Raymond M. Bergner's webpage

At ISU, Practicum is what you might call the "flex course" in the curriculum. In other words, in most courses, there is a set agenda -- a series of pre-established topics that are taken up in a certain sequence. In Practicum, there will be such topics but another core agenda is to try to be as responsive as possible to students' ongoing needs -- often needs which cannot be anticipated -- in their practicum placements. In each class period, the first question will usually be, "Anyone got any issues, problems, needs, or anything else from their placement experiences that they'd like to discuss?"

Then, each day we will take up some topic. I have a few that I think always need to be discussed, and we will determine others on the basis of student needs. Late in semester we will do case presentations.

COURSE OBJECTIVES:

The primary objective of the practicum experience is to acquire clinical competence. This includes...

1. COMPETENCE AT INDIVIDUAL CASE FORMULATION (ASSESSMENT). A critical skill to be acquired is that of becoming able to formulate case conceptualizations. These are essentially mini-theories or hypotheses that include both (a) a clear delineation of the client's problem (i.e., a diagnosis) and (b) an explanatory account of what is maintaining the problem. A good formulation is ACCURATE; it fits the facts; it is closely tied to the actual data of the case; nothing is made up (a surprisingly common occurrence). A good formulation is COMPREHENSIVE; i.e., it ties together all, or a large portion of the data from the case into a unitive account wherein all the facts of the case "hang together"--like a scientific theory that provides a fit for a lot of the observed phenomena. A case formulation may often include a DSM diagnosis, but it would not be limited to that: when one has established that a client is dysthymic, for example, the work of assessment has just begun. A good case formulation is USEFUL. It heuristically suggests directions and strategies to bring about change.

2. COMPETENCE AT FORMING A GOOD THERAPEUTIC RELATIONSHIPS. Such actions as carefully and empathically listening to the client, conveying an understanding, being on the client's side, legitimizing, refraining from coercion, giving the client the benefit of the doubt, and more, all conduce to a positive therapeutic relationship, and so the practicum student must acquire competence here.

3. COMPETENCE AT EXECUTING CHANGE OPERATIONS EFFECTIVELY. The focus here is on the skillful implementation of change techniques, whatever this might entail in a given case. For example, in one situation, it might entail skillfully getting the client to rethink a maladaptive idea, in another role-playing a difficult situation, and in yet another giving a homework assignment.

Historically, it is in area 3 -- the skillful execution of change operations -- that students-in-training have had the most difficulty. To borrow a phrase from the Solution Focussed folks, they have had a hard time "having a conversation for change" -- of sitting down with a client and conducting an interview that accomplishes such things as defining a workable problem and then discussing this problem in a way that has a high probability of bringing about change in the client. While other techniques such as exposure, desensitization, role playing, and designing good homework assignments are all highly valuable, it is the therapeutic conversation that is the essential medium for all of this. It is within this medium that we do such things as establish an alliance with the client, define a workable problem, bring about vital changes in the client's thinking and world view, and set up other interventions that we wish to implement.

LEARNING FORMATS:

Lecture / Discussion

Observational learning (e.g., of therapy videos)

Role playing

Debate

Case presentations (final 10 class sessions will be devoted to these)

TOPICS:

1. What is it important to accomplish in the first therapy session? Why?

2. What is a "workable problem formulation" and how do you create one?

3. What are the primary reasons why suicidal clients are suicidal? What are some good

ideas for helping such suicidal clients?

4. How can we get the reluctant or involuntary client to commit to therapy?

E.g., the reluctant spouse or adolescent.

5. How might we help resistant clients to be less resistant?

6. What is "motivational interviewing" and how is it relevant to #s 5 and 6?

7. What can we do if, on first encounter, we dislike our client?

8. How can we deal with clients who intimidate?

9. What are the "necessary ingredients" for a good therapeutic relationship? Why?

10. Are there any general policies or procedural guidelines for psychotherapy that are useful

regardless of your theoretical approach to therapy?

11. What are some good ideas for approaching couples in therapy?

12. Should we do play therapy at all or only deal with the family of the child?

13. If we do play therapy, what are some good ideas for conducting such therapy?

Further topics to be determined over course of semester based primarily on

student needs as these arise.

READINGS:

Miller, W., & Rollnick, S. (2002). Motivational interviewing

(2d. ed.). New York: Guilford.

Beck, A. (1979). Cognitive therapy of depression. New York:

Guilford. (Tape that accompanies book).

Bergner R (2007). Status dynamics: Enriching the paths to therapeutic change.

Ann Arbor, MI: Burns Park Publishers.

EVALUATION: Evaluation in practicum will be based on performance in three

general areas:

1. Attendance (100 points).

“Eighty percent of success in life is just showing up.”

--Woody Allen

Deduction of 10 points for any class missed without a valid excuse.

2. Class participation (100 points).

Requirement here is that student (a) be engaged and paying attention

during class period, and (b) that he or she make one or two

contributions per class period.

I will simply monitor this class by class. Basic idea here is that

you refrain from doing what a few students have done in the past,

which was to come to class but then remain silent the entire

time, fail to pay attention, and even work surreptitiously on other

tasks during class time.

3. Evaluations from outside practicum supervisors, especially final evaluation (150

points).

4. Quizzes: Unfortunately, in the past, many students have neglected to read assigned

readings for this course since we have never had tests or quizzes in the class. Thus,

there will be a short objective style quiz, worth 10 points, for all assigned readings.

(total points to be determined by number of quizzes).

Grading scale: A = 90% of total points

B = 80%

C = 70%

Etc.