Training of Psychiatric Social Workers


Lesson 9


Short Answer


1. Compare and contrast the training of psychiatric social workers, clinical psychologists, and psychiatrists.


Psychiatric social worker is a mental health professional whose specialized training prepares him/her to consider the social context of people’s problem. He/she is trained to consider the social contexts of people problems, so these practitioners may involve family members in the therapy or at least become acquainted with clients’ homes or work settings. Clinical psychologist is an individual who has earned a doctorate in psychology and whose training is in the assessment and treatment of psychological problems. Psychiatrist is an individual who has obtained an M.D. degree and also has completed postdoctoral specially training in mental and emotional disorders; a psychiatrist may prescribe medications for the treatment pf psychological disorders.


2. What symptoms in schizophrenia do antipsychotic alter? List the names of two different antipsychotic drugs. What are some of the side effects of antipsychotic drugs.


Antipsychotic alters the schizophrenic symptoms of delusions, hallucinations, social withdrawal, and occasional agitation. Antipsychotic drugs work by reducing the activity of the neurotransmitter dopamine in the brain; chlorpromazine blocks or reduces the sensitivity of dopamine receptors. Clozapine directly decreases dopamine activity and increases the level of serotonin activity, which inhabits the dopamine system. The side effect of these drugs is that they decrease the overall level of brain activity. And, since dopamine is important in motor control, muscle disturbances often occur, which the patients may have involuntary movement of jaw, lip, and tongue.


3. Describe the therapist’s major tasks in providing Freudian psychoanalysis. Provide examples.


Freudian psychoanalysis is the form of psychodynamic therapy developed by Sigmund Freud, that is an intensive and prolonged technique for exploring unconscious motivations and conflicts in neurotic, anxiety-ridden individuals. The main tasks are to resolve adequately the inner conflicts between the unconscious, irrational impulses of the id and the internalized social constraints imposed by the superego. The goal of psychoanalysis is to establish intrapsychic harmony that expands awareness of the forces of the id, reduces overcompliance with the demands of the superego, and strengthens the role of ego. The main ways are free association and catharsis, dream analysis, transference and countertransference.


4. Define transference. Discuss its importance in psychodynamic therapy.


Transference is the process by which a person in psychoanalysis attaches a therapist feelings formerly held toward some significant person who figured in a past emotional conflict. During the therapy of psychoanalysis, the patient usually develops an emotional reaction toward the therapist. The therapist is identified with a person who has been at the center of an emotional conflict in the past. Then the patient can attach the emotion to the subject by transference, which a therapist helps a patient to interpret the present transferred feelings by understanding their original source in earlier experiences and attitudes.


5. Discuss how psychodynamic and behavior therapists view the nation of symptom substitution.


Psychodynamic therapies assume that a patient’s problems have been caused by the psychological tension between unconscious impulses and the constraints of one’s situation. These therapies locate the core of the disorder inside the disturbed person. Behaviour therapies focus on observable outer behaviours. Behaviour therapists argue that abnormal behaviours are acquired through a learning process that follows the basic principles of conditioning and learning. Psychodynamic therapists predict that treating the outer behaviours only while leaving the inner problems unsolved will result in symptom substitution, which is the appearance of a new physical or psychological problem. Behaviour therapy is good at curing deviant behaviours and personal problems which include fears, compulsions, depression etc., and it is better in curing specific personal problems than general problems.


6. Describe how a token economy operates. In what situations is this type of intervention used? Be sure to discuss the use of behavioral contracts as a component of this treatment.


Token economies are a positive reinforcement strategy in contingency management that desired behaviors are explicitly defined, and token payoffs are given by institutional staff when the behaviors are performed. These tokens can later be exchanged for some rewards and privileges. This system is found effective in modifying patients’ behaviors regarding self-care, upkeep of their environment, and frequency of their positive social interactions.


7. Describe what is meant by social skills training. Provide your own example.


Social skills