University of Southern California s3

University of Southern California School of Social Work

Sowk 617 Section: 60673 SUBSTANCE ABUSE WTH CONSIDERATION OF OTHER ADDICTIVE DISORDERS Summer 2010

Instructors Name: Michael Todd Kilmer, LCSW Office: Telephone: 619.889.6955 Office Hours: By appointment Email: [email protected] or [email protected]

I. COURSE DESCRIPTION

Addiction is a widespread problem in all cultures, especially in the United States. It now cuts across all ages, both sexes and all cultural/ethnic groups. Our understandings of substance use and abuse and treatments are some of the most rapidly evolving and also controversial areas of knowledge in the mental health and medical fields. This course is designed to (1) educate students on the nature of alcoholism and substance abuse; and other manifestations of addiction (in the areas of eating, gambling, work, money and relationships); (2) to develop an understanding of prevention and treatment models; (3) to develop a healthy appreciation for the controversies in the field; (4) and to develop an understanding of the relationship between and among all compulsive disorders.

The course will introduce the student to the field of alcoholism, substance abuse, and the other addictive disorders by reviewing definitions of the problems, as well as the major research in the fields. The student will be exposed to national demographics on incidence with attention to vulnerable age, sex and ethnic and cultural groups. The relationship between contemporary culture and addiction will be analyzed.

Special attention will be paid to family issues related to the generation and treatment of substance abuse/addiction. Specific attention will be given to each compulsive disorder and treatment approaches introduced, as all phenomena are manifestations of similar dysfunctions. Models of treatment will also be introduced. The class will be exposed to the field of molecular psychology and the developing research on the chemical nature of the brain and its relationship to addiction.

Throughout the course, we will be looking at the relationship between clinical treatment and the various support groups. Finally, an effort will be made to integrate the learnings in this class with the foundation of social work practice and knowledge that each student brings to this course (through classes and field placement).

1 II. COURSE OBJECTIVES

Upon completion of the course students will be able to reinforce and expand knowledge and skills essential to social work practice with substance abuse/addictive individuals and families.

1. Explore and understand: a. The nature of alcoholism and substance abuse and compulsive disorders. b. Effects of the individual, family, business and society. c. Prevention and Treatment--Development and Systems model(s) of recovery. d. The chemical nature of the brain and its relationship to alcohol and drug addiction. e. Controversies in the Literature. f. The social work profession--its view, role and perspective on substance abuse. g. The nature of addiction in the family.

2. Identify, describe and differentiate between functional and dysfunctional behavior and development. a. Ability to understand the complexity of the interaction of factors resulting in alcohol/drug abuse and other addictions. b. Knowledge of physical, psychological, social and cultural effects of alcohol/drug use and other addictions. c. Increased awareness of prevention/treatment programs. d. Increased awareness of clinical models of treatment for application. e. Increased analytical awareness of different views or controversies in the literature. (Etiology to treatment.)

III. COURSE FORMAT

1. Lecture 2. Film Library 3. Field Observation 4. Class Discussion 5. Clinical Case Studies

IV. COURSE EVALUATION AND GRADING

Within the School of Social Work, grades are determined in each class based on the following standards which have been established by the faculty of the School: (1) Grades of A or A- are reserved for student work which not only demonstrates very good mastery of content but which also shows that the student has undertaken a complex task, has applied critical thinking skills to the assignment, and/or has demonstrated creativity in her or his approach to the assignment. The difference between these two grades would be determined by the degree to which these skills have been demonstrated by the student. (2) A grade of B+ will be given to work which is judged to be very good. This grade denotes that a student has demonstrated a more-than-competent understanding of the material being evaluated in the assignment. (3) A grade of B will be given to student work which meets those basic requirements of the assignment. It denotes that the student has done adequate work on the assignment and meets basic course expectations. (4) A grade of B- will denote that a student’s performance was less than adequate on an assignment, reflecting only moderate grasp of content and/or expectations. (5) A grade of C would reflect a minimal grasp of the assignment, poor organization of ideas and/or several significant areas requiring improvement. (6) Grades between C- and F will be applied to denote a failure to meet

2 minimum standards, reflecting serious deficiencies in all aspects of a student’s performance on the assignment.

All students are expected to regularly attend class and be on time. A student with more than two unexcused absences during the course of this class may receive a no credit. A student who is tardy three or more times to class may receive a grade of no credit. If a student receives a no credit grade in this seminar, they will be required to repeat this class.

Class grades are based on the following:

1. Class Participation: 10% 2. Written Assignment (Addiction Recovery): 30% 3. Mid-Term Exam 30% 4. Final Exam 30%

NOTE: Both the Mid-Term and Final Exams will be in class and without notes. The exams will consist of essay, multiple choice, matching, and fill in the blank type of questions.

Final Grade:

Class grades will be based on the following: 3.85 – 4 A 3.60 – 3.84 A- 3.25 – 3.59 B+ 2.90 – 3.24 B 2.60 – 2.87 B- 2.25 – 2.25 C+ 1.90 – 2.24 C

Final Grade:

100% - 93 = A 89% - 87% = B+ 79% - 77% = C+ 69% - 67% = D+ 92% - 90 = A - 86% - 83% = B 76% - 73% = C 66% - 63% = D 82% - 80% = B- 72% - 70% = C- 62% - 60% = D- 59% and below = F

NOTE: Please refer to the Student Handbook and University Catalogue for additional discussion of grades and grading procedures and for discussion of academic integrity.

ASSIGNMENTS: Written assignments must adhere to the citation and referencing standards put forth in the 6th Edition Publication Manual of the American Psychological Association.

V. ATTENDANCE POLICY

Students are expected to attend all classes. Students with more than two unexcused absences (or 6 hours absence from alternative class schedule) may risk failure. This policy exists because the social work program is one of professional preparation. In addition to acquiring theoretical knowledge, students are expected to acquire professional values, to integrate knowledge from a range of courses, to develop professional skills and be socialized into the profession. Members of the faculty of the School of Social Work are convinced that this cannot be accomplished through independent study alone. Thus, attendance at classes is required unless

3 legitimate and special reasons exist for absences or tardiness. Any such absences or tardiness should be discussed directly with the course instructor.

University of Southern California policy permits students to be excused from class, without penalty, for the observance of religious holy days. This policy also covers scheduled final examinations which conflict with students’ observance of a holy day. Students must make arrangements in advance to complete class work which will be missed, or to reschedule an examination due to holy days observance.

VI. COURSE EXPECTATIONS AND GUIDELINES  Each student is expected to be in class, and be attentive, including no internetting, playing video games, and emailing during class.  Each student is expected to do field experience (support meeting) and hand in reaction paper.  Each student is expected to complete the final exam.

Late Assignments

Assignments are due on the day and time specified. Extension will be granted only for extenuating circumstances. If the assignment is late, the grade will be affected, usually lowered by ½ grade per day, including weekend days.

Incompletes

A final grade of incomplete can only be given under extreme circumstances and must be requested in writing (as stated by University policy.)

VII. COURSE OUTLINE

Session 1, Wednesday, May 19, 2010: Introduction and Understanding the process of addiction  Introduction to course (format, syllabus, assignments, objectives and overview of course material).

Required Reading: Kinney, Chapter 1, 3, and 6 DSM-IV-TR, pp. 191-212, 293-294 Read Miller and Brown and pace your reading throughout the semester. Miller and Rollnick – Motivational interviewing. Brown, Stephanie, & Yalom, Irvin. (1997). Treating alcoholism. Jossey-Bass

Optional Additional Reading: Sanders, T., Sanders, M. White, William, W. (2006). When I get low, I get high: The portrayal of addiction and recovery in African American Music. Counselor. December. Vailant, G. ( ). The Alcohol-Dependent Drug-Dependent Person. Chapter 31. White, W. (2001). A disease concept for the 21st century. Counselor. April. White, W. (2001). Addiction disease concept: Advocates and critics. Counselor. February.

4 Session 2, Monday, May 24, 2010: Understanding how each type of drug and alcohol work on the body / Alcohol and other sedative-hypnotics

Required Reading: Kinney, Chap 2, 12 DSM-IV-TR, pp. 212-222, 284-293

Optional Additional Reading:

Session 3, Wednesday, May 26, 2010: Motivation to use / Opiates

Required Reading: Kinney, Chapter 4 DSM-IV-TR, pp. 269-277

Session 4, Monday, May 31, 2010: Memorial Day (Campus is closed); however, you are still accountable for your reading assignments. Strengths-based assessment and Motivational Interviewing / Cocaine and methamphetamine

Required Reading: Kinney, Chap 8 www.samhsa.gov (TIP-35 – Enhancing Motivation for Change in Substance Abuse Treatment) DSM-IV-TR, pp. 244-249-, 223-231

Optional Additional Reading: Brown, Cha 2 Miller, Chap 1, 2, 3, 4, 15 Mueser Chap 4, 5, 6,7,9

Session 5, Wednesday, June 2, 2010: Levels and models of care / Tobacco/nicotine, caffeine and other stimulants

Required Reading: Kinney, Chap 9 www.samhsa.gov (TIP 34- Brief Interventions and Brief Therapies for Substance Abuse) DSM-IV-TR, pp. 264-269, 231-234

Session 6, Monday, June 7, 2010: Lab (instructions are provided separately)

Required Reading:

5 Session 7, Wednesday, June 9, 2010: Field Study Day of Drug and Alcohol Support Groups.

Required Reading:

Session 8, Monday, June 14, 2010: Assessment and intervention with Co-occurring disorders / Marijuana Mid-term examination & Support Group report paper due

Required Reading: Kinney, Chap 11 www.samhsa.gov (TIP 42 – Substance Abuse Treatment for Persons with Co-Occurring Disorders) DSM-IV-TR, pp. 234-241

Optional Additional Reading: Brown, Chap 5 Miller, Chap 24

Session 9, Wednesday, June 16, 2010: Special populations (women, men, adolescents, forensic, people of color.

Required Reading: Kinney, Chap 10

Optional Additional Reading: Miller, Chap 22, 24 Mayeda, S. & Sanders, M. (2007). Counseling difficult-to-reach adolescent male substance abusers. Counselor. April. Vol. 8, No. 2. Mayeda, S. & Sanders, M. (2007). Counseling difficult-to-reach adolescent males with substance disorders: A strength-based approach. Counselor. June. Vol. 8, No. 3

Session 10, Monday, June 21, 2010: Early Treatment / Hallucinogens and inhalants

Required Reading: DSM-IV-TR, pp. 251-263, 278-283 Miller, Chapter 5, 6, 7, 8

Optional Additional Reading: Brown, Chapter 3

Session 11, Wednesday, June 23, 2010: Interventions in the transitional phase of recovery

Required Reading: Miller, Chap 9, 10, 11, 12

6 Optional Additional Reading: Brown, Chap 4, 6, 7

Session 12, Monday, June 28, 2010: Recovery with families and Addiction in the workplace

FINAL EXAM

Required Reading: Kinney, Chap 7 and 13 www.samhsa.gov (TIP 39 – Substance Abuse Treatment and Family Therapy)

Optional Additional Reading: Brown, Chap 8, 9, 10 Miller, Chap 23

VIII. REQUIRED TEXTBOOK READING

Brown, Stephanie, & Yalom, Irvin. (1997). Treating alcoholism. Jossey-Bass. Kinney, Jean. (2007). Loosening the grip. McGraw-Hill Humanities. Miller, William and Rollnick, Stephen. (2002). Motivational interviewing: Preparing people to change addictive behavior, The Guilford Press. Diagnostic and Statistical Manual of Mental Disorder IV-TR (American Psychiatric Association, 2002)

Optional Reading

Small, J. (1989). Becoming naturally therapeutic: A return to the true essence of helping. Bantum Books. Mueser, Noordsy, Drake, Fox. (2002). Integrated treatment for dual disorders: A Guide for effective practice. The Guilford Press. Articles and other readings are available through ARES and Blackboard.

http://sowk.wordpress.com/

RECOMMENDED READING: Refer to Bibliography for additional recommended reading.

Useful Web Sites U.S. Department of Health and Human http://ncadi.samhsa.gov Services and SAMHSA’s National Clearinghouse for Alcohol and Drug Information NIAAA: National Institute on Alcohol Abuse and http://www.niaaa.nih.gov Alcoholism NIDA: National Institute on Drug Abuse http://drugabuse.gov SAMHSA: Substance Abuse & Mental Health http://samhsa.gov Services Administration Office of National Drug Control Policy http://whitehousedrugpolicy.gov HRC: Harm Reduction Coalition http://www.harmreduction.org MOTHERRISK: Treating the Mother – http://www.motherisk.org/women/index.jsp Protecting the Unborn TPRC: Transdisciplinary Drug Abuse http://tprc.usc.edu Prevention Research Center

7 IX. ACADEMIC ACCOMMODATIONS

Students requesting academic accommodations based on a disability are required to register with Disability Services and Programs DSP each semester. A letter of verification for approved accommodations can be obtained from DSP. Please be sure the letter is delivered to your instructor as early in the semester as possible. Accommodations can ONLY be made if letter is delivered BEFORE assignment due date. DSP is located in STU 301 and is open 8:30am – 5:00 pm, Monday through Friday. The phone number for DSP is 213-740-0776. Web-based information regarding DSP can be found at www.usc.edu/student-affairs/asn/DSP/

X. EMERGENCY RESPONSE INFORMATION

To receive information, call main number (213)740-2711, press #2. “For recorded announcements, events, emergency communications or critical incident information.”

To leave a message, call (213) 740-8311 For additional university information, please call (213) 740-9233 Or visit university website; http://emergency.usc.edu

If it becomes necessary to evacuate the building, please go to the following locations carefully and using stairwells only. Never use elevators in an emergency evacuation.

University Park Campus City Center MRF – Lot B Front of the building (12th & Olive) SWC – Lot B Orange County Campus WPH – McCarthy Quad Faculty Parking Lot VKC – McCarthy Quad Skirball Campus Front of building San Diego Academic Center Parking Lot

Do not re-enter the building until given the “all clear” by emergency personnel.

8 Addiction Recovery Support Group Assignment

Because 12-step programs (Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, Marijuana Anonymous, Methadone Anonymous, etc.) and other support groups (SMART Recovery, Women for Sobriety) can be vitally important as a resource for people struggling with dependence, all human services professionals ought to have familiarity with their functioning. Each student is asked to submit a brief paper concerning one of the following options.

Option #1: This option is for students who have not participated as members of a 12-step program.  The student will attend two traditional 12-step meeting or other non-traditional self-help arena at two different locations. One place to locate AA meetings is by going to http://aasandiego.org.  Be sure to attend an OPEN meeting where visitors are welcome.  Try to go alone. If you do find the need to carpool, do not sit in the meeting with your friend. Be aware of how you are feeling, your thoughts, and the dynamics of the group. Please do not take notes or write during the meeting as anonymity is a strong value within self-help meetings and is adhered to by participants. o Briefly describe the meeting, including location, time of day, and composition of the group (including sociocultural aspects such as gender, class, race, etc.) o Describe a story that was told at the meeting. Apply this person’s description of their addiction and recovery to Jellineck’s curve. o Identify at least two published research articles on outcomes associated with 12 step group attendance and write a brief (one – two paragraph summary of those articles and how those articles fit your experience. o Compare academic references and class content to your experience. From a theoretical point of view, how do the 12 steps work as therapeutic tools? o In a paragraph or three, describe your personal experience of the meeting. What dynamics resonated with you? What dynamics discouraged you? What is your personal opinion about the usefulness of 12 step groups for people with addictions and give a rationale for your opinion.

Option #2: This option is for students who have participated as members in a 12-step or other addiction recovery support group.

Please discuss the manner in which you have made use of participation in a fellowship, including only that information which you feel comfortable sharing with the instructor. Has participation been positive? What reservations my you have or not have about the fellowship? What ought human to services professionals to know about the fellowship in order to be able to assist clients in considering participation? Also, identify at least two published research articles on outcomes associated with 12 step group attendance and write a brief (one – two paragraph summary of those articles and how those articles fit with your experiences).

Paper length: 3-5 pages

Assignments are due on the day and time specified. Extension will be granted only for extenuating circumstances. If the assignment is late, the grade will be affected, usually lowered by ½ grade per day, including weekend days.