Social Work Exam Study Guide (Made 2022)

NOTE + GENERAL INFO - Also, sorry for the chaos today, im reorganizing the doc to flow logically better :)

Hi everyone, I’m Rachel 🥰 and I’m the owner of this document! I want to start by congratulating you on making it this far! I’m so excited for all of you as you work towards becoming social workers. Remember that your score does not reflect your self-worth or your potential in this field. You’re here just to pass the exam! Also connect with me on linkedin, I love talking about my work and I am happy to answer any questions!!

If you come across any new information relevant to the exam or if there’s something important I might have missed, please don’t hesitate to suggest an edit. (For the most part) I’ve started to note when a commenter has recommended an edit for transparency purposes (“Commenter’s Contribution”).

I am happy to add to what I have, create a whole new section if necessary, and/or add any resources that you think may be helpful (i.e. practice exam questions, youtubers who have been helpful to you, etc.) If you would like to make an edit and/or add something, please email me @ racheljuliewolk@gmail.com. Unfortunately, too many people are messing up the formatting and I am not able to be on top of this document 24/7, so I am taking away editing/commenting access. Sorry for the inconvenience! I don’t want you to have to waste your money when social work school is already stupidly expensive and you’re all working so hard at your internships without pay.

I apologize for my delay in responding to emails, I have been extremely busy! I am going to try and stay more on top of it!

Here is a link that you can make a copy to edit for yourself. Please do not make any edits on the page - this is for those who want to print/copy to their own google doc: Copy of Document- Edit Access Open 

(Mnemonics are moved to a different tab because I find them to be more confusing than helpful other than THINK, which I don’t think is necessary either– go to the left hand “document tabs” to find them.)

Table of Contents

NOTE + GENERAL INFO - Also, sorry for the chaos today, im reorganizing the doc to flow logically better :)        0

NASW CODE OF ETHICS        5

HOW TO ANSWER QUESTIONS – THINK        6

T – Triage        6

H– Hypothesize        7

I– Integrate        7

N– Navigate        7

K– Know your role        7

HUMAN DEVELOPMENT        7

Erikson’s 8 Stages of Psychosocial Development        7

Mary Ainsworth Attachment Theory:        8

Play Stages:        8

End of Life Development: Kubler Ross Stages of Grief        8

Piaget’s Cognitive Development Theory        8

Kohlberg’s Moral Development        8

Freud’s Psychosexual Development        9

Neo-Freudian        9

Psychodynamic Concepts        9

Defense Mechanisms        9

Margaret Mahler Object Relations Theory        10

Parenting Styles        10

BEHAVIORIAL THEORY        11

Learning Theory        11

Key Techniques in Behavioral Therapy        11

Cognitive Distortions        11

TRAUMA & RESILIENCE        12

Crisis Theory        12

Types of Trauma & Definitions        12

Trauma Responses        12

Trauma Treatment        13

Trauma Interventions        13

THEORIES BEHIND INTERVENTIONS        13

Stages of Change        13

Communication Skills        13

Strengths Perspective        14

Interventions to Know (not outlined in other sections)        14

SYSTEMS THEORY & FAMILY THERAPY        14

Systems Theory        14

Types of Family Therapy        14

Concepts in Family Dynamics        15

GROUP THERAPY        15

Theory        15

Core Group Concepts        16

Group Dynamics        16

Group Roles        16

SOCIAL WORK IN COMMUNITIES        17

ORGANIZATIONAL THEORIES        17

Prevention Levels        17

Organizational Theories        18

Social Work Practice Roles        18

Settings        18

RESEARCH        19

Types of Research        19

Research Designs        19

Validity        19

Program evaluation types:        20

ASSESSMENT TOOLS        20

Tools (Assessments, Screenings, Scales, etc.)        20

Mental Status Exam        21

DSM-5 DIAGNOSES        22

1. Neurodevelopmental DO        22

2. Psychotic DO        22

3. Mood DO        22

4. Anxiety DO        22

5. Trauma & Stress Related DO        23

6. OCD & Related DO        23

7. Somatic Sx- Related DO        23

8. Disruptive, Impulse Control, Conduct        23

9. Neurocognitive DO        23

10. Personality DO        23

11. Other        24

MEDICATION        24

Medications        24

Antipsychotics        24

Mood Stabilizer        24

Anti Anxiety        24

Antidepressants        24

Stimulants        25

For Alcohol Use DO        25

SUPERVISION        25

Supervision vs consultation:        25

Types of supervision:        25

Formats:        25

Test Formatting:

• Now until August 2nd: Pearson VUE,  exam will be split into two sections with a mandatory 10 minute break. When you have submitted the first section of the exams, you cannot go back to edit your answers. There are no changes to the grading, scheduling process, or examination fees. Please check the new ASWB exam guide for more information and what to expect for test day. Good luck everyone! The questions are still multiple choice and there are a mix of 3-4 answer choices in the questions.
• ASWB Exam Changes in August 2026

NASW CODE OF ETHICS

I recommend reading the Code of Ethics at least once before your exam!

NASW Core Values: service, social justice, dignity/worth, relationships, integrity, competence

Core Ethical Principles

• Client self-determination (limit = harm to self/others, abuse, legal mandate)
• Confidentiality protected by HIPAA
• Informed consent/ Informed  refusal = client declines treatment knowingly (document client’s understanding of risks when declining recommended treatment)

• Assent for clients who cannot consent.

• Competence: Practice within scope, Consult/Get Supervision/Refer when needed

Breaking Confidentiality: (Expanded on below in “THINK”)

• Danger to self or others, duty to warn.

• Mandatory Reporting: (child, elder, dependent adult abuse/neglect/exploitation) → report, do not investigate, only gather minimal necessary information.

• Court order or Subpoena (limited disclosure after consultation) – follow jurisdictions/company’s legal requirements

• Subpoena ≠ automatic release / Court order = must comply
• Testimonial privilege: clients holds right to prevent th from testifying about their treatment

Boundaries

• Crossing = minor/can be therapeutic (self disclosure) vs. Violation = harmful/exploitative
• Dual relationships (asses & avoid if possible), Gifts only if small/clinically appropriate
• No sexual relationships
• No social media contact
• Address impaired colleagues directly and then report if unresolved

Documentation

• Purpose: track progress & fit of interventions, continuity of care, legal protection, communication with providers, meet requirements
• Includes assessments, diagnosis, treatment plans, progress notes, risk, consent, discharge planning, releases, correspondence
• Keep ~7 years (longer for minors; varies by state), Rights apply even after client death
• Client access generally allowed (with limits, document and deny if it would cause harm to client)
• Ethical decision-making: Prioritize safety, Consult + document, Choose least harmful option

• Law overrides ethics only when required

Negligence vs malpractice:

• Negligence = failure to meet standard of care
• Malpractice = negligence + harm + legal damages, common causes of claims: suicide, sexual misconduct, breach of confidentiality, improper treatment, abandonment
• Duty of Care: legal obligation to provide competent professional services

Termination: Must include planning, referral, continuity

• Abrupt termination = abandonment

Clinical Exam Patterns

• Elder confusion: rule out medical causes first
• Child behavior issues: consider ecological and developmental factors
• Unconditional positive regard: accepting and valuing clients without judgment or conditions.

HOW TO ANSWER QUESTIONS – THINK

Clinical Sequencing

T – Triage

Safety first (risk to self/others, medical issues) Assess lethality → stabilize → plan → follow-up

Risk Assessment: determine level of danger ct poses to self and others 

Suicide Risk: Prior attempts, plan/means, substance use, isolation, sudden ↑ energy after depression (Protective Factors: Support system, beliefs, family responsibility)

• Suicidal Ideation: thoughts about suicide ranging form passive to active
• Plan (how) vs Intent (determination/desire to follow through)
• DO NOT use safety contracts - outdated
• Make Safety Plan: warning signs, internal coping strategies, social contacts, professional resources, means restriction

Homicide Risk: Threats to identifiable person, access to weapons – Duty to warn

Crisis Intervention: Ensure safety & Stabilize before assessing → Plan & follow-up can come after.

Clear Child Abuse – CPS

• Conduct child abuse assessment when theres reasonable suspicion of abuse or neglect
• Indicators of physical abuse: unexplained injuries, patterns inconsistent with explanation, injuries at different healing stages
• Behavioral indicators: age inappropriate sexual knowledge/behavior, regression, nightmares, avoidance of specific people
• Psychological Maltreatment of Children: Patterns of caregiver behaviors that harm emotional development and sense of self worth
• Signs of neglect in children:  poor hygiene, untreated medical issues, malnutrition, lack of supervision.

Elder Abuse

• Signs of Elder abuse: unexplained injuries, sudden financial changes, withdrawal, fear of caregiver
• Financial exploiting elderly: illegal or improper use of elder funds, considered abuse

H– Hypothesize

ASSESS BEFORE ACTION!

Never assume. Consider medical, psychiatric, developmental, and environmental causes.

Medical conditions can mimic psychiatric symptoms

Examples from practice test: Assess before action!

• Empty bottles of alcohol  during a house visit. → ask the client.
• Ct refuses services because it’s “God’s Will” → explore use of religion.
• Teacher tells SW that a child is coming to school with messy clothing & occasional bruises → talk to student

I– Integrate

Integrate all domains: Bio-Psycho-Social-Spiritual Lens + cultural, spiritual dimensions

N– Navigate  

Choose the least invasive, most ethical, client-centered option, evidence based interventions (“research indicates” “studies show” “the social worker uses clinical judgement to..)

K– Know your role

Follow legal/ethical duties (mandated reporting, confidentiality limits, scope of practice).

Do not treat alcohol or drug addiction unless you specialize

HUMAN DEVELOPMENT

Erikson’s 8 Stages of Psychosocial Development

Memorized using this video  

1. Trust vs. Mistrust (0–1, infancy)
2. Autonomy vs. Shame/Doubt (1–3, toddler)
3. Initiative vs. Guilt (3–6, preschool)
4. Industry vs. Inferiority (6–12, school age)
5. Identity vs. Role Confusion (12–18, adolescence)

1. limbic system > prefrontal cortex
2. Synaptic proliferation and pruning
3. Key issues: sexuality, gender, substance use, suicide risk, technology use

6. Intimacy vs. Isolation (20s–40s)
7. Generativity vs. Stagnation (40s–60s)
8. Ego Integrity vs. Despair (60s+)

Mary Ainsworth Attachment Theory:

• Secure: distressed when caregiver leaves, soothed on return
• Anxious-ambivalent: clingy, distressed, angry on return
• Avoidant: appears unaffected, physiologically stressed
• Disorganized: inconsistent, fear-based behavior toward caregiver

Play Stages:

Likely don’t need to know the specifics, but good to know general development to identify when child behavior warrants further testing.

• 2-3: Parallel play
• 3-4: associative play, magical thinking, imaginary friends
• 4-5: cooperative play, theory of mind develops
• 5-6: rule-based games, fairness understanding

Red Flags on the Exam Tests

• No babbling by 12 months, No single words by 16 months. No 2-word phrases by 24 months, No pretend play by 24 months, No interests in other children by 36 months
• Loss of previously acquired skills at any age

End of Life Development: Kubler Ross Stages of Grief

• Stages: denial, anger, bargaining, depression, acceptance (nonlinear)
• Supporting dying clients: control, connection, meaning, forgiveness, legacy, symptom management
• Waves of sadness, self esteem remains intatct, can have positive memories

Piaget’s Cognitive Development Theory

• Sensorimotor (0–2): sensory learning, object permanence, intentional action
• Preoperational (2–7): symbolic thinking, egocentrism, magical thinking
• Concrete Operational (7–11): logical thinking about concrete events, conservation, **take others perspectives**
• Formal Operational (12+): abstract and hypothetical thinking

Kohlberg’s Moral Development

• Preconventional: Elementary school level (< 9) punishment/reward-based morality
• Conventional: Early Adolescence, social approval and law/order orientation, “good girl/bad girl”
• Postconventional: Teens & adults, abstract ethics, social contract, universal principles (rare)

Freud’s Psychosexual Development

• Conscious, Preconscious, Unconscious
• Id (impulses), ego (the self, mediator), superego (higher morality)
• Latent: Alternate meaning, interpretation / Manifest: Literal subject matter

Neo-Freudian

Moves from sexual drives to broader motivations (social, unconscious, striving for meaning/perfection). Examples: ego psychology, Adler Individual psychology (Behavior driven by inferiority feelings, striving for superiority, and social belonging), self psychology (focus on unmet childhood needs, focus on empathy

• Psychoanalysis is the original, intensive therapy developed by Sigmund Freud that focuses on uncovering unconscious conflicts through techniques like free association and dream analysis.
• Psychodynamic therapy is a modern, less intensive adaptation that still explores unconscious processes and early relationships but in a more flexible and time-limited format.

Psychodynamic Concepts

• Transference (T= to therapist): client’s unconscious redirection of feelings from past relatiomshipo onto therapist
• Countertransference (C= to client)
• Resistance = clients unconscious defense against therapeutic change or exploring painful material
• Interpretation = therapist offering meaning about unconscious patterns or conflicts
• Working through
• Free association

Defense Mechanisms

A big part of psychodynamic therapy (exploring how unconscious patterns and past experiences influence present functioning)

• Projection: put feelings on others
• Displacement: redirect emotion to safer target
• Sublimation: healthy outlet
• Reaction formation: act opposite
• Intellectualization: avoid emotion with logic
• Splitting (BPD): all good/all bad
• Denial / repression / dissociation
• Other Examples:

• Regression
• Rationalization
• Undoing
• Identification
• Introjection
• Compensation
• Isolation of affect
• Suppression (voluntary)

Margaret Mahler Object Relations Theory

• Separation-individuation: developing self while maintaining attachment
• Key phases:

• Differentiation: self vs caregiver
• Practicing: exploration and independence
• Rapprochement (15–24 months): independence + need for reassurance
• Object constancy: caregiver remains secure when absent

• Stranger anxiety: 6–12 months
• Separation anxiety: 8–12 months

Parenting Styles

Maslow’s Hierarchy of Needs

1. Physiological Needs- Food, water, shelter, sleep
2. Safety Needs- Protection from elements/danger
3. Social Needs- Love & Belongingness; friendship, intimacy, affection)
4. Esteem Needs- Self-respect & respect from others
5. Self-Actualization- Realizing personal potential
6. Self Transcendence

BEHAVIORIAL THEORY

Learning Theory

• Classical conditioning (Pavlov): stimulus → involuntary response
• Operant conditioning (Skinner): behavior shaped by consequences

• Reinforcement ↑ behavior / Punishment ↓ behavior
• Positive = add / Negative = remove (NOT “bad”)

• Extinction = behavior stops due to removal of reinforcement
• Shaping = reinforce steps toward target behavior
• Bandura = observational learning

Key Techniques in Behavioral Therapy

Systematic desensitization = relaxation + anxiety hierarchy

In vivo desensitization = real-life exposure

Cognitive Behavioral Therpay (CBT): change thoughts + behaviors (most effective for depression, anxiety DO, PTSD, OCD, and eating disorders)

• Structure: agenda setting, HW review, working on skills, assigning new HW
• Cognitive restructuring =  identifying and challenging distorted thoughts to change feelings and behaviors
• Partializing = break problems into parts
• Psychoeducation = teach client skills/info
• Behavioral Activation: Increase engagement in rewarding activities to improve mood
• Systemic Desensitization: pairing relaxation with gradual exposure to anxiety provoking stimuli
• Rational Emotive Behavior Therapy (REBT) = challenge irrational beliefs

Dialectical Behavioral Therapy (DBT): comprehensive treatment combining CBT with mindfulness for emotional dysregulation, initially created for cts with DBT

• Dialetics: balancing opposites, acceptance and change  
• Radical Acceptance: fully accepting realit as it is without fighting it

1. Mindfulness = non jiudgemental awareness of present moment
2. Distress tolerance = getting through crisis without making it worse i.e. TIPP
3. Emotion regulation
4. Interpersonal Effectiveness = skills for asking for what you need while maintaining relationships and self respect

Cognitive Distortions

• Catastrophizing
• Black-and-white thinking
• Personalization
• Overgeneralization
• Mind reading
• Emotional reasoning
• Should statements

TRAUMA & RESILIENCE

Crisis Theory

• Stages: Precipitating event, Increased tension, Failed coping Crisis
• Goal: Restore previous level of functioning.
• Three types of Crisis: maturational (developmental), situational (unexpected events), existential (internal conflicts)

Types of Trauma & Definitions

• Primary Trauma
• Secondary Trauma: trauma sx from indirect exposure to others’ trauma aka vicarious trauma
• Big T (life threatening events) vs little t trauma (distressing experiences that affect functioning)
• Intergenerational Trauma: trauma effects passed down through generations via parenting and social patterns  
• Historical Trauma: cumulative emotional and psychological wounding across generations from traumatic experiences.
• Developmental Trauma: trauma occurring during critical developmental periods affecting brain development
• Betrayal Trauma: trauma perpetrated by someone the victim depends on for survival or well being
• Sanctuary Trauma: re-traumatization within systems meant to help i.e. hospitals, shelters, therapy 
• Acute Trauma (single incident) vs chronic trauma (repeated exposure over time)
• Post traumatic growth: positive psychological change resulting from struggle with highly challenging circumstances

Trauma Responses

• 4 F responses to trauma: Fight, flight, freeze, fawn
• Dissociation: disconnection from thoughts
• Trauma bonding: strong emotional attachment to abuser developed through intermittent reinforcement
• Trauma reenactment: unconsciously recreating aspects of traumatic experience in current relationships and/or situations

Trauma Treatment

When should trauma processing begin? After the stabilization phase of trauma treatment where ct has adequate coping skills and emotional regulation abilities. (THINK!)

• Core of trauma informed care: safety, trustworthiness and choice
• Titration: processing trauma in small manageable doses rather than overwhelming amounts.
• Pendulation: moving between activation and calm states during trauma processing
• Imaginal Exposure: verbally recounting traumatic memory repeatedly to process and reduce distress
• Dual Awareness: maintaining awareness of both past trauma and present safety simultaneously
• In vivo exposure: gradual confrontation with safe situation avoided dur to trauma, confronts feared situations in real life.

Polyvagal Theory: 3 state model of nervous system: ventral vagal (safe), sympathetic (fight/flight), dorsal vagal (shutdown)

• Hyperarousal: state of increased psychological and physiological tension
• Hypoarousal: a nervous system "shutdown" response that occurs when the body becomes overwhelmed by stress or trauma
• Window of Tolerance: range of emotional arousal where person can function effectively (doesn’t have to be calm)

Trauma Interventions

• EMDR: trauma therapy
• Somatic Experiencing: trauma therapy, focused on physical sensations & releasing stored trauma energy
• Prolonged Exposure Therapy: CBT based, 8-15 weekly 90 minute sessions, gradually confront trauma, for PTSD, relies on intensive trauma memory processing.
• TF-CBT: gradual exposure
• Cognitive Processing Therapy (CPT): helping ct evaluate and change unhelpful beliefs about trauma

• Stuck points: beliefs preventing recovery from trauma

THEORIES BEHIND INTERVENTIONS

Engagement → Assessment → Planning → Intervention → Evaluation → Termination

Stages of Change

Used a lot in readiness for alcohol abuse treatment.

• Precontemplation: no insight → build rapport
• Contemplation: ambivalent
• Preparation: small steps
• Action → Maintenance → Relapse possible

Communication Skills

• Reflection = feelings
• Clarification = clarify meaning
• Confrontation = challenge inconsistency
• Active listening = attending + responding
• Reframing = new perspective
• Universalization = normalize experience
• Silence = therapeutic tool
• Congruence/genuiness = therapist being authentic and transparent in therapeutic relationship

Strengths Perspective

• Client strengths
• Resilience
• Protective factors
• Empowerment
• Solution-focused interventions

Interventions to Know (not outlined in other sections)

• Solution Focused Brief Therapy (SFBT): Future & goal oriented approach focusing on solutions and client strengths rather than problems.

• Uses: Miracle question, Scaling questions (rating problem/progress 1-10 to identify change and next steps), Exception finding (times where problem doesnt occur or is less severe’ identified existing solutions)
• Change talk: clients own arguments for change

• Child Play Therapy (multiple types)
• Motivational interviewing: client centered approach, enhancing intrinsic motivation for change through exploring ambivalence, good for alcoholics

• OARS: Open questions,  Affirmations, Reflective listening, Summaries
• Four processes: engaging, focusing, evoking, planning

• Narrative Therapy (explored in family therapy as well): externalization aka separating person from problem to reduce shame and increase personal agency
• Person Centered Therapy: humanistic approach emphasizing therapists unconditional positive regard

SYSTEMS THEORY & FAMILY THERAPY

Systems Theory

• Problems are understood within relationships and systems, not individuals alone – Families function as interconnected units
• Behavior is shaped by ongoing interaction patterns, not single causes

• Circular causality: behavior is mutual and cyclical (no simple cause → effect)
• Feedback loops: repetitive interaction patterns that maintain problems
• Role theory: behavior is shaped by social roles (parent, child, worker, etc.)

Types of Family Therapy

• Structural Family Therapy (Minuchin): family organization (boundaries, hierarchy, subsystems)

• Boundaries: Rigid (isolated), Diffuse (enmeshed), Clear (healthy)
• Techniques: joining, mapping, enactment, unbalancing, reframing

• Strategic Family Therapy: problem is dysfunctional interaction pattern → change the strategy, not insight

• Tools: directives, paradoxical interventions, reframing, ordeals
• First-order change: small adjustments (no real change)
• Second-order change: pattern change

• Bowen Family Therapy: focus on differentiation

• Triangulation, emotional fusion (overinvolvement), emotional cutoff (avoidance)
• Genograms to track multi-generational patterns

• Narrative Family: Problem is the story, not the person

• Externalization: separate person from problem
• Unique outcomes: times problem did not control behavior
• Re-authoring: build new identity story
• Definitional ceremonies: others witness new narrative

• Emotionally Focused Family Therapy: attachment based, focus on emotional bonding and changing negative interaction cycles.
• Gottman Method (couples therapy): build friendship.
• Multi-Family Groups:

• Psychoeducational groups: teach skills/info
• Support groups: shared experience and peer support
• Therapy groups: multiple families working on relationships

Concepts in Family Dynamics

• Role reversal: perspective shifting, Scapegoating dynamics visible in positioning/roles
• Cross-family dialogue: interaction across families’
• Fishbowl: one family interacts while others observe
• Patterns:  Enmeshed – too much closeness, low independence, Disengaged – too little connection, emotional distance, Balanced – flexible boundaries (healthy goal)
• Scapegoating: one member blamed for system issues
• Parentification: child takes adult role
• Family secrets: hidden patterns affecting system
• Genograms: 3+ generations map of family patterns, Shows relationships, trauma, mental health, alliances, cutoff, Symbols: square = male, circle = female, X = death

GROUP THERAPY

Theory

Tuckman’s Stages of Group Development: Forming, storming, norming, performing, adjourning

Yalom’s Therapeutic Factors (What heals groups)

• Most seen on exam: Universality (“I’m not alone”) & Cohesiveness (belonging/safety in group)
• Instillation of hope: “If others improve, I can too”
• Altruism: helping others boosts self-worth
• Interpersonal learning: learning from others
• Catharsis: emotional release
• Corrective emotional experience: reworking past relational patterns in group

Core Group Concepts

• “Here and now” focus: process > content (how members interact in group)
• Group is the agent of change (not just leader)
• Cooperative learning increases outcomes
• Confidentiality is limited (cannot be guaranteed between members)
• Open (members come/go; e.g., AA) / Closed (fixed membership)
• Types: support, therapy, psychoeducational, task, crisis

Group Dynamics

• Groupthink: conformity → poor decisions
• Group polarization: more extreme opinions
• Psychodrama: role play
• Folie à deux: shared delusion

Group Roles

• Task Roles (productive): Initiate, inform, summarize, coordinate, evaluate
• Maintenance Roles (support group): Encourage, harmonize, gatekeep, set norms
• Individual Roles (problematic): Aggressor, blocker, monopolizer, silent member, recognition seeker, dominator, confessor, “yes-but” complainer
• Therapist use of self: Redirect + set limits + engage group

• Self-disclosure (limited)
• Modeling
• Countertransference = clinical data, they can give you useful information about what is happening in the therapeutic relationship.

SOCIAL WORK IN COMMUNITIES

Self-determination + empowerment + collective power, Shift power to communities; challenge systems of oppression; Intervene more with vulnerable populations

Ethics Audit: structured review of an organization’s systems, decisions, and behavior to identify ethical risks, gaps, and compliance issues, then fix them and track improvement over time.

Power Sources (why someone can influence others’ behavior): Coercive (fear), reward (incentive), expert (knowledge), referent (respect), legitimate (position.title), informational (access to info)

Community Models

• Locality Development: community-led, SW = facilitator; participation, consensus, empowerment
• Social Planning: data-driven, rational, problem solving SW = expert; needs assessment, program design
• Social Action: confronting injustice, advocacy + protest; challenge power structures
• Social Reform: System-wide change through collaboration, Policy/system-level reform, coalition-building across orgs

Decision Process: Orientation → Conflict → Emergence → Reinforcement

Fiscal Management: planning, acquisition, allocation, control, reporting

Evaluation:

• Cost-benefit = money vs money
• Cost-effectiveness = cost vs outcomes
• Outcome = did goals get met

ORGANIZATIONAL THEORIES

Prevention Levels

• Primary = prevent problem before it starts (education, prevention programs)
• Secondary = early identification + intervention with at-risk groups
• Tertiary = treatment after problem exists to reduce impact/recurrence

Organizational Theories

• Classical theory = efficiency + structure + hierarchy
• (Scientific Management, Weber Bureaucracy)
• Focus: rules, productivity, reward/punishment
• Neoclassical theory = human relationships matter
• Focus: worker satisfaction, groups, communication, participation
• Modern theory = systems approach (Person-in-Environment)
• Focus: organization = interrelated parts affected by environment

Social Work Practice Roles

• Advocate = speaks up for client rights and access
• Broker = connects clients to services/resources
• Change agent = works to improve systems/services
• Counselor = helps improve coping and functioning
• Mediator = resolves conflict between parties neutrally
• Mobilizer = organizes community resources/people

Key exam ideas:

• Broker = connect
• Advocate = fight for
• Counselor = treat/support
• Change agent = system improvement

Settings

• School SW:

• Do NOT diagnose learning disabilities
• Psychologist does testing, SW gathers collateral info + supports student
• Must report suspected abuse

• CPS / Child Welfare

• Safety + investigation
• Family preservation first
• Removal is last resort
• Permanency planning = stable long-term placement

• Hospital / Inpatient SW

• Risk assessment is critical
• NEVER discharge with active SI/HI
• Focus on safe discharge planning

RESEARCH

Types of Research

• Qualitative = words, meaning, interviews, focus groups, observation
• Quantitative = numbers, surveys, measurable data

Research Designs

• Experimental design: Random assignment + control group;

• strongest design
• only design that can show cause and effect by comparing outcomes between groups after an intervention.

• Quasi-experimental design:

• No random assignment but has comparison groups, commonly used in real-world settings
• suggests relationships but cannot fully establish causation.
• include a separate control or comparison group to establish baseline validity
• Example: A school district wants to test the impact of a new math software on student test scores. School A gets the software and School B does not.

• Pre-experimental design:

• No control group and no random assignment, weakest design, usually one group pre-test/post-test
• very limited conclusions about cause and effect.
• Example: School A implements new math software and compares exam scores from before and after implementing it.

• Single-subject design:

• One client or case studied over time; client serves as their own control
• uses repeated phases such as A-B (baseline → intervention) or A-B-A (baseline → intervention → return to baseline)
• helps show whether change is linked to intervention but limited generalizability.
• Example: Child A engages in new therapy. Therapist tests mood before and after implementation of therapy.

• Correlational design:

• Examines relationships between variables only
• does not test cause and effect; shows whether variables move together (positive, negative, or no relationship).

• Descriptive design: Describes characteristics of a sample or situation

• no relationships or causation tested
• summarizes data using percentages, averages, or observations.

Validity

• Validity = accuracy of what is being measured
• Reliability = consistency of results across time or repeated measures
• Internal validity = whether changes are truly caused by the intervention (cause-and-effect confidence)
• External validity = whether findings can be generalized to other populations or settings

Program evaluation types:

• Formative = used during the program to improve or modify it while it is running
• Summative = done at the end of the program to evaluate overall effectiveness and outcomes
• Process = looks at how the program was implemented and what was actually done
• Outcome = measures whether the program achieved its intended changes in clients or conditions
• Needs assessment = done before a program starts to identify problems, gaps, and what services are needed

ASSESSMENT TOOLS

Why? Provides objective approaches

Signs (observable indicators) vs Symptoms (subjective experiences reported by client)

Clinical Formulation:  comprehensive understanding linking assessment data into coherent explanation  

Ongoing Assessment: continuous evaluation through treatment to monitor progress and adjust interventions

Working hypothesis in assessment: preliminary understanding of clients issues that guide initial treatment

Differential Diagnosis: process of distinguishing between conditions with similar presentations

• Rule out medical FIRST!!!

Clinical Judgement: professional reasoning process combing knowledge

Collateral Information: important when client has impaired insight, cognitive issues, or is danger to self

Screening (brief tool, identify potential issues) vs Assessment (comprehensive evaluation)

Tools (Assessments, Screenings, Scales, etc.)

• WHODAS 2.0 (World Health Organization Disability Assessment Schedule):  how mental or physical disorders affect a person’s functioning in daily life
• Biopsychosocial Assessments
• Columbia Suicide Severity Rating Scale (C-SSRS): standardized tool to assess suicide risk across 6 levels from ideation to attempt
• SAD PERSONS Scale: Mnemonic for suicide risk – sex, age, depression, previous attempt, ethanol (alcohol), rational thinking, social supports, organized plan, no spouse, sickness
• CAGE Questionnaire:  screening tool for alcohol use based on four questions –  cut down, annoyed, guilty, eye opener
• AUDIT: Alcohol use disorders identification test, 10 item screening for hazardous/harmful alcohol use.
• PCL-5: PTSD checklist for DSM5, 20 item self report measure for PTSD sx.
• GAD-7: 7 item screening tool for GAD severity
• ACEs: adverse childhood experiences, potentially traumatic events in childhood such as neglect, household dysfunction and abuse.
• PHQ-9: patient health questionnaire - 9 item depression screening and severity measure

Mental Status Exam

Quick assessment of current functioning, usually based on: appearance, orientation (awareness of time/place, etc.), speech pattern, affect/mood, impulsive/potential for harm, judgment/insight, thought processes/reality testing, intellectual functioning/memory – in line with: ASSESS BEFORE ACTION

• Mood: clients sustained emotional state

• Euthymic: stable mood
• Euphoric:  excessively elevated
• Dysthymic: persistently depressed mood  

• Affect: observable emotional expression in the moment

• Blunted: reduced emotional expressiveness but some visible emotions present
• Flat: absence of emotional expression, no visible emotional response
• Labile: rapidly changing emotional expressions inconsistent with situation
• Restricted: reduced in range and intensity of emotional expression
• Appropriate: emotional expression consistent with situation and thought content
• Incongruent: emotional expression not matching thought content or situation

• Speech:

• Circumstantial: eventually reaches the point but includes excessive and unnecessary detail
• Tangential: Goes off topic and never returns to the original point
• Flight of ideas: rapid shifting between loosely connected thoughts (seen in mania)
• Thought Blocking: sudden stopping in middle of though due to interruption in thinking
• Poverty of Speech: minimal verbal responses with little content
• Pressured Speech: rapid, excessive speech with a sense of urgency that is difficult to interrupt
• Ideas of Reference: Believing unrelated events or objects have personal significance
• Confabulation: making up stories to fill memory gap without awareness they are false
• Perseveration: repetition of responses or behaviors despite changing questions or situations

• Levels of Consciousness: alert, drowsy, lethargic, stuporous, comatose

Common Symptoms Amongst Diagnoses

Negative Sx: absence or reduction of typical behaviors, emotions, and mental functions.

• Avolition: a severe, clinical lack of motivation or ability to start and sustain goal-directed activities.
• Anhedonia: is the inability to experience pleasure or joy from activities that you would normally find rewarding.
• Alogia: Poverty of speech

Positive Sx: exaggerated or added mental phenomena i.e. delusions, hallucinations, disorganized speech

DSM-5 DIAGNOSES

The DSM-5 replaced the Not Otherwise Specified (NOS) categories with two options

• Other Specified Disorder: the clinician can explain why the symptoms do not meet full criteria for a specific disorder but still provides a reason for the subthreshold presentation.
• Unspecified Disorder: clinician does not specify why the full criteria are not met, often due to limited information or time.

1. Neurodevelopmental DO

Intellectual Disability: IQ less than 70, severity  based on adaptive functioning deficits (conceptual, social, practical) not IQ.

Autism Spectrum Disorder: social communication deficits + repetitive behaviors; support level 1–3.

ADHD: symptoms present before age 12.

2. Psychotic DO

Brief Psychotic Disorder (1 day to 1 month)

Schizophreniform (1 to 6 months)

Schizophrenia (6+ months, 1 month of active sx)

Schizoaffective Disorder (psychosis + mood episodes)

Delusional Disorder (≥1 month, delusions only)

• Delusions: fixed false belief not consistent with cultural background
• Hallucinations: false perceptions (sensory), most likely = auditory

3. Mood DO

Major Depressive Disorder (≥2 weeks, 5 symptoms)

Persistent Depressive Disorder (≥2 years adults)

Bipolar I (mania ≥1 week or hospitalization)

Bipolar II (hypomania + depression)

Cyclothymic Disorder (≥2 years fluctuating)

Disruptive Mood Dysregulation Disorder (children, chronic irritability)

4. Anxiety DO

Generalized Anxiety Disorder (≥6 months)

Panic Disorder 1+ month, Recurrent unexpected panic attacks, Worry about future attacks

Agoraphobia Fear of places where escape is difficult

Separation Anxiety Disorder Excessive fear of separation from attachment figures

5. Trauma & Stress Related DO

PTSD ≥1 month, re-experiencing + avoidance + hyperarousal – 4 sx clusters: intrusion, avoidance, negative cognitions/mood, arousal/reactivity

Acute Stress Disorder <1 month

Adjustment Disorder within 3 months of stressor

Reactive Attachment Disorder: Severe early neglect, inability to form stable attachments

6. OCD & Related DO

OCD (obsessions + compulsions)

Hoarding Disorder

Trichotillomania

7. Somatic Sx- Related DO

Somatic Symptom Disorder Physical symptoms + excessive thoughts/behaviors

Illness Anxiety Disorder Fear of illness with minimal/no symptoms

Conversion Disorder Neurological symptoms without medical cause

Factitious Disorder (incl. by proxy): Intentionally producing symptoms to assume sick role

Malingering (NOT a mental disorder, important distinction): Faking symptoms for external gain

8. Disruptive, Impulse Control, Conduct

Childhood Dx:

Oppositional Defiant Disorder (ODD)  Angry, argumentative, defiant behavior,

Conduct Disorder (precursor to antisocial PD) Violation of rights of others, Aggression, theft, serious rule violations

9. Neurocognitive DO

Delirium (acute, fluctuating, reversible)  key feature is inattention

Major Neurocognitive Disorder (dementia/Alzheimer’s): Significant cognitive decline

Mild Neurocognitive Disorder mild decline, still independent

Korsakoff’s Syndrome Thiamine deficiency (often alcohol-related), Memory loss + confabulation

10. Personality DO

Cluster A (odd/eccentric)

• Paranoid: distrust
• Schizoid: detachment, no desire for relationships
• Schizotypal: odd beliefs, magical thinking

Cluster B (dramatic/emotional)

• Antisocial: disregard for rights of other
• Borderline: instability in mood, relationships, self-image
• Histrionic: excessive emotionality and attention-seeking
• Narcissistic: grandiosity, lack of empathy

Cluster C (anxious/fearful)

• Avoidant: wants relationships but fears rejection
• Dependent: excessive need to be cared for
• OCPD: perfectionism, control, rigidity (ego-syntonic)

11. Other

• Substance Use Disorder: 2+ criteria within 12 months indicating problematic pattern. Severity levels = mild (2-3 criteria), moderate (4-5 criteria), severe (6+ criteria)
• Binge Eating Disorder:  weekly for at least 3 months

MEDICATION

Medications

SUPERVISION

Supervision vs consultation:

• Consultation: advice you can accept or reject; not hierarchical, usually informal, not ongoing.
• Supervision: formal, ongoing relationship where a supervisor is responsible for guidance, evaluation, and professional development. (Go to for ethical dilemma)

• Choose actions that protect client safety first
• Use supervisor for ethical issues, risk, or uncertainty
• Follow agency hierarchy when in doubt

Types of supervision:

• Educational: teaches clinical skills; focuses on assessment, intervention, treatment; includes transference/countertransference (skill learning)
• Administrative: agency rules, documentation, policy, job performance, accountability (Policy/documentation issues)
• Supportive: reduces stress, burnout, secondary trauma; supports worker wellbeing (burnout/stress  support)

Formats:

• Individual: 1:1; most focused, best for sensitive/ethical issues; time-consuming
• Group:  one supervisor + multiple SWs; shared learning; less individualized
• Peer: equals supporting each other; helpful but NOT a substitute for formal supervision

Mnemonics

Commenter’s Note: Something to note is that clients who have recently been released from an involuntary hospitalization are at increased risk for suicide. They have been stabilized by treatment and now have the energy to follow through with their plan. Always complete Suicide/Safety assessment following release.

• Red flags for suicide include: Giving away valued possessions. Example: An elderly client who recently lost his wife and is coming to you for treatment attempts to gift you with a painting. Inquire about the significance of the item and reason behind giving it away.