Virginia Summer Institute for Addiction Studies: Registration 2018

Virginia Summer Institute for Addiction Studies: Registration 2018

Sunday, July 15: 3:30 – 5:00 PM Pre-Conference Packet Pick-Up: The Woodlands Conference Center

Last Name: First Name: ______

Institution/Agency:______

Phone (H): ______Phone (W): ______

E-Mail Address: ______

Do you wish to have your email address given to a vendor: YES NO

E-Mail address if different from above for vendor:______

Affiliation: VATARP VAAP SAARA VCB EVMS CSB DJJ/DOC VCA NASW/VSCSW (Check all that apply)

Credentials: CSAC CADC CAC-AD CAADC PHD MD RN

LMFT LPC NCACI & II LSATP MAC PRSS/CPRS

LCSW MSW Other ______

Credit for Attendance:VSIAS enjoys the privilege to be an education provider for a number of credentialing and academic organizations. Inherent in this privilege is the ethical responsibility that VSIAS accepts to ensure that attendance credits are awarded fairly and honestly. To this end, an individual must attend a minimum of 80 percent of a session to receive credit. VSIAS Faculty will take steps to ensure this is the case. We trust you will understand and support why there must be no exceptions to this requirement. Additionally, VSIAS will take required actions in those cases should an individual misrepresent membership or credentials status. VSIAS provides a professional learning experience and therefore has an ethical responsibility to ensure the good name of the Virginia Summer Institute for Addiction Studies as a reputable and credible conference. Thank you for your support in this matter.

Training Contact Hours provided by: All Pending

Grab-n-Go Lunches Monday and Wednesday are included in your registration fee. Awards Luncheon Tuesday $5:

**NO lunches provided for On-Site Registrations

Monday Grab-n-Go: (select one) Regular Meal Vegetarian Meal Gluten-Free None

Tuesday Awards Luncheon – Cost $5 Regular Meal Vegetarian Meal Gluten-Free None

Wednesday Grab-n-Go: (select one) Regular Meal Vegetarian Meal Gluten-Free None

Registration Fees:

Registration through June 15, 20181-Day $225 2-Day $375 3-Day $425

Student1-Day $180 2-Day $300 3-Day $340 (Must supply letter from Advisor Stating Fulltime Student in Behavioral Health Field at time of registration)

Registration after June 15, 2018 & On-Site 1-Day $250 2-Day $425 3-Day $500

Student 1-Day $200 2-Day $340 3-Day $400 (Must supply letter from Advisor Stating Fulltime Student in Behavioral Health Field at time of registration)

Active Duty Military - Monday, July 16, 2018Only Monday Registration with Lunch $125 ***Must bring ID, Uniforms welcomed

Tuesday Awards Luncheon Cost (Limited seating) $5

Total Amount Paying$______

There are three methods of payment:

1 - Personal or Agency Check: Check number: Amount of check:

2 - PayPal Payment:

If you pay by credit card, you may email your registration form. If you pay by check, please mail both the form and check together, so there is no delay in your receiving a confirmation for your sessions.

3 - Purchase Order # ______

Federal Tax I.D. No. 65-1176624 and DUNS No. 962331331

PARTICIPANT NAME (LAST, FIRST) PLEASE PRINT:

Sunday, July 15 from 3:30 – 5:00 PM Pre-Conference Break-out: “The Surge in Peer Recovery Support Across Virginia” 1.50 CE

Will Attend Will Not Attend

Training Session Selection
MONDAY, JULY 16 AM SESSIONS – 8:30 - 11:45 AM (3.25 CE)
Keynote SessionSTEFANIE CARNES: Sexual Addiction: Diagnostic Challenges and New Research
LUNCHBOX SESSIONS - 12:00 - 1:00 PM (1.00 CE)
JENNIFER FAISON: General Assembly Action on Issues Related to Addiction
MONDAY, JULY 16 PM SESSIONS – 1:15 - 4:30 PM (3.25 CE)
SHANNON GARRETT: Engaging Adolescents in Treatment, Lets Have Some Fun Doing It
NANCY JOHNSTON: Mindfulness: Core Concepts + Core Practices + Core Self (bring yoga mat)
APRIL ASHWORTH: Successful Recovery: Getting Clean and Staying Clean
MONDAY, JULY 16 EVENING SESSION 5:30 – 7:30 PM(2.0 CE)
JOHN BEAVER: REVIVE! Training of Trainers
TUESDAY, JULY 17 EARLY AM SESSION 7:45 - 8:15 AM (0.5 CE)
FULL / NANCY JOHNSTON: Morning Mindfulness
TUESDAY, JULY 17 AM SESSIONS – 8:30 - 11:45 AM (3.25 CE)
Plenary Session CC NUCKOLS: Healing the Healer: Understanding & Overcoming Compassion Fatigue
TUESDAY, JULY 17PM SESSIONS – 1:15 - 4:30 PM (3.25 CE)
LISA SMITH: Mobilizing the Community Towards Recovery
BARBARA BURKE: The Disease Model: Utilizing a Continuum of Care for Young People
CYNDI TURNER/CRAIG JAMES: Alcohol Treatment According to the New DSM-5 Diagnostic Spectrum
DENISE HALL: Introduction to Motivational Interviewing
SAULO ORTIZ: God Bless This Broken Road – Fighting Clinical Burnout from Treatment
TUESDAY, JULY 17 EVENING SESSION 5:30 – 7:30 PM (2.00 CE)
MICKEY HARDEN: Riding the Wave of Peer Support in Virginia
WEDNESDAY, JULY 18 EARLY AM SESSION 7:45 - 8:15 AM (0.5 CE)
FULL / NANCY JOHNSTON: Morning Mindfulness
WEDNESDAY, JULY 18 AM SESSIONS – 8:30 - 11:45 AM (3.25 CE)
Plenary Session ALEX HILERT/DANIEL GUTIERREZ: Urge Surfing or Wiping Out: Mindfulness for Change and andRecovery
WEDNESDAY, JULY 18 8:30 AM – 4:30 PM (7.5 CE) MARY MCQUOWN’S REQUIREDPRE-REQUISITE BEFORE CLASSROOM SETTING –
SEE WRITE-UP & BRING REQUIRED MATERIALS
MARY MCQUOWN: Peer Recovery Specialists Supervisors Training (SUPERVISORY LEVEL)
WEDNESDAY, JULY 18 LUNCHBOX SESSIONS - 12:00 - 1:00 PM (1.00 CE)
ASHLEY HARRELL: Medicaid Addiction & Recovery Treatment Services – Maximizing Opportunities for Substance Use Disorder Treatment
WEDNESDAY, JULY 18PM SESSIONS – 1:15 - 4:30 PM (3.25 CE)
DAVID SAVINSKY: Assessing the Family for Treatment Fit: Utilizing the Sequential Family Addictions Model
DENISE HALL: Advanced Motivational Interviewing Skills
MICHAEL GILLETTE: Professional Boundaries and Clinical Ethics
JEB BIRD & DR. DOUGLAS BROWN: Transforming Addiction Treatment – Embracing Science to Treat a
Health Condition