Tuesday, May 23, 2017

The Code of Ethics - Informed Consent

Here's an essential piece of the NASW Code of Ethics, a favorite of exam writers--section 1.03, Informed Consent. In six quick paragraphs, lots of fodder for LCSW exam questions:

(a) Social workers should provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent. Social workers should use clear and understandable language to inform clients of the purpose of the services, risks related to the services, limits to services because of the requirements of a third-party payer, relevant costs, reasonable alternatives, clients’ right to refuse or withdraw consent, and the time frame covered by the consent. Social workers should provide clients with an opportunity to ask questions.
(b) In instances when clients are not literate or have difficulty understanding the primary language used in the practice setting, social workers should take steps to ensure clients’ comprehension. This may include providing clients with a detailed verbal explanation or arranging for a qualified interpreter or translator whenever possible.
(c) In instances when clients lack the capacity to provide informed consent, social workers should protect clients’ interests by seeking permission from an appropriate third party, informing clients consistent with the clients’ level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients’ wishes and interests. Social workers should take reasonable steps to enhance such clients’ ability to give informed consent.
(d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients’ right to refuse service.
(e) Social workers who provide services via electronic media (such as computer, telephone, radio, and television) should inform recipients of the limitations and risks associated with such services.
(f) Social workers should obtain clients’ informed consent before audiotaping or videotaping clients or permitting observation of services to clients by a third party.
Don't stop with reviewing this one section. Check out the entire Code of Ethics. It's a click away. 

Monday, January 30, 2017

Into the DSM - Narcissistic Personality Disorder

NPD has been thrown around in the news a lot lately. Does that make it any more likely to show up on the social work licensing exam? Hard to say. Exam writers read the news too! Criteria for NPD are:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
4. Requires excessive admiration.
5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
6. Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
8. Is often envious of others or believes that others are envious of him or her.
9. Shows arrogant, haughty behaviors or attitudes.

And that's it. Simple--and difficult--as that. Narcissistic personality disorder is grouped with antisocial personality disorder, borderline personality disorder, and histrionic personality disorder in Cluster B.

Seasoned social workers can usually assess the presence of a personality disorder pretty quickly, without knowing which PD they're facing. The quick summary you'll hear all the time in the field: "Cluster B." On the exam you have to be more certain--know these criteria and how to distinguish from the other personality disorders and you'll be able to correctly answer without too much difficulty.

For further reading, try the Mayo Clinic's NPD page: http://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/basics/definition/con-20025568 and Wikipedia's pages, linked here: https://en.wikipedia.org/wiki/Cluster_B_personality_disorders

Good luck on the exam!