What is Congruence?

On the ASWB clinical exam outline, you'll find the item "The concept of congruence in communication." It's in the Therapeutic Relationship section. So, what's congruence? As usual, the Internet stands ready with many answers. First, a definition:

a communication pattern in which the person sends the same message on both verbal and nonverbal levels.

Okay, that rings a bell. Here's more detail in a definition of mood congruence:

consistent with one's mood, a term used particularly in the classification of mood disorders. In disorders with psychotic features, mood-congruent psychotic features are grandiose delusions or related hallucinations occurring in a manic episode or depressive delusions or related hallucinations in a major depressive episode, while mood-incongruent psychotic features are delusions or hallucinations that either contradict or are inconsistent with the prevailing emotions, such as delusions of persecution or of thought insertion in either a manic or a depressive episode. 

And that's that--for the licensing exam, you're up to speed. Will this show up on the exam? Maybe not as a "define this" question, but as a subtle part of an assessment vignette? Could be.

Want more? Keep on clickin':

Mood congruence (Wiki)
Congruent communication (PeoplePolarity.com)
Active Listening (AnalyticTech.com)

Good luck with the exam!

Getting Ready for the ASWB Exam

You're going on a journey. You think about what you'll need ahead of time. You get your things together, pack 'em, hit the road. So what if the journey is along the road to licensure? What are you going to need? How do you get ready? Here are some ideas about how to prepare and what to pack.

First, it's good to have a general sense of what to expect once you've gotten moving. In this case, you've got a testing center to get to. An exam to take. A passing result to celebrate.

The testing center is a knowable. Once you're registered, you've got an address. Let the Internet tell you what to expect on your drive, or, if you're the mega-preparing type, drive the drive ahead of time. See the testing center, give it a nod, and say, "I will be passing an exam inside you soon."

The basic structure of the exam is also knowable. It's four hours long, 170-questions wide. (Yes, there are 20 "tester" questions that don't count toward your score. But you can't know which those are, so better to set that factoid aside.) You'll get basic instructions about what you can and can't bring--physically--to the exam. Usually what you can bring with you is less than nothing. But you probably can bring some water and a snack to leave if you want a quick break and boost. (Can be helpful!) 

Okay, so that's your map. (Leaving out your choice of how to celebrate after.) You've got the physical dimension down. Now how do you prepare internally? What do you need to pack into your thinking parts?

There's also a lot of knowable about what facts and wisdom you're expected to arrive with on exam day. Okay, there's no Internet mapping program to walk you through the licensing exam, but there are exam content outlines (available at aswb.org). They spell out the entire range of what you might expect to be tested on. The outlines point to more places to get things know, such as the DSM and the NASW Code of Ethics. There are also practice exams aplenty available on the www to help you get accustomed to the experience of taking the exam. Practice tests can guide your approach to the types of questions you're likely to encounter and speed your journey once you sit down for the real thing.

That leaves a second internal element: your nerves. Anxiety has a way of fogging people up and making simple tasks seem overwhelming. And, unless you're a extraordinarily cool customer, anxiety is just going to be a part of ASWB exam prep. (A feature, not a bug, as they say in programming land.) Anticipate some nerve jangling on your journey and pack some tools to help you handle it. Rules of thumb: increase self-care (sleep, food, exercise, meditation, down time...); explore your worries (this is CBT--do a thought log, imagine the worst case, realize that, though the stakes may be high, you'll be fine. The test doesn't define you. It's something you've chosen to do. You've gotten this far...etc.)

What'd we forget to mention? Pack that too! Should be a decent trip. You may even learn something useful along the way. Have a great one, have fun, and good luck!

Social Work Exam Prep: Psychiatric Terms Quiz

If you followed the link on the previous post to Wikipedia's glossary of psychiatric terms, you may have gotten a little overwhelmed. There's a lot there that never has and never is likely to show up on the social work licensing exam. But some of those concepts are a part of social work and a potential part of the exam. So, with that in mind, here's a quick quiz for you. We'll put the terms up top and the definitions after the break. See if you can summon the definitions without straining too much. Good luck on the quiz and good luck on the exam!

Define:

1. Anhedonia

2.  Clang associations (aka Clanging)

3.  Flight of Ideas

4.  Folie à deux

5.  Thought Blocking

6.  Word Salad

Answers (via Wikipedia):

1. Anhedonia refers to an inability to experience pleasure, and may be described as a feeling of emotional emptiness. It can be a negative symptom of schizophrenia. It also may be seen in severe depressive states and schizoid personality disorder.

2.  Clang associations are ideas that are related only by similar or rhyming sounds rather than actual meaning. Example: "He ate the skate, inflated yesterdays gate toward the cheese grater."

3.  Flight of ideas describes excessive speech at a rapid rate that involves fragmented or unrelated ideas. It is common in mania.

4.  Folie à deux.  Also called induced psychosis, folie à deux is a delusional disorder shared by two or more people who are closely related emotionally. One has real psychosis while the symptoms of psychosis are induced in the other or others due to close attachment to the one with psychosis. Separation usually results in symptomatic improvement in the one who is not psychotic.

5.  Thought blocking refers to an abrupt stop in the middle of a train of thought; the individual may or may not be unable to continue the idea. This is type of formal thought disorder that can be seen in schizophrenia.

6.  Word Salad is characterized by confused, and often repetitious, language with no apparent meaning or relationship attached to them. It is often symptomatic of various mental illnesses, such as psychoses, including schizophrenia.

How'd you do?

Psychiatric Terms for the Social Work Exam

You're not being tested on you knowledge of psychiatry for the social work licensing exam. Often, you're being tested on whether or not you know the line between what social workers do and what MDs do. "Refer for psychiatric evaluation" is the correct answer to many vignette questions that try to trap overzealous, scope-of-practice disregarding social workers in overshooting the limits of the profession.

That said, there's a lot of overlap between what psychiatrists and social workers see and the terminology they use. MDs prescribe meds. Social workers do most everything else. To communicate with each other, and within the field in general, common language is needed. Here, via Wikipedia, is a list of psychiatric terms you might consider eyeballing as you prepare for the SW test. Lots of it is irrelevant to the social work exam--but not all! Here are a few semi-random selections to whet your appetite for psychiatric/social work lingo.

Abreaction
Abreaction is a process of vividly reliving repressed memories and emotions related to a past event. Sigmund Freud used hypnosis to rid their patients of pathological memories through abreaction

Ideas of reference
Ideas of reference are a delusional belief that general events are personally directed at oneself. For example, someone might believe that he or she is receiving messages from the TV that are directed especially at him or he.

 

Stockholm syndrome

The Stockholm syndrome is a psychological response sometimes seen in a hostage, in which the hostage exhibits loyalty to the hostage-taker, in spite of the danger (or at least risk) in which the hostage has been placed. Stockholm syndrome is also sometimes discussed in reference to other situations with similar tensions, such as battered person syndrome, child abuse cases, and bride kidnapping.

Exam Prep Help: Eye on Ethics

If you've searched around the web for answers to just about any tricky social work ethics question, than you've probably encountered Frederic Reamer's Eye on Ethics column in Social Work Today magazine. Reamer, author of the book Social Work Values and Ethics, and many others hands out his ethics wisdom for free in the online column. Happily for social work exam studiers, many of the columns contain vignettes about social workers faced with grey-area decisions, not at all unlike the ones that show up on the exam. Below, a sample of recent columns. Dig in--can't hurt. You're very likely to learn something you'll use on the exam, in practice, or both. Enjoy!

• Elastic Boundaries in Social Work — Proceed With Caution
• The Evolution of Social Work Ethics
• The Concept of Standard of Care
• Ethics Consultation: The Wisdom of Crowds
• Ethics Education in Social Work — Transformation of a Profession

Least Expensive Social Work Exam Practice?

Pretty sure, with or without coupon codes, this is it:

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Reducing Social Work Exam Anxiety

Here's a vignette: A social worker is seeing a new client who says she has a huge exam to take that will help advance her career. Since the client has never taken an exam like this one, she finds herself anxious and worried. She's been procrastinating and ruminating about the possibility of failing the exam. What is the BEST course of action for the social worker to take with the client?

Without an ABCD to choose from, how would you answer?

And what if that client were you?

On the exam, the best answer would probably be something about using CBT to challenge client's negative thoughts and reduce symptoms of anxiety. In real life--your life--that very well may work. Have you tried it? If not, here's a different kind of ABCD to consider--an REBT-based thought log. Here, ABCD is a handy way to remember thought log steps. Looks like this:

A is the activating event--what's stressing you out (in this case, the looming social work licensing exam).

B are your beliefs about the exam (e.g., "I don't have enough time to study." "I'm terrible at multiple choice tests." "I'm going to fail").

C are the consequences these thoughts lead to--emotional, physical, and behavioral (e.g, worried (emo), rapid heartbeat (phys), procrastinating (bx)).

D is for disputes--thoughts you can use to challenge the beliefs from B. Usually you can just say the opposite, and give some supporting evidence. CBT is about facts on the ground (not in your head). For the thoughts mentioned above, that might look like this:

"I do have enough time to study--I just have to wake up earlier or study during lunch."

"I'm not terrible at multiple choice tests. They make me anxious, but I've passed a bunch of them in the past. If I was so terrible with school stuff, I wouldn't have an MSW and wouldn't be preparing for this exam in the first place."

"I can't tell the future; I don't know if I'm going to fail or not. If I get focused, study, manage my anxiety, and all that other good stuff, I have a good shot at passing the exam. Thousands of people pass this exam every year. They're no smarter than me. They're not better social workers than me. Even if I don't pass this time, I can retake the test. Eventually, I will be licensed. Then I'll look back and laugh."

Try using this ABCD to get ready for the onslaught of ABCD answers you'll face on the exam. Maybe it'll help some. Write it out or think it through--either way. But you know what works best to keep you steadied and serene. You've seen what works for clients. Usually increased self-care is part of the package--more exercise, better food, progressive muscle relaxation, meditation... Decreasing anxiety isn't one size fits all. But you're a social worker. You know it's doable. Like social workers tell clients all the time, anxiety is very treatable. That goes for yours too.

Good luck!