Workshop 1
Awareness and Connection in Ethnically and Racially Diverse Therapist-Client Dyads
Monnica Williams, University of Louisville
Chad T. Wetterneck, Rogers Memorial Hospital
Basic level of familiarity with the material
Primary Topic: Ethnic, Cultural, Diversity
Key Words: Cultural Differences, Diversity, Therapeutic Alliance
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Given the increasing diversity of clients seeking CBT, there is a growing need to enhance the cultural sensitivity of therapeutic interventions with ethnoracial minority populations. This workshop will provide clinical perspectives on how to incorporate cultural factors into CBT. The presenters will discuss strategies for making treatment more relevant when working with underserved and marginalized populations. An assessment of functional and nonfunctional behaviors of both therapists and clients will be examined from the behaviorally based Functional Analytic Psychotherapy (FAP) perspective. Additionally, presenters will address how certain therapies can be adapted when working with clients with diverse backgrounds, particularly as many empirically supported interventions were developed among relatively homogeneous research populations. Topics will include: strategies to build alliances across diverse therapeutic dyads; modifications to psychoeducation to include the role of racism and discrimination; identifying ethnoracial biases of the therapist; and how to identify and prevent committing microaggressions against clients, which can rupture the therapeutic alliance (and how to repair them if you do). This workshop will include demonstrations and opportunities will be provided for participants to ask questions and discuss cases.
You Will Learn:
- 1. How to build a strong therapeutic alliance with clients who are ethnoracially different than the therapist.
- 2. How to address and integrate cultural issues in therapy.
- 3. How to identify and avoid microaggressions against clients.
Recommended Readings:
Sue, D. W., Capodilupo, C., Torino, G., Bucceri, J., Holder, A., Nadal, K., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271-286. Terwilliger, J. M., Bach, N., Bryan, C., & Williams, M. T. (2013). Multicultural versus colorblind ideology: Implications for mental health and counseling. In A. Di Fabio (Ed.), Psychology of counseling. Hauppauge, NY: Nova Science Publishers. Vandenberghe, L., Tsai, M., Valero, L., Ferro, R., Kerbauy, R. R., Wielenska, R. C., . . . Muto, T. (2010). Transcultural Functional Analytic Psychotherapy. In Kanter et al. (Eds.), The practice of functional analytic psychotherapy. New York: Springer.
Workshop 2
A Manualized Cognitive-Behavioral Therapy Group for Treating Diverse Addictive Behaviors
Bruce S. Liese, University of Kansas Medical Center
Moderate level of familiarity with the material
Primary Topic: Addictive Behaviors
Key Words: Addictive Behaviors, Group CBT, Substance Use Disorders, Addiction Syndrome, Behavioral Addictions
Over the past few decades an increasing amount of research has focused on behavioral addictions, and in 2013 the American Psychiatric Association introduced the term "behavioral addictions" into its Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for the first time. Individual and group cognitive-behavioral therapies continue to be the most empirically supported treatments for addictive behaviors, and group therapy continues to be the most common modality used to treat addictive behaviors, likely due to its cost-effectiveness.
Over the past 20 years we have developed the cognitive-behavioral therapy addictions group (CBTAG). The following are basic characteristics of this group: (1) it includes members with diverse addictions to drugs, alcohol, nicotine, and gambling at all stages of readiness to change; (2) groups are open and new members may enter on a rolling basis; (3) sessions are active, structured, educational, and supportive; (4) groups range from 4 to 8 members and sessions last 90 minutes; (5) group facilitators use a combination of guided discovery and didactics adapted to group members' presenting problems; (6) goals include modification of addictive behaviors and development of coping strategies.
Various educational methods will be used in this workshop. Some material will be presented in lecture format and participants will be encouraged to ask questions and discuss this material throughout the workshop. Case examples will be provided to illustrate group content and process. Attention will be paid to common challenges in facilitating such a group. Role-play demonstrations will be used to directly teach participants how to conduct the CBTAG.
You Will Learn:
- 1. How to design and facilitate a CBTAG, including structure, content, essential components, and facilitative conditions that optimize the group therapy experience.
- 2. How to conceptualize individuals with diverse chemical and behavioral addictive behaviors and associated problems according to a CBT framework, as part of the treatment process in the CBTAG.
- 3. Effective strategies for anticipating and addressing challenging group members and group processes.
Recommended Readings:
Liese, B.S. (2014). Cognitive-behavioral therapy for addictions. In S.L.A. Straussner (Ed.), Clinical work with substance abusing clients (3rd ed., pp. 225-250). New York: Guilford Press. Shaffer, H. J., LaPlante, D. A., & Nelson, S. E. (Eds.). (2012). APA Addiction syndrome handbook: Volumes 1 and 2. Washington, DC: American Psychological Association. Wenzel, A., Liese, B.S., Beck, A.T., & Friedman-Wheeler D.G. (2012). Group cognitive therapy of addictions. New York: Guilford Press.
Workshop 3
Introduction to the Unified Protocol for Transdiagnostic Treatment for Emotional Disorders
Todd J. Farchione, Center for Anxiety and Related Disorders, Boston University
Matthew W. Gallagher, VA Boston Healthcare System
Introductory level of familiarity with the material
Primary Topic: Treatment-Transdiagnostic
Key Words: Anxiety, Depression, CBT, Transdiagnostic
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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 mechanism-focused transdiagnostic treatment that purports to address underlying vulnerabilities (neuroticism: negative emotionality and distress aversion) for common mental disorders rather than focusing on diagnostic symptoms. This allows the UP to simultaneously address comorbid conditions and by providing a treatment that more adequately maps on to real-word patient presentations, the UP may be more acceptable to clinicians in community settings. This workshop will (a) provide a brief overview of the theoretical foundation and empirical evidence supporting the development of the UP; (b) introduce attendees to the protocol's core treatment components; and, using illustrative case example, (c) explore how these components can best be applied to clinical practice.
You Will Learn:
- 1. The potential advantages associated with a transdiagnostic approach to treatment, relative to using a cognitive-behavioral protocol designed to address the symptoms of a single disorder.
- 2. The primary treatment components of the UP.
- 3. How the core UP treatment elements can be applied across diagnoses and to address comorbidity.
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. (2014). 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.
Workshop 4
Applying Evidence-Based Assessment to Bipolar Disorder: Assessing Quickly and Accurately to Reach Better Outcomes
Eric A. Youngstrom, University of North Carolina at Chapel Hill
Moderate level of familiarity with the material
Primary Topic: Child
Key Words: Assessment, BPD, Child, Treatment
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Although Kraepelin described cases of prepubertal onset of manic syndromes a century ago, and case reports appeared in subsequent decades, the modern study of bipolar disorder in children and adolescents is only 20 years old. The knowledge base has increased exponentially since then. PubMed now has more than 8,500 articles indexed about pediatric bipolar disorder (PBD), and the pace of publication continues to accelerate. This workshop distills the explosion of new data into concrete action steps that a clinician can use immediately. Several recent meta-analyses have compiled the research evidence into quantitative summaries and clinically actionable recommendations. In 2011, Van Meter et al. meta-analyzed 12 epidemiological studies (from 1,500 reviewed hits) about rates of bipolar I and bipolar spectrum disorders in youths; though six studies have been published since, general conclusions remain similar. Likewise, Kowatch et al. (2005) published a preliminary meta-analysis of phenomenological features in pediatric bipolar disorder; now the available samples more than double the number of cases with research diagnoses of bipolar disorder included. Similar progress has been made in terms of assessment, where a meta-analysis started with 4,094 hits and finished with 27 studies, 63 effect sizes, N = 10,232 youths, of whom 1,719 had PBD diagnoses, including parent, youth, and teacher report. We integrate these findings into a set of clinical recommendations for evidence-based assessment for PBD. These steps add less than 5 minutes and less than 5 dollars to the typical assessment, yet yield large gains in accuracy, more agreement about next clinical action, and better outcomes.
You Will Learn:
- 1. Base rates in different settings, such as public schools, outpatient services, forensic settings, and inpatient units, and how to use these benchmarks to evaluate efficiently.
- 2. Assessment procedures to aid in differential diagnosis and measuring response to treatment.
- 3. New methods for interpreting test results, including methods that take into account the clinical setting.
Recommended Readings:
Youngstrom, E.A. (2013). Future directions in psychological assessment: Combining evidence based medicine innovations with psychology's historical strengths to enhance utility. Journal of Clinical Child and Adolescent Psychology, 42, 139-159. doi: 10.1080/15374416.2012.736358. Youngstrom, E.A., Choukas-Bradley, S., Calhoun, C.D., & Jensen-Doss, A. (2015). Clinical guide to the evidence-based assessment approach to diagnosis and treatment. Cognitive and Behavioral Practice, XX, 20-35. doi: 10.1016/j.cbpra.2013.12.005. Youngstrom, E.A., & Frazier, T.W. (2013). Strategies for evidence-based assessment in children and adolescents: Measuring prediction, prescription, and process. In D. Miklowitz, W. E. Craighead, & L. Craighead (Eds.), Psychopathology: History, diagnosis, and empirical foundations (2nd ed., pp. 36-79). New York: Wiley. Youngstrom, E.A., & Perez Algorta, G. (2014). Pediatric bipolar disorder. In E. Mash & R. Barkley (Eds.), Child psychopathology (3rd ed., pp. 264-316). New York: Guilford Press.
Workshop 5
Recovery-Oriented Cognitive Therapy: An Evidence-Based Program to Promote Successful Goal-Achievement and Resilience for Individuals With Schizophrenia, in and out of the Hospital
Paul Grant, University of Pennsylvania
Aaron Brinen, University of Pennsylvania
Aaron T. Beck, Perelman School of Medicine, University of Pennsylvania
Basic level of familiarity with the material
Primary Topic: Chronic Mental Illness/Schizophrenia
Key Words: Recovery, Schizophrenia, Community Integration
Low-functioning individuals with schizophrenia experience a profound sense of apartness and deprivation. Problems that hinder these individuals from participating in the community include negative symptoms, hallucinations, grandiose beliefs, disorganized behavior, and aggressive actions towards others. Within an evidence-based, recovery-oriented framework, instructors will show how to apply the cognitive model, adapted to individuals with schizophrenia, to understand and overcome these challenging problems. Instructors will demonstrate specific procedures to: (a) evoke obscured strengths and capacities, (b) energize aspirations for the future, (c) identify promising targets of future-oriented action, (iv) promote positive action toward those targets. By focusing resources in meaningful activities in the real world, the individuals experience success and a sense of belonging. They can substitute the external world for the internal world, and draw new, more helpful conclusions about themselves and others. The workshop features role-plays, presentation of video and audio, and will be relevant to hospital and community service providers.
You Will Learn:
- 1. Specific procedures to establish connection with individuals who are isolated, demoralized, disorganized, and traditionally difficult to engage.
- 2. How to identify behavioral targets that will promote motivation and presage a series of nested success experiences (recovery operationalized).
- 3. How to use a cognitive conceptualization to design interventions to change beliefs and promote long-term change and progress toward recovery.
Recommended Readings:
Beck, A.T., Rector, N., Stolar, N.M., & Grant, P.M. (2009). Schizophrenia: Cognitive theory, research, and therapy. New York: Guilford. Grant, P.M., Huh, G.A., Perivoliotis, D., Stolar, N.M., & Beck, A.T. (2012). Randomized trial to evaluate the efficacy of cognitive therapy for low-functioning patients with schizophrenia. Archives of General Psychiatry, 69(2), 121-127. doi: 10.1001/archgenpsychiatry.2011.129. Chang, N., Grant, P.M., Luther, L., & Beck, A.T (2014). Effects of a recovery-oriented cognitive therapy training program on inpatient staff attitudes and incidents of seclusion and restraint. Community Mental Health Journal, 50, 415-421. doi: 10.1007/s10597-013-9675-6
Workshop 6
Cognitive Behavioral Therapy for Mental Contamination
Roz Shafran, UCL Institute of Child Health
Maureen Whittal, Vancouver CBT Centre
Advanced level of familiarity with the material
Primary Topic: OC and Related Disorders
Key Words: Mental Contamination, Behavioral Experiments, Treatment Development
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Treatment outcomes for OCD have plateaued over the past 20 years. This problem has led to a call for adaptations to the gold-standard treatment and conceptualizations of the problem. Recent work on mental contamination is one such adaptation. Fears of contamination and washing are one of the most common OCD presentations and are reported by one-third of patients. Until recently the focus has been on illness-based fears triggered by physical contact with a threatening object such as a doorknob or money or the ground. There is increasing focus on the understanding and treatment of contamination fears that arise in the absence of any physical contact with a stimulus. Such "mental contamination," the feeling of being polluted, dirtied, infected, or endangered in the absence of a physical contaminant, has been found to effect just under half of people with OCD. Mental contamination is often associated with betrayal or humiliation and the individual perceives him- or herself as uniquely vulnerable. There are particular challenges with conducting exposure and response prevention for mental contamination, including that the source of the contaminant is typically human, the contamination is generated internally (e.g., by memories), and there is often a moral quality. The workshop will focus on the nature, assessment, and treatment of mental contamination using cognitive behavioral methods. The intervention does not involve exposure and response prevention but instead focuses on the meaning of contamination, implications for the self, imagery rescripting, and behavioral experiments. Experimental evidence for the intervention will be presented.
You Will Learn:
- 1. To recognize and assess mental contamination.
- 2. About the relationship between physical and mental contamination.
- 3. How to adapt standard cognitively focused CBT to mental contamination.
Recommended Readings:
Coughtrey, A. E., Shafran, R., Lee, M. J., & Rachman, S. (2013). the treatment of mental contamination: A case series. Cognitive and Behavioral Practice, 20, 221-231. http://dx.doi.org/10.1016/j.cbpra.2012.07.002. Rachman, S., Coughtrey, A., E., Shafran, R., & Radomsky, A. (2014). Oxford Guide to the Treatment of Mental Contamination. New York: Oxford University Press. Shafran, R., Radomsky, A. S., Coughtrey, A.E., & Rachman, S. (2013). Advances in the cognitive behavioural treatment of obsessive compulsive disorder. Cognitive Behaviour Therapy. doi: 10.1080/16506073.2013.773061.
Workshop 7
Translating CBT Principles to the Role of a Behavioral Health Consultant in Integrated Primary Care
Risa B. Weisberg, VA Boston Healthcare System and Brown University
Cara H. Fuchs, Brown University
Basic level of familiarity with the material
Primary Topic: Health Psychology/Behavioral Medicine
Key Words: Integrated Care, Behavioral Health Consultant
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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. Empirically supported cognitive-behavioral 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 discussion 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 and evidence-based care in an integrated primary care context. Experiential exercises and clinical examples will be used as illustrations.
You Will Learn:
- 1. The role and scope of responsibilities of a behavioral health consultant in primary care.
- 2. How to prepare for and conduct the crucial first consult visit, from a CBT perspective.
- 3. Ways to deliver CBT principles in an integrated primary care context.
Workshop 8
Going Digital: Building eHealth and mHealth Interventions
Stephen M. Schueller, Northwestern University
Mark Begale, Northwestern University
David C. Mohr, Northwestern University
Basic level of familiarity with the material
Primary Topic: Other (Technology)
Key Words: Technology, Design, Interventions
eHealth and mHealth interventions are rapidly being developed to promote the goals of behavioral and cognitive therapies. These interventions require cross-disciplinary teams that can understand the conceptual and practical challenges to creating technological interventions and have the skills necessary to move from concept to design to implementation.
This workshop will provide a cross-disciplinary demonstration of the overall development process of eHealth and mHealth applications in academic research settings with presenters including psychologists and a technologist. A model for the development of behavioral intervention technologies will be presented. This model emphasizes adopting perspectives from all involved stakeholders and creating a common language and taxonomy for discussing these interventions with experts from diverse backgrounds. Strategies for design will be covered, including user-centered design and usability testing, pilot and field trials, and single-case designs. Clinical research and technological challenges will be described and exemplified through case studies of eHealth and mHealth technology development projects. Research methodologies specific to the evaluation of eHealth and mHealth interventions will also be discussed.
In order to experience some of the issues that confront clinical researchers in designing and developing behavioral intervention technologies, attendees will participate in the design of an eHealth/mHealth intervention, which will include brainstorming and prototyping their own technology-based intervention, and a simple version will be created during the session.
You Will Learn:
- 1. To describe the process of creating an eHealth/mHealth intervention.
- 2. To use the presented model to help conceptualize the design of eHealth/mHealth interventions.
- 3. Examples of eHealth/mHealth intervention studies.
Recommended Readings:
Ben-Zeev, D., Schueller, S. M., Begale, M., Duffecy, J., Kane, J. D., & Mohr, D. C. (2014). Strategies for mHealth research: Lessons from 3 mobile intervention studies. Administration and Policy in Mental Health and Mental Health Services Research. Advanced Online Publication. doi: 10.1007/s10488-014-0556-2. Mohr, D. C., Schueller, S. M., Montague, E., Burns, M., & Rashidi, P. (2014). The Behavioral Intervention Technology Model: An integrated conceptual and technological framework for eHealth and mHealth interventions. Journal of Medical Internet Research, 16, e146. Roth, W. R., Vilardaga, R., Wolfe, N., Bricker, J. B., & McDonell, M. G. (2014). Practical considerations in the design and development of smartphone apps for behavior change. Journal of Contextual Behavioral Science, 3, 269-272
Workshop 9
State-of-the-Art Adverse Event Monitoring for Behavioral Health Clinical Trials
John D. Roache, University of Texas Health Science Center at San Antonio
Alan L. Peterson, University of Texas Health Science Center at San Antonio
Tabatha Blount, University of Texas Health Science Center at San Antonio
Introductory level of familiarity with the material
Primary Topic: Research Methods/Statistics
Key Words: Adverse Events, Monitoring, Research, Ethics
Most behavioral health clinical trials limit Adverse Event (AE) monitoring to Serious Adverse Events (SAEs) such as suicide attempts, completed suicides, and psychiatric hospitalizations. Other possible AEs or "side effects" of behavioral treatments, such as temporary increases in anxiety related to exposure therapy, are often considered a normal part of therapy and are therefore not documented as possible AEs. Monitoring of AEs is ethically required by Institutional Review Boards and for all human research involving the delivery of treatment interventions in clinical trials. The monitoring of AEs is well-established for clinical trials involving medications and medical devices. The importance of AE monitoring has been largely undervalued and not routinely used in behavioral health clinical trials. The identification of possible risks and side effects of behavioral treatment is an essential component of informed consent and, consequently, a requisite for conducting ethical behavioral health clinical trials. The limited number of previously published behavioral health clinical trials that used proper AE monitoring actually demonstrated behavior therapy had less risks and greater benefits than the comparison psychotherapies. Failure of researchers to use state-of-the-art AE monitoring may perpetuate the public belief of the possible negative side effects of behavioral interventions. This workshop will provide state-of-the-art guidelines for the use of AE monitoring in behavioral health clinical trials as established in the STRONG STAR Consortium and integrated into numerous randomized clinical trials. Participants will practice classifying and documenting AEs, SAEs, and Unanticipated Problem Involving Risk to Subjects/Others (UPIRSOs) using real-world data from ongoing clinical trials.
You Will Learn:
- 1. The role of adverse event monitoring in conducting ethical behavioral health clinical trials according to Institutional Review Boards and national guidelines.
- 2. How to effectively implement adverse event monitoring in behavioral health clinical trials.
- 3. How to define and classify Adverse Events, Serious Adverse Events, and Unanticipated Problem Involving Risk to Subjects or Others using examples from ongoing behavioral health clinical trials.
Recommended Readings:
Barlow, D. H. (2010). Negative effects from psychological treatments. A perspective. American Psychologist, 65, 13-20. Peterson, A. L., Roache, J. D., Raj, J., & Young-McCaughan, S. (2013). The need for expanded monitoring of adverse events in behavioral health clinical trials. Contemporary Clinical Trials, 34, 152-154.
Workshop 10
When Lfe Gives You Lemons . . . Use Strengths-Based CBT's Four-Step Model to Build Resilience
Christine A. Padesky, Center for Cognitive Therapy, Huntington Beach
Kathleen A. Mooney, Center for Cognitive Therapy, Huntington Beach
Basic level of familiarity with the material
Primary Topic: Treatment - CBT
Key Words: Resilience, Strengths-Based CBT
"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 four-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 along with structured participant role-plays and question-and-answer segments which 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:
- 1. To identify areas of strength that relate to resilience.
- 2. Practice Socratic methods to elicit client-generated metaphors for resilience.
- 3. Build and apply a personal model of resilience to create win-win responses for 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: An International Quarterly, 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].
Workshop 11
Integrated Group CBT for Depression and Substance Abuse
Kimberly Hepner, RAND Corporation
Basic level of familiarity with the material
Primary Topic: Addictive Behaviors/Substance Abuse
Key Words: Substance Abuse, Depression, Group Therapy, CBT, Integrated Care, Co-Occurring Disorders
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Despite calls for integrated treatment for patients with co-occurring mental health and substance use disorders, clinicians need better tools and treatments to more easily implement high-quality, integrated approaches for these patients. BRIGHT (Building Recovery by Improving Goals, Habits, and Thoughts) is an engaging group CBT targeting depression in patients with co-occurring alcohol and drug problems. Adapted from an empirically supported depression intervention, BRIGHT has demonstrated effectiveness in improving both depression and substance abuse outcomes. This hands-on, interactive workshop will provide participants with an overview of BRIGHT, including review of the published treatment manual, companion group member workbook, supporting group implementation tools, and newly released online training options. Practical strategies for screening group members, implementing BRIGHT, and troubleshooting clinical challenges that can arise during the course of group CBT will be reviewed. The unique needs of patients with co-occurring mental health and substance use disorders will be highlighted, with an emphasis on how this impacts delivery of CBT. The workshop will provide a discussion of how BRIGHT can be adapted for use in a variety of settings, including substance abuse or mental health settings and as an individual treatment.
You Will Learn:
- 1. How BRIGHT addresses the relationship between mood and substance use in an integrated treatment.
- 2. How to adapt basic CBT strategies to meet the unique needs of patients with co-occurring mental health and substance use disorders.
- 3. Strategies for implementing BRIGHT in your clinical and/or research setting.
Recommended Readings:
Hepner, K.A., Miranda, J., Woo, S., Watkins, K.E., Lagomasino, I., Wiseman, S.H., & Muñoz, R.F. (2011). Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT): A group cognitive behavioral therapy for depression in clients with co-occurring alcohol and drug use problems - Group leader's manual. Santa Monica, CA: RAND Corporation, TR-977/1-NIAAA. http://www.rand.org/pubs/technical_reports/TR977z1. Hepner, K.A., Miranda, J., Woo, S., Watkins, K.E., Lagomasino, I., Wiseman, S.H., & Muñoz, R.F. (2011). Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT): A group cognitive behavioral therapy for depression in clients with co-occurring alcohol and drug use problems - Group member's workbook. Santa Monica, CA: RAND Corporation, TR-977/2-NIAAA. http://www.rand.org/pubs/technical_reports/TR977z2. Watkins, K.E., Hunter, S.B., Hepner, K.A., Paddock, S.M., de la Cruz, E., Zhou, A.J., & Gilmore, J. (2011). An effectiveness trial of group cognitive behavioral therapy for patients with persistent depressive symptoms in substance abuse treatment. Archives of General Psychiatry. 68(6), 577-584.
Workshop 12
Using Social Skills Training in Clinical Practice With Children and Adolescents
Susan H. Spence, Griffith University
Basic level of familiarity with the material
Primary Topic: Child (Other), Treatment-ACT
Key Words: Social Skills Training, Children and Adolescents, Social Competence
Many children with emotional and behavioral problems show deficits in social skills in their interactions with other people, including peers, less familiar adults, and, in some instances, family members. Such deficits, not surprisingly, tend to lead to adverse social outcomes and impair effective social relationships. Clinicians, therefore, frequently identify social skills deficits as an issue during the cognitive behavioral analysis, and it is important that a component of the intervention focuses on rectifying social skills deficits. If social skills deficits are left untreated, they are likely to result in adverse interpersonal consequences that, in turn, may perpetuate or exacerbate issues such as depression, anxiety, and conduct problems. Thus, if poor social skills are not tackled during treatment, the long-term effectiveness of psychological therapies may be reduced.
This workshop will focus on the developing practitioner skills in identifying social skills deficits and using specific strategies for enhancing social skills with young people, including modeling, behavioral rehearsal within and between sessions (including the use of role-play and reverse role-play methods), and feedback. The workshop will include video demonstrations, didactic content, experiential tasks, role-play, and case exemplars.
The skills learned during the workshop will be applicable as a treatment component for a significant proportion of young clients, presenting with a broad spectrum of emotional and behavioral issues. Clinicians will be better equipped to identify social skills problems and to make use of social skills training methods within their clinical practice, including within CBT and IPT interventions.
You Will Learn:
- 1. How to identify social skills deficits.
- 2. How to use strategies of modeling, behavioral rehearsal, and feedback to teach social skills with young people.
- 3. How to engage young people in role-play and reverse role-play for behavioral rehearsal of social skills.
Recommended Readings:
O'Shea, G., Spence, S.H., Donovan, C.L. (2014). Interpersonal factors associated with depression in adolescents: Are these consistent with theories underpinning interpersonal psychotherapy? Clinical Psychology and Psychotherapy. doi: 10.1002/cpp.1849. O'Shea, G., Spence, S.H., Donovan, C.L. (2014). Group versus individual interpersonal psychotherapy for depressed adolescents. Behavioural and Cognitive Psychotherapy. doi:10.1017/S1352465814000216
Workshop 13
Exposure-Based Interventions for Complex Presentations of Obsessive-Compulsive Symptoms
Dean McKay, Fordham University
Fugen Neziroglu, Bio-Behavioral Institute
Moderate level of familiarity with the material
Primary Topic: Adult Anxiety
Key Words: Obsessive-Compulsive Disorder, Exposure Therapy, Complex Case Formulation
Exposure-based treatment is highly effective in alleviating symptoms associated with OCD. While the broad concept of conceptualization of exposure therapy is well known, the development of these interventions remains challenging for many clinicians. This is due, in part, to the complex nature of many symptoms of OCD. For example, some common symptoms of OCD involve obsessions whereby the feared consequences are long after any exposure treatment ends (i.e., concerns with blasphemy). Another common complication involves comorbid psychiatric disturbance (i.e., OCD symptoms due to trauma). Finally, given the complexity of symptoms, while there are very few circumstances that would rule out the application of exposure, other strategies may need to be implemented preexposure. Accordingly, the development of clinical skills in assessing and determining treatment planning when symptoms are present that would contraindicate the initial use of exposure is warranted.
Accordingly, this workshop has two broad aims. One aim is to describe methods for conceptualizing exposure exercises for common complex obsessive-compulsive problems. These include symptoms where the feared consequence is long after the exposure, and symptoms associated with, or a consequence of, other forms of psychopathology (i.e., trauma). The second aim is to describe methods for determining under what conditions exposure would be suitable, versus conditions where it calls for prior treatment strategies followed by exposure.
You Will Learn:
- 1. How to conceptualize exposure exercises for complex obsessive-compulsive symptoms.
- 2. Methods for creatively engaging clients in exposure for complex symptoms.
- 3. A decision heuristic for determining suitable conditions for implementing exposure therapy.
Recommended Readings:
Craske, M.G., Treanor, M., Conway, C.C., Zbozniak, T., Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23. McKay, D., Sookman, D., Neziroglu, F., Wilhelm, S., Stein, D., Kyrios, M., Mathews, K., & Veale, D. (2015). Efficacy of cognitive-behavior therapy for obsessive-compulsive disorder. Psychiatry Research, 225, 236-246. Veale, D., & Neziroglu, F. (2010). Body dysmorphic disorder: A treatment manual. London: Wiley Blackwell.