Sacha, a Satir-oriented therapist, notices that her client, who often reports feeling overwhelmed, is often ill and exhausted. What might Sacha be doing during her assessment of the client?
A) Making a mind-body connection between her client's emotional issues and how they are manifesting in his or her body
B) Considering the specific aspects of self her client values and the aspects of which he or she is ashamed
C) Assessing the motivation behind the client's problematic behaviors and interactions
D) Viewing the context for the potential problems and determining the client's potential weaknesses
A
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A dual-career couples with two children below the age of seven comes for counseling. What is the counselor's first task?
a. to determine which adult members to see b. to see the adults and children separately c. to arrange for child care during the counseling session d. to determine which problems stem from the dual-career situation and which from their marital relationship
Has there been a recent stressful event occurring in Josie’s life? Is an adjustment disorder warranted?
DSM Diagnosis 313.81 Oppositional Defiant Disorder 315.0 Reading Disorder 315.1 Mathematics Disorder 315.2 Disorder of Written Expression 317 Mild Intellectual Disability Rationale Oppositional Defiant Disorder was diagnosed due to the following behaviors that are present both at school and at home: ? Josie loses her temper easily ? She constantly argues and tests limits with adults ? She refuses to comply with classroom directions ? She is touchy or easily annoyed by others ? She is often angry as evidenced her consistent profanity and verbal assaults of staff. Josie was diagnosed with a mild intellectual disability because of her cognitive impairment and low adaptive abilities. Additionally, the Learning Disorder diagnoses were given because, even if a person has a mild intellectual disability, learning disorders should be listed if the person’s achievements are below expected levels for his or her cognitive functioning. In her testing Josie scored in the Very Low Range in all three categories, typically near the first percentile. Additional Information Required A key element to help with the diagnosis would be knowledge of the early course of Josie’s behavior. There is no information about how she behaved in childhood and her early teens. What were some of the early signs that she was having problems? Another area in which there is no information is her response to vocational skills training at school. Because Josie is 19, she needs to be prepared with job skills when she graduates from high school. We do have information that her behavior has been addressed in school by suspension, detention, and locked support. It would be important to know if there is a behavioral modification in place adapted for persons her age that emphasizes functional analysis of her behaviors, shaping, and positive reinforcement. As with all cases of ODD and CD, family intervention remains the most effective intervention. Therefore, Josie’s parents will be given training in behavioral modification so they can apply a similar structure to the one that Josie faces at school. It is important that her parents exercise consistency in their discipline methods. The social worker needs to empower Josie’s mother to involve Josie’s father in treatment efforts and, if that fails, reach out to him herself. Josie’s mother needs more support in the home in order to follow through with requests for Josie to do chores or listen to what she says, especially in the face of Josie’s escalating anger. Josie does seem to gain a sense of pride from assisting the teacher in the classroom. To capitalize on this, the social work intern will arrange for Josie to get a job on the school campus. In working with people with mental retardation, it is important to alter the conditions that might trigger behavior problems (Rush & Frances, 2000). What seems to be partly contributing to Josie’s frustration is her difficulty with schoolwork. A behavioral modification plan, adapted for her age, can be put into place, emphasizing functional analysis of her behaviors, shaping, and positive reinforcement. Working with Josie in an individual or group basis is also important for overcoming her ODD symptoms. Anger management with people with mental retardation has been proven effective in two randomized controlled trials (Taylor, Novaco, Gillmer, & Thorne, 2002; Willner, Jones, Tams, & Green, 2002). Josie should prove an appropriate candidate for such training. The focus needs to be learning to cope with stressors, and developing skills to express frustration appropriately. Although the diagnosis of Reactive Attachment Disorder was quickly ruled out because Josie appears to have attachments (to her mother and sister, for instance) and can form relationships (her teacher, some peers), little is known about the manifestation of Reactive Attachment Disorder as youth mature into adolescence and early adulthood. Josie was given to an orphanage at 6 weeks of age. Her mother doesn’t know much about Josie’s early history but it can be surmised that her care at a Romanian orphanage was less than optimal and comprised multiple caregivers. Whether Josie formed an attachment to a caregiver in the orphanage is not known. Further, environmental deprivation may have contributed to Josie’s learning disabilities and mental retardation.
According to the definition by Barker, the generalist often coordinates the efforts of specialists by facilitating communication between them, thereby fostering:
a. Group work b. Continuity of care c. Self determination d. Professional technique
Under the Family and Medical Leave Act of 1993, businesses with 2 or more
employee are required to grant up to 12 weeks of unpaid leave annually when a child is born or adopted. Indicate whether the statement is true or false