AMFTRB Comprehensive Exam | Questions & Answers (100 %Score) Latest Updated
2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions
Definition of Crisis - A situation in which client's goals/intentions are interrupted in such a way that they
cause an emotional response from client; person may feel fear, anger, shock, anguish about the
situation
Four Phases When dealing with crisis - 1. Crisis occurs, client responds, often in negative manner that
involves difficult feelings
2. Client may then become more frustrated/stressed, depending on the continuation of crisis situation
3. Some clients easy their own tension about situation depending on how they handle it; instituting
coping mechanisms, acting out in fear/anger, giving up, attempting to solve the problem
4. Situation surrounding crisis is somehow resolved, whether it is because the client successfully dealt
with situation, repressed/avoided managing it
Crisis Intervention - Stepping into a potentially harmful/stressful situation to avoid escalation on part of
client
First, assess situation to determine if client/anyone else is in danger
Then, decide what type of help is most appropriate
EX: critical event (suicide) requires swift/successful intervention, not a support group
Then carry out necessary treatment/help
Help client become calm to talk about feelings/identify coping mechanisms
Stabilize situation and bring client down from state of crisis
Crisis Intervention Approach to Social Work Practice - - Psychodynamic, ego psychology (Freud, Erikson,
Rapoport) and Lindemann's work on loss/grief
- Intellectual development (Piaget)
- Social science: stress theory, family structure, role theory
Human Behavior Assumptions in Crisis Intervention Approach - - Individual has tendency to a natural
progressive growth the prevails over regression
- Stress during crisis induces disequilibrium/anxiety that allow therapeutic accessibility; crisis can create
opportunities to develop new coping mechanisms/growth or give rise to dysfunctional behavior
,- Crisis occurs when established coping skills dont resolve stress effectively; crisis inflicts an array of
affective, cognitive, behavioral tasks; crisis can reactivate old problems
- An individual in crisis is not ill but is dealing with a challenge that is part of the human condition; crisis
therapist doesnt necessarily assume the presence of a pathological/DSM disorder; individual in crisis is
affected by the past but present situation is more relevant
Critical Incident Stress Debriefing - Designed as a meeting for involved professionals following a stressful
event/crisis
Takes place as soon as possible after event
Give them a chance to express feelings about event
Designed to avoid buildup of stressful emotions/negative feelings rather than repress/move on
Feelings, fears, concerns of those involved can be addressed
Support - The provision of feelings of comfort/understanding for a person in position of distress
Eases psychological burden associated with stress/confusion
Higher sense of well-being knowing there is someone who understands, will listen, can help in time of
need
May come from several sources
Actual helping relationship is one source of providing support; Client speaks with/relies on therapist to
discuss emotional needs/feelings
May occur when therapist provides help through physical action rather than just listening
Finally, may support client in crisis; emergency support helps client manage feelings and prevent further
harm
Grief - Reaction associated with loss
May or may not be immediate after an event
Therapist should understand certain characteristics of grief in order to identify behaviors/activities and
better help client
Physical Characteristics: weakness, increased pain, sleep disturbance, loss of appetite
Emotional reactions: crying, anger, withdrawal, lack of warmth toward others, distracted behavior
Manifest in: restless behavior, irritability, exaggerated responses to minor incidents
Feelings reported: guilt, intense sadness, confusion, despair
,Working through steps of grief may eventually lead to acceptance of the situation
--Could be applied to client struggling with personal conflict/disappointment with a situation
Initially client should accept working through grief is a process and resolution is not instant
Second, help client express feelings associated with grief through discussing emotions
Work through negative feelings to prevent continued pain through memories
Learn how to liven in new environment through practical experience/management of emotions
Finally, learn how to forge ahead to new things (developing new relationships, changing careers,
hobbies)
Reassurance - Affirming/encouraging another person through verbal responses
Validate client, provide support through managing confusion, making decisions, experiencing setbacks
Remind client of strategies learned for coping with challenging situations
Reduces client's stress level through affirmation
Goals are to increase client's levels of confidence, remind client of work/positive outcomes discussed
during helping relationship, to decrease client's level of anxiety to mobilize them to action, remind client
of strengths/positive attributes that instill greater self-assurance for future decisions
External Stress, Internal Distress, Transitional State - Categorized according to cause of the stress
Some conditions are beyond client's control while others result from personal choice
External stress factors: can cause crisis, are beyond power of client to control; ex: crimes committed
against client, unemployment, natural disasters, illness, loss, bereavement
Internal Distress: result of external factors; based on how client responds to stress/crisis; ex: depression,
hopelessness, suicidal ideation
Transitional States: cause stress for client and may/may not be related to personal choice; ex: job
changes, divorce, relocation, having a baby
Reactive Attachment Disorder - child rarely seeks/responds to comfort when upset, usually due to
neglect of emotional needs by caregiver (foster/institutionalized child)
Disinhibited Social Engagement Disorder - child has decreased hesitations regarding interacting with
unfamiliar adults
Doesnt question leaving normal caregiver to go off with stranger
, posttraumatic stress disorder (PTSD) - persistently re-experiencing a severe trauma for MORE than ONE
MONTH
Individual exhibits arousal-anxiety symptoms, avoidance of things associated with trauma/numbness
Acute Stress Disorder - anxiety and dissociative symptoms develop WITHIN ONE MONTH of experiencing
trauma
Adjustment Disorder - client has behavior/emotional changes occurring WITH 3 MONTHS of a stressor
These changes can cause distress for the client and are disproportional to actual stressor
Trauma-Related Social Work Practice with Adults - - Trauma victim experiences threat to physical
integrity/life; trauma experience confronts person with extreme situation of fear/helplessness
- Trauma may be chronic/repeated/may take form of one event of short duration
- Many symptoms related to PTSD/domestic violence are self-protective attempts at coping with realistic
threats
Human Behavior Assumptions for Trauma-related social work practice - - Most individuals experience
world as a basically safe place in which they are worthy participants
- Trauma can challenge/reverse these assumptions about world and oneself
- Resilience: an innate capacity to self-regulate after experiencing a stressor so extreme its traumatic
- Resilience is derived from both internal/environmental resources
- Resilience can be more difficult to achieve/sustain when trauma is more severe, is chronic, and/or
when the perp is someone who should be a caretaker/trusted protector
Physical Abuse - Extreme physical discipline that exceeds normative community standards
Physical indicators: bruises/broken bones on infant without adequate explanation or in unusual places;
lacerations; fractures; burns in odd patterns; head injuries; internal injuries; open sores; untreated
wounds/illnesses
Behavioral Indicators: overly compliant, passive, undemanding, overly aggressive, demanding, hostile,
role reversal behavior, extremely dependent behavior re: parental, emotional, physical needs;
developmental delays
