Download Diagnosis and Treatment Planning - American Counseling Association

COUNSELOR EDUCATION
SAINT JOSEPH COLLEGE
Summer 2010
COUNSELING 544.01 Diagnosis and
Treatment Planning -online
Credits: 3
Judith C. Durham, PhD, APRN, NCC, LPC,
Cell: 860 716 7266
e-mail: [email protected]
Office hours: by appointment:
Course Description: This course addresses individual diagnosis from a variety of perspectives:
biologic, developmental, cultural and interpersonal. It will provide students with a broad theoretical
base for understanding psychopathology, from not only an individual, descriptive, symptoms
perspective as presented in the DSM-IV-TR, but also from a contextual systemic perspective
including developmental hallmarks, familial patterns and socio-cultural contributors. This ability to
diagnose will form a beginning foundation for treatment planning associated with various
diagnostic categories.
Projected Learning Goals and Objectives: Students will be able to demonstrate their ability to
conceptualize and articulate the formation of a clinical case, not only from a description of present
behavior and diagnostic formulation as presented in the DSM-IV-TR, but also take into account
multiple determinants of behavior including familial patterns, defense mechanisms, developmental
hallmarks, etc. This ability to conceptualize material will also provide students with a beginning
ability to formulate treatment recommendations associated with the various diagnostic categories.
Course Policies and Methods:
This asynchronous class will be delivered online through the SJC Blackboard System. It is
expected that students complete one Class each week and posted by the final day for each class
week. Each Class has an accompanying Required Reading, Lecture and Discussion posted in the
Assignment and Discussion sections of Blackboard. Each student must respond to the professor
generated questions/exercises within the Discussion for each class and also respond to other
students answers. Professor will monitor Discussion and respond as necessary. The student’s
participation in the discussion will be 40% of the final grade. Students should expect to spend
several hours each week completing Discussion Board assignments much like one would spend
several hours each week in a summer class.
Professor will be ‘in class’, processing emails, and reading the Discussion Board
approximately twice a week. Students are encouraged to post all questions in the course Discussion
folder under the heading of "Questions to Instructor". This is so that all students may benefit
from the answers and information shared just as one would in an actual classroom setting. Please do
not email professor with general course questions, but rather put them in the Discussion folder.
If you have more personal questions, those may be sent to me directly - [email protected]
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It is recommended that students register for an account (free) at www.medscape.com as this will be
an invaluable source for diagnostic and treatment information. In conducting web based research for
class Assignments and Discussions, it is important that students evaluate the quality of the material
on the web sites by addressing questions such as:
Who is responsible for the site? When was it last updated?
Where is it housed? -and, is it a commercial site-- .com or an 'edu' or 'org' web site? or one
that includes an address like"~klonoski" which means it belongs to an individual person.
Is there a web address for asking questions about the information in the site?
How objective is the author(s)?
Grading Requirements: Each student is expected to visit the online class regularly, read the
assigned readings as scheduled, and participate in online class discussions. The Case exams are to
be submitted (in the Digital Drop Box in Blackboard) on time unless there are extenuating
circumstances that must be discussed with the instructor first. All papers must be well written and in
APA format. Professor will email Case Exams back to the student via their SJC mail box.
1. Analysis and multiaxial DSM-IV diagnosis of four case vignettes that will be posted in
the Assignments section of Blackboard. The analysis must include a differential medical
assessment , discussion of cognitive, affective and behavioral signs, symptoms and
etiologic hallmarks, as well as treatment recommendations. Students should consult
outside sources for treatment recommendations and make treatment recommendations
specific too the person, not the diagnosis. There is a great deal of information available on
the web and through the online data bases of the SJC Library:
http://www.sjc.edu/academics/library/research/databases/default.html
Students must be able to clearly articulate why they choose one diagnosis as opposed to
other possibilities. Students must integrate their assigned reading in these analyses and
cite references. What is important is not so much the correct answer, but the thinking that
guided the student in the process, and the attention to all the details of the case. These should
be about 5-7 pages in length (per case). Each worth 15% of grade. Due June 2; June 23;
July 7; July 21. Papers must be well organized, express concepts in a clear and fluid manner,
and develop ideas with enough elaboration and detail to adequately cover the subject. The
proper mechanics of writing (i.e. spelling, punctuation, verb tense) is a must.
Worth 60 % of grade; Total Points – 60, 15 for each paper.
15 points: Written using APA style of citations and referencing. Integration of all
salient information from ppt’s. and other posted material, text, and information from
web based sources.
14 points: Written using APA style of citations and referencing. Integration of essential
information from ppt’s. text, and web based information.
13 points: Written using APA style of citations and referencing. Paper is basically
accurate, although some salient information from text, ppt’s or web based sources is
missing.
12 points: Not written using APA Style, or essential information from text, ppt’s or
web based sources is missing.
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2. Participation in online discussions. Worth 40% of grade. Citations for sources (web, text,
etc.) must be included. The grading criteria for the Discussion Board is as follows:
 1 point for responding to the question
 2 points if your response integrated material from the assigned texts or online
sources
including appropriate citations.
 3 points if your response integrated information/research from the texts and
web sources including appropriate citations and URL.
 4 points—Includes all of the above done exceptionally well.
Evaluation Methods: Students will be evaluated on the quality of their work as well as their
preparation for and participation in class discussions. This means that students will need to keep up
with the required reading. Written and oral work must reflect the ability to communicate in a
professional manner at a graduate level.
Criteria for graduate level papers.
 Fluidity and clarity of expression.-ideas are expressed in a manner that clearly communicates
ideas and provides for smooth reading.
 Organization-the paper introduces and advances the central ideas in a manner that is organized
and provides clear links and transitions form topic areas.
 Elaboration and detail-the ideas presented are adequately supported and fully developed.
 Critical thinking-the writer has demonstrated skilled analysis, synthesis and scholarly critique
citing credible and appropriate, current sources from the field.
 Reference-the work uses footnotes and cites references in adherence with APA documentation
standards.
 Language-writer uses college level vocabulary and word choice.
 Grammar-writer must use standard English with appropriate spelling, punctuation, verb tense,
sentence structure etc.
All papers must be double spaced using APA format. I recommend that you consult the
American Psychological Association Publication Manual, 6th ed. (2009) (APA). Papers must be
well organized, express concepts in a clear and fluid manner, and develop ideas with enough
elaboration and detail to adequately cover the subject. The proper mechanics of writing (i.e.
spelling, punctuation, verb tense) is a must.
Required Texts:
American Psychiatric Assoc. (2000). Diagnostic and Statistical Manual of Mental DisordersIV-TR. (DSM-IV-TR). Washington: DC.
Maddux, J. E. & Winstead, B. A. (2008). Psychopathology: Foundations for
Contemporary
Understanding, 2nd ed. New Jersey: Erlbaum Associates.
COOSE ONE OF THE FOLLOWING PERSOANLITY DISORDER TEXTS:
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O’Donohue, W., Fowler, K. A., & Lilienfeld, S. O. (2007). Personality Disorders: Toward DSM-V
Los Angeles: Sage Publications.
Millon, T., Millon, C.M., Meagher, S., & Grossman, S. (2004). Personality Disorders in Modern
Life, 2nd edt. New Jersey: John Wiley & Sons, Inc.
Required Articles (posted on BB)
Nestler, E. J. (2002). From neurobiology to treatment: Progress against addiction.
Nature Neuroscience, Vol 5(Suppl), Special issue: Beyond the bench:
The practical promise of neuroscience. pp. 1076-1079.
Nestler, E. J. (2001). Molecular Neurobiology of Addiction. American Journal on Addictions,
Vol. 10, Issue 3, 201-217.
Van der Kolk, B. (2001). The psychobiology and psychopharmacology of PTSD. Human
Psychopharmacology Clinical and Experimental. Jan; Vol 16(Suppl1): S49-S64.
Van der Kolk, B.,Hostetler, A., Herron, N., & Fisler, R. E., (1994). Trauma and the
development of borderline personality disorder. Psychiatric-Clinics-of-NorthAmerica. Dec; Vol 17(4): 715-730.
Van der Kolk, B. A., & Fisler, R. E. (1994). Childhood abuse and neglect and loss of
self-regulation. Bulletin of the Menninger Clinic. Spr; Vol 58(2): 145-168.
Internet Resources
www.medscape.com excellent information, current research
http://www.webmd.com/ very understandable, user friendly, includes numerous videos.
http://www.psychpage.com/
http://www.mentalhealth.com/
http://www.emedicine.com/
http://www.dsmivtr.org/
St Joseph College Library: http://www.sjc.edu/academics/library/research/databases/default.html
http://www.medilexicon.com/medicaldictionary.php?t=39111
www.medterms.com
Course Outline
Class 1 - May 12-19: Introduction to Assessment, Mental Status Exam
Introductions, course overview, Terminology, understanding multiple frames of reference,
e.g. individual and the family, biological, cultural, developmental and socio-political/social
justice issues. Mental Status Exam & fundamentals of assessment.
Objectives:
After completing this unit the student will be able to:
 Describe multiple frames of reference regarding what contributes to disease,
dysfunction, pathology and/or symptoms.
 Use basic nomenclature (including defense mechanisms) frequently used in
Diagnosis and Assessment.
 Describe the basic components of a good assessment interview and Mental
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Status Examination.
Since this unit presents is only a brief overview of the multitude of terms that one will encounter in
process of understanding psychiatric diagnoses, students might consider purchasing a psychiatric
dictionary of terms. There are many available and any one will do. Here is an online glossary of
psychiatric terms http://en.wikipedia.org/wiki/Glossary_of_psychiatry
Required Reading:
Posted lectures and/or power points (in Course Assignments)
Maddux & Winstead, Chapt 1,2,3,4
O’Donohue, chapt 2 OR Millon, Chapt. 1, 2, 3
DSM Read pp. 819-828 in the DSM IV TR, Glossary of Technical Terms.
Mental status Exams:
http://www.psychpage.com/learning/library/assess/mse.htm
http://www.emedicine.com/med/topic3358.htm
Discussion Board Exercises: Please introduce yourself to your classmates in the folder in the
Discussion Board section of Black Board.
Exercise # 1.
1. Discuss how an eating disorder such as anorexia might develop (etiological considerations)
being influenced by the following frames of reference: family & developmental influences;
biological influences; culture & socio-political influences.
Exercise # 2.
The following are a list of examples that you are to match with the appropriate terms from a
psychiatric glossary or dictionary.
 The hand washing of Lady MacBeth.
 Laughing at a funeral.
 A child falls out of a tree and develops a fear of heights.
 Feeling spiders crawl on ones body during the D.T.’s
 Going from laughing to crying within seconds.
Exercise # 3: After reading the case posted in the Course documents section of BB (Ms Z.),
develop a hypothetical Mental Status (in paragraph form) exam on this woman. You will obviously
need to invent many of the case details. Please make your details seemingly consistent with the
information that is presented. In addition to the ones listed above, there are numerous online
resources for the mental status exam that also provide case examples. (You may work with each
other to do this exercise, via email contact. When you post your final MS exam, please list the
names of all contributors.)
Class 2: May 19-26: DSM-IV TR--Use of the manual, case examples, multiaxial diagnosing,
implications for use/abuse.
Objectives:
Following this learning unit students will:
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Be able to articulate the history of the DSM and the interface between the DSM
and the ICD.
Be able to summarize the significant changes proposed for the DSM V.
Be able to use the DSM IV TR multiaxial diagnosis system.
Be able to locate and use the DSM decision trees for various diagnostic
subgroups: substance induced disorders, psychosis, mood, anxiety, and
somatoform.
Be able to articulate the three differential diagnostic clusters for personality
disorders.
Understand the Insurance and Managed care implications diagnosing.
Required Reading:
DSM, Introduction, p. XIX-XXXVII, Use of Manual, p. 1-37, 745-759, skim p. 819-828.
Maddux & Winstead, Chapt 5, 6
Posted lectures and/or power points.
Discussion Board Exercise:
Exercise #1
Students are to read the case example (Ms S.) below and discuss (through the Discussion
Board) the appropriate strategy for determining an Axis I or Axis II diagnoses ( e.g. use of
decision trees or personality clusters or ?? ). Students are to also discuss Axis IV and V and
the rationale for their selections. It is expected that students will come to a group consensus
about the appropriate diagnostic categories for the case examples and will write this as
shown on page 35 of the DSM IV TR.
Questions to consider as you are developing you five axial diagnoses:
1. Which, if any, decision tree would you use?
2. Do you think the primary diagnosis is an Axis I or II ? Why? What is your diagnosis?
3. What factors are you considering in determining your GAF score?
Case Example:
Ms. S is a 28 year old, single operating room nurse who was brought to the ER by
her roommate following the ingestion of 15 meprobamate tablets. Her roommate was
concerned as she stated that she really wanted to die. Shortly after swallowing the tablets,
however, she induced vomiting. Now also after gastric lavage, she states that she feels
terrific and wants to go home. She is now treating you, the clinician, with a combination of
contempt and seduction.
Other relevant history is that since the age of 12, Ms S has been intermittently
preoccupied with suicidal thoughts, but this is her first attempt. Her state of mind preceding
the attempt was one of extreme anger and despair. This incident was precipitated by her
boyfriend storming out of the house, as he was fed up with her constant demands and
moodiness. She states that her boyfriend will pay for the way he treated her by storming
out.
Exercise #2: medscape.com has a great deal of information on this topic, as well as
http://www.dsmivtr.org/
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1. When is DSM V scheduled to be released?
2. What are the major proposed changes?
Class 3: May 26-June 2: Common Disorders of Childhood— Externalizing
Disorders: Biological framework for childhood disorders, family dysfunction, ADHD, ODD,
Conduct disorder, Fetal Alcohol Syndrome.
Objectives: Following this learning unit students will:
1. Be able to describe the major features and etiology of ADHD.
2. Be able to describe the major symptoms of Tourettes Syndrome.
3. Be able to describe the major features and etiology of ODD & Conduct Disorder.
4. Be able to describe the major features and etiology of Fetal Alcohol Syndrome.
First Case analysis due
Required Reading:
DSM, p. 39-134.
Maddux & Winstead, Chapt 16, 18
ADHD- http://www.nimh.nih.gov/publicat/adhd.cfm
http://www.webmd.com/video/adhd-brain-scans
http://www.thebraingym.net/addadhd.htm
Conduct Disorder:
http://mentalhealth.samhsa.gov/publications/allpubs/CA-0010/default.asp
Tourettes
http://www.youtube.com/watch?v=EuhyVHLlfXE&feature=channel
http://www.tourettesyndrome.net/tourette.htm
Fetal Alcohol Syndrome: http://www.cdc.gov/ncbddd/fas/default.htm
Posted lectures and/or powerpoints
Discussion Excerises
Excerise # 1
1. Articulate the dynamic commonality and differences between ADD, ODD, & Conduct
Disorder, including the differences in boys and girls. (This does not mean just list the symptoms as
presented in the DSM)
2. Locate and share with your classmates (on Discussion Board) websites that are helpful in
providing an in depth understanding of these diagnoses and associated treatment strategies.
Exercise # 2
1. Describe and discuss the FAS spectrum of disorders. What is the critical time in utero for
its development? How much alcohol does it take?
Exercise # 3
1. Locate websites that are helpful in your understanding of Tourettes and discuss etiological and
treatment information about this disorder.
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Class 4: June 2-9 Common Disorders of Childhood – Internalizing Disorders
School phobia, Separation Anxiety, overanxious disorder, reactive attachment disorder,
Asperger’s, and Autism.
Objectives
Following this learning unit students will:
1. Be able to describe the major features and etiology of school phobia.
2. Be able to describe the major features and etiology of separation anxiety disorder.
3. Be able to describe the major features and etiology of over anxious disorder of childhood.
4. Be able to describe the major features and etiology reactive attachment disorder.
5. Be able to describe the major features contributing to resilience.
6. Be able to describe and differentiate between the sx. of Aspergers & Autism.
Required Reading
Posted lectures and/or powerpoints
Fraiburg, Ghosts in the Nursery
http://www.traumaresources.org/emotional_trauma_online_video.htm (watch these 6 short
videos)
Maddux & Winstead, Chapt 17
Resilience- http://www.athealth.com/consumer/disorders/childresilience.html
Autism: watch video- http://autismtreatmentcenter.org/media:video,31,0
http://www.nlm.nih.gov/medlineplus/autism.html
http://www.autismtreatmentcenter.org/index.php
www.autismresearchinstitute.com
http://www.medscape.com/viewarticle/721051?src=mp&spon=12&uac=27155MN
Discussion Board Exercises:
Exercise # 1
1. Asperger's and Autism are now thought of as a ‘spectrum disorder’. What does this
mean? Describe the differences and commonality of symptoms and treatment
recommendations.
Exercise # 2
2.Using Internet Resources find information and discuss the primary different presentations
of Reactive Attachment Disorder and scenarios which might give rise to these different
presentations of this disorder. What are suggested treatment strategies?
Exercise # 3
3. What is the essential point in the Ghosts in the Nursery Article?
Class 5: June 9-16: Adolescent Disorders and Family Dysfunction
Common disorders including eating disorders & systemic issues.
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Objectives: Following this learning unit students will:
Be able to articulate how dysfunction develops as a composite of the developmental tasks of
the adolescent and the systemic family context .
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Be able to describe the common disorders of adolescence, including eating disorders.
Be able to describe treatment strategies.
Required Reading
DSM- p. 583-596.
Posted lectures and/or powerpoints
Maddux & Winstead, Chapt 12
Discussion Board Exercises:
Exercise # 1
Using Internet Resources find information on the following and respond:
1. Describe the different types of eating disorders. Do they have different etiologies? Family
dynamics?
2. What is the co-morbidity (for the individual and family) between eating disorders and other
disorders?
3. Cognitive-behavioral therapy (CBT) for eating disorders. What is the efficacy? How is it
done? What does it include?
4. Family Treatment for eating disorders: What is the purpose? How is it done? What does it
include?
5. What is the incidence of sexual abuse in individuals who develop eating disorders?
Exercise # 2
Are self mutilative behaviors in adolescents an indication of significant pathology? Discuss.
Class 6: June 16-23: Anxiety, Panic, Phobias, and Somatoform Disorders
Objectives:
Following this learning unit students will:
Be able to describe the different types of anxiety disorders.
Describe several different types of treatment for Anxiety disorders.
Second Case analysis due
Required Reading:
DSM-, p. 429-519.
Maddux & Winstead, Chapt 8, 14
Posted lectures and/or power points
http://www.webmd.com/video/too-scared-social-anxiety-disorder
http://www.webmd.com/video/generalized-anxiety-disorder
http://www.webmd.com/anxiety-panic/guide/anxiety-panic-guide-overview-facts
Resources for families:
Anxiety Disorders Association of America (ADAA) : www.adaa.org
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Northern County Psychiatric Associates : www.baltimorepsych.com
Discussion Board Exercises:
Exercise # 1 Using Internet resources, please discuss the following questions:
1. Why do you think OCD has been included in the DSM as an anxiety disorder? What
characteristics does it share with other anxiety disorders? Describe treatment
recommendations.
2. Describe the differences between generalized anxiety, social anxiety (social phobia),
and a panic attack. Discuss treatment similarities and differences.
Exercise # 2
1. Why are somatoform disorders difficult to treat? And What are the recommended forms of
treatment?
Class 7: June 23-30: Mood Disorders/ BiPolar Disorder, SAD, Cyclothymia
Biologic and socio-cultural bases for mood disorders, major depression, dysthymia,
bipolar disorders, suicide, depression in women.
Objectives:
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Following this learning unit students will:
Be able to differentiate between Dysthymia, Major Depression and Bipolar Disorder.
Be able to articulate the various etiologies of depression.
Be able to discuss the cultural variances in the presentation of depressive symptoms.
Be able to articulate the differences between BiPolar I & Bipolar II.
Be able to articulate the typical symptom picture in the presentation of Bipolar
Disorder in Children.
Be able to describe various treatment strategies for depression, including medication
and talk therapy.
Required Reading:
DSM-, p. 345-428.
Posted lectures and/or power points
Maddux & Winstead, Chapt 9,
Biology Meds & Depressionhttp://www.medscape.com/viewarticle/418726
Recurrent Depression http://www.medscape.com/viewarticle/418728
Anxiety & Depression http://www.medscape.com/viewarticle/451325_3
BiPolar Disorder test http://www.webmd.com/video/bipolar-nose-test
NPR - Mental Illness in children-( listen)
http://www.npr.org/templates/story/story.php?storyId=1439204
Discussion Board Exercises
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Exercise # 1
1. Briefly summarize the key elements of the following article and describe how this information
might be used.
Biology, Meds & Depression- http://www.medscape.com/viewarticle/418726
(you may need to copy and paste these link after you sign into medscape, rather than
try to use it as if it is live) How might you use this information?
2. Describe the gender differences in depression and how socialization influences may
effect the difference in rates. How do differences in ethnicity and culture affect the
presentation of depressive symptoms?
Exercise # 2
1. Using the text and web resources, describe the differences between Bipolar I, Bipolar II and
Cyclothymia.
2. Describe the typical symptom presentation of Bipolar Disorder in Children.
3. Describe the typical symptom presentation of Bipolar Disorder in Adolescents.
4. Discuss how are they the same/different?
Exercise # 3
5. What population group is at greatest risk for suicide? Next? Next?
Class 8: June 30- July 7: Psychotic Disorders
Schizophrenia, process-reactive, schizoaffective, schizophreniform, brief reactive
psychosis.
Third Case analysis due
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Objectives: Following this learning unit students will:
Be able to Describe the emotional, psychological and cognitive manifestations of psychosis.
Be able to articulate the positive and negative symptoms of schizophrenia.
Be able to Describe the different types of schizophrenia with their corresponding symptoms.
Be able to Describe the similarities and differences between Schizophrenia, Schizoaffective
Disorder and BiPolar Disorder.
Required Reading:
DSM- p. 297-344.
Maddux & Winstead, Chapt 11.
Watch the Movie, A Beautiful Mind
Posted lectures and/or power points
Discussion Board Exercises:
Exercise # 1
1. There are many possible etiologies to psychosis beside schizophrenia. Describe one
(different from what your classmates have described).
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Exercise # 2
Students are to watch the Movie, A Beautiful Mind and answer the following questions:
1. What symptoms did John Nash display that are characteristic of Schizophrenia?
2. Did he display both positive and negative symptoms? Describe them.
3. What symptoms did he display that are characteristic of Schizoaffective or Bipolar
Disorder?
4. What do you think would be the most accurate diagnosis for John Nash as represented in the
video. Why?
Exercise # 3
1. Have atypical antipsychotic agents revolutionized the treatment of schizophrenia?
Why/why not?
THERE ARE TWO CLASS # 9, BOTH OF WHICH ARE DATED JULY 7- 14.
STUDENTS WHOSE LAST NAMES BEGIN WITH A - K ARE TO DO THE
FIRST CLASS DISCUSSION EXERCISES; STUDENTS WHOSE LAST
NAMES BEGIN WITH L- Z ARE TO DO THE SECOND CLASS
EXERCISES. EVERYONE IS TO READ BOTH SETS OF CLASS
DISCUSSIONS.
Class 9: July 7 -14: Personality Disorders, Cluster A (Paranoid, Schizoid, Schizotypal)
Objectives:
Following this learning unit students will:
Describe and distinguish between the characteristics of each Cluster A Personality Disorder
including developmental history, cognition, defense mechanisms, and interpersonal
relationships
Required Reading:
DSM-IV, p. 629-673, 751-753. DSM p. 685-729.
Posted lectures and/or power points
Millon: Chapts 11,12,13, Review Chapt 1,2,&3. OR O’Donohue, chapt 3, 4, 5.
http://www.nlm.nih.gov/medlineplus/personalitydisorders.html
Schizoid http://www.youtube.com/watch?v=hY59VuqQGuE&feature=related
Schizotypal http://www.youtube.com/watch?v=IJRQGxvTeT8&feature=related
Paranoid http://www.youtube.com/watch?v=kw_yIamuHhQ
Discussion Board Questions:
Exercise # 1
Using web resources and the Millon or Donohue text, discuss:
1. The family dynamics which might give rise to each of these disorders.
2. How are the three personality disorders in this group similar/different from the others in
the group.
Exercise # 2
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3. Personality Disorders tend to present the greatest treatment challenges. Why, and what
does “egosyntonic” have to do with it? How are ego dystonic disorders different and
why are they somewhat easier to treat?
Class 9: July 7- 14: Personality Disorders, (con’t) Cluster C (Dependent, Obsessive
Compulsive, Passive Aggressive, & Avoidant)
Objectives:
Following this learning unit students will:
Describe and distinguish between the characteristics of each Cluster C Personality Disorder
including developmental history, cognition, defense mechanisms, and interpersonal
relationships.
Required Reading:
http://www.nlm.nih.gov/medlineplus/personalitydisorders.html
Millon, Chapts. 6,7,8 OR O’Donohue, 10,11,12,13.
Posted lectures and/or power points
Watch: http://www.youtube.com/watch?v=vIsg2V0mf6Y
http://www.youtube.com/watch?v=3Q8rzt1v6RE&feature=related
Obsessive Compulsive Personality Disorder
http://www.youtube.com/watch?v=MhSDO5ogadA&feature=related
Dependent http://www.youtube.com/watch?v=OuLv-FkC34s
Avoidant http://www.youtube.com/watch?v=OCKOQUs6wUk
Discussion Board Questions:
Exercise # 1
1. Using web resources and the Millon or Donohue text, discuss the family dynamics which
might give rise to each of these disorders.
2. How the three personality disorders in this group are similar/different from the others in
the group. Are the similarities and differences more symptomologic, developmental, or
etiologic?
Exercise # 2
1. What are the proposed DSM V changes to Personality Disorders, especially the ones
in this cluster?
Class 10: July 14 - 21: Personality Disorders, (con’t) Cluster B (Borderline, Histrionic,
Narcissistic, AntiSocial)
Final Case Analysis Due
Objectives: Following this learning unit students will:
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Describe and distinguish between the characteristics of each Cluster B Personality
Disorder including developmental history, cognition, defense mechanisms, and
interpersonal relationships
Required Reading:
Millon, Chapts. 5,9,10,14 OR O’Donohue, chapt 6,7,8,9.
Posted lectures and/or power points
http://www.nlm.nih.gov/medlineplus/personalitydisorders.html
Watch: http://www.youtube.com/watch?v=xzMVcO8unKY
Histrionic http://www.youtube.com/watch?v=8msOeHlOiTo
http://www.videojug.com/interview/histrionic-personality-disorder
Antisocial http://www.youtube.com/watch?v=4epc4A7kS2Q&feature=related
Borderline http://www.youtube.com/watch?v=WgNqw25MAug&feature=related
Narcissistic http://www.youtube.com/watch?v=f_8lE6IfZm8&feature=related
Discussion Board Questions:
Exercise # 1
1. Using web resources and the Millon or Donohue text, for each personality disorder
within this cluster, briefly describe the characteristics, etiology,
developmental/family history, and treatment considerations. You may work in pairs
or groups and do this in chart form- please sign all names to the postings.
Exercise # 2
2. Find a video online that offers a good illustration one of these personality disorders
and share the url with your classmates.
3. Pick one of these personality disorders and discuss treatment recommendations.
Class 11: July 21- 28: Dissociative Disorders, Trauma, Rape, PTSD, DID;
Substance Abuse Disorders
Impact of race, abuse, battering, sociopolitical and cultural factors.
Abuse, addiction, alcohol & other substances.
Required Reading:
DSM, p. 519-533, 463-472; 191-295.
VanderKolk, Vanderkolk & McFarlane
Posted lectures and/or power points
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Objectives: Following this learning unit students will:
Understand the difference between the experience of trauma and symptoms of
PTSD.
Understand the defensive development of dissociation and symptoms of PTSD.
Be able to describe the neurobiology of trauma.
Be able to describe how numerous diagnoses could be as a result of trauma.
Be able to describe the course or stages of alcohol dependence.
Be able to articulate the difference between abuse, addiction, and dependence.
Be able to discuss the dangers of Ecstasy use.
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Discussion Board Exercises:
Exercise # 1
1. Name as many disorders as possible that could originate from ‘Trauma’ and describe the
relationship with traumatic antecedents and whether their origin might be biologic or
psychological in nature.
Exercise # 2
2. As succinctly as possible, describe the neurobiology of trauma. What is happening in the
body and in the brain?
Exercise # 3
3. Describe the stages of alcohol dependence. What is happening physiologically?
Is the picture different in men than in women? Why?
4. Which parts of the brain and which neurotransmitters are most commonly associated with
addiction?
5. What is Naltrexone and what is the hypothesis for why it works in alcohol and other times
of addiction?
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Academic Integrity: Academic integrity is the responsibility a student assumes for honestly
representing all academic work. That responsibility implies that the student will in no way either
misrepresent her/his work or unfairly advance her/his academic status and will neither encourage
nor assist another student in doing so. Academic work includes quizzes, tests, mid—term
examinations, final examinations, research projects, take home assignments, laboratory work, and
all other forms of oral or written academic endeavor. Since this standard is inherent in the
philosophy of Saint Joseph College, it shall be upheld by all members of the community. It is the
responsibility of each member of the College to refer any perceived threat to this code to a member
of the Judicial Review Board. Questions also may be referred to a member of the Board.
Documented Disability: Important Notice to All Students: Saint Joseph College is committed to
ensure the full participation of all students in its programs. Accordingly, if a student has a
documented disability, and, as a result, needs reasonable accommodation(s) to attend, participate, or
complete course requirements, then he or she should inform the instructor at the beginning of the
course. For further information about services through Saint Joseph College for students with
disabilities, contact the Coordinator of Disability Services. To be provided with reasonable
accommodation(s) you must present appropriate full documentation of your disability to the
Coordinator of Disability Services. Please consult with your professor and contact the Coordinator
of Disability Services at 860-231-5366.
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Professional Readiness Statement The Faculty of the Counselor Education Program recognize
their ethical obligation to monitor the readiness of those wishing to enter the counseling profession.
The Ethical Code of the American Counseling Association (ACA), section F9a, F9b, holds that
counselor educators are obligated to address personal and professional limitations of students and
supervisees. Section F.9 of the ACA Code of Ethics (2005) states:
F.9.a. Evaluation
Counselors clearly state to students, prior to and throughout the training program, the levels
of competency expected, appraisal methods, and timing of evaluations for both didactic and
clinical competencies. Counselor educators provide students with ongoing performance
appraisal and evaluation feedback throughout the training program.
F.9.b. Limitations
Counselor educators, through ongoing evaluation and appraisal, are aware of and address the
inability of some students to achieve counseling competencies that might impede
performance. Counselor educators 1. assist students in securing remedial assistance when
needed, 2. seek professional consultation and document their decision to dismiss or refer
students for assistance, and 3. ensure that students have recourse in a timely manner to
address decisions to require them to seek assistance or to dismiss them and provide students
with due process according to institutional policies and procedures.
The Faculty take their ethical responsibilities stated and implied with in the ACA Code of Ethics
seriously. Therefore, the Faculty will function as an educational team to assess and monitor the
presence of any limitations that may impede a student's progress within the program and/or in the
delivery of counseling services. This assessment will address academic and non-academic
(interpersonal functioning) aspects of the student's performance. The Faculty will meet once each
semester to assess each student's progress in academic and personal development domains and make
recommendations regarding specific concerns. If a student discloses personal information to a
Faculty member, that faculty member may share that information with other appropriate faculty.
Such information will only be shared to the extent necessary to assess the student's ability to serve
in the role of a professional counselor. Faculty members may also consult each other if it is
observed that a student behaves in a manner that is inappropriate, unprofessional, and/or raises
questions regarding that student's readiness for the profession. Faculty will address issues of
readiness with individual students as detailed in the 2008-2009 Counselor Education Student
Handbook.
Policy Addressing Students' Class Attendance
Regular class attendance is expected. The three credit hour of graduate course is universally
understood to mean 45 hours of classroom work across the course of one academic semester or its
equivalent. When a grade is assigned at the end of the semester, it is taken to mean that the student
met the semester hours of classroom instruction and participation requirement. For this reason,
students are expected to attend all class sessions. The Faculty understands that there may be a rare
emergency that could have an impact on one's attendance, and it is recommended that students
notify the faculty member in advance and make appropriate arrangements for work that will be
missed. It must be clear that missing a class, regardless of the reason, does not relieve the student
of the responsibility for work missed and can have an impact on one's final grade. Missing several
classes may negatively affect a students grade. In the event of extenuating circumstances that cause
several classes are to be missed, the faculty member may draft a remedial plan that might include
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(but is not limited to) an alternate method of completing course work or the recommendation that
the course be repeated.
Additional Reading- Optional
Castillo, R. J. (1996). Culture & Mental Illness: A client centered approach. Pacific
Grove, CA: Brooks/Cole.
Clinical Handbook of Psychotropic Drugs, 13th edition. K. Bezchlibnyk-Butler & J.J.
Jeffries. Seattle: Hogrefe & Huber Pulb.
Morrison, J. (2001). DSM-IV Made Easy: The Clinicians Guide to Diagnosis. New York:
The Guilford Press.
Drug Handbook for Health Professions (2nd Edition).(2002), by Robert Kizior and Barbara
Hodgson. W.B. Saunders, Co.
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Erk, R. R. (2004). Counseling Treatment for Children and Adolescents with DSM-IV-TR
Disorders. NJ: Pearson, Merrill Prentice Hall. (Required for Coun 544.02)
James, B. (1994). Human Attachment and Trauma. Handbook for the treatment of
attachment trauma problems in children. New York: Lexington Books.
Knapp, S. E. , & Arthur E. Jongsma, Jr., A. (2002). The School Counseling and School
Social Work Treatment Planner. New York: John Wiley & Sons, Inc.
Jongsma, Jr., A., & Peterson, L.M. (2003). The Complete Adult Psychotherapy
Treatment Planner, 3rd Edition. New York: John Wiley & Sons, Inc.
•Sinacola, R.S. & Peters-Strickland, T. (2006). Basic Pharmacology for Counselors and
Psychotherapists. Boston, MA: Pearson Education, Inc.
VanderKolk, B. A. (1998). The psychology and Psychobiology of Developmental Trauma.
In A. Stoudemire. (Ed) Human Behavior; An Introduction for Medical Students.
New York: Lippencott.., pp. 383-399.
VanderKolk, B. & McFarlane, A.C. (1996). The black hole of trauma. In B.A.
VanderKolk, A. C. McFarlane, & L. Weisaeth (Edt), Traumatic Stress: The Effects
of Overwhelming Experience on Mind, Body and Society. New York: Guilford
Press., pp. 3-23.
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