THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
COURSE NUMBER:
COURSE TITLE:
SEMESTER & YEAR:
INSTRUCTOR:
OFFICE HOURS:
SOWO 755
Issues for Contemporary Clinical Practice
Spring, 2013
Marilyn Ghezzi, MSW, LCSW
TTK, 563-C
919-962-6490
mghezzi@email.unc.edu
12-2 Tuesdays or by appointment
COURSE WEBSITE:
is available through https://sakai.unc.edu
COURSE DESCRIPTION: This is a seminar designed to help prepare students for contemporary clinical
practice, covering topics such as managed care, independent practice and self-care.
COURSE OBJECTIVES:
1. Address ethical issues that develop as a clinical social worker including dual roles, liability
issues, confidentiality and competency.
2. Understand how managed care impacts clinical social work practice.
3. Identify professional development issues important for longevity in the field, such as
supervision, self-care, on-going use of evidence-based practices, and networking.
4. Be exposed to a variety of clinical social work roles and the various issues that arise based on
the setting (e.g. home visits vs. working in a hospital as part of an interdisciplinary team).
5. Assess current level of competence and comfort level with working within various social work
settings and with clients from a range of diverse backgrounds and issues.
EXPANDED DESCRIPTION: This course will build on the Advanced Practice classes students will take in
their concentration year. It is designed to help students think about the variety of options for clinical
social work practice, as well as help them to identify and begin to address issues that may impact their
own practices, regardless of the setting. This seminar will help students to prepare for longevity in the
field by helping them begin to incorporate self-care and professional development practices
immediately upon graduation. In addition, the basics of how to develop an independent practice will be
discussed. Ethical issues and self-awareness will also be discussed in relation to how these issues may
impact their ability to be an effective practitioner.
1
REQUIRED TEXTS/READINGS:
Willer, J. (2009). The beginning psychotherapist’s companion. Lanham, MD: Rowman & Littlefield
Publishers, Inc.
Other assigned readings will be posted on our Sakai site
CLASS ASSIGNMENTS
Refer to description of assignments at the end of this syllabus.
1. Supervision paper : 30%
2. Professional Development Plan: 50%
3. Class Attendance and Participation: 20%
CLASS PARTICIPATION
Class participation counts for 20% of your final grade. Everyone will receive a standard score of 100
for participation, in recognition of a norm of attendance, contributions to small group activities and
informed participation in class discussion. Informed participation means that you clearly demonstrate
that you have completed assigned readings and can offer analysis, synthesis and evaluation of written
material. Excellent participation also means that your comments are thoughtful, focused and respectful.
Points will be deducted from the base score if you miss class, are late, leave early, disappear for long
periods on break or are unprepared. Please turn off cell phones during class.
This class will use a variety of teaching and learning methods to cover the content. These different
methods include: small group activities; lecture; guest speakers; role-plays; and class discussions. The
development of a supportive learning environment is fostered by respectfully listening to the ideas of
others, being able to understand and appreciate a point of view which is different from your own,
clearly articulating your point of view, and linking experience to readings and assignments. If you will
not be able to attend a class, let the instructor know as soon as possible. It is also your responsibility to
obtain handouts, information about class content, and information about announcements, etc., from
your classmates. In order to fully participate in and benefit from each class session, students must
complete required readings and come to class prepared to discuss them.
See grading rubric on page 4 of syllabus for professional conduct/participation.
GRADING SYSTEM
In accordance with the Graduate school, letter grades are assigned to the following numeric ranges:
H = 94 and above
P = 80 to 93
L = 70 to 79
F = 69 and below
2
SUBMITTING WRITTEN ASSIGNMENTS AND 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
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 5% reduction every 24 hours that the assignment is late.
Papers should be submitted to the Sakai Dropbox at the start of class. The Professional Development
plan final assignment is due by midnight on March 8th and should be submitted to the Sakai Dropbox.
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.
HONOR CODE
The Student Honor Code is always in effect in this course. The Instrument of Student Judicial
Governance (http://instrument.unc.edu/) requires that you vouch for your compliance on all your
written work. You must write the following pledge in full on each document title page: “I have neither
given nor received any unauthorized assistance on this assignment.” Sign and date it. 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.
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
Please turn off all cell phones or other devices that would disrupt the learning environment of the
classroom. Laptops are allowed during lecture only or when being used for a class activity. Laptops
should be closed during class discussion and other activities that do not require the use of a laptop.
APA AND WRITTEN ASSIGNMENTS
The School of Social Work faculty has adopted APA style as the preferred format for papers and
publications. The best reference is the Publication Manual of the American Psychological Association,
Sixth Edition (2009) that is available at most bookstores. The following web sites provide additional
information: http://juno.concordia.ca/help/howto/apa.php
Students are strongly encouraged to review the materials on the School of Social Work’s website
http://ssw.unc.edu/students/writing . This page includes numerous helpful writing resources such as
tutorials on understanding plagiarism, quick reference guide to APA, writing tips and ESL materials.
Students are also strongly encouraged to review the section on plagiarism carefully. All instances of
academic dishonesty will result in disciplinary measures pre-established by the School of Social Work
and the University.
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Class Participation Rubric
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)
F
No effort
0-70
L- 70-80
Infrequent
Effort
Absent
Little or No effort, disruptive, disrespectful.
P 80-90
Moderate
Effort
*
Present, not disruptive (This includes 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.
*
P+ 90-94
Good Effort
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.
*
Demonstrates consistent ongoing involvement.
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.
H 95-100
Excellent
Effort
*
Demonstrates excellent preparation: has analyzed readings exceptionally well,
relating it to readings and other material (e.g., readings, course material, discussions,
experiences, etc.).
*
Offers analysis, synthesis, and evaluation of 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.
*
4
Demonstrates ongoing very active involvement.
COURSE OUTLINE
Class 1:
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Introduction January 14
Overview of the Course
What is clinical social work?
Current challenges in our field
Being strengths based as a clinical social worker
What do you want to learn in this course?
Mirabito, D.M. (2012). Educating a new generation of social workers: Challenges and skills needed for
contemporary agency based practice. Clinical Social Work, 40, 245-254.
Bransford, C.L. (2011). Reconciling paternalism and empowerment in clinical practice: An
intersubjective perspective. Social Work, 56(1), 33-41.
January 21 - MLK Holiday- NO CLASS
Class 2:
Supervision - January 28
 Supervision – types of supervision
 Continuing education
 Licensure
Readings:
Ladany, N. (2008). Getting the most out of supervision. In Practicing counseling and psychotherapy:
Insights from trainees, supervisors and clients. (pp. 101-134). New York: Routledge.
Willer, J. (2009). The supervisor-supervisee relationship. In The beginning psychotherapist’s
companion (pp. 13-24). Lanham, MD: Rowman & Littlefield Publishers, Inc.
Willer, J. (2009). Your professional development. In The beginning psychotherapist’s companion (pp.
347-357). Lanham, MD: Rowman & Littlefield Publishers, Inc.
5
Class 3:
Independent Practice: Process Issues - February 4
Panel discussion with social workers in private practice
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Is private practice right for you?
Business/managed care considerations
Ethical dilemmas
Finding a niche/area of practice
At what point are you ready?
Readings:
Bradley, D.L.M. (1996). Private practice: A personal perspective. OASW-News Magazine, 23, 10.
Green, R.G., Baskind, F.R., Mustian, B.E., Reed, L.N., Taylor, H.R. (2007). Professional education and
private practice: Is there a disconnect? Social Work, 52, 151-159.
Peck, S. (2007). Private practice: When it’s not right for you. The New Social Worker, 14, 24-25.
van Heugten, K. (2001). Aspects of the early life histories of social workers in private practice: From
marginality to reflective practice. Psychoanalytic Social Work, 8, 57-78.
Class 4:
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Independent Practice: Nuts and Bolts- February 11
Record keeping
Screening
Forms (e.g. release forms, consent for treatment, policies)
Referral networks
Collateral contacts
Insurance/Payment issues
Malpractice
Readings:
Willer, J. (2009). Informed consent, confidentiality and HIPPA. In The beginning psychotherapist’s
companion (pp. 89-100). Lanham, MD: Rowman & Littlefield Publishers, Inc.
Willer, J. (2009). Progress notes and the chart. In The beginning psychotherapist’s companion (pp.
153-177). Lanham, MD: Rowman & Littlefield Publishers, Inc.
Willer, J. (2009). The therapeutic frame. In The beginning psychotherapist’s companion (pp. 25-38).
Lanham, MD: Rowman & Littlefield Publishers, Inc.
6
Class 5:
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Supervision (cont.), Technology and Clinical Social Work - February 18
Continued discussion of supervision issues
Use of technology with clients
Looking at your own online presence
Boundary issues and technology
Mishna, F., Bogo, M., Root, J., Sawyer, J. & Khoury-Kassabri, M. (2012). “It just crept in”: The digital
age and implications for social work practice. Clinical Social Work Journal, 40, 277-286.
Mattison, M. (2012). Social work practice in the digital age: Therapeutic e-mail as a direct practice
methodology. Social Work, 57(3), 249-258.
Willer, J. (2009). Professional electronic communications. In The beginning psychotherapist’s
companion (pp. 79-85). Lanham, MD: Rowman & Littlefield Publishers, Inc.
Class 6: – Clinical social work roles, managed care, safety -
February 25
Supervision paper due today
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Review various clinical social work roles such as inpatient, clinic based, community based,
residential settings, medical social work, community outreach, etc.
Considerations for each role regarding: safety, managed care, ethical issues, role satisfactions
and stressors
Boundary issues/ethics
Cohen, J. (2003). Managed care and the evolving role of the clinical social worker in mental health.
Social Work, 48(1), 34-43.
Spencer, P.C., & Munch, S. (2003). Client violence towards social workers: The role of management in
community mental health programs. Social Work, 4, 532-544.
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Rowe, M., Frey, J., Bailey, M., Fisk, D., & Davidson, L. (2001). Clinical responsibility and client
autonomy: Dilemmas in the mental health work at the margins. American Journal of
Orthopsychiatry, 71(4), 400-407.
Willer, J. (2009). Boundaries. In The beginning psychotherapist’s companion (pp. 39-59). Lanham,
MD: Rowman & Littlefield Publishers, Inc.
Class 7:
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Self-care, vicarious trauma, burnout – March 4
Importance of self-care and self-awareness
What self-care strategies to use
Burnout, secondary trauma, compassion fatigue, vicarious traumatization
How do our histories impact the work?
Readings:
Willer, J. (2009). Vicarious traumatization and burnout. In The beginning psychotherapist’s companion
(pp. 339-346). Lanham, MD: Rowman & Littlefield Publishers, Inc.
Bellows, K. (2007). Psychotherapists’ personal psychotherapy and its perceived influence on clinical
practice. Bulletin of the Menninger Clinic, 71, 204-226.
Radey, M., & Figley, C.R. (2007). The social psychology of compassion. Clinical Social Work
Journal, 35, 207-214.
Strozier, A.L., & Stacey, L. (2001). The relevance of personal therapy in the education of MSW
students. Clinical Social Work Journal, 29, 181-195.
Final Assignment: Professional Development Plan due on Friday, March 8 at midnight
Supplemental Reading:
Rønnestad, M.H., & Skovholt, T.M. (2001). Learning arena for professional development:
Retrospective accounts of senior psychotherapists. Professional Psychology: Research and
Practice, 32, 181-187.
Hamama, L. (2012). Burnout in social workers treating children as related to demographic
characteristics, work environment, and social support. Social Work Research, 36(2), 113-125.
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Gerdes, K. E., & Segal, E. (2011). Importance of empathy for social work practice: integrating new
science. Social Work, 56(2), 141-148.
Ji, J., Kao, D., & Kim, H. (2011). Burnout and physical health among social workers: a three-year
longitudinal study. Social Work, 56(3), 258-268.
Gardner, F., Savaya, R., & Stange, D. (2011). Stressful encounters with social work clients: a
descriptive account based on critical incidents. Social Work, 56(1), 63-71.
Gelman, C., Fernandez, P., Hausman, N., Miller, S., & Weiner, M. (2007). Challenging endings: First
year MSW interns' experiences with forced termination and discussion points for supervisory
guidance. Clinical Social Work Journal, 35, 79-90.
Supplemental Reading about Supervision:
McTighe, J.P. (2010). Teaching the use of self through the process of clinical supervision. Clinical
Social Work Journal, 39, 301-307.
Stovel, L. & Steinberg, P.I. (2008). Learning within psychotherapy supervision. Smith College Studies
in Social Work, 78(2/3), 321-336.
Alonso, A. (2000). On being skilled and deskilled as psychotherapy supervisor. Journal of
Psychotherapy Practice and Research, 9(1), 55-61.
Yourman, D.B. (2003). Trainee disclosure in psychotherapy supervision: The impact of shame. Journal
of Clinical Psychology, 59(5), 601-609.
Hawkins, P. & Shohet, R. (2006). Maps and models of supervision. In Supervision in the helping
profession (3rd ed.). New York, NY: McGraw-Hill (pp.56-79).
This article is particularly useful for learning how to be a supervisor.
In addition to these articles, I have some good books on supervision which you are welcome to look
over to see if there are chapters that might be relevant for your particular interests.
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ASSIGNMENTS
Supervision Paper: Due Feb. 25
This paper is designed to help you reflect on your feelings/experiences in clinical supervision thus far
in your career and to contextualize those experiences through an understanding of the professional
literature about clinical supervision. In addition to the required course readings on supervision, read
two or three of the supplemental supervision articles that look interesting to you. Please answer the
following questions in a 4-5 page double-spaced paper following APA rules.
Reflect on your experiences thus far with supervision in your field placements and/or other human
services jobs you have held. Describe any critical experiences, good or bad that have shaped your view
of supervision. Discuss your reactions to these experiences and your thoughts about supervision in
general in light of the readings on supervision and our class lecture and discussions. Discuss your
hopes for supervision in the future, what might work best for your learning style and what might be
personally challenging for you in clinical supervision.
In addition to considering yourself as a supervisee, consider what may be involved in your own
transition to becoming a supervisor. What will be difficult for you as a supervisor? What type of
supervisor will you be? What are you looking forward to about becoming a supervisor? What might
you need to work on in yourself in order to be a good clinical supervisor?
Please demonstrate in the paper that you have read the materials about supervision and considered them
thoughtfully. Apply the concepts to your particular situation.
Grading Criteria
Possible Pts.
The student clearly described their own experiences in supervision and covered all aspects
of the assignment.
5
The student appropriately applied the course readings on supervision to their own
situation.
10
The student demonstrated an understanding of the course readings on supervision and the
didactic material presented.
10
The paper was written well with no errors and followed APA format
5
Total
30
10
Professional Development Plan- Due Friday, March 8
Objective:
As a professional social worker, you will need to be conscious of how to develop your skills and
knowledge in the area of clinical social work. This assignment is to increase your attention to your own
needs as a new clinician and to develop concrete steps that you will take to reach your own personal
goals.
Description:
The aim of this assignment is to help you organize your professional goals into as many concrete steps
as necessary to help you know where to go in your career. The outline below should be followed to
ensure that you have considered critical areas for professional development. However, you should not
feel limited by this outline, as there may be other essential areas that you would want to include in your
plan. It is the hope of this assignment that you will feel more prepared to begin your social work career
with this document as a guide.
Outline for Professional Development Plan:
1. Identify your short and long term goals
a. What are your short term goals (2-4 years post-graduation)
b. What are your long term goals (5 years and beyond)
c. What are the populations and settings where you want to work
2. What are the immediate skills, tasks needed to reach your goals
a. Supervision – type, style, orientation, consideration of learning styles, on the job vs.
outside
b. Licensure – in what state? Test time frame, necessary steps to complete process, such as
recommendations, forms, etc.
c. Job searches – where will you look? What are some contacts that you can identify to
help?
d. What organizations might be helpful?
i. Clinical Society?
ii. NASW? NABSW?
iii. School of Social Work
iv. Previous supervisors/placements?
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3. What steps will you take to ensure you are working on self-care?
a. What are the concrete steps you will take?
b. Where does personal therapy come into play?
c. What do you know works for you to stay healthy and balanced? (e.g. spiritual group,
time off, balanced case load, varying types of work)
4. Professional Development- What are the skills/competencies that you will need to meet your
goals?
a. What additional training do you need?
i. Post-graduate courses
ii. Ph.D.?
iii. Certificate coursework
iv. Additional training in theoretical approaches
v. Other certifications, such as expressive arts, psychoanalytic, EMDR, etc
b. Where will you find the specific training you need?
c. Do you need to contact places to get on listservs?
d. Are there fellowships or post-master’s training programs that you would want to seek
out?
5. Ethics
a. Do you have a place to go when faced with ethical dilemmas?
b. What steps will you take to ensure your safety in the field? Do you need additional
training in therapeutic holds, etc?
c. What will you do to maintain your boundaries both in face to face work with clients and
online?
i. Thought about issues of self-disclosure? What will you say when asked the
tough questions?
ii. How available will you be outside of work? What limits might you need to set
about work hours/overtime? What are your thoughts about cell phone/pager
availability and how that fits for you personally?
6. Other areas that are relevant for your personal goals
a. How will your short-term goals lead into your long-term goals?
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b. What other areas do you need to consider?
Grading Criteria:
Criteria
Possible
Pts.
1. Each of the areas listed in the outline have been addressed and the plan is
specific, concrete, thoughtful and reflective concerning personal
professional needs.
35
2. The document reflects content and knowledge from the course, such as
resources identified in the course or specific issues raised in class
discussion
10
3. The writing was clear and well organized with no errors and followed APA
format
5
Total points
13
50