SPRING 2012 CNS 765: Addiction Counseling Wake Forest University Department of Counseling

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1 Instructor: Philip Clarke SPRING 2012 CNS 765: Addiction Counseling Wake Forest University Department of Counseling Time and location: Wednesdays 2-4:30PM, Tribble A105. Office hours are by appointment. Course Content : This course is an entry level introduction to substance abuse counseling, based on theory, research, and application. Thus, it is structured to provide the student with a broad array of information drawn from theoretical formulations, research findings and practical/clinical application. My goal for this class is to facilitate your learning by introducing you to such concepts as pharmacological issues and terminology, models of addiction, theories on etiology, diagnosis and assessment, and numerous evidence based treatment strategies. The emphasis of the course will be on clinical application, exploring interventions such as motivational interviewing, dialectical behavioral therapy (behavioral chaining and diary cards), relapse prevention, developmental models of addiction, group and experiential activities, family based interventions, and 12-step self-help groups. Clinical application will be taught via small lecture, cased studies, video, and/or role play. Some, but not all, applications will be practiced in class. Usually, for any given topic conceptual and theoretical information will be presented first, followed by application via case studies, video, and in-class practice. I encourage students to be actively engaged in the learning process, and participation in discussions, groups, video analyses, etc. is expected. Course Objectives: Knowledge, Skills, and Practices 1. To assist students in their understanding of problematic substance use and its extensive and multifaceted impact on the individual, family, and society. From assigned readings, class discussions, case studies, and outside class experiences, students will be able to conceptualize the variety of individuals who present with problematic substance use, verbalize and detect the signs and symptoms of substance use disorders, and be familiar with assessment devices and differential diagnostic criteria. 2. To introduce and familiarize students with the licit and illicit substances related to problematic use. Students will be able to group substances in their appropriate psychopharmacological categories and identify their medical effects and other distinct consequences. 3. To instruct students in several models and formulations of addiction, including traditional theories on etiology. Students will be familiar with the stages of change process as well as motivational strategies to handle resistance. Clinical application from a variety of perspectives will be discussed and practiced, including individual, group, family, and 12-step self-help groups.

2 4. Integrate theory, outcome research, practice, and personal experiences related to substance use and misuse for the purpose of developing your own professional stance/orientation in the field of chemical dependency counseling. Methods of instruction: The classes will be taught utilizing didactic lectures, videos, role play, guest speakers, experiential demonstrations, and discussion. Students are encouraged to actively participate in order to gain the maximum benefit. We will use a combination of class discussion, practice exercises, lectures, student presentations, and guest lecturers to engage the course material. Required Texts Brooks, F., & McHenry, B. (2009). A contemporary approach to substance abuse and addiction counseling: A counselor s guide to application and understanding. Alexandria, VA: American Counseling Association. Student performance evaluation criteria and procedures Readings, Attendance, Late Assignments, and General Etiquette Please be on time, attend class regularly, and actively participate in group discussions and presentations. Because this is graduate class, I would like instructors and students to share responsibility for learning experiences. Your enthusiasm and energy are important for your learning, your peers learning, and the overall success of the class. Although it is possible to have one excused absence and receive an A for the course, two or more missed classes will compromise your grade. If you believe you will miss more than one class this semester, you may be asked to enroll in the course at another time. The assigned readings are an important supplement to what we talk about in class; they are an important component of your learning and will help facilitate group activities, participation, and class discussion. Late assignments are subject to grade penalties. One letter grade will be deducted for each day the assignment is late (therefore, if you hand an assignment in that is considered A work 2 days late you will receive a C, if the assignment was B work, you would receive a D ). Assignments not handed in during class time are considered one day late. Cheating, submitting work other than your own, or plagiarism will result in an F in the course and will be reported to the proper University personnel. Midterm Exam Core: 1.b; 2.f; 3.b.d.g.h; 5.a.c.d.e; 8.a.e. A midterm examination will be given on March 7, The midterm will be in a multiple choice/essay format. The exam will consist of material covered in the required readings and class from the beginning of the semester.

3 Please choose one from the following two assignments Research paper (6-8 pages) Core: 1.b; 3.d.g.h; 5.d The purpose of this research paper is for you to explore in greater depth a topic in substance abuse/substance abuse counseling that you find interesting. Many students enjoy the freedom to independently explore topics that interest them, and this assignment is designed to facilitate that process. Students will be required to write a 6-8 page research paper on a topic approved by the instructor (a list of potential topics will be provided for you). For this paper, you must include at least 5 articles from professional, peer-reviewed counseling and psychology-based journals. Your tasks are to study a current issue in substance abuse today and discuss implications for treatment strategies presented in the literature. The paper should conform to APA guidelines, which can be found in the APA publication manual (6 th edition). Typically, I do not separate content from the clarity/organization of your paper. Therefore, it is important to pay close attention to grammatical issues and the neatness of your paper. In addition to the paper, the student will create a resource packet with helpful information on their topic for their peers to keep. The student will present their findings and resource packet in class at the Addictions Counseling Colloquium. Due April 18, Case Study Films and Biographies (6-8 pages) Core: 1.b; 3.b.d.f.g.h; 5.d.e.g; 8.a.e. Students will select a narrative (either biography or a movie) from the list provided to you to write up as a case study. The case study will include (a) a thorough AOD assessment of the presenting concern, including family history, risk of abuse/dependency or potential, and quantity and frequency of use, with accompanying diagnosis (b) needs/defense mechanisms, (e) relevant strengths that can be used in counseling, (f) a comprehensive treatment plan implementing short-term and long-term goals, theoretical approaches, and interventions. The case study must include terms, concepts, and ideas learned in this course as well as other counseling courses. The case study should be no longer than 8 pages. Typically, I do not separate content from the clarity/organization of your paper. Therefore, it is important to pay close attention to grammatical issues and the neatness of your paper.in addition to the paper, the student will create a resource packet with helpful information on their topic for their peers to keep. The student will present their findings and resource packet in class at the Addictions Counseling Colloquium. Due April 18, Final Exam Core: 1.b; 2.f; 3.b.d.g.h; 5.a.c.d.e; 8.a.e. An optional take-home final examination will be on distributed on May 2, 2012 and will be due by 5PM on May 7, The final will be a multiple choice/essay

4 format. The exam will consist of material covered in the required readings and class since the midterm exam. Practicum Assignments 1. You will be required to enter into an Abstinence Contract (with a Positive Behavior Addition and a list of at least 3 individuals who will support you) with yourself for the entire Fall semester wherein you will be asked to abstain from a particular food, substance, activity, behavior, etc. of your choosing, one of which has some value to you (i.e., it would be difficult for you to give up). A written contract containing your name and the item from which you have chosen to abstain for 14 weeks of the semester (form will be provided) is due to the instructor by the second week of the semester. Students will meet periodically in small in-class groups to process their experiences honoring (or not honoring) their abstinence contracts. As part of this assignment, I will assign each of you a sponsor from class who you can confide in should you have difficulties remaining abstinent. Sponsors can be available outside of the class; however, it is up to the sponsor to make the determination of providing contact information (i.e., home phone, cell phone, etc.). That is, for purposes of this class if a sponsor does not want to be available outside of class, please respect his or her choice. You will receive a Satisfactory (S) or Unsatisfactory (U) based on your completion of this outside of class requirement. Core: 1.d; 3.g.h. 2. You will be required to attend 3 open meetings of self-help support/recovery groups (or 3 meetings in addition to your home meeting if you are a person in recovery). Examples include Alcoholics Anonymous, Narcotics Anonymous, Al-Anon (for family and friends concerned about a family member s problematic use) in your area (a list of possible groups in the greater Triad area can be made available), or another group meeting, which has as its primary purpose the support of persons attempting to manage problematic substance use. A maximum of 1 of these groups can be online (e.g., rational recovery). You will receive a Satisfactory (S) or Unsatisfactory (U) based on your completion of this outside of class requirement. 3. Keep a reflective journal of your abstinence experiences and 12 step group experiences. Although daily entries are not required, they have been reported to be most helpful by previous students. The journal should be typed or neatly written and at least have one entry per week related to your abstinence and 12-Step experiences. Each entry should be roughly 250 words minimum (half of a typed, double-spaced page). I will collect the entries at the first class each month (i.e. 3 times total), thus there should be a minimum of 4 entries at each grading period worth 5 points each (15 points total). It is preferred that your journals are typed rather than hand written. Note particular difficulties you had, times it was easy to abstain, what factors led you to relapse, how you felt attending your first group meeting, etc. The reflective journal contains your own thoughts and feelings. I periodically may ask you to bring the journal and share excerpts with the class and groups. As a guideline for your journal entries, always reflect on how your experiences might parallel someone who is addicted to a

5 harder substance. The reflective journal will be turned in for credit. Please document the date of each 12-Step meeting attendance in your journal and sign your name next to the date. Core: 1.b.g; 3.f.g.h. 4. Please choose one assignment from a and b below. a. Attempt to work through the 12 steps of Alcoholics Anonymous (or Narcotics Anonymous) related to your forbidden substance, food, behavior, etc. Document your experiences through each of the 12 steps. That is, list the respective step you are working on, and the struggles, successes, surprises, etc. that accompanied you while trying to successfully achieve each step. How far did you get? What did you like/dislike about this process, and the 12 steps? Would you recommend self-help groups to your clients? This paper should be 4-5 typed, double-spaced pages using a 12-point font in Times New Roman. Due on LAST DAY of CLASS, 5/2/2012. Core: 1.d; 3.a.d.f.g.h; 6.a.d. b. Create a movie or home video or other creative project (collage, artwork, etc) that represents your experiences related to your abstinence journey. Students will have the option to permission to show their creativity to the class. This project can be as creative as you wish, but must address the abstinence experiences. Consider focusing on the developmental path of your experiences (e.g., from a difficult struggle to, relapse(s), to eventual liberation over the course of the semester). Note: If you are creating a CD or DVD (or something similar), please include a description of how the songs, videos, movies, etc. relate to your experiences. Due on LAST DAY of CLASS, 5/2/2012. Core: 1.b.g; 3.f.g.h. 5. Periodically, you will be asked to meet with your in-class sponsor to discuss your goals and progress related to your abstinence. Brief in-class assignments and topics will be provided to give direction to these meetings. The dates for these meetings are variable, and information as to when these meetings will occur will be provided in class. 6. Additional in class activities and brief homework activities may be added that expand these experiential learning opportunities. Grading Your final grade depends on the number of points you have accumulated throughout the semester. In order to pass the class and receive the grade you have earned based on your point total, you must receive a Satisfactory (S) for all outside of class experience assignments. An Unsatisfactory (U) on any outside of class experience assignment will result in an F in the class. The total number of points you can accumulate is 200. The following is a breakdown of points and the grading scale: Midterm Exam Research Paper/Case Study 50 points = 25% of final grade 70 points = 35% of final grade

6 Journal Entries 15 points total (5 per entry) + 12-Steps/Creative Project 15 points = 15% of final grade Final Exam 50 points = 25% of final grade A ( > 93%) A- (90-92%) B+ (87-89%) B (83-86%) B- (80-82%) C+ (77-79%) C (73-76%) C- (70-72%) D (60-69%) F (0-59%) Schedule of Classes and Assignments Tentative Course Outline CNS 765 Spring 2012 Please Note: Students will often meet in small groups to process outside of class experiences. I have provided this small group schedule in the outline below; however, the days and times for these groups may vary, depending on need and class availability/time. Because substance abuse is a rapidly changing and advancing field, there may be occasion to cover topics not on the syllabus, depending on the relevance of the topic to the course and students. Date Topic & Activities Readings & Assignments 1/18/2012 Welcome, course introduction, and practicum information; importance of substance use training mechanisms of action; substance classifications: short & long term effects/dangers 1/25/2012 Substance classifications, con t. Models of addiction Focus: Disease Models 2/1/2012 Dr. Masicampo: Self-regulation skills TBA Guest 12-Step facilitation Brooks & McHenry, 2009 Chapters 1-3 Abstinence Contract due Meet with sponsor Brooks & McHenry, and Chapter 12

7 2/8/2012 Models of Addiction Continued Ruth Anderson Formulations of addiction: Psychoanalytic and the addictive personality Small group discussion: abstinence 2/15/2012 Formulations of addiction: Cognitive and Behavioral Models Small group discussions: 12-steps 2/22/2012 Substance use assessment & treatment planning; diagnostic categories/criteria; signs and symptoms of problematic substance use Journal Check Brooks & McHenry, Chapter Questions Attend your first 12-step group by this date Brooks & McHenry, Chapter 4 Evans (1998) article Journal Check 2/29/2012 Assessment and treatment planning con t Assigned reading TBA 3/7/2011 MIDTERM EXAM MIDTERM EXAM 3/14/2012 SPRING BREAK SPRING BREAK 3/21/2012 Stages of client change, ambivalence; readiness to change and how people change; introduction to Motivational Interviewing MI video Small group discussions: 12-Steps 3/28/2012 Relapse prevention and the recovery process Journal Check Brooks & McHenry, Chapter 6 Miller & Rollnick Reading Attend your second 12-step group by this date Brooks & McHenry, Chapter 11 Journal Check 4/4/2012 Small group discussion Developmental model in treatment of alcoholism Dr. Brown video 1 Brooks & McHenry, Chapter 7

8 4/11/2012 Developmental model in treatment of alcoholism Dr. Brown video 2 Attend your third 12-Step group by this date 4/18/2012 Addiction Counseling Colloquium Research Paper/Case Study Projects Due: Addiction Counseling Colloquium 4/25/2012 Addiction in the family Addiction in Schools-Guest Lecturer Final Journal Check 5/2/12 Addiction in the family- Part II Where to go from here? Putting it all together and course wrap-up Practicum creative projects LAST CLASS Brooks & McHenry, Chapter 8 Assigned Reading TBA Abstinence Contract Ends Final Journal Check Brooks & McHenry, Chapter 13 (Optional) Final journals due and 12- Step/Creative Projects Due DAY of SHARING FINAL EXAM DUE by MONDAY, 5/7 AT 5:00pm Please Note: Whereas it is my intention to closely follow this syllabus/course outline, situations may occur in which we must deviate from it. The instructor reserves the right to change the syllabus/course outline as needed. Disaster Planning/Catastrophic Event: In the event that campus meetings cannot be held due to inclement weather or pandemic or other disaster, please continue with the assigned readings and adhere to due dates of assignments. If the internet is available, please send assignments to clarkepb@wfu.edu. Additionally, class materials or assignments will be ed and Professor Clarke will be available for normal office hours by or by phone. Assignments can be mailed to the Department of Counseling care of Wake Forest University, Winston Salem, NC

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