University of Tennessee
College of Social Work

Evidence-Based Substance Abuse Treatment

Social Work 530 - 005
Summer 2009 – Tuesdays and Thursday (10:00-12:00)
2 Credit Hours
Room 328 Henson Hall 
David A. Patterson, Ph.D.
Professor 

Address

224 Henson Hall

Phone

865-974-7511

Office Hours

Tuesday and Thursday afternoons or by appointment

E-mail
Home Page

dpatter2@utk.edu
http://web.utk.edu/~da

 
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)

Methods to Attain Objectives

The primary learning format will be lectures, classroom exercises, and activities, which involve all students as active learners. Class lectures and exercises are based on the understanding that readings assigned for that topic have been completed prior to class.

Assignments                                                   

% of Grade

Attendance and Participation

  10

Special Substance Abuse Topic Paper or Digital Project

  45

Final

  45

Total

100

Student grades letter grades are assigned based on the total points distribution for the class. Students in the first standard deviation above the mean will receive a B+. Students in the second standard deviation above the mean will receive an A. Students in the first standard deviation below the mean will receive a B and those in the second standard deviation below the mean will receive a C+.

Paper

In this paper you are to examine an area of substance abuse treatment of interest to you. This is an opportunity to develop specialized knowledge about a particular area of substance abuse treatment. Topics might include, but are not limited to, the efficacy of partial hospitalization treatment, treatment of cocaine addicted mothers, outpatient treatment of adolescents, prison addiction treatment, or treatment of individuals with dual diagnoses. If you have questions about the paper or wish to discuss possible topics, please email me.

The paper should include the following:

1. a biopsychosocial description of the problem or population including recent research findings,

2. a discussion of the social impact of the problem or population (why is this population or problem important?),

3. a review of treatment methods with special attention paid to evidence-based practice methods,

Criteria for evaluation of papers will include clarity, organization, synthesis of material, and overall mastery of content. Organization of your paper can enhance your grade. Papers need a beginning, middle, and an end. Introduce your topic and outline what will be covered in the paper. Use subheadings to direct the reader in the body of the paper. Summarize your conclusions at the end.

The paper must be typed and there must be at least 12 non-Internet references. The paper should be in APA format. The length should be 14 -18 pages and it may be turned in any time. It must be submitted no later than July 2th. Papers should be submitted to the digital drop box of the Blackboard course site. 

Alternative Digital Project  - Motivational Interviewing

This project requires the production of a 10-15 minute digital video (on digital video tape or DVD) demonstrating specific Motivational Enhancement skills.  Students may work in teams of 2 or 3 members.  Ideally, the edited final cut of the video will show the interviewer (helper) and the "client" in a Motivational Interviewing role play and indicate with titles the Motivational Interviewing principles employed.  Projects will be graded on the quality of the skills demonstrated and the overall quality of the digital project.


Course Outline

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

6/2/2009 -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


6/4/2009 - 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)


6/9/2009 - Neurophysiology and Pharmacology of Substance Abuse
Course Competencies 3 & 4

What Is Craving? Model and Implications for Treatment

 The Neurobiology of Substance Dependence: Implications for Treatment, Kosten, George, & Kleber Clinical Textbook of Addictive Disorders (2005). Blackboard Course Site - Documents 

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

The Neurobiology of Drug Addiction - NIDA- Science of Drug Abuse and Addiction

http://www.drugabuse.gov/scienceofaddiction/brain.html

The Biological Basis of Addiction

Pharmacology (Chapter 4) Drug Use and Abuse (2004) Blackboard Course Site - Documents


6/11/2009 - Drugs of Abuse 
Course Competencies 3 &4

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


6/16/2009 - Diagnosis, Assessment, and Treatment
Course Competency 6

Current methods of assessing substance use: A review of strengths, problems, and developments

Detoxification From Alcohol and Other Drugs

Center on Alcoholism, Substance Abuse, and Addictions - Assessment Instruments

Criteria for Substance Dependence Diagnosis

Substance Use Screening & Assessment Instruments Database

Transtheoretical Model - Stages of Change

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


6/18/2009 - 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 

 Motivation and Treatment Interventions

Evidence-Based Substance Abuse Treatment Resources 

Relapse Prevention

The Matrix Model

Supportive-Expressive Psychotherapy

Individualized Drug Counseling

Motivational Enhancement Therapy

Behavioral Therapy for Adolescents

Multidimensional Family Therapy (MDFT) for Adolescents

Multisystemic Therapy (MST)

Combined Behavioral and Nicotine Replacement Therapy for Nicotine Addiction

Community Reinforcement Approach (CRA) Plus Vouchers

Voucher-Based Reinforcement Therapy in Methadone Maintenance Treatment

Day Treatment with Abstinence Contingencies and Vouchers


6/23/2009 - Motivational Interviewing
Course Competency 7
Enhancing Motivation for Change in Substance Abuse Treatment - SAMHSA/CSAT Treatment Improvement Protocols 
DiClemente and Scott - Stages of Change: Interactions with Treatment Compliance and Involvement-Blackboard Course Site – Documents

Motivational Interviewing Digital Demonstration


6/25/2009 - Evidence-Based Substance Abuse Treatment Practices
Course Competency 7, 9, 11

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

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

6/30/2009 -  Co-Occurring Disorders, Adolescent Treatment, Harm Reduction and Treatment of Special Populations
Competencies 8, 9, and 10

Adolescents and Treatment of Alcohol Use Disorders

Interventions for Alcohol Use and Alcohol Use Disorders

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

Substance Abuse Treatment and Family Therapy

Women and Alcohol

Sexual Orientation and Alcohol Use Disorders

Ethnicity, Culture, and Alcohol

Truama and Substance Abuse

Comorbidity of Alcohol and Psychiatric Disorders (NIAAA, 2005)

Substance Abuse Treatment for Persons With Co-Occurring Disorders (SAMSHA, TIP 42)
 Harm Reduction – MacMaster 2004- Blackboard Course Site – Documents

7/2/07Final Due - Course Competencies 1-11


Major Readings and Bibliography

Alcoholics Anonymous. (1976).  Alcoholics anonymous, AA World Service: New York, NY.

Akers, R. L. (1992) Drugs, Alcohol, and Society. Belmont, CA: Wadsworth Publishing Co.

Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (1993). Cognitive Therapy of Substance Abuse. The Guilford Press: New York.

Booth, B. M. , Yates, W. R. , Petty, F. & Brown, K. (1991). Patient factors predicting early alcohol-related readmissions for alcoholics: role of alcoholism severity and psychiatric co-morbidity. Journal of Studies on Alcohol, 52(1), 37-43.

Des Jarlais, D. (1995).  Harm reduction: a framework for incorporating science into drug policy.  American journal of public health, 85, 10-12.

Drucker, E.  (1995).  Harm reduction: a public health strategy.  Current issues in public health, 1, 64-70.

Fishbein, D. H. & Pease, S. E. ( 1996) The Dynamics of Drug Abuse. Boston, MA: Allyn & Bacon.

Frances, R. J. (1988). Update on alcohol and drug disorder treatment. J Clin Psychiatry, 49 (9), 13-17.

Frances, R. J., Miller, S. I., & Mack, A. H. (2005). Clinical Textbook of Addictive Disorders, 3rd. Ed., New York: The Guilford Press.

GAP Committee. (1991). Substance abuse disorders: A psychiatric priority. Am J Psychiatry, 148 (10), 1291-1300.

Gerstein, D. R. (1994). Outcome research, drug abuse. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 45-64). Washington, DC: American Psychiatric Press, Inc.

Golden, S. J., Khantzian, E. J., & McAuliffe, W. E. (1994). Group therapy. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 303-314). Washington, DC: American Psychiatric Press, Inc.

Gomberg, E. S. L. (1993). Women and alcohol: Use and abuse. The Journal of Nervous and Mental Disease. 181, (4), 221-219.

Haaken, J. (1990). A critical analysis of the co-dependence construct. Psychiatry, 53, (November) 396-406.

Hester, R. K. (1994). Outcome research, alcoholism, In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 35-44). Washington, DC: American Psychiatric Press, Inc.

Hester, R. K. & Miller, W. R. (1995) Handbook of Alcoholism Treatment Approaches: Effective Alternatives, 2nd Ed.. Boston, MA: Allyn and Bacon.

Jenson, J. , Howard, M. O. & Yaffe, J. (in review). Treatment of adolescent substance abusers: issues for practice and research.

Kaminer, Y. (1994). Adolescent substance abuse. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 415-437). Washington, DC: American Psychiatric Press, Inc.

Kaufman, E. (1994). Family therapy: Other drugs. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 331- 349). Washington, DC: American Psychiatric Press, Inc.

Leccese, A. P. (1991). Drugs and Society: Behavioral Medicines and Abusable Drugs. Englewood Cliffs, NJ: Prentice-Hall.

McNeece, C. A. & DiNitto, D. M. (1994). Chemical Dependency: A systems approach. Englewood Cliffs, NJ: Prentice-Hall.

Miller, W. R. (1992). The effectiveness of treatment for substance abuse, Journal of Substance Abuse Treatment, 9, 93-102.

Miller, W., & Rollnick, S. (1991).  Motivational interviewing: Preparing people to change addictive behavior.  New York: Guilford Press.

Narcotics Anonymous. (1988). Narcotics anonymous. Van Nuys, CA: NA World Service Office.

Peele, S. (1989). Diseasing of America. Lexington, MA: Lexington Books.

Schonttenfeld, R. S., (1994). Assessment of the patient, In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 25-33). Washington, DC: American Psychiatric Press, Inc.

Steinglass, P. (1994). Family therapy: Alcohol. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 315-329). Washington, DC: American Psychiatric Press, Inc.

Van Womer, K. & Davis, D. R. (2003). Addiction Treatment: A Strengths Perspective. Pacific Grove, CA: Brooks-Cole.

Yaffe, J. , Jenson, J. M. , & Howard, M. O. (in review). Gender differences in substance abuse: implications for treatment of women.

Yalisove, D. (2002). Introduction to Alcohol Research: Implications for Treatment, Prevention, and Policy. Boston: Allyn & Bacon.