ASWB Advanced Generalist cheat sheet

DSM-5-TR diagnostic thresholds require symptom counts, duration, functional impairment, and exclusion of substance or medical causes; a diagnosis is not assigned when criteria are only partially met.

Differential diagnosis rule: when two conditions share symptoms, assign the diagnosis with the more specific and complete criteria; record the other as a rule-out or unspecified category rather than double-coding.

Mental status examination domains: appearance, behavior, speech, mood, affect, thought process, thought content, perception, cognition, insight, and judgment; document each domain separately.

Suicide risk formulation uses static factors (prior attempt, family history, male sex, older age) and dynamic factors (current ideation, access to means, substance use, agitation, insomnia); document both.

Grief versus major depression: acute grief features waves of sorrow triggered by reminders, yearning, and preserved self-esteem; persistent complex bereavement disorder requires marked yearning or preoccupation beyond 12 months in adults.

Standardized instruments yield scores relative to norms; a screening score above cutoff indicates need for further assessment, not a diagnosis.

Neurocognitive screening (e.g., MMSE, MoCA) is influenced by education and culture; low scores require corroborating functional and history data before conclusions.

Validity threats in assessment: halo effect, confirmatory bias, recency effect, and cultural bias in instruments; mitigate by triangulating collateral, records, and behavioral observation.

Evidence-based practice integrates best available research, client values and preferences, and practitioner expertise; no single element alone determines intervention selection.

Stages of change (Prochaska): precontemplation, contemplation, preparation, action, maintenance, and relapse; interventions are matched to stage, and relapse is treated as a stage rather than failure.

Motivational interviewing core elements: open questions, affirmations, reflective listening, and summarizing, delivered in the spirit of partnership, acceptance, compassion, and evocation.

Cognitive behavioral treatment targets the cognitive triangle linking thoughts, feelings, and behaviors; cognitive restructuring challenges distortions such as catastrophizing, all-or-nothing thinking, and mind reading.

Task-centered and crisis intervention models are short-term and structured; crisis intervention prioritizes immediate safety, stabilization, and linkage rather than insight-oriented work.

Trauma-informed practice principles: safety, trustworthiness, peer support, collaboration, empowerment, and cultural humility; avoid re-traumatization through choice and transparency.

Family systems concepts: circular causality, homeostasis, boundaries, triangulation, and differentiation; intervention targets interaction patterns rather than an identified patient.

Treatment planning requires measurable, time-bound objectives derived from the client's prioritized goals, with documented review dates and criteria for discharge.

Informed consent requires capacity, disclosure of risks and benefits, alternatives, voluntariness, and documentation; consent is ongoing and may be withdrawn.

Confidentiality exceptions include imminent danger to self or others, suspected abuse or neglect of children or vulnerable adults, court order, and client waiver; disclose the minimum necessary information.

Multiple relationships are evaluated by risk of exploitation or impaired judgment, not by categorical prohibition; sexual relationships with current clients are always prohibited.

Supervisory responsibility: the supervisor retains accountability for client care and must ensure supervisee competence, informed consent disclosure of supervisee status, and documented supervision.

Termination and referral rules: avoid abandonment, provide pretermination counseling, offer referrals, and document the reason and plan.

NASW Code of Ethics core values: service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence.

Macro practice levels: case advocacy, cause advocacy, community organizing, program development, and policy analysis; each targets change at a different system level.

Cultural competence evolves into cultural humility: lifelong self-reflection, power awareness, and institutional accountability rather than mastered knowledge of group traits.