PLYMOUTH STATE UNIVERSITY Addictions & Related Disorders (CRN: 30025) CO-5720.01 Teaching Lecturer: Robert A. Ulman, LCMHC, MLADC Work Site: The Plymouth State University Counseling & Human Relations Center Office Hours: Wednesday By appt.; meeting place to be arranged Tel.: (603) 535-2461 E-mail: raulman@plymouth.edu Room: Rounds Hall 118 CONTENT AREAS: Diagnosis of Substance Use Disorders Substance Use Disorder Evaluation & Assessment Models for Treatment & Intervention of Substance Use Disorders Treatment & Intervention with Special Populations Co-occurring Substance Use & Other Mental Health Disorders Effects of Common Mind-Altering Substances Substance Abuse & Disaster Behavioral Health Responses International Certification &Reciprocity Consortium (IC&RC) Licensing Requirements; 12 Core Functions KNOWLEDGE AND SKILLS OUTCOME: 1. Understands the history, philosophy, and trends in addiction counseling. 2. Understands ethical and legal considerations specifically related to the practice of addiction counseling. 3. Knows the roles, functions, and settings of addiction counselors, as well as the relationship between addiction counselors and other mental health professionals. 4. Knows the professional organizations, competencies, preparation standards, and state credentials relevant to the practice of addiction counseling. 5. Understands a variety of models and theories of addiction related to substance use and other addictions. 6. Knows the behavioral, psychological, physical health, and social effects of psychoactive substances and addictive disorders on the user and significant others. 7. Recognizes the potential for addictive disorders to mimic a variety of medical and psychological disorders and the potential for medical and psychological disorders to coexist with addiction and substance abuse. 8. Understands factors that increase the likelihood for a person, community, or group to be at risk for or resilient to psychoactive substance use disorders. 9. Understands the impact of crises, disasters, and other trauma-causing events on persons with addictions. 10. Understands the operation of an emergency management system within addiction agencies and in the community.
METHODS OF INSTRUCTION: Lecture, discussion, reading, experiential work, small group processing REQUIRED TEXTS: SUBSTANCE ABUSE information for School Counselors, Social Workers, Therapists & Counselors by Gary L. Fisher & Thomas C. Harrison 5 th Ed. 2013 ADDITIONAL READINGS: Alcoholics Anonymous Available online via the link below http://www.aa.org/bigbookonline/en_tableofcnt.cfm Substance Abuse Treatment For Persons With Co-Occurring Disorders: A Treatment Improvement Protocol (TIP 45) Provided in PDF format via Blackboard RESERVED READINGS: Clinical Work with Substance Abusing Clients edited by Shulamith Lala Ashenberg Straussner 2 ND ED. 2004 Chapters 14-17 RECOMMENDED TEXTS: Diagnostic Statistical Manual IV-TR, American Psychiatric Association, Washington, DC, 2000 STUDENT PERFORMANCE EVALUATION CRITERIA AND PROCEDURES: 1. Reading, Attendance and Participation: * Read assigned material (see Assignment Schedule) before class and participate in class discussions * As 20% of your grade for the course is based on your active participation in class, your reading, regular attendance and involvement will be critical to comprehension, skill development and demonstration of your knowledge of the course material 2. In Class Activities: * Compile one Substance Use History based upon a role-play with fellow class participant (CACREP CMHC Standards D1, G1, H2) * Group processing of the Substance Use History experience (CACREP CMHC Standards D1, G1, H2) * Present three (3) brief verbal journal article summaries (focusing on chosen special population) throughout the course, these will be integrated into the final paper. (CACREP CMHC Standards E3, I1, I3)
* Provided three examples of Alcohol & Other Drug Evaluations use the biopsychosocial history and assessment results to develop accurate multi-axial diagnoses for co-occurring disorders. (CACREP CMHC Standards C2, C4, G1, K1, K3, L1, L2) * Viewing two brief videos identify critical information for assessing clients exhibiting psychotic-like symptoms when possible substance use is unknown. Identify recommendations that will assist the medical personnel and mental health clinicians in actually diagnosing and treating the individual. (CACREP CMHC Standards A6, C2, D8, G1, H3, K3) * Active discussion regarding Spirituality vs. Religiosity based upon the reading of Alcoholics Anonymous Chapter 4 pp 44-57. Identify how spirituality impacts the recovery process. Discuss how the clinician s spiritual beliefs affect the counseling process. (CACREP CMHC Standards D3, D4, D8) * Group discussion of the American Society of Addiction Medicine s (ASAM) placement criteria. Identify community resources and agencies that provided services at each placement level. (CACREP CMHC Standards D4, F1, G1, H4) 3. Papers: * Fact Sheet- compilation of information regarding one specific substance. Information will include name, slang terms, symptoms of intoxication, symptoms of overdose and treatment approaches. Also identify how abuse of this substance might lead to misdiagnosis of other mental health issues. (CACREP CMHC Standards A6, D3, D8, J1, K3) * Written paper on a special population of your own choosing from Chapters 14 thru 20 of the reserved text Clinical Work with Substance Abusing Clients. The paper needs to focus on a brief summary, application to your current, or projected, work environment and potential resources or referrals. The information for the chosen population needs to be supported by a minimum of five applicable journal articles. Length of paper is to be a minimum of 10 pages (CACREP CMHC Standards C4, D4, D8, E3, F1, I1, I3, J1) *Journal Article Summaries- brief verbal presentations with an APA style annotated bibliography of journal articles related to your research for Written Paper or Fact Sheet. They may, or may not, be articles you use in your completed written assignments. (CACREP CMHC Standards F3, I1, I3) CLASS TOPICS AND ASSIGNMENT SCHEDULE: (Please Note if you have digital copy of the Fisher & Harrison Text the assigned pages may not align. Please pay attention to the chapter notations) Date Subject/Activity Readings
3/4/15 Introduction to Course Fisher & Harrison Chapter 1 pp 1-11 Bio/Psycho/Social History Fisher & Harrison Chapter 6 pp 101-116 Substance Use History 3/11/15 Screening & Intake Procedures TIP 42 Appendix K only Confidentiality Fisher & Harrison Chapter 5 pp 86-100 Diagnostic Criteria Fisher & Harrison Chapter 6 Substance Use Disorders Review pp 116-121 Brief Presentation of Journal Articles 3/18/15 Assessment Models TIP 42 Chapter 4 only Screening, Inventories & Assessment Tools Brief Presentation of Journal Articles 3/25/15 Neurobiology of Addiction Fisher & Harrison Chapter 2 pp 12-35 ASAM Patient Placement Criteria Levels of Care Brief Presentation of Journal Articles 4/1/15 Treatment Modalities & Fisher & Harrison Chapter 8 Interventions pp 136-167 Treatment Planning Documentation & Record Keeping Medication Assisted Treatment 4/8/15 Motivational Interviewing Fisher & Harrison Chapter 7 Harm Reduction pp 122-135 Stages of Change Brief Presentation of Journal Articles 4/15/14 Self-Help; Spirituality Alcoholics Anonymous Chapter 4 Vs. Religiosity pp 44-57 Treatment of Specific Substances Fisher & Harrison Chapter 8 Overview of Special Populations pp 169-186 Brief Presentation of Fisher & Harrison Chapter 9 Journal Articles pp 187-208
4/22/15 Prevention & Community Fisher & Harrison Chapter 15 Intervention pp 311-329 Children & Families Fisher & Harrison Chapter 11 Collateral Interviews pp 203-232 4/29/15 State Licensing Requirements (MLADC) Collaboration Clinical Supervisory Activities 5/6/15 Current Issues in Drug Treatment Handouts Course Evaluation PAPERS DUE The 2009 CACREP Standards assessed (A) and covered (c) in this course. CORE STANDARDS 3.g. theories and etiology of addictions and addictive behaviors, including strategies for prevention, intervention, and treatment. CLINICAL MENTAL HEALTH COUNSELING Students who are preparing to work as clinical mental health counselors will demonstrate the professional knowledge, skills, and practices necessary to address a wide variety of circumstances within the clinical mental health counseling context. In addition to the common core curricular experiences outlined in Section II.G, programs must provide evidence that student learning has occurred in the following domains: FOUNDATIONS A. Knowledge 6. Recognizes the potential for substance use disorders to mimic and coexist with a variety of medical and psychological disorders. COUNSELING, PREVENTION, AND INTERVENTION C. Knowledge 2.Knows the etiology, the diagnostic process and nomenclature, treatment, referral, and prevention of mental and emotional disorders. 4. Knows the disease concept and etiology of addiction and co-occurring disorders. D. Skills and Practices 1. Uses the principles and practices of diagnosis, treatment, referral, and prevention of mental and emotional disorders to initiate, maintain, and terminate counseling. 3. Promotes optimal human development, wellness, and mental health through prevention, education, and advocacy activities.
4. Applies effective strategies to promote client understanding of and access to a variety of community resources. 8. Provides appropriate counseling strategies when working with clients with addiction and co-occurring disorders. DIVERSITY AND ADVOCACY E. Knowledge 3. Understands current literature that outlines theories, approaches, strategies, and techniques shown to be effective when working with specific populations of clients with mental and emotional disorders. F. Skills and Practices 1. Maintains information regarding community resources to make appropriate referrals. ASSESSMENT G. Knowledge 1. Understands various models and approaches to clinical evaluation and their appropriate uses, including diagnostic interviews, mental status examinations, symptom inventories, and psychoeducational and personality assessments. H. Skills and Practices 2. Demonstrates skill in conducting an intake interview, a mental status evaluation, a biopsychosocial history, a mental health history, and a psychological assessment for treatment planning and caseload management. 3. Screens for addiction, aggression, and danger to self and/or others, as well as cooccurring mental disorders. 4. Applies the assessment of a client s stage of dependence, change, or recovery to determine the appropriate treatment modality and placement criteria within the continuum of care. RESEARCH AND EVALUATION I. Knowledge 1. Understands how to critically evaluate research relevant to the practice of clinical mental health counseling. 3. Knows evidence-based treatments and basic strategies for evaluating counseling outcomes in clinical mental health counseling. J. Skills and Practices 1. Applies relevant research findings to inform the practice of clinical mental health counseling. DIAGNOSIS
K. Knowledge 1. Knows the principles of the diagnostic process, including differential diagnosis, and the use of current diagnostic tools, such as the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). 2. Understands the established diagnostic criteria for mental and emotional disorders, and describes treatment modalities and placement criteria within the continuum of care. 3. Knows the impact of co-occurring substance use disorders on medical and psychological disorders. L. Skills and Practices 1. Demonstrates appropriate use of diagnostic tools, including the current edition of the DSM, to describe the symptoms and clinical presentation of clients with mental and emotional impairments. 2. Is able to conceptualize an accurate multi-axial diagnosis of disorders presented by a client and discuss the differential diagnosis with collaborating professionals. ADDICTION COUNSELING Students who are preparing to work as addiction counselors will demonstrate the professional knowledge, skills, and practices necessary to work in a wide range of addiction counseling, treatment, and prevention programs, as well as in a mental health counseling context. In addition to the common core curricular experiences outlined in Section II.G, programs must provide evidence that student learning has occurred in the following domains. FOUNDATIONS A. Knowledge 1. Understands the history, philosophy, and trends in addiction counseling. (c) 2. Understands ethical and legal considerations specifically related to the practice of addiction counseling. (c) 3. Knows the roles, functions, and settings of addiction counselors, as well as the relationship between addiction counselors and other mental health professionals. (c) 4. Knows the professional organizations, competencies, preparation standards, and state credentials relevant to the practice of addiction counseling. (c) 5. Understands a variety of models and theories of addiction related to substance use and other addictions. (c) 6. Knows the behavioral, psychological, physical health, and social effects of psychoactive substances and addictive disorders on the user and significant others. (c) 7. Recognizes the potential for addictive disorders to mimic a variety of medical and psychological disorders and the potential for medical and psychological disorders to coexist with addiction and substance abuse. (c)
8. Understands factors that increase the likelihood for a person, community, or group to be at risk for or resilient to psychoactive substance use disorders. 9. Understands the impact of crises, disasters, and other trauma-causing events on persons with addictions. (c) 10. Understands the operation of an emergency management system within addiction agencies and in the community. (c) COUNSELING, PREVENTION, AND INTERVENTION C. Knowledge 1. Knows the principles of addiction education, prevention, intervention, and consultation. (c) 2. Knows the models of treatment, prevention, recovery, relapse prevention, and continuing care for addictive disorders and related problems. (A) 3. Recognizes the importance of family, social networks, and community systems in the treatment and recovery process. (c) 4. Understands the role of spirituality in the addiction recovery process. (A) 5. Knows a variety of helping strategies for reducing the negative effects of substance use, abuse, dependence, and addictive disorders. (c) 6. Understands the principles and philosophies of addiction-related self-help programs. (c) 7. Understands professional issues relevant to the practice of addiction counseling, including recognition, reimbursement, and right to practice. 8. Understands the principles of intervention for persons with addictions during times of crises, disasters, and other trauma-causing events. DIVERSITY AND ADVOCACY E. Knowledge 1. Understands how living in a multicultural society affects clients with addictions. (c) 2. Understands current literature that outlines theories, approaches, strategies, and techniques shown to be effective when working with specific populations of clients with addictions. (A) 3. Knows public policies on local, state, and national levels that affect the quality and accessibility of addiction services. (c) 4. Understands effective strategies that support client advocacy and influence public policy and government relations on local, state, and national levels to enhance equity, increase funding, and promote programs that affect the practice of addiction counseling. (c) ASSESSMENT 7. Knowledge 1. Understands various models and approaches to clinical evaluation for addictive disorders and their appropriate uses, including screening and assessment for addiction, diagnostic interviews, mental status examination, symptom inventories, and psychoeducational and personality assessments. (c)
2. Knows specific assessment approaches for determining the appropriate level of care for addictive disorders and related problems. (c) 3. Understands the assessment of biopsychosocial and spiritual history. (c) 4. Understands basic classifications, indications, and contraindications of commonly prescribed psychopharmacological medications so that appropriate referrals can be made for medication evaluations and so that the side effects of such medications can be identified. (c) 8. Skills and Practice 1. Demonstrates skill in conducting an intake interview, a mental status evaluation, a biopsychosocial history, a mental health history, and a psychological assessment for treatment planning and case management. (A) 2. Applies assessment of clients addictive disorders to the stages of dependence, change, or recovery to determine the appropriate treatment modality and placement criteria in the continuum of care. (A) RESEARCH AND EVALUATION 9. Knowledge 1. Understands how to critically evaluate research relevant to the practice of addiction counseling. (A) 2. Knows models of program evaluation for addiction counseling treatment and prevention programs. (c) 3. Knows evidence-based treatments and basic strategies for evaluating counseling outcomes in addiction counseling. (A) 10. Skills and Practice 1. Applies relevant research findings to inform the practice of addiction counseling. (c) 2. Develops measurable outcomes for addiction counseling programs, interventions, and treatments. (c) 3. Analyzes and uses data to increase the effectiveness of addiction counseling programs. (c) DIAGNOSIS K. Knowledge 1. Knows the principles of the diagnostic process, including differential diagnosis, and the use of current diagnostic tools, such as the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). (A) 2. Knows the impact of co-occurring addictive disorders on medical and psychological disorders. (c) 3. Understands the established diagnostic and clinical criteria for addictive disorders and describes treatment modalities and placement criteria within the continuum of care. (c) 4. Understands the relevance and potential cultural biases of commonly used diagnostic tools as related to clients with addictive disorders in multicultural populations. (c)
L. Skills and Practices 1. Demonstrates appropriate use of diagnostic tools, including the current edition of the DSM, to describe the symptoms and clinical presentation of clients with addictive disorders and mental and emotional impairments. (a) 2. Is able to conceptualize an accurate multi-axial diagnosis of disorders presented by clients and communicate the differential diagnosis with collaborating professionals. (A) POLICIES Statement of Expectations: Plymouth State University s Counselor Education and School Psychology (CESP) Department is charged with the task of preparing individuals to become professional counselors and school psychologists in a variety of settings and to assume positions of leadership in the field. In order to fulfill these responsibilities, faculty evaluate students based on their academic, professional, and personal qualities. The PSU CESP department attempts to establish a learning community where students can develop professionally. We do this by providing an environment in which students rights and responsibilities are respected, and by respecting the dignity and worth of each student. A student s progress in the program may, however, be interrupted for failure to comply with academic standards or if a student s interpersonal or emotional status interferes with education/training and client care related to requirements for self and others. For example, in order to ensure proper training and client care, a counselor-in-training must abide by relevant ethical codes and demonstrate professional knowledge, technical and interpersonal skills, professional attitudes, and professional character. These factors are evaluated based on one s academic performance and one s ability to convey warmth, genuineness, respect, and empathy in interactions with clients, classmates, staff, and faculty. Students should be able to demonstrate the ability to accept and integrate feedback, be aware of their impact on others, accept personal responsibility, be able to express feelings appropriately, and evidence professional judgment in decision making relative to issues and situations encountered in the program. Late Assignments: Consistent with graduate level expectations, all assignments are expected on their due dates. However, exceptions to this rule may be made due to circumstances beyond the control of students such as family emergencies, illness, injury, power outages, computer malfunctions, accidents and other situations. Because of these
potentialities, students are advised to complete their assignments in advance of the due date. If possible, the student should request an extension for the assignment from the instructor before the assignment is due. If this is not possible, the student should contact the instructor as soon as possible after the due date. If an extension is granted, the assignment should be submitted no later than one week from the due date. In cases where the reason for the delay may require a longer time period to complete, the decision to allow a longer extension will be made on a case-bycase basis. Students may be asked to provide documentation to verify their request for an extension. Assignments that are handed in beyond the due date for which no extension is granted will not be accepted and result in a failing grade for the assignment. Incomplete Grades: Incomplete grades are strongly discouraged and should only be requested for emergency situations. If an IC grade is given, students will have no more than one full semester to complete the course requirements. After that, the registrar will record an F grade that will stand, and the course will have to be retaken. Academic Integrity is the foundation of the pursuit of knowledge. All members of the academic community are expected to be dedicated to the pursuit of knowledge in an honest, responsible, respectful and ethical manner. Every violation of academic integrity is an affront to the academic community. Violations of academic integrity make fair evaluation impossible and cast doubt upon the seriousness with which students accept the responsibility of acquiring an education. Visit plymouth.edu/registrar/policies/academic_standing for more information on University policies and procedure regarding academic integrity. (from page 12 of the College of Graduate Studies 2009-2010 Catalog). Please review APA guidelines on what constitutes plagiarism. Accommodations of Student Needs: Plymouth State University is committed to providing students with documented disabilities equal access to all university programs and facilities. If you think you have a disability requiring accommodations, you must register with the PASS office in Lamson library (535-2270). If you have a Letter of Academic Accommodation for this course from the PASS office, please provide me with that information privately so that we can review those accommodations. Computers and cell phones Use in Class:
Computers and cell phones may be brought into the classroom but their use should be appropriate. Computers should be limited to academic class-related uses such as note-taking. During class discussions, videos and student presentations, they should not be open. Cell phones play an important role in emergency situations but they should be kept on vibrate and not be used for receiving or sending text messages during the class meeting.