Workshops

Friday, November 18 | 8:30 AM – 11:30 AM

Presented by:
Rachel Merson, Psy.D., Research Assistant Professor, Boston University Center for Anxiety and Related Disorders

Rachel Busman, Psy.D., Senior Director, Child and Adolescent Anxiety & Related Disorders Programs,
Cognitive and Behavioral Consultants

Jami Furr, Ph.D., Senior Psychologist, Clinical Assistant Professor, Florida International University

Participants earn 3 continuing education credits

Abstract:

Selective Mutism (SM) is an anxiety disorder characterized by a persistent inability to speak in some situations, such as at school or in the community, despite the ability to speak in other places, such as at home. SM affects about 1% of the population (APA, 2013). Often first diagnosed in early childhood, SM can persist for many years, and treatment can be more challenging as the disorder progresses.

Although cognitive behavioral therapy is a widely used empirically-supported treatment for child anxiety (Walkup et al., 2008), this intervention, which relies heavily on the ability to share thoughts and feelings, does not always lead to meaningful change for youth with SM (Ooi et al., 2016). Rather, treatments that focus on behavioral interventions may result in more robust outcomes including increased speech and reduced anxiety (Bergman et al., 2013; Oerbeck et al., 2014). In particular, adaptations of Parent Child Interaction Therapy have shown promise treating internalizing disorders in young children (Carpenter et al., 2014), including SM (Catchpole et al., 2019; Cornaccio et al., 2019).

Parent Child Interaction Therapy for Selective Mutism (PCIT-SM) offers a structured, yet individualized, approach for working with youth with SM and their caregivers. Child Directed Interaction (CDI) strategies strengthen parent-child relationships, build rapport with new speaking partners, and increase an anxious child’s comfort in new settings. Verbal Directed Interaction (VDI) strategies offer a framework for practicing “brave talking” using shaping, fading, exposure, and positive reinforcement (see Furr et al., 2020 for more details).

In our clinical experience, families seeking SM treatment have often struggled to find providers who are well versed in this impairing anxiety disorder. Even clinicians with expertise treating child anxiety more broadly often have difficulty effectively addressing SM. As such, this institute will provide attendees with a robust foundation in PCIT-SM through didactic content, live demonstrations, videos, role plays, and interactive activities. Attendees will learn CDI and VDI strategies, ways to optimally involve caregivers in treatment, and how to support the generalization of gains from the clinic to real world settings.

Long-term Goals: 

1. Recognize, diagnosis, and treat selective mutism with increased confidence, nuance, and sophistication.
2. Describe selective mutism symptoms, educate caregivers and school personnel about SM, and correct common misperceptions about the disorder.

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

1. Explain the negative reinforcement cycle that leads to the development and maintenance of selective mutism symptoms.
2. Describe at least three assessment measures and procedures used in the evaluation/diagnosis of youth with selective mutism.
3. Explain the skills used for warm up (Child Directed Interaction) and effectively prompting and reinforcing speech (Verbal Directed Interaction).
4. Describe how to transfer speech to a new communication partner using principles such as shaping, fading, and positive reinforcement.
5. List at least three strategies for generalizing speaking to school and community settings.

Session Outline

• Selective Mutism Psychoeducation
  • Diagnostic criteria and prevalence rates
  • Related features and comorbidity patterns
  • Common SM misconceptions
  • Factors that impact the development and maintenance of SM
• Parent-Child Interaction Therapy for SM (PCIT-SM)
  • Overview and research base
  • Child Directed Interaction (CDI)
    • PRIDE skills
  • Verbal Directed Interaction (VDI)
    • Setting speaking goals/creating a “brave talking” hierarchy
    • Using effective prompts for eliciting speech
    • Positive reinforcement for brave behavior
  • PCIT-SM Skills Implementation
    • Transferring speech with fading and shaping
      • In the clinic
      • At school
      • In the community

Recommended Readings:

Carpenter, A., Puliafico, A., Kurtz, S., Pincus, D., & Comer, J. (2014). Extending Parent-Child Interaction Therapy for early childhood internalizing problems: New advances for an overlooked population. Clinical Child and Family Psychological Review, 17, 340-356.

Catchpole, R., Young, A., Baer, S., & Salih, T. (2019). Examining a novel, parent-child interaction therapy informed behavioral treatment of selective mutism. Journal of Anxiety Disorders, 66, 102-112.

Cornacchio, D., Furr, J. M., Sanchez, A. L., Hong, N., Feinberg, L. K., Tenenbaum, R., Del Busto, C., Bry, L. J., Poznanski, B., Miguel, E., Ollendick, T. H., Kurtz, S. M. S., & Comer, J. S. (2019). Intensive group behavioral treatment (IGBT) for children with selective mutism: A preliminary randomized clinical trial. Journal of Consulting and Clinical Psychology, 87, 720–733.

Furr, J.M., Sanchez, A., Hong, N., & Comer, J.S. (2020). Exposure therapy in selective mutism. In Peris, T., Storch, E., & McGuire, J. (Eds.), Exposure therapy for children with anxiety and OCD: Clinician’s guide to integrated treatment (pp.113-142). Amsterdam, Netherlands: Elsevier.

Kotrba, A. (2015). Selective mutism: An assessment and intervention guide for therapists, educators, & parents. Eau Claire, WI: PESI.

Friday, November 18 | 8:30 AM – 11:30 AM

Presented by:
Amie Newins, Ph.D., Associate Professor, University of Central Florida
Deborah C. Beidel, ABPP, Ph.D., Professor of Psychology, University of Central Florida

Participants earn 3 continuing education credits

Long-term Goals: 

1. Implement imaginal exposure for PTSD with at least one patient
2. Use at least one TMT skills training module with at least one patient experiencing trauma-related symptoms

Abstract: Individuals exposed to traumatic events are at risk of developing posttraumatic stress disorder (PTSD), which is associated with significant social and occupational impairment. Furthermore, PTSD is a specific risk factor for suicidal behaviors. Trauma Management Therapy (TMT) is a cognitive-behavioral treatment protocol designed to treat PTSD in adults. This protocol can be administered in a standard outpatient format (i.e., weekly sessions) or intensive outpatient (IOP) format (i.e., daily sessions). TMT has been shown to be efficacious for treating combat-related PTSD in military personnel both in a standard outpatient format (Beidel et al., 2019) and an IOP format (Beidel et al., 2017). Furthermore, data from our clinic suggest this treatment is effective for first responders, survivors of mass violence, and survivors of sexual assault.

TMT combines imaginal exposure to the patient’s trauma memory to target re-experiencing symptoms of PTSD, in vivo exposure to trauma reminders and situations that elicit hypervigilance and startle responses, and skills training to target the cognitive, mood, and sleep disturbances that accompany PTSD. TMT includes four specific skills training modules: anger management; brief behavioral activation for depression; sleep hygiene; and social reintegration. These skills modules can be administered in individual or group therapy. In this workshop, participants will learn about the entire TMT protocol, including both types of exposure therapy and the four skills training modules. Recommendations for assessment and for determining whether TMT is the best fit for patients will be provided. The presenters will use case examples to demonstrate some of the key aspects of the treatment protocol. Common challenges in successful implementation of TMT will also be discussed.

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

1. Identify the two types of exposure used in Trauma Management Therapy (TMT).
2. Describe the scene construction process for imaginal exposure for PTSD.
3. Create an exposure hierarchy for a hypothetical patient with PTSD.
4. Explain the differences between imaginal and in vivo exposure for PTSD.
5. Describe at least two core aspects of each of the four TMT skills training modules.

Session Outline

• Overview of Trauma Management Therapy (TMT) Components
• Role of Classical and Operant Conditioning in PTSD
• Emotional Processing Theory
• Imaginal Exposure Therapy for PTSD
• In Vivo Exposure Therapy for PTSD
  • Therapist accompanied
  • Program practice
• TMT Skills Training
  • Brief Behavioral Activation
  • Anger Management
  • Sleep Hygiene
  • Social Reintegration

Recommended Readings:

Beidel, D. C., Frueh, B. C., Neer, S. M., & Lejuez, C. W. (2017). The efficacy of Trauma Management Therapy: A controlled pilot investigation of a three-week intensive outpatient program for combat-related PTSD. Journal of Anxiety Disorders, 50, 23-32. https://doi.org/10.1016/j.janxdis.2017.05.001

Stander, V. A., Thomsen, C. J., & Highfill-McRoy, R. M. (2014). Etiology of depression comorbidity in combat-related PTSD: A review of the literature. Clinical Psychology Review, 34(2), 87-98. https://doi.org/10.1016/j.cpr.2013.12.002

Lopez, C. M., Lancaster, C. L., Gros, D. F., & Acierno, R. (2017). Residual sleep problems predict reduced response to Prolonged Exposure among veterans with PTSD. Journal of Psychopathology and Behavioral Assessment, 39, 755-763. https://doi.org/10.1007/s10862-017-9618-6

Friday, November 18 | 8:30 AM – 11:30 AM

Presented by:
Robin Weersing, Ph.D., Professor, SDSU/UCSD Joint Doctoral Program in Clinical Psychology
Michelle Rozenman, Ph.D., Assistant Professor, University of Denver
Araceli Gonzalez, Ph.D., Associate Professor, California State University Long Beach

Participants earn 3 continuing education credits

Abstract:

Anxiety and depression are collectively the most common mental health concerns in childhood and adolescence and co-occur with each other at staggering rates. Transdiagnostic interventions aim to address core processes common to anxiety and depression, and may therefore be more efficient in regards to time, clinician effort, and youths’ skill-building as compared to sequencing separate treatments for anxiety and depression. One such transdiagnostic intervention, Brief Behavioral Therapy (BBT; Weersing et al., 2021), has demonstrated efficacy for youth ages 8-16 with anxiety and/or depression when implemented by Master’s-level clinicians in pediatric primary care. BBT is brief (8-12 sessions), results in functional improvement and symptom reduction (Weersing et al., 2017) with effects sustained over the course of 32-week follow-up (Brent et al., 2020), and is cost-saving compared to community mental health treatment (Lynch et al., 2021). Recent preliminary data also support a video-visit version of BBT to increase intervention access for youth in low-resource settings (R56MH125159); this work in particular may be especially relevant in current times of national and world-wide physical and mental health crises. This clinician-focused workshop aims to introduce BBT as a treatment option for youth with anxiety, depression, or their co-occurrence. Following an introduction to the scientific evidence and theoretical underpinnings of this transdiagnostic approach, clinicians are presented with a step-by-step guide to BBT session content. Specific foci of the workshop targeting anxious avoidance and depressive withdrawal with “graded engagement” or increased approach and reduced behavioral avoidance, and use of the intervention’s problem-solving module to address symptoms, familial communication, and treatment non-compliance. Case examples and sample intervention materials are utilized throughout to supplement attendee experience.

Long-term goals:

1. Identify when a transdiagnostic approach might be appropriate for youth symptom presentation in clinical practice
2. Incorporate a graded engagement/transdiagnostic approach to treatment of youth with anxiety/depression comorbidity.

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

1. Describe theoretical and empirical rationale for why a transdiagnostic approach may be well-suited to treating youth anxiety and depression.
2. Describe how core treatment techniques might be packaged and implemented using a behavioral transdiagnostic approach.
3. Identify youth characteristics and symptoms that may be particularly well-suited for the Brief Behavior Therapy protocol.
4. Describe and understand the session content and sequencing of skills in the Brief Behavior Therapy protocol.
5. Discuss implementation considerations when using Brief Behavior Therapy with internalizing youth.

Outline:

• Evidence base and rationale provided for BBT as a transdiagnostic intervention for youth anxiety, depression, and/or their comorbidity
• Overall description of BBT components and trajectory
• Session-by-session content provided: psychoeducation, relaxation and pleasant activity scheduling, problem solving, graded approach/behavioral activation
• Problem solving typical treatment challenges

Recommended Readings:

Weersing, V. R., Brent, D. A., Rozenman, M. S., Gonzalez, A., Jeffreys, M., Dickerson, J. F., … & Iyengar, S. (2017). Brief behavioral therapy for pediatric anxiety and depression in primary care: a randomized clinical trial. JAMA psychiatry, 74(6), 571-578.

Weersing, V. R., Gonzalez, A., & Rozenman, M. (2021). Brief Behavioral Therapy for Anxiety and Depression in Youth: Therapist Guide. Oxford University Press.

Rozenman, M., Gonzalez, A., & Weersing, V. R. (2020). Transdiagnostic exposure-based intervention for anxiety and depression in children and adolescents. In Exposure Therapy for Children with Anxiety and OCD (pp. 361-382). Academic Press.

Weersing, V. R., Rozenman, M. S., Maher-Bridge, M., & Campo, J. V. (2012). Anxiety, depression, and somatic distress: Developing a transdiagnostic internalizing toolbox for pediatric practice. Cognitive and behavioral practice, 19(1), 68-82.

Brent, D. A., Porta, G., Rozenman, M. S., Gonzalez, A., Schwartz, K. T., Lynch, F. L., … & Weersing, V. R. (2020). Brief behavioral therapy for pediatric anxiety and depression in primary care: A follow-up. Journal of the American Academy of Child & Adolescent Psychiatry, 59(7), 856-867.

Friday, November 18 | 12:00 PM – 3:00 PM

Presented by:
Brian C. Chu, Ph.D., Professor, Rutgers University

Laura C. Skriner, Ph.D., Clinical Psychologist, The Center for Stress, Anxiety, Mood

Participants earn 3 continuing education credits

Abstract:

The initial, ongoing, and returning spread of COVID-19 has forced substantial changes in all domains of life. Perhaps no domain of life has been impacted as much as the schooling and education of our youth. Schools have had to make difficult and creative decisions to meet the demands of an ever-evolving health climate and uncertain information about risk, protections, and community preferences. Even with mandated vaccinations and re-definitions of “normality,” school attendance, student engagement, and student supports require continued and thoughtful reconceptualization. How is attendance conceptualized in remote, in-person, and hybrid formats? How is engagement monitored and encouraged in each variation? How does this context resemble other traumatized contexts? How has this pandemic disproportionately impacted under-resourced school districts in communities of color? Drawing from examples and data across the United States and the state of New Jersey, this webinar will discuss models (e.g., the National Association of School Psychologists, COVID-19 School Adjustment Risk Matrix) for identifying students at risk for emotional distress and discuss their relevance for school attendance and engagement. The workshop will focus on illustrating established CBT interventions/strategies, adapted to this new context. An additional focus will help attendees consider engagement as a key outcome beyond school/classroom attendance. Multiple case studies will be presented and attendees will work in small groups to offer solutions. Attendees are also encouraged to bring local examples for group consultation. Presenters will moderate a discussion of effective interventions and help attendees tailor established interventions to their local contexts. This workshop is designed for clinicians with moderate direct clinical experience conducting CBT with school-aged youth or consulting with schools.

Long-term Goals:

1. Be able to educate fellow school professionals about school and student factors that contribute to engagement problems.

2. Be able to provide psychoeducation about student struggles in school engagement.

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

1. Assess school structures related to COVID-19 and how they impact school attendance metrics for school-age youth.
2. Evaluate school’s climate for 3 levels of risk factors according to the NASP COVID-19 School Adjustment Risk Matrix and its implications for triage of at-risk students.
3. Analyze a youth’s school refusal behavior across 5 domains, including attendance and engagement, by using functional assessment strategies to identify maintaining functions.
4. Apply decisional analysis to analyze motivating reasons to increase engagement and attendance at school.
5. Analyze environmental contingencies and plan “daily renewable reward” plans with caregivers to reinforce youth approach behaviors.

Session Outline

1. Appearance of School attendance, school refusal, and school engagement in context of ongoing management of COVID-19.
2. Describe NASPs system for identifying at-risk students, making use of school and home environments.
3. Review effective strategies for addressing school attendance problems and poor engagement
   1. Functional Analytic Approach, motivational interviewing
   2. Working with parents: daily renewable reward
   3. Coordinating with schools: active collaboration
4. Practice role-plays using prepared vignettes
5. Consultation of cases from audience

Recommended Readings:

Kearney, C. A., & Childs, J. (2021). A multi-tiered systems of support blueprint for re-opening schools following COVID-19 shutdown. Children and Youth Services Review, 122, 105919

Heyne, D., Gren-Landell, M., Melvin, G., & Gentle-Genitty, C. (2019). Differentiation between school attendance problems: Why and How? Cognitive and Behavioral Practice, 26(1), 8-34.

Chu, B. C., & Pimentel, S. (In press). Treatment Plans and Interventions: Child and Adolescent Mood and Anxiety Disorders (Translating Evidence-Based Treatments into Personalized Therapies). New York: Guilford Press.

National Association of School Psychologists. (2020). Returning to School Following COVID-19 Related School Closures: The COVID-19 School Adjustment Risk Matrix (C-SARM) [handout]: The COVID-19 School Adjustment Risk Matrix (C-SARM)

Waite, P., Button, R., Dodd, H., & Creswell, C. (2020). Supporting children and young people with worries about COVID-19. Online handout downloaded at: https://emergingminds.org.uk/wp-content/uploads/2020/03/COVID19_advice-for-parents-and-carers_20.3_.pdf

Friday, November 18 | 12:00 PM – 3:00 PM

Presented by:

Scott Waltman, ABPP, Psy.D., Psychologist, Center for Dialectical and Cognitive Behavior Therapies

Lynn McFarr, Ph.D., Executive Director, CBT California/DBT California

Dennis Tirch, Ph.D., Director, The Center for Compassion Focused Therapy

Robyn D. Walser, Ph.D., Clinical Psychologist, National Center for PTSD

Participants earn 3 continuing education credits

Long-term Goals:

1. Increase capacity to use contextual, compassionate, and dialectical thinking in a collaborative therapy dyad
2. Improve ability to empower clients and facilitate therapeutic experiential processes

Abstract: Socratic Questioning is a critical skill across several evidence-based practices, serving as an element of an effective and empathically attuned rapport. This workshop builds on previous ABCT trainings on Socratic Questioning. It is geared to the broad tent of ABCT, highlighting how therapists of any behavior therapy variation may use the Socratic process to think “with the client and not for them” effectively. An overview of a conceptual framework for Socratic strategies, integrating third-wave behavioral approaches that have often placed less emphasis on Socratic Questioning as a treatment tool, will be included. Participants will learn how traditional cognitive strategies can be adapted to make their use consistent with the principles of mindfulness, acceptance, and compassion-focused approaches such as DBT, ACT, and CFT. A barrier to using Socratic strategies with DBT clients is exploring beliefs can be impeded by high levels of emotion dysregulation. Trainers will cover principles of Movement, Speed, and Flow, and risk for invalidation and dysregulation. Previous barriers to integrating these strategies into ACT have been perceptions that traditional cognitive interventions are incompatible with acceptance and defusion strategies. Strategies that are consistent with an ACT perspective will be explored, specifically, Socratic use of the hexaflex model of psychological flexibility will be demonstrated with an emphasis on experiential work that supports the Socratic method. Finally, rather than using the Socratic process to explicitly pursue cognitive change, the CFT therapist aims to embody and train compassion for self and others through a mindful relational process. Socratic Questioning in CFT facilitates turning towards suffering and unwanted thought and feelings in the context of the therapeutic dyad, opening up new ways of responding with compassionate action. Compassion-focused Socratic dialogue with the therapist serves as a “guide on the side” rather than the “sage on the stage.” Throughout this workshop, participants will learn direct strategies and tools that allow mindfulness, acceptance, and compassion-oriented therapists to build their competency and fluency in Socratic dialogue, opening new possibilities for recovery.

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

• Describe a 4-step model for Socratic Dialogue
• Use Socratic strategies in a manner that is consistent with relational frame theory and acceptance and commitment therapy with at least two clinical presentations.
• Utilize two Socratic questions to promote psychological flexibility.
• Use two Socratic strategies in a manner that is consistent with the DBT model.
• Complete one cognitive chain analysis.

Session Outline

• Provide brief didactic overview of Socratic questioning
• Group Discussion about Socratic strategies within mindfulness-based and acceptance-based CBTs
• Instruction and Demonstration of Socratic strategies from a DBT perspective
• Instruction and Demonstration of Socratic strategies from an ACT perspective
• Instruction and Demonstration of Socratic strategies from a Compassion-Focused Therapy perspective
• Group Skills Practice
• Consolidation of Learning

Recommended Readings:

Waltman, S. H., Codd, R. T., McFarr, L. M. & Moore. B. A. (2020). Socratic Questioning for Therapists and Counselors: Learn How to Think and Intervene like a Cognitive Behavior Therapist. New York: Routledge. www.routledge.com/9780367335199

Brock, M. J., Batten, S. V., Walser, R. D., & Robb, H. B. (2015). Recognizing common clinical mistakes in ACT: A quick analysis and call to awareness. Journal of Contextual Behavioral Science, 4, 139-143.

Bonavitacola, L., Miller, A. L., McGinn, L. K., & Zoloth, E. C. (2019). Clinical guidelines for improving dialectical thinking in DBT. Cognitive and Behavioral Practice, 26(3), 547-561.

Tirch, D., Silberstein-Tirch, L. R., Codd, R. T., Brock, M. J., & Wright, M. J. (2019). Experiencing ACT from the inside out: A self-practice/self-reflection workbook for therapists. Guilford Publications.

Padesky, C. A. (2019, July). Action, dialogue & discovery: Reflections on Socratic Questioning 25 years later. Invited Address presented at the meeting of the Ninth World Congress of Behavioural and Cognitive Therapies, Berlin, Germany. https://padesky.com/pdf_padesky/SocDialogue-2019-padesky.pdf

Friday, November 18 | 12:00 PM – 3:00 PM

Presented by:
Yoni Ashar, Ph.D., Assistant Professor, University of Colorado School of Medicine

Daniella Deutsch, MSW, Co-Founder, Pain Reprocessing Therapy Center

Participants earn 3 continuing education credits

Abstract: Chronic pain is the leading cause of disability nationally, and its prevalence is increasing across age groups. Medical treatments for chronic pain are often ineffective, hindered by difficulties identifying peripheral tissue causes of pain. Psychological treatments typically view pain as a lifelong, chronic condition to be managed, aiming to help patients live gracefully with pain; their effects on pain intensity are typically small. Here, we introduce a novel therapeutic framework, Pain Reprocessing Therapy (PRT), integrating advances from neuroscience, psychology, and medicine to more effectively treat chronic pain. PRT rests on the premise that many cases of chronic pain are driven primarily by fear-avoidance learning and maladaptive functional changes in predictive processing and pain construction—termed “primary” or “neuroplastic” pain. Critically, this suggests that cases of primary chronic pain can be “unlearned”—with symptoms mostly or completely eliminated. A core component of PRT is the reappraisal of somatosensory and interoceptive sensations as brain-generated and non-dangerous. In a recently completed clinical trial (N = 151), 66% of patients randomized to PRT were pain-free or nearly so at post-treatment, as compared to less than 20% of controls, with gains largely maintained for 1 year post-treatment (Ashar et al., 2022 JAMA Psych). This workshop will provide clinicians an introduction to the PRT framework. It will provide clinical tools to assess for primary (vs. secondary) chronic pain and a collection of psychotherapeutic techniques integrating mindfulness, cognitive restructuring, and exposure-based approaches aiming to eliminate or nearly eliminate chronic pain.

Long-term Goal: Learn skills and knowledge to support patients’ recovery from primary chronic pain

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

1. Assess for the presence of primary vs. secondary pain

2. Communicate the primary pain diagnosis effectively to patients

3. Lead a patient in a somatic tracking exercise, pivoting as barriers are encountered

4. Structure effective exposures for primary chronic pain

5. Integrate existing psychotherapeutic tools to treat emotional or interpersonal processes contributing to pain

Outline:

• Review of primary (nociplastic) pain model, describing how fear-avoidance learning, predictive processing, stress, and perceived threats can drive chronic pain in the absence of peripheral tissue injury
• Learn how to conduct assessments distinguishing primary vs. secondary chronic pain
• Learn how to provide primary pain patient education to support pain recovery
• Learn cognitive behavioral techniques, including somatic tracking, supporting the recovery from chronic pain

Recommended Readings:

Ashar YK, Gordon A, Schubiner H, et al. Effects of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients with Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79:13-23. doi:10.1001/jamapsychiatry.2021.2669

Lumley MA, Schubiner H. Psychological Therapy for Centralized Pain: An Integrative Assessment and Treatment Model. Psychosom Med. 2019;81(2):114-124. doi:10.1097/PSY.0000000000000654

Gordon A, Ziv A. The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain. Avery Publishing; 2021.

Donnino MW, Thompson GS, Mehta S, et al. Psychophysiologic symptom relief therapy for chronic back pain: a pilot randomized controlled trial. PAIN Reports. 2021;6(3):e959. doi:10.1097/pr9.0000000000000959

Barrett LF. The theory of constructed emotion: an active inference account of interoception and categorization. Soc Cogn Affect Neurosci. 2017;12(1):1-23. doi:10.1093/scan/nsw154

Friday, November 18 | 12:00 PM – 3:00 PM

Presented by:

Andrea Temkin, Psy.D., Clinical Psychologist, Weill Cornell Medicine

Lisa Coyne, Ph.D., Founder & Executive Director, New England Center for OCD and Anxiety

Samuel Fasulo, Ph.D., Clinical Assistant Professor, NYU Langone Child Study Center

Anthony Puliafico, Ph.D., Associate Professor of Medical Psychology, Columbia University Clinic for Anxiety and Related Disorders (CUCARD)-Westchester

Participants earn 3 continuing education credits

Abstract:

Researchers and clinicians have seen a significant rise in youth and young adult mental health concerns over the course of the pandemic. Isolation from peers, delayed milestones, interrupted opportunities, unprecedented academic hurdles, and a barrage of changes to family systems and daily life have unsurprisingly left our kids, teens, and emerging adults reeling. Parents have been overwhelmed with this reality- faced with the impossible task of trying to support their children while themselves struggling to cope with the personal and professional fallout caused by the pandemic. While parent involvement has long been considered an important component within many youth and young adult treatments, the impact of COVID-19 on our youth has emphasized the importance of working with parents and caregivers to support their children. This is particularly true given the impact of the pandemic on developmental and contextual factors, such as decreased opportunity for youth to practice independence and increased time spent together in close quarter. This workshop will highlight a number of key approaches and tools that are particularly important for parents helping children and adolescents in moments of crisis. The presenters will provide insight from a range of perspectives, including Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy, Dialectical Behavior Therapy, and Parent Management Training. Discussion will focus on the strengths of each approach in helping parents tackle some of the most challenges moments in their children’s’ lives, from plummeting academics and peer isolation, to increased risk of self-harm and suicide. Skills covered will include parent coping, validation, de-escalation, and minimizing accommodation. In addition to live role-plays, this workshop will allow for participation and practice from audience members to ensure a solid understanding of the skills discussed and increased comfort in delivery.

Long-term Goals:

1. Provide a rationale for prioritizing different parenting approaches based on presenting problem.
2. Articulate importance of parenting support in youth treatment and use accessible language to convey this to caregivers.

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

• Describe at least one key principle and the theoretical focus of CBT, DBT, ACT, and PMT-oriented approaches to parenting treatment.
• Identify three strategies parents can use to help youth struggling with anxiety, depression, attentional difficulties, and other mental health concerns.
• Demonstrate how to explain a new parenting skill, such as validation or emotion regulation, to a caregiver in session.
• Help parents practice and use parenting strategies in moments of youth mental health crisis.

Session Outline

Recommended Readings:

Whittingham, K., & Coyne, L. (2019). Acceptance and commitment therapy: the clinician’s guide for supporting parents. Academic Press.

Albano, A. M., & Pepper, L. (2013). You and your anxious child: Free your child from fears and worries and create a joyful family life. Avery.

Russell, B. S., Hutchison, M., Tambling, R., Tomkunas, A. J., & Horton, A. L. (2020). Initial challenges of caregiving during COVID-19: Caregiver burden, mental health, and the parent–child relationship. Child Psychiatry & Human Development, 51(5), 671-682.

Fitzpatrick, O., Carson, A., & Weisz, J. R. (2021). Using mixed methods to identify the primary mental health problems and needs of children, adolescents, and their caregivers during the coronavirus (COVID-19) pandemic. Child Psychiatry & Human Development, 52(6), 1082-1093.

Saturday, November 19 | 8:30 AM – 11:30 AM

Presented by:

Sandra Pimentel, Ph.D., Chief, Child and Adolescent Psychology, Montefiore Medical Center/AECOM

Ryan DeLapp, Ph.D., Attending Psychologist, Montefiore Medical Center

Participants earn 3 continuing education credits

Abstract:

Cognitive behavioral therapy (CBT) is a well-established approach for treating a variety of youth mental health concerns, including anxiety, depression, and disruptive behaviors. Though broadly effective, there is room to optimize treatment delivery and maximize engagement from youth who rarely self-refer and present across developmental levels and learning styles. CBT clinicians may benefit from learning to creatively and flexibly adapt effective strategies for youth and families while maintaining fidelity to core cognitive-behavioral principles.

This workshop aims to enhance participating clinicians’ abilities to be more culturally responsive and personalized to the interests of child, adolescent, and young adult patients. By definition, pop culture is widely accessible and available. Therefore, this workshop will demonstrate how pop culture references and themes can be harnessed to teach and engage youth throughout their treatment course and across presenting problems. The presentation will demonstrate how pop culture can enhance rapport, destigmatize mental illness, make treatment developmentally appropriate, and help clinicians build an arsenal of creative therapy teaching tools.

More specifically, the presenters will draw from music, sports, superheroes, TV/film, videogames, and other domains in the context of the CBT case conceptualization and while providing multiple examples for key CBT interventions (e.g., psychoeducation, cognitive strategies, behavioral activation, exposures, etc.). The workshop will provide guidance on how clinicians can utilize metaphors, models, in-office, and virtual telehealth props, and pop culture templates across these interventions. Oh and it will be FUN!

Long-term Goals:

1. Increase CBT skill acquisition and mastery by utilizing pop cultural references to engage different learning styles  
2. Reduce stigma by highlighting the intersection of culturally relevant pop culture references and effective therapy interventions

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

• Identify at least three strategies for incorporating pop culture into teaching youth about the CBT model.
• Identify at least three strategies for incorporating pop culture examples into multiple CBT components (e.g., modeling, cognitive restructuring, exposures).
• Consider at least three pop culture references for creating therapeutic materials and props
• Discuss how pop culture can be utilized to destigmatize mental health and treatment-seeking
• Discuss how to introduce a superhero narrative in the application of CBT.

Session Outline

1. Becoming a Pop Culture Detective and Curator – The latest and most intriguing pop culture references are ever-evolving. While some references are timeless and enduring, some are fleeting and “viral.” What’s hot today quickly becomes yesterday’s news. And, yesterday’s news may become today’s new trend. As CB therapists progress through their careers, they can develop a sharp eye for the classic, trending, catchy, illustrative, psychoeducational, and/or inspirational pop culture references. As such, this presentation will begin with discussing important steps for strengthening a clinician’s ability to identify, adapt, and incorporate cultural references into therapy practice (aka your pop culture detective skills).
2. Implementing Pop Culture Detective and Curator skills – The presenters will demonstrate creative and fun options for using pop culture references to enhance the implementation of core CBT interventions (e.g., psychoeducation, cognitive strategies, behavioral activation, exposures, etc.).
3. Practicing your Pop Culture Detective and Curator skills – The presenters will incorporate experiential skill rehearsal activities (e.g., role play and case examples) to help attendees to practice identifying, adapting, and incorporating pop cultural references into their clinical practice.

Recommended Readings:

Scarlet, J. (2017). Superhero Therapy, Mindfulness skills to help teens and young adults deal with anxiety, depression, and trauma. New Harbinger Publications, Oakland.

Rosenberg,RS., Baughman, SL., & Bailenson, JN. (2013). Virtual Superheroes: Using Superpowers in Virtual Reality to Encourage Prosocial Behavior, PloS one.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055003#s5.

Pena, J., & Chen, M. (2017). With great power comes great responsibility: Superhero primes and expansive poses influence prosocial behavior after a motion-controlled game task, Computers in Human Behavior, 76, 378-385.

Saturday, November 19 | 8:30 AM – 11:30 AM

Presented by:
Stefanie T. LoSavio, ABPP, Ph.D., Assistant Professor of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio

Patricia Resick, ABPP, Ph.D., Professor of Psychiatry and Behavioral Sciences, Duke University Medical Center

Participants earn 3 continuing education credits

Long-term Goals:

1. Deliver CPT with fidelity to core elements
2. Improve CPT patient outcomes

Abstract:

Cognitive processing therapy (CPT) is an evidence-based treatment for posttraumatic stress disorder (PTSD) and has been shown to be effective across a range of populations and settings. However, research has shown that therapist factors impact whether patients complete CPT and how much improvement they have in their symptoms. Therapist factors might include therapists’ influential beliefs about the treatment, such as who it is appropriate for CPT and when it should be stopped, as well as therapists’ fidelity and skill in delivering key treatment elements. This workshop will provide background on the role of therapist factors in patient outcomes, provide tools and strategies for therapists to self-reflect on their thoughts about CPT that may impact treatment delivery, and highlight skills of therapists that have been linked to improved patient outcomes. Specifically, therapists will have an opportunity to hone their skills in two core CPT skills that have been associated with patient outcome: identifying and prioritizing “assimilated” beliefs about why the traumatic event happened and using Socratic questioning to evaluate problematic trauma-related beliefs. The presenters will also discuss how to balance flexibility and fidelity, including when it is important to stick to the protocol and where there are opportunities to tailor treatment to the individual client. The workshop will include a mixture of didactic training, video and live demonstration, and experiential practice for CPT learners of all levels treating adolescents and adults. This presentation is consistent with this year’s conference theme, “Emergency & Disaster Preparedness and Response: Using Cognitive and Behavioral Science to Make an Impact.” The presenters will highlight essential ingredients of an evidence-based treatment so that providers can quickly deploy and adapt it to respond to emergencies and disasters to improve care.

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

• Self-assess attitudes and beliefs about CPT that may influence treatment delivery
• List two core elements of CPT that predict patient outcome
• Differentiate assimilated beliefs from accommodated and over-accommodated beliefs
• Demonstrate Socratic questioning on an assimilated belief
• Describe essential CPT elements and acceptable protocol modifications

Session Outline

• Overview of CPT
• Self-Assessment of Beliefs Related to CPT Delivery
• Reviewing the Evidence:
  • Research on the Role of Therapist Beliefs on CPT Outcomes
  • Common Concerns about CPT: Summary of Relevant Studies
  • Therapist Behaviors Linked to Patient Outcomes
• Enhancing Key Therapist Skills:
  • Identifying and Prioritizing Assimilated Beliefs
  • Honing Your Skills in Socratic Questioning
• Balancing Flexibility and Fidelity

Recommended Readings:

Resick, P., Monson, C., & Chard, K. (2017). Cognitive processing therapy for PTSD: A comprehensive manual. New York, NY: Guilford Press

Farmer, C. C., Mitchell, K. S., Parker-Guilbert, K., & Galovski, T. E. (2017). Fidelity to the cognitive processing therapy protocol: Evaluation of critical elements. Behavior Therapy, 48(2), 195-206.

LoSavio, S. T., Dillon, K. H., Murphy, R. A., & Resick, P. A. (2019). Therapist stuck points during training in cognitive processing therapy: Changes over time and associations with training outcomes. Professional Psychology: Research and Practice, 50(4), 255–263.

Holder, N., Holliday, R., Williams, R., Mullen, K., & Surís, A. (2018). A preliminary examination of the role of psychotherapist fidelity on outcomes of cognitive processing therapy during an RCT for military sexual trauma-related PTSD. Cognitive Behaviour Therapy, 47(1), 76-89.

Marques, L., Valentine, S. E., Kaysen, D., Mackintosh, M.-A., De Silva, L. E. D., Ahles, E. M., & Wiltsey-Stirman, S. (2019). Provider fidelity and modifications to cognitive processing therapy in a diverse community health clinic: Associations with clinical change. Journal of Consulting and Clinical Psychology, 87(4), 357–369.

Saturday, November 19 | 8:30 AM – 11:30 AM

Presented by:
Alyssa A. Rheingold, Ph.D., Professor, Medical University of South Carolina
Joah Williams, Ph.D., Associate Professor, University of Missouri-Kansas City

Participants earn 3 continuing education credits

Abstract:

She was no longer wresting with the grief but could sit down with it as a lasting companion and make it a sharer in her thoughts. -G. Eliot

Grief Recovery with Individualized Evidence-Based Formulation Approach (GRIEF Approach) is a modular treatment for adult violent loss (homicide, suicide, traffic crash) survivors that integrates evidence-based cognitive behavioral strategies from existing trauma and grief interventions to address mental health problems associated with traumatic death. GRIEF Approach targets symptoms underlying three main mental health issues associated with traumatic loss: posttraumatic stress, depression, and prolonged grief. The model includes 8 modules encompassing cognitive, behavioral, and experiential techniques, including behavioral activation and therapeutic exposures. Module selection is guided by a thorough assessment of symptoms with a multicultural lens. GRIEF Approach is comprehensive and flexible, ensuring treatment is tailored to each survivor’s unique symptoms. This workshop offers an overview of responses to violent loss and latest research on recovery trajectories. Participants learn assessment driven conceptualization strategies to guide module selection as well as empirically supported techniques for working with violent loss survivors. Video demonstrations and real-time exercises designed to teach clinicians how to implement the treatment are provided.

Long-term Goals:

Attendees will be able to synthesize literature from both the trauma and grief field into treatment conceptualization of violent loss survivors’ difficulties and walk away with specific empirically supported techniques for working with violent loss survivors.

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

1. Identify common trauma and grief responses to traumatic loss (homicide, suicide, traffic crash) and how these reactions can appear differently in the context of individual and sociocultural factors.
2. Distinguish between prolonged grief, depression, and PTSD and 2 ways to assess each both within a clinical interview and self-report assessments.
3. List 3 existing evidence-based interventions for PTSD, depression, and prolonged grief
4. Describe 8 modules based on a tailor an individualized treatment plan based upon symptom presentation of a traumatic loss survivor.
5. Describe 3-4 evidence-based strategies (e.g., meaningful behavioral activation, therapeutic exposure, revising bonds) for trauma and grief difficulties

Session Outline

Grief terminology and definitions

Prevalence of violent loss

Grief trajectory

PTSD vs Prolonged Grief Disorder vs Depression after violent loss

Other clinical considerations

Grief and trauma interventions overview and limitations

GRIEF Approach overview

Grief and trauma assessment considerations

GRIEF Approach decision tree

GRIEF Approach Module 1: Psychoeducation

GRIEF Approach Module 2: Emotion Identification and Cognitive Restructuring

GRIEF Approach Module 3: Identifying and Building Strengths

GRIEF Approach Module 4: Managing Strong Emotions

GRIEF Approach Module 5: Building Positive Support Network

GRIEF Approach Module 6: Meaningful Behavioral Activation

GRIEF Approach Module 7: Revising Bonds

GRIEF Approach Module 8: Therapeutic Exposure

Putting it all together

Case Example

Discussion and Examples

Recommended Readings:

Rheingold, A.A. & Williams, J.L. (2018). A Module-based comprehensive approach for
addressing heterogeneous mental health sequelae of violent loss survivors. Death Studies, 42, 164-171. DOI: 10.1080/07481187.2017.1370798

Williams, J.L., Rheingold, A.A., McNallan, L.J., & Knowlton, A.W. (2018). Survivors’
perspectives on a modular approach to traumatic grief treatment. Death Studies, 42, 155-163. DOI: 10.1080/07481187.2017.1370796 PMID: 29300145

Rheingold, A. A., & Williams, J. L. (2015). Survivors of homicide: Mental health outcomes, social support, and service utilization among a community-based sample. Violence and Victims, 30, 870-883. doi: 10.1891/0886-6708.VV-D-14-00026

Pearlman, L. A., Wortman, C. B., Feuer, C. A., Farber, C. H., & Rando, T. A. (2014). Treating traumatic bereavement: A practitioner’s guide. Guilford Press.

Bordere, T., Rheingold, A., & Williams, J. (2021). Grief following homicide. In H. L. Servaty-Seib & H. S. Chapple (eds.), Handbook of thanatology, 3rd ed. (pp. 388-416). Association for Death Education and Counseling.

Saturday, November 19 | 12:00 PM – 3:00 PM

Presented by:
Larry I. Cohen, LICSW, Cochair and cofounder, National Social Anxiety Center

Participants earn 3 continuing education credits

Abstract:

This session provides an intensive overview of five evidence-based cognitive-behavioral strategies for the treatment of social anxiety disorder: behavioral experiments/exposure; cognitive restructuring; external mindfulness plus thought defusion; assertion training; and core belief change work. Attendees will learn how to apply, combine, and adapt these strategies to the needs of socially anxious individuals. Several of these strategies will be demonstrated during the session through clinical role plays. There will also be discussion on how to design and implement exposures as behavioral experiments to test and modify automatic thoughts, underlying assumptions and core beliefs for the purpose of decreasing social anxiety and building self-confidence. Many client worksheets, instructional handouts, and questionnaires are provided for use and adaptation in your own practices.

Long-term Goals:

1. Design individualized, evidence-based treatment strategies to help their socially anxious clients test and modify their anxious cognitions and behaviors while pursuing their values and goals.
2. Design individualized, evidence-based strategies to help their socially anxious client decrease their reliance on avoidance, self-monitoring, rumination and other safety-seeking behaviors.

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

• Describe 3 strategies to train clients in the use of external mindfulness and thought-feeling defusion when socially anxious.
• Describe 3 strategies to train clients in different means of doing cognitive restructuring before and after social anxiety triggers.
• Describe 3 strategies to help clients design, carry out and learn from behavioral experiments / exposures to test socially anxious thoughts and underlying core beliefs, and to increase client motivation to carry out such experiments.
• Describe 2 strategies to train clients in the use of assertive defense of the self to increase self-confidence in handling fears come true.
• Describe 3 strategies to help clients identify and modify underlying core beliefs that contribute to their social anxiety.

Session Outline

INTRODUCTION

• Resources for therapists and for consumers
• Basic facts about social anxiety, and the role of shame
• Diversity factors in social anxiety
• The vicious cycle of socially anxious cognition, feelings and behavior
• Overview of outcome studies on social anxiety treatment
• Integrating the 3 waves: debates and syntheses
• Assessment, progress monitoring and relapse prevention

EXTERNAL MINDFULNESS (CURIOSITY TRAINING)

• Rationale: self-focus and self-evaluation as safety-seeking behavior
• Debate on external mindfulness + thought-feeling defusion vs. internal mindfulness (meditation)
• Helping clients understand and master external mindfulness and defusion
• Clinical demonstrations

COGNITIVE RESTRUCTURING (REFRAMING)

• Rationale: changing cognition that contributes to anxiety
• Themes of socially anxious hot thoughts
• Debate on defusing from negative thoughts vs. changing them
• Debate on how and when to do cognitive restructuring for social anxiety
• Use of experiments and imagery to do cognitive restructuring
• Helping clients understand and master cognitive restructuring
• Use of cognitive restructuring, mindfulness and defusion to overcome worry/rumination
• Clinical demonstrations

BEHAVIORAL EXPERIMENTS (EXPOSURES)

• Rationale: changing cognition, pursuing values and reducing anxiety through real-life experience
• Debate on exposures vs. experiments: habituation / value pursuit / changing cognition
• How to help clients choose experiments
• Straightforward vs. paradoxical (social mishap, de-catastrophizing, shame-attacking) experiments
• Helping clients understand, identifying, and minimize safety-seeking behaviors
• How best to carry out experiments: before, during and after
• In-session experiments and use of video evidence
• Homework experiments and strategies to increase follow-through
• Use of surveys as experiments
• Clinical demonstrations

ASSERTIVE DEFENSE OF THE SELF (HEAD-HELD-HIGH ASSERTION)

• Rationale: increase self-confidence in handling fears come true
• Practicing the strategy in session
• Homework to master the strategy
• Debate on the limitations of the strategy, and ways to address these limitations
• Clinical demonstrations

CORE BELIEF CHANGE WORK

• Rationale: to modify beliefs that contribute to shame and anxiety
• Debate on whether to target core beliefs at all when treating social anxiety
• Helping clients identify their unhealthy core beliefs and healthy alternatives
• Homework and in-session strategies to modify core beliefs
• Clinical demonstrations

Recommended Readings:

Warnock-Parkes, E., Wild, J., Thew, G. R., Kerr, A., Grey, N., Stott, R., Ehlers, A., & Clark, D. M. (2020).  Treating social anxiety disorder remotely with cognitive therapy.  The Cognitive Behaviour Therapist, 13, E30.  doi: 10.1017/S1754470X2000032X

Hofmann, S. G. & Otto, M. W. (2017).  Cognitive behavioral therapy for social anxiety disorder (2nd ed.), 24-63.  Routledge. 

Hope, D. A., Heimberg, R. G., & Turk, C. L. (2019).  Managing social anxiety: A cognitive-behavioral approach – Therapist guide (3rd ed.), 1-34.  Oxford University Press.

McEvoy, P. M., Saulsman, L. M. & Rapee, R. M. (2018). Imagery-enhanced CBT for social anxiety disorder, 16-38.  Guilford Press.

Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E. & Pilling, S. (2014).  Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis.  The Lancet: Psychiatry, 368-376.  doi.org/10.1016/S2215-0366(14)70329-3

Saturday, November 19 | 12:00 PM – 3:00 PM

Presented by:
Maria Karekla, Ph.D., Associate Professor, University of Cyprus

Megan Kelly, Ph.D., Professor of Psychiatry, University of Massachusetts Medical School, Worcester, MA

Participants earn 3 continuing education credits

Abstract:

The application of Acceptance and Commitment Therapy (ACT) for the treatment of many problems where craving is a core feature is growing (e.g., substance use, tobacco use, overeating). Cravings are intense desires for using or consuming certain substances with the goal of feeling pleasure and satisfaction. They are a key component of addiction-related problems, including addictions to substances like tobacco, alcohol, and drugs. substance use, tobacco use, overeating). Individuals presenting with addictions often have difficulty managing cravings, although this is an inevitable aspect of experiencing substance use and other addictive behaviors. Research finds that cravings are reported by 58% to 97% of the general population (Gendall, Joyce & Sullivan, 1997), and they occur as often as 2–4 times-per-week (Hill, 2007). Difficulties involving cravings are associated with substantial distress, functional impairment, and low quality of life.

This workshop presents practical strategies based in ACT to help individuals to cope and manage cravings at the core of common addictions. The workshop will also present the latest research in ACT for dealing and overcoming cravings, and examine the efficacy, the mechanisms, and processes of change of ACT for the treatment of craving-related problems. Concepts will be illustrated using live demonstrations, experiential exercises, metaphors, and worksheets. This workshop is designed to teach skills needed to explore ACT as an assessment model and intervention method for addressing cravings and addictions. It will be mostly experiential and will balance an understanding of the model with a personal connection with the issues raised in ACT, and with skill development.

Long-term Goals:

1. Describe the basic tenets and core processes of ACT as they apply to cravings and addictions
2. Utilize experiential exercises, role-plays, and a variety of hands-on techniques to cultivate a direct experience with the ACT approaches to craving and addictions.

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

• Apply a functional behavioral analysis approach to craving-related problems
• Describe how to use mindfulness, acceptance, experiential exercises, metaphors, and defusion techniques, to improve well-being in individuals with craving-related issues.
• Explain case conceptualization based on ACT processes and how to practically work with exposure of current cravings.
• Explain the latest culturally-adapted ACT advances when working with craving related problems
• Discuss data on the efficacy of ACT for craving-related issues and addictive behaviors.

Session Outline

• What are Cravings?
• Reasons for Addressing Cravings and Addictions
• Values and Addictions
• External vs. Internal Triggers
• Acting with Willingness
• Taking a Step Back From Cravings
• Self-Compassion
• Committed Action
• Common Challenges to Managing Cravings
• Addressing Slips and Relapses
• Getting Support for Managing Cravings and Addictions
• Other Treatments for Cravings and Addictions
• Summary and Wrap-Up

Recommended Readings:

Karekla, M., & Kelly, M. (2022). Cravings and Addictions: Free Yourself from the Struggle of Addictive Behavior with Acceptance and Commitment Therapy. New Harbinger Publications.

Kelly, M. M., Sido, H., Forsyth, J. P., Ziedonis, D. M., Kalman, D., & Cooney, J. L. (2015). Acceptance and commitment therapy smoking cessation treatment for veterans with posttraumatic stress disorder: a pilot study. Journal of dual diagnosis, 11(1), 50-55.

Karekla, M., Georgiou, N., Panayiotou, G.P., Sandoz, E., Kurz, S., & Constantinou, M. (2020). Cognitive Restructuring vs. Defusion: Impact on craving, healthy and unhealthy food intake. Eating Behaviors, 37. https://doi.org/10.1016/j.eatbeh.2020.101385.

Gloster, A. T., Walder, N., Levin, M.E., Twohig, M.P., & Karekla, M., (2020). The empirical status of Acceptance and Commitment Therapy: A review of meta-analyses. Journal of Contextual Behavior Science, 18, 181-192. https://doi.org/10.1016/j.jcbs.2020.09.009

Karekla, M., Savvides, S.N., & Gloster, A. (2020). An Avatar-led Intervention Promotes Smoking Cessation in Young Adults: A Pilot Randomized Clinical Trial. Annals of Behavioral Medicine, 54 (10), 747-760. doi: 10.1093/abm/kaaa013.

Osaji, J., Ojimba, C., & Ahmed, S. (2020). The use of acceptance and commitment therapy in substance use disorders: a review of literature. Journal of Clinical Medicine Research, 12(10), 629. doi: 10.14740/jocmr4311

Gul, M., & Aqeel, M. (2021). Acceptance and commitment therapy for treatment of stigma and shame in substance use disorders: a double-blind, parallel-group, randomized controlled trial. Journal of Substance Use, 26(4), 413-419. doi: 10.1080/14659891.2020.1846803

Byrne, S. P., Haber, P., Baillie, A., Costa, D. S., Fogliati, V., & Morley, K. (2019). Systematic reviews of mindfulness and acceptance and commitment therapy for alcohol use disorder: should we be using third wave therapies?. Alcohol and Alcoholism, 54(2), 159-166. doi: 10.1093/alcalc/agy089