DBT and the Social Work Exam

dbt and the social work exam Here's another therapy you shouldn't be surprised to see appear on the social work licensing exam: Dialectical Behavioral Therapy (DBT). What's DBT? Here are some quick answers to that question--thank the Internet:

That last link--from the source--includes this quick and helpful summary:

Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, Ph.D., ABPP, at the University of Washington, is a comprehensive cognitive-behavioral treatment that was originally developed to treat chronically suicidal individuals suffering from borderline personality disorder (BPD). DBT has been found especially effective for those with suicidal and other multiply occurring severely dysfunctional behaviors. Research has shown DBT to be effective in reducing suicidal behavior, psychiatric hospitalization, treatment dropout, substance abuse, anger, and interpersonal difficulties.

Key here: DBT, BPD, "research has shown." This last phrase is essential for any therapy you're tempted to think of as a BEST choice on the exam. How might a DBT question look on the exam? Maybe something like this: On intake, a social worker notes that a client struggles with relationships, often idealizing, then devaluing people in her life (Substitute any combination of BPD symptoms here). What would be the BEST therapy to try with this new client? A) CBT B) DBT C) IPT D) Psychodynamic therapy. Since you're in a DBT blog post, the answer should come extra easily. The question being asked is, do you know what DBT is? Do you know what it treats? You do? Great. Right answer, next question.

For more detail about DBT, here are a pair of podcasts, ready to fill your ears with wisdom:

Consider yourself prepped on DBT! Good luck with the exam. For more practice, including questions about DBT, sign up with SWTP!

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CBT and the Social Work Exam

cbt tree A good rule of thumb for the social work licensing exam: "When in doubt, it's CBT." Why? Cognitive Behavioral Therapy is research validated therapy practice. That is, it works--studies say so. And the Code of Ethics says social workers should using treatments that work. And CBT's here-and-now focus is social work friendly. It works short term. It works on a wide array of symptoms--the very ones social workers face in day-to-day practice: anxiety, depression, panic, phobias, on and on.

CBT's been around long enough to have spawned new variations on its themes. Those "third wave" treatment approaches may also show up in good light on the exam. Treating BPD? Try DBT.

A typical question on the social work exam will pit CBT against its less-validated ancestors and cousins. "A so-and-so client seeks a social worker's help with such-and-such trauma. What is the BEST available treatment option?"  A) Explore childhood roots of trauma (psychodynamic psychotherapy), B) Use EMDR to lessen experience of trauma, C) Use Rogerian principles to build rapport, D) Decrease symptoms with CBT.

You get the idea. Each approach may be helpful. It may even be your personal favorite approach to helping clients. But it's not what the social work examiners want to hear. Ask yourself, which is validated, targeted, quick, effective, and mainstream? That's D. That's CBT.

To brush up on Cognitive Behavioral Therapy, some quick reading, listening, and a video:


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Social Work Exam Resource: Human Development Theory

human development to come Part of effective prepping for the social work licensing exam is gauging just how much is necessary to know about a given topic to get through the test. There's so much information that can potentially end up on the exam. Do you need to know any every topic in detail? Probably not. This is especially true for theories of human development and other knowledge areas. Everything you're likely to need to know about Freud or Erikson, for example, can be summed up in not much more than a chart.

Take Freud. You'll usually be able to handle a Freud item on the exam by knowing just the basic vocabulary--id, ego, superego; oral, anal, phallic, etc.; psychoanalysis. For better or worse, depth of knowledge isn't always being tested. For knowledge questions, a little knowledge is usually enough. That's why pages like these can be so useful as you prep for the social work exam.  Here, free of charge, are the basics about Freud and Erikson, and also Skinner, Piaget, and Bronfenbrenner. Need to review any of that material? There it is.

That'll take care of some of the knowledge questions on the exam. But remember, the questions that lend themselves to flash card prep are just a fraction of what's on the exam. The bulk of the test concerns the type of close-call judgments that social workers face in actual practice--vignettes that test your ability to apply social work values and ethics to a variety of situations. Others that dig for bias and cultural insensitivity. To prep for these, practice questions are usually best. And, of course, continuing to do what you do, being a social worker, walking the walk, talking the talk. Soon, you'll be passing the test. Good luck!

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Code of Ethics Spotlight: Sexual Relationships

code of ethics spotlight sexual relationships Here's a section of the NASW Code of Ethics that doesn't need a lot of rereading and figuring. Can ethical social workers have sexual relationships with clients or former clients? No. It takes the code a while to get this said, in Section 1.09, Sexual Relationships. Here's a quick summary, point by point:

(a) No SW sexual activity with current clients.

(b) No SW sexual activity with people close to client. 

(c) No SW sexual activity with former clients. Can harm the client.

(d) No SW services for former sexual partners.

Simple enough. Tempted to have sex with a client, a former client, a client's friend, or to be therapist or social worker to a former sexual partner? Don't. It's unethical.

Here's Frederic Reamer (as usual) detailing the whys and whats of this section of the code in Social Work Today: Facing Up to Social Worker Sexual Misconduct.

All of this really could be folded into the dual relationship section of the code, but given that this is an area that social workers and other therapy types lose their licenses over with some regularity, it seems to have warranted its very own detailing. For more on dual relationships, here's another SWT article, Respecting Boundaries.

A licensing exam question about all of the above might look something like this:

A social worker in private practice finds herself growing sexually attracted to a male client. What should she do FIRST?

A. Terminate with the client and wait two years before beginning a sexual relationship.

B. Terminate with the client and refer him to another therapist.

C. Seek supervision regarding countertransference.

D. Discuss the attraction with the client before deciding whether or not to terminate.

Best answer? A is easiest to eliminate--it directly contradicts the code. B & D are tempting. Maybe this client does need to be referred out. Would you refer the client without tell him why? If no, than D. If yes, than B. Happily, there's another, better answer here: C, seek supervision first. Sexual attraction to a client is also known as erotic countertransference. Before considering termination, the social worker should explore the issue in supervision. How is the intimacy of therapy being confused with other types of intimacy? How to remedy? 

Make sense? Great. Want more questions? Sign up with SWTP for complete, realistic social work licensing exam practice tests.

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Code of Ethics Spotlight: Conflicts of Interest

code of ethics spotlight conflicts of interest Next up on our Code of Ethics tour is a big one--lots of potential social work licensing exam questions lurk in this section. It's 1.06, Conflicts of Interest--follow the link for the text in its entirety. Here's a quick summary:

(a) Avoid conflicts of interest. Inform clients of real or potential conflicts. Resolve and keep the client if possible, though termination may sometimes be necessary.

(b) Don't exploit the social worker role to further personal, political or business interests.

(c) No dual relationships. If unavoidable, set boundaries, protect clients

(d) Keep things clear when working with people who know each other.

Contained in part c, a simple, helpful definition of what constitutes a dual relationship:

Dual or multiple relationships occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively.

What type of questions rooted in this section of the code might you encounter on the exam? A bunch. Some quick examples:

For A: How best to proceed with a client you realize is dating your sister? (Probably terminate.)

For B: Your client gives you a good stock tip. What do you do? (Don't invest.)

For C: You learn your client has kids in the same school as you, should you terminate? (No, probably not.)

For D: Two of your clients start dating each other--they both know the other is in treatment with you. Can you acknowledge to each that you see the other for treatment? (Nope, not without a release. Confidentiality always trumps.)

That's just scraping the surface. You can probably come up with plenty more of your own (feel free to post 'em in comments if you do).

Here's some reading that explores implications for some of the above:

Remember, the social work exam isn't out to trick you. If you've got these essential parts of the code of ethics under your belt, you'll be able to breeze through a large chunk of the exam. Just takes some reading and, of course, practice. Good luck!


For practice questions regarding conflicts of interest, the code of ethics, and much more, sign up for SWTP exams!

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