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.
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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
cognitive-behavioral social work practice
family-systems social work practice
psychodynamic social work practice.
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:
-- 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;
-- 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.
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
[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.
Hallstrom, L. (Producer/Director) (1993). What’s Eating Gilbert
Grape? [Motion picture]. United States. Paramount Pictures.
The Case of Gilbert Grape
Antonio Gonzalez-Prendes, Ph.D., ACSW
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.
…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.
Relevant Developmental/Childhood Data
Rules (“Shoulds”) / Conditional Assumptions (If…then…)
Automatic Thoughts (meaning of A.T.’s)
Father: Suicide. Depressed?
Mother: Stays home, overeats. Depressed?
“I am unlovable/insignificant/not good enough”
Rules (reflect rigid responsibility & low self-worth)
“I should attend to others”, “I must do for others”
“If I please others then I am worthwhile”
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.
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.
Presented by Dr. Arlene Weisz
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:
or sequences of interactions
Include a focus on culture and gender
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?
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?
Attempted solutions to mother’s and Arnie’s difficulties—do they really solve the problem?
What constrains people from making changes?
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
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
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
Strengthen the family hierarchy
Teach problem solving
Help the family face its grief when the time is right
Jerrold R. Brandell, Ph.D., BCD
oedipal victory/object loss
wishes and actions
seedling to grape – instantaneously
what childhood and adolescence?
mirroring, self-calming and self-soothing
who’s the selfobject here, anyway?
Gilbert and Arnie
girlfriend or dynamic therapist?
the ‘six-session solution’
psychological growth via the
treatment relationship/”holding environment”
potential pitfalls for the therapist
making unconscious conscious;“where id was, there ego shall be”
the telling and retelling of the client’s personal narrative
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
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
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
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
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)
WORK WITH THOSE FACING HEALTH-RELATED
ALL AGE LEVELS AND ALL SOCIAL WORK MODALITIES
SETTINGS INCLUDE HOSPITAL, HOSPICE, HOME CARE AGENCIES
FOCUS ON NEEDS AND CONCERNS OF OLDER ADULTS
ADDRESS AGE-RELATED STRESSORS, LIFE TRANSITIONS, LOSS ISSUES, HEALTH CHANGES