SWGS 6439 Take-home Midterm - Spring 2024 (1).docx

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Fordham University Graduate School of Social Service SWG 6439 – Evidence-Based Practice with Children and Families Take Home Midterm Examination Spring, 2024 Name: Maria Swayne Each multiple-choice, fill-in-the-blank, and true/false question is worth 2 points. Please bold your answer choice. 1. How does MST aim to reduce long-term rates of criminal behavior? A) By relocating individuals to new communities B) Through intensive supervision C) By focusing on changing the youth's natural ecology D) By providing legal education 2. Which of the following actions is not one of the five steps of evidence-based practice? A) Appraising B) Applying C) Assimilating D) Asking E) Analyzing F) Acquiring 3. What is the primary goal of evidence-based practice (EBP) in social work? A) Maximizing profits for social service agencies B) Reducing the workload of social workers C) Providing interventions and services based on research and empirical evidence D) Promoting traditional methods regardless of their effectiveness 4. True or False: In Family systems therapy, the symptom bearer is always the problem within the family that needs to be changed. 5. During Functional Family Therapy, therapists typically: A) Use confrontational techniques B) Avoid discussing sensitive family issues C) Work collaboratively with family members to set goals D) Focus on individual therapy techniques Final - 1

6. Which outcome is MST specifically designed to improve? A) Academic grades B) Family functioning and youth behavior C) Professional skills D) Physical health 7. Which of the following is a primary eligibility criterion for receiving Intensive In-home Child and Adolescent Psychiatric services? A) Having a diagnosis of a physical illness B) Being over the age of 65 C) Demonstrating a risk of harm to oneself or others D) Having a high income level 8. MDFT was developed to treat: A) Marital conflicts B) Substance abuse in adolescents C) Geriatric cognitive disorders D) Individual adult psychopathology 9. Which of the following is a key component of MST? A) Medication management B) Individual therapy C) Family and community-based interventions D) Inpatient hospitalization 10. Which of the following is a key component of evidence-based practice in social work? A) Relying solely on personal experience and intuition B) Utilizing client feedback exclusively C) Integrating professional judgment, client preferences, and the best available research evidence D) Following the same interventions for every client regardless of their needs 11. MDFT is effective in: A) Decreasing adolescent substance use B) Improving family functioning C) Reducing behavioral problems in school D) All of the above Final - 2

12. How can social workers ensure cultural competence while implementing evidence-based practice? A) By disregarding cultural differences in favor of standardized interventions B) By relying solely on their personal cultural backgrounds C) By integrating cultural considerations into the selection and adaptation of evidence-based interventions D) By avoiding working with clients from diverse cultural backgrounds 13. In MDFT, therapy sessions typically involve: A) Only the individual adolescent B) Only the parents or guardians C) Separate and joint sessions with adolescents, parent(s), and the family D) Group therapy with unrelated individuals 14. What is the difference between efficacy studies and effectiveness studies? Efficacy studies are completed in a well-controlled research context , and effectiveness studies are completed in the “real world” clinical setting . 15. What is the primary goal of Intensive In-home Child and Adolescent Psychiatric services? A) Providing long-term residential care B) Offering brief outpatient therapy C) Facilitating stabilization and support within the home environment D) Conducting academic tutoring sessions 16. Which of the following is a primary focus of Intensive In-home Child and Adolescent Psychiatric services? A) Isolating the child from family members B) Enhancing coping skills and problem-solving abilities C) Reducing parental involvement in treatment D) Administering long-term residential care 17. What does the term "best available research evidence" refer to in evidence-based practice? A) The research evidence that supports the social worker's personal beliefs B) The most recent research studies published in reputable journals C) The research evidence that aligns with the preferences of the social work organization D) The highest quality research evidence applicable to the specific context and needs of the client population Final - 3

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18. Who are the primary recipients of Intensive In-home Child and Adolescent Psychiatric services? A) Young adults aged 18-25 B) Children and adolescents with severe emotional or behavioral challenges C) Senior citizens with dementia D) Middle-aged individuals with depression 19. MDFT therapists work on improving: A) Communication between family members B) Parenting practices C) Adolescent's problem-solving skills D) All of the above 20. Functional Family Therapy is particularly effective in treating: A) Schizophrenia B) Juvenile delinquency and substance abuse C) Marital issues in older adults D) Career-related stress 21. How are treatment goals determined in Intensive In-home Child and Adolescent Psychiatric services? A) Solely by the child or adolescent B) Through collaboration between the treatment team and family members C) By the insurance company D) By the primary care physician 22. Which of the following is NOT typically provided by Intensive In-home Child and Adolescent Psychiatric services? A) Medication management B) Family therapy C) Inpatient hospitalization D) Crisis intervention 23. MDFT is based on which theoretical framework? A) Cognitive-Behavioral Theory B) Psychoanalytic Theory C) Systemic Family Therapy D) Humanistic Therapy Final - 4

24. How long does the typical course of treatment last in Intensive In-home Child and Adolescent Psychiatric services? A) 6 months B) 1 to 3 months C) 3 to 5 years D) Indefinitely 25. Functional Family Therapy is primarily designed to address issues in what population? A) Elderly couples B) Adolescents with behavioral and emotional problems C) Adults with anxiety disorders D) Young children under 10 26. Which of the following is a key component of Functional Family Therapy? A) Long-term hospitalization of adolescents B) Medication management for the entire family C) Improving family communication and support D) Individual therapy sessions excluding family members 27. Which is not a characteristic of a successful clinician within in-home family treatment? A) Following protocols B) Embracing an “approach” C) Working Sequentially D) Ensuring Client Accountability 28. Functional Family Therapy therapy typically includes: A) Only individual sessions with the adolescent B) Only group sessions with other troubled youths C) Family sessions with all members of the immediate family D) Sessions with extended family and community members 29. What is a key advantage of Intensive In-home Child and Adolescent Psychiatric services over traditional outpatient therapy? A) Lower cost B) Greater frequency and intensity of services C) Access to specialized medication D) Limited involvement of family members Final - 5

30. The primary goal of Functional Family Therapy is to: A) Identify the troubled youth as the sole problem within the family B) Change negative family behavioral patterns C) Focus on past traumas of individual family members D) Encourage family members to live independently 31. Functional Family Therapy therapists focus on: A) Blaming family members for problems B) Understanding and respecting individual family roles C) Promoting separation in dysfunctional families D) Focusing therapy on the youngest family member 32. Which is not an area of focus for structural family therapy: A) Enactment B) Restructuring C) Assessment of boundaries D) Assessing individual’s specific issues Short Answer Questions 1. Explain why there continues to be an emphasis in the behavioral health field on implementing or delivering evidence-based practices. (2 pts.) There continues to be an emphasis in the behavioral health field on implementing or delivering evidence-based practices because it is proven more effective in improving client outcomes . Evidence-based practices are specific interventions that have already met a defined set of research standards. It consists of clearly defined intervention parameters, such as a treatment manual and required training in the specific model with its specified set of tools. Using evidence-based practices in the behavioral health field allows clinicians to provide their clients with the best possible care by delivering treatment from an established framework supported by empirical evidence that can help meet clients’ specific needs. Evidence-based practices can help avoid providing ineffective treatment and making incorrect diagnoses. 2. Consider what might be different about delivering services in your office instead of in a client’s home. Provide a brief description of how you would approach entering a family’s home the first time, which would help increase both your comfort and the potential ambivalence the family might have about having you in their home. (2 pts.) The “rules” and parameters of therapeutic work differ when practiced in an office versus within a client’s home. As clinicians, we must be mindful of these considerations to practice in a way that is comfortable for ourselves and respectful to the client and their family. I must admit that when delivering services in my office, I would feel more comfortable and in control of my surroundings. Yet, I would feel the opposite when providing services in a client’s home. For example, I would feel like I have less control due Final - 6

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to safety concerns, interruptions, distractions in daily living, and confidentiality concerns. It could also be challenging to clarify and maintain professional-client boundaries. However, there are advantages to seeing a client in their own home, such as eliminating the barriers to accessing clinic-based services. It allows the client and their family to be in a more comfortable and familiar setting, increases the opportunity to involve all family members as needed, and also increases the opportunity to identify natural supports within the family’s ecology. It also allows the therapist to observe behavior in a less artificial context and provide feedback and guidance that is informed by the family’s natural context. I would approach entering a family’s home for the first time by negotiating the parameters and entering the family’s context with respect. I would be honest and transparent when introducing myself and clarifying my role and the purpose of my visit. I would increase their comfort by being open and honest about the process. I would let them know that I am there to help them through this challenging moment by following a treatment model that has proven to help many children and families like theirs. I would continue with explaining our course of treatment in more detail to ease their anxiety and ensure they fully understand it by answering any questions and addressing any concerns. 3. Given the intensity of service delivery of models like MST, MDFT, and IICAPS and the severity of presenting concerns for those programs, it is most typical that the youth and family have already had other therapy experiences that might or might not have been perceived as helpful. They may even be ambivalent about entering another course of treatment. (5 pts.) a. How would you address that in the first session to set the expectation that working with you as the therapist for one of those models will be different? Provide three specific statements you will make or questions you will ask to help set expectations for the treatment being different and effective. During the first session, my use of active and reflective listening skills is essential to understanding the client and their family’s experience with therapy. I would gear towards open-ended questions to allow for self-reflection and ask them statements such as: 1. What did you enjoy or find useful in your previous therapy sessions? 2. What did you dislike or find not useful in your previous therapy sessions? 3. What do you wish to accomplish in this new course of treatment? I think statements 1 and 2 will allow the client and their family to reflect on their therapy experience as a whole and pinpoint what they actually enjoyed and disliked about their previous course of treatment instead of just saying statements such as, “I just did not like it” without giving some real thought about why that is the case. Meanwhile, statement number 3 will shift them from thinking about their past experiences and gear them to think about their future experience in therapy and the goals they wish to reach. Overall, I believe answers to these questions will allow me as a clinician to know if this course of treatment is the right fit for them or modify the course of treatment to provide the best treatment to the client and family. Final - 7

b. What statements might you make to increase parents’ motivation to be actively involved in treatment even though they may be exhausted or hopeless? Provide two specific statements. To do the following, I would be empathetic with the client and their family by validating and normalizing their feelings of feeling exhausted/hopeless. This will let them know that it is ok to have these feelings. I would say statements such as: 1. I realize you are feeling exhausted/hopeless, and it is okay to feel like that right now because you are dealing with a challenging situation. 2. I want you to know that you are not alone in feeling this way. Many of the families we see start off seeing are in the same place you are, feeling exhausted/hopeless. But I want you to know that many of these committed families do not end up feeling the same way. I would continue by explaining my role and experience as a clínician to give the client and their family full transparency and a sense of security. I would also explain our course of treatment to inform them what they’re getting into and what to expect. Lastly, I would share some success stories to let them know that they are not alone and give them hope that it can get better. 4. Go to the mstservices.com website. Read the four success stories of Allen, Tallah, Juan, and Anna and answer the following questions (8 pts.): a. Based on the research, why is MST a good fit for the presenting concerns bringing each of those families into treatment? Although each story of the client and their family is unique, MST was a good fit for presenting concerns bringing each family into treatment. This is because MST is a family-based, community-oriented treatment that effectively reduces juvenile crime and improves family functioning. MST also proves to be effective with families who have multiple risk factors for juvenile delinquency, such as poverty, violence, and substance abuse. MST is also a good fit for families who are struggling with other factoring issues contributing to the presenting concerns, such as mental health problems, family conflict, and parenting skills. b. What is similar about the approach/focus the therapists used in all four cases? The approach/focus the therapists used in all four cases was similar due to shifting their client’s focus on identifying their goals in treatment and helping them achieve them. The therapists also worked with their clients to establish a rapport based on full support and trust. This approach to creating a good therapeutic alliance was effective because it allowed the therapist to get to know the client and understand their needs. It also allowed the client to feel seen and heard. This kind of support is essential for clients to make progress in treatment. Final - 8

5. Consider a problem behavior you or a client have struggled with, and draw a fit circle illustrating the complexity of multiple systems that directly contribute to that behavior occurring or being sustained. Put the specific problem behavior you are addressing in the circle's center. You should have ten contributing drivers, with at least two contributing “drivers” each from an individual, family, peer, and ecological community context, and present them in a way that shows how the driver explicitly and directly influences the individual’s problem behavior . (8 pts.) 6. Go to MDFT.org. Once on the website, go to Proven Impact and then Case Studies. Choose one of the case studies and discuss how the MDFT therapist approached getting the parent(s) and youth to communicate with each other more effectively. Include strategies the therapist used in sessions with the youth alone, the parent(s) alone, and then with the parent(s) and youth together. (6 pts.) Joy's case study demonstrated an effective approach to the MDFT model. The therapist was able to treat the youth alone, the parents alone, and the parents and youth together effectively. When treating the youth alone, the therapist focused on building a foundation and engagement during this first stage. The therapist focused on Adolescent Engagement Intervention (AEI) and was able to encourage the youth to a collaborative process to formulate goals by presenting himself as her ally in this process by reaffirming to the youth that he would be part of this journey with her for the next several months and would also be helping her parents to assist her in the transitions she was facing. Also, the therapist asked the youth to share her perceptions of her life, where things had gotten off track, how she felt she would like her life to change, and how she saw her parents being able to help her in that process. This allowed the youth to voice her concerns and express her hopes. When treating the parents, the therapist spent time alone with the mom and stepfather and together as a couple. The therapist assessed current and past stressors and burdens as individuals and as a couple. The therapist also evaluated current and past parenting styles. The therapist found that parents disagreed about their basic parenting approach and spent time reflecting on their conflicts as a couple as well. The therapist allowed parents to be honest about their hurt and disappointments and worked with them Final - 9

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to determine what approach they would like to take as a parenting team. Throughout this process, the therapist encouraged parents to strengthen feelings of love and commitment and motivate them as individuals, a couple, and parents in this journey. When treating the youth and parents together, the therapist could assess family interactions and understand the family's journey and history. The therapist was able to do this by asking each family member to share their perceptions of the family’s strengths and things they liked about each other. He asked the parents to share positive memories of the youth to revitalize her parents’ feelings of love and commitment, highlight the youth’s many attractive characteristics, and build her competence and self-worth. The therapist also noticed the theme of the youth’s expected perfection in the family and facilitated a conversation about it. It allowed the youth to speak freely about feelings of high expectations of being perfect and being afraid to express any “negative emotions” to parents. This allowed the youth to move into the next stage of therapy, in which theme development and exploration intensified, and the therapist made requests for each family member to change. This case study presents the transition from adolescence into young adulthood. It describes the MDFT therapist’s role in helping teenagers and parents work through these issues and make the many changes necessary for successful preparation for this new life stage. 7. MST, MDFT, and IICAPS emphasize the importance of assessing the family's strengths and vulnerabilities and the broader social/ecological context surrounding the family. Identify three things you would want to consider/explore in the assessment or discussions with a family you are working with related to culture that will help you work most effectively with the family. How will you show the family that you value and respect their perspectives? (5 pts.) When working with families, having cultural competency as a clinician is essential. We deal with families from different backgrounds, values, beliefs, and traditions. To work effectively with them, a clinician needs to understand the client and family's culture. Exploring the family's values, beliefs, and traditions is necessary. I would also like to explore how their culture affects how the family communicates, how they interact with each other, and their outlook on the world. I would demonstrate to the family that I value and respect their perspectives by presenting as an open-minded clinician, respectful of their values and traditions, and always willing to learn about the family's culture. Final - 10

SWGS 6439 Take-home Midterm - Spring 2024 (1).docx

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