TICKETED SESSIONS | Workshops

There are numerous negative psychosocial outcomes associated with childhood trauma, and difficulties can persist into adulthood. It is essential that children receive effective treatment to alter this negative trajectory. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has the strongest evidence base of any treatment for childhood trauma, and has demonstrated its efficacy in over 14 randomized controlled trials, the gold standard of treatment outcome research. TF-CBT has been widely adopted by clinicians and organizations nationally and internationally for use with children and families impacted by child sexual abuse as well other forms of childhood trauma and/or traumatic loss. There has been an increasing interest in providing TF-CBT in a group format, as group therapy allows clinicians to serve several children and their families at one time in a cost-efficient manner. This workshop will provide a review of TF-CBT along with helpful tips for implementing the model in parallel groups with children and their caregivers. The presenters will demonstrate this group approach in a fun, interactive manner utilizing role-plays and other activities to assist clinicians with implementing the treatment successfully in a group format.

You Will Learn:

• This training will help participants understand the history, development, and research supporting TF-CBT.
• This training will help participants effectively assist children and teens in the aftermath of trauma using TF-CBT in a group format.
• This training will help participants effectively assist caregivers in the aftermath of trauma using TF-CBT in a group format.

Recommended Readings:

Cohen, J., Mannarino, A., & Deblinger, E. (2012). Treating trauma and grief in children and adolescents: A clinical guide New York: Guilford Press.

Deblinger, E., Stauffer, L., & Steer, R. (2001). Comparative efficacies of supportive and cognitive behavioral group therapies for children who were sexually abused and their nonoffending mothers. Child Maltreatment, 6(4), 332-343.

TF-CBTWeb, a free-of-charge online training on the implementation of TF-CBT: www.musc.edu/tfcbt

Interoceptive exposure (IE) is an effective treatment for clients who fear their arousal-related body sensations. Although most often used to treat individuals with panic disorder, IE is a transdiagnostic technique that may be used to target anxiety sensitivity associated with other clinical problems such as PTSD, social anxiety disorder, health anxiety, and specific phobias. Although IE is specifically efficacious in reducing anxiety sensitivity, little is known about how to deliver this procedure in an optimally effective manner. Research from our group suggests that client outcomes vary substantially according to how IE is delivered, and that prolonged and intense IE may be much more effective, yet equally acceptable, compared to the less intense delivery style commonly recommended in popular treatment protocols.

This Workshop will present a prolonged and intense approach to IE that incorporates clinical research findings with an inhibitory learning theory perspective. Attendees will be provided an overview of the principles and procedures of IE, including the process of conducting an IE assessment and selecting specific IE exercises to target idiosyncratic client concerns. We will demonstrate common IE exercises and recommend strategies for optimally delivering these exercises to maximize inhibitory learning. Case examples and video clips of therapy sessions will be used to highlight the clinical use of IE as well as barriers to its optimal delivery. The workshop will be geared toward clinicians with a basic level of experience using exposure therapy and will emphasize specific, practical techniques that can be immediately incorporated into clinical practice.

You Will Learn:

• The theory underlying the optimal use of interoceptive exposure to reduce the fear of anxiety.
• To implement interoceptive exposure, including assessment strategies, treatment planning, and delivering exposure tasks.
• To identify strategies for maximizing patient outcomes by optimizing inhibitory learning in interoceptive exposure.

Recommended Readings:

Deacon, B. J., Kemp, J., Dixon, L. J., Sy. J. T., Farrell, N. R., & Zhang, A. (2013). Maximizing the efficacy of interoceptive exposure by optimizing inhibitory learning: A randomized controlled trial. Behaviour Research and Therapy, 51, 588-596.

Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. (2010). Exposure therapy for anxiety: Principles and practice. New York: Guilford Press.

Craske, M., G., Kitcanski, K., Zelokowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008). Optimizing inhibitory learning during exposure therapy. Behavior Research and Therapy, 46, 5-27.

Despite the success of CBT, a sizable subgroup of individuals with commonly co-occurring disorders such as generalized anxiety disorder and major depressive disorder fail to make sufficient treatment gains, thereby prolonging their deficits in life functioning and satisfaction. These patients often display temperamental features reflecting heightened sensitivity to underlying motivational systems related to threat/safety and reward/loss as well as perseveration (i.e., worry, ruminate) as a way to manage this motivationally relevant distress, often to the detriment of engaging new contextual learning. Using this hypothesized profile as a framework, Emotion Regulation Therapy (ERT) was developed as a theoretically derived, evidence-based treatment integrating principles from traditional and contemporary CBT with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on the motivational responses and corresponding regulatory characteristics of individuals with distress disorders. Initial ERT findings demonstrate considerable evidence for the efficacy as well as for the underlying proposed mechanisms. Attendees will learn to help clients to (a) expand their understanding of anxiety and depression using a motivational and emotion regulation perspective; (b) cultivate mindful awareness and acceptance of sensations, bodily, responses, and conflicting emotions; (c) develop emotion regulation skills that promote a distanced and reframed meta-cognitive perspective; (d) apply these skills during emotion-based exposure to meaningful behavioral actions and associated internal conflicts to taking these actions; and (e) build a plan to maintain gains and take bolder action despite the ending of the therapeutic relationship.

You Will Learn:

• To expand your understanding of anxiety and depression using a motivational and emotion regulation perspective.
• ERT skills designed to promote mindful awareness and emotion regulation.
• How these skills can be used during emotion-based exposure to meaningful behavioral actions and associated internal conflicts to taking these actions.

Recommended Readings:

Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Ritter, M. R. (2013). Emotion regulation therapy for generalized anxiety disorder. Cognitive and Behavioral Practice, 20, 282-300. doi:10.1016/j.cbpra.2013.02.00

Mennin, D. S., & Fresco, D. M. (2013). What, me worry and ruminate about DSM-5 and RDoC?: The importance of targeting negative self-referential processing. Clinical Psychology: Science and Practice, 20, 259-268.

Mennin, D. S., & Fresco, D. M. (2014). Emotion regulation therapy. In J. J. Gross (Ed.), Handbook of emotion regulation (2nd ed., pp. 469-490). New York: Guilford Press.

The movement to integrate behavioral health consultants (BHCs) into primary care is rapidly growing. With the enactment of the Affordable Care Act, more primary care practices will be eager to hire behavioral health consultants. However, traditional clinical psychology training has not adequately prepared psychologists for the role of BHC in primary care and there are limited opportunities to acquire this unique training. BHCs are expected to serve as collaborative consultants to primary care providers, which is often a new role for mental health providers who are used to practicing with relative independence. Additionally, evidence-based treatments developed in specialty mental health settings do not easily translate to primary care where behavioral health treatment is brief, contact is less frequent, sessions are shorter, and the focus is on collaborative care and identifying opportunities to address interacting mental and physical health concerns. This workshop will provide participants with the unique opportunity to learn about primary care behavioral health integration from psychologists who have served as BHCs and conducted treatment research in primary care. Content will include descriptions of the dimensions of integrated care and the responsibilities of the BHC in primary care, suggestions on how to prepare for and manage an initial consultation session, things to consider when developing a treatment plan/recommendations, and strategies for delivering CBT principles in an integrated primary care context. Role-plays and clinical examples will be used as illustrations.

You Will Learn:

• Participants will be able to describe different models of primary care behavioral health integration.
• Participants will be able to explain the role and scope of responsibilities of a behavioral health consultant in primary care.
• Participants will be able to describe ways to deliver CBT principles in an integrated primary care context.

The efficacy of weekly outpatient CBT for children and adolescents with OCD has been well established. However, intensive CBT protocols (i.e., longer, more frequent sessions delivered over a shorter period of time) have been shown to produce similar improvements more quickly. In turn, functional impairments (such as missed school or declining grades, and difficulty participating in social or family activities) may be resolved more rapidly, with less overall developmental disruption. Despite its benefits, there are few programs or practitioners who provide intensive CBT.

This workshop will provide clinicians with the tools needed to implement intensive CBT for children and adolescents with OCD. An individually tailored treatment protocol, including ACT and exposure/response prevention treatment components, will be presented. Specific treatment components include: (a) standard, developmentally appropriate psychoeducation about OCD; (b) cognitive training (e.g., obsessions are "junk mail" messages to be filtered out) and cognitive defusion exercises; (c) development of fear and avoidance hierarchies, informed by standard assessment measures; (d) therapist-assisted exposure/response prevention, including imaginal, in-clinic, and community exposures; (e) planning between-session exposures; and (f) reduction of family accommodation. Issues specific to intensive treatment will be addressed, including how to determine the number and length of sessions needed for each case, which youth are most likely to benefit (considering age, cognitive ability, and severity of OCD), how/when to include parents in the sessions, and how to coordinate with schools and outpatient providers.

You Will Learn:

• The benefits of using intensive versus standard CBT protocols for youth with OCD.
• How to deliver effective CBT within longer and more frequent sessions, with emphasis on developing effective exposure/response prevention plans.
• Which youth are most likely to benefit from intensive CBT for OCD.

Recommended Readings:

Lewin, A.B., Storch, E.A., Merlo, L.J., Adkins, J.W., Murphy, T., & Geffken, G.A. (2005). Cognitive behavioral therapy for pediatric obsessive compulsive disorder: A treatment protocol for mental health providers. Psychological Services, 2(2), 91-104.

The proliferation of disorder-specific treatment manuals has created unintended barriers for implementation and dissemination of evidence-based psychological treatments. Research emerging from the field of emotion science suggests that individuals suffering from anxiety and mood disorders experience negative affect more frequently and more intensely than healthy individuals, and that they tend to view these experiences as more aversive. Deficits in emotion regulation, emerging out of unsuccessful efforts to avoid or dampen the intensity of uncomfortable emotions, have been found to cut across the emotional disorders and have become a core target for therapeutic change. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP; Barlow et al., 2011) is a transdiagnostic, emotion-focused cognitive-behavioral treatment (CBT) that targets deficits in emotion regulation that occur across the neurotic spectrum. This workshop will review the theoretical foundation and empirical evidence supporting the development of transdiagnostic, followed by a description and demonstration of how to apply core UP treatment modules, along with recent developments, including similarities and differences between the UP and traditional CBT for anxiety and mood disorders. Audiovisual and role-play illustrations of core treatment interventions (e.g., mindful awareness, emotion exposures) will be presented, along with detailed case examples involving complex comorbidity. Attendees will be invited to participate in exercises as part of these demonstrations. You Will Learn: How to develop a unified, transdiagnostic case conceptualization for patients presenting with a broad range of emotional disorders. How to apply emotion-focused treatment concepts and strategies (e.g., objective monitoring, emotional awareness training, cognitive reappraisal, reduction of emotional avoidance and maladaptive emotion-driven behaviors) to patients presenting with comorbid emotional disorders. How to design and implement effective emotion exposures, including the latest developments in administering the UP for mood disorders and complex comorbidities such as borderline personality disorder and PTSD.

Recommended Readings:

Barlow, D.H., Farchione, T.J., Fairholme, C.P., Ellard, K.K., Boisseau, C.L., Allen, L.B., & Ehrenreich-May, J. (2011). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist guide. New York: Oxford University Press.

Farchione, T.J., Fairholme, C.P., Ellard, K.K., Boisseau, C.L., Thompson-Hollands, J., Carl, J.R., Gallagher, M.W. & Barlow, D. H. (2012).The unified protocol for the transdiagnostic treatment of emotional disorders: A randomized controlled trial. Behavior Therapy, 43, 666-678.

Payne, L. A., Ellard, K. K., Farchione, T.J., Fairholme, C. P., & Barlow, D. H. (in press). Emotional disorders: A unified transdiagnostic protocol. In D.H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (5th ed.). New York: Guilford Press.

"When life gives you lemons, make lemonade." You've probably heard this phrase so many times that it seems trite, but proverbs like this one point out the importance of being resilient in the face of life's challenges. Therapists know giving advice does not change behavior. So how can a therapist help clients become more resilient in the face of adversity?

This workshop teaches a 4-step model that helps clients build a personal model of resilience (PMR). It is a model that is easily integrated with classic CBT approaches and other evidence-based therapies. Drawing on the principles of strengths-based CBT, five key methods are highlighted: (a) how to identify and integrate strengths into CBT, (b) when and how to introduce resilience, (c) the timing and rationale for therapeutic smiling, (d) use of imagery and metaphor, and (e) the importance of silence for fostering client creativity.

This workshop is loaded with clinical demonstrations, structured participant role-plays, and question-and-answer segments that clarify the theory, rationale, methods, and application of a PMR. Common therapy pitfalls are identified along with recommended alternative approaches.

Participants are strongly encouraged to download and read Padesky and Mooney's 2012 paper before attending the workshop. Greater familiarity with this material will foster increased depth of workshop learning (i.e., the more you know, the more you will learn).

Disclaimer: No actual lemons will be harmed in the course of this workshop.

You Will Learn:

• Identify areas of strengths that relate to resilience
• Practice Socratic methods to elicit client-generated imagery and metaphors of resilience
• Build and apply a personal model of resilience (PMR) to create win-win responses to acute and chronic life challenges

Recommended Readings:

Mooney, K.A., & Padesky, C.A. (2000). Applying client creativity to recurrent problems: Constructing possibilities and tolerating doubt. Journal of Cognitive Psychotherapy, 14(2), 149-161.[available from http://padesky.com/clinical-corner/publications]

Padesky, C. A., & Mooney, K.A. (2012). Strengths-based Cognitive-Behavioural Therapy: A four-step model to build resilience. Clinical Psychology & Psychotherapy, 19 (4), 283-90. [available from http://padesky.com/clinical-corner/publications]

Current trends within the scientific community are shifting away from a symptom-based, disorder-specific approach that prescribes different treatment interventions for separate disorders toward a transdiagnostic perspective that focuses on the common psychological processes (mechanisms) underlying different disorders. However, the continually expanding armamentarium of treatment options often leaves therapists feeling confused and overwhelmed when trying to effectively target patient problems. Largely based on the presenters' forthcoming book (Frank & Davidson, 2014), this workshop offers a transdiagnostic road map as a flexible and practical resource for therapists striving to make sound clinical decisions for their patients in real time across a diverse range of psychological problems. The road map delineates pathways to address the many challenges of assessment and treatment by presenting a transdiagnostic case formulation model that incorporates specific mechanisms derived from the empirical literature, a method for linking those mechanisms with patients' problems, and a step-by-step process to guide clinicians through the treatment process from intake to termination. The most recent transdiagnostic mechanisms (TDMs) from the empirical literature will be reviewed, illustrating their role as underlying vulnerabilities and patterns of responses that are hypothesized to trigger and maintain symptoms and functional impairments across diagnostic categories. Experiential exercises will be included to teach participants how to assess presenting problems for relevant TDMs, develop TDM-driven case formulations, determine mechanism change goals to meet treatment objectives, and utilize a functionally based categorization system of clinical options to target TDMs with individualized treatment plans incorporating second- and third-wave cognitive-behavioral interventions.

You Will Learn:

• To consider specific transdiagnostic mechanisms derived from the empirical literature when developing individualized case formulations.
• Strategies for developing transdiagnostic mechanism hypotheses.
• How to design patient-specific treatment plans by choosing interventions from all three waves of CBT based on their functional utility in targeting identified transdiagnostic mechanisms.

Recommended Readings:

Frank, R. I., & Davidson, J. (2014). A transdiagnostic road map to case formulation and treatment planning: Practical guidance for clinical decision making. Oakland, CA: New Harbinger.

Persons, J. B. (2008). The case formulation approach to cognitive-behavioral therapy. New York: Guilford Press.

ABCT clinicians strive to be scientist-practitioners and to both consume and contribute to the research literature. However, contributing to the research literature while working in a private practice setting is difficult. This training workshop will teach attendees to identify and begin to overcome obstacles to conducting research in their private practice. Participants will set goals for their workshop experience and for implementing what they learn in the workshop in their clinical practice (and will give the presenter permission to collect data to evaluate their progress and to allow her to use those data for research purposes). The workshop will cover ethical issues and how and when to obtain informed consent from patients. Because the foundation of a clinical practice in which research is conducted is a practice in which the clinician collects data at intake and at every therapy session to guide the clinical work, the workshop will also describe procedures and present tools that can be used to conduct a comprehensive intake assessment and to track process and outcome at every session. Attendees will learn to strengthen skills in addressing patient noncompliance with progress monitoring procedures. Finally, workshop participants will select research questions that are feasible for a private practice setting, and identify strategies that will help them write up the project and submit it for a conference presentation and journal publication.

You Will Learn:

• Strategies to address ethical issues that arise when conducting research in a private practice setting.
• Strategies to overcome obstacles to conducting research in your private practice.
• Tools and skills for monitoring your patients' therapy progress at every session.

Recommended Readings:

Hayes, S. C., Barlow, D. H., & Nelson-Grey, R. O. (1999). The scientist-practitioner: Research and accountability in the age of managed care. Boston: Allyn and Bacon. (especially Chapter 9).

Lambert, M. J., Harmon, C., Slade, K., Whipple, J. L., & Hawkins, E. J. (2005). Providing feedback to psychotherapists on their patients' progress: Clinical results and practice suggestions. Journal of Clinical Psychology, 61, 165-174.

Persons, J. B. (2007). Psychotherapists collect data during routine clinical work that can contribute to knowledge about mechanisms of change in psychotherapy. Clinical Psychology: Science and Practice, 14(3), 244-246.

Cognitive-behavioral therapists place substantial emphasis on the use of effective and empirically supported psychotherapy methods. Increasingly, CBT trainers have turned attention to the utilization of scientifically supported instructional methods. This workshop will review empirically verified instructional models and procedures and outline methods for integrating these procedures into CBT training and supervision. A second goal of the workshop is to describe training methods specific to working with diverse trainees. Most training is geared toward the traditional psychotherapist practicing in a traditional outpatient setting. The current demand for training in CBT is in more diverse groups. Training methods and strategies must be modified in accordance with the trainee's level of psychotherapy experience and work setting. Frequently encountered training issues and alternative approaches will be described in this workshop to increase the effectiveness of training in a variety of environments. You Will Learn: Specific techniques for training providers in CBT that employ principles of adult learning. How to adapt your training methods by trainee discipline and treatment delivery setting. Evidence-based supervisory methods. Recommended Readings: Fairburn, C.G., & Cooper, Z. (2011). Therapist competence, therapy quality, and therapist training. Behavior Research and Therapy, 49(6-7), 373-378. Sudak, D.M., Codd, R.T., Sokol, L., Gittes-Fox, M., Ludgate, J., Reiser, R., & Milne, D. (2014). Teaching and supervising cognitive-behavioral therapy. Manuscript submitted for publication. [Expected publication date October, Wiley.]

Acceptance and Commitment Therapy (ACT) is a principle-based behavioral intervention that is designed to address human suffering in a mindful and compassionate way. While ACT has been applied to a wide variety of problems, it is well suited to the treatment of trauma and is a promising intervention when considering different treatment avenues with multidiagnosed and challenging cases. The painful emotional experience and aftermath of trauma and the disorderly experiences of life can often lead individuals to view themselves as "damaged" or "broken" in important ways. The difficult emotions and thoughts associated with trauma are linked to a variety of behavioral problems ranging from substance abuse to relationship problems to social problems. ACT seeks to reduce rigid and inflexible attempts to control negative and difficult emotions by fostering acceptance through mindfulness and defusion techniques. The ultimate goal is psychological and behavioral flexibility in the service of a more workable and values-based life-a way of making order out of a disorderly world.

You Will Learn:

• How maladaptive avoidance of internal experiences is associated with many problems in life functioning.
• How human language participates in suffering and affects our relationship with private internal experiences.
• The six core competencies of ACT and how they are used in treatment of trauma.

Recommended Readings:

Luoma, J., Hayes, S. C., & Walser, R. D. (2007). Learning acceptance and commitment therapy: A skills training manual for therapists. Oakland, CA: New Harbinger.

Scarlet, J., Lang, A. J., Walser, R. D. (in press). Acceptance and Commitment Therapy (ACT) for Posttraumatic Stress Disorder. In G. Wynn & D. Benedek (Eds.), Complementary and alternative medicine for PTSD. New York: Oxford University Press.

Walser, R. D., & Westrup, D. (2007). Acceptance and commitment therapy for the treatment of post-traumatic stress disorder and trauma-related problems. Oakland, CA: New Harbinger.

Cognitive Behavioral Social Skills Training (CBSST) is a psychosocial rehabilitation intervention for consumers with schizophrenia or other forms of serious mental illness. In CBSST, consumers set very specific recovery goals related to living, learning, working, and socializing in their community of choice, and then learn cognitive, communication, and problem-solving skills to help them achieve these goals. CBSST can be delivered as a group therapy, individual therapy, or in the context of case management (e.g., assertive community treatment), and can be adapted for specific populations (e.g., addictions; geriatric consumers). This is a practical workshop that will provide a basic overview of the evidence-based cognitive behavior therapy (CBT), social skills training (SST), and problem-solving training interventions used in CBSST. A skills-based CBT approach is used to teach consumers how to catch, check, and change ("the 3C's") inaccurate dysfunctional thoughts that interfere with goal-directed activities, including defeatist expectancies ("It won't be fun"), low self-efficacy beliefs ("I can't do it"), and anomalous beliefs ("Spirits will harm me if I go out"). SST is used to teach communication skills to improve assertive engagement in interpersonal interactions, and problem-solving skills facilitate recovery goal achievement and combat negative symptoms and depression. The primary goal of this workshop is to provide novice to intermediate providers with a foundation in CBSST and practical clinical guidance on delivering the three CBSST modules.

You Will Learn:

• Develop a basic understanding of CBT and SST principles and methods for serious mental illness.
• Discuss current research supporting the efficacy of CBT and SST for consumers with schizophrenia.
• Choose appropriate CBSST treatment techniques to meet the unique needs of different consumers.

Recommended Readings:

Bellack, A.S., Mueser, K.T., Gingerich, S., & Agresta, J. (2004). Social skills training for schizophrenia: A step-by-step guide (2nd ed.). New York: Guilford Press.

Granholm, E., McQuaid, J.R., & Holden, J. (in press). Cognitive behavioral social skills training (CBSST): A practical guide and consumer workbook. New York: Guilford Press.

Kingdon, D.G., & Turkington, D. (2005). Cognitive therapy of schizophrenia. New York: Guilford Press.

This workshop is designed to offer practitioners a base understanding of the available options in mobile technologies and to provide real-world examples using both a range of available therapy/monitoring-specific applications as well as the features inherent in most smartphones as adjunctive tools. The core of this workshop will focus on the specific tools available to practitioners to enhance their existing therapeutic techniques. Specifically, the workshop will provide the following: (a) the current research on mobile interventions, including its current strengths and limitations; (b) privacy rules and ethical practices when integrating mobile technologies into care; (c) a review of consent procedures when integrating digital technologies into care and the risks involved in integration; (d) the features inherent in smartphones that can be used to enhance services and available programs to utilize these features; (e) available applications and devices, including those that target self-monitoring and diary, mindfulness and meditation, activity and physiological feedback, cognitive restructuring and multi-target specialty applications (e.g., self-harm) and; (f) future developments and directions in mobile health. This workshop is a collaboration of members from the Technology and Behavior Change SIG. You Will Learn: Privacy, consent, and ethical regulations when using mobile phone applications for therapy. Smartphone features that can enhance current therapeutic techniques. How a variety of mobile and wearable applications can improve your practice (e.g. daily diary and progress tracking).

Recommended Readings:

Aguilera, A. & Muench, F. (2012). There's an app for that: Information technology applications for cognitive behavioral practitioners. the Behavior Therapist, 35(4), 65-73.

Miller G. (2012). The smartphone psychology manifesto. Perspectives on Psychological Science, 7(3), 221-237.

Price, M., Yuen, E. K., Goetter, E. M., Herbert, J. D., Forman, E. M., Acierno, R., & Ruggiero, K. J. (in press). mHealth: A mechanism to deliver more accessible, more effective mental health care. Clinical Psychology & Psychotherapy.