NCE PRACTICE EXAM

According to Jean Piaget and his theory on cognitive development, children between the ages of 2-7 years possess more concrete thinking and can comprehend time through past, present and future themes. During this stage they are more "egocentric". This is part of Piaget's theory on cognitive development.

Stranger anxiety begins in an infant at 5 to 9 months old when an unfamiliar person other than the child's parents attempts to hold or closely approach the child. This behavior intensifies about one year and discontinues when the child reaches 2 years of age.

Learned behavior is a set of behaviors learned when the child interacts with his or her caretaker (mother) who provides food as comfort. This helps to form attachment. Separation anxiety begins around 6 to 8 months and the behaviors include being upset and anxious when the caregiver is out of his or her sight or leaves the room. Separation Anxiety Disorder occurs later in childhood and is characterized by excessive worry about being away from a caregiver. This behavior is not typical or appropriate for the age of the child at which it occurs.

Self-actualization, according to Maslow, is where a person needs to be his or herself despite one's environment. Typically, only 1% of the population consistently operates on this level. An individuals who is "self actualized" is in a position to find his or her true calling (i.e, an actor, writer, or musician). The other listed answer options are other needs in the hierarchy.

Denial is a primitive defensive where one has the inability to acknowledge his or her true feelings, wishes, or behaviors that are consciously intolerable. In this example, Craig has the inability to acknowledge that his father sexually abused him.

Acting out is an emotional conflict, that is dealt with through actions rather than feelings. Compensation enables one to make up for deficiencies. For example, a physically short man may work out at the gym to obtain a bigger physique to appear bigger than he actually is. Dissociation is a process that enables a person to split mental functions in a manner that allows him or her to express forbidden or unconscious impulses without taking responsibility for the action.

Projection, which the case worker is exhibiting, is a primitive defense, attributing one's disowned attitudes, wishes, and feelings onto some external object or person. In this case, the case worker does not like certain behaviors of the client and projects her feelings of dislike onto the client.

Projective Identification is a form of projection. However, its more utilized with individuals diagnosed with Borderline Personality Disorder (BPD), which they are unconsciously perceiving others' behaviors as a reflection of one's own identity. Introjection is generally where a person adopts or replicates the behaviors or attributes of others. Incorporation is a primitive behavior where "psychic" representations of a person (parts of a person) are figuratively ingested. This individual is not exhibiting their true authentic self.

Homeostasis is another term for "steady state" as it relates to systems theory. "Homeostasis" or "steady state" in systems theory is when a sense of "balance" is achieved within a family system. Families strive for a sense of balance or "homeostasis". When it's not present, rules or interactions may need to be adjusted in order to achieve or restore this balance.

"Input" is obtaining resources from the environment that are necessary to attain the goals of the system. "Open system" is a system with cross-boundary exchange. "Differentiation" is becoming specialized in structure and function.

Ethnicity refers to the idea that one is a member of a particular cultural, national or racial group. They may share the same culture, religion, race, language or place of origin. For example, two people can share the same race but have different ethnicities.

Race is not a fixed meaning, it is related to a particular social, historical, and geographical context. Society today refers to "race" based on one's skin color. Cultural identity is defined as the identity of a group or culture of an individual who is influenced by his or her self-identification with that group or culture. Cultural diversity is the quality of diverse or different cultures.

A needs assessment is a systematic process for determining and addressing gaps between current and desired conditions. It examines the strengths and weaknesses of a program with the aim of improving it in order to meet current and future challenges. There are multiple methods for conducting needs assessments, which can be conducted by consultants, staff and volunteers who are internal or external to the community clinic. "Formative evaluation" examines the processes as they occur during the implementation phase of a program. "Summative evaluation" focuses on determining a program's effectiveness or examining it outcomes. "Cost-benefit analysis" determines the financial costs of operating a program as compared with the fiscal benefits of its outcomes.

The Myers-Briggs Type Indicator (MBTI) is a forced-choice, self -report inventory that attempts to classify individuals along four theoretically independent dimensions on how people perceive the world around them. The four dimensions are extraverted, introverted, sensation, and intuition.

The Beck Depression Inventory (BDI) is a 21-item test, presented in a multiple-choice format that assesses the presence and degree of depression in adolescents and adults. The Minnesota Multiphasic Personality Inventory (MMPI) is an objective verbal inventory designed as a personality test for the assessment of psychopathology consisting of 550 statements, 16 of which are repeated. The Rorschach Inkblot Test is used to assess one's perceptual reactions and other psychological functioning. It is one of the most widely used projective test.

A social worker takes on different roles throughout the group process, which has a beginning, middle, and end. In the "beginning" stage, a social worker identifies the purpose of the group and his or her role. This stage is characterized as a time to convene, to organize, and to set a plan. In addition, members are likely to remain distant or removed until they have had time to develop relationships.

Intermediate stage is not part of this stage. The middle stage is where almost all of the group's work will occur. Relationships are strengthened as a group so that the tasks can be worked on. The end stage consists of the group reviewing its accomplishments. Feelings are associated with the termination of the group are addressed.

There are only three phases on the cycle of violence. Phase I, "Tension Building" where there are signs of abuse may be present (i.e. multiple verbal arguments, anger, and blaming). Phase II "Battering incident" is the shortest period of the cycle, where the greatest abuse (physical and/or verbal) occurs. Phase III, "Loving Contrition" is where the batterer offers many apologies and states that he or she may never engage in those acts again. This stage is also called the "honeymoon stage". Phase IV does not exist.

The Biopsychosocial Model incorporates hereditary predisposition, emotional and psychological problems, social influences, and environmental problems.

The Medical Model views addiction as a chronic, progressive, relapsing, and potentially fatal medical disease. The Family and Environment Model is based on the explanation that substance abuse can be found in family and environmental factors such as behaviors shaped by family and peers, personality factors, physical and sexual abuse, disorganized communities, and school factors. The Social Model considers drug use as learned and that it is reinforced from others who serve as role models.

Delusions are false fixed beliefs, often times not based in reality (i.e. a client believes that they are being watched by aliens from a distant planet). Hallucinations are based one's five senses but are not real (i.e. a client seeing an "person" in a corner of a room when there is no one there or no stimulus).

An individual's depression can develop from many origins. However, the two distinct causes of depression are endogenous depression and exogenous depression. Endogenous depression is caused by biochemical imbalance where an individual may receive medication management to manage its symptoms. However, exogenous depression is caused by psychosocial stressors where one may not feel they are getting their needs met and may need coping tools to manage his or her depression.

Compensation is not a step of the 6 six components of the problem-solving process. The six steps are Engaging, Assessing (includes a focus on client strengths and not just weaknesses); Planning, Intervening, Evaluating, and Terminating.

Positive reinforcement increases probability that behavior will occur (i.e. praising, giving tokens, or otherwise rewarding positive behavior.

Positive punishment is a presentation of undesirable stimulus following a behavior for the purpose of decreasing or eliminating that behavior (i.e. hitting, shocking). Negative punishment is the removal of a desirable stimulus following a behavior for the purpose of decreasing or eliminating that behavior (i.e. removing something positive, such as a token or dessert). Negative reinforcement is behavior increase because a negative (aversive) stimulus is removed (i.e. remove shock).

The Child Abuse Prevention and Treatment Act of 1974 is legislation that provides federal funding to states in support of prevention, assessment, investigation, prosecution, and treatment activities for addressing child abuse and neglect.

Family Educational Rights and Privacy Act (FERPA) of 1974 protects the privacy of educational records. The law applies to all schools that receive funds under an applicable program of the United States Department of Education. FERPA gives parents certain rights with respect to their children's education records. The Education for Handicapped Children Act of 1975 guarantees a free, appropriate public education to all children with disabilities between the ages of 3 and 21. Children receiving such services should be provided with Individualized Educational Plans (IEPs) that are revised annually. Indian Child Welfare Act of 1978 gives American Indian/Native American/Indigenous nations or organizations jurisdiction over child welfare cases that involve an American Indian/Native American/Indigenous child in order to protect the integrity of American Indian/Native American/Indigenous families.

Social Work aims to solve problems in human relationships and empower their clients. They achieve this goal by engaging in three levels of intervention: Micro, Mezzo, and Macro. The "mini" intervention does not exist. The Macro intervention is the third level of intervention for social workers. This level stresses the importance of economic, historical, sociopolitical, and environmental influences on client well-being and functioning. Social workers determine how these factors can facilitate growth and/or create problems for clients.

The "Micro" intervention is where social workers concentrate on helping clients solve their problems. These problems may relate to difficulties with partners/spouses, children, other family members, coworkers, and/or neighbors. At the micro level, social workers help clients to access needed services from other agencies, as well as provide direct support and counseling.
The "Mezzo" intervention the second level of intervention for social workers, which is also known as "meso". Mezzo interventions apply to larger groups or communities. At the mezzo intervention level, social workers attempt to make connections between the micro and macro levels

The SOAP format of a progress note (Subjective, Objective, Assessment, and Plan) captures the client's records and progress when receiving ongoing services and support. In the "Assessment" part of the note, the social worker pulls together the subjective and objective findings and consolidates them into a short assessment.

During the interviewing process with a client, there are multiple techniques that a social worker may utilize. A social worker may use "interpretation" by pulling together patterns of behavior to get a new understanding based on what the client is presenting.

Universalization is the generalization or normalization of the client's presenting behavior. Clarification is when the social worker reformulates the problem in a client's words to make sure that the client and social worker are on the same page. Reframing and relabeling is the social worker stating a problem in a different way so that the client can see possible solutions.

Social workers utilize both verbal and non-verbal techniques in interviews with clients to exhibit that they are attentive and listening to their client's needs. "Active listening" involves attentive listening by asking open-ended questions, and making statements to show that the social worker is "actively" listening to the client.

"Silence" by social workers, show acceptance of clients' feelings and promotes introspection or time to think about what has been learned. "Reframing" by social workers shows clients that there are different perspectives and ideas that can help to change negative thinking patterns and promote positive change. Social workers "exhibiting desirable facial expression" include direct eye contact if culturally appropriate, with warmth and concern reflected through varied facial expressions in an interview.

When engaging a client in any service, the client's consent must be obtained before the service is rendered. The most appropriate service-related form to obtain a client's consent is an "informed consent for services". Once this form is obtained and signed by the client, the client may engage and utilize services.

Consent for Release of Information is prior to releasing any information to a third-party (other than mandatory report). Clients must have reviewed and signed consents for such disclosures. A Do Not Resuscitate Order or DNR is a specialized advanced directive. A DNR is a legal decision not to have cardiopulmonary resuscitation (CPR) if a client's heart stop or if a client stops breathing. Unless given other instructions, medical personnel will try to revive those in these situations. This form is mostly used in acute care medical settings. An Advance Directive is a legal document that allows clients to make decisions about medical and end-of-life care ahead of time. They give clients ways to communicate wishes to others when they are unable to do so.

According the the NASW Code of Ethics, 1999--1.06 Conflicts of Interests, social workers should inform clients when a real or potential conflict of interest arises. In addition, the social worker should take reasonable steps to resolve the issue in a manner that makes a clients' interests primary and protects the clients' interests to the greatest extent possible. Lastly, social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to a client. A "dual relationship" in the field of social work is a situation where multiple roles exist between a therapist (case worker) and client. In instances when a dual relationship is unavoidable, social workers should take steps to protect clients' and are responsible for setting clear, appropriate, and culturally sensitive boundaries.

Steps B, C, and D are part of the essential steps in ethical problem-solving in social work practice. Answer A is not part of the essential steps because the ethical standards are not defined by the Advanced Social Worker but by the NASW Code of Ethics. Social workers cannot rely on their supervisors or co-workers on the ethical standards. Social workers should refer to the Code of Ethics first when researching ethical standards of the social work profession.

The mission of the social work profession is rooted in a set of core values. The core values are Service, Social Justice, Dignity and worth of the person; Importance of human relationships; Integrity, and Competence.

According to the NASW Code of Ethics, 1999--1.03 Informed Consent, prior to receiving services or participating in research, clients must be informed of certain provisions of the service or intervention and consent to them. These elements are often explicitly stated on a form, which a client signs and dates. However, the requirement and storage of the form in a client's file is not critical to obtaining informed consent.

The client is exhibiting "transference" during this session with his social worker. Transference refers to redirection of a client's feelings for a significant person to a social worker. Transference was first described by Sigmund Freud, who acknowledged its importance for a better understanding of a client's feelings. On the other hand, "countertransference" refers to the redirection of a social worker's feelings toward a client, or more generally, a social worker's emotional entanglement with a client. Projection is a primitive defense, attributing one's disowned attitudes, wishes, and feelings onto some external object or person.

"Burnout" is a state of physical, emotional, psychological, and/or spiritual exhaustion. It can be manifested by cynicism or a lack of satisfaction in working with clients to resolve their problems.

"Vicarious Trauma" (similar to Secondary Trauma) is the emotional exposure that counselors/therapists have from working with people as they are hearing client's traumatic experiences and become witnesses to the pain, fear, and terror that trauma survivors have endured. "Compassion Fatigue" is a syndrome consisting of a combination of the symptoms of secondary trauma and burnout. It usually represents the overall experience of emotional and physical fatigue that Social Workers can experience due to the prevalent use of empathy when treating clients who are distraught and experiencing emotional pain.
 

Evaluations in the field of social work should include a review of both quality and quantity of the work performed by the social work professional. Social work evaluations should identify both strength and weaknesses of the social worker. In addition, they should also be specific and individualized to the professional social worker.

The senior social worker is performing "supervision". The senior social worker is supervising the fellow social worker (employee). Supervision is providing administrative and educational support to another fellow social worker (employee). Supervision ensures that the responsibility of an employee is performed in an acceptable manner. "Consultation" does not have the same level of responsibility or accountability of an employee. The social worker does not have to implement the suggestions or advice of his or her supervisor as in the case of supervision. "Peer support" is when an employee uses colleagues for feedback or assistance with professional activities. Peer supervision is similar to the concept and responsibilities of "supervision" performed by a paraprofessional who has more experience and general responsibilities of his fellow peer (paraprofessional).