Title: Helping Clients Quiet Their Mind and Get to Sleep: A Client-Centered Approach to Cognitive Behavioral Therapy for Insomnia

Level: Basic to Moderate

Presenters:

Colleen E. Carney, Ph.D., Ryerson University

Abstract:

This Institute provides training on CBT for insomnia with a focus on counter-arousal strategies to address the arousal complaints in insomnia, including worry, rumination, and excessive mentation in bed. The materials will be presented via demonstrations of techniques, as well as applied exercises, such as devising behavioral experiments, experiential exercises for fatigue management, calculating sleep schedule recommendations from actual sleep diaries, and trouble-shooting from a thought record. Knowing how to deliver CBT for insomnia in those with complex problems, including high cognitive arousal, is a must for clinicians. This Institute will provide step-by-step cognitive-behavioral strategies for insomnia, with a special emphasis on the types of adherence issues you are likely to encounter in your practice as you treat other disorders, such as pain, anxiety, and depression. The format for the Institute will be a mix of didactic instruction, experiential exercises, and demonstrations from a leading clinician in the area of comorbid insomnias and cognitive arousal. The presenter is the author of the only CBT workbook written expressly for comorbid insomnias, and a self-help book on cognitive arousal strategies in insomnia.

You Will Learn:

1. Present sleep regulation information to clients.

2.Tailor CBT for insomnia, especially in cases with pain, trauma, anxiety or depression.

3. Manage cognitive arousal.

Recommended Readings:

Carney, C.E., & Manber, R. (2009). Quiet your mind and get to sleep: Solutions to insomnia for those with depression, anxiety or chronic pain. Oakland, CA: New Harbinger.

Edinger, J.D., Carney, C.E., & Wohlgemuth, W. (2008). Pre-therapy cognitive dispositions and treatment outcome in behavioral insomnia therapy. Behavior Therapy, 39, 406-416.

Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research & Therapy, 40, 869-893.

Title: The Compassionate Use of Exposure Strategies in Acceptance and Commitment Therapy

Level: Basic to Moderate

Presenters:

John P. Forsyth, Ph.D., University at Albany, SUNY

Abstract:

Acceptance and Commitment Therapy (ACT) balances mindfulness and acceptance processes with commitment and behavior change processes to (a) weaken the influence of cognitive fusion and emotional avoidance, while (b) promoting greater experiential and psychological flexibility in the service of valued ends. This work can be challenging for both therapists and clients alike, for much of ACT work involves contacting difficult and painful psychological content without defense and for a purpose other than psychological relief. Thus, understanding the application and integration of exposure strategies is essential for effective ACT work.

This Institute will cover traditional CBT exposure strategies and show how they are modified, framed, and applied within ACT. Thus, this session will go more deeply into the nuanced application of exposure within ACT and for a broad range of clinical concerns.

Using a combination of didactic and experiential activities, the exercises will highlight a gentle and compassionate stance when using exposure strategies in the context of mindfulness, acceptance, and values work. Participants will be encouraged (but never forced or coerced) to engage the material at a personal level and also in the context of their clinical work. Worksheets and other practical tools will be provided.

You Will Learn:

1. How to conceptualize and apply exposure-based strategies in a traditional sense (CBT), and then in an ACT context.

2. How to frame exposure exercises within ACT (i.e., fostering willingness).

3. How acceptance, mindfulness, and defusion strategies can be intermingled with exposure to enhance psychological flexibility.

Recommended Readings:

Eifert, G. H., & Forsyth, J. P. (2005). Acceptance and Commitment Therapy for anxiety disorders: A practitioner's treatment guide to using mindfulness, acceptance, and values-based behavior change strategies. Oakland, CA: New Harbinger.

Forsyth, J. P., & Eifert, G. H. (2008). The mindfulness and acceptance workbook for anxiety: A guide to breaking free from anxiety, phobias, and worry using Acceptance and Commitment Therapy. Oakland, CA: New Harbinger.

Title: Evidence Based Assessment and Treatment of Bipolar Disorder in Youth

Level: Basic to Moderate

Presenters:

Mary A. Fristad, Ph.D, ABPP, Ohio State University

Eric A. Youngstrom, Ph.D., University of North Carolina at Chapel Hill,

Abstract:

Until recently, bipolar disorder was rarely diagnosed in youths. Now diagnostic rates have exploded and “bipolar” is the most common diagnosis for psychiatrically hospitalized youths. There is concern that bipolar disorder is being overdiagnosed and overmedicated in children. Fortunately, there has been a surge of evidence about the validity of carefully diagnosed bipolar in youths, along with better evidence-based tools for assessment and treatment. This Institute discusses key assessment and therapy issues, including the following: how bipolar disorder manifests clinically, presentation similarities and differences in children versus adults, how to use self-report and parent-report measures to aid in DSM-5 diagnosis and treatment, the role of RDoC, and specific treatment strategies. We summarize the available biological interventions, emphasizing what nonprescribing clinicians need to know about these treatments. We then concentrate on how to implement therapeutic techniques used in individual-family and multifamily psychoeducational psychotherapy, one of the most promising evidence-based approaches to managing mood disorders in youth. This program will utilize lecture format, case presentations, demonstrations, role-plays and question-and-answer periods. Often challenging conventional wisdom, the Institute presents new evidence from NIMH grants that can be applied immediately in practice.

You Will Learn:

1. Evidence-based assessment methods that aid in differential diagnosis and measuring treatment response.

2. Which symptoms and risk factors are helpful in recognizing bipolar disorder, and which may be “red herrings”.

3. Specific therapeutic techniques to treat youth with bipolar disorder.

Recommended Readings:

Fristad, M.A., Goldberg Arnold, J.S. & Leffler, J. (2011). Psychotherapy for children with bipolar and depressive disorders. New York: Guilford Press.

Kowatch, R.A., Fristad, M.A., Findling, R.L & Post, R.M. (2009). A clinical manual for the management of bipolar disorder in children and adolescents. Arlington, VA: American Psychiatric Press.

Youngstrom, E.A. (2009). Definitional issues in bipolar disorder across the life cycle. Clinical Psychology: Science and Practice, 16, 140-160. doi: 10.1111/j.1468-2850.2009.01154.x

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

Title: Psychotherapy for the Interrupted Life: An Evidence-Based Treatment for Adult Survivors of Childhood Abuse

Level: Basic

Presenters:

Tamar Gordon, Ph.D., Ferkauf Graduate School Adjunct Faculty

Christie Jackson, Ph.D., Director of the PTSD Clinic, New York Harbor Healthcare System

Susan Trachtenberg Paula, Ph.D., Jewish Board of Family and Children’s Service

Abstract:

This Institute will present Marylene Cloitre’s Skills Training in Affective and Interpersonal Regulation/Narrative Story Telling (STAIR/NST), a type of CBT specifically developed for individuals with complex PTSD. Participants will learn and practice new interventions for teaching skills that are often particularly compromised in individuals with multiple traumas, notably difficulties with emotional and interpersonal functioning. Training will also include the use of exposure therapy for treating PTSD in this population, and ways in which exposure may differ when dealing with complex trauma versus single-incident traumas, such as a motor vehicle accident. A basic familiarity with the impact of trauma on functioning is recommended, as well as knowledge of CBT. Teaching modalities will include PowerPoint, role-plays, and other experiential exercises, as well as case presentations.

You Will Learn:

1. Summarize theory of complex trauma and PTSD.

2. Teach emotion-regulation skills to trauma survivors.

3. Assess patient schemas and interpersonal skills.

Recommended Readings:

Cloitre, M., Cohen, L.R., & Koenen, K.C. (2006). Treating survivors of childhood abuse: Psychotherapy for the interrupted life. New York: Guilford Press.

Cloitre, M., Stovall-McClough, K.C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C., & Petkova, E. (2010). Treatment for PTSD related to childhood abuse: A randomized controlled trial. American Journal of Psychiatry, 167, 915-924.

Jackson, C., Cloitre, M., & Nissenson, K. (2009). Cognitive behavioral treatment of complex traumatic stress disorders. In C. A. Courtois & J. D. Ford (Eds.), Complex traumatic stress disorders: An evidence-based clinician’s guide. New York: Guilford Press.

Title: Radically Open–Dialectical Behavior Therapy (RO-DBT): For Disorders of Overcontrol

Level: Basic

Presenters:

Thomas. R. Lynch, Ph.D., University of Southampton

Abstract:

Self-control, the ability to inhibit competing urges, impulses, or behaviors, is highly valued by most societies. However, excessive self-control has been linked to social isolation, aloof interpersonal functioning, maladaptive perfectionism, inhibited expressions, and difficult-to-treat mental health problems, such as anorexia nervosa, obsessive compulsive personality disorder, and refractory depression. Based on 19 years of research, two NIMH-funded randomized controlled trials (RCTs) targeting depression and overcontrolled personality disorders, an open trial with adult anorexia nervosa, and a large ongoing multisite RCT (http://www.reframed.org.uk), the aim of this Institute is to introduce clinicians to the new theory and strategies underlying Radically Open–Dialectical Behavior Therapy (RO-DBT) for disorders of overcontrol (treatment manual pending; Guilford Press).

RO-DBT posits emotional loneliness as the core problem underlying maladaptive overcontrol. Heightened threat sensitivity and diminished reward sensitivity are hypothesized to transact with early family experiences emphasizing “mistakes intolerable” and “self-control imperative” to produce overcontrolled coping. A novel thesis linking the communicative functions of emotional expression to the formation of close social bonds will be introduced, as well as new skills emphasizing receptivity, self-enquiry, and flexible responding. New approaches to activate a neurobiologically based social-safety system, signal cooperation, enhance forgiveness, and change envy/bitterness will be introduced using videos and role-play.

You Will Learn:

1. Explain the biosocial theory for overcontrol (OC) and recognize core differences between undercontrol and overcontrol.

2. Describe the RO-DBT treatment hierarchy—and the five OC behavioral themes.

3. Describe the importance of activating a neural substrate associated with the ventral vagal complex and social-safety when working with OC.

Recommended Readings:

Lynch, T. R., & Cheavens, J. S. (2008). Dialectical behavior therapy for comorbid personality disorders. Journal of Clinical Psychology, 64(2), 154-167.

Lynch, T. R., Cheavens, J. S., Cukrowicz, K. C., Thorp. S., Bronner, L., & Beyer, J. (2007). Treatment of older adults with co-morbid personality disorder and depression: A Dialectical Behavior Therapy approach. International Journal of Geriatric Psychiatry, 22, 131-143.

Lynch, T.R., Gray, K.L.H., Hempel, R.J., Titley, M., Chen, E.Y., & O’Mahen, H.A. (2013). Radically Open-Dialectical Behavior Therapy for adult anorexia nervosa: Feasibility and outcomes from an inpatient program. BMC Psychiatry, 13, 293

Lynch, T.R., Hempel, R.J., & Dunkley, C. (in press). Remembering our tribal nature: Radically Open-Dialectical Behavior Therapy for disorders of overcontrol. American Journal of Psychotherapy.

Title: Parent-Child Interaction Therapy

Level: Basic to Moderate

Presenters:

Cheryl B. McNeil, Ph.D., West Virginia University

Abstract:

This Institute describes Parent Child Interaction Therapy (PCIT), an evidence-based behavioral treatment for families of young children with disruptive behavior disorders. PCIT is based on Baumrind’s developmental theory, which holds that authoritative parenting—a combination of nurturance, good communication, and firm limits—produces optimal child mental health outcomes. In PCIT, parents learn authoritative parenting skills through direct therapist coaching of parent child interactions, guided by observational data collected in each session. Parents receive immediate guidance and feedback on their use of techniques such as differential social attention and consistency as they practice new relationship enhancement and behavioral management skills. Videotape review, slides, handouts, and experiential exercises will be used to teach participants the basic interaction skills and therapist coding and coaching skills used during treatment sessions. Applications of PCIT within physically abusive families and other special populations will be discussed.

You Will Learn:

1. Participants will become knowledgeable about theoretical framework and assessment procedures used in PCIT.

2. Participants will become familiar with the child-directed component of PCIT.

3. Participants will become familiar with the parent-directed interaction component of PCIT.

Recommended Readings:

Go to www.pcit.org for a list of the PCIT literature, as well as the treatment integrity manual for conducting PCIT.

Eyberg, S.M. (2005). Tailoring and adapting parent-child interaction therapy for new populations. Education and Treatment of Children, 28, 197-201.

Hood, K.K., & Eyberg, S.M. (2003). Outcomes of parent-child interaction therapy: Mothers’ reports on maintenance three to six years after treatment. Journal of Clinical Child and Adolescent Psychology, 32, 419-429.

McNeil, C.B., & Hembree-Kigin, T. (2010). Parent-Child Interaction Therapy (2nd ed.). New York: Springer.

Title: Motivational Interviewing: Skill Building and Updates

Level: Moderate to Advanced

Presenters:

Daniel W. McNeil, Ph.D., West Virginia University

Trevor A. Hart, Ph.D., Ryerson University

Emily M. Selby-Nelson, PsyD, Cabin Creek Health Systems

Abstract:

This Institute provides updates on recent definitional and conceptual changes to Motivational Interviewing (MI) with the publication of the third edition of the classic text in 2013, as well as development and practice of skills. Designed for professionals and trainees with prior experience using MI, this presentation will cover advanced methods to assist clients with behavior change, including integrating MI with CBT. Starting with “engaging” and “focusing” processes in MI, this institute will emphasize how to help clinicians work with their clients to move from these initial phases to “evoking” of ambivalence and “planning” for behavior change steps. Using demonstrations, role-play, and film, the application of new methods to increase and sustain client motivation will be discussed, as will strategies for responding productively to resistance. Practice in evoking “change talk” (in contrast to “sustain talk” and avoidance) in sessions will be covered, along with applying MI at critical junctures in treatment. A trainer who is a member of the Motivational Interviewing Network of Trainers will introduce experiential components in which participants work with one another in dyads and groups, and with the trainers, to polish skills in a comfortable, interactive, and supportive learning environment.

You Will Learn:

1. To describe and conceptualize the MI model.

2. To recognize and utilize newly articulated MI processes.

3. To apply key MI processes to increase client motivation for behavior change.

Recommended Readings:

Arkowitz, H., Westra, H. A., Miller, W. R., & Rollnick, S. (2008). Motivational Interviewing in the treatment of psychological problems. New York: Guilford Press.