PSY8554 - Advanced Clinical Skills

(1 to 3 units)

3 unit courses:

1. Advanced Assessment: this is the second semester of a two-semester course in psychological assessment of adults, adolescents, and children. Heavy emphasis will be placed on integrating cognitive/ achievement, and personality measures within the context of clinical history, behavioral observations, and cultural considerations into a well-organized assessment report. Verbal feedback of assessment findings will be covered as well. A collaborative therapeutic assessment approach is utilized. Please note there is a mandatory lab assessment fee for this course.
2. Case Formulation: The clinical case formulation is an integral element of the assessment, treatment planning, and therapeutic process in all psychotherapeutic encounters. This seminar provides a rigorous method for creation of a formulation that accounts for the patient’s current functioning and capabilities in all domains of living. The case formulation method used in this seminar is informed by developmental, cultural, biological, and social domains of the patient’s life. Students prepare and discuss numerous clinical case formulations during the semester.
3. Child Therapy: This course will explore the theory, research and clinical applications in the field of child psychotherapy. Students are expected to learn the professional procedures for initiating a therapeutic relationship with a child as a client, as well as their legal and ethical responsibilities regarding that relationship. The course covers a variety of therapeutic interventions and the typical problems they are best suited to treat, with the emphasis on developmentally, ethnically, legally, and culturally responsive strategies in order to meet treatment needs of child clients.
4. Clients with Chronic Illness or Disability: There are expanding roles for mental health professions to treat clients with chronic illness or disability (CID). In addition to supportive psychotherapy, many types of interventions can have an impact on a client’s symptoms, functioning and quality of life. This skill-building course covers psychosocial aspects of CID, common medical and psychological diagnoses, treatment issues, multicultural aspects of health and treatment, and evidenced-based interventions. Particular attention will be on autoimmune diseases and pain, depression, anxiety, and stress management with CID populations. 
5. Complex Trauma: Brain/Body/Health: This course will explore the theory, research and clinical expression of complex trauma in adults and children. Specifically, this course will look at how complex trauma impacts the brain, both anatomically and functionally, the autonomic nervous system and body senses, and consequently health and health behaviors. Students will learn about how complex trauma can impact the developing brain, the autonomic nervous system, and the somatic nervous system.  This knowledge will build a foundation to help understand illnesses and risky health behaviors to which survivors of complex trauma are vulnerable.  This course will also emphasize critically thinking about interventions that would match this model/formulation of complex trauma’s impact and appropriate cultural adaptations. 
6. Contemporary Issues in Psychoanalytic Psychotherapy:  In recent years there have been significant developments in the theoretical purview and clinical and social applications of psychoanalytic psychology. In this seminar we will focus on the areas of trauma, gender and sexualities, multiculturalism, dynamic systems theory and neuroscience, attachment and development. We also consider current research about the empirical foundations and evidence based-practice of psychoanalytically informed psychotherapy. Clinical illustrations and research findings are considered in each area of study.
7. Couples: This section of Advanced Clinical Skills provides an overview of the most important theories of couple therapy. The course introduces students to the clinical assessment of couples, techniques of interview, and strategies of intervention. Special emphasis is given to systems theory, mechanisms of change, and issues of diversity. It is designed to be a skills-based course in which students will learn theory and practice techniques from a variety of relationship models, including Sue Johnson’s Emotionally Focused Therapy, John Gottman’s Sound Marital House, and Dan Wile’s Collaborative Couples Therapy.The course combines diverse teaching-learning strategies, such as lectures, group discussions, dyad/triad presentations, videotape analysis, experiential exercises, and guest speakers on special topics. 
8. Dialectic Behavior Therapy: This course focuses on developing an understanding of the DBT model and being able to utilize it effectively. It includes a review of the behavioral and cognitive therapy underpinnings of DBT, with extensive coverage of the dialectical principles that differentiate it from other approaches. The biosocial factors that lead to emotional, interpersonal, cognitive, and behavioral dysregulation will be explained.  Included are methods of assessing, gaining client commitment to therapy, enhancing motivation, interventions, and specific skills training to help clients who have difficulty regulating emotions and behaviors. Emphasis will be on specific DBT strategies for suicidal, parasuicidal, and other impulsive and disruptive behaviors. Included is examination of cultural differences, the roles these play in expression of emotion and behaviors, and how individual differences can be assessed and treated. DBT for borderline personality disorder is covered, and extended to use in the treatment of other disorders.
9. Early Childhood Mental Health: This course is an introduction to early childhood mental health at child development centers subsidized by the State to serve low-income, high-risk families. The course begins with theoretical frameworks, including a review of systems, attachment and reinforcement theory. It then addresses understanding child behavior, and the underlying meaning it communicates to caretakers and providers, within cultural context. The culture of the classroom is also explored, as is the role of psychologists in working with educators in such classrooms. Parental and family influences on early childhood mental health are also addressed in the context of diversity.
10. Feminist Approaches to Psychotherapy: This seminar addresses the theory and practice of feminist therapy. The approach is considered in historical context, and the epistemological base of more traditional approaches, as well as the feminist approach, are explored. The emphasis is on application and focuses upon discussion of clinical issues and case supervision through discussion and role play. 
11. Mindfulness Appr to Health Psych: This asynchronous on-line course examines mindfulness approaches to health psychology. It consists of two major parts. The first part of the course surveys literature related to the definitions, concepts and measurement of mindfulness. Theoretical and experiential exploration of mindfulness will be emphasized. Students will be expected to maintain mindfulness practices and to keep a journal of their experiences. Mindfulness is considered as a personal and professional tool in therapeutic settings. The second part of this course will be organized around the clinical applications of mindfulness meditations, and mindfulness based intervention in clinical health settings. Students will review evidence based studies on using mindfulness concepts with chronic health problems, e.g., pain, cancer, insomnia, addiction, etc.
12. Narrative Approaches: This course introduces students to the theory and practice of Narrative Therapy. It focuses on the work of Michael White and David Epston and their development of a “storied therapy”. The course assists students in conceptualizing problems as located within stories that influence identity. Problems are also situated within a socio-cultural context. In addition, the course attends to those moments that stand in contradiction to the plot of problems, and represent the promise of potential “counterstories” that may profoundly reshape identities. 
13. Psychother. For Personality Dis.: This seminar examines the clinical phenomena of narcissism, masochism, borderline conditions, and perversions from a variety of psychodynamic perspectives. Classical, Object-Relations, Self-Psychological, and Contemporary Relational perspectives on the etiology and treatment of these personality disorders are considered and contrasted. Clinical, literary, and film material is used to illustrate the manifestations of these conditions in both the internal and inter-personal worlds of the patient.
14. Psychotherapy with Older Adults: This course reviews normal aspects of the aging process; demographics of the changing older adult population; special features of counseling older adults including developmental tasks, life review, unfinished issues from the past, grief work, gender and cultural issues, and family dynamics; assessment of depression, dementia, delusions, elder abuse and substance abuse among older adults; special issues and needs of caregivers and adult children of aging parents; resources for professionals caregivers, adult children and their parents; ethical issues with older adults;  and professional opportunities in gero-counseling.  This course meets the BoP requirements for coursework in aging and long-term care.
15. Trauma Identification, Assmnt, Trtmnt: This course will cover best-practices and evidence-based practices for the screening and intervention of trauma, both incidents and trauma-related diagnoses including Acute Stress Disorder, PTSD, and PTSD with dissociative features.  The course will span different populations and theoretical orientations.  We will discuss cultural perceptions of trauma, response, and intervention. We will also cover issues in the field related to identification, assessment, diagnosis, and intervention and emerging practices.

2 unit courses:

1. Acceptance & Commitment Therapy: An overview of the history, philosophy, methods and application of mindfulness and acceptance within cognitive-behavioral therapy, with emphasis on acceptance and commitment therapy (ACT).  Students will learn about the theoretical and empirical background of this burgeoning field, practice mindfulness and other experiential methods, observe videos of therapy sessions, integrate empirical literature and clinical experience, and explore techniques in clinical role play.  By the end of the course, students should be familiar with the major models of mindfulness-based therapies within the cognitive-behavioral therapy (CBT) field.  They will have extensive experience with mindfulness meditation and have practiced basic skills of ACT. 
2. Assessing/Remediating Legal Competency:  The focus is on the legal, psychological, theoretical, and ethical issues pertaining to competency in a variety of contexts. Students will review research and practice issues involved in assessing and treating a various types of legal incompetence. They will also review benchmark legal cases addressing various aspects of competency. Specific topics include competency theory, competency to stand trial, other criminal competencies (e.g., to consent to searches/seizures, to confess, to waive the right to counsel, to testify, and to be sentenced to death), competency restoration and involuntary medication, competence to consent to medical treatment, testamentary capacity (e.g., for wills, trusts, and advance medical directives), other civil competencies (including conservatorships, guardianships, and substituted judgment), juveniles and developmental immaturity, and competency issues pertaining to people with developmental disabilities.
3. Clients with Substance Use Problems: This course will provide student clinicians with a general overview of treatment for substance use disorders, focusing on current empirically validated approaches to treatment. This course will identify and examine the etiology of substance use disorders and current interventions, including the various approaches for conceptualizing addiction and chemical dependency. Included are illicit, prescription, over-the-counter, marijuana, and alcohol use, and comorbidities. Special attention will be paid to treatments geared toward specific substances of abuse, treatment modalities, and treatments for special populations of substance using clients.
4. Disability, Law & Families: Course provides an overview of key concepts, including prejudice, stigma and discrimination against persons with disabilities, and statutes and case law on the civil rights of persons with disabilities as they relate to procreation, custody, parenting, and family life. Psychologists’ roles as consultants and providers in these contexts are explored. Specific legal issues are covered, including the IDEA, IEPs, early intervention laws, and California statutory requirements for mental health services for minors in special education.
5. East Asian Meditation in Health:  This course explores East Asian meditation practices and ways in which they can be used to work with the mind and emotions to enhance physical and psychological well-being.  Students will gain an understanding of views and practices of Buddhist, Daoist, and Confucian schools of meditation and exposure to the techniques of therapies that involve the use of meditation.  Meditation techniques covered will include various types of evidence-based mindfulness therapies, compassion practices, dream yoga, and meditation practices focusing on self-cultivation through interpersonal interactions.  The course will include an examination of current physiological, neuropsychological and clinical research on effects of meditation practice.  Additionally, the class will discuss views of the self, mind, and world associated with East Asian meditation traditions and possible implications for psychotherapy with populations influenced by these cultural views.
6. Family Violence & Psychol. Trauma: Focus on family violence conceptualized as pathologies of power. Clinical theory, research and implications for practice examined from cultural, psychological, psychoanalytic, feminist and sociopolitical perspectives. Discussions of patriarchy, the politics of power and violence, gender entrapment, gender role socialization, constructions of masculinity and cultural complexities will illuminate the intersection of individual and social pathologies that result in family violence.
7. Integrating Spirituality into Psychotherapy:  This course is designed to increase students’ awareness and knowledge of client spirituality in the context of psychotherapy.  Course material focuses on an understanding the developmental and existential nature of how people seek and find meaning in traditional and non-traditional spiritual and religious experiences. Techniques are presented to engage clients in accessing spiritual resilience, addressing current conflicts and traumatic backgrounds, and artfully engaging spirituality in the therapy process.  Students will develop self-awareness skills and knowledge of client’s spiritual experiences to inform therapeutic interventions and enrich the therapeutic alliance.  Spirituality is viewed in a larger context as an important aspect of multicultural and personal diversity.
8. Palliative Care:  Serving those with life-limiting illness is an integral and important part of health care. When working with patients and their families and communities at the end of life, it is essential to assess the overall quality of care they are receiving, to identify sources and ways of alleviating suffering as appropriate, and to help patients and their families determine what decisions need to be made and who needs to be involved in making/implementing those decisions. Psychologists can play vital roles in the field of palliative care, providing clinical servicers, research, teaching, public policy design and evaluation, organizational leadership, and advocacy. This course provides students with a foundation on which to build this unique and increasingly necessary set of skills and knowledge, and how to develop interprofessional relationships through which these activities can be successfully accomplished.
9. Psychother. for Loss/Grief/Mourning:  From graduation to divorce to retirement to death, loss is a fundamental human experience. Losses, and the subsequent processes of grief and mourning, are the foci of this course. We will weave together three strands of inquiry during the term: responses in the personal, clinical, and social realms. Taking a lifespan approach, varieties of loss that are developmentally expected as well as unanticipated will occupy the majority of our study. Particular attention to death and its personal and societal implications for clinical practice includes interventions to facilitate mourning and adjustment to loss on the individual, family and community levels. Social justice approaches to loss on both a micro as well as macro level, e.g., colonization and genocide, will be addressed.
10. Psychotherapy Practice Management: This course addresses the practical dimensions of managing a psychotherapy practice. It includes office selection and structuring, financial arrangements and billing, record keeping systems, hiring and managing clerical staff, developing and maintaining electronic records, HIPAA compliance, advertising, developing and maintaining referral networks, linkage to community services, and valuing, selling and closing a practice. Ethical considerations are addressed with respect to each of these areas of concern. Psychologists as Managers in Community and Health Care Organizations Psychologists are increasingly finding themselves in the position of managing other people, but are often not trained to perform this function. This course addresses basic management theories and practical applications. Historical and current approaches to management roles are reviewed, and problems related to community services and health care settings are addressed.
11. Therapy for Sleep Disorders:  This course covers basic sleep hygiene, sleep cycles, diagnosis of sleep disorders, apnea, prescription and OTC medications uses and contraindications, and evidence-based treatments.

1 unit courses

1. Approaches to Pain Management:  This course covers the physiology and types of pain, uses and misuses of pain medications, pain beliefs and attributions, and mind-body techniques for pain management.
2. Clinical Applications of Psychopharm: This course explores psychopharmacology from several perspectives. The medications for mental illnesses: Depression, Bipolar illness, Anxiety, and Psychosis especially, are examined considering individual case examples. The use of herbal and other non-prescription alternative treatments are also discussed. Applications of psychopharmacology in key patient populations such as children, adolescents, women, varying ethnic groups, substance abusers and the elderly are explored.
3. Suicide Prevention: The Advanced Clinical Skills Workshop provides small-group presentation and discussion of suicide and suicide prevention at an advanced level. Students will learn to assess and address risk factors associated with suicide, and critically discuss the application of treatment approaches to individuals presenting with increased suicide risk. Included is discussion of therapeutic relationship issues, and the interplay of disability status, sexual orientation, social class, culture, gender, and ethnicity with suicide assessment and treatment.
4. Therapist Expressive Behaviors: This course presents an overview of research on the value of expressive nonverbal behavior for physicians, educators, leaders, and psychotherapists.  The bulk of the course is devoted to practicing improvisational methods designed to promote expressive nonverbal behavior.  At the end of the course, students will be familiar with extensive research linking expressive nonverbal behavior to positive social outcomes.  They will have explored their own expressive range, including in clinical role-play application.
5. Using Telehealth/Internet Interventions:  Covered in this course are newer methods of therapy delivery, including phone follow-up, phone appointments, online interventions, apps, and indications and contraindications for telehealth, structuring sessions, ethics and legalities, and security of communications.