THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
FALL 2010
COURSE NUMBER: SOWO 844
COURSE TITLE: ADOLESCENT MENTAL HEALTH: THEORY AND PRACTICE
ROOM, DAY, AND TIME COURSE MEETS: TTK 107, MONDAY, 2:00-4:50 P.M.
INSTRUCTOR: MATTHEW O. HOWARD, MSW, PH.D., DANIELS DISTINGUISHED PROFESSOR
EMAIL: MOHOWARD@EMAIL.UNC.EDU
TEACHING ASSISTANT: AHMED WHITT; AHMEDW@EMAIL.UNC.EDU
OFFICE PHONE: 919-932-8732
HOME PHONE: 314-330-3479 (CELL)
OFFICE HOURS: FRIDAY, 10 A.M.-12:00 P.M. OR BY APPOINTMENT.
COURSE DESCRIPTION:
This course is a seminar on adolescent mental health covering both the social context of
adolescent mental health problems and intervention theories and skills to address those problems.
It covers assessment, practice theories, and evidenced-based interventions.
COURSE OBJECTIVES:
1. Understand the context for adolescent development in the 21st century and how that
context inhibits or promotes mental health symptoms and disorders.
2. Identify myths and assumptions about adolescents that get in the way of accurate
diagnosis and treatment.
3. Understand the legal framework in which adolescents and their parents seek treatment
and the implications of this framework for practice.
4. Consider the impact of difference on how we understand particular symptoms and
disorders in adolescents.
5. Understand the role of the family in intervention with adolescents.
6. Describe in detail selected evidence-based practice models for working with adolescents
around specific mental health problems and to be able to match these intervention models
to appropriate mental health problem areas.
7. Be able to engage adolescents and their parents in particular treatment models.
8. Be able to use specific skills associated with particular models to intervene with
adolescents and their families.
SKILLS TO BE ACQUIRED IN THIS CLASS:
1. The ability to go beyond information gathering to create a nuanced assessment and
treatment plan for an adolescent and their family;
2. The ability to consider and identify cultural understandings of illness that may impact
treatment;
3. The ability to identify evidence-based treatments for particular disorders;
4. The beginning ability to employ various evidenced-based treatments that will be helpful
to the child or family system.
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REQUIRED TEXTS
All of the books listed below are available at the student bookstore, although you might be able
to get them more cheaply at on online bookstore. Many of the books are inexpensive, but several
are more costly. I can loan out my instructor copy to students who cannot afford one or more of
the course texts.
1. Perry, B.D., & Szalavitz, M. (2006). The boy who was raised as a dog and other stories from
a child psychiatrist’s notebook: What traumatized children can teach us about loss, love, and
healing. Basic Books: New York, New York. ISBN-10: 1572247037. Cost: $10.85 at
Amazon.com on 06/29/2010.
Perry is a leading child and adolescent psychiatrist, Senior Fellow at The Child Trauma
Academy, and former Chief of Psychiatry at Texas Children’s Hospital. This book pairs him
with a gifted and award-winning journalist. Each of the chapters in this fascinating book
describes a different case. The stories are gripping and convey important lessons about the role
of trauma in the lives of children and adolescents and the various adaptations they make to these
experiences. Everyone I asked to read this book (to help me preview it for this course) loved it.
This is the first book we will read.
2. Clancy, S.A. (2009). The trauma myth: The truth about the sexual abuse of children and its
aftermath. Basic Books: New York, New York. ISBN-10: 0465011688X. Cost: $16.50 at
Amazon.com on 06/29/2010.
This book raised a firestorm of controversy in relation to current conceptualizations of the
psychological effects of early life sexual victimization. In it, Clancy challenges the assumptions
of the prevailing “traumatogenic” model of the experience and consequences of childhood sexual
abuse. This is the second book we will read. It is well written and a quick read. We will read
the Perry and Szalavitz and Clancy books during the first three weeks of class and then have an
assignment asking you to compare and contrast the books in terms of their implications for how
we view, treat, and prevent childhood sexual abuse and its consequences in adolescence and
adulthood.
3. Preston, J., O’Neal, J.H., & Talaga, M.C. (2010). Child and adolescent psychopharmacology
made simple, 2nd Edition. New Harbinger Publications, Oakland, CA. ISBN-10: 1572247037.
Cost: $15.57 at Amazon.com on 06/29/2010.
John Preston authors the most readable and useful psychopharmacology texts for social workers
and other clinicians currently available (in my opinion). His other books include
“Psychopharmacology Made Ridiculously Simple” and “Handbook of Clinical
Psychopharmacology for Therapists.” This book is very short, easy to read, yet very
comprehensive and informative regarding the use of psychotropic medication in children and
adolescents. All practitioners, parents, and informed citizens should understand the basics of
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psychotropic medication given the ubiquity of their usage in contemporary society. Students will
need to read this book by midterm in the class.
4. Sadock, B.J., & Sadock, V.A. (2009). Kaplan and Sadock’s Concise Textbook of Child and
Adolescent Psychiatry. Lippincott Williams & Wilkins. ISBN-10: 0781793874. Cost: $57.92 at
Amazon.com on 06/29/10.
This child and adolescent mental health textbook is derived from the 10th edition of Kaplan and
Sadock’s Synopsis of Psychiatry, a text that has been used for almost 40 years to train
psychiatrists, clinical psychologists, and psychiatric social workers. The coverage of mental
health disorders in children and adolescents is comprehensive, particularly in the areas of
etiology, diagnosis, and treatment. Students will read this book by midterm and will then be
tested over its contents. I will provide you with a detailed study guide and you can expect to do
very well on the exam if you read the book and complete the study guide.
All students are required to read the first four books by midterm. Students then select one of
three tracks to complete requirements of the second half of the class.
Track 1: Clinical Track.
This track is for students who want to do clinical work with adolescents in the future. Students
will select two of the three books listed below and will read them and then prepare reviews of the
books as described below.
5. Cohen, J.A., Mannario, A.P., & Deblinger, E. (2006). Treating trauma and traumatic grief in
children and adolescents. New York: Guilford Press. ISBN-13:978-1-59385-308-2. Cost:
$57.92 at Amazon.com on 06/29/10.
This book describes a cognitive-behavioral intervention developed and tested by this group of
leading clinician-researchers in the trauma and traumatic grief areas. The trauma-focused CBT
intervention is considered evidence-based and the text does a good job of describing the impact
and assessment of trauma and traumatic grief in children and adolescents, as well as presenting
the psychoeducation, parenting, relaxation, affect regulation, and cognitive skills training
methods that are a part of TF-CBT approach.
6. Mufson, L. Dorta, K.P., Moreau, D., & Weissman, M. (2004). Interpersonal psychotherapy
for depressed adolescents (2nd Ed.). New York: Guilford Press. ISBN: 1-59385-042-5. Cost:
$35.64.
This text presents another evidence-based psychotherapy, one that is rooted in a psychodynamic
model, but that heavily emphasizes the role of interpersonal relationships in depression.
Interpersonal psychotherapy is also used with depressed adults and has proven effective in
reducing depression in adolescents and adults. The book includes interesting discussions
regarding the clinical features of depression in adolescents, current treatments available for
adolescent depression, and origins and applications of interpersonal psychotherapy treatment.
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The text also addresses important issues in clinical work with adolescents having to do with
crisis management, use of medication in conjunction with psychosocial interventions, and issues
having to do with suicidal, assaultive, substance abusing, sexually active, and GLBT adolescent
clients.
7. Eisen, E.R., & Schaefer, C.E. (2005). Separation anxiety in children and adolescents: An
individualized approach to assessment and treatment. Guilford Press: New York, New York.
ISBN-10: 159385482X. Cost: $30.00 for paperback version at Amazon.com on 06/29/10.
This is a well written book describing a cognitive-behavior approach to the treatment of
separation anxiety in children and adults. Separation anxiety is more prevalent than is generally
appreciated and has long-term consequences that can last even into old age. This book is
particularly recommended for students who may want to practice with youth in school settings.
Track 2: Individualized Track
If you pick this track, you will select two books of your own choosing that have to do with
adolescents and then read and review them (see below). Two examples of books I read this
summer that would be appropriate choices are listed below. Once you have determined which
books you want to read, please discuss your selections with me. I want you to have the chance to
tailor this course to your specific interests and needs, but hope that the books you choose will be
useful in terms of understanding adolescent development or specific policy issues or clinical
conditions (e.g., eating disorders).
5. Weill, C.L. (2009). Nature’s choice: What science reveals about the biological origins of
sexual orientation. Routledge: New York, New York. ISBN-10: 0-7890-3475-5.
Remember, this is just an example of the type of book you might select. I found this book
exceptionally interesting. The author was a Ph.D.-level chemist who had a long scientific career
in the neurobiology area. She then retired and got her M.S.W. at the University of Denver and
then went into practice working with GLBT clients in the Fort Collins, CO area. Her book
reviews the origins of human sexual orientation. I found it very enlightening and, of course,
coming to terms with your sexual and gender orientation are key issues of adolescence.
6. Karen, R. (1994). Becoming attached: First relationships and how they shape our capacity
to love. Oxford University Press.
This is a wonderful book examining the history of attachment theory and related research
findings and what they tell us about the role of early life experiences and temperament in
determining the nature and quality of later life relationships. The book is incredibly well written
and easy to read, though lengthy.
If you decide to take the individualized track, make sure to pick two books that are really
important to your future career, or that you have been dying to read, and try to make sure they
will challenge you a little.
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Track 3: Mix and Match Track
If you select Track 3, you will complete a variety of different activities during the second half of
the course. These activities include:
1. Complete an On-line Course in Trauma-Focused CBT: This is an on-line course that can be
accessed at the following link: http://tfcbt.musc.edu/. You must register to participate, but
participation is free.
2. Read John Krakauer’s book, “Into the Wild,” and/or watch the film “Into the Wild.”
Prepare a one-page single-spaced paper addressing the following issues: What do you make of
the protagonist and do your views of him change throughout the book? Is he mentally ill or do
you agree with Krakauer that he made a few bad mistakes that cost him his life? What are the
implications of this book for how we define deviance as a society? What relevance does
defining deviance have for social work practice?
3. Watch the Frontline video Growing Up Online,
http://www.pbs.org/wgbh/pages/frontline/kidsonline/. Please prepare a one-page, single-spaced
report addressing the following topics: Are these issues that teens today face new to you or were
these issues part of your own adolescence? In your experience, are clinicians addressing these
issues in practice or are there large areas of teen life that we miss? In what circumstances would
it be important to know about a young person’s “cyber life” and what kinds of questions do you
think clinicians should routinely ask given the information in this program?
4. Watch the Frontline video “Inside the Teenage Brain” and explore the website.
http://www.pbs.org/wgbh/pages/frontline/shows/teenbrain/. What are the implications of this
work for your work with teenagers and their parents? How does it relate to diagnosis and
treatment choices?
5. Complete the four on-line mini-courses offered by the Child Trauma Academy
(http://www.childtraumaacademy.com/) entitled “The Amazing Human Brain and Human
Development,” “Surviving Childhood: An Introduction to the Impact of Trauma,” “The Cost of
Caring: Secondary Traumatic Stress and the Impact of Work with High-Risk Children and
Families,” and “Bonding and Attachment in Maltreated Children.” You can find these courses
under the “training” link at the Child Trauma Academy Website.
OTHER TEXTS TO CONSIDER FOR YOUR PROFESSIONAL LIBRARY:
James, B. (1989). Treating traumatized children: New insights and creative interventions. New
York: Free Press. ISBN: 0-669-20994-5
Kazdin, A.E. and Weisz, J.R. (Eds.). (2003). Evidenced-based psychotherapies for children and
adolescents. New York: Guilford Press. ISBN: 1-57230-683-1
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Reinecke, M.A., Dattilio, F.M., & Freeman, A. (eds). (2003). Cognitive therapy with children
and adolescents.
Rolland, J.S. (1994). Families, illness, & disability: An integrative treatment model. New York:
Basic Books. ISBN: 0-465-02915-9. 5
Ryan, C. & Futterman, D. (1998). Lesbian and gay youth: Care and counseling. New York:
Columbia University Press. ISBN: 0-231-11191-6
TEACHING METHODS
To be enjoyable, our class should be interactive. Comfort and cohesion in this class will be
created by interactions that reflect social work values. You are encouraged to state your point of
view. At the same time, please keep in mind that supportive learning conditions are created and
fostered by listening to the ideas and beliefs of others and reflecting upon those which may be
different from your own. Your contributions to making this a safe and respectful classroom
environment are appreciated. Attending and participating in class are important and I do notice
who attends.
CLASS ASSIGNMENTS
A. Assignment 1: The first assignment is a paper comparing and contrasting the first two books
we will read: The Boy Who was Raised as a Dog and “The Trauma Myth.” I conceive of this
assignment as an approximately 3-to-6 page paper, double-spaced, and formatted as you prefer.
I want you to describe each book (length, structure, style, intended audience, effectiveness in
achieving its aims, etc.) in sufficient detail such that it is clear to me you read the book carefully
and pondered its content. Then, I want you to address the contrasting perspectives on trauma
presented in each book. How do Perry and Clancy differ in their understanding of trauma and
what do they see as the reasons for the adverse impact of trauma on functioning in adolescence
and adulthood? This assignment is due September 27thth and worth 10 points.
B. Assignment 2: For this assignment, you will read Child and Adolescent Clinical
Psychopharmacology Made Simple. You will turn in your book with your name inscribed in it
and with highlighting or underlining and with notes in the margins. I want to be able to review
your book and make sure that you read it and thought carefully about the material. You do not
have to take encyclopedic notes, but it should be clear to me that you have thought about the
material. You might note questions that arise in your thinking as you read or issues that are
unclear to you that I might be able to answer when I review your book. This assignment is
worth 5 points and is due on or before November 1st.
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C. Assignment 3: This assignment will consist of a midterm multiple-choice, true-false exam
over the contents of the Concise Textbook of Child and Adolescent Psychiatry. I will distribute
a study guide one to two weeks prior to the midterm that will greatly focus your studying for the
exam. Students who read the text and complete the study guide will do very well on the exam.
This exam will be worth 25 points and will be administered on November 1st.
All students complete Assignments 1-3 and they are worth 40 points. For the second half of the
course, students select Track 1: Clinical Track, Track 2: Individualized Track, or Track 3: Mix
and Match Track and complete assignments worth an additional 50 points.
Track 1: Clinical Track and Track 2: Individualized Track
D. Assignment 4: This assignment involves a book review due on November 22nd. This paper
should be approximately 3-to-5 pages in length, double-spaced, and should describe one of the
books selected for reading in the second half of the class. In the case of Track 1 students, this
will be one of the three clinical books described above. For Track 2 students, this book will be
an instructor-approved book of their own choosing. Describe the length, structure, organization,
style, aims, and effectiveness of the book in achieving its ends. The purpose of this assignment
is to convey to me that you have read and thought about the book. I do not expect anything
profound, but enjoy hearing your reactions to these materials, and I think the assignment can
help you formulate your thoughts about a given reading. This assignment is worth 25 points.
E. Assignment 5: This assignment is a book review due on the last day of class. It should
follow the same guidelines as for Assignment 4 above. This assignment is worth 25 points.
Track 3: Mix and Match Track: Assignments 4-8
The second half of the class for Track 3 students will consist of completing the 5 assignments
described above for the Track 3 option. Each of these assignments is worth 10 points and they
can be completed on a schedule wholly determined by the student.
Attendance and Classroom Participation: Attendance and classroom participation are very
important to me. If you are a shy person and it is hard for you to speak up in class, that is fine,
but please do let me know. I consider attendance very important and hope you will only miss
class for dire personal or important professional reasons. If you have to miss class for one of
these reasons, please let me know so that I am aware of these circumstances.
Bonus Point Opportunities: During many class sessions, I will hand out readings that can be
turned in later for bonus points that are added to your point total. Bonus point readings are worth
one point each and must be read and highlighted/underlined and notes recorded on them. If you
achieve a point total of 125 or more points, you will receive a grade of H+. Students receiving
an H+ grade will be given a personalized letter of excellence at the conclusion of the course and
can count on me to provide a recommendation for them for use in future job hunting efforts or
for academic purposes.
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GRADING SYSTEM
The points received for each assignment will be totaled to determine the final grade.
125 and above
94 -125
80 – 93
70 – 79
69 and below
H+
H
P
L
F
POLICY ON INCOMPLETE GRADES AND LATE ASSIGNMENTS: Assignments should be completed
on time. If a situation arises that prohibits you from completing the assignment on time, a request
for an extension must be made in advance of the due date. Approved extensions will not affect
the grade. Any unapproved delays, or assignments completed after an approved extension date,
will begin to accrue a 1-point reduction every 24 hours that the assignment is late. No make-up
exams will be given unless the student has an emergency. If the student is allowed to take a
make-up exam, the exam may be in a different format or have different questions than the
regular exam. If you face unavoidable obstacles, discuss the circumstances with me and we will
decide together whether a grade of incomplete should be considered. Incomplete grades will be
given only in compliance with University policy.
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
Students with disabilities that affect their participation in the course and who wish to have
special accommodations should contact the University’s Disabilities Services at the beginning of
the semester and provide documentation of their disability. Disabilities Services will notify the
instructor that the student has a documented disability and may require accommodations.
Students should discuss the specific accommodations they require (e.g., changes in instructional
format, examination format) directly with the instructor.
POLICY ON THE USE OF ELECTRONIC DEVICES IN THE CLASSROOM
Students are asked to silence cellular phones and pagers during class time. Your PDA’s and
smart phones should remain in your purse, backpack, coat pocket, etc. It is not appropriate to
update your calendar, surf the web, text other people, do Sudoku, tweet, or otherwise disengage
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during class. If you have an extenuating situation that means you will likely be receiving a phone
call that you must take during class, please let me know in advance.
COURSE OUTLINE
CLASS 1
08/30/10
INTRODUCTIONS, REVIEW OF SYLLABUS, INTRODUCTION TO THE COURSE.
READING ASSIGNMENT FOR CLASS 2: CHAPTERS 1-5 (THROUGH PAGE 124) IN THE BOY WHO WAS
RAISED AS A DOG
CLASS 2
09/13/10
GROWING UP IN THE 21ST CENTURY: WHAT’S DIFFERENT ABOUT TEENS TODAY?
INTRODUCTION TO CHILD AND ADOLESCENT PSYCHIATRY: TERMINOLOGY, DIAGNOSIS, AND
INTERVIEWING
READING ASSIGNMENT FOR NEXT WEEK: CHAPTERS 6-11 (finish book) in The Boy Who Was
Raised as a Dog.
CLASS 3
09/20/10
Developmental Disabilities
Learning Disorders
Motor Skills Disorder: Developmental Coordination Disorder
Pervasive Developmental Disorder
READING ASSIGNMENT FOR NEXT WEEK: READ ENTIRE BOOK, “THE TRAUMA MYTH.”
ASSIGNMENT 1 DUE NEXT WEEK
CLASS 4
09/27/10
Attention Deficit Disorders
Disruptive Behavior Disorders
Feeding and Eating Disorders of Infancy and Early Childhood
Tic Disorders
READING ASSIGNMENT FOR NEXT WEEK: CHAPTERS 1-3 (THROUGH PAGE 43) IN KAPLAN AND
SADOCK’S CONCISE TEXTBOOK OF CHILD AND ADOLESCENT PSYCHIATRY; READ INTRODUCTION
AND CHAPTER 1 IN PRESTON ET AL. PSYCHOPHARMACOLOGY BOOK.
CLASS 5
10/04/10
Elimination Disorders
Reactive Attachment Disorder of Infancy or Early Childhood
Stereotypic Movement Disorder and Disorders of Infancy, Childhood, or Adolescence Not
Otherwise Specified
Mood Disorders and Suicide
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READING ASSIGNMENT FOR NEXT WEEK: CHAPTERS 4-8 (PAGES 44-100) IN KAPLAN AND SADOCK’S
CONCISE TEXTBOOK OF CHILD AND ADOLESCENT PSYCHIATRY; READ CHAPTERS 2 AND 3 IN
PRESTON ET AL. PSYCHOPHARMACOLOGY BOOK
CLASS 6
10/11/10
Anxiety Disorders
Obsessive-Compulsive Disorder
PTSD
SAD
GAD
Social Phobia
Selective or Elective Mutism
Early Onset Schizophrenia
READING ASSIGNMENT: CHAPTERS 9-14 (PAGES 101-146) IN KAPLAN AND SADOCK’S CONCISE
TEXTBOOK OF CHILD AND ADOLESCENT PSYCHIATRY; CHAPTERS 4, 5, AND 6 IN PRESTON ET AL.
PSYCHOPHARMACOLOGY BOOK
CLASS 7
10/18/10
Adolescent Substance Abuse
Additional Conditions that May be a Focus of Clinical Attention
READING ASSIGNMENT FOR NEXT WEEK: CHAPTERS 15-20 (PAGES 147-228) IN KAPLAN AND
SADOCK’S CONCISE TEXTBOOK OF CHILD AND ADOLESCENT PSYCHIATRY; FINISH PRESTON ET AL.
PSYCHOPHARMACOLOGY BOOK
10/25/10
CLASS 8
Eating Disorders in Adolescents
Self-Mutilation/Cutting Behavior
Emotion Regulation
Review for Midterm
THERE IS NO READING ASSIGNMENT THIS WEEK. FINISH THE PSYCHOPHARMACOLOGY BOOK AND
STUDY GUIDE FOR THE MIDTERM EXAM.
CLASS 9
11/1/10
Midterm Exam
Turn in Psychopharmacology Book for My Review
Video/Pizza and Pop
CLASS 10
11/08/10
Social Context of Modern Adolescence
Media Influences
Youth Violence
Access to Firearms
Gangs
Sibling Violence
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Relationship Violence
Bullying/Cyber Bullying
Stalking
Sexting
CLASS 11
11/15/10
Adolescent Sexuality
Concerns about Appearance
Sexual Orientation
Gender Identity
Teen Pregnancy
STDs
Family Issues: Divorce, Family Dysfunction and Other Issues
11/22/10
CLASS 12
School Performance and Problems
Drop Out and Truancy
Gifted Adolescents
Preparing for a Career and Economic Independence
Entrepreneurship FIRST BOOK REVIEW ASSIGNMENT DUE FOR TRACK 1 AND TRACK 2 STUDENTS
CLASS 13
11/20/10
Health Problems of Adolescents
Obesity
Diabetes
HIV
Kidney Disease, Asthma, Epilepsy and other chronic illnesses
Coping with the Death of Parents, Sibling, Friends, Classmates and Threats to Health
12/06/10
CLASS 14
COURSE REVIEW AND COURSE EVALUATIONS
SECOND BOOK REVIEW ASSIGNMENT IS DUE FOR TRACK 1 AND TRACK 2 STUDENTS
ND
TRACK 3 STUDENTS MUST HAVE TURNED IN ALL 5 ASSIGNMENTS FOR THE 2 HALF OF THIS
CLASS BY TODAY.
Good Work! Happy Holidays!
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