THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
FALL 2011
COURSE NUMBER: SOWO 844
COURSE TITLE: ADOLESCENT MENTAL HEALTH: THEORY AND PRACTICE
ROOM, DAY, AND TIME COURSE MEETS: TTK 226A, MONDAY, 2:00-4:50 P.M.
INSTRUCTOR: MATTHEW O. HOWARD, MSW, PH.D.
EMAIL: MOHOWARD@EMAIL.UNC.EDU
OFFICE PHONE: 919-932-8732
HOME PHONE: 314-330-3479 (CELL)
OFFICE HOURS: MONDAY, 5:00 P.M. -6:00 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 may be able to
get them more cheaply at an online bookstore. The books are excellent and inexpensive.
1. Krakauer, J. (2007). Into the wild. Anchor Press. ISBN-10: 0307387178. Cost: $9.00 at
Amazon.com on 08/21/2011.
Jon Krakauer is among the finest living journalists. Into the Wild is the story of Christopher
McCandless and his trek into the wilderness of Alaska. The book is beautifully written and
raises many interesting questions relevant to adolescent development, decision-making, and
mental health. This is the first book we will read. You should come to our second class on
September 12th having read the entire book (that allows you 2 weeks to read the book because
September 5th is Labor Day, a holiday, and class does not meet that day).
2. 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: $9.16 at
Amazon.com on 08/21/2011.
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. Cases in the book also have important implications for prevention and treatment of
mental disorders in adolescents. Everyone I asked to read this book (to help me preview it for
this course) loved it. This is the second book we will read.
3. Grandin, T., & Scariano, M. M. (1996). Emergence: Labeled autistic. Warner Books.
ISBN-10: 0446671827. Cost: $10.36 at Amazon.com on 08/21/11.
Temple Grandin is perhaps the most famous living person with autism spectrum disorder. This
book is her autobiography and was selected because it provides insight into the challenges
children and adolescents with mental health disorders face including stigma, misunderstanding,
and abuse.
4. Laser, J.A., & Nicotera, N. (2011). Working with adolescents: A guide for practitioners.
Guilford Press. Cost: $30.59 at Amazon.com on 08/21/11. ISBN-10: 1609180356
This is a new textbook specifically dedicated to mental health practice issues involving
adolescents. Chapters 1-3 provide excellent coverage of theoretical issues in assessment and
treatment of adolescents, Chapters 4 -9 provide thorough coverage of the adolescent in family,
school, neighborhood, and cultural contexts, and Chapters 10-15 discuss clinical interventions
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for substance abuse, mental health disorders, delinquency, and various other sexual, gender
identity, and behavioral issues.
5. Colapinto, J. (2006). As nature made him: The boy who was raised as a girl. Harper
Perennial. ISBN-10: 0061120561 Cost: $10.19 at Amazon.com on 08/22/11.
This book describes the tragic life story of David Reimer, one of the most famous cases of the
past quarter-century in medicine, psychology, and social work. I don’t want to reveal the story,
but can say that the book has many implications for the study of gender identity and its
developmental origins. The book also traces the history of the study of gender identity and one
of the most influential clinicians and scientists active in this area—John Money. This book has
important implications for the appreciation of gender identity issues in adolescents.
6. One book of your own choosing addressing some aspect of the cultural context of adolescent
development or clinical assessment and treatment of adolescents. Some examples of books I
could suggest are:
General Interest
Garbarino, J. (1999). Lost boys: Why our sons turn violent and how we can save them. Anchor
Books. ISBN: 0-385-49932-9
Kindlon, D., & Thompson, M. (2000). Raising Cain: Protecting the emotional life of boys.
Ballantine Books. ISBN 9078-0-345-43485-2
Shandler, S. (1999). Orphelia speaks: Adolescent girls write about their search for self. Harper
Perennial. ISBN 0-06-095297-0
Simmons, R. (2002). Odd girl out: The hidden culture of aggression in girls. Harcourt. ISBN:
0-15-602734-8
Simmons, R. (2010). The curse of the good girl: Raising authentic girls with courage and
confidence. Penguin Press. ISBN 978-0-14-311798-8
Clinical
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
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the psychoeducation, parenting, relaxation, affect regulation, and cognitive skills training
methods that are a part of TF-CBT approach.
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.
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.
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.
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 want to practice with youth in school settings.
Sexual Orientation
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.
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.
OTHER BOOK POSSIBILITIES DEPENDING UPON YOUR INTERESTS
James, B. (1989). Treating traumatized children: New insights and creative interventions. New
York: Free Press. ISBN: 0-669-20994-5
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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
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.
CLASS ASSIGNMENTS
A. Assignment 1: This assignment is completed September 12th (Class 2) and worth 15 points.
This assignment will consist of reading the Jon Krakauer book, Into the Wild, participating in a
discussion of the book during class on September 12th and then completing an in-class writing
exercise on the book that day. You will want to read the book carefully so that you can respond
to questions about it. The questions will be fairly general, so that I do not expect a lot of rote
memorization. Group A will lead a 20-30 minute discussion of this book (see below)
B. Assignment 2: This assignment is due September 26th (Class 4) and is worth 15 points. To
complete this assignment, you will read the Bruce Perry book, “The Book Who Was Raised as a
Dog…, participate in a class discussion of this book on September 26th, and then complete an inclass writing exercise about the book that day. I will also be passing out two case studies having
to do with the classic cases of Genie and The Wild Boy of Aveyron, which you should read prior
to Class 4 Group B will lead a 20-30 minute discussion of this book during class that day.
C. Assignment 3: This assignment is due October 10th (Class 6) and is worth 15 points. To
complete this assignment, you will read the Temple Grandin book, “Emergence: Labeled
autistic,” participate in a class discussion of this book on October 10th, and then complete an inclass writing exercise about the book that day. Group C will lead a 20-30 minute discussion of
this book during class that day.
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D. Assignment 4: This assignment is due by the end of the semester and is worth 15 points.
For this assignment, you will prepare annotated notes on the Working with Adolescents textbook.
There are several options available for completing this assignment. You can annotate the
textbook as you read it, taking notes and writing comments and questions in the margins as you
read and then turning the book into me when you are done for review by me. Alternatively, you
can prepare typewritten notes and questions about your reading and turn those into me. This will
be graded essentially as a pass/fail assignment. I simply will be checking to make sure that you
have read the textbook. The notes need not be voluminous. One page of notes per chapter
would be fine. If you have any concerns about how you are doing with your note taking, check
with me and I will provide necessary feedback.
E. Assignment 5: This assignment is due November 14th (Class 11) and is worth 15 points. To
complete this assignment, you will read the Colapinto book, “As Nature Made Him: The Boy
Who Was Raised as a Girl,” participate in a class discussion of this book on November 14th, and
then complete an in-class writing exercise about the book that day. Group D will lead a 20-30
minute discussion of this book during class that day.
F. Assignment 6: This assignment is due December 5th (Class 14) and is worth 15 points. For
this assignment, you will prepare a brief (2-4 page) review of the book you personally selected to
read for this class and will submit the book review on the last day of class. You will also make a
5-minute in-class presentation about the book describing the author, intended audience, and basic
points of the book.
Attendance and Classroom Participation: Attendance and classroom participation are very
important to me and will be worth up to 10 points. 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 some 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.
GRADING SYSTEM
The points received for each assignment will be totaled to determine the final grade.
110 and above
94 -109
80 – 93
70 – 79
69 and below
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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
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.
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COURSE OUTLINE
CLASS 1/INTRODUCTION
08/29/11
Topics:
INTRODUCTION TO THE COURSE
REVIEW OF SYLLABUS
INTRODUCTIONS
GROUP ASSIGNMENTS
DVD: THE LOST CHILDREN OF ROCKDALE COUNTY, FRONTLINE DOCUMENTARY
REQUIRED READINGS FOR CLASS 2:
1. Working with Adolescents: A Guide for Practitioners: Forward (xiii-xviii) and Chapter 1:
Challenges in Clinical Work with Adolescents: An Overview (pp. 3-13).
2. Krakauer, J. Into the Wild. Read the entire book by Class 2. You have two weeks to read it
and it is a relatively short and quick read.
CLASS 2/INTO THE WILD
09/12/11
Topics:
GROUP A LED DISCUSSION OF INTO THE WILD
IN-CLASS WRITING EXERCISE ON INTO THE WILD
CHALLENGES IN CLINICAL WORK WITH ADOLESCENTS
THE PUSH-PULL OF ADOLESCENT DEVELOPMENT
RESILIENCE IN ADOLESCENCE
REQUIRED READINGS FOR CLASS 3:
1. Working with Adolescents: A Guide for Practitioners: Chapter 2: The Push-Pull of
Adolescent Development (pp. 14-35).
2. Read one-half of The Boy who was Raised as a Dog
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CLASS 3/CONTEXTUAL FACTORS IN ADOLESCENT DEVELOPMENT 09/19/11
Topics:
THE CONTEXT OF ADOLESCENT DEVELOPMENT
THE FAMILY CONTEXT
THE SCHOOL CONTEXT
THE NEIGHBORHOOD CONTEXT
MASS MEDIA AND TECHNOLOGY INFLUENCES
PROTECTIVE FACTORS
REQUIRED READINGS FOR CLASS 4:
1. Working with Adolescents: A Guide for Practitioners: Chapter 3: Resilience in Adolescence
(pp. 36-50).
2. Read the second half of The Boy who was Raised as a Dog.
3. Read the classic case studies: Innocence Lost: the Story of Genie and The Wild Boy of
Aveyron: The Story of Victor (I will distribute).
CLASS 4/THE BOY WHO WAS RAISED AS A DOG
09/26/11
Topics:
GROUP B LED DISCUSSION OF THE BOY WHO WAS RAISED AS A DOG
IN-CLASS WRITING EXERCISE FOR THE BOY WHO WAS RAISED AS A DOG
DVD: SECRET OF THE WILD CHILD: THE REVEALING STORY OF GENIE
DISCUSSION OF THE RAIN MAN, THE ELEPHANT MAN, HELEN KELLER AND THE ISSUE OF RESILIENCE
TRAUMA, DISABILITY, AND ITS AFTERMATH
REQUIRED READINGS FOR CLASS 5:
1. Working with Adolescents: A Guide for Practitioners: Chapter 10: Substance Abuse (pp. 163179).
2. Read the first half of the book: Emergence: Labeled Autistic.
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CLASS 5/ ADOLESCENT SUBSTANCE ABUSE 10/03/11
Topics:
EPIDEMIOLOGY OF ADOLESCENT SUBSTANCE ABUSE
ASSESSMENT AND DIAGNOSIS OF ADOLESCENT SUBSTANCE ABUSE
TYPES OF DRUGS THAT ARE USED
POLYDRUG USE AND PSYCHIATRIC COMORBIDITY
CONSEQUENCES OF ADOLESCENT DRUG USE
RISK FACTORS FOR ADOLESCENT DRUG USE
PREVENTION OF ADOLESCENT DRUG USE
TREATMENT OF ADOLESCENT DRUG USE
REQUIRED READINGS FOR CLASS 6:
1. Working with Adolescents: A Guide for Practitioners: Chapter 4: Internal Assets and
Individual Attributes Associated with Healthy Adolescent Outcomes (pp. 51-70) and Chapter 5:
The Family Environment (pp. 71-93).
2. Read the second half of the book: Emergence: Labeled Autistic.
CLASS 6/EMERGENCE: LABELED AUTISTIC 10/10/11
Topics:
BRIEF DISCUSSION OF AUTISM SPECTRUM DISORDERS/PERVASIVE DEVELOPMENTAL DISORDERS
GROUP C LED DISCUSSION OF EMERGENCE: LABELED AUTISTIC
IN-CLASS WRITING EXERCISE FOR EMERGENCE: LABELED AUTISTIC
FILM: TEMPLE GRANDIN
REQUIRED READINGS FOR CLASS 7:
1. Working with Adolescents: A Guide for Practitioners: Chapter 11: Sexual Orientation and
Gender Identity Development (pp. 180-199).
2. Read the first half of As Nature Made Him: The Boy Who was Raised as a Girl
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CLASS 7/ADOLESCENT SEXUALITY AND GENDER IDENTIFICATION 10/17/11
Topics:
EPIDEMIOLOGY OF ADOLESCENT SEXUAL BEHAVIORS
SEXUAL ORIENTATION
GENDER IDENTITY DEVELOPMENT
STDS
TEEN PREGNANCY
CONCERNS ABOUT APPEARANCE
REQUIRED READINGS FOR CLASS 8:
1. Working with Adolescents: A Guide for Practitioners: Chapter 13: Sexual Behaviors, Sexually
Transmitted Diseases Including HIV/AIDs, and Pregnancy (pp. 219-235).
2. Chapter 5: Gestational Neurohormonal Theory (pp. 49-55) in Nature’s Choice: What Science
Reveals about the Biological Origins of Sexual Orientation by Cheryl L. Weill. Instructor will
distribute.
3. Read the second half of As Nature Made Him: The Boy Who was Raised as a Girl
CLASS 8/AS NATURE MADE HIM
10/24/11
Topics:
GROUP D LED DISCUSSION OF AS NATURE MADE HIM: THE BOY WHO WAS RAISED AS A GIRL
IN-CLASS WRITING EXERCISE FOR AS NATURE MADE HIM: THE BOY WHO WAS RAISED AS A GIRL
DVD: SEX UNKNOWN: EXPLORE THE FATEFUL CONSEQUENCES OF GENDER REASSIGNMENT
INTRODUCTION TO ASSESSMENT OF MENTAL HEALTH DISORDERS IN ADOLESCENTS
REQUIRED READINGS FOR CLASS 9:
1. Working with Adolescents: A Guide for Practitioners: Chapter 14: Delinquency (pp. 236-249).
2. Working with Adolescents: A Guide for Practitioners: Chapter 15: The Joys of Working with
Adolescents (pp. 250-262).
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CLASS 9/VIOLENCE, AGGRESSION, AND ANTISOCIAL BEHAVIOR
10/31/11
Topics:
BULLYING/CYBER-BULLYING
AGGRESSION/BULLYING IN GIRLS
YOUTH VIOLENCE
RELATIONSHIP VIOLENCE
GANGS/FIREARMS
LD/ADD/OD/CD
REQUIRED READINGS FOR CLASS 10:
1. Working with Adolescents: A Guide for Practitioners: Chapters 4-6: (pp. 51-112).
2. Working with Adolescents: A Guide for Practitioners: Chapter 12: (pp. 200-218).
CLASS 10/MOOD AND ANXIETY DISORDERS IN ADOLESCENTS
11/07/11
Topics:
OCD
PTSD
SAD
GAD
Social Phobia
Selective or Elective Mutism
Mood Disorders
Suicide
REQUIRED READINGS FOR CLASS 11:
1. Working with Adolescents: A Guide for Practitioners: Chapters 7-9: (pp. 113-162). Prepare to
turn in your notes for this book or the annotated book sometime between class weeks 11-14.
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CLASS 11/OTHER MENTAL HEALTH PROBLEMS
11/14/11
Topics:
Early Onset Schizophrenia
Developmental Disabilities
Motor Skills Disorder: Developmental Coordination Disorder
Tic Disorders
Eating Disorders
Self-Mutilation/Cutting Behavior
Adjustment Reactions to Divorce, etc.
Additional Conditions that May be a Focus of Clinical Attention
REQUIRED READINGS FOR CLASS 12:
1. Read one half of a book of your choice on adolescents.
CLASS 12/HEALTH PROBLEMS OF ADOLESCENTS 11/21/1
Topics:
Obesity
Diabetes
Kidney Disease, Asthma, Epilepsy and other chronic illnesses
Coping with the Death of Parents, Sibling, Friends, Classmates
Emerging Threats to Health
REQUIRED READING FOR CLASS 13:
1. Continue reading the book of your choice
CLASS 13/SCHOOL PROBLEMS OF ADOLESCENTS
11/28/11
Topics:
School Performance and Problems
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Drop Out and Truancy
Gifted Adolescents
Preparing for a Career and Economic Independence
Entrepreneurship
REQUIRED READING FOR WEEK 14: FINISH READING THE BOOK YOU SELECTED AND PREPARE A
MINUTE PRESENTATION OF IT FOR NEXT WEEK AND A 2-4-PAGE BOOK REVIEW.
CLASS 14
12/05/11
Topics:
1.
2.
3.
4.
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Turn in the book review on the book you selected.
All students will present their 5-minute book reviews.
Turn in your notes or annotated book for the “Working with Adolescents” textbook.
Complete course evaluations and review course
5-