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Name That Defense Mechanism

defendedHere's a quick quiz that should help you lock down your ease with defense mechanism. What are defense mechanisms? Wikipedia wants to tell you:

A defense mechanism is an unconscious psychological mechanism that reduces anxiety arising from unacceptable or potentially harmful stimuli. Defense mechanisms are not to be confused with conscious coping strategies. Sigmund Freud was one of the first proponents of this construct.

Okay, but which defense mechanism is which? Here's a short list of examples, courtesy of Simply Psychology. You provide the name of the defense mechanism. Good luck!

1. A young man has no conscious awareness of his desire to hurt his father.

2. A smoker refuses to admit to herself that smoking is bad for one's health.

3. A person comes to believe that their anger toward a rival started with the rival's misbehavior toward them.

4. A person frustrated by their boss, goes home and kicks their dog.

5. An angry person feels relief from working long hours.

How'd you do? Answers are in comments.

There are more defense mechanisms where these came from. Read up on the sites linked above and also here:

To get realistic exam questions about defense mechanisms and much more in SWTP's full-length mock exams, sign up!

Good luck on the exam!

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Quick Quiz: Catatonia and the Social Work Exam

catatoniaCatatonia is not a diagnosis, but a symptom of other diagnoses (e.g., depression, schizophrenia). It's characterized by unresponsiveness  even when apparently awake. That, you probably knew. In the catatonia section of DSM-5 is a small flurry of vocabulary you probably don't already know.  You don't have to know this vocabulary to consider yourself prepared for the social work licensing exam. It's not likely to be on the exam. It just might come in handy. Maybe.

Here's a quick matching game to help you get it all-the-way learned. Your job: pair the symptom of catatonia with its description. To make it easier, you might consider quickly reading the list here before trying to do the matching. We were stumped by these here at SWTP HQ and we managed to get licensed. So, really, this is just an extra!

And...go!

 

Symptoms

1. Stupor

2. Catalepsy

3. Waxy flexibility

4. Mutism

5. Negativism

6. Posturing

7. Mannerism

8. Stereotypy

9. Echolalia

10. Echopraxia

 

Description

A. Slight, even resistance to positioning by examiner

B. Opposition or no response to instructions or external stimuli.

C. Mimicking another's speech.

D. Repetitive, abnormally frequent, non-goal-directed movements.

E. Spontaneous and active maintenance of a posture against gravity.

F. Mimicking another's movements.

G. Odd, circumstantial caricature of normal actions.

H. No psychomotor activity; not actively relating to the environment.

I. Passive induction of a posture held against gravity.

J. No, or very little, verbal response.

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Answers are in comments.

How'd it go?

For more about catatonia, read up here:

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Self-Determination and the Social Work Exam

self-determinationOur question-a-section trek through the NASW Code of Ethics continues. All aboard!

Next up, 1.02, Self-Determination. The section is quick:

Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients' right to self-determination when, in the social workers' professional judgment, clients' actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.

What kind of questions might emerge from this section? Lots of 'em. The section lends itself to questions which assess for social worker overreach, cape-wearing, and rescue-mindedness over simple client care. Which kind of gives away the answer to an item like this:

A client tells a social worker that she plans to take a psychedelic drug over the weekend in an effort to decrease her anxiety. What should the social worker do?

A. Explain the dangers of psychedelic drugs to the client.

B. Discuss the pros and cons of the plan.

C. Notify police about the planned illegal drug use.

D. Refer the client to a psychiatrist for anxiety medication.

How do you wind your way to the right answer here? Take it step by step. Eliminate the most eliminatable first. Call the cops (C)? Social workers and police would rarely be off the phone with each other if social workers made a reporting call every time a client discussed drug use. Also, confidentiality. The other three are more reasonable. Which one is right?  Referring to an MD doesn't directly address the drug-taking plan the client has introduced. Explaining dangers risks alienating the client. Answer B respects client self-determination while opening a discussion about the wisdom of the plan. It's the best of the offered answers. BTW, worth noting that the client isn't just making stuff up--recent research shows psychedelics can be useful in mental health treatment. But you didn't need to know that to answer the question correctly. You just had to remember section 1.02.

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Social Worker Commitment to Clients and the Social Work Exam

commitment to clientsStarting today, a new initiative: Let's start taking the NASW Code of Ethics section by section, sketching out how the ASWB exam use each a test question. Because you can be sure that's how a good chunk of the exam is being written. Writer X sits down to a blank page and has to make questions appear. Where to turn? How about the Code of Ethics?

First up (for us and for the imaginary Writer X), the first section of the Code, 1.01, Commitment to Clients. It says, in part:

[S]ocial workers' responsibility to the larger society or specific legal obligations may on limited occasions supersede the loyalty owed clients, and clients should be so advised. (Examples include when a social worker is required by law to report that a client has abused a child or has threatened to harm self or others.)

Unlike the rest of the Code, this section actually suggests its own exam questions. Abuse calls, duty to warn...anything about reporting is rooted, at least in part, in 1.01. So, here's today's free practice question:

A social worker meets with a client who says she's been thinking of killing herself by jumping off a freeway overpass. What should the social worker do?

That sounds serious. Suicidal ideation and a plan. Let's see the answer options...

A. Report the client's plans to the police.

B. Initiate a psychiatric hold.

C. Discuss the timeframe of the client's plan.

D. Explore the roots of the client's suicidality.

In essence, the questions asks, to report or not to report? The client has S/I and plan about how to do it. So how do you answer? There's one big thing missing here--a when. Lots of people think about suicide and how they'd attempt. Fewer people actually make an attempt. Does this client intend to carry out her plan? The vignette doesn't say. That means, more assessment is needed before a report should be made. That narrows things down to C or D. D may be helpful in ongoing therapy, but it doesn't address the here and now reporting question. The way to get that answers is to ask the client about her intent (aka "discuss the timeframe"). Voila, an answer.

For realistic exam practice about 1.01 and much more, sign up!

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HIPAA and the Social Work Exam

hipaa and the social work exam Here's something you can reasonably expect to see covered on the social work licensing exam: the Health Insurance Portability and Accountability Act, HIPAA for short. If you've worked in an agency, you've very likely encountered HIPAA rules, HIPAA trainings, and, perhaps, HIPAA headaches. On the exam, HIPAA may show up in an item about record sharing. A client requests access to psychotherapy notes, say. Or a client sues a social worker and requests access to psychotherapy notes. How do you answer? Know your HIPAA. Here are a couple of key sections from the CSWA's helpful HIPAA explanation page:

Patient Rights

...include the right to receive a health care provider's Notice of Privacy Practices, and the opportunity to object or opt-out of certain types of communications... The Privacy Standards also provide individuals the right to access PHI, and the right to request amendments to PHI. One of the things HIPAA attempts to do is make it easier for individuals to access their PHI. As such, clients have the right to inspect and copy their PHI, in whole or in part, for as long as the covered entity maintains the information...

Psychotherapy Notes

Psychotherapy Notes are a specific category in the HIPAA rule. Psychotherapy notes are what most clinicians call "process notes" or the actual verbal and non-verbal record of what takes place in the therapy session. The HIPAA description of psychotherapy notes is "raw data." Psychotherapy notes are specifically protected in the HIPAA rule and belong to the clinician. The general rule is that a clinician may not use or disclose psychotherapy notes for any purpose, including most treatment, payment and healthcare operations, unless the client's authorization is obtained. Specific exceptions where an authorization is not required include use by the originator of the notes for supervision and training purposes; and uses for defense in a legal action...

Additionally, psychotherapy are, according to HIPAA, supposed to remain separate from the rest of the client's records.

How should client information be stored? How long do you have to store records? HIPAA has answers for these questions as well. Knowing them should give you a leg up on the exam.

More HIPAA pages worth a look:

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