Mini Workshop 1
The Mindful Way Through Muddy Emotions
Susan M. Orsillo, Suffolk University
Lizabeth Roemer, University of Massachusetts, Boston
Introductory level of familiarity with the material
Primary Topic: Treatment- Mindfulness
Key Words: Acceptance-Based Behavioral Therapy, Mindfulness, Anxiety
Acceptance-based behavioral therapies (ABBT) have demonstrated efficacy in both reducing symptoms and promoting quality of life for clients suffering from a wide range of clinical disorders. Helping clients to distinguish between clear and muddy emotions and change their response to their emotions are core strategies that can be used to decrease the intensity and chronicity of distress and enhance behavioral flexibility. However, there are a number of common stuck points that can arise over the course of therapy that make this work challenging. The goal of the current mini-workshop is to help therapists to identify commonly encountered obstacles and to provide an overview of various clinical strategies that can be used to overcome these barriers. Drawing from both the presenters’ clinical experience and their program of research developing and testing the efficacy of an ABBT for GAD, the presenters will share clinical strategies, describe case examples, and provide handouts and exercises that participants can use in their own clinical practice.
You will learn:
· To describe methods that can assist clients in identifying clear and muddy emotions.
· To identify strategies that contribute to the development and maintenance of muddy emotions.
· To articulate strategies to help clients respond differently to clear emotions when they arise.
Recommended Readings: Hayes-Skelton, S. A., Roemer, L., & Orsillo, S. M. (2013). A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 81, 761-773. Orsillo, S.M., & Roemer, L. (2011). The mindful way through anxiety. New York: Guilford Press. Roemer, L., & Orsillo, S.M. (2009). Mindfulness and acceptance-based behavioral therapy in practice. New York: Guilford Press.
Mini Workshop 2
Supporting Women After Abortion: Exploring Multiple Perspectives on Experiences, Stigma, and Values
Presenter(s) Information: Jennifer Katz, SUNY Genese
Primary Topic: Gender/Women’s Issues
Key Words: Abortion, Stigma, Values, Reproductive Decisions, Women’s Health
Deciding to terminate a pregnancy can be a difficult decision that may lead some women to seek professional services. Unfortunately, many mental health professionals have limited training in supporting women who are coping with difficult abortion experiences. This mini-workshop will increase mental health professionals’ competency to assist women in therapy both before and after an abortion. The first aim of this mini-workshop is to increase participants’ knowledge about abortion by discussing medical and narrative descriptions of abortion. Participants will also learn about the personal, interpersonal, and sociocultural obstacles many women face in seeking abortion services. The second aim of this mini-workshop is to enable mental health professionals to explore stigma and values related to abortion and other reproductive decisions. Participants will reflect on their personal values related to abortion and women’s reproductive decision-making generally that may influence their professional work. After completing this workshop, participants will be better positioned to conduct therapy with abortion patients in a way that both minimizes stigma and matches with their patients’ values.
You will learn:
· To identify common concerns and stressors reported by help-seeking abortion patients
· To challenge different types of abortion-related stigma affecting women who have abortions as well as professionals who work with abortion patients.
· To clarify personal values related to abortion, reducing potential biases that might adversely affect interactions with patients who have or who will have abortions.
Recommended Readings: Baumgardner, J. (2008). Abortion and life. Brooklyn, NY: Akashic Books. Major, B., Appelbaum, M., Beckman, L., Dutton, M. A., Russo, M. F., & West, C. (2009). Abortion and mental health: Evaluating the evidence. American Psychologist, 64, 863-890. Solinger, R. (2013). Reproductive politics: What everyone needs to know. New York: Oxford University Press.
Mini Workshop 3
Affect Regulation Training for Substance Use Disorders: Helping Clients to Engage With Negative Emotions
Paul R. Stasiewicz, Research Institute on Addictions, University at Buffalo
Clara M. Bradizza, Research Institute on Addictions, University at Buffalo
Kim S. Slosman, Research Institute on Addictions, University at Buffalo
Basic level of familiarity with the material
Primary Topic: Addictive Behaviors/Substance Use
Key Words: Affect Regulation, Alcohol, Emotion, Smoking, Treatment
The combination of negative affect and difficulties regulating negative affect has implications for the development, maintenance, and treatment of substance use problems. This introductory mini-workshop on how to implement Affect Regulation Training (ART) for individuals with a substance use disorder will begin with instruction in the conceptualization of the ART intervention and describe its basic components. The remainder of the mini-workshop will provide a step-by-step guide on how to implement a core therapeutic principle of ART—learning to engage with unpleasant emotions and cravings.
During this session, participants will be presented with case vignettes that illustrate use of ART in smoking cessation and in the treatment of alcohol use disorders. Workshop participants will also receive instruction on how to construct a hierarchy of high-risk negative affect smoking and drinking situations with their clients and how to help clients choose appropriate high-risk for substance use situations. Several high-risk situations will be used to illustrate how ART strategies may deepen a client’s awareness of the physical sensations, thoughts, emotions, and urges that often precede substance use. Participants will learn how to use such information to help clients accept and tolerate negative emotions without resorting to substance use.At the end of this mini-workshop, participants should be able to describe the theoretical rationale for ART, explain this rationale to clients, construct a hierarchy of negative affect smoking and drinking situations, implement strategies designed to elicit engagement with affective and craving responses, monitor clients' affective and craving responses during the intervention, and assign between-session homework.
You will learn:
· The underlying rationale for Affect Regulation Training.
· To construct a hierarchy of negative affect substance use situations.
· To implement the ART strategies of mindfulness and prolonged direct experiencing of emotion to enhance engagement with negative affect.
Recommended Reading: Stasiewicz, P. R., Bradizza, C. M., Schlauch, R. C., Coffey, S. F., Gulliver, S. B., Gudeski, G., & Bole, C. W. (2013). Affect regulation training (ART) for alcohol dependence: Development of a novel intervention for negative affect drinkers. Journal of Substance Abuse Treatment, 45, 433-443. PMCID: PMC3773302
Mini Workshop 4
Security and Ethics of Information Technology Use in Psychological Treatment
Jon D. Elhai, University of Toledo
Basic level of familiarity with the material
Primary Topic: Training and Professional Issues
Key Words: Technology, Treatment, Professional Issues, Electronic Communication
In recent years, cognitive-behavioral psychologists have increasingly incorporated information technology into patient care, including use of smartphones, tablets and laptops for electronic communication, psychological assessment, homework assignment completion, and record keeping. Yet weaknesses exist in these technologies that can put patient privacy at risk. In this mini-workshop, issues of ethics, privacy, and security of such technology will be discussed in regard to patient care. Discussion and details are offered on free, easy-to-use software application solutions for securing patient communication and records. Also discussed are such issues as using encrypted wireless networks, secure email, encrypted messaging and videoconferencing, privacy on social networks, and others. For nontechnologically savvy users, this discussion will likely be unfamiliar, though the information will be presented in very basic, nontechnical terms. Even for advanced, technologically savvy users, a good deal of this information will likely be unfamiliar and of interest.
You will learn:
· Ethical issues in the use of electronic communication with patients.
· Common security vulnerabilities in electronic communication with patients.
· Secure software solutions for maintaining privacy and security in electronic patient communication.
Recommended Readings: DeJong, S. M., & Gorrindo, T. (2014). To text or not to text: Applying clinical and professionalism principles to decisions about text messaging with patients. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 713-715. Electronic Frontier Foundation (n.d.). Want a security starter pack? In Security self-defense. Available from: https://ssd.eff.org/en/playlist/want-security-starter-pack. Elhai, J. D., & Frueh, B. C. (in press). Security of electronic mental health communication and record-keeping in the digital age. Journal of Clinical Psychiatry.
Mini Workshop 5
Evidence-Based Treatment of Bipolar Disorder in Youth
Mary A. Fristad, Ohio State University
Basic level of familiarity with the material
Primary Topic: Child
Key Words: Assessment, BPD, Child, Treatment
Until recently, bipolar disorder was rarely diagnosed in youth. Now diagnostic rates have exploded and “bipolar” is the most common diagnosis for psychiatrically hospitalized youth. 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 mini-workshop provides a brief overview of evidence-based assessment of bipolar disorder in youth and summarizes available biological interventions, emphasizing what nonprescribing clinicians need to know about these treatments. The majority of the mini-workshop focuses on how to conceptualize comprehensive care, delineates specific therapeutic techniques, demonstrates examples of their use and describes treatment cases, including challenging aspects of care. Therapeutic techniques taught come from the individual-family and multifamily versions of psychoeducational psychotherapy (IF-PEP, MF-PEP), one of the most promising evidence-based approaches to managing mood disorders in youth. Treatment techniques include: learning about the disorder and its treatment, differentiating the child from the disorder, building emotion-regulation “tool kits,” CBT fundamentals, problem solving, verbal and nonverbal skill enhancement, improving “healthy habits” (sleep hygiene, eating and exercise), navigating the mental health and school systems to build more effective treatment teams, changing maladaptive family patterns, and specific symptom management strategies. This program will utilize lecture format, case presentations, demonstrations, and question-and-answer periods. Often challenging conventional wisdom, the mini-workshop presents new evidence from NIMH grants that can be applied immediately in practice.
You will learn:
· A conceptual model of care.
· Specific therapeutic techniques to treat youth with bipolar disorder.
· Specific therapeutic techniques to implement with parents of youth with bipolar disorder.
Recommended Readings: Fristad, M.A., Goldberg, A., & Leffler, J. (2011). Psychotherapy for children with bipolar and depressive disorders. New York: Guilford Press. Fristad, M.A., & MacPherson, H. (2014). Evidence-based psychosocial treatments for bipolar disorder in youth. Journal of Clinical Child and Adolescent Psychology, 43(3), 339-55 doi: 10.1080/15374416.2013.822309. 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.
Mini Workshop 6
Mastering the Art of Behavioral Chain Analyses in Dialectical Behavior Therapy
Shireen L. Rizvi, Rutgers University
Lorie A. Ritschel, University of North Carolina School of Medicine
Moderate level of familiarity with the material
Primary Topic: Treatment
Key Words: DBT, BPD
DBT is an evidence-based treatment used for individuals with borderline personality disorder (BPD) and other difficulties with emotion dysregulation. At its core, DBT is a behavioral treatment that relies heavily on careful, precise behavioral assessment. The primary method for behavioral assessment in DBT is the “chain analysis”—a moment-by-moment assessment of the events leading up to and following a target behavior (e.g., self-injury).
For myriad reasons, many clinicians have trouble conducting chain analyses. Clients may find them aversive, may respond in a nonlinear fashion, or may fail to remember important components of the chain. Additionally, therapists may have trouble formulating relevant questions, staying on target, and being behaviorally specific. Furthermore, therapists may miss important elements of the chain (e.g., reinforcers) that may explain the repetitive nature of ineffective behaviors. Increasing one’s skill in conducting chain analyses will likely lead to the generation of more effective solutions and, therefore, improved clinical outcomes.
In this mini-workshop, didactic material, clinical examples, and experiential learning exercises will be utilized to help audience members refine their approach to chain analyses. A focus on solutions for problems that arise within the context of conducting chain analyses will be emphasized and ways to minimize these problems from reoccurring will be offered.
This mini-workshop is designed for clinicians with some direct clinical experience conducting DBT; basic DBT principles will not be reviewed.
You will learn:
· How to identify obstacles that interfere with problem definition and procedures in chain analyses.
· How to conceptualize and define antecedents and consequences associated with ineffective behaviors (e.g., self-injury) from a behavioral standpoint.
· How to generate and implement solution analyses to remediate ineffective behaviors.
Recommended Readings: Linehan, M.M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York: Guilford Press. Rizvi, S.L., & Ritschel, L.A. (2014). Mastering the art of chain analysis in Dialectical Behavior Therapy. Cognitive and Behavioral Practice, 21, 335-349.
Mini Workshop 7
Towards the Provision of Culturally Competent Couple Therapy: Clinical Considerations When Working With Same-Sex Couples
Brian Buzzella, VA San Diego Healthcare System
Sarah Whitton, University of Cincinnati
Shelby Scott, University of Denver
Basic
Primary Topic: G/L/B/T
Key Words: Lesbian, Gay, Bisexual, Same-Sex, Couples, Couple Therapy
While same- and opposite-sex couples generally report similar relationship quality, satisfaction, and communication patterns, these couples also present with meaningful differences. For instance, same-sex couples may be more egalitarian in division of household tasks and female same-sex couples may be especially good at resolving conflict. Same-sex couples exist within a cultural context that places unique stresses on their relationships, including the need to carefully consider when and to whom to “come out” to in order to balance access to support and exposure to stigma. Additionally, same-sex couples have fewer community-wide relationship standards and may need to actively evaluate preferred relationship formats within the context of an ongoing relationship. These stressors can tax a couple’s resources and have been associated with heightened risk for relationship dissolution.
Given a cultural history of discrimination, same-sex couples may be cautious when pursuing relationship services, wishing to evaluate whether a given provider is culturally competent, knowledgeable, and affirming towards same-sex relationships. Unintended microaggressions may increase same-sex couples’ unease.
This mini-workshop will have two major goals: (a) to educate practitioners about same-sex couples, emphasizing the unique challenges and differences faced by this population; and (b) to provide practical advice for how to work with same-sex couples in a culturally competent way. Practitioners will learn strategies for creating gay-affirming couple therapy spaces, including how to sensitively respond to the needs of same-sex couples. Practices to be discussed include wording of professional materials, framing of relational challenges, and adaptions to evidence-based practice to meet the needs of same-sex couples.