Exam DSM: Culture-Bound Syndromes

Here's a category filled with items you're more likely to encounter on the social work licensing exam than you necessarily might in day-to-day social work practice: Culture-bound syndromes.

The DSM has a long list of syndromes that are typical of people from certain cultures or places.  Exam writers may lean toward including them as a way to test for both DSM depth and general cultural awareness. A conscientious exam writer might reasonably be expected to favor the more common of the syndromes--those specific to populations largely represented in the U.S. and Canada--Latinos, for instance (that would include nervios and susto).

You don't need to memorize the whole list of syndromes. Just have a passing acquaintance--enough so that you'll recognize them by name if they do come up on the exam. Here are some handy places to get brushed up on culture-bound syndromes on the web:

• Culture-Bound Syndrome (Wikipedia)
• Culture-Bound Syndromes Flash Cards (Quizlet)
• DSM-IV Culture-Bound Syndromes (Psychxi)

Good luck on the exam!

Q&A: How many questions on the social work exam? What score do I need to pass?

Some questions pop up from time to time in email and as search terms that show up in site stats. Here are a couple of regulars:

Q: How many questions are there on the social work exam?

A: Two answers: 170 or 200. It's 170 for all ASWB administered exams, 200 for the standard written exam administered by the California BBS. Which is you? If you're in California, 200. Everywhere else, 170. You know who you are.

Note: Not all of the exam questions account toward your score. Some are testers (20 on the ASWB, --their usefulness is being gauged before they're made real questions on some future exam. There's no way to know which questions are testers, so you may as well treat them all as real. That said, keeping in mind that some questions are testers can help you maintain calm and composure if you hit a few questions that makes no sense or seem way too hard or that you just don't know. Just shrug it off--"Must be a tester"--make your best guess and move on.

Q: What score do I need to pass the social work exam?

A: Depends upon the state. States set their own pass rates--check with your state board to get a precise number if you want it.  Passing percentages tend to land in the 70-75% range. So, for a state with a 72% requirement, that's 122 out of 170 or 108 out of 150 (excluding testers). For those preparing with online practice exams (a good idea), a good guideline is to aim for percentages coming in at high 70s/low 80s before going to sit for the real thing.

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Exam DSM: Depression

It's very unlikely that you're going to get past the social work licensing exam without encountering a question that deals one way or another with symptoms of depression. While some culture-bound symptoms and other things you may never encounter in day-to-day practice may also show up, what kind of exam would it be without including this fundamental mental health scourge? You probably already know everything you need to know about depression to get through these questions on the exam, but just in case, below are some places to go for some quick review. Run your eyes back over the criteria, sure, but questions on the social work exam are most likely to deal with areas where depression intersects with safety, ethics, and law. When do you refer for medication...for hospitalization...how do you assess for suicide risk? What's the best way to treat depression? Read up!

• Depression at NIMH
• Major depressive disorder at Wikipedia 
• Depression at PsychCentral

And here's a bonus link--a conversation about social workers and depression from the Social Work Podcast.

Exam DSM: Bipolar Disorder

Here's another DSM dx that you shouldn't be surprised to find on the social work licensing exam--not any more surprised than you'd be to find it in any social work job setting. Along with being essential diagnostic knowledge for social workers, bipolar disorder has the extra allure for exam writers of involving extra vocabulary with which they can fill exam question--manic...hypomanic...bipolar I...bipolar II. Worth knowing, worth reviewing.

Get extra familiar with bipolar disorder here:

• NIMH Bipolar Disorder
• Psych Central Bipolar Disorder
• Wikipedia Bipolar Disorder

Exam DSM: Anxiety Disorders

Anxiety disorders make up a huge part of what social workers see in clinical settings (and out of them, for that matter). It's a good bet that you'll see questions covering anxiety disorders on the social work licensing exam. Remember, you don't need to know every detail about each anxiety disorder--especially the more obscure details. But why not enter the exam (and work...and life) armed with a basic knowledge of how they're categorized, diagnosed, and treated. Sounds more complicated than it is. For example: category: OCD, dx: symptoms (obsessions, compulsions), tx: CBT, exposure, etc.  Here are some places on the web to do some anxiety brushing up:

• Anxiety Disorders at NIMH
• Anxiety Disorder at Wikipedia
• Anxiety Disorders at WebMD

Exam DSM: Global Assessment of Functioning (GAF)

Have you had to "GAF" someone in your clinical work? If so, great, you're ready for an Axis V question if it comes up on the social work licensing exam. If  not, you can get up to speed very quickly.  Just take a look at the scale, posted and explained on these sites and others

• GAF @ Wikipedia
• The Five Axes @ PsyWeb
• GAF Training via Washington State

What number would you give yourself today? When you were at your worst? At your best? How about someone you know or know of who is really struggling--no work, few friends, addiction... Where would they land if you were called to assign them a number on the Global Assessment of Functioning scale.

It can feel odd for social workers to have to label a client with such a definitive-sounding measure. Social workers are generally looking to remove labels and to avoid pathologizing clients. But the GAF is part of the DSM and part of clinical social work practice, especially when insurance companies are involved. And so it's part of the knowledge you might reasonably be expected to have as you arrive at exam day. You probably won't be expected to know exactly what a given number means, but just to have a general sense of how the GAF works, what's high, what's low, what's what. If you've read through once, now you do!

Exam DSM: Personality Disorders

The DSM is huge. There's way too much information in there for you to have completely memorized, or to come even close. Wiser thing to do as you're approaching the social work licensing exam, try imagining what you'd do if you were writing the exam.

What diagnoses are crucial to know about for carrying out day-to-day social work? Is it really important that every social worker have a handle on every obscure diagnosis? Not really. If something unfamiliar presents itself, they can look it up. Better that they are familiar with the diagnoses that most commonly turn up in social work settings. You know the ones: mood disorders, substance abuse disorders, psychotic disorders, disorders particular to specific groups (e.g., children and the elderly). And, of course, the focus of the links below, personality disorders. You know these when you see them; here are some places to brush up on the details:

• PsychCentral Personality Disorders
• Wikipedia Personality Disorders
• Medline Personality Disorders

Enjoy and good luck on the exam!