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Crisis Intervention and the Social Work Exam

off balance While touring various theories and interventions that may come up on the social work exam, don't forget to take some time for something that you can be fairly certain to encounter on the big test (and in social work practice): crisis intervention. Let's start with a definition--Wikipedia has a straightforward one:

Crisis Intervention is emergency psychological care aimed at assisting individuals in a crisis situation to restore equilibrium to their biopsychosocial functioning and to minimize the potential for psychological trauma. Crisis can be defined as one's perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person's current resources and coping mechanisms.

Simple enough. Worth stressing here is that what constitutes a crisis is in the eye of the beholder/client. One person's catastrophe is another's Tuesday afternoon. Also note the goal of crisis intervention. It's not to help improve or change a client's situation, it's to restore equilibrium. Once the client is back at their baseline functioning, crisis intervention is done.

For the exam, that means avoid "explore roots of problem"-type answers on any crisis or crisis-like vignettes. Here-and-now, active, directive, equilibrium restoring is the social worker's role. (As a general guideline, "explore roots of..." answers are best eyed with suspicion on the exam.)  Look for "assess" as a FIRST step.  Things like "defuse" and "identify resources" come next. 

Keep in mind, while common sense doesn't always work on the exam, for crisis intervention questions, you can usually go with your gut, just as you would in the field.

Here's more about crisis intervention on the web:

Good luck!

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Existential Therapy and the Social Work Exam

existential therapy Did you have to read The Stranger or maybe some Sartre in school? If so, you know something about existentialism. If not, or if you need brushing up, here's Merriam-Webster:

ex·is·ten·tial·ism: a chiefly 20th century philosophical movement embracing diverse doctrines but centering on analysis of individual existence in an unfathomable universe and the plight of the individual who must assume ultimate responsibility for acts of free will without any certain knowledge of what is right or wrong or good or bad

Okay, so that's existentialism. What's existential therapy? And will this be on the social work licensing exam? To the second question, the answer is, could be. Maybe. You can probably pass the exam without having the first clue about what existential therapy is. This is not a topic to sweat or cram or otherwise worry yourself with.

The first question--what is it?--takes a little more space to answer. Some might argue that all therapy is existential therapy--that is, all approaches to treatment have to grapple with client's sense of powerlessness, aloneness, and with mortality and free will. Existential therapy makes those grapplings central to treatment.

What that might look like: A conscious effort is made in existential therapy to explore questions of...existence.  Death--and denial of death--are addressed head-on. What is the client's experience of death? Of funerals? What beliefs does the client have about death? Same goes for the rest of the list above (powerlessness, etc.). Explore, examine, repeat. For much more on the topic, you can try Irvin Yalom's Existential Therapy.

For a more easily digested amount of detail, here's the web:

Happy test prepping and good luck on the exam!

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Gestalt Therapy and the Social Work Exam

Young Fritz Perls Once you've got down the basics--CBT, DBT, psychodynamic therapy, and the like--you're ready to dig deeper in your licensing exam prep. That means you'll be putting together knowledge about material that may not actually appear on the exam. If you get up-to-speed on a dozen additional theories, you may only see a few of them show up on the test. But that's a few extra items you'll be prepared to answer. Very much worth doing. Especially since the amount of knowledge you need to have about any of these theories for the exam is pretty minimal. If you're in a rush, remember that most of what you need to know about, say, solution-focused therapy, for the exam can be fit on a flash card. For SFT, it's included in the name of the treatment: It's a treatment that is focused on solutions. If you also know that the miracle question is an solution-focused therapy intervention, you're more-or-less good to go for the exam. (Just the exam, not actually doing the work.) Same goes for lots of other approaches, including Gestalt Therapy. What's Gestalt Therapy?  GoodTherapy has a good answer:

Gestalt therapy focuses on here-and-now experience and personal responsibility. It was developed by Fritz Perls, Laura Perls, and Paul Goodman. The objective, in addition to overcoming symptoms, is to become more alive, creative, and free from the blocks of unfinished issues which may diminish optimum satisfaction, fulfillment, and growth. Gestalt therapy relies heavily on the interpersonal relationship between client and therapist that is developed and nurtured over the course of therapy. This technique is also classified as an experiential approach to psychotherapy because it involves actions that are both intentional and experimental to facilitate change.

Keywords for a Gestalt Therapy flash card: experiential...awareness...personal responsibility. Also remember that empty chair work is associated with Gestalt. That may actually be all you need to have down to navigate an exam question on the topic.  Of course, there's lots more to Gestalt Therapy, and much of it may be helpful in your social work practice. Take this simple intervention: When a client refers generally about a problem, or in second person--"You get really upset when someone lies to you"--a Gestalt Therapist may direct the client to use "I" instead of "you": "I get really upset when someone lies to me." Naming the "someone" might be the next step. Awareness, personal responsibility. It's a good intervention for lots of reasons, and one you don't have to completely identify with Gestalt Therapy to utilize with clients.

For more about Gestalt Therapy, the web stands ready:

If you've got a commute, the last link, to the Social Work Podcast's half-hour about Gestalt is especially recommended. Listen, learn, enjoy!

Good luck on the exam.

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Psychodynamic Therapy and the Social Work Exam

psychodynamic psychotherapyFor most vignette questions on the social work licensing exam where a client presents with a problem and the social worker needs to choose the BEST intervention, you'll be given a choice between something here-and-now, problem-solving, and practical and something else: psychodynamic psychotherapy.  As discussed in previous posts, the correct answer for exam is almost always going to be the here-and-now, problem-solving, practical intervention, usually CBT or a variation on CBT (e.g., exposure therapy or DBT), not psychodynamic therapy. Why? Basically, because that's where the research points. CBT is all about evidence--evidence that challenges client's irrational thoughts, evidence that establishes the effectiveness of the treatment. Psychodynamic psychotherapy by it's nature doesn't necessarily lend itself to the same type of research and evidence building. It's the Beck Depression Inventory, not the [Name Your Favorite Psychodynamic Theorist] Depression Inventory.

That doesn't mean you can skip knowing about psychodynamic theory and practice when preparing for the social work exam. Chances are, it'll be on there. Maybe not as the correct answer in a "which intervention" question, but there are plenty of other ways for examination writers to test the depth of your social work knowledge. One example: "A social worker using psychodynamic psychotherapy sees a client with such-and-such symptoms. Which intervention is the social worker MOST likely to use?" The answers may be full of good interventions from CBT. "Challenge automatic negative thoughts," say. But that's not psychodynamic, and it's not the right answer here. Needless to say, reading the question carefully is usually a good idea!

What's psychodynamic psychotherapy all about? You probably covered it in school at least a little. But here are some handy places on the web to get better acquainted with the basics:

That's a start. Should be plenty, but there's lots more free info on the topic all over the net. Happy reading, and good luck on the exam!

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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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