THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
COURSE NUMBER: SOWO 857
COURSE TITLE: ADVANCED CLINICAL PRACTICE WITH FAMILIES
SEMESTER AND YEAR: FALL 2009
INSTRUCTOR:
Paul R Smokowski, M.S.W., Ph.D., C.P.
School of Social Work
CB # 3550, 325 Pittsboro St.
Chapel Hill, NC 27599-3550
Phone: 919-843-8281
Email: smokowsk@email.unc.edu
OFFICE HOURS:
Mondays 1-2pm or Fridays 12:30-2pm or by appointment
COURSE DESCRIPTION: This advanced practice course is devoted to intervention with
families. Intervention methods will be applied to families coping with major life
stressors and relational problems. Family therapy models are covered.
COURSE OBJECTIVES:
By the end of the course, students will:
1. Understand issues social workers face in working with families, especially those
issues that differentially affect clinical work with families from socioeconomically
disadvantaged, vulnerable, and oppressed groups, with emphasis on women, on
individuals with disabilities, on gays and lesbians, on African-Americans, on Latinos,
and on other minority groups.
2. Articulate how stressors and problems (such as depression, anxiety, or substance use)
both influence family patterns of functioning and are potentiated by family patterns of
functioning.
3. Describe the role of explanatory and practice theory in social work, and compare and
contrast the concepts and assumptions that underpin major conceptual frameworks for
social intervention with families. Major conceptual frameworks for social intervention
with families that will be focused on are: systemic, structural, communications,
experiential, psychodramatic, psychodynamic, and cognitive-behavioral family
intervention.
4. Formulate a comprehensive assessment of a family using appropriate concepts and
measures from our research and clinical knowledge base on family functioning.
5. Apply conceptual frameworks and models of family intervention to case examples and
demonstrate mastery of the practice models in simulated sessions (e.g. role play
scenarios) with clients.
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6. Understand and articulate how social work values and ethics guide social interventions
with families.
EXPANDED DESCRIPTION:
This course is facilitated as a skills-training laboratory for working with families.
Relational patterns and processes, rather than individual concerns, will be stressed.
Development of family systems thinking and acquisition of advanced assessment and
social intervention skills will be paramount throughout the semester. Using a diverse
array of interactive exercises, video modeling, and simulation scenarios will facilitate
skills acquisition. Students will be expected to maintain a high level of active
participation, will demonstrate their practice skills in front of others, and will serve as
consultants for each other.
Special emphases will be placed on vulnerable, disadvantaged, and diverse
families. This is an advanced practice elective in the Direct Practice Concentration. It
will be expected that students have already had an advanced HBSE course in their Field
of Practice.
Field experience working with families is particularly helpful for working in this
class. Students should leave this course with increased confidence in their ability to
analyze patterns, assess, and intervene using diverse family systems perspectives.
REQUIRED TEXTS/READINGS:
Nichols, M. & Schwartz, R.C. (2006). Family therapy: Concepts and methods (7th
Edition). Needham Heights, MA: Allyn and Bacon.
The text is available at the student bookstore or can be ordered over the internet (e.g.,
www.amazon.com, www.bestbookbuys.com, or www.textbooks.com)
Readings from sources other than the textbooks are available on Blackboard.unc.edu.
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 appreciate
your contributions to making this a safe and respectful class for learning and growth.
CLASS ASSIGNMENTS
Mid-Term Paper: Assessment of a Family Assess a family that you are familiar with.
This can be a family you worked with in your internships, a friend’s family, or a family
presented in a video of your choice (with prior approval by the instructor). For this
assignment, families must have at least three members. It is harder to assess your
family of origin or your family of choice for this assignment. Show that you understand
the basic concepts necessary to do a family assessment. Apply concepts from the course
texts and class discussions to the family you assess. You must show competence in
analyzing family process dynamics. Consider concepts such as family system roles,
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boundaries, projections, emotional cutoffs, rules, traditions, strengths, risk factors and
major transitions. Use approximately 4 pages to assess the family’s dynamics. Then,
you must discuss how you would plan to intervene with this family. If there is a
particular model you would use, please indicate this and say why you would choose this
model. Length of paper: 6 pages, double-spaced, typed. This paper is due on October
19th, 2009. It is worth 35% of your class grade.
Final Paper Each student will choose one topic that relates to family stress and
dysfunction (e.g. substance abuse, marital infidelity, adolescent delinquency) and will
describe in detail how at least two systems of family therapy would intervene in a family
experiencing that stressor. The paper must include a detailed discussion of clinical
techniques that are used by clinicians working with families with the chosen stressor.
This will serve as the final exam for the course. This paper is due on the final day of
class, and will be 8-10 pages long, in APA format with references appropriately cited
from professional sources (e.g. scholarly journals and books). At least three references to
professional literature are required to be included in the paper. The final paper is worth
30% of your class grade.
Presentations of Final Paper Each student will have 15 minutes to present their research
from the final paper. These presentations will take place on the final two sessions of
class. The presentation is worth 5% of the final grade.
Presentation of a Practice Technique Each student will research one practice technique
in depth and make a presentation to the class on how to use that technique. The
technique can be one that is found in the textbook (e.g., family sculpting, using the
miracle question, motivational interviewing, etc.), may be from your field placement, or
may be from some other resource. The important issue is that the student understands the
technique well enough to be able to teach others how to do it. Each technique
presentation will go for twenty minutes. Students should provide a one-page handout that
summarizes critical information on their technique. This presentation is worth 10% of the
final grade.
Theoretical Matrix. Students will fill in a comprehensive matrix detailing the aspects of
different schools of family therapy. The professor will hand out the blank matrix. This is
worth 10% of the final grade. It will be completed in class on November 16th.
Demonstration of Practice Skills Students must be able to put skills that are presented in
class into practice. Analyzing in writing is not enough. Consequently, students will be
graded on the quality of their clinical skills. Clinical skills will be evaluated using roleplay simulations throughout the semester. If a student does not believe that his or her
skills are adequately demonstrated in a clinical simulation, he or she can negotiate with
the professor to demonstrate these clinical skills using another medium (i.e. submitting a
videotape). This will be a rare case. Participation in role-playing is expected. The
professor will give the most weight to skills demonstrated at the end of the semester
when students should have the most expertise and feel most comfortable role-playing.
However, the professor will also take into account how much growth students have
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shown in their skills from the beginning to the end of the semester. Demonstration of
practice skills is worth 5% of the class grade.
ATTENDANCE AND PARTICIPATION
Attendance is required and the class will rely heavily on discussion and
participation in role-playing. It is expected that students will read the material and apply
and discuss readings and field experiences in class. Students are expected to attend all
class sessions. If there is some reason that you cannot attend a class, please contact the
instructor or leave a message for the instructor at the School of Social Work. Students
who miss three class sessions will be penalized by one letter grade. The Instructor will
also track tardiness. Coming in more than fifteen minutes late is tabulated as missing half
a class session. Students who miss three class sessions will not receive an H; those
missing four or more class sessions will receive an "F" as their final grade for the class.
Class Participation: Students are expected to contribute "meaningfully" to class
discussion. The instructor may call upon students to respond to assigned readings/class
discussion. Please let the instructor know if you have special concerns about speaking in
front of the class. At the beginning of each class session, time will be allocated to
address questions about readings/assignments.
GRADING SYSTEM
The School of Social Work operates on an evaluation system of Honors (H), Pass
(P), Low Pass (L), and Fail (F). For this class, the numerical value of an H ranges from
94 - 100; a P is 80 - 93; an L is 70 - 79. A grade of P is considered entirely satisfactory.
On a traditional grading scale, a P would range from B- to A-. The grade of Honors
signifies that the work is clearly excellent in all respects. Only a small percentage of
students attain Honors. A student receiving nine or more Low Passing credits is ineligible
to continue in graduate school.
The final grade for the course will be determined as follows:
Family Assessment Midterm
Presentation of a Practice Technique
Theoretical Matrix
Demonstration of Practice Skills
Class Participation
Presentation of Final Paper
Final Lit Review Paper
35%
10%
10%
5%
5%
5%
30%
POLICY ON INCOMPLETES AND LATE ASSIGNMENTS
Unless negotiated in advance with the professor, assignments are due on the date
specified in the syllabus. Submitting assignments late must be negotiated with the
professor. One letter grade will be deducted from assignments turned in late (within 48
hours). Students will receive an “F” on assignments not submitted within the 48 hour
grace period.
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POLICY ON ACADEMIC DISHONESTY:
All academic work submitted by students will be conducted within the guidelines
and spirit of the Honor Code, which is described in The SSW Manual and the Graduate
School Record. 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 may notify
the professor if they wish to have special accommodations in instructional format,
examination format, etc., considered.
READINGS AND COURSE OUTLINE
Class I (8/31): Moving from Individual to Family Practice
Introduction, Overview of Syllabus
Assumptions underlying practice with families
Practice Skills Emphasized: How to move from individual, to couples, and finally
to family interventions.
Nutt, Roberta L.; Stanton, Mark; (2008). Family psychology specialty practice.
Professional Psychology: Research and Practice, 39(5), 519-528.
Unit I: Foundations: Action-oriented Brief Family Therapy
Class II (9/14): Family Assessment - Family Processes, Systems, and Stress
Topic: What makes a family functional or dysfunctional? The fundamental
concepts of family therapy.
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (6th
Edition). Needham Heights, MA: Allyn and Bacon, pp 374-397 and 87-112.
Hughes, Elizabeth K.; Gullone, Eleonora (2008). Internalizing symptoms and
disorders in families of adolescents: A review of family systems literature.
Clinical Psychology Review, 28(1), 92-117.
Hooper, Lisa M.; (2007). The application of attachment theory and family
systems theory to the phenomena of parentification. The Family Journal, 15(3),
217-223.
Practice Skills Emphasized: Circular Questioning
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NOTE: Class will meet from 9-10:30. Then, we will attend the Clinical Lecture Series
presentation. Please register online.
Responding to client therapy-interfering behaviors using behavioral principles and
techniques - Jennifer Kirby, PhD
Drawing from dialectical behavior therapy and behavioral analysis, Dr. Kirby presents an
approach to assessing and intervening on client behaviors that interfere with therapeutic
progress, and provides interventions to enhance the therapeutic alliance and treatment
process.
Class III (9/21): Action Methods for Family Intervention
Topic: How to use brief, action-oriented techniques in marital and family therapy.
Action Techniques: Role reversal, mirroring, doubling, soliloquy
Required reading for this class
Blatner, A. (1999). Psychodramatic methods in psychotherapy. In D.J. Wiener
(Ed.) (1999). Beyond Talk Therapy: Using Movement and Expressive Techniques
in Clinical Practice. Washington, D.C.: APA, pp.125-143.
Proctor, Kerry; Perlesz, Amaryll; Moloney, Banu; O'Neill, Imogen; McIlwaine,
Fiona; (2008). Exploring theatre of the oppressed in family therapy clinical work
and supervision. Counselling & Psychotherapy Research, Vol 8(1), Mar, 2008.
Special issue: Australian Counselling and Psychotherapy Research. 43-52.
Leveton, Eva; (2005). Escaping the Blame Frame: Experiential Techniques With
Couples. Journal of Group Psychotherapy, Psychodrama & Sociometry, Vol
58(2), Sum, 2005. Special issue: Treatment of Couples and Families With
Psychodrama and Action Methods: The Case of Generic Psychodrama. pp. 55-69.
Wiener, D.J. (1999). Rehearsals for growth: Applying improvisational theater
games to relationship therapy. In D.J. Wiener (Ed.) (1999). Beyond Talk Therapy:
Using Movement and Expressive Techniques in Clinical Practice. Washington,
D.C.: APA, pp.165-180.
Wiener, Daniel J.; Pels-Roulier, Laurie; (2005). Action Methods in Marriage and
Family Therapy: A Review. Journal of Group Psychotherapy, Psychodrama &
Sociometry, Vol 58(2), Sum, 2005. Special issue: Treatment of Couples and
Families With Psychodrama and Action Methods: The Case of Generic
Psychodrama. pp. 86-101.
Class IV (9/28): Techniques used in Early Sessions
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (6th
Edition). Needham Heights, MA: Allyn and Bacon, pp 49-84.
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Kipper, David A.; Ritchie, Timothy D.; (2003). The effectiveness of
psychodramatic techniques: A meta-analysis. Group Dynamics: Theory,
Research, and Practice, Vol 7(1),13-25.
Fow, Neil Robert (1998). Partner-focused reversal in couple therapy.;
Psychotherapy: Theory, Research, Practice, Training, Vol 35(2), Sum, 1998. pp.
231-237.
Action Techniques: Putting ecomaps into action, spectograms, the Diamond of
Opposites
Unit II: Practice-Based Intervention Models
Class V (10/5): Bowenian Systems Approaches
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (5th
Edition). Needham Heights, MA: Allyn and Bacon, pp 115-143.
Farmer, Chris; Geller, Marcia; (2005). The Integration of Psychodrama With
Bowen's Theories in Couples Therapy. Journal of Group Psychotherapy,
Psychodrama & Sociometry, Vol 58(2), Sum, 2005. Special issue: Treatment of
Couples and Families With Psychodrama and Action Methods: The Case of
Generic Psychodrama. pp. 70-85.
Butler, John F. (2008). The family diagram and genogram: Comparisons and
contrasts. American Journal of Family Therapy, 36(3), 169-180.
Bartle-Haring, Suzanne; Glebova, Tatiana; Meyer, Kevin; (2007). Premature
Termination in Marriage and Family Therapy within a Bowenian Perspective.
American Journal of Family Therapy, 35(1), 53-68.
Cook, Linda; (2007). Perceived conflict, sibling position, cut-off, and
multigenerational transmission in the family of origin of chemically dependent
persons: An application of Bowen Family Systems Theory. Journal of Addictions
Nursing,18(3), 131-140.
Video Aids: Bowenian Therapy with Philip Guerin or Family Secrets
Practice Skills Emphasized: Working with Triangles and intergenerational
projections; Working with the family projection process in action.
Class VI (10/12): Structural Approaches
Short Class due to University Day starts 10am - 1pm
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (6th
Edition). Needham Heights, MA: Allyn and Bacon, pp 171-196.
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Kim, Josephine M (2003). Structural Family Therapy and Its Implications for the
Asian American Family. The Family Journal, Vol 11(4), 388-392.
Springer, David W.; Orsbon, Sarah H.; (2002). Families helping families:
Implementing a multifamily therapy group with substance-abusing adolescents.
Health & Social Work, Vol 27(3), 204-207.
Vetere, Arlene; (2001). Structural family therapy. Child Psychology & Psychiatry
Review, Vol 6(3), 133-139.
Video Aids: Aponte working with a Latino blended family
Practice Skills Emphasized: Boundary-Making
Class VII (10/19): Solution-Focused Approaches
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (5th
Edition). Needham Heights, MA: Allyn and Bacon, pp 320-335.
O’Halloran, M.S. (1999). Family Involvement in the Treatment of Anorexia
Nervosa: A Solution-Focused Approach. The Family Journal 7; 384-388.
Corcoran, J. (2002). Developmental adaptations of solution-focused family
therapy. Brief Treatment and Crisis Intervention, Vol 2(4), 301-313.
Aambo, Arild (1997). Tasteful solutions: Solution-focused work with groups of
immigrants. Contemporary Family Therapy: An International Journal, Vol 19(1),
63-79.
Practice Skills Emphasized: Working with the Miracle Question in action
Mid-Term Paper: Assessment of a Family due by the end of this class session.
NOTE: Class will meet from 9-10:30. Then, we will attend the Clinical Lecture Series
presentation. Please register online.
The journey of grief: For the clinician and client - Steve Bradley-Bull, MA, MEd, LPC
In this workshop, Steve Bradley-Bull helps us to work effectively with clients who have
experienced significant loss by exploring and integrating our own losses and perspectives
on life, death, and grief, and sharing therapeutic tools to help navigate the grief process.
Class VIII (10/26): Strategic & Cognitive Behavioral Approaches
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (5th
Edition). Needham Heights, MA: Allyn and Bacon, pp 145-168, 246-274.
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Avrahami, Eliyahu; (2003). Cognitive-behavioral approach in psychodrama:
Discussion and example from addiction treatment. The Arts in Psychotherapy, Vol
30(4), 2003. pp. 209-216.
Treadwell, Thomas W.; Kumar, V. K.; Wright, Joseph H.; (2002). Enriching
psychodrama through the use of cognitive behavioral therapy techniques. Journal
of Group Psychotherapy, Psychodrama & Sociometry, Vol 55(2-3), Sum-Fal, 5565.
Cannon, E. & Levy, M. (2008). Substance-using Hispanic youth and their
families: Review of engagement and treatment strategies.; The Family Journal,
16(3), 199-203.
Distelberg, B. J. (2008). History of evidence-based practices: An interview with
José Szapocznik. The Family Journal, 16(2), 173-179.
Gardner, B.C., Burr, B.K., & Wiedower, S.E. (2006). Reconceptualizing Strategic
Family Therapy: Insights from a Dynamic Systems Perspective. Contemporary
Family Therapy: An International Journal, 28(3), 339-352.
Santisteban, D.A., Suarez-Morales, L. Robbins, M.S., Szapocznik, J. (2006).
Brief Strategic Family Therapy: Lessons Learned in Efficacy Research and
Challenges to Blending Research and Practice. Family Process, 45(2), 259-271.
Video Aids: Strategic Therapy with James Coyne
Practice Skills Emphasized: Working with anxiety and depression in action
Class IX (11/2): Communications Approaches
Required reading for this class
McLendon, J. (1999). The Satir system in action. In D.J. Wiener (Ed.) (1999).
Beyond Talk Therapy: Using Movement and Expressive Techniques in Clinical
Practice. Washington, D.C.: APA, pp.29-54.
Beaudry, Gilles; (2002). The family reconstruction process and its evolution to
date: Virginia Satir's transformational process. Contemporary Family Therapy:
An International Journal, Vol 24(1), 79-91.
Roberts, J. (1999). Beyond words: The power of rituals. In D.J. Wiener (Ed.)
(1999). Beyond Talk Therapy: Using Movement and Expressive Techniques in
Clinical Practice. Washington, D.C.: APA, pp.55-78.
Lee, Richard H.; (2005). The couple's therapist as coaching double in a model
encounter. Journal of Group Psychotherapy, Psychodrama & Sociometry, Vol
58(3), 107-118.
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Video Aids: Jean McLendon working with an African American single mother
and her son. Or Virginia Satir video.
Practice Skills Emphasized: Family sculpting and communication typologies
Class X (11/9): Psychodynamic & Experiential Approaches
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (5th
Edition). Needham Heights, MA: Allyn and Bacon, pp 220-243 and 198-217.
Kanofsky, S. & Lieb, R. J. (2007). Control Mastery Theory and family therapy.
Psychotherapy: Theory, Research, Practice, Training, 44(3), 316-332.
Klontz, Bradley T.; Wolf, Eve M.; Bivens, Alex; (2000). The effectiveness of a
multimodal brief group experiential psychotherapy approach. International
Journal of Action Methods: Psychodrama, Skill Training, and Role Playing, Vol
53(3-4), 119-135.
Video Aids: John Edwards video
Practice Skills Emphasized: Using metaphor, imagery, and role-playing
Class XI (11/16): Theoretical Matrix
Theoretical Matrix completed during first half of class
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (5th
Edition). Needham Heights, MA: Allyn and Bacon, pp 337-353.
Vetere, Arlene; Dallos, Rudi; (2008). Systemic therapy and attachment narratives.
Journal of Family Therapy, 30(4), 374-385.
Besa, David (1994). Evaluating narrative family therapy using single-system
research designs. Research on Social Work Practice, Vol 4(3), 309-325.
NOTE: Class will meet from 9-10:30. Then, we will attend the Clinical Lecture Series
presentation. Please register online.
Treating clients and ourselves with positivity - Barbara Fredrickson, PhD
Drawing from her groundbreaking research in positive psychology, Dr. Fredrickson describes
how positive emotions increase our resources in some surprising ways, contributing to a
momentary and a cumulative effect on our experience.
Class XII (11/23): Narrative Therapy & Integrating Models
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (5th
Edition). Needham Heights, MA: Allyn and Bacon, pp 354-372.
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Green, Eric J.; (2008). Individuals in conflict: An Internal Family Systems
approach. The Family Journal, 16(2), 125-131.
Price, David M. (2004). Rebuilding Shattered Families: Disclosure, Clarification
and Reunification of Sexual Abusers, Victims, and Their Families. Sexual
Addiction & Compulsivity, 11(4), 187-221.
Practice Skills Emphasized: Changing family narratives; Internal Family Systems
Therapy
Class XIII (11/30): Discussion of Final Papers
Student presentations of techniques researched in final papers.
Required reading for this class
Nichols, M. & Schwartz, R.C. (2001). Family therapy: Concepts and methods (5th
Edition). Needham Heights, MA: Allyn and Bacon, pp 400-451.
Class XIII (12/7): Wrap Up, Final Paper due by end of class period