A mother and her twleve-year-old son meet with a social worker after the child was referred by his primary care physician, who has diagnosed the boy with encopresis. The boy makes it clear he doesn't want to talk about the condition and doesn't want to meet with the social worker. What treatment goal is likely to be MOST effective in reducing symptoms of encopresis?
A. The child will learn to identify and replace cognitive distortions that contribute to his feelings of shame.
B. The child's mother will establish a behavior plan that rewards him for using the toilet at regular intervals.
C. The child will learn to talk to his mother about his feelings about encopresis in family therapy.
D. The child will learn to talk openly about the encopresis to reduce his shame and embarrassment.
What do you think?
Let's take the answers one at a time. Remember you're looking for a treatment goal, not an intervention.
A. Identify cognitive distortions (intervention: CBT). Replacing cognitive distortions might be effective in reducing the child's shame but won't likely reduce his behavioral symptoms. So, no.
B. Behavior modification--rewarding the child for regular toilet habits--is likely to reduce the child's symptoms. This one's in the running. But always read through all answers. There may be a still better answer in the bunch.
C. Voice feelings. While there may be a psychodynamic route to symptom reduction in this case, having the child talk about his feelings about encopresis in family therapy isn't likely to reduce his symptoms.
D. More talking. Talking about his symptoms might help reduce this child's embarrassment but won't likely resolve his encopresis.
So, really only one contender this time. Which makes it easier than many questions on the ASWB exam, which often have two decent answers doing battle. This time, provided you aren't drawn to the CBT and talk-therapy options, you've got your answer without too much difficulty: B, behavior mod.
To read up about encopresis symtpoms and treatment, here's a good resource. To keep preparing for the social work licensing exam, you're already in the right place. Sign up to get started with full-length exams.
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