Which is not a symptom of burnout?
a. De-individuation of clients
b. Feeling exhilarated and overly energized
c. Lack of personal accomplishment
d. None of the above, they are all symptoms of burnout
B
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In behavioral therapy, a punishment _____________.
a. is a barrier between goals b. increases a behavior c. decreases a behavior d. B and C only e. all the above
Deinstitutionalization was implemented more because of financial concerns than for treatment reasons
Indicate whether the statement is true or false
Is Michael’s gender identity associated with significant distress or impairment in his social or occupational functioning?
DSM Diagnosis F43.22 Adjustment disorder with anxiety F64.1 Gender dysphonia in adolescents and adults F60.1 R/O Schizoid personality disorder Rationale Michael qualifies for the diagnosis of gender dysphoria because she: 1. Has experienced a lifelong incongruence between her experienced (female but fluid) and assigned (male) gender and has taken measures to become an alternate gender. She has feelings and engages in behaviors consistent with a gender other than her assigned sex, has a desire to be rid of male secondary sex characteristics, and has a desire to possess female secondary sex characteristics; 2. Experiences associated clinically significant distress in interpersonal functioning; in this instance with regard to her primary relationship. Michael also meets criteria for the adjustment disorder because her development of anxiety symptoms appears to be the direct result of conflicts with her partner, which have apparently become more acute in recent weeks. With this diagnosis it is assumed that if the current stressors are resolved Michael will return to her previous and presumably satisfactory level of functioning. Michael may qualify for a diagnosis of schizoid personality disorder in that she demonstrates a pervasive pattern of detachment from social relationships and a restricted range of emotions in most interpersonal relationships. It will be important to attend to this possible diagnosis because its associated behaviors could have implications for Michael’s being able to maintain an adequate support system. Additional Information Required Michael has presented an outline of a social history to the social worker but more information is needed in several areas to fully understand his problem and current quality of interpersonal functioning. More needs to be learned about Michael’s overall self-esteem and how it is affected by stress. It will be important to learn more about the overall quality of Michael’s interpersonal skills (to understand if he is capable of generating support from others), how he has been treated by others over the years with regard to his gender identity, and why he has become more withdrawn since reaching adulthood. Is this isolative behavior comfortable for Michael or does it represent an avoidance strategy and perhaps a personality disorder? Risk and Resilience Assessment Nothing can be known at this time of any genetic or biological influences on Michael’s process of identifying primarily as a woman rather than a man during her adolescent and young adult years. Now that she is an adult, her protective influences include the support of her partner, her evident willingness to disclose her gender identity to some other persons, and the growing cultural acceptance of gender diversity in this culture. On the other hand, Michael’s risk influences include his limited peer group and the present conflict with his major significant other around her gender presentation. What questions could be used to assess for additional strengths in Michael and Matt? For the couple: 1. What are your personal goals for the next five years or so? What personal assets or other resources do you think can help you reach them? 2. What are the good things about your relationship with each other? Which of those things do you want to continue? 3. Have the two of you experienced relationship problems or challenges before? If so, how have you been able to resolve them? For Michael: 4. In what ways has art been a constructive, satisfying activity for you? Do you ever want to get back into it? Is there anything else that satisfies you in the same ways? 5. It seems that you have faced a number of serious challenges in your life, challenges that have been quite stressful. What did you do to get through those times? 6. Think about the times in your life when you have felt the most secure. What was it about those times that helped you feel that way? What were you doing? Who was around, if anyone? Intervention Plan Michael’s reason for seeking help is to address and resolve the conflict in her primary relationship. The conflict is apparently related to how she presents herself gender-wise to her partner Matt. Michael is not seeking help in considering any adjustments in her gender identity. The beginning intervention plan, which includes his partner Matt, includes the following goal: Goal: To resolve partner conflicts about gender presentation so that the relationship can return to its previous satisfactory status. In working toward this goal, the social worker will provide couples counseling focusing on family systems theory to help the couple clarify their thoughts and feelings in a safe environment and engage in mutual problem-solving that will result, if successful, in each person being satisfied with the state of their emotional and sexual relationship. While other issues for intervention may emerge later, this basic issue needs to be addressed first. Critical Perspective Michael’s presentation differs somewhat from that of Jamie (in the first case presentation). Jamie has a “fixed” transsexual identity, and Michael’s is more fluid, which is not problematic for her but may create problems for the people close to her, who perhaps see, or want to see, her with a more “settled” gender identity. That is, Matt, and perhaps other friends she may have in the future, may come to perceive her as having a certain gender identity and then become confused when she moves some distance from that position. It is not Michael’s problem, but theirs, but at the same time she’s the one who may suffer if the relationship changes. All of this is to again point out a general problem with the diagnosis of gender dysphoria – the individual may suffer negative emotional symptoms because of the reactions of others, not because of any internal turmoil. The diagnosis may be helpful because it alerts the social worker to the fact that gender identity plays a part in the client’s presenting problem, but it may not be the problem in itself.
The ______ approach to leadership asserts that every member will be a leader at times by taking actions that serve group tasks
a. Trait b. Position c. Leadership-style d. Distributed-functions