Answer and Rationale for FREE Practice Question on Self-Harm

Posted by Heidi Tobe

September 28, 2017 at 11:59 AM

 

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Yesterday we posted the following question on self-harm, and today we have the answer and rationale for you!

Question:

A 25-year-old woman has been working with a social worker for two years around issues of anxiety, depression, and non suicidal self-injury. For the past 18 months, the client has abstained from cutting herself, but came into the most recent session wearing long sleeves on a hot summer day. The social worker inquired about this and the client lifted her sleeves to reveal several shallow cuts on her forearms that appeared to be healing. The client stated that she got into a fight with her best friend a few nights ago and in a moment of intense emotion engaged in cutting. What should the social worker do FIRST?

A. Discuss voluntary hospitalization with the client

B. Teach the client coping skills to utilize in moments of intense emotion

C. Explore the thoughts and feelings that preceded the client’s self-injury

D. Refer the client to an MD to take care of the client’s injuries

Answer:

After reading through the question and possible answers for this question, what answer did you come up with? This is a good example of a question that could show up on either of the ASWB practice exams to determine whether you are able to differentiate between the steps you would take with a client engaging in self-harm versus one who is actively suicidal. Let’s go through each of the answer options one at a time and think about them.

  • Answer A: does the client need to be hospitalized? Not at this time. Nothing in the question stem indicates that the client is having suicidal thoughts or is a risk to herself. The question stem specifies that the client engages in non suicidal self injury, meaning, she is engaging in self harm without the intent of killing herself. Further, the cuts are on her forearm and are described as shallow and healing normally, so there is no medical emergency that would indicate a need for hospitalization. Especially for therapists inexperienced with self-injury, seeing a client’s self-inflicted injuries can be alarming and upsetting. From a place of concern and wanting to make sure our clients are safe, we can jump to too extreme of interventions, such as unnecessary hospitalization.
  • Answer B: does the client need concrete coping skills to help her cope during moments of intense emotion? Definitely. This is something you would want to do, but is not necessarily what you would do.
  • Answer C: should we explore the thoughts and feelings the client had before engaging in self-injury? Yes! This answer option allows us to stay in the moment and respond to what the client has shared. Exploring her thoughts and feelings leading up to her self-injury will help us gain a better understanding of the precipitating factors and triggers for this behavior. From there we could discuss various coping skills for the thoughts and emotions that triggered this behavior (B).
  • Answer D: does the client need a medical evaluation? Probably not. The question indicates that the cuts were shallow and healing normally. Nothing else in the question stem indicates a need to seek medical attention.

Which answer did you choose? Does the rationale fit with your understanding of self-injury, or did you learn something new with this scenario? If you have any further questions, we encourage you to check in with a TDC Coach. We are here to support you! 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? We look forward to helping you PASS your exam with confidence! 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. . Once you pay for the program, we are with you until you pass: extensions are always free, materials are structured and comprehensive, and you have access to a coach for 1:1 support. 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

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Topics: Exam Prep, LCSW Exam Prep, Social Work Exam Prep, Suicide Prevention

LCSW/LMSW FREE Practice Question: Self-Harm

Posted by Heidi Tobe

September 27, 2017 at 1:56 PM

September is Suicide Prevention Month, and here at TDC we’ve been using our blog to begin conversations around this often-taboo topic. On both the social work and MFT licensing exams, this topic is sure to show up in several forms. We have focused our free practice questions this month on suicide and today we explore the topic of self-injury. These topics are highlighted on licensing exams because our licensing organizations want to ensure that we are equipped with the knowledge and skills necessary to recognize the signs and symptoms of risk to self, distinguish between life threatening and non life threatening behaviors, and take the appropriate steps based on the level of risk.

TDC’s 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 explores this topic.

SAMPLE QUESTION:

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A 25-year-old woman has been working with a social worker for two years around issues of anxiety, depression, and non suicidal self-injury. For the past 18 months, the client has abstained from cutting herself, but came into the most recent session wearing long sleeves on a hot summer day. The social worker inquired about this and the client lifted her sleeves to reveal several shallow cuts on her forearms that appeared to be healing. The client stated that she got into a fight with her best friend a few nights ago and in a moment of intense emotion engaged in cutting. What should the social worker do FIRST?

A. Discuss voluntary hospitalization with the client

B. Teach the client coping skills to utilize in moments of intense emotion

C. Explore the thoughts and feelings that preceded the client’s self-injury

D. Refer the client to an MD to take care of the client’s injuries

So, what would we do here? 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: Exam Prep, LCSW Exam Prep, Social Work Exam Prep, Suicide Prevention

Answer and Rationale for LCSW/LMSW Practice Question on Suicidal Clients

Posted by Bethany Vanderbilt

September 14, 2017 at 11:59 AM

Yesterday we posted the following question about suicidal clients, and today we have the answer and rationale for you!

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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

After looking at the question and answer set yesterday, what did you think? This is a good example of an item that could show up on any of the ASWB exams, and one in which there are multiple answer options that look “right.” So, let’s go through the answer choices one at a time and think about them.

    • Answer A: does the client need a medical evaluation? Probably. He’s having symptoms (sleep disturbance, change in appetite, restlessness) that could indicate a medical problem, so we would want to rule that out. In many cases, this answer would take priority, but let’s see what else we have going on here.
    • Answer B: does the client need concrete coping skills to help address his stress and sleep issues? Probably. This would be something you would, in most cases, do with a client in this situation, but it wouldn’t be prioritized over an answer like A.
    • Answer C: should we ask this client if he’s having thoughts of suicide or self harm? ABSOLUTELY. He has a number of factors that put him at an extremely high risk: he’s an older male, he’s had multiple losses (spouse and job), he’s experiencing symptoms consistent with depression, and maybe most significantly, he’s expressing HOPELESSNESS (feeling like things are going downhill). This is the best answer, and would take priority over the medical referral because the suicidal risk is imminent (we want him to live to make it to the doctor’s office).
    • Answer D: should we respond to his feelings? Of course we would want to demonstrate empathy and compassion for this client. C is still a better answer to the question, though, as the social worker should feel comfortable directly addressing the potential for risk in this situation.

Do you want to be TDC’s next success story? Our exam prep materials provide you with everything you need to pass your exam and nothing you don’t. Once you pay for the program, we are with you until you pass: extensions are always free, materials are structured and comprehensive, and you have access to a coach for 1:1 support. We’ve taken the guess work out of studying so you can focus on the real task: PROFESSIONAL DEVELOPMENT.

You can find more information about our social work exam prep programs HERE.

Be sure to tune in next month for another practice question and discussion!

 

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Topics: Exam Prep, LCSW Exam Prep, Social Work Exam Prep, Suicide Prevention

Veterans Service Scholarship Winners

Posted by Heidi Tobe

August 18, 2017 at 2:07 PM

On Monday we announced our five winners for Therapist Development Center's 2017 Veterans Service Scholarship. Today, we share a bit of each of their stories. We hope you are as inspired by each of them as we are!

Fernando Chavarria

Michigan State University

After receiving his undergraduate degree in communications, Fernando Chavarria had no plans to pursue education in a different field. It wasn't until Mr. Chavarria was offered a career as a Peer Specialist that he began considering the social work profession. On a daily basis, Mr. Chavarria collaborated with clinicians and it was during this time that he discovered that the field of social work was one comprised of complex communication, relationship building, and collaborative efforts-something not so far off from his original field of communication.

During his time in the military, Mr. Chavarria saw what it looked like to push his mind and body to new limits, increased his confidence and determination, and learned that "impossible is just the body operating without the mind." Mr. Chavarria worked on the short-term inpatient medical floor of the VA Hospital for his first-year internship, assisting with discharge planning and high risk screenings. This experience provided him greater insight into the types of support and interventions provided through the field of social work. Mr. Chavarria has an innate desire to help his fellow comrades and wants to do everything he can to help fellow veterans stay alive in both mind and body when they return home. He plans to become a clinical social worker with the VA upon graduation and to move into positions of leadership that will allow him to advocate for organizational changes that will lead to more effective delivery of recovery-oriented care.

Dr. Brady is a psychologist at the agency where Mr. Chavarria is a Peer Support Specialist. Dr. Brady was so impressed by his clinical skills that she has had him assist in sessions with veterans. She describes Mr. Chavarria as "extraordinary in his authentic depth, ability to connect with others, and ability to convey understanding and accurate empathy” and goes on to state that she has “never seen anyone better.” Dr. Brady has seen Mr. Chavarria “able to offer even difficult feedback in a way which meets with acceptance. He has this essential clinical skill honed, yet keeps striving to encompass more of the human experience." Mr. Chavarria is someone Dr. Brady states has a great deal of life experience and wisdom and is able to use these to lead humbly and authentically. She expects that Mr. Chavarria's clinical social work career will "deeply touch many lives, and help bring about advances.

 

Jonathan Gill

The Ohio State University

As a United States Marine Corps service member who decided to 'come out' after witnessing the repeal of Don't Ask, Don't Tell, Jonathan Gill discovered a community of hidden LGBT service members who created their own support networks due to the stigma of reaching out for help. He encountered many individuals who silently struggled with issues of substance use and mental health issues, failing to get the services they needed. It was during that time that he learned about his own identity, what trauma is like, and how one needs to seek healing once they are removed from the trauma.

During his first-year internship, Mr. Gill met veterans and non-veterans experiencing chronic homelessness. He witnessed and heard stories of trauma and chronic homelessness that he was surprised to find were in his own back yard. Mr. Gill is currently pursuing his Masters degree in Social Work at The Ohio State University, with an internship at the Chalmers P. Wylie VA Ambulatory Care Center in Columbus, Ohio. Mr. Gill’s goal is to work with veterans as a clinical social worker for the VA to address the needs of those transitioning into the civilian world, with an emphasis on homeless reduction, vocational rehab, trauma-informed care, and substance use disorders after graduation. Mr. Gill is interested in using his shared identity as a veteran to build strong therapeutic alliances in his clinical work.

Anna Stewart is one of Mr. Gill’s instructors at The Ohio State University and has worked with Mr. Gill over the last year in three very unique settings, which include a student run free health clinic, a field seminar course, and overseeing his field placement experience. Ms. Stewart describes Mr. Gill as "one of the most motivated students I have ever worked with" and someone who is "humble in his approach to his work and education.” She goes on to share that “he asks for help when needed and never assumes he knows it all. His humble nature allows him to quickly build rapport with patients/clients allowing them to feel at ease." She describes his involvement and commitment to the service of others through his time in the Marine Corps and other campus and community volunteer activities as "commendable" and shares that Mr. Gill is someone who is already "an agent of change for vulnerable and oppressed populations” and that she "can't wait to see where his career takes him.

 

Kelli Hatzenbuehler

University of Nebraska Omaha

Kelli Hatzenbuehler has worked for the United States army for 20 years. Through both her and her husband’s military service, Ms. Hatzenbuehler has learned first-hand about the sacrifices service members make, including being away from their children and spouses for extended periods of time. Through her service, Ms. Hatzenbuehler has developed a great deal of empathy that she will take with her into her career as a clinical social worker.

Ms. Hatzenbuehler recognizes that there is often a language barrier between veterans/service members and the civilian population and believes she is able to understand that language and the unique problems that veterans face. Ms. Hatzenbuehler was first deployed in 2003. During her first year of deployment, she lost three members of her unit. In the thirteen years that this unit has been home, 3 additional members were lost to suicide. Ms. Hatzenbuehler wants to assist service members and veterans when they are feeling hopeless and hopes to do so by working at the VA or a similar entity as a clinical social worker. 

William Buettner has worked with Ms. Hatzenbuehler for over 5 years in the Resilience and Suicide Prevention Office of the Nebraska National Guard and has served in the same units with her on occasion for the past 10 years. Mr. Buettner describes her as someone who "uses her empathy to relate to people in crises and or distress...her empathy helps make the persons at risk talk more freely." He describes Ms. Hatzenbuehler as a person of integrity who "takes the ethical road and helps others along that path." He shares that Ms. Hatzenbuehler is "an expert in her field and looked at by her peers as a subject matter expert” and is someone who continually strives to become better at her duties, consistently rising to the top.

 

Kevin Rumley

Western Carolina University

As a United States Marine Corps combat wounded veteran who has undergone 32 surgeries, Kevin Rumley is someone who has witnessed first-hand the devastation and chaos of war. Mr. Rumley received world class psychotherapeutic and physiological rehabilitative care, including services from clinical social workers at the Walter Reed Medical Center. This along with his early maternal introduction to serving others were catalysts for his passion to become a clinical social worker. It was through his military service that Mr. Rumley's belief in the critical importance of building relationships and active-listening were solidified. He learned that “only through listening can we begin to understand.” Mr. Rumley describes himself as “a veteran for peace” and strongly believes that clinical social workers have the capacity to change lives. He is passionate about recovery, resiliency, and fighting for social justice and is someone who strives to be a positive agent of change within his community.

During his first-year internship serving at the Buncombe County Veterans Treatment Court, he found that non-punitive treatment-based programs are effective modalities for reducing recidivism. He discovered the importance of self-care and boundaries in this difficult work. Mr. Rumley learned that it is through open dialogue and ongoing advocacy that change can occur and that to be the most effective clinician possible, he must remain open and receptive to his environment. Mr. Rumley has worked at NC Brookhaven Behavioral Health, a Service Disabled Veteran-Owned Small Business, for the last five years on the ACT Team (assertive community treatment). He plans to become an LCSW, LCAS, and EMDR practitioner, promoting change on an interpersonal level through EMDR and on a policy level with the goal of instituting harm reduction clinics in rural parts of Western North Carolina. Mr. Rumley additionally hopes to pursue his DSW in the future.

Susanne J. Loar served as Mr. Rumley’s supervisor for the North Carolina Substance Abuse Professional Practice Board for the past two years. Ms. Loar shared that Mr. Rumley is dedicated to assisting people-especially veterans-in their recovery from substance use and mental health disorders. She describes him as "an advocate for veterans living in the community." Ms. Loar reports that Mr. Rumley has been unofficially running the team while he pursues his graduate degree and shares that his "innate intelligence, ethical integrity and vast experience have added value to the individuals and to the wider community.” She describes Mr. Rumley as "a great advocate for people on medication assisted programs” and that he “brings empathy and expertise in the field." Further, Mr. Rumley “has been instrumental in setting up and following veteran's through the veteran's court system" and has been a "driving force in the local and state judicial system." Ms. Loar states that Mr. Rumley is "a tremendous addition to the field of social work" and that she "cannot think of a person more deserving" of this scholarship.

 

Shayne Wiggins

Western New Mexico University

Shayne Wiggins was drawn to the field of clinical social work after returning from his deployment with the United States Marines. He had a difficult time finding a military social worker who was also a veteran. It was through this experience that Mr. Wiggins realized 1. there is shortage of master's level social workers who can provide services through a veteran's lens and 2. many veterans who have experienced combat trauma may feel more comfortable opening up to a professional who can relate to their military experiences.

Mr. Wiggin’s military experience taught him how to fight through adversity and serve with honor. During his deployment, he developed integrity, dedication, commitment, and honor to both his country and his shipmates. His first-year internship taught him that he is a culturally competent social worker in training and that becoming a competent social worker takes commitment and dedication-two things that Mr. Wiggins has. Mr. Wiggins plans to practice clinical social work with veterans who have experienced combat trauma, homeless veterans living with substance use disorders, and veterans who are survivors of military sexual trauma and assault. He recognizes that these are underserved populations that deserve well-trained and competent clinicians that understand their trauma and can help them resolve and manage their traumatic experiences through empirical translational science.

According to Kendrick Lockett, who Mr. Wiggins met through his internship at the Atlanta Mission organization, Mr. Wiggins is someone who "has a gift for working with those who have been subjugated and marginalized within our society." Mr. Lockett stated that "our veteran services have improved significantly since his internship began here” and that “he has excelled in his internship above and beyond the agency's expectations." Mr. Lockett describes Mr. Wiggins as someone who "exemplifies strong attributes and abilities in becoming a clinical social worker.

 

We at the Therapist Development Center believe that more can and should be done by every civilian American to support our troops and veterans, so we are now offering our programs FREE for any veteran or active duty military, including each of our scholarship applicants. To learn more about how to obtain this offer, click HERE. To learn more about our social work exam preparation programs, click HERE.

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: Exam Prep, Social Justice, Social Work Exam Prep, Professional Development

2017 Veterans Service Scholarship Winners

Posted by Bethany Vanderbilt

August 16, 2017 at 1:47 PM

Congratulations to the 5 winners of the 2017 Veterans Service Scholarship:

1. Fernando Chavarria of Michigan

2. Jonathan Gill of Ohio

3. Kelli Hatzenbuehler of Nebraska

4. Kevin Rumley of North Carolina

5. Shayne Wiggins of New Mexico

We would like to thank everyone who participated in our 1st annual Veterans Service Scholarship for 2nd year MSW students. We had more than 50 applicants from 21 states and 29 schools! Our entire scholarship committee was impressed by the service and quality of our applicants and it was extremely difficult to select our winners. We are inspired by each of your stories and hopeful for the positive impact you will have on this field and the world. Stay tuned for a piece featuring each of our scholarship winners.

We at the Therapist Development Center believe that more can and should be done by every civilian American to support our troops and veterans, so we are now offering our programs FREE for any veteran or active duty military, including each of our scholarship applicants. To learn more about how to obtain this offer, click HERE. To learn more about our social work exam preparation programs, click HERE.

On behalf of the Therapist Development Center team, we wish you the best in your careers as clinical social workers and we know the world will be a better place with your contributions to the field.

Sincerely,

Bethany Vanderbilt, LCSW

Executive Director

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Topics: Exam Prep, Social Justice, LCSW Exam Prep, Social Work Exam Prep

ASWB Exam Changes: Exploring Upcoming Changes to the LMSW and LCSW Exams

Posted by Heidi Tobe

August 9, 2017 at 10:51 AM

The ASWB recently announced that they will be making changes to their licensing exams, to take effect January 2, 2018. 

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First of all, don't panic! These changes are being implemented to ensure exam content is 1. relevant to current practice and 2. demonstrates both the opinions and the expertise of a diverse group of stakeholders (ASWB, 2017). We have already been getting a number of emails and calls from test takers anxious about these upcoming changes-and rightfully so, as the exam is daunting enough without the uncertainty of new material. The ASWB states, “the updates to the blueprints can generally be described as a touching up and refining of details, with only a few specific topics receiving more extensive adjustments” (ASWB, 2017). This is good news! The changes being made for the LMSW and LCSW exams are minor (the exam undergoing the greatest changes is the Advanced Generalist Exam-an exam you don’t have to worry about if you are on the path to clinical licensure!).


Percentage Changes
 

masters exam

 

As is shown in the diagram above, for the Master’s Level exam, the percentage of Professional relationships, values, and ethics questions is decreasing by 2% from 27% to 25%, the percentage of Human development, diversity, and behavior in the environment questions is decreasing by 1%. The number of Assessment and intervention planning questions are staying the same. What was formerly known as the "Direct and indirect practice" is retitled "Interventions with clients/client systems” and will be increasing by 3%.

 

Clinical exam

 

As shown in the diagram above for the Clinical exam, the number of Professional values and ethics questions are increasing by 1%. The greatest change in questions is in Human development, diversity, and behavior in the environment, which is decreasing from 31% to 24%. Assessment, diagnosis, and treatment Planning questions are increasing from 26% to 30% and Psychotherapy, clinical interventions, and case management is increasing from 25% to 27%.

As you can see, the greatest percentage changes are 3% within any content area for the Master’s level exam and 7% for the Clinical level exam.

So What’s Changing?

We have spent a great deal of time comparing the blueprints for the current exams and the exams to be released in 2018. Here’s what we found: The new blueprints are more lengthy and detailed. The biggest thing we noticed, though, is that the new blueprints seem largely to be expounding upon the outline of the previous blueprints. For example, what once stated “The impact of the environment (e.g. social, physical, cultural, political, economic) on individuals” now states “The impact of the environment (e.g. social, physical, cultural, political, economic) on individuals, families, groups, organizations, and communities” (emphasis added). What used to simply state “interview techniques” now states “The principles and techniques of interviewing (e.g., supporting, clarifying, focusing, confronting, validating, feedback, reflecting, language differences, use of interpreters, redirecting.” What used to say “Indicators and dynamics of abuse and neglect” now states “Indicators of abuse and neglect throughout the lifespan” (emphasis added). “Throughout the lifespan” is a phrase we noted came up frequently in the new blueprints, along with “client systems”

How Does This Impact My Studying?

Honestly, not much. Overall, we think these changes could be a really good thing for people preparing for their licensing exams as the ASWB has taken some of the guess work out of what may show up on the exam. What is great for our users is that we have always been proponents of not over studying and steer away from filling our program with obscure pieces of knowledge that are unlikely to show up on the exam (there’s nothing worse than trying to memorize hundreds of pages of content from a thick textbook!). We encourage those preparing for the exam not to let their anxiety get the best of them, over studying each bullet point of the new blueprints in depth (the ASWB has broken it down well for you, so you don’t need to add more bullet points beneath their bullet points!). Trying to study too much content can feel productive, but is not. Our anxiety tells us if we study every bit of information possible, then we will be best prepared. We know from preparing over 20,000 test takers for their licensing exams that more isn’t always better! Rest assured, TDC has it covered.

TDC is known for providing you, our test takers, with everything you need to pass the exam and nothing you don’t. For years, TDC has already been breaking down these content areas further and in more detail as the ASWB is doing now. Does this mean we will not be making any changes to reflect the new exams? Absolutely not! We want to continue to provide the best exam prep out there and have full intentions of continuing to do so by making small changes based on what the ASWB is putting out later this year. We will be working hard to incorporate some of the minor changes being made to the exams, including ensuring our mock exams reflect accurately the percentage of questions being tested on in each content area for the LMSW and LCSW exams. Later this year, the ASWB will release updated practice exams online so that individuals testing on or after January 2, 2018 have practice materials that fully and accurately reflect the modified exams.

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!

References

https://www.aswb.org/2018-exam-blueprints/

Diagrams retrieved from: https://www.aswb.org/2018-exam-blueprints/how-are-the-exams-changing/

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Topics: Exam Prep, LCSW Exam Prep, Social Work Exam Prep

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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LCSW/LMSW Practice Question: Defense Mechanisms

Posted by Heidi Tobe

August 2, 2017 at 11:34 AM

This week we address another topic that is likely to show up on any one of the licensing exams you are preparing for, whether you're getting ready to take the LCSW, LMSW, or BSW exam: Defense Mechanisms. In each of our exam preparation programs, Amanda Rowan does an excellent job of teaching you how to distinguish between the defense mechanisms and apply the knowledge to exam questions. Here is one such question:

bigstock--180428599.jpgA 16-year-old male is suspended after repeated offenses of bullying a classmate. While meeting with the principal the student states, "EVERYONE makes fun of that kid! You just don't see it!" What defense mechanism is the client using?

A. Sublimation

B. Rationalization

C. Internalization

D. Denial

The correct answer is B, Rationalization. Sublimation occurs when an individual changes socially unacceptable impulses into socially acceptable behaviors. In a situation like this, sublimation may look like the 16-year-old male channelling his need for power into the role of “protector” and standing up for students who are picked on. Internalization would occur if the 16-year-old male had seen his parents or an older sibling engaging in bullying behavior and took that on as a part of himself and his identity. Denial would involve him denying engaging in the behavior at all, saying something like “I never bullied him!”

The 16-year-old is engaging in rationalization by making an otherwise unacceptable behavior justified by applying logic or reason (in this case, the idea that “everyone else is doing it”) to the behavior.

Trying to learn and apply all of the defense mechanisms can feel overwhelming. We recommend trying to think of personal or client examples for each of them to help make them stick better in your mind. What have you done to learn all of the defense mechanisms? Comment below with what has worked for you!

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Topics: Exam Prep, LCSW Exam Prep, Social Work Exam Prep, Practice Questions