I. I. The Concentration in The Concentration in Interpersonal Practice:Interpersonal Practice: One of two concentrations available to One of two concentrations available to

advanced year graduate students in our advanced year graduate students in our SchoolSchool – – Continues two time-honored Continues two time-honored traditions: traditions:

substantive and intensive education for substantive and intensive education for clinical practice clinical practice

scholarly rigorscholarly rigor

II. We offer students three II. We offer students three trackstracksor options to choose from or options to choose from among:among:

cognitive-behavioral social work cognitive-behavioral social work practicepractice

family-systems social work practicefamily-systems social work practice psychodynamic social work practice. psychodynamic social work practice.

Each of these options – Each of these options –

is as rigorous and systematic as the other two, is as rigorous and systematic as the other two, and in fact designed to be comparable in every and in fact designed to be comparable in every major respectmajor respect

requires a two-term commitment, totaling eight requires a two-term commitment, totaling eight credit hours over the academic year; students credit hours over the academic year; students may not select one term of one track and second may not select one term of one track and second term of a different track term of a different track

is conceived as a combined human behavior is conceived as a combined human behavior and clinical methods course, and is further and clinical methods course, and is further intended to achieve integration along several intended to achieve integration along several different axes: different axes:

-- there is an equal and consistent focus on -- there is an equal and consistent focus on children, adolescents, and adults in readings, children, adolescents, and adults in readings, lectures, and clinical case review portions of the lectures, and clinical case review portions of the course; course;

-- the focus on psychopathology/dysfunction is -- the focus on psychopathology/dysfunction is counterbalanced by a comparable emphasis on counterbalanced by a comparable emphasis on clinical diagnostic skills, whether these are clinical diagnostic skills, whether these are linked to the beginning, middle, or end stage of linked to the beginning, middle, or end stage of the treatment process;the treatment process;

-- the content on clinical process dimensions is -- the content on clinical process dimensions is complementary to content on clinical method complementary to content on clinical method and technique; and technique;

-- clinical case reviews permit a useful -- clinical case reviews permit a useful integration of field experiences with didactic integration of field experiences with didactic classroom learning; classroom learning;

-- the variable of time and its implications for -- the variable of time and its implications for interpersonal practice are identified and brief interpersonal practice are identified and brief models of treatment are elucidated; models of treatment are elucidated;

-- ethical dimensions of practice, content on -- ethical dimensions of practice, content on human diversity, and material on socially human diversity, and material on socially disenfranchised, marginalized, and vulnerable disenfranchised, marginalized, and vulnerable populations are all accorded emphasis; populations are all accorded emphasis;

-- various models or paradigms for research on -- various models or paradigms for research on aspects of clinical process and/or for the aspects of clinical process and/or for the evaluation of practice are also introduced. evaluation of practice are also introduced.

III.III. HowHow exactly did we decide exactly did we decide on these particular three on these particular three theory bases?theory bases?

each system is widely used in social work each system is widely used in social work practice today practice today

each boasts a substantial clinical and research each boasts a substantial clinical and research literatureliterature

we have at least one full-time faculty member we have at least one full-time faculty member with the expertise and background with the expertise and background

We also decided that we would like to do a few We also decided that we would like to do a few things well, rather than to offer a little bit of things well, rather than to offer a little bit of everythingeverything

IV.IV. Finally, “which theory Finally, “which theory track should I choose?” track should I choose?”

[written material to be distributed][written material to be distributed]illustration of how each of these theoretical illustration of how each of these theoretical

systems works – using material from the systems works – using material from the film “Gilbert Grape”film “Gilbert Grape”

Please remember, also, that selecting Please remember, also, that selecting one theoretical orientation doesn’t one theoretical orientation doesn’t lock you into that orientation lock you into that orientation forever.forever.

Behavior, Psyche, and Behavior, Psyche, and System in “What’s Eating System in “What’s Eating GilbertGilbert Grape?”Grape?”

Three Clinical ApproachesThree Clinical Approaches

Hallstrom, L. (Producer/Director) (1993).Hallstrom, L. (Producer/Director) (1993). What’s Eating Gilbert What’s Eating Gilbert

Grape? Grape? [Motion picture]. United States. Paramount Pictures[Motion picture]. United States. Paramount Pictures ..

Cognitive-Behavioral Cognitive-Behavioral Treatment & Treatment & AssessmentAssessmentThe Case of Gilbert GrapeThe Case of Gilbert Grape

Presented by:Presented by:

Antonio Gonzalez-Prendes, Ph.D., ACSWAntonio Gonzalez-Prendes, Ph.D., ACSW

What is CBT?What is CBT?

Problem-focused, present-oriented, time-limitedProblem-focused, present-oriented, time-limited

Operates on basic assumptionsOperates on basic assumptions:: Cognition plays a central role in human adaptationCognition plays a central role in human adaptation Emotional disorders result primarily from:Emotional disorders result primarily from:

Irrational, unrealistic, biased, rigid & distorted thinkingIrrational, unrealistic, biased, rigid & distorted thinking Thinking can be monitored & changed Thinking can be monitored & changed Cognitive change Cognitive change → clinical improvement→ clinical improvement

CBT is not “positive thinking”CBT is not “positive thinking”

Thoughts are just thoughts, not facts.Thoughts are just thoughts, not facts.

CBT maintains that …CBT maintains that …

……information processing information processing and and meaningmeaning are are central in determining our emotional and/or central in determining our emotional and/or behavioral reactions.behavioral reactions.

……cognitions mediate/moderate these processes cognitions mediate/moderate these processes and how we adapt to life’s events. and how we adapt to life’s events.

Cognitive Case ConceptualizationCognitive Case Conceptualization(Judith Beck, 1995)(Judith Beck, 1995)

Relevant Developmental/Childhood DataRelevant Developmental/Childhood Data↓↓

Core BeliefsCore Beliefs↓↓

Intermediate BeliefsIntermediate Beliefs↓ ↓↓ ↓

Rules (“Shoulds”) / Conditional Assumptions (If…then…)Rules (“Shoulds”) / Conditional Assumptions (If…then…)↓↓

Compensatory StrategiesCompensatory Strategies↓↓

Automatic Thoughts (meaning of A.T.’s)Automatic Thoughts (meaning of A.T.’s)↓ ↓↓ ↓

Emotions BehaviorsEmotions Behaviors

Relevant developmental/childhood dataRelevant developmental/childhood data Father: Suicide. Depressed?Father: Suicide. Depressed? Mother: Stays home, overeats. Depressed?Mother: Stays home, overeats. Depressed?

Core BeliefsCore Beliefs ““I am unlovable/insignificant/not good enough”I am unlovable/insignificant/not good enough”

RulesRules (reflect rigid responsibility & low self-worth) (reflect rigid responsibility & low self-worth) ““I should attend to others”, “I must do for others”I should attend to others”, “I must do for others”

Conditional AssumptionsConditional Assumptions ““If I please others then I am worthwhile”If I please others then I am worthwhile”

Compensatory StrategiesCompensatory Strategies Self-denial; passive; unemotional.Self-denial; passive; unemotional.

Automatic thoughtsAutomatic thoughts ( (when asked what he wantswhen asked what he wants)) ““I want to be a good person” (Contingent on pleasing I want to be a good person” (Contingent on pleasing

others?)others?) ““I can’t do this, I can’t”I can’t do this, I can’t”

Emotions & BehaviorsEmotions & Behaviors EmotionsEmotions: Shallow, flat, resigned attitude, : Shallow, flat, resigned attitude,

unexpressive. Cannot bring himself to feel. unexpressive. Cannot bring himself to feel. Resentment, bitterness, anger? Resentment, bitterness, anger? →→ “Beached whale”“Beached whale” BehaviorsBehaviors: Does for others even when burdened. : Does for others even when burdened.

Unable to set boundaries. Unable to set boundaries.

Treatment of Gilbert GrapeTreatment of Gilbert Grape What does Gilbert want? How would he like to What does Gilbert want? How would he like to

think, act, feel differently?think, act, feel differently? Get the “rest of the story”. Strengths? Abilities?Get the “rest of the story”. Strengths? Abilities? Awareness of his “cognitive set”.Awareness of his “cognitive set”. Assess validity & functionality of beliefs and Assess validity & functionality of beliefs and

rules.rules. Evidence, alternative explanations, pros & cons, etc. Evidence, alternative explanations, pros & cons, etc.

Restructure rigid rules & negative core beliefs.Restructure rigid rules & negative core beliefs. Build new cognitive & behavioral skills.Build new cognitive & behavioral skills. Use homework and behavioral experiments.Use homework and behavioral experiments. General General → → SSpecific; Vague/abstractpecific; Vague/abstract→ → CConcrete. oncrete.

A Family Systems A Family Systems PerspectivePerspective

Presented by Dr. Arlene WeiszPresented by Dr. Arlene Weisz

Family Systems Family Systems UnderstandingsUnderstandings

There are a number of different models.There are a number of different models. We are teaching an integrative approachWe are teaching an integrative approach

allowing the social worker to combine the most allowing the social worker to combine the most relevant parts of different models.relevant parts of different models.

For example, we can look at: For example, we can look at: structurestructure emotional systems emotional systems or sequences of interactions or sequences of interactions

Include a focus on culture and genderInclude a focus on culture and gender

StructureStructure Are the roles working well for the Are the roles working well for the

family at this stage of family at this stage of development?development?

Who is in charge?Who is in charge? What are the boundaries like What are the boundaries like

between individuals and between between individuals and between the family and the outside world?the family and the outside world?

Emotional systemsEmotional systems Does the family have some Does the family have some

strengths in terms of caring for strengths in terms of caring for each other?each other?

How does the family deal with loss How does the family deal with loss and separation?and separation?

How does the family deal with How does the family deal with conflict and anger?conflict and anger?

Sequences of Sequences of interactionsinteractions

Attempted solutions to mother’s Attempted solutions to mother’s and Arnie’s difficulties—do they and Arnie’s difficulties—do they really solve the problem?really solve the problem?

What constrains people from What constrains people from making changes?making changes?

Family Systems Family Systems InterventionsInterventions

Would keep family Would keep family dynamics in minddynamics in mind Whether meeting with whole family Whether meeting with whole family Or Gilbert alone (most motivated for Or Gilbert alone (most motivated for

change)change) Recognize that changes made by one Recognize that changes made by one

person affect the whole family systemperson affect the whole family system And that an individual’s behavior makes And that an individual’s behavior makes

sense in the context of the systemsense in the context of the system

Would try to see the whole Would try to see the whole family at least oncefamily at least once Family meetings show the family’s Family meetings show the family’s

interactions to the social workerinteractions to the social worker Rather than having an individual Rather than having an individual

describe what happens at homedescribe what happens at home During sessions, the family can During sessions, the family can

experiment with new interactions with experiment with new interactions with help from the therapisthelp from the therapist

Family meetings would Family meetings would focus onfocus on

Forming an alliance with all of the Forming an alliance with all of the family membersfamily members

Observing family interactions in Observing family interactions in the here and nowthe here and now

Developing goals the whole family Developing goals the whole family can agree oncan agree on

Goals might be to: Goals might be to: Strengthen the family hierarchyStrengthen the family hierarchy Teach problem solvingTeach problem solving Increase individualityIncrease individuality Help the family face its grief Help the family face its grief

when the time is rightwhen the time is right

““What’s Eating Gilbert What’s Eating Gilbert Grape?”Grape?” A Psychodynamic Perspective onA Psychodynamic Perspective onClinical Assessment and TreatmentClinical Assessment and Treatment

Presented by Presented by

Jerrold R. Brandell, Ph.D., Jerrold R. Brandell, Ph.D., BCDBCD

Gilbert and the Mother of all Gilbert and the Mother of all GrapesGrapes

oedipal victory/object lossoedipal victory/object loss wishes and actionswishes and actions seedling to grape – instantaneouslyseedling to grape – instantaneously

Gilbert’s childhood and Gilbert’s childhood and adolescenceadolescence

what what childhood and adolescence?childhood and adolescence? mirroring, self-calming and self-soothingmirroring, self-calming and self-soothing who’s the who’s the selfobjectselfobject here, anyway? here, anyway? Gilbert and ArnieGilbert and Arnie

Gilbert and the G.F. Gilbert and the G.F. (Girlfriend)(Girlfriend)

girlfriend or dynamic therapist?girlfriend or dynamic therapist? the defensesthe defenses free associationfree association

Gilbert’s (hypothetical) Gilbert’s (hypothetical) treatmenttreatment

the ‘six-session solution’ the ‘six-session solution’ psychological growth via thepsychological growth via the

treatment relationship/”holding treatment relationship/”holding environment” environment”

potential pitfalls for the therapistpotential pitfalls for the therapist

The process of dynamic The process of dynamic therapytherapy

making unconscious conscious;making unconscious conscious; “where “where id was, there ego shall be”id was, there ego shall be”

the telling and retelling of the client’s the telling and retelling of the client’s personal narrativepersonal narrative

resistanceresistance new adaptationsnew adaptations

““What’s Eating Gilbert What’s Eating Gilbert Grape”Grape”

What’s in a title?What’s in a title?

SPECIAL INTEREST SPECIAL INTEREST AREAS FOR AREAS FOR INTERPERSONAL INTERPERSONAL PRACTICE STUDENTSPRACTICE STUDENTS

FAMILIES-AT-RISKFAMILIES-AT-RISK FOCUS ON WORK WITH THE FAMILY UNITFOCUS ON WORK WITH THE FAMILY UNIT

FOSTER FAMILY, ADOPTIVE FAMILY, AT-RISK FOSTER FAMILY, ADOPTIVE FAMILY, AT-RISK OF SEPARATIONOF SEPARATION

ADDRESS ISSUES OF POVERTY, ADDRESS ISSUES OF POVERTY, INTERACTIONAL STRESSES, DEPRESSION, INTERACTIONAL STRESSES, DEPRESSION, CHILD MANAGEMENT CHALLENGES, CHILD MANAGEMENT CHALLENGES, VIOLENCEVIOLENCE

IMPROVE FAMILY FUNCTIONING AND IMPROVE FAMILY FUNCTIONING AND DEVELOP RESOURCESDEVELOP RESOURCES

CHILD WELFARECHILD WELFARE

FOCUS ON CHILD/ADOLESCENT AND SOME FOCUS ON CHILD/ADOLESCENT AND SOME DIRECT WORK WITH THE FAMILYDIRECT WORK WITH THE FAMILY

SEPARATION FROM FAMILY AND COPING SEPARATION FROM FAMILY AND COPING WITH ADJUSTMENT ISSUES, BEHAVIORAL WITH ADJUSTMENT ISSUES, BEHAVIORAL DIFFICULTIES, DEPRESSION/ANXIETYDIFFICULTIES, DEPRESSION/ANXIETY

FACILITATE ADJUSTMENT, FURTHER COPING FACILITATE ADJUSTMENT, FURTHER COPING SKILLS, ASSIST WITH GREIVING, STRENGTHEN SKILLS, ASSIST WITH GREIVING, STRENGTHEN ADAPTIVE SKILLSADAPTIVE SKILLS

SUBSTANCE ABUSESUBSTANCE ABUSE

WORK WITH ALCOHOL AND DRUG PROBLEMS; WORK WITH ALCOHOL AND DRUG PROBLEMS; ADDRESS THEIR IMPACT ON THE INDIVIDUAL ADDRESS THEIR IMPACT ON THE INDIVIDUAL AND FAMILY/SIGNIFICANT OTHERSAND FAMILY/SIGNIFICANT OTHERS

MAY ADDRESS DUAL DIAGNOSIS ISSUESMAY ADDRESS DUAL DIAGNOSIS ISSUES

WORK IN INPATIENT, OUTPATIENT SETTINGS; WORK IN INPATIENT, OUTPATIENT SETTINGS; RANGE OF REHABILITATION MODELSRANGE OF REHABILITATION MODELS

SCHOOLSSCHOOLS WORK WITH SCHOOL PERSONNEL, TEACHERS, CHILDREN WORK WITH SCHOOL PERSONNEL, TEACHERS, CHILDREN

(BOTH REGULAR AND SPECIAL EDUCATION); FAMILY (BOTH REGULAR AND SPECIAL EDUCATION); FAMILY MEMBERSMEMBERS

ASSESS EDUCATIONAL DISABILITIES IN CHILDREN; ASSESS EDUCATIONAL DISABILITIES IN CHILDREN; COMPLETE INTERVENTION PLANS TO FURTHER STUDENT COMPLETE INTERVENTION PLANS TO FURTHER STUDENT LEARNINGLEARNING

LEAD PSYCHOEDUCATIONAL GROUPS TO FURTHER LEAD PSYCHOEDUCATIONAL GROUPS TO FURTHER STUDENT ADJUSTMENT AND EDUCATIONAL SUCCESSSTUDENT ADJUSTMENT AND EDUCATIONAL SUCCESS

MAY HAVE INVOLVEMENT IN COMMUNITY WORK; MAY HAVE INVOLVEMENT IN COMMUNITY WORK; DEVELOPING PARTNERSHIPS BETWEEN THE SCHOOL DEVELOPING PARTNERSHIPS BETWEEN THE SCHOOL AND THE COMMUNITYAND THE COMMUNITY

MENTAL HEALTHMENTAL HEALTH SOCIAL WORK TREATMENT WITH INDIVIDUALS, FAMILIES SOCIAL WORK TREATMENT WITH INDIVIDUALS, FAMILIES

AND GROUPS; CHILD, ADOLESCENT AND ADULT CLIENTS AND GROUPS; CHILD, ADOLESCENT AND ADULT CLIENTS COPING WITH A RANGE OF PSYCHOSOCIAL DIFFICULTIESCOPING WITH A RANGE OF PSYCHOSOCIAL DIFFICULTIES

DEVELOP ASSESSMENT SKILLS, CRISIS INTERVENTION DEVELOP ASSESSMENT SKILLS, CRISIS INTERVENTION SKILLS, TREATMENT SKILLS, GROUP WORK SKILLS, SKILLS, TREATMENT SKILLS, GROUP WORK SKILLS, CASE MANAGEMENT/DISCHAARGE PLANNING SKILLSCASE MANAGEMENT/DISCHAARGE PLANNING SKILLS

WORK IN INPATIENT/OUTPATIENT SETTINGSWORK IN INPATIENT/OUTPATIENT SETTINGS

COMMUNITY MENTAL HEALTH AGENCIES, FAMILY COMMUNITY MENTAL HEALTH AGENCIES, FAMILY SERVICE AGENCIES, HEALTH MAINTENANCE SERVICE AGENCIES, HEALTH MAINTENANCE ORGANIZATIONS (HMO)ORGANIZATIONS (HMO)

HEALTH CAREHEALTH CARE

WORK WITH THOSE FACING HEALTH-WORK WITH THOSE FACING HEALTH-RELATED RELATED

DIFFICULTIESDIFFICULTIES DISABILITYDISABILITY DEATHDEATH

ALL AGE LEVELS AND ALL SOCIAL ALL AGE LEVELS AND ALL SOCIAL WORK MODALITIESWORK MODALITIES

SETTINGS INCLUDE HOSPITAL, SETTINGS INCLUDE HOSPITAL, HOSPICE, HOME CARE AGENCIESHOSPICE, HOME CARE AGENCIES

AGING/GERONTOLOGYAGING/GERONTOLOGY

FOCUS ON NEEDS AND CONCERNS OF FOCUS ON NEEDS AND CONCERNS OF OLDER ADULTSOLDER ADULTS

ADDRESS AGE-RELATED STRESSORS, ADDRESS AGE-RELATED STRESSORS, LIFE TRANSITIONS, LOSS ISSUES, LIFE TRANSITIONS, LOSS ISSUES, HEALTH CHANGESHEALTH CHANGES