LCSW Study Help

Sample Written Question's about the 5150 law

2010-09-30T16:47:00.000-07:00

Sample Written Question 1.

A 5150 hold:

A. Must be signed by a medical doctor.

B. Can be used to hold an inebriated person in the drunk tank to be released upon sobriety with a citation issued.

C. May not apply in some counties in California.

D. Requires the signature of a family member or notification to the public defender's office that the person is held against their will (typically the county of consevatorship will notify both the family and the public defender).

Sample Written Question 2.

Sara's social worker initiated a 5150 hold after she became suicidal. At the end of 72 hours she was recertified by a psychiatirist for an additional 14 days. Sara is afraid to live in her neighborhood without some kind of gun for protection and the hopital told her she must turn in her gun. She calls the social worker and is furious. The social worker should:

A. Terminate with Sara as she is a danger to
the social worker.

B. Terminate with Sara as she can no longer ethically treat her.

C. Advise Sara she can not possess a gun for at least five years.

D. Intervene with the hosptial to allow Sara to keep her gun in order to provide for her safety.

LCSW Written Exam Sample Questions from the Content Area of Treatment Planning.

2010-08-26T21:04:00.000-07:00

Just a few questions from the treatment planning domain. I will post answers under comments.

1. What intervention is most indicated were patients present with a specific phobia?

A. Implosion.

B. Flooding.

C. Cognitive Behavioral Therapy.

D. Exposure therapies.

2. Treatment for a six year old child who presents with symptoms of mental retardation, has never attended school, and shows speech and motor delays should include.

A. Language stimulation, Cognitive Behavioral Therapies, and a developmental approach that abandons goals associated with the child's chronological age in favor of those at his mental age.

B. Recreational therapies, individual therapy, parent-skill training.

C. An approach that pushes the child toward developmental goals appropriate for a six year old, special education classes, and collaboration with medical professionals.

D. Social skills training, language stimulation therapies and a developmental approach targeting the motor skill and language development delays over introduction into a special education classroom.

3. Joe has been struggling with major depression. He calls your office and says he is giving up. When you ask him what that means he hangs up. You should.

A. Try to call Joe back.

B. Try to get a family member to check on Joe.

C. Consider traveling to Joe's home to intervene.

D. Call the police and warn them that Joe may be suicidal.

Learn the key principles of Law, Ethics and Diagnosis as a route to passing.

2010-08-26T20:25:00.000-07:00

The LCSW and MFT exams contain some content areas that are hard to wrap your head around. Researchers and theorists abound and not all the literature in agreement. There are three content areas, law, ethics and diagnosis, where the literature is more clear cut. In short, there is a correct answer and an authoritative body of text to refer to when choosing that answer.

This means as long as you have mastered the content areas of law, ethics and diagnosis you should get questions from these content areas correct. Law, ethics and diagnosis questions are far less subjective than questions from other content areas and you should make every attempt to get these content areas right every time.

Sample Case Vignette: Harrison Interventions

2010-08-17T11:07:00.000-07:00

Harrison, a high school student, is referred by a medical doctor. The doctor suggests that an unhealthy family dynamic may have resulted in Harrison developing an ulcer and then not following medical treatment even though it would likely relieve his ulcer symptoms. Harrison's parents say that he seems unhappy and that athletics has taken over his life. Harrison angrily says he is the victim and the problem is his parents constant worry about him. He insists that his mother is controlling and that his father goes along when his mother is "getting crazy." His father describes pride in Harrison's athletic prowess and commitment to wrestling but is concerned that Harrison eats excessively after dieting for days in an attempt to make his wrestling weight. After sessions of eating, Harrison engages in strenuous exercise and takes pills he purchases at a health food store to manage his weight. Harrison insists that he follows the label instructions on the diet supplements. Harrison is not underweight and family members deny any evidence of throwing up to keep his weight down. Recently Harrison has been skipping school to work out which has affected his grades.

What interventions are appropriate for the vignette above?

Get a consent to discuss Harrison's training program with his wrestling coach.

Introduce a behavior modification program designed to get Harrison going to school regularly.

Refer Harrison back to the medical doctor for treatment of his ulcer.

Refer Harrison to a child psychiatrist for a medication evaluation.

Work with the parents to develop consistant rules and rewards to reinforce healthy behaviors in Harrison and get him back in school.

Have the parents monitor Harrison for one half hour after meals to eliminate the possibility he is throwing up in an effort to reduce his weight. .

Refer Harrison for a second medical opinion examining the impact of his binging, exercise and the ulcer.

Refer Harrison to a neuropsychologist to eliminate the possiblity that his binging is not the result of a neurological condition.

Consider hospitalizing Harrison as a danger to himself until his exercise and binging is under control.

Get an Authorization to speak with Harrison's doctor.

Begin individual therapy with Harrison.

Consider a DBT group focused on eating disorders.

Suggest that Harrison attend a meeting of Narcotics Anonymous to address his over use of pills.

Initiate structural family therapy session and meet with the family each week.

Refer Harrison's mother to individual counseling.

Refer both parents to parent support and education groups to help them better cope with Harrison's behaviors.

Sample Case Vignette: Harrison and the Law

2010-08-16T10:39:00.000-07:00

What legal issues should you consider?

Harrison may not consent to undergo treatment with you.

You will need a Release of Information to work with other professionals involved in the case.

Harrison's medical problems are outside your scope of competence.

Harrison may need to be hospitalized as a danger to himself if his symptoms continue.

Harrison says he is a "victim" and you may have a reporting requirement.

Your license must be displayed in your office.

Harrison's parents should have been informed of the costs of therapy prior to the first session.

Where there is shared custody both parents must consent in order to provide treatment.

Some of Harrison's medical problems are outside your scope of practice.

If he continues to resist treatment Harrison may need to be hospitalized as a danger to himself.

It is illegal to not attend school in the State of California.

You must have a signed Informed Consent from at least one parent in order to continue treatment.

Harrison's medical problems are outside your scope of practice.

You will need a Release of Information to work with other professionals involved in the case.

You must keep accurate records about the session including records gathered from the medical doctor.

You must have Informed Consent to treat Harrison from either parent.

Once again rate each element from zero to three. Any answer group where an element rates a zero as illegal, untrue or contraindicated can be eliminated at the outset.

Sample Case Vignette: Harrison's Diagnosis

2010-08-16T00:10:00.000-07:00

Try out the following vignette. I suggest you use a scoring system.

The AATBS system ranks each of the total sixteen answer elements from 0 to 2. The score of zero indicates the element is clearly a wrong answer and a score of two represents a likely answer.

Innovative Testing Services uses a scoring system from 0 to 3. The score of zero indicates the element is clearly a wrong answer, a score of one is a "maybe," a score of two represents a likely answer and score of three indicates a response that should appear in any correct answer. I think this system makes more sense as it allows you to rank essential elements higher than elements that are simply good.

Vignette

Harrison, a high school student, is referred by a medical doctor. The doctor suggests that an unhealthy family dynamic may have resulted in Harrison developing an ulcer and then not following medical treatment even though it would likely relieve his ulcer symptoms. Harrison's parents say that he seems unhappy and that athletics has taken over his life. Harrison angrily says he is the victim and the problem is his parents constant worry about him. He insists that his mother is controlling and that his father goes along when his mother is "getting crazy." His father describes pride in Harrison's athletic prowess and commitment to wrestling but is concerned that Harrison eats excessively after dieting for days in an attempt to make his wrestling weight. After sessions of eating Harrison often engages in strenuous exercise and takes pills he purchases at a health food store to manage his weight. Harrison insists that he follows the label instructions on the diet supplements. Harrison is not underweight and family members deny any evidence of throwing up to keep his weight down. Recently Harrison has been skipping school to work out which has affected his grades.

What diagnosis should be considered for Harrison?

Obsessive Compulsive Personality Disorder.

Bulimia Nervosa

Eating Disorder NOS

Anorexia Nervosa

Binge Eating Disorder.

(Unknown) Substance Abuse

V Code Partner Relational Problem

V Code Academic Problem

Major Depressive Disorder, with Atypical Features.

Borderline Personality Disorder.

Binge Eating Disorder.

Obsessive Compulsive Disorder.

Major Depressive Disorder, with Atypical Features.

Bulimia Nervosa

V Code Noncompliance With Treatment

(Unknown) Substance Abuse

****************************************

Post your responses and I will post the answer and the next question about Harrison next week.

Help Studying for the Exam

2010-08-14T11:10:00.000-07:00

This blog is designed to discuss both the written and the vignette LCSW exam for the State of California. Please feel free to contribute your thoughts or feelings about the exam. In this way everyone can learn together.

Some Comments About the Second Test:

Many people I supervise find the second test much harder. This is because the second test seeks to use the highest taxonomic level of cognitive skill which is evaluation (Osterlind, 1998).

Taxonomy refers to the classification of concepts, as well as to the principles underlying those classifications. In the second test you are required to apply principles you know when classifying answer elements as good or bad. In short, you must know the principles of social work practice, or core body of knowledge for social work, and then apply what you know to the vignettes.

This is the reason that many people who study very, very hard for the second test experience a reduction in their ability to evaluate which answers are correct. We often hear the compliant, “The more I have been studying for the vignette questions the worse I am scoring on the practice test.”

This is because vignette questions are asking something different from you. For this reason we have to focus our study differently. Obsessive study methods focused on memory and recall that paid off for many test takers who passed the first BBS exam can lead to increased confusion and attraction to elements that are incorrect distracters when taking the test.

Don’t get us wrong, studying is good and there is a direct relationship between spending time studying for the test and passing (Hinrichsen, 1974). Developing an understanding of the central principles of social work practice always plays a vital role in passing the Board Licensure Examination. However, memorizing highly detailed material is as likely to impair your ability to isolate and choose the correct elements from various answer groups. We advise prospective test takers to keep things very simple by studying the central principles of social work practice when approaching the written vignette and then to practice applying those central principles. In general, you should practice by taking practice tests that hone your skill at test-taking as opposed to studying for the test by reading or memorizing material.

Good preparation should include learning some very basic principles about risk assessment, cultural competence, ethics and law. The art of passing is applying these principles during the test to choose correct answers. The reason even honor students aren't spared from failing in the Board Licensure Examination is that factors like rationalization, over-confidence, over-preparation, and anxiety can get in the way of making rational decisions during the exam. Most of us in the industry know that obsessive accumulation of detail can get in the way of reading the questions, assessing what the Board is asking for, and applying your knowledge to choose the correct answer.

Good results always favor those who had a good preparation. The trick in passing Board Licensure Examination is to understand that it will not rely entirely on how knowledgeable or intelligent you are. But you will increase your chances of passing if you develop a simple understanding of important principles over attempts to study everything you could see on the test.

It helps to have studied hard in college, it helps to have had a wide variety of clinical experiences and it clearly helps to have had great supervision. None of these is necessary to pass the test. However, if you do not have a good understanding of core subject material you have little chance of outsmarting the test.

Immerse yourself in practice test problems. Start with what you know and build on your current ability. It is not helpful to continue to retake practice questions where you are scoring 50% or less over and over. Most students feel overwhelmed when they retake practice exams they are failing consistently. If you are overwhelmed, focus on an area of strength and master it. If you feel weak at everything, choose one of the smaller content areas and work to understand it. (Ethics is a good starting point as you can read the entire ethics code in an hour).

Participation in this blog is free and we seek to make it as helpful as possible. It is a moderated blog meaning I or another moderator review the content you write before posting it. I do this only to ensure accuracy. Your comments will not be filtered for being challenging or critical as long as they are respectful and accurate.

For more on the learning curve and the relationship between study and performance see the following.

Allen, G. J., Lerner, W. M., & Hinrichsen, J. J. (1972). Study behaviors and their relationships to test anxiety and academic performance. Psychological Reports, 30, 407-410.

Hinrichsen, J. J. (1974). Prediction of grade point average from estimated study behaviors, Psychological Reports, 31, 974.

Wagstaff, R., & Mahmoudi, H. (1976). Relation of study behaviors and employment to academic performance. Psychological Reports, 38, 380-382.