Workshops

Workshop #1: ACT for Life: Using Acceptance and Commitment Therapy to Prevent Suicide and Build Meaningful Lives

Sean M. Barnes, Ph.D., Clinical Research Psychologist, Rocky Mountain MIRECC
Lauren M. Borges, Ph.D., Clinical Research Psychologist, Rocky Mountain MIRECC
Nazanin H. Bahraini, Ph.D., Clinical Research Psychologist, Rocky Mountain MIRECC
Robyn D. Walser, Ph.D., Clinical Research Psychologist, National Center for PTSD

Category: Suicide and Self-Injury, Treatment – Mindfulness & Acceptance
Keywords: ACT (Acceptance & Commitment Therapy), Suicide, Recovery

Familiarity with the material: basic to moderate, moderate, moderate to advanced, advanced

Participants earn 3 continuing education credits.

Suicide is a leading cause of death, and competency in suicide risk assessment and prevention is a vital component of clinical practice. Yet responding to suicide risk can be a tremendous source of stress and place therapists at odds with their clients. Acceptance and Commitment Therapy (ACT) provides a powerful and balanced approach to suicide prevention by promoting life in addition to preventing suicidal behavior. The workshop will begin with a concise review of the literature on ACT and suicide. Then participants will learn to apply key components of ACT for Life, a brief empirically-based intervention developed via a formative evaluation with ACT and suicide prevention experts (Barnes et al., 2021). Case examples and experiential exercises will be used to build skills for working effectively and compassionately with clients at risk of suicide, while still maintaining best practices for suicide prevention. We will identify therapist challenges to working with clients considering suicide and discuss methods for overcoming these barriers. Participants will learn how to maintain an ACT therapeutic stance when conducting suicide risk assessment, practice emphasizing function over form when identifying drivers of suicidal thoughts and behaviors and create an ACT-consistent safety plan. We will demonstrate how to join with clients in acknowledging and accepting the pain that leads them to desire death, while still empowering them to engage in values-consistent behavior, building a meaningful life of their choosing. This workshop will not include a comprehensive introduction to ACT and is recommended for attendees with at least some previous ACT training and experience.

Outline:

• Challenges of working with clients considering suicide
• Phenomenon of suicide from a contextual behavioral perspective
• Brief review of empirical support for using ACT to prevent suicide
• Introduction to ACT for Life protocol
• Functional suicide risk assessment
• Undermining the control agenda and turning toward values-based living
• Engaging mindfulness processes with clients thinking of suicide
• Engaging behavior change processes with clients thinking of suicide
• ACT-consistent safety planning
• Discussion and questions

At the end of this session, the learner will be able to:

1. Conceptualize suicidal behavior from a contextual behavioral perspective.
2. Describe one tool for assessing the function of suicidal behavior.
3. Identify at least two strategies for using ACT to reduce suicide risk.
4. Help clients create ACT-consistent safety plans.

Recommended Readings:

Barnes, S. M., Borges, L. M., Smith, G. P., Walser, R. D., Forster, J. E., & Bahraini, N. H. (2021). Acceptance and Commitment Therapy to promote recovery from suicidal crises: a randomized controlled acceptability and feasibility trial of ACT for Life. Journal of Contextual Behavioral Science, 20, 35-45.

Walser, R. D., Gavert, D. W., Karlin, B. E., et al. (2015). Effectiveness of Acceptance and Commitment Therapy in treating depression and suicidal ideation in Veterans, Behavior Research and Therapy, 74, 25-31.

 Bahraini, N. H., Devore, M. D., Monteith, L. L., Forster, J. E., Bensen, S., & Brenner, L.  A. (2013). The role of value importance and success in understanding suicidal ideation among Veterans. Journal of Contextual Behavioral Science, 2 (1), 31-38.

 Luoma, J.B. & Vilatte, J.L. (2012). Mindfulness in the treatment of suicidal individuals. Cognitive and Behavioral Practice, 19 (2), 265-276.

Workshop #2: Advanced Training in Trauma Focused Cognitive Behavioral Therapy: Applications to Developmental Disabilities

Peter J. D’Amico, ABPP, Ph.D., Director, Child & Adolescent Psychology, Northwell Health Long Island Jewish Medical Center
Daniel Hoover, ABPP, Ph.D., Director, Horizons Clinic, Center for Child and Family Traumatic Stress, Kennedy Krieger Institute

Category: Autism Spectrum and Developmental Disorders, Trauma and Stressor Related Disorder and Disasters
Keywords: Autism Spectrum Disorders, Trauma, Treatment

Moderate level of familiarity with the material

Participants earn 3 continuing education credits.

Neurodiverse youth are exposed to maltreatment, bullying, abuse, potentially traumatizing medical and restraint procedures, and other adverse childhood experiences at approximately be 2-3 times that of their neurotypical peers. Despite this prevalence, neurodiverse youth are an underserved and poorly understood group among mental health clinicians and those who treat traumatic stress, in part due to being underrepresented in both the treatment literature and in graduate training programs. However, clinicians have implemented Trauma-Focused Cognitive Behavior Therapy (TF-CBT) with them. For over two decades, many children with trauma related symptoms have been effectively treated due to model’s flexibility and applicability to both single and complex trauma, as well as cultural backgrounds. The efficacy of TF-CBT has been demonstrated in almost two dozen randomized controlled trials and across the developmental spectrum for many types of trauma and settings. Significant progress has been made in adapting TF-CBT to meet the needs of youth and caregivers with significant limitations in cognitive, language, and other executive functions. The growing evidence base in the literature about the effectiveness of CBT for anxiety in (high-functioning) autism spectrum disorders is used as a guide for adapting EBT’s for a wider range of neurodiversity.

Our presenters, who include a certified TF-CBT trainer, and a director of a trauma clinic serving neurodiverse youth, will describe the problems of bias and diagnostic overshadowing, in the assessment of trauma in neurodiverse youth. An initial focus is the importance of child self-report, and the current state of the literature in this area. A formal model is presented based on a “matrix” implementing TF-CBT modules, using performance and self-report measures, while accounting for youths’ and caregivers’ a) verbal comprehension; b) visual-spatial skills; c) sensory differences; d) motivation for treatment; and e) ability to generalize skills learned in therapy. Recommendations for treatment structure, process, and supplemental resources from neurodiversity literature will be provided, to apply TFCBT flexibly within fidelity. The steps and approach will be illustrated by clinical case examples.

Outline:

• Scope of the Problem
• Assessment and diagnosis with IDD + Trauma
• Trauma Response & Neurodiversity
• Results of TF-CBT Therapist Survey
• Treatment considerations tailoring TF-CBT to children and families with IDD
• Applications of Adaptations to PRACTICE Modules

Long-term Goal:

To identify and implement best fit accommodation strategies when tailoring TF-CBT for youth with Intellectual and Developmental Disabilities

At the end of this session, the learner will be able to:

1. Determine the appropriateness of TF-CBT for my clients based on evidence-based assessments of both ASD and PTSD.
2. Explain the need to adapt standard assessment and TF-CBT techniques to the special needs of youth with developmental disabilities who have been traumatized.
3. Flexibly tailor TFCBT PRACTICE modules while keeping fidelity, taking into account developmental needs.
4. Describe variations of trauma narration modified for youth with ASD.

Recommended Readings:

Cohen, J.A., Mannarino, A.P., & Deblinger, E. (2017). Treating Trauma and Traumatic Grief in Children and Adolescents. Second Edition. New York: Guilford.

Grosso, C. A. (2012). Children with developmental disabilities. Trauma-focused CBT for children and adolescents: treatment applications, 149-174.

Cohen, J.A., Mannarino, A.P., Kliethermes, M., &. Murray, L.A. (2012).  Trauma-focused CBT for youth with complex trauma. Child Abuse & Neglect, 36, 528–541.

Hoover, D. W. (2015). The effects of psychological trauma on children with autism spectrum disorders: a research review. Review Journal of Autism and Developmental Disorders, 2(3), 287-299.

Hoover, D. W., & Kaufman, J. (2018). Adverse childhood experiences in children with autism spectrum disorder. Current opinion in psychiatry, 31(2), 128.

Workshop #4: Family Based Interpersonal Psychotherapy (FB-IPT) for Preadolescent Depression

Laura J. Dietz, Ph.D., Associate Professor, University of Pittsburgh

Category: Child / Adolescent – Depression, Parenting / Families
Keywords: Child, Depression, Evidence-based practice

Basic to moderate level of familiarity with the material

Participants earn 3 continuing education credits.

Family Based Interpersonal Psychotherapy (FB-IPT) for Depressed Preadolescents is a primary intervention to reduce the burden of early-onset depressive disorders in children between the ages of 8-12 years, with a secondary focus on preventing or delaying depression recurrence in adolescence for this high-risk group. FB-IPT directly addresses two domains of interpersonal impairment associated with preadolescents’ depressive symptoms: parent-child conflict and peer impairment. FB-IPT focuses on improving communication and problem solving skills in the parent-child relationship, the primary context for children’s social and emotional development to improve the quality of the parent-child relationship and to buffer depressed preadolescents from the effects of peer stress, as well as to rehearse effective interpersonal behavior with peers.

Adapted from IPT-A, FB-IPT includes several developmental modifications for 8-12 year-olds: 1) increased parental involvement and structured dyadic sessions, with individual meetings with parents and parent-child sessions for teaching and role-playing communication and problem solving skills, 2) an expanded Limited Sick Role, to shape parental expectations for depressed preadolescents’ performance across contexts and provide parenting strategies for decreasing conflict, and 3) an increased focus on comorbid social anxiety, to decrease depressed preadolescents’ interpersonal avoidance and to enhance their communication and interpersonal problem solving skills with peers. As in adult and adolescent protocols, FB-IPT structures treatment around an identified “problem areas” temporally associated with the onset of depressive symptoms (loss, disputes, transitions, and interpersonal deficits) and structures treatment into 3 phases.

To date, FB-IPT is one of the few psychosocial interventions for depression in preadolescent children that has demonstrated superior outcomes when compared to an active comparison treatment condition. As such, FB-IPT has promise as an efficacious intervention with readily measurable targets and mechanisms of action.

Outline:

• Background/ Rationale for FB-IPT for Depressed Preadolescents
  Overview of FB-IPT/ Developmental Modifications to IPT-A
• Initial Phase of FB-IPT –
  • Preadolescent Interpersonal Inventory
    Mood Thermometer & Closeness Circle
  • Initial Phase of FB-IPT – Expanded Limited Sick Role (LSR) and Parent Tips
    Role play of Expanded LSR and Introducing Parent Tips
  • Presentation of Family Based Problem Areas and Formulation
• Break, Questions
• BREAKOUT 1: Small groups practice of Expanded LSR with Parent
• Middle Phase of FB-IPT – Overview and Problem Area Strategies for Preadolescents and Parents
  • Middle Phase Techniques (Tween Tips)
    • Depression Circle (Communication Analysis)
    • Suggesting Solutions / Interpersonal Problem Solving (Decision Analysis)
    • Experiments for Decreasing Interpersonal Avoidance

Role Play Middle Phase Session with Problem Area (Disputes/ Transition)

• BREAKOUT 2: Small groups practice of Depression Circle/ Communication Analysis with Preteen and Parent
• Termination Phase of FB-IPT
• Discussion

At the end of this session, the learner will be able to:

1. Describe the theoretical framework and 3 developmental adaptations in Family Based Interpersonal Psychotherapy (FB-IPT) for Depressed Preadolescents.
2. Explain the differences in structuring individual and dyadic meetings with preadolescents and parents in all three phases of FB-IPT.
3. Identify the 4 Tween and Parent Tips introduced when delivering FB-IPT to preadolescents and parents.
4. Demonstrate effective use of key clinical techniques in FB-IPT with role-plays and case examples.
5. Integrate strategies specific to FB-IPT into psychotherapy for depressed preadolescents and their parents.

Long-Term Goal:

• Improve general clinical efficacy when working with depressed preadolescents who likely have a parent(s) with a history of depression.

Recommended Readings:

Dietz L. J. (2020). Family-Based Interpersonal Psychotherapy: An Intervention for Preadolescent Depression. American journal of psychotherapy, 73(1), 22–28. https://doi.org/10.1176/appi.psychotherapy.20190028

Dietz L. J. (2017). Family-Based Interventions for Childhood Depression. Journal of the American Academy of Child and Adolescent Psychiatry, 56(6), 464–465. https://doi.org/10.1016/j.jaac.2017.03.019

Shomaker, L. B., Tanofsky-Kraff, M., Matherne, C. E., Mehari, R. D., Olsen, C. H., Marwitz, S. E., Bakalar, J. L., Ranzenhofer, L. M., Kelly, N. R., Schvey, N. A., Burke, N. L., Cassidy, O., Brady, S. M., Dietz, L. J., Wilfley, D. E., Yanovski, S. Z., & Yanovski, J. A. (2017). A randomized, comparative pilot trial of family-based interpersonal psychotherapy for reducing psychosocial symptoms, disordered-eating, and excess weight gain in at-risk preadolescents with loss-of-control-eating. The International journal of eating disorders, 50(9), 1084–1094. https://doi.org/10.1002/eat.22741

Dietz, L. J., Weinberg, R. J., Brent, D. A., & Mufson, L. (2015). Family-based interpersonal psychotherapy for depressed preadolescents: examining efficacy and potential treatment mechanisms. Journal of the American Academy of Child and Adolescent Psychiatry, 54(3), 191–199. https://doi.org/10.1016/j.jaac.2014.12.011

Workshop #5: Healing Interpersonal & Racial Trauma: Cultural Considerations for Integrating Racial Socialization in TF-CBT for Black Children & Families

Isha W. Metzger, Ph.D., Assistant Professor, University of Georgia

Category: Culture / Ethnicity / Race, Treatment – CBT
Keywords: African Americans / Black Americans, Trauma, Treatment

Moderate level of familiarity with the material

Participants earn 3 continuing education credits.

The negative consequences of interpersonal trauma (e.g., physical abuse) take a disproportionate toll on Black youth due to the compounding stress of experiencing unique race related stressors both directly (e.g., microaggressions) and vicariously (e.g., witnessing police brutality in the media). Children’s Advocacy Centers (CACs) are part of the acute response after a concern for trauma to provide community-based services to children and families to help prevent and treat negative sequelae. However, these organizations do not systematically consider racial stress and trauma in their intakes, assessment, or treatments. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an efficacious evidence-based trauma treatment for youth who experienced trauma. To increase their utility in responding to and treating interpersonal trauma, both CACs and TF-CBT, should integrate and address cultural factors (e.g., system mistrust) that are likely to influence Black families’ willingness to engage in treatment for trauma. In addition, Black youth rely on particular assets and strengths in their families and communities to reduce negative mental and behavioral health outcomes from interpersonal and race-related stressors. For instance, racial socialization is the protective process of transmitting cultural behaviors, attitudes, and values to prepare youth to cope with racial stressors, and is associated with positive outcomes including increased resilience, coping abilities, and decreased problem behaviors and anxiety in Black youth. This workshop will provide an overview of the impact of interpersonal and racial stress and trauma on mental health and behavioral outcomes for Black youth. This workshop will also present qualitative research on organizational barriers and facilitators to service utilization and engagement for ethnic minority caregivers referred for treatment at CACs. Last, a focus of this workshop will be on providing participants an overview of groundbreaking research, applied strategies, and resources for utilizing racial socialization and other cultural considerations to deliver TF-CBT in a culturally affirming and validating manner for Black youth and families who are healing from interpersonal and racial trauma.

Outline:

• Interpersonal and Racial Trauma: Statistics and Outcomes
• Resilience through Racial Socialization and Racial Identity
• Results from Community Based Participatory Research at Children’s Advocacy Center’s
• Trauma Focused Cognitive-Behavior Therapy
• Putting it all together: PRACTICE in Response to Interpersonal and Racial Stressors
  • Psychoeducation
  • Relaxation
  • Affect Identification and Emotion Regulation
  • Cognitive Restructuring
  • Trauma Narrative
  • In-Vivo Exposure
  • Conjoint Parent-Child Sessions
  • Enhancing Safety
• Resource Sharing
• Q&A

At the end of this session, the learner will be able to:

1. Identify ways that interpersonal and racial stress and trauma impact Black youth development.
2. Describe research on barriers and facilitators to trauma treatment utilization for ethnic minority youth and families.
3. Discuss the protective role of racial socialization on behavioral and mental health outcomes for Black youth.
4. Demonstrate the ability to utilize 2-3 strategies towards integrating racial socialization as a culturally specific cognitive-behavioral treatment strategy for Black clients.

Long-Term Goal:

• Contribute to multidisciplinary teams to make culturally informed decisions pertaining to client engagement, assessment, and treatment.

Recommended Readings:

Metzger, I., Anderson, R., Are, F., & Ritchwood, T (in press, 2020). Healing interpersonal and racial trauma: Integrating Racial Socialization into TF-CBT for African American Youth. Child Maltreatment. https://doi.org/10.1177/1077559520921457.

Wang, M.-T., Henry, D. A., Smith, L. V., Huguley, J. P., & Guo, J. (2020). Parental ethnic-racial socialization practices and children of color’s psychosocial and behavioral adjustment: A systematic review and meta-analysis. American Psychologist, 75(1), 1–22. https://doi.org/10.1037/amp0000464

Anderson, R., Metzger, I., Applewhite, K., Sawyer, B., Jackson, W., Flores, S., McKenny, M., & Carter, R. (2020). Hands Up, Now What?: Participant Reactions to Family and School Racial Socialization Interventions to Reduce Racial Stress for Black Youth. Journal of Youth Development. 93-109. https://doi.org/10.5195/jyd.2020.755.

Coard, S. I., Wallace, S. A., Stevenson, H. C., & Brotman, L. M. (2004). Towards culturally relevant preventive interventions: The consideration of racial socialization in parent training with African American families. Journal of Child and Family Studies, 13(3), 277-293. https://doi.org/10.1023/B:JCFS.0000022035.07171.f8

Neblett, E. W., White, R. L., Ford, K. R., Philip, C. L., Nguyên, H. X., & Sellers, R. M. (2008). Patterns of racial socialization and psychological adjustment: Can parental communications about race reduce the impact of racial discrimination?. Journal of Research on Adolescence, 18(3), 477-515. https://doi.org/10.1111/j.1532-7795.2008.00568.x

Workshop #6: How to Apply Dialectical Behavior Therapy When Treating Emotion Dysregulation Complicated by Sexual and Gender Minority Stress

Colleen Sloan, Ph.D., Staff Psychologist & Assistant Professor, VA Boston Healthcare System & Boston University School of Medicine

Jeffrey M. Cohen, Psy.D., Assistant Professor of Medical Psychology (in Psychiatry), Columbia University Medical Center

Category: LGBTQ+, Treatment – Other
Keywords: DBT (Dialectical Behavior Therapy), LGBTQ+, Stigma

Basic to moderate level of familiarity with the material

Participants earn 3 continuing education credits.

Dialectical Behavior Therapy (DBT) is an evidence-based treatment for emotion dysregulation. DBT conceptualizes emotion dysregulation as a reasonable outcome of a transactional process between biological temperament and an invalidating environment. Additionally, it has been proposed that individuals with little biological vulnerability may experience emotional and behavioral dysregulation in the context of chronic and pervasive invalidation. Sexual and gender minority (SGM) people may experience chronic invalidation of their identities in the form of societal stigma, discrimination, marginalization, and other oppressive social forces. These examples of invalidation contribute to well-documented mental health disparities for SGM people including elevated rates of suicide, substance use, and depression, indicative of emotional and behavioral dysregulation. While many mental health professionals are motivated to use interventions like DBT to treat these problems, many less are adequately prepared to comprehensively treat emotional and behavioral dysregulation impacted by minority stress in SGM people. With this in mind, disparities for this marginalized group will persist and the impact and outcomes of evidence-based practice, particularly DBT, will be limited. This workshop is designed to provide some basic knowledge regarding mental health problems and minority stress in SGM populations along with strategies to conceptualize and intervene in these problems, utilizing DBT and minority stress (Meyer, 2003) frameworks. Attention to intersecting identities (e.g., Black transgender women) will be integrated throughout this workshop. Presenters will demonstrate how to effectively apply DBT strategies and teach DBT skills to address presenting problems and symptoms of SGM clients. The workshop aims to develop and/or enhance application of basic DBT strategies and tools to the needs of a marginalized community. Specific application of DBT skills from each skills module will also be included. Case vignettes, experiential exercises and role-plays, will be embedded throughout this workshop. The broader implications as they relate to public health and social justice will be integrated throughout this workshop.

Outline:

• DBT is a treatment option when working with sexual and gender minority (SGM) people who evidence emotional and behavioral dysregulation.
  • SGM people may experience chronic and pervasive invalidation of their identities and experiences in the form of stigma, discrimination, and oppression.
  • SGM may be more likely than non SGM people to experience and evidence emotional and behavioral dysregulation patterns as a reasonable response to chronic invalidation
• Mental health professionals may be motivated to help SGM clients improve their lives but may not be adequately prepared to comprehensively treat emotional and behavioral dysregulation
  • Gaps in mental health treatment options will persist
  • Mental health disparities for SGM people will continue
• DBT can be tailored to address the unique needs of marginalized people, particularly SGM people.
  • DBT can be integrated minority stress frameworks.
  • DBT skills training can be adapted to attend to minority stress
  • Cultural humility can be incorporated into the provision of DBT when working with marginalized people
• This workshop will demonstrate application of DBT skills training and individual psychotherapy tools when treating SGM individuals.

At the end of this session, the learner will be able to:

1. Articulate case conceptualizations of emotional and behavioral dysregulation using an integration of dialectical behavior therapy and SGM stress frameworks.
2. Utilize at least two specific DBT strategies and skills (e.g., chain analysis) to address emotion dysregulation in SGM individuals.
3. Apply at least three validation strategies to address clinical distress in SGM individuals.
4. Demonstrate cultural humility and affirmation when conducting effective DBT skills training when treating SGM individuals.
5. Apply change-based strategies in DBT to promote social justice for SGM communities.

Long-Term Goal:

• Learners will be able to describe how to integrate biosocial formulation of emotion dysregulation with minority stress frameworks to more effectively conceptualize presenting problem for SGM clients.
• Learners will utilize affirming case formulations to tailor DBT skills training and strategies to treat clinical distress when working with SGM clients.

Recommended Readings:

Cohen, J. M., Norona, J. C., Yadavia, J. E., & Borsari, B. (2020). Affirmative dialectical behavioral therapy skills training with sexual minority veterans. Cognitive and Behavioral Practice. https://doi-org.ezproxy.bu.edu/10.1016/j.cbpra.2020.05.008

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi-org.ezproxy.bu.edu/10.1037/0033-2909.129.5.674

Pantalone, D. W., Sloan, C. A., & Carmel, A. (2019). Dialectical behavior therapy for borderline personality disorder and suicidality among sexual and gender minority individuals. In S. A. Safren & J. E. Pachankis (Eds.), The Handbook of Evidence-Based Mental Health Practice with Sexual and Gender Minorities. New York: Oxford.

Rizvi, S. L., Steffel, L. M., & Carson-Wong, A. (2013). An overview of dialectical behavior therapy for professional psychologists. Professional Psychology: Research and Practice, 44(2), 73–80. https://doi-org.ezproxy.bu.edu/10.1037/a0029808

Sloan, C. A., Berke, D. S., & Shipherd, J. C. (2017). Utilizing a dialectical framework to inform conceptualization and treatment of clinical distress in transgender individuals. Professional Psychology: Research and Practice, 48(5), 301–309. https://doi-org.ezproxy.bu.edu/10.1037/pro0000146

Workshop #7: Supporting Caregivers of Children with ADHD: An Integrated Parenting Program

Christina Danko, Ph.D., Assistant Clinical Professor, University of Maryland, College Park
Andrea Chronis-Tuscano, Ph.D., Professor, University of Maryland, College Park

Category: Parenting / Families, ADHD – Child
Keywords: ADHD, Parent Training, Evidence-Based Practice

Moderate level of familiarity with the material

Participants earn 3 continuing education credits.

Parent mental health is often not addressed in evidence-based interventions for children with disruptive behavior disorders, such as Attention-Deficit/Hyperactivity Disorder (ADHD). Many evidence-based programs for children with ADHD rely on parents to implement treatment. This can be particularly difficult for parents who struggle with their own depression, executive functioning deficits, emotion dysregulation, or other mental health symptoms. Parent mental health impacts the trajectory of children with ADHD and ADHD treatment outcomes, pointing to the importance of providing parents with their own skills so they can better support their child with ADHD.

This workshop will present on a flexible parenting program that integrates cognitive, behavioral, and emotion-focused intervention components. Supporting Caregivers of Children with ADHD incorporates a focus on parent mental health within a behavioral parenting intervention. Presenters will utilize case examples, interactive role plays, and video to engage clinicians in learning skills to intervene with children with ADHD and their parents. The presenters will discuss approaches to target parent factors within behavioral parent training to increase treatment engagement and improve treatment outcomes.

Outline:

• Rationale for addressing parent mental health in Behavioral Parent Training
• Considerations that influence child developmental trajectory and treatment outcome
• Brief review of the Transactional Model of ADHD in Families
• Review of existing research pertaining to Supporting Caregivers of Children with ADHD: An Integrated Parenting Program
• Overview of the Integrated Parenting Program
• Overview of program content
• Discussion of session structure
• Considerations when using the manual
• Description of selected modules from the Integrated Parenting Program
• Module 2: Special Time and Pleasant Activities

• Practice activity and discussion
  Module 3: Maintaining a Consistent Schedule and Time Management

• Case example
  Module 4: Praise and Positive Thinking

• Video and Role play: Using positive thinking to support effective parenting
  Module 5: Ignoring and Relaxation
  Module 6: Time Out and Privilege Removal

• Role play: Addressing caregiver cognitions and coping skills
  Module 8: Working Effectively with the Schools and Assertiveness
  Module 9: Emotion Coaching

• Video, Practice activity and discussion
  Case example
  Audience Question & Answer

At the end of this session, the learner will be able to:

1. Describe 3 reasons why integrating a focus on parent mental health yields optimal benefit of parenting interventions for children with ADHD.
2. List principles of cognitive-behavioral therapy and organizational skills training that should be used in behavioral parent training, using a flexible and idiographic approach.
3. Use 2 CBT components, such as behavioral activation and cognitive restructuring, with parents to address parent mental health symptoms and support effective parenting.
4. Use 3 organizational skills training strategies with parents to support their ability to implement behavioral parent training skills.

Long-Term Goal:

• Use CBT strategies to collaboratively address parent mental health concerns that are impacting behavioral parent training with a client’s caregiver.

Recommended Readings:

Chronis-Tuscano, A., O’Brien, K., & Danko, C. M. (2020). Supporting Caregivers of Children with ADHD: An Integrated Parenting Program, Therapist Guide. Oxford University Press.

Chronis-Tuscano, A., Clarke, T. L., O’Brien, K. A., Raggi, V. L., Diaz, Y., Mintz, A. D., … & Lewinsohn, P. (2013). Development and preliminary evaluation of an integrated treatment targeting parenting and depressive symptoms in mothers of children with attention-deficit/hyperactivity disorder. Journal of Consulting and Clinical Psychology, 81(5), 918.

Harold, G. T., Leve, L. D., Barrett, D., Elam, K., Neiderhiser, J. M., Natsuaki, M. N., … & Thapar, A. (2013). Biological and rearing mother influences on child ADHD symptoms: revisiting the developmental interface between nature and nurture. Journal of Child Psychology and Psychiatry, 54(10), 1038-1046.

Johnston, C., & Chronis-Tuscano, A. (2015). Families and ADHD. In R. A. Barkley (Ed.), Attention-deficit/hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). New York, NY: Guilford.

Mazursky-Horowitz, H., Felton, J. W., MacPherson, L., Ehrlich, K. B., Cassidy, J., Lejuez, C. W., & Chronis-Tuscano, A. (2015). Maternal emotion regulation mediates the association between adult attention-deficit/hyperactivity disorder symptoms and parenting. Journal of Abnormal Child Psychology, 43(1), 121-131.

Workshop #8: Upgrading Our Toolkit for Assessment and Treatment of Mood Problems and Bipolar Disorder

Eric A. Youngstrom, Ph.D., Professor of Psychology and Neuroscience, University of North Carolina at Chapel Hill

Category: Bipolar Disorders, Dissemination & Implementation Science
Keywords: Assessment, Bipolar Disorders, Implementation

Moderate level of familiarity with the material

Participants earn 3 continuing education credits.

Mood problems are common and can be debilitating or dangerous. They are one of the main issues we work with clinically. Yet they can have many different causes and supporting factors, and benefit from different treatments. Fortunately, there has been a surge of evidence about the validity of carefully diagnosed mood disorders, and better understanding of how sleep and other factors may be pieces of the puzzle. This workshop discusses key assessment and therapy issues, including: how bipolar and other mood disorders manifest clinically, similarities and differences in youths versus adults, how to use self-report and other-report measures to aid case formulation and treatment, and ideas about well-supported specific treatment strategies. The workshop blends lecture, case presentations, and links to a wealth of free assessments and information, as well as question-and-answer interactions. Often challenging conventional wisdom, the workshop presents new evidence that can be applied immediately in practice.

At the end of this session, the learner will be able to:

1. Describe the use of evidence-based assessment methods that aid in differential diagnosis and measuring treatment response.
2. Find free, easy to use tools to aid case formulation and measured treatment progress.
3. Explain how to integrate a conceptual model for working within systems-of-care into your practice with cases dealing with mood problems.
4. Explain how many points of change would be a sign of improvement or worsening on short, free scales to track progress.
5. Use TRIP Database to quickly gauge the support for different psychological and non-psychological (e.g., yoga, CBD oil…) options.

Recommended Readings:

Fristad, M. A., & Roley-Roberts, M. E. (2019). Bipolar disorder. In M. J. Prinstein, E. A. Youngstrom, E. J. Mash, & R. Barkley (Eds.), Treatment of Disorders in Childhood and Adolescence (4th ed., pp. 212-257). Guilford Press.

Youngstrom, E. A., & Prinstein, M. J. (2020). Introduction to Evidence-Based Assessment: A Recipe for Success. In E. A. Youngstrom, M. J. Prinstein, E. J. Mash, & R. Barkley (Eds.), Assessment of Disorders in Childhood and Adolescence (5th ed., pp. 3-29). Guilford Press.

Youngstrom, E. A., Van Meter, A., Frazier, T. W., Hunsley, J., Prinstein, M. J., Ong, M.-L., & Youngstrom, J. K. (2017). Evidence-Based Assessment as an integrative model for applying psychological science to guide the voyage of treatment. Clinical Psychology: Science and Practice, 24(4), 331– 363. https://doi.org/10.1111/cpsp.12207

Youngstrom, E.A., Choukas-Bradley, S., Calhoun, C.D., & Jensen-Doss, A. (2015). Clinical guide to the evidence-based assessment approach to diagnosis and treatment. Cognitive and Behavioral Practice, 22, 20-35. doi: 10.1016/j.cbpra.2013.12.005

Becker-Haimes, E. M., Tabachnick, A. R., Last, B. S., Stewart, R. E., Hasan-Granier, A., & Beidas, R. S. (2020). Evidence Base Update for Brief, Free, and Accessible Youth Mental Health Measures. Journal of Clinical Child & Adolescent Psychology, 49(1), 1-17. https://doi.org/10.1080/15374416.2019.1689824

Workshop #9: What To Do When Therapy Isn’t Working: A Transdiagnostic Model For Assessing Progress, Changing Course, and Improving Outcomes in the Treatment of Anxiety and its Related Problems

Rochelle I. Frank, Ph.D., Private Practice & Assistant Clinical Professor, U. C. Berkeley & The Wright Institute
Joan Davidson, Ph.D., Co-Director, S. F. Bay Area Center for Cognitive Therapy

Category: Adult Anxiety, Treatment – CBT
Keywords: Anxiety, Treatment, Transdiagnostic

Moderate level of familiarity with the material

Participants earn 3 continuing education credits.

Therapists often feel “stuck” when trying to figure out why their anxious patient’s presenting problems are not resolving. This can be a demoralizing experience for both clinician and client. In this workshop, we offer an in-depth look at ten pivotal explanations that will help therapists more accurately assess actual and perceived treatment failure, and guide them in modifying therapy to facilitate achievement of client goals and improve outcomes.

Transdiagnostic case formulation sheds light on what might be driving patients’ problems, and on possibilities for resolving treatment impasses. Using the presenters’ roadmap (Frank & Davidson, 2014) specifying a methodology for categorizing and identifying transdiagnostic mechanisms (TDMs), and targeting them in individualized treatment plans, participants will learn to reassess and modify their case formulations when patients seem to not be improving. For example, the TDMs originally identified may not be correct, and new hypotheses about clients’ underlying vulnerabilities and coping responses may need to be explored. Alternatively, clients may struggle with motivation and willingness to change – especially if they must modify or relinquish long-held and valued coping behaviors in order to get better.

Case conceptualization models also are useful in helping therapists consider potential problems when treatment appears to not be working. Specifically, and perhaps most importantly, how is progress being measured, and is it appropriate to both the client and the difficulties for which they are seeking therapy? Also, are there family or cultural considerations that potentially impede – or could improve -therapeutic gains? Similarly, the client may have specific concerns they have not yet revealed due to feelings of shame which, undetected and unaddressed, could negatively impact treatment outcomes. Ruptures in the therapeutic alliance, as well as the therapist’s own TDM-driven limitations (e.g., perfectionistic strivings that convey pressure or are perceived as judgmental by the client) also can result in premature termination or treatment failure. Video demonstrations and group discussion will augment didactic instruction to illustrate both identification and resolution of these problems.

Outline:

Audience survey re: experiences of treatment failure (15 mins)

Overview of 10 pivotal reasons why clients are not, or may not appear to be, improving (30 mins; PowerPoint, group discussion)

Overview of transdiagnostic formulation model to guide investigation and resolution of potential reasons for actual and perceived lack of client progress (30 mins; PowerPoint)

Illustrate how to use the transdiagnostic model when identifying and revising conceptualizations about what’s not working in therapy (45 mins; video demonstration)

Illustrate how to use components of general case conceptualization models to further explicate and resolve potential obstacles to progress (25 minutes; video demonstration)

Address discrepancies between therapist and client perceptions of treatment progress (25 minutes; clinical vignettes, group discussion)

Wrap-up and review (10 mins)

At the end of this session, the learner will be able to:

1. Identify 5 core components of the TDM case formulation model to reconsider when a patient does not appear to be making progress in treatment.
2. Identify 3 problems when setting treatment goals that might be interfering with patients’ progress.
3. Identify 5 progress monitoring problems to consider when a patient does not appear to be making progress in treatment.

Long-Term Goal:

1. Discuss 2 possible problems in the therapeutic alliance to consider that might be interfering with patents’ progress.
2. Assess their TDMs that might be negatively impacting clients’ motivation, engagement in, and response to treatment.

Recommended Readings:

Frank, R. I., & Davidson, J. (2014). The transdiagnostic road map to case formulation and treatment planning: Practical guidance for clinical decision making (Oakland, CA: New Harbinger)

Persons, J. B. (2016). Science in practice in cognitive behavior therapy. Cognitive and Behavioral Practice, 23, 454-458.

Persons, J. B., Beckner, V. L., & Tompkins, M. A. (2013). Testing case formulation hypotheses in psychotherapy: Two case examples. Cognitive and Behavioral Practice, 20, 399 – 409.

Lloyd, C. E., Duncan, C., & Cooper, M. (2019). Goal measures for psychotherapy: A systematic review of self-report, idiographic instruments. Clinical Psychology Science and Practice, https://doi.org/10.1111/cpsp.12281.

American Psychological Association, APA Task Force on Race and Ethnicity Guidelines in Psychology. (2019). Race and ethnicity guidelines in psychology: Promoting responsiveness and equity. Retrieved from http://www.apa.org/about/policy/race-and-ethnicity-in-psychology.pdf.