Professor: Marcia Spira, Ph

Loyola University Chicago

School of Social Work

ADVANCED CLINICAL SOCIAL WORK WITH OLDER ADULTS

SOWK 632

Prerequisites: All 500 requirements

Course Description:

The focus of this course is on specialized practice with an aging clientele. It is the advanced level course, and while the curriculum includes review of the basic concepts of gerontology/geriatric practice, it challenges students to move beyond basic levels of knowledge. It is intended to help students adapt social work theory (person-in-environment), practice principles, standards, and values to practice with older adults.

This course includes a critical analysis of the theoretical underpinnings of gerontological thought and assists students to view aging through multiple perspectives, including psychodynamic, cognitive- behavioral, developmental process, social construction and disease models. Examination of the physiological, psychological, and sociological phenomena serves to highlight the numerous factors which influence societal and individual perceptions of aging. These areas of study consider the influences of ethnicity, culture, economics, demographics, physical challenges, gender and sexual orientation.

Social work practice and treatment issues are identified to help students to develop assessment skills and interventions for work with older clients and their families with diverse needs. Special attention is given to approaches for those clients with specific disabilities. Concrete service delivery and policy implementation are addressed in addition to individual, small group and family treatment techniques. Students learn the process of using selection criteria and expectations for particular outcomes as they learn to choose among intervention options. A strong interdisciplinary orientation is emphasized with special foci on law and medicine. They are encouraged to set realistic goals and address the problems for aging adults in a comprehensive and thoughtful manner.

Learning Objectives:

Upon completion of this course students shall demonstrate:

Knowledge:

1.Understand how the impact of historical, political, and societal responses to aging influence current societal responses and social policy formation.

2. Understand the normal physical, psychological, cognitive and social changes associated with aging and the impact these changes have on families.

3.Understand the ethical issues of social and economic justice as they relate to increasing needs for care and service of older adults.

Values:

1.Respect for the aging clients’ autonomy, accumulated knowledge, life experience, and history of interpersonal relationships as well as coping capacities.

2.An appreciation for the effects of cultural, racial, sexual orientation, gender, religious, and ethnic values as they influence and determine clients’ choices and lifestyles.

3.An appreciation for the need for self-determination regardless of clients’ age or disability.

Skills:

1. An ability to assess the biopsychosocial needs of older adults, giving recognition to clients’ strengths and life experiences.

2. An ability to collaborate with other professionals and participate in interdisciplinary approaches to practice and research with older clients.

3.An ability to engage in a therapeutic relationship with older adults and their families.

Teaching Methodology

This course stresses integration of theory and practice principles, in both, academic and field work. It is taught in seminar style. This is achieved through lectures, class discussions, case presentations, and anecdotal illustrations. A representative range of both reading and special reports will be assigned. Students in this course will have some freedom in making choices to study and integrate the material presented. In addition, an occasional guest lecturer with specific expertise will address the class.

The content of this course will be divided into three categories. The first area of study will review the basics of gerontology and the biopsychosocial changes that may challenge the client and social worker. The next section will focus on the aspects of assessment and practice, as well as research that is tailored to meet the needs of aging clients and their families (including interdisciplinary care). The last portion will address obstacles to practice and social policy (including aspects of laws that apply to the elderly), responses to the future needs of the older adult client and research questions. Additional content may be added in specific areas when relevant.

Respect for Diversity

We are committed to the recognition and respect for variations in racial, ethnic, and cultural backgrounds and in class, gender, age, physical and mental ability, religion, and sexual orientation. We value ethnically sensitive and culturally competent social work education and practice. We will uphold the ethical standards set forth by the profession and the Jesuit ideals of the university. This will be demonstrated through readings, lectures, case presentations and assignments. We expect that students will demonstrate comparable respect for diversity of their classmates, faculty and clients, and commit to address issues of marginalization, oppression, prejudice and discrimination.

Special Needs

Any student with special needs or difficulties in learning and completing course assignments is strongly encouraged to see the instructor as son as possible. Please refer to the Student Handbook for student rights and available resources pertaining to assistance with special needs or disabilities.

Academic Integrity

Academic integrity is essential to a student’s professional development, their ability to serve others, and to the University’s mission. Therefore, students are expected to conduct all academic work within the letter and the spirit of the Statement on Academic Honesty of Loyola University Chicago, which is characterized by any action whereby a student misrepresents the ownership of academic work submitted in his or her name. Responsibilities of Academic Honesty are detailed in The Graduate manual of the Loyola University Chicago. This commitment ensures that a student of the School of Social Work will neither knowingly give nor receive any inappropriate assistance in academic work, thereby, affirming personal and professional honor and integrity. Students may not use the same assignment content to fulfill different course requirements.

Required Textbook:

McInnis-Dittrich, K. (2009). Social work with older adults: A biopsychosocial approach to assessment and intervention. Boston: Allyn and Bacon.

Pachana, N. A., Laidlaw, K., & Knight, B. (2011). Casebook of clinical geropsychology: International perspectives on practice. Oxford: Oxford University Press.

Recommended Textbooks:

Knight, B. G. (2004). Psychotherapy with older adults(3rd ed.). Thousand Oaks: Sage.

Laidlaw, K., Thompson, L. W., Thompson, D., & Siskin, L. (2003). Cognitive behaviour therapy with older people. Chichester: Wiley.

Assignments:

The objectives of the course will be met by completion of three of the following assignments. You have discretion over the order of the assignments. For instance, some of you may want to complete the interview assignment first, others may want to make that your final.

Assignment(25 points)

Elder Interview

This assignment should provide you with an understanding of ethnicity and aging from the perspective of an older person. You will conduct an interview with an older person who represents a different ethnic, cultural, racial, sexual orientation, or sociohistorical experience from your own. Conduct the interview with the older adult using appropriate social work interviewing skills, knowledge about older adults from a strengths perspective, values and ethical considerations, and conscious use of self. The name and some other identifying information about the elder should be altered enough to protect their identity and they should be guaranteed confidentiality.

Guidelines for questions:

When and where were you born?

Tell me about your childhood (hometown, parents, siblings, etc.).

Describe your teenage years (school, interests, friendships, etc.).

Tell me about your formal and informal education and your work experiences.

Tell me about your family life – births, deaths, illness, marriages, divorces.

What were some of the most significant moments or events in your life?

What lessons have you learned about life and living?

Describe the people who guided or influenced you the most in your life.

What risks did you take in life?

What regrets or unfulfilled desires do you have?

What dreams or hopes do you have for the future?

What advice about life do you have for young people?

Write a 5 - 7 page paper about this experience addressing the following points:

·A brief summary of the older person’s history including some pertinent childhood, family, education, employment, physical and mental health, ethnicity, current status, etc.

·Why did you select this person? Demonstrate that the selected person is chosen purposefully, not merely by convenience. Discuss the similarities and differences between your own ethnic/cultural/sociohistorical experience and that of the interviewed elder.

·What social work skills, values and knowledge did you use in conducting the interview?

·What ethical issues did you confront?

·If you had the opportunity to conduct the interview again, what would you do the same? What would you do differently?

·Review the interview and determine from the older person’s perspective what s/he considers her/his most significant contribution. Why did you select this issue? What words, phrases or nonverbal behavior was used by the person you were interviewing that provided clues to its salience?

·Identify three concepts from the class readings and discussions about aging that you observed or experienced during the interview and explain the concept.

·Extra credit

·Interview a close relative or friend of the older person.

Ask him/her the same questions about the older person to get a sense of what they know and
if the perceptions of the older person are different through the eyes of this “informant” than from the eyes of the older person. How are the perceptions different? Why do you think this is so?

Assignment (25 points)

Everyone must complete one of these assignments. Choose between Option A or B.

Option A

Skill development assignment-small group project and presentation

This assignment enables students to formulate an intervention or technique and teach it to the rest of the class.

Form a small group (3-4 people) and select a particular skill or technique relevant to practice with older adults (e.g., reminiscence). Prepare a presentation that details the context in which your chosen skill would be used. Include any theory that supports the particular skill. For instance, theory on family practice supports mediation skills, theory on individual development may be useful in reminiscence). Be prepared to develop exercises that will allow fellow students to practice this skill in class. You are encouraged to have handouts. You may want to talk with practitioners in the community who use these skills to learn about their experiences. You need to provide citations, including web sites for any and all resources you utilized in your review of the literature and presentation planning so that students who wish to explore the topic further will know where to begin. Evidence based practice research is encouraged.

Option B

Aging Issues Journal

For this assignment the student will keep a journal reflecting on aging issues. A variety of sources should be used, including movies, books, television shows, articles from newspapers and magazines, all forms of advertising, quotes from conversations with peers, family. In addition, it would be very appropriate to reflect further on aging issues that have discussed in this class or in other social work classes. This journal should not only include actual clips and quotes but should also be a reflection of one’s own personal reactions and attitudes towards aging issues. The entries should be thoughtful and well written, an intelligent effort to integrate your personal reactions to aging issues. A minimum of 10 typed pages is expected.

Final Assignment (25 points) Due in last class session

Everyone must complete one of these assignments. Choose between Option A, B, or C

Option A

Attend a local professional organization meeting related to social work and aging. Examples would be the ASA (American Society on Aging) Chicagoland roundtable discussion group that meets at Rush University Medical Center. These monthly meetings are an excellent opportunity for professionals in the area to meet and discuss critical issues on aging. For more information, visit

Another professional organization would be the Chicago Bridge group, a group that is designed to meet the needs of professionals who are new to the field of aging. Information on these meetings will be distributed in class. These meetings are in the evening so they would not conflict with your field placement.

There are a number of other groups that meet in the area and information on these opportunities will be shared in class. This assignment is a great networking opportunity for anyone who is seriously considering a career in the field of aging. Write a short 3 page summary of this experience and report to class on your personal observations and reactions. This summary should include your observations of the benefits of this networking experience as well information about the aging information that was shared at the meeting.

Option B

Take a tour of 2 senior living programs across the continuum of care – independent living, assisted living, supportive living, nursing home, etc. If you work in such a setting, you should visit a different setting. It would be preferable to visit a setting that is a completely different level of care from what you are already familiar. Find out about entrance requirements, services provided, fees and costs. Write a short 3 page summary of this experience and report to class on your personal observations and reactions.

Option C:

Aging Issue Paper

This paper should be approximately 8 - 10 pages in length (typed, double-spaced) and should be properly referenced. In addition, you will be expected to present a brief class presentation on your paper. Critically examine the current state of knowledge regarding a specific problem or concern that affects older adults and/or their families. Be sure to address the following issues:

1) Describe the problem and its characteristics as specifically as possible.

2) Estimate the prevalence of this problem and indicate any gender, ethnic or class difference in its prevalence and presentation.

3) Consider the impact of the problem, identifying likely contributing, mediating and moderating factors. Indicate which individuals or groups are most likely to be affected and why. Critically evaluate evidence for and against your claims.

4) Identify unresolved issues or gaps in existing knowledge regarding this problem (e.g., ethical issues, legal issues, societal attitudes, etc.).

5) Identify practice and policy implications related to this problem and/or its effects.

The remaining 25 points of grade will be based on Attendance and Class Participation

Students are expected to keep regular attendance, contribute readily to class discussion and participate in classroom exercises. In addition, a major part of this grade will be based on students preparing for class by completing and presenting a review of assigned readings. The final 25 points of your grade will be based on this expectation.

Class I:

The context of social work practice with elders

* Aging quiz

* Demographic data

* Settings for gerontological social work

* Ageism, racism, sexism, homophobia: discrimination and bias with older adults

* Myths about aging

*Personal and professional issues in work with elders

*Supervision

In Class exercise on stereotypes of aging

Required Readings:

McInnis-Dittrich, K. (2009). Social work with older adults: A biopsychosocial approach to assessment and

intervention. Boston: Allyn and Bacon. Chapter 1: The context of social work practice with older adults.

Pachana, N. A., Laidlaw, K., & Knight, B. (2011). Casebook of clinical geropsychology: international perspectives on practice. Oxford: Oxford University Press. Chapter 7: Clinical supervision for psychotherapy with older adults.