HPC 6280 Assessment and Diagnosis in Marriage and Family Therapy
Spring 2012
2-4:50pm Tuesdays
COE 424
Instructors:
Karen L. Caldwell, Ph.D.
Office Phone 262-6045
Office hours: By appointment
336B College of Education Building
e-mail: caldwllkl@appstate.edu
Laura Gambrel, MA, LPC, PhD Candidate
Cell Phone: 530-559-6779
Office hours: By appointment
College of Education Building
e-mail: gambrell@appstate.edu
Course Description
A seminar designed to provide a background in diagnosis and assessment including skills necessary to
conduct a relational assessment interview, as well as the development of assessment skills through the use of
family sculpture, family genogram, role play, and exercises.
Course Goals & Objectives
1. Students will be introduced to the basics of assessment and diagnosis from a systemic/relational
framework.
2. Students will understand the theoretical concepts related to individual and systemic assessment and
diagnostic instruments that pertain to mental health and relational functioning
3. Students will understand, from a relational/systemic perspective, traditional psychodiagnostic
categories and procedures, and the assessment and treatment of major mental health issues including
the treatment options through psychopharmacology. Issues related to work with developmentally
disabled individuals will be addressed in the service-learning component of the course.
4. Students will be introduced to the use of a variety of assessment methods and instruments and become
familiar with issues relating to the use of standardized assessment instruments.
5. Students will understand the limitations of the extant models of assessment and diagnosis, especially
as they relate to different cultural and ethnic groups.
Competencies in Assessment and Diagnosis: The following core competencies in Assessment and
Diagnosis in MFT have been identified by the Commission on the Accreditation for Marriage and Family
Therapy. This course is designed to begin developing competencies in the following areas:
Core Competency
Understand principles of human
development; human sexuality; gender
development; psychopathology;
psychopharmacology; couple processes;
and family development and processes
(e.g., family, relational, and system
dynamics).
Understand the major behavioral health
disorders, including the epidemiology,
etiology, phenomenology, effective
treatments, course, and prognosis.
Rationale for how addressed
Human development and sexuality
issues are introduced in other
courses but these issues are
important in case conceptualization
and diagnostic process.
Psychopathology introduced in
discussion of DSM criteria.
Psychopharmacology introduced in
reading and in-class discussion
DSM discussion, reading, in-class
discussion
How assessed in this course
-Psychosocial
history/substance abuse
assessment assignment
-WebCT quizzes (optional)
-Written treatment plan
-final exam
-WebCT quizzes (optional)
-Written treatment plan
-final exam
2
Core Competency
Understand the clinical needs and
implications of persons with comorbid
disorders (e.g., substance abuse and
mental health; heart disease and
depression).
Comprehend individual, marital, couple and
family assessment instruments appropriate
to presenting problem, practice setting, and
cultural context.
Understand the current models for
assessment and diagnosis of mental health
disorders, substance use disorders, and
relational functioning.
Understand the strengths and limitations of
the models of assessment and diagnosis,
especially as they relate to different
cultural, economic, and ethnic groups.
Understand the concepts of reliability and
validity, their relationship to assessment
instruments, and how they influence
therapeutic decision making.
Assess each clients’ engagement in the
change process.
Systematically integrate client reports,
observations of client behaviors, client
relationship patterns, reports from other
professionals, results from testing
procedures, and interactions with client to
guide the assessment process.
Develop hypotheses regarding relationship
patterns, their bearing on the presenting
problem, and the influence of extratherapeutic factors on client systems.
Consider the influence of treatment on
extra-therapeutic relationships.
Rationale for how addressed
How assessed in this course
Special session on assessment of -WebCT quizzes (optional)
substance abuse
-Written treatment plan
Discussion of comorbid disorders
integrated in course material
Introduction to instruments focused -Videotaping assignment on
on PREPARE/ENRICH but
interpreting results
extended to other instruments in
videotaping assignment
Special section on using DSM in a -final exam
systemic/relational framework
Reading Alarcon (1995) article and -final exam
discussion in class of Appendix in
DSM with cultural considerations
Session on PREPARE/ENRICH as -final exam
example
-treatment plan video
Development of treatment plan
-treatment plan
Videotaping of treatment plan
development
-treatment plan video
Psychosocial hx assignment and
discussion along with treatment
planning video
-Psychosocial hx assignment
-treatment plan video
Psychosocial hx assignment and
discussion along with treatment
planning video
Consider physical/organic problems that
Psychosocial hx assignment and
can cause or exacerbate
discussion along with treatment
emotional/interpersonal symptoms.
planning video
Diagnose and assess client behavioral and Psychosocial hx assignment and
relational health problems systemically and discussion along with treatment
contextually.
planning video
Provide assessments and deliver
Psychosocial hx assignment and
developmentally appropriate services to
discussion along with treatment
clients, such as children, adolescents,
planning video
elders, and persons with special needs.
Apply effective and systemic interviewing Psychosocial hx assignment and
techniques and strategies.
discussion along with treatment
planning video
-Psychosocial hx assignment
-treatment plan video
-Psychosocial hx assignment
-treatment plan video
-Psychosocial hx assignment
-treatment plan video
-Psychosocial hx assignment
-treatment plan video
-Psychosocial hx assignment
-treatment plan video
3
Core Competency
Administer and interpret results of
assessment instruments.
Screen and develop adequate safety plans
for substance abuse, child and elder
maltreatment, domestic violence, physical
violence, suicide potential, and
dangerousness to self and others.
Assess family history and dynamics using a
genogram or other assessment
instruments.
Elicit a relevant and accurate
biopsychosocial history to understand the
context of the clients’ problems.
Identify clients’ strengths, resilience, and
resources.
Elucidate presenting problem from the
perspective of each member of the
therapeutic system.
Evaluate assessment methods for
relevance to clients’ needs.
Assess ability to view issues and
therapeutic processes systemically.
Evaluate the accuracy and cultural
relevance of behavioral health and
relational diagnoses.
Assess the therapist-client agreement of
therapeutic goals and diagnosis.
Utilize consultation and supervision
effectively.
Rationale for how addressed
Treatment planning video
assignment
Reading on suicide, substance
abuse.
Introduced to other issues in ethics
class and intense focus in clinical
issues course
Psychosocial hx videotape
How assessed in this course
-treatment planning video
Psychosocial hx videotape
Psychosocial hx videotape
Psychosocial hx assignment and
discussion along with treatment
planning video
Psychosocial hx assignment and
discussion along with treatment
planning video
Psychosocial hx assignment and
discussion along with treatment
planning video
Psychosocial hx assignment and
discussion along with treatment
planning video
Psychosocial hx assignment and
discussion along with treatment
planning video
Treatment planning video
-Psychosocial hx assignment
-treatment plan video
-final exam
Psychosocial hx videotape
-Psychosocial hx assignment
-treatment plan video
-Psychosocial hx assignment
-treatment plan video
-Psychosocial hx assignment
-treatment plan video
-Psychosocial hx assignment
-treatment plan video
Treatment planning video
In-class discussion and handout on Showing videos
using supervision
Introduce method of supervision
through requirement of taping and
showing tape
Course Requirements
1. Attendance and Participation (20% of final grade)
Students are expected to be prepared for classes by being up-to-date with assigned readings. Students
will take turns being the ”Reporter”. The Reporter prepares a 2-3 page, typewritten summary of the
article/chapter which will serve as an informal document designed to facilitate the group’s discussion of the
reading. The question the Reporter is responding to is, “What did the author say?” Ninety percent of the
response should be devoted to the author’s main points (either summarize or “lift” the author’s sentences or
paragraphs), and 10 percent is devoted to “My reactions.” Here the Reporter provides his or her editorial
opinions, reactions, etc. The Reporter brings copies of his/her written summary to class for everyone in the
class. The reporter then starts the discussion of the reading with his/her summary and others respond to the
question, “What reactions or comments do you wish to make concerning this article?”
Class attendance and meaningful participation in the class are essential. It is often impossible to "redo"
missed class time because of the interactional nature of the class. There is a 1-absence maximum, including
excused absences. Your grade will be reduced for absences beyond the maximum. Chronic lateness is rude
and evidence of lack of readiness for professional practice. Please be on time.
4
Attendance Policy. It is the policy of Appalachian State University that class attendance is an important part
of a student's educational experience. Students are expected to attend every meeting of their classes and are
responsible for class attendance. Only one absence is allowed with the expectation that prior notification will
be provided to the instructor. Additional absences will result in the loss of five (5) points to the final semester
grade. Notification can be communicated via telephone, email, or in person. Regardless of what reasons there
may be for absence, students are accountable for all academic activities.
In addition, faculty members are required to make reasonable accommodations for students requesting to miss
class due to the observance of religious holidays. All ASU students are allowed a minimum of two absences
per year for religious observances. Up to two absences for such observances will be excused, without penalty
to the student, provided that the student has informed the instructor in the manner specified in the syllabus.
Notice must be given by the student to the instructor before the absence occurs and no later than three weeks
after the start of the semester in which the absence(s) will occur. Arrangements will be made to make up work
missed by these religious observances, without penalty to the student. For the purposes of this policy, ASU
defines the term “religious observance” to include religious holidays, holy days, or similar observances
associated with a student’s faith that require absence from class.
2. Psychosocial history/substance abuse assessment (20% of final grade) Due date: 2-14
Students will make a 15-minute video of an intake interview conducting a substance abuse
assessment/psychosocial history interview role-play. The student will present the video to their peers for
feedback and the written report to the instructor.
3. Assessment Instrument Interpretation videotape (20% of final grade) Due date 4-4
Students will find a standardized assessment instrument and complete an assessment of volunteer clients.
Students will videotape interpreting the results of the assessment to their clients. Turn in to the instructor a
written treatment plan that outlines your focus in the session and anticipates on-going work with the client.
4. Final exam (40% of final grade) Due 5-2
Practice quizzes are available on AsuLearn for each Content area. These quizzes are on the basic ideas in the
reading assignments for a class, and are intended to help you learn the material. You may take a quiz as many
times as you wish, but the quizzes will NOT be available after the LAST day of class.
Tentative Course Schedule (AsuLearn Content Module Titles in Italics)
Date
Class 1
1-17
Class 2
1-24
Topics
Intro to course, issues in systemic/relational assessment
Benson, Long, & Sporakowski, M. J. (1992)
Bartlett (2002)
Denton (2002)
Intro to taking a Psychosocial history
Interviewing and observational skills in a family interview
Using DSMIV in a Systemic/Relational Framework
DSM-IV-TR, pp. xxiii-37, 897- 903.
Reader: ____________________________
Wynne, Watson, & Shields (2002)
Reader: ____________________________
5
Class 2
(con’t)
Lewis-Fernández & Díaz (2002)
Reader: ____________________________
DSM in Systems Framework- Quiz 1
Class 3
1-31
Mental Status Examinations and
Assessing for Substance Abuse
Polanski & Hinkle (2000)
Reader: ____________________________
DSM-IV-TR, pp. 191-295
Reader: ____________________________
Class 3
Con’t
Class 4
2-7
See assessment instruments on AsuLearn specific to screening for alcohol/substance
abuse problems.
Mental Status Exams – Quiz 2
Introduction to Psychopharmacology
Collaboration with Prescribing Professionals
Ingersoll & Rak, pp. 16-51
Reader (ch.3 pp. 38-51):________________________
Intro to Psychopharmacology – Quiz 3
Class 5
2-14
Intake video presentations
Class 6
2-21
Assessment Instrument Review, Reliability, Validity,
The example of PREPARE/ENRICH
AsULearn reading titled: Assessment Instrument Review
Class 7
2-28
Assessing for mood disorders in family members
The role of MFT in assessing the appropriateness of hospitalization
Sommers-Flanagan & Sommers-Flanagan (1995)
Reader: ____________________________
Ingersoll & Rak, pp. 79-105, 164-192
Reader (ch. 5): _______________________
Reader (ch. 8): _______________________
DSM-IV-TR, pp. 345-428
Reader: _____________________________
Mood Disorders – Quiz 4
6
Class 8
3-6
Marriage and family therapy treatment plans
Clinical Reasoning
Jongsma & Peterson (2006).
Coombs, Chapter 8: “Assessment, diagnoses, and treatment planning”
Reader: ___________________________
3-13
NO CLASS – UNIVERSITY HOLIDAY
Class 9
3-20
Developmentally appropriate assessments for children and adolescents
DSM-IV-TR, pp. 39-134
Reader: _____________________________
Coombs, Chapter 16 “Behavioral and relationship problems”
Reader: ____________________________
Ingersoll & Rak, pp. 193-222
Reader: _____________________________
AsuLearn reading summaries from Garbarino – “What children can tell us”
Assessing Children – Quiz 5
Class 10
3-27
Assessing for eating disorders in family members
DSM-IV-TR, pp. 583-595.
Reader: ____________________________
Assessing for personality disorders in family members
DSM-IV-TR, pp. 685-730
Reader: ____________________________
Eating Disorders – Quiz 6
Class 11
4-3
4-10
Assessment Instrument interpretation – Treatment Planning video presentations
Class 12
4-17
Assessing for anxiety disorders in family members
No Class – State Holiday
DSM-IV-TR, pp. 429-484
Reader: ____________________________
7
Ingersoll & Rak, pp. 106-133
Reader: ____________________________
Wehrenberg on anxiety-management techniques
Anxiety Disorders – Quiz 7
Class 13
4-24
Schizophrenia and psychosis
DSM-IV-TR, pp. 297-344
Reader: ____________________________
Ingersoll & Rak, pp. 134-163
Reader: ____________________________
Review and closing activities
May 1
Hold in case of Snow Day Make-up
Weather Policy
Classes may be postponed in cases of severe weather. A telephone tree will be used to notify class members if this
becomes necessary. Use reasonable judgment and do not put yourself at unnecessary risk. The university’s policy on
cancelling or delaying the start of classes is available on the university’s web site at
http://www.policy.appstate.edu/weatherpolicy.html.
In the event of inclement weather, class may be held via nonsynchronous Internet conversations using
AsuLearn’s forum function. A telephone tree will attempt to notify students of this change and email
notification will also be sent unless there is an electrical outage. To be considered “present” when the class meets in
on-line session, you must submit a minimum of 2 substantive on-line contributions prior to the next scheduled in-class
meeting time. At least one of these responses must clearly refer to the postings of other class members (this will be
evidence of your having read the postings of your classmates.)
Academic Integrity
Appalachian State University’s Academic Integrity Code is designed to create an atmosphere of trust, respect,
fairness, honesty, and responsibility. You can find a complete copy of the university's academic integrity policy
at the Office of Student Conduct web site: http://studentconduct.appstate.edu/.
Americans with Disabilities
Appalachian State University is committed to making reasonable accommodations for individuals with
documented qualifying disabilities in accordance with the Americans with Disabilities Act of 1990, and Section
504 of the Rehabilitation Act of 1973. Those seeking accommodations based on a substantially limiting
disability must contact and register with The Office of Disability Services (ODS) at
http://www.ods.appstate.edu/ or 828-262-3056. Once registration is complete, individuals will meet with ODS
staff to discuss eligibility and appropriate accommodations.
You can see the university policy statements at http://academicaffairs.appstate.edu/syllabi
Reading
•
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Required Texts:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder, Fourth edition, Text
Revision. Washington, DC: American Psychiatric Association.
Jongsma, A. E., & Peterson, L. M. (2006). The complete adult psychotherapy treatment planner. 4th ed. Hoboken, NJ:
John Wiley & Sons.
Ingersoll, R. E., & Rak, C. F. (2006). Psychopharmacology for helping professionals: An integral exploration.
Belmont, CA: Thomson Brooks/Cole.
•
Material available through library reserves and on AsuLearn content pages.
Alarcon, R. D. (1995). Culture and psychiatric diagnosis: Impact on DSM-IV and ICD-10. Cultural Psychiatry,
18(3), 449-465.
Bartlett, C. V. (2002, May/June). The politics of identity: Thoughts on the future of the medical model and
family therapy. Family Therapy Magazine, 1(3), 10-17.
Benson, M. J., Long, J. K., & Sporakowski, M. J. (1992). Teaching psychopathology and the DSM-III-R from a
family systems therapy perspective. Family Relations, 41, 135-140.
Coombs, R. H. (Ed.) (2005). Family therapy review: Preparing for comprehensive and licensing examinations.
Mahway, NJ: Lawrence Erlbaum Associates.
Denton, W. (2002, May/June). Relational diagnosis and the DSM. Family Therapy Magazine, 1(3), 18-19.
Garbarino, J. (1989). What children can tell us: Eliciting, interpreting, and evaluating information from children. San
Francisco, CA: Jossey-Bass.
Lewis-Fernández, R., & Díaz, N. (2002). The cultural formulation: A method for assessing cultural factors
affecting the clinical encounter. Psychiatric Quartlery, 73(4), 271-295.
Lopez, S., & Hernandez, P. (1987). When culture is considered in the evaluation and treatment of Hispanic
patients. Psychotherapy, 24(1), 120-126.
Patterson, J., Williams, L., Grauf-Grounds, C., & Chamow, L. (1998). Developing a treatment focus (pp. 6996). In Essential skills in family therapy. NY: Guilford.
Polanski, P., & Hinkle, J. S. (2000). The mental status examination. It's use by professional counselors. Journal
of Counseling and Development, 78(3), 357-364.
Roth, A., & Fonagy, P. (1996). What works for whom?: A critical review of psychotherapy research. NY: Guilford
Press.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (1995). Intake interviewing with suicidal patients: A
systematic approach. Professional Psychology: Research and Practice, 26(1), 41-47.
Spitzer, R. L., Gibbon, M., Skodol, A. E., Williams, J. B. W., & First, M. B. (2002). DSM-IV-TR casebook: A
learning companion to the diagnostic and statistical manual of mental disorders, fourth edition, text revision.
Washington, DC: American Psychiatric Publishing, Inc.
9
Wehrenberg, M. (Sept/Oct, 2005). Anxiety-management techniques. Psychotherapy Networker, 47-49, 56-59, 70.
Wynne, L, Watson, B., & Shields, C. (2002, May/June). A conversation with Dr. Lyman Wynne: The role of
diagnosis in family therapy. Family Therapy Magazine, 1(3), 20-25.
Grading Scale
100 to 94 points A
93 to 91
A90 to 88
B+
87 to 85
B
84 to 82
B81 to 79
78 to 75
74 to 71
70 and below
C+
C
CF