a social worker is seeing a client who has been living in a domestic violence shelter with her children after she experienced a major physical assault from her husband in front of the children the client informs the social worker that her children are not comfortable in the shelter and that she is planning to return home with them where her abusive husband still lives what should the social worker do first okay so the first thing i want to do knowing that this is a clinical intervention question because it's asking me what should the social worker do first is i want to determine where i am in the helping process which simply means um are you in the beginning um in the engagement or assessment phase are you in the middle where you're already working with the client and so forth so it just says that the social worker is seeing a client who has been living in a domestic violence shelter um so this doesn't tell me that whether or not i'm in the beginning whether or not i've been working with the client it's just saying that the social worker is seeing um the client so i don't know if this is a new relationship or something that's been going on so i'm not gonna assume i'm gonna move past that so now i'm gonna look for what is the presenting issue here and when i say presenting issue or the presenting problem i don't just mean what the client came in for or what the client is seeing the social worker about i want to know what is the most critical issue that we need to prioritize at this time now i stress that because the presenting problem sometimes can be multiple things so we need to learn how to or for aswb purposes we need to know how to prioritize the issues that the clients have and deal with the most critical issue first so we're looking for what is the most important issue that is taking place right now in the here and now that is going on with this client that we need to be addressing so um the fact that she's been living in the domestic violence shelter with the children after she experienced the major physical assault well first of all that is not going to be the presenting problem because it says after she experienced the major physical assault from her husband that means that already happened we're looking for something that is happening right now in the present so we do want to consider the whole situation but we want to focus on what's going on in the present because that's what we're going to determine our answer from so it also says that the client informs the social worker that her children are not comfortable in the shelter and that she is planning to return home with them where her abusive husband lives well this is present tense this is something that she is currently telling the social worker so this is happening right now in this session so now we want to examine okay so what is the question asking of me well we know that this is a first question so when we have a first question i want you to think of what is the most important thing that we need to be doing we've already determined what we need to prioritize so what's the most important thing we need to be doing about the issue that we are prioritizing so that just sounds like what is the most important thing that we need to be doing about this client telling us that she wants to return home with her children into this environment where her abusive husband lives okay so now we're going to go to the answer choices and we're going to go through them one by one so that we can um kind of compare them as we go which will help us to weed out the answers and better understand what we're looking for this is extremely important when you're trying to break down these clinical intervention questions knowing what you are looking for instead of just reading all the answer choices and trying to pick what you believe sounds best it is very important to just understand what you're looking for okay so is the most important thing that we need to do about this client wanting to return home um where her abusive husband lives with her children um is the most important thing that we're going to do is to accept the client's decision to return home yes maybe i mean that is you know she does have a right to self-determination so that is uh something important is that the first thing we're gonna do maybe maybe not so i'll definitely just put a pause on this one and see what else um the other options are presenting so be with the most important and notice that i am just interchanging the word first with most important because that's where my focus is first i'm doing what's most important so is the most important thing to do about this problem is to would it be to explain how domestic violence affects children well that too could also be very important to do in a situation where you have a client that is planning to return home with her children uh where domestic violence is taking place okay so we're gonna pause that one as well um okay so see would the most important thing be to encourage the clients within the abusive relationship for the sake of her children well we know out the gate we're going to eliminate that one because we can't ever tell anybody what to do about their relationship the social worker should never encourage the clients in their relationship the client must make this decision on her own so we're not going to encourage that okay so d with the most important thing be to file a report with child protective services so looking back at the presenting problem remember that whatever answer you choose has to directly address the presenting problem that you have identified which is why it is so important for you to identify the correct presenting problem so following a report with cps is that going to address this is that the most important thing that we need to do well we know that cps um we report to them when we know that children are being abused or neglected or what have you so in this situation it doesn't say anything about the children being abused or physically assaulted so the first thing i don't think that's the first thing that we're going to do um i don't think that's warranted at this time because it doesn't state that they were being abused it states that the mother was uh physically assaulted and we don't want to assume so we're only gonna go with what the vignette says so i'm gonna eliminate this one on those grounds that it does not tell me that these children were being abused by their father or they were put in an abusive situation on themselves okay what's going on between the mom and the dad physically that is between them so now we're left with two answer choices which is a good thing because because this will help to eliminate a lot of anxiety instead of you focusing on all the all four answer choices now you have to do is just go back and compare each one of these answer choices with whether or not they address the presenting problem and what the question is asking you well we know what what the presenting problem is and we know that the question is asking us to do the most important thing about it so we have to determine which one of these directly addresses the presenting problem and is the most important thing that we need to focus on so again the presenting problem is that the client wants to return home with her children she's planning to return home with them where her abusive husband still lives so with the most important thing to do be to accept the client's decision to return home um although we must respect the client's right to self-determination um we still must first prioritize the safety of the children um and that is mentally as well as physically so anytime children are involved in a domestic violence situation their safety does take take precedence now that is different from following a report with cps saying that they are being abused so um accepting this decision to return home yes ultimately we have to do that but the answer is b because the first and most important thing that we really need to do is first explain how domestic violence affects children okay explaining the impacts of domestic violence on children is the first thing that the social worker should do to help the client understand the potential consequences of her decision okay so bringing them back into that home where domestic violence is prevalent and where they're experiencing these physical assaults what are the potential consequences that um could affect these children how is this affecting your children um in the short term as well as in the long term so we want to prioritize the children in the situation and just explain and make sure she has a clear understanding of those effects and those consequences for her children okay that's not to say that we can stop her from going that's not to say that we have to file a report with dcfs because um she's choosing to do that but we the we have to um explain to her those consequences for those children okay and then maybe some of these other choices um outside of c we can probably entertain especially a if she's still after we explain and if she's still adamant about returning home to her husband then we have to accept her decision okay now keeping an eye on the situation or whether or not the children are um at risk for abuse that's a whole other situation that we're not gonna get into because i don't want you guys overthinking the question like i know some of you already are um when you're thinking about domestic violence between a husband and a wife keep in mind the scenario does not say that the children are in any type of danger so we are not going to assume that so this is why b is the answer because it directly addresses the problem here the problem is she's trying to take these children back into this abusive environment so she does need to know the effects of that now let's look at a next question a social worker receives a referral from a psychiatrist for a man diagnosed with end-stage heart failure who has been sending out death threats to his neighbors during the initial interview the man reports that he no longer feels like himself and that his mind comes and goes he also states that he feels alienated and vengeable most of the time after clarifying that the man has no real plans to hurt himself or anyone else what should the social worker do next all right so right off the bat we see that a social worker receives a referral from a psychiatrist so we want to point that out that we know that we are at the beginning of the helping process which means we are either engaging and are assessing the client okay so in the beginning of the helping process we are either engaging them building rapport or we are assessing them gathering and promoting information that could be either or or both okay so keep in mind that we are at the beginning of the process now this is relevant because we when we go to choose an answer we have to make sure that whatever answer we choose is relevant to the stage or phase of the helping process that we're in okay so we don't want to pick an answer that is uh making reference to terminating the client when we're still only in the beginning phase of the helping process so keep that in mind all right so now we want to kind of determine uh what is the presenting problem here all right so also it lets me know here that doing an initial interview again so that lets me know that i am doing an initial interview so i am in the stage where i'm trying to gather information from this client the man reports that he no longer feels like himself that his mind comes and goes he also states all of this stuff right here that i'm not going to reread to you guys okay so we need to determine what is the most critical thing that is going on with the man right now that we need to address okay is it the fact that this man is diagnosed with end-stage heart failure and he has been sending out death threats to his neighbor well that's the reason why he came but that's not what he's currently doing in the session remember we want to stay live here now so we are not going to um consider this as our presenting problem but we are going to consider it as something that's going on in the situation so here anything that a client reports or informs or states or fields we want to pay attention to that because that is almost always um directly related to if not being the presenting problem okay so the man tells you that he's no longer feeling like himself and he he's also stating that he's feeling alienated and vengeful most of the time so we're gonna go with what this man says especially because it's in quotations and for some reason on the aswb exam i feel like if you see something in quotations definitely pay attention to it so we're going to go off of what he's saying specifically say specifically that he's saying that you know he feels alienated and vengeful most of the time um so this is the next question so we want to know what the question is asking of us so we want to pay attention to the type of question this is this is the next question so with the next question you want to consider what's the last thing the social worker has already done if anything so to dispel the myth um that you always use the last sentence before you know the what should the social worker do next that is not always true in some cases that is but if that is not always true you always want to first focus on what is the last thing that the social worker did okay so in this situation it just happens to work out that the last thing the social worker did was clarify that the man has no real plans to hurt himself okay so we definitely want to pay attention to that and it just so happens that that is the last sentence before um the question so after we clarify so we know that we're in the beginning phase where we're gathering information and so after the social worker clarifies that this man really doesn't want to hurt himself what is the next thing we do after that okay is it going to be refer the man to a support group for end-of-life patience now remember our answer is going to be directly correlated to what the presenting problem is which is the man saying that he no longer feels like himself his mind is coming and going and he feels alienated and binge for most of the time so is referring the man to a support group for end of life patients going to address this issue possibly is this something we do while we are in an initial interview because remember we have to do something that is related to the phase of the process that we're in so possibly yeah we can definitely refer the man um to a group so we're going to pause that one b is the next thing we're going to do about this presenting problem after clarifying that he has no real plans to hurt himself or anyone else um is it going to be to encourage a man to spend as much time with his family and friends as possible um i really don't see the relevance in that choice so i'm gonna eliminate that one right off the bat um because that doesn't address the primary physical problem of how this man is feeling so family and friends yeah maybe somewhere down the line but that is not gonna be the very next thing we want to encourage the client to do c explore the man's feelings about the end of life stage and provide coping techniques that is definitely something we can do in the initial interview we've already clarified that he really doesn't want to hurt himself so exploring his feelings and providing some you know preliminary coping techniques could definitely be something we do next okay so we're gonna pause that one too d well the next thing be to have the man involuntary committed to an inpatient facility for safety well d is not necessary at this time because the man is not suicidal or homicidal okay the social worker should um definitely assess and explore the man's feelings since there is no imminent safety risk okay so referring him to a support group that is definitely something that we could do um but i don't think it's the very next thing that we should do while we are here live in this intake interview now normally we don't get into you know providing coping techniques or um or teaching skills in an initial interview however in this situation because we've already clarified he came in with these feelings and stating you know he feels alienated and vengeful um and we've already clarified that he has no plans to hurt himself the next thing as well as the best thing that we can do for this client is to talk to him about his his feelings about the end of uh life stage and provide him some ways to possibly cope with that okay so um that's not going into you know an intervention stage with him that's just exploring his feelings and just providing him letting him know okay so here's some ways that you can probably cope with your diagnosis okay um and then maybe after that if you want to refer him to a support group that would be fine okay so i want to point out that this referral is from a psychiatrist so the client is already being monitored for possible psychiatric issues this is an initial interview which means we are at the beginning stages of the helping process although the client is stating multiple feelings or multiple issues we must prioritize and focus on what is the main thing right now and the main thing right now is that he feels alienated and vengeful most of the time which means he probably feels alone and that he really wants to you know hurt somebody so that's more important than you know him feeling no longer feeling like himself or his mind comes and goes so we want to focus on that so um we're considering everything in the situation but let's since we are in this initial interview let's explore his feelings let's assess his feelings assess and explore are always well i don't say always but they're usually used interchangeably to mean the same thing so um let's explore his feelings about the engine end of life stage and then just possibly offer some brief coping techniques not saying you have to teach him coping techniques we're just going to provide him some basic coping techniques um to get him started okay because mind you we are still in the initial interview okay so that is why c is the answer and just not referring him next to a support group because that's not going to help the fact that you know he's not feeling like himself or he's feeling vengeful most of the time yes it is going to help um him with some of the issues he's having but most importantly we want to discuss his feelings because he's at the he knows that he is at the end stage with his condition so let's just talk about his feelings um after we clarified that he didn't want to hurt himself