University of Southern California s3

University of Southern California School of Social Work

SOWK 641

Treating Trauma and Post Traumatic Stress

In Military Social Work and Veterans Services

Fall 2010

Professor: Leslie Martin, LCSW

Office Hrs. Tuesdays 6:15-7:00PM or by appointment

Office: TBA

Day/Time: Tuesdays 4:10PM to 7:00PM

Location: MRF 229

E-mail

I. Course Description

This course, Treating Trauma and Post-Traumatic Stress in the Military and Veteran Services, builds on previous courses in a number of ways. Previous knowledge and skill regarding life cycle issues, developmental theory, personality theory, and general systems theory will be applied to practice with military service populations. Generic practice skills in working with individuals and their support systems, carried through from the foundation year, will have a new application specifically to military service and veteran clients. Core concepts of relationship, the therapeutic alliance, problem solving, and the phases of treatment are applied to post-traumatic stress disorder, and its co occurring disorders. Within a bio-psycho-social, eco-systemic framework, specific interventions deriving from a variety of theoretical bases, including neurobiological, psychodynamic (i.e. self psychology, object relations, ego-supportive, attachment theory), resiliency, cognitive-behavioral, and behavioral schools are examined for use in treatment of PTSD. Evidence-based and empirically-supported treatments will be emphasized. The student's introductory skills obtained in the first year, regarding work with clients experiencing common presenting problems, will be advanced. Students will learn how to treat clients from diverse military, ethnic, class, gender, sexual orientation and disability groups, especially those seeking treatment in urban settings such as San Diego and Los Angeles.

Further, the phases of treatment will be applied to intervention for PTSD and trauma work with military populations. The course opens with a unit on Assessment and we will then examine treatment from various theoretical perspectives. The impact of social injustice on those seeking services and the effects of stigma will be examined within this course. Building on first year content, we will address practical implications of work with culturally diverse client groups: ethnic and racial minorities of color, sexual minorities, women, and other gender related issues in clinical practice. Content will be applied to work in military clinical settings. Knowledge of ethical considerations and the value-base of social work practice will be advanced and applied directly to work in military settings. Throughout the course, we will discuss the effects on the social worker of working with highly distressed clients and the value base of service providers.

II. Course Objectives:

Within these parameters, objectives are to enable the student to:

1. Become knowledgeable about the nature of trauma and its clinical and sub-clinical presentations, particularly as they relate to combat, military sexual trauma and other military related traumatic experiences.

a. Apply differential diagnostic skills in assessing: Acute Stress Disorder

(ASD); Posttraumatic Stress Disorder (PTSD); Traumatic Brain Injury

(TBI); Adjustment Disorders; and Anxiety Spectrum Disorders. Identify the relevance of these diagnoses in military and veterans social work services.

b. Understand the differences between Simple and Complex PTSD, their etiology and relevance for military social work practice.

c. Be able to distinguish and diagnose the three symptoms clusters of PTSD: Re-experiencing, Avoidance, and Hyperarousal.

d. Be able to identify dissociation and understand its risks in clinical treatment and its role in trauma resilience and recovery.

2. Become knowledgeable about, and be able to apply, best practices and current evidence-based models for dealing with trauma and PTSD.

a. Understand the reciprocal nature of the bio-psycho-social components and how each contributes to, and is affected by, the others in working with trauma.

b. Be able to identify the goals and course of trauma-based treatment.

3. Deepen understanding of the therapeutic relationship and its impact on the treatment process in working with traumatized clients with and without PTSD.

4. Increase knowledge of the neurobiological underpinnings of trauma and PTSD

and how these inform military social work practice.

5. Increase understanding of diversity issues, including gender, race, culture, disability status and sexual orientation, and how they influence symptom presentation and treatment intervention.

6. Become cognizant of potential ethical dilemmas and ways of resolving them in working with clients with trauma and PTSD given the culture and context of the military milieu, command deployment priorities and the misuse of diagnoses, e.g.,

personality disorders in military settings and PTSD in veteran services settings.

7. Increase understanding of the interaction of PTSD with co-occurring disorders such as Traumatic Brain Injury (TBI), depressive disorders, substance abuse, other anxiety disorders, and their post deployment manifestations such as domestic violence.

8. Be able to identify risk factors for PTSD and resiliency factors for recovery as

they apply to post deployment and post discharge stressors and family

reintegration.

9. Understand issues of social injustice, and class disadvantages and be able to advocate for adjunctive services to military clients so that they may eventually reintegrate into a complex urban environment.

III. COURSE FORMAT

Modes of instruction will consist of a combination of didactic lecture, in-class discussion, student presentations, experiential exercises, videotapes, and possible guest speakers. Individual and group in-class activities will be used to provide application of content, theories and concepts.

IV. COURSE EVALUATION AND GRADING

Grading Policy

Grades in the School of Social Work are determined based on the following standards that have been established by the faculty of the School:

A Grade of A or A- is reserved for student work which not only demonstrates strong mastery of content but which also shows that the student has undertaken a complex task, has applied critical thinking skills to the assignment, and/or has demonstrated creativity in her or his approach to the assignment. The difference between these two grades would be determined by the degree to which these skills have been demonstrated by the student.

A grade of B+ will be given to work that is judged to be very good and demonstrates a more-than-competent understanding of the material being tested in the assignment.

A grade of B will be given to student work, which meets the basic requirements of the assignment and demonstrates work that meets course expectations at an adequate level.

A grade of B- will indicate that a student’s performance was less than adequate on an assignment and reflects only moderate grasp of content and/or expectations.

A grade of C would reflect a minimal grasp of the assignments, poor organization of ideas and/or several areas requiring improvement.

Grades between C- and F will denote a failure to meet minimum standards, reflecting serious deficiencies in all aspects of a student’s performance on the assignment.

Note: Please refer to the Student Handbook and University Catalogue for additional discussion of grades and grading procedures, and for discussion of academic integrity.

Class grades will be based on the following:

3.85 – 4 A

3.60 – 3.84 A-

3.25 – 3.59 B+

2.90 – 3.24 B

2.60 – 2.87 B-

2.25 – 2.50 C+

1.90 – 2.24 C

Final Grade:

93 – 100 A

90 – 92 A-

87 – 89 B+

83 – 86 B

80 – 82 B-

77 – 79 C+

73 – 76 C

70 – 72 C-

Class grades will be based on the following:

Mid-term examination (multiple choice) 30%

(Encompasses reading material up to week 7)

PTSD articles (oral presentation) 10%

(Student discusses for 1-5 minute and distributes PTSD relevant article to the class)

Journal Entry (11 journal entries) 10%

(5 minutes end of each class, collected prior to final week)

Session with Thought Record-Mind over Mood 30%

(Complete session with client prior to final week)

Intake Form (Assessment) 20%

V. ATTENDANCE POLICY

Students are expected to attend every class and to remain in class for the duration of the session. Failure to attend class or arriving late may impact your ability to achieve course objectives which could affect your course grade. Students are expected to notify the instructor by telephone or email of any anticipated absence or reason for tardiness.

University of Southern California policy permits students to be excused from class, without penalty, for the observance of religious holy days. This policy also covers scheduled final examinations which conflict with students’ observance of a holy day. Students must make arrangements in advance to complete class work which will be missed, or to reschedule an examination, due to holy days observance.

VI. COURSE EXPECTATIONS AND GUIDELINES

Students are expected to read the assigned readings for each class and to use them as the basis for informed participation in class discussions. Class participation will include case presentation, role plays, and self-reflective exercises. Evaluation of class participation will be based on the quality of ideas presented.

Guidelines for all Written Work: Grading criteria for the content of written work include: thoroughness, logical development of points, clarity of written expression, application of theory/readings from the course and from independent research, and appropriateness of the product to the assignment given. Each sentence or portion of a sentence must be completely in the student’s own words (paraphrased), unless a direct quotation is used, which is indicated by quotation marks and its respective citation (see APA 5th Edition). All words and ideas borrowed from literary sources must be attributed by citation. Written assignments will be graded not only on content but also on professional presentation including structure, spelling, punctuation and proper use of the English language. Students having difficulty with written communication skills are encouraged to seek outside assistance in editing their work prior to submission.

VII. REQUIRED TEXTBOOKS

Briere, J. and Scott, C. (2006). Principles of Trauma Therapy. Thousand Oaks, CA: Sage Publications.

Greenberger, D. and Padesky, C. (2000) Mind Over Mood. New York. Guilford Press.

Herman, J. (1997). Trauma and Recovery. New York: Basic Books

Paulson, D. and Krippner, S. (2007). Haunted by Combat. Westport, CT: Praeger Security International

VIII. ACADEMIC ACCOMMODATIONS

Any student requesting academic accommodations based on a disability is required to register with Disability Services and Programs (DSP) each semester. A letter of verification for approved accommodations can be obtained from DSP. Please be sure the letter is delivered to the instructor as early in the semester as possible. DSP is located in STU 301 and is open from 8:30 a.m. to 5:00 p.m., Monday through Friday. The phone number for DSP is (213) 740-0776.

IX. COURSE OUTLINE, READINGS AND ASSIGNMENTS

Unit 1: Introduction

Session 1: Introduction to the topic

· History of the concept of trauma and PTSD

· Military-specific events that lead to PTSD

· Phenomenology of PTSD: what does it look/feel/sound like?

Required Reading

Herman:

Chapter 1: A forgotten history

Chapter 2: Terror

Chapter 3: Disconnection

Paulson and Krippner

Chapter 1: An Overview of trauma and the Mind/Body

Chapter 2: History of the dx and tx of PTSD.

Chapter 3: The phenomenology of PTSD

Briere: Chapter 2: Effects of Trauma