THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
COURSE NUMBER:
COURSE TITLE:
SEMESTER & YEAR:
INSTRUCTOR:
SOWO 755
Issues for Contemporary Clinical Practice
Spring, 2016
Marilyn Ghezzi, MSW, LCSW
TTK, 563-C
919-962-6490
mghezzi@email.unc.edu
OFFICE HOURS:
COURSE WEBSITE:
is available through https://sakai.unc.edu
COURSE DESCRIPTION: This is a seminar designed to help prepare students for contemporary clinical
practice, covering topics such as managed care, independent practice and self-care.
COURSE OBJECTIVES:
1. Address ethical issues that develop as a clinical social worker including dual roles, liability
issues, confidentiality and competency.
2. Understand how managed care impacts clinical social work practice.
3. Identify professional development issues important for longevity in the field, such as
supervision, self-care, on-going use of evidence-based practices, and networking.
4. Be exposed to a variety of clinical social work roles and the various issues that arise based on
the setting (e.g. home visits vs. working in a hospital as part of an interdisciplinary team).
5. Assess current level of competence and comfort level with working within various social work
settings and with clients from a range of diverse backgrounds and issues.
EXPANDED DESCRIPTION: This course will build on the Advanced Practice classes students will take in
their concentration year. It is designed to help students think about the variety of options for clinical
social work practice, as well as help them to identify and begin to address issues that may impact their
own practices, regardless of the setting. This seminar will help students to prepare for longevity in the
field by helping them begin to incorporate self-care and professional development practices
immediately upon graduation. In addition, the basics of how to develop an independent practice will be
discussed. Ethical issues and self-awareness will also be discussed in relation to how these issues may
impact their ability to be an effective practitioner.
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REQUIRED TEXTS/READINGS:
Willer, J. (2014). The beginning psychotherapist’s companion. (2nd ed.). New York, NY: Oxford
University Press.
Other assigned readings will be posted on our Sakai site
TEACHING METHODS:
This course is a true seminar which means that there is less lecture and more class discussion and
activity. This class will use a variety of teaching and learning methods to cover the content. These different
methods include: small group activities; lecture; guest speakers; role-plays; and class discussions.
CLASS ASSIGNMENTS
Refer to description of assignments at the end of this syllabus.
1. Supervision paper : 30%
2. Professional Development Plan: 50%
3. Class Attendance and Participation: 20%
CLASS PARTICIPATION
Class participation counts for 20% of your final grade. Everyone will receive a standard score of
100 for participation, in recognition of a norm of attendance, contributions to small group activities and
informed participation in class discussion. Informed participation means that you clearly demonstrate
that you have completed assigned readings and can offer analysis, synthesis and evaluation of written
material. Excellent participation also means that your comments are thoughtful, focused and respectful.
Points will be deducted from the base score if you miss class, are late, leave early, disappear for long
periods on break or are unprepared. Please turn off cell phones during class.
The development of a supportive learning environment is fostered by respectfully listening to the
ideas of others, being able to understand and appreciate a point of view which is different from your
own, clearly articulating your point of view, and linking experience to readings and assignments. If you
will not be able to attend a class, let the instructor know as soon as possible. It is also your
responsibility to obtain handouts, information about class content, and information about
announcements, etc., from your classmates. In order to fully participate in and benefit from each class
session, students must complete required readings and come to class prepared to discuss them.
.
GRADING SYSTEM
In accordance with the Graduate school, letter grades are assigned to the following numeric ranges:
H = 94 and above
P = 80 to 93
L = 70 to 79
F = 69 and below
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PAPER SUBMISSION AND POLICY ON INCOMPLETES AND LATE ASSIGNMENTS
A grade of “Incomplete” will be given only in extenuating circumstances and in accordance with
SSW and University policy. All papers and assignments are to be submitted electronically to the
Dropbox in our Sakai site and are due at the beginning of class on the dates noted on this syllabus. Ten
percent will be deducted from your grade for each day that a paper is late. If you have a situation arise
that may prohibit you from completing the assignment on time, any request for an extension on the
papers must be done in advance of the due date (at least 24 hours) for the paper. Approved delays will
not affect the grade.
Your cover sheet for the paper should contain your name, PID# and honor code pledge. Do not put
your name in the body of the paper that you submit to Sakai, instead use your PID# as a running head
on each page.
POLICY ON ACADEMIC DISHONESTY
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 this written work". In keeping with the UNC Honor Code, if 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
POLICY ON ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES
The University of North Carolina – Chapel Hill facilitates the implementation of reasonable
accommodations, including resources and services, for students with disabilities, chronic medical
conditions, a temporary disability or pregnancy complications resulting in difficulties with accessing
learning opportunities.
All accommodations are coordinated through the Accessibility Resources and Service Office. In the
first instance please visit their website http://accessibility.unc.edu, call 919-962-8300 or email
accessibility@unc.edu. Please contact ARS as early in the semester as possible.
USE OF LAPTOPS OR OTHER ELECTRONIC DEVICES
Please turn off all cell phones or other devices that would disrupt the learning environment of the
classroom. Laptops are allowed during lecture only or when being used for a class activity. Laptops
should be closed during class discussion and other activities that do not require the use of a laptop.
APA AND WRITTEN ASSIGNMENTS
The School of Social Work faculty has adopted APA style as the preferred format for papers and
publications. The best reference is the Publication Manual of the American Psychological Association,
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Sixth Edition (2009) that is available at most bookstores. The following web sites provide additional
information: http://juno.concordia.ca/help/howto/apa.php
Students are strongly encouraged to review the materials on the School of Social Work’s website
http://ssw.unc.edu/students/writing . This page includes numerous helpful writing resources such as
tutorials on understanding plagiarism, quick reference guide to APA, writing tips and ESL materials.
Students are also strongly encouraged to review the section on plagiarism carefully. All instances of
academic dishonesty will result in disciplinary measures pre-established by the School of Social Work
and the University.
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COURSE OUTLINE
Class 1:
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Introduction January 11
Overview of the Course
What is clinical social work?
Current challenges and opportunities in our field
How to achieve longevity as a clinical social worker
What do you want to learn in this course?
Readings:
Mirabito, D.M. (2012). Educating a new generation of social workers: Challenges and skills needed for
contemporary agency based practice. Clinical Social Work, 40, 245-254.
Lundgren, L. & Krull, I. (2014). The Affordable Care Act: New opportunities for social work to take
leadership in behavioral health and addiction treatment. Journal of the Society for Social Work
and Research, 5(4), 415- 438.
Bransford, C.L. (2011). Reconciling paternalism and empowerment in clinical practice: An
intersubjective perspective. Social Work, 56(1), 33-41.
January 18 - MLK Holiday- NO CLASS
Class 2:
Supervision - January 25
• Supervision – types of supervision
• Importance of supervisory relationship
• Parallel process, countertransference
Readings:
Ladany, N. (2008). Getting the most out of supervision. In Practicing counseling and psychotherapy:
Insights from trainees, supervisors and clients. (pp. 101-134). New York, NY: Routledge.
Willer, J. (2014). The supervisor-supervisee relationship. In The beginning psychotherapist’s
companion (pp. 13-24).
Hoge, M.A., Migdole, S., Cannata, E. & Powell, D.J. (2014). Strengthening supervision in systems of
care: Exemplary practices in empirically supported treatments. Clinical Social Work Journal,
42, 171-181.
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Ornstein, E.D. & Moses, H. (2010). Goodness of fit: A relational approach to field instruction. Journal
of Teaching in Social Work, 30, 100-114.
.
Class 3: Supervision (cont.), Technology and Clinical Social Work – February 1
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Continued discussion of supervision issues
Use of technology with clients
Boundary issues and technology
Required Readings:
The entire issue of the March, 2015 issue of the Clinical Social Work Journal, Vol. 43(2) is entitled:
Entering the Digital World: Cybertechnology and Clinical Social Work Practice. Each student will pick
one article to read from that issue and will “teach” the class about that topic.
Willer, J. (2014). Professional electronic communications and data security. In The beginning
psychotherapist’s companion (pp. 80-99).
Optional reading:
Mattison, M. (2012). Social work practice in the digital age: Therapeutic e-mail as a direct practice
methodology. Social Work, 57(3), 249-258.
Mishna, F., Bogo, M., Root, J., Sawyer, J. & Khoury-Kassabri, M. (2012). “It just crept in”: The digital
age and implications for social work practice. Clinical Social Work Journal, 40, 277-286.
Class 4: Independent Practice: February 8
Panel discussion with social workers in private practice
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Is private practice right for you?
Business/managed care considerations
Ethical dilemmas
Finding a niche/area of practice
At what point are you ready?
Readings:
Green, R.G., Baskind, F.R., Mustian, B.E., Reed, L.N., Taylor, H.R. (2007). Professional education and
private practice: Is there a disconnect? Social Work, 52, 151-159.
Lord, S.A. & Iudice, J. (2012). Social workers in private practice: A descriptive study of what they do.
Clinical Social Work Journal, 40, 85-94.
Brennan, C. (2013). Ensuring ethical practice: Guidelines for mental health counselors in private
practice. Journal of Mental Health Counseling, 35(3), 245-261.
This article has a nice overview of key issues in ethical practice including HIPAA, informed
consent, billing, recordkeeping. Although the article focuses on private practice nearly all of
the issues discussed are also relevant for agency practice.
Peck, S. (2007). Private practice: When it’s not right for you. The New Social Worker, 14, 24-25.
Optional Reading:
van Heugten, K. (2001). Aspects of the early life histories of social workers in private practice: From
marginality to reflective practice. Psychoanalytic Social Work, 8, 57-78.
Class 5: Independent Practice: Nuts and Bolts- February 15
Supervision
Paperdue
Duetoday
Today
Supervision Paper
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•
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Record keeping
Forms (e.g. release forms, consent for treatment, policies)
Referral networks
Collateral contacts
Insurance/Payment issues
Malpractice
Readings:
Willer, J. (2014). Confidentiality and Informed Consent. In The beginning psychotherapist’s
companion (pp. 103-116).
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Willer, J. (2014). Progress notes and the chart. In The beginning psychotherapist’s companion (pp.
167-192).
Willer, J. (2014). The therapeutic frame. In The beginning psychotherapist’s companion (pp. 26-41).
Lanham, MD: Rowman & Littlefield Publishers, Inc.
Class 6: – Clinical social work roles, managed care, safety •
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February 22
Review various clinical social work roles such as inpatient, clinic based, community based,
residential settings, medical social work, community outreach, etc.
Considerations for each role regarding: safety, managed care, ethical issues, role satisfactions
and stressors
Boundary issues/ethics
Readings:
Cohen, J. (2003). Managed care and the evolving role of the clinical social worker in mental health.
Social Work, 48(1), 34-43.
Spencer, P.C., & Munch, S. (2003). Client violence towards social workers: The role of management in
community mental health programs. Social Work, 4, 532-544.
Rowe, M., Frey, J., Bailey, M., Fisk, D., & Davidson, L. (2001). Clinical responsibility and client
autonomy: Dilemmas in mental health work at the margins. American Journal of
Orthopsychiatry, 71(4), 400-407.
Willer, J. (2014). Boundaries. In The beginning psychotherapist’s companion (pp. 42-64).
Willer, J. (2014). Violence Risk Management. In The beginning psychotherapist’s companion (pp. 311338).
Class 7:
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•
•
•
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Self-care, vicarious trauma, burnout – February 29
Importance of self-care and self-awareness
What self-care strategies to use
Burnout, secondary trauma, compassion fatigue, vicarious traumatization
How do our histories impact the work?
Readings:
Willer, J. (2014). Caring for yourself and your clients. In The beginning psychotherapist’s companion
(pp. 363-381).
Willer, J. (2014). Becoming a psychotherapist: Challenges, rewards and growth. In The beginning
psychotherapist’s companion (pp. 382-396).
Bellows, K. (2007). Psychotherapists’ personal psychotherapy and its perceived influence on clinical
practice. Bulletin of the Menninger Clinic, 71, 204-226.
Radey, M., & Figley, C.R. (2007). The social psychology of compassion. Clinical Social Work
Journal, 35, 207-214.
Optional Reading:
Strozier, A.L., & Stacey, L. (2001). The relevance of personal therapy in the education of MSW
students. Clinical Social Work Journal, 29, 181-195.
Final Assignment: Professional Development Plan due on Friday, March 4 at midnight
Supplemental Reading:
Acker, G.M. (2010). How social workers cope with managed care. Administration in Social Work, 34,
405-422.
Hamama, L. (2012). Burnout in social workers treating children as related to demographic
characteristics, work environment, and social support. Social Work Research, 36(2), 113-125.
Gerdes, K. E., & Segal, E. (2011). Importance of empathy for social work practice: integrating new
science. Social Work, 56(2), 141-148.
Ji, J., Kao, D., & Kim, H. (2011). Burnout and physical health among social workers: a three-year
longitudinal study. Social Work, 56(3), 258-268.
Gardner, F., Savaya, R., & Stange, D. (2011). Stressful encounters with social work clients: a
descriptive account based on critical incidents. Social Work, 56(1), 63-71.
Gelman, C., Fernandez, P., Hausman, N., Miller, S., & Weiner, M. (2007). Challenging endings: First
year MSW interns' experiences with forced termination and discussion points for supervisory
guidance. Clinical Social Work Journal, 35, 79-90.
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Rønnestad, M.H., & Skovholt, T.M. (2001). Learning arena for professional development:
Retrospective accounts of senior psychotherapists. Professional Psychology: Research and
Practice, 32, 181-187.
Supplemental Reading about Supervision:
McTighe, J.P. (2010). Teaching the use of self through the process of clinical supervision. Clinical
Social Work Journal, 39, 301-307.
Stovel, L. & Steinberg, P.I. (2008). Learning within psychotherapy supervision. Smith College Studies
in Social Work, 78(2/3), 321-336.
Alonso, A. (2000). On being skilled and deskilled as psychotherapy supervisor. Journal of
Psychotherapy Practice and Research, 9(1), 55-61.
Yourman, D.B. (2003). Trainee disclosure in psychotherapy supervision: The impact of shame. Journal
of Clinical Psychology, 59(5), 601-609.
Hawkins, P. & Shohet, R. (2006). Maps and models of supervision. In Supervision in the helping
profession (3rd ed.). New York, NY: McGraw-Hill (pp.56-79).
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ASSIGNMENTS
Supervision Paper: Due Feb. 15
This paper is designed to help you reflect on your feelings/experiences in clinical supervision thus far
in your career and to contextualize those experiences through an understanding of the professional
literature about clinical supervision. In addition to the required course readings on supervision, read
two or three of the supplemental supervision articles that look interesting to you. Please answer the
following questions in a 5-6 page double-spaced paper following APA rules.
Reflect on your experiences thus far with supervision in your field placements and/or other human
services jobs you have held. Describe any critical experiences, good or bad that have shaped your view
of supervision. Discuss your reactions to these experiences and your thoughts about supervision in
general in light of the readings on supervision and our class lecture and discussions. Discuss your
hopes for supervision in the future, what might work best for your learning style and what might be
personally challenging for you in clinical supervision.
In addition to considering yourself as a supervisee, consider what may be involved in your own
transition to becoming a supervisor. What will be difficult for you as a supervisor? What type of
supervisor will you be? What are you looking forward to about becoming a supervisor? What might
you need to work on in yourself in order to be a good clinical supervisor?
Please demonstrate in the paper that you have read the materials about supervision and considered them
thoughtfully. Apply the concepts to your particular situation.
Grading Criteria
Possible Pts.
The student clearly described their own experiences in supervision and covered all aspects
of the assignment.
5
The student appropriately applied the course readings on supervision to their own
situation.
10
The student demonstrated an understanding of the course readings on supervision and the
didactic material presented.
10
The paper was written well with no errors, followed APA format, followed guidelines for
anonymous submission
5
Total
30
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Professional Development Plan- Due Friday, March 4
Objective:
As a professional social worker, you will need to be conscious of how to develop your skills and
knowledge in the area of clinical social work. This assignment is to increase your attention to your own
needs as a new clinician and to develop concrete steps that you will take to reach your own personal
goals.
Description:
The aim of this assignment is to help you organize your professional goals into as many concrete steps
as necessary to help you know where to go in your career. The outline below should be followed to
ensure that you have considered critical areas for professional development. However, you should not
feel limited by this outline, as there may be other essential areas that you would want to include in your
plan. It is the hope of this assignment that you will feel more prepared to begin your social work career
with this document as a guide.
Outline for Professional Development Plan:
1. Identify your short and long term goals
a. What are your short term goals? (2-4 years post-graduation)
b. What are your long term goals? (5 years and beyond)
c. What are the populations and settings where you want to work?
2. What are the immediate skills, tasks needed to reach your goals
a. Supervision – type, style, orientation, consideration of learning styles, on the job vs.
outside
b. Licensure – in what state? Test time frame, necessary steps to complete process, such as
recommendations, forms, etc.
c. Job searches – where will you look? What are some contacts that you can identify to
help?
d. What organizations might be helpful? Consider Clinical Society, NASW, NABSW,
other psychotherapy organizations, groups for particular types and areas of practice such
as DBT or EMDR, psychoanalysis, marital therapy, groupwork, etc.
3. What steps will you take to ensure you are paying attention to self-care?
a. What are the concrete steps you will take?
b. Where does personal therapy come into play?
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c. What do you know works for you to stay healthy and balanced? (e.g. spiritual group,
time off, balanced case load, varying types of work)
4. Professional Development- What are the skills/competencies that you will need to meet your
goals?
a. What additional training do you need?
For example:
i. Post-graduate courses
ii. Ph.D.
iii. Certificate coursework
iv. Additional training in theoretical approaches
v. Other certifications, such as expressive arts, psychoanalytic, EMDR, etc
b. Where will you find the specific training you need? What is your time frame for further
training?
c. Are there fellowships or post-master’s training programs that you would want to seek
out?
5. Ethics
a. Do you have a place to go when faced with ethical dilemmas?
b. What steps will you take to ensure your safety in the field? Do you need additional
training in therapeutic holds, non-violent crisis intervention, etc?
c. What will you do to maintain your boundaries both in face to face work with clients and
online?
i. Thought about issues of self-disclosure? What will you say when asked the
tough questions?
ii. How available will you be outside of work? What limits might you need to set
about work hours/overtime? What are your thoughts about cell phone/pager
availability and how that fits for you personally?
6. Other areas that are relevant for your personal goals
a. How will your short-term goals lead into your long-term goals?
b. What other areas do you need to consider?
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Grading Criteria:
Criteria
Possible
Pts.
1. Each of the areas listed in the outline have been addressed and the plan is
specific, concrete, thoughtful and reflective concerning personal
professional needs.
35
2. The document reflects content and knowledge from the course, such as
resources identified in the course or specific issues raised in class
discussion
10
3. The writing was clear and well organized with no errors and followed APA
format
5
Total points
14
50