Raymond M. Bergner's webpage

Practicum is a "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 the 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, after discussing this, each day we will take up some topic. There is a list below of topics that have often come up in previous years, and we can determine others on the basis of student needs. In the second half of the semester we will do case presentations. We may also have guest speakers on certain select topics as needed.

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 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 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 when implemented competently and in appropriate circumstances, 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.

POTENTIAL CLASS 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, adolescent, or mandated client)?

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

6. What is "motivational interviewing" and how is it relevant to nos. 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 on the following:

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, (b) make one or two contributions per class

period, and (c) if there has been an assigned reading, show evidence

of having read this assignment. (I reserve the right, if it becomes clear

assigned readings are not being read, of giving quizzes on these, the

results of which will be counted in the class participation grade.)

3. Quality of student's case presentation (50 points).

4. Taped interview session. Each student will be required to present and go over a taped

intake interview with me. Details will be provided in class (50 points.)

5. Evaluation from outside practicum supervisors at end of semester (200 points).

Grading scale: A = 90% of total points

B = 80%

C = 70%

Etc.