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THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
Fall Semester, 2010
COURSE NUMBER:
COURSE TITLE:
TIMES:
SOWO 853
Brief Treatment
Mondays 2-4:50, Fall Semester
INSTRUCTOR:
Melissa D. Grady, Ph.D., L.C.S.W.
TTK 563-H; 919-843-0063
mgrady@email.unc.edu
Tuesdays 12-3 or by appointment
is available through http://blackboard.unc.edu
OFFICE HOURS:
COURSE WEBSITE:
COURSE DESCRIPTION: This advanced practice elective covers theories and application of three
models of brief psychotherapy. Skill building, critical thinking, and utilization of empirical
support are emphasized.
COURSE OBJECTIVES:
1. Knowledge of and beginning practice skills in models of brief treatment including
psychodynamic brief psychotherapy, cognitive-behavioral brief psychotherapy, and solution
focused brief therapy. In addition, the students will learn some of the prominent models of
trauma intervention.
2. An understanding of managed care and its impact on mental health practice.
3. The ability to apply evidence and client factors when considering choices around intervention
models.
4. Knowledge of ethical considerations in brief treatment.
5. An ability to assess, formulate goals and design intervention strategies for clients using the
models of practice introduced in the course.
6. Critically examine how client factors such as race, sexual orientation, gender identity,
spiritual beliefs, ethnicity, class, and other characteristics impact the implementation of social
work interventions.
EXPANDED DESCRIPTION:
This is an advanced direct practice elective. It is conducted as a seminar with the classes
involving a combination of lecture, discussion, skill-building exercises, and videotaped case
examples. The models covered will include solution-focused, cognitive-behavioral, trauma and
psychodynamic/interpersonal models applied to planned short-term treatment as well as crisis
intervention. Topics such as cultural competence, managed care, and common crises will be
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discussed. Students will be challenged to consider how ethical issues, managed care, client
differences (e.g. race, ethnicity, gender identity, sexual orientation, class, spiritual beliefs) and
the evidence based practice process all impact both the choices of intervention, as well as how
each intervention will need to be uniquely tailored to individual clients’ needs. With each model
presented, students will consider the role of the relationship and the difference in the use of self o
the worker.
REQUIRED TEXTS:
Dewan, M.J., Steenbarger, B.N., & Greenberg, R.P. (Eds.). (2004). The art and science of brief
psychotherapies: A practitioner’s guide. Washington, D.C.: American Psychiatric Press.
RECOMMENDED TEXTS:
Beck, Judith S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press.
Levenson, H. (1995) Time-limited dynamic psychotherapy: A guide to clinical practice. New
York: Basic Books.
Walter, J. & Peller, J. (1992). Becoming solution-focused in brief therapy. Levittown, PA:
Brunner/Mazel.
OTHER READINGS:
All other readings will be on the Blackboard website for the course.
TEACHING METHODS:
The development of a supportive learning environment, reflecting the values of the social work
profession, is essential for the success of this class. A supportive learning environment is
fostered by listening to the ideas and views of others, being able to understand and appreciate a
point of view which is different from your own, articulating clearly your point of view, and
linking experience to readings and assignments. I will appreciate your contributions to making
this a safe and respectful class for learning and growth.
CLASS ASSIGNMENTS:
1. The course will be conducted as a seminar, so being present and participating actively is
essential to the learning experience. Attendance will be noted and utilized in determining the
final grade. If it is necessary to miss, the instructor should be contacted in advance and
arrangements should be made to get class notes from another student. Active participation in
discussion is important, but quality of comments and questions is more important than
quantity. Case illustrations are encouraged and will enhance class participation grade. Please
see class participation criteria below
2. It is assumed that students are adult learners who have already become proficient at
assimilating information. Therefore it is expected that discussion and learning can take place
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at the level of evaluating ideas as to their plausibility, place in the larger body of social work
knowledge, strengths, limitations, and clinical relevance.
3. A theory summary grid will be turned in near the end of each unit. (See Appendix A for
Grade sheet)
4. One paper is assigned. (See Appendix B for Grade Sheet)
EVALUATING PERFORMANCE:
Weighting of class assignments is as follows:
30% Paper
10% Class Attendance and Participation
20% Each Unit’s Theory Summary (Total 60%)
Please put your PID ONLY on the papers – NOT your name – on any written work or
assignments that you turn into the instructor.
GRADING SYSTEM
All grades are converted to the following scale:
94 and above
H
80-93
P
70-79
L
69 and below
F
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CLASS PARTICIPATION:
Professional Conduct
Class participation is more than mere attendance. It is arriving on time, reading the assigned material,
preparing for class with questions, contributing appropriately to class discussions, doing assignments,
and participating in class activities. The class participation grade is a subjective grade given by the
professor. The professor will use this matrix to determine the class participation grade (modified from
Maznevski, M.(1996). Grading Class Participation. Teaching Concerns.
hhtp://www.virginia.edu/~trc/tcgpart.htm).
Grade
Class Participation Criteria
(Carpenter-Aeby, 2001)
0
No effort
60-70
Infrequent
Effort
70-80
Moderate
Effort
80-90
Good
Effort
90-100
Excellent
Effort
Total Pts
Absent
No effort, disruptive, disrespectful.
 Present, not disruptive (This means coming in late.)
 Tries to respond when called on but does not offer much.
 Demonstrates very infrequent involvement in class.
 Demonstrates adequate preparation: knows basic case or reading facts, but
does not show evidence of trying to interpret or analyze them.
 Offers straightforward information (e.g. straight from the case or reading),
without elaboration or very infrequently (perhaps once a class).
 Does not offer to contribute to discussion, but contributes to a moderate
degree when called on.
 Demonstrates sporadic involvement.
 Demonstrates good preparation: knows case or reading facts well, has
thought through implications of them.
 Offers interpretations and analysis of case material (more than just facts)
to class.
 Contributes well to discussion in an ongoing way: responds to other
students’ points, thinks through own points, questions others in a
constructive way, offers and supports suggestions that may be counter to
the majority opinion.
 Demonstrates consistent ongoing involvement.
 Demonstrates excellent preparation: has analyzed case exceptionally well,
relating it to readings and other material (e.g., readings, course material,
discussions, experiences, etc.).
 Offers analysis, synthesis, and evaluation of case material, e.g. puts
together pieces of the discussion to develop new approaches that take the
class further.
 Contributes in a very significant way to ongoing discussion: keeps analysis
focused, responds very thoughtfully to other students’ comments,
contributes to the cooperative argument-building, suggest alternative ways
of approaching material and helps class analyze which approaches were
effective.
 Demonstrates ongoing very active involvement.
of 100 points
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POLICY ON INCOMPLETES AND LATE ASSIGNMENTS:
It is expected that assignments will be completed at times noted in the syllabus. If you have a
situation arise that may prohibit you from completing the assignment on time, any request for
delay of an assignment/exam must be done in advance of the due date (at least 24 hours) on an
assignment/exam. Approved delays will not affect the grade. Any unapproved delays or
assignments completed after an approved delay date will begin to accrue a 10% reduction every
24 hours that the assignment is late. Papers are due at the start of class. Papers that are handed in
after the beginning of class will be considered late and there is a 10% deduction for every 24
period past the due date/time of the paper. In other words, if the paper is due at 2:00, and turned
in at 11:00 pm that night, there will be a 10% deduction. The clock begins at the start of class.
If the student meets unavoidable obstacles to meeting the time frame, the student should discuss
the circumstances with the instructor to determine if an initial grade of incomplete (INC) would
be appropriate. I prefer not to give an incomplete grade and will give incompletes 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 which affect their participation in the course may notify the instructor
if they wish to have special accommodations in instructional format, examination format, etc.
Please contact the University’s Disability office to request the paperwork necessary for approved
accommodations.
USE OF LAPTOPS OR OTHER ELECTRONIC DEVICES
No laptops or other electronic devices are permitted in the classroom, unless you have a specific
documented learning disability. Please turn off all cell phones or other devices that would disrupt
the learning environment of the classroom.
APA FORMATTING
It is an expectation of this course that you will correctly cite all of your material following the 5th
ed. of the APA manual. If you are not familiar with this style, please refer to the manual, the
study guide on the school’s website or see Diane Wyant, the School’s editor at
dwyant@email.unc.edu
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Course Schedule:
August 30
Class 1 - Introductions
September 13 Class 2 – Psychodynamic: Intro
September 20 Class 3 – Psychodynamic: Techniques
September 27 Class 4 – Psychodynamic: Application
October 4
Class 5 – Psychodyamic/IPT with children and adolescents
October 11
Class 6 – CBT: Review/Techniques
Journal on Psychodynamic Therapy Due
October 18
Class 7 – CBT: Application/Narrative differences
October 25
Class 8 – CBT: Application with children and adolescents
November 1
Class 9 – SFT: Introduction
Journal on CBT Due
November 8
Class 10 – SFT: Techniques and application
November 15 Class 11 – SFT: Application with children and adolescents
November 22 Class 12 – Comparison of all three models
Journal on SFT Due
November 29 Class 13 – Crisis Intervention
December 6
Class 14 – Course wrap-up
Final Paper Due
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Course Outline
Class 1:
Introduction
Overview of the Course
History and ethics of Brief Social Interventions
Client Selection
Goal Setting
Managed Care
Skill-Building Exercise in Client Selection
Skill-Building Exercise in Formulating Measurable Behavioral Objectives
Dulmus, C.N., & Wodarski, J.S. (2002). Six critical questions for brief therapeutic interventions.
Brief Treatment and Crisis Intervention, 2(4), 279-285.
Class 2:
Intro to Psychodynamic
Psychodynamic Developmental Models
History of Model/Basic tenets
Readings:
Brandell, J. (2004). Enter Freud: Psychodynamic thinking in clinical social work. In
Psychodynamic social work (pp. 3-24). New York, NY: Columbia University Press.
Steenbarger, B.N., Greenberg, R.P., & Dewan, M.J. (2004). Doing therapy briefly. In Dewan et
al.
Walsh, J. (2010). Psychodynamic theories I: Ego psychology. In Theories for direct social work
practice (pp. 32-61) (2nd ed.). Belmont, CA: Wadsworth Cengage Learning.
Walsh, J. (2010). Psychodynamic theories II: Object relations. In Theories for direct social work
practice (pp. 62-89) (2nd ed.). Belmont, CA: Wadsworth Cengage Learning.
Class 3:
Psychodynamic Techniques
Skill-Building Exercise in Client Selection, Formulating a Focal Issue
Psychodynamic techniques: Confrontation, Clarification, Interpretation
Evidence base for psychodynamic models
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Readings:
Levenson, H. (2004). Time-limited dynamic psychotherapy: Formulation and intervention. In
Dewan et al.
McWilliams, N. (2008). Psychoanalysts: The next generation. Psychologist Psychoanalyst
(Official Publication of Div. 39), XXVIII, pp. 1-3.
Shendler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65
98-109. DOI: 10.1037/a0018378
Read one of the following empirical research articles:
Fonagy, P., Roth, A., & Higgitt, A. (2005). Psychodynamic psychotherapies: Evidence-based
practice and clinical wisdom. Bulletin of the Menninger Clinic, 69(1), 1-58.
Hoglend, P. (2003). Long-term effects of brief dynamic psychotherapy. Psychotherapy
Research, 13(3), 271-292.
Leichsenring, F., & Rabung, S. (2008). Effectiveness of long-term psychodynamic
psychotherapy: A meta-analysis. Journal of the American Medical Association, 300(13),
1551-1565.
Class 4:
Psychodynamic and its application
Additional techniques, such as resistance
Application of model to low-income and other non-majority clients
Writing goals
Cultural differences and psychodynamic therapy
Readings:
Leichsenring, F., Rabung, S., & Leibing, E. (2004). The efficacy of short-term psychodynamic
psychotherapy in specific psychiatric disorders. Archives of General Psychiatry, 61,
1208-1216.
Mattei, L. (1996). Coloring development: Race and culture in psychodynamic theories. In J.
Berzoff, L.M. Flanagan, & P. Hertz (Eds.) Inside out and outside in: Psychodynamic
clinical theory in contemporary multicultural context (pp. 221-245). Northvale, NJ: Jason
Aronson Press.
Wheelock, I. (2000). The value of psychodynamic approach in the managed care setting.
American Journal of Psychotherapy, 54(2), 204-215.
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Recommended:
Wong, E.C., Kim, B.K., Zane, N., Kim, I., & Huang, J.S. (2003). Examining culturally based
variables associated with ethnicity: Influences on credibility perceptions of empirically
supported interventions. Cultural Diversity and Ethnic Minority Psychology, 9(1), 88-96.
Class 5:
Psychodynamic and its application with Children and Adolescents
Discussion of how to modify techniques and theory with children
Differences in use of self
Sand tray – example of technique
Readings:
Brandell, J. (2004). Children. In Psychodynamic social work (pp. 257-291). New York, NY:
Columbia University Press.
Brandell, J. (2004). Adolescents. In Psychodynamic social work (pp. 292-318). New York, NY:
Columbia University Press.
Plotts, C., Lasser, J., & Prater, S. (2008). Exploring sandtray therapy: Application to individuals
with traumatic brain injury. International Journal of Play Therapy, 17(2), 138-153.
Class 6:
Introduction to CBT JOURNAL ON PSYCHODYNAMIC THERAPY DUE
Overview of Cognitive-Behavioral Models of Social Intervention,
Basic tenets of the model, assumptions and goals
Beck video of CBT
Readings:
Beck, A.T. (2005). The current state of cognitive therapy: A 40-year retrospective. Archives of
General Psychiatry, 62, 953-959.
Beck, J.S., & Bieling, P.J. (2004). Cognitive therapy: Introduction to theory and practice. In
Dewan et al.
McGinn, L.K., & Sanderson, W.C. (2001). What allows cognitive behavioral therapy to be brief:
Overview, efficacy, and crucial factors facilitating brief treatment. Clinical Psychology:
Science and Practice, 8(1), 23-37.
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Class 7:
CBT Techniques
Cognitive-Behavioral Models – case formulations and techniques
Videotape: Donald Michenbaum “Narrative CBT”
Client diversity and impact on interventions
Readings:
Eubanks-Carter, C., Burckell, L.A., & Goldfried, M.R. (2005). Enhancing therapeutic
effectiveness with lesbian, gay, and bisexual clients. Clinical Psychology: Science and
Practice, 12(1), 1-18.
Hembree, E.A., Roth, D., Bux, D.A., & Foa, E.B. (2004). Brief behavior therapy. In Dewan et al.
Muroff, J. (2007). Cultural diversity and cognitive behavior therapy. In T. Ronen, & A. Freeman
(Eds.), Cognitive behavior therapy in clinical social work practice (109-146). New York,
NY: Springer Publishing Company.
Class 8:
CBT with Children and Adolescents
Application of CBT to children and adolescents
Modification of language, terms and strategies
Readings:
Bloom, B.L. (2002). Brief psychotherapy with children and adolescents: Recent outcome studies.
Brief Treatment and Crisis Intervention, 2(3), 261-273.
Edelman, S., & Remond, L. (2005). Group cognitive behavior therapy program with troubled
adolescents: A learning experience. Family Behavior Therapy, 27(3), 47-59.
Ronen, T. (2007). Cognitive behavior therapy with children and adolescents. In T. Ronen, & A.
Freeman (Eds.), Cognitive behavior therapy in clinical social work practice (189-211).
New York, NY: Springer Publishing Company.
Class 9:
Intro to SFT
Solution-Focused Models of Social Intervention
Tenets of Model
Miracle Question
Readings:
Pachankis, J.E., & Goldfried, M.R. (2004). Clinical issues in working with lesbian, gay, and
bisexual clients. Psychotherapy: Theory, Research, Practice, Training, 41(3), 227-246.
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Steenbarger, B.N. (2004). Solution-focused brief therapy: Doing what works. In Dewar et al.
Walsh, J. (2010). Solution-focused therapy. In Theories for direct social work practice (pp. 230252). Belmont, CA: Thomson, Brooks/Cole.
Class 10:
SFT Techniques and Application
Ethnic Differences
Skill-Building Exercise in Defining Goals
Videotape: Insoo Kim Berg & Norman Rouse on goal setting with substance abusers
Techniques
Skill-Building Exercise in Finding Exceptions to the Problem, Scaling, Constructing
Hypothetical Solutions (“The Miracle Question”), and Constructing Homework
Assignments.
Readings:
Chazin, R., Kaplan, S., & Terio, S. (2000). The strengths perspective in brief treatment with
culturally diverse clients. Crisis Intervention, 6(1), 41-50.
Corcoran, J. (2000). Solution-focused family therapy with ethnic minorities. Crisis Intervention
& Time Limited Treatment, 6(1), 5-12.
de Shazer, S., & Dolan, Y. (2007). Questions, misconceptions, and joys. In More than miracles:
The state of the art of solutions-focused brief therapy (pp. 153-164). New York, NY:
Routledge.
Gingerich, W.J., & Eisengart, S. (2000). Solution-focused brief therapy: A review of the
outcome research. Family Process, 39(4), 477-498.
Class 11:
SFT: Application to children and adolescents
Modification techniques to children and adolescents
Inclusion of family in work with children and adolescents
Video – “I’d hear laughter”
Readings:
Corcoran, J. (2002). Developmental adaptations of solution-focused family therapy. Brief
Treatment and Crisis Intervention, 2(4), 301-313.
Nims, D.R. (2007). Integrating play therapy techniques into solution-focused brief therapy.
International Journal of Play Therapy, 16(1), 54-68.
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Reiter, M.D. (2004). The Surprise Task: A solution-focused formula task for families. Journal of
Family Psychotherapy, 15(3), 37-45.
Class 12:
Application of case to all 3 Models
JOURNAL ON SFT THERAPY DUE
Role plays of cases using all three models
Critically examine the strengths and limitations of each model
Create goals and objectives within each case
How do you decide when to integrate or blend models?
How to choose among the models? Process of EBP.
Readings:
Lazarus, A.A. (2005). Is there still a need for psychotherapy integration? Current Psychology:
Developmental, Learning, Personality, Social, 24(3), 149-152.
Greenberg, R.P. (2004). Essential ingredients for successful psychotherapy. In Dewan et al.
Mullen, E.J., Bellamy, J., Bledsoe, S.E. (in press). Evidence-based practice. In R. Grinnel (Ed.)
Social work research and evaluation (chp. 25)(8th ed.). New York, NY: Oxford
University Press.
Winston, A., & Winston, B. (2001). Toward an integrated brief psychotherapy. Journal of
Psychiatric Press, 7, 377-390.
Class 13:
Crisis Intervention
Crisis Intervention
Psychological First Aid
Suicide Prevention
Readings:
Cunningham, M. (2000). Spirituality, cultural diversity and crisis intervention. Crisis
Intervention, 6, 65-77.
Roberts, A.R. & Ottens, A.J. (2005). The seven-stage intervention model: A road map to goal
attainment, problem-solving, and crisis resolution. Brief Treatment and Crisis
Intervention, 5(4), 329-339.
Vernberg, E.M., Steinberg, A.M., Jacobs, A.K., Brymer, M.J., Watson, P.J., et al. (2008).
Innovations in disaster mental health: Psychological First Aid. Professional Psychology:
Research and Practice, 39(4), 381-388.
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Class 14:
Course Wrap-up
Termination – How to know when to terminate?
Dilemmas faced in brief treatment
Course wrap-up
Remaining questions
Readings:
Mander, G. (2003). Dilemmas in brief therapy. Psychodynamic Practice, 9(4), 485-500.
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APPENDIX A
THEORY SUMMARY GRID AND GRADING CRITERIA
Objective: The purpose of the theory summary grid is to be able to demonstrate familiarity with
class material and to demonstrate critical thinking regarding the applicability of the model to
clinical material.
Description of Assignment:
The theory summary assignment requires the student so demonstrate mastery and critical
thinking of the course content. The goal is demonstrate how you understand the model, what you
see as its strengths/limitations, and how you feel it fits for you and WHY. What do you like
about it? What don’t you like about it? Could you imagine using it? In what circumstances?
Students may get a blank grid in the Assignments folder on blackboard and fill in the blank
sections using bullets or outline form. The questions provided should be considered, but the
student is welcome to include additional information that goes beyond the provided questions.
Grading Criteria
The summary clearly provides information on the basic tenets and
concepts of the model
The strengths and limitations of the model have been discussed
The student has discussed how the model fits for him/her and why. Could
you imagine using this model? When, where, why and with whom?
Total Points
Pts.
Possible
5
5
5
15
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SOWO 853
Brief Treatment: Theory Summary Grid
Model:
Domain
Main Elements of the model
What are the main tenets of
the model?
What are the main
assumptions?
What is the stance of the
therapist?
Strengths/Limitations
For whom might this model
work?
For whom might this model
not work?
Your views on the strengths
Your views on the
weaknesses or limitations
Fit for You
How has it made me feel?
What has my reactions,
opinions thoughts about it?
How does this information or
perspective relate to my field
practice experience or other
professional experience?
How does this information or
perspective relate to my own
life experience?
Would you use this model?
Is this model a good fit for
my personality and belief
system about how problems
are created?
How does it fit with your
views on what will be helpful
with clients?
PID:
Discussion
Synthesis:
Provide 2-3 paragraphs that give a brief summation of your critical thinking about the model and include
any other information you feel would be helpful to share. Some possible topics might be: What does the
research support? Is there a disconnect for you with the assumptions of the theory and the practice model
in any way? Any other critical areas that were not covered above.
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APPENDIX B
BRIEF THERAPY PAPER ASSIGNMENT
Objective: The objective of this paper is to solidify students’ knowledge of the three major
modalities of treatment by applying the concepts from this course to a case.
Description of Assignment:
1. Take one of your cases that you have had either in your field or previous work/volunteer
experiences.
2. Give a brief description of the case (1-2 pages) that includes a brief history, current life
situation, and presenting problem, and any other relevant information that you deem
appropriate.
3. Apply each of the following models to that case: Solution-focused Therapy; CognitiveBehavioral Therapy; and Psychodynamic Therapy (approximately 2-3 pages on each
model). This application includes:
a. A formulation of the case using the models (how would the model describe the
problem/situation ), and
b. List 3 treatment goals that would be appropriate for the client, using the language
and perspective of the model.
4. After you have described the models, choose one that you think is the best fit for this case
and give your rationale for why you would approach the case from that perspective. This
discussion should include the three evidence-based process components:
a. Outcomes studies that fit for the case/situation (from class readings and other
sources at least 5 total)
b. Your fit with a particular model and what you would bring to the case
c. Issues of client specificity: intelligence level; patterns from the past; what worked
or hasn’t worked for them before; etc.
Grading Criteria
The case example well written
Each model of treatment applied accurately and clearly. There a clear case
formulation using each model (10 points for each model = Total of 30 points)
Pts.
Possible
5
30
The goals for each model fit the language of the model AND address the presenting
problem (5 points for each model = Total of 15 points)
15
The student advocated for the use of one model clearly, using the three areas of
EBP criteria for the basis of their position as listed in #4 of paper description (10
pts for each section = Total of 30 points)
Appropriate number of references are used, in APA format and well utilized in the
paper
The document reflects an understanding of various dimensions of diversity as they
may apply to the assessment, goals, intervention and evaluation.
The document is well written, uses nonjudgmental language and has no errors
Total Points
30
10
5
5
100