Fall 2009 Psychology 360
Dr.
Norcross 3
credits
Clinical
Psychology
Catalog Description: (Prerequisites: Psyc 110; a grade of C or higher in Psyc 225) An overview of contemporary clinical psychology focusing on its practices, contributions, and directions. Topics include clinical research, psychological assessment, psychotherapy systems, community applications, and emerging specialties, such as health and forensic psychology. Fall only. (W – designated as a Writing Intensive course.)
Faculty Information:
Professor: John C. Norcross, PhD, ABPP, Professor of Psychology
Contact numbers: 941-7638 (office); norcross@scranton.edu (e-mail); 585-5726 (home)
Web page: academic.scranton.edu/faculty/norcross/
Office hours: Mon 8:15 – 10:00, Tue 1:15 – 2:30, and by appointment
Office location: 224 Alumni Memorial Hall
Teaching assistant: Mr. Brian A. Zaboski (zaboskib2@scranton.edu; 570-574-4468)
Required Texts:
Trull,
T. J. (2005). Clinical psychology (7th edition).
VandenBos,
G. R., McNeil, J., Norcross, J. C., & Freedheim, D. K. (1995). The
anatomy of psychotherapy: Viewer's guide to the APA Psychotherapy
Videotape Series.
Evaluation Process: Your grade in this course will be determined by your performance on weekly quizzes, a final examination, and three papers. In cases of “borderline” grades, your attendance and class participation will also be considered.
There will be twelve weekly quizzes (12 points apiece) and one final examination (25 points). The weekly quizzes will be given for 10 minutes at the beginning of the Tuesday class; these quizzes will cover lecture material, reading assignments, film presentations, class handouts, and related classroom information. Make-up quizzes are not available. The final examination will assess your knowledge of material covered in the last two weeks of class.
Three papers, accorded 25 points apiece, are also requested. Detailed instructions for preparing the papers are attached. You have three options for each of the papers.
Paper 1: Biofeedback; Cochrane Synopsis; Autobiography of Mental Health Patient
Paper 2: Biofeedback; Behavior Therapy Simulations; APA Psychotherapy Videotape
Paper 3: Biofeedback; Gratitude Letter; APA Psychotherapy Videotape
Putting it all together:
Best 10 of 12 quizzes 120
Final examination 25
Three papers (25 each) 75
Total 220 possible points
Course
Policies: Regular class attendance is essential for a comprehensive
understanding of the subject matter. You are responsible for all announcements
made in class. If absent from a class, you are responsible for the material
covered. If absent from a class in which a videotape is shown, you may be able
to obtain and watch it in the
Please refer to the University’s Academic Code of Honesty (revised May 1998). Plagiarism or dishonest quiz behavior on your part will result in a grade of F for the course. As stated in the Student Handbook: Failures in the area of academic honesty strike at the heart of what is essential to the University community – the pursuit of truth.
Any student who, because of a disability, may require some special arrangements in order to meet the course requirements, should contact me privately as soon as possible so that I may consider and then make appropriate accommodations.
You are encouraged to participate fully and civilly in class. At the same time, we will not tolerate disruptive or offensive behavior that is antithetical to our university ideals or that is contrary to a conducive learning environment. Civility is a fragile construct that each of us must cherish and protect.
Please turn off your cell phone or pager while in class. Violation of this policy will demand punishment – though one that does not infringe on your eighth amendment rights.
Our class time will involve lectures, discussions, videotapes, and demonstrations. The primary function of the lectures is to supplement, not to repeat, the textbooks. The lectures will, therefore, contain information not found in the readings, and you will be tested on this material. You are free to decline participation in any discussions or activities.
Course Calendar and Assignments:
Dates Topics Reading Assignment
Aug 25 Welcome; Definitions T1, T3
Aug 27 Clinical Training
Sep 1 Historical Perspectives T2 Quiz #1
Sep 3 Clinical Research
Sep 8 Psychological Assessment T4, T6 Quiz #2
Sep 10 Psychological Assessment
Sep 15 Behavioral Assessment T9, T10 Quiz #3
Sep 17 Actuarial and Clinical Judgment Paper #1
Sep 22 Psychotherapy and Behavior Change T11, VIntro Quiz #4
Sep 24 Psychotherapy and Behavior Change
Sep 29 Psychoanalytic Psychotherapies T12, V3 Quiz #5
Oct 1 Psychoanalytic Psychotherapies
Oct 6 Behavioral and Cognitive Therapies T14, V11 Quiz #6
Oct 8 Behavioral and Cognitive Therapies
Oct 13 Fall Break; no class
Oct 15 Behavioral and Cognitive Therapies
Oct 20 Humanistic and Existential Therapies T13, V5 Quiz #7
Oct 22 Humanistic and Existential Therapies Paper #2
Oct 27 Group Therapies T15 Quiz #8
Oct 29 Couples & Family Therapy
Nov 3 Psychotherapy Research Articles Quiz #9
Nov 5 Psychotherapy Integration
Nov 10 Community Intervention T16 Quiz #10
Nov 12 Community & Positive Psychology article
Nov 17 Health Psychology T17, T18 Quiz #11
Nov 19 Clinical Neuropsychology Paper #3
Nov 24 Forensic
Psychology; Pediatric & Geropsych T19, T20 Quiz
#12
Nov 26 Thanksgiving Break; no class
Dec 1 Prescription Privileges; International; Prospects Fox Article
Dec 3 Clinical Jeopardy
Final exam
Films for Clinical Psychology:
Oct 1 Short-Term Dynamic Therapy (APA Psychotherapy Videotape)
Oct 8 Harry: Behavioral Treatment of Self-Abuse
Oct 15 Cognitive-Behavior Therapy (APA Psychotherapy Videotape)
Oct 20 Three Approaches to Psychotherapy (Ellis and Rogers tapes)
Oct 22 Three Approaches to Psychotherapy (Ellis, Rogers, and Perls tapes)
Oct 27 Process Experiential Therapy (APA Psychotherapy Videotape)
Nov 12 An Ounce of Prevention (World of Abnormal Psychology Videotape)
Nov 24 Commitment Evaluation
GUIDELINES FOR THE PAPERS
All three papers must be typed double-spaced with conventional fonts and one-inch margins. The target word count is between 1,250 and 1,500. For the sake of my sanity and your grade, please proofread and spell check your papers. Avoid cover sheets and extra blank pages (save trees!). Please record your word count at the end of each paper and place your name on the back of the last page.
Collaboration and consultation with other students are not permitted in preparing these papers. You may consult with the Writing Lab and the professor, but otherwise the papers must represent your original, independent work.
Cochrane Synopsis
The Cochrane is a database comprised of systematic reviews which identify and expertly synthesize randomized clinical trials (RCTs) on a given health-care topic. The Cochrane Database of Systematic Reviews (CDSR) is considered a “gold standard” of evidence-based practice in mental health. Here is where many mental health professionals find the most recent and balanced conclusions of what treatments work for a particular mental disorder or life challenge.
Think of yourself as a clinical psychologist practicing in a private office, a clinic, or a hospital. You turn to the Cochrane to address an interesting and practical question with which you are confronted in your clinical work. How might you think, relate, or behave differently as a result of the scientific research?
Start by going to thecochranelibrary.com and getting familiar with the site. At the top left of the page under the BROWSE header, click on By Topic. Restrict your search to three of the listed topics: Depression, Anxiety and Neurosis; Developmental, Psychosocial and Learning Problems; Drugs and Alcohol. And restrict yourself to a Review of treatments (e.g., psychotherapy, pharmacotherapy, prevention, self-help). You will find literally of dozens of Cochrane reviews. Scan the various reviews, and then select one for this assignment.
The purpose of your paper is not to abstract the review nor to repeat its contents. Rather, the assignment is intended to review the study's principal purposes, methodologies, and findings in a concise and practical manner. The central question to keep in mind is, "What are the specific implications of this research for the practice of clinical psychology?"
Below are the outline and the required headings for your synopsis.
Article: Cite the author, article, and Cochrane database in APA format.
Central Purpose: Review the author's main objectives for conducting the review.
Method: Summarize the characteristics of studies and the number of patients included in the review.
Major Findings: Describe the major findings. Check that the findings you describe directly relate to the central purpose of the review.
Practice Implications: Highlight the practice implications for clinical psychology. Demonstrate how this Cochrane review can influence clinical work. Avoid general conclusions, such as "Psychologists can help people more" and "Research is valuable," in favor of concrete and specific implications for treating a particular disorder or life challenge based on the results of this review.
Impressions: Mention the reasons you selected this topic and the review’s most important limitations.
Autobiography
of a Mental Health Patient
People
adore personal, compelling stories of self-transformation. Autobiographies
provide an inside view of psychological disorders and life challenges, drawing
on the human capacity for self-description and self-analysis. Memoirs
complement scientific research and case studies performed from the outside
looking in. Written in the person’s own words, an autobiography emphasizes
issues that the writer, as distinct from a therapist or researcher, considers
important. Autobiographies describe disorders in family and environmental
context, provide interesting narratives with strong story lines, and in the
end, typically reveal a successful outcome.
For this assignment, you read an autobiography written by a mental health client which appears on the following list and which you have not previously read. You then complete an Autobiographical Review form (which will be distributed in class). A list of 25 approved autobiographies follows.
Breaking Free from Compulsive Eating by Geneen Roth (compulsive eating)
A Grief Observed by C. S. Lewis (grieving)
Elegy for Iris by John Bayley (a spouse’s Alzheimer’s)
Death be Not Proud by John Gunther (a parent’s loss of an adolescent)
A Man Named Dave by Dave Pelzer (childhood abuse)
The Lost Boy by Dave Pelzer (childhood abuse)
Broken Cord by Michael Dorris (fetal alcohol syndrome)
An Unquiet Mind by Kay R. Jamison (bipolar disorder)
Heart of a Woman by Maya Angelou (women’s issues)
The Wheel of Life by Elisabeth Kubler-Ross & Todd Gold (death & dying)
Darkness Visible by William Styron (depression)
Motherless Daughter by Hope Edelman (loss of a parent)
Feeding the Hungry Heart by Geneen Roth (weight management)
I Never Promised You a Rose Garden by Joanne Greenberg (schizophrenia)
The Noonday Demon by Andrew Solomon (depression)
After the Death of a Child by Ann Finkbeiner (grieving the death of a child)
Out of the Depths by Anton Boisen (schizophrenia)
The Panic Attack Recovery Book by Shirley Swede & Seymour Jaffe (anxiety disorder)
Girl, Interrupted by Susanna Kaysen (borderline personality disorder)
ADHD Handbook for Families by Paul Weingartner (ADHD)
Too Much Anger, Too Many Tears by Janet Gotkin & Paul Gotkin (schizophrenia)
Nobody nowhere: The extraordinary autobiography of an autistic by D. Williams (autism)
Undercurrents: A therapist's reckoning with her own depression by M. Manning (depression)
Getting better: Inside Alcoholics Anonymous by N. Robertson (alcoholism)
Am I still visible? A woman's triumph over anorexia nervosa by S. Heater (anorexia)
A drinking life: A memoir by P. Hamill (alcoholism)
Behavior Therapy Simulations
For
this paper you will write a summary of your experiences with the Behavior
Therapy Case Simulations. These simulations were designed by Dr. Matthew
Lambert of
Locate an open workstation in the Psychology Department Computer Lab (AMH 202). Anticipate spending two hours in the computer lab to complete the project. Click on Start and then click on Psych Tools. Then click on Simulations. Use your mouse to move the arrow to one of the four cases, titled Mr. Howard, Mr. Kopf, Ms. Barnes, and Ms. Mayne. Click on one of the cases and you are into the program. Read the instructions carefully.
Experiment with the case of Mr. Howard to learn the format and options of the exercise. The first simulation will serve as a practice case. Follow the on-screen instructions to run the simulation. After you terminate the therapeutic relationship, view and print the summary. To do so, simply follow the instructions on the screen to receive your printed copy. Please be patient; it may take a minute to process and print.
Then complete the remaining three case simulations. Like a behavior therapist in practice, you are expected to review intake information, conduct assessments, provide treatment, and follow-up with the patient. The entire process will consume two hours of your time on average; you are encouraged to break up the cases into two days.
Here are some helpful hints provided by students who have previously completed the assignment.
♦ If you are unfamiliar with a particular assessment device or treatment method, then you can access information on them before deciding whether to proceed.
♦ Return to the Main Menu for additional information and options as often as you desire.
♦ Maximize the screen size for viewing ease.
♦ Remember that your grade does not depend on the effectiveness with which you treat the simulated patients.
♦ Do not expect to cure the patient with the first treatment method or within a few sessions.
♦ And consider taking a break between the simulations so that your mind does not wander and your eyes do not cross.
Your 3 printed summaries should be attached to your finished paper, which will analyze your computer interactions. Please address in your paper the following themes: (a) your expectations going into the simulations and whether your expectations were borne out; (b) your assessment of the software and the assessment and treatment methods offered by the program; (c) a review of your assessment and treatment of the three cases (one long paragraph per case, using the printouts as guides); (d) speculations on why certain treatments were effective and others were not; (e) lasting lessons about behavior therapy/psychotherapy from the experience (one-half page in length); and (f) how you might improve the course assignment (given the current software).
APA Psychotherapy Videotapes
Your paper will analyze and discuss a psychotherapy session contained in the APA Psychotherapy Videotape Series. The first step is to decide which of the following 10 videotapes you would particularly like to watch. You may watch as many as you like, but your paper will analyze only one of them.
Laura S. Brown, PhD: Feminist Therapy
Lillian Comas-Diaz, PhD: Ethnocultural Psychotherapy
Marvin R. Goldfried, PhD: Cognitive-Affective Behavior Therapy
Florence Kaslow, PhD: Family Systems
Arnold A. Lazarus, PhD: Multimodal Therapy
John C. Norcross, PhD: Prescriptive Eclectic Therapy
G. Alan Marlatt, PhD: Relapse Prevention for Addictions
David M. Clark, PhD: Cognitive Therapy for Panic Disorder
Richard A. Gardner, MD: Psychotherapy of Children with Conduct Disorders
The second step is to read the respective pages in The Anatomy of Psychotherapy or the booklet accompanying the videotape about that therapeutic approach. The chapter includes a biographical sketch of the therapist, a synopsis of the therapeutic approach, a summary of the patient's background, and a description of the previous psychotherapy sessions. Once you have read the material, you will possess the same information as the psychologist conducting the session.
The
third step is to proceed to the
The fourth step is to watch the videotape, recording your prominent reactions to the clinician and client and answering specific questions presented in italics. These will serve as the basis for your written paper.
The fifth step is to write your paper, which will consist of your answers to the italicized questions, Stimulus Questions About the Videotaped Session in the viewer’s guide, and to the following three General Questions:
What are your general reactions to the session?
What do you think were the strengths and weaknesses of this approach?
After reading about the patient and viewing the session, what are the patient’s DSM diagnoses?
Do not answer the questions in the first four sections of the chapter (About Dr. X; Synopsis of Brand X Psychotherapy; Client Background & Precipitating Events; Process Notes from Initial Session); only answer the questions in the Stimulus Questions About the Videotaped Session section and the three General Questions above.
Kindly structure your paper by creating two centered headings – Stimulus Questions, General Questions – and then numbering your answers under each. Please do not provide an introduction to your paper (just begin with your answer to the first question), and please do not repeat the question (simply answer it). Remember to address all parts of the multipart questions. When asked for the DSM diagnoses, kindly provide a DSM multiaxial diagnoses, using the I, II, II, IV, and V format.
Biofeedback Assignment
Biofeedback is a popular intervention in clinical practice, especially in health psychology, and encompasses a wide array of procedures. The defining features of biofeedback are that: (1) some aspect of the person's biological functioning (e.g., blood pressure, heart rate, galvanic skin response) is systematically monitored by an apparatus; (2) the apparatus feeds back information on the biological functioning to the person by way of a visual or auditory signal; and (3) the person then attempts to modify that signal by changing the biological functioning. For example, a person suffering from essential hypertension might be hooked up to a machine that measures blood pressure and that registers the systolic pressure on a visual display. With instruction and practice in relaxation training, the person will gradually be able to lower his/her systolic pressure.
For the purposes of this course, the Psychology Department has purchased 12 mobile biofeedback relaxation systems. These systems employ abbreviated training in progressive muscle relaxation, imagery, diaphragmatic breathing, and biofeedback itself. Although less intense than what one would typically receive in psychotherapy, this training exercise will provide you with hands-on experience with relaxation training and biofeedback, heretofore limited to the classroom.
Our biofeedback kits provide feedback on two biological functions: galvanic skin response and finger temperature. The feedback is in the form of either an auditory signal (a tone) or a visual signal (meter).
Most students will have the opportunity to sign-out the biofeedback kits during the semester for a three-week period. The kit contains all the essential materials: Instruction manual; GSR monitor; relaxation CD; temperature probe; and visual feedback meter. (For health reasons, we have removed the ear plug.) Once you sign-out the kit you are personally responsible for its safe return.
Follow these steps, in this order, to complete the assignment. Two weeks are required to complete all the steps.
1. Read pages 474 - 476 in the Trull textbook on biofeedback.
2. Review the Instruction Manual accompanying the GSR2 Biofeedback Relaxation System.
3. Listen to the CD (How to get the most from your GSR2).
4. Begin and maintain a running log of your relaxation activities on the attached table. Record the date, time, location, feedback type, relaxation methods, and your subjective units of discomfort (SUDs) on a 0 to 10-point scale (where 0 is perfectly relaxed and 10 is very uncomfortable) before your relaxation exercise and after you have finished. Staple the completed log to your paper.
5. Practice the relaxation exercise on the CD (fully-narrated relaxation exercise) without using the biofeedback system on two different days.
6. Acquaint yourself with the GSR monitor using the tone feedback on two 15-minute occasions on two different days.
7. Use the GSR monitor with the CD relaxation exercise on three different days.
8. On one of these days, inject an annoying external stressor -- such as a ringing telephone, alarm clock, or kitchen timer -- and observe the difference. On that same day, inject an annoying internal stressor -- such as a mild unpleasant thought or image -- and observe the difference.
9. Experiment on different days with the GSR monitor using the auditory signal (tone) versus using the visual signal (meter).
10. Choose the most effective signal display (auditory or visual) for you and then practice that on at least three occasions.
11. Try the biofeedback system in different locations. Perhaps in quiet and noisy places or locations with and without other people.
12. Experiment with the GSR system. Try different variations and alternative means of relaxation, beyond those given in these instructions. For example, try different types of music, various relaxation tapes, before and after exercising, while petting a dog or cat, or watching an exciting television show.
13. Return the biofeedback kit to your professor during class time. Thank the professor profusely for such a valuable exercise!
The resulting paper will summarize your experiences with the relaxation and biofeedback exercise. Kindly address the following questions:
♦ What is your prior experience with formal relaxation methods?
♦ What were your expectations going into the exercise?
♦ What type of feedback signal (tone or meter) worked best for you?
♦ Which relaxation technique -- muscle relaxation, imagery, deep breathing, biofeedback signal, or any combination thereof -- was most effective in helping you attain a deep sense of relaxation?
♦ Which was least helpful?
♦ How long did your relaxation typically last after the session?
♦ Did you discern any differences in relaxation efficacy due to the time of day?
♦ Any differences due to the location?
♦ What occurred when you intentionally introduced noxious stimuli when you were relaxing?
♦ Did you observe difference in your reaction between an external stressor and an internal stressor?
♦ How did you experiment with the biofeedback unit? What were the results of the experiments?
♦ Overall, how well did you relax?
♦ Did your SUDs ratings reliably decrease pre-relaxation to post-relaxation?
♦ If so, what was the average decrease (excluding those times when you introduced noxious stimuli)?
♦ Did the changes in the tone and meter generally match your SUDs ratings?
♦ Did you find the assignment valuable? Why or why not?
♦ What did you learn from the assignment about biofeedback, relaxation, and how you relax?
Gratitude
Letter
A gratitude letter is a popular, research-supported method of positive psychology. This method entails writing letters of gratitude to people who have been especially kind to you but who have never been properly thanked. Research indicates that a gratitude visit can temporarily increase your happiness.
For this assignment, read Seligman et al.’s American Psychologist article on positive psychology (as distributed in class). Then identify two living individuals who have been especially kind to you but who have never been properly thanked. These should not be psychology professors, college roommates, or romantic interests.
Word process (single-space) a gratitude letter of at least 625 words to the two individuals. Format the letters with the date, recipient’s address, body, closing, and your name/signature. The letters should describe your grateful feelings and the reasons for your gratitude. Begin the letters with the reasons you are expressing gratitude now (e.g., In our Clinical Psychology course, we are studying positive psychology and one of its methods, a gratitude letter). Provide specific examples of the person’s assistance or contribution to you. Discuss the consequences of the person’s kindness on your functioning and future. Detail your gratitude; avoid general and diffuse praise in favor of the specific and concrete. Please do not include general news about your life, your job, or your hot friends; the gratitude letter is exclusively about thanking somebody for their kindness. Sign your name to the letter.
Provide me with copies of the two letters, deleting (if you like) the names of the recipients and any overly personal details. I will treat the content of the letters as confidential and will return them to you (for mailing) once graded.
After revising the letters based on my feedback, put them in the mail. Mail the letters to the intended recipients; that is part of the assignment.
Date |
Time |
Location |
Feedback Type |
Relaxation
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