1 School of Social Work University of Wisconsin-Madison 1350 University Avenue Madison, WI 53706 SW712 Psychopathology in Social Work, Fall 2013 Class Day & Time: Thursday 1:20 3:15 Location: Room 114, Social Work Instructor: Dale Decker, LCSW, CSAC Office hours: Thursday, Noon to 1 pm or by appointment; Room 202. Email: dedecker@wisc.edu Phone: 608-345-1349 I. Catalogue Description This course teaches social workers to recognize selected major mental disorders and to become familiar with social work practice approaches used in treatment of these disorders. II. Course Overview This advanced practice course aims to convey a knowledge base in, and orientation to, psychopathology, which will facilitate advanced social work practice. The Diagnostic and Statistical Manual of Mental Disorders-V (DSM-5) (APA, 2013) is used as the organizing framework for reviewing major mental disorders. We will focus on the identification and description of mental disorders, and what is known (and not known) about their social context and etiology (biological, psychological and socio-cultural factors). We will explore issues of diversity related to diagnosis and treatment of specific mental disorder categories. As part of this class we will also discuss the strengths and weakness of our current medical model approach to mental health in the United States, major revisions in and controversies relating to the new DSM-5, the strengths and weaknesses of this diagnostic system, the role of social workers in psychiatric diagnosis, the relationship between diagnosis and assessment, and issues pertaining to ethical practice. This class will not provide in-depth, skill-based learning in specific clinical interventions, but we will review what is known about effective treatments for specific classes of disorders (psychological, social and psychopharmacological). Our primary focus will be on assessment and case planning that integrates diagnostic information to ensure that interventions are consistent with the individual s strengths and needs.
2 III. Course Competencies, Practice Behaviors, & Assignments Successful completion of this course implies that students will have progressed towards achieving some of the core social work competencies by demonstrating the following practice behaviors: Competencies Addressed In Course 2.1.1: Identify as a professional social worker and conduct oneself accordingly. 2.1.2 Apply social work ethical principles to guide professional practice. 2.1.3 Apply critical thinking to inform and communicate professional judgments. 2.1.4 Engage diversity and difference in practice. 2.1.6 Engage in researchinformed practice and practice-informed research. 2.1.7 Apply knowledge of human behavior and the social environment. Advanced Practice Behaviors for Focus Area and Advanced Elective Courses Apply knowledge of social services, policies, and programs relevant to the focus area, to advocate with and/or on behalf of clients for access to services. Evaluate ethical dilemmas related to problems and issues in mental health. Identify and synthesize multiple sources of knowledge on mental health disorders to understand practice issues related to the assessment and treatment of major mental illness. Demonstrate an understanding of how culture and values affect diverse conceptualizations and constructions of mental health disorders and their treatment. Critically evaluate and utilize theoretical and empirical research relevant to the problems and/or populations addressed in the focus area. Evaluate and apply knowledge of human behavior and the social environment to choose methods of assessment, intervention, and evaluation most appropriate to the concentration problems/populations. Assignments Measuring Behavior Group poster Book Report Homework Diagnostic assignment Group Poster Book Report Diagnostic assignment Quizzes Quizzes
Competencies Addressed In Course 2.1.10a Engage, assess, intervene, and evaluate individuals, families, groups, organizations, and communities. 2.1.10b: Assess individuals and families 2.1.10c: Intervene with individuals and families SEMESTER CALENDAR Advanced Practice Behaviors for Focus Area and Advanced Elective Courses Employ diverse strategies to engage with individuals, families, groups, organizations, and communities related to the area of focus. Assess individuals, families, groups, organizations, and communities to determine a range of potentially effective and appropriate interventions to improve practice outcomes related to the focus area. Demonstrate ability to intervene at different levels (with and/or on behalf of individuals, families, groups, 3 Assignments Measuring Behavior Quizzes Diagnostic assignment Group Poster Poster Book report Group Poster Quizzes Sept. 5: Oct. 17: Nov. 14: Nov. 21: Dec. 3: Dec.??: First day of lecture First Person Book Report Due Mid-term Exam Handed Out Mid-term Exam Due Group Poster Assignment Due Final Exam (time, and location TBD) IV. Course Content Week 1 (September 5): Introduction to the DSM V 1. Review of syllabus and assignments 2. Introduction to the DSM V 3. Use of a biopsychosocial assessment and treatment model 4. Strengths-based and empowerment model of mental health diagnosis and treatment 1. DSM V (pp. 1-25). 2. Wasow, M. (2001). Strengths versus deficits, or musician versus schizophrenic. Psychiatric Services, 52, 1306-1307. 3. Wakefield, J. (2013). DSM-5: An overview of changes and controversies. Clinical Social Work Journal, 41(2), 139-154 4. Rosenhan, D. (1973). On being sane in insane places. Science, 179, 250-258.
Recommended Readings: 1. Sands, R.G. Chapter 4: The biopsychosocial assessment. In Clinical Social Work Practice in Behavioral Mental Health. Boston: Allyn and Bacon, 2001. Week 2 (September 12): Theories of Etiology and Assessment of Mental Disorders 1. How culture and values affect diverse conceptualizations and construction of mental health problems and its treatment 2. Exploration of personal values and beliefs in the diagnosis and treatment of mental disorders. 3. Theories about the etiology of mental disorders 4. Standardized assessment instruments 1. Lopez, S.R., & Guarnaccia, P.J.J. (2000) Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51, 571-598. 2. Jacobson, N., & Greenley, D. (2001). What is recovery? A conceptual model and explication. Psychiatric Services, 52, 482-485. Recommended Readings: 1. Lewis-Fernandez, R. & Diaz, N. (2002). The cultural formulation: A method for assessing cultural factors affecting the clinical encounter. Psychiatric Quarterly, 73 (4), 271-295. Week 3 (September 19): Psychopharmacology for Social Workers 1. Major classes of medications used in the treatment of major mental illness. 2. Major side effects associated with major classes of medications. 3. Ethical issues associated with the administration of psychotropic medications 1. DSM V (pp. 709-715). 2. Diamond, R.J. Instant Psychopharmacology. Chapters 1 & 2 Weeks 4 & 5 (September 26 & October 3): Schizophrenia and Related Psychotic Disorders 1. Description of describe these disorders, including their signs, symptoms, subtypes, functional characteristic, natural history, course, prognosis, and distribution and manifestations across cultural groups and by gender. 2. Diversity in the range of experiences of persons with these disorders and the diversity in the experiences of their family/significant others. 3. What is known and not known about effective interventions for these disorders. 1. DSM-V (pp. 87-122). 2. Carlat, D. (2005). Assessing Psychotic Disorders. In The psychiatric interview (pp.190-209). PA: Lippincott Williams & Wilkins. 4
3. Lieberman, J. et al. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. The New England Journal of Medicine, 353, 1209-1223 4. McFarlane, W. R., Dixon, L., Luken,E. & Lucksted, A. (2003). Family psychoeducation and schizophrenia: A review of the literature. Journal of Marital and Family Therapy, 29, 223-245. 5. Diamond, R.J. Instant Psychopharmacology. Chapters 3 & 4 Recommended Readings: 1. Hooley, J. M. (1998). Expressed emotion and psychiatric illness: From empirical data to clinical practice. Behavior Therapy, 29, 631-646. 2. Test, M.A. Community-based treatment models for adults with severe and persistent mental illness (pp. 399-419). In J.B.W. Williams & K. Ell (Eds.), Advances in Mental Health Research. Washington, D.C.: NASW Press, 1998. Week 6 (October 10): Bipolar Disorders 1. Same as weeks 4 & 5 but with respect to bipolar disorders 1. DSM-V (pp.123-154 ). 2. Diamond, R.J. Instant Psychopharmacology. Chapter 6 Week 7 (October 17): Depressive Disorders and Suicide 1. Same as weeks 4 & 5 in relation to Depressive Disorders 1. DSM-V (pp. 155-188). 2. Diamond, R.J. Instant Psychopharmacology. Chapter 5 3. Miller, D. and McConaughy, S. (2005). Assessing risk for suicide. In Clinical Interviews for children and adolescents: Assessment to Intervention (pp. 184-199). New York: The Guilford Press. Week 8 (October 24): Anxiety Disorders & Obsessive-Compulsive Disorder 1. Same as weeks 4 & 5 but with respect to anxiety disorders 1. DSM-V (pp. 189-242). 2. Diamond, R.J. Instant Psychopharmacology. Chapter 7 Week 9 (October 31): Trauma Related Disorders and Dissociative Disorders 1. PTSD 2. Adjustment disorders 3. Other specified trauma and stressor related disorders 4. Acute Stress Disorder 5
1. DSM V: Trauma- and Stressor-Related Disorders and Dissociative Disorders (pp. 265-307). 2. Briere, J. n. & Scott, C (2013). The effects of trauma (Chapter 2). Principles of trauma therapy: A guide to symptoms, evaluation, and treatment (2 nd edition). Thousand Oaks, CA: Sage Publications. Week 10 (November 7): Substance Use Disorders 1. Same as weeks 4 & 5 in relation to Substance Use Disorders with a focus on Alcohol and Opioid Use Disorders 1. DSM-V (pp. 481-503 and pp. 541-550). Week 11 (November 14): Gender Dysphoria 1. Same as 4 & 5 but with respect to gender dysphoria 1. DSM-V (pp. 451-460). 2. Additional reading TBA Week 12 (November 21): Neurodevelopmental disorders (focus on Autism, ADHD, Conduct Disorders) 1. Same as weeks 4 & 5 but with respect to childhood neurodevelopment disorders 1. DSM-V: Neurodevelopmental disorders (pp. 50-66 & pp. 461-475) 2. Additional readings TBA Week 13 (November 28): Thanksgiving Day Holiday. No class Week 14 (Tuesday December 3): Mental Health Awareness Day: Poster Presentations (class meets from noon to 1:15) This will be a joint session with the other section of Social Work 712. For students who have class or field conflicts that cannot be resolved, please see me for alternative activities. Week 15 (December 12): Personality Disorders 1. Same as weeks 4 & 5 but with respect to personality disorders 1. DSM: Personality Disorders 2. Diamond, R.J. Instant Psychopharmacology. Chapter 7 3. Robins et al (2004). Dialectical behavior therapy. In Hayes, Follette, Linehan (Eds.), Mindfulness and Acceptance (pp. 30-44). New York: Guildford Press. 6
7 V. Texts and Reading Materials for the Course Required Texts: American Psychiatric Association: Diagnostic and statistical manual of mental disorders: DSM 5, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013. Diamond, R. J. (2009). Instant Psychopharmacology (3rd Edition). N.Y.: W.W. Norton. Required articles are on reserve in the Social Work library and available via our class Learn@MyUW webpage. You may also purchase a copy of the reading packet at Bob s Copy at 208 N. Charter. Go to www.bobscopyshop.com/ to place your order. You must place the order ahead of time. There will be no pre-printed reading packets available. Recommended text: Kring, A., Johnson, S., Davison, G. & Neale, J. (2013). Abnormal Psychology, 12th Edition DSM-5 Update. NJ: John Wiley & Sons. VI. Evaluation of Competencies and Practice Behaviors: Assignments, Grading and Methods Academic honesty and plagiarism: Unless explicitly noted, you are expected to work independently/individually on assignments for this class. Plagiarism involves the use of others words, ideas, or evidence without clearly acknowledging the source. Plagiarism is unacceptable and will be treated as a serious ethical breach with possible penalties including: a failing grade on the assignment, failing the class, and/or referral to the Dean of Students Office. Maintaining ownership of your work is often challenging when writing papers using multiple sources. Nevertheless, intentional plagiarism is academic dishonesty. Plagiarism occurs when you do any of the following on an assignment: 1. Use someone else s words either verbatim or almost verbatim without citation (even if the work does not have a clear author for instance in a website) 2. Use someone else s evidence, line of thinking, or idea without citation 3. Turn in someone else s work as your own, as in copying a peer s paper or purchasing a ready-made paper 4. Turn in previously submitted work as if new, without the instructor s approval Grading Scale & Standards Points Grade What the point totals & subsequent grade generally indicate 94-100 A Outstanding, excellent work in all areas 88-93 AB Outstanding, excellent work in many areas 82-87 B Meets expectations in all areas 76-81 BC Meets expectations in most areas; below in others 70-75 C Below expectations in most areas; not acceptable graduate work 64-69 D Below expectations in all areas <64 F Course failure
8 Assignments and Exams The purposes of the assignments and the evaluation and grading system described here are: 1) to enhance learning, 2) to stimulate the integration of classroom work with practice, and 3) to assess the extent to which the course competencies and practice behaviors are achieved. "First Person Book Report (75 points) Each student will select and read a book written by a person with a mental illness or by a close family member of a person with a mental illness (a "first person account"). A list of suggested books will be provided but you may choose a different book with advance permission. Each student will write a two page summary of the book. An outline for the two page summary will be handed out in class on Sept. 26. Two page summary Due in class Oct. 17. Short Homework Assignments (100 points) There will be 10 homework assignments distributed throughout the semester and due the following class period. For most of the assignments, you will be asked to read one or more case studies and address the following issues: 1. Determine a tentative diagnosis of the client including diagnoses to rule out, 2. Provide a rationale for making this diagnosis, 3. Provide suggested interventions for this diagnosis Each assignment is 10 points. Group Poster for Mental Health Awareness Day (100 points) Students will work in small groups to develop a poster on a mental health diagnosis. The poster will cover the prevalence of the diagnosis, course of diagnosis, risk factors, behaviors and symptoms associated with the diagnosis, culture-related diagnostic issues and evidence based treatments. An outline of the poster will be provided in class. We will hold a poster session on December 3rd in the student lounge, inviting all interested students in the MSW program to attend. Take Home Mid-Term Exam (200 points) This will cover all required readings and class content/material up to an including readings for November 7. Its content will assess the degree to which the course objectives have been met as they relate to these units. The exam will be in essay form. 7 page limit. Exam to be distributed in class on Nov. 14. Exam response is due Tuesday, Nov. 21 in class. Final Exam (175 points) Course Grade Multiple choice. You will be permitted two double-sided pages of notes for the final exam and the DSM-V. No other materials. Date of final exam TBA. It will be given during exam week.. A list of concepts that will be covered on the exam will be posted on December 3. There are a total of 650 points for the class. At end of the semester, I will divide your total score by 650 to determine the percentage of points that you have earned for the semester.
Quizzes Throughout the semester, there will be quizzes on the readings and lecture material. These quizzes are not graded and do not count toward your final grade. However, the quizzes will assist you in studying for the final exam and will help you monitor your learning. They also will help me identify material that I should review again in class. VII. COURSE POLICIES The course will be both didactic and interactive. Lecture, small group discussions, class exercises, and group projects will all be used in the learning process. The lecture and readings include chapters from the required textbooks, scholarly articles, case videos, and vignettes. Each week the powerpoint presentation for the week s lecture will be posted on LEARN@UW the night before class. Students are responsible for printing the powerpoint presentations if they desire a hard copy. Copies will not be made available in class. The lectures will integrate the reading and additional outside lecture material. Students are expected to: 1. Attend class weekly and read required materials prior to the lecture class, 2. Attend and actively participate in class discussions, 3. Complete all assignments required for the lecture and small group discussions 4. Complete a midterm and final exam, a book report assignment, and work in a group to develop a poster about a specific mental health diagnosis and its treatment. The instructor is expected to: 1. Be available to students to answer questions and to hear concerns, 2. Begin and end classes on time, 3. Create a supportive and open atmosphere conducive to learning, 4. Assure that course objectives are being met, and 5. Assure that the class is accessible to all students. Accommodation of student disability If you are a student with a disability (e.g., physical, learning, psychiatric, vision, hearing, etc.) and think you might need special assistance or a special accommodation in this class, please speak with me as soon as possible. I will be very glad to collaborate with you to design accommodations as needed to meet your learning needs. Late work policy At times it is necessary for students to submit work later than the due date. If a student a) communicates with me prior to the due date, b) provides me with a reasonable explanation as to why the work is late, AND c) we come to an agreement about a different deadline the lateness may be excused. Otherwise, late work will not be accepted. 9
10 Additional Information Past students of this course have found study groups very helpful in reviewing and preparing for the exams. I encourage you to set up study groups early in the course. Cell phones and other distractions must be turned off or silenced during class. If you choose to use a laptop during class, please ensure that you do not distract others. Some of our class discussions may be about cases from your field placements. As always, please respect the confidentiality of your clients and do not use identifying information. I greatly appreciate student input and criticism. In person or written (anonymous or identified) comments are always welcome. There will also be opportunities to give formal feedback during the semester. Class lectures will not cover all of the reading material. Exams and assignments may include material not covered in class. Therefore, it is important to keep up with the assigned readings.