Presenter: Jennifer D. Street, LCSW
Class Meeting Week Eight
Welcome
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Agenda
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 Agenda
 Announcements
 Learning Goals
 Resource of the Week
 Is it ethical??
 Practice Behaviors
 Review Questions
 Chapter 8 Learning Activities
 Questions
 Wrap-Up
Announcements
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 Mid-Term Discussion
 Biopsychosocialspiritual assessment is based on the video of the case of Jane
 Clarify Grading
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DQ 1=10
DQ3=10
Week 4 Engagement/Paraphrasing=20
Week 6 Rx Planning=10
DQ 14=10
Biopsychosocialspiritual Assessment=100
Case Presentation=100
Video Tape Skills Demo=100
Video Tape Analysis Paper=100
Mid-Term=100
Final=100
TOTAL 660
 Mid-Term reminder of policies:
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3.0 Cumulative GPA
Attendance Requirements
Biopsychosocialspiritual
Assessment
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Module 8 Assignment: Bio-psycho-social-spiritual assessment
The Biopsychosocialspiritual assessment paper is due next week by Sunday at 11:59. You can start working on
the paper this week. Click on links below to view the video and the assignment instructions.
Students will observe a video in class from which you will develop a bio-psycho-social-spiritual assessment and
intervention plan. An outline to follow for this assignment is attached to this assignment. The paper length is
approximately seven (7) pages. 2. Students will select a theoretical approach from class (behavioral, clientcentered, cognitive, ego psychology, systems, etc) as a foundation for the assessment. 3. Write a one-page
discussion of the rationale for selecting this approach, i.e. how did you select this method for working with this
client? What research exists that supports your choice? Include at least 2 references to support your choice. The
one page discussion of the theoretical approach will be the first page of the Bio-psycho-social-spiritual
Assessment. 4. The following five pages of the paper will be the Bio-psycho-social-spiritual Assessment that
includes two measurable goals and objectives. This would be the type of report that might be used for a custody
evaluation or in-patient assessment. Use the format attached to this assignment for your assessment. 5. The final
part of this assignment will be a condensed Bio-psycho-social diagnostic summary, similar to one that might be
found in a medical hospital chart. This would highlight what is viewed as the most important aspects of the five
page in-depth assessment - utilize the format attached to this assignment for your diagnostic summary.
SWK530_Biopsychosocial_diagnostic_summary_format.doc
SWK530_Biopsychosocialspiritual_Assessment_Rubric.pdf
SWK530_Biopsychosocialspiritual_Assessment_Guideline.doc
The Case of Jane
http://www.edb.utexas.edu/faculty/rochlen/TheoriesApp/person/person_jane.html
Learning Goals
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By the end of class today, students will be able to:
 Identify and exemplify practice behaviors 33, 34, 35
& 38
 Utilize the “Six Anger Styles” with a client
 Demonstrate competence in ethical decision making
 Teach stress management coping skills to a client
 Complete assessment questions related to chapter 8
 Understand and demonstrate mastery of client
coping skills
Practice Behaviors
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33. Assess client strengths and limitations
34. Develop mutually agreed-on intervention goals and objectives
35. Select appropriate intervention strategies
38. Help clients resolve problems
Resource of the Week
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Six Anger Styles
Six Anger Styles
STUFFERS
Stuffers are conflict avoiders, people who deny
or bury their anger; their motto is “peace at any
price.” They often have lots of tension under the
surface. The underlying problem is never
addressed and therefore can’t be solved. People
who stuff their anger may become depressed,
or they may become physically sick, with
stomachaches, headaches, or other physical
complaints. Teens who have parents who stuff
their anger don’t have the opportunity to learn
how to problem-solve.
WITHDRAWERS
Withdrawers use passive-aggressive means to
express their anger. The term passive-aggressive
means expressing anger in subtle, indirect ways.
Some husbands are passive-aggressive; they
don’t talk to their wives for days when they are
angry. Some teens that are angry about a divorce
express their anger by letting their grades go
down. Or some teens who are angry at their
parents show their anger by not doing their
chores or by not doing what they are told. These
are subtle, not obvious, ways to show anger.
Sometimes the withdrawers hurt themselves the
most by their withdrawing – they suffer the
consequences of not having a closer relationship
when they don’t communicate. They suffer the
consequences of low grades. When parents are
passive-aggressive, or withdrawn, their children
often feel guilty and responsible, and they are
always wondering what they’ve done wrong.
People who withdraw, also miss out on using
their anger to work for them. They don’t solve
the underlying problem.
BLAMERS
express their anger by letting their grades go
down. Or some teens who are angry at their
parents show their anger by not doing their
chores or by not doing what they are told. These
are subtle, not obvious, ways to show anger.
often feel guilty and responsible, and they are
always wondering what they’ve done wrong.
People who withdraw, also miss out on using
their anger to work for them. They don’t solve
the underlying problem.
BLAMERS
Blamers express their anger by blaming their
problems on other people by name calling, by
attacking, or by putting other people down.
Teens often blame their problems on their peers,
their siblings, their parents, or their teachers.
Parents often blame their problems on their
children, their spouse, their own parents, or their
work situation. Teenagers in families where one
or both parents are blamers may have low selfesteem because they begin to believe what they
are told. They may feel guilty and responsible
for the family problems. Or they may become
blamers, too, and never take responsibility for
their own behavior.
TRIANGLERS
Trianglers express their anger in devious and
manipulative ways. Instead of expressing their
anger directly, they pull someone else in, or they
try to get someone else to be angry. For
instance, a mother who is angry with her
husband may tell her son what the husband has
done, so the son will be angry with the husband
too.
Adolescents often use triangling. For example,
Jenny might be angry because her best friend,
Stephanie, said something to hurt her feelings.
Rather than dealing with Stephanie directly,
Jenny tells another friend, Maggie, something
bad about Stephanie so that Maggie is mad at
Stephanie too. In families where there are
trianglers, a lot of tension may be below the
surface. Kids may have the feeling that they or
someone else has done something wrong, but
they don’t know what.
EXPLODERS
Exploders use violence to express anger. This
may range from pushing, shoving, kicking, and
slapping to hitting, punching, choking, using a
weapon, or even killing. These are all harmful
behaviors. Teens who grow up in violent
families are often scared that they or someone
else is going to get hurt. They often intervene in
order to rescue one parent, and sometimes the
teens get hurt as well. Sometimes violent
parents get angry at teens who try to rescue. If a
teenage daughter is very close to a mother who is
beaten by the father, the girl might believe that
she should be beaten, too, and may not be able to
set limits when she starts dating. Children in
violent families worry about divorce; they also
worry that someone will be hurt fatally and that
the violent parent will go to jail. Violent parents
are often unpredictable in their violence. Their
children never know what to expect. They are
often hypervigilant, constantly scanning the
mood of the violent parent, or of the family, to
help them predict whether this is a safe time.
Sometimes after violent fights with each other,
the parents might get mad at the children,
ignoring them, sending them to their rooms, or
taking their anger out on them. Sometimes the
parent directs the violence to the oldest son or
daughter, sometimes with the other parent
watching. Teens in this position often wonder
why their mother stands by and allows them to
be beaten by their father. Teens in violent
families often think their families are “different”
and wish they could be like other families that
they think are happy. Teens in these families
also sometimes feel ashamed of their families,
and ashamed of themselves, thinking something
is the matter with them.
PROBLEM SOLVERS
Problem solvers can admit that they are angry
and they look at why they are angry. They put
thinking between their feelings and their
behavior. They see if they are angry about a
problem they can solve; if so, they use their
anger to give them power to change themselves.
Problem solvers use their problem-solving skills
in anger situations. If problem solvers have a
problem they can’t solve, they express their
anger in helpful ways so they can let go. Teens
who grow up in families where the parents are
problem solvers will learn how to problem-solve
when they are angry. They learn the
consequences of their behavior; they don’t feel
put down; they feel safe; and they learn to use
their anger to work for them.
Is It Ethical????
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Is it ethical???
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Scenario 4: “Cynthia is an outpatient therapist at a
hospital and has a client she sees for obsessive
compulsive disorder. The client is a successful business
man with several companies, and he offers her an
unbelievable chance to invest in a company he just
started that has the potential to make millions. Cynthia
refuses to talk about it during the session, but she
arranges to meet him for coffee after work. She decides
to invest in this new company.”
Taken from Horn, Thomas © 2011 “Is it ethical?: 101 Scenarios in everyday social work practice, a discussion workbook”
Is it ethical???, cont’d
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 Is Cynthia engaging in ethical behavior? If so,
explain your reasoning. If not, explain.
 How might this arrangement effect their therapeutic
relationship?
 How should Cynthia handle this ethical dilemma?
Taken from Horn, Thomas © 2011 “Is it ethical?: 101 Scenarios in everyday social work practice, a discussion workbook”
Chapter Eight
Highlights
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Role Play a client/counselor session in which you are assessing for the
impact of stress on your client and then teaching a stress management
skill of the client’s choosing:
Positive Imagery
Breathing Exercises
Muscle Relaxation
You have 10 minutes to be the client and 10 minutes to be the therapist
Review Questions
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Question 1
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 1) According to Burns (1990), a person diagnosed
with an alcohol or drug dependent disorder may
state, "I'll only have one beer. That won't hurt me. In
fact, I’ll feel better" This is an example of which
cognitive distortion?
A) Denial
B) Fortune telling
C) Emotional reasoning
D) None of the above.
Question 2
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2.) Lang and Jakubowski discuss five different types of
assertion. Which of the following is NOT one of the types?
A) Basic assertion
B) Confrontative assertion
C) Aggressive assertion
D) Empathic assertion.
The ToolBox
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Teaching Client’s Coping Skills
Let’s practice…
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In what type of client or client situation would you use
the following strategies?
 Cognitive therapy(cognitive distortions, negative selftalk, rational responses)
 Assertiveness Training
 Anger Management
 Stress Management
 Stress Inoculation
 Crisis Management
 Dialectical Behavior Therapy
 Motivational Interviewing (transtheoretical)
Exercise
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Role Play 1
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 Divide into pairs. Practice using ego-supportive
techniques with a client who is experiencing feelings
of anger toward his/her boss.
Role Play 2
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 With a partner in a role play situation, practice using
the three steps of systematic desensitization with a
client experiencing generalized anxiety.
Role Play 3
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 Establish a token economy for an eight year old child
diagnosed with autism. Include schedules for
reinforcement, thinning, shaping, and time-out from
reinforcement. The primary goal is to assist the client
in improving skills for potty training.
Role Play 4
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 While working in pairs, practice educating the
person role playing a client regarding the concepts
associated with the ABC model of cognitive therapy.
Then practice using both cognitive and behavioral
techniques to help improve the client’s depressed
mood.
Questions?
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Did we meet our learning goals???
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By the end of class today, students will be able to:
 Identify and exemplify practice behaviors 33, 34, 35
& 38
 Utilize the “Six Anger Styles” with a client
 Demonstrate competence in ethical decision making
 Teach stress management coping skills to a client
 Complete assessment questions related to chapter 8
 Understand and demonstrate mastery of client
coping skills
For Next Week…
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At this point, you should have completed everything from
Modules 1-8
This week, complete:
 Module 9
 Turn in Biospychosocialspiritual assessment
Have a great week!
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