THE UNIVERSITY OF TENNESSEE

COLLEGE OF SOCIAL WORK

SW 530 Seminar in Clinical Social Work:
Evidence-Based Substance Abuse Treatment

Course #530 - 2 Credit Hours

Tuesdays 9:40 – 12:25

306 Henson Hall

David A. Patterson, Ph.D.
Professor

224 Henson Hall

974-3351 or 974-7511

Office Hours: Wednesday afternoons or by appointment

dpatter2@utk.edu

http://web.utk.edu/~dap/

Code of Conduct
It is the student's responsibility to have read the College of Social Work Ethical Academic and Professional Conduct Code that is in the College of Social Work MSSW Handbook (www.utk.csw.edu).

The Honor Statement
An essential feature of The University of Tennessee is a commitment to maintaining an atmosphere of intellectual integrity and academic honesty. As a student of the University, I pledge that I will neither knowingly give nor receive any inappropriate assistance in academic work, thus affirming my own personal commitment to honor and integrity. (Hilltopics, 2008).

Disability
If you need course adaptations or accommodations because of a documented disability or if you have emergency information to share, please contact The University of Tennessee Office of Disability Services at 2227 Dunford Hall (865) 974-6087. This will ensure that you are properly registered for services.

Course Description
This is a concentration elective course. This course is intended to prepare students for evidence-based practice in the field of substance abuse treatment. The course will present an integrative biopsychosocial model for the understanding and treatment of substance abuse. Course content includes an overview of the history of substance abuse, a review of models of addiction, a multidimensional model of the addiction process, the physiological affects of commonly abused substances, assessment and diagnosis of substance abuse disorders, and specific, evidence-based interventions adolescent and adult clients.

Course Rationale
Substance abuse is epidemic at this time in our culture. Social workers, regardless of practice setting, encounter the individuals and systems impacted by substance abuse. In order to respond to the needs of individuals, families, groups, and communities effected by substance abuse it is essential that social workers understand the multi-causal nature of the phenomenon. This course is designed to provide students with the knowledge, skills, and sensitivity to practice in the area of substance abuse treatment.

Course Competencies: By the completion of this course, the students are expected to be able to (through course activities, assignments, and/or exams):

1) Articulate key elements of the sociopolitical-history of substance abuse in the United States. (Diversity-adv. 4, CT/EBP-adv. 3, HBSE-adv. 2) (Content: Brief history of substance abuse across time and cultures, Review of policies and sociopolitical factors that sustain and constrain substance abuse, Examination of the role of sex, religion, and commerce in alteration of consciousness and related substance use across time)

2) Articulate an understanding of the etiology and epidemiology of substance abuse. (HBSE-adv. 1, Diversity-adv. 2, CT/EBP-adv. 1) (Content: Prevalence of use, abuse, and substance dependence, Epidemiological sources and resources, Substance abuse etiological theories and empirical evidence)

3) Articulate knowledge of the basic pharmacology of drugs of abuse. (HBSE-adv. 1) (Content: Basic neurophysiology, drug classifications, dosage, dose response curve, drug interactions, drugs of abuse)

4) Articulate knowledge of physiological reactions to drugs of abuse including overdose, craving, tolerance, withdrawal, and other adverse effects on health. (HBSE-adv. 1) (Content: General physiological and neurological model of addiction)

5) Demonstrate knowledge of models of and resources for evidence-based substance abuse treatment. (CT/EBP-adv. 1, Practice-adv. 1, 2, 3) (Content: NIDA, NIAAA, SAMHSA resources)

6) Demonstrate knowledge and skills in clinical screening, assessment, and diagnosis of substance use, misuse, and abuse. (Practice-adv. 1, CT/EBP-adv. 1, Values and Ethics-adv. 1) (Content: Substance abuse screening and assessment instruments, motivational interviewing, brief interventions, diagnostic criteria)

7) Demonstrate advanced skills in the use of motivational interviewing techniques. (CT/EBP-adv. 1, 2) (Content: Basic and advanced motivational interviewing skills)

8) Develop evidence-based, substance abuse treatment plans. (CT/EBP-adv. 1, 2) (Content: NIDA, NIAAA, SAMHSA resources)

9) Describe strategies for adapting evidence-based substance abuse treatment interventions to individuals, families and groups of varying backgrounds such as age, ethnicity, culture, gender, affectional preference, and religious affiliation. (Diversity-adv. 1, 2, 3, 4) (Content: Current research literature on between group and within group variations in patterns of substance use and abuse, genetic vulnerabilities and protective factors, Risk and protective factors associated with age, ethnicity, culture, and socioeconomic status)

10) Demonstrate knowledge of treatment planning and delivery for individuals with co-occurring disorders. (CT/EBP-adv. 1, Practice-adv. 1, 2, 3) (Content: NIDA, NIAAA, SAMHSA resources for treatment of individuals with co-occurring disorders)

11) Articulate an understanding of the ethical challenges and their resolution in substance abuse treatment including confidentiality, informed consent, the duty to care, and respect for client self-determination. (Values and Ethics-adv., 1, 2, 3) (Content: The unique and complex ethical challenges that arise in substance abuse treatment)

12) Demonstrate an understanding of the processes of recovery, relapse, and relapse prevention. (CT/EBP-adv. 1, Practice-adv. 1, 2, 3) (Content: Motivation Enhancement Therapy, NIDA, NIAAA, SAMHSA resources for recovery and relapse prevention, Cognitive-Behavior Therapy)

Grading – SW 530

Assignments	% of Grade
Midterm – Course Competencies 1-7	35
Class attendance and active participation	10
Motivational Interviewing Demonstration Video – Course Competency 7	20
Final – Course Competencies 1-12	35
Total	100

Motivational Interviewing Demonstration Video – Competency 7

This project requires the production of a 10-15 minute digital video (on digital video tape or DVD) demonstrating basic and advanced motivational interviewing skills. Students may work in teams of 2. Each student assume the role of interviewer (helper) and the "client" in a motivational interviewing role play. Projects will be graded on the quality of the skills demonstrated.

Course Outline

Readings listed here are subject to change and addition until the first day of class.

1/13/09 - Introduction/Course Overview/Historical Review of Addictions

Course Competency 1

Historical and Social Context of Psychoactive Substance Use Disorders - Joseph Westermeyer - Clinical Textbook of Addictive Disorders (2005). Blackboard Course Site – Documents

Forces of Habit: Drugs and the Making of the Modern World (2001) – David T. Courtwright

Chapter 1 – The Big Three: Alcohol, Tobacco, and Caffeine

Chapter 2 – The Little Three: Opium, Cannabis, and Coca

Chapter 5 - A Trap Baited with Pleasure

Blackboard Course Site – Documents

1/20/09 - Etiological Models of Substance Abuse

Course Competency 2

The Genetics of Alcohol and Other Drug Dependence (2008) Alcohol Research and Health

Etiology and the Natural History of Alcoholism (NIAAA, 2005)

Environmental Factors Affecting Alcohol Use: Cultural and Social Research Findings - Daniel Yalisove - Blackboard Course Site – Documents

Epidemiology and Theories of Addiction

Epidemiology of Alcohol Abuse Problems in the United States (NIAAA, 2005)

Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys (2008) PLOS Medicine

An Epidemiologic Analysis of Co-Occurring Alcohol and Drug Use and Disorders (2008) Alcohol Research and Health

Nationwide Trends (NIDA, 2008)

1/27/09 - Neurophysiology and Pharmacology of Substance Abuse

Course Competencies 3 & 4

Shared Mechanisms of Alcohol and Other Drugs (2008) Alcohol Research and Health

What Is Craving? Model and Implications for Treatment (1999) Alcohol Research and Health

Prelude to Passion: Limbic Activation by ‘‘Unseen’’ Drug and Sexual Cues (2008) www.plosone.org

Pharmacology-Drug Use and Abuse (2004) - Blackboard Course Site – Documents

Alcohol and Its Effects on the Body - (Chapter 3) - Daniel Yalisove -Digital reserve

Introduction to the Brain -http://www.drugabuse.gov/pubs/teaching/Teaching2.html

The Reward Pathway and Addiction - http://www.drugabuse.gov/pubs/teaching/Teaching2.html

The Action of Heroin (Morphine) - http://www.drugabuse.gov/pubs/teaching/Teaching2.html

The Action of Cocaine - http://www.drugabuse.gov/pubs/teaching/Teaching2.html

Introduction to Drugs of Abuse: Cocaine, Opiates (Heroin) and Marijuana (THC) - http://www.drugabuse.gov/Teaching/teaching4.html and http://www.drugabuse.gov/Teaching/teaching5.html

2/3/09 - Drugs of Abuse

Course Competencies 3 &4

Health Effects of Specific Drugs - NIDA InfoFacts: Science-Based Facts on Drug Abuse and Addiction (2008)

Commonly Abused Drugs - http://www.nida.nih.gov/DrugsofAbuse.html

Review each of the drugs above in the Vaults of Erowid - http://www.erowid.org/psychoactives/

2/10/09 – Stages of Change----Diagnosis and Assessment

Course Competency 6

Transtheoretical Model - Stages of Change

A 'Stage of Change' Approach to Helping Patients Change Behavior - American Family Physician (March 1, 2000)

Current methods of assessing substance use: A review of strengths, problems, and developments- Journal of Drug Issues, Fall 2001; Linda Richter; Patrick B Johnson

Substance Use Screening & Assessment Instruments Database

Screening Alcohol Problems in Social Work Settings (NIAAA, 2005)

Diagnosis and Assessment of Alcohol Use Disorders (NIAAA, 2005)

2/17/09 - Models And Resources For Evidence-Based Substance Abuse Treatment

Course Competency 5

CSAT Inventory of Effective Substance Abuse Treatment Practices

http://csat.samhsa.gov/treatment.aspx

National Registry of EBP -http://www.nrepp.samhsa.gov/

Evidence-based practices for treating substance abuse disorders

http://adai.washington.edu/ebp/matrix.pdf

Research Refines Alcoholism Treatment Options

National Treatment Trends - NIDA, 2003

Motivation and Treatment Interventions

An overview of the effectiveness of adolescent substance abuse treatment models Youth and Society; Dec 2001

Scientifically Based Approaches to Drug Addiction Treatment

2/24/09 - Motivational Interviewing Skill Building

Course Competency 7

Enhancing Motivation for Change in Substance Abuse Treatment - SAMHSA/CSAT Treatment Improvement Protocols – Chapters 1- 5

DiClemente and Scott - Stages of Change: Interactions with Treatment Compliance and Involvement -Digital reserve

3/3/09 – Motivational Interviewing Skill Building

Course Competency 7

Enhancing Motivation for Change in Substance Abuse Treatment - SAMHSA/CSAT Treatment Improvement Protocols – Chapters 6 – 9, Appendix B

3/10/09 - Online Midterm Due-Post Test Review

Course Competency 8

Discussion of digital demonstration projects

Developing Evidence-Based, Substance Abuse Treatment Plans

Cognitive Behavioral Approaches to Substance Abuse Treatment

Brief Interventions and Brief Therapies for Substance Abuse – SAMHSA (2000)

Cognitive Therapy - Beck, Liese, and Najavits, Clinical Textbook of Addictive Disorders (2005) Blackboard Course Site – Documents

A Cognitive-Behavioral Approach: Treating Cocaine Addiction

3/17/09 - Spring Break!

3/24/09 - Adolescent Substance Abuse

Course Competency 8

Adolescents and Treatment of Alcohol Use Disorders

Alcohol and Development in Youth - Scope of the Problem

Interventions for Alcohol Use and Alcohol Use Disorders

Psychosocial Processes and Mechanisms of Risk and Protection

Social and Psychological Influences on Emerging Adult Drinking Behavior

The Quality of Highly Regarded Adolescent Substance Abuse Treatment Programs

Results of an In-depth National Survey (2004) - Blackboard Course Site – Documents

3/31/09 -Treatment with Groups --- Ethical issues in Addiction Treatment

Course Competencies 9 and 11

Group Therapy, Self-Help Groups, and Network Therapy, Galanter, Hayden, Castaneda, & Franco. Clinical Textbook of Addictive Disorders (2005) Blackboard Course Site – Documents

Substance Abuse Treatment: Group Therapy (SAMSHA TIP 41)

Legal and Ethical Issues in the Prevention and Treatment of Alcohol Use Disorders

4/7/09 – Co-Occurring Disorders, Self Help, Mutual Help and Harm Reduction

Course Competency 10

Comorbidity of Alcohol and Psychiatric Disorders (NIAAA, 2005)

Substance Abuse Treatment for Persons With Co-Occurring Disorders (SAMSHA, TIP 42)

Alcoholics Anonymous and Other 12-Step Groups - Chad D. Emrick -Digital reserve

Harm Reduction – MacMaster 2004- Blackboard Course Site – Documents

4/14/09- Treatment of Special Populations

Course Competency 9

Women and alcoholism: A biopsychosocial perspective and treatment approaches

Substance Abuse Treatment and Family Therapy

Women and Alcohol

Sexual Orientation and Alcohol Use Disorders

Ethnicity, Culture, and Alcohol

Trauma and Substance Abuse ------ http://www.seekingsafety.org/

Seeking Safety: An Evidence Based Model for Substance Abuse and Trauma/PTSD

4/21/09 - Drug Courts - Relapse and Prevention - Class Wrap-up

Course Competency 12

Substance abuse counselors’ treatment philosophy and the content of treatment services provided to offenders in drug court programs Faye S. Taxman, Ph.D. , Jeffrey A. Bouffard, Ph.D. - Digital Reserve

Painting the Current Picture: A National Report Card on Drug Courts and Other Problem Solving Court Programs in the United States (2005) – Also see http://www.whitehousedrugpolicy.gov/enforce/drugcourt.html

Juvenile Drug Court: Enhancing Outcomes by Integrating Evidence-Based Treatments (2006) Blackboard Course Site – Documents

Prevention Materials - Mind over Matter

Preventing Drug Abuse Among Children and Adolescents: A Research Based Gu –

4/28/09 – Final Due – Course Competencies 1-12