A few weeks ago a student had asked at the end of educational lab“What’s the one thing social workers should know?” Time was up, but I assured him we would get to that question. Today, walking into my seminar, it was filled to capacity with both those who wanted answers and those who were in the trenches of a practicum and thought they had the answer.
Heads turned to look at the student who has asked the question, hands went up, and answers bounced off of each other. I let out a loud whistle “We can’t learn from each other if we’re talking over each other.”
Many of the answers were enlightened. A young male stood up “Maslow’s hierarchy of needs.” I watched more than a dozen scribble it down and asked the young man to elaborate. He looked around and said “Here’s a few of them: working with a victim of domestic violence- medical and safety issues would take priority over needing to provide patient with information, educational resources, supports, and options. The number one thing that should be focused on is helping the woman develop a safety escape plan for herself and her children to a woman’s shelter, attorney, and physician. Validation and re-empowerment comes in time.”
I could see some heads nod in agreement and it left me wondering how many of these students were doing front line work in their practicum. One individual stated knowing the three parenting styles: authoritarian (rely only on forceful, punitive discipline to force compliance) – these parents are often conflicted and irritable; authoritative parenting (allow children autonomy but explain restrictions) – energetic and friendly, cooperative with adults; and permissive parenting (parents make relatively few demands) – parents are impulsive and aggressive, parents often low in achievement.
A few of the student’s peers challenged the student on why this was important. Without missing a beat, the student said, it can tell you a lot about the person’s home life and up bringing the – students started to discuss Munchausen syndrome and malingering. I nodded in agreement and thought back to my days as an Emergency Room social worker. Before I could get lost in thought, the gentleman who originated the question stood and said, “It is great hearing from my peers; but what do you think, Professor?”
I leaned in and said “Always rule out a medical cause for symptoms before making a psychiatric diagnosis. A diagnosis can follow an individual for the duration of their lifetime.”
Another student stood and asked, “But what if you have to give them a diagnoise on the spot?”
I assured herthat was often unlikely as in a good medical setting she would be a part of an interdisciplinary team, but I assured her the safe bet was NOS category, not otherwise specified. This category means that the patient presents with a symptom pattern that conforms to the general guidelines for a mental disorder, but the symptoms do not meet all the criteria for any of the specific disorders. For example: Psychotic disorder NOS or Dementia NOS. Another student stood and asked, “How do you remember the characteristics of personality disorder?”
I smiled and replied “Great question, let’s talk about diagnosis next time. Email me your question.”
What the one thing you think social workers should know, or what is one thing that you wish someone told you about your profession?