1 The University of North Carolina at Chapel Hill School of Social Work COURSE NUMBER: COURSE TITLE: SEMESTER AND YEAR: INSTRUCTOR: COURSE WEBSITE: SOWO 855 Treatment of Trauma and Violence Fall 2013 Marilyn Ghezzi, MSW, LCSW Office: 563C Phone: 919-962-6490 Email: mghezzi@email.unc.edu https://www.unc.edu/sakai/ OFFICE HOURS: Tuesdays from 12-2 or by appointment COURSE DESCRIPTION: This course reviews models of trauma and violence within the psychosocial context. You will learn beginning skills for intervening in a variety of direct practice settings with diverse client populations. COURSE OBJECTIVES: 1. Critical Understanding of Theory for Practice: You will demonstrate a critical understanding of the primary theories that guide assessment and intervention for violence (e.g. macro, feminist, socio-cultural) as well as a capacity to explain how these theories inform and guide social work practice decisions. 2. Comprehensive Assessment: You will demonstrate the ability to assess clients for trauma histories, understand risk and resiliency issues for this population and formulate a case and develop a treatment plan using CBT theoretical principles, research, and the evidence-based practices they inform. 3. Knowledge of and Skills in Best Practices: You will be able to use your assessment skills to develop a comprehensive treatment plan based on evidence, client needs/issues and your knowledge of theory to adequately address the issues facing clients. You will demonstrate knowledge of and skill in best practices for trauma survivors and perpetrators of sexual abuse (based on current empirical knowledge and theories) as well as an understanding of the importance of simultaneously intervening with frequently cooccurring problems (e.g., comorbidity with other mental health syndromes). 4. Understanding the Impact of Diversity: You will assess and evaluate how current assessment procedures and treatment practices effectively address issues related to diversity, considering age, class, color, culture, disability, ethnicity, family structure, gender, marital status, national origin, race, religion, spiritual development, sex, sexual orientation, and populations at risk. 5. Values, Ethics and Self-Awareness: Using professional ethics and values as guidelines, you will demonstrate a capacity to manage your own personal values and feelings related to violence and trauma. 2 EXPANDED COURSE DESCRIPTION: Building on foundation practice skill knowledge, this course aims to build and extend your capacity to assess and intervene in the area of trauma and violence. This course will cover issues related to the assessment and treatment of multiple forms of trauma (e.g. combat, sexual abuse, domestic violence) via trauma theory and cognitive-behavioral lenses. In addition, other evidence-based models designed to treat survivors of trauma will be presented and evaluated. Since interpersonal trauma could not occur without the perpetrator, this course will discuss information on the perpetrators of violence and abuse, including the skills needed to treat this population. Trauma and violence can significantly impact intervention providers. Therefore, this course will also focus on self-care and vicarious traumatization for the service provider. Social work practice in the area of trauma can present unique challenges for social justice, the interaction between policy and direct practice, and self-awareness of personal values and feelings. Building on your foundation knowledge of social justice, policy and professional values and ethics, this course aims to extend your capacity to: 1) attend to issues of social justice specific to trauma and violence; 2) recognize how policy shapes and can determine interventions for individuals and family systems; and 3) manage personal feelings and values that may affect your ability to practice social work in the area of trauma. REQUIRED TEXTS: Taylor, S. (2006). Clinician’s guide to PTSD: A cognitive-behavioral approach. New York, NY: The Guilford Press. Zayfert, C. & Becker, C.B. (2007). Cognitive-behavioral therapy for PTSD: A case formulation approach. New York, NY: The Guilford Press. OTHER TEXTS WHICH YOU MAY FIND HELPFUL: Blaustein, M. (2010). Treating traumatic stress in children and adolescents : How to foster resilience through attachment, self-regulation, and competency. New York: Guilford Press. Briere, J. (2006). Principles of trauma therapy : A guide to symptoms, evaluation, and treatment. Thousand Oaks, Calif.: Sage Publications. Bryant-Davis, T. (2011). Surviving sexual violence : a guide to recovery and empowerment. Lanham, Md.: Rowman & Littlefield Publishers. Courtois, C. A. (2009). Treating complex traumatic stress disorders : An evidence-based guide. New York: Guilford Press. Follette, V.M., & Ruzek, J.I. (Eds.). (2006). Cognitive-behavioral therapies for trauma (2nd ed.). New York, NY: The Guilford Press. Najavits, L.M. (2002). Seeking Safety: A treatment manual for PTSD and substance abuse. New York, NY: The Guilford Press. 3 Rogers, A.G. (2006). The Unsayable: The hidden language of trauma. New York, NY: Random House. van der Kolk, B. A., McFarlane, A., & Weisaeth, L. (Eds.). (1996). Traumatic stress: The overwhelming experience on mind, body and society. New York, NY: The Guilford Press. OTHER READINGS: All other readings will be on the Sakai website for the course. CLASS ASSIGNMENTS: There are two required papers for this course. Please see the appendices of the syllabus for a thorough description of the assignments and the grading criteria that will be used to evaluate the contents of the papers. TEACHING METHODS: This course utilizes lecture, discussion, experiential exercises, role playing and video clips. These teaching strategies will be used to help students master the theoretical approaches and necessary skills needed to intervene with trauma clients. It is expected that each student will be involved in this course; thus participation in discussion, exercises and role-playing is mandatory. DISTRIBUTION OF ASSIGNMENTS FOR COURSE GRADE: Case Formulation and Treatment Planning 45% Evidence-Based Practice Paper – 40% Class Participation – 15% Please see full descriptions of assignments at end of syllabus. GRADING SYSTEM: H = 94 and above P = 80 to 93 L = 70 to 79 F = 69 and below CLASS PARTICIPATION: Class participation counts for 15% 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 assignments, 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. This course is structured as a seminar; all class members are expected to share responsibility for participating in discussions and for presenting materials needed by the class. Some classroom time will be spent working in small task groups, experiential activities 4 and role plays; therefore, class attendance is crucial. 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. POLICY ON PAPER SUBMISSON, INCOMPLETES AND LATE ASSIGNMENTS: All papers and assignments are to be submitted electronically to the Drop Box in our Sakai site and are due at the beginning of class on the dates noted on the Schedule, unless a change in date has been announced by the instructor in class. Five points (based on a 100 point scale) will be deducted for each day that a paper is late. Please put only your PID # on the cover sheet for your paper. Do not put your name on the paper that you submit to Sakai. Use your PID# as a running head on each page. In class, please turn in a hard copy of the one page cover sheet with your name, PID# and signed honor code pledge. 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. USE OF LAPTOPS OR OTHER ELECTRONIC DEVICES: Laptops are allowed in the classroom and I encourage you to bring your laptop to view the powerpoints and to use for class exercises when we need to access materials online. However, I will ask that you close laptops during class discussions and activities which do not require the use of laptops. Cell phones should be turned off at all times during class. 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, Sixth Edition (2009) that is available at most bookstores. The following web sites provide additional information: http://juno.concordia.ca/help/howto/apa.php (general information about documentation using APA style) Students are strongly encouraged to review the materials on the School of Social Work’s website 5 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. Course Outline: Week 1-August 20: Introduction Student/Instructor introductions Overview of course Discussion of self-care and vicarious traumatization Beginning discussion of effects of trauma Week 2- August 27: Explanatory Theories of Trauma and Violence Review of theories of violence What is trauma? Who is affected? Normal responses to trauma vs. PTSD, including discussion of DSM-5 Readings: Taylor text – Chapter 1 Johnson, R. (2004). Theories of violence and their influence on the practice of counseling. Psychotherapy in Australia, 10(4), 40-44. Malik, N.M., & Lindahl, K.M. (1998). Aggression and dominance: The roles of power and culture in domestic violence. Clinical Psychology: Science and Practice, 5(4), 409-423. Becker-Blease, K. A. & Freyd, J. J. (2005). Beyond PTSD: An evolving relationship between trauma theory and family violence research. Journal of interpersonal Violence 20(4) 403-411. Optional reading: Hines, D. A., Brown, J., & Dunning, E. (2007). Characteristics of callers to domestic abuse helpline for men. Journal of Family Violence, (22), 63-72. Van Soest, D., & Bryant, S. (1995). Violence reconceptualized for social work: The urban dilemma. Social Work, 40(4), 549-557. 6 Week 3-September 3: Impact of Trauma and Assessment of Trauma Survivors Assessment strategies for victims/survivors Use of formal tools, semi-structured interviews and unstructured interviews Readings: Taylor text – Chapters 2 and 6 Stamm, B.H., & Friedman, M.J. (2000). Cultural diversity in the appraisal and expression of trauma. In A.Y. Shalev, R. Yehuda, & A.C. McFarlane (Eds.), International handbook of human response to trauma (pp. 69-85). New York, NY: Kluwer Academic/Plenum Publishers. Pratt, E.M., Brief, D.J., & Keane, T.M. (2006). Recent advances in psychological assessment of adults with posttraumatic stress disorder. In V.M. Follette & J.I. Ruzek (Eds.), Cognitive-behavioral therapies for trauma (2nd ed.) (pp. 34-61). New York, NY: The Guilford Press. (Replace this?)) Week 4- September 10: Introduction to Trauma Theory, CBT and approaches to treatment Overview of CBT Overview of trauma theory Readings: Zayfert & Becker – Chapter 1 Briere, J. (2006). Central issues in trauma treatment. In Principles of trauma therapy : A guide to symptoms, evaluation, and treatment. (pp. 67-85). Thousand Oaks, Calif.: Sage Publications. Ronen, T. (2007). Cognitive behavior therapy with children and adolescents. In T. Ronen, & A. Freeman (Eds.), Cognitive behavior therapy in clinical social work practice (pp.189-211). New York, NY: Springer Publishing Company. Optional Reading Lebowitz, L., Harvey, M., & Herman, J. (1993). A stage-by-stage dimension model of recovery from sexual trauma. Journal of Interpersonal Violence, 8(3), 378-391. 7 Wright, J.H., Basco, M.R., & Thase, M.E. (2006). Basic principles of cognitivebehavioral therapy. In Learning cognitive-behavioral therapy: An illustrated guide (pp. 1-26). Washington D.C.: American Psychiatric Press. Week 5-September 17: Developing a Case Formulation How does CBT explain PTSD symptoms? What is a formulation and how does it differ from diagnosis? Develop a case formulation based on CBT concepts Readings: Zayfert & Becker – Chapters 2 and 3 Taylor – Chapter 8 Optional Reading: Wright, J.H., Basco, M.R., & Thase, M.E. (2006). Assessment and formulation. In Learning cognitive-behavioral therapy: An illustrated guide (pp. 45-63). Washington D.C.: American Psychiatric Press. Week 6- September 24: CBT Interventions: Cognitive Interventions Cognitive Restructuring Psychoeducation Readings: Note: There is some redundancy in the readings for this week, however these concepts are so important that I thought it would be useful for you to have multiple ways to learn them. Each different chapter explains the concepts slightly differently. You may find that you do not need to read each chapter in its entirety if you have already grasped the key concepts. Zayfert & Beckert – Chapters 5 and 8 Taylor – Chapters 9, 10 and 11 Deblinger, E., Thakkar-Kolar, R., & Ryan, E. (2006). Trauma in childhood. In V.M. Follette & J.I. Ruzek (Eds.), Cognitive-behavioral therapies for trauma (2nd ed.) (pp. 405-432). New York, NY: The Guilford Press. Optional Reading 8 Cohen, J. A., Mannarino, A.P., Berliner, L., & Deblinger, E. (2000). Trauma-focused cognitive behavioral therapy for children and adolescents: An empirical update. Journal of Interpersonal Violence, 15(11), 1202-1223. Week 7- October 1: CBT Interventions: Behavioral Interventions Exposure therapies Activity Scheduling, Behavioral activation Readings: Note: There is some redundancy in the readings for this week, however these concepts are so important that I thought it would be useful for you to have multiple ways to learn them. Each different chapter explains the concepts slightly differently. You may find that you do not need to read each chapter in its entirety if you have already grasped the key concepts. Taylor- Chapters 12 and 13 Zayfert & Beckert- Chapters 6 and 7 Wright, J.H., Basco, M.R., & Thase, M.E. (2006). Behavioral methods I. In Learning cognitive-behavioral therapy: An illustrated guide (pp. 123-150). Washington D.C.: American Psychiatric Press. Wright, J.H., Basco, M.R., & Thase, M.E. (2006). Behavioral methods II. In Learning cognitive-behavioral therapy: An illustrated guide (pp. 151-172). Washington D.C.: American Psychiatric Press. Week 8- October 8: Treatment Planning/Creating a Treatment Plan Treatment plans Miscellaneous therapeutic techniques Readings: Zayfert & Becker – Chapters 4, 9 and 10 Jaycox, L.H., Zoellner, L., & Foa, E.B. (2002). Cognitive-behavioral therapy for PTSD in rape survivors. Journal of Clinical Psychology, 58(8), 891-906. 9 Week 9- October 15: Complex PTSD Courtois, C. A. (2004). Complex trauma, complex reactions: Assessment and treatment. Psychotherapy: Theory, Research, Practice, Training, 41(4), 412-425. Ford, J.D. & Cloitre, M. (2009). Best practices in psychotherapy for children and adolescents. In C.A. Courtois & J.D. Ford (Eds.), Treating complex traumatic stress disorders : An evidence-based guide. (pp. 59-81). New York: Guilford Press. Resick, P. A., Bovin, M. J., Calloway, A. L., Dick, A. M., King, M. W., Mitchell, K. S., . . . Wolf, E. J. (2012). A critical evaluation of the complex PTSD literature: Implications for DSM-5. Journal of Traumatic Stress, 25(3), 241-251. doi:10.1002/jts.21699 Week 10- October 22- Interpersonal Violence Guest speaker- Case Formulation and Treatment Plan Paper Due Specific needs for this population regarding intervention and assessment Safety planning Social justice issues – impact of acculturation, immigration, cultural norms, discrimination within larger society Readings: To be determined Week 11-: October 29- Working with Veterans Guest speaker: Special issues when treating veterans Cognitive processing therapy Readings: Kaysen, D., Lindgren, K., Zangana, G. A. S., Murray, L., Bass, J., & Bolton, P. (2013). Adaptation of cognitive processing therapy for treatment of torture victims: Experience in Kurdistan, Iraq. Psychological Trauma: Theory, Research, Practice, and Policy, 5(2), 184-192. doi:10.1037/a0026053 10 Riggs, D.S., Cahill, S.P. & Foa, E.B. (2006). Prolonged exposure treatment of posttraumatic stress disorder. In V.M. Follette & J.I. Ruzek (Eds.), Cognitivebehavioral therapies for trauma (2nd ed.) (pp. 65-95). New York, NY: The Guilford Press. Thompson M. & Gibbs, N. (2012). Army Suicides. Time Magazine, 180(4), 24-31. Week 12- November 5: Trauma in Cultural Context Guest Speaker- Guest Speaker- Lori Schweickert, MD The complexities of culture in treating trauma Overview of unique issues when working with victims of trauma from different socioethnic groups Readings:To be determined Week 13: November 12- Other theoretical approaches to working with trauma and violence and other modalities Attachment theory Biological Psychodynamic Groupwork Couple and family approaches Readings: Figley, C. R. & Figley, K. R. (2009). Stemming the tide of trauma systemically: The role of family therapy. The Australian and New Zealand Journal of Family Therapy 30(3), 173-183. Hemsley, C. (2010). Why this trauma and why now? The contribution that psychodynamic theory can make to the understanding of post-traumatic stress disorder. Counseling Psychology Review, 25(2) 13-20. Hill, J. S., Lau, M. Y., Sue, D. W. (2010). Integrating trauma psychology and cultural Psychology: Indigenous perspectives on theory, research, and practice. Traumatology, 16(4), 39-47. Williams, W. E. (2006). Complex trauma: Approaches to theory and treatment. Journal of Loss and Trauma, 11, 321-335. 11 Jeffreys, M. (2009). Clinician’s guide to medications for PTSD. National Center for PTSD. http://www.ptsd.va.gov/professional/pages/clinicians-guide-to-medications-for-ptsd.asp Optional Reading: Basham, K. (2011). Transforming the legacies of childhood trauma in couple and family therapy. Social Work in Health Care. 17(14). 37-41. Bannink, F. (2008). Posttraumatic success: Solution-focused brief therapy. Brief Treatment and Crisis Intervention, 8(3), 215-225. McCluskey, M. J. (2010). Psychoanalysis and domestic violence: Exploring the application of object relations theory in social work field placement. Clinical Social Work, 38, 435-4. Lynch, S.M. (2011). Restoring relationships: Group interventions for survivors of sexual traumas. In T. Bryant-Davis (Ed.), Surviving sexual violence: A guide to recovery and empowerment (pp. 179-198). Lanham, Maryland: Rowman & Littlefield Publishers. Week 14- November 19: Perpetrators of Violence Demographics Theories of causation Treatment Readings: Grady, M. D. (2009). Sex offenders part I: Theories and models of etiology, assessment and intervention. Social Work in Mental Health, 7, 353-371. Truscott, D. & Evans, J. (2009). Protecting others from homicide and serious harm. In J.L. Werth, E.R. Welfel, & G.A. Benjamin (Eds.), The Duty to Protect (pp. 6177). Washington, D.C.: American Psychological Association. Brown, T.L., Borduin, C.M.,& Henggleler, S.W.(2001). Treating juvenile offenders in community settings. In J.B. Ashford, B.D.Sales & W.H. Reid (Eds.), Treating Juvenile Offenders with Special Needs. (pp.445-464). Washington, D.C.: American Psychological Association. Optional Reading: 12 Ward, T., Hudson, S.M., & Johnston, L. (1997). Cognitive distortions in sex offenders: An integrative review. Clinical Psychology Review, 17(5), 479-507. NOVEMBER 26- NO CLASS- HAPPY THANKSGIVING! Week 15- December 3: Self-Care/Vicarious Traumatization and Course wrap-up Evidence Based Practice Paper Due Self-care techniques How to recognize vicarious traumatization Changes in personal schemas Readings: Bride, B.E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63-70. Ryan, K. & Cunnigham, M. (2007). Self-help for the helpers: Preventing vicarious traumatization. In N.B. Webb (Ed.) Play therapy with children in crisis: Individual, group and family treatment (pp. 443-458). New York, NY: The Guilford Press. Other articles which may be of interest Campbell, R., Dworkin, E., & Caabral G. (2009). An ecological model of the impact of sexual assault on women’s health. Trauma, Violence and Abuse, 10(3), 225-246 Gill, D. A., Picou, S., & Ritchie (2011). The Exon Valdez and BP oil spills: A comparison of initial social and psychological impacts. American Behavioral Scientist, XX(X), 1-20. Koffman, S. Ray, A., Berg, S., Covington, L., Albarran, N. M., & Vasquez, M. (2009). Impact of comprehensive whole child intervention and prevention program among youths at risk of gang involvement and other forms of delinquency Children and Schools 31(4), 239-245. Helms, J. E., Nicholas, G., & Green, C. E. (2010) Racism and ethnoviolence as trauma: Enhancing professional training. Traumatology, 16(4). 53-62. Wasco, S. M. (2010). Conceptualizing the harm done by rape: Applications of trauma theory to experiences of sexual assault. Trauma, Violence and Abuse, 4(4), 309-322. 13 George, M. (2012). Migration traumatic experiences and refugee distress: Implications for social work practice. Clinical Social Work Journal. Advance online publication. doi:10.1007/s10615-012-0397-y Shapiro, F. & Maxfield, L. (2002). Eye movement desensitization and reprocessing (EMDR):Information processing in the treatment of trauma. Psychotherapy in Practice, 58(8), 933-946. Naparstek, B. (2004). How and why imagery heals trauma. In Invisible heroes: Survivors of trauma and how they heal (pp. 149-179). New York, NY: Bantam Dell. 14 Case Formulation Paper and Treatment Plan Social Work 855: Treatment of Trauma and Violence Due Date: October 22 This paper is designed to enable you to demonstrate your ability to formulate/describe a clinical case using a CBT framework. You are being asked to assess the presenting problems/symptoms of the case and link these to the CBT model of assessment. Additionally, you will be able to practice developing a thorough and consistent plan for intervention based on your assessment and formulation. I would prefer that you use your own case for this assignment, but if you do not have an appropriate trauma case, you can use a case that I will provide. If you use a case from your field placement or work please take steps to ensure client confidentiality by altering or leaving out identifying information. All client names should be changed. I. Presenting problem and brief psychosocial history- In this section of the paper, please explain client’s presenting problem and history, including information about family of origin, presenting symptoms, and history of trauma. Remember that “presenting problems can include symptoms, current stressors… and difficulties in adaptive functioning…” (Taylor, 2006, p. 135). This section should also report the DSM diagnosis . II. Formulation section: In this section you will describe the symptoms and presenting problem using CBT as an explanatory model. Each symptom should be listed, followed by an explanation of why the person has those symptoms according to the CBT model of trauma. This process should be done for the presenting problem as well, if it is separate from the symptoms described in the case. One helpful way to think about your formulation is to include predisposing, precipitating, perpetuating and protective factors to explain your client’s unique situation. (See Taylor Chapter 8 for a review of these elements) III. Treatment plan section: This section should build on your case formulation section. You will use the formulation as the basis for your treatment plan. The treatment plan should be consistent with the assessment, meaning that the interventions should address the symptoms listed in the assessment, and the types of interventions (e.g. modality, duration, specific skills) should match up with the problems listed and causes for those problems. Your treatment plan should have clearly written goals and objectives that are measureable with realistic time frames for completion. The plan should be consistent with the client’s needs as well as his/her cultural background. In addition, the modality or modalities of treatment (e.g. group, individual, family) should be discussed and a brief rationale given for your choices. Your plan should also include any other interventions that you deem necessary for the client outside of the CBT model. These could include but are not limited to; the creation of a safety plan, a referral to another agency for additional assistance, 15 advocacy work, case management, medication referral, addressing social justice issues on behalf of your client on a policy level, inclusion of a spiritual leader, etc. This paper should be approximately 7-9 pages total. Grading Criteria 1. The presenting problem, history and DSM diagnosis are clear and thorough. 2. Each of the symptoms and/or presenting problems in the case are listed with a thorough and clear explanation using the CBT model. Within the explanation, there is a discussion as to the purpose or functionality of each of the symptoms. 3. For each of the symptoms listed for the client, you have listed an appropriate intervention to address the symptoms/problems. 4. For each intervention, there is an appropriate time-frame for when the goal should be met and there are 2-3 objectives listed for each issue being addressed. The goals and objectives are written according to the model learned in class. The appropriate modality or modalities are included in the treatment plan (e.g. individual, family, group). 5. For each intervention, there is an appropriate method of evaluation for how to determine whether the goals and objectives have been met. 6. The interventions are consistent with the client’s individual needs in terms of their culture, gender, sexual orientation, religion, class, language or other issues of diversity. There is a discussion of social justice issues or other broader issues that might play a role in this case, such as lack of access to services, homophobia, racism, etc. 7. Other non-CBT/direct therapeutic interventions have been considered that would address the needs of the client. 8. The paper is clearly written with NO writing errors and APA formatting is followed. Total Points possible 15 20 10 15 10 10 10 10 100 16 Evidence Based Practice Paper Social Work 855: Treatment of Trauma and Violence Due Date: December 3 Objective: A major part of what you will do as a practitioner is to provide a rationale to your clients, your clients’ family members, or insurance providers for the intervention choices you recommend and implement with your clients. This paper is aimed to help you gain the skills to both explain the reasons for your choices, as well as determine through the available research whether what you are recommending is appropriate for your client. Description: In this paper, you are to provide a rationale as to why you feel that the treatment plan you created for your client in the previous assignment was an appropriate plan or not. Your paper should explain how well the intervention model you used, namely CBT, fit with the assessment you completed of the client’s needs. This explanation should include how well the specific interventions matched up with the needs of the client, both in terms of their symptoms as well as broader needs, cultural, gender factors, or any other factor relevant to your client’s specific situation. This paper should also include a discussion of the outcome literature regarding CBT and the treatment of individuals who have suffered from a trauma. What does the research say about the efficacy of CBT for your client’s diagnosis? In addition, you should provide a rationale for other interventions that you recommended for your client that were outside of the CBT framework. Are there other theoretical approaches that might better serve the client? Summarize the evidence for the use of any other approaches suggested. This paper should be about 7 pages and a minimum of 5 references should be included that were not assigned readings for this course. Grading Criteria There is a clear rationale provided regarding how appropriate or inappropriate, you feel the CBT-based treatment plan fit with the symptoms/problems of the client. You summarized relevant literature to support your position regarding the choice of CBT for someone with your client’s diagnosis. There is a clear rationale and summary of the literature regarding the other proposed interventions listed in the treatment plan There is a thoughtful discussion of how well CBT or other approaches meet the specific needs of the client, in terms of their culture, sexual orientation, age, gender, spirituality and other issues of diversity. Several new creative conclusions or connections are made and fully explained. Critical thinking should be evident. At least 5 scholarly resources were used which were not assigned course readings. The writing was clear with NO errors and APA formatting was used throughout the paper. Total Points possible 20 20 15 15 10 10 10 100