PSYCHOSOCIAL INTERVENTION PRACTICUM
Psychology 694B, Fall and Spring semesters, 2011-2012
Fall Seminar: Mondays 12-4pm, Psych. 240
Clinical supervision schedule TBA
Instructors and staff
David Sbarra, Ph.D. (fall practicum director, CBT instructor)
Associate Professor of Psychology
Psychology 408; office hours by appointment
Office: 626-6426; home: 326-8080; Cell: 990-1272
Email: sbarra@email.arizona.edu
Michael Rohrbaugh, Ph.D. (Clinic Director, spring practicum director, FST
instructor/supervisor)
Professor of Psychology
Psychology 246; office hours by appointment
Office: 621-7485
Cell: 271-9510
Email: michaelr@email.arizona.edu
Randall Garland, Ph.D. (fall CBT supervisor and instructor)
Medical Consultant, Dept. of Economic Security, Disability Determination Services
Administration
Office and cell: 322-9334; home: 323-8018
Email: Randall.J.Garland@ssa.gov
Julie Feldman, Ph.D. (Clinic-community liaison)
Instructor, Department of Psychology
Cell: 403-2010
Email: julief@u.arizona.edu
Amanda Bryan
Fall practicum TA
Cell: 707-235-5065; Email: abrody@email.arizona.edu
Florencia Lebensohn-Chialvo
Fall R25 Assistant
Cell: 260-4322; Email: flc@email.arizona.edu
Howard Allen and Susan Boulio (clinical program administrative assistants)
Office: 621-1867
Email: howarda@u.arizona.edu, or sboulio@email.arizona.edu
Description
This two-semester practicum course for clinical psychology doctoral students is an introduction
to the applied aspects of psychosocial intervention. The practicum parallels the required two-
1
semester didactic course on Psychosocial Intervention (625a,b). Students need not have prior
experience working with clients or managing cases on their own. The core of the practicum is
supervised clinical work with clients in the Psychology Department Clinic. Fall semester cases
will be treated primarily in a cognitive-behavioral therapy (CBT) framework and spring semester
cases primarily in a family-systems therapy (FST) framework. Concurrent with their clinical
work, students will participate in a weekly practicum seminar throughout the year. In addition to
discussions and demonstrations, the seminar includes several required exercises-- a clientinstructor exercise, a CBT skills workshop, and a series of case formulation and simulation
exercises that are part of the clinical psychology program’s NIH (R25) training grant, and written
case treatment plan-- the guidelines for which will be reviewed in class. During the year students
will assume primary responsibility as Psychology Department Clinic house-staff. Each student
will see a series of Clinic cases, with a normal load consisting of two to three active cases at any
given time. In addition to primary case-management, there will be many opportunities to observe
clinical work both on video and from behind a one-way mirror. In the spring semester, much of
the clinical work with families and couples will be supervised live, in a consultation-team
format.
Practicum activities will range from the immediate, often very personal experience of doing
therapy to standing back and thinking critically about it. The main forum for reflection and
critical thinking is the Monday afternoon seminar, where regular attendance is required. In
addition to addressing professional issues and basic clinical skills, the seminar will juxtapose
therapy theories to highlight their different implications for intervention, consider focal issues at
the intersection of clinical science and practice, and promote critical examination of "therapy"
generally.
The practicum is taught by a faculty team: Dave Sbarra, the fall practicum director and principal
CBT instructor, will lead the Monday afternoon seminar. Randy Garland will supervise the fallsemester CBT cases, primarily in the format of weekly group-supervision meetings. Michael
Rohrbaugh will oversee the operation of the Clinic throughout the year. In the spring semester,
Michael Rohrbaugh will instruct the weekly practicum seminar and provide supervision. Finally,
two especially important members of the practicum team are Howard Allen and Susan Boulio
(the clinical program’s administrative assistants), who manage most of the day-to-day activities
in the Clinic.
Readings
Two required texts for the fall semester are available in the University Bookstore:
-- Beck, J.S. (2011). Cognitive behavior therapy: Basics and beyond. (2nd edition). New
York: Guilford Press.
-- Woody, S.A, Detweiler-Bedell, J., Teachman, B.A., & O’Hearn, T. (2003). Treatment
Planning in Psychotherapy. New York: Guilford Press.
Copies of additional readings (some optional, some required) will be made available at no
expense to students. Also, it is recommended that you purchase a copy of David Barlow’s
Clinical Handbook. Barlow, D.H. (2008). Clinical Handbook of Psychological Disorders: A
Step-by-Step Treatment Manual (4rd edition). New York: Guildford Press. This book is
available at Amazon.com.
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The Psychology Department Clinic
The setting for practicum clinical work is the Psychology Department Clinic. Fall-semester
referrals to the Clinic come from Counseling and Psychological Services (CAPS), a division of
Student Health Services, and from professionals and agencies in the community. Spring-semester
child, couple, and family cases come primarily from the community.
Clinic clients pay a minimal fee (maximum $20 per session for individuals), which the therapist
sets and collects. Treatment is usually limited to about 10 sessions.
We will schedule clinic appointments beginning the week of September 12th and aim to have
two to three cases for everyone by the end of September. Therapists must be thoroughly familiar
with the Psychology Clinic Procedures (see attached documents) before they begin to see clients.
They should also be familiar with the APA ethical guidelines and Arizona statutes relevant to the
practice of psychology (see handouts), which will be discussed in class.
Course requirements
To complete the intervention sequence (694b) in a satisfactory manner, a student must: treat and
manage assigned cases in a competent an ethical manner; make timely and adequate entries in
the clinical record (chart); attend and participate in the practicum seminar and related activities;
and, complete all assigned exercises (e.g., client-instructor exercise, simulation exercises, case
presentation, and a written treatment plan).
Evaluation
At the end of each semester the instructor and/or supervisor will provide evaluative feedback to
each student regarding (a) clinical skills, (b) professional behavior, and (c) contribution to the
seminar.
NIH (R25) Clinical Training Grant
In 2008, our graduate program received a clinical training grant from NIH/NIDA. The PI for this
project is Varda Shoham, and both Michael Rohrbaugh and Dave Sbarra are Co-PIs on the
project. The grant focuses on developing and using “simulate case” exercises to improve our
delivery of empirically-validated behavioral treatments, in particular cognitive and behavioral
therapy for adult depression (CBT practicum), family systems therapy for adolescent drug abuse
(FST practicum), and motivational interviewing for adult alcohol abuse (MI practicum). The case
simulation exercises implemented and refined in these practicums will ultimately be used in a
series of dissemination workshops designed for practicing clinicians in community. During the
fall CBT practicum, you will have the opportunity to be a participant in these simulation
exercises while also playing a vital role in the refinement of the exercise and preparation for
dissemination to the community.
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TENTATIVE Practicum Seminar Schedule
Fall Semester, 2011
(Mondays, 12:00 – 4:00pm, Psych 240)
Caveat Emptor: There are a variety of ways to teach psychotherapy skills. One way is to
develop clinical skills to treat specific disorders (e.g., do this for depression, do that for PTSD).
We will NOT be doing this. Instead, we will focus on building a reliable and functional basic
therapy tool set that begins with interviewing skills, moves through conceptualization and
formulation, and ends with the accumulation of intervention skills. Of course, we will discuss
specific disorders, and you will find that many of the basic skills are applicable to a wide-range
of problems. When you treat a particular condition or population, one of your main charges is to
determine the “best” therapy and to continue learning new skills.
Date
Topic
8/22
Orientation and procedures; meet the supervisors and staff; interview warm-up
Readings to be completed by this class period: None, but note that the entire Beck
(1995) book is due for the next class session.
TBD*
CBT skills workshop (evening seminar with Garland)
8/29
Clinical intake interview; interviewing skills; building your “game plan” for a first
session; dealing with clinical emergencies (e.g., suicidality, homicidality)
Readings to be completed by this class period:
1. Beck (1995), entire book.
2. Rogers, C. (1957). The necessary and sufficient conditions of therapeutic
personality change. Journal of Consulting Psychology, 21, 95-103.
3. Arkowitz, H., & Miller, W.R. (2008). Learning, applying, and extending
Motivational Interviewing. In H. Arkowitz, H.A. Westra, W.R. Miller, & S.
Rollnick (Eds), Motivational Interviewing for the treatment of psychological
problems. (pp. 1-25). New York: Guilford Press.
4. SKIM: Ackerman, S. J., & Hilsenroth, M. J. (2003). A review of therapist
characteristics and techniques positively impacting the therapeutic alliance.
Clinical Psychology Review, 23, 1-33.
5. SKIM: Epstein, L. (1985). Talking and listening. (Chapter 2: Four common
problems and their solutions).
6. SKIM: Morrison, J. (1995). The first interview (Introduction – Chapter 3,
pages 1-22).
7. Optional: Chapter 7 from Elliott, R. (2004). Learning emotion-focused
therapy: The process-experiential approach to change. Washington, DC:
American Psychological Association.
8/30
Client-instructor exercise (3pm – 5pm), NOTE SPECIAL DAY: TUESDAY
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9/5
LABOR DAY, NO CLASS!
9/12
Case formulation (for yourself and your client; long-term and short-term)
Readings to be completed by this class period:
1. Woody et al. (2003), entire book.
2. Review Cognitive Therapy Rating Scale (CTRS) and CTRS Manual
9/19
Behavior therapy skills: Theory and practice of behavioral/functional analysis,
behavioral activation (BA), activity scheduling… etc.
Readings to be completed by this class period:
1. Dimidjian, S., Martell, C. R., Addis, M. E., Herman-Dunn, R., & Barlow, D.
H. (2008). Behavioral activation for depression. In Clinical handbook of
psychological disorders: A step-by-step treatment manual (4th ed.). (pp. 328364). New York, NY US: Guilford Press.
2. SKIM: Jacobson, N.S., Martell, C.R., & Dimidjian, S. (2001). Behavioral
activation treatment for depression: Returning to contextual roots. Clinical
Psychology: Science and Practice, 8, 255-270. [If you’re interested, you
might want to read the original BA dismantling study: Jacobson, N.S.,
Dobson, K.S., Truax, P.A., Addis, M.E., Koerner, K., Gollan, J.K, Gortner, E,
& Prince, S.E. (1996). A component analysis of cognitive-behavioral
treatment for depression. Journal of Consulting and Clinical Psychology, 64,
295-304.]
3. Kohlenberg, R.J., & Tsai, M. (1994). Functional Analytic Psychotherapy: A
radical behavioral approach to treatment and integration. Journal of
Psychotherapy Integration, 4, 175 – 201. PLEASE PAY SPECIAL
ATTENTION TO 184-191.
4. Antony, M. M., & Roemer, L. (2003). Behavior therapy. In A. S. Gurman &
S. B. Messer (Eds.), Essential psychotherapies: Theory and practice (2nd ed.).
(pp. 182-223). New York: Guilford Press.
9/26
CBT in action: DTRs; agenda setting; homework assignment and review
Readings to be completed by this class period:
1. Dobson, K.S., & Dozois, D.J.A. (2001). Historical and philosophical bases of
the cognitive behavioral therapies. In K. S. Dobson (Ed.), Handbook of
cognitive-behavioral therapies (pp. 3-39). New York: Guilford Press.
2. SKIM: Persons, J.B., & Davidson, J. (2001). Cognitive-behavioral case
formulation. In K. S. Dobson (Ed.), Handbook of cognitive-behavioral
therapies (pp. 86-111). New York: Guilford Press.
3. Allen, L. B., McHugh, R. K., & Barlow, D. H. (2008). Emotional disorders: A
unified protocol. In D. H. Barlow (Ed.), Clinical handbook of psychological
disorders: A step-by-step treatment manual (4th ed.). (pp. 216-249). New
York: Guilford Press.
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10/3
CBT in action, redux.
Case #1 Formulation Exercise due via email by 10/7/11 at 12pm
10/10
Discuss Case #1 Formulation Exercise and prepare for Case #1 Simulation
Exercise
10/17
Case #1 Simulation
10/24
Discuss Case #1 Simulation; ethics ethical dilemmas in clinical settings; working
with diverse clients
Readings to be completed by this class period:
1. Stuart, R.B. (2004). Twelve practical suggestions for achieving multicultural
competence. Professional Psychology: Research and Practice, 35, 1-9.
2. Miranda, J., Bernal, G., Lau, A., Kohn, L., Hwang, W.-C., & LaFromboise, T.
(2005). State of the science on psychosocial interventions for ethnic minorities.
Annual Review of Clinical Psychology, 1, 113-142.
3. Review Connie Beck’s handout, Steps to Conducting an Ethical Analysis
4. Read and complete detailed notes on the “Wisconsin Dilemmas”.
5. Baird, B.N. (1999). The internship, practicum, and field placement handbook.
(Chapter 3: Ethical and Legal Issues).
10/31
Halloween Edition (come in costume): ESTs in practice; clinical decision making;
complex case situations
Readings to be completed by this class period:
1. Ruscio, A. M., & Holohan, D. R. (2006). Applying empirically supported
treatments to complex cases: Ethical, empirical, and practical considerations.
Clinical Psychology: Science and Practice, 13, 146-162.
2. Abramowitz, J. S. (2006). Toward a functional analytic approach to
psychologically complex patients: A comment on Ruscio and Holohan (2006).
Clinical Psychology: Science and Practice, 13, 163-166.
3. Persons, J. B. (2006). Case formulation-driven psychotherapy. Clinical
Psychology: Science and Practice, 13, 167-170.
4. Wolfe, B. E. (2006). Employing empirically supported treatments: A researchinformed clinical practitioner perspective. Clinical Psychology: Science and
Practice, 13, 171-178.Psychopharmacology (with TBA, time TBA)
WRITTEN TREATMENT PLANS DUE TO SBARRA BY EMAIL (TARGET
DATE)
Case #2 Formulation Exercise due via email by 11/4/11 at 12pm
11/7
Discuss Case #2 Formulation Exercise and prepare for Case #2 Simulation Exercise
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11/14
Case #2 Simulation
11/21
Structured Case Presentations
11/28
Catch-up or off…
12/5
Review of Simulation #2 and Seminar Wrap-up & Termination
Readings to be completed by this class period:
1. Merrill, K.A., Tolbert, V.E., & Wade, W.A. (2003). Effectiveness of cognitive
therapy for depression in a community mental health center: A benchmarking
study. Journal of Clinical and Consulting Psychology, 71, 404-409.
2. Lebow, J. (1995). Open-ended therapy: Termination in marital and family
therapy. In R. Mikesell, D. Lusterman, & S. McDaniel (Eds.), Integrating family
therapy (pp. 73-86). Washington, DC: American Psychological Association.
* Note different time.
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GUIDELINES FOR CLIENT-INSTRUCTOR EXERCISE
AUGUST 2010
1. This simulated therapy exercise is set for Tuesday, August 31st. It will run from 1pm
until 4pm. You will be assigned a specific 2-hour window (from 1-3pm, or 2-4pm;
you only need to come during your assigned session); if you’re in the first session,
please arrive no later than 12:45pm).
2. Each student therapist will conduct a 40-minute interview with a simulated client you
have not met. Additionally, each student will watch other students in their team; all
students will conduct the intake with a different simulated client.
3. Conduct the session as you would a real first interview: After a brief greeting, begin
by explaining our clinic procedures (e.g., confidentiality, videotaping, supervision,
colleagues behind mirror, etc.), obtaining informed consent using the standard Clinic
form, and then beginning the videotaping. Then move to the business of asking about
the problem and what brings the client for help. Your main goals for the session are to
(1) establish a therapeutic alliance with the client, and (2) obtain a clear description of
the problem. You may also want to discuss specific treatment goals and begin to
frame a general direction or purpose for therapy, but avoid trying to solve the client's
problem right away by giving advice, offering premature interpretations, etc. Close
the session in a manner that seems appropriate (e.g., suggesting a homework task) and
offer to schedule another appointment – which we won't actually keep.
4. The therapist also has the option of taking a brief (2-4 minute) consultation break
about 2/3 - 3/4 of the way through the session to talk with the observer(s) behind the
mirror. This can be helpful in validating or redirecting the process, or planning how to
close the session. The therapist and observer should decide before the interview how
they want to handle this.
5. Each student clinician should select one brief (max. 4 min) video segment from her or
his own session and bring it to the next group supervision meeting with Randy or Peg.
In choosing the segment, consult with the observers of your session. The clip could be
of something that you both agree went well or something you thought was difficult or
perplexing (e.g., What could we have done differently here?). Be sure to set the
starting point on the tape before the supervision meeting.
6. Each individual clinician should also come to the supervision meeting with some
ideas about personal goals for skill development during the semester (e.g., something
you might monitor and work on).
Have fun!
Dave, Michael, Randy, and Sarah
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