UNIVERSITY OF TENNESSEE COLLEGE OF SOCIAL WORK

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1 UNIVERSITY OF TENNESSEE COLLEGE OF SOCIAL WORK SW607 Rebecca (Becky) Bolen, Ph.D. Neuroscience for Clinical Practice 2311 Dunford Hall Social Work Credit Hours I. Course Rationale To practice accountably and effectively, social workers must be able to understand their clients and their presenting issues within their clients developmental contexts. In supportive environments, individuals flourish as they progress through developmental stages and stagesalient tasks. Other environments, because of risk factors associated with them, are less supportive of wellbeing. Even so, brain plasticity provides humans with an amazing capacity to adapt to these less supportive and sometimes frankly maladaptive environments, although sometimes at great cost to themselves. Especially for young children, the costs to the developing brain of less adaptive environments are profound because their brains actually become organized around repeated experiences within these less adaptive environments. Also, genetics play a role in terms of gene expression and potential as well as gene-environment interactions in regards to these less adaptive environments. Neurophysiological changes and behaviors resulting from these earlier less adaptive environments are often conceptualized by clinicians as psychopathology or presenting problems of clients. Understanding human development as a series of processes mediated by the brain within an environment-dependent context profoundly reframes not only our understanding of our clients and their presenting problems, but also how to intervene appropriately with clients and their environments. This different understanding of human development also suggests the critical importance of effective prevention programs and social policies that promote wellbeing, as well as interventions directed at changing the larger environments of individuals. Thus, knowledge gained in this course will allow clinical social workers not only to better understand, contextualize, and assess clients and their presenting problems, but also to develop more appropriate interventions, prevention programs, or policies for working with or for the benefit of clients and for the necessary environments to support human wellbeing. II. Course Objectives Students will demonstrate understanding of fundamental principles of brain development and neurophysiological functioning. 1. Students will demonstrate understanding of fundamental principles of brain development and neurophysiological functioning. 2. Students will demonstrate an applied understanding of the role of neurophysiology in psychosocial functioning. 3. Students will demonstrate knowledge of assessment resources for evaluation of neurophysiological factors in clinical presentation and psychosocial functioning. 1

2 III. Student Learning Objectives Students will be able to: i. Identify, discuss and give examples of social neurophysiological dysfunction and disorders. ii. Analyze social neurophysiological development and functioning in clients. iii. Recommend appropriate methods of assessment for different social neurophysiological dysfunction and disorders. iv. Determine probable precursors of client social neurophysiological dysfunction. v. Propose a plan of treatment based upon principles of neurophysiology. IV. Course Description Neuroscience for clinical practice provides a neuroscience framework for understanding lifespan development, trauma, addictions and other mental health disorders, psychotropic medications, and attachment. Neurophysiologic development provides a foundation for understanding the processes of human development and how these processes are influenced by culture and the environment. This course examines on the social brain, with a special emphasis on those parts of the brain that mediate attachment and the emotions. This course reviews genetics and geneenvironment interactions, neurophysiological development across the lifespan, the effects of stress and trauma on the brain, and assessment of neurophysiological processes. V. Learning Environment This class is a blended online (partial asynchronous, partial synchronous) class. The student is a co-creator of the learning experience and environment. It is the purpose of this class to provide knowledge and access to resources that will serve as a springboard for class collaboration and group projects. The course will include recorded lectures using voice-over PowerPoint, discussion blogs, reading assignments, assignments involving social media, online activities, and online group presentations. VI. Texts Required for Course Simpkins, C. A., & Simpkins, A. M. (2013). In Neuroscience for clinicians: Evidence, models, & practice (pp ). Springer. You may purchase this book or read it online through the UTK library at Fontaine, C., & Fontaine, M. (2006). Comeback: A mother and daughter s journey through hell and back. New York: Regan Books. Recommended Books There are several excellent books that integrate neurophysiology and therapy. You will not need them for class but you might consider purchasing them for your clinical practice. They include: Cozolino, L. (2013). The neuroscience of human relationships: Attachment and the developing brain (2 nd ed.). New York, New York: W. W. Norton. 2

3 Hart, S. (2008). Brain, attachment, personality. An introduction to neuroaffective development. Karnac. Perry, B. D., & Szalavitz, M. (2006). The boy who was raised as a dog. And other stories from a child psychiatrist s notebook. New York, New York: Basic Books. Wilkinson, M. (2010). Changing minds in therapy: Emotion, attachment, trauma, and neurobiology. New York, New York: W. W. Norton. VII. University Policies CODE OF CONDUCT. It is the responsibility of the student to read the College of Social Work Ethical Academic and Professional Conduct Code located in the College of Social Work MSSW Handbook (www.utk.csw.edu). HONOR STATEMENT. The University of Tennessee maintains a commitment to an atmosphere of intellectual integrity and academic honesty. Students of the University must pledge that they neither knowingly give nor receive any inappropriate assistance in academic work (Please see Hilltopics). STUDENTS WITH DISABILITIES POLICY: For course adaptations or accommodations because of a documented disability or to share emergency information, contact The University of Tennessee Office of Disability Services at 2227 Dunford Hall (865) to ensure that you are properly registered for services. VIII. INFORMATION LITERACY/TECHNOLOGICAL RESOURCES: This course will be conducted online using Blackboard. STUDENTS MUST HAVE A WORKING KNOWLEDGE OF ALL ASPECTS OF BLACKBOARD, PARTICULARLY ACCESSING ASSIGNMENTS AND LEARNING RESOURCES, VIEWING POWERPOINT PRESENTATIONS, SUBMISSION OF ASSIGNMENTS, UTILIZING BLACKBOARD FOR GROUP WORK AND GROUP PRESENTATIONS, AND COMMUNICATION WITH THE INSTRUCTOR AND STUDENTS. In addition, students should have a working knowledge of various social media (YouTube, Facebook, itunes, etc.) and be able to incorporate these into the learning experience. This will be covered in greater detail in the first session of the course and on Blackboard IX. Course Requirements, Assignments, Assessment, and Evaluation Methods READINGS All readings other than the required texts are on the BlackBoard site for this class and can be downloaded or read from there. BLACKBOARD AND WEB SITE The content for this course is provided via a web page for each week s content. This web page is accessed via BlackBoard, which will contain the syllabus, access to the discussion board and other BlackBoard tools, and grade book. The weekly web page contains all required readings, videos, handouts, and other material. Over time, it will contain much more information that is intended to help immerse the student in the content for that week. It may 3

4 include optional synopses of recent studies, longer papers that provide complementary information, optional videos and audio clips, cartoons, or a photo gallery for each week. This is a work in progress. For this first year, you may see little more than the placeholders for this information. GRADING CRITERIA Course Criteria Points Participation 5 Build-the-Brain Exercise 20 Quiz 1 10 Quiz 2 10 Quiz 3 10 Quiz 4 10 Quiz 5 10 Assessment paper 25 Final Grade The following grading scale is used for the final grade: points A points B points B points C points C points D points D <63 points F Rubrics for Evaluation of Assignments All rubrics for evaluating assignments are posted on BlackBoard within the Assignments menu. Build-a-Brain Exercise In this exercise, which will continue throughout the semester, each group will be required to build a brain that can be displayed digitally. The group may use its combined creativity to determine how it will build this brain. It might be a physical or symbolic representation of a brain, but it has to be able to be presented in an online environment. The purpose of this exercise is to identify the relevant parts of the social brain and their relevance to human social development as well as to identify the effects of chronic stress or trauma on the different parts of the social brain. The definition of the social brain for this exercise is those parts of the brain that contribute directly or indirectly to the social (interpersonal) development of the individual. Groups may work asynchronously (not face-to-face) or synchronously (face-to-face) using online sessions or other tools available through your Groups space on BlackBoard. Grading will be based upon the group s creativity, accuracy, and thoroughness in presenting the parts of the social brain, their functions, and the effects of chronic stress and trauma on these parts. 4

5 Class Participation The online class includes both units and sections within those units. There are 5 units and 9 sections. There will be an online class for every unit, for a total of five 2-hour online classes. There will four additional 1-hour online classes for each additional section that is not the end section of a unit (i.e., sections 2, 4, 5, and 7). All online classes will be held within BlackBoard Collaborate on Thursday evenings starting at 6:30 EST. Attendance is required and your participation grade will be based upon how much you participate in the class discussion and the quality of your participation. Quizzes Five quizzes will be given during the semester. Quizzes will be given after each of the five units. A study guide is provided for each unit or section.. Assessment Assignment The primary assignment for this course is a neuroscience analysis and assessment of Mia Fontaine in the book, Comeback. You will assess her at the time she entered residential treatment, although you may use material throughout the entire book to buttress your assessment. To complete this assignment, you will need to consider Mia s behaviors, cognitions, and affect that can be interpreted from a neuroscience lens. More specifically, you will need to analyze examples in the book that provide an understanding of Mia s neurophysiological development through adolescence, considering both positive and negative factors that might have affected her development. You can consider these neural and genetic processes within developmental and/or environmental contexts. Instead of writing a paper of your assessment, you will instead do a bulleted outline of indicators or processes of more or less healthy neurophysiological development, first describing it in greater detail (although succinctly) and supporting your rationale for it, and then describing examples from the book that buttress your explanation. Make sure to underline the specific process to make sure there is no misunderstanding. It is also very important that you support your contention of why you think Mia is exhibiting that indicator or process. You will use the following format: 1. First indicator or process of more or less healthy neurophysiological development a. Succinct explanation of this neurophysiological event (with APA 6 style citations of references used) b. Examples from the book that support your assessment (pg. number, paragraph number in Comeback) 2. Second indicator or process. a. Succinct explanation. b. Examples from.. 3. Third.. For example, if the person you were assessing was a 7-year-old boy, John, who would be triggered by any presumed threat at school, even if it were minor, and enter a rage state that seemed beyond his control to calm himself, you might discuss this as follows: 1. John s rages that were triggered any time he seemed to perceive even a minor threat. 5

6 a. Given his history of severe physical abuse and witnessed domestic violence, he appears to be experiencing a hyperactived stress response. Over time, this type of hyperactivation occurs after continued threats become sensitized and then generalized (Doe, 2015; Smith, 2015), thus responding to a more minor and less relevant stressor as if the original trauma were occurring. This response is more typical of traumatized boys than traumatized girls (Adams, 2015). b. Examples i. When John was in class and another boy dropped his book, John appeared very startled and then charged the boy while yelling at him (pg. 27, par. 1) ii. When John was in residential treatment, one of the male staff told him that he would lose points because of a certain more negative behavior. John flew into a rage, saying he did not deserve to be punished, and trying to hit the staff person. After he was finally able to calm down, he was very apologetic, saying he didn t like acting like that (pg. 49, par. 2). In the previous example, the process being identified was a hyperactivated stress response. The example indicated why it was likely that he was experiencing it and what it was, and then provided a couple examples of when it seemed to occur. Better assignments will be able to identify, interpret, and support inferences for more indicators or processes. After completing this portion of the assignment, you are to include a brief plan outlining your suggested treatment strategy for Mia and support how and why it will address the issues you listed in the first part of the assignment. 6

7 SYLLABUS SUMMARY Unit Sect Content Assignments Due Due Date 1 1 Setting the Framework 2-hr. Online Session Aug. 21 Quiz 1 Aug Gene-Environment Interaction & the Social Brain 2 Gene-environment interaction 1-hr. Online Session Sept. 4 3 Social brain 2-hr. Online Session Sept. 11 Quiz 2 Sept Lifespan Development 4 Neonatal & Zero to three 5 Childhood & Adolescence 1-hr. Online Session Oct. 2 6 Adulthood 2-hr. Online Session Oct. 9 Quiz 3 Oct Stress & Trauma 7 Stress 8 Trauma 2-hr. Online Session Oct. 30 Quiz 4 Nov Treatment 2-hr. Online Session Nov. 13 Build-a-Brain Presentations Quiz 5 Nov. 20 Final Assignment Nov. 26 Note: All readings for the sections should be completed by the time of the online session for that section. For example, readings for Section 3 need to be completed by Sept.11. 7

8 UNIT & SECTION I: SETTING THE FRAMEWORK Required Readings Cozolino, L. (2013). Part 1. The emergence of social neuroscience. In The neuroscience of human relationships: Attachment and the developing brain (2 nd ed., pp. 3-33). New York, New York: W. W. Norton. Cozolino, L. (2013). Part 2. The social brain: Structures and functions. In The neuroscience of human relationships: Attachment and the developing brain (2 nd, ed., pp ). New York, New York: W. W. Norton. Optional Papers and Tutorial (based on previous knowledge of DNA, genes, chromosomes, protein, Mendellian genetics) A guide to your genome. (2008). National Human Genome Research Institute (pp. 1-16) detoyourgenome07.pdf Learn.Genetics (2009). Tour of the basics. A web-based tutorial. O Neil, D. (2008). Mendel s genetics. UNIT II: GENE-ENVIRONMENT INTERACTION AND THE SOCIAL BRAIN SECTION 2: GENETICS OVERVIEW Required Readings Jorde, L. B. (2008). Genes and genetic diseases. In Understanding Pathophysiology (4 th ed., pp , 46 50). St. Louis, MO: Elsevier Stiles, J. (2008). Chapter 2. The Gene. Evolution of a concept. In The fundamentals of brain development: Integrating nature and nurture (pp ). Cambridge, MA: Harvard University Press. Champagne, F. A. (2010). Epigenetic influence of social experiences across the lifespan. Developmental Psychobiology, Curley, J. P., Jensen, C. L., Mashoodh, R., & Champagne, F. A. (2011). Social influences on neurobiology and behavior: Epigenetic effects during development. Psychoneuroendocrinology, 36, Required Videos Learn.Genetics (2009). The epigenome at a glance. PBS Nova (2007). Ghost in your genes. Optional Web Sites Learn. Genetics (2009). Genetic disorders library. Human Genome Project. 8

9 Optional PowerPoint Slide Shows U.S. Department of Energy Genome Programs. Genomics and Its Impact on Science and Society: The Human Genome Project and Beyond. (PowerPoint slides). SECTION 3: SOCIAL BRAIN Required Readings Simpkins & Simpkins (2013). Unlocking the key to neuroscience terminology. (pp ). Simpkins & Simpkins (2013). Neurons and neurotransmitters. (pp ). Simpkins & Simpkins (2013). Brain structures. (pp ). Simpkins & Simpkins (2013). Brain pathways. (pp ). Read until the section, Fear and Stress Pathway. Simpkins, C. A., & Simpkins, A. M. (2013). Neuroplasticity and neurogenesis: Changing moment-by-moment (pp ). Springer. Coan, J. A. (2008).Chapter 11. Toward a neuroscience of attachment. In J. A. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (2 nd ed., pp ). New York, NY: Guilford. Recommended readings Heatherton, T. F. (2011). Chapter 19. Building a social brain. In A. Todorox, S. T. Fiske, & D. A. Prentice (Eds.), Social neuroscience: Toward understanding the underpinnings of the social mind (pp ). New York, NY: Oxford University Press. UNIT III. LIFESPAN APPROACH SECTION 4: NEONATAL AND 0-3 PERIODS Optional Readings If you are not very familiar with attachment theory and its propositions, I recommend reading the following materials. You will be held accountable for basic knowledge of the different types of attachment and the primary principles of attachment. Davies, D. (2010). Chapter 1. Attachment as a context of development. In Child development: A practitioner s guide (pp. 7 38). New York, NY: Guilford. Hart, S. (2011). Chapter 1: The dynamic interaction between caregiver and infant. The impact of attachment (pp. 3 37). New York, New York: W. W. Norton. Required Readings Simpkins & Simpkins (2013). Brain development through the lifespan. In Neuroscience for clinicians: Evidence, models, & practice (pp ). Springer. Read until the section, Critical and Sensitive Periods in Childhood. Hart, S. (2011). Chapter 2: The impact of dynamic interaction on brain development. The impact of attachment (pp ). New York, New York: W. W. Norton. 9

10 Gunnar, M. R., & Loman, M. M. (2011). Chapter 4. Early experience and stress regulation in human development. In D. P. Keating (Ed.), Nature and nurture in early childhood development (pp ) Cambridge, NY: Cambridge University Press. Nuñez, S. C., Roussotte, F., & Sowell, E. R. (2011). Focus on: Structural and functional brain abnormalities, fetal alcohol spectrum disorders. Applied Research & Health, 34(1), Johnston, M.,& Blue M. (2006) Chapter 6. Neurobiology of autism. In: Autism; A neurobiological disorder of early brain development. International Review of Child Neurology Series, T. Tuchman, I. Rapin, (Eds.) 80-92, London, England: Mac Keith Press. Required Video Wider than the Sky SECTION 5: CHILDHOOD AND ADOLESCENCE Required Readings Simpkins & Simpkins (2013). Brain development through the lifespan. In Neuroscience for clinicians: Evidence, models, & practice (pp ). Springer. Read from the section, Critical and Sensitive Periods in Childhood, through the section, Adolescence and Refining of the Brain. Hart, S. (2008). Chapter 11. Girls, boys, men, and women: the impact of sex hormones and environment on differences between the sexes. In Brain, attachment, personality: An introduction to neuroaffective development (pp ). London: Karnac. Steinberg, L. (2009). Should the science of adolescent brain development inform public policy? American Psychologist, Frank, C. K., & Temple, E. (2009). Chapter 15. Cultural effects on the neural basis of theory of mind. Cultural influences on brain function (pp ). New York, New York: Elsevier. Bava, S., & Tapert, S. F. (2010). Adolescent brain development and the risk for alcohol and other drug problems. Neuropsychological Review, 20, Steinberg, L. Dahl, R., Keating, D., Kupper, D. J., Masten, A. S., & Pine, D. S. (2006). The study of developmental psychopathology in adolescence: Integrating affective neuroscience with the study of context. In D. Cicchetti & D. J. Cohen, (Ed.), Developmental psychopathology: Vol. 2. Developmental neuroscience (pp ). Hoboken, NJ: John Wiley & Sons. Recommended Readings Garrett, B. (2009). Excerpt: Drugs, addiction, & reward. Brain & behavior: An introduction to biological psychology (2 nd ed., pp ) Los Angeles, CA: Sage. Required Video The teenage brain: A world of their own. PBS (video) 10

11 SECTION 6: ADULTHOOD AND OLDER ADULTHOOD Simpkins & Simpkins (2013). Brain development through the lifespan. In Neuroscience for clinicians: Evidence, models, & practice (pp ). Springer. Read from the section, The Aging Brain, through the end of the chapter. Garrett, B. (2009). Excerpt: Sexual orientation. Brain & behavior: An introduction to biological psychology (2 nd ed., pp ) Los Angeles, CA: Sage. Kempermann, G. (2006). Chapter 4. Adult neurogenesis In P. B. Baltes, P. A. Reuter- Lorenz, & F. Rosler (Eds.), Lifespan development and the brain: The perspective of biocultural co-constructivism (pp ). Cambridge, MA: Cambridge University Press. Gunning, F. M. & Brickman, A. M. (2010). Chapter 6. Structural brain changes associated with normal aging. In H. J. Alzenstein, C. F. Reynolds, & M. Fernandes (Eds.), Neuroimaging research in geriatric mental health (pp ). New York: Springer. Burke, S. N., & Barnes, C. A. (2006). Neural plasticity and the ageing brain. Neuroscience, 7, Zec., R. F., & Burkett, N. R. Chapter 8. Neuropsychology of Alzheimer s disease and other dementias. In Bush, S. S., & Martin, T. A. (Eds.), Geriatric neuropsychology: Practice essentials (pp ). New York, NY: Taylor & Francis. Required Video PBS (2002). The aging brain: Through many lives. (Video access through BlackBoard) UNIT IV. STRESS & TRAUMA SECTION 7. STRESS Gunnar, M. R., & Vazquez, D. (2006). Chapter 13. Stress neurobiology and developmental psychopathology.. In D. Cicchetti, & D. J. Cohen (Eds.), Developmental psychopathology: Vol. 2. Developmental neuroscience (p ). Hoboken, NJ: John Wiley & Sons. Green, T. L., & Darity, W. A. (2010).Under the skin: Using theories from biology and the social sciences to explore the mechanisms behind the Black-White health gap. American Journal of Public Health, (100, S1, No. 81), S36-S40. Southwick, S. M., Davis, L. L., Aikins, D. E., Rasmusson, A., Barron, J., & Morgan, C. A. (2007). Neurobiological alterations associated with PTSD. In M. J. Friedman, T. M. Keane, P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp ). New York, NY: Guilford. Champagne, F.A. & Curley, J.P. (2005). How social experiences influence the brain. Current Opinion in Neurobiology 15, Putnam, F. W. (2005). The developmental neurobiology of disrupted attachment. Lessons from animal models and child abuse research. In Berlin, L. J., Ziv, Y., Amaya-Jackson, L., & Greenberg, M. T. (Eds.), Enhancing early attachments: Theory, research, intervention, and policy (pp ). New York, NY: Guilford. 11

12 Required Video When the Bough Breaks. California Newsreel. (Video access through BlackBoard). See website at for more information. SECTION 8. TRAUMA Perry, B. D. (2008). Chapter 4. Child maltreatment: A neurodevelopmental perspective on the role of trauma and neglect in psychopathology. In T. P. Beauchaine & S. P. Hinshaw (Eds.), Child and adolescent psychopathology (pp ). Hoboken, NJ: Wiley & Sons. Mead, H. K., Beauchaine, T. P., & Shannon, K. E. (2010). Neurobiological adaptations to violence across development. Development and Psychopathology 22, Schmahl, C., Lanius, R. A., Pain, C., & Vermetten, E. (2010). Biological framework for traumatic dissociation related to early life trauma. In Lanius, R. A., Vermetten, E., & Pain, C. The impact of early life trauma on health and disease: The hidden epidemic. Cambridge University Press. van der Kolk, B. A. (2003). The neurobiology of childhood trauma and abuse. Child & Adolescent Psychiatric Clinic of North America, 12, Required Presentations Overview. Adverse Childhood Experiences Study. Academy on Violence & Abuse. Felitti, V. J., (2011). Adverse childhood experiences and their relationship to adult wellbeing and disease: Turning gold into lead. Putnam, F. W. (2011). ACEs change the landscape. Academy on Violence & Abuse Anda, R. F. (2011). A public health framework. Academy on Violence & Abuse UNIT V & SECTION 9. CLINICAL APPLICATION Simpkins & Simpkins (2013). Regulating emotions. (pp ). Read until section, Working with Interoception Sensing. Hart, S. (2011). Chapter 7: Limbic exchange: Treatment effect across therapeutic approaches. In The Impact of Attachment (pp ). New York: W. W. Norton. Siegel, D. J. (2006). An interpersonal neurobiology approach to psychotherapy. Awareness, mirror neurons, and neural plasticity in the development of wellbeing. Psychiatric Annals, 36(4), Cozolino, L. (2002). Chapter 3. Neural integration in different models of psychotherapy. In The neuroscience of psychotherapy: Building and rebuilding the human brain (pp ). New York, NY: W. W. Norton. Hart, S. Chapter 8. (2011). Intervention and neuroaffective developmental psychology. In The Impact of Attachment (pp ). New York: W. W. Norton. Recommended Readings Remainder of chapter by Simpkins & Simpkins. 12

13 CONCLUSION Figley, C. R., Lovre, C., & Figley, K. R. (2011). Compassion fatigue, vulnerability, and resilience in practitioners working with traumatized children. In V. Ardino (Ed.). Post-traumatic syndromes in childhood and adolescence: a handbook of research and practice. Boston, MA: Wiley-Blackwell. 13

UNIVERSITY OF TENNESSEE COLLEGE OF SOCIAL WORK SW607 Neuroscience for Clinical Practice 3 credit hours Fall, 2015

UNIVERSITY OF TENNESSEE COLLEGE OF SOCIAL WORK SW607 Neuroscience for Clinical Practice 3 credit hours Fall, 2015 UNIVERSITY OF TENNESSEE COLLEGE OF SOCIAL WORK SW607 Neuroscience for Clinical Practice 3 credit hours Fall, 2015 Rebecca (Becky) Bolen, Ph.D. Thursdays 202 Henson Hall 6:30 PM EST 865-974-3206 rbolen@utk.edu

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