Counselor education saint joseph college



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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: jdurham@sjc.edu

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.
P
rojected 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 - jdurham@sjc.edu

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.

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 Disorders-

IV-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:
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-North-

America. 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

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:

  • 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/


  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 ChildhoodExternalizing 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.


  1. Be able to describe the major features and etiology of ODD & Conduct Disorder.

  2. 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.

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.


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 .

  • 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

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: 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

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.


  1. Describe the typical symptom presentation of Bipolar Disorder in Children.

  2. Describe the typical symptom presentation of Bipolar Disorder in Adolescents.

  3. Discuss how are they the same/different?


Exercise # 3

  1. 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
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).

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

  1. 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:

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

  1. Find a video online that offers a good illustration one of these personality disorders and share the url with your classmates.

  2. 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


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.

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?

________________________________________________________________________________
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.

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 (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.



  • 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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