THE UNIVERSITY OF TENNESSEE COLLEGE OF SOCIAL WORK. 616 Advanced EBP for Addictions and Dual Diagnosis Treatment (3) Fall 2014

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1 THE UNIVERSITY OF TENNESSEE COLLEGE OF SOCIAL WORK 616 Advanced EBP for Addictions and Dual Diagnosis Treatment (3) Fall 2014 Instructor: R. Lyle Cooper, Ph.D., LCSW Phone: (home between 9-7 only) Office Hours: by appointment Class time: Tuesdays 5:30-7PM CST (6:30-7 EST) indicated on the outline. Code of Conduct It is the student's responsibility to have read the College of Social Work Ethical Academic and Professional Conduct Code that is in the College of Social Work MSSW Handbook ( Students are also expected to sign and adhere to the Social Work Field Placement Code of Conduct. The Honor Statement An essential feature of The University of Tennessee is a commitment to maintaining an atmosphere of intellectual integrity and academic honesty. As a student of the University, I pledge that I will neither knowingly give nor receive any inappropriate assistance in academic work, thus affirming my own personal commitment to honor and integrity. (Hilltopics). University Civility Statement Civility is genuine respect and regard for others: politeness, consideration, tact, good manners, graciousness, cordiality, affability, amiability and courteousness. Civility enhances academic freedom and integrity, and is a prerequisite to the free exchange of ideas and knowledge in the learning community. Our community consists of students, faculty, staff, alumni, and campus visitors. Community members affect each other s well-being and have a shared interest in creating and sustaining an environment where all community members and their points of view are valued and respected. Affirming the value of each member of the university community, the campus asks that all its members adhere to the principles of civility and community adopted by the campus: Disability If you need course adaptations or accommodations because of a documented disability or if you have emergency information to share, please contact The University of Tennessee Office of Disability Services at 2227 Dunford Hall (865) This will ensure that you are properly registered for services. Dimensions of Diversity The College of Social Work and the University of Tennessee welcome and honor all people. In accordance with the U.S. Council on Social Work Education and the U.S. National Association of Social Workers, the College of Social Work defines the dimensions of diversity as the intersectionality of multiple factors, including age, class, color, culture, mental or physical disability, ethnicity, gender, gender expression, gender identity, immigration status, marital status, national origin, political ideology, race, religion, sex, and sexual orientation. The College values intellectual curiosity, pursuit of knowledge, and academic freedom and integrity. A person s diverse life experiences may include oppression, poverty, marginalization, and alienation as well as privilege, power, and acclaim. The College of Social Work promotes social justice and social change, and strives to end discrimination, oppression, poverty, and other forms of social injustice.

2 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 other students. Course Rationale Co-morbid substance abuse and mental health disorders will be encountered by social workers in all areas of practice. Current research on dual diagnosis indicates integrated treatment of substance misuse and mental illness is the most effective approach to treatment. This course will provide an understanding of the intersection of multiple diagnoses, and enable social workers to effectively treat multiple diagnoses in their area of practice. Student Learning Objectives By the completion of this course, students are expected to be able to demonstrate (through course activities, assignments, and/or exams): 1. Critically analyze current models of dual diagnosis. 2. Demonstrate skill in motivational interviewing. 3. Apply theoretical knowledge to the development of case conceptualization and treatment planning with clients experiencing multiple diagnoses. 4. Select appropriate theories for use in student practice areas based on research evidence, practice experience and wisdom, and theoretical match with the population they serve. (evidence based practice, critical thinking in clinical practice). Course Description Examines the interaction of addictive and other mental health disorders. Particular focus is placed on case-conceptualization, assessment, and intervention with multiply diagnosed clients. Learning Environment This class is an online class. Combining synchronous and asynchronous sessions. 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 live and recorded lectures through BlackBoard Collaborate, discussion boards, reading assignments, and assignments involving social media. Required Texts: Mueser, K.T., Noordsby, D.L., Drake, R.E., & Fox, L. (2003). Integrated Treatment for Dual Disorders: A Guide to Effective Practice. Guilford Press: New York. 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 other students. Course Requirements:

3 EVALUATION PROCEDURES AND GRADES A(95-100) Outstanding/Superior. Exceptional Performance. Consistently exceeds expectations. B+ (90-94) Very good. Student consistently meets and occasional exceeds normal expectations for the course. B (85-89) Good. Student consistently meets normal expectations for the class. C+ (80-84) Average. There is unevenness in grasping course content. Student is inconsistent in meeting normal expectations for the course. C (75-79) Poor. There is a lack of understanding of the course content. Student does not meet course expectations. F (74 and below) Very Poor. There is a lack of attendance or incomplete assignments. Course expectations are not met. ASSIGNMENTS Discussion Boards (2 X 10%): Learners are expected to first respond to the discussion board question posted, and then read and reply to at least three of their peers posts. Please note that I will be reading the posts as you put them up, but will rarely comment. I do not comment to allow for free consideration of the ideas in the reading without looking to me for correct responses. Also, you are encouraged in these assignments to question, brain-storm, and analyze your readings. You will not be graded on the accuracy of your interpretation, but rather the depth to which you explore and apply the material. Discussion Board 1 should be posted to BlackBoard by October 24, 6PM CST, and Discussion Board 2 should be posted to BlackBoard by October 31, 6PM CST. Dual Disorder Assessment Critique(15%): Learners will find an assessment tool or protocol that could be used to assess for the presence of either substance abuse among persons suffering from mental illness OR an assessment for a particular mental illness among substance misusing clients. Learners will find at least two scholarly articles describing the application of this tool, and discuss the merits, difficulties and possible modifications that would need to be made to the tool in order to use it with your population. This paper should be no more than two pages double-spaced. This assignment should be posted to the Discussion Board by September 5, 6PM CST. Motivational Interviewing Video (25%): Learners will demonstrate motivational interviewing with a dual diagnosis that they are likely to encounter in their practice. For example, if you work in the military you may conduct an interview with a client experiencing both PTSD and alcohol abuse. This video should be no longer than 20 minutes in length. Learners will be graded using the Motivational Interviewing Treatment Integrity Code (MITI). The link to your YouTube video should be posed in the discussion board by September 26, 2013, 6PM CST. Motivational Interviewing Video Critique (10%): Learners will be assigned two peers to conduct a review of their Motivational Interviewing Video. Learners will utilize the MITI to provide a quantitative assessment of their peers adherence to MI in their videos, and will provide narrative comments on the fellow students performance. This exercise is designed to give the learner an experience of providing supervision on MI. This assignment should be posted to Discussion Board by October 3, 6PM CST. Group Presentations on Dual Diagnosis (30%): In small groups (3-5) learners will develop a 45 minute presentation on the intersection of substance misuse with a particular mental illness. The presentation should include:

4 1. A theoretical explanation of the intersection of this particular disorder that should include both neurophysiological and social understandings of this dual disorder. 2. An introduction to assessment tools used with this population. 3. A description of treatments applied to this group including, individual, group, and family interventions. 4. A discussion of the evidence supporting the interventions employed with this group. This presentation will be delivered using the BlackBoard Collaborate platform. Should learners wish to employ a different method of presentation please notify the professor well in advance of the presentation date assigned. Creativity is encouraged! You will be teaching your peers, and should take into account both the content and the process of the presentation. A more detailed description of this assignment, as well as a grading rubric for this assignment are available on the BlackBoard site. Two assignments per night will be presented during each of the last four class sessions, November 7, November 14, and November 21. August 26, 2014, COURSE OUTLINE BASICS OF DUAL DISORDERS Chapter 1: Substance Abuse and Severe mental Illness, pp Chapter 2: Principles of Integrated Treatment, pp Chapter 3: Basic Organizational Factors, pp Crawford, V., Crome, I. B., & Clancy, C. (2003). Co-existing problems of mental health and substance misuse (dual diagnosis): A literature review. Drugs: Education, Prevention and Policy, 10, S1-S74. Feltenstein, M. W., & See, R. E. (2008). The neurocircuitry of addiction: An overview. British Journal of Pharmacology, 154, Kendler, K. S. (1985). A twin study of individual with both schizophrenia and alcoholism. British Journal of Psychiatry, 147, Kessler, R. C. (2004). Impact of substance abuse on the diagnosis, course, and treatment of mood disorders: The epidemiology of dual diagnosis. Biological Psychiatry, 56, September 2, 2014 Tracy, J. I., Josiassen, R. C., & Bellack, A. S. (1995). Neuropsychology of dual diagnosis: Understanding the combined effects of schizophrenia and substance use disorders. Clinical Psychology Review, 15(2), ASSESSMENT Chapter 4: Assessment I: Detection, Classification, and Functional Assessment, pp Carey, K.B. (2002). Clinically useful assessments: Substance use and comorbid psychiatric disorders. Behaviour Research and Therapy, 40, Tiet, Q. Q., Finney, J. W., & Moos, R. H. (2008). Screening psychiatric patients for illicit drug use disorders and problems. Clinical Psychology

5 Review, 28, Vincent, P. C., Bradizza, C. M., Carey, K. B., Maisto, S. A., Stasiewicz, P. R., Connors, G. J., & Mercer, N. D. (2011). Validation of the revised Problems Assessment for Substance Using Psychiatric Patients. Addictive Behaviors, 36, September 9, 2014 Asynchronous class ASSIGNMENT: Dual Disorder Assessment Critique posted to Discussion Board by September 5, 6PM CST TREATMENT PLANNING Chapter 5: Assessment II: Functional Analysis and Treatment Planning, pp Horsfall, J., Cleary, M., Hunt, G. E., & Walter, G. (2009). Psychosocial treatments for people with co-occurring severe mental illnesses and substance use disorders (dual diagnosis): A review of empirical evidence. Harvard Review of Psychiatry, 17, Kelly, T. M., Daley, D. C., & Douaihy, A. B. (2012). Treatment of substance abusing patients with comorbid psychiatric disorders. Addictive Behaviors, 37, Lawrence-Jones, J. (2010). Dual diagnosis (drug/alcohol and mental health): Service user experiences. Practice: Social Work in Action, 22(2), September 16, 2014 Asynchronous class CASE MANAGEMENT APPROACHES Chapter 6: Stage-wise Case Management, pp Minkoff, K. (2001). Developing standards of care for individuals with cooccurring psychiatric and substance use disorders. Psychiatric Services, 52(5), Tsai, J., Bond, G. R., Salyers, M. P., Godfret, J. L., & Davis, K. E. (2010). Housing preferences and choices among adults with mental illness and substance use disorders: A qualitative study. Community Mental Health Journal, 46(4), September 23, 2014 MOTIVATIONAL INTERVIEWING Chapter 7: Motivational Interviewing, pp Miller, W.R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change. Guilford: New York.

6 Chapter 1: Why do people change? Pp Chapter 2: Ambivalence: The dilemma of Change, pp Chapter 3: Facilitating Change, pp Chapter 4: What is Motivational Interviewing? Pp BlackBoard Videos Rounder Video Ponytail Video Example of MI with Nonverbal Client NOTE: There is more video material available on BlackBoard that includes discussions by the developers of MI of the various techniques employed in MI as well as examples of micro skills. If you have time these videos are excellent learning experiences. September 30, 2014 : This class may go beyond the hour and a half allotted, and your second class is asynchronous to allow for this. October 7, 2014 Asynchronous class: MOTIVATIONAL INTERVIEWING Miller, W.R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change. Guilford: New York. Chapter 5: Change and Resistance: Opposite Sides of a Coin, pp Chapter 6: Buidling Motivation for Change, pp Chapter 7: Respnding to Change Talk, pp Chapter 8: Responding to Resistance, pp Moyers, T.B., Martin, T., Manuel, J.K., Miller, W.R., & Ernst, D. (2010). Revised Global Scales: Motivational Interviewing Treatment Integrity University of New Mexico, Center on Alcoholism, Substance abuse and Addictions. ASSIGNMENT: Motivational Interviewing Mock Video COGNTIVE BEHAVIORAL THERAPY Chapter 8: Cognitive-Behavioral Counseling, Barrowclough, C., Haddock, G., Wykes, T., Beardmore, R., Conrod, P., Craig, T., & Tarrier, N. (2010). Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomized controlled trial. BMJ: British Medical Journal, 341, Conrod, P. J., & Stewart, S. H. (2005). A critical look at dual-focused cognitive behavioral treatments for comorbid substance use and psychiatric disorders: Strengths, limitations, and future directions. Journal of Cognitive Psychotherapy: An International Quarterly, 19(3), Hides, L, Carroll, S., Catania, L., Cotton, S. M., Baker, A., Scaffidi, A., & Lubman, D.I. (2010). Outcomes of an integrated cognitive behavior therapy (CBT) treatment program for co-occurring depression and substance misuse in young people. Journal of Affective Disorders,

7 121, Hunter, S. B., Watkins, K. E., Hepner, K. A., Paddock, S. M., Ewing, B. A., Osilla, K. C., & Perry, S. (2012). Treating depression and substance use: A randomized controlled trial. Journal of Substance Abuse Treatment, 43, Kushner, M. G., Donahue, C., Sletten, S., Thuras, P., Abrams, K., Peterson, J., & Frye, B. (2006). Cognitive behavioral treatment of comorbid anxiety disorder in alcoholism treatment patients: Presentation of a prototype program and future directions. Journal of Mental Heath, 15(6), October 14, 2014 Asynchronous class ASSIGNMENT: Motivational Interviewing Video Critique, posted to Discussion Board by 6PM CST. GROUP INTERVENTIONS Chapter 9: Persuasion Groups, pp Chapter 10: Active Treatment Groups, pp Chapter 11: Social Skills Training Groups, Chapter 12: Self-Help Groups, Santa Ana, E. J., Wulfert, E., & Nietert, P. J. (2007). Efficacy of group motivational interviewing (GMI) for psychiatric inpatients with chemical dependence. Journal of Consulting and Clinical Psychology, 75(5), Timko, C., Sutkowi, A., Cronkite, R. C., Makin-Byrd, K., & Moos, R. H. (2011). Intensive referral to 12-step dual-focused mutual-help groups. Drug and Alcohol Dependence, 118, October 21, 2014 Timko, C., Sutkowi, A., & Moos, R. (2010). Patients with dual diagnoses or substance use disorders only: 12-step group participation and 1-year outcomes. Substance Use and Misuse, 45, ASSIGNMENT: Discussion Board 1: Describe possible group interventions you can employ with the clientele you serve, or plan to serve. Post to BlackBoard by October 24, 6PM CST. WORKING WITH FAMILIES Chapter 13: Family Collaboration, pp Chapter 14: Behavioral Family Therapy, Chapter 15: Multiple Family Groups, Barrowclough, C., Haddock, G., Tarrier, N., Lewis, S. W., Moring, J., O Brien, R., Schofield, N., & McGovern, J. (2001). Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. American Journal of Psychiatry, 158(10),

8 Moore, B. C. (2005). Empirically supported family and peer interventions for dual disorders. Research on Social Work Practice, 15(4), Mueser, K. T., Glynn, S. M., Cather, C., Zarate, R., Fox, L., Feldman, J., Wolfe, R., & Clark, R. E. (2009). Family intervention for cooccurring substance use and severe psychiatric disorders: Participant characteristics and correlates of initial engagement and more extended exposure in a randomized controlled trial. Addictive Behaviors, 34, October 28, 2014 Asynchronous class ASSIGNMENT: Discussion Board 2: Describe possible family interventions you can employ with the clientele you serve or plan to serve. Post to BlackBoard by October 31, 6PM CST. OTHER TREATMENT APPROACHES Chapter 16: Residential Programs and Other Housing Options, pp Chapter 17: Involuntary and Coerced Interventions, pp Chapter 18: Vocational Rehabilitation, pp Chapter 19: Psychopharmacology, pp Chapter 20: Research on Integrated Dual-Disorder Treatment This is also the Annual Program Meeting of the Council on Social Work Education (10/31-11/3). Could be a great experience, and opportunity for you to network. Maybe think about submitting one of your papers there for next year. November 4, :30-8:30 CST November 11, 2013 November 18, 2013 Synchronous Class Session, 6-8CST STUDENT PRESENTATIONS ON DUAL DIAGNOSIS STUDENT PRESENTATIONS ON DUAL DIAGNOSIS STUDENT PRESENTATIONS ON DUAL DIAGNOSIS