PSY-8561-McClintock+Greenberg

** CSPP  ** ** One Beach Street, Suite 100  ** ** San Francisco, CA 94133  ** ** 415-955-2100  **
 * ALLIANT INTERNATIONAL UNIVERSITY **

COURSE INFORMATION FORM
= = =** School: California School of Professional Psychology **= ** Term & Year: Spring 2009 **
 * Course Title: Consultation: Medical Settings **
 * Course Number: PSY 8561 **
 * Units: 2 **

Day/Time: 3/20, 3/21 & 4/3, 4/4
=** INSTRUCTOR: Tamara McClintock Greenberg, PsyD, MS **= ** OPEN TO YEAR LEVEL ** : **All** The PsyD and Ph.D. clinical psychology programs are organized to enable students to build sequentially on knowledge and skills. This course is part of the PsyD/PhD shared curriculum. Each course in the PsyD and PhD program is designed to accomplish program specific learning outcomes (or training goals and objectives). This course helps in the fulfillment of the following PsyD program learning: Consultation/ Education and Management/Supervision - students demonstrate mastery in: a) Understanding the role of the psychologist in complex systems.    b)  Understanding general principles of consultation, education, management and supervision. c) Providing consultation, education, management and supervision for a specific population and/or setting     In the Ph.D. program, this course helps in the fulfillment of the following Ph.D. program learning outcomes, e.g., goals and objectives:     Objective: To integrate research findings and clinical literature with clinical practice.    a. Apply research on psychopathology to clinical diagnosis and case formulation    b. Incorporate psychotherapy research to treatment selection and evaluation    c. Evaluate treatment effectiveness through ongoing assessment of patient psychological functioning     d. Modify treatment interventions based on an evaluation of patient psychological functioning.   ** A. COURSE DESCRIPTION ** :     This course will address the varying and complex roles of psychologists in medical settings. The role of consultant is unique and involves assessment, individual and family psychotherapy, psychopharmacological recommendations, active involvement on multidisciplinary teams as well as more subtle interventions with multidisciplinary team members. These multiple roles will be discussed with an emphasis on how to build a consultation practice. Ethical issues and dilemmas will be presented as they relate to consultation in medical settings. Issues related to diversity including disparities in health care will be discussed. Prerequisite: some knowledge of health psychology. ** B. PURPOSE OF THE COURSE ** : This course is designed to enhance student's knowledge of health psychology and medical research and to provide the knowledge and skills required to provide psychological services to medical patients. Students will gain advanced diagnostic skills as they apply to the medical setting including unique issues involved in diagnosing mood disorders and delerium, which are common in medical patients. By the end of the course students will have an understanding of how to apply course concepts in their work with patients who have or develop medical problems in the course of psychotherapy, as well as how to develop a medical consultation practice. ** C. SPECIFIC LEARNING OUTCOMES ** : ** D. INSTRUCTIONAL STRATEGY ** : This course will utilize didactic and small and large group discussions as primary learning strategies. Discussions will focus on clinical diagnosis of medical patients and ethical issues in medical settings and those that arise on multidisciplinary treatment teams. All lectures will be provided using power point, so students have both audio and visual access to material. The writing assignments will help students learn further about the clinical application of research. Will discuss economic and racial disparities in health care, class, racial, sexual orientation, and ethnic differences regarding experiences in healthcare, and cultural differences in expectations from heath care providers. ** F. **** DESCRIPTION OF COURSE REQUIREMENTS AND ASSESSMENT METHODS: ** Grades will be based on attendance and class participation (25%), oral presentation (25%) and a paper (50%). ** Class participation (25% of grade): ** Sharing ideas and engaging in intellectual discussions are a required part of the course. That being said, I am sensitive to the fact that not all students are comfortable talking in large groups. Therefore, participation is encouraged in the large group, but if this is too uncomfortable, then participation must be active in the small group exercises. Since we are meeting for a limited period of time, and given the nature of the presentations attendance for the entire course is required. If an emergency arises and you need to miss part of the course speak to me privately to see if there is a way to make up missed portions of the class. ** Paper Requirement (50% of grade): ** Write a 8-12 page paper on any aspect of medical consultation that interests you. The purpose of this assignment is for you to learn more about an aspect of medical consultation that you are curious about and for you to apply the research on mind-body topics to the application of psychological services. Therefore, all topics related to medical consultation are options for you to consider. For example, you can write about an aspect of health psychology research, such as the impact of social support on morbidity and mortality in heart disease patients, depression and myocardial infarction, stress and illness, optimism and its’ effects on health, class and racial disparities in health care, etc. Additionally, you can write about issues specific to medical consultation settings such as the psychological treatment of elderly long-term care patients, issues in treating chronic pain patients, the role of psychologists in acute hospital settings, rehabilitation settings, or even outpatient behavioral medicine services such as biofeedback, smoking cessation, etc. Papers need to have at least 8 research articles or chapters cited (you may include your readings) and should not only talk about the research but **implications for the provision of medical consultation services.** For example, if you write about heart disease and depression, you need to not only discuss the research, but talk about what the research means and how psychologists can intervene with this population. **Talking about interventions is vital to receiving a good grade on the paper.** Even if you do not have experience with the population you are describing, try to apply what you have learned by discussing how we as psychologists can intervene with patients. You can include psychological interventions, pharamacological interventions, family interventions, interventions targeted at health behaviors, and consultation to multidisciplinary teams (but don’t just address talking to multidisciplinary teams, patients are our first concern). If you are currently working with medical patients, feel free to use case examples to illustrate your points. In other words, imagine that you have a medical consultation practice and try to explain what you think the major research and clinical issues might be related to your population/setting of interest. There are big differences between medical research and psychological research as it relates to medical problems and psychological issues. For a well- rounded paper, it is required that you use both psychological and medical research in your paper. In other words, when you do your literature searches I strongly suggest you search Pubmed (which is the primary medical database) as well as psychological databases for your references. Pubmed is free and open to the public. You also have access to Medline through CSPP, which is an acceptable alternative. The web address for Pubmed is  []. Papers must be in APA format with respect to citations of references as well as style. For questions regarding APA format please refer to the fifth edition of the Publication Manual of the American Psychological Association (2001). The paper is due no later than May 4 th, but feel free to turn it in earlier. You can mail your paper to: Tamara McClintock Greenberg 1801 Van Ness Avenue #200 San Francisco, CA 94109 Or you can e-mail it to: __ tamaragreenberg@gmail.com __ E-mailing papers is preferable as it is less use of paper. I will use track changes to comment on your paper and will send it back via e-mail. **Please put your first name and last initial as the file name and attach the file to your e-mail.** Late papers are highly discouraged. In order to be fair to students who turn in their papers on time, late papers will result in a half grade deduction per day until the paper is received. Grading for papers will be based on the ability to integrate both psychological and medical research, applying this research to clinical situations, clarity and coherence, as well as use of APA style and format. Papers need to begin with a statement (a "thesis statement" of sorts) that explains what you intend to do in the paper and how you intend to do it. E.g. a paper on depression and heart disease would start with a statement such as, "In this paper the research implicating depression in the development of heart disease will be reviewed. Critiques of existing research will be addressed, followed by the implications of the research. A case example will illustrate the importance of psychological interventions in heart disease patients." Letter grades will be assigned unless students have elected to take the course as a credit/no credit course. ** Oral presentation (25% of grade): ** On the last day of class (April 4th) you will be asked to present one article that you will use in your paper. Your presentation doesn’t have to be longer than 10-15 minutes. Please do not use an article from the reference list that I provided. Simply present an article and briefly describe the research methodology and the major findings of the article. Say a few words about how the article applies to medical consultation. You are free to take a few minutes to talk about your paper and to get feedback (if you want it) about how to structure your paper. **Provide me with a copy of the article and a one-paragraph summary of it.** READING LIST: **Required:** **Clinical Counselling in Medical Settings.** Ed. Thomas, P., Davison, S., Rance, C. Taylor and Francis, NY, 2001. (Initially published by Brunner-Routledge, East Sussex.) **A Therapist’s Guide to Understanding Common Medical Problems.** Andrew Kolbasovsky. W.W. Norton and Company, NY, 2008. Sheppard, VB, Zambrana, RE, O’Malley, A.S. Providing health care to low income women: a matter of trust. Family Practice, 2001;1(5):484-491. Doescher M.P, Saver, B.G, Franks, P. et al. Racial and ethnic disparities in perceptions of physician style and trust. Archives of Family Medicine, 2000;9:1156-1163 Zuger, A. Dissatisfaction with medical practice. New England Journal of Medicine, 2004;350(1);69-75. Street, R.L., Gordon, H.S., Ward, M, et al. Patient participation in medical consultations: why some patients are more involved than others. Medical Care 2005;43(10) 960-969. ** Optional: ** (For advanced health psychology students and those wanting additional medical and psychopharmacological knowledge): ** Psychological Assessment in Medical Settings. ** Rozensky, R., Sweet, J.J., Tovian S.M. Plenum, NY, 1997. A great comprehensive book on assessment and psychometric issues in evaluating medical patients. ** The Psychological Impact of Medical Illness: A Practical Guide for Primary Care Physicians. ** Greenberg, T.M. Springer 2007. Covers much of the research we address in class, with additional chapters on psychopharmacology, working with families, the culture of medicine and issues in adapting to acute and chronic illness. ** The Psychiatric Mental Status Examination. ** Trzepacz, PT, Baker, RW. 1993, Oxford. A great in-depth, step-by step guide to mental status exams that is neuropsychological and psychiatric in its’ approach.   1. __Policies Related To Class Attendance, Lateness, Missed Exams or __ __Assignments__ The University expects regular class attendance by all students. Each student is responsible for all academic work missed during absences. When an absence is necessary, students should contact the instructor as courtesy and to check for assignments. See the University Catalog for the complete policy on attendance (http://www2.alliant.edu/download/2005/catalog/3_Academic_Policies.pdf).  2. __Responsibility to Keep Copies __ Remember – it is good practice to keep copies of ALL major assignments/papers you turn in. On rare occasions, work may be lost because of computer failure or other mishaps.  3. __Respectful Speech and Actions __ <span style="font-family: 'Times New Roman','serif';">Alliant International University, by mission and practice, is committed to fair and respectful consideration of all members of our community, and the greater communities surrounding us. All members of the University must treat one another as they would wish to be treated themselves, with dignity and concern. <span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif';"> As an institution of higher education, Alliant International University has the obligation to combat racism, sexism, and other forms of bias and to provide an equal educational opportunity. Professional codes of ethics (e.g., from the APA for psychology students) and the Academic Code shall be the guiding principles in dealing with speech or actions that, when considered objectively, are abusive and insulting. <span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif'; msolist: Ignore;">4. __<span style="font-family: 'Times New Roman','serif';">Academic Code of Conduct and Ethics __<span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif';">The University is committed to principles of scholastic honesty. Its members are expected to abide by ethical standards both in their conduct and in their exercise of responsibility towards other members of the community. Each student’s conduct is expected to be in accordance with the standards of the University. **//The complete Academic Code, which covers acts of misconduct including assistance during examination, fabrication of data, plagiarism, unauthorized collaboration, and assisting other students in acts of misconduct, among others, may be found in the University Catalog.//** The University reserves the right to use plagiarism detection software. <span style="font-family: 'Times New Roman','serif';"> <span style="background: yellow; font-family: 'Times New Roman','serif'; mso-highlight: yellow; msohighlight: yellow; msolist: Ignore;">5. __<span style="background: yellow; font-family: 'Times New Roman','serif'; mso-highlight: yellow;">Evaluation of Students’ Professional Development and Functioning __ <span style="background: yellow; font-family: 'Times New Roman','serif'; mso-highlight: yellow;">In CSPP, multiple aspects of students’ professional development and functioning (e.g., cognitive, emotional, psychological, interpersonal, technical, and ethical) will be evaluated throughout the process of education and training in our professional psychology and MFT programs. This kind of comprehensive evaluation is necessary in order for faculty, staff, and supervisors to appraise the professional development and competence of their students. <span style="font-family: 'Times New Roman','serif';"> See the University Catalog for the complete CSPP policy on “Evaluation of Student Competence: A. Student Disclosure of Personal Information” (Appendix B). <span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif'; msolist: Ignore;">6. __<span style="font-family: 'Times New Roman','serif';">Disability Accommodations Request __ <span style="font-family: 'Times New Roman','serif';">If you need disability-related accommodations in this class, please see me privately. All accommodations must be requested in a timely manner (at least 2 weeks ahead of time) with a letter of support for Alliant’s Office of Disability Services. If you have questions about accommodations, please contact the Office of Disability Services. <span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif'; msolist: Ignore;">7. __<span style="font-family: 'Times New Roman','serif';">Policy on Course Requirements During Religious Holidays __<span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif';">Alliant International University does not officially observe any religious holidays. However, in keeping with the institution’s commitment to issues of cultural diversity as well as humanitarian considerations, faculty are encouraged to appreciate students’ religious observances by not penalizing them when they are absent from classes on holy days. Alliant International University faculty will be sensitive to these matters. Students should be similarly respectful of faculty members’ right to observe religious days. <span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif'; msolist: Ignore;">8. __<span style="font-family: 'Times New Roman','serif';">Resources for Obtaining Tutoring or Other Student Support Services __<span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif';">Tutors are available to help students with course-based or exam-based needs. Contact the Director of Student Support Services for information on obtaining tutoring – or other student support services – on your campus. <span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif'; msolist: Ignore;">9. __<span style="font-family: 'Times New Roman','serif';">Problem Solving Resources __<span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif';">If problems arise with faculty, other students, staff, or student support services, students should use the University Problem Solving Procedures located on the web at [] or contact the University Ombudsperson at rkunard@alliant.edu. <span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif'; msolist: Ignore;">10. __<span style="font-family: 'Times New Roman','serif';">IRB policy [if applicable] __ <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; mso-ansi-language: EN-US; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;"> <span style="font-family: 'Times New Roman','serif';"> <span style="font-family: 'Times New Roman','serif';"> WEEKLY SYLLABUS INSTRUCTORS NAME: Tamara McClintock Greenberg, PsyD, MS   Phone: 415-775-7220 e-mail: tamaragreenberg@gmail.com COURSE NUMBER: Psy8561 COURSE NAME: Consultation: Medical Settings Friday March 20th: Review syllabus and course requirements, large group discussion on the role of consultants, lectures on mind-body research, distinction between consultation and psychotherapy, culture of Western Medicine, European vs. American models of healthcare, consultation populations, specific medical/psychological assessment issues in medical patients (delirium vs. mental illness, complications in the diagnosis of mental illness is medical populations). Saturday September 21st : Small group discussion of clinical vignettes, lecture on specific medical populations (chronic pain, long-term care patients, acute hospital patients, rehabilitation patients, outpatient consultation), psychological issues in health related populations, specific treatment modalities and theoretical orientations as applied to medical patients. // Clinical Counselling in Medical Settings: // Chapters 1, 5 (83-89) Chapter 3 is optional // A Therapist’s Guide to Understanding Common Medical Problems: // Introduction and chapters 2-4 Zuger, A. Dissatisfaction with medical practice. __New England Journal of Medicine__, 2004; 350(1);69-75. // The Psychological Impact of Acute and Chronic Illness // : Chapters 2-4, // Psychological Assessment in Medical Settings: // Chapter 1, 3, 11 (pp190-192) Chapter 5 is suggested for persons who area not specialized in health psychology or those who have limited experience with medical patients // The Psychiatric Mental Status Evaluation: // Browse book for areas of personal interest in conducting mental status evaluations Friday April 3rd: Specific populations continued (chronic pain, surgery, hospice/palliative care) communication with physicians and medical staff, ethical issues in consultation (small group exercise and discussion), psychological interventions with staff and families Saturday April 4th: Racial and economic disparities in health care, patient-physician trust, patient compliance, developing a consultation practice, student presentation of articles, discussion of paper topics ** Required readings for weekend two: ** // Clinical Counselling in Medical Settings: // Chapters 7, 8, 9 (you can omit the case starting on p. 156 if you don’t have time to read the whole chapter, but try to read at least a couple of the case examples if you can) // A Therapist’s Guide to Understanding Common Medical Problems: // Chapters 6, 9, & 12 Sheppard, VB, Zambrana, RE, O’Malley, A.S. Providing health care to low income women: a matter of trust. __Family Practice__, 2001;1(5):484-491. Doescher M.P, Saver, B.G, Franks, P. et al. Racial and ethnic disparities in perceptions of physician style and trust. __Archives of Family Medicine__, 2000;9:1156-1163 Street, R.L., Gordon, H.S., Ward, M, et al. Patient participation in medical consultations: why some patients are more involved than others. __Medical Care__ 2005;43(10) 960-969. // The Psychological Impact of Acute and Chronic Illness // : The end of chapter one which discusses socioeconomic and racial disparities in health care, chapters 6-7 // Psychological Assessment in Medical Settings: // Chapters 6, 7 (101-116), 13 Chapters 2 and 11 are optional <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 90%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;"> ** Appendix A  **
 * Room: TBA  **
 * Contact: tamaragreenberg@gmail.com, 415-775-7220 **
 * Grading: Letter grades **
 * I. RATIONALE: **
 * // II. COURSE DESCRIPTION, PURPOSE, STUDENT LEARNING OUTCOMES and ASSESSMENT:  //**
 * 1)  Present the multi-faceted roles of psychologists in health care settings.
 * 2)  Discuss acculturation to medical settings/current conflicts in U.S. medicine.
 * 3)  Address different healthcare models (e.g British system vs. U.S. system of integrating mental health).
 * 4)  Discuss the distinctions between consultation and psychotherapy. Present different therapeutic models of consultation (e.g. CBT, psychodynamic, assessments).
 * 5)  Increase knowledge base with regards to common medical conditions and the interaction of these conditions with psychological disorders.
 * 6)  Discuss ethical and legal issues as they pertain to consultation in medical settings.
 * 7)  Discuss the wide applicability of psychological services in health care settings.
 * 8)  Address special issues related to assessment in healthcare settings.
 * 9)  Discuss cross-cultural issues and ethnic, racial, class, and sexual orientation disparities in the American healthcare system.
 * E. Class Component on Multicultural and International Issues: **
 * <span style="font-family: 'Times New Roman','serif';">III. Course Readings and Materials: **<span style="font-family: 'Times New Roman','serif';">
 * <span style="font-family: 'Times New Roman','serif';">IV. Policies and Procedures: **<span style="font-family: 'Times New Roman','serif';">
 * //<span style="font-family: 'Times New Roman','serif';">Behavioral Expectations/Attendance //**
 * <span style="font-family: 'Times New Roman','serif';">V. Course Schedule: **
 * Weekend one: **
 * Required readings for weekend one: **
 * Additional Optional Readings for weekend one: **
 * Weekend two: **
 * Additional Optional Readings for weekend two: **

Academic Standing Status for CSPP Doctoral Students
Use the following grade equivalencies to translate campus based to CSPP systems. A & B = Credit with no “some concerns” or no “serious concerns” C = marginal pass or “some concerns” D/F = fail or “serious concerns” In the following, substitute the grade equivalencies from above. ** Good Academic Standing ** – Any record of performance which does not qualify for Warning, Probation, Termination, or all A and B’s. ** Warning ** – One grade of C or lower ** Probation ** – (a) In the first 60 units of the program: Two C’s OR one C and one D/F. (b) During the entire program: Three C’s OR one D/F and one C  ** Termination ** – Students will be terminated from the program if their GPA falls below a 3.0 or if they are on probation for 2 terms.

Related Issues:
1. Students placed on academic warning or probation status will return to good standing upon receiving of all A/B’s in the semester following the semester which qualified the person for warning/probation status. 2. Students must repeat a course for which a no credit grade is received. Both grades will remain on the transcript. 3. Students may be placed on warning, probation, or terminated for other performance, ethical or professional behavior, such as acts of misconduct, unprofessional behavior, failure to complete 67% of the units attempted every academic year, failure to complete their educational program within a reasonable period of time, or failure to pass comprehensive, preliminary, or other competency exams (Please refer to local program and system-wide polices). 4. A student may be required to take a mandatory leave of absence, a modified sequence or reduced load of courses, or to repeat or take additional courses if their academic work or professional development requires serious remediation. <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;"> ** Appendix B  ** (Adapted from the Student Competence Task Force of the Council of Chairs of Training Councils (CCTC), [], December 4, 2003) Professional helpers are expected to demonstrate competence within and across a number of different but interrelated dimensions. Because programs that educate and train professional helpers also strive to protect the public and profession, faculty, training staff, and supervisors in such programs have a legitimate and vested interest in the comprehensive evaluation of student competence to include multiple aspects of development and functioning (e.g., cognitive, emotional, psychological, interpersonal, technical, and ethical). In CSPP, multiple aspects of students’ professional development and functioning (e.g., cognitive, emotional, psychological, interpersonal, technical, and ethical) will be evaluated throughout the process of education and training in our professional psychology and MFT programs. This kind of comprehensive evaluation is necessary in order for faculty, staff, and supervisors to appraise the professional development and competence of their students. Faculty, staff, and supervisors have a professional, ethical, and potentially legal obligation to: (a) evaluate the interpersonal competence and emotional well being of student trainees who are under their supervision, and who provide services to clients and consumers, and (b) ensure—insofar as possible—that the trainees who complete their programs are competent to manage future relationships (e.g., client, collegial, professional, public, scholarly, supervisory, and teaching) in an effective and appropriate manner. Faculty, staff, and supervisors will evaluate student competence in areas other than coursework, seminars, scholarship, comprehensive examinations, or related program requirements. Students may therefore be required to participate in learning activities that require different levels of self-disclosure. These multiple evaluative areas include, but are not limited to, demonstration of sufficient: (a) interpersonal and professional competence (e.g., the ways in which students relate to clients, peers, faculty, allied professionals, the public, and individuals from diverse backgrounds or histories); (b) self-awareness, self-reflection, and self-evaluation (e.g., knowledge of the content and potential impact of one's own beliefs and values on clients, peers, faculty, allied professionals, the public, and individuals from diverse backgrounds or histories); (c) openness to processes of supervision (e.g., the ability and willingness to explore issues that either interfere with the appropriate provision of care or impede professional development or functioning); and (d) resolution of problems or issues that interfere with professional development or functioning in a satisfactory manner (e.g., by responding constructively to feedback from supervisors or program faculty; by participating in personal therapy in order to resolve problems or issues).
 * Student Disclosure of Personal Information **