California State University, Sacramento
Division of Social Work
Social Work 204D
Multi-Level Practice with Persons Experiencing
Vulnerable Life Conditions
Case Management with People with Psychiatric Disabilities & Gerontology
Spring 2010
Dr. David Demetral, Ph.D., LCSW
Phone: 278-7168
E-mail: &
General Description:
SW 204D represents the fourth semester practice course in the Social Work curriculum. It builds upon and expands the SW 204A/B in substantial ways. Where the SW204A/B provided an opportunity for the student/consumer to achieve competence in the provision of direct and indirect services within an agency setting, it is recognized that the Multi-Level Practice will generally move toward more autonomous practice, supervisory levels of practice, and even administrative roles within organizations. Conceptually SW 204 A/B provided increased awareness and knowledge about generalist practice, which was then primarily shaped by the field setting in which the student/consumer was placed. SW204A/B also was constructed on a “linear” format in which individuals, families, groups, organizations and communities were covered one after another. SW 204D pulls from this linear base and demands that the student begins to conceptualize vertically by considering each of these levels of intervention concurrently. SW204D extends this learning conceptually by demanding integration of the foundation content into the skillful independent application of social work intervention strategies within at least two levels of intervention simultaneously. To support this expected change in sophistication and function, SW 204D provides advanced knowledge or skills in at least five areas:
1) Concepts, and models needed to understand the recovery and strengths based models with people with psychiatric disabilities;
2) Exposure to and expectation of mastery of advanced practice skills to address complex contemporary practice situations in Mental Health and Gerontology;
3) Ability to conduct disciplined and systematic practice based on clearly articulated theoretical principles through exploration, synthesis, and refinement of generic and generalists competencies; and
4) Ability to engage in theoretical and practice evaluation activities necessary to display accountability and evidence of effective practice.
Specific Knowledge, Skills, and Values Competencies
At the conclusion of this practice course the student/consumer should be able to
demonstrate mastery via written probed response, behavioral display in laboratory role-play, and behavioral display in the field practicum site of the following:
1. Knowledge of the Multi-Level relationship between social conditions, ethnic/sexual identity, economic resource availability, biological predisposition/current state and impact, psychological patterns of coping and adapting to stress and challenge, as they simultaneously
-2-
impact the presentation of the client system story (Assessed in response sets);
2. Knowledge of multiple theoretical perspectives (postmodern ecological, cognitive & cognitive behavioral individuals, families, and skills training group(s) (Assessed in the response sets in which the model must be identified) ;
3. Knowledge of the specific characteristics that differentiate “functional/adaptive” behavior(s) from “non-functional/maladaptive” behavior(s) in individuals, families, and groups. (Assessed in the response sets);
4. Knowledge of multiple methods, techniques, strategies of intervention, and how to determine which methods are related to which theoretical models and the timing for those strategies in the support/change process (Assessed in the response sets);
5. Knowledge of the interrelationship between social condition ecologically, human behavior presentation, social policy, and accountable research methodology and how to integrate your knowledge from these areas into your practice framework (Assessed in the response sets, particularly those focused on gender and ethnicity and mental health conditions);
Skills Objectives:
Demonstrated behavioral competence (skills) in the classroom laboratory, the field practicum, and in written probes:
· Initiating and completing accurate, in depth bio-psycho-social assessment. These assessments will address at least two levels of concurrent areas of intervention. Assessed in the response sets, and Bio-Psych-Social Field Assignment.
· Skill in gathering, utilizing, and evaluating data on client systems and problems as a basis for understanding their complex characteristics (i.e. assessing the individual, family, or small group within the context of the neighborhood/organization and specifically identifying supports and barriers in those messo/macro contexts) (Assessed in the response sets)
· Skills in developing in collaboration with the client’s system(s) realistic goals, objectives, and techniques designed to prevent problems, promote change, and improve the quality of the transaction within/between the client’s system and the ecology in which it exists (i.e. developing collaborative linkages to address and support micro level client systems change efforts) (Assessed in the field dialogue sessions)
· Skills at developing realistic contractual agreements and relationships with client systems
that permits the coordination of interventions while encouraging and protecting the rights
of the client’s system to determine its own destiny (i.e. using advocacy, brokerage, mediation
skills with messo and macro systems to address and facilitate supportive
commitments on behalf of the micro client system)(Assessed in the Field dialogue sessions)
· Demonstrated skillful application of intervention(s) in client systems and complex problem situations in consistent and deliberate ways that will improve, modify, or prevent dysfunction/maladaptive coping Assessed in the response sets; in class vignettes & discussions;
· Demonstrated skills in the areas of advocacy, brokering, and networking at the messo/macro level as well as coach, a mediator, a counselor, a teacher at the micro/mezzo levels. (As reflected in the professional journal)
-3-
· Skills at determining and using the most appropriate strategies and tools for evaluating the effectiveness of intervention in relation to those problems identified across two of the micro/messo/macro levels concurrently (assessed in the response sets).
· Skills in gathering, recording, understanding, and utilizing primary and secondary data and research findings as a basis for change in practice techniques and strategies and as a means of evaluating movement (or lack thereof) in the client’s system (assessed in the journal write-up)
· Skills in the effective termination of service, as well as the practice strategies necessary to increase the probability of maintenance and generalization of intervention gains post intervention. This is the essence of EMPOWERMENT...teaching the client to apply strategies of micro and messo intervention when faced with a life challenge in the future.
Format of the Course
Student/consumers are in multiple placements, with varying degrees of autonomous concurrent (micro/messo/macro) practice opportunities, and each section of this course is made
up of a mixture of student/consumers at different levels of competence in the expected areas.
Many of the students in the course have already had exposure to mental health conditions, even the DSM IV, yet intervention within a postmodern and recovery framework has not been addressed. This course will allow the student to synthesize and reinforce their practice-based experiences with a context focused on the “best practice” model of intervention with persons experiencing mental health and disability issues.
Realizing this reality, this course is structured within a process/experiential “laboratory” type framework. Every week is devoted to a “hands on” practice discussion/ demonstration/ simulation using specific reading and case material relevant to that section of the course (i.e. if the class is covering depressive disorders- specific clinical (individual & family) readings and vignettes will be used to role play and discuss assessment and intervention ideas using the postmodern theoretical models as the framework for the discussion.
Methods of Evaluation:
1. Weekly Response Set Write-ups:
You are responsible for developing answers to the questions for consideration directly related to your readings. You may develop your answer(s) using either the narrative or a bulleted outline of the essential “critical points” for each question. You are to use these questions to facilitate discussion in your small “clinical dialogue
Groups”, and the large class discussion during the class. If you do not have your response set, you will get a zero, and no late sets will be accepted. These sets are being graded on the depth and breadth of your thoughts/clinical considerations, and the completeness of your outlined answer. Your responses must be typed up.
50 points each (250)
There are (5) response sets & one web-based training due throughout the semester.
January 28th & February 11th, 2010.
March 11th & April 8th & April 15th, 2010.
*** Gerontology Web-Based Training due by 5/6/2010
(Required ONLY IF you want the Gerontology Certificate).
-4-
2. SW 204D & SWRK 295D CASE ANALYSIS (100 points). This Bio-Psycho-Social Analysis is the common analysis for all of the sections of SW204C/D & SWRK 295C/D. It is designed to assess your advanced competence in the following “objectives” for all MSW II students.
v Apply and provide a rationale for the use of theoretical models and intervention skills to individuals, families and/or a small group;
v Fully develop, articulate and apply an integrated practice approach that is informed by empirical support;
v Apply skills for culturally competent practice with and on behalf of individuals, families and small groups.
v Demonstrate an increased sense of self: awareness of strengths and limitations, development of professional boundaries, and awareness of transference and counter transference,
v Apply ethical decision-making models to legal and ethical dilemmas in practice.
v Select evaluation strategies that are appropriate to the needs of the situation and are grounded in social work theory and research (both qualitative and quantitative methods);
v Develop differential assessment, diagnosis and intervention plans based upon relevant theoretical models and the social work perspective.
v Develop the conscious use of relationship as a principle skill in social work practice with and behalf individuals, families and small groups.
v Apply the core aspects of advanced practice to specific practice situations (e.g., field placement, client populations, agencies, programs, and services).
Due: February 25th, 2010
3. Participation in class assignments, discussions, and exercises. This includes the completion of the readings and the questions sets. If you miss two (2) classes your grade will automatically be lowered one full letter grade. If you miss three (3) classes you will be dropped from the course. The class meets at 6:30, and a break for getting a small drink or small item for eating will be provided between 7:30 & 7:45. Please remain in the classroom during class, as frequent disruptions resulting from students getting up and leaving are not considerate to the professor, group and process. Attendance Grade is determined as follows:
10= Present, verbal and non-verbal language represent that you are psychologically supportive of classmates (avoid hostile, demeaning, invalidating verbal behaviors), the professor and their opinions, respectful of the process, prepared an sharing in the class;
8=Present, verbal and non-verbal language represent that you are psychologically supportive of classmates, the professor and their opinions, respectful of the process, do not actively participate in the process/discussion;
6= Present with hostile, un-supportive, demeaning, and generally invalidating/insensitive verbalizations.
Total: 140 Points
Total possible points: 490
-5-
Texts: Required
1. Corcoran, Jacqueline, Cognitive-Behavioral Methods for Social Workers, Pearson (Allyn & Bacon), ISBN 0-205-42379-5, 2006 (Required).
2. Kathleen-Dittrich, Kathleen, Social Work with Older Adults, 3rd Edition, 2009, Allyn & Bacon (Pearson Education, Inc.) (Required), ISBN-10: 0205593607)
Recommended:
3. Preston & Johnson, Clinical Psychopharmacology Made Ridiculously Simple, ISBN # 0-940780-44-5
4. Duncan, Barry and Sparks, Jacqueline, Heroic Clients, Heroic Agencies: Partners for Change, A Manual for Client-Directed, Outcome-Informed Clinical Services Talking Cure.com, Revised 2007 http://www.talkingcure.com/bookstore.asp (cost $39.95. Click on web-site & then look for the “Client-Directed, Outcome-Informed Treatment & Training Manual; click on that and download your book. Phone: 773-404-5130, FAX 773-404-1840, e-mail:
Course Outline
Clinical Social Work Practice in Mental Health: The Recovery Model
Session One: January 28th, 2010
The Recovery Model & Postmodernism
Heroic Clients Heroic Agencies: Alternative Visions of Therapist Identity
· What is your identity as a Therapist?
· What Works in Therapy
· What is the client’s theory of change?
· How do you learn about the client’s theory of change?
· How to honor the client’s theory of change.
Response Set #1: Clinical Application Paper is due: 50 Points
Dr. Demetral will e-mail Recovery Model Response Set
Readings:
Recovery Readings and Resource articles:
· Go to www.bu.edu/cpr for Recovery Model Readings
· Click on Repository of Recovery Resources
· Click on Articles
· Click on “Definition of Recovery”; “Process of Recovery”; Facilitators of Recovery”; and Outcomes of Recovery” to get a passionate and moving perspective and overview of the Recovery Model.
Many of the articles are available for free download by clicking on the article title. These documents are offered in Adobe Portable Document Format (PDF), viewable with Adobe Acrobat Reader software available for free download from the Adobe web site.
-6-
Recovery Documents & Reports (click ctrl & left click your mouse)Recovery Fact Sheet 2005 a free download, the fact sheet features the topical headings such as: What is recovery? Is recovery possible? What is recovery like for someone living with a serious
Psychiatric disability? And a list of resources that provides an opportunity for a reader to further explores additional information on their own and at their own pace.
* Implementing Recovery-based Care: Tangible Guidance for SMHAs 2004 The National Association of State Mental Health Program Directors (NASMHPD) and the National Technical Assistance Center for State Mental Health Planning (NTAC). Description: This report features a collection of essays and information from a variety of national experts on psychiatric rehabilitation. The report includes a panel discussion on workforce issues, a preview of measurement tools now in development, case studies of successful systems and ideas at the state and local levels, and print and online resources for more information.
* Shifting to a Recovery-Based Continuum of Community Care 2003This report discusses the need for the culture of mental health care to shift to a culture based on self-determination, empowering relationships, and full participation of mental health consumers in the work and community life of society. The President's New Freedom Commission on Mental Health. Report of the Subcommittee on Consumer Issues. Rockville, MD
* Emerging New Practices in Organized Peer Support 2003This report provides and overview of peer support services in the United States in order to guide and promote understanding and integration of peer-run support within the continuum of community mental healthcare. Alexandria, VA: National Technical Assistance Center for State Mental Health Planning, National Association of State Mental Health Program Directors