CALL FOR PRESENTATIONS
Deadline Tuesday, December 19, 2017
Community Mental Health Association of Michigan (formerly MACMHB)
2018 Annual Winter Conference
February 5, 2018 Pre-Conference Institute
February 6 & 7, 2018 Full Conference
Radisson Plaza Hotel & Suites, Kalamazoo
Purpose of this form: Training program planners at CMHAM use the information requested in this form for several things – to assure appropriateness of content; to assess whether the presentation meets criteria for social work “Continuing Education Clock Hours,” and/or substance abuse professional certification “Contact Hours”; and to develop program description.
· Required to send: 1) completed submission form and 2) a resume for each presenter.
· Return via email to by Deadline Tuesday, December 19, 2017
· We allow for a maximum of 3 presenters during a workshop.
· Workshops are generally 90 minutes; a small number of double sessions may be considered.
· Presenter Compensation: The conference budget will not provide honorariums for workshop presenters. Presenters will receive a complimentary conference registration for the day of their presentation. Due to the high cost of travel, CMHAM is not able to reimburse workshop presenters for mileage. If presenters are not able to participate due to lack of reimbursement, special arrangements may be made with CMHAM when you are notified of your accepted proposal.
PROPOSED TIME:Check all your availability: / ☐Pre-Conference Institute February 5, 2018 (☐all day or ☐½ day)
☐February 6, 2018 Morning (10:00am – 11:30am)
☐February 6, 2018 Afternoon (1:30pm – 3:00pm)
☐February 6, 2018 Afternoon (3:30pm – 5:00pm)
☐February 7, 2018 Morning (10:30am – 12:00pm)
TARGET AUDIENCE: / ☐Clinical Staff
☐Administrative/Executive Leadership
☐Board Members
☐Individuals Receiving Services, Family Members
TARGETED EXPERIENCE LEVEL:
Check all that apply: / ☐ Basic: Introduction to content area; may include providing information about a particular condition, treatment method or issue. Outcome: Learning and comprehending content.
☐ Intermediate: Information builds on knowledge that participants with some experience already have. Focus on skill-building or adding knowledge; possibly with a brief overview of basic information. Outcomes: Using information in concrete situations and understanding the underlying structure of the material.
☐ Advanced: Content for people who have been working in this area and have a clear understanding of the issues. Covers complexities involved in the work and means to address them. Outcomes: Synthesizing material to create new patterns or structures or evaluating material for a specific purpose.
WORKSHOP TITLE:
WORKSHOP DESCRIPTION: Provide a brief description (10-12 sentences) for the conference brochure. Limit of 175 words.
LEARNING OBJECTIVES: [Include a MINIMUM of 3 - MAXIMUM of 4]
Learning Objectives must be measurable/observable and illustrate knowledge or a skill that a participant will be able to demonstrate after completing the workshop.
Use words such as: define, repeat, record, list, recall, name, relate, specify, cite, recount, restate, summarize, describe, recognize, explain, express, identify, translate, exhibit, solve, apply, employ, use, demonstrate, illustrate, operate, calculate, show, interpret, classify, differentiate, group, compare, organize, contrast, examine, categorize / TIMED AGENDA:
During the workshop, indicate the amount of time spent on each objective listed below.
Total of all objectives should equal 90 minutes.
Participants will be able to: 1. / # of Minutes:
Participants will be able to: 2. / # of Minutes:
Participants will be able to: 3. / # of Minutes:
COURSE CONTENT: Check all that apply
Topics covered by the course content and activity in accordance with R 338.2908o (3)(a) of the Social Work General Rules of the State of Michigan:
☐Theories and concepts of human behavior in the social environment
☐Social work practice, knowledge and skills
☐Social work research, program evaluation, or practice evaluation
☐Social work agency management or administration
☐Development, evaluation, and/or implementation of social policy
☐Social work generalist practice
☐Social work clinical practice
☐Diversity and social justice
☐Social work ethics and standards of professional practice (presenter must be a licensed social worker)
☐Pain/Pain symptom management, including but not limited to, behavior management, psychology of pain, behavior modifications and stress management. Must address physical pain.
☐Other; describe:
EXPLAIN THE RELEVANCE THIS WORSHOP HAS TO SOCIAL WORK:
CULTURAL DIVERSITY & SOCIAL JUSTICE: Explain how this presentation addresses cultural diversity and social justice perspectives:
WHICH CURRENT ISSUES IN SOCIAL WORK PRACTICE ARE ADDRESSED IN THE WORKSHOP? Check all that apply.
☐Diversity, cultural, linguistic competencies, multiculturalism
☐Social work values and ethics
☐Assessment, diagnosis and treatment of mental, emotional or behavioral disorder, condition and/or additions
☐Assessment, diagnosis and treatment of specific populations (e.g. aging)
☐Non-clinical practice
☐Other; describe:
PRACTICE AREAS: Which of the following practice areas are incorporated into the workshop? Check all that apply.
☐Knowledge base
☐Engagement/relationship building
☐Assessment
☐Planning
☐Intervention/treatment
☐Evaluation
☐Termination of treatment
WORKSHOP APPLIES TO WORK WITH: Check all that apply.
☐Individuals
☐Groups
☐Organizations
☐Communities
☐Social Systems
CONFERENCE TRACK: You MUST select ONE track that your proposed workshop best fits.
☐Promising, Emerging and Evidence-Based Practices
☐Integrated Healthcare Initiatives
☐Consumer Integration and Relationship Building, Empowerment and Peer Services
☐Mental Health Recovery-Oriented Services
☐Public Policy Developments and Trends
☐Clinical Care Assessment: Quality, Cost, Fidelity Integrity, and Outcomes Dimensions
☐Children’s Mental Health Services
☐Board Member Development, Governance and Leadership
☐Developmental Disabilities Services and Supports
☐Substance Use Disorder Prevention and Treatment
☐Advocacy Training and Support for Consumers/Families
BIBLIOGRAPHY: There must be 3 references given that are relevant to the content of this presentation. APA format required.
2 references must not be any older than five years. Do not list websites.
1.
2.
3.
PRESENTER INFORMATION: MAXIMUM OF 3 PRESENTERS.
Primary Presenter Information:
☐CV or Resume Attached
Name:
Degrees/Credentials:
(MSW, MA, PhD, etc.)
Title:
Organization:
Address:
Phone Number:
Email Address:
REQUIRED: Presenter bio to be used in the conference program. 3-5 sentences.
Co-Presenters Information (if applicable):
☐CV or Resume Attached
Name:
Degrees/Credentials:
(MSW, MA, PhD, etc.)
Title:
Organization:
Address:
Phone Number:
Email Address:
REQUIRED: Presenter bio to be used in the conference program. 3-5 sentences.
Co-Presenters Information (if applicable):
☐CV or Resume Attached
Name:
Degrees/Credentials:
(MSW, MA, PhD, etc.)
Title:
Organization:
Address:
Phone Number:
Email Address:
REQUIRED: Presenter bio to be used in the conference program. 3-5 sentences.
The conference budget will support modest honorariums for plenary speakers; however we do not provide honorariums for workshop presenters. Presenters will receive a complimentary conference registration for the day of their presentation. Due to the high cost of travel, CMHAM is not able to reimburse workshop presenters for mileage. If presenters are not able to participate due to lack of reimbursement, special arrangements may be made with CMHAM when you are notified of your accepted proposal.
Deadline: Tuesday, December 19, 2017 to Chris Ward at