been since the implementation of the DSM 5? What have the practical implications been of these changes? We encourage you to share in the comments section below.

If you are preparing for your licensure exams and still haven’t signed up for an exam preparation program, our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE. We look forward to helping you PASS your exam with confidence!

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Topics: MFT, Exam Prep, Social Work Exam Prep, DSM, Professional Development

MFT Practice Question: Elder and Dependent Abuse and Neglect

Posted by Robin Gluck

July 14, 2017 at 7:46 PM

Last week’s MFT blog explored a complicated question on child abuse and neglect reporting. This week, we continue exploring the topic of abuse and neglect, but shift our focus to elders and dependent adults. In California, the laws regarding elder and dependent adult abuse overlap quite a bit with those for child abuse, but there are also some differences to keep in mind.

 

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What are some of the key differences? While this is not an exhaustive list, a few to be aware of include:

1. Therapists are only mandated to report when the elders/dependents are residents of California. If, in your professional capacity, you become aware of elder/dependent abuse occurring outside of California, you are not required to make a report. In contrast, we are mandated to report child abuse and neglect to California authorities regardless of where the victim resides.

2. There are a total of seven categories of abuse and neglect that require us to report: physical abuse, abandonment, abduction, isolation, financial, neglect, and deprivation of necessary goods or services. In cases of child abuse and neglect, the law does not address abduction or financial abuse.

3. When, how, and where to report elder and dependent abuse and neglect will vary based on where it occurred, which is not the case with child abuse and neglect.

These are just a couple of the differences-and you want to make sure you know ALL of the differences for the exam. In TDC's programs, Amanda Rowan explains in further detail the differences in reporting requirements between elder and dependent adult abuse/neglect and child abuse/neglect and provides easy to understand guidelines for your reporting requirements as an MFT.

With this in mind, let’s take a look at our question of the week:

A therapist works with clients residing in a long-term living facility. One of the therapist’s newer clients shares in a session that he is upset because he witnessed an employee rough handling and yelling at one of the residents during their daily activities. In response to the employee’s actions, the resident appeared visibly shaken and began crying. He asks the therapist to please not say anything because he is concerned the employee will know he was the one to complain. Based on the information and concerns shared by the client, how should the therapist manage the ethical and legal obligations in this case?

A) Report the client’s concerns to management and follow the facility’s guidelines for reporting abuse

B) Ask the client for more detailed information regarding the incident before making a report and safety plan with the client.

C) Report the abuse to law enforcement and local ombudsman and process report with client.

D) Report the suspected abuse to a supervisor to address client’s concerns and safety plan with the client.

According to California law, therapists are required to report elder and dependent adult abuse or neglect when they have reasonable suspicion of abuse. Therapists are not required to be certain that abuse or neglect has occurred, nor do they need to investigate once the threshold of reasonable suspicion has been met. In addition, once we have enough information for reasonable suspicion, we must report to the appropriate authorities, even if we have concerns regarding the consequences our reporting could have on the client. Based on the information presented in this question, how would you proceed?

Answer:

The best answer to this question is C. This question is not only asking how we would manage our legal obligations, but our ethical obligations as well. Based on the information presented, there is reasonable suspicion that abuse is taking place in the long-term care facility. When abuse occurs in a long-term care facility, we must file a report with law enforcement and the local ombudsman. In addition, the second half of answer C addresses our ethical obligations; processing the report will allow us to address any safety concerns and trust issues with our client. Answer A is incorrect because it is prioritizing management’s reporting requirements over the law, which may or may not match our legal mandate. Answer B is shifting toward investigation, which is not our role as therapist. Once there is reasonable suspicion, report what you know! Answer D, while addressing the client’s concerns, again ignores our legal mandate.

Which answer did you choose? Does the rationale fit with your understanding of the law and how you would work in the clinical setting? Or did you learn something new with this scenario? If you have any further questions feel free to check in with a TDC coach. We are here to support you all along the way. And if you came up with the same answer-great job! You are right on the right track to getting licensed.

Still haven’t signed up for an exam preparation program? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

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Topics: MFT

Career Outlook for Marriage and Family Therapists

Posted by Amanda Rowan

August 2, 2016 at 1:07 PM


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Conflicts within a family are a regular occurrence, and can sometimes require outside help, such as a mediator who can give proper advice to help mend what may be on the verge of breaking. Some people find joy in defusing relationship problems and helping others see what they can do to change. If you feel that you are among these people, becoming a marriage and family therapist may be the right path for you.

 Marriage and Family Therapy is among the most rewarding professional careers. Assisting others and making lives a little bit brighter every day, is a gift that some of the most kind and selfless people possess. If you feel you are among this gifted group, you may have the right mindset to become a marriage and family therapist.

 What is involved in becoming a licensed marriage and family therapist?

 Let’s start with the job description:

 Simply put, a marriage and family therapist is responsible for educating family members so they can resolve their own conflicts within marriage and family. A therapist will use his or her knowledge of family theory and apply techniques and principles to help struggling couples and families find a proper resolution to help them sustain healthy relationships.

 This type of professional should have an advanced degree and be comfortable being self-employed. Very few will work with social service organizations.

 What type of projected growth to expect:

 The Bureau of Labor Statistics has reported that there were approximately 33,700 of this type of therapist who were employed in the U.S. in 2014. An increase of 15% was projected over the  years of 2014-2024. That is an increase of 5,000 jobs by the end of the year 2024.

 What are the factors of growth:

 Health insurance plays a big role in the career growth of a marriage and family therapist. Health insurance is now required to cover mental health counseling services, which means more people are taking advantage of this service.

 How you can improve your prospects:

 There is a very small number of marriage and family therapist in rural areas of the United States, so these areas offer the best prospects for employment. All professionals must hold a license in the state where they practice. Certification and licenses will boost your career prospects.

 What to expect from your salary:

 This goes back to the findings of the Bureau of Labor Statistics of 2014. They have reported that a marriage and family therapist earned an on average salary of $48,000 annually. However, annual wages for the low 10% was $30,510, and the high 10% was $78,920. Employers that paid the highest wages were both through the government and religious organizations.

If you feel like becoming a marriage and family therapist is your true calling, you now understand what it takes and a general idea of what your career path will look like. You can find all the information you need to become the light for those who are suffering with their marital and family relationships on our website. Bringing loved ones back together is something that comes with a whole lot of patience and heart. Do you have what it takes? 

 

 



 

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Topics: MFT

Top 10 Reasons Teens Go To Therapy

Posted by Amanda Rowan

July 26, 2016 at 1:30 PM


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Top 10 Reasons Teens Go to Therapy

The teen years are difficult ones. For some, adolescence can be more difficult. Teenagers who are having a particularly hard time sometimes choose take advantage of therapy and find healthy ways to cope with their various troubles and circumstances. Of all the reasons juveniles go to therapy, below are the most common.


  1. Depression

Many teens suffer from self-esteem issues which can lead to depression. Those who feel overly worried, depressed, sad or shy can benefit from therapy because they need someone who will support and encourage them. In many cases, therapy is the first time someone really listens to them and tries to be supportive.

  1. Anxiety Disorders

Some teens get overly anxious, whether that be about speaking in front of class or preparing for exams or being confronted by a bully. Teens who are so anxious that they in some way feel stuck, seek therapy to gain the courage, peace and confidence to overcome their fears.

  1. Behavior Problems

Anger, depression, low self-esteem, sadness and learning disabilities can result in teens making foolish decisions and cause harm to themselves and others. Those who want to stop their destructive habits such eating disorders, addictions, over spending, smoking, nail biting, using drugs, and self-harm can find success in therapy.  

  1. Substance Abuse Issues

Unfortunately, teens are prone to peer pressure and don’t always make the right decisions. Exposure to drinking and drug abuse often occur during adolescence. Teens seek therapy to break free of the addictions and substance abuse issues that they know are harming them.

  1. Stress

The pressure to succeed in school or extracurricular activities can leave some teens burned out and overwhelmed. When teens seek out therapy, they can learn time management skills, how to prioritization and set boundaries.

  1. School-Related Issues

School can be a challenge for some teens, whether they have a learning or attention problem, get anxious, have behavioral problems such as anger, or being bullied. Some teens also seek therapy because they struggle with self-confidence, making friends or coping with peer pressure.  

  1. Legal Problems

Teens struggle with peer pressure and self-esteem problems which can lead them into hanging out with the wrong crowd and making terrible decisions. Teens who get into trouble with the law are usually encouraged, if not forced, to go to therapy. Teens who decide for themselves that therapy is their best option to stop and begin afresh

  1. Low Self-Esteem

Teens need to feel loved, accepted and worth listening to. They are bombarded with peer pressure, bullying and judgment. Therapy offers teenagers with low self-esteem a listening ear and a safe place where they feel wanted and accepted as they are.

  1. Trauma

There are some adolescents who have experienced traumatic events and need someone outside their friends and family to talk to about it. Teens who have experienced a traumatic event seek the safety, listening ear and outside perspective of a therapist.

  1. Grief

Like adults, therapy can greatly help grieving teenagers walk through it and handle it in a healthy way. Grief can be the result of many causes such as the death of a loved one, divorce or separation of parents, alcoholism or addiction of a parent, news of a chronic illness or anything else. Some teens resort to some destructive coping strategies to push through the pain. Therapy provides hurting and grieving teenagers an outlet to process their feeling and make more sense of their situations.

 


There is a lot going on in the lives of adolescents during middle school and high school years. Teens seek therapy to help them address, handle and overcome a wide range of obstacles and personal struggles. As a professional therapist, you can have a great impact and influence on the lives of teens. If you’re interested in learning more about becoming a licensed therapist, we invite you to read some of our professional development resources.



 

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Topics: MFT, Family Therapy, Teen Therapy