Clinical Practice SWES Practice Exam

In context of therapeutic goals, what should a social worker understand about borderline and narcissistic personality disorders?

1. Both disorders involve significant anxiety

2. They are primarily focused on relational dynamics

3. The clients typically lack insight into their behaviors

4. They can be effectively treated with group therapy alone

The correct answer is: The clients typically lack insight into their behaviors

The choice that states clients typically lack insight into their behaviors aligns well with the understanding of borderline and narcissistic personality disorders. Individuals with these disorders often struggle to recognize or acknowledge the underlying motivations for their actions and the impact those actions have on others. This lack of insight can stem from the nature of the disorders themselves; for instance, narcissistic personality disorder often involves a distorted self-image and a lack of empathy, which can prevent individuals from seeing situations from other people's perspectives. Similarly, those with borderline personality disorder may experience intense emotions and fear of abandonment, leading to behaviors that they might not fully comprehend or take responsibility for. Understanding the lack of insight is crucial for social workers because it informs their approach to treatment. It highlights the importance of developing therapeutic rapport and using techniques that can help enhance awareness and insight over time. This might involve working on emotional regulation, examining interpersonal patterns, and gradually fostering a greater understanding of one's behaviors and their consequences. While relational dynamics are a significant focus of treatment for these disorders, insight into one's behaviors is a fundamental aspect that enables clients to engage effectively with therapeutic processes. Additionally, while anxiety can be present in these disorders, it is not a defining characteristic. The effectiveness of group therapy alone can vary widely based on individual needs