Friday, September 23, 2016

Into the DSM - Schizophrenia

Schizophrenia will doubtless come up for social workers employed in clinic settings. That means it's one of the diagnoses that you may find appear on the social work licensing exam. Here are the criteria:

A. At least two of the following for a significant portion of the time during a one-month period:

1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (e.g., flat affect)

B. Level of functioning is markedly below level at onset of symptoms.

C. Disturbance persists at least six months.

D. Schizoaffective, depressive, and bipolar disorder ruled out.

E. Symptoms not attributable to the effects of a substance.

F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, a schizophrenia diagnosis is made only if prominent delusions or hallucinations are present for at least one month.

Specifiers include:
  • First episode, currently in acute episode
  • First episode, currently in partial remission
  • First episode, currently in full remission
  • Multiple episodes (acute, partial, or full remission)
  • Continuous
  • With catatonia
DSM-5 also includes a severity rating for schizophrenia--each symptom can receive its own rating ranging from 0 (not present) to 4 (present and severe).

For further reading, including risk factors and treatment, take a look at

Friday, September 09, 2016

Into the DSM - Autism Spectrum Disorder

New in DSM-5, autism spectrum disorder covers a wide array of symptoms. It's wise to review them ahead of sitting for the social work licensing exam. Here we go...

A. Persistent deficits in social communication and social interaction across multiple contexts, for example:

  • Deficits in social-emotional reciprocity (back-and-forth conversation, sharing of interests)
  • Deficits in nonverbal communication (eye contact, body language)
  • Deficits in developing, maintaining, and understanding relationships (adjusting behavior to context, making friends)
B. Restricted, repetitive patterns of behavior, interests, or activities, including at least two of the following:
  • Stereotyped or repetitive motor movements (lining up toys, echolalia, idiosyncratic phrases)
  • Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior 
  • Highly restricted, fixated interests that are abnormal in intensity or focus
  • Hyper- or hyporeactivity to sensory input (indifference to pain/temperature, adverse response to specific sounds...)
C. Symptoms present in early development.

D. Symptoms cause clinically significant impairment.

E. Disturbances not better explained by an intellectual development disorder or global developmental delay.

Specifiers include:
  • With or without intellectual impairment
  • With or without language impairment
  • Associated with a medical or genetic condition or environmental factor
  • Associated with another neurodevelopmental, mental, or behavioral disorder
  • With catatonia
Since ASD encompasses old (DSM-IV-TR) diagnoses of autistic disorder, Asperger's disorder, and pervasive developmental disorder, severity levels play an important part in the diagnosis. More about those in a future post!

For further reading try NIMH and/or the CDC.

Friday, August 05, 2016

Into the DSM - Panic Disorder

Panic disorder can be summed up in four words: Recurrent unexpected panic attacks. But there's more to it than that. First, what's a panic attack (and what's not a panic attack)? The DSM answers: A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes. During that time, four of the following symptoms occur:

1. Palpitations, pounding heart, or accelerated heart rate.
2. Sweating.
3. Trembling or shaking.
4. Sensations of shortness of breath or smothering.
5. Feelings of choking.
6. Chest pain or discomfort.
7. Nausea or abdominal distress.
8. Feeling dizzy, unsteady, light-headed, or faint.
9. Chills or heat sensations.
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization (being detached from oneself).
12. Fear of losing control or "going crazy."
13. Fear of dying.

With that you know most of what you need to know about the diagnosis, but not all. There's a crucial addition--criterion B: At least one of the attacks has been followed by one month (or more) of one or both of the following:

1. Persistent concern or worry about additional panic attacks or their consequences.
2. A significant maladaptive change in behavior related to the attacks (e.g., avoidance)

Of course, there are the usual "not better explained by" caveats. And that's it.

Risk factors for panic disorder include:
  • Family history of panic.
  • Major life stress or life changes.
  • Trauma.
  • Excessive caffeine intake and/or smoking.
  • History of childhood physical or sexual abuse.
With the above information digested, consider yourself readied for a panic disorder question on the ASWB exam. For further study try: Panic attacks and panic disorder at

Saturday, July 16, 2016

Mental Status Exam

The questions in the mental status exam include all the basic of social work assessment. While the MSE's lack of full exploration into the biopsychosocialspiritual components of client experience makes it an imperfect tool for social work, it's still a good start. That's why you'll see the MSE used in many clinical settings and why you shouldn't be surprised to see a question about the MSE on the social work licensing exam (e.g., "A social workers asks a client to spell a word backwards. What is the social worker assessing for?")

The general elements covered in the MSE are as follows:
  • General Appearance
  •  Psychomotor Behavior
  • Mood and affect
  • Speech
  • Cognition
  • Thought Patterns
  •  Level of Consciousness
There's too much detail in the exam to recount here, but click through to the further reading to get more comfortable with the details of the exam. 

Further reading: "How to Do a Mental Status Exam," and Mental Status Examination at Wikipedia.

Tuesday, July 12, 2016

Into the DSM - Bipolar I Disorder

To meet criteria for bipolar I disorder, a manic episode is required--it may be followed by a hypomanic or major depressive episode. (For bipolar II, a hypomanic episode + a current or past major depressive episode are required.) Here are the criteria for a manic episode:

A. Distinct period of abnormally and persistently elevated, expansive, or irritable mood with increased goal-directed activity or energy, lasting at least 1 week.

B. Three or more of the following during the mood disturbance:
  1. Inflated self-esteem or grandiosity
  2. Decreased need for sleep
  3. Increased talkativeness
  4. Racing thoughts or flight of ideas
  5. Distractibility
  6. Increased goal-directed activity or psychomotor agitation
  7. Excessive risk-taking
C. Mood disturbance severe enough to cause impairment.

D. Episode is not attributable to effects of a substance or another medical condition.

Hypomanic episodes include many of the same symptoms, but are not severe enough to cause marked impairment in social or occupational functioning or to require hospitalization.

Specifiers for bipolar I disorder include:
  • With anxious distress
  • With mixed features
  • With rapid cycling
  • With melancholic features
  • With atypical features
  • With mood-congruent psychotic features
  • With mood-incongruent psychotic features
  • With catatonia
  • With peripartum onset
  • With seasonal pattern
Risk factors include:
  • Having a first-degree relative (e.g., parent or sibling) with the disorder.
  • Substance abuse
  • High stress
  • Major life changes (e.g., death of loved one)
For further study: Bipolar I Disorder at

Wednesday, July 06, 2016

Into the DSM-5 - Schizoaffective Disorder

If you've encountered schizoaffective disorder in your work  with clients, questions about the diagnosis on the licensing exam shouldn't give you much trouble. For everyone else, here's a quick primer. The essential formula to remember with schizoaffective disorder is psychotic symptoms + mood symptoms which are independent of the psychotic symptoms. Common rule-outs: schizophrenia, bipolar disorder, MDD with psychotic features.

There are two essential criteria:
  • Major mood episode concurrent with symptoms of schizophrenia
  • Delusions or hallucinations in the absence of mood symptoms at some point
 Specifiers include:
  • Bipolar type
  • Depressive type
  • With catatonia
Risk factors: Having a blood relative with schizophrenia, schizoaffective disorder, or bipolar disorder; stress; drug use.

For further study: Schizoaffective disorder at

Thursday, June 30, 2016

Theories and Methods - Attachment Theory

Attachment Theory, conceived by John Bowlby and furthered by Mary Ainsworth, explores the centrality of attachment bonds in human development and emotional life. Particular attention is paid to the degree of security infants and children feel in relationship to their caregivers and the consequences when a felt sense of security is lacking (as in cases of even mild emotional neglect). Mary Ainsworth's experimental "strange situation" examined the responses of children to different caregiver behaviors and identified a set of attachment patterns (e.g., anxious-resistant, avoidant...) which followed the children into their adult relationships. Radical when originated, attachment theory has since been thoroughly integrated into much clinical practice, especially that of social workers.

For futher review: Attachment theory at Wikipedia, at Simply Psychology, attachment theory books at Amazon.

Monday, June 20, 2016

Studying with Social Work Podcasts

Some people learn best via text, others via charts and images, still others like to listen their way to knowledge. Everyone can benefit from the free audio exam preparation available on the net. Podcasts are a great way to load up on information and general social work knowledge. Early episodes of the Social Work Podcast are especially useful as they cover the very theories and approaches that may show up on the ASWB exam. (Here's a helpful menu of useful Social Work Podcast episodes.) Other podcasts may make for inefficient but effective social work exam studying. An episode of inSocialWork, focused on one content area (and not designed for exam preparation) will give you the type of depth of knowledge that will make it impossible to miss a question on that topic. But will that topic actually show up on the exam? There's no saying. What you will get is a ever-increasing sense of what it means to be a social worker and how social workers think about difficult questions. That's something you can bring to just about every question on the exam! Links:

Thursday, May 19, 2016

Developmental Theory to Know for the Social Work Exam

It seems that straightforward knowledge questions have been phased out of the social work licensing exam over time. You're not likely to see something asking, "The areas in Freud's tripartite theory of personality are:" Too dry, simple, and unsocialworky to make it onto the test. (You know the answer: Superego, Ego, Id.) Be less surprised to see vignettes that draw upon your understanding of various theories, while also testing your basic social work grounding. "A mother brings her 8-year-old to see a social worker reporting [some difficult, upsetting controversial, or otherwise heartbreaking symptom]. A social worker using attachment theory is MOST likely to see these symptoms as:" You've had to weather the impact of the symptoms, keep your eye on what's being asked, and, as a bonus, know something about attachment theory. Answer enough of those correctly, and you're a licensed social worker! Toward that end, here's Wikipedia's list of developmental psychology theories (from the page about developmental psychology, naturally). To lightly review:
It's worth restating here that light review is what's called for. You will not be expected to have deep knowledge about all of the above. The ASWB exam is designed to assess beginning social workers, not PhD candidates (and not psychologists). Adjust your study intensity appropriately. Good luck!

Friday, March 11, 2016

Study Resource: Eye on Ethics

Let's dig a little deeper into one of the free exam prep resources linked in the previous post. Frederic Reamer, PhD's Social Work Today column, "Eye on Ethics" looks at the kind of ethical dilemmas that social workers face every day. Those are the very same ethical quandaries you're likely to see posed as questions on the LCSW exam. Some "Eye on Ethics" columns include vignettes that are strikingly similar to those that appear on the exam. If exam writers are getting some inspiration from the colum, it wouldn't be a huge surprise. Take a look at some of these for starters--a semi-informed take on some of "Eye on Ethics" greatest hits:
Reading Reamer's column is a relatively painless way to soak up social work ethics and prepare for the licensing exam maybe without feeling like you're studying. Enjoy.

Monday, October 26, 2015

Free Social Work Exam Help

One of the enduring truths about the social work licensing exam is that it costs too much. It's expensive to register for the exam; preparation time is expensive (in a time equals money sense); exam materials can cost an outrageous amount. And while we're at it, why not lump in the cost of an MSW? It all adds up to more than most social workers can easily afford. That's something this blog aims to alleviate,in part. Reading through these pages costs you nothing (except time). Elsewhere on the web, there are resources aplenty that can help you gather the all the content you need to know for the exam. If you're especially resourceful, you may be able to piece together exam practice enough to help you get a sense of the exam process. Got exam content and process under your belt? You're ready to go.

Here are some favorites, new and old, obvious and less-obvious, worth checking out:

The NASW Code of Ethics.  Did they hand Code of Ethics booklets out at graduation? That was free. So is this online version. A test-preparation essential. - The ASWB administers the exam. The exam content outlines live on their site and are free of charge.

Study Guide for the Social Work Licensing Exam - SWTP's free offering, includes basics, study tips, and some free exam practice questions. After the Code and the Exam Content Outlines, a good place to start.

The Social Work Podcast - Great explorations of social work topics, many relevant to the exam--especially the ones about various psych theories.

Eye on Ethics - Dr. Frederic Reamer's long-running column in Social Work Today presents a wide variety of dilemmas similar--or perhaps identical--to the ones you'll face on the exam.

This is just a starter list. Also don't forget Wikipedia--good for deepening understanding about pretty much any social work topic you can think of. Other free, info-rich sites are a Google search away. If you've found ones you think are especially great, don't hesitate to share them in comments. Thanks and happy studying.

Thursday, June 25, 2015

DSM-5 Arrives

It's been quiet here, but you may still have heard the rumbling of an approaching giant: DSM-5. The new, purple edition of the APA's Diagnostic and Statistical Manual of Mental Disorders has been in circulation for a couple of years, but until now, you may have been able to avoid it. If you're preparing for the LCSW exam (or any other social work licensing exam), avoiding it is--as of July 1st, 2015--no longer an option. But don't fear. While the DSM-5 may have big impact on some clients by, for example, widening autism or narrowing bipolar disorder, for your exam prepping purposes, the switch isn't a huge deal. The little changes are minor enough to probably escape the interest of ASWB exam item writers. The big changes are in small enough number to be manageable. While this blog may examine some of the more likely-to-show-up-on-the-exam changes in future posts, to take a big gulp of DSM-5 change info, try the links below. Happy reading, happy studying.

For review: DSM-5 changes (APA); DSM-5 changes (Psych Central); DSM-5 (Wikipedia)

Tuesday, March 10, 2015

Theories and Methods - Mahler

Margaret Mahler was a Hungarian-born psychoanalyst who worked with disturbed youth and developed the separation-individuation theory of child development. In Mahler's theory, young children pass through a series of stages, each of which has an associated task or action (similar to Erikson's stages that way):
  • Normal Autistic Phase (First few weeks of life; achieve equilibrium)
  • Normal Symbiotic Phase (Up till around 5 months old; develop dim awareness of caretaker)
  • Separation-Individuation Phase (divided into three phases:)
    • Hatching (5-10 months; exit autistic shell)
    • Practicing (10-16 months; locomotion and accompanying anxiety about separateness)
    • Rapprochement (16-24 months; mobility, language, reuniting)
Mahler proposes that, if the process of separation-individuation goes awry, a reliable sense of individual identity in the adult is compromised.

Will Margaret Mahler show up on the social work exam? Don't count on it.'s not unheard of. Good luck.

For further review: Margaret Mahler at Wikipedia; chart of stages via

Friday, February 06, 2015

Theories to Know for the Social Work Exam

Every time an ambitious PhD gets hold of a grant, it seems like a new approach to psychotherapy is born. Which is great, but can be overwhelming. Just look at Wikipedia's list of psychotherapies for a sense of how vast the literature on psychotherapy is. If you're preparing for the social work exam, not to worry. What you might reasonably expect to see appear on the exam doesn't include that whole list. Far from it. The Code of Ethics directs social workers to utilize empirically validated forms of psychotherapy. Social work schools like students to be grounded in the history of psychotherapy. In those two categories, you should be able to locate everything that might possibly show up on the exam, theory-wise. If it's not empirically validated or historically relevant, it might be interesting to learn about, but that's learning that won't necessarily help you on exam day. Here's a quick list of therapy's greatest hits--with links to Wikipedia, pruned from the longer list. A cheat sheet for your exam prep:
Remember not to overstudy. You don't need to know all of these inside and out for the social work exam. You just need a general idea of what's what with each (if that!)--some key concepts and no more. Anything missing? Comments are open.

Wednesday, October 01, 2014

Social Workers' Ethical Responsibilities as Professionals

It can't be stressed enough how important familiarity with the NASW Code of Ethics can be for easing your way through the social work licensing exam. Yes, there are content questions on the exam that require you knowing specifics about theory, about diagnosis, etc. You can cram that information into your brain any which way you prefer. But the majority of exam questions require more subtlety and understanding of what it means to be a social worker. Scenario questions presenting situations that don't have an obvious solution can trip people up on the exam. For those, get prepared by giving the Code of Ethics a careful read, reread, and rereread.

Here, to encourage you in that, are section-by-section links to part four of the code, Social Workers' Ethical Responsibilities as Professionals. It's buried in the middle of the code's six sections--not first, not last, not least.
  • 4.01 Competence
  • 4.02 Discrimination
  • 4.03 Private Conduct
  • 4.04 Dishonesty, Fraud, and Deception
  • 4.05 Impairment
  • 4.06 Misrepresentation
  • 4.07 Solicitations
  • 4.08 Acknowledging Credit
As you browse through, see if you can think up potential exam items that each section lends itself to. If you're feeling really ambitious and generous, post them in comments!

Update: Code no longer hosted at Use the NASW version instead.

Monday, September 22, 2014

3 Tips to Managing LCSW Exam Anxiety

Part of ramping up to any of life's big tests is experiencing some anxiety. That's true for big changes, big transitions, big gains, big loses, and especially when the big test you're facing is...a big test. The LCSW exam is as big a test as you've likely faced in recent years. Anxiety is as natural part of exam prep as there is. With that in mind, here a three tips to managing social work exam anxiety.

1. Try CBT. Study while you self-soothe. If you don't already use CBT with clients, try it out on yourself as you're exam prepping. CBT is evidence-based treatment for anxiety and therefore very likely to turn up on the social work licensing exam. It's also very likely to help you out of upward-spiraling anxiety. Under the CBT umbrella fall countless useful interventions. Start with the basics. Do a thought log regarding your feelings about the social work licensing exam. What are your fears? How realistic are they? Thought logging can help you challenge your automatic negative thoughts and replace them with a more realistic assessment of the exam-prepping process. Then go from there...

2. Increase self-care.  (This is really the "B" in CBT, but let's count it as a separate item.) Studying for the exam adds one more thing to a social worker's usually wildly busy day. It doesn't have to be the thing that throws your entire life out of whack. While you may have to cut back on some self-care traditions that have been helpful in the past (e.g., hours of zoning out in front of the TV), keep track of your overall self-care and make sure it's dialed up, not down. Look at the fundamentals: exercise, sleep, nutrition. You're worth it!

3. Remember past coping. Social workers see clients who have found their coping resources outstripped by their circumstances. Still, they find ways to help. Exam prep time is ideal for turning your best social work interventions back on yourself. Be strengths-based. What's helped you in the past? Dig through your coping toolbox and put that stuff back to work for you. You know best how to manage your anxiety.

And... If you really want to take anxiety reduction seriously, write yourself an exam anxiety treatment plan complete with goals and objectives. Remember, your well-being is more important than the letters that follow your name! Good luck.

Tuesday, August 26, 2014

The Science of Studying

One of these science of studying articles pops up pretty regularly. Here's a new one via NPR which encourages an on/off study pattern (instead of on/on/on/on): Studying? Take A Break and Embrace Your Distractions. From the article:

Distraction is one of those things everybody is worried about certainly every parent, with the iPhones and people jumping on Facebook and so on. And of course if you're spending your entire time tooling around on Facebook, you're not studying, so that's a problem.

However, there's a whole bunch of science looking at problem-solving. In problem-solving, when you get stuck, you've run out of ideas, distraction is really your best friend. You need to stand up, let it go walk around the block, go to the cafe, drink a beer, whatever it is and that is really your best shot at loosening the gears a little bit and allowing yourself to take a different and more creative approach to the problem.

If answering exam vignettes isn't "problem-solving," I don't know what is. So, set down the practice tests, step away, catch a breath. Just make sure you get back to studying sooner than later. Happy studying. Good luck on the exam!

Sunday, August 10, 2014

Social Work Exam Acronyms

Some questions on the social work licensing exam are simple to get right or wrong. You either know the answer or you don't. This Eriksonian stage happens at this or that age...the DSM diagnosis has such and such criteria...breaking confidentiality is or isn't appropriate in a given situation. These are questions you can study for--cram for, if that's your style. For the other questions--for the bulk of the exam--it's not what you know, exactly, it's how you apply it. It's putting your general understanding of social work principles to work in the strange context of the exam. Vignette questions with the dreaded two (or three...or four) good answers fit in this category. The "what is the FIRST step the social worker should take?" questions. To have an improved shot at narrowing these down, some like to go into the exam armed with acronyms to guide decision making.

So, here are a few acronyms pulled from the web (original sources u/k). If you have others--known to the world, or creations of your own--please feel free to share them in comments.

Please use them with caution. These acronyms may end up creating confusion, not decreasing it. Feel free to ignore them completely. Instead of FAREAFI, when in doubt, go with your knowledge of the NASW Code of Ethics, go with your textbook social work learning, and go with your gut. It's a fair bet that more people pass that way than do using acronyms.

That said, here we go:

FAREAFI.  This may come handy in FIRST and BEST questions--if unsure about what the FIRST/BEST intervention would be, start with F (feelings) and go from there):
  • F: Feelings of the client be acknowledged first above all. Begin building rapport.
  • A: Assess
  • R: Refer
  • E: Educate
  • A: Advocate
  • F: Facilitate
  • I: Intervene
ASPIRINS is supposed to help with BEST questions as well. Acknowledge client concerns/assess, and go from there. (You could stress protecting life first, couldn't you? But that would be PASIRINS--not as easy to remember.)
  • A: Acknowledge client concerns and Assess
  • S: Start where the patient is.
  • P: Protect life.
  • I: Intoxicated? Do not treat.
  • R: Rule out medical issue.
  • I: Informed consent.
  • N: Non-judgmental.
  • S: Support self-determination.
AREA-FI gives an alternate version of the above. If you can make sense of how best to apply it, go for it!
  • Acknowledge
  • Refer
  • Educate
  • Advocate
  • Facilitate
  • Intervene
Good luck!

Sunday, August 03, 2014

Knowing Which DSM to Study

Are you confused about the new DSM as it relates to the social work licensing exam? Let's get that settled and off your anxiety plate. DSM-5 is out and in use. It's purple, it's big, it's controversial. And, as of this post (August, '14), it's not yet appearing on the test. Not anywhere. It will soon and not-so-soon, depending upon where you're sitting for the exam.  Here are your guidelines, straight from the horses' mouths:

From the ASWB which administers most exams--just not California:
No content related to DSM-5 will appear on the exams until July 2015. [Everywhere but California.] 
That's most people--49 states plus Canada. If you're taking the exam between now and July, '14, study DSM-IV-TR. People in sunny CA have to put down their surfboards and get their DSM-5 knowledge together sooner. From the California BBS:
Exam administrations December 1, 2014 and after: DSM-5 [California only.]
Two different exam administrators, two different times to expect to see DSM-5 questions on the exam. Since everyone's eventually going to be using DSM-5 diagnoses, the California people may have an advantage in that they don't have to dig into two different DSMs. But it's not hard to imagine a big, everywhere-but-California sigh of relief at getting to push that particular information loading down the road some.

Wherever you are, whichever DSM you're learning, good luck!

Tuesday, July 15, 2014

The Code of Ethics - Ethical Principles

Developing familiarity with the NASW Code of Ethics is a central part of preparing for the social work licensing exam. To help you along that path, here's something to focus on today: the six ethical principles delineated in the code. They are:
  1. Service
  2. Social Justice
  3. Dignity and Worth of the Person
  4. Importance of Human Relationships
  5. Integrity
  6. Competence
Links go to descriptions (courtesy of They're worth reviewing. As you wrestle with choosing between two answers on the exam (you can usually narrow down to a best two), you might think about these ethical principals. Which answer best reflects the Code of Ethics? That's going to be the one to mark.

For further review:
The NASW Code of Ethics, and, perhaps, Social Work Values and Ethics.

Monday, June 30, 2014

Theories and Methods - Solution-Focused Therapy

Solution-focused therapy (SFT) is an outcome-focused approach developed by Steve de Shazer, Insoo Kim Berg, and others. SFT is usually brief, always goal directed, and concerned with the future. SFT discards analyzing problems and their origins, instead turning all attention to what can be done. Toward this end, SFT has a handful of signature interventions. The most well-known of these (and most likely to show up on the LCSW exam) is the Miracle Question, which asks, "If you woke up and found your problem (e.g., anxiety, depression, other symptom) was gone, what would be different? How could you tell?" The question elicits specifics from the client that can suggest solutions and/or become goals for therapy. Other SFT interventions include scaling questions, exception-seeking questions, and coping questions. When is a problem worst/best? When is a problem absent? How is it that a client is able to function well in some areas despite the problem? Since solution-focused therapy shares the problem-solving orientation seen in much of social work, it is not unheard of to see SFT questions on the licensing exam.

For further review: Solution-focused brief therapy at Wikipedia, and assorted SFT books via Amazon.

Monday, June 16, 2014

Theories and Methods - DBT

If you're not yet familiar with Dialectical Behavior Therapy (DBT) and are preparing for the social work licensing exam, now's the time to get comfortable with the basics. DBT was developed by Marsha Linehan to help people with Borderline Personality Disorder. Like CBT, DBT is rigorously rooted in research and results. Like CBT, DBT aims to help people with behavioral and cognitive regulation. What DBT adds is a focus on emotional regulation, distress tolerance, acceptance, and mindfulness.

DBT clients learn to use their "wise mind" (the just-right blend of emotion and reason) with the help of a series of acronyms (e.g., "DEAR MAN," and "ACCEPTS")--simple guides to a long list of coping skills. DBT has been shown to be helpful for clients with and without BPD. Given its research orientation, targeted symptoms, and apparent effectiveness, DBT is precisely the type of approach you can expect to see show up on the social work exam.

For further review: DBT at Wikipedia and the Skills Training Manual for Treating Borderline Personality Disorder, by Marsha Linehan.

Friday, June 06, 2014

The Code of Ethics

The majority of questions on the social work licensing exam aren't pulling for specific information about DSM diagnoses, developmental theories, and the like. They're vignettes that test for a core sense of social work values and ethics. How to prepare for those? The key reading is free, short, and just a click away: The NASW Code of Ethics. You've encountered it before, no doubt. As you're preparing for the exam, it's time to dig back in. It's worth rereading, word for word. And while you're doing that, you might pause with each section to imagine how the section might be tested for on the exam. Sometimes that will be obvious, sometimes less so.

Also valuable for preparing for ethics questions is Frederic Reamer's Eye on Ethics column from Social Work Today. Many of the dozens of columns contain their own vignette questions, exploring close-call situations that social workers often face. These closely resemble the very scenarios that you'll be asked to consider as you sit for the exam.

Thursday, May 15, 2014

Theories and Methods - CBT

Cognitive Behavior Therapy (CBT) posits that our experience can be divided into three categories: thoughts, feelings, and behavior. You may have seen a diagram showing all three interlinked. Your behavior influences your thoughts and feelings, your feelings influence your thoughts and behavior, and so on. The primary interventions in CBT look at with what you think and what you do (thus, "cognitive behavior therapy"). The behavioral part has its roots in Skinner and the other behaviorists. Exposure therapy, for example, is a CBT intervention.

The cognitive piece gets the most attention in the CBT literature. The notion is that thoughts are the first stop in our reaction to any given experience. We think, then we feel and act. In CBT, special care is taken to examine those thoughts and determine if they hold up to close scrutiny. Is the thought rational, based in evidence, or not? Irrational thoughts usually are one of several types, included on the list of cognitive distortions (e.g, "mind reading," "fortune telling," "jumping to conclusions").

CBT is practical, interested in evidence, and, more than many other approaches to psychotherapy, has ample evidence showing that it is effective with a wide range of mental health issues (not least, anxiety and depression). For all of these reasons, you can be fairly certain you will encounter questions about CBT on the social work licensing exam.

For further review: Cognitive Behavior Therapy, Basics and Beyond, by Judith Beck.

Monday, May 12, 2014

The Blog is Back!

We're very excited to announce that, after an over four year hiatus, this blog is returning to action. Coming soon, more posts--more assessment, DSM, theories and methods, and lots more to help you pass the LCSW exam. By now, chances are that most of you who read and used these pages over the first burst of blogging, 2006 through 2010, have already taken and passed the exam. You're now out there doing all kinds of great social work. Please don't be shy about checking in in comments and letting everyone know what you've been up to! For those of you new to the blog, welcome. There are years of terrific posts by  to sort through, plus lots of helpful comments from people struggling with and eventually triumphing over the test. You're next.

Interested in helping blog about the exam? Have questions you'd like to see answered here? Write thelcswexam [+] gmail. Looking forward to the coming years of helping you get licensed!

Tuesday, January 05, 2010

A New Year

I am finally finished with the bulk of my dissertation. This allows me to diversify my interests and time into other writing projects. I finally have some energy to put back into this project and hopefully get some things going again.

To that end, I have designed a brief (5 question) survey for the readers of this blog. If you could take a few moments to fill it, I would appreciate it. This will help me focus my energy and writing into the most needed areas.

Click here to take the Online Survey

Monday, February 02, 2009

New Information

I was looking at the stats for this website today and it seems as though, on average, 30 people visit the website daily. This is a little surprising to me, since I haven't really updated the content all too frequently. However, it tells me that some people are finding value in what is written here.

I have had an internal debate about what I want to do with this blog. Do I want to just leave it alone and post occasionally (when the mood strikes or an email I receive asks a particular question)? Do I want to make a concerted effort to post more material pertaining to taking the exam? Do I want to work on more exam preparation material?

For me, answering these questions comes down to (1) the service this blog is providing for others and (2) a cost-benefit analysis related to my time. I am writing my dissertation at the moment and that certainly takes up a majority of my time. I know I have asked this before and received a few responses from folks. However, I am asking for your help in determining the direction of this blog. Is what is here enough? Would you like to see more information, and what shape should that information take to be most helpful? The more you can help me understand how you use this blog, the better I can decide where to go in the future.


Monday, December 01, 2008

Minor Additions

I added a few resources to the "Theories and Methods" posts about particular psychotherapies. If there wasn't a good text or the texts were too expensive I didn't bother to add them.

The links will take you to a copy of the book on Amazon with prices and its associated reviews. If you have other resources that would fit with particular theories pass them along and I will try and add them to each list as appropriate.

Thanks for reading.

Sunday, November 02, 2008

What would you do first?

These questions are, quite possibly, the most annoying questions on the entire LCSW exam. I remember studying my materials, taking a practice exam, missing numerous questions and scratching my head until it felt like it was bleeding. Invariably, I would wind up missing a few of these "what would you do first" type questions.

The first thing to try and combat my own neuroses about these questions was take them to my supervisor. I would ask him the questions I missed and give him the answers. Interestingly enough we would often agree on the first things we would do, and we would often be wrong according to the materials. How did this seeming exercise in futility help me?

First, it gave me another opinion on the exam. My supervisor was an MSW, DSW and had been in public and private clinical practice for many many years. Hearing his opinion on the question helped me believe in my own gut instincts related to Social Work practice. It also added some perspective to the questions and answers.

Second, our conversations helped me laugh a bit at the exam and alleviate some of the stress and discomfort I was experiencing related to taking the test. Thankfully, we had the kind of supervisory relationship where we were able to talk freely and laugh at both our successes and failures. The relationship provided me an opportunity to study for the exam and understand that Social Work practice is a complex entity that cannot be fully encapsulated in multiple choice questions.

Finally, our conversations helped me reframe the questions so that I could take my incredulity out of my reading of the questions and answer them as best I could. For me, that reframing of the question proved vital. When I would encounter a question that me what I would do first, I would read the question as "Blah, blah, blah, what would the book do first in this situation?" (Usually with the first part of the question replacing the blah, blah, blah). I needed to "divorce" myself from the question so that I could think as the materials would want me to and answer the question appropriately.

So, how might this help you prepare?

(1) If you still have a supervisory relationship, use it for preparation when you have the opportunity. Bounce your missed questions off of the supervisor and learn from their experience in the field. If you don't have this kind of relationship, then find a Social Worker whose practice you admire and sit down with them and ask for their help. You may find that they answer a question the same way you do and you can feel some vindication. They may answer it "correctly" and can help you understand their rationale.

(2) Find a way to put the questions into words that you can stomach. Social work is a wonderful, diverse and complex discipline. Not everyone practices it in the same manner, nor should we. However, the exam attempts to measure your knowledge according to the assumption of a "perfect" world practice. Therefore, we have to put aside some of the methods we have learned and enter a "perfect" world in order to answer the questions as asked. Read the question with whatever reframing you find most helpful, then answer according to your understanding of the study materials you used rather than the experiences you have. Your experiences are important, yet for the exam your ability to study and recall is more important.

Good luck in your studies, I hope this helps.


Wednesday, March 19, 2008

5 tips for passing the exam

Reaching the point of taking the LCSW exam is a mixed blessing at best. It means that you have met the requisite hours of practice and supervision, which is a testament to your tenacity and clinical abilities. It also means that a new chapter of studying and anxiety is opened as you prepare to add four new letters behind your name and take a timed test that covers a broad range of topics.
From time to time I will receive emails from people who are preparing to take the exam or who have taken it and not passed. Inevitably, these emails include some request for advice about how to study or prepare for the exam. So, I thought I would cull the advice I have given over the past year or two into one post.
I am not doing this so that you will no longer email me. I do the best I can to respond to each one that I receive. I also know that I will not cover every anxiety or frustration with one post, but for those who like lists and things in a neat little package here are my tips for passing the exam.
  1. Think about the way you study best and do that more often. There are a myriad of materials out there to help you prepare for the exams. These range from practice exams to study guides to study guides with practice exams, etc. Most, if not all, of these guides are dry as a bone and merely regurgitate the material you need to know to pass the exam. They have their formulas for getting the material across to you. However, they do not know you best, you do. So, take the materials you choose to study and adapt them to the ways in which you learn. For me, this blog is the result of the way I learn. I needed to re-write the material I was studying in my own words in order to really get a grasp on it. Instead of a pen and paper I took to my laptop and wrote a series of notes that became my study guide. All of the posts on this blog concerning the theories and methods were the result of my homemade study guide. So, think about the ways you learn: flashcards, quizzes, study groups, putting things in your own words, etc. and adapt the study guides to your taste not vice versa.
  2. The exam doesn't care how you practice social work. This is one of the hardest lessons to learn and it took me a while to really grasp its meaning. My impression of the exam is that it does not measure real world application of Social Work principles and guidelines; instead, it measures "ideal" (read textbook) applications of these principles. One of the helpful things I took into the exam was a sense that I needed to reframe the questions so that my answers reflected not what I would do first but what "the book" would do first. Therefore, when I encountered a "what would you do first" question I could usually eliminate two of the responses right off the bat. Then I would generally choose the more conservative response from the remaining choices. This may not work for all of these questions but it helped me get into a frame of mind that had me answering questions as the book would want me to answer them rather than the way I think the questions should be answered.
  3. The exam measures your ability to remember data. This is not an exam that measures the efficacy of your practice or your ability to help people in a way that empowers them. This exam measures your skills at memorization. Now, I realize this is a fairly cynical view of a standardized test. However, I cannot think of another way to put it. The national exam was created as a method to take the subjectivity of licensure committees out of the process and have an "objective" tool that measures knowledge of social work practice and principles. If you don't pass the first time around, it says absolutely nothing about how good a social worker you are. The only thing a failing score reveals is that you might need more time memorizing the material and putting it to use the way the test wants you to.
  4. The exam is not always "right." The earlier you give up fighting the questions and their "right" answers, the earlier you can get on with studying the material as needed. I remember studying for the exam and talking with my supervisor about some of the questions and answers. He and I would read some of the questions and talk about how we would answer them given the choices on the test. In each one of these Q&A sessions there would be one or two questions that we would agree on that the test would count as wrong. He had his doctorate in social work and was a successful private practitioner for many years and he still couldn't always get the right answers according to the test. You have to remember that the correct answer for the test may not be your way of answering the question, but it is still the correct answer. Unfortunately, you will not get very far by arguing with the computer over which "answer" you should perform first in a particular situation. Instead, study for the purpose of the exam and remember that the real world is a lot messier than answer A, B, C, or D.
  5. You have already passed. Remember that the exam is merely the culmination of a long road of clinical practice and supervision. To get to this point in your career you have most likely been through 100 hours of supervision and thousands of hours of clinical practice. Your supervisor has signed off on your capabilities as a social work practitioner. People have come to you for therapeutic help and returned again and again because they believe you can help them. All in all, to get to the point where you can even take the test requires the implicit and explicit approval of a number of people in your life. They know you are a good social worker, regardless of the outcome of your exam. The LCSW exam does not prove that you are a good social worker, that you care about the self-determination of others, or that you stand for justice and provide a voice for the voiceless. Clients wouldn't return if you were a bad social worker, supervisors wouldn't sign the necessary forms if you weren't a good clinician. The fact of the matter is that you have a crowd of people who know that you are ready to take the exam and approve of your doing so. In essence, you have already passed the difficult part; the exam is more a formality than a gate-keeper.
So, there you have it. These five tips helped me put the exam in what I felt was the proper perspective. To be sure, I studied hard and often. However, I was not about to let the exam dictate how I felt about my abilities to practice as a clinical social worker. I merely thought of it as one more step on an already long and most completed journey, a step that affirmed what I already knew from experience. Namely, that I was a good social worker and that I could practice effectively, ethically and compassionately.