Clinical Flashcards

A selective serotonin reuptake inhibitor is used to treat anxiety, serious depression, and obsessive-compulsive behavior.

Answer: Citalopram

Citalopram (brand name Celexa) is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed to treat major depressive disorder, generalized anxiety disorder, and obsessive-compulsive disorder. SSRIs work by increasing the amount of serotonin, a neurotransmitter, in the brain, which helps to regulate mood and reduce symptoms of these conditions. The other options are either also SSRIs (Sertraline, Fluoxetine) or a tricyclic antidepressant (Doxepin), but Citalopram is a correct example of an SSRI used for these purposes.

exaggerating health symptoms in order to gain sympathy or play the "sick role"

Answer: Factitious disorder

Factitious disorder is characterized by intentionally feigning or exaggerating physical or psychological symptoms to assume the 'sick role' and gain attention, sympathy, or care. The primary motivation is internal, stemming from a psychological need to be seen as ill, rather than external incentives like financial gain or avoiding responsibilities (which would be malingering). This distinguishes it from somatic symptom disorder (where symptoms are genuinely experienced but cause excessive distress) and illness anxiety disorder (preoccupation with having a serious illness despite minimal symptoms).

A condition that may arise in a number of situations and treatment procedures and is brought on by some component of the intervention given to treat the presenting problem.

Answer: iatrogenic condition

An iatrogenic condition is an adverse outcome, disease, or complication that is caused by medical examination or treatment. This term specifically refers to problems that arise as a direct result of an intervention intended to help the patient, such as side effects from medication, complications from surgery, or even psychological distress caused by a diagnostic procedure. It highlights the potential for harm inherent in any medical or therapeutic intervention.

Problems like the depletion of natural resources are some examples of how it manifests.

Answer: Societal regression

Societal regression refers to a decline in the overall functioning, development, or well-being of a society. The depletion of natural resources is a significant example of this, as it indicates a failure in sustainable practices and a deterioration of the environmental foundations necessary for long-term societal health and prosperity. This issue impacts future generations and represents a step backward in collective human progress.

The act of showing someone you care and that you're supporting them

Answer: Mirroring

In a therapeutic context, mirroring often refers to the act of reflecting back a client's emotions, body language, or verbalizations to demonstrate empathy, understanding, and support. By subtly echoing the client's expressions, the therapist conveys that they are actively listening and attuned to the client's experience, thereby fostering rapport and a sense of being cared for and supported. This active engagement helps build a stronger therapeutic alliance.

Different control and experimental groups rather than random groups

Answer: quasi-experimental design

A quasi-experimental design is a research method that aims to establish a cause-and-effect relationship between variables, but without the random assignment of participants to experimental and control groups. Instead, it utilizes pre-existing groups or other non-random methods for comparison. This design is often used when random assignment is impractical or unethical, making it distinct from true experimental research which requires randomization.

What the caregiver learns from the patient's symptoms (like an MD on an interesting case)

Answer: tertiary gain

Tertiary gain refers to the benefits that someone *other than* the patient receives from the patient's illness or symptoms. This can include a caregiver gaining attention, sympathy, or even professional satisfaction and knowledge, such as a doctor learning from an interesting or complex case. It is distinct from primary gain (internal psychological benefits for the patient) and secondary gain (external benefits for the patient).

You are told at a client's initial consultation that the client has previously received care from other social workers. When you inquire about the client's prior therapies, he says they were in the past and he'd like to move on, adding that he would prefer that the records of those therapies not be made public. You ought to FIRST:

Answer: Acknowledge the client’s right to decide whether to release the records or not

The client has a fundamental right to self-determination and confidentiality regarding their personal information, including past treatment records. The social worker's primary ethical responsibility is to respect this autonomy and acknowledge the client's right to decide whether to release these records. This step must be taken first before exploring reasons or discussing the focus of current treatment, as it upholds the client's control over their own care.

Deborah and Daniele are meeting for their regularly scheduled session. Due to Deborah's striking resemblance to Daniele when she was Deborah's age, their therapeutic alliance is beginning to resemble a casual friendship. Daniele wants to avoid Deborah making the same mistakes she did because Deborah's life circumstances are similar to her own. What kind of interaction is most likely to occur in this situation?

Answer: Parallel process

Parallel process occurs when the dynamics of the client-therapist relationship unconsciously mirror the dynamics of another significant relationship in the client's life, or when the therapist's own unresolved issues are activated by the client's situation. In this scenario, Daniele's personal identification with Deborah and her desire to prevent Deborah from making 'the same mistakes she did' indicates that Daniele's personal history is influencing her professional role and the therapeutic dynamic, which is a classic manifestation of parallel process, often intertwined with countertransference.

A recent client self-reports to you that she has been using cocaine frequently for a number of years. What should you do first, exactly?

Answer: Gather as much information from her as you can

In any initial assessment, especially with complex issues like substance abuse, the first and most crucial step is to gather comprehensive information from the client. This involves understanding the history, frequency, impact, and the client's perspective on their cocaine use, as well as other relevant life circumstances. This thorough information gathering is essential for accurate diagnosis, developing an appropriate treatment plan, and building a trusting therapeutic relationship.

The therapeutic intervention that would be LEAST helpful to use with an older client is:

Answer: Using a nondirective therapy modality in which the client sets the pace

While client-centered approaches have value, older clients, particularly those facing complex age-related challenges such as cognitive decline, multiple losses, or physical health issues, often benefit more from structured, supportive, and sometimes more directive interventions. A completely nondirective therapy where the client solely sets the pace might be overwhelming or less effective for those who need more guidance, structure, or specific problem-solving strategies to address their unique needs. Therefore, it would be the least helpful.

The BEST definition of "substitution" is:

Answer: A defense mechanism in which the individual has an unattainable goal or emotion and replaces it with one that is more attainable.

Substitution, as a defense mechanism, involves replacing an unacceptable or unattainable goal, emotion, or object with one that is more acceptable or attainable. This allows the individual to reduce anxiety, frustration, or disappointment by redirecting their energy towards a more realistic or socially sanctioned alternative. It helps manage difficult feelings by finding a more achievable outlet.

The Velasco family shows up to your practice for counseling. Mr. and Mrs. Velasco's children appear to be under rigorous parental control and adhere to strict behavioral guidelines. Despite not having any behavioral issues at school and performing extremely well academically, you realize as therapy goes on that the kids have very poor self-esteem and don't appear pleased. Which parenting approach best suits the given circumstances?

Answer: Authoritarian parenting

Authoritarian parenting is characterized by high demands and low responsiveness, with strict rules, high expectations, and little warmth or open communication. While children may achieve academically due to strict discipline, this parenting style often leads to lower self-esteem, unhappiness, and a lack of autonomy, as seen in the Velasco children. Parents prioritize obedience and control over their children's emotional needs and independence.

The LEAST probable diagnostic indicators of "disorganized" schizophrenia are:

Answer: Periods of relatively adequate daily functioning scattered with episodes of severe psychotic thought/behaviors that cause pervasive disruption in areas such as activities of daily living, communication, relations with others, etc.

Disorganized schizophrenia (now often referred to as 'schizophrenia with prominent disorganized symptoms' in DSM-5) is characterized by severe and pervasive disorganization in thought, speech, behavior, and affect, leading to chronic impairment in daily functioning. The description of 'periods of relatively adequate daily functioning scattered with episodes of severe psychotic thought/behaviors' is more characteristic of other forms of schizophrenia, such as paranoid or undifferentiated types, or perhaps a different psychotic disorder, rather than the chronic and pervasive disorganization central to this subtype. The other options are hallmark features of disorganized schizophrenia.

The BEST explanation of "translational research" that applies to social work practice is as follows:

Answer: It is the adaptation of findings of basic empirical research performed according to rigorous scientific methods, so that knowledge acquired in those settings can be extended into practical application and naturalistic field research settings.

Translational research bridges the gap between basic scientific discoveries and their practical application in real-world settings. In social work, this means taking evidence-based findings from rigorous empirical research and adapting them for use in clinical practice, community programs, and policy development. Its goal is to ensure that scientific knowledge is effectively translated into interventions and services that improve human well-being.

The MOST suitable design for this kind of clinical practice environment is a single topic design:

Answer: Inpatient psychiatric facility

A single-subject (or single-case) design is particularly suitable for inpatient psychiatric facilities because it allows for intensive, individualized monitoring of treatment effectiveness for a single client or a small group. In such settings, interventions can be precisely controlled and measured against baseline behaviors, making it ideal for evaluating the impact of specific therapies on individual patients with severe and complex mental health conditions where group studies might be impractical or unethical.