Education | Advanced Practicum in Counseling
G624 | 6213 | Dr. Thomas Sexton


Course Description
This course is designed to enhance students’ development as
counseling psychology practitioners. Its purpose is to provide
intensive supervision and instruction to students at the doctoral
degree level in counseling psychology. The majority of class time
will be spent discussing therapeutic change mechanisms, learning
about the effective assessment, and the treatment of individual,
family, and group clients.  Students are to comply with the
administrative responsibilities required by placements regarding
client care.  Students are required to develop well-written treatment
plans for each client, read and discuss assigned reading material,
and make formal case presentations.  Topics covered in this course
include empirical/evidence based counseling protocols, common factors
in therapeutic change, interpersonal process/therapeutic change
mechanisms in therapeutic interactions, as well as the ethical,
professional, and sociocultural issues associated with the assessment
and treatment of clients.

TEXTS
	
Lambert, M. J. 2003).  Handbook of Psychotherapy and Behavior Change
(5th Edition).  Wiley & Sons:  New York:  NY.
	
Beutler, L. E., Harwood, M. T. (2000).  Prescriptive Psychotherapy:
A Practical Guide to Systematic Treatment Selection.  Oxford,
University Press: New York, NY.

Additional articles, as assigned.


COURSE OBJECTIVES

1.  Expand the application of counseling theory to practice and
through required readings, practice, and group and individual
supervision.

2.  Develop an understanding of the research evidence to support a
wide range of therapeutic interventions.

3.  Investigate the common and specific factors in the therapeutic
change process.

4.  Develop an understanding of the common change mechanisms related
to successful therapeutic interventions.

5.  Develop a systems approach to mental health provision by gaining
knowledge about the influence of community and agency dynamics on
client demography and service utilization.

6.  Develop skills in crisis intervention, especially as related to
potential suicide or homicide intervention.

7.  Learn the process of ethical decision-making in regard to
clinical and therapeutic events.

ASSIGNMENTS
During the course of the practicum, you are required to:
Attend the practicum seminar 9:30 a.m. to 12:00 p.m on Monday of
each week.  Please arrive on time and prepared for the group
discussion topic.  Please read each assignment prior to class.
Students taking G624 as an advanced placement are expected to meet
with the instructor during the first and last week of class to
discuss community placement.  Community placement students must have
instructor approval for all placement sites prior to
beginning/changing.

Students taking G624 for Advanced Practicum (3 semester hours) are
required to be on site (in the Center for Human Growth) for 8-12
hours per week.  An additional time will be required to see clients
(to a total of 16 hours/week).

All students are expected to keep up-to-date chart/case notes,
completing treatment plans in a timely manner and performing all
other administrative duties required of your site.

All students are expected to participate in regular individual
supervision with the course instructor (if working in the Center) or
the site supervisor (if off site).

All students are expected to demonstrate proficiency in counseling
techniques and in developing systematic approaches to intervening
with clients through clear, complete, comprehensive, and defensible
treatment plans that are based in the clinical research evidence.

All students are expected to demonstrate responsively to issues as
age, race, culture, and gender in the context of the counseling
relationship.

Read assigned material and complete selected assignments.

Behave in accordance with the Ethical Codes of the American
Psychological Association.
Students taking G624 for Advanced Practicum (3 semester hours) are
required to:

Formal Case Presentation:  Prepare and present one formal case
present of a current client.  The case presentation will be in two
parts.  In the first presentation you will cover the points noted
below.  The case presentation should be approximately 45 minutes.
The goal of this presentation is for you to demonstrate you ability
to discuss a case in a systematic, coherent, and internally
consistent way. These will be used to illustrate details of your
presentation.  On the day of the presentation please provide two copy
of a detailed outline to the instructor and each member of the
class.  The outline should be complete and cover each detail of the
presentation.  You will be graded on the quality of your
presentation.  The second part of the presentation will be at the end
of the semester.  Here you will present a follow up of the case with
video examples of each of the areas noted below.  In addition, you
will provide a detailed evaluation of the strengths and weaknesses of
your approach to the case.

Your first presentation should include the following topics:

(1) Description of the client’s view of the presenting problem.

(a) background of the problem
(b)  causal attributions, emotions, behavioral competencies
associated with the problem.
(c)  relevant client history that provides context for the presenting
problem.
(d)  preexisting client factors that contribute to the presenting
problem

(2)  Therapist description of presenting problem

(a)  intrapsychic aspects of the problem.
(b)  interpersonal aspects of the problem.
(c)  contextual aspects of the problem
(d)  theoretical/conceptual explanation of the problem

(3)  Treatment plan

(a)  process goals (change mechanisms targeted)
-attributional targets
-alliance targets
-influence targets
(b)  outcome goals
(c)  systematic approach to process and outcome goals

(4)  Diagnostic impressions (DSM-IV multiaxial diagnosis)

(5)  Progression of treatment (using video examples)

(6)  Evaluation of process and outcome goals (evaluate each on a –3-
significant negative progress to 0- no progress, to +3-significant
positive progress)

Change Model Presentation:  Prepare and present your model of
therapeutic change.  Your presentation should build on and apply the
concepts from class discussion and the required reading.  This
presentation should focus on your view of the active change process
in counseling.  Of particular interest are the active ingredients
that you think contribute to successful change.  On the day of the
presentation please provide the instructor with two copies and each
class member one copy of a detailed outline that covers each element
of your presentation.  You will be graded on the quality of your
presentation.

Your presentation should include the following topics:

(1)  Guiding theoretical/conceptual principles of the model

(2)  Etiology of clinical problems

(a)  intrapsychic mechanisms related to clinical problems
(b)  interpersonal mechanisms related to clinical problems
(c)  contextual factors related to clinical problems

(3)  Goal(s) of therapeutic change

(a)  proximal goals
(b)  distal goals

(4)  Mechanism of therapeutic change-how change occurs

(a)  interpersonal factors that contribute to change (within and
outside therapy)
(b)  model specific factors in therapeutic change

(5)  Roles in therapy

(a)  role of the client
(b)  role of the therapist

(6)  Influence of age, race, culture and gender in therapeutic change

EVALUATION AND GRADING SUMMARY
1.  Class attendance and participation (includes discussion of cases
and readings, presenting tapes and client material) (5%)
2.  Quality of interventions, systematic approach to clients, ability
in managing client cases (50%)
3.  Formal Case Presentation (15%)
4.  Change Mechanism Presentation (30%)

	Final Grades and Points
90-100 points	A
80-89 points B
70-79 points C
60-69 points D
50-59 points F

Advanced Placement students will be evaluated according to feedback
received from the site supervisor .

DISSCUSSION TOPICS
Class will be a combination of topic and clinical case discussions.
The following is a schedule of anticipated topics. It is your
responsibility to prepare for each discussion by completing the
relevant (assigned and supplemental) readings.

Class		
Date				
Topic					

1 	
9/1	
Fundamental questions in effective practice:  What are the important
issues?
-what is the basis of good practice?
-change models

2	
9/8	
No class

3	
9/15	
Common Factors, Change mechanisms, empirical foundations, and
therapeutic change.  The Indiana Change Model
Reading:
Chapter 1:  Introduction & Historical Overview
Chapter 3:  Theoretical challenges to practice and research

4	
9/22	
Client factors:  understanding client through systematic assessment
-DSM-IV Diagnostic classifications/assessment
-Relational Assessment
-Therapy informing assessment
Reading:	
Chapter 6:  Theoretical challenges to practice and research

5	
9/29	
Process Factors
-Common change mechanisms in effective psychotherapy practice
-treatment plans that inform practice	
Reading:	
Chapter 6:  The Influence of Client Variables on Psychotherapy
Chapter 7:  Therapist Variables
Assigned readings


6 	
10/6	
Empirical Foundations
-The role of science in counseling practice
-lessons from the empirical knowledge base
-the role of process and outcome research in practice
Reading:	
Chapter 5:  Efficacy and Effectiveness of Psychotherapy

7		
10/13	
Case Presentations

8	
10/20	
Case Presentations

9	
10/27	
Change mechanisms with specific client disorders
Reading:	
Chapter 9: Behavior Therapy with Adults
Chapter 10:  Cognitive and Cognitive Behavioral Therapies
		
10	
11/3	
Change mechanisms with specific client disorders
Reading:	
Chapter 11:  Research on Experiential Psychotherapies
Chapter 17:  Research on Psychotherapy with Culturally diverse
populations

11	
11/10	Change mechanisms with specific client disorders
Reading:	
Chapter 14:  Small Group Techniques
Chapter 15:  Health Psychology

12	
11/17	EVT/EST Protocols/approaches
Reading:	
assigned

13	
11/24	
Change Model Presentations

14	
12/1	
Change Model Presentations

15	
12/8	
Final