Institutes are designed for clinical practitioners and include discussions and displays of specific intervention techniques. Participants in the full-day Institutes can earn 7 CE credits; participants in half-day Institutes earn 5 hours of CE.
A Comprehensive Treatment Program for Clients With Anger Disorders
Raymond DiGiuseppe, St. John's University and The Albert Ellis Institute
Basic to moderate level of familiarity with the material
Anger is a primary emotion that in excess can be extremely dysfunctional, impairing relationships, work, and health. This presentation proposes a model for understanding anger as a clinical problem and a taxonomy for understanding anger disorders. This model can guide assessment, diagnosis, and treatments. Data from a large sample of clients who present with anger problems support the taxonomy of anger clients. Assessment strategies will be taught that identify which dysfunctional aspects of anger require intervention in individualized clients. A review of the outcome literature of anger treatments will provide the basis of treatment planning. The model involves the individualization of treatments based on a behavioral analysis of the individuals triggering provocations, response, and the function of the anger. The development of treatment plans from assessment data will lead to the use of motivational enhancement, relaxation, skill replacement training, cognitive restructuring, exposure interventions, and systemic strategies into the treatment plans.
You will learn:
To conduct a comprehensive assessment of dysfunctional anger that will lead to a successful treatment plan;
To implement motivational enhancement and other strategies to develop a successful therapeutic alliance with angry clients;
To implement cognitive, skills development, exposure, and systemic interventions with angry clients.
Recommended Readings: Brondolo, E., DiGiuseppe, R., & Tafrate, R. C. (1997). Exposure-based treatment for anger problems: Focus on the feeling. Cognitive and Behavioral Practice, 4, 75-98. o Deffenbacher, J. L., Oetting, E. R., & DiGiuseppe, R. A. (2002). Principles of empirically supported interventions applied to anger management. The Counseling Psychologist, 30, 262-280. o DiGiuseppe, R., & Tafrate, R. C. (2003). Anger treatment for adults: A meta-analytic review. Clinical Psychology: Science and Practice, 10, 70-84. o DiGiuseppe, R., & Tafrate, R. C. (2007). Understanding anger disorders. New York: Oxford University Press.
Working With Bipolar Disorder in Children and Adolescents: Clinical Presentation, Assessment Strategies, and Treatment
Eric A. Youngstrom, University of North Carolina at Chapel Hill
Moderate level of familiarity with the material
Until recently, bipolar disorder was rarely diagnosed in youths. Now the rate of diagnosis has exploded more than 40-fold in the last 15 years, with "bipolar" becoming the most common diagnosis for psychiatrically hospitalized youths. There is great concern that bipolar disorder is being overdiagnosed and overmedicated in children. Fortunately, there has been a surge of evidence about the validity of the bipolar diagnosis in youths, along with better evidence-based tools for assessment, diagnosis, and treatment. This Institute discusses key clinical issues, including: how bipolar disorder manifests clinically, how it appears similar or different in children versus adults, how to use specialized self-report and parent-report measures to aid in differential diagnosis, and how to use CBT to address the specific needs of children and adolescents dealing with bipolar disorder. Often challenging conventional wisdom, the institute presents evidence that can be applied immediately in practice.
You will learn:
The similarities and differences between the typical presentation of bipolar disorder in children and the classic adult presentation;
What assessment procedures are available to aid in differential diagnosis and measuring response to treatment, and what the evidence base is that supports them;
Which symptoms and risk factors are helpful in recognizing bipolar disorder, and which may be "red herrings";
How often bipolar disorder might be occurring in children and adolescents in different settings, such as public schools, outpatient services, forensic settings, and inpatient units;
A framework for applying cognitive behavioral techniques with adolescents who have bipolar disorder, including specific techniques for in session.
Recommended Readings: Kowatch, R. A., Fristad, M. A., Birmaher, B., Wagner, K. D., Findling, R. L., & Hellander, M. (2005). Treatment guidelines for children and adolescents with bipolar disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 213-235. o Youngstrom, E. A. (in press). Definitional issues in bipolar disorder across the life cycle. Clinical Psychology: Science and Practice [Special issue: Bipolar disorder (Edited by E. Youngstrom & P. Kendall)]. o Youngstrom, E. A., Birmaher, B., & Findling, R. L. (2008). Pediatric bipolar disorder: Validity, phenomenology, and recommendations for diagnosis Bipolar Disorders, 10, 194-214. o Youngstrom, E. A., Freeman, A. J., & Jenkins, M. M. (2009). The assessment of bipolar disorder in children and adolescents. Psychiatric Clinics of North America, 18, 353-390.
CBT for Trichotillomania and Other Body-Focused Repetitive Behaviors
Martin Franklin, University of Pennsylvania School of Medicine
Douglas W. Woods, University of Wisconsin, Milwaukee
All levels of familiarity with the material
Recent studies have documented the significant functional impairment and comorbidity associated with trichotillomania (TTM) and other "body-focused repetitive behaviors" (BFRBs). In the proposed institute, Drs. Franklin and Woods will describe a cognitive-behavioral conceptualization of TTM applicable to children, adolescents, and adults, and will present on treatment strategies that flow directly from this empirically informed conceptualization. Individuals who attend the workshop will: (a) develop a working knowledge of these disorders and their underlying etiology, (b) become familiar with the state-of-the-art methods of assessing the disorders, and (c) become familiar with the treatment outcome literature and with the specific techniques used to treat the disorders. Various instructional methods will be employed including didactic instructions, videotaped samples of actual treatment in both youths and adults, and role-play demonstrations. Ample opportunity will be allowed for discussion of audience members' own clinical cases and conceptual questions.
You will learn:
About the current empirical literature on TTM, BFRBs, and their treatment across the developmental spectrum in order to provide patients with sufficient information to guide treatment choice;
To design and implement a CBT plan according to current conceptualizations of TTM and BFRBs;
To devise strategies to address specific difficulties likely to arise in treating TTM and BFRBs, such as motivational problems, affect dysregulation, and family factors that may exacerbate symptoms and require clinical attention.
Recommended Readings: Franklin, M. E., Flessner, C. A., Woods, D. W., Keuthen, N. J., Piacentini, J. C., Moore, P. S., Stein, D. J., Cohen, S., Wilson, M., & The Trichotillomania Learning Center Scientific Advisory Board. (2008). The Child and Adolescent Trichotillomania Impact Project (CA-TIP): Exploring descriptive psychopathology, functional impairment, comorbidity, and treatment utilization. Journal of Developmental and Behavioral Pediatrics, 29, 493-500. o Franklin, M. E., & Tolin, D. F. (2007). Treating trichotillomania: Cognitive behavioral therapy for hair pulling and related problems. New York: Springer. o Tolin, D. F., Franklin, M. E., Diefenbach, G. J., Anderson, E., & Meunier, S. A. (2007). Pediatric trichotillomania: Descriptive psychopathology and an open trial of cognitive-behavioral therapy. Cognitive Behaviour Therapy, 36, 129-144. o Woods, D. W., Flessner, C. A., Franklin, M. E., Keuthen, N. J., Goodwin, R., Stein, D. J., Walther, M., & Trichotillomania Scientific Advisory Board. (2006). The Trichotillomania Impact Project (TIP): Exploring phenomenology, functional impairment, and treatment utilization. Journal of Clinical Psychiatry, 67, 1877-1888. o Woods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006). A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania. Behaviour Research and Therapy, 44, 639-656.
Dialectical Behavior Therapy With Couples, Parents, and Families
Alan E. Fruzzetti, University of Nevada, Reno
Jill S. Compton, Duke University Medical Center
Basic level of familiarity with the material
DBT has been shown in dozens of studies to reduce self-harm and other problems associated with emotion dysregulation. DBT has been adapted for use with couples, parents, and families. In these interventions the focus is on how partners and parents can be engaged to help a family member reduce severe dysfunctional behavior, and on how to improve family relationships in general. This Institute will introduce the concepts, strategies, and skills used to work with families from a DBT perspective. After a brief orientation to the treatment model, lectures, role-plays, experiential exercises, and video will be used to demonstrate how to (a) build a treatment target hierarchy with families (including self-harm, aggression, relationship problems); (b) use traditional DBT skills and new DBT family skills; (c) apply chain analyses with two or more family members simultaneously; and (d) integrate acceptance and change strategies (and skills) into solutions.
You will learn:
To utilize a transactional model that explains the role of emotion dysregulation in couple and family distress;
To use DBT family intervention strategies with parents or partners of someone who engages in self-harm or other severely dysfunctional behaviors;
To apply specific DBT skills that can be used in family interventions (e.g., relationship mindfulness, accurate expression, validation).
Recommended Readings: Fruzzetti, A. E. (2006). The high conflict couple: A dialectical behavior therapy guide to finding peace, intimacy, and validation. Oakland, CA: New Harbinger. o Fruzzetti, A. E., & Fantozzi, B. (2008). The treatment of borderline personality and related disorders. In A. Gurman (Ed.), Clinical handbook of couple therapy (4th ed., pp. 567-590). New York: Guilford Press. o Fruzzetti, A. E., Santisteban, D. A., & Hoffman, P.D. (2007). Dialectical Behavior Therapy with families. In L. A. Dimeff & K. Koerner (Eds.), Dialectical behavior therapy in clinical practice: Applications across disorders and settings (pp. 222-244). New York: Guilford Press. o Linehan, M. (1993b). Skills training manual for treating borderline personality disorder. New York: Guilford Press.
An Acceptance-Based Behavioral Therapy Approach to Treating Generalized Anxiety Disorder and Comorbid Disorders
Susan M. Orsillo, Suffolk University
Lizabeth Roemer, University of Massachusetts at Boston
Moderate level of familiarity with the material
Generalized anxiety disorder is one of the least successfully treated of the anxiety disorders, yet it is associated with significant economic and human burden. This Institute will offer clinicians methods and strategies (drawn from Acceptance and Commitment Therapy, Mindfulness-Based Cognitive Therapy, and Dialectical Behavior Therapy) that can be used to target the experiential/emotional avoidance that is characteristic of GAD and to encourage clients to mindfully engage in their lives. Case examples and exercises will illustrate the central elements of the treatment as well as considerations and challenges in successfully implementing them with clients. Outcome data from our recently completed RCT will also be presented.
You will learn:
How to conceptualize the presenting problems of those with GAD as experiential avoidance;
How to develop a treatment plan based on an acceptance-based behavioral model;
How to utilize specific mindfulness and other acceptance-based methods to target avoidance;
How to apply methods aimed at increasing choice, flexibility, and a sense of fulfillment in the lives of your clients.
Recommended Readings: Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press. o Orsillo, S. M., & Roemer, L. (Eds.). (2005). Acceptance- and mindfulness-based approaches to anxiety: Conceptualization and treatment. New York: Springer. o Roemer, L., & Orsillo, S. M. (2009). Mindfulness- and acceptance-based behavioral therapies in practice. New York: Guilford Press. o Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.
Advanced Case Conceptualization Skills in Cognitive Processing Therapy for PTSD
Patricia A. Resick, National Center for PTSD and Boston University
Candice M. Monson, National Center for PTSD and Boston University School of Medicine
High level of familiarity with the material
The purpose of this Institute is to provide advanced training in the implementation of cognitive processing therapy (CPT) for PTSD and related comorbid disorders. Please attend this session only if you have implemented CPT with trauma victims prior to attendance. The CPT protocol will be reviewed in only a cursory manner, and participants are asked to review the protocol prior to attending. We will focus on critical thinking, case conceptualization, strategies for improving therapists' use of trauma-specific Socratic dialogue, and issues of chronic avoidance and treatment nonadherence. Attention will be paid to selection of which trauma to process first and what to do when clients cling tenaciously to their guilt and self-blame. Implementation across different types of trauma and different formats for delivery will be discussed. Objectives of the workshop are to assist participants in implementing CPT effectively, to consider complex cases, and to advance participants' trauma-focused cognitive therapy skills.
You will learn:
How to overcome treatment-interfering behaviors (e.g., problems in attendance, not completing homework) to improve the efficacy of CPT;
How to think through the logic to follow in Socratic dialogue for challenging beliefs;
Who should attend? Clinical psychologists or other mental health professionals who work with trauma survivors with PTSD and who have received basic training in CPT.
Recommended Readings: Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting & Clinical Psychology, 74, 898-907. o Resick, P. A., Galovski, T. E., Uhlmansiek, M. O., Scher, C. D., Clum, G. A., & Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243-258. o Resick, P. A., Monson, C. M., & Chard, K. M. (2007). Cognitive processing therapy: Veteran/military version. Washington, DC: Department of Veterans' Affairs. [Email Patricia.Resick@va.gov for a copy.] o Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitive processing therapy, prolonged exposure and a waiting condition for the treatment of posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867-879.
Mindfulness-Based Cognitive Therapy and Prevention of Relapse in Major Depression
Zindel V. Segal, University of Toronto
Mark A. Lau, University of British Columbia
All levels of familiarity with the material
This Institute will be an interactive learning experience combining didactic instruction with experiential exercises to teach the key aspects of Mindfulness-Based Cognitive Therapy (MBCT). MBCT is a group intervention integrating CBT for depression with mindfulness meditation to teach formerly depressed patients new skills to help prevent relapse/recurrence. Key themes include experiential learning and the development of an open and acceptant mode of response, in which one intentionally faces behavioral difficulties and affective discomfort. Increased mindfulness allows early detection of relapse-related patterns of negative thinking, feelings, and body sensations, allowing them to be "nipped in the bud" at a stage when this may be much easier than if such warning signs are not noticed or are ignored. Formulation of specific relapse/recurrence prevention strategies are included in the later stages of treatment. MBCT is now included in the National Institute of Clinical Excellence (NICE) Guidelines in the UK for prevention of recurrent depression.
You will learn:
The link between the development of MBCT and a model of cognitive vulnerability to depression;
About the structure of MBCT and the core therapeutic tasks that accompany each of the group sessions;
Three forms of mindfulness training used in MBCT: the body scan, mindfulness of the breath, and 3-minute breathing space.
Recommended Readings: Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31-40. o Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness Based Cognitive Therapy for depression: A new approach to preventing relapse. New York: Guilford Press. o Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V., Soulsby, J., Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615-623. o Williams, J. M. G., Teasdale, J. D., Segal, Z. V., & Kabat-Zinn. J. (2007). The mindful way through depression: Freeing yourself from chronic unhappiness. New York: Guilford Press.
Functional Analytic Psychotherapy: Maximizing Therapeutic Impact by Using the Client-Therapist Relationship
Mavis Tsai, Independent Practice and University of Washington
Robert J. Kohlenberg, University of Washington
Minimal to moderate level of familiarity with the material
Increase the emotional intensity, interpersonal focus, and impact of your CBT. Functional Analytic Psychotherapy (FAP) employs functional analysis to create deep, meaningful, and healing therapeutic relationships by focusing on the subtle ways clients' daily life problems occur in the therapy session. FAP uses awareness, courage, and love (behaviorally defined) in the therapist-client relationship to produce significant change. Innovations in therapeutic rationales and treatment planning lead clients to go beyond presenting symptoms into their purpose and passion for living. FAP can be applied to a wide range of clinical problems, including: depression, anxiety, intimacy issues, personality disorders, problems of the self, and OCD. This Institute will include videotaped therapy segments, experiential exercises, demonstrations, and client handouts. Considered one of the third-wave cognitive-behavioral therapies, FAP is integrative and provides a conceptual and practical framework that will help super-charge your next therapy session.
You will learn:
How to make clients' learning experiences more powerful by addressing the subtle ways their daily life problems are brought into the session;
Five therapeutic rules to guide treatment plus concrete exercises to increase connection, intensity, and effectiveness in your interventions;
When commonly used interventions can be inadvertently countertherapeutic.
Recommended Readings: Kohlenberg, R. J., Kanter, J. W., Bolling, M. Y., Parker, C., & Tsai, M. (2002). Enhancing cognitive therapy for depression with functional analytic psychotherapy: Treatment guidelines and empirical findings. Cognitive and Behavioral Practice, 9, 213-229. o Kohlenberg, R. J., & Tsai, M. (1994). Functional analytic psychotherapy: A radical behavioral approach to treatment and integration. Journal of Psychotherapy Integration, 4(3), 175-201. o Kohlenberg, R. J., & Vandenberghe, L. (2007). Treatment-resistant OCD, inflated responsibility, and the therapeutic relationship: Two case examples. Psychology and Psychotherapy-Theory Research and Practice, 80, 455-465. o Tsai, M., Kohlenberg, R. J., Kanter, J. W., Kohlenberg, B. S., Follette, W. C., & Callaghan, G. M. (2008). A guide to functional analytic psychotherapy: Awareness, courage, love and behaviorism. New York: Springer.
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