Workshops

Covering concerns of the practitioner/educator/researcher, these remain an anchor of the Convention. Workshops are offered on Friday and Saturday, are 3 hours long, and are generally limited to 60 attendees. Participants in these Workshops can earn 3 continuing education credits per workshop.

 

Friday, November 17 | 8:30 AM – 11:30 AM

#1: Implementing the Collaborative Assessment and Management of Suicidality in Schools

 

Friday, November 17 | 8:30 AM – 11:30 AM

 

Presented by:

Amy M. Brausch, Ph.D., Professor of Psychological Science, Western Kentucky University

Kurt Michael, Ph.D., Senior Clinical Director, Jed Foundation

Participants earn 3 continuing education credit

 

Categories: Suicide and Self-Injury, Treatment-Other

Keywords: Suicide, Adolescents, Evidence-Based Practice

Basic to moderate level of familiarity with the material


 

Rates of suicide ideation and attempts for youth remain high in the United States, and there is a lack of evidence-based treatment for suicide risk for adolescents. Many youth only have access to mental health resources and services through their school, and suicide-specific assessment and treatment frameworks are needed within this setting.

The Collaborative Assessment and Management of Suicidality (CAMS) treatment framework aims to help suicidal patients manage suicide thoughts and behaviors on an outpatient basis as much as possible, while also addressing individualized drivers of suicide as a focus of treatment and learning alternate ways of coping. The Suicide Status Form (SSF), which guides the treatment process through assessment, treatment planning, and stabilization planning, has been validated for adolescents ages 12-17 (Brausch et al., 2021). An NIMH-funded randomized clinical trial is currently underway to evaluate the effectiveness of CAMS-4Teens. School mental health providers have successfully implemented CAMS in schools, and the initial data show that it is an acceptable and feasible approach in secondary educational settings, especially in schools that have an established capacity to serve students onsite via university-school partnerships (e.g., Capps et al., 2019; Kirk et al., 2019).

Providing comprehensive suicide-specific treatments in a context where the youth spend most of their day is an important innovation to consider, especially given some of the access barriers and mental healthcare disparities impacting minoritized youth disproportionately still in the shadow of a global pandemic. The workshop presenters will discuss both the successes and challenges of implementing CAMS in schools, including a detailed review of a yet-to-be published open trial which assessed the utility and effectiveness of using CAMS in rural K-12 settings.

In summary, this workshop will provide an overview of the CAMS Framework®, its evidence base for decreasing suicide ideation and increasing hope in both adults and adolescents, and specific strategies for implementing CAMS in high school settings.

 

At the end of this session, the learner will be able to:
    1. Describe the research to date on using CAMS with teens.
     
    2. Differentiate how the CAMS treatment framework is utilized with adolescents ages 12 and up.
     
    3. Evaluate readiness and capacity to implement CAMS in a school environment.
     
    4. Implement specific strategies to incorporate CAMS into existing K-12 service delivery models with fidelity.
     
    5. Assess and use strategies for managing challenges with CAMS implementation that arise in K-12 settings.

 

Long-Term Goals:

Implement CAMS-4Teens into K-12 school settings to increase youths’ access to a suicide-focused treatment framework.

 

Outline:
    • Adolescent Suicide
     

      • Review of Epidemiology
       
      • Suicide ideation, attempts, and deaths; for whom is risk increasing?

     
    • CAMS
     

      • Review CAMS treatment framework
       

        • Therapeutic assessment using the Suicide Status Form (SSF)
         
        • Suicide-specific treatment framework that focuses on suicide risk first
         
        • Treatment plan includes stabilization plan and interventions tailored to “drivers” of suicide, individualized for each client
         
        • Focus on collaboration, honesty, and empathy

       
      • Review of CAMS-4 Teens
       

        • Psychometric and clinical trial research
         
        • Structure of first session with parents/caregivers
         
        • Review of the Stabilization Support Plan (SSP)
         
        • Tips and considerations for involving parents/caregivers

       
      • Implementing CAMS-4Teens in K-12 schools
       

        • Review of different models
         
        • Ideas for adaptations
         
        • Ideas for schools in rural areas
         
        • Review of successful implementation
         
        • Strategies for navigating challenges and barriers
         
        • Review of research on CAMS in schools

 

Recommended Readings:

O’Connor, S. S., Brausch, A. M., Ridge Anderson, A., & Jobes, D. (2014). Applying the Collaborative Assessment and Management of Suicidality (CAMS) to suicidal adolescents. The International Journal of Behavioral Consultation & Therapy, 9, 53-58.

Brausch, A. M., O’Connor, S. S., Powers, J. T., McClay, M. M., Gregory, J. A., & Jobes, D. A. (2020). Validating the Suicide Status Form for the Collaborative Assessment and Management of Suicidality in a psychiatric adolescent sample. Suicide and Life-Threatening Behavior, 50, 263-276. DOI: 10.1111/sltb.12587

Adrian, M., Blossom, J. B., Chu, P. V., Jobes, D., & McCauley, E. (2022). Collaborative Assessment and Management of Suicidality for teens: A promising frontline intervention for addressing adolescent suicidality. Practice Innovations, 7, 154-167.

Swift, J. K., Trusty, W. T., & Penix, E. A. (2021). The effectiveness of the Collaborative Assessment and Management of Suicidality (CAMS) compared to alternative treatment conditions: A meta-analysis. Suicide and Life-Threatening Behavior, 51, 882-896.

Schorr, M., Van Sant, W., & Jameson, J. P. (2017). Preventing suicide among students in rural schools. In Eds. (K. D. Michael & J. P. Jameson), Handbook of Rural School Mental Health, pp. 129-145. Springer International Publishing.

#2: CBT for Chronic GI Disorders (They’re More Common than You Think!)

 

Friday, November 17 | 8:30 AM – 11:30 AM

 

Presented by:
Melissa G. Hunt, Ph.D.,

Associate Director of Clinical Training, University of Pennsylvania

Participants earn 3 continuing education credit

 

Categories: Health Psychology / Behavioral Medicine – Adult, Treatment -CBT

Keywords: Health Psychology, Treatment Development, Anxiety

All levels of familiarity with the material


 

Gastrointestinal disorders are exacerbated by stress and are also stressful. Irritable Bowel Syndrome (IBS) is a highly prevalent (approximately 10% of the population) disorder of gut-brain interaction that is highly co-morbid with anxiety disorders and depression and shares conceptual overlap with panic disorder, agoraphobia, social anxiety and ARFID.

It also leads to considerable disability and distress. Managing these patients effectively requires a good understanding of the biopsychosocial and cognitive underpinnings of IBS as well as the kinds of avoidance behaviors that maintain and exacerbate both symptoms and disability. General CBT skills are essential, but incorporating GI specific phenomena (like bowel control anxiety and fear of food) are also important.

There is significant empirical evidence supporting the use of CBT in treating IBS. The inflammatory bowel diseases (IBD: Crohn’s Disease and ulcerative colitis), have clear pathophysiology, but share some of the same symptoms and can lead to heightened risk for secondary IBS. In addition, many IBD patients experience shame, avoidance and social anxiety about their condition.

This workshop will cover what is known about the etiology and symptoms of IBS, how IBS patients present in clinical practice; IBS in the context of co-morbid panic and agoraphobia, social anxiety disorder, ARFID and depression; formulating appropriate treatment goals and basic cognitive and behavioral strategies for treating IBS, including IBS that is comorbid or secondary to a more serious IBD.

Case material reflecting patients along a spectrum of severity will provide for lively discussion and acquisition of new skills and techniques. Audience participation, clinical questions and role-playing will be welcomed, leading to interactive, experiential, in-depth training. Application of evidence-based psychotherapies to chronic GI disorders is now referred to as psychogastroenterology.

Unfortunately, there are very few providers trained in GI informed psychotherapy. We desperately need more skilled clinicians to treat this large and underserved population. ABCT’s membership is an obvious target audience, since they bring solid CBT skills and need only acquire an understanding of GI specifics.

 

At the end of this session, the learner will be able to:
    1. Identify when GI symptoms are causing or exacerbating distress and disability in treatment seeking psychiatric patients
     
    2. Develop a case conceptualization that integrates GI disorders with any co-morbid mood or anxiety disorders
     
    3. Identify the unique cognitive distortions and behavioral avoidance strategies (especially fear of incontinence and dietary restrictions) that tend to maintain and exacerbate distress and disability.
     
    4. List the real complications, medication adverse effects and sociobehavioral complexities faced by patients with IBD
     
    5. Modify the standard CBT approach to treat GI patients effectively, including collaborating successfully with gastroenterologists and considerations about medication

 

Long-Term Goals:
    • Always ASK about GI symptoms with every new patient and incorporate GI symptoms into your case conceptualization.
     
    • Include GI specific knowledge in treatment planning and intervention.

 

Outline:
    • Prevalence, etiology, presentation and psychiatric co-morbidity of both Irritable Bowel Syndrome and Inflammatory Bowel Disease.
     
    • Cognitive (e.g. catastrophizing) and behavioral (e.g. agoraphobic avoidance and dietary restriction) factors that exacerbate distress and disability.
     
    • How to modify standard CBT for depression and anxiety disorders to address GI specific issues including bowel control anxiety, ARFID, shame and secrecy.


     

    Recommended Readings:

    Kinsinger SW. Cognitive-Behavioral therapy for patients with irritable bowel syndrome: current insights. Psychol Res Behav Manag 2017;10:231–7.

    Shah K, Ramos-Garcia M, Bhavsar J, et al. Mind-body treatments of irritable bowel syndrome symptoms: an updated meta-analysis. Behav Res Ther 2020;128:103462.

    Yeh H-W, Chien W-C, Chung C-H, et al. Risk of psychiatric disorders in irritable bowel syndrome-a nationwide, population-based, cohort study. Int J Clin Pract 2018;72:e13212.

    Hunt, M. (2021). Coping with Crohn’s and Colitis: A Patient and Clinician’s Guide to CBT for IBD. Routledge: Taylor and Francis Group, New York, NY.

    Hunt, M. (2022). Reclaim Your Life from IBS: A Scientifically Proven CBT Plan for Relief Without Restrictive Diets, Second Edition, Routledge: Taylor and Francis Group, New York, NY.

#3: Cultivating Joy and Post-traumatic Growth in Clients from Diverse Backgrounds Using Compassion and Humility

 

Friday, November 17 | 8:30 AM – 11:30 AM

 

Presented by:

Mudita A. Bahadur, Ph.D., Psychologist, Private Practice

Janeé Steele, Ph.D., LPC, Licensed Professional Counselor, Kalamazoo Cognitive and Behavioral Therapy, PLLC

Hollie Granato, Ph.D., Clinical Psychologist, Private Practice

Lisa Bolden, Psy.D., Assistant Professor & Chief Clinical Officer, UCLA & Emmada Psychology Center

Participants earn 3 continuing education credit

 

Categories: Oppression and Resilience Minority Health, Racial Trauma

Keywords: Racial Trauma, Resilience, CBT

Moderate level of familiarity with the material


 

With increased isolation from the COVID-19 pandemic coupled with racial trauma in BIPOC communities, the recent mass-shootings and attacks on LGBTQA+ populations, extensive anti-immigrant sentiment for migrant populations, and the loss of reproductive rights for women, there is a need for culturally relevant mental health support. Research suggests that being able to support clients with culturally-sensitive and compassionate care, which acknowledges the trauma and stress while also cultivating post-traumatic growth, can engender greater transformation and joy post recovery. Accordingly, this workshop will focus on cultivating post-traumatic growth in clients experiencing stress and trauma directly related to their identity and diversity.

Post-traumatic growth, as defined by Tadeshi and Calhoun (1996), consists of five main domains: (1) greater appreciation for life, (2) close relationships, (3) new possibilities, (4) personal strength, and (5) spiritual development. As such, learners will be guided in strategies to expand cultural humility within the framework of post-traumatic growth, distinguishing this construct from resilience. Presenters will use case vignettes from diverse backgrounds to demonstrate culturally sensitive methods for acknowledging trauma and building post-traumatic growth. Case-conceptualizations will be explored to challenge intermediate beliefs and behaviors which may be involved in post-traumatic growth. Participants will also be provided opportunities to engage in role-playing exercises supported with key phrases to generate a culturally humble orientation to clinical practice. Finally, presenters will discuss assessment tools to measure baseline joy and treatment outcomes.

All the presenters in this workshop are members of the Diversity Action Committee of the Academy of Cognitive and Behavioral Therapies, and represent diverse backgrounds and identities. The presenters bring years of clinical and research experience, and will draw on cases and professional examples from their roles within mental health agencies across the country.

 

At the end of this session, the learner will be able to:
    1. Define post-traumatic growth.
     
    2. Identify the five main domains of post-traumatic growth.
     
    3. Identify culturally sensitive methods to acknowledge the psychological effects of oppression.
     
    4. Identify and challenge trauma-related intermediate beliefs to engender post-traumatic growth.
     
    5. Identify the relationship between thoughts, emotions, and behaviors related to post-traumatic growth.
     
    6. Identify one tool for the measurement of joy.
     
    7. Describe the difference between resilience vs post-traumatic growth.

 

Long-Term Goals:
    • Understand how to integrate post-traumatic growth into case conceptualization and treatment planning with culturally diverse clients in session.
     
    • Increase cultural humility for clinicians.

 

Outline:
    • Opening exercise
     
    • Define post-traumatic growth, the five areas
     
    • Present case vignettes and explore of case conceptualizations
     
    • Introduce interventions and strategies to challenge trauma related intermediate beliefs
     
    • Role-playing demonstration
     
    • Participant Role-playing exercise
     
    • Introduce assessment measures for joy and growth
     
    • Self-assessment of post-traumatic growth
     
    • Discussion, Questions, Comments

 

Recommended Readings:

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic Growth: Conceptual Foundations and Empirical Evidence. Psychological Inquiry, 15(1), 1-18

Ortega-Williams, A., Beltrán, R., Schultz, K., Ru-Glo Henderson, Z., Colón, L., & Teyra, C. (2021). An integrated historical trauma and posttraumatic growth framework: A cross-cultural exploration. Journal of Trauma & Dissociation, 22(2), 220-240.

Grier-Reed, T., Maples, A., Houseworth, J., & Ajayi, A. (2022). Posttraumatic growth and flourishing in the face of racial trauma. Psychological trauma: Theory, research, practice, and policy.

Weiss, T., & Berger, R. (2010). Posttraumatic growth and culturally competent practice: Lessons learned from around the globe. John Wiley & Sons.

Steele, J. M., & Newton, C. S. (2022). Culturally adapted cognitive behavior therapy as a model to address internalized racism among African American clients. Journal of Mental Health Counseling, 44(2), 98-116.

Friday, November 17 | 12:00 PM – 3:00 PM

#4: Feeling stuck? FA it out! Putting the Fun Back into Functional Assessment for Kids and Families

 

Friday, November 17 | 12:00 PM – 3:00 PM

 

Presented by:

Sandra S. Pimentel, Ph.D., Chief, Child and Adolescent Psychology, Montefiore Medical Center- Einstein

Brian C. Chu, Ph.D., Professor and Clinical Department Chair, Rutgers University

Participants earn 3 continuing education credit

 

Categories: Child / Adolescent – Anxiety; Child / Adolescent – Depression

Keywords: Child, Case Conceptualization / Formulation, Clinical Decision Making

Basic to moderate level of familiarity with the material


 

The ever-lasting challenge in clinical practice is how to address the needs of a seemingly infinite number of clinical presentations and client needs with a limited toolbox of evidence-based practice. How do you address social anxiety in the context of ongoing bullying at school? How do you account for a history of family conflict and neglect? How does one accommodate developmental disabilities and complicated comorbidities?

There are few behavioral techniques as straightforward, but also as robust and flexible, as functional assessment. Functional Assessment (FA) is more of a process than a technique, one that prompts the clinician to continuously assess the antecedents or circumstances (e.g., person, place, object, event, thought, feeling, action) that prompts consistent emotional or behavioral responses. Understanding what internal and environmental consequences that maintain functional and impairing patterns can help the clinician to develop a holistic conceptualization of the client.

The current workshop aims to help attendees re-acquaint themselves with this foundational approach and apply to real-world situations. The presenters will highlight strategies to help youth and families become their own best FA detectives – using worksheets and metaphors to sleuth out the puzzles of their own behavioral-emotional traps.

Multiple case studies will be presented and attendees will work in small groups to brainstorm case conceptualizations to make treatment plans that target the youth’s primary goals while keeping it interesting and relevant. The presenters will share worksheets and handouts from their newly published text to illustrate FA, chain analysis, case conceptualization, and treatment planning. Attendees may also bring local examples for group consultation. Presenters will moderate a discussion of effective interventions and help attendees tailor established interventions to their local contexts.

 

At the end of this session, the learner will be able to:
    1. Describe and employ a continuous assessment process using functional assessment to understand the circumstances that prompt and maintain behavioral-emotional traps.
     
    2. Apply the functional assessment process across emotional and behavioral states to personalize conceptualization to diverse clients, problems, and clinical contexts.
     
    3. Instruct youth and caregivers in using FA and chain analysis to identify their own behavioral and parenting traps.
     
    4. Devise a treatment plan based on a personalized FA that incorporates youth, family, and community factors that maintain behaviors.

 

Long-Term Goals:
    • Become a more flexible, principles based cognitive-behavioral therapist that uses continuous assessment in their conceptualization and treatment planning.
     
    • Communicate about (e.g., treatment planning, case conceptualization) and teach (e.g., to trainees, colleagues) FA principles and strategies to facilitate continuity of care in interdisciplinary settings.

 

Outline:
    I. Youth and family cases are ever and increasingly challenging

      A. Complex clinical profiles: how comorbidity and severity of psychological disorders requires.
      B. Challenging social and family contexts
      C. How these challenges require flexibility and adaptation in CBT

    II. Functional Assessment

      A. Basic premise/principles
      B. How FA is inherently contextual and flexible

    C. How it aids case conceptualization, treatment planning, and moment-to-moment decision-making
    III. Case illustrations in case conceptualization

      A. Using FA to tease out common mechanisms across disorders: anxiety, mood, and behavioral
      B. Using FA to understand the impact of medical, educational, and developmental conditions in youth
      C. Using FA to understand how cultural issues impact the youth, like intergenerational conflict, community trauma and social injustice

    IV. Case Illustrations to guide how to respond to moment-to-moment decisions

      A. Using FA to guide effective exposures and behavioral experiments to optimize learning and minimize safety behavior
      B. Using FA/case conceptualizations to direct assessment of parent-child interactions and family-based exposures
      C. Using FA to conduct assessment of risk behaviors.

 

Recommended Readings:

Chu, B. C., & Pimentel, S. (2023). CBT Treatment Plans and Interventions for Depression and Anxiety Disorders in Youth. New York: Guilford Press.

Pimentel, S.S., & DeLapp, R.D. (2022). Superheroes and CBT for Youth, In RD Friedberg & EV Rozmid (Eds.), Creative CBT with Youth Clinical Applications Using Humor, Play, Superheroes, and Improvisation (pp. 143-174), Springer Publications. https://doi.org/10.1007/978-3-030-99669-7

Rizvi, S. L., & Ritschel, L. A. (2014). Mastering the art of chain analysis in dialectical behavior therapy. Cognitive and Behavioral Practice, 21(3), 335-349.

Hoffman, L. J., & Chu, B. C. (2019). When is seeking safety functional? Taking a pragmatic approach to distinguishing coping from safety. Cognitive & Behavioral Practice, 26(1), 176-185. https://doi.org/10.1016/j.cbpra.2018.11.002

Badin, E., Alvarez, E., & Chu, B. C. (2020). Cognitive Behavioral Therapy for Child and Adolescent Anxiety: CBT in a Nutshell. In Cognitive Behavioral Therapy in Youth: Tradition and Innovation (pp. 41-71). New York: Humana (Springer).

#5: Fostering Queer Joy: How to do Affirmative Cognitive Behavior Therapy With LGBTQ+ Youth & Their Families

 

Friday, November 17 | 12:00 PM – 3:00 PM

 

Presented by:

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

Ilana Seager van Dyk, Ph.D., Senior Lecturer in Clinical Psychology, Massey University

Participants earn 3 continuing education credit

 

Categories: LGBTQ+, Treatment – CBT

Keywords: LGBTQ+, CBT, Adolescents

Moderate level of familiarity with the material


 

Due to ongoing anti-LGBTQ+ stigma in society, LGBTQ+ youth experience higher rates of mental health concerns relative to their cisgender, heterosexual peers (Russell & Fish, 2016). Fortunately, families with LGBTQ+ children frequently seek mental health treatment, offering an exciting opportunity for mental health professionals to help shift these vulnerable youths’ mental health trajectories towards wellbeing.

Mental health providers can potentially combat systemic injustices and cultivate joy in LGBTQ+ youth with affirming mental health treatments (e.g., Craig & Austin, 2016; Pachankis et al., 2022). However without training in LGBTQ+ affirming care, mental health providers may feel ill equipped to work with this population (Gandy et al., 2013), and LGBTQ+ youth may be less comfortable seeking care from providers (e.g., Zullo et al., 2021). As a result, it is likely that LGBTQ+ mental health disparities will persist, and the impact of evidence-based practice, including CBT, may be limited.

This workshop aims to provide attendees with the basic tools needed to use evidence-based clinical practice (i.e., CBT) with LGBTQ+ youth and their families using an affirming, minority stress-informed lens. Using live demonstrations, Drs. Cohen and Seager van Dyk will teach attendees how to conceptualize cases using this lens, as well as how to adapt existing CBT techniques (e.g., exposures, cognitive flexibility) to be sensitive to the unique needs and challenges experienced by this population (e.g., gender dysphoria, coming out).

This workshop will highlight strategies for navigating difficult conversations with family members of LGBTQ+ youth (e.g., parents, caregivers), and give attendees concrete ideas for how to foster well-being and joy among LGBTQ+ youth and their families.

 

At the end of this session, the learner will be able to:
    1. Develop case conceptualizations using an integration of cognitive behavioral and LGBTQ+ affirmative frameworks.
     
    2. Foster pride and queer joy among LGBTQ+ youth and their families.
     
    3. Identify strategies for adapting CBT when working with LGBTQ+ youth including how to explain minority stress.
     
    4. Learn how to speak with caregivers and parents about supporting LGBTQ+ youth identity development and mental health.
     
    5. Identify two or more strategies that can be implemented to affirm LGBTQ+ identities in clinical practice.
     
    6. Locate resources and referrals for gender affirming healthcare.

 

Long-Term Goals:

Reduce mental health disparities for LGBTQ+ youth by providing evidence-based and affirming care.

 

Outline:
    • Overview of landscape for LGTBQ+ youth and their families
     
    • Overviews of LGBTQ+ and gender affirmative models of care
     
    • Introduction to integrating affirmative care into CBT with LGBTQ+ youth & families
     
    • Clinical roleplay of therapy session with LGBTQ+ youth
     
    • Clinical roleplay of therapy session with caregiver(s) of LGBTQ+ youth
     
    • Discussion of additional treatment considerations and anticipated problems

 

Recommended Readings:

Cohen, J. M. & Feinstein, B. A. (2020). Adapting cognitive and behavioral strategies to meet the unique needs of sexual and gender minorities. The Behavior Therapist, 43(3), 81 – 86.

Zullo, L., Seager van Dyk, I., Ollen, E. W., Ramos, N., Asarnow, J.R., & Miranda, J. (2021). Treatment recommendations and barriers to care for suicidal LGBTQ youth: A quality improvement study. Evidence-Based Practice in Child and Adolescent Mental Health, 6(3), 393-409.

Craig, S. L., Iacono, G., Pascoe, R., & Austin, A. (2021). Adapting clinical skills to telehealth: Applications of affirmative cognitive-behavioral therapy with LGBTQ+ youth. Clinical Social Work Journal, 49(4), 471-483.

Chen, D., Berona, J., Chan, Y. M., Ehrensaft, D., Garofalo, R., Hidalgo, M. A., … & Olson-Kennedy, J. (2023). Psychosocial Functioning in Transgender Youth after 2 Years of Hormones. New England Journal of Medicine, 388(3), 240-250.

Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3).

#6: Introduction to Psychedelic Assisted Therapy for CBT Clinicians

 

Friday, November 17 | 12:00 PM – 3:00 PM

 

Presented by:

Jason B. Luoma, Ph.D., CEO, Portland Psychotherapy Clinic, Research, & Training Center

Brian Pilecki, Ph.D., Psychologist, Portland Psychotherapy Clinic, Research, & Training Center

Participants earn 3 continuing education credit

 

Categories: Transdiagnostic, Treatment – Other

Keywords: Transdiagnostic, Evidence-Based Practice, Treatment

Basic level of familiarity with the material


 

Psychedelic-assisted therapy is showing promise as a highly effective form of mental health treatment and appears poised to become a major new form of mental health care moving forward. Patients participating in psychedelic-assisted therapy often relate that their sessions were among the most meaningful experiences in their life, often rating them similarly to events like the birth of a first child or getting married. Thus, these interventions don‘t just reduce suffering, they appear to increase meaning-making, fulfillment, and positive mental health.

This workshop, led by presenters currently running clinical trials of this type of therapy, will provide CBT professionals with an evidence-based overview of this new clinical area. Differences between the most common psychedelics will be outlined and results from the most recent and rigorous clinical trials will be summarized. The basic model of psychedelic-assisted psychotherapy using ACT and CBT models will be explained with an emphasis on highlighting the importance of preparation and integration in obtaining therapeutic benefits from a psychedelic experience. Mechanisms of change will be discussed, including intriguing findings suggesting that psychedelic-assisted therapy may functions more through increasing positive functioning, meaning, self-transcendence, flexibility, interpersonal engagement, and fulfillment rather than directly reducing symptoms.

The current legal status of psychedelics will be reviewed, including recent state level initiatives toward legal psychedelic service access. Diversity and equity issues will be reviewed including lack of access for underserved and non-majority populations and the risks of cultural appropriation involved in modern psychedelic science. We will also provide recommendations on obtaining further training for those who want to learn more. This workshop will help clinicians understand the current state of psychedelic science, as well as to have more informed and evidence-based conversations with clients about psychedelics and their potential risks and benefits, legal status, and timeline for public accessibility.

 

At the end of this session, the learner will be able to:
    1. Describe the theory and practice of psychedelic assisted psychotherapy.
     
    2. Summarize research findings and identify the clinical applications with the most empirical support.
     
    3. Discuss the current legal status of psychedelic assisted psychotherapy at a state and federal level.
     
    4. Describe the role of CBT in preparation for and integration of psychedelic experiences.
     
    5. List at least 3 current problems in the literature relating to diversity and equity in psychedelic science and practice.
     
    6. Outline the differences between common psychedelics being studied.
     
    7. Provide recommendations on obtaining further training for interested professionals.

 

Long-Term Goals:

Attendees should be able to critically analyze and articulate the current state of research on psychedelic-assisted therapy, including an understanding of the common psychedelics, their therapeutic mechanisms, and the empirical support behind their use. This knowledge should enable participants to engage in informed, evidence-based conversations about psychedelic-assisted therapy, its potential risks, benefits, and legal implications both within their professional circles and with their clients.

 

Outline:
    I. Introduction

      A. Presentation of the significance and promise of psychedelic-assisted therapy as a new form of mental health treatment

    II. Psychedelic Substances

      A. Outline of the differences between common psychedelics
      B. Review of the most recent and rigorous clinical trial results

    III. The Basic Model of Psychedelic-Assisted Therapy

      A. Overview of the use of Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) models in psychedelic-assisted therapy
      B. Emphasis on the crucial role of preparation and integration for therapeutic benefits

    IV. Mechanisms of Change in Psychedelic-Assisted Therapy

      A. Discussion on neuroscience models of change
      B. Discussion of psychological models of change with focus on psychological flexibility

    V. Legal Status of Psychedelics

      A. Overview of the current federal and state-level legal status
      B. Discussion on recent initiatives toward legal psychedelic service access

    VI. Diversity and Equity in Psychedelic Science and Practice

      A. Review of current problems related to diversity and equity in psychedelic science
      B. Examination of the risks of cultural appropriation in modern psychedelic science

    VII. Further Training

      A. Recommendations on obtaining additional training for interested professionals

 

Recommended Readings:

Watts, R., & Luoma, J. B. (2020). The use of the psychological flexibility model to support psychedelic assisted therapy. Journal of Contextual Behavioral Science, 15, 92-102.

Luoma, J. B., Sabucedo, P., Eriksson, J., Gates, N., & Pilecki, B. C. (2019). Toward a contextual psychedelic-assisted therapy: perspectives from acceptance and commitment therapy and contextual behavioral science. Journal of Contextual Behavioral Science, 14, 136-145.

Williams, M. T., & Labate, B. C. (2020). Diversity, equity, and access in psychedelic medicine. Journal of Psychedelic Studies, 4(1), 1-3.

Yaden, D. B., Earp, D., Graziosi, M., Friedman-Wheeler, D., Luoma, J. B., & Johnson, M. W. (2022). Psychedelics and psychotherapy: Cognitive-behavioral approaches as default. Frontiers in psychology, 1604.Leger, R. F., & Unterwald, E. M. (2022). Assessing the effects of methodological differences on outcomes in the use of psychedelics in the treatment of anxiety and depressive disorders: A systematic review and meta-analysis. Journal of Psychopharmacology, 36(1), 20-30.

Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020). A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy. Journal of psychoactive drugs, 52(4), 289–299. https://doi.org/10.1080/02791072.2020.1769878

Saturday, November 18 | 8:00 AM – 11:00 AM

#7: Managing Implicit Bias in Clinical Interactions with Evidence-Based Strategies

 

Saturday, November 18 | 8:00 AM – 11:00 AM

 

Presented by:

Freda F. Liu, Ph.D., Associate Professor, University of Washington School of Medicine

Participants earn 3 continuing education credit

 

Categories: Mental Health Disparities, Workforce Development / Training / Supervision

Keywords: Mental Health Disparities, Cognitive Biases / Distortions, Therapeutic Relationship

Basic level of familiarity with the material


 

Clinician implicit bias has been identified as a significant contributor to persistent healthcare inequities in many subspecialties including mental healthcare (Maina et al., 2018). Clinician bias has been shown to negatively impact clinician-patient communication, trust, and relationship, and has been found to be associated with biased decision-making and inequitable care, disproportionally impacting minoritize and marginalized populations (Zescott, Blair, & Stone, 2016).

Decades of research on implicit social cognition has led to the identification of some effective strategies for managing the impact of implicit bias in social interactions (Lai et al., 2016). In recent years, these strategies have been adapted for use in clinician-patient interactions in primary care (Stone et al., 2020) and youth mental health (Liu et al., 2022) with promising results for reducing clinician implicit bias.

This 3-hour workshop will provide didactic and practical training on the most effective strategies (per the evidence-base) for managing one’s own biases. The workshop will include a brief introduction to the cognitive processes and evolutionary function underlying implicit prejudice and stereotyping (with experiential exercises and live demonstrations). Then building on this foundational understanding that all human beings have biases, workshop attendees will learn specific bias-management strategies, with step-by-step instructions on how to use each strategy during clinical interactions. Attendees will integrate their learning with structured opportunities to practice through “real plays” and “role plays” work with case vignettes and their lived experience.

Workshop will also include a discussion of implementation barrier and facilitators to promote post-training skills use and practice sustainment.

 

At the end of this session, the learner will be able to:
    1. Describe how unchecked clinician implicit bias can lead to healthcare inequities and poorer outcomes for minoritized or marginalized patients/clients.
     
    2. Explain the social cognitive processes involved in implicit biases that makes them difficult to manage.
     
    3. Demonstrate the effective use of at least 2 out of 3 bias management strategies.
     
    4. Identify common pitfalls when using bias management strategies during clinical interactions.
     
    5. Create an implementation and sustainment plan for integrating bias management strategies into one’s clinical practice.

 

Long-Term Goals:
    • Help clinicians better understand how implicit bias may function in their clinical interactions and the broader context of our biases and its downstream impact.
     
    • Integrate evidence-based bias management strategies into routine clinical practice.

 

Outline:
    1. Background

      a. Overview of examples of health and mental inequities throughout the literature
      b. Understanding the broader context of bias in the United States beyond healthcare

    2. Bias Literacy

      a. Social cognitive process underlying implicit bias
      b. The Implicit Association Test (live demo)
      c. The role of clinicians bias in inequitable care and outcomes

    3. Strategies for Managing Implicit Bias in Clinical Interacations (real plays and role plays)

      a. Setting the Stage

        i. Increasing self-awareness (mindfulness)
        ii. Cultivating willingness and curiosity

      b. Evidence-based skills practice

        i. Seeking Commonality
        ii. Perspective Gaining
        iii. Counter Stereotyping

      c. Recovering from missteps
      d. Systemic approaches

    4. Question & Answer
    5. Personal Commitment to on-going practice


 

Recommended Readings:

Zestcott, C. A., Blair, I. V. & Stone, J. Examining the presence, consequences, and reduction of implicit bias in health care: a narrative review. Group Process. Intergroup Relat. 19, 528–542 (2016).

Stone, J., Moskowitz, G. B., Zestcott, C. A. & Wolsiefer, K. J. Testing active learning workshops for reducing implicit stereotyping of Hispanics by majority and minority group medical students. Stigma Health Wash. DC 5, 94–103 (2020).

Liu, F. F., Coifman, J., McRee, E., Stone, J., Law, A., Gaias, L., … & Lyon, A. R. (2022). A brief online implicit bias intervention for school mental health clinicians. International Journal of Environmental Research and Public Health, 19(2), 679.

Tajeu, G. S., Juarez, L., Williams, J. H., Halanych, J., Stepanikova, I., Agne, A. A., … & Cherrington, A. L. (2022). Development of a Multicomponent Intervention to Decrease Racial Bias Among Healthcare Staff. Journal of General Internal Medicine, 37(8), 1970-1979.

Maina, I. W., Belton, T. D., Ginzberg, S., Singh, A. & Johnson, T. J. A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Soc. Sci. Med. 1982 199, 219–229 (2018).

#8: Network-Informed Personalized Treatment for Eating Disorders

 

Saturday, November 18 | 8:00 AM – 11:00 AM

 

Presented by:

Rachel M. Butler, Ph.D., Postdoctoral Fellow, University of Louisville

Cheri A. Levinson, Ph.D., Associate Professor, University of Louisville

Christina Ralph-Nearman, Ph.D., Research Assistant Professor, University of Louisville

Participants earn 3 continuing education credit

 

Categories: Eating Disorders, Treatment – Other

Keywords: Anorexia, Eating, Treatment Development

All levels of familiarity with the material


 

Eating disorders (EDs) are serious mental illnesses associated with high mortality rates and detrimental effects on functioning and quality of life (Arcelus et al., 2011; Jenkins et al., 2011). Current evidence-based treatments for EDs such as enhanced cognitive behavioral therapy (Fairburn, 2008) result in remission for only 30-50% of individuals, and no evidence-based treatments exist for adults with anorexia nervosa (AN) or atypical AN (Kaidesoja et al., 2022). These current gold-standard ED treatments often use a ‘one-size-fits-all’ approach, which may be limited due to the high degree of heterogeneity in symptoms both within and across diagnoses (Levinson et al., 2018).

One method of addressing heterogeneity is to personalize treatment to the individual using data-driven approaches. Transdiagnostic Network-informed Personalized Treatment for Eating Disorders (T-NIPT-ED) seeks to address the issue of heterogeneity in symptoms and treatment response by personalizing treatment using idiographic (i.e., one person) network analysis (Levinson et al., 2021; Piccirillo et al., 2019). T-NIPT-ED takes a cognitive-behavioral theoretical approach to address a wide variety of symptoms including cognitions, affect, behavior, and co-occurring disorders using 18 symptom-specific interventions.

Data suggests that T-NIPT-ED is feasible, acceptable, and leads to decreases in ED symptom severity, related pathology (e.g., worry, depression) and clinical impairment at posttreatment and one-year follow-up (Levinson et al., in press). To enhance feasibility with clinicians, we developed the Awaken Digital Guide, a companion digital mobile application that securely collects and identifies personalized treatment targets and matching evidence-based treatments delivered in a clinician-friendly and easy to use manner. This workshop will provide attendees with foundational knowledge of personalized treatment for EDs through lecture, demonstrations, and group-based learning activities. Additionally, clinician-facing software for calculating idiographic networks and selecting treatment targets in clinical practice will be demonstrated.

Attendees will leave confident in their ability to implement T-NIPT-ED in their clinical practice.

 

At the end of this session, the learner will be able to:
    1. Explain the evidence for transdiagnostic network-informed personalized treatment for eating disorders.
     
    2. Utilize clinician-facing software to facilitate network-informed personalized treatment in clinical practice.
     
    3. Describe at least three symptoms targeted by network-informed personalized treatment for eating disorders.
     
    4. Describe at least three evidence-based interventions used in network-informed personalized treatment for eating disorders.
     
    5. Use transdiagnostic network-informed personalized treatment with clients with eating disorders.

 

Long-Term Goals:
    1. Use data-driven personalized assessment methods with eating disorders.
     
    2. Use network-informed personalized treatment with clients with eating disorders in clinical practice.

 

Outline:
    • Background on personalized treatment for EDs
     

      • Why personalize treatment?
       
      • Evidence from pilot trial

     
    • Network-informed personalized treatment
     

      • Overview of treatment
       
      • Collecting ecological momentary assessment data
       
      • Calculating and understanding network analysis

     
    • Demonstration of clinician-facing software to compute networks
     
    • Discussion of symptoms targeted and demonstration of treatment modules
     
    • Questions and Discussion


 

Recommended Readings:

Borsboom, D., & Cramer, A. O. (2013). Network analysis: an integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology, 9, 91-121.

Levinson, C. A., Hunt, R. A., Keshishian, A. C., Brown, M. L., Vanzhula, I., Christian, C., … & Williams, B. M. (2021). Using individual networks to identify treatment targets for eating disorder treatment: a proof-of-concept study and initial data. Journal of Eating Disorders, 9, 1-18.

Levinson, C. A., Vanzhula, I. A., Brosof, L. C., & Forbush, K. (2018). Network analysis as an alternative approach to conceptualizing eating disorders: Implications for research and treatment. Current Psychiatry Reports, 20, 1-15.

Levinson, C. A., Cash, E., Welch, K., Epskamp, S., Hunt, R. A., Williams, B. M., … & Spoor, S. P. (2020). Personalized networks of eating disorder symptoms predicting eating disorder outcomes and remission. International Journal of Eating Disorders, 53, 2086-2094.

Levinson, C.A., Williams, B.M., Christian, C., Hunt, R.A., Keshishian, A.C., Brosof, L.C., Vanzhula, I.A., Davis, G.G., Brown, M.L., Bridges-Curry, Z., Sandoval-Araujo, L.E., & Ralph-Nearman, C. (in press). Personalizing eating disorder treatment using idiographic models: An open series trial. Journal of Consulting and Clinical Psychology.

#9: Practice Adaptations for Affirming CBT for Transgender and Gender Diverse Adults

 

Saturday, November 18 | 8:00 AM – 11:00 AM

 

Presented by:

Debra Hope, Ph.D., Aaron Douglas Professor AVC & Graduate Dean, University of Nebraska-Lincoln

Nathan Woodruff, Chair, Local Community Board, Trans Collaborations

Participants earn 3 continuing education credit

 

Categories: LGBTQ+, Treatment – CBT

Keywords: CBT, Professional Development, Resilience

Basic to moderate level of familiarity with the material


 

The recent increase in empirical research on the transgender and gender diverse (TGD) people’s mental health concerns and affirmative mental health services offer CBT therapists an opportunity to serve these clients with an evidence-based approach for the first time. This workshop is based on the work of Trans Collaborations, our community-based participatory research (CBPR) collaborative that centers the voices and lived experience of transgender and gender diverse adults, especially in underserved areas.

After a brief introduction to terminology and TGD communities’ lived experience, this workshop will emphasize practical applications that clinicians can use immediately to transform their practice and clinical work to be affirming for TGD adults. Presenters will describe the community-based, empirically-derived Trans Collaborations Adaptations for Psychological Services as applied to case-formulation driven CBT for adults. Topics will include incorporating TGD intersectional identities into case formulations, adaptations for common CBT interventions, common themes in cognitive work with TGD clients, affirming use of cognitive restructuring around experiences of marginalization, therapists’ implicit assumptions about gender, and progress monitoring tools.

We will also address assessing the practice environment to be TGD-affirming. Although the emphasis will be on CBT for common outpatient mental health concerns, we will include some discussion of the CBT therapist’s potential contribution to social, legal, and medical gender affirmation.

Consistent with the CBPR approach, presenters represent both the academy and community. Teaching methods will include didactics, roleplays, video demonstrations, and Q&A.

 

At the end of this session, the learner will be able to:
    1. Implement cognitive restructuring in an affirming manner with adults who identify as transgender or gender diverse seeking treatment for anxiety, depression, marginalization stress, or other common outpatient concerns.
     
    2. Adapt at least two common CBT interventions (e.g., exposure, behavioral homework) to be affirming of the lived experience of adults who identify as transgender or gender diverse.
     
    3. Assess their website and practice for barriers to care for adults who identify as transgender or gender diverse.
     
    4. Incorporate gender and other identities within an intersectional framework into case formulation for all clients.
     
    5. Implement affirming progress monitoring tools.

 

Long-Term Goals:

Attendees will have foundational knowledge and skills to serve transgender and gender diverse adults in current best practices and to form a basis for continuing education as the evidence-base develops.

 

Outline:
    1. Introductions and context of community-based participatory research approach
     
    2. Trans 101 – basic information about transgender and gender diverse people, sociopolitical context, resiliency, and mental health disparities
     
    3. Evidence of efficacy of CBT with transgender and gender diverse clients
     
    4. Overview of Trans Collaborations Practice Adaptations
     
    5. Application of the Practice Adaptations (roleplays and video demonstrations)

      a. Setting of services
      b. Therapist behaviors and considerations
      c. Case conceptualization
      d. Cognitive restructuring
      e. Common specific behavioral interventions
      f. Multidisciplinary collaborations and referrals
      g. Progress monitoring

    6. Role of advocacy
     
    7. Q & A


 

Recommended Readings:

dickey, l. m. & Puckett, J. A. (2022). Affirmative Counseling for Transgender and Gender Diverse Clients. Hogrefe Publishing.

Hope, D.A., Holt, N. R., Woodruff, N., Mocarski, R., Meyer, H. Puckett, J. A., Eyer, J., Craig, S., Feldman, J., Irwin, J., Pachankis, J., Rawson, K.J., Sevelius, J., Butler, S. (2022). Bridging the gap between practice guidelines and the therapy room: Community-derived adaptations for psychological services with transgender and gender diverse adults in the Central United States. Professional Psychology: Research and Practice 53, 351-361. doi: 10.1037/pro0000448

Holt, N. R., Huit, T. Z., Shulman, G. P., Meza, J. L., Smyth, J. D., Woodruff, N., Mocarski, R., Puckett, J. A., & Hope, D. A. (2019). Trans Collaborations Clinical Check-in (TC 3 ): Initial Validation of a Clinical Measure for Transgender and Gender Diverse Adults Receiving Psychological Services. Behavior Therapy, 50(6), 1136–1149. doi: 10.1016/j.beth.2019.04.001

Holt, N. R., Ralston, A. L., Hope, D. A., Mocarski, R., & Woodruff, N. (2021). A systematic review of recommendations for behavioral health services with transgender and gender diverse adults: The three-legged stool of evidence-based practice is unbalanced. Clinical Psychology: Science and Practice, 28, 186-201. doi.org/10.1037/cps0000006

Holt, N. R., Hope, D. A., Mocarski, R., & Woodruff, N. (2019). First impressions online: The inclusion of transgender and gender nonconforming identities and services in mental healthcare providers’ online materials in the USA. International Journal of Transgenderism, 20(1), 49-62, doi.org/10.1080/15532739.2018.1428842

Saturday, November 18 | 11:30 AM – 2:30 PM

#10: Regulation of Cues Treatment: A Novel Treatment for Overeating, Binge Eating and Weight Loss

 

Saturday, November 18 | 11:30 AM – 2:30 PM

 

Presented by:

Kerri Boutelle, Ph.D., Professor, University of California, San Diego

Dawn Eichen, Ph.D., ., Assistant Professor, University of California, San Diego

Participants earn 3 continuing education credit

 

Categories: Weight Management, Eating Disorders

Keywords: Eating, Exposure, Evidence-Based Practice

Moderate level of familiarity with the material


 

Current behavioral treatments of obesity result in clinically significant weight loss for approximately 50% of patients and binge eating treatments result in significant decreases in binge eating in 40-60% of patients. Targeting underlying mechanisms of overeating and binge eating could improve current treatment and maintenance outcomes. The behavior susceptibility theory suggests that individuals who overeat are less sensitive to internal hunger and satiety signals and more sensitive to external environmental cues to eat.

We developed the Regulation of Cues (ROC) program which addresses these two underlying mechanisms of overeating. ROC integrates appetite awareness skills to target satiety responsiveness and inhibitory skills to target food cue responsiveness, as well as psychoeducation and in vivo learning with food. Importantly, ROC does not recommend calorie counting. We have utilized this treatment with adults with obesity and/or binge eating and children with obesity and their parent. This workshop will a) outline the key components of the ROC program; b) present findings from published and current studies that utilize ROC; c) demonstrate how to implement ROC using case examples, role-plays and audience participation; d) discuss common challenges with the implementation of ROC. Upon completion, workshop participants will appreciate the rationale for the ROC program, learn about the data supporting ROC, and develop the basic knowledge and skills to deliver the ROC program in clinical settings.

Workshop attendees will partake in an appetite awareness training exercise and a cue exposure treatment exercise to gain a first-hand experience of what the ROC treatment entails.

 

At the end of this session, the learner will be able to:
    1. Define the behavioral susceptibility theory
     
    2. Outline the key components of the ROC program
     
    3. Identify the findings from published and current studies that utilize ROC
     
    4. Describe how to provide ROC in group and individually
     
    5. List common challenges when implementing ROC and how to address them

 

Recommended Readings:

Boutelle, K. N., Eichen, D. M., Peterson, C. B., Strong, D. R., Kang-Sim, D. J. E., Rock, C. L., & Marcus, B. H. (2022). Effect of a novel intervention targeting appetitive traits on body mass index among adults with overweight or obesity: a randomized clinical trial. JAMA Network Open, 5(5), e2212354-e2212354.

Boutelle, K. N., Manzano, M. A., & Eichen, D. M. (2020). Appetitive traits as targets for weight loss: The role of food cue responsiveness and satiety responsiveness. Physiology & behavior, 224, 113018.

Boutelle, Knatz, Carlson, Bergmann, Peterson et al. (2017) An open trial targeting food cue reactivity and satiety sensitivity in overweight and obese binge eaters. Cognitive and Behavioral Practice 24(3). 363-373.

Boutelle, K. N., Kang Sim, D. E., Manzano, M., Rhee, K. E., Crow, S. J., & Strong, D. R. (2019). Role of appetitive phenotype trajectory groups on child body weight during a family-based treatment for children with overweight or obesity. International journal of obesity, 43(11), 2302-2308.

#11: RUBI Parent Training for Young Children With Autism and Mild to Moderate Disruptive Behaviors

 

Saturday, November 18 | 11:30 AM – 2:30 PM

 

Presented by:

Elizabeth Cross, Ph.D., Psychologist, Center for Autism and Related Disorders, the Kennedy Krieger Institute; Assistant Professor, Johns Hopkins University School of Medicine

Ji Su Hong, M.D., Child Adolescent Psychiatrist, Assistant Professor, Johns Hopkins University School of Medicine

Kate McCalla, Ph.D., Assistant Clinical Director, Licensed Psychologist, Center for Autism and Related Disorders, Kennedy Krieger Institute

Karen Bearss, Ph.D., Associate Professor, University of Washington

Participants earn 3 continuing education credit

 

Categories: Autism Spectrum and Developmental Disorders, Treatment – Other

Keywords: Autism Spectrum Disorders, Parent Training, Externalizing

Basic to moderate level of familiarity with the material


 

It has been well documented that challenging behavior, such as irritability, aggressive behaviors, and noncompliance, are very common in autistic youth and emerge in early childhood. Literature indicates overwhelming rates of aggressive behaviors in children with autism (aggression to a caregiver 68%, aggression to non-caregivers 49%, and self-injury 27.7%), and challenging behavior problems are strongly associated with poor quality of life, social isolation, behavioral crisis, school problems, and parental stress and depression (Kanne & Mazurek, 2011; Lecavalier et al., 2006; Soke et al., 2016). RUBI PT is a manualized, time-limited parent training intervention for autistic youth, which has strong evidence for reducing challenigng behaviors and improving daily living skills (Bearss et al., 2015).

In this workshop, we will provide the audience with an in-depth educational experience on RUBI PT through didactic instruction, videoclips, role-play of a RUBI session, and educational handouts. Several core RUBI sessions will be discussed in detail, including behavioral principles (emphasizing the antecedent-behavior-consequence model), prevention strategies, reinforcement, planned ignoring, and functional communication training. We will review how RUBI PT is structured, and the audience will have the opportunity to see how a RUBI session is conducted. Lastly, we will review the current evidence supporting the efficacy of RUBI.

 

At the end of this session, the learner will be able to:
    1. Describe the basic behavioral principles that are the foundation of RUBI
     
    2. Explain how behavioral strategies, such as reinforcement and planned ignoring, can be used by parents
     
    3. Identify the type of patients who would benefit from RUBI
     
    4. Describe how RUBI is structured
     
    5. Identify the current evidence supporting the efficacy of RUBI

 

Long-Term Goals:
    1. Promote awareness of autism-specific behavioral parent training (i.e., the RUBI Parent Training Program)
     
    2. Provide an introduction of RUBI so that clinicians may pursue further training in RUBI

 

Outline:
    1. Learn about basic principles of applied behavior analysis (ABA) on which RUBI PT was developed

      a. Behavioral principles
      b. Prevention strategies
      c. Reinforcement
      d. Planned ignoring
      e. Functional communication training

    2. Discuss the structure of RUBI PT

      a. Overview of session content and behavior support plan
      b. Structure of treatment
      c. Treatment materials: therapist manual; parent workbook; video vignettes
      d. Engaging families in treatment

    3. Review of the current evidence supporting RUBI PT
     
    4. Speakers will do a brief role-play of a RUBI session


     

    Recommended Readings:

    Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M., … & Scahill, L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial. JAMA, 313(15), 1524-1533.

    Scahill, L., Bearss, K., Lecavalier, L., Smith, T., Swiezy, N., Aman, M. G., … & Johnson, C. (2016). Effect of parent training on adaptive behavior in children with autism spectrum disorder and disruptive behavior: Results of a randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 55(7), 602-609.

    Burrell, T. L., Postorino, V., Scahill, L., Rea, H. M., Gillespie, S., Evans, A. N., & Bearss, K. (2020). Feasibility of group parent training for children with autism spectrum disorder and disruptive behavior: a demonstration pilot. Journal of Autism and Developmental Disorders, 50(11), 3883-3894.

    Bearss, Karen, et al. “Feasibility of parent training via telehealth for children with autism spectrum disorder and disruptive behavior: A demonstration pilot.” Journal of Autism and Developmental Disorders 48.4 (2018): 1020-1030.

    Iadarola, S., Levato, L., Harrison, B., Smith, T., Lecavalier, L., Johnson, C., … & Scahill, L. (2018). Teaching parents behavioral strategies for autism spectrum disorder (ASD): Effects on stress, strain, and competence. Journal of Autism and Developmental Disorders, 48(4), 1031-1040.

Workshop #12: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents: An Introductory Workshop

 

Saturday, November 18 | 11:30 AM – 2:30 PM

 

Presented by:

Sarah M. Kennedy, Ph.D., Assistant Professor, University of Colorado School of Medicine

Elizabeth Halliday, MS, Ph.D. Student, University of Miami

Participants earn 3 continuing education credit

 

Categories: Transdiagnostic

Keywords: Transdiagnostic, Adolescents

Basic to moderate levels of familiarity with the material


 

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is a modular, core-dysfunction focused intervention that can be used flexibly with a range of emotional disorders, including anxiety, depression, obsessive-compulsive disorder, and their common comorbid presentations. The UP-A includes cognitive behavioral strategies, including emotion education and awareness, flexible thinking, problem-solving, and interoceptive and situational exposures, and mindfulness strategies to address emotional disorder symptoms, emotional distress, and related impairment.

The UP-A primarily aims to reduce avoidance of strong emotions by addressing maladaptive behaviors, across disorders, that contribute to a negative reinforcement cycle and therefore maintain symptoms. Parent-related factors (e.g., overprotection, criticism, modeling) are also addressed. This workshop will provide an introduction to the UP-A, including a review of the rationale for treatment, case formulation, and clinical content review. Didactic review of clinical strategies will be supplemented by behavioral role plays, experiential practice, and video review.

The workshop will emphasize how to best tailor these strategies to varying client presentations, including culturally-responsive modifications, and treatment length, implement the modules flexibly, and use the UP-A to optimize and personalize treatment outcomes. Highlights from the upcoming UP-C/UP-A 2.0 will also be presented.

 

At the end of this session, the learner will be able to:
    1. List two reasons for using transdiagnostic treatment approaches for adolescents.
     
    2. Identify the core-dysfunction targeted by the UP-A.
     
    3. Conceptualize a case using the UP-A treatment model.
     
    4. List the core modules and session content of the UP-A.
     
    5. List two types of emotion-focused behavioral experiments.

 

Long-Term Goals:
    • Identify cases appropriate for the UP-A and utilize the UP-A model to form case conceptualizations.
     
    • Utilize learned information to supplement further training to prepare to use the UP-A with cases.

 

Outline:
    • Briefly review the empirical support for the UP-A, including the support for different clinical presentations
     
    • Orient participants to UP-A materials
     
    • Review the UP-A treatment model case conceptualization.

      • Transdiagnostic approach
       
      • Define and describe neuroticism.

        • Neuroticism: pattern or temperament that is present from an early age.
         
        • Individuals high in neuroticism experience high levels of negative emotions more frequently than others, become distressed, anxious, and uncomfortable, and take actions to suppress, avoid, escape, distract from, or otherwise control these feelings in effort to relieve oneself from distress.

      • Review the cycle of negative reinforcement associated with emotional behaviors.

        • When faced with a trigger, clients engage in emotional disorders, which results in short-term relief, but in the long-term, may get them into trouble, cause them to miss out on things, makes things more difficult for them, and prevents them from seeing what may have happened if they did not engage in that emotional behavior. Because the emotional behaviors provide relief, they are negatively reinforced, thus creating a cycle of behaviors.

      • Illustrate how to apply the case conceptualization to various clinical presentations.

        • Present how the treatment model applies to comorbid anxiety and depression.
         
        • Present the Cycle of Angry behaviors.
         
        • Present a case conceptualization of OCD.

    • Describe the eight modules of the UP-A and their strategies/goals.

      • Module 1: Building and Keeping Motivation
       
      • Module 2: Getting to Know Your Emotions and Behaviors
       
      • Module 3: Introduction to Emotion-Focused Behavioral Experiments
       
      • Module 4: Awareness of Physical Sensations
       
      • Module 5: Being Flexible in Your Thinking
       
      • Module 6: Awareness of Emotional Experiences
       
      • Module 7: Situational Emotion Exposure
       
      • Module 8: Reviewing Accomplishments and Looking Ahead
       
      • Module P: Parenting the Emotional Adolescent

    • Demonstrate UP-A concepts and strategies using video of role-plays, participant role-plays, and live demonstration, as time permits
     
    • Present UP-A content related to parent factors.
     
    • Present UP-A tailoring and modification strategies

      • How to shorten UP-A and prioritize modules
       
      • Culturally responsive modifications
       
      • Personalizing the ordering of modules

    • Coming soon: UP-A 2.0
     

      • Review considerations for a new edition of the manual
       

        • Reducing and streamlining worksheets
         
        • Beginning exposures sooner in treatment
         
        • Expanding Module P

 

Recommended Readings:

Ehrenreich-May, J., Kennedy, S. M., Sherman, J. A., Bilek, E. L., Buzzella, B. A., Bennett, S. M., & Barlow, D. H. (2017). Unified protocols for transdiagnostic treatment of emotional disorders in children and adolescents: Therapist guide. Oxford University Press.

Ehrenreich-May, J., Rosenfield, D., Queen, A. H., Kennedy, S. M., Remmes, C. S., & Barlow, D. H. (2017). An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. Journal of Anxiety Disorders, 46, 46-55.

Sherman, J. A., Tonarely, N. A., & Ehrenreich-May, J. (2018). Targeting comorbid anxiety and depression using the unified protocol for transdiagnostic treatment of emotional disorders in adolescents. Clinical Case Studies, 17(2), 59-76.

Sherman, J. A., & Ehrenreich-May, J. (2020). Changes in risk factors during the unified protocol for transdiagnostic treatment of emotional disorders in adolescents. Behavior Therapy, 51(6), 869-881.

Ehrenreich-May, J., & Kennedy, S. M. (Eds.). (2021). Applications of the unified protocols for transdiagnostic treatment of emotional disorders in children and adolescents. Oxford University Press.

Saturday, November 18 | 3:00 PM – 6:00 PM

Workshop #13: Mental Contamination in OCD: A Cognitive Approach to Identification and Treatment

 

Saturday, November 18 | 3:00 PM – 6:00 PM

 

Presented by:

Maureen Whittal, Ph.D., Psychologist, Vancouver CBT Centre/University of British Columbia

Roz Shafran, Ph.D., Ph.D. Professor of Translational Psychology, University College London

Participants earn 3 continuing education credit

 

Categories: Obsessive Compulsive and Related Disorders, Adult Anxiety

Keywords: OCD (Obsessive-Compulsive-Disorder), Cognitive Therapy, Behavior Experiments

Moderate to advanced level of familiarity with the material


 

Mental contamination (MC), defined as feelings of dirtiness or pollution in the absence of physical contact, has been found to be in present in almost half of people with obsessive compulsive symptoms and overlaps with contact contamination (CC). People high in MC are often those with the most severe overt compulsions (e.g., hours in the shower, scrubbing themselves to the point of the skin being raw, chapped and bleeding) as well as avoidance which can be extreme.

A substantial amount of theoretical and empirical work has been completed on MC and its relationship to trauma, disgust and other manifestations of obsessive-compulsive disorder (OCD). However, work on the treatment of MC has not kept pace. One of the aims of this presentation is to provide an overview of the assessment and treatment strategies to use with clients with different forms of MC. This workshop will begin with the description of the clinical manifestation of MC in OCD and its core characteristics, including a comparison between CC and MC. Information will be presented on how to identify MC and measures will be provided that can be used in assessment and tracking of progress.

Building on the phenomenology, we will provide an overview of establishing a shared formulation of MC and how to engage clients in interventions. The main components of treatment will be presented, including psychoeducation (e.g., the role of the human source in MC, mislabelling of mood states), monitoring of specific episodes of MC and the role of appraisal. The meaning of contamination will be discussed through the use of surveys and behavioral experiments. Experiences associated with feelings of betrayal and humiliation are commonly associated with the onset of MC. The role of imagery and imagery rescripting to combat these upsetting precipitating events will be discussed. People with MC can experience a high personal moral code which is often imputed on others and in turn contributes to an explanation of how a stimulus becomes a trigger.

Strategies will be presented to contain and limit the imputation of morals on others as well as decrease the individual’s own moral code. Treatment strategies will end with a discussion of relapse prevention. The session will be interactive with role-plays, videos and experiential exercises.

 

At the end of this session, the learner will be able to:
    1. Assess MC and the relationship with contact contamination.
     
    2. Derive a shared formulation focusing on the maintenance of MC.
     
    3. Identify treatment strategies specific to MC.
     
    4. Describe the theoretical basis for the specialized treatment for MC

 

Outline:
    I. Phenomenology of MC

      a. Comparison to contact contamination (CC)

    II. Identification of MC

      a. Self-report assessment tools
       
      b. Self-monitoring of MC episodes

    III. Building a case formulation

      a. Focusing on the role of appraisal
       
      b. Identification of factors that contribute to maintenance of MC

    IV. An overview of treatment strategies for MC
     

      a. Psychoeducation and the meaning of contamination (role of appraisal)
       
      b. The role of imagery and imagery rescripting
       
      c. Addressing the imputation of a high moral code (if present)
       
      d. Relapse prevention

 

Recommended Readings:

Coughtrey, A. E., Shafran, R., Lee, M., & Rachman, S. (2013). The Treatment of Mental Contamination: A Case Series. Cognitive and Behavioral Practice, 20(2), 221-231. https://doi.org/10.1016/j.cbpra.2012.07.002

Millar, J.F.A., Coughtrey, A.E., Healy A., Whittal, M.L. & Shafran R (in press). The current status of mental contamination in obsessive compulsive disorder: A systematic review. Journal of Behavior Therapy and Experimental Psychiatry

Rachman, S., Coughtrey, A., Shafran, R., & Radomsky, A. (2014). Oxford guide to the treatment of mental contamination. Oxford University Press. Oxford.

Melli, G., Bulli, F., Carraresi, C., Tarantino, F., Gelli, S., & Poli, A. (2017). The differential relationship between mental contamination and the core dimensions of contact contamination fear. Journal of Anxiety Disorders, 45, 9-16. https://doi.org/10.1016/j.janxdis.2016.11.005

Radomsky, A.S., Coughtrey, A, Shafran, R & Rachman S. (2018). Abnormal and normal mental contamination. Journal of Obsessive-Compulsive and Related Disorders, 17, 46-51

Workshop #14: Use of Motivational Interviewing for Individuals with PTSD: Ways to Increase Treatment Engagement, Retention, and Readiness to Change

 

Saturday, November 18 | 3:00 PM – 6:00 PM

 

Presented by:

Debra Kaysen, ABPP, Ph.D., Professor, Stanford University

Denise Walker, Ph.D., Research Professor, University of Washington, Seattle

Participants earn 3 continuing education credit

 

Categories: Trauma and Stressor Related Disorder and Disasters, Treatment – CBT

Keywords: PTSD (Posttraumatic Stress Disorder), Motivational Interviewing, Evidence-Based Practice

Basic to moderate levels of familiarity with the material


 

Posttraumatic Stress Disorder (PTSD) is prevalent and associated with high individual and societal costs. There are effective interventions for PTSD which are increasingly disseminated throughout healthcare systems. However, individuals often do not access these treatments, and even for those who do, they may not receive an effective dose of treatment.

Of those with PTSD, less than half ask for help, and of those referred to specialty care less than half complete the referral. Motivational interviewing has been recommended as one way to strengthen treatment engagement among those seeking treatment for PTSD. However, these recommendations do not typically provide guidance about how to deliver Motivational Interviewing (MI) for individuals with PTSD or how to integrate these practices into an evidence-based PTSD intervention.

The purpose of this workshop is to provide attendees the basics of delivering Motivational Interviewing for individuals with PTSD. MI is a widely applied and well-researched intervention (Miller & Rollnick, 2012) aimed at helping individuals resolve ambivalence for behavior change. Motivational Interviewing has been evaluated as a prelude to treatment (Kantor, et al., 2017), an adjunct to existing treatment such as CBT (Steinberg et al., 2002), stand-alone treatment (Project MATCH; Miller, 1992) and as aftercare or maintenance intervention (Walker et al., 2015, 2016).

This workshop includes an overview on why MI can be particularly useful when working with individuals with PTSD and when MI may be appropriate. Following a review of research on MI, participants will receive an overview on the principles of MI. Lastly, we will discuss the StressCheck as one example of an MI-based intervention, with feedback.

We will discuss using the StressCheck, as an example of the use of MI to increase treatment engagement. Specific topics such as how to MI skills to address ambivalence and avoidance behavior, use of MI to promote treatment selection and adherence, how to recognize change talk for people with PTSD, and using MI to address co-occurring problems will also be discussed.

 

At the end of this session, the learner will be able to:
    1. Review MI principles and techniques as applied to the treatment of PTSD.
     
    2. Assess when it is appropriate to use MI in PTSD treatment.
     
    3. Identify four areas of PTSD treatment and engagement that may benefit from the use of MI
     
    4. Recognize examples of change talk for individuals with PTSD.
     
    5. Discuss how MI may be useful during PTSD treatment in addressing co-occurring disorders.

 

Long-Term Goals:
    1. Identify strategies to build change talk among people with PTSD.
     
    2. Incorporate MI practice as a way to enhance PTSD treatment broadly including assessment, treatment selection, and treatment engagement.

 

Outline:
    • Overview on the core tenets of MI.
     
    • Review of common challenges in PTSD treatment
     
    • How to use MI to address common challenges in PTSD treatment
     
    • Use of MI skills to address ambivalence and avoidance behavior
     
    • Use of MI to promote treatment selection
     
    • Use of MI to increase treatment adherence
     
    • Change talk for people with PTSD
     
    • Using MI to address co-occurring problems

 

Recommended Readings:

Seal, K. H., Abadjian, L., McCamish, N., Shi, Y., Tarasovsky, G., & Weingardt, K. (2012). A randomized controlled trial of telephone motivational interviewing to enhance mental health treatment engagement in Iraq and Afghanistan veterans. General hospital psychiatry, 34(5), 450-459.

Marker, I., & Norton, P. J. (2018). The efficacy of incorporating motivational interviewing to cognitive behavior therapy for anxiety disorders: A review and meta-analysis. Clinical Psychology Review, 62, 1-10.

Lundahl, B. W., Kunz, C., Brownell, C., Tollefson, D., & Burke, B. L. (2010). Research Article A Meta-Analysis of Motivational Interviewing: Twenty-Five Years of Empirical Studies. Research on Social Work Practice, 20(2), 137–160. https://doi.org/10.1177/1049731509347850

Murphy, R. T., Thompson, K. E., Murray, M., Rainey, Q., & Uddo, M. M. (2009). Effect of a motivation enhancement intervention on veterans’ engagement in PTSD treatment. Psychological Services, 6(4), 264–278. https://doi.org/10.1037/a0017577

Westra, H. A., & Aviram, A. (2013). Core skills in motivational interviewing. Psychotherapy, 50(3), 273.

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