Introduction to Social Work Practice: A Practical Workbook
Publication Year: 2010
Introduction to Social Work Practice orients the students to the role of the professional social worker. The first chapter delineates the differences between being a good friend and being a good clinician in terms of social/emotional factors, professionalism, and self-disclosure. The second chapter covers techniques for building a trusting working environment that is conducive to processing sensitive issues along with an overview of key therapeutic communication skills. The remaining five chapters detail an easy-to-remember five-step problem-solving model to guide the clinical process: 1. Assessment, 2. Goal, 3. Objectives, 4. Activation, 5. Termination.
Key features include:
role-play exercises; brief essay and response questions to build and test key communication skills; discussion points; glossary of terms; diagrams and charts that graphically represent the flow of the helping process.
The workbook ...
- Front Matter
- Back Matter
- Subject Index
Part I: Defining the Professional Relationship
- Chapter 1: What Does a Social Worker Do … and Not Do?
- Social Work Diversity
- Social/Emotional Factors
- Personal Contact
- Topic of Conversation
- Scope of Practice
- Positive Regard
- Implicit Self-Disclosure
- Professional Self-Disclosure
- Advantages of Self-Disclosure
- Disadvantages of Self-Disclosure
- Self-Disclosures Should Be Honest
- Self-Disclosure Guidelines
- Concept Reviews
- Discussion Points
- Role-Play 1.1: Too Much Pressure (Involvement, Scope of Practice, Advice)
- Role-Play 1.2: Sobering Thoughts (Topic of Conversation, Confidentiality, Self-Disclosure)
- Role-Play 1.3: New in Town (Personal Contact, Time, Positive Regard)
Part II: Mutual Understanding
- Chapter 2: Fundamentals of Communication
- Fostering Sensitive Disclosure
- Rebuilding Rapport
- Nonjudgmental Attitude
- Emotional Aspects
- Emotional Language
- Concept Reviews
- Discussion Points
- Role-Play 2.1: Never-Ending Stories (Summarizing, Focusing, Identifying and Resolving Discrepancies)
- Role-Play 2.2: Sad Sam (Matching, Empathy, Specificity)
- Role-Play 2.3: Caustic Coworkers (Open-Ended Questions, Reflection/Paraphrasing, Rebuilding Rapport)
- Video Interview Self-Critique Exercise
Part III: The Process
- Chapter 3: Step I—Assessment: Where Is the Client Now?
- Before Meeting the Client
- Case Review
- Introduction to Diagnosis
- Principles of Diagnosis
- Mental Health Diagnosis (DSM)
- Advantages of Mental Health Diagnoses
- Disadvantages of Mental Health Diagnoses
- Additional Attributes of Mental Health Diagnoses
- After Meeting the Client
- Welcome to Therapy: What the Client Needs to Know
- Learning About the Client
- Written Assessment
- Mental Status Exam
- Concept Reviews
- Discussion Points
- Written Assessment
- Mental Status Exam and Role-Play
- Chapter 4: Step II—Goal: Where Does the Client Want to Be?
- Rationale for Setting a Goal
- Problems Versus Goals
- Intrinsic Versus Extrinsic Goals
- Fundamental Attributes of a Goal: Smart
- Supplemental Attributes of a Goal
- Concurrent with the Client's Values
- Additional Techniques for Identifying a Goal
- Recap Problems
- Magical Goals
- Serial and Parallel Goals
- Concept Reviews
- Discussion Points
- Role-Play 4.1: Plethora O' Problems (Recap Problems, Problems Versus Goals, SMART Goals)
- Role-Play 4.2: Gobs O' Goals (SMART Goals, Serial and Parallel Goals, Intrinsic Versus Extrinsic Goals)
- Role-Play 4.3: A Little Too Quiet (Specificity, Magical Goals, Attainable)
- Chapter 5: Step III—Objectives: How Does the Client Get from Here to There?
- Time Frame
- Objectives in Detail: The Strategic Plan
- Specifying Resources: Brainstorming Demonstrated
- Step I: Generate Ideas
- Step II: Sort
- Step III: Select
- Alternate Sources for Assembling Strategies
- Serial and Parallel Planning
- Client Perspective
- Concept Reviews
- Discussion Points
- Role-Play 5.1: A Dark and Brainstormy Night (Goal, Brainstorming, Objectives)
- Role-Play 5.2: Objection to Objectives (Resources, Serial and Parallel Goals, Objectives)
- Role-Play 5.3: Lights, Camera, Inaction (Actions, Time Frame, Brainstorming)
- Chapter 6: Step IV—Activation: Moving from Intention to Implementation
- Five Stages of Change
- Laying the Groundwork for Change
- Positive Mindset
- Social Support
- Identifying and Resolving Problems in Activation
- Addressing Dysfunctional Beliefs
- Review Objectives/Goals
- Concept Reviews
- Discussion Points
- Role-Play 6.1: Blue Is for Girls, Pink Is for Boys? (Social Support, Addressing Dysfunctional Beliefs, Stress)
- Role-Play 6.2: Someone Else's Idea? (Ownership, Homework, Social Support)
- Role-Play 6.3: The Checkered Flag … Almost (Social Support, Addressing Dysfunctional Beliefs, Review Objectives/Goals)
- Chapter 7: Step V—Termination: Continuing the Mission Independently
- What Is Termination?
- When Does Termination Happen?
- How Does Termination Happen?
- Termination Need Not Be Forever
- Types of Termination
- Progressive Termination
- At the Start of the Process
- During the Process
- At the Close of the Process
- Mutual Emotional Aspects of Termination
- Emotional Aspects of the Social Worker
- Emotional Aspects of the Client
- Consolidating Gains
- Posttermination Planning
- Goal Still in Progress
- Goal Accomplished
- Next Goal
- Concept Reviews
- Discussion Points
- Role-Play 7.1: I'll Drink to That … Not! (Maintenance, Next Goal, Termination Need Not Be Forever)
- Role-Play 7.2: Family and Beyond (Termination Need Not Be Forever, Emotional Aspects of the Client, Emotional Aspects of the Social Worker)
- Role-Play 7.3: Dissatisfaction Guaranteed (Emotional Aspects of the Client, Consolidating Gains, Emotional Aspects of the Social Worker)
[Page ii]For Mom and Dad
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Tell me, and I'll forget. Show me, and I may remember. Involve me, and I'll understand.—Anonymous
Welcome to this workbook. The purpose of this text is to orient you to the field of social work practice. In a nutshell, one might think of the social work profession as an opportunity to help improve the quality of people's lives. One of the privileges of being a social worker is the diversity of opportunities that are available in the workforce. Depending on your talents, training, interests, and opportunities, you may find yourself working in a variety of capacities ranging from adoption to hospice care. While some members of the social work profession dedicate themselves to the administrative, planning, or policy development services, others will have more direct contact with clients. Regardless of your long-run goals, your proficiency with the skills detailed in this text will provide you with an essential foundation for advancing your social work career.
This book presents an introduction to the practice principles and ethics of the social work profession, an essential set of communication skills that can be used to work effectively with clients and peers in a variety of settings, and an intuitive five-step problem-solving template to help focus your collaborative efforts with clients. The text is organized into three sections:
Part I, Defining the Professional Relationship (Chapter 1), delineates key differences between your role as a social helper, informally providing supportive guidance to family, friends, and acquaintances, and your evolving role and responsibilities in your professional capacity as a social work practitioner.
Part III, The Process (Chapters 3–7), presents a five-step problem-solving model—Assessment, Goal, Objectives, Activation, and Termination (acronym: A GOAT)—as a vehicle for collaboratively advancing the client through the change process:
Step I Assessment Where is the client now? Step II Goal Where does the client want to be? Step III Objectives How does the client get from here to there? Step IV Activation Moving from intention to implementation Step V Termination Continuing the mission independently
[Page xi]You have likely used something akin to this intuitive problem-solving model, perhaps without articulating each discrete step, in your efforts to achieve a variety of goals, as in this tangible example:
Step I Assessment I have a car, and I'm currently in Southville. Step II Goal I want to get to Northland. Step III Objectives I need a map, directions, fuel, food, and drink. Step IV Activation Starting tomorrow, I'll drive from 8:00 a.m. to 4:00 p.m. Step V Termination When I arrive in Northland, I'll get my bearings [next Assessment], and then here's what I'll do… [next Goal] …
The above example demonstrates how you can apply this model in a successive fashion wherein the accomplishment of one goal logically leads to the identification and pursuit of the next step in a progressive mission. Alternatively, the accomplishment of one goal may lead to the pursuit of an entirely different project.
The five-step process demonstrated in Chapters 3–7 should be considered as a suggested framework for conceptualizing and executing the path through a case. As with many other stepwise models, it is recognized that real life does not necessarily happen in a linear order. For example, the first topic that a client may wish to discuss may be his or her goal (Step II in the model). Alternatively, a client who is allotted a limited number of sessions may feel driven to discuss concerns regarding termination (Step V) early in the process. Additionally, expect that throughout the natural course of working with clients, there may be a bit of justifiable jumping around from step to step. Consider a case in which the client is at the activation phase (Step IV), during which a critical figure in his or her life becomes no longer able to provide support, whether in the form of emotional encouragement, financial aid, accommodations, or other assistance. This may require revisiting other steps, which might involve reassessing the client's condition (Step I), reevaluating the goal (Step II), identifying alternate objectives (Step III), and so on. In short, consider thinking of the proposed model as a guide, not a straitjacket. Also, keep in mind that in most stepwise models, the advancement from one step to another may take the form of discrete, identifiable breaks; other times, advancement through the steps can be more of a seamless progression. As you gain experience, consider adapting the model proposed in this text in a fashion that accommodates your own personality, approach to social work, theoretical orientation, setting, and each client's distinctive characteristics and needs.
For sake of brevity and clarity, the examples and exercises contained in this workbook focus primarily on interventions with individuals; however, this problem-solving model is relatively portable. It is compatible with a variety of theoretical orientations and settings (e.g., couple, family, group, community).
In simplistic terms, you might think of the social work process as an intertwined two-part mission: Part 1 involves gaining an understanding of the client and the client's system/living environment. Part 2 entails using your comprehension of the client's realm to collaboratively work toward helping him or her evolve into the next higher version of him- or herself. This is accomplished via setting and executing meaningful goals based on the client's talents, resources, and preferred life direction.
Some acronyms are used to present systematic models throughout the text. It is not the author's intent to have you merely memorize and reproduce these models verbatim on demand—that kind of learning has little real-world value and is typically forgotten promptly after finals. Rather, the [Page xii]mnemonic devices and proposed models are presented as tools to organize concepts in order to help you build a cohesive image in your mind. Naturally, you will need to be flexible when applying these tools and techniques in order to accommodate the unique characteristics of each client, his or her situations, and your own style.
Throughout the text, there are dialogue examples consisting of two streams of text: (1) Italicized text represents the script of the spoken words between the social worker and the client. (2) Roman (nonitalicized) text provides a running commentary detailing the social worker's thought process, progressive impressions, intentions, and rationale.
Throughout this text, there are multiple references to the Code of Ethics of the National Association of Social Workers (NASW). It is recommended that you familiarize yourself with the most recent version, which can be found online at the NASW public Web site: http://www.socialworkers.org. It will be helpful to have access to the NASW Code of Ethics as you proceed through this text.
Through your desire to help, your natural curiosity, and the application of social work theories, ethics, and principles, you will have the opportunity to come to know the unique world that is each client. Embrace the privilege to help advance the quality of life of those you serve.
Overview of Exercises[Page xiii]
This text is presented as an interactive workbook, enabling you to apply and reinforce your understanding of the materials as you advance through the text. Exercises in the form of concept reviews, discussion points, and role-plays are presented at the conclusion of each chapter.Concept Reviews
Concept reviews provide a means for consolidating key ideas presented in each chapter. In addition to the meaning that you derive from the text, your personal perspective, experiences in your field settings, and peer consultations will undoubtedly influence your unique interpretation and implementation of each concept in your actual social work practice settings. Hence, make an effort to use your own ideas and experiences when responding to concept review questions as shown in Figure A.Figure A Sample Concept ReviewDiscussion Points
Discussion points offer you and your colleagues the opportunity to exchange ideas and opinions on a diverse array of social work issues. The purpose of such discussion points is to provide a forum to help you integrate the discrete points raised in the text with your personal experience and perspective.
The goal of these discussion points is not necessarily to identify the right answer and to arrive at a generally acceptable consensus, though in some cases this may occur. Rather, consider these discussion points as a means for exploring the diversity of clinical issues, alternatives, dilemmas, and [Page xiv]ethics from multiple subjective vantage points. Such open discussions can provide you with alternate ways of conceptualizing a case or suggest additional frameworks within which to approach a problem. Write down the ideas that emerge. You may use “+” and “−” signs to flag ideas that you do and do not agree with, as shown in Figure B. Your instructor may have you complete these exercises as class discussions, small groups, pairs, or solo (without the + / − indicators).Figure B Sample Discussion PointsRole-Plays
The role-play exercises enable you to practice implementing the principles and skills presented in a safe, simulated, real-life setting. Each role-play specifies the client's characteristics and circumstances and suggested performance parameters for the client and the social worker. The role-plays are meant to approximate an actual encounter with a client. As such, try to avoid the temptation to script or rehearse the role-plays in advance, as this can stiffen or constrain the spontaneity and natural flow of the experience.
Before or during the role-plays, feel free to enhance or modify the existing scenario, within reason. As you gain more experience, you may choose to invent additional role-play scenarios of your own. This can help bring a sense of realism to these practice situations.
The clients in the role-plays have been assigned unisex names and gender-free circumstances. This means that either a female or a male can plausibly play the part of the client.
The person playing the part of the client should adjust his or her performance to the approximate skill level of the person acting as the social worker. For example, if you are finding that a role-play is too easy for the social worker, consider incrementally stepping up the situation by adding some complicating factor(s). Conversely, if the social worker seems to be struggling with the role-play, consider reducing the complexity of the client's problem or adjusting the client's attitude accordingly.
The person playing the social worker may use the skills suggested but need not necessarily constrain him- or herself to that brief list. As your skill base builds, you will likely become more comfortable in the role-play process. Consider saying, within reason, whatever seems necessary in order to effectively implement the role-plays.
You may wish to specify supplemental client characteristics that are not stated in the text. Briefly negotiate this with your partner prior to embarking on the role-play. For instance, as you gain more experience and comfort in performing the role-plays, you may want to consider portraying the client as coming from a cultural or an ethnic background that is different from your own. To facilitate [Page xv]authenticity, you may wish to consider aptly renaming the client. This can offer the person playing the social worker the opportunity to implement the communication skills in a fashion that is conducive to the client's unique social attributes.
During a role-play, you may find yourself stuck or having an unexpected adverse emotional reaction. Occasionally, engaging in or even observing a role-play can conjure up strong feelings, thoughts, or memories. If this happens, raise your hand and say, “Wait” or “Stop,” indicating that you need to suspend the role-play. Take some time to confer with your partner, classmates, or instructor to address your questions or feelings. Also, if you notice that your role-play partner or someone else present is having an adverse reaction to the role-play, consider halting the role-play to tend to his or her reaction. Remember: Real life takes precedence over role-plays. After the issues are settled, the participants should mutually decide if a role-play should be resumed from where you left off, restarted from the beginning, or abandoned.Role-Play Debriefing
Role-plays should run about 5 to 10 minutes. Consider using a stopwatch or a countdown timer. To end a role-play, say something like, “OK, let's stop here” or “Cut.” This explicit statement marks the end of the role-play, at which time both participants are to halt their portrayal of the fictitious characters.
After each role-play, participants should take some time to informally talk about their emotional experience as it pertains to their portrayals in the role-play. Next, the person who played the social worker should discuss the role-play from an evaluative standpoint:
Providing Role-Play Feedback
- What skills did you feel most comfortable with?
- What skills do you feel you need to improve?
- What were the most challenging parts of the role-play?
- What do you wish you would have said or done differently?
- What goal did you have in mind?
- Did something surprise you?
The purpose of the role-plays is to offer you the opportunity to take the skills from the printed page and “test-drive” them in a safe, near-to-real-life environment where nobody can get hurt. The ultimate goal of role-playing is to recognize points of proficiency and, most essentially, to identify opportunities for improvement.
Constructive criticism can be challenging to assemble and tactfully deliver; however, politely withholding negative feedback essentially defeats the purpose of the role-play experience. Failing to point out areas that can be improved is a disservice to the individual, as well as to the multitude of clients that he or she will encounter who may benefit from more effective communication.
After each participant has processed his or her initial feelings, the person who played the client should provide some feedback to the individual who portrayed the social worker. The person who played the social worker should take detailed notes as he or she is receiving the feedback.
The person who played the client should start by offering some genuine positive feedback. Describe the skill(s) that the person demonstrated most proficiently. Next, it is time for some constructive criticism. While it is important to provide an honest appraisal of your peer's performance, it is equally essential not to overwhelm him or her. Focus on offering feedback on one or two skills that you feel need the most improvement.
People are more receptive when feedback is phrased in a positive and specific fashion.
[Page xvi]In terms of speaking positively, instead of saying, “You had a very cold attitude,” consider saying something like, “I can see that you were trying to be efficient, but I think I would have felt more relaxed if you were a little more personable and less officious.”
With respect to specificity, it is OK to begin with some general feedback (e.g., “You seemed to have a judgmental attitude with this client.”), but to the extent possible, provide specific examples supporting your general evaluation. Wherever possible, use actual quotes or paraphrase specific instances in the interview that support your claims (e.g., “When you said, ‘I can't believe that you'd even think of doing XYZ,’ it felt like you were judging me. From that point on, I really didn't want to tell you much more about anything.”). Consider taking some notes during these exercises. These notes can be useful in providing specific feedback after the role-play.
Next, the person who portrayed the social worker may respond to the person who played the client.
If observers are present, they may offer their impressions of the social worker's performance one at a time. Observers are welcome to briefly reiterate positive feedback that has already been given, but each observer should restrict negative feedback to one recommendation. Avoid repeating negative feedback that has already been mentioned.
Finally, the person who is being reviewed should take some time to verbalize his or her peers’ positive remarks, along with the recommendations that were given and his or her related feelings. The ultimate goal of the role-play process is for the person playing the social worker to compose a customized “to-do” list (e.g., “It seems like I'm fairly solid with skills A and B—those come pretty naturally—but it looks like I need to work on applying X and Y. Those still felt a little bit awkward to me.”) and build a plan for improving those skills.
After each role-play wherein you play the social worker, complete the corresponding self-evaluation worksheets. As objectively as possible, rate your proficiency with each skill used according to the numbered scale (1 = needs further work, 5 = excellent), and write a brief note as shown in Figure C. Notice that in Figure C, two additional blank rows are provided for you to list and evaluate your use of supplemental skills (e.g., Clarification) that were not specifically included in the role-play parameters. The purpose of this self-evaluation is to focus your skill development efforts by identifying proficiencies and specific areas to improve.Figure C Sample Role-Play Evaluation Form[Page xvii]Role-Play Case Notes
Document your brief encounter in case note style, as if you were making an actual entry in the client's chart as shown in Figure D. This will enable you to practice your documentation skills while considering the nature of the exchange that you had with the client.
Figure D Sample Role-Play Case Notes
Role-plays, though simulated situations, can be exhilarating. These exchanges can be emotionally and cognitively intense for participants and observers. After completing a role-play, debriefing, and documentation, consider taking a moment to clear your head. After a brief break, you and your partner may choose to exchange roles and rerun the exercise for additional practice. As your skills evolve, you may wish to consider revisiting some of the role-plays, taking note of improvements in your performance over time.
As you embark on the role-play exercises, try not to be too hard on yourself or your peers. As with any skill that demands real-time implementation, this sort of communication can take some time to achieve proficiency. Even the most capable social workers occasionally misspeak or misunderstand. With practice, you will find yourself intuitively employing these skills, enabling you to focus less on the names and parameters of each skill and more on the client's issues. Enjoy the process.[Page xviii]
Appendix A: Sample Mental Status Exam (MSE)[Page 261]
As stated earlier in the text, there is no universal format for a mental status exam (MSE). The content may vary depending on such things as setting, agency practices, forms, client population, level of detail available, and the time allotted to carry out an MSE. The following are some of the topics commonly covered in an MSE:
- Condition under which the MSE is conducted
- Description of person/appearance
- State of consciousness
- Motor behavior
- Speech quality
- Thought process
- Thought content
- Intellectual functioning
- Mental health diagnosis
- Treatment recommendations
The following is a sample of a fairly typical MSE. For clarity, each section begins as a new paragraph beginning with the section header. Alternatively, this could have been written in a more narrative fashion, without explicit section breaks.
MSE for Adrian
Condition under which the MSE is conducted—Adrian was interviewed in a private one-on-one office at Acme Mental Health Center during her first appointment on July 16 at 4:00 p.m. Adrian is a new client brought in by her parents who are concerned, describing her as “so depressed and dark.” Adrian confirms that there have been persistent (verbal) confrontations with her parents and academic problems, both of which have grown progressively worse over the past 6 months.
Description of person/appearance—Adrian is a 16-year-old Caucasian female, approximately 5 ft, 10 in. (about 1.8 m), of appropriate weight, with fair skin; long, straight, light-brown hair; blue eyes; and no glasses. She presents as moderately attractive and well groomed, with good personal hygiene, age-appropriate clothing and use of cosmetics (skillfully applied facial makeup and elaborate multicolored nail polish), pierced ears (one pierce in each earlobe), and no observable tattoos or scars, and she is wearing seven rings (costume jewelry)—two on some fingers. She carries a simple, average-sized purse.
[Page 262]State of consciousness—Adrian presents as alert and oriented x3. She is attentive and provides prompt and reasonable responses to most questions.
Motor behavior—Adrian's stride is somewhat slow—once seated, she sat fairly still with her arms crossed most of the time.
Affect—Adrian presents with a good range of emotion that is context appropriate. Initially, she presented as fairly blunted with limited facial expression and negative eye contact. She describes her overall mood as “terrible … just bad,” which is consistent with her discussion of circumstances at home and school. She exhibits some elevation in her affect when discussing her boyfriend and hopes for an enduring and loving future with him.
Speech quality—Verbalizations are articulate and tend to be consistent with her depressive affect: slow, low in volume, occasionally to the level of a whisper. When her voice becomes inaudible, she belligerently repeats her words or phrases upon (courteous) request. Adrian tends to resist engaging in dialogue—her adaptation (in this setting) is to respond to questions in a relatively brief fashion. After warming up, her responses became somewhat more forthcoming and detailed.
Thought process—Adrian presents with cogent thinking. Her responses to questions, though occasionally briefly delayed, reflect attentiveness and logical/linear reasoning, appropriately addressing the questions as asked. She demonstrates the ability to reason concretely and abstractly in manners that are contextually appropriate.
Thought content—Adrian's thoughts seem to focus on her perception that her parents are unnecessarily rigid in their thinking, rules, punishments, and overprotective style. Adrian explains that this interferes with her ability to speak and act freely/spontaneously and restricts her interaction with friends (e.g., curfews, no sleepovers, no out-of-town travel with friends). There is no evidence of thought disorders or dangerousness to self or others.
Perceptions—Adrian does not exhibit signs of perceptual anomalies and denies any history of hallucinations or illusions but does report occasionally having exceptionally vivid dreams during nocturnal sleep about once a week over the last few months.
Judgment—Adrian presents with appropriate judgment, guided by a good sense of conscience, reasonably anticipating the consequences of her actions.
Memory—Memory appears to be intact: reliable and rapid recall of immediate, recent, and remote incidents.
Intellectual functioning—Adrian's conversational engagement demonstrates her ability to think effectively both concretely and abstractly. Adrian comfortably and appropriately demonstrates a sophisticated vocabulary and analogical thinking. Prior academic report cards indicate above-average academic performance despite comments detailing recurring disruptive/distracting socializing with peers during class time. More recent report cards show a substantial decline in marks, classroom conduct, and verbal confrontations with teachers.
Mental health diagnosis
I: 296.22—Major Depressive Disorder, Single Episode, Moderate (provisional)
V61.20—Parent-Child Relational Problem
II: V71.09—No Diagnosis on Axis II
III: Adrian reports no physical health problems or diagnoses and no history of major injuries or accidents.
IV: Persistent confrontations over multiple issues with parents, escalating over past 5–6 months. Low to moderate sibling and peer support. Academic problems appear to be secondary to family and social stressors.
V: GAF = 68 (current), 82 (highest in last year)
Treatment recommendations—Recommend weekly individual sessions with Adrian along with weekly family sessions to assess general family history, structure, norms, functioning, and dynamics among parents and siblings. To provide referral to Dr. Ralston for mental health evaluation for possible short-term use of antidepressant medication. To coordinate treatment plan with Dr. Ralston and monitor progress. To reassess in 3 months.
Appendix B: Diagnostic Terminology[Page 263]
The following is a partial list of diagnostic terminology that you may encounter or use in case documentation.
- Agitation—Small movements
- Agnosia—Unable to recognize or identify objects
- Alogia—Poverty of speech (brief, empty replies)
- Anhedonia—Unable to experience any pleasure (prolonged)
- Aphasia—Disorganized language
- Apraxia—Inability to do motor tasks
- Ataxia—Uncoordinated muscular movements
- Avolition—Inability to initiate and persist in goal-directed activities
- Bradycardia—Slow pulse
- Catalepsy—See “Waxy flexibility”
- Catatonic excitement—Unstimulated excessive motor activity
- Catatonic negativism—Resistance to instruction or attempts to being physically moved
- Catatonic posturing—Inappropriate or bizarre physical positioning
- Catatonic rigidity—Rigid posture, resistance to being physically moved
- Circumstantial speech—Includes excessive nonessential details in responses or storytelling
- Delusion—False belief system
- Dysarthria—Neurological speech impediment
- Echolalia—Repeating the interviewer's word(s) verbatim
- Echopraxia—Mirroring others’ physical actions
- Hyperactivity—Larger movements
- Hyperacusis—Very sensitive to sound
- Hypnagogic phenomenon—Hallucination occurring just prior to falling asleep
- Ideas of influence—Believing that others control one's thoughts [Page 264]
- Ideas of reference—Believing that other things, people, or events are related to oneself
- Labile—Quickly cycling affect
- Logorrhea—Too much speech
- Macropsia—Perceiving objects as larger than they actually are
- Micropsia—Perceiving objects as smaller than they actually are
- Myocardial infarction (MI)—Heart attack
- Nystagmus—Involuntary rapid eye oscillations
- Orientation—(x3) person, place, time
- Postpartum—After childbirth
- Poverty of speech—Too little speech
- Preservation—Needless repetition of same idea
- Pressured speech—Speaks fast or in a high volume; may be difficult or impossible to interrupt
- Psychomotor retardation—Movements too idle
- Stereotypical movement—Repetitive non-goal-directed movements
- Tachycardia—Elevated pulse
- Thought broadcasting—Believing that others are hearing or receiving one's thoughts
- Thought insertion—Believing that others put thoughts into one's head
- Waxy flexibility—Able to pose client into unusual, sustained positions (with catatonic schizophrenics)
Appendix C: Documentation, Symbols, and Abbreviations[Page 265]
Some clinical settings accept selected symbols and abbreviations in case documentation; others do not. Be sure to find out what style of documentation is customary at each facility. The following is a list of some of the most commonly used symbols and abbreviations.
Notations often used in social work settings:
- ψDx—Mental health diagnosis (DSM)
- A/Ox3—Alert and fully oriented (to person, place, and time)
- D/C—Discharge or discontinue
- R/T—Related to
- S/O—Significant other
- Sw—Social worker
Supplemental notations often used in medical social work settings:
- BID—Twice a day
- NPO—Nothing by mouth
- PRN—As needed
- Q4H—Every 4 hours (can use any number)
- QD—Once daily
- QID—Four times a day
- QOD—Every other day
- Sfx—Side effects
- TID—Three times a day
References[Page 266]1995). Culture and psychiatric diagnosis: Impact on DSM-IV and ICD-10. Psychiatric Clinics of North America, 18(3), 449–465.(American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text rev.). Washington, DC: Author.1989). The use of self-disclosure by professional social workers. Social Casework, 70(6), 259–267., & (2007). DSM and the death of phenomenology in America: An example of unintended consequences. Schizophrenia Bulletin, 33(1), 108–112. http://dx.doi.org/10.1093/schbul/sbl054(1998). The changing American college student: Thirty-year trends, 1966–1996. The Review of Higher Education, 21, 115–135.(1988). Afro-Americans. In L.Comas-Diaz & E. E. H.Griffith (Eds.), Clinical guidelines in cross-cultural mental health (pp. 151–181). New York: Wiley.(1993). Mental health care of ethnic elders. In A. C.Gaw (Ed.), Culture, ethnicity, and mental illness (pp. 517–522). Washington, DC: American Mental Health Press., & (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.(2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1–26. http://dx.doi.org/10.1146/annurev.psych.52.1.1(2003). Recommendations for the treatment of American Indian populations. In Council of National Psychological Association for the Advancement of Ethnic Minority Interests (Ed.), Psychological treatment of minority populations (pp. 24–28). Washington, DC: Association of Black Psychologists.(1989). Brief prescriptive therapy in two-plus-one sessions: Initial cases from the clinic. Behavioral Psychotherapy, 17, 161–175. http://dx.doi.org/10.1017/S014134730001613X(1992). The management of organizations. Boston: Houghton Mifflin., & (1980). Doing psychotherapy. New York: Basic Books.(1988). Understanding psychotherapy: The science behind the art. New York: Basic Books.(1976). Cognitive therapy and emotional disorders. New York: International Universities Press.(1990). Cognitive therapy of personality disorders. New York: Guilford Press., & (2005). Cognitive therapy for challenging problems: What to do when the basics don't work. New York: Guilford Press.(1997). Handbook for communication and problem-solving skills training: A cognitive-behavioral approach. New York: Wiley., & (1997). Homophobia and heterosexism in social workers. Social Work, 42(4), 319–332. http://dx.doi.org/10.1093/sw/42.4.319, & (1993). Informing practice decisions. New York: Macmillan., & (1988). Cubans. In L.Comas-Diaz & E. E. H.Griffith (Eds.), Clinical guidelines in cross-cultural mental health (pp. 233–261). New York: Wiley., & (2004). Key competencies in brief dynamic psychotherapy: Clinical practice beyond the manual. New York: Guilford Press.(1980). Problem focus and change in a brief treatment model. Social Work, 25, 89–93., & ([Page 267]1997). Planned short-term psychotherapy: A clinical handbook. Needham Heights, MA: Allyn & Bacon.(2003). Evaluating practice: Guidelines for the accountable professional. Boston: Allyn & Bacon., , & (2002). Empathy. In J. C.Norcross (Ed.), Psychotherapy relationships that work (pp. 89–108). New York: Oxford University Press., , , & (1997). Empathy reconsidered: New directions in psychotherapy. Washington, DC: American Psychological Association. http://dx.doi.org/10.1037/10226-000, & (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research and Practice, 16(3), 252–260. http://dx.doi.org/10.1037/h0085885(1996). Our time is up: Forced termination during psychotherapy training. American Journal of Psychotherapy, 50(3), 347–359., , & (1993). The helping relationship ((5th ed.). Needham Heights, MA: Allyn & Bacon.1955). Studies on hysteria. In The standard edition of the complete psychological works of Sigmund Freud (Vol. 2). London: Hogarth Press. (Original work published 1895), & (1998). Intergroup relations. In D. T.Gilbert, S. T.Fiske, & G.Lindzey (Eds.), The handbook of social psychology (, & (4th ed., pp. 554–594). New York: McGraw-Hill.1981). Research on interviewing techniques. In S.Leinhardt (Ed.), Social methodology (pp. 389–437). San Francisco: Jossey-Bass., , & (1977). Beyond counseling and therapy (, & (2nd ed.). New York: Holt, Rinehart & Winston.1991). Relationships among goal difficulty, business strategies, and performance on a complex management simulation task. Academy of Management Journal, 34, 400–424. http://dx.doi.org/10.2307/256448, & (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357. http://dx.doi.org/10.1037/0033-2909.98.2.310, & (1967). The impact of the Hawthorne effect in experimental designs in educational research. Columbus: Ohio State University.(1978). Interpersonal and attitudinal outcomes in cooperating interracial groups. Journal of Research and Development in Education, 12, 97–113.(2000). Measures for clinical practice: A sourcebook (, & (3rd ed., Vols. 1&2). New York: Free Press.2005). Counseling strategies and interventions (, & (6th ed.). Boston: Pearson Education.1998). Participation in the 1990 decennial census: Politics, privacy, pressure. American Politics Quarterly, 26, 59–80. http://dx.doi.org/10.1177/1532673X9802600104, , & (1994). Proposed revisions to mandatory reporting laws: An exploratory survey of child protection service agencies. Child Welfare, 73(1), 15–27., , & (1993). Multicultural assessment perspectives for professional psychology. Boston: Allyn & Bacon.(1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum. http://dx.doi.org/10.1007/978-1-4899-2271-7, & (1979). Psychotherapy and self-disclosure. In G.Chelune & associate (Eds.), Self-disclosure (pp. 177–224). San Francisco: Jossey-Bass., & (1971). Development and preliminary evaluation of the social problem solving inventory. Psychological Assessment, 2, 156–163. http://dx.doi.org/10.1037/1040-3522.214.171.124, & (1994). The skilled helper ((5th ed.). Pacific Grove, CA: Brooks/Cole.2006). Essentials of skilled helping: Managing problems, developing opportunities. Belmont, CA: Wadsworth.(1989). Personal strivings: An approach to personality and subjective well-being. Journal of Personality and Social Psychology, 51, 1058–1068. http://dx.doi.org/10.1037/0022-35126.96.36.1998(1994). Keeping boundaries: Maintaining safety and integrity in the psychotherapeutic process. Washington, DC: American Mental Health Press.([Page 268]1993). Essential interviewing (, , , & (4th ed.). Pacific Grove, CA: Brooks/Cole.1998). Essential interviewing—A programmed approach to effective communication (, , , & (5th ed.). Pacific Grove, CA: Brooks/Cole.2003). Patient self-disclosure: A review of the research. Journal of Clinical Psychology, 59(5), 589–600. http://dx.doi.org/10.1002/jclp.10161(2002). Disclosure to therapists: What is and is not discussed in psychotherapy. Journal of Clinical Psychology, 58, 359–370. http://dx.doi.org/10.1002/jclp.1148, & (1994). Measures for clinical practice (, & (2nd ed.). New York: Macmillan.2005). Anthropological aspects of psychiatry. WMW Wiener Medizinische Wochenschrift, 155(23), 517–523. http://dx.doi.org/10.1007/s10354-005-0214-0(1976). To have or to be?New York: Harper & Row.(1989). The practice of brief psychotherapy. New York: Pergamon.(2006). Research–practice partnership in mental health: Lessons from participants. Administration and Policy in Mental Health and Mental Health Services Research, 33, 517–528. http://dx.doi.org/10.1007/s10488-006-0062-2, , & (1993). Mental health care of Chinese Americans. In A. C.Gaw (Ed.), Culture, ethnicity, and mental illness (pp. 245–280). Washington, DC: American Mental Health Press.(1995). Human motivation: A psychosocial approach. Pacific Grove, CA: Brooks/Cole.(1985). Self-awareness and self-confrontation: Effects of self-focused attention on members of clinical population. Journal of Personality and Social Psychology, 48, 662–675. http://dx.doi.org/10.1037/0022-35188.8.131.522, , , , , & (2003). Therapist self-disclosure in cognitive-behavioral therapy. Journal of Clinical Psychology, 59(5), 555–568. http://dx.doi.org/10.1002/jclp.10159, , & (1976). Clinical behavior therapy. New York: Holt, Rinehart & Winston., & (1994). Clinical behavior therapy (, & (Expanded ed.). New York: Wiley.1981). Termination as a loss experience for the counselor. Personal and Guidance Journal, 59, 347–350. http://dx.doi.org/10.1002/j.2164-4918.1981.tb00565.x(1993). The contribution of social support to coping strategies. Applied Psychology International Review, 42, 323–340. http://dx.doi.org/10.1111/j.1464-0597.1993.tb00748.x(1996). The professional counselor (, & (3rd ed.). Boston: Allyn & Bacon.2000). The professional counselor: A process guide to helping (, & (4th ed.). Needham Heights, MA: Allyn & Bacon.2001). The professional counselor (, & (4th ed.). Boston: Allyn & Bacon.2005). Counseling strategies and interventions (, & (6th ed.). Boston: Allyn & Bacon.2003). A student's dictionary of psychology (, & (4th ed.). London: Hodder Arnold.1995). Behavior therapy: A contextual approach. In A. S.Gurman & S. B.Messer (Eds.), Essential psychotherapies: Theory and practice. New York: Guilford., , & (1993). Direct social work practice: Theory and skills (, & (4th ed.). Belmont, CA: Brooks/Cole.1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 94, 319–340. http://dx.doi.org/10.1037/0033-295X.94.3.319(1988). Development of a system for categorizing client reactions to therapist interventions. Journal of Counseling Psychology, 35, 27–36. http://dx.doi.org/10.1037/0022-0184.108.40.206, , , & (1992). Minority children and adolescents in therapy. Newbury Park, CA: Sage.(1989). An empirical examination of the antecedents of commitment to difficult goals. Journal of Applied Psychology, 74, 18–23. http://dx.doi.org/10.1037/0021-9010.74.1.18, , & (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38(2), 139–149. http://dx.doi.org/10.1037/0022-0220.127.116.11, & (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41, 159–164. http://dx.doi.org/10.1037/0003-066X.41.2.159, , , & ([Page 269]1982). The clinical measurement package: A field manual. Homewood, IL: Dorsey Press.(1983). Intentional interviewing and counseling. Monterey, CA: Brooks/Cole.(1938). Progressive relaxation ((Rev. ed.). Chicago: University of Chicago Press.1990). The social work interview: A guide for human service professionals ((3rd ed.). New York: Columbia University Press.1994). Confidentiality after Tarasoff. Health and Social Work in Education, 19(3), 217–222., & (1988). Guiding therapeutic change. Champaign, IL: Research Press., & (1993). A dark side of the American dream: Correlates of financial success as a central life aspiration. Journal of Personality and Social Psychology, 63, 410–422. http://dx.doi.org/10.1037/0022-3518.104.22.1680, & (1996). Further examining the American dream: Differential correlates of intrinsic and extrinsic goals. Personality and Social Psychology Bulletin, 22, 280–287. http://dx.doi.org/10.1177/0146167296223006, & (2004). Writing SOAP notes with patient/client management formats ((3rd ed.). Philadelphia: F. A. Davis.2007). Therapeutic communication: Developing professional skills. Thousand Oaks, CA: Sage.(1991). The complete therapist. San Francisco: Jossey-Bass.(1986). The termination process in open-ended psychotherapy: Guidelines for clinical practice. Psychotherapy, 23(4), 526–531. http://dx.doi.org/10.1037/h0085652(1988). Ending therapy: The meaning of termination. New York: New York University Press.(2004). The efficacy and effectiveness of psychotherapy. In M. J.Lambert (Ed.), Bergin and Garfield's handbook of psychotherapy and behavior change (, & (5th ed., pp. 139–193). New York: Wiley.1998). Referral and termination issues for counsellors. London: Sage.(1994). Mandated reporting and child abuse fatalities: Requirements for a system to protect children. Social Work Research, 18(1), 41–54.(1993). Personal projects and the distributed self: Aspects of a cognitive psychology. In J.Suls (Ed.), Psychological perspectives on the self (Vol. 4). Hillsdale: NJ: Lawrence Erlbaum.(2002). Building a practically useful theory of goal setting and task motivation: A 35-year odyssey. American Psychologist, 57(9), 705–717. http://dx.doi.org/10.1037/0003-066X.57.9.705, & (1979). Termination: That difficult farewell. American Journal of Psychotherapy, 33, 583–591., & (1991). Human change processes: The scientific foundations of psychotherapy. New York: Basic Books.(2006). Evidence-based psychiatry: Understanding the limitations of a method. Journal of Evaluation in Clinical Practice, 12(3), 325–329. http://dx.doi.org/10.1111/j.1365-2753.2006.00604.x(1975). Timing of self-disclosure, reciprocity of self-disclosure, and reactions to an initial interview. Journal of Counseling Psychology, 22(4), 303–308. http://dx.doi.org/10.1037/h0076694, & (1973). Time-limited psychotherapy. Cambridge, MA: Harvard University Press.(1986). Hispanic mental health issues. In C. B.Wilkerson (Ed.), Ethnic psychiatry (pp. 61–87). New York: Plenum. http://dx.doi.org/10.1007/978-1-4613-2219-1_3(1993). Mental health care of Mexican Americans. In A. C.Gaw (Ed.), Culture, ethnicity, and mental illness (pp. 431–466). Washington DC: American Mental Health Press.(1954). Motivation and personality. New York: Harper & Row.(1990). Mental health effects of women's multiple roles. American Psychologist, 45, 381–384. http://dx.doi.org/10.1037/0003-066X.45.3.381(1994). Problem solving in the helping professions. Pacific Grove, CA: Brooks/Cole., & (1986). Strategies for teaching students about termination. The Clinical Supervisor, 4(4), 45–56. http://dx.doi.org/10.1300/J001v04n04_05, , & (1977). Cognitive-behavior modification: An integrative approach. New York: Plenum. http://dx.doi.org/10.1007/978-1-4757-9739-8(1987). Anxiety and stress disorders: Cognitive behavioral assessment and treatment. New York: Guilford Press., & (2000). How much is enough: Endings in psychotherapy and counselling. London: Routledge.([Page 270]National Association of Social Workers. (1996). Code of ethics of the National Association of Social Workers. Washington, DC: Author. Available at http://www.socialworkers.org1993). The goal is to say “good-bye” and have the treatment effects generalize and maintain: A cognitive-behavioral view of termination. Journal of Cognitive Psychotherapy: An International Quarterly, 7(4), 251–263., & (2002). Skills and techniques for human service professionals: Counseling environment, helping skills, treatment issues. Pacific Grove, CA: Brooks/Cole.(1983). Is follow-up necessary in evaluating psychotherapy?Psychological Bulletin, 93, 261–278. http://dx.doi.org/10.1037/0033-2909.93.2.261, & (1992). The affective impact of a clinical social worker's interviewing styles: A series of single-case experiments. Research on Social Work Practice, 2(1), 6–27. http://dx.doi.org/10.1177/104973159200200102(2003). Handbook of professional ethics for psychologists: Issues, questions, and controversies. Thousand Oaks, CA: Sage. http://dx.doi.org/10.4135/9781412990004, & (1987). The transfer syndrome. Canadian Journal of Psychiatry, 32, 674–678.(2005). Assessing and treating culturally diverse clients: A practical guide ((3rd ed.). Thousand Oaks, CA: Sage.1998). People of the lie. New York: Simon & Schuster.(1996). Counseling across cultures (, , , & (4th ed.). Thousand Oaks, CA: Sage.2005). Misdiagnosis of bipolar disorder. The American Journal of Managed Care, 11(9), S271–S274.(2000). Collaborative social work: Strength-based generalist practice. Itasca, IL: F. E. Peacock.(1992). In search of how people change. American Psychologist, 47, 1102–1114. http://dx.doi.org/10.1037/0003-066X.47.9.1102, , & (1993). Toward an expanded and updated conceptualization of termination: Implications for short-term individual psychotherapy. Professional Psychology: Research and Practice, 24, 426–432. http://dx.doi.org/10.1037/0735-7028.24.4.426(1996). Acceleration of changes in session impact during contrasting time-limited psychotherapies. Journal of Consulting and Clinical Psychology, 64, 577–586. http://dx.doi.org/10.1037/0022-006X.64.3.577, , , , , & (1981). Cultural and historical perspectives in counseling American Indians. In D. W.Sue & D.Sue (Eds.), Counseling the culturally different: Theory and practice (pp. 216–255). New York: Wiley.(1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 22, 95–103. http://dx.doi.org/10.1037/h0045357(1986). Issues in the training of counselors for Asian Americans. In H. P.Lefley & P. B.Pedersen (Eds.), Cross-cultural training for mental health professionals (pp. 199–209). Springfield, IL: Charles C Thomas., , & (1993). Research methods for social work (, & (2nd ed.). Pacific Grove, CA: Brooks/Cole.1996). Evidence-based medicine: What it is and what it isn't [Electronic version]. British Medical Journal, 312, 71–72. Retrieved August 1, 2008, from http://www.bmj.com/cgi/content/full/312/7023/71http://dx.doi.org/10.1136/bmj.312.7023.71, , , , & (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York: Guilford Press., & (1992). Struggle with self: The personal projects of students seeking psychological counseling. Scandinavian Journal of Psychology, 33, 330–338. http://dx.doi.org/10.1111/j.1467-9450.1992.tb00922.x(1997). Positive and negative self-goals and subjective well-being: Prospective study. Journal of Adult Development, 4, 171–186. http://dx.doi.org/10.1007/BF02510596, & (2001). Life goals and well-being: Towards a positive psychology of human striving (pp. 149–150). Seattle, WA: Hogrefe & Huber., & (1977). A study of the helping process. Vancouver, Canada: University of British Columbia.(1999). The skills of helping individuals, families, groups, and communities (([Page 271]4th ed.). Itasca, IL: F. E. Peacock.1991). History and mental status examination. In J.Sadavoy, L.Lazarus, & L.Jarvik (Eds.), Comprehensive review of geriatric psychiatry. Washington, DC: American Mental Health Press., & (1988). Criteria for therapist self-disclosure. American Journal of Psychotherapy, 52(3), 404–415.(1976). The impact of therapist disclosure on patient disclosure. Journal of Transpersonal Psychology, 23, 3–6.(1993). The impact of privacy and confidentiality concerns on survey participation: The case of the 1990 U.S. census. Public Opinion Quarterly, 57, 465–482. http://dx.doi.org/10.1086/269391, , & (1981). Cultural and historical perspectives in counseling blacks. In D. W.Sue & D.Sue (Eds.), Counseling the culturally different: Theory and practice (pp. 141–185). New York: Wiley.(1983). Interrupted treatment and forced terminations. International Journal of Psychoanalytic Psychotherapy, 9, 337–352.(1996). Object relations brief therapy. Northvale, NJ: Aronson.(2007). Does psychotherapy research inform treatment decisions in private practice?Journal of Clinical Psychology, 63(3), 267–281. http://dx.doi.org/10.1002/jclp.20347, & (1984). Psychotherapy in a new key: A guide to time-limited dynamic psychotherapy. New York: Basic Books., & (2006). Cognitive behavioral therapy for clinicians. Philadelphia: Lippincott Williams & Wilkins.(1992). The challenge of multiculturalism: The road less traveled. American Counselor, 1(1), 6–14.(Sue, D. W., & Sue, D. (Eds.). (2003). Counseling the culturally different: Theory and practice (4th ed.). New York: Wiley.2005). The role of services researchers in facilitating intervention research. Mental Health Services, 56, 537–542., , , , , & (1996). The international dictionary of psychology ((2nd ed.). New York: Crossroads.2004). Patient-centered communication: Do patients really prefer it?Journal of General Medicine, 19(11), 1069–1079. http://dx.doi.org/10.1111/j.1525-1497.2004.30384.x, , , , , & (1994). Positive illusions and well-being revisited: Separating fact from fiction. Psychological Bulletin, 116, 21–27. http://dx.doi.org/10.1037/0033-2909.116.1.21, & (1991). Cultural diversity and treatment of children. Journal of Consulting and Clinical Psychology, 59, 799–812. http://dx.doi.org/10.1037/0022-006X.59.6.799(1988). Cognitive processes underlying context effects in attitude measurement. Psychological Bulletin, 103, 299–314. http://dx.doi.org/10.1037/0033-2909.103.3.299, & (2000). The psychology of survey response. New York: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511819322, , & (1971). Research on certain therapist interpersonal skills in relation to process and outcome. In A. E.Bergin & S. L.Garfield (Eds.), Handbook of psychotherapy and behavior change: An empirical analysis. New York: Wiley., & (1994). A primer on single-subject design for clinical social workers. Washington, DC: National Association of Social Workers.(2001). Unwitting exposure of the therapist: Transferential and countertransferential dilemmas. Journal of Psychotherapy Practice and Research, 10, 14–22.(1976). The language of feelings. New York: Pocket Books.(1998). A whack on the side of the head ((3rd ed.). New York: Warner Books.2002). Termination of therapy: An effort at integration. Journal of Psychotherapy Integration, 12, 373–383. http://dx.doi.org/10.1037/1053-0422.214.171.1243(Webster's new world/Stedman's concise medical dictionary. (1987). New York: Prentice Hall.1979). Termination initiated by the therapist: A countertransference storm. American Journal of Psychiatry, 136(10), 1302–1305., & (2006). National survey of psychotherapy training in psychiatry, psychology, and social work. Archives of General Psychiatry, 63, 925–934. http://dx.doi.org/10.1001/archpsyc.63.8.925, , , , , , et al. ([Page 272]1993). Empowering families at termination: A structural/strategic orientation. Journal of Family Psychotherapy, 4(1), 33–44. http://dx.doi.org/10.1300/j085V04N01_02, & (2002). Essentials of interviewing. New York: Wiley., & (1986). The mental health of black Americans: Mental health diagnosis and treatment. In C. B.Wilkinson (Ed.), Ethnic psychiatry (pp. 13–59). New York: Plenum. http://dx.doi.org/10.1007/978-1-4613-2219-1_2, & (1997). The use of psychological laboratory to study sensitive topics. In L.Harrison & A.Hughes (Eds.), The validity of self-reporting drug use: Improving the accuracy of survey estimates (pp. 416–438). NIDA Monograph 167. Rockville, MD: National Institute on Drug Abuse.(1990). Social support and interpersonal relationships. In M. S.Clark (Ed.), Review of Personality and Social Psychology, 12, 265–289. Newbury Park, CA: Sage.(2002). Opportunities in social work careers ((Rev. ed.). New York: McGraw-Hill.1990). Referral issues in psychotherapy and psychoanalysis. American Journal of Psychotherapy, 44(1), 85–94., & (World Health Organization. (1992). International statistical classification of diseases and related health problems (10th rev.). Geneva: American Psychiatric Publishing.1908). The relation of strength to stimulus to rapidity of habit formation. Journal of Comparative and Neurological Psychology, 18, 459–482. http://dx.doi.org/10.1002/cne.920180503, & (
About the Author[Page 281]
Herschel Knapp, PhD, MSSW, is a psychotherapist and health science researcher in Los Angeles, California. His experience includes helpline work, acute care in hospitals (ER, ICU, CCU, oncology), and longer-term psychotherapy in both in- and outpatient settings with a diverse client population. He has served as a behavioral science representative advocating for quality of life on the Patient Care Committee, Palliative Care Committee, Ethics Committee, and Cancer Committee. He has taught at the university level, provided intern supervision, and presented numerous clinical trainings in hospitals, schools, and the community. He is currently involved in biobehavioral research directed at improving healthcare services to cancer patients and enhancing access to HIV testing. He is a member of the National Association of Social Workers and the American Psychological Association. His contributions to the field have earned him membership in Phi Kappa Phi Academic Honor Society, Phi Alpha National Honor Society for Social Work, and Who's Who Among Students in American Universities and Colleges. He is the author of the textbook Therapeutic Communication: Developing Professional Skills (2007).