Next stop on our ASWB exam content outline tour: Placement options based on assessed level of care. This may be an area you have hands-on experience. Remember to apply your textbook experience (what should be doable), rather than lived experience (what's actually doable) when picking your answer on the licensing exam. Let's review the topic, then try a practice question.

Placement decisions in social work and mental health settings depend on a client’s assessed level of care, which is determined by factors such as safety risks, functional ability, medical needs, mental health status, and social support. Below is a breakdown of placement options based on different levels of care:

Outpatient Care (Lowest Level of Care)

For clients who are stable and can function independently with minimal support.

Placement Options:

  • Outpatient Therapy
    • Weekly or biweekly individual, group, or family therapy.
    • Appropriate for mild mental health concerns (e.g., anxiety, mild depression).
  • Intensive Outpatient Programs (IOP)
    • Structured treatment (typically 3-5 days per week, a few hours per session).
    • Best for clients who need more support but can still live at home.
  • Partial Hospitalization Program (PHP)
    • Day treatment (5 days a week, 4-6 hours per day).
    • Appropriate for moderate to severe mental health needs (e.g., severe depression without suicidal intent).

Common Populations Served:

  • Clients with stable housing and support systems.
  • Those with low risk for self-harm or harm to others.
  • Individuals transitioning from higher levels of care (e.g., hospitalization).

Residential Treatment (Moderate to High Level of Care)

For clients needing structured care due to mental health, substance use, or safety concerns.

Placement Options:

  • Short-Term Residential Treatment (Crisis Stabilization Units, Detox Centers)
    • Typically lasts a few days to weeks.
    • Used for immediate stabilization of mental health crises or substance withdrawal.
  • Long-Term Residential Treatment (Rehabilitation Centers, Therapeutic Communities)
    • 30-90+ day programs for substance use disorders, eating disorders, or severe mental illness.
    • Provides intensive therapy, medical monitoring, and skill-building.
  • Group Homes/Supervised Living
    • Semi-structured housing for clients with developmental disabilities, chronic mental illness, or behavioral challenges.
    • Offers 24/7 supervision and support for daily living skills.

Common Populations Served:

  • Individuals unable to live independently due to psychiatric symptoms.
  • Teens or adults in recovery from substance use disorders.
  • Clients transitioning from psychiatric hospitals.

Inpatient and Hospital-Based Care (Highest Level of Care)

For clients in crisis who require 24/7 medical and psychiatric supervision.

Placement Options:

  • Acute Psychiatric Hospitalization
    • Short-term hospitalization (days to weeks).
    • For clients who are actively suicidal, homicidal, or experiencing psychosis.
  • Long-Term Psychiatric Care (State Hospitals, Forensic Units)
    • For severe mental illness requiring prolonged stabilization (e.g., schizophrenia with frequent relapses).
    • Some facilities house clients with legal involvement.
  • Medical Detoxification Units
    • 24/7 monitoring for clients with severe withdrawal risks (e.g., alcohol, benzodiazepines).

Common Populations Served:

  • Individuals at risk of harming themselves or others.
  • Clients experiencing severe psychotic or manic episodes.
  • People with life-threatening withdrawal symptoms.

Decision-Making Factors for Placement:

Social workers assess the least restrictive, yet most appropriate setting using:

Risk Level: Suicidal ideation, self-harm, aggression.
Functionality: Ability to perform activities of daily living (ADLs).
Medical Needs: Co-occurring conditions requiring medical supervision.
Support System: Presence of caregivers or housing stability.
Legal Status: Involvement in the justice system may require forensic care.

On the Exam

An ASWB exam question derived from this material might look like this:

A social worker is assessing a 22-year-old client diagnosed with bipolar disorder. The client has been experiencing increased impulsivity, severe mood swings, and auditory hallucinations. The client has a history of noncompliance with medication and was recently evicted due to aggressive behavior toward neighbors. The client is not suicidal or homicidal but has no stable housing or support system. What is the MOST appropriate placement option?

A. Intensive Outpatient Program (IOP)

B. Acute Psychiatric Hospitalization

C. Long-Term Residential Treatment

D. Outpatient Therapy with Case Management

The client is not actively suicidal or homicidal, so acute psychiatric hospitalization (B) is not required. Intensive outpatient programs (A) and outpatient therapy (D) require stable housing, which the client lacks. Long-term residential treatment (C) is best because the client has severe symptoms, no housing, and a history of  medication noncompliance.

Get lots more practice like this on SWTP's full-length practice tests.

Place Me There Now.




February 19, 2025
Categories :
  knowledge  
  practice  
Previous
Next