Sunday, February 14, 2010
Firstly, the server crashed at my site so my test was delayed by a day. Talk about a let down! To have all that adrenaline pulsing and to feel ready to just get it over with and then to find out you can't. Not to mention postponing the celebratory drinks at my husband's holiday party that night :( However, I have to say the staff at the testing site were extremely apologetic and helpful in getting us all rescheduled.
The next day I returned, feeling glad that at least I had done a "practice run" (i.e. how to get there, where to park, layout of the site). The actual exam wasn't too bad. I think one key point to remember is to acknowledge feelings and build rapport first. Frankly, I began to second guess myself because it seemed like there were 20 questions related to this.
There were only 2 questions on the test where I had NO CLUE! I basically had to guess. Many questions I knew right away I found it helpful to use tips from the LICSW Review course that I took through the Washington NASW chapter (hierarchy of needs, build rapport/acknowledge feelings, rule out medical issues). I only had one medication question, so I over prepared in that area. I flagged more than I thought I would (maybe 30 or 35) and went back to review only the flagged questions. As 3 hours approached I was mulling over the flagged questions and just second guessing myself so I took a deep breath and hit "QUIT".
My coworker told me that when you hit quit, the screen goes blank and then a "You passed" screen with the score pops up. This did not happen for me -- instead it asked me to take a short survey about my testing experience. I immediately feared that I had failed and they wanted to survey me to see why. Silly, I know, but they literally hold you hostage and make you go through a 10 question survey before you get your score. I personally don't find it a very ethical survey since you cannot opt out -- but once it was over I got the "You passed" screen and I was relieved to put it all behind me.
Hope this was helpful and good luck to all of you out there!
Thursday, December 17, 2009
As the day of reckoning quickly approaches I am trying to keep in mind what I think will be the most pertinent points to guide my reasoning and application on the test.
- Licensure is mostly to protect the consumer, use that to guide your answers
- Safety of the client/family/public first (always choose the answer that protects)
- Always rule out a medical condition first when given assessment options
- Pay attention to qualifiers or buzz words (Most, First, Least, Next)
- Choose the answer that directly relates back to the patient's presenting problem when given multiple plausible intervention choices
- Respond to the item as it appears (don't read into it or apply it to a real life situation you have had)
- Don't let your past experience lead you astray! Remember, this is a hypothetical client! They are looking for a textbook answer (not the think outside the box answer)
- If you are unsure, look at the answers, is there one that is clearly different than the other three Example: Enmeshed families often display: a) positive communication b) healthy boundaries c) respect for one another's self determination d) lack of boundaries Obviously 3 of these answers are "healthy" traits and one (lack of boundaries) is not. You could pick the one that is clearly different or mutually exclusive from the others even if you did not know the definition of an enmeshed family.
- Always consider rapport building. Whenever possible acknowledge the clients feelings or statements before moving on.
Hopefully by 2pm tomorrow I will be finished with my LICSW exam with a big smile one my face. Then I can relax, celebrate the holidays and hopefully enjoy some fresh powder in the mountains of Montana! Will keep you posted.
Thursday, September 3, 2009
Friday, August 28, 2009
- Behavior Therapy is the application of techniques intended to create behavioral changes that are based on the principles of the conditioning theories of learning.
- These are characterized by multiple theories and techniques.
- The foundation is in Pavlov's classical conditioning, Skinner's operant conditioning and Bandura's Social Learning theaory.
- Skinner: behavior can be empirically investigated only through the measurement of observable behavior
- Withholding reinforcement = extinction
- This paradigm also includes Cognitive Behavior approaches
- All behavior is learned and can be defined and changed
- Change occurs by rearranging "contingencies of reinforcement" - altering what happens before and after the behavior
Social Learning Theory: Comprised of 3 elements
- Target Behaviors (the target of change)
- Anticedent behaviors or events (events that precede the behavior)
- Consequences (events that follow the behavior)
Behavior Therapy Paradigm A-B-C
A (anticentent) ->B (behavior) -> C (consequences)
- In treatment the client(s) must identify DESIRED behaviors not just the undesired
- Coercive Process - negative reinforcement, the termination of a behavior (threats) upon occurrence of the desired behavior (compliance)
- Information processing- acquisition, storage and utilization of information (includes perception, language and memory).
- Beliefs and Belief Systems- ideas attitudes and expectations about self, others and experience
- Self Statements- private monologues that influence behavior and feelings
- Problem solving and coping - conceptual and symbolic processes involved in arriving at effective responses to problematic situations.
Behavioral Social Work Practice: goal is to increase desireable behavior and decrease undesirable behavior so the client can improve daily functioning.
- Focus on the here and now
- Build on client strengths
- Etiology of behavior is not investigated
- Traditionally a diagnostic label was not pursued and thought of as stigmatizing but with current approaches, there is more integration of diagnostic classifications (likely due to requirements from insurance companies)
- Build a strong therapeutic relationship
- Involve the client as much as possible in each step of the assessment/intervention
- Identify problematic behavior (perception of who does what)
- Identify priorities, antecedents & consequences
- Identify contingencies
- Identify recurrent patterns
- Secure a commitment
- Begin to identify targets (desireable behaviors)
- Discuss possible targets
- Allow time for all family members to present concerns (if applicable)
- When targets are established, set conditions for a baseline measure
- Determine if assessment indicates a change, does one or more participants require more attention (i.e. should it be couples therapy rather than family therapy?)
- Identify target behaviors
- Establish new antecedents
- Establish new consequences
- Formulate a written contract
- Follow up call
- Reference contract, any changes require a consensus from family/clients
- Check tally (in families parents usually tally target behaviors) provide positive reinforcement
- Discuss problems between sessions
- Conflict resolution
- Evaluate program design
- When target behaviors reach desired frequency, move toward termination
- Evaluate progress
- Set conditions for maintenance
- Review basic learning principles
- Have family continue tally for 4 weeks
- Set up appt at 4 weeks for termination and f/u
- Very helpful for anxiety, depression, phobias, addiction, sexual dysfunction, relationship issues.
- Often paired with systematic desensitization
- Most recommended treatment for Phobic Disorders
- Also indicated for social skills training, hyperactivity, developmental problems
- Interventions must consider cultural issues and differences
- Empirically validated
- Sometimes combined with pharmacotherapy
- Need to maintain a record of what approaches work most effectively with what problems
Adapted from Social Work Treatment by Francis J. Turner, 4th Ed.
Thursday, August 13, 2009
- Creating an awareness of the effect of beliefs/thinking on behavior.
- Highlight relevant beliefs
- Teach the client to dispute/change irrational beliefs -- often using the ABC format and extending it to D (Disputing) and E (new Effect)
- Prescribing homework that actively practices disputing self defeating beliefs, inferences and evaluations.
- Infant (birth to 18mos) Trust vs. Mistrust: learns to trust self, environment
- Toddler (18mos to 3yrs) Autonomy vs. Shame and Doubt: learns to believe in him/herself
- Preschool (3 to 5) Initiative vs. Guilt: learns to take initiative in play rather than mimicking
- Latency State (6 to 12) Industry/Competence vs. Inferiority: learns that he/she is capable and able to accomplish
- Adolescence (12 to 18) Identity vs. Role Confusion: searches for individuality from environment
- Young Adult (19 to 40) Intimacy vs. Isolation: searches for meaningful relationships
- Middle Adult (40 to 65) Generativity/Productivity vs. Self Absorption or Stagnation: search for meaning through intergenerational communication
- Late Adulthood (65 to death) Ego Integrity vs. Despair: looking back with either feelings of accomplishment or despair
Thursday, August 6, 2009
2 types of development
- Learning (nurture) -- environmental influences
- Maturation (nature) -- genetic/biological influences
Critical Periods: early development periods during which particular experiences are essential.
Stages: organization of behaviors/thoughts during particular early periods of development defined by relatively abrupt change.
- Infant stage: baby born with reflexes (automatic behavior: startle, sucking). Vision nearsighted, interested in novelty. Smiles at 4-6 weeks in response to faces. Rhythmic "conversations".
- Adolescence: more myelination of the frontal lobes may allow for improved self control. Biological development - increased hormones, sex organs develop, growth spurt. Intellectual - formal operational (abstract reasoning), independence, questioning.
- Aging: older adults experience decline in short-term memory and attention. Transition theories - unanticipated, anticipated, non event, chronic hassle. Major Milestones - starting out, marriage or living alone, parenthood, empty nest, midlife crisis, retirement widowhood.
Social Development: Developing how we relate to others
Attachment: emotional connection between infant and caregiver
- Harlow's monkey studies: showed the fear of unknown fosters attachment. Monkeys preferred soft, cuddly surrogates even if they did not have food. Monkeys raised w/o mothers were socially incompetent, aggressive and unable to raise their own babies.
3 styles of Attachment (Ainsworth)
- Secure - warm relationship, baby does not fear abandonment
- Resistant - close relationship, but baby fears abandonment
- Avoidant - distant relationship, baby/child indifferent to whether mother is present
Socialization: process by which one acquires the patterns of behavior of their society.
Parenting Styles: (parents are one source of socialization)
- Autocratic: parents strict, rigid, require obedience and conformity
- Authoritative: reciprocal (most effective): parents are firm but fair, make & enforce rules, allow questions and encouraged appropriate independence
- Permissive: parents do not make rules or enforce them
More to come!
Adapted from Bar Charts Quick Study Academic: Psychology and Sparkcharts Psychology.
a) It has been a very long time since college/grad school (or it feels that way)
b) There is so much POTENTIAL material for test questions
c) I need direction! Otherwise I surely will study all the things that I will never get a test question about.
Here it is -- after poking around on the ASWB website, the content areas of the test! I am keeping these in mind and using them as a guide.
Human Development 22%
Diagnosis and Assessment 16%
Psychotherapy/Clinical Practice 16%
The Therapeutic Relationship 7%
Professional Values and Ethics 10%
Clinical Supervision, Staff Development 4%
Practice Evaluation, Utilization of Research 1%
Service Delivery 5%
Clinical Practice Management 5%