Human Development & Environment
27%of exam
Assessment & Intervention Planning
24%of exam
Assessment ToolsRisk AssessmentBiopsychosocial AssessmentMental Status Exam
Interventions with Client Systems
24%of exam
Evidence-Based InterventionsTherapy ModelsCrisis InterventionCase Management
Professional Values & Ethics
25%of exam
Quick Facts
- Exam
- ASWB Masters
- Credential
- LMSW (MSW-level)
- Questions
- 170 (150 scored)
- Time
- 4 hours
- Pass
- Criterion-referenced
- Format
- CBT, Pearson VUE
- Level
- MSW graduate
- Blueprint
- 2018 (thru Aug 2 2026)
Erikson's 8 Stages
8 stages, 8 conflicts, birth to late life
Trust vs mistrustAutonomy vs shameInitiative vs guiltIndustry vs inferiorityIdentity vs confusionIntimacy vs isolationGenerativity vs stagnationIntegrity vs despair
Delirium vs Dementia
Delirium
- Acute onset
- Fluctuating attention
- Often reversible
Dementia
- Gradual onset
- Stable attention early
- Usually progressive
Sudden vs slow
Diagnosis Picker by Symptoms
- 2+ weeks depressed mood→Major depressive disorder(DSM-5-TR)
- 2+ years mild depression→Persistent depressive disorder
- 1 week elevated/irritable mood→Manic episode
- 4 days elevated mood only→Hypomanic episode
- 6+ months excess worry→Generalized anxiety disorder
- Trauma symptoms over 1 month→PTSD
Erikson Psychosocial Stages
- Trust vs Mistrust
- Infancy hope
- Autonomy vs Shame
- Toddler will
- Initiative vs Guilt
- Preschool purpose
- Industry vs Inferiority
- School-age competence
- Identity vs Confusion
- Adolescent fidelity
- Intimacy vs Isolation
- Young adult love
- Generativity vs Stagnation
- Midlife care
- Integrity vs Despair
- Late life wisdom
DSM-5-TR Duration Thresholds
4 days, 1 week, 2 weeks, 6 months
Hypomania: 4 daysMania: 1 weekMDD: 2 weeksGAD: 6 monthsPDD: 2 yearsODD: 6 months
MDD vs Persistent Depressive Disorder
MDD
- 2+ weeks
- Episodic
- Can be severe
PDD
- 2+ years
- Chronic, low-grade
- Milder symptoms
Duration decides
Piaget Stages & Attachment
- Sensorimotor
- Birth to 2 years
- Preoperational
- Symbolic, egocentric thinking
- Concrete operational
- Logical, concrete thinking
- Formal operational
- Abstract, hypothetical reasoning
- Secure attachment
- Comfort with closeness
- Anxious attachment
- Fears abandonment
- Avoidant attachment
- Dismisses closeness needs
- Disorganized attachment
- Fear plus approach
Mania vs Hypomania
Mania
- 1+ week
- Marked impairment
- May need hospital
Hypomania
- 4+ days
- No major impairment
- No psychosis
Severity and duration
DSM-5-TR Duration Thresholds
- MDD
- 2+ weeks symptoms
- Persistent depressive d/o
- 2+ years chronic
- Manic episode
- 1 week (or hospitalized)
- Hypomanic episode
- 4+ consecutive days
- GAD
- 6+ months worry
- Acute stress d/o
- 3 days to 1 month
- PTSD
- Symptoms over 1 month
- Adjustment disorder
- Within 3 months onset
PTSD vs Acute Stress Disorder
PTSD
- Over 1 month
- Chronic course possible
Acute stress disorder
- 3 days to 1 month
- Resolves or becomes PTSD
Timing after trauma
Key DSM-5-TR Categories
- Schizophrenia
- 1mo active, 6mo total
- Bipolar I
- Requires 1 manic episode
- Bipolar II
- Hypomania plus depression
- BPD
- Instability, fear of abandonment
- ASPD
- Pattern disregard for others
- Delirium
- Acute, fluctuating attention
- Dementia (NCD)
- Gradual, stable attention
- ODD
- 6+ months defiance
Assessment Tools & Scales
- PHQ-9
- Depression severity screen
- GAD-7
- Anxiety severity screen
- C-SSRS
- Suicide risk screen
- SCID-5
- Structured diagnostic interview
- MSE
- Appearance, mood, cognition, insight
- Biopsychosocial assessment
- Bio + psych + social
Risk & Safety Assessment
- Suicide risk factors
- Prior attempt, means, plan
- Protective factors
- Reasons for living
- Stanley-Brown Safety Plan
- Structured safety planning tool
- Means restriction
- Limit access to lethal means
- Homicidality assessment
- Specific plan, means, intent
- Danger to others
- Duty to warn triggers
First-Line Treatments by Diagnosis
PTSD=CPT/EMDR | OCD=ERP | OUD=Buprenorphine | AUD=Naltrexone
PTSD: CPT or EMDROCD: ERPOUD: buprenorphine/methadoneAUD: naltrexone/acamprosateBPD: DBT
Intervention Picker by Presentation
- PTSD symptoms→CPT, PE, or EMDR
- OCD compulsions→ERP
- Opioid use disorder→Buprenorphine or methadone
- Alcohol use disorder→Naltrexone or acamprosate
- Pursue-withdraw couple cycle→EFT
- Active suicidal ideation→Safety planning, means restriction
Evidence-Based Interventions by Condition
- PTSD
- CPT, PE, or EMDR
- OCD
- ERP (exposure response prevention)
- OUD
- Buprenorphine or methadone (MOUD)
- AUD
- Naltrexone or acamprosate
- BPD
- DBT, MBT, or TFP
- Child trauma
- TF-CBT
- Adolescent anorexia
- FBT (family-based treatment)
- Panic disorder
- CBT with exposure
Therapy Models & Theories
- CBT
- Reframe distorted thoughts
- MI
- Explore ambivalence, roll resistance
- SFBT
- Focus on solutions, exceptions
- EFT
- De-escalate attachment cycles
- Bowen family systems
- Differentiation of self
- Structural family therapy
- Realign family hierarchy
- Psychodynamic
- Insight into unconscious patterns
- Strengths-based practice
- Build on client capacities
Crisis & Case Management
- Crisis intervention
- Stabilize, safety, short-term
- Tuckman stages
- Form, storm, norm, perform
- Case management
- Link, coordinate, monitor services
- Discharge planning
- Aftercare and follow-up
- Termination readiness
- Goals met, client stable
- ROM/FIT
- Track outcomes each session
NASW Six Core Values
Service, Social Justice, Dignity, Relationships, Integrity, Competence
Service firstSocial justiceDignity and worthHuman relationships matterIntegrity alwaysCompetence maintained
Confidentiality vs Duty to Warn
Confidentiality
- Default protection
- Client controls disclosure
Tarasoff duty
- Identified victim named
- Overrides confidentiality
Danger breaks silence
Ethics Action Picker
- Client threatens identified victim→Warn and protect (Tarasoff)
- Suspect child or elder abuse→Mandated report immediately
- Feeling attraction to client→Seek supervision, set boundary
- Unsure how to handle case→Consult, don't just proceed
- Subpoena for records arrives→Consult legal counsel first
- Client requests self-harm secrecy→Assess risk, break confidentiality
NASW Code of Ethics
- 1.06
- Conflicts of interest
- 1.07
- Privacy and confidentiality
- 1.09
- Sexual relationships prohibited
- 1.13
- Payment and bartering
- 1.16
- Termination of services
- 4.04
- Dishonesty, fraud, deception
- 4.05
- Impairment self-report
- 6.04
- Social and political action
Supervision vs Consultation
Supervision
- Hierarchical oversight
- Evaluates performance
Consultation
- Peer-to-peer input
- No evaluative authority
Oversight vs advice
Confidentiality & Legal Duties
- Tarasoff duty
- Warn and protect identified victim
- Mandated reporting
- Suspected abuse or neglect
- HIPAA minimum necessary
- Share only what's needed
- Informed consent
- Voluntary, informed, competent agreement
- Subpoena vs consent
- Need consent or court order
- Privileged communication
- Protects client, not public
Supervision & Self-Care
- Clinical supervision
- Oversight of practice skills
- Consultation
- Peer input, no oversight
- Countertransference
- Worker's reaction to client
- Burnout
- Exhaustion from chronic stress
- Secondary trauma
- Absorbing client's traumatic material
- Self-care planning
- Prevent impairment, sustain practice
Common Traps
Confidentiality vs Mandated Reporting
Confidentiality protects client ≠ Reporting duty overrides it
MDD vs Persistent Depressive Disorder
MDD is 2+ weeks ≠ PDD is 2+ years
Mania vs Hypomania Duration
Mania needs 1 week ≠ Hypomania needs 4 days
Supervision vs Consultation Role
Supervision evaluates performance ≠ Consultation just advises
Self-Determination vs Duty to Protect
Client chooses own path ≠ Danger overrides autonomy
Delirium vs Dementia Onset
Delirium is acute ≠ Dementia is gradual
Last Minute
- 1.Domain weights 27-24-24-25%
- 2.MDD needs 2+ weeks symptoms
- 3.Mania needs 1+ week duration
- 4.Tarasoff overrides confidentiality for danger
- 5.Mandated reporting is not optional
- 6.170 total questions, 150 scored
- 7.4-hour computer-based Pearson VUE exam
- 8.Criterion-referenced pass, no fixed percent
- 9.Read vignette twice, pick BEST
- 10.Safety planning beats no-suicide contracts
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