Code of Ethics Review: Respect Toward Colleagues and the Social Work Exam

respectEthics are in the daily spotlight these days. They're never out of daily consideration for practicing social workers. And ethics are even more front-burner for social workers preparing to pass the social work licensing exam. Let's dive back in where we left off months ago and take the second part of the NASW Code of Ethics section by section. Part two of the code covers SOCIAL WORKERS' ETHICAL RESPONSIBILITIES TO COLLEAGUES. Social work ethics don't end with your interaction with clients. Peers and co-workers are covered too! Like here in the first item, 2.01, Respect:

2.01 Respect

(a) Social workers should treat colleagues with respect and should represent accurately and fairly the qualifications, views, and obligations of colleagues.

(b) Social workers should avoid unwarranted negative criticism of colleagues in communications with clients or with other professionals. Unwarranted negative criticism may include demeaning comments that refer to colleagues' level of competence or to individuals' attributes such as race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability.

(c) Social workers should cooperate with social work colleagues and with colleagues of other professions when such cooperation serves the well-being of clients.

In a nutshell, be nice to your fellow social workers!

How might this material show up on the exam?

Imagine a question like this:

A client at an inpatient facility asks a veteran social worker if she can have her case transferred away from a young social worker at the facility. "He has no idea what he's doing," says the client. "He's like a chicken with its head cut off." The veteran social worker has observed the same thing. How should the veteran social worker proceed?

A. Let the client know she's seen the same behavior and follow facility rules regarding transfers.

B. Encourage the client to discuss her wants and needs with the new social worker.

C. Discuss the client's report with the new social worker and a supervisor.

D. Have the client's case transferred to the veteran social worker.

What do you say?

As usual, narrow it down. D. seems too abrupt (not enough respect). A. involves negative criticism of a colleague that may be accurate, but is unnecessary here (still not enough respect). C. would be a better answer if it didn't rope in a supervisor right away (show the colleague some respect--talk to him alone first). That leaves as the best of the offered answers B. Both the client and the anxious social worker may benefit from a discussion about the client's experience of treatment (respect for client and colleague).

It's all about respect!

As with many ethics-based questions on the exam, this isn't a slam dunk. It's not like a DSM question that you either know or you don't. But it's typical of the ASWB exam. You know a couple of answers aren't right and you end up stuck choosing between two that seem pretty good but not great. You take your best shot, you move on, you PASS the exam!

Good luck!

Start with SWTP's complete practice tests by building your own exam bundle here.

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Free Practice Question: Client's Previous Treatment Records

conferring with clinicianFrom the earliest days of SWTP, here's a question that never got included in an exam. It may have been too easy. We've toyed with it a little--made it a little trickier--and present here as another in our long series of free practice questions. Follow along on Facebook to see what others are saying. 

A client comes to a social worker for help with recurring bouts of depression. She's new in town, but has received therapy from a mental health clinic where she used to live. The client is not sure whether she's comfortable having the old and new clinicians communicating. In order to be MOST effective, the new social worker should:

A. Explore the client's discomfort with the communication before contacting the previous therapist.

B. Contact the client's previous therapist just once to discuss general impressions of the client.

C. Explain to the client that it will be easier to make progress with thorough information about prior treatment.

D. Ask the client to explain her reluctance to share information about her prior treatment.

What do you say?

Let's take the answers one by one:

A. may be appealing since it involves checking in with the client before reaching out to the prior clinician. But exploring isn't the same as getting permission. Without written consent, contacting the previous clinician violates the client's confidentiality.

B. has the same problem. Whether it's one contact or a thousand, no consent means no contact allowed.

C. While it may be true that more information equals more progress, the best, most effective of the choices offered here is...

D. Exploring the reluctance to share information about prior treatment is the best choice. Don't be fooled by "MOST effective." On the exam (as in practice!), abiding by the Code of Ethics is always the first priority.

So, breaking confidentiality? No good. Trying to get to comply and cooperate. Better, but still not great. Being where the client is, discussing her feelings, exploring her history--that's doing social work. The correct answer is D!

For more about client confidentiality, read up in the Code of Ethics and then in these articles, which each present different exam-like questions about client rights, records, and confidentiality:

Get started with full-length, real-time practice tests by signing up and building your own practice test bundle! Good luck on the exam!!!

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Trauma- and Stressor-Related Disorders and the Social Work Exam

acute stressLet's all keep going. Here's another free practice question to help you get prepared to pass the ASWB exam.This time, we're digging into the Trauma- and Stressor-Related Disorders chapter of the DSM. The disorders included there are:

Reactive Attachment Disorder (inhibited, withdrawn behavior toward adult caregivers + emotional disturbance + history of neglect)

Disinhibited Social Engagement Disorder (child actively approaches and interacts with unfamiliar adults)

Posttraumatic Stress Disorder (Intrusion symptoms and avoidance following exposure to trauma)

Acute Stress Disorder (Symptoms following between three days to one month of exposure to trauma)

Adjustment Disorders (Emotional or behavioral symptoms in response to stressor, within 3 months of onset)

Got it? Here's a question:

A woman tells a social worker that she's been "a wreck" ever since being sexually assaulted a few weeks ago. She says she's been irritable, lashing out angrily for no apparent reason. She reports being hypervigilant and having difficulty concentrating. In which of the following categories do these symptoms belong?

A. Intrusion Symptoms

B. Negative Mood

C. Dissociative Symptoms

D. Arousal Symptoms

What do you say?

Not sure? Well, here are each of those categories spelled out.

Intrusion symptoms:  Recurrent, involuntary, and intrusive distressing memories; recurrent distressing dreams; flashbacks; distress in response to internal or external cues that symbolize or resemble an aspect of the traumatic event/s.

Negative Mood: Persistent inability to experience positive emotions.

Dissociative Symptoms: An altered sense of reality of one's surroundings and one's self; an inability to recall an important aspect of the traumatic event/s.

Arousal Symptoms: Sleep disturbance; Irritable behavior and angry outbursts; hypervigilance; problems with concentration; exaggerated startle response.

So, you have your answer! (It's D, right?)

One category of symptoms didn't make it into the A-D list. Avoidance Symptoms: Efforts to avoid distressing memories, thoughts, or feelings associated with the event/s; efforts to avoid external reminders of the event/s.

Another quick question:

The woman is reporting these symptoms within three months of the sexual assault, so the MOST likely diagnosis for her would be _________________.

PTSD or acute stress disorder?

Unless you skipped the info up top, you know the answer. Acute stress disorder is diagnosed between three days and one month since a trauma. For PTSD to be diagnosed, at least a month has to have passed since the trauma occurred. The best diagnosis for the woman is acute stress disorder.

There you have it. You're ever-more ready to pass the social work licensing exam. For more questions from the DSM and all parts of the content outline, sign up for SWTP's full-length practice tests. Each test has thorough rationales and links for additional study. Get started now! Good luck!

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Narcissistic Personality Disorder and the Social Work Exam

selfiePreparing for the ASWB exam? Here's a free practice question, this one from the Personality Disorders chapter of the DSM. But first, can you define all the personality disorders. Do you know which cluster each belongs in?

Here they all are:

Cluster A: Paranoid Personality Disorder, Schizoid Personality Disorder, Schizotypal Personality Disorder

Cluster B: Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder, Narcissistic Personality Disorder

Cluster C: Avoidant Personality Disorder, Dependent Personality Disorder, Obsessive-Compulsive Personality Disorder

Other Personality Disorders: Personality Change Due to Another Medical Condition, Other Specified Personality Disorder, Unspecified Personality Disorder

For details on all of these, take a look at PsychCentral's summaries. But first, let's zoom in on Cluster B and a recently much-discussed diagnosis: NPD.

A woman tells a social worker that she believes her husband, a successful businessman, is "a clinical narcissist." She says he's "completely obsessed with himself." Which of the following can the social worker tell the woman is a common symptom of narcissistic personality disorder?

A. Discomfort in situations in which he or she is not the center of attention.

B. Is unwilling to recognize or identify with the feelings or needs of others.

C. Inappropriate, intense anger or difficulty controlling anger.

D. Repeated lying, use of aliases, or conning others for personal profit or pleasure.

What do you say?

If you know the cluster B diagnoses in some detail, the answer comes much more easily. All but one of the listed symptoms come from other cluster B disorders. Let's take them one at a time:

A. sounds a lot like NPD. Needing to be the center of attention. But it's not. It's a criteria for histrionic personality disorder. Wait, really? Yep. Histrionic personality disorder is characterized by "a pervasive pattern of excessive emotionality and attention seeking..." It's attention-focused, not self-importance focused.

D., repeated lying for profit or pleasure, sounds like NPD too, but, this one is a criterion for antisocial personality disorder ("A pervasive pattern of disregard for and violation of the rights of others..."). NPD can include taking advantage of others, but not necessarily outright, repeated lying, conning, or using aliases.

C., anger problems, sounds a little like NPD too. But it's more indicative of BPD ("a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity")--and that's where that criterion comes form.

Which leaves...the correct answer! B., lack of empathy.  For diagnosis of NPD, five of nine possible criteria have to be exhibited. Here are the full nine:

1. Grandiose sense of self-importance.

2. Preoccupied with fantasies of success, power, brilliance...

3. Believes that he or she is "special" and can only be understood by other special/high-status people.

4. Requires excessive admiration.

5. Sense of entitlement.

6. Interpersonally exploitative.

7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.

8. Often envious of others or believes others are envious of him or her.

9. Shows arrogant, haughty behaviors or attitudes.

That's NPD. You've no doubt encountered it at work and elsewhere. Maybe you'll encounter it on the social work licensing exam. If you do, you'll be ready. Congratulations in advance!

For more about narcissistic personality disorder, try:

To get started with full-length practice tests (which include DSM and lots, lots more), sign up!

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PTSD and the Social Work Exam

nightmareLet's hop to the Trauma- and Stressor-Related Disorders chapter of the DSM. It's stressful out there, so questions from this chapter may seem especially pertinent. Today's free social work licensing exam prep is about posttraumatic stress disorder (PTSD):

A client  reports intrusive distressing memories and recurring nightmares for the last month, ever since hearing about the sexual assault of a close friend. The client says she has had trouble talking to the friend since the reported events--"It's just too disturbing." When diagnosing the client, the social worker should keep in mind:

A. PTSD can only be diagnosed with three or more intrusion symptoms present (e.g., memories, dreams, flashbacks).

B. The diagnosis cannot be PTSD because the trauma was only reported, not experienced or witnessed.

C. PTSD can only be diagnosed when avoidance of trauma-associated stimuli is present (e.g., not talking to the friend).

D. PTSD can only be diagnosed after symptoms have been present for three months.

What do you say?

Items like this take a fair amount of focus and close reading (in addition to familiarity with PTSD criteria). But that's exactly what you're practicing for, right?

Let's eliminate the answers one by one.

A...isn't right. PTSD requires the presence of one or more intrusion symptoms, not three or more.

B...isn't right. PTSD can be diagnosed whether the trauma (exposure to actual or threatened death, serious injury, or sexual violence) was experienced, witnessed, or involved close family or a close friend. Repeated or extreme exposure to trauma (as experienced by EMTs, workers) also counts.

D...isn't right. PTSD symptoms need to be present for one month, not three.

That leaves one answer, the correct answer, answer C! PTSD can only be diagnosed when the avoidance of trauma-associated stimuli is present, and, in this vignette it's present. The client reports difficulty talking to the friend.

You may have had other diagnoses in mind, but since they weren't offered, they can't be the right answer, no matter how correct they are.

All make sense? If not, let us know!

With each practice question, you're more and more prepped for the real thing--the ASWB exam. Good luck!

For more details about PTSD criteria and symptoms, take a look at these sites:

For more questions about PTSD and lots, lots more, try SWTP's full-length, real-time practice tests!

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