I. The Concentration in Interpersonal Practice:

1. I. The Concentration in Interpersonal Practice: One of two concentrations available to advanced year graduate students in our School – Continues two time-honored traditions: substantive and intensive education for clinical practice scholarly rigor

2. II. We offer students three tracksor options to choose from among: cognitive-behavioral social work practice family-systems social work practice psychodynamic social work practice.

3. Each of these options – is as rigorous and systematic as the other two, and in fact designed to be comparable in every major respect requires a two-term commitment, totaling eight credit hours over the academic year; students may not select one term of one track and second term of a different track is conceived as a combined human behavior and clinical methods course, and is further intended to achieve integration along several different axes:

4. -- there is an equal and consistent focus on children, adolescents, and adults in readings, lectures, and clinical case review portions of the course; -- the focus on psychopathology/dysfunction is counterbalanced by a comparable emphasis on clinical diagnostic skills, whether these are linked to the beginning, middle, or end stage of the treatment process; -- the content on clinical process dimensions is complementary to content on clinical method and technique;

5. -- clinical case reviews permit a useful integration of field experiences with didactic classroom learning; -- the variable of time and its implications for interpersonal practice are identified and brief models of treatment are elucidated; -- ethical dimensions of practice, content on human diversity, and material on socially disenfranchised, marginalized, and vulnerable populations are all accorded emphasis; -- various models or paradigms for research on aspects of clinical process and/or for the evaluation of practice are also introduced.

6. III. Howexactly did we decide on these particular three theory bases? each system is widely used in social work practice today each boasts a substantial clinical and research literature we have at least one full-time faculty member with the expertise and background We also decided that we would like to do a few things well, rather than to offer a little bit of everything

7. IV. Finally, “which theory track should I choose?” [written material to be distributed] illustration of how each of these theoretical systems works – using material from the film “Gilbert Grape” Please remember, also, that selecting one theoretical orientation doesn’t lock you into that orientation forever.

8. Behavior, Psyche, and System in “What’s Eating GilbertGrape?”Three Clinical Approaches Hallstrom, L. (Producer/Director) (1993). What’s Eating Gilbert Grape? [Motion picture]. United States. Paramount Pictures.

11. Cognitive-Behavioral Treatment & Assessment The Case of Gilbert Grape Presented by: Antonio Gonzalez-Prendes, Ph.D., ACSW

12. What is CBT? Problem-focused, present-oriented, time-limited Operates on basic assumptions: Cognition plays a central role in human adaptation Emotional disorders result primarily from: Irrational, unrealistic, biased, rigid & distorted thinking Thinking can be monitored & changed Cognitive change → clinical improvement CBT is not “positive thinking” Thoughts are just thoughts, not facts.

13. CBT maintains that … …information processing and meaning are central in determining our emotional and/or behavioral reactions. …cognitions mediate/moderate these processes and how we adapt to life’s events.

14. Cognitive Case Conceptualization(Judith Beck, 1995) Relevant Developmental/Childhood Data ↓ Core Beliefs ↓ Intermediate Beliefs ↓ ↓ Rules (“Shoulds”) / Conditional Assumptions (If…then…) ↓ Compensatory Strategies ↓ Automatic Thoughts (meaning of A.T.’s) ↓ ↓ Emotions Behaviors

15. Relevant developmental/childhood data Father: Suicide. Depressed? Mother: Stays home, overeats. Depressed? Core Beliefs “I am unlovable/insignificant/not good enough” Rules (reflect rigid responsibility & low self-worth) “I should attend to others”, “I must do for others” Conditional Assumptions “If I please others then I am worthwhile”

16. Compensatory Strategies Self-denial; passive; unemotional. Automatic thoughts (when asked what he wants) “I want to be a good person” (Contingent on pleasing others?) “I can’t do this, I can’t” Emotions & Behaviors Emotions: Shallow, flat, resigned attitude, unexpressive. Cannot bring himself to feel. Resentment, bitterness, anger? →“Beached whale” Behaviors: Does for others even when burdened. Unable to set boundaries.

17. Treatment of Gilbert Grape What does Gilbert want? How would he like to think, act, feel differently? Get the “rest of the story”. Strengths? Abilities? Awareness of his “cognitive set”. Assess validity & functionality of beliefs and rules. Evidence, alternative explanations, pros & cons, etc. Restructure rigid rules & negative core beliefs. Build new cognitive & behavioral skills. Use homework and behavioral experiments. General → Specific; Vague/abstract→ Concrete.

18. A Family Systems Perspective Presented by Dr. Arlene Weisz

19. Family Systems Understandings There are a number of different models. We are teaching an integrative approach allowing the social worker to combine the most relevant parts of different models. For example, we can look at: structure emotional systems or sequences of interactions Include a focus on culture and gender

20. Structure Are the roles working well for the family at this stage of development? Who is in charge? What are the boundaries like between individuals and between the family and the outside world?

21. Emotional systems Does the family have some strengths in terms of caring for each other? How does the family deal with loss and separation? How does the family deal with conflict and anger?

22. Sequences of interactions Attempted solutions to mother’s and Arnie’s difficulties—do they really solve the problem? What constrains people from making changes?

23. Family Systems Interventions

24. Would keep family dynamics in mind Whether meeting with whole family Or Gilbert alone (most motivated for change) Recognize that changes made by one person affect the whole family system And that an individual’s behavior makes sense in the context of the system

25. Would try to see the whole family at least once Family meetings show the family’s interactions to the social worker Rather than having an individual describe what happens at home During sessions, the family can experiment with new interactions with help from the therapist

26. Family meetings would focus on Forming an alliance with all of the family members Observing family interactions in the here and now Developing goals the whole family can agree on

27. Goals might be to: Strengthen the family hierarchy Teach problem solving Increase individuality Help the family face its grief when the time is right

28. “What’s Eating Gilbert Grape?”A Psychodynamic Perspective onClinical Assessment and Treatment Presented by Jerrold R. Brandell, Ph.D., BCD

29. Gilbert and the Mother of all Grapes oedipal victory/object loss wishes and actions seedling to grape – instantaneously

30. Gilbert’s childhood and adolescence what childhood and adolescence? mirroring, self-calming and self-soothing who’s the selfobject here, anyway? Gilbert and Arnie

31. Gilbert and the G.F. (Girlfriend) girlfriend or dynamic therapist? the defenses free association

32. Gilbert’s (hypothetical) treatment the ‘six-session solution’ psychological growth via the treatment relationship/”holding environment” potential pitfalls for the therapist

33. The process of dynamic therapy making unconscious conscious;“where id was, there ego shall be” the telling and retelling of the client’s personal narrative resistance new adaptations

34. “What’s Eating Gilbert Grape”What’s in a title?

35. SPECIAL INTEREST AREAS FOR INTERPERSONAL PRACTICE STUDENTS

36. FAMILIES-AT-RISK FOCUS ON WORK WITH THE FAMILY UNIT FOSTER FAMILY, ADOPTIVE FAMILY, AT-RISK OF SEPARATION ADDRESS ISSUES OF POVERTY, INTERACTIONAL STRESSES, DEPRESSION, CHILD MANAGEMENT CHALLENGES, VIOLENCE IMPROVE FAMILY FUNCTIONING AND DEVELOP RESOURCES

37. CHILD WELFARE FOCUS ON CHILD/ADOLESCENT AND SOME DIRECT WORK WITH THE FAMILY SEPARATION FROM FAMILY AND COPING WITH ADJUSTMENT ISSUES, BEHAVIORAL DIFFICULTIES, DEPRESSION/ANXIETY FACILITATE ADJUSTMENT, FURTHER COPING SKILLS, ASSIST WITH GREIVING, STRENGTHEN ADAPTIVE SKILLS

38. SUBSTANCE ABUSE WORK WITH ALCOHOL AND DRUG PROBLEMS; ADDRESS THEIR IMPACT ON THE INDIVIDUAL AND FAMILY/SIGNIFICANT OTHERS MAY ADDRESS DUAL DIAGNOSIS ISSUES WORK IN INPATIENT, OUTPATIENT SETTINGS; RANGE OF REHABILITATION MODELS

39. SCHOOLS WORK WITH SCHOOL PERSONNEL, TEACHERS, CHILDREN (BOTH REGULAR AND SPECIAL EDUCATION); FAMILY MEMBERS ASSESS EDUCATIONAL DISABILITIES IN CHILDREN; COMPLETE INTERVENTION PLANS TO FURTHER STUDENT LEARNING LEAD PSYCHOEDUCATIONAL GROUPS TO FURTHER STUDENT ADJUSTMENT AND EDUCATIONAL SUCCESS MAY HAVE INVOLVEMENT IN COMMUNITY WORK; DEVELOPING PARTNERSHIPS BETWEEN THE SCHOOL AND THE COMMUNITY

40. MENTAL HEALTH SOCIAL WORK TREATMENT WITH INDIVIDUALS, FAMILIES AND GROUPS; CHILD, ADOLESCENT AND ADULT CLIENTS COPING WITH A RANGE OF PSYCHOSOCIAL DIFFICULTIES DEVELOP ASSESSMENT SKILLS, CRISIS INTERVENTION SKILLS, TREATMENT SKILLS, GROUP WORK SKILLS, CASE MANAGEMENT/DISCHAARGE PLANNING SKILLS WORK IN INPATIENT/OUTPATIENT SETTINGS COMMUNITY MENTAL HEALTH AGENCIES, FAMILY SERVICE AGENCIES, HEALTH MAINTENANCE ORGANIZATIONS (HMO)

41. HEALTH CARE WORK WITH THOSE FACING HEALTH-RELATED DIFFICULTIES DISABILITY DEATH ALL AGE LEVELS AND ALL SOCIAL WORK MODALITIES SETTINGS INCLUDE HOSPITAL, HOSPICE, HOME CARE AGENCIES

42. AGING/GERONTOLOGY FOCUS ON NEEDS AND CONCERNS OF OLDER ADULTS ADDRESS AGE-RELATED STRESSORS, LIFE TRANSITIONS, LOSS ISSUES, HEALTH CHANGES