The Catholic University of America

Transcription

1 CUA The Catholic University of America National Catholic School of Social Service Washington, DC Fax SSS665 Theories & Models for Use in Health Care Fall, 2017 Cheryl Hughes, LICSW, OSW-C (3 Credits) I. COURSE PURPOSE Chronic physical and mental health conditions such as cancer, HIV/AIDS, renal failure, and schizophrenia can disrupt every aspect of daily living for the person with the diagnosis as well as their families and friends. Patients and families psychological, social, spiritual, and financial resources can be severely challenged due to prolonged treatments, adverse reactions and complications, long-term recovery, and rehabilitation. With the increased focus on the social determents of health it is important the social workers have a solid foundation of these concepts as they work with people with health and illness issues. This course provides theoretical and practical model approaches to guide clinical social work biopsychosocialspiritual assessments and interventions appropriate for use with a diverse population with individuals and families facing a health or illness issue. Through lectures, class participation, and course assignments, students will be able to apply theories and models to working with individual, families, and teams with physical and mental health conditions. Content will include working within multidisciplinary teams, the importance of cultural awareness of individuals, families, communities, and organizations, and the social determinants of health. Finally, an emphasis will also be placed on the ethical dilemmas that confront social workers in health care settings including end of life care. This course is consistent with the mission of the National Catholic School of Social Service. The complete mission statement can be found at II. COMPETENCIES AND PRACTICE BEHAVIORS The Council on Social Work Education (CSWE) requires that students meet 10 core competencies, which are operationalized as practice behaviors. Each course is designed to cover one or more of the 10 core competencies and each course is also designed to 1

2 cover some, but not all of the practice behaviors within a competency. Upon completion of this course, students will able to demonstrate the following practice behaviors within the noted competencies: Competency Practice Behaviors Professional Identity: Identify as a professional social worker & conduct self accordingly Ethical Practice: Apply social work ethical principles to guide clinical practice. Critical Thinking: Apply critical thinking to inform and communicate professional judgments Diversity in Practice: Engage diversity and demonstrate awareness of the complexities regarding identity differences and how they play out in clinical practice Human Rights & Justice: Advance human rights through understanding how social and economic justice Social workers demonstrate professional use of self across all practice settings; Develop, manage, and maintain therapeutic and professional relationships with clients within the person-inenvironment and strengths perspectives. Social workers recognize and manage personal biases in practice settings; Social workers recognize and negotiate the complexities that can arise when organizational policies/procedures interface with competing professional standards for ethical social work practice in settings in which they practice. Social workers engage in reflective practice; Social workers evaluate the strengths and weaknesses of multiple theoretical perspectives and differentially apply them to client situations. Social workers use their self-awareness to understand the influence of their personal biases and values in working with others; Social workers practice within the context of difference in shaping the life experiences of clients, themselves, and the working alliance. Social workers practice with the understanding that societal structures and values may oppress, marginalize, and alienate, or create, enhance, and privilege 2

3 factors impact clinical practice different cultural groups within a society. Research Based Practice: Engage in research- informed practice and practice-informed research Social workers critically evaluate and utilize theoretical models and empirical research methods for the purpose of informing and evaluating social work practice and programs. Human Behavior: Apply knowledge of human behavior and the social environment Social workers differentially apply theories of human behavior that address the biopsycho-social-spiritual nature of clients and the social environment to guide social work practice. Practice Contexts: Respond to contexts that shape practice Social workers assess the current political, economic, social, and cultural climate as it affects the most vulnerable members of society; III. ADDITIONAL EDUCATIONAL OBJECTIVES Upon completion of this course, students will be able: 1. To differentiate various social determinants of health, articulate how the various social determinants of health influence access to health care, and understand how social determinants of health, if addressed, could benefit vulnerable populations. 2. To understand the nature of chronic health conditions and the disease continuum from the point of diagnosis to treatment to remission to recurrence of disease to the need for palliative or terminal care in the context of the patient s cultural experience. 3. To define the impact of chronic illnesses on family functioning with the ability to implement effective interventions that emphasize family strengths. IV. COURSE REQUIREMENTS A. Required readings No textbook is required for this course. All required and recommended reading will be available via Blackboard. 3

4 Across the Life Course. Annual Review of Public Health, 32, Braveman, P. (2014). What are health disparities and health equity? Why we need to be clear. Public Health Report 129 (2), 5-8. Bravemen, P., Egerter, S., &Williams, D. R. (2011). The Social Determinants of Health: Coming of Age Social Relationships and Health Behavior. Annual Review of Public Health, 32, Cagle, J., & Bolte, S. (2009). Sexuality and life-threatening illness: implications for social work and palliative care. Health &Social Work, 34(3), Chummun, H. (2009). Reducing the incidence of coronary heart disease. British Journal of Nursing, 18(14), Cooper, R. S., Ferguson, A., Bodurtha, J. N., & Smith, T. J. (2014). AMEN in challenging conversations: Bridging the gaps between faith, hope, and medicine. Journal of Oncology Practice, 10(4), e191 e 195. De Souza, J. et al., (2017) Measuring financial toxicity as a clinically relevant patientreported outcome: the validation of the comprehensive score for financial toxicity (COST). Cancer, Folkman, S., & Lazarus, R. S. (1988). The relationship between coping and emotion: Implications for theory and research. Social Science &Medicine, 26(3), Gallo-Silver, L. (2011). Sexuality, sensuality, and intimacy in palliative care. In T. Altillio & S. Otis-Green (Eds.) Oxford textbook of palliative social work ( ). New York, NY: Oxford. Gellis, Z. D., McGinty, J., Tierney, L., Jordan, C., Burton, J., & Misener, E. (2008). Randomized controlled trial of problem-solving therapy for minor depression in home care. Research on Social Work Practice, 18(6), Greer, J., Park, E., Prigerson, H., & Safren, S. (2010). Tailoring cognitive-behavioral therapy to treat anxiety comorbid with advanced cancer. Journal of Cognitive Psychotherapy, 24(4), doi: / Haslam, S. A., O Brien, A., Jetten, J., Vormedal, K., & Penna, S. (2005). Taking the strain: Social identity, social support, and the experience of stress. British Journal of Social Psychology, 44, Judd, R. G. & Sheffield, S. (2010). Hospital social work: Contemporary roles and professional activities. Social work in Health Care, 49(9),

5 Juczynski, Z., (2006). Health-related quality of life: theory and measurement. Folia Psychologica, 10, Kinrade, T, Jackson, A. C., & Tomnay, J. (2011). Social workers perspectives on the psychosocial needs of families during critical illness. Social Work in Health Care, 50(9), Matthews, K. A. & Gallo, L. C. (2011). Psychological perspectives on pathways linking socioeconomic status and physical health. Annual Review in Psychology, 62, Miller, W. R. & Arkowitz, H. (2015). Learning, applying, and extending MI. In H. Arkowitz,W.R., Miller, & S. Rollnick (Eds.) Motivational interviewing in the treatment of psychological problems (pp1-32). New York, NY: Guilford. National Cancer Institute (2005). Theory at a glance: A guide for health promotion practice (2nd Ed.). Washington, DC: U.S. Department of Health and Human Services, National Institute of Health. 5aa48ee1da4d/TAAG3.pdf Nester, J., (2016). The importance of interprofessional practice and education in the era of accountable care. North Carolina Medical Journal, 77(2), Nilsson, D. (2007). Adapting coping theory to explain the concept of adjustment. Social Work in Health Care, 45(2), Nilsson, D., Joubert, L., Holland, L., & Posenelli, S. (2013). The why of practice: Utilizing PIE to analyze social work practice in Australian hospitals. Social Work in Health Care, 52, Olson, D. H. (2000). Circumplex model of marital and family systems. Journal of Family Therapy, 22, Schrodt, P. (2005). Family communication schemata and the circumplex model of family functioning. Western Journal of Communication, 69(4), Valdez. C. R., Chavez, R., &Woulfe, J. (2013). Emerging adults lived experience of formative family stress: The families lasting influence. Qualitative Health Research, 23(8), Whitlock, E. P, Orleans, T., Pender, N., & Allan, J. (2002). Behavioral counseling interventions: An evidenced-based approach. American Journal of PreventiveMedicine, 22 (4), Additional readings will be assigned throughout the semester. 5

6 B. Course Assignments 1. Social Determinants of Health Assignment each student will select a vulnerable population who seek and receive care in the agency of their field placement. Using the social determinants of health model identify which social determinants are likely present in this group and whether they are negative or positive influences on their particular health issue. They will also discuss how this information would be included in a biopsychosocialspiritual assessment. This will be a paper using APA style. 2. Improving Cultural Knowledge Assignment each student will select a different cultural group. Each will research what general aspects of cultural norms, history, beliefs, and health seeking behaviors. Identify aspects of a culture that are important for social workers working in health care settings and with people with health and illness issues. The format for the write-up will be developed by the class as a whole. The final outcome is a document that will be shared with everyone in the class. This is intended to be the beginning of a Cultural Knowledge portfolio that each can build upon to enhance care and understanding of those we will work with now and in the future. 3. Scholarly Paper a two part paper will make up the complete scholarly paper. The first part will address a theory based assessment of an individual client. The second part of the paper will address a theory/model based assessment of the same client s family, identify an intervention based on the assessment(s), and address cultural and ethical issues at both the individual and family level. Due dates of assignments will be determined during class 2 of the semester. C. Grading Policy and Weights of Assignments Grades will be based on the CUA Grading Policy as described in the Graduate Announcements. Full credit will not be given for assignments that are submitted late. The following provides weights for the various course assignments: Social Determinants of Health Assessment 15% Cultural Knowledge Summary 20% Scholarly Paper Part 1 25% Scholarly Paper Part 2 25% Constructive and active class participation 15% Letter Grade Grading System Numeric Range A A B B B C F

7 D. Preparation, Attendance & Participation Students are required to attend classes and are expected to participate meaningfully in class discussion/exercises and online forums as required. The class participation grade will be determined by the instructor s perception of the student s preparation for and contributions to class discussion/activities. Different students will make different kinds of contributions. Some will have an easy time with spontaneous interactions while others will be more comfortable making planned statements about key ideas from the readings or other sources. Both types of contributions are valued. E. Course and Instructor Evaluation NCSSS requires electronic evaluation of this course and the instructor. At the end of the semester, the evaluation form may be accessed at using your CUA username and password. Additional informal written or verbal feedback to the instructor during the semester is encouraged. Once received attempts will be made to make adjustments based on the feedback.. V. Class Expectations Please refer to NCSSS Announcements or appropriate Program Handbook for Academic Requirements ( ), including scholastic and behavioral requirements. NCSSS is committed to creating an open and inclusive learning environment where all members, including students, faculty, administrators, and staff strive to listen to and learn from one another. We recognize that in a multicultural society, it is inevitable that issues or tensions will arise relative to diversity and different life experiences. When such issues occur inside or outside of the classroom NCSSS members agree to engage in respectful and productive discussions until learning is enhanced and understanding is deepened for all involved. A. Scholastic Expectations All written work should reflect the original thinking of the writer, appropriately reference ideas and authors from the literature, and adhere to the current APA-6 format. B. Behavioral Requirements Students are expected to maintain accepted standards of professional conduct and personal integrity in the classroom. Students are expected to: Attend class prepared for active engagement in all discussions and exercises. Recognize and avoid behavior that jeopardizes the learning and teaching environment of other students or the instructor. 7

8 Demonstrate competence in planning academic activities and in following through on those plans. Reasonably respond to and respect others reactions to one s comments or actions in the classroom. Use an appropriate level of instructor s time and attention in and out of class. Behave in a manner that is consistent with the ethical principles of the social work profession Adhere to additional expectations as provided by the instructor. C. Academic Honesty Joining the community of scholars at CUA entails accepting the standards, living by those standards, and upholding them. Please refer to University Policy ( ) and appropriate Program Handbooks. D. Confidentiality Students are expected to adhere to the Confidentiality Agreement that they sign. This agreement covers practice materials in classes, supervisory sessions, case conferences, seminars, and other educational settings within the NCSSS BSW and MSW programs that are for professional learning purposes only and subject to strict professional confidentiality standards. These same standards also extend to various forms of written communication and peer consultation. Students will also refrain from using social media outlets (blogs, twitter, Facebook, and so on), or to discuss practice settings, program responsibilities, and projects with individuals who are not in teaching or supervision roles directly related to the situation. E. Accommodations Students with physical, learning, psychological, or other disabilities seeking course accommodations must be certified by the Disability Support Services (DSS) Office. Accommodations are provided based upon the DSS instruction letter and only after it is presented to and discussed with the instructor. Students are expected to arrange a meeting with the course instructor as soon as possible to discuss these accommodations. F. Use of Electronic Devices Laptops and other electronic devices are permitted in the classroom only for course purpo ses (e.g., note taking or course work). Cell phones or other electronic devices that would disrupt the learning environment of the classroom are to be turned off prior to the beginning of the class and put away during class. 8

9 Class 1 Class Schedule THIS IS NOT THE FINAL LIST OF READINGS Introduction and overview of course - Role of the social worker in health care settings - The language of health, illness, and prevention - Cultural awareness, knowledge, skills, and encounters Required Reading Cooper, R. S., Ferguson, A., Bodurtha, J. N., & Smith, T. J. (2014). AMEN in challenging conversations: Bridging the gaps between faith, hope, and medicine. Nester, J., (2016). The importance of interprofessional practice and education in the era of accountable care. North Carolina Medical Journal, 77(2), 128- Recommended Readings Judd, R. G. & Sheffield, S. (2010). Hospital social work: Contemporary roles and professional activities. Social work in Health Care, 49(9), Nilsson, D. et al., (2013). The why of practice: Utilizing PIE to analyze social work practice in Australian hospitals Class 2 Theories of Change - What are theories and why do we use them? - Health behavior and promotion theories that may help social workers support individuals and families - The Ecological Perspective Health Belief Model - Transtheoretical Model of Stage of Change - Social Cognitive Theory Required Reading NCI, Theory at a glance, pages 3 16, Recommended Reading: Whitlock et al., (2002). Evaluating primary care behavioral counseling interventions: An evidenced-based approach. Class 3 Social Determinants of Health - What are social determinants and why are they important? Required Reading health Braveman, P. (2014). What are health disparities and health equity? Why we need to be clear. Public Health Report 129 (2),

10 Bravemen, P., Egerter, S., &Williams, D. R. (2011). The Social Determinants of Health: Coming of Age Social Relationships and Health Behavior. Annual Review of Public Health, 32, Across the Life Course. Annual Review of Public Health, 32, Recommended Reading Matthews, K.. A. & Gallo, L. C. (2011). Psychological perspectives on pathways linking socioeconomic status and physical health. Annual Review in Psychology, 62, Class 4-5 Stress Model Theory - Stress Model Theory - Defining the meaning of illness - The interactive process of primary and secondary appraisal Internal vs. external resources - Effective vs. ineffective coping strategies Required Reading Folkman, S., & Lazarus, R. S. (1988). The relationship between coping and emotion: Implications for theory and research. Nilsson, D. (2007). Adapting Coping Theory to Explain the Concept of Adjustment. Social Work in Health Care, 45(2), Haslam, S. A., O Brien, A., Jetten, J., Vormedal, K., & Penna, S. (2005). Taking the strain: Social identity, social support, and the experience of stress. Class 6 Application of Stress Model Theory as a guide for clinical assessment with a focus on culture and social determinants of health Class 7-8 The Circumplex Model of Family Functioning (CMFF) - Adaptability and cohesion - Salient components of the CMFF: Boundaries; coalitions, family life cycle Required Reading Olson, D.H. (2000). Circumplex model of marital and family systems. Schrodt, P. (2005). Family communication schemata and the circumplex model of family functioning. Kinrade, T, Jackson, A. C., & Tomnay, J. (2011). Social workers perspectives on the psychosocial needs of families during critical illness. Social Work in Health Care, 50(9), Class 9 Application of the CMFF to specific case scenarios 10

11 Required Reading: Valdez. C. R., Chavez, R., &Woulfe, J. (2013). Emerging adults lived experience of formative family stress: The families lasting influence. Qualitative Health Research, 23(8), Class10 Health Related Quality of Life (HRQOL) Required Reading: Cagle, J., & Bolte, S. (2009). Sexuality and life-threatening illness: implications for social work and palliative care. Gallo-Silver, L. (2011). Sexuality, sensuality, and intimacy in palliative care. Steinke, E. (2005). Intimacy needs and chronic illness: Strategies for sexual counseling and self-management. Class 11 Motivational Interviewing Required reading: Miller, W. R. & Arkowitz, H. (2015). Learning, applying, and extending MI. In H. Arkowitz, W. R. Miller, & S. Rollnick (Eds.) Motivational interviewing in the treatment of psychological problems (pp. 1 32). Class 12 Problem-solving intervention Required Reading: Nezu, C. M., Nezu, A. M. & Colosimo, M. M. (2015). Case formulation and the therapeutic alliance in contemporary problem-solving therapy (PST). Journal of Clinical Psychology, 71(5), Gellis, A. D. et al., (2008). Randomized controlled trial of problem-solving therapy for minor depression in home care. Class13 Pulling it all together Discuss Cultural Knowledge packet. - Social Workers using the social determinants of health in assessments and interventions. - Review of the semester 11