Multi-Level Practice with Vulnerable and Resilient Populations

Multi-Level Practice with Vulnerable and Resilient Populations

Advanced Integrative Social Work Practice

Social Work 204C

Fall, 2010

Andrew Bein, Ph.D., LCSW, PPSC

4015 Mariposa Hall

; 278-6170

#cs204csy10

Office Hours: Thursday, 1:00-4:00 or another time that meets our needs. Please do not hesitate to request another meeting time. You can assume a fast response time if you email me

  1. Course Description

SWK 204C/D represents the third and fourth semester practice courses in the Social Work curriculum. It builds upon and expands 204A/B in substantial ways. Where SWK 204A/B provided an opportunity for the student to achieve competence in the provision of direct and indirect services within an agency setting, it is recognized that the advanced generalist will move toward more autonomous practice, supervisory responsibilities, administrative and leadership roles within organizations and in the community. SWK 204C/D extends knowledge of generalist practice by requiring integration of the foundation content into the skillfully independent application of social work intervention strategies with at least two levels of intervention simultaneously.

To support this expected change in sophistication and function, SWK204 C/D providesadvanced knowledge or skills in at least five areas. 1) Concepts and models needed to understand practice with individuals, families, and groups, in the context of social service organizations, and the community environment. 2) Exposure to and expectation of mastery of advanced practice skills to address complex direct practice situations including individual/family/group techniques 3) Increased skills to concurrently address more complex indirect practice situations including supervision, administrative and organizational issues affecting clients, 4) Ability to conduct disciplined and systematic practice based on clearly articulated theoretical principles that inform generalist competencies; and 5) Ability to engage in theoretical and practice research and evaluation activities necessary to support evidence based practice and demonstrate accountability and effective client outcomes.

SWK 204C/D focuses on developing the student’s capacity to think critically and systematically so that she or he can select from a broader range of theoretical concepts and methods, appropriate intervention strategies likely to be productive in a given time and place. This course educates students to address complex challenges through synthesis of multilevel analysis and action.

SWK 204C/D requires the student to integrate the awareness and knowledge gained in SWK 202 and SWK 250 when considering problem presentation, and the potential range of interventions that dignify and “fit” that particular client’s socioeconomic, political, and cultural system. SWK 204C/D requires the student to have an integrated knowledge of the theories of human behavior, particularly developmental-systems-biological, small group dynamics and the complex theories of community and organizational behavior, so that when considering complex intervention alternatives it is being done within the context of basic theory mastery in these areas. In this way SWK 204C/D extends the SWK 235A/B series into concurrent practice application. In SWK 204D students are expected to integrate policy practice knowledge from SWRK 251 which is taken concurrently, with their multilevel work with individuals, families and groups.

Organizing Framework and Theoretical Perspectives

Module One: The Mental Health-Recovery Module

Using predominately a Postmodern-Constructivist philosophical and theoretical base, the mental health module focuses on the shift in mental health policy and practice in the United States, and particularly in California to a recovery-based model of practice. The practice in this module is based on the strengths based model of social support for persons in recovery from chronic and persistent mental illnesses. The socio-political construction of mental illness is explored as well as the realization that differential diagnosis is essential in today’s clinical practice context. The role of the social worker as advocate, coach, mediator, family educator, and political activist are explored in this module. The Recovery Model is the overarching model for this module. The Constructivist Cognitive Behavioral Model, the Interpersonal Model, and the Psycho-Educational model are presented as methods of best practice and evidenced based strategies.

Module Two: Children, Adolescents, and Families

This module provides a multi-level and interdisciplinary perspective on intervention with children and adolescents based on best practices and theory on interventions that promote healthy development of children and adolescents as well as environments that support human development. The model used in the module on children and families is based on the practice literature that incorporates risk and protective factors, including the construct of resilience. The Multi-Contextual Model is used to assess race, ethnicity, gender, orientation, power, and culture. In this module the “language of trauma” is interpreted as an adaptational coping response to violence. The student becomes an interpreter of the language of what “maladaptive behavior” is trying to tell us, and how a more humanistic response to the child and adolescent using biological-psychological-and social interventions is synchronous with social work ethics and values. Attachment, Cognitive Behavioral, Family Systems, Narrative, Solution Focused, Eco-Behavioral, Psycho-Educational and Strength based models of intervention are covered in this module. Collaborative practice strategies with schools, foster families, courts, and social service agencies provide contexts for multi-level practice in this module.

Module Three: Trauma and Recovery Model

The interplay between the social context that serves as an antecedent to violence and trauma, and the psychobiological responses of the victimized are considered in this module. The specific traumas of child physical and sexual abuse as well as the power of the neglectful invalidating environments are fully explored. Domestic Violence (including violence against Gay, Lesbian, Bisexual and Transgender, the Disabled, and the Aged) is considered from the structural and institutionalized antecedents to the neuro-biological base of trauma. The socio-political, structural and contextual factors are explored as antecedents to institutionalized trauma, and then the synthesis of biological, affective, cognitive, and behavioral modalities are considered from assessment to treatment. Concepts like resiliency, protective factors, vulnerability, and even predisposition to traumatic responses and experiences are fully explored in this module within a life cycle framework with consideration to social and cultural adaptations. Beyond empowerment of the victimized, this module also demands that the student fully synthesize and integrate knowledge of trauma transference, vicarious trauma, and compassion fatigue into their practice. Self care and spirituality are also woven throughout this module.

Module Four: Health and Wellness

The ecological model incorporates the “person in the environment and serves as the overarching model for this module. This module allows the faculty and students to focus on a range of vulnerable populations including a concentrated training in gerontology, persons with HIV/AIDS, adolescent health (eating disorders, pregnancy, suicide), or with areas of practice like drug use/abuse/dependence. The practitioner’s own health, wellness, and presence receive special attention in this module.

II.Course Objectives

Building on the theoretical frameworks that students bring from the foundation curriculum (generalist, ecosystem, strengths, and empowerment perspectives) students should be able to:

1.Apply and provide a rationale for the use of multiple theoretical models and intervention skills to individuals, families and small groups.

  1. Fully develop, articulate and apply an integrated practice approach that is informed by empirical support.
  1. Demonstrate a heightened sense of self as it relates to the dynamics of differenceand commitment to social justice.
  1. Apply skills for culturally competent practice with and on behalf of individuals, families and small groups.
  1. Demonstrate an increased sense of self: awareness of strengths and limitations, development of professional boundaries, and awareness of transference and counter transference.
  1. Apply ethical decision making models to legal and ethical dilemmas in practice.
  1. Select evaluation strategies that are appropriate to the needs of the situation and are grounded in social work theory and research .
  1. Apply leadership skills in practice contexts (e.g., small group facilitation, case conferencing, multidisciplinary teams, interagency collaboration, advocacy, and program development).
  1. Develop differential assessment, diagnosis and intervention plans based upon relevant theoretical models and the social work perspective.
  1. Develop the conscious use of relationship as a principle skill in social work practice with and behalf individuals, families and small groups.
  1. Apply the core aspects of advanced practice to specific practice situations (e.g., field placement, client populations, agencies, programs, and services).

Specific Competencies

By the conclusion of this course the student is expected to be able to:

1. Apply at least three theoretical perspectives, to assessment and intervention with an individual, family, group and/or community.

2. Apply integrated health and mental health intervention strategies that promote well-being, access to services and strengthen community prevention efforts.

3. Engage in independent reflective practice and examine the helping relationship integrating ethics, values, integrity, use of self, concepts of self development, mutuality, and social justice.

4. Critically analyze a case from a multilevel perspective. Based on this analysis, the student is able to coherently articulate and explain the social work process involved in the assessment and intervention plan, intervention theories to be used, intervention skills employed; develop, administer and identify use of outcome measures in the process, and be able to demonstrate competence in engagement with transition/termination.

5. Demonstrate integration of knowledge from HBSE, Policy, Diversity, and Research into the formulation.

6. Articulate a coherent and integrated understanding of violence and its traumatic consequences both globally and locally, at the institutional, interpersonal, and structural/cultural levels. Intervene at multiple levels using relevant theoretical models.

7. Assess the relationships between community and family systems in a variety of life situations and events, and be able to formulate interventions to address prevention of community and family dysfunction, enhance functioning of communities and families, and help remediate community and family needs.

8. Demonstrate organizational leadership skills. Interpret the social work role/perspective. Assess and intervene with intra and inter-organizational systems with specific reference to program and service delivery, implementation of a continuum of care, services integration, and inter-organizational cooperation, coordination and collaboration.

9. Understand the potential strengths and weaknesses of evidence based practice to guide assessment and intervention at all levels. Use case and community data for needs assessment to inform program and resource development, maintenance and enhancement. Choose, design, and implement appropriate process and outcome evaluation methods.

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III.Course Expectations

This course requires your active participation. In order to enhance feelings of safety and to create a positive learning environment, the following are important:

  • You are prompt. This condition is important for a class that begins at 8:00 A.M.
  • You have read the assigned material and come to class prepared.
  • You get your needs met by interacting with classmates and by raising your concerns and criticisms with the instructor.
  • You do not ridicule or belittle others.
  • You recognize your own biases and prejudices and respect others with whom you disagree
  • You are committed to personal/professional growth and self-exploration.
  • You resolve issues that you may have with other group members. If you are not sure how to accomplish this task, we can discuss possible strategies.It is not acceptable to miss class in order to avoid the group.

Consider that there is a parallel process between the way that you may engage in the course and the approaches that your clients may take. On one end there is the approach of how can I engage in this class so that I have a meaningful and helpful experience. On the other end is the approach: how can I do the least amount of work, engage in the most superficial way possible and still meet the professor’s requirements?

IV.Course Format and Philosophy

Many times we approach learning experiences with expectations about what we will get from them. The model in the academic setting translates to the professor’s giving information and papers/tests and the student’s getting knowledge and grades. I hope that in this class the linear giving and getting gives way to a fluid process of giving to each other. I believe that in order for this process to occur, we will have to: (1) frame our work together as giving to, receiving from, and growing with each other as well as with

our communities and clients; (2) open our hearts and be vulnerable and real; (3) explore parts of ourselves that are often hidden and make us feel uncomfortable; (4) move toward

full acceptance of ourselves and the people whom we serve; (5) maintain our commitment to be aware of our intentions, to be aware of our thoughts and feelings, and to cultivate a positive, effective presence.

Let’s identify guidelines that will help us achieve #1-5 as a class:

1.5.

2.6.

3.7.

4.8.

Additionally, I want you to know that I am aware of people’s energy level. This class spans nine hours and some of are in class after a busy week. Do what you can to come into the class as awake and present as possible. Get as much rest as you can and limit your alcohol and drug intake this semester. Any alcohol consumption the Thursday or Friday before the class is probably not a good idea.

Come to class with the intention that you are going to connect with the experience instead of the expectation that you will “mail it in.” If you are in the “mailing it in” mode at this point of your life, I would like for you to commit to another approach or to choose another class.

Special Conditions:

  • Attendance is essential. One full absence or the equivalent (arriving late/leaving early) will adversely impact your grade; Missing more than one class (or missing a class and coming late/leaving early) jeopardizes your chances of passing the course.
  • There are many students with one form of disability or another. Please let me know as soon as possible of particular needs that you may have. You are entitled to special accommodations and services if you have been officially identified as needing this assistance. If you have not done so already, please contact the Office of Services to Students with Disabilities @ 916-278-6955 for further information.
  1. Course Texts

Arkowitz, H., Westra, H., Miller, W. & Rollnick, S. (2008). Motivational interviewing in the treatment of psychological problems.New York: Guilford.

Austin, M., Brody, R. & Packard, T. (2009). Managing the challenges in human service organizations: A casebook. Los Angeles: Sage.

Davidson, L., Tondora, J., Lawless, M., O’Connell, M. & Rowe, M. (2009). A practical guide to recovery oriented practice: Tools for transforming mental health care. N. Y.: OxfordUniversity Press.

*Other readings will be made available

  1. Course Assignments and Grading
  1. Reflection Paper – Integrates readings (cite them) field and life experiences, classroom activities and personal thoughts and feelings. Stay current on readings and engaged in the class to do well. 10/9/10 (4-5 pages) 15
  1. Leadership / Supervision Dilemma Paper – Integrate readings and conduct

actual interview to explore a relevant dilemma at the field site. Conduct

analysisof site and leadership/supervision dynamics. 10/30/10

(4-5 pages)20

3. Journals: Four extensive, thoughtful entries as directed in the syllabus. Three

are emailed: i, ii, iv; (1 ½ - 2 pages each) 9/27; 10/9; 10/30; 12/1 5

4.Intervention Analysis Paper – Incorporation of motivational interviewing, counseling theory and intervention, use of self, and analysis of ecological/agency context . 11/20/10 (10-12 pages) 40

Class Participation

Attendance, involvement, engagement with classroom agreements, promptness,

in-class demonstration of commitment to learning 20

Total 100

  1. Course Outline

September 11, 2010

Overview of course / Intentions, expectations, and agreements / Introductions / Field work;

Motivation and ambivalence / Client-centered perspective / Elicit change talk;

Managerial roles / Competing values / Managerial functions / Introduction to recovery

Arkowitz et al. (2008). Chapter 1

Austin et al. (2009). Chapter 1

*Primary texts are in bold and italics

October 9, 2010

Mental health recovery / “Never be able to again” / Recovery as civil rights > “managing symptoms” / Collaboration / Spiritual view of recovery / Taming illness & maximize health / Motion and action > outcome / Stigma / Practitioner and supervisor roles / Client’s theory of change / heroic stories

Leadership / Ethics / Founder’s syndrome / Supervision / Challenges with employees

Motivational interviewing and anxiety disorders: PTSD, OCD

Solution-focused work and crisis intervention

Davidson et al. (2009). Chapters 1 & 2

Duncan, B., Miller, S. & Sparks, J. (2004). The heroic client. San Francisco: Jossey-Bass, pp. 49-80.

Austin et al. (2009).Chapters 4 & 7

Arkowitz et al. (2008).Chapters 2, 3 & 4

Cooper, M. & Lesser, J. (2008). Clinical social work practice: An integrated approach. Boston: Allyn & Bacon, pp. 196-209.

Reflection Paper Due – October 9, 2010

Summarize each of the five readings – by author(s) – through October 9th and

include reflections and analysis (five pages)

Journal II –

Email by October 20 2010

Reflections on Recovery

October 30, 2010

Concerns and misunderstandings about recovery / Recovery and system transformation / Recovery and substance use / Culturally responsive care / Relational caring

Dilemmas in planning and program design / Financial pressures and discussions of: productivity and performance; opportunism and survival

Motivational interviewing and medication (schizophrenia) / Motivational interviewing and dual diagnosis