I. The Concentration in Interpersonal Practice:

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I. The Concentration in Interpersonal Practice

• One of two concentrations available to advanced
  year graduate students in our School Continues
  two time-honored traditions
• substantive and intensive education for clinical
  practice
• scholarly rigor

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II. We offer students three tracksor options to
choose from among

• cognitive-behavioral social work practice
• family-systems social work practice
• psychodynamic social work practice.

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Each of these options

• is as rigorous and systematic as the other two,
  and in fact designed to be comparable in every
  major respect
• requires a two-term commitment, totaling eight
  credit hours over the academic year students may
  not select one term of one track and second term
  of a different track
• is conceived as a combined human behavior and
  clinical methods course, and is further intended
  to achieve integration along several different
  axes

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• -- there is an equal and consistent focus on
  children, adolescents, and adults in readings,
  lectures, and clinical case review portions of
  the course
• -- the focus on psychopathology/dysfunction is
  counterbalanced by a comparable emphasis on
  clinical diagnostic skills, whether these are
  linked to the beginning, middle, or end stage of
  the treatment process
• -- the content on clinical process dimensions is
  complementary to content on clinical method and
  technique

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• -- clinical case reviews permit a useful
  integration of field experiences with didactic
  classroom learning
• -- the variable of time and its implications for
  interpersonal practice are identified and brief
  models of treatment are elucidated
• -- ethical dimensions of practice, content on
  human diversity, and material on socially
  disenfranchised, marginalized, and vulnerable
  populations are all accorded emphasis
• -- various models or paradigms for research on
  aspects of clinical process and/or for the
  evaluation of practice are also introduced.

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

• each system is widely used in social work
  practice today
• each boasts a substantial clinical and research
  literature
• we have at least one full-time faculty member
  with the expertise and background
• We also decided that we would like to do a few
  things well, rather than to offer a little bit of
  everything

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IV. Finally, which theory track should I
choose?

• written material to be distributed
• illustration of how each of these theoretical
  systems works using material from the film
  Gilbert Grape
• Please remember, also, that selecting one
  theoretical orientation doesnt lock you into
  that orientation forever.

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Behavior, Psyche, and System in Whats Eating
Gilbert Grape? Three Clinical Approaches

• Hallstrom, L. (Producer/Director) (1993).
  Whats Eating Gilbert
• Grape? Motion picture. United States.
  Paramount Pictures.

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(No Transcript)
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(No Transcript)
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Cognitive-Behavioral Treatment Assessment

• The Case of Gilbert Grape
• Presented by
• Antonio Gonzalez-Prendes, Ph.D., ACSW

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What is CBT?

• Problem-focused, present-oriented, time-limited
• Operates on basic assumptions
• Cognition plays a central role in human
  adaptation
• Emotional disorders result primarily from
• Irrational, unrealistic, biased, rigid
  distorted thinking
• Thinking can be monitored changed
• Cognitive change ? clinical improvement
• CBT is not positive thinking
• Thoughts are just thoughts, not facts.

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CBT maintains that

• information processing and meaning are central
  in determining our emotional and/or behavioral
  reactions.
• cognitions mediate/moderate these processes and
  how we adapt to lifes events.

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Cognitive Case Conceptualization(Judith Beck,
1995)

• Relevant Developmental/Childhood Data
• ?
• Core Beliefs
• ?
• Intermediate Beliefs
• ?
  ?
• Rules (Shoulds) / Conditional Assumptions
  (Ifthen)
• ?
• Compensatory Strategies
• ?
• Automatic Thoughts (meaning of A.T.s)
• ? ?
• Emotions Behaviors

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• Relevant developmental/childhood data
• Father Suicide. Depressed?
• Mother Stays home, overeats. Depressed?
• Core Beliefs
• I am unlovable/insignificant/not good enough
• Rules (reflect rigid responsibility low
  self-worth)
• I should attend to others, I must do for
  others
• Conditional Assumptions
• If I please others then I am worthwhile

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• Compensatory Strategies
• Self-denial passive unemotional.
• Automatic thoughts (when asked what he wants)
• I want to be a good person (Contingent on
  pleasing others?)
• I cant do this, I cant
• Emotions Behaviors
• Emotions Shallow, flat, resigned attitude,
  unexpressive. Cannot bring himself to feel.
• Resentment, bitterness, anger? ? Beached whale
• Behaviors Does for others even when burdened.
  Unable to set boundaries.

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Treatment of Gilbert Grape

• What does Gilbert want? How would he like to
  think, act, feel differently?
• Get the rest of the story. Strengths?
  Abilities?
• Awareness of his cognitive set.
• Assess validity functionality of beliefs and
  rules.
• Evidence, alternative explanations, pros cons,
  etc.
• Restructure rigid rules negative core beliefs.
• Build new cognitive behavioral skills.
• Use homework and behavioral experiments.
• General ? Specific Vague/abstract? Concrete.

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A Family Systems Perspective

• Presented by Dr. Arlene Weisz

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Family Systems Understandings

• There are a number of different models.
• We are teaching an integrative approach
• allowing the social worker to combine the most
  relevant parts of different models.
• For example, we can look at
• structure
• emotional systems
• or sequences of interactions
• Include a focus on culture and gender

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Structure

• Are the roles working well for the family at this
  stage of development?
• Who is in charge?
• What are the boundaries like between individuals
  and between the family and the outside world?

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Emotional systems

• Does the family have some strengths in terms of
  caring for each other?
• How does the family deal with loss and
  separation?
• How does the family deal with conflict and anger?

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Sequences of interactions

• Attempted solutions to mothers and Arnies
  difficultiesdo they really solve the problem?
• What constrains people from making changes?

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Family Systems Interventions
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Would keep family dynamics in mind

• Whether meeting with whole family
• Or Gilbert alone (most motivated for change)
• Recognize that changes made by one person affect
  the whole family system
• And that an individuals behavior makes sense in
  the context of the system

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Would try to see the whole family at least once

• Family meetings show the familys interactions to
  the social worker
• Rather than having an individual describe what
  happens at home
• During sessions, the family can experiment with
  new interactions with help from the therapist

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Family meetings would focus on

• Forming an alliance with all of the family
  members
• Observing family interactions in the here and now
• Developing goals the whole family can agree on

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Goals might be to

• Strengthen the family hierarchy
• Teach problem solving
• Increase individuality
• Help the family face its grief when the time is
  right

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Whats Eating Gilbert Grape? A Psychodynamic
Perspective onClinical Assessment and Treatment

• Presented by
• Jerrold R. Brandell, Ph.D., BCD

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Gilbert and the Mother of all Grapes

• oedipal victory/object loss
• wishes and actions
• seedling to grape instantaneously

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Gilberts childhood and adolescence

• what childhood and adolescence?
• mirroring, self-calming and self-soothing
• whos the selfobject here, anyway?
• Gilbert and Arnie

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Gilbert and the G.F. (Girlfriend)

• girlfriend or dynamic therapist?
• the defenses
• free association

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Gilberts (hypothetical) treatment

• the six-session solution
• psychological growth via the
• treatment relationship/holding
  environment
• potential pitfalls for the therapist

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The process of dynamic therapy

• making unconscious conscious where id was,
  there ego shall be
• the telling and retelling of the clients
  personal narrative
• resistance
• new adaptations

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Whats Eating Gilbert Grape Whats in a
title?
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SPECIAL INTEREST AREAS FOR INTERPERSONAL PRACTICE
STUDENTS
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FAMILIES-AT-RISK

• FOCUS ON WORK WITH THE FAMILY UNIT
• FOSTER FAMILY, ADOPTIVE FAMILY, AT-RISK OF
  SEPARATION
• ADDRESS ISSUES OF POVERTY, INTERACTIONAL
  STRESSES, DEPRESSION, CHILD MANAGEMENT
  CHALLENGES, VIOLENCE
• IMPROVE FAMILY FUNCTIONING AND DEVELOP RESOURCES

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CHILD WELFARE

• FOCUS ON CHILD/ADOLESCENT AND SOME DIRECT WORK
  WITH THE FAMILY
• SEPARATION FROM FAMILY AND COPING WITH ADJUSTMENT
  ISSUES, BEHAVIORAL DIFFICULTIES,
  DEPRESSION/ANXIETY
• FACILITATE ADJUSTMENT, FURTHER COPING SKILLS,
  ASSIST WITH GREIVING, STRENGTHEN ADAPTIVE SKILLS

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SUBSTANCE ABUSE

• WORK WITH ALCOHOL AND DRUG PROBLEMS ADDRESS
  THEIR IMPACT ON THE INDIVIDUAL AND
  FAMILY/SIGNIFICANT OTHERS
• MAY ADDRESS DUAL DIAGNOSIS ISSUES
• WORK IN INPATIENT, OUTPATIENT SETTINGS RANGE OF
  REHABILITATION MODELS

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SCHOOLS

• WORK WITH SCHOOL PERSONNEL, TEACHERS, CHILDREN
  (BOTH REGULAR AND SPECIAL EDUCATION) FAMILY
  MEMBERS
• ASSESS EDUCATIONAL DISABILITIES IN CHILDREN
  COMPLETE INTERVENTION PLANS TO FURTHER STUDENT
  LEARNING
• LEAD PSYCHOEDUCATIONAL GROUPS TO FURTHER STUDENT
  ADJUSTMENT AND EDUCATIONAL SUCCESS
• MAY HAVE INVOLVEMENT IN COMMUNITY WORK
  DEVELOPING PARTNERSHIPS BETWEEN THE SCHOOL AND
  THE COMMUNITY

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MENTAL HEALTH

• SOCIAL WORK TREATMENT WITH INDIVIDUALS, FAMILIES
  AND GROUPS CHILD, ADOLESCENT AND ADULT CLIENTS
  COPING WITH A RANGE OF PSYCHOSOCIAL DIFFICULTIES
• DEVELOP ASSESSMENT SKILLS, CRISIS INTERVENTION
  SKILLS, TREATMENT SKILLS, GROUP WORK SKILLS, CASE
  MANAGEMENT/DISCHAARGE PLANNING SKILLS
• WORK IN INPATIENT/OUTPATIENT SETTINGS
• COMMUNITY MENTAL HEALTH AGENCIES, FAMILY SERVICE
  AGENCIES, HEALTH MAINTENANCE ORGANIZATIONS (HMO)

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HEALTH CARE

• WORK WITH THOSE FACING HEALTH-RELATED
• DIFFICULTIES
• DISABILITY
• DEATH
• ALL AGE LEVELS AND ALL SOCIAL WORK MODALITIES
• SETTINGS INCLUDE HOSPITAL, HOSPICE, HOME CARE
  AGENCIES

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AGING/GERONTOLOGY

• FOCUS ON NEEDS AND CONCERNS OF OLDER ADULTS
• ADDRESS AGE-RELATED STRESSORS, LIFE TRANSITIONS,
  LOSS ISSUES, HEALTH CHANGES