The Catholic University of America

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1 CUA The Catholic University of America National Catholic School of Social Service Washington, DC Fax SSS 802 Clinical Social Work with Adults Fall 2017 (3 credits) This course outline is the property of NCSSS and the instructor and may be distributed with written permission. I. COURSE PURPOSE Building on the first year theoretical framework of ecological systems, the purpose of this course is to prepare the student for advanced clinical practice with adult individuals in varied settings with diverse populations. Practice skills are primarily rooted in the explanatory concepts of psychodynamic, cognitive, and behavioral theories as applicable within a multicultural context. Intervention skills are based on a strengths perspective which includes psychodynamic and cognitive-behavioral practice, clinical case management skills, and current clinical models of practice. We will also integrate the latest findings in mindfulness, neurobiology, and chemistry. Particular emphasis will be placed on application of theory with adult clients through didactic teaching, role-play, observation of DVDs, and classroom discussion. 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 ten core competencies and each course is also designed to 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 Competency #1 Professional Identity: Identify as a clinical social worker & conduct self accordingly. Practice Behaviors #2. Social workers practice with a clear understanding of the professional strengths, capacities, and limitations of clinical social work; #3. Social workers understand how clinical

2 2 Competency #2 Ethical Practice: Apply social work ethical principles to guide clinical practice. Competency #3 Critical Thinking: Apply critical thinking to inform and communicate professional judgments. Competency #4: Diversity in Practice: Engage diversity and demonstrate awareness of the complexities regarding identity differences and how they play out in clinical practice. Competency #5 Human Rights & Justice: Advance human rights through understanding how social and economic justice factors impact clinical practice Competency #6 Research Based Practice: Engage in research-informed practice and practice-informed research Competency #7 Human Behavior: Apply knowledge of human behavior and the social environment. theories from multiple disciplines inform the practice of clinical social work; #1.Social workers recognize and manage personal biases as they affect the clinical relationship in the service of clients wellbeing; #1. Social workers distinguish, appraise, and integrate multiple sources of knowledge, including research-based knowledge, and practice wisdom in an ongoing process of assessment and intervention; #3. Social workers include personal reflection in clinical decision making, are adept at differential diagnosis, and articulate both client strengths and vulnerabilities in the diagnostic process; #2. Social workers use their self-awareness to reflect on and diminish the influence of their personal biases and values in working with others; #3. Social workers recognize and communicate their understanding of the importance of difference in shaping the life experiences of clients, themselves, and the working alliance; #1. Social workers use knowledge of the effects of oppression, discrimination and historical trauma on the client and client system to guide treatment planning and intervention; #2. Social workers understand how power and inequities are initiated and reinforced, and are cognizant not to replicate power inequalities in the relationship; #1. Social workers demonstrate the ability to apply research concepts and strategies to inform social work practice and programs; #2. Social workers critically evaluate and utilize theoretical and empirical research relevant to the problems and/or populations seen in clinical practice; #1. Social workers synthesize and differentially apply theories of human behavior that address the bio-psycho-social-spiritual nature of clients and the social environment to guide clinical

3 3 Competency #9 Practice Contexts: Respond to contexts that shape practice. Competency #10 Engage, Assess, Intervene, Evaluate: Engage, assess, and intervene with individuals, families, and groups. practice; #1. Social workers continuously assess and identify changing locales, populations, scientific and technological developments, and emerging societal trends to provide relevant clinical services to clients; Engagement: Social workers: #3. Attend to the interpersonal dynamics and contextual factors that may strengthen or harm the therapeutic working alliance Assessment: Social workers: #1. Use a multi-dimensional assessment, that includes bio-psycho-social-spiritual data, as well as client strengths, coping capacity, and readiness for change #2. Use differential and multi-axial diagnostic processes #3. Co-construct therapeutic goals and clinical objectives to address psychosocial distress, and engage in ongoing reassessment of those goals Intervention: Social workers: #1. Co-construct and select therapeutic interventions that best address the client s presenting problem and risk factors, and use multiple intervention plans to address compound problems or complex trauma #2. Incorporate client strengths, capacities, and protective factors in the therapeutic intervention plan Evaluation: Social workers: #1. Critically analyze, monitor, and evaluate interventions III. COURSE REQUIREMENTS A. Required Texts Corcoran, J. & Walsh, J. (2016). Clinical assessment and diagnosis in social work practice (3 rd Ed,). New York, NY: Oxford University Press Grady, M. D., & Dombo, E. A. (2016). Moving beyond assessment: A practical guide for

4 4 beginning helping professionals. New York, NY: Oxford University Press. Yalom, I. (2002). The gift of therapy. New York: Harper Collins. B. Highly Recommended Texts (Note: Several Chapters are from each text are listed as Required Reading and/or Recommended Reading throughout the semester. These texts will be on reserve at the library, but not available on Blackboard due to Copyright restrictions.) Berzoff, J., Melano, L., Flannagan, L., & Hertz, P. (2011). Inside out and outside in: Psychodynamic clinical theory and practice in contemporary multicultural contexts (3rd Ed.). Northvale, NJ: Jason Aronson. [listed as Berzoff] Dobson, S. K. (2010). Handbook of cognitive-behavioral therapies (3 rd Ed). New York: Guilford. [listed as Dobson] Yalom, I. (2002). The gift of therapy. New York: Harper Collins. [listed as Yalom] C. Helpful Texts Allen, J. G. (2001). Traumatic Relationships and Serious Mental Disorders. New York: Wiley & Sons. Appleby, G, Colon, E., and Hamilton, J. (2007). Diversity, oppression and social functioning: Person-in-environment and intervention (2 nd Ed.). Boston: Pearson. Badenoch, B., (2008). Being a brain-wise therapist. New York: W.W. Norton. Bentley, K., & Walsh, J. (2006). The social worker and psychotropic medication (3 rd Ed.). New York: Brooks/Cole. Brandell, J. (2004). Psychodynamic social work. New York: Columbia University Press. Briere, J. & Scott, C. (2006). Principles of trauma therapy. Thousand Oaks, CA: Sage. Dass-Brailsford, P. (2007). A practical approach to trauma. Thousand Oaks, CA: Sage. DuPont, R., Spencer, E., DuPont, C. (2003). The anxiety cure: An eight-step program for getting well. (2 nd Ed.). Hoboken, NJ : John Wiley & Sons, Inc. Epstein, M. (2007). Psychotherapy without the self. New Haven: Yale University Press. Griffith, J. & Griffith, M. (2002). Encountering the sacred in psychotherapy. New York: Guilford Press. Hodge, D. (2003). Spiritual assessment. Botsford, CT: North American Association of Christians in Social Work. Kottler, J. A. & Carlson, J. (2003). Bad therapy: Master therapists share their worst failures. New York: Routledge. Siegel, D., (2007). The Mindful Brain. New York: W.W. Norton. Siegel, D., (2010). The Mindful Therapist. New York: W.W. Norton.

5 5 Stern, D. (2004). The present moment in psychotherapy and everyday life. New York: W.W. Norton. Welwood, J. (2000). Toward a psychology of awakening. Boston, MA: Shambhala. D. Other Required Readings There are other required readings listed for each week that come from scholarly journals. These articles are posted on Blackboard and can be accessed by going to Students must login using their CUA username and password. Individuals not enrolled in this course may not have access to the Blackboard page or readings. E. Course Assignments 1. Attendance and Class Presence/Participation Students are expected to complete all assigned readings, arrive to class on time, and be fully prepared to actively participate in all class exercises and discussions. Class participation requires the student to have reviewed the readings in advance, and be fully present and engaged in the material for the entire class meeting. All clinical content in discussions must be kept confidential, in keeping with the Student Confidentiality Agreement. Missing class sessions will result in a significantly reduced grade. Arriving to class late or leaving early (30 minutes or more) will be considered an absence. 2. Discussion Board Postings Students are expected to post one question from the readings to the Blackboard Discussion Board no later than 12:00 pm the day of class for classes These guide discussion and be assessed on the quality of content related to readings and appropriateness for furthering discussion of content in the classroom. 3. Scholarly Paper Choose one of the topics on the syllabus and write a scholarly paper on an aspect of the topic (speak with the professor first for approval). Follow the NCSSS guidelines for scholarly paper. For additional information, refer to the student handbook for requirements of a scholarly paper, and to the CUA web site for links to APA style formatting. See Addendum for more detailed information. Due Class 8. Note: Papers are due at the beginning of the class. Papers handed in late will be deducted 10 points for each 24 hour period after the start of the class meeting. 4. Integrative Examination Class 14 open notes/open book. F. Grading Policy 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. No credit will be given for assignments submitted after they have been reviewed in class. The assignments described above

6 6 will be the basis for the final grade. Grades will be based on the extent to which students achieved course objectives as demonstrated by the quality of course assignments and class participation. The following weighting of course assignments will apply: In-Class Participation 20% Discussion Board Postings 20% Scholarly Paper 30% In-Class Exam 30% Grading System Letter Grade Numeric Range A A B B B C F 0-69 G. 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. H. 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. Additionally, informal written or verbal feedback to the instructor during the semester is encouraged and attempts will be made to respond to requests. IV. 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

7 7 learn from one another. We recognize that in a multicultural society, it is inevitable that issues or tensions relative to diversity and different life experiences will arise. It is how we handle these events that matters. Therefore, when such issues occur inside or outside of the classroom - we agree to engage in respectful and productive discussion with one another until learning is enhanced and understanding is deepened by 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 persona l 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. 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 thos e 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.

8 8 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. The instructor reserves the right to create a technology-free classroom should the use create problems in the learning environment.

9 9 CLASS SCHEDULE Part I: Clinical Social Work: From Assessment to Termination Class 1: Historical and philosophical roots of strengths based clinical 8/31/17 practice with adults Grady & Dombo Chapters 1, 2 & 4 Siegel, Chapter 1 Welwood, Introduction Class 2: Clinical assessment and initial interview: Addressing bio-psycho- 9/7/17 social-spiritual dimensions of the person. Corcoran & Walsh, Chapters 1 & 2 Grady & Dombo, Chapters 5, 6, 7, 8 & 9 Yalom, Chapters 2 & 10 Class 3: Moving from Assessment to Case Theory and Intervention 9/14/17 Planning Part I: Using Concepts from Psychodynamic Theories Ganzer, C. (2007) The use of self from a relational perspective. Clinical Social Work Journal, 35, Holinger, P. (2009). Winnicott, Tomkins, and the psychology of affect. Clinical Social Work Journal, 37 (2) Shilkret, C. (2005). Some clinical applications of attachment theory in adult psychotherapy. Clinical Social Work Journal, 33(1), Class 4: Moving from Assessment to Case Theory and Intervention 9/21/17 Planning Part II: Using Concepts from Cognitive Theory, Behavioral Theory, and Cognitive Social Learning Theory Beckerman, N. L. & Corbett, L. (2010). Mindfulness and cognitive therapy in depression relapse prevention: A case study. Clinical Social Work Journal, 38,

10 10 Benight, C. C. & Bandura, A. (2004). Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behavior Research and Therapy, 42, Early, B. P. & Grady, M. D. (2016). Embracing the contribution of both behavioral and cognitive theories to Cognitive Behavioral Therapy: Maximizing the richness. Clinical Social Work Journal (online). Grady & Dombo Chapters 10 & 11 Class 5: Resistance, Insight, Interpretation in the Working Through Phase 9/28/17 & Addressing Termination Brandell, Chapters 9 &14 Grady & Dombo, Chapters 12, 13, 14 & 15 Part II: Process Issues in Treatment Classes 6&7: Transference, Countertransference, Projective Identification, 10/5-12/17 and Identity Difference in Clinical Practice Aymer, S. R. (2016) I can t breathe : A case study Helping Black men cope with race-related trauma stemming from police killing and brutality. Journal of Human Behavior in the Social Environment, 26(3-4) Brandell, Chapter 8 Grady & Dombo, Chapter 3 Mancillas, A. (2000). Recognizing and utilizing projective identification in brief psychodynamic therapy: A case example. Clinical Social Work Journal, 34(3), Miller, J., Donner, S. & Fraser, E. (2004). Talking when talking is tough: Taking on conversations about race, sexual orientation, gender, class and other aspects of social identity. Smith College Studies in Social Work, 74(2), Otuyelu, F., Graham, W., & Kennedy, S. A. (2016) The death of Black males: The unmasking of cultural competence and oppressive practices in a microaggressive environment, Journal of Human Behavior in the Social Environment, 26(3-4), Wilkins, E. J., Whiting, J. B., Watson, M. F., Russon, J. M., & Moncrief, A. M. (2013). Residual effects of slavery: What clinicians need to know. Contemporary Family Therapy, 35, Yalom, Chapters 13, & 49

11 11 Part III: Neurobiology & Persistent Mental Illnesses Class 8: Working with Clients who have Chronic and Persistent Mental 10/19/17 Illnesses: Clinical Case Management with Adult Clients Corcoran, Chapter 17 Groves, L. C. & Kerson, T. B. (2011). The influence of professional identity and the private practice environment: Attitudes of clinical social workers toward addressing the social support needs of clients. Smith College Studies in Social Work, 81, Kanter, J. (2012). Social care with the severely mentally ill: Psychodynamic perspectives. In J. Berzoff (Ed.), Falling Through the Cracks: Psychodynamic Practice with Vulnerable and Oppressed Populations ( ). NY: Columbia University Press. Kondrat, D. C. & Teater, B. (2012). The looking-glass self: Looking at relationship as the mechanism of change in case management of persons with severe mental illness. Families in Society, 93(4), *** Note : Papers Due*** Class 9: Intersections of Neurobiology, Chemistry, and Mental Health 10/26/17 Disorders Required Readings Grady & Dombo, Chapter 18 Corcoran & Walsh, Chapters 3, 4, 5 & 13 Farmer, R. L. (2014). Interface between psychotropic medications, neurobiology, and mental illness. Smith College Studies in Social Work, 84, Montgomery, A. (2002). Converging perspectives of dynamic theory and evolving neurobiological knowledge. Smith College Studies in Social Work, 72(2), Part IV: Interventions for Specific Presenting Issues Class 10: Clinical assessment and intervention for personality disorders: 11/2/17 Focus on Borderline Personality Disorder and Dialectical Behavioral Therapy

12 12 Required Readings Corcoran & Walsh, Chapter 16 Neacsiu, A. D., Rizvi, S. L. & Linehan, M. M. (2010). Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behaviour Research and Therapy, 48(), Travers, C., & King, R. (2005). An investigation of organic factors in the neuropsychological functioning of patients with borderline personality disorder. Journal of Personality Disorders 19(1) Class 11: Clinical Assessment and Intervention for Major Depression 11/9/17 & Bipolar Disorders: Focus on Brief Psychodynamic Psychotherapy and CAMS Approach to Addressing Suicidality Required Readings Center for Substance Abuse Treatment. (2012). Chapter 7 Brief Psychodynamic Therapy in Brief Interventions and Brief Therapies for Substance Abuse, pp Rockville, MD: Author. Corcoran & Walsh, Chapters 12 & 15 Jobes, D. A. (2012). The Collaborative Assessment and Management of Suicidality (CAMS): An evolving evidence-based clinical approach to suicidal risk. Suicide and Life-Threatening Behavior, 42(6), National Institute of Mental Health. (2008). Mental Health Medications. Washington, DC: Author. Class 12: Clinical Assessment and Intervention for Anxiety Disorders 11/16/17 Intervention focus: Mindfulness-Based Cognitive-Behavioral Therapy (MBCBT) Corcoran & Walsh, Chapter 7 Evans, S., et al. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, Hoffman, S. G., et al. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting Clinical Psychology, 78(2): National Institute of Mental Health. (2008). Mental Health Medications. Washington, DC: Author. Class 13: Clinical assessment and intervention for sexual abuse trauma 11/30/17 Intervention focus: Trauma Focused Cognitive-Behavioral Therapy (TFCBT) Cohen & Mannarino (2008). Disseminating and implementing Trauma-Focused

13 13 CBT in community settings. Trauma, Violence, & Abuse, 9(4), Corcoran & Walsh, Chapter 9 Dombo, E.A., & Bass, A. P. (2014). The trials and tribulations of a practitionerresearcher: Challenges and lessons learned through testing a Feminist- Cognitive-Relational Social Work Model of practice. Journal of Evidence-Based Social Work, 11(1/2), Dombo, E. A., Gray, C., & Early, B. P. (2013). The trauma of moral injury: Beyond the battlefield. Journal of Religion & Spirituality in Social Work: Social Thought, 32(3), Dombo, E. A., & Gray, C. (2013). Engaging spirituality in addressing vicarious trauma in clinical social work: A self-care model. Social Work and Christianity, 40(1), Hall, J. (2003). Dissociative experience of women child abuse survivors: A selected constructive view. Trauma, Violence, & Abuse, 4(4), Class 14: 12/7/17 In-Class Integrative Exam Open Notes/Books

14 14 Scholarly Paper Assignment Students will choose a dimension of clinical social work practice with individual adults and address a clinical social work intervention or response designed to address the issue. The paper is to include a literature review using scholarly references (no websites and no class notes) and provide a critical analysis of the current response, and concrete recommendations for improvements or changes. The paper must be written in APA style and follow the MSW Program s expectations for a scholarly paper. Write the final paper using the following headings, with appropriate subheadings, to structure your writing, and include reference pages in APA format. Introduction: A brief statement about the focus and purpose of the paper. The introduction should give your reader an understanding of the dimension of clinical social work practice you will focus on. Briefly state why this is a social work issue, and why your reader should want to learn more about it (1/2 page, 5 pts). Literature Review: Review the literature on your issue from the scholarly literature. Address the history of social work s role with this issues and the understanding of the social and interpersonal factors that contribute to it. Summarize the current, state of the art interventions and evidence-base (or not) for its use. Address applicable explanatory theory and models of practice (6-7 pages, 40 pts). Critique: Discuss the strengths and weaknesses of the state of the art practice with this issue. Address gaps in services or inconsistencies, strengths and weaknesses regarding evidence supporting the interventions, etc (2 pages, 15 pts). Future Directions for Social Work: Propose ways to strengthen what already exists and/or new methods of alleviating the problem and/or its sequela. Be concrete about what you, as a future social work leader, would do to improve upon the current state of the art on this dimension of clinical social work (2 pages, 15 pts). Conclusion: Summarize the findings of your paper. What are your final thoughts on the current social work practice? How might your critique strengthen the role of social workers in this area? (1/2 page, 5 pts). Use the correct APA format, grammar, and writing style. Be sure to use subheadings throughout the paper to denote the different sections and sub-sections (20 points).