Page 1 of 20. University of Minnesota School of Social Work Syllabus

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1 Part I: Course information SW 8901-Assessment and Treatment of Trauma 2 credits Faculty contact: Name: Phone: Office Location: University of Minnesota School of Social Work Syllabus SW 8901-Assessment and Treatment of Trauma 1. Course descriptions: a. Short Version: Provides an overview of the sociopolitical context of trauma and its impact on diverse populations of individuals, families, and communities. Discusses evidence-based approaches for addressing trauma on multiple system levels through applications to case conceptualization and treatment planning. b. Long Description: This course provides an overview of the sociopolitical context of trauma and its impact on diverse populations of individuals, families, and communities. The course discusses evidence-based approaches for addressing trauma on multiple system levels through applications to case conceptualization and treatment planning with several populations of survivors including survivors of mass disasters, childhood abuse and domestic violence as well as veterans, refugees and torture survivors. This course begins by reviewing the developmental consequences of childhood trauma as background for understanding the treatment of Complex Posttraumatic Stress Disorders in adulthood. It reviews current assessment and diagnostic challenges and practices with diverse communities. The course presents evidence-based psychodynamic and cognitive-behavioral approaches to case conceptualization and treatment planning. Students will gain practice in interviewing, assessment, and interventions for acute stress reactions, interventions for the treatment of single incident and complex traumas, and knowledge about working with special populations. Students will learn about the use of self in treatment, the impact of secondary trauma on therapists and strategies for self-care. Pre-requisites: 1. This is an advanced social work class, and the material presented in this class is at an advanced level. Social Work students enrolled in this course should have completed the foundation classes listed below, or have advanced standing status. SW Human Behavior and the Social Environment SW Policies and Programs in American Social Welfare SW Social Work Practice Methods: Individuals and Systems SW Social Work Practice Methods: Families and Groups Page 1 of 20

2 SW Models of Community Intervention SW Social Work Research Methods 2. You must have completed or be concurrently enrolled in SW 8451: Assessment and Engagement in Clinical Social Work Practice or have permission of the instructor. 3. If you are not a Social Work student, you need permission of the instructor Clinical Licensure Hours: This course contains some clinical content, as required by the Minnesota Board of Social Work for eligibility for the Licensed Independent Clinical Social Worker (LICSW). The number of hours in each required category is listed below: Area Differential Diagnosis Assessment based treatment planning Clinical Intervention Methods Evaluation methodologies SW values and ethics Culturally specific clinical assessment Other areas Hours Part II: Course outcomes Course Outcomes: Students will develop knowledge of: 1. The developmental consequences of childhood trauma on brain development, attachment and relationships in adulthood, capacities for affect regulation and the ability to engage in psychotherapy for trauma as adults. 2. Interviewing skills with trauma survivors, assessment of trauma survivors, diagnostic criteria and processes, standard measures of trauma symptoms and case conceptualization of trauma. 3. Neurobiology of trauma and the integration of psychopharmacology and psychotherapy approaches to the treatment of acute stress and posttraumatic stress disorder. 4. Evidence based psychodynamic approaches to the treatment of complex posttraumatic stress disorder. 5. Evidence based cognitive behavioral approaches to the treatment of trauma including prolonged exposure, cognitive processing therapy, dialectical behavioral therapy, and narrative exposure therapy. 6. The use of self in the diagnosis and treatment of trauma including knowledge of common aspects of transference and countertransference reactions, concepts of vicarious or secondary trauma and strategies for self-care of the therapist. 7. The impact of diversity on the assessment and treatment of trauma within multicultural populations as well as strategies for working cross-culturally. 8. Community based strategies for intervention after community level trauma. Social Work Practice Competencies Successful completion of this course implies that the student has achieved competency in the following practice behaviors: Competency: Identify as a professional social worker and conduct oneself accordingly Social workers serve as representatives of the profession, its mission, and its core values. They know the Page 2 of 20

3 profession s history. Social workers commit themselves to the profession s enhancement and to their own professional conduct and growth. Social workers: Practice Behavior Covered in class through (i.e., activity, reading, content) Assessed Advanced: Apply knowledge of social services, policies and programs relevant to their area of practice Advanced: Develop a plan for ongoing professional education, including supervision. Programs relevant to the evidence based assessment and treatment of trauma are covered in every session of the course This topic is covered in week 2: Introduction to vicarious trauma dn mindfulness based approaches to self-care and in Week 7: Treatment of complex PTSD in adulthood, a case presentation. Evidence based treatment approaches are assessed in Paper II: Integrated Treatment Plan Journals collected at three times during the course require students to respond to their plans for self-care including the use of supervision and ongoing professional education. Also, students respond to questions about countertransference and how they would address it in supervision in each paper assignment. Competency: Apply social work ethical principles to guide professional practice Social workers have an obligation to conduct themselves ethically and to engage in ethical decisionmaking. Social workers are knowledgeable about the value base of the profession, its ethical standards, and relevant law. Social workers: Covered in class through (i.e., Practice Behavior Assessed Advanced: Identify and analyze value-based and ethical dilemmas that arise in their area of practice, using professional codes of ethical standards and through appropriate professional consultation. activity, reading, content) When these conflicts arise in case examples, they are discussed however this is not the focus of this course. Competency: Apply critical thinking to inform and communicate professional judgments Social workers are knowledgeable about the principles of logic, scientific inquiry, and reasoned discernment. They use critical thinking augmented by creativity and curiosity. Critical thinking also requires the synthesis and communication of relevant information. Social workers: Practice Behaviors Advanced: Identify and synthesize multiple sources of knowledge to understand policy and practice issues related to their area of practice. Advanced: Identify and evaluate models of assessment, prevention, intervention and evaluation that are appropriate to their area of practice. Covered in class through (i.e., activity, reading, content) The course focuses on practice issues and skill development but does not delve into policy Every session of this course focuses on assessment, intervention and evaluation of evidence based practice. Assessed Paper 1: Diagnostic Assessment Paper 2: Integrated treatment plan with a survivor EP Engage diversity and difference in practice Social workers understand how diversity characterizes and shapes the human experience and is critical to the Page 3 of 20

4 formation of identity. The dimensions of diversity are understood as the intersectionality of multiple factors including age, class, color, culture, disability, ethnicity, gender, gender identity and expression, immigration status, political ideology, race, religion, sex, and sexual orientation. Social workers appreciate that, as a consequence of difference, a person s life experiences may include oppression, poverty, marginalization, and alienation as well as privilege, power, and acclaim. Social workers: Covered in class through (i.e., Practice Behavior Assessed Advanced: Engage in practice that challenges the systems of privilege and oppression by utilizing the culturally relevant assessments and interventions specific to the context of their area of practice activity, reading, content) Culturally relevant assessment and treatment is covered in week 3, 4, 5 and week 12. Paper 1: Diagnostic Assessment paper covers influence of diversity of assessment Paper2: treatment plan covers influence of diversity on treatment. EP Advance human rights and social and economic justice Each person, regardless of position in society, has basic human rights, such as freedom, safety, privacy, an adequate standard of living, health care, and education. Social workers recognize the global interconnections of oppression and are knowledgeable about theories of justice and strategies to promote human and civil rights. Social work incorporates social justice practices in organizations, institutions, and society to ensure that these basic human rights are distributed equitably and without prejudice. Social workers: Covered in class through (i.e., Practice Behaviors Assessed Advanced: Gain a full comprehension about disparities and their development, contribute to knowledge about institutional barriers to equality and apply concentrationappropriate strategies to advance social and economic justice. activity, reading, content) The treatment of trauma is introduced by discussing the sociopolitical context that places people at risk for trauma based in multiple interlocking discriminations and in this regard the context for treatment is viewed as a human rights strategy, to restore dignity, leadership, power and voice to those who have been victimized. Contextual factors contributing to trauma are assessed in Paper1: Case conceptualization and Paper 2: Treatment plan EP Engage in research-informed practice and practice-informed research Social workers use practice experience to inform research, employ evidence-based interventions, evaluate their own practice, and use research findings to improve practice, policy, and social service delivery. Social workers comprehend quantitative and qualitative research and understand scientific and ethical approaches to building knowledge. Social workers: Practice Behaviors Advanced: Demonstrate ability to evaluate practice and/or programs in an area of concentration Covered in class through (i.e., activity, reading, content) Treatment Planning is discussed weeks Students learn evidence based approaches to trauma treatment with children and adults as well as how to evaluate their effectiveness. Assessed Evaluation of treatment is focused on in Paper 2: Treatment Plan Advanced: Demonstrate ability use The course focuses on program Students are asked to raise Page 4 of 20

5 practice experience to shape research questions, methods and processes to advance knowledge in an area of concentration. evaluation of treatment interventions. Students raise research questions in the context of understanding issues related to treatment effectiveness. questions about the course material at three different times in their journal submissions. Competency: Apply knowledge of human behavior and the social environment Social workers are knowledgeable about human behavior across the life course; the range of social systems in which people live; and the ways social systems promote or deter people in maintaining or achieving health and well-being. Social workers apply theories and knowledge from the liberal arts to understand biological, social, cultural, psychological, and spiritual development. Social workers: Practice Behavior Advanced: Evaluate and synthesize theories and perspectives of human behavior and the social environment to choose and apply methods of assessment, intervention and evaluation in their area of practice CMH only: Demonstrate knowledge of ethnocultural, biological, psychological and spiritual frameworks, and multi-axial diagnostic classification systems used in the formulation of comprehensive mental health assessment and intervention planning. Covered in class through (i.e., activity, reading, content) Students are introduced to developmental antecedents of complex ptsd in weeks 3 and 4. They cover psychodynamic and cognitive behavioral theories in choosing approaches to treatment weeks This is covered in weeks 1-6. Assessed Students choose a treatment plan approach and offer a theory of change in Paper 2: Treatment Plan Paper1: Diagnostic Assessment/case conceptualization. Competency: Respond to contexts that shape practice Social workers are informed, resourceful, and proactive in responding to evolving organizational, community, and societal contexts at all levels of practice. Social workers recognize that the context of practice is dynamic, and use knowledge and skill to respond proactively. Social workers: Practice Behavior Advanced: Assess the impact of historical and contemporary contexts on practice and policy in their area of practice. Advanced: Organize and advocate with community members, program participants, service providers, community organizations, policy makers and the public to improve practice and service delivery in their Covered in class through (i.e., activity, reading, content) Briefly discussed in week 1 and the discussion of the development of treatment approaches in weeks I discuss my work in this regard in class but it is not covered or assessed. Not assessed. Assessed area of practice. CMH Competency: (a)-(b) Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities Professional practice involves the dynamic and interactive processes of engagement, assessment, intervention, and evaluation at multiple levels. Social workers have the knowledge and skills to practice with individuals, families, groups, organizations, and communities. Practice knowledge includes identifying, analyzing, and Page 5 of 20

6 implementing evidence-based interventions designed to achieve client goals; using research and technological advances; evaluating program outcomes and practice effectiveness; developing, analyzing, advocating, and providing leadership for policies and services; and promoting social and economic justice. Covered in class through (i.e., Practice Behavior Assessed Advanced - Engage: Use empathy and collaborative interviewing skills to engage clients in identifying their strengths and problems. Advanced - Engage: Establish rapport and maintain effective working relationships with clients in clinical mental health settings. Advanced - Engage: Employ diverse strategies to arrive at a collaborative focus of work and desired outcomes in clinical social work mental health practice. Advanced - Assess: Employ knowledge of the DSM-IV, the psychosocial assessment interview, and collateral information from key informants and agencies when appropriate to develop a comprehensive collaborative assessment. Advanced - Assess: Conduct risk assessment according to ethical and legal standards pertaining to child maltreatment, homicide, suicide and other life threatening circumstances. Advanced - Assess: Assess individuals, families, groups, organizations, and communities to determine a range of potentially effective and appropriate interventions to improve practice outcomes related to clinical social work practice in mental health. Advanced - Intervention: Use appropriate evidenced-based interventions to help clients resolve identified and agreed upon problems. Advanced - Intervention: Maintain accurate records documenting the assessment, interventions and outcomes. activity, reading, content) Weeks 1-6 Week 5: Interviewing and Diagnostic Assessment Week 5, Interviewing Week 6, 7, TF-CBT, DBT Week 10, PE Week 12-15, special populations and approaches Week 5: Interviewing and Diagnostic Assessment Weeks 3&4;, Understanding developmental antecedents of trauma This knowledge has been covered in previous courses, not a focus of this course. Weeks 12-15, focusing on special populations and contexts for treatment Weeks 6-15 covering evidence based interventions for trauma Covered in weeks 6-15 through introduction to manualized treatments Paper 1: Diagnostic Assessment and through interactive classroom practice with engagement, alliance, collaborative assessment. Paper 1: Diagnostic Assessment Paper1 : Diagnostic Assessment and interactive classroom practice Paper1: Diagnostic Assessment and interactive classroom practice Paper2: Treatment plan Paper 2: Integrated treatment plan approach applied to a case/community intervention Paper 2: Integrated treatment plan Advanced - Evaluate: Apply research Weeks 5-15 covering Paper1: Diagnostic Assessment Page 6 of 20

7 skills to analyze, monitor, evaluate and improve treatment alliance and interventions and programs in clinical social work practice in mental health. Advanced - Evaluate: Communicate and disseminate research and evaluation results to a variety of local, regional, national or global audiences when appropriate. diagnostic assessment and evidence based treatments This is not specifically discussed. Paper 2: Treatment plan Part III: Course requirements Required Texts: Briere, J. & Scott, C. (2006). Principles of Trauma Therapy: A guide to Symptoms, Evaluation and Treatment. Sage Publications. Herman, J. L. (1997). Trauma and Recovery: The aftermath of violence from domestic abuse to political terror. Basic Books. Kabat-Zinn, J. (2005) Full catastrophe living; using the wisdom of your body and mind to face stress, pain and illness. Bantam Dell, Random House, New York, NY. Sapphire. (1996). Push. New York: Vintage Books. Zayfert, C. & Becker, C. B. (2008). Cognitive Behavioral Therapy for PTSD. New York: Guilford Press. Required Training: Complete TF-CBT online training located at (4-10 hours) It is recommended that you begin this training and work toward completing it by the end of spring break. Recommended Texts: Courtois, C.A. & Ford, J.D. (2009) Treating complex traumatic stress disorders: An evidence-based guide. The Guilford Press. New York, NY. Foa, E. B., Keane, T. M., Friedman, M.J., & Cohen, J.A. (2009) Effective treatments for PTSD: Practice guidelines from the international society for traumatic stress studies. The Guilford Press. New York, NY. Foa, E., Hembree, E., Olaslov, R. (2007) Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences therapist guide. Oxford University Press. New York, NY. Perlman, S.D. (1999) The Therapist s Emotional Survival: Dealing with the pain of exploring trauma. Rowman & Littlefield Publishers. Page 7 of 20

8 Pearlman, L. & Saakvitne, K. Trauma and the Therapist: Countertransference and Vicarious Traumatization in Psychotherapy with Incest Survivors. Dimeff, L., & Koerner, K. (2007) Dialectical Behavior Therapy in Clinical Practice: Applications across disorders and settings. Guilford Press. Schauer, M., Neuner, F., Elbert, T. (2005) Narrative Exposure Therapy: A Short-term Intervention for Traumatic Stress Disorders after War, Terror, or Torture, Hogrefe & Huber, Ashland, OH. Najavitz, L. (2002) Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. The Guilford Press, New York, NY. 2. Assignments 1. Facilitating discussion: Several students will volunteer to lead discussion for each of the class meetings. Please sign up for dates to lead discussion on the first day. The discussion questions are already developed for the classes on complex trauma. The students who sign up for this session will play the role of leading discussion and compiling evidence to share in a large group discussion. Discussion questions for your week should be submitted to the instructor via on Wednesday before the upcoming Friday class. Please submit at least three questions for discussion. Please ensure that your classmates are successful at generating discussion by doing the reading ahead of time. (5% of grade) 2. Group Secondary Trauma Journal Project: Each student will be required to keep a journal throughout the course on their reactions to the cases discussed and course material. The journal should include weekly entries (2-3 pages double spaced) that respond to the following questions: 1) What are your feelings in response to the readings? 2) What are your thoughts/questions about the readings? 3) What are your behavioral responses to the material (positive and negative) and 4) What are some self-care strategies for addressing your thoughts and feelings? How often and for how long did you practice selfcare strategies? You may answer these questions in relation to the content of your weekly reading including commenting on secondary trauma, self-care strategies, assessment and treatment approaches to trauma, counter-transference, and other topics discussed in the course. Your journals will be turned in at four different times in the semester as noted on your syllabus. The journals that you submit should represent a composite of what you wrote in your weekly journal. They will be graded 5 points each. The instructor will offer brief comments to encourage continued exploration and they will be returned prior to the next journal assignment. Your final journal assignment will be to get together with three other classmates and share your answers to these questions throughout the course in a meaningful way. After sharing your responses, create a group three page document that represents your best answer to the questions listed above. Your final journal assignment will be worth 5% of your grade. The purpose of the group journal project is twofold: 1) to work toward developing comfort with using your own feelings and reactions as information for understanding your clients and 2) to become more comfortable using your colleagues for peer consultation on counter-transference and vicarious trauma reactions. Page 8 of 20

9 3.Diagnostic Assessment and Case Conceptualization of Precious. This will be a five page assessment paper that demonstrates your ability to apply concepts of developmental trauma to the diagnosis and conceptual discussion of a case of childhood abuse. A detailed outline of the paper will be provided after the second class. (30% of grade) Alternative assignment for non-mental health concentrators: This will be a five page assessment paper that demonstrates your ability to apply concepts of developmental trauma to the diagnosis and conceptual discussion of the impact of trauma on families and communities. A detailed outline of the paper will be provided after the second class. (30%) 4.Detailed Treatment of a Trauma Survivor. This will be a 7 page paper that demonstrates your ability to apply a treatment method to a trauma survivor. You may choose one of three client descriptions that will be provided in class. An outline for this paper will be provided. (40% of grade) Alternative assignment for non-mental health concentrators: This will be a 7 page paper that demonstrates your ability to apply knowledge of the impact and treatment of trauma to family and community level interventions. You may choose from an alternative list of community level traumas to focus your paper. An outline for this paper will be provided. (40% of grade) Grade Distribution and Assignment Weighting The grade weight and due date for each assignment is listed below: Assignment Due Date Points Case Conceptualization of 30 Precious/community Reflective Journals and final 25 (5 points each) group journal Treatment Process Plan for 40 survivor/community Class Participation and leading discussions Ongoing 5 Evaluation and Grading Scale A A B B B C C C D D Page 9 of 20

10 Course Policies There are many University and School of Social Work policies that govern this course. Please go to to see a complete description of all the policies. Part IV: Course content Week 1: Introduction to the Treatment of Trauma Topics: Review syllabus, introduce research question associated with course Students share placements and interest/experience in trauma therapy Students listen to MPR interview with 35W bridge survivors Understanding the experience of trauma and sitting with trauma Required Reading: reading may be assigned related to listening to trauma Begin reading of Sapphire. (1996). Push. New York: Vintage Books. Activity: Students will listen to two survivors of the 35W bridge collapse who were interviewed two months after the bridge collapsed. Listen for the different trauma symptoms/reactions that each survivor describes. Take out a piece of paper and list the symptoms as you hear them. Then take a minute to think about your reaction to listening to each survivor. What feelings or thoughts came up for you while you listened? Break into smaller groups for discussion of what you wrote. Discuss how what you experienced can be used to understand the experience of the survivors. If you were a therapist for these survivors, what would you do to begin to help them? We will revisit this question later in the course. Week 2: Topics: Introduction to Vicarious Trauma and Mindfulness based approaches to selfcare Lecture: Understanding vicarious trauma as normal reactions to working with trauma survivors and self-care strategies Practice with mindfulness and relaxation exercises Use of writing and journaling for self-care throughout the course Required Reading: Pearlman, L. & Saakvitne, K. (1995) Trauma and the Therapist. Chapter 18: Addressing vicarious traumatization. W.W. Norton and Co., Inc.: New York. Kabat-Zinn, J. (2005) Full catastrophe living; using the wisdom of your body and mind to face stress, pain and illness. Bantam Dell, Random House, New York, NY. Part I and Chapters 19 and 20. Pennebaker, J. W. (1997) Writing about emotional experiences as a therapeutic process. Psychological Science. 8:162. Page 10 of 20

11 Antal, H. M.A. & Range, L. (2005) Psychological impact of writing about abuse or positive experiences. Violence and Victims, Vol 20, No. 6, Continue reading of Sapphire. (1996). Push. New York: Vintage Books. Recommended: Perlman, S. D. (1999). The Therapist s Emotional Survival: Dealing with the Pain of Exploring Trauma. Read Chapters 2, 3 and 4 over the next few weeks. Week 3: Topics: Understanding the developmental antecedents of Complex Posttraumatic Stress Disorder in Adulthood: attachment, attunement, affect regulation First Journal assignment is due! Lecture: Overview of traumatic development with attention to modern theory and research on attachment, attunement and affect regulation. Required Reading: Sapphire. (1996). Push. New York: Vintage Books. Underline passages related to attachment style in one color, passages related to attunement in another color and passages related to affect regulation in another color. This practice will be helpful for writing your paper assignments. Main, M. (2000). The Organized Categories of Infant, Child, and Adult Attachment: Flexible vs Inflexible Attention under Attachment-Related Stress, Journal of the American Psychoanalytic Association, 48 (4), pp Hesse, E. & Main, M. (2000). Disorganized Infant, Child, and Adult Attachment: Collapse in Behavioral and Attentional Strategies, Journal of the American Psychoanalytic Association, 48(4), Fraiberg, S., Adelson, E., & Shapiro, V. (1975). Ghosts in the nursery: A psychoanalytic approach to the problems of impaired infant-mother relationships. Journal of the American Academy of Child Psychiatry, 14, Shore, J.& Allan, N. (2008). Modern attachment theory; The central role of affect regulation in development and treatment. Clinical Social Work Journal, 36:1, pp Recommended Reading: On attachment in psychotherapy: Slade, A. (2004). Two therapies: Attachment organization and the clinical process. In L.Atkinson & S. Goldberg (Eds), Attachment Issues in Psychopathology and Intervention Mahwah, anj: Lawrence Erlbaum Associates. Steele, H. & Steele, M. (2008). Clinical Applications of the Adult Attachment Interview. New York: Guilford Press. Pp Page 11 of 20

12 Wallin, D.J. (2007) Attachment in Psychotherapy. New York: Guilford Press. (Chapter 1: Attachment and Change) On the integration of theory about attachment, attunement and affect regulation: Siegel, D. J. (1999). The Developing Mind: How relationships and the brain interact to shape who we are. New York: The Guilford Press. (Chapter 3: Attachment. pp ). Activities: Using the novel Push, come to class prepared to discuss the concepts of attachment, attunement and affect regulation in relation to Precious and her mother. If there is time, we will also discuss the parents described in Ghosts in the Nursery. The class discussions are organized around the following questions: 1. What are the attachment styles of Precious and her mother? Come to class prepared with quotes from Push that describe the attachment styles of Precious and her mother. If Precious came to you for psychotherapy as an adult, how would you expect her attachment style to impact the therapy relationship? 2. Discuss the concept of attunement and whether or not there is evidence of attunement in Precious? Provide quotes from the book. Refer to your articles. 3. Discuss whether or not Precious was able to regulate her affect. Give evidence in quotes/passages from the book. How is her capacity to regulate her affect related to her attachment style? Refer to your articles. How would she behave in therapy? Understanding Secondary or Vicarious Trauma as a natural reaction to working with trauma Discuss your reactions to reading, Push 1. How did you feel reading the novel? What was the hardest part about listening to Precious? When you felt these difficult feelings, what did you do to take care of yourself or in reaction to these feelings? (positive and negative reactions) 2. Imagine that you were the therapist listening to Precious. How would you handle your feelings while responding to her empathically? Do you think it is okay to express feelings in front of your clients? If so, how would you do that? Week 4: Topics: Understanding the developmental antecedents of Complex Posttraumatic Stress Disorder in Adulthood: mentalization Lecture: the development of the capacity for mentalization or reflective functioning in adult psychotherapy Required reading: Page 12 of 20

13 Sapphire. (1996). Push. New York: Vintage Books. Underline/highlight passages related to the development of mentalization in Precious in a different color. This practice will be helpful for writing your paper assignments. Slade, A. (2005). Parental reflective functioning: An introduction. Attachment and Human Development,7 (3), Fonagy, P. and Bateman, ( 2008) A., The development of borderline personality disorder a mentalizing model. Journal of personality Disorders, 222: 4-21 Activities: Using the novel Push, come to class prepared to discuss the concepts of reflective functioning and mentalization in relation to Precious and her mother. If there is time, we will also discuss the parents described in Ghosts in the Nursery. The class discussions are organized around the following questions: 1. How does Precious capacity for reflective functioning/mentalization change over time? How does this capacity grow through her experiences at Each One, Teach One? Provide evidence from the book. 2. If you were her therapist, how would you help her to develop her capacity for reflective functioning? Understanding Secondary or Vicarious Trauma as a natural reaction to working with trauma 1. What were you thinking about Precious as you read her story? Did you have any thoughts that made you feel uncomfortable? Were you curious to read about her abuse? Did you feel avoidant of this material? How do you respond to or use the thoughts that you have about your clients in session? 2. What are some self-care strategies that you can use to help manage overwhelming thoughts and feelings in response to the traumatic material in this course and in session with your clients? 3. How did the readings from The Therapist s Emotional Survival help you understand your experience? Week 5: Topics: Diagnostic Assessment of Trauma Lecture: Assessing Trauma including PTSD and Comorbid Disorders Diagnosing Acute Stress, PTSD, Major Depressive Disorder, Personality Disorders, Differential Diagnoses Changes to PTSD for DSM V. Page 13 of 20

14 Interviewing survivors Required Reading: Briere, J. & Scott, C. (2006) Principles of Trauma Therapy. Chapters 2, 3 and 4 covering definitions, effects and assessment of trauma. Herman, J.L. (1992) Trauma and Recovery, Chapters 2-5. Ford., J. & Courtois, C. Defining and Understanding Complex Trauma and Complex Traumatic Stress Disorders pp , in Courtois, C. & Ford, J. (2009) Treating Complex Traumatic Stress Disorders, New York: Guilford Press. Schillaci, J., Yanasak, E., Adams, J.H., Dunn, N.J., Rehm, L.P., Hamilton, J. D., (2009). Guidelines for Differential Diagnoses in a Population with Posttraumatic Stress Disorder. Professional Psychology: Research and Practice, 1, Wilson, J.P. & Tang, C.S. (2007). Chapter 2: Cultural-Ecological Perspectives on the Understanding and Assessment of Trauma in Cross-Cultural Assessment of Psychological Trauma and PTSD. Springer. Recommended Reading: Foa, E.B., Keane, T. M., Friedman, M.J., Cohen, J.A. (2009) Effective Treatments for PTSD. New York: Guilford Press. Activities: Practice with Interviewing Assessment and Diagnosis using measures in role plays Utilize invisible consultant model (handouts) Week 6: Treatment of Complex PTSD in Children Topics: Lecturer: Ann Gearity, Lecture: Treatment of Complex PTSD Required reading: Gearity, A. Developmental Repair: A training manual. Washburn Center for Children. Chapter 4: Developmental Repair: The model. Downloadable from website.: instructions will be provided in class. Ford, J. & Cloitre, M. Best Practices in Psychotherapy for Children and Adolescents, in Courtois,C. & Ford, J. Treating Complex Traumatic Stress Disorders: An evidence-based guide. Chapter 3, p.59. Week 7: Treatment of Complex PTSD in Adulthood Introduction to Dialectical Behavioral Therapy First Paper: Case Conceptualization of Precious is due! Page 14 of 20

15 Topics: Activities: Sequelae of Complex PTSD in adulthood Recognizing and working with transference and countertransference paradigms Lecture: Kim Pavlik Case presentation of treatment of complex ptsd (powerpoint discussion) Lecture: Dialectical Behavioral Therapy Briere, J. & Scott, C. (2006). Chapters 4 & 5 Principles of Trauma Therapy: A guide to Symptoms, Evaluation and Treatment. Sage Publications. Herman, J.L. (1992) Trauma and Recovery, Part II. Dimeff, L. & Linehan, M. (2001) Dialectical behavior therapy in a nutshell. The California Psychologist, 34, Lynch, T., Trust, W., Salsmen, N., Linehan, M. (2007) Dialectical behavior therapy for borderline personality disorder. Annual Review of Clinical Psychology, 3: Wallin, D.J. (2007) Chapter 14, The Unresolved Patient: Healing the Wounds of Trauma and Loss. In Attachment in Psychotherapy. New York: Guilford Press. Recommended reading: Davies, J.M. & Frawley, M. G. (1994) Treating The Adult Survivors of Childhood Sexual Abuse: A Psychoanalytic Perspective. Chapters 8 and 9. The Impact of Trauma on Transference and Countertransference. Week 8: Introduction to Cognitive Behavioral Approaches to Treating Trauma Journal Assignment is due! Topics: Activities: Lecture: Introduction to Cognitive Behavioral Therapy for Trauma TF-CBT for Children Discussion of Readings Practice with Exposure Techniques Breathing Retraining Required reading: Complete TF-CBT online training located at (4-10 hours) Page 15 of 20

16 Bratton, S. C., Ray, D, Rhine, T. & Jones L. (2005) The efficacy of play therapy with children: A metaanalytic review of treatment outcomes. Professional Psychology: Research and Practice, 30, 4, Zayfert, C. & Becker, C. B. (2008). Cognitive Behavioral Therapy for PTSD. New York: Guilford Press. Chapters 1,2 Schnurr, P.P. et. al. (2007). Cognitive behavioral therapy for posttraumatic stress disorder in women: A randomized controlled trial. JAMA, 297 (8): Recommended Reading: Cohen, J. (2006). Treating Trauma and Traumatic Grief in Children and Adolescents. Orsofsky, J.D. (2004) Young Children and Trauma: Intervention and Treatment. Guilford Spring Break Week 9: Topics: Understanding the Neurobiology and Psychopharmacology of Trauma Second Journal Assignment is due! Guest Speaker: Dr. Eric Brown, MD Medical Director, PTSD Team, Veterans Affairs Medical Center The Impact of Trauma on the Brain Required Reading: Ford., J. & Courtois, Chapter 2: Neurobiological Developmental Research, pp in Courtois, C. & Ford, J. (2009) Treating Complex Traumatic Stress Disorders, New York: Guilford Press. Kimble, M. & Kaufman, M. (2004) Clinical correlates of neurological change in posttraumatic stress disorder: an overview of critical systems. Psychiatric Clinics of North America, 27, Chapter 16: Pharmacotherapy, pp , in Courtois, C. & Ford, J. (2009) Treating Complex Traumatic Stress Disorders, New York: Guilford Press. Van der Kolk, B. (2003) The neurobiology of childhood trauma and abuse. Child and Adolescent Psychiatric Clinics, 12, Activities: Week 10: Discussion of neurobiology lecture, questions Discussion of implications for treatment, changes in brain functioning after treatment Cognitive Behavioral Approaches to Treatment of Trauma Introduction to Prolonged Exposure Page 16 of 20

17 Topics: Activities: Prolonged Exposure Therapy Lecture: Kim Pavlik Film: Prolonged Exposure Lecture: Prolonged Exposure Practice with Prolonged Exposure Required reading: Zayfert, C. & Becker, C. B. (2008). Cognitive Behavioral Therapy for PTSD. New York: Guilford Press Chapters 4-7. Rauch, S. & Foa, E. (2006) Emotional Processing Theory (EPT) and Exposure Therapy for PTSD. Journal of Contemporary Psychotherapy, 36: Week 11: Topics: Activties: Continuation of Cognitive Behavioral Approaches to Treating Trauma Cognitive Processing Therapy Lecture on Cognitive Processing Therapy Lecture: Kim Pavlik Practice with Cognitive Processing Therapy Required reading: Zayfert, C. & Becker, C. B. (2008). Cognitive Behavioral Therapy for PTSD. New York: Guilford Press Chapters 8-9. Research on CPT sent via Week 12: Responding to Disaster Situations: Green Cross Working with refugees and war trauma; Narrative Exposure Therapy Third journal assignment is due! Topics: Guest Speaker: Dan Casey, Executive Director Green Cross Academy of Traumatology Lecture: Understanding trauma in refugee populations Introduction to Narrative Exposure Therapy (Patty) Adapting NET to outpatient settings Activities: Discussion of readings Guest lecture Practice with constructing a lifeline Page 17 of 20

18 Required reading: Possible film Mendenhall, Tai, J. and Berge, J. (2010) Family therapists in trauma-response teams: bringing systems thinking into interdisciplinary fieldwork. Journal of Family Therapy, 32, van der Veer, Guus. Counselling and Therapy with Refugees and Victims of Trauma: Psychological problems of victims of war, torture and repression. Chapter 1. Second edition. John Wiley & Sons. Selected chapters. Nickerson, A., Bryant, R. A., Silove, D., & Steel, Z. (2011) A critical review of psychological treatments of posttraumatic stress disorder in refugees. Clinical Psychology Review, 31, Robjant, K. (2010 )The emerging evidence for Narrative Exposure Therapy: A review. Clinical Psychology Review, 30, Ruf, M., Schauer, M., Neuner, F., Catani, C., Schaur, E., Elbert, T. (2010) Narrative Exposure Therapy for 7-16 year olds; A randomized controlled trial with traumatized refugee children. Journal of Truamatic Stress, 23, 4, Week 13: Treating Co-morbid Disorders: Substance Use Topics: Lecture on seeking safety program with veterans Lecture: Jennifer Simmelink, MSW, Doctoral Candidate, SSW Required reading: Hien, D. A. et. al (2010) Do treatment improvements in PTSD severity affect substance use outcomes? A secondary analysis from a randomized clinical trial in NIDA s clinical trials Network. American Journal of Psychiatry, 167:1, January. Jacobsen, L. K., Southwick, S. M., & Kosten, T. R. (2001). Substance use disorders in patients with posttraumatic stress disorder: A review of the literature. The American Journal of Psychiatry, 158(8), Najavits LM (2004). Assessment of trauma, PTSD, and substance use disorder: A practical guide. In: Wilson JP, Keane T (Eds.), Assessing psychological trauma and PTSD (2nd ed.), pages New York: Guilford Press. Najavitz, L. (2002) Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. The Guilford Press, New York, NY. Pages Week 14: Working with Domestic Violence Final Paper on Treatment of Trauma is due! Page 18 of 20

19 Topics: Activities: Guest Speaker: Emily Becher, MS, LAMFT, Doctoral Student, FSoS Family Social Science Working with Domestic Violence Practice generating safety plans with domestic violence survivors Practice with family approaches Required Reading: Davis, J., (1997). Safety Planning, Greater Hartford Legal Alliance. DeGue, S. & DiLillo, D. (2009). Is animal cruelty a red flag for family violence?: Investigating cooccurring violence toward children, partners, and pets. Journal of Interpersonal Violence, 24: Frederick, L. Effective Advocacy on Behalf of Battered Women. Battered Women s Justice Project. Minnesota Domestic Violence Fact Sheet, National Coalition Against Domestic Violence. Swan, S. & Snow D. (2002). A typology of women s use of violence in intimate relationships. Violence Against Women, (8), Zink, T. Levin, L., Putnam, F., Beckstrom, A. (2007). Accuracy of five domestic violnece screening questions with non-graphic language. Clinical Pediatrics, 46:2, Week 15: Topics: Interventions for Acute Stress Final journal assignment is due! Group journal assignment is due! Guest Speaker: Tai Mendenhall, University Medical Corps First Responders Activities: Course evaluation Practice with Acute Stress and First responder scenarios Practice with 35W bridge scenarios Processing evaluation of course Required reading: Briere, J. & Scott, C. (2006). Chapter 10: Treating the Effects of Acute Trauma. Principles of Trauma Therapy: A guide to Symptoms, Evaluation and Treatment. Sage Publications. Vernberg, E. M. et. al. (2008). Innovations in Disaster Mental Health: Psychological First Aid. Professional Psychology: Research and Practice. Vol. 39, No Additional Bibliography Page 19 of 20

20 Cohen, J. (2006). Treating Trauma and Traumatic Grief in Children and Adolescents. Courtois, C.A. & Ford, J.D. (2009) Treating complex traumatic stress disorders: An evidence-based guide. The Guilford Press. New York, NY. Davies, J.M. & Frawley, M. G. (1994) Treating The Adult Survivors of Childhood Sexual Abuse: A Psychoanalytic Perspective. Chapters 8 and 9. The Impact of Trauma on Transference and Countertransference. Dimeff, L., & Koerner, K. (2007) Dialectical Behavior Therapy in Clinical Practice: Applications across disorders and settings. Guilford Press. Foa, E., Hembree, E., Olaslov, R. (2007) Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences therapist guide. Oxford University Press. New York, NY. Foa, E.B., Keane, T. M., Friedman, M.J., Cohen, J.A. (2009) Effective Treatments for PTSD. New York: Guilford Press. Najavitz, L. (2002) Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. The Guilford Press, New York, NY Orsofsky, J.D. (2004) Young Children and Trauma: Intervention and Treatment. Guilford Perlman, S. D. (1999). The Therapist s Emotional Survival: Dealing with the Pain of Exploring Trauma. Pearlman, L. & Saakvitne, K. Trauma and the Therapist: Countertransference and Vicarious Traumatization in Psychotherapy with Incest Survivors. Schauer, M., Neuner, F., Elbert, T. (2005) Narrative Exposure Therapy: A Short-term Intervention for Traumatic Stress Disorders after War, Terror, or Torture, Hogrefe & Huber, Ashland, OH. Slade, A. (2004). Two therapies: Attachment organization and the clinical process. In L.Atkinson & S. Goldberg (Eds), Attachment Issues in Psychopathology and Intervention Mahwah, anj: Lawrence Erlbaum Associates. Steele, H. & Steele, M. (2008). Clinical Applications of the Adult Attachment Interview. New York: Guilford Press. Pp Siegel, D. J. (1999). The Developing Mind: How relationships and the brain interact to shape who we are. New York: The Guilford Press. (Chapter 3: Attachment. pp ). Wallin, D.J. (2007) Attachment in Psychotherapy. New York: Guilford Press. (Chapter 1: Attachment and Change) Page 20 of 20