FAQs

This week brings us to Factors Affecting Mental Health. Most of these factors, including environmental and psychosocial factors, are recorded on Axis IV of the DSM Multiaxial Assessment. You will see these factors in many test questions and will often be asked to prioritize interventions based on multiple stressors/factors. Let's look at an example: Sample: A family contacts a social worker for help with an increase in conflict and fighting. During the intake, the wife tells the social worker that her husband's mother recently moved in with the family after his father passed away. She goes on

This week, we're moving on to Axis III -- Medical Conditions. A medical condition warrants recording on Axis III of a DSM-IV-TR diagnosis when it affects the client's mental health (so if someone has diabetes, but has had it for years and is managing it well, it might not be recorded). Here's one way this topic will almost certainly come up on the exam: Sample: A 47 year-old man seeks services from a social worker for symptoms of depression. In the initial session, the man reports that he has had difficulty sleeping, has been feeling hopeless, and has been suffering from near-constant

While the DSM-IV-TR considers Mental Retardation one of the Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence, we've decided to look at it as part of our tour of Axis II Disorders. Mental Retardation is on Axis II because of its lifelong trajectory and pervasive affect on functioning. Here's one way it may come up in a test item: Sample: A social worker begins treatment with a mother and her 5 year-old son. When she greets the family in the waiting room, the social worker notices several distinct facial features on the child that would indicate Down's Syndrome. When the

Ah, Personality Disorders. This category of disorders is guaranteed to come up on the exam, both in terms of differential diagnosis and in terms of treatment interventions/approaches. Let's take a look at a sample test item: Sample: A 24 year-old woman presents for an initial appointment wearing what appears to be an afghan and 3-D glasses. She tells the social worker that her mother recommended that she see a therapist for "social issues." With prompting, the woman reports that she does not have any close friends and has never had an intimate relationship. She says, "These glasses give me the

This week, we're taking a look at Sexual and Gender Identity Disorders. It's important that you feel comfortable bringing up the issue of sex with your clients; they may present with feelings of shame, embarrassment, anger or confusion and it's essential that you demonstrate your ability to work with them by introducing sex as an acceptable topic for discussion. Differential diagnosis is one of the most likely forms it will take on the exam. Sample: During an initial appointment, the social worker asks a husband and wife their reasons for seeking treatment. The wife hesitantly tells the social

When a news story focuses on mental illness, it's often Schizophrenia, Major Depressive Disorder or Bipolar Disorder that takes center stage. Recently, however, a news story put a different kind of mental illness in the spotlight, and I have to admit, for me, it's been fascinating to follow. Before I give too much away, here's a sample question that was partially inspired by the recent story involving the high school students in New York. Sample: A 17 year-old girl is admitted to a psychiatric unit after sudden onset of symptoms. According to her assessment, 2 weeks before her admission, she

Hey all, this week we are looking at grief and Bereavement. This topic comes up on the exam in a few ways: differential diagnosis (usually between Bereavement, Adjustment Disorder, and Major Depressive Disorder); stages of grief; and the expression of grief throughout the life cycle. Here's a sample question to get us going: Sample A 53 year-old man seeks help from a social worker in private practice. During the assessment, the man reports that his wife of 25 years died a month ago in a car accident. The man tells the social worker that he has been having difficulty sleeping and does not feel

Again, my apologies for the delay in getting the post up. This week, we’re looking at Anxiety Disorders. These can come up on the exam in a variety of ways: in reference to medications, treatment modalities, diagnoses…the list is long. Here’s a sample question to get us thinking about differential diagnoses: Sample: A social worker at a VA clinic is assigned a new client: a 26 year-old male who was sent home after a roadside bomb killed several members of his unit 3 weeks ago. Since the explosion, the man has been unable to sleep and has been refusing to sit in the front seat of the car. When

It’s Tuesday…late on Tuesday, but still Tuesday, so it’s Hot Topic time! Now that we’re into the diagnostic categories, it’s important to start looking at questions and thinking about differential diagnoses – what information do you need for an initial diagnostic impression? What are the features that distinguish similar disorders from one another? This week, we’re looking at Mood Disorders: Sample Question: A social worker in private practice receives a referral for a 32 year old woman who reports ongoing difficulties with social and romantic relationships. During the initial appointment, the

I don’t know about all of you out there, but until I interned on an acute inpatient psychiatric unit, I really had no idea what a person experiencing psychosis really looked like (clinically speaking). This category of disorders, distinguished by the primary symptoms of delusions, prominent hallucinations, disorganized speech, or disorganized or catatonic behavior, is bound to come up on the exam in a variety of ways. Here’s just one: Sample Question: A social worker in a community mental health clinic begins an intake on a 22 year-old male. During the course of the intake, the social worker