Psychology 520-01: Basic Clinical Skills Fall, 2003

 

Page overview:

 

Professor

Required texts

Course prerequisites

Course overview

Materials needed

Course requirements

Computation of grades

Base groups

Additional readings and websites

General note

READING LIST and CALENDAR

Mini-projects

Professor: Dr. Steven Meyers

Required Texts:

Westra, M. (1996). Active communication. Pacific Grove, CA: Brooks/Cole.

Morrison, J. (1995). The first interview: Revised for DSM-IV. New York: Guilford.

Hackney, H. L., & Cormier, L. S. (2001). The professional counselor: A process guide to helping (4th ed.). Boston: Allyn and Bacon.

Axline, V. M. (1969). Play therapy. New York: Ballantine Books.

 

Articles and book chapters distributed in class.

Course Prerequisites:

This course has two prerequisites: Abnormal Psychology (PSYC 201) and Theories of Personality (PSYC 342/442). You must have completed these two courses at this or another university in order to receive credit for this class. Concurrent enrollment in PSYC 442 is acceptable.

Course Overview:

This three-credit course will provide you with the didactic foundation and practical experience to develop basic clinical skills that are vital for psychotherapy. We will review relevant theory and research that will help you learn how to (a) empathically listen to clients' concerns, (b) conduct a thorough clinical interview, and (c) describe and implement a range of core interventions to ameliorate clients' presenting problems. Specific clinical skills will be discussed, applied, and practiced throughout the semester. Special emphasis will also be given to learning how to work with clients of diverse backgrounds.

Materials Needed:

You will need an audiotape recorder and at least two audiotapes for this class. If you do not already have one, I recommend that you buy a basic microcassette recorder. Microcassette recorders cost approximately $35.00 and can be purchased at the Roosevelt University bookstore or at many local stores. Please bring these materials to each class.

Course Requirements:

1. Class participation

Participation entails attending class meetings and participating in activities. During class, you will practice basic listening, interviewing, or intervention skills; therefore it is very important that you attend all sessions. Moreover, you will submit a written exercise that reflects your use of these skills at the end of each class session. These exercises will be evaluated on a three-point scale: very good ("1.0"), improvement needed ("0.5"), and absent/not turned in ("0.0"). If you receive a grade of 0.5, you have one week from the date that the assignment was returned in class to revise and resubmit to receive full credit. Be sure to submit the original copy with your revision. Revisions received after one week will not receive additional credit. These written exercises (in total) will account for 20% of your final grade.

2. Mini-projects

Mini-projects are experiential exercises that you will complete at home. Mini-projects, each of which is described in greater detail at the end of the syllabus, will allow you to practice and reflect on the clinical skills addressed in this course. Your responses to these mini-projects are to be stapled, typewritten, double-spaced, and contain 1-inch margins on all sides. Each should also include your name, the assignment date, and the assignment title. There will be 4 mini-projects during the semester; due dates are indicated on the course calendar. Mini-projects will be graded on a 10-point scale and will (in total) account for 25% of your final grade. Late submissions will be penalized at a rate of 1.5 points per day. Late submissions must be emailed to me as MS Word documents enclosed as an attachment.

3. Quizzes

There are two take-home quizzes for this course. For the first quiz, you will audiotape a 30-minute conversation with another adult (e.g., a friend, classmate, or relative) outside of class in which you will demonstrate understanding and skillful use of empathic listening skills. Afterwards, you will transcribe the audiotaped conversation (see the Morrison text, Appendix C for an example of a transcription) and will analyze your statements. A more detailed set of instructions will be provided before the quiz. This quiz will be collected on September 24 and will account for 15% of your final grade. Late quizzes will be penalized at a rate of 20 points (out of 100) per day. Late submissions must be emailed to me as MS Word documents enclosed as an attachment.

You will demonstrate understanding and skillful use of effective inquiry skills in the second quiz. On October 15, you will conduct a 30-minute interview of another student who will be acting as a "pseudo-client" during class. You will audiotape your interview, transcribe it at home, and will analyze your statements. A more detailed set of instructions will be provided before the quiz. This quiz will be collected on October 22 and will account for 15% of your final grade. Late quizzes will be penalized at a rate of 20 points (out of 100) per day. Late submissions must be emailed to me as MS Word documents enclosed as an attachment.

4. Final exam

The final exam will be an open-notes, closed-book test that is administered on December 10. You will receive a case study of a client who is experiencing psychological difficulties. From this information, you will develop treatment goals to address the client's problems and will describe and apply several treatment techniques. The final exam will account for 25% of your final grade.

Computation of Grades:

Weighted scores from each component of the class (class participation exercises, mini-projects, quizzes, and the final exam) will be added together. Numerical grades will be converted to letter grades according to the following scale. Please note that there will be absolutely no "rounding" of final scores under any circumstance. For example, a final score of 89.99 will translate into a "B" for the course.

Grade	Total Points
A	90.00 to 100
B	80.00 to 89.99
C	70.00 to 79.99
D	60.00 to 69.99
F	59.99 and below

A test grade or final grade of A implies that the student demonstrates the ability to describe and apply clinical interventions in a highly accurate and thorough manner. Moreover, these interventions (as described and applied) would be very likely to produce client behavior change. A test grade or final grade of B implies that the student demonstrates the ability to describe clinical interventions fairly accurately, but displays some deficiency in applying these therapeutic techniques in a rigorous or individualized manner. This grade generally implies that these clinical interventions (as described and applied) would probably produce client behavior change. A test grade or a final grade of C suggests that the student demonstrates the ability to summarize some aspects of relevant clinical interventions, but omits vital components of these techniques when describing and applying them. This grade generally implies that the student would likely experience significant difficulty producing client behavior change given his or her level of knowledge as evidenced by test or course performance.

I also want to inform you that I strictly follow the Registrar's policy for assigning Incompletes for this course. That is, a grade of I will only be assigned when a small portion of the total semester's work has to be completed and the student has a compelling reason why the work cannot be completed within the regular timeframe. I encourage you to withdraw from PSYC 520 if you feel that you will be unable to complete the requirements for the course within the expected timeframe. The last day to drop courses with the W grade is November 14.

In the absence of a documented, legitimate reason for missing a test or quiz, a grade of F will be assigned. Make-up exams will only be permitted in circumstances of extreme hardship; the format and content will be at the discretion of the instructor. Other assignments will not be accepted after the specified due dates or will be strictly penalized as stated previously.

Please note that you must earn a grade of B or higher in PSYC 520 to receive your Master's degree in Clinical Psychology or Clinical Professional Psychology from Roosevelt University.

Academic Dishonesty:

All students will be held to the University's standards on academic dishonesty, as described in the student handbook and planner and on the University's website. Ignorance of standards will not be accepted as an excuse. Students found guilty of academic dishonesty will receive an F for the course, and their names will be forwarded to the Student Services office.

Base Groups:

Base groups are long-term cooperative learning groups with stable membership whose primary responsibility is to provide each student the support, encouragement, and assistance they need to make academic progress. Base groups personalize the work required and the learning experience. During this course you will be part of a base group consisting of three or four participants. These base groups will stay the same during the entire course. The members of your base group should exchange phone numbers, addresses, and information about schedules as you may wish to meet outside of class.

At the beginning of each meeting, students will meet in their base groups for approximately five minutes to:

1. Congratulate each other for living through the time since last class session, and to check to see that none of their group is under undue stress.

2. Review what members have read and done since last class session. Members should be able to give a brief summary of what they have read, thought about, and done in terms of course responsibilities. They may come to class with resources they have found, or copies of work they have completed and wish to distribute to their base group members.

Base groups are available to support individual group members. If a group member arrives late, or must leave early on occasion, the group can provide information about what that student missed. In addition, members of base groups may wish to study together for the final exam in this course. Questions regarding course assignments and class sessions may be addressed in the base group; however, clarification is always available from the instructor.

All members are expected to contribute actively to the class discussions, strive to maintain effective working relationships with other participants, complete all assignments, assist group members in completing assignments as necessary, and express their ideas in discussion.

Additional Psychotherapy Readings:

The required readings in this course provide you with a basic foundation to conduct psychotherapy. However, becoming a skillful therapist is a life's work. There are many other sources that can provide you with more detailed information and pertinent examples if you are interested. Here are several places to start.

General texts

Ivey, A. E., D'Andrea, M., Ivey, M. B., & Simek-Morgan, L. (2002). Counseling and psychotherapy: A multicultural perspective (5th ed.). Boston: Allyn and Bacon.

Hutchins, D. E., & Vaught, C. C. (1997). Helping relationships and strategies (3rd ed.). Pacific Grove, CA: Brooks/Cole.

Empathic listening

Rogers, C. (1942). Counseling and psychotherapy. Boston: Houghton-Mifflin.

Rogers, C. (1961). On becoming a person. Boston: Houghton-Mifflin.

Displaying empathy with diverse clients

Aponte, J. F., Rivers, R. Y., & Wohl, J. (2000). Psychological interventions and cultural diversity (2nd ed.). Boston: Allyn and Bacon.

Ponterotto, J. G., Casas, J. M., Suzuki, L. A., & Alexander, C. M. (Eds.). (2001). Handbook of multicultural counseling (2nd ed.). Thousand Oaks, CA: Sage.

Clinical interviewing

Sullivan, H. S. (1954). The psychiatric interview. New York: Norton.

Shea, S. C. (1988). Psychiatric interviewing. Philadelphia: W. B. Saunders Company.

Psychodynamic interventions

Wachtel, P. L. (1993). Therapeutic communication: Principles and effective practice. New York: Guilford.

Basch, M. F. (1980). Doing psychotherapy. New York: Basic Books.

Cognitive interventions

Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.

Behavioral interventions

Wolpe, J. (1992). The practice of behavioral therapy (4th ed.). New York: Pergamon.

Family systems interventions

Nichols, M. P., & Schwartz, R. C. (2004). Family therapy: Concepts and methods (6th ed.). Boston: Allyn and Bacon.

Taibbi, R. (1996). Doing family therapy: Craft and creativity in clinical practice. New York: Guilford Press.

Interventions with children

Kronenberger, W. G., & Meyer, R. G. (2001). The child clinician's handbook (2nd ed.). Boston: Allyn and Bacon.

Related Websites

General Note:

I am committed to the education of each student in this course. If there is a problem that is negatively affecting your course performance, contact me immediately so that we can develop an appropriate plan to help you succeed in this class. I urge you not to wait until the end of the semester or until after an assignment is due to speak with me. I encourage you to attend my office hours or contact me by telephone, voice mail, fax, or e-mail.

READING LIST AND CALENDAR

Date	Topic	Readings and Assignments
Unit 1: Empathic Listening Skills
9/3	AN INTRODUCTION TO PSYCHOTHERAPY	Recommended: Taibbi, R. (1996). Doing family therapy: Craft and creativity in clinical practice. New York: Guilford Press, pp. 1-9.
9/10	VERBAL AND NONVERBAL COMMUNICATION	Westra, Chapters 2 to 4. Nichols, M. P. (1995). The lost art of listening. New York: Guilford, Chapters 1 and 4. Note: Mini-project 1 (Observing communication) due in class today
9/17	REFLECTION	Westra, Chapter 6 and pp. 121-127. Morrison, Chapter 3. Hackney & Cormier, Chapter 3. Note: Quiz 1 distributed in class today
9/24	DISPLAYING EMPATHY WITH DIVERSE CLIENTS	Wohl, J. (1995). Traditional individual psychotherapy with ethnic minorities. In J. F. Aponte, R. Y. Rivers, & J. Wohl (Eds.), Psychological interventions and cultural diversity (pp. 74-91). Boston: Allyn and Bacon. American Psychological Association. (1993). Guidelines for providers of psychological services to ethnic, linguistic, and culturally diverse populations. American Psychologist, 48, 45-48. American Psychological Association. (2000). Guidelines for psychotherapy with lesbian, gay, and bisexual clients. American Psychologist, 55, 1440-1451. Note: Quiz 1 collected at the beginning of class today
Unit 2: Clinical Interview Skills
10/1	QUESTIONING STRATEGIES AND AN OVERVIEW OF INTERVIEWS	Westra, Chapter 5. Morrison, Chapters 1, 2, 4, 6, 7, 10, and 17.
10/8	ASSESSING CLIENTS' PROBLEMS IN THE INTERVIEW	Morrison, Chapters 5, 8, 9, 11, 12, 13, 14, and Appendices A and B. Note: Mini-project 2 (Interviewing) due today
10/15	INTERVIEWING QUIZ	Morrison, Chapter 19 and Appendices C and E. Note: Quiz 2 administered in class today
Unit 3: Core Intervention Skills
10/22	SELECTING TARGETS AND SETTING GOALS	Hackney & Cormier, Chapters 5 and 6. Recommended: Chambless, D. L., et al. (1998). Update on empirically validated therapies, II. The Clinical Psychologist, 51(1), 3-21. Note: Quiz 2 collected at the beginning of class today
10/29	PSYCHODYNAMIC AND AFFECTIVE INTERVENTIONS	Teyber, E. (1997). Interpersonal process in psychotherapy: A relational approach (3rd ed.). Pacific Grove, CA: Brooks/Cole, Chapters 3 and 5. Morrison, Chapter 16. Hackney & Cormier, pp. 150-167.
11/5	COGNITIVE INTERVENTIONS	Hackney & Cormier, Chapter 8. Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press, Chapter 14. Note: Mini-project 3 (A-B-C-D analysis) due today
11/12	BEHAVIORAL INTERVENTIONS	Hackney & Cormier, Chapter 9.
11/19	FAMILY SYSTEMS INTERVENTIONS	Hackney & Cormier, Chapter 10. Note: Mini-project 4 (Self-monitoring) due today
11/26	THANKSGIVING	No class today.
12/3	INTERVENTIONS WITH CHILDREN	Axline, pp. 28-50, Chapters 3 to 15, and Chapter 19.
12/10	EXAM	Final exam. Closed book, open notes.

MINI-PROJECT 1:

OBSERVING COMMUNICATION AND YOUR LISTENING SKILLS

Find a place to sit where you can observe other people for about 20 minutes. A lunchroom or park is ideal because there are lots of people interacting and you will not stand out. Select two or three people and watch the way they interact. Try to label their emotions based on the behaviors you observe. Behaviors are the external actions that may provide inexact clues to emotions, so be sure to keep behaviors and feelings separate.

Are they active or listless, smiling or shouting, and so on? What does this information tell you about their emotional state? How do you know what they are feeling? Look closely and describe what clues you have about their emotions. Summarize your responses in a narrative.

Next, audiotape yourself having a discussion with another adult (e.g., a friend, classmate, or relative). Try to be as relaxed as possible; it may take a few minutes to get past the awareness of the microphone. Take turns being speaker and listener, and select topics that you are familiar with and are comfortable talking about. Record 20 minutes of conversation.

Listen to the recording as if it weren't you talking. What do you like or dislike about the sound of your voice? Are there things that you do that would make you comfortable or uncomfortable as a listener? Try not to be overly critical, and attend to both the positive and the negative. Also, play and discuss the recording with a partner or some other trusted person. Keep in mind that the other person can give only his or her own opinion. Be careful not to interrupt or defend, just listen to what the person has to say regarding your voice and how you listen. You can always take or leave their feedback; it doesn't obligate you to change. Summarize your responses in a narrative.

MINI-PROJECT 2:

INTERVIEW EXERCISE

Audiotape an interview with another adult (e.g., a friend, classmate, or relative) in which you demonstrate your understanding of questioning skills and the content of clinical interviews. You should clearly explain the purpose of the assignment to the person ("pseudo-client") whom you choose to work with. More specifically, you must ask the person if he or she would feel comfortable discussing a personal issue with you for this class for approximately 30 min. The person must consent to having this conversation audiotaped and must understand that I (and your classmates) will hear the tape. In addition, this person must be aware that you will be practicing clinical interview skills (i.e., this will not be a "normal conversation"). Remember, you will not be talking about yourself or trivial topics. Rather, the conversation must remain focused on the pseudo-client's presenting problems. Possible "presenting problems" include: psychological distress that he or she has been experiencing, conflicted feelings about his or her family, an issue that she or he has struggled with in the past, a recent crisis, and difficulties at school, work, or home.

The purpose of this exercise is to display your understanding of clinical interview techniques. This will be demonstrated by your skillful use of: (a) nonspecific open questions; (b) moderately focused open questions; (c) highly focused closed questions; (d) questions that encourage elaboration and concrete examples of the presenting problems; (e) questions that encourage clarification; (f) questions that explore the frequency, intensity, and duration of problems; and (g) systematic inquiry techniques.

In addition, it is essential that you communicate empathy during the clinical interview. This will be demonstrated by your frequent and appropriate use of: (a) verbal encouragers, (b) paraphrasing, (c) summarizing, (d) reflecting, and (e) verbal tracking.

Remember to avoid: (a) long, multiple questions; (b) leading questions; (c) "why" questions; (d) negatively phrased questions; (e) advising, (f) using psychological jargon, (g) reassuring, (h) acting like a "know-it-all," (i) using trite statements, (j) inappropriate self disclosure, (k) moralizing or judging, and (l) shifting topics when you feel uncomfortable.

Afterwards, transcribe 10 minutes of the audiotaped clinical interview. Your transcription should be typewritten and should closely follow the format provided in Appendix C of the Morrison text. In addition to recording verbal statements, note significant nonverbal behavior in parentheses. Include many comments in italics that explain how you are demonstrating effective clinical interview techniques at that particular point. Examine (but do not copy) such comments in Appendix C of the Morrison text for illustrations.

MINI-PROJECT 3:

A-B-C-D ANALYSIS AND COUNTERING INTERVENTIONS

Important: Begin working on this exercise a full week before the due date listed on the syllabus!

1. Identify a problem situation that consistently evokes strong and unpleasant feelings for you.

2. Identify and list in writing typical thoughts that you have about this situation. If this is difficult for you, ask yourself the question: "What goes through my mind during these times?" Be sure to focus on thoughts rather than emotions at this point.

3. List the specific emotions or feelings associated with these thoughts that are distressing or uncomfortable. Rate the intensity of each emotion on a scale of 1 to 10 (1 = not intense, 10 = extremely intense).

4. Examine your list of thoughts from Step 2 and categorize each thought as either "rational, true beliefs (RB)" or "irrational, false beliefs (IB)." Remember that if the belief can be supported by data, facts, or evidence and can be substantiated by an objective observer, it is an RB. If it cannot be supported, it is an IB.

5. Examine and challenge each IB that you developed and categorized in Steps 2 and 4. Use questions such as "What makes it so?" and "Where is the proof?" to challenge each of these thoughts. Write down at least two counters for each IB. Remember that a counter is a statement that contradicts the false belief, yet is a believable statement.

6. Use these counters for at least three days in actual situations. Each time that you become aware that you are starting to think an IB, whisper or think to yourself the counters that you developed to challenge that IB.

7. Identify and list any behavioral effects (changes in your actions) and emotional effects (changes in how you feel) after your consistent use of your counter statements. Re-evaluate the intensity of your feelings now and compare them to the ratings that you listed earlier in the week in Step 3.

MINI-PROJECT 4:

SELF-MONITORING AND SELF-REWARD

Important: Begin working on this exercise a full week before the due date listed on the syllabus!

1. Choose an undesirable habit or a self-defeating behavior/thought that you frequently experience and want to change. If you have trouble thinking of something to change, consider selecting a thought or behavior that if changed would make you a better therapist (e.g., reducing the number of apprehensive thoughts you have about becoming a counselor, increasing the number of open-ended questions that you use when speaking with people). Define the undesirable habit or self-defeating thought in clear terms that make it easy to count or measure. This detailed narrative describing your target behavior should also include a functional analysis (i.e., current antecedents, associated thoughts/feelings/actions, and consequences).

2. Observe, count, and record how often the undesirable habit or self-defeating behavior/thought occurs for three days. You should use a recording system that makes the most sense given the nature of the target behavior (i.e., frequency count, recording the length of time, or interval method coding as well as antecedent conditions; see Chapter 9 in Hackney & Cormier).

3. Starting on Day 4, you will also use self-reward to change your undesirable habit or self- defeating behavior/thought. First, think of a reward that you could give yourself at least once a day if you earn it. The self-reward may be verbal-symbolic, imaginal, or material. Second, determine the criteria for earning your self-reward. That is, exactly what do you have to do to earn the reward? Use self-reward in addition to the observing, counting, and recording that you did before in Step 2 for three days (i.e., Days 4, 5, and 6).

4. Make a graph (i.e., a histogram) that reflects the changes in the frequency of the target behavior across this six day period. The number of daily occurrences of the undesirable habit or self- defeating behavior/thought will be on the vertical axis of your graph. The day number (1 through 6) will be on the horizontal axis. The graph should be neatly constructed and the axes should be labeled.

5. Summarize your experience and progress using self-monitoring and self-reward in a narrative that is 2 pages in length. Discuss how the two phases (self-monitoring and self-reward) differed in terms of their impact on the target behavior. Highlight the key factors that determined whether this project worked for you. Discuss ways that the project could have had a greater impact on your behaviors. Tie your observations to relevant concepts from lecture and the text. Finally, remember to hand in your completed tally sheets (from Steps 2 and 3) and the histogram (from Step 4) with your narrative.

Last updated: August 28, 2003