THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL School of Social Work Course Number: SoWo760.01 Course Title: Alcohol, Tobacco, & Other Drugs (ATOD): Clinical Practice Semester: Fall 2013, Tuesdays 6:00pm - 8:50pm, TTK Room #102 L. Worth Bolton, ACSW, LCAS, CCS Clinical Assistant Professor UNC-CH School of Social Work – CB#3550 Office Suite 4th Floor - #466 301 Pittsboro Street Chapel Hill, N.C. 27599-3550 Work: 919-389-9224 FAX: 919-962-6562 email: lwbolton@email.unc.edu Office Hours: Office Hours by appointment only, Mondays & Tuesdays through the semester. Course Description: Students develop knowledge, skills, and attitudes specific to clinical practice with adults having Substance-Related Disorders. This will include effective interventions in a variety of clinical settings utilizing evidence-based and evolving best-practice methodologies. Course Objectives: At the conclusion of this course, students should be able to: 1. Understand the process by which the social worker, client and appropriate significant others determine the most effective course of action based on the client’s needs and characteristics, as well as available community resources. (Screening) 2. Identify methods for assessing and responding to crisis needs of persons abusing or dependent on substances, with particular concern for medical needs, likelihood of self-harm, available resources and other agency-related conditions. (Crisis Intervention) 3. Know how to use an ongoing assessment process that accents client strengths and is sensitive to such issues as those related to age, gender, race, ethnicity, culture, sexual orientation, rurality, and disability. (Assessment) 4. Identify effective ways to collaborate with clients to develop desired treatment outcomes and to design short-term and long-term strategies for achieving these outcomes. (Treatment Planning) 5. Discuss service coordination activities, such as referral, liaison, and collateral contacts, which are necessary to bring services, agencies, resources, and clients together in a planned effort to help achieve the established goals. (Case Management) (2) 6. Articulate a knowledge of multiple approaches to counseling individuals, small groups, and significant others that have demonstrated effectiveness with Substance-Related Disorders. (Counseling) 7. Provide culturally relevant formal and informal educational programs to individuals, small groups, and significant others that raise awareness, identify risk and resiliency factors, support the recovery process, and explain the impact of addiction on the family system. (Client Education) 8. Know the requirements for clinical charting of assessment, treatment planning, progress notes, discharge planning, written reports, and other client-related data. (Reports and Recordkeeping) Expanded Course Description: As one of four courses offered in the Certificate in Substance Abuse Studies Program the primary focus of this course are the methods of engaging clients with substance-related disorders in a therapeutic relationship. It will build on knowledge gained in direct practice foundation courses and SoWo 700 is a prerequisite for this course. Specifically, it will provide students with a knowledge base on the clinical aspects of addiction treatment, explain and demonstrate assessment, treatment planning and client placement skills that are effective with this practice population in a variety of clinical settings. Utilizing current research findings on effective interventions and defining clinical pathways for efficacious practice, the course works to develop student awareness of evidence-based practices in addictions counseling. Additionally, students will be asked to examine attitudes that may help or hinder effective clinical practice to include common ethical issues that arise with this client population. Required Texts: Fletcher, Anne M. (2013) Inside rehab: the suprising truth about addiction treatment: and how to get help that works. First published by Viking Penguin, a member of Penguin Books Group (USA) Inc. (This text will be available in the student bookstore.) White W.L, Kurtz, E., & Sanders, M. (2006) Recovery Management. Chicago, IL. Published by the Great Lakes Addiction Technology Transfer Center. (This text, is provided by the Behavioral Healthcare Resource Program from your Course Instructor, to be returned at the end of the semester, or paid for if lost or damaged ($9.50).) Recommended Readings: Copies of recommended readings will be passed out in class at various times during the semester. These are not required however, some “Extra Credit” questions on exams will be taken from “recommended readings”. (3) Teaching Methods: Class sessions will involve Lecture, Question & Answer, Large & Small Group Discussion, Clinical Case Studies, and the use of Audio-Visual Aids (LCD projector, VCR, dry erase board). This mix of teaching methodologies will insure cognitive, affective, and experiential stimulation regarding clinical interactions with substance-abusing clients. Students are expected to have completed required readings before coming to class and also expected to actively participate in class discussions & activities. Clinical work with this population involves issues from many points of view and the ability to listen to ideas and opinions that differ from your own will enhance the development of a supportive learning environment. The rapidly changing technologies related to clinical work with this population and the legal issues related to illicit drug use will challenge the class to realistically examine “best practice” models that reflect the values of the social work profession. It is appropriate to share materials from work settings and internships, personal experiences, comments, concerns and observations are also welcome. Confidentiality is expected of all class members when personal sharing occurs. If students have personal issues surface in class and would like support to address their concerns, they are encouraged to ask the instructor for referral information. Assignments: 1) Written Assignment (*Optional) 09/03/13 - Topic Approved by Instructor 11/26/13 - Paper Due at Beginning of Class Students should identify a concern or area of interest they have about clinical social work services with substance-related problems. The focus of this paper can be related to practice following a particular theory of addiction, addressing specific family issues, working with the dually diagnosed or other diverse population clients, using a particular treatment modality or counseling approach, structured by a specific policy issue, etc. The format of the paper should be as follows: Introduction (Explains why the student chose this topic, why it is of interest) Key Points (Discusses research findings about this topic.) Conclusion (Synthesizes research with student’s ideas about the topic.) References (APA Format throughout the assignment.) This 8-10-page paper should be typed, double-spaced, 1-inch margins, minimum of three references per page, and use current APA style. The paper will be graded on clarity of ideas expressed, use of resources, and correct format/grammar. Papers will be turned in at the beginning of class on the due date unless prior arrangements have been made in advance with the instructor. As with exams, students are encouraged to discuss your paper with your classmates and anyone else, for that matter. Students must remember to give citations in their paper for ideas that are not their own, whether or not those ideas have been written down somewhere. For example, if a student comes up with a brilliant example to illustrate a point and you use it in your paper, then you must cite him/her in a citation. (NOTE: Please refer to the APA Style Guide, The SSW Manual, and the SSW Writing Guide for information on attribution of quotes, plagiarism and appropriate use of assistance in preparing assignments. All written assignments should contain a signed pledge from you stating that; “I have not given or received unauthorized aid in preparing/completing this written work”. (4) In keeping with the UNC Honor Code, if a reason exists to believe that academic dishonesty has occurred, a referral will be made to the Office of the Student Attorney General for investigation and further action as required.) 2) Examinations There will be two (2) exams, a mid-semester and final exam. They will be in class, closed book exams administered under the University Honor Code, and are designed to evaluate knowledge, understanding, and application of the material covered in class and in the required readings. Study groups are permissible and, in fact, can be excellent for preparation. Exam One – October 15, 2013 @ 6:00 – 8:50pm The first exam will consist of multiple choice, matching, short answer, & fill-in-the-blanks questions and will cover all lectures and reading assignments through October 15, 2013. Exam Two – December 03, 2013 @ 6:00 – 8:50pm The second will be inclusive of all assignments since the Mid-Term Exam and consists of multiple choice questions, matching, sentence completion, true/false and a case study requiring short answers and written activities pertinent to clinical practice discussed during previous classes. Policy on Incomplete and Late Assignments: Any deviation from announced deadlines for written assignments or examinations must be cleared in advance with the Instructor. Make-up exams must be taken within one week of the announced date and will require documentation of illness or family crisis to be scheduled. Assignments received late will have three (3) points deducted commensurate with the number of days late they were received but no assignment will be accepted if it is more than five (5) school days late. Policy on Missed Classes (See attached “Substance Abuse Movies” listing) If a class session is missed the student will be given ample opportunity to make up the missed hours. The School of Social Work has entered into an agreement with the NC Substance Abuse Professional Practice Board regarding the Certificate of Substance Abuse Studies and the required 180 hours of required education, therefore each course represents 45 contact hours. Hours missed are made up to stay consistent with the Board’s request that each course contain 45 contact hours. (This is particularly important to those Students and Practitioners in the Certificate of Substance Abuse Studies Program.) Policy on Accommodations for Students with Disabilities: Students with disabilities which affect their participation in the course may notify the instructor if they wish to have special accommodations in instructional format, examination format, or other issues considered and addressed. Grading System: Courses in the School of Social Work are graded as H or H- (High, indicating clear excellence), P+, P, or P- (Pass, indicating entirely satisfactory work), L (Low Pass), and F (Fail, indicating (5) performance is not acceptable at the graduate level). Only the letter grades H, P, L, and F appear on official transcripts, but it is customary within the School to use pluses and minuses to provide students with more specific feedback. MSW Student’s final grade for this course will be determined as follows: First Examination 45% of final grade (40%) Final Examination 45% of final grade (40%) Class Participation/Attendance 15% of final grade (10%) *NOTE: Students electing to write a paper will have a different % distribution. First & Final Exams 40% each of final grade Written Assignment 10% of final grade Class Attendance/Participation 10% of final grade MSW Practitioner’s will not receive a formal grade on official university records for this course, however, a P (70%) or better is required to receive a certificate of completion for the course. Successful completion of the course will be determined as follows: First Examination 45% of final grade Second Examination 45% of final grade Class Participation/Attendance 10% of final grade Class participation will include attendance and active participation in all phases of class activities. Making relevant comments with regards to the assigned/recommended readings and the ability to apply covered material to class discussions is an important part of the learning process and will be considered in assigning a percentage of grade from “Class Participation/Attendance”. Written assignment, examinations, and final grade will be based on the following percentage scale: H = 94 - 100 L = 70-79 P = 80 - 93 F = 69 and below Evaluation of Student Performance: The following factors are considered when determining the grade earned by each student in this course: - An “F” will be assigned for failing to complete any of the above-mentioned requirements as set forth in this syllabus. Total score for all assignments completed that fall below a grade of 70 also will result in a course grade of “F”. - An “L” will be assigned when a student has excessive absences or tardiness from class without justifiable reason and fails to participate in class discussions and activities. An inability to produce written work that demonstrates graduate-level skills, (e.g. excessive spelling, punctuation, grammatical, and citation errors) will also adversely affect a student’s grade. Students are expected to use a 12-point font and the reference style of the Publication Manual of the American Psychological Association, 5th edition. - A “P” will be awarded for completion of all requirements as set forth in this syllabus and with none of the deficiencies noted above. A “P” as defined by the Graduate School signifies entirely satisfactory work. (6) - An “H” is awarded to students whose work reflects “clear excellence” as defined by the Graduate School. “Clear excellence” means exceeding “P-level” requirements in two ways: (a) analysis & evaluation of class practice, and (b) extensive use of scholarly literature in written assignment. (*NOTE: For a student to be eligible for a grade of “H”, all graded assignments must be at the 94 & above grade level AND the “written assignment” must be completed when due. You do not have to complete the written assignment to pass this course, however if you do not complete the “written assignment” you will not be considered for the “H” even though your exam grades may meet or exceed the 94 average). Overview of Class Presentations and Required Readings (NOTE: This overview gives projected listing of topics and readings for each class session. Adjustments will be made and discussed at the conclusion of each class session determined by pace and process of class discussions/activities and student learning needs.) Date Session # Topics______________ ___________________________Readings 08/20/13 1 Introductions/Expectations & Course Overview Class Activity – “Effective Addiction Therapist” “Principles of Effective Addiction Treatment” “Clinical Guidelines for SA Psychosocial Treatments” Course Syllabus Class Handout Class Handout Class Handout 08/27/13 2 What’s Wrong Addiction Treatment? What Will Help? Pages 1-4 Rehab Nation: THE QUESTIONS AND THE ISSUES Pages 5-42 “Confrontation in Addiction Treatment” White, W. & Miller, W. 09/03/13 3 Going Inside: WHAT IT’S LIKE TO BE IN REHAB Pages 43-92 Intro to ASAM Criteria Class Handout Screening and Assessment Tools Website (*Topics due to Instructor for required “Honors” written assignment) 09/10/13 4 The Cost of Rehab: FROM THE WALLET TO THE HEART Pages 93-121 ASAM (cont) Class Handout 09/17/13 5 Getting the Best for Your Buck: WHAT ADDICTION TREATMENT SHOULD LOOK LIKE Pages 122-178 Evidence-Based Practices in Addiction Treatment “SAMHSA’s National Registry of Evidence-Based Practices” 09/24/13 6 Rehab Isn’t for Everyone: IN FACT, IT’S NOT FOR MOST PEOPLE Pages 179-204 One Size Doesn’t Fit All: HOW COOKIE-CUTTER APPROACHES AT REHAB GET IN THE WAY Pages 205-245 (7) 10/01/13 7 When it comes to Rehab, Teens are Not Just Little Adults: MORE QUESTIONS THAN ANSWERS Pages 246-298 “Recovery Management” Text Assigned by Number 10/08/13 8 LCAS Graduate Panel Exam Review Q & A “Recovery Management” Text Assigned by Number 10/15/13 9 Mid-Term Exam Mid-Term Course Evaluation 10/22/12 10 When it’s not ”just” a Drug and Alcohol Problem: FROM DEPRESSION TO SEX ADDICTION Pages 299-335 “Recovery Management” Class Text Recovery Oriented Systems of Care Class Handout (Black Ink Pen or #2 Lead Pencil) 10/29/13 11 Helping People Stay the Course: ON USING IN REHAB, REPEAT VISITS, SUCCESS, “SUCCESS” AND IMPROVING THE ODDS Pages 335- 378 Intro to Motivational Interviewing Class Handout “OARS” and “Change Talk” 11/05/13 12 Getting What you Need: ADVICE FROM THE PROS AND A LOOK AT “DREAM” TREATMENT Pages 379-406 Intro to Motivational Interviewing Class Handout “Dealing with Client Discord” 11/12/13 13 MI Practice with Case Studies 11/19/13 14 Introduction to Cognitive Behavioral Therapy “Functional Analysis” and “Social Skills Training” Class Handout 11/26/13 15 Introduction to Twelve Step Facilitation Therapy Therapist Role & Function” (*Written Assignments due at the beginning of class) Class Handout 12/03/13 16 Final Exam Student Evaluations Class Handout Substance Abuse Movies Activity (8) Choose any video you wish. Suggestion: Watch the video once without trying to catch every detail, think about it for a while then watch the video again with an eye to the guidelines. Make sure that you follow the guidelines in writing your reaction paper after viewing the movie. You will get additional points if you incorporate class reading assignments (cited) into your paper (2 pages) as you address the points stressed in the guidelines. GUIDELINES: 1) Indicate why you chose the movie that you chose. 2) What do you think is/was the main point of the movie? 3) What part did you like the most? What part the least? 4) Would you recommend this movie to someone? Why? 5) Would this be a good movie to show to a client group? The List 1. A Streetcar Named Desire 2. Affliction 3. Angela’s Ashes 4. Basketball Diaries 5. Barfly 6. City by The Sea 7. Clean & Sober 8. Chasing the Dragon 9. Drugstore Cowboy 10. Days of Wine & Roses 11. Dazed & Confused 12. Ironweed 13. Jacob’s Ladder 14. Joe The King 15. Jungle Fever 16. Lady Sings the Blues 17. Leaving Las Vegas 18. Man with the Golden Arm 19. New Jack City 20. Pay It Forward 21. Radio Flyer 22. Requiem For A Dream ® 23. Rush 24. Traffic 25. Trainspotting 26. 28 Days 27. The Lost Weekend 28. Ulee’s Gold (If you have a movie that is “substance abuse specific” that is not listed here, I am open to other movies if you let me know in advance – LWB) 29. When A Man Loves A Woman 30. The 25th Hour 31. SherryBaby ®