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Office of Mental Health

Schools of Social Work Deans' Consortium Project
for Evidence-Based Practice in Mental Health
Course Syllabus (2008 Update)

The original syllabus was developed and written in 2004 by:

Lauren B. Gates, Ph.D., Columbia University
Zvi D. Gellis, Ph.D., SUNY at Albany
Patricia Joyce, DSW, Adelphi University
Ellen P. Lukens, Ph.D., Columbia University
Susan Mason, Ph.D., Yeshiva University
Nancy J. Smyth, Ph.D., University at Buffalo
Shelly Wiechelt, Ph.D., University at Buffalo

The additional following faculty participated in the 2008 update:

Ellen Tuchman, Ph.D. New York University
Catherine Dulmus, Ph.D., University at Buffalo
Eric Hardiman, Ph.D., University at Albany
Jean Dingee, LCSW, New York State Office of Mental Health
Charles Robbins, Ph.D., Stony Brook University
Sekile Nzinga-Johnson, Ph.D., SUNY Brockport

Production of this report was supported by a grant from the New York State Office of Mental Health in partnership with the New York State Social Work Deans' Consortium.

Social workers play a significant role in the delivery of mental health services. With the increased national emphasis on evidence-based practices, that is, providing interventions with demonstrated research support, there is a need to ensure that social workers are conversant in these approaches to ensure quality mental health systems that are effective and efficient. The content in this syllabus was developed specifically with this aim, and is to be included in the presentation of this course.

The course syllabus was designed for student use and provides a week by week outline of classroom topics and readings. Week eight is a "free week" meant to give faculty the option of either expanding a topic under review or to provide time for presentations by a guest speaker. Four texts were selected for as options for required course readings and twelve were recommended as additional options. In light of the fact that an enormous amount of information will be covered in thirteen weeks, selection of the texts included not only considerations of cost to the student, but presentation of relevant material that was fairly brief and straightforward. A list of supplemental required readings is also listed for each weekly module.

Course Description

This course is aimed at developing the knowledge and skills necessary for working with individuals with a diagnosis of serious mental illness using recovery-oriented, evidence-based practices.  It is designed for MSW students and MSW mental health practitioners.  Students will become familiar with evidence-based practices, within a recovery-oriented paradigm, as a general approach to practice as well as specific evidence-based interventions to use for individuals with a diagnosis of serious mental illness.  It is assumed that students will have a basic knowledge of serious mental illness as a pre- or co-requisite, however a review will be provided.  Students will learn to examine research literature to determine the various levels of support for specific interventions and essential principles for translating research into practice.  In addition, they will identify the appropriate treatment outcomes that reflect effective, quality mental health practice.  Each evidence-based practice presented will also be examined for its utility with diverse groups.  Providing assessment and treatment to a diverse group of individuals with a diagnosis of serious mental illness is the focus of this course and will be discussed in detail.

Prerequisite: Foundation year in MSW program or equivalent.

Prerequisite or Co-requisite: Psychopathology

Objectives

At the completion of this course students will be able to:

  1. Critically review the research literature to determine the level of evidence that exist for a practice (including distinguishing between evidence-based practice, best practices, and areas with emerging research knowledge).
  2. Translate research, identified in the literature as demonstrating effective treatment outcomes, into practice principles for individuals with a diagnosis of  serious mental illness (include the role and measurement of fidelity).
  3. Describe strategies to evaluate and monitor client progress over time in treatment outcomes that are appropriate for specific interventions for individuals with a diagnosis of serious mental illness.
  4. Demonstrate a working knowledge of the recovery paradigm as it relates to working with individuals with a diagnosis of serious mental illnesses.
  5. Demonstrate an understanding of the value and importance of using self-help strategies with consumers of mental health services.
  6. Describe the importance of using evidence-based practices with individuals with a diagnosis of serious mental illness.
  7. Discuss for which type of clients the evidence base on a given practice exists.
  8. Discuss principles for adapting interventions for use with diverse groups of clients.
  9. Describe unique components of assessment and treatment planning that are relevant for each evidence-based practice, client trauma history, and coexisting substance abuse problems for people with serious mental illness.
  10. Describe the role of social work values and ethics in evidence-based practice with individuals with a diagnosis of serious mental illness.
  11. Describe principles of technology transfer for organizational change in mental health.

Readings

Required Texts: 

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health practice:  A textbook..  New York:  W.W. Norton.

    And/OR

  • Rosenberg, J. and S.  (2006). Community Mental Health: Challenges for the 21st Century. Oxford: Taylor and Francis Press

    And

  • Preston, J., O'Neal, Talaga, M. (4th ed.). Handbook of clinical psychopharmacology for therapists. New Harbinger Pub. Inc. 

    And

  • Miller, R., & Mason, S.E.  Diagnosis schizophrenia. (2002). New York: Columbia University Press

Recommended Texts:

  • Briggs, H., & Rzepnicki, T. (2004).  Using evidence in social work practice: Behavioral Perspectives.  Chicago: Lyceum Books, Inc. 
  • Gambrill, E. (2006).  Social work practice: A critical thinkers guide.  USA: Oxford University Press.
  • Linhorst, D. (2005).  Empowering people with severe mental illness:  A practical Guide. NY, Oxford University Press.
  • Lefley, H. P. (2005).  Advanced family work for schizophrenia:  An evidence-based approach. London, Gaskell Publications. A short book containing 19 case studies detailing how clinicians deal with special problems that arise in family psychoeducation for schizophrenia.
  • McFarlane, W.  (2002). Multiple family groups in the treatment of severe psychiatric  disorders. New York: Guilford Press.
  • Norcross, J.C. et al (Eds.) (2006).  Evidence-based practices in mental health:  Debate and dialogue on the fundamental questions.  APA, Washington, DC.
  • Paul, R. and Elder, L. (2005).  A guide for educators to critical thinking competency standards: standards, principles, performance indicators, and outcomes with a critical thinking master rubric.  Foundation for Critical Thinking. 64 pages $4.00 each for 25 copies. Can be ordered online www.criticalthinking.org Leaving OMH site.
  • Paul, R. and Elder, L. (2005).  Critical thinking concepts and tools.  Foundation for Critical Thinking. 19 pages $2.00 each for 25 copies.
  • Pyrczak, F. (1999).  Evaluating research in academic journals.  L.A, California:  Pyrczak Publishing.
  • Sands, R.G. (2001).  Clinical social work practice in behavioral mental health:  A postmodern approach to practice with adults.  Needham Heights, Mass: Allyn & Bacon.
  • Thyer, B. & Wodarski, J. (Eds.) (2007).  Social work in mental health:  An evidence-based approachNY: Wiley.
  • Watkins, T.R., Lewellen, A., and Barrett, M.C. (2001).  Dual diagnosis: An integrated approach to treatment.  Thousand Oaks, CA: Sage Publications

Assignments

  1. Mental Health Interventions:

    Case Application: Class sessions 3-13 cover specific mental health interventions. Using the case the instructor provides, write three brief papers (3-5 pages) on three of these interventions (one paper on each intervention)  and how they might be applied to the case example. Included in the paper should be: your assessment of how well the intervention meets the client's needs, anticipated barriers to implementing the intervention and how they might be addressed, and the degree to which the interventions are compatible with social work values. [Note to instructor: this assignment could be completed through class presentations & role plays instead of through a paper; see case in curriculum guide]

    Modified versions: 

    1. Students will choose a racial/ethnic group and conduct and report on research answering the question: What are the obstacles faced by members of this group in accessing needed mental health services?  Students complete a short paper with references. 
    2. Students present a one hour "group" demonstration/training for one intervention (social skills, family psycho-education, or motivational interviewing) and provide an overview to the class of the readings and the intervention, demonstrate the intervention through role-play, and then train the class in the intervention.
    3. Option # 1 - Select a client from your placement setting whose medication you would like to understand. Briefly provide a brief summary of the presenting issues for this client (up to two pages)
      • Presenting problem
      • Diagnosis
      • Major Strengths
      • Major challenges and stressors
      • Major supports
      • Treatment setting
      • Medication(s) and dose
      • Rationale for medicine and dose (Why this particular medication or set of medications?)
      • How is the medication monitored?  By whom?
      • Observation of compliance and effectiveness

      Then address the following questions:

      • Is the current treatment plan successful?  What's working?  What's not?
      • Is the client aware of what medication(s) he or she is taking? How does he or she understand the use of and adherence to medication in relationship to overall treatment?
      • What are the implications of selecting this particular medication for the client?  What needs to be monitored in the future? What does the client need to know about the particular medication (or set of medications) that he or she is taking>
      • How would you work with the client to increase knowledge regarding the selection of the medication(s)  and the importance of adherence to treatment?

      In a concluding section, reflect on what you have learned through the process of preparing the paper.

      Option #2 - Select a diagnosis and a medication that is used to treat someone with that diagnosis...

      Conduct a literature based and internet based search to gather some basic information on the medication.

      First, provide a detailed description of the medication that you have selected.

      • What group or groups of clients would be a candidate for this particular medication?  Why?

      How does the medicine work (action in the brain)?  See the following web site to help you out: http://thebrain.mcgill.ca/ Leaving OMH site

      • What are some of the benefits of the drug? Risks? Side effects? Dosage?
      • When would the medication be indicated for a particular client or group of clients?  Contraindicated?

      In the second part of the paper, describe the medication in a fashion that would be understandable to an individual with a psychotic disorder and/or the caregiver for such individual.  Prepare an informational description that you could use to teach a client or group of clients about this particular medication.  Attend to language and simplicity of presentation. As you write, consider what questions a client might ask (i.e. what that client might need or want to know). 

      In a concluding section, reflect on the challenges involved in learning about the particular medication that you select so that you would in turn be able to educate your client(s) effectively.

      Note:  for either option, provide a brief list of references (articles, websites etc).  Use APA style. 

  2. Evaluating the Evidence for an Intervention [Note to instructor: select one of  the following assignments-details are available in the curriculum guide]:
    1. Poster Session: choose a specific intervention related to individuals with a diagnosis of serious mental illness and create a poster session that summarizes the intervention (including key components for fidelity); its goals, targets & desired outcomes; the nature of the evidence supporting the intervention; and what future research needs to focus on to enhance its level of empirical support, or to demonstrate it's effectiveness with key populations. Posters will be presented at the class poster session, and you will need to provide poster reprints so your classmates can each have a copy. The instructor will distribute a more detailed description of this assignment. [Note to instructor, see curriculum guide].
    2. Research Evaluation Paper: Choose a specific research article that evaluates an intervention related to individuals with a diagnosis of serious mental illness. For example, you might decide to focus on cognitive therapy with individuals with a diagnosis of schizophrenia. Your intervention can be covered in the course, but you must pull in literature beyond the course syllabus. Write a paper that addresses the following questions/points: description of the intervention (including key components for fidelity), goals/targets/desired outcomes of this intervention, nature of all the evidence supporting the intervention, categorize the intervention according to one of the Level of Evidence classification models given to you by the instructor, discuss what additional research is needed on this intervention to enhance its level of empirical support, or to demonstrate it's effectiveness with key populations . [Note to instructor, see curriculum guide for more detail on the assignment and for Level of Evidence models].
    3. Group Presentation on Evidence-Based Practice: develop and present a one hour presentation on one of the interventions covered in the class. Presentations should include, at a minimum: description of the intervention, summary of the research support for the intervention, and any local/regional agencies that provide the intervention. Presentations will occur in the scheduled class session where the intervention is to be discussed. Guest speakers (agency staff, consumers, etc.) are allowed, but they can't do the entire presentation.
  3. Class Participation: Class sessions will involve a variety of class activities, including discussion and role plays that are essential to learning the course content.

Module One (prepared by Drs. Ellen Lukens and Ellen Tuchman)

Introduction to Course & Recovery, Stigma & Mental Illness –

  • Review of course, syllabus & assignments
  • Review of bio-psycho-social model
  • Recovery framework
  • Stigma

Required Readings:

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health practice:  A textbook.  New York:  W.W. Norton. Chapter 1 and 13.

    And/Or

  • Rosenberg, J. & Rosenberg, S. (2006).  Community mental health:  Challenges for the 21st century. New York: Routledge Press.  Chapters 2 and 3.
  • Deegan, P. (2003). Discovering recovery. Psychiatric Rehabilitation Journal 26(4), 368-376.
  • Liberman, R. P. & Kopelowicz, A. (2005). Recovery from schizophrenia: A concept in search of research.  Psychiatric Services, 56(6), 735-742.
  • Ridgway, P.  (2001). Restorying psychiatric disability: Learning from first person recovery narratives.  Psychiatric Rehabilitation Journal, 24(4), 335-343.
  • Corrigan, P., Markowitz, F., & Watson, A. (2004).  Structural levels of mental illness stigma and discrimination.  Schizophrenia Bulletin 30 (3), 481-491.
  • Estroff, S., Penn, D., & Toporek, J.  (2004). From stigma to discrimination:  An analysis of community efforts to reduce the negative consequences of having a psychiatric disorder and label.  Schizophrenia Bulletin 30 (3), 493-509.

Recommended Readings:

  • New York City Voices Recovery Stories:  Personal stories of mental health recovery http://www.newyorkcityvoices.org/recovery.html Leaving OMH site
  • Onken, S.J. et al. (2004). An analysis of the definitions and elements of recovery. a review of the literature. Pre-conference paper prepared for the National Consensus Conference on Mental Health Recovery and Systems Transformations. SAMHSA. Rockville, MD.
  • Steele, K. & Berman, C.  (2001). The Day the Voices Stopped: A Memoir of Madness and Hope.  Basic Books.
  • Surgeon General (1999).  Overview of recovery [in Chp. 2, The fundamentals of mental health and illness]. In Mental health: A report of the Surgeon General. [Electronic version]. Rockville, MD: Office of the Surgeon General, US Public Health Service. Retrieved May 10, 2003 from:  http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec10.html Leaving OMH site
  • Surgeon General (1999). The roots of stigma [in Chp. 1, Introduction and themes]. In Mental health: A report of the Surgeon General. [Electronic version]. Rockville, MD: Office of the Surgeon General, US Public Health Service. Retrieved May 10, 2003 from: www.surgeongeneral.gov/library/mentalhealth/chapter1/sec1.html#roots_stigma Leaving OMH site

Module 2 (Prepared by Dr. Catherine Dulmus)

Introduction to Evidence-based practice and Review of Serious Mental Illness (SMI)

  • Importance of using evidence based practice
  • Policy/system context for EBP
  • Ethical issues involved in EBP
  • Responsible use of EBP
  • Social work
  • Utilization of fidelity and outcome measurements

Required Readings:

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health  practice:  A textbook.  New York:  W.W. Norton. Chapters 3, 7, 9 and 10 

    And/Or

  • Rosenberg, J. & Rosenberg, S. (2006).  Community mental health:  Challenges for the 21st century. New York: Routledge Press.  Chapters 4, 5 and 7. 
  • McNeece, A., & Thyer, B. (2004). Evidence-based practice in social work. Journal of Evidence-based Social Work, 1(1), 7-25.
  • Thyer, B.A. (in press).  Interventions with adults.  In K. M. Sowers &  C.N. Dulmus (Editors-in-Chief).  The Comprehensive Handbook of Social Work and Social Welfare, Vol 3, Practice.  Hoboken, NJ: John Wiley & Sons. 1-52 (to forward as an electronic attachment to faculty)

Recommended Readings:

  • Magill M. (2006).  The future of evidence in EBP.  Who will answer the call for clinical relevance?  Journal of Social Work 6(2), 101-115. 

Module 3 (Prepared by Dr. Eric Hardiman)

 PACT—Program for Assertive Community Treatment 

  • Differentiating ACT from case-management
  • Tracking expected outcomes for ACT interventions
  • PACT Program Fidelity Components
  • Critical Perspective of Service Delivery
  • Comprehensive bio-psycho-social assessment
  • Treatment Planning
  • Effective teamwork skills
  • Client-Centered Problem Solving Therapy

Required Readings:

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health practice:  A textbook.  New York:  W.W. Norton. Chapters 2,  4, and 14.

    And/Or

  • Rosenberg, J. & Rosenberg, S. (2006).  Community mental health:  Challenges for the 21st century. New York: Routledge Press.  Chapters 16.
  • Dixon, L. (2000). Assertive Community Treatment; Twenty-five years of gold Psychiatric Services, 51(6), 759-765.
  • O'Hara, A. (2007).  Housing for People With Mental Illness: Update of a Report to the President's New Freedom Commission.  Psychiatric Services, 58(7), 907-913.
  • Lehman, A. F., Dixon, L. B., Kernan, E. DeForge, B. R., & Postrado, L. T. (1997).  A randomized trial of assertive community treatment for homeless persons with severe mental illness.  Archives of General Psychiatry, 54 , 1038-1043.
  • Phillips ,S.D., Burns, B.J., Edgar, E.R., Mueser, K.T., Linkins, K.W., Rosenheck, R.A., Drake, R.E., McDonel Herr, E.C. (2001)   Moving Assertive Community Treatment Into Standard Practice. Psychiatric Services, 52(6), 771-779.
  • Tam, C., & Law, S. (2007). Best Practices: A Systematic Approach to the Management of Patients Who Refuse Medications in an Assertive Community Treatment Team Setting.  Psychiatric Services, 58(4),457-459.

Recommended Readings:

  • Angell B, Mahoney CA, Martinez NI: Promoting treatment adherence in assertive community treatment. Social Service Review 80:485–526, 2006
  • Bond, G. (2001). Assertive Community Treatment: Best practice. Presented at New York State Office of  Mental Health Best Practices Conference, June 11, 2001, Workshop 11: Theory and Practice: Assertive Community Treatment. Retrieved March 23, 2003, from http://www.omh.state.ny.us/omhweb/aboutomh/transcripts/bond.htm.
  • Gomory, T. (2005). Assertive Community Treatment (ACT): The Case Against the "BestTested" Evidence-Based Community Treatment for Severe Mental Illness. In S. A. Kirk (Ed.) Mental disorders in the social environment: Critical perspectives. New York, NY: Columbia University Press

Module 4 (Prepared by Jean Dingee, LCSW)

Motivating for Change and Motivational Interviewing

  • Empowerment focus—importance of client choice
  • Using motivational enhancement techniques with people who have serious mental illness.
  • Tracking consumer motivational outcomes with assessment tools and choosing treatment modalities based on outcomes
  • Transtheoretical model and stages of change
  • Motivational interviewing
  • Use of the trans-theoretical model and motivational interviewing to address mental health problems (see Smyth, 1996)

Required Readings:

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health practice:  A textbook.  New York:  W.W. Norton. Chapter 5 and 6. 
  • Miller, W. & S. Rollnick (2002) (Eds.), Motivational interviewing: Preparing people for  change (2nd ed.). New York: The Guilford Press. (faculty to assign readings)
  • Rollnick, S. & Miller, W. R. (1995).  What is motivational interviewing?.  Behavioral and Cognitive Psychotherapy, 23, 325-334.
  • Smyth, N.J. (1996). Motivating clients with dual disorders: A stage approach. Families in Society, 77(10), 605-614.

Recommended Readings:

  • Squires, D. & Moyers, T. (2001) Motivational Interviewing. University of New Mexico.  www.bhrm.org/guidelines/Add guidelines.Htm

Module 5 (Prepared by Drs. Ellen Lukens and Ellen Tuchman)

Wellness Self-Management and Recovery

  • Motivating clients to engage in self-management
  • Recovery treatment planning, and monitoring and evaluating progress toward treatment goals
  • The symptoms of psychosis, depression, and mania are reviewed<.
  • The culture of recovery
  • The management of symptoms
  • Mutual Aid and its healing components
  • Interventions and outcomes for the strength-based perspective
  • Trusting relationships and outcome measures

Required Readings:

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health practice:  A textbook.  New York:  W.W. Norton. Chapter 17.

    And/Or

  • Rosenberg, J. & Rosenberg, S. (2006).  Community mental health:  Challenges for the 21st century. New York: Routledge Press.  Chapter 3, pp.25-34.
  • Mellman, T.A., Miller, A.L., Weissman, E. M., Crisman, M.L., Essock, S.M. & Marder, S.R. (2001).  Evidence-based pharmacologic treatment for people with severe mental illness: A focus on guidelines and algorithms, Psychiatric Services, 52(5), 619-625. 
  • Miller, R., & Mason, S.E. (2002).  Diagnosis schizophrenia, pp. 95-103, Coping with Positive and Negative Symptoms, (chapter 10), pp. 104-113, Coping with Other Symptoms and Side Effects, (chapter 11). 
  • Mueser, K.T., Corrigan, P.W., Hilton, D.W. et al. (2002). Illness Management and  Recovery: A review of the research. /Psychiatric Services/ 53(10), 1272-1284.

Recommended reading:

Module 6 (Prepared by Jean Dingee, LCSW)

Medication Management

  • Methods of working with clients to follow medication regimes (social skills training, motivational enhancement, and behavioral tailoring)
  • Informed consent to medications and the right to decline medication
  • Monitoring medication side effects and benefits, utilizing current dosage and duration recommendations to achieve benefit
  • The social work role in medication management
  •  Psychotropic medications, their use and their limitations
  • Techniques that help clients adhere to medication regimens

Required Readings:

  • Drake, R.E., Merrens, M.R. and Lynde, D. W. (2005).  Evidence-Based Mental Health Practice- A Texbook.  New York: Norton & Company.  Chapter 19. 
  • Johnson, J., Oneil and Talaga (2002 3rd ed).Handbook of psychopharmacology for therapists. New Harbinger Pub. Inc (faculty to assign readings).
  • Merck Manual Home Edition www.merck.com/mmhe/index.html Leaving OMH site.    This is the text online version of the 2nd ed. Of Merck Manual Home ed. which contains medical and drug info for the general public.  See section on mental health disorders then go to topics of choice for your class to include:  Depression & Mania Scizophrenia (for causes, symptoms, diagnosis, prognosis, drug treatments and rehabilitation issues).  Faculty to assign readings   
  • Miller, R., & Mason, S.E.  Diagnosis schizophrenia. (2002). New York: Columbia University Press, pp. 68-81, Medication, (chapter 8).
  • Texas Algorithms – Anticonvulsants in BiPolar I Disorder  www.medscape.com/viewarrticle/524844 ( or see other disorders). Faculty to assign reading.

Module 7 (Prepared by Dr. Susan Mason)

Treatment for Concomitant Mental Health and Substance Abuse Problems

  • Integrated treatment approaches
  • Biopsychosocial model
  • Controversies in dual diagnosis treatment
  • Drugs of abuse
  • Assessment
  • Treatment planning
  • Expected course of treatment with individuals with dual disorders and tracking progress
  • Relapse prevention using social skills training

Required Readings:

  • Drake, R.E., Merrens, M.R. and Lynde, D. W. (2005).  Evidence-Based Mental Health Practice- A Texbook.  New York: Norton & Company.  Chapter 15.
  • And/Or
  • Rosenberg, J. & Rosenberg, S. (2006).  Community mental health:  Challenges for the 21st century. New York: Routledge Press.  Chapters 6 and 15. 
  • Drake, R.E., Essock, S.M. Shaner, A., Carey, K.B., Minkoff, K., Kola, L. et al. (2001). Implementing dual diagnosis services for clients with severe mental illness. Psychiatric Services, 52, 469-476.
  • Drake, R.E., Wallach, M.A., & McGovern, M.P. (2005). Future directions in preventing relapse to substance abuse among patients with severe mental illness. Psychiatric Services, 56(10), 1297-1302.
  • Info Facts on Drugs of Abuse at: http://www.nida.nih.gov/DrugPages/ (Site provides detailed description of each drug of abuse and its effects.)
  • Miller, R., & Mason, S.E. (2002).  Diagnosis schizophrenia, pp. 114-128, Alcohol, Drugs and Safer Sex, (Chapter 12)
  • NAMI web cite on Dual Diagnosis: www.nami.org/helpline/dualdiagnosis.htm Leaving OMH site
  • Watkins, Lewellen and Barrett (2001).  Dual Diagnosis:  An integrated approach to treatment.  Thousand Oaks, CA:  Sage Publications (faculty to select reading)

Recommended Reading:

  • Brunette, M. F., et al. (2005).  Pharmacologic treatments for co-occurring substance use disorders in patients with schizophrenia:  A research review.  Journal of Dual Diagnosis, 1 (2), 41-55. 
  • Davis, K.E. & O'Neill, S.J. (2005). A  focus  group analysis of relapse prevention strategies for persons with substance use and mental disorders. Psychiatric Services, 56(10), 1288-1291.
  • Mueser, K.T. et al. (2005).  Psychosocial interventions for adults with severe mental illnesses and co-ocurring substance use disorders:  A review of specific interventions. Journal of Dual Diagnosis, 1 (2), 57-82. 
  • Verduin, M. L., et al. (2005).  Substance abuse and bipolar disorder.  Medscape Psychiatry and Mental Health.  Retrieved 12/13/05 from www.medscape.com/viewarticle/515954 Leaving OMH site

Module 8 (Free Week)

Or

Module 8 (Prepared by Dr. Charles Robbins)

Example of a" stand alone" module prepared for the project by Dr. Charles Robbins which can be presented during week 8 or the material can be integrated throughout the course modules.

Module Topic: Cultural Competency in the Delivery of Mental Health Evidenced-Based Practice

Goals/Purpose:

  • To teach students the definitions of culture and cultural competence
  • To highlight the importance of cultural competence when delivering mental health services
  • To highlight the range of diversity issues including age, culture, ethnicity, gender, race, and sexual orientation

Objectives:

Following completion of this module, students will be able to:

  1. Define the concept of culture and the centrality that it has in the lives of consumers and practitioners.
  2. Explore mental health morbidity and the burden of disease within each of the major cultures with which the students will be practicing.
  3. Understand what it takes to ensure that a program's policies and practices ensure the delivery of culturally competent services.

Topic Outline:

  1. Culture – Race – Ethnicity
    1. Provide working definitions for the students of each of these significant concepts.
    2. Explore where they might overlap but how they are separate concepts
    3. Highlight the significance that each of these concepts has in the lives of consumers and providers of service
  2. Cultural Competence
    1. Present multiple definitions from the literature of cultural competence
    2. What does it take to be a culturally competent practitioner?
    3. When is an agency or program culturally competent?
  3. Incidence of Mental Illness Diagnosis and the Burden of Illness
    1. Mental Health Care for African Americans
    2. Mental Health Care for Hispanic Americans
    3. Mental Health Care for American Indians and Alaska Natives
    4. Mental Health Care for Asian Americans and Pacific Islanders
    5. Mental Health Care for Gay, Lesbian, Bisexual and Transgendered Individuals
    6. Mental Health Care for geriatric consumers
  4. National Standards for Culturally and Linguistically Appropriate Services in Health Care

Suggested Session Instruction methods and Class Activities:

  • Lecture
  • Discussion
  • Suggested In-Class Activities:
    1. Have students consider their own experiences accessing health care services and the impact that their culture might have had on the quality of care they received
    2. Have students reflect on how the culture/ethnicity of the clients/consumers with whom they worked impacted the services they provided
    3. Discuss what the students feel it would take to make one a culturally competent service provider

Required Readings:

  • U.S. Department of Health and Human Services, U.S. Public Health Service. (2001). Mental health: Culture, Race and Ethnicity – A Supplement to Mental Health: A Report of the Surgeon General.  Retrieved June 2007 from http://www.surgeongeneral.gov/library/mentalhealth/cre/sma-01-3613.pdf.
  • U.S. Department of Health and Human Services, Office of Minority Health. (March 2002). National Standards or Culturally and Linguistically Appropriate Services in Health Care.  Retrieved June 2007 from http://www.omhrc.gov/assets/pdf/checked/executive.pdf
  • U.S. Department of Health and Human Services, Office of Minority Health, Agency for Healthcare Research and Quality. (August 2004).  Setting the Agenda for Research on Cultural Competence in Health Care.  Retrieved June 2007 from http://www.ahrq.gov/research/cultural.pdf Leaving OMH site.
  • National Center for Cultural Competence.  Georgetown University Center for Child and Human Development.  Foundations of Cultural & Linguistic Competence. Retrieved June 2007 from http://www11.georgetown.edu/research/gucchd/nccc/foundations/frameworks.html Leaving OMH site.
  • The Commonwealth Fund. (October 2006) . The Evidence Base for Cultural and Linguistic Competency in Health Care.  Retrieved June 2007 from http://www.commonwealthfund.org/usr_doc/Goode_evidencebasecultlinguisticcomp_962.pdf?section=4039 Leaving OMH site

Recommended Readings:

  • Bartels S J, et. al. (2002) Evidence-Based Practices in Geriatric Mental Health Care Psychiatric Services. 53:11, 1419 – 1431
  • Cain, V. S. & Kington, R.S. (2003).  Investigating the Role of Racial/Ethnic Bias in Health Outcomes.  American Journal of Public Health, 93:2, 191 – 192.
  • Carten, Alma J. (2006) African Americans and Mental Health. In Rosenberg, J. & Rosenberg, S.  Community Mental Health: Challenges for the 21st Century (125-140)   New York: Routledge Taylor & Francis Group.
  • Gonzalez, M. J. & Acevedo, G.  (2006) Psychological Interventions with Hispanic       Patients: A Review of Selected  Culturally Syntonic Treatment Approaches. In Rosenberg, J. &  Rosenberg, S.  Community Mental health: Challenges for the 21st Century (125-140)  New York: Routledge Taylor & Francis Group.
  • Kung. W.W., & Tseng, Y. (2006) Mental Health Issues of Chinese Americans: Help- Seeking Behaviors and Culturally Relevant Services. In Rosenberg, J. & Rosenberg, S.  Community Mental Health: Challenges for the 21st Century (125-140)     New York: Routledge Taylor & Francis Group.
  • M, Afifi. (2007). Gender Differences in Mental Health. Singapore Medical Journal,     48:5, 385-391.
  • Moradi, B. & Risco, C. (2006). Perceived Discrimination Experiences and Mental Heath     Of Latina/o American Persons.  Journal of Counseling Psychology, 53:4, 411-421.
  • National Medical Association.  Cultural Competence Primer.  Retrieved June 2006 from http://www.askme3.org/pdfs/NMAPrimer.pdf.
  • New York State Office of Mental Health.  NYS OMH Fact Sheet: Cultural Competence,     Evidence Based Practices and Planning,  Retrieved June 2007 from http://www.omh.state.ny.us/omhweb/ebp/culturalcompetence.htm
  • Noh, S. & Kaspar, V. (2003). Perceived Discrimination and Depression: Moderating Effects of Coping, Aculturation, and Ethnic Support. American Journal of Public       Health, 93:2, 232 – 238.
  • Page, J., & Blau, J. (2006).  Public Mental Health Systems: Breaking the Impasse in the     Treatment of Oppressed Groups.  In Rosenberg, J. & Rosenberg, S.  Community      Mental Health: Challenges for the 21st Century (103-116).  New York: Routledge     Taylor & Francis Group.
  • Rosenberg, J., Rosenberg, S., Huygen, C., Klein, E. (2006).  Stigma, Sexual Orientation,     And Mental Illness. In Rosenberg, J. & Rosenberg, S.  Community      Mental Health: Challenges for the 21st Century (117-124).  New York: Routledge     Taylor & Francis Group.
  • Snowden, L. R. (2003).  Bias in Mental Health Assessment and Intervention:  Theory     And Evidence.  American Journal of Public Health, 93:2, 239-265.
  • Stanhope, V., Solomon, P., Pernell-Arnold, A., Sands, R., & Bourjolly, J. (2005).      Evaluating Cultural Competence Among Behavioral Health Professionals.      Psychiatric Rehabilitation Journal, 28:3, 225 – 233.
  • U.S. Department of Health and Human Services, Center for Mental Health Services      Administration, Center for Mental Health Services.  (January 2001).  Cultural      Competence Standards in Managed Care Mental Health Services:  Four Underserved/Underrepresented Racial/Ethnic Groups.  Retrieved June 2007 from     http://mentalhealth.samhsa.gov/publications/allpubs/SMA00-3457/default.asp Leaving OMH site.
  • U.S. Department of Health and Human Services, Office of Minority Health. (March     2002).  Teaching Cultural Competence in Health Care: A Review of Current      Concepts, Policies and Practices.  Retrieved June 2007 from http://www.omhrc.gov/assets/pdf/checked/em01garcia1.pdf .
  • Van Citters A D, Bartels S J. (2004). A Systematic Review of the Effectiveness of    Community-Based Mental Health Outreach Services for Older Adults. Psychiatric Services. 55:11, 1237 – 1249.
  • Williams, D.R., Neighbors, H.W., & Jackson, J.S. (2003)  Racial/Ethnic Discrimination and Health: Findings from Community Studies.  American Journal of Public Health,     93:2, 200 -208.
  • Yon A, Scogin F.  (2007).  Procedures for Identifying Evidence-based Psychological Treatments for Older Adults. Psychology and Aging. 22:1, 4-7.

Module 9 (Prepared by Drs. Ellen Lukens and Ellen Tuchman)

Family Intervention

  • Using psycho-education to enhance family members' ability to support the client's recovery
  • Parenting issues for parents with a diagnosis of serious mental illness
  • Overview and definition of psycho-education in the context of evidence-based practice
  • Literature-based examples and applications of psycho-education as evidence-based practice
  • Theoretical and historical overview of psycho-education
  • History of psycho-education in relationship to the family and consumer advocacy movements
  • Structure, content,  format, timing, flexibility
  • Implications for practice & policy

Required Readings:

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health practice:  A textbook..  New York:  W.W. Norton.  Chapter 18.
  • Dixon, L. McFarlane, W., Lefley, H., Lucksted, A., Cohen, M., Falloon, I., Mueser, K., Miklowitz, D., Solomon, P. & Sondheimer, D.  (2001). Evidence-based practices for services to families of people with psychiatric disabilities.  Psychiatric Services, 52(7), 903-910.
  • McFarlane, W.  (2002). Multiple family groups in the treatment of severe psychiatric disorders.  New York: Guilford Press, The therapeutic social network, pp. 36-48 & Joining with families and patients, 104-112. (SCAN and forward copy to fac.)

Recommended Readings:

  • Lukens, E. & McFarlane Wm (2004).  Psychoeducation as EBP:  Considerations for practice, research and policy.  Brief Treatment and Crisis Intervention 4, 205-   225.
  • McFarlane, W., Dunne, E., Lukens, E., Newmark, M., McLaughlin-Toran, J., Deakins, S. et al. (1993). From Research to clinical practice: Dissemination of New York State's family psychoeducation project. Hospital & Community Psychiatry 44, 265-270.
  • McFarlane, W., Lukens, E., Link, B., Dushay, R., Deakins, S., Dunne, E., et al (1995). Multiple Family Groups and Psychoeducation in the Treatment of Schizophrenia.  Archives of General Psychiatry, 52, 679-687.
  • Moore, B. C. (2005).  Empirically supported family and peer interventions for dual disorders.  Research on Social Work Practice 15/ 4, 231-245. 
  • Sherman, M. & Carothers, R. (2005).  Applying the readiness to change model to implementation of family interventions for serious mental illness.  Community Mental Health Journal, April, V41, p115 -128. 

Module 10 (Prepared by Dr. Lauren Gates)

Supported Employment

  • The role of the social worker in providing vocational support to clients in competitive employment
  • Gain an understanding of the steps to attain vocational goals
  • Setting the stage:  Why are we talking about work for individuals with a diagnosis of serious mental illness?  What is work?
  • Supported employment as an approach to promote integrated, competitive employment
  • Key Supported Employment components
  • Evidence for key components
  • Implications for social work practice.

Required Readings:

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health practice:  A textbook..  New York:  W.W. Norton.  Chapter 16.  
  • Akabas, S. H., Gates, L. B., Oran-Sabia, V.  (2006). Work opportunities for rewardingcareers (WORC): Insights from implementation of a best practice approach toward vocational services for mental health consumers.  Journal of Rehabilitation 72(1), 19-26.
  • Cook, J. A. et al. (2005).  Results of a multisite randomized trial of supported employment interventions for individuals with SMI.  Arch. Gen. Psychiatry 62, 505-512

Recommended Readings: 

  • Bond, G. R. (2004).  Supported employment: Evidence for an evidence-based practice. Psychiatric Rehabilitation Journal 27(4), 345-359.
  • Gates, L.B. et al. (2004).  Performance-based contracting:  Turning vocational policy into jobs.  Administration and Policy in Mental Health, 31(3), 219-240.
  • Gioia, D. (April 2005).  Career development in schizophrenia:  A heuristic framework  Community Mental Health Journal 41, 307-326. 
  • Gioia, D.  (2006). Examining work delay in young adults with schizophrenia.  American Journal of Psychiatric Rehabilitation, 9, 167-190.
  • Leff, H.S., et al (2005).  Effects of job development and job support on competitive employment for persons with SMI.  Psychiatric Services, 56, 1237-1244. 
  • Macias, C., Rodican C. F., Hargreaves W. A., Jones, D. R., et al. (2006). Supported Employment Outcomes of a Randomized Controlled Trial of ACT and Clubhouse Models. Psychiatric Services 57(10), 1406- 1415.
  • Marrone, J. et al. (2005).  How mental health and welfare to work interact:  the role of hope, sanctions, engagement, and support.  American J. of Psychiatric  Rehabilitation 8, 81-101. 

Module 11 (Prepared by Dr. Susan Mason)

Social Skills Training

  • Application of social learning theory
  • Using social skills training with people who have serious mental illness.
  • Adapting social skills training for use with individuals with a diagnosis of specific disorders (schizophrenia, bipolar disorder, and depression).
  • Tracking social skill development outcomes and using them to inform future practice
  • Social skills training models. 
  • Outcome data for social skills training.

Required Readings:

  • No text readings
  • Kopelowicz, A, Liberman, R.P., and Zarate, R. (2006). Recent advances in social skills training for schizophrenia. Schizophrenia Bulletin, 32, S12-23
  • Liberman, R.P., & Martin, T. Social Skills Training. Available at: www.bhrm.org/guidelines/liberman%20social%20skills%20training.pdf Leaving OMH site.  
  • Miller, R., & Masons S.E. (2004). Cognitive enhancement therapy: A therapeutic treatment strategy for first-episode schizophrenia patients. Bulletin of the Menninger Clinic, 68(3) 213-230.
  • Tsang, H.W.H (2001). Social skills training to help mentally ill persons find and keep a job. Psychiatric Services, 52, 7, 891-895.

Module 12 (Prepared by Dr. Nancy J. Smyth)

Trauma and Serious Mental Illness

  • Role of trauma and serious mental illness as an area of emerging research.
  • Epidemiology of trauma and severe mental illness.
  • Etiology of trauma, post-traumatic stress disorder, and related illnesses in individuals with a diagnosis of serious mental illness.
  • Implications for service delivery: assessing trauma in individuals with a diagnosis of serious mental illness.

Required Readings:

  • No text readings
  • Jennings, Anna (2004).  Models for developing trauma informed behavioral health systems and trauma specific services.  Prepared for National Technical Assistance Center, NTSC, SAMHSA, HHS. www.anafoundation.org/mdt.pdf.  (faculty to select readings). 
  • Morrissey, Jos., et al.(2005).  Twelve month outcomes of trauma-informed interventions for women with co-occurring disorders.  Psychiatric Services, 56 (10) 1213-1222.  
  • Mueser, K. T. et al. (2007).  The trauma recovery group:  A cognitive-behavioral program for PTSD in persons with SMI.  Community Mental Health Journal, 43, 281-304.
  • Tucker, W. M. (2002). How to include the trauma history in the diagnosis and treatment of psychiatric inpatients. Psychiatric Quarterly, 73(2), 135-144.

Recommended Readings: 

  • Breslau, N. (2002). Epidemiologic studies of trauma, post-traumatic stress disorder, and other psychiatric disorders. Canadian Journal of Psychiatry, 41(10), 923-929.
  • National Center for Trauma Informed Care (provides link to SAMHSA's  Women, Co-occurring Disorders & Violence Study) provides training and technical assistance, and resources.  http://Mentalhealth.samhsa.gov/nctic/ Leaving OMH site
  • National Center for PTSD: www.ncptsd.org Includes treatment manuals and an online searchable database of trauma articles, called PILOTS.

Module 13 (Prepared by Dr. Eric Hardiman)

Peer Support & Self-help Module

  • Overview and definition of peer support in the context of evidence-based practice
  • Mechanisms for consumer-provided services and self-help programs
  • Consumer-provided services (defined as services in which consumers or family are paid as providers to deliver mental health services)
  • Self-help groups (examples)
  • On-line and/or telephone support groups
  • Peer support/self-help principles
  • Benefits/outcomes for consumer providers of service
  • Benefits/outcomes for family providers of service
  • Review of key outcome studies for consumer recipients of service
  • Benefits for mental health provider system
  • Implications for practice and policy
  • External peer support programs

Required Readings:

  • No text readings
  • Hardiman, E.R., Theriot, M.T., & Hodges, J.Q. (2005). Evidence-based practice in mental health:  Implications and challenges for consumer-run programs. Best Practices in Mental Health,1(1),105-122 .
  • Holter, M.C., Mowbray, C.T., Bellamy, C.D., MacFarlane, P., Dukarski, J., (2004). Critical Ingredients of Consumer Run Services: Results of a National Survey. Community Mental Health Journal, 40(1), 47-63.
  • Rowe, M., Bellamy, C., Baranoski, M., Wieland, M., O'Connell, M.J., Benedict, P., Davidson, L., Buchanan, J., & Sells, D. (2007). A Peer –Support, Group Intervention to Reduce substance use and criminality among persons with severe mental illness.  Psychiatric Services, 58(7), 955-961.
  • Solomon, P. (2004). Peer Support/Consumer Provided Services Underlying Processes, Benefits, and Critical Ingredients.  Psychiatric Rehabilitation Journal, 27(4), 392-     401.
  • Solomon, P. & Draine, J. (2001).  The state of knowledge of the effectiveness of consumer provided services.  Psychiatric Rehabilitation, 25, 20-27.

Recommended Readings: 

  • Dixon, L., Stewart, T, Burland, J., Delahanty, J. Lucksted, A. & Hoffman, M (2001).  Pilot study of the effectiveness of the family-to-family education program.  Psychiatric Services, 52, 965-967.
  • Mowbray, C.T., Moxley, D.P., & Collins, M.E. (1998).  Consumers as mental health providers: First-persons accounts of benefits and limitations.  The Journal of Behavioral Health Services & Research, 25(4), 397-411
  • Mowbray, C.T., Robinson, E.A., & Holter, M.C. (2002).  Consumer drop-in centers: Operations, services, and consumer involvement.  Health and Social Work, 27, 248-261.

Module 14 (Prepared by Dr. Catherine Dulmus)

Acting as an Agent for Change for "Technology Transfer"

  • Principles for "technology transfer"
  • Steps involved in implementing organizational change
  • Stages of change applied to organizations & systems
  • Addressing resistance in organizations
  • Planning for the future—staying on top of a changing knowledge base

Required Readings:

  • Drake, R. E., Merrens, M.R., & Lynde, D.W. (2005).  Evidence-based mental health practice:  A textbook..  New York:  W.W. Norton. Chapter 8 and Epilogue: The future of EBP in mental health.
  • Aarons, G.A., & Sawizky, A.C.  (2006). Organizational culture and climate and mental health attitudes toward evidence-based practice.  Psychological Services, 3(1), 61-72. 
  • Addiction Technology Transfer Centers (2000).  The change book: A blueprint for technology transfer. Rockville, MD: Center for Substance Abuse Treatment.  [Electronic Version] Accessed on May 10, 2003 at: http://www.nattc.org/resPubs/cbResources.html#cb Leaving OMH site (in Adobe pdf format, or you can order print copies for minimal cost).
  • Rosenbeck, R. (2001).  Organizational process:  A missing link between research and practice.  Psychiatric Services, 52, 1607- 1612.

Recommended Readings: 

  • Farkas, M, et al (4/2005).  Implementing recovery oriented EBP:  Identifying the critical dimensions.  Community Mental Health Journal v41, pg 141-159.
  • Hardina, D. et al. (2006).  An Empowering Approach to Managing Social Service OrganizationsNY:  Springer Publishing.
  • Hodges, J. & Hardiman, E. R. (2006).  Promoting healthy organizational partnerships and collaborations between consumer-run and community mental health agencies.  Administration and Policy in Mental Health and Mental Health Services Research.

Addendum

"Diversity Issues in Mental Health and Evidence Based Practices" (Prepared by Dr. Sekile Nzinga-Johnson).  Can be integrated with another module or material can be integrated throughout the course material.  

  • Culture & mental illness
  • Review current debates regarding underserved, oppressed and minority   groups in treatment
  • Review race, class, gender, sexual orientation issues in Mental Health treatment and evidence based practices

Required Readings:

  • Drake, R. E. et al. (2005). Chapter 12: The interface of cultural competency and evidence-based practices.

    And/Or

  • Rosenberg & Rosenberg (2006). Section III: Community Mental health with underserved  populations
  • Sparks (2002). Chapter 11: Depression and Schizophrenia in Women: The intersection of gender, race/ethnicity and class. Ballou, M. & Brown, L.S., (Eds). Rethinking Mental Health & Disorder: Feminist Perspectives –ER

Recommended Reading:

  • Solomon, A. (1992). Clinical diagnosis among diverse populations: A multicultural  perspective. Families in Society, 73(6), 371-377.
  • Surgeon General. (2001). Culture counts: The influence of culture and society on mental health. In Mental health, culture, race and ethnicity: A supplement to mental health: A report of the Surgeon General. [Electronic version]. Rockville, MD: Office of the Surgeon General, US Public Health Service. Retrieved May 10, 2003 from: www.mentalhealth.org/cre/toc.asp Leaving OMH site

© New York State Office of Mental Health, 2004 (Revised 2008)

Comments or questions about the information on this page can be directed to the Social Work EBP Project.