TICKETED SESSIONS | Master Clinician Seminars

The Stanley-Brown Safety Planning Intervention is a widely used, brief intervention that provides patients with a prioritized and specific set of coping strategies and sources of support that can be used should a suicidal crisis occur. The intent of the safety plan is to help individuals lower their imminent risk for suicidal behavior by consulting a predetermined set of potential coping strategies and a list of individuals or agencies whom they may contact. By following a predetermined set of internal coping strategies, social support activities, and help-seeking behaviors, patients have the opportunity to evaluate those strategies that are most effective. The presentation will include a review of the evidence supporting this intervention and latest advances in the delivery of this intervention, including a discussion of the barriers and facilitators when implementing safety planning within the health system. A demonstration of safety planning will be provided.

At the end of the session, the learner will be able to:

• Describe the rationale for the Safety Planning Intervention.
• Describe how to collaboratively develop a safety plan.
• Describe how to evaluate the quality of the Safety Planning Intervention.
• Describe the evidence supporting the use of the Safety Planning Intervention.
• Describe the barriers and facilitators when implementing safety planning in the health system.

Recommended Readings:

Stanley, B., & Brown, G. K. (2012). Safety Planning Intervention: A brief intervention to mitigate suicide. Cognitive and Behavioral Practice 19(2), 256-264.

Stanley, B., Brown, G.K., Brenner, L.A., Galfalvy, H.C., Currier, G.W., Knox, K.L, Chaudhury, S.R., Bush, A.L., & Green, K.L. (2018). Comparison of the Safety Planning Intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry 75(9), 894-900.

Stanley, B., Brown, G.K., Currier, G.W., Lyons, C., Chesin, M., & Knox, K.L. (2015). Brief intervention and follow-up for suicidal patients with repeat ED visits enhances treatment engagement. American Journal of Public Health 105(8), 1570-2.

Stanley, B., Chaudhury, S., Chesin, M., Pontoski, K., Bush, A.M., Knox, K.L., & Brown, G.K. (2016). An emergency department intervention and follow-up to reduce suicide risk in the VA: Acceptability and effectiveness. Psychiatric Services 67(6), 680-683.

Stewart, K.L., Darling, E.V., Yen, S., Stanley, B., Brown, G.K., & Weinstock, L.M. (2019). Dissemination of the Safety Planning Intervention (SPI) to university counseling center clinicians to reduce suicide risk among college students. Archives of Suicide Research Page, 1-11.

Abstract envy is a universal emotion that we can observe in animals, children, and adults and is a key emotion in dominance hierarchies. It is an emotion that has evolved because those higher in dominance hierarchies are conferred greater advantage. There are three manifestations of envy-hostile, depressed, and benign-where the latter is equivalent to admiration and often emulation. Envy is a social emotion focused on problematic comparisons with others, while jealousy is a concern about the threat to a relationship. We can be jealous of someone who threatens a valued relationship and also envious of the qualities that make them appear desirable in comparison with ourselves. Individuals are more likely to experience envy when the target behavior is valued by them, they believe it is possible that they might achieve these goals, they view the target of envy as "undeserving," and they value status and recognition. Envy is associated with depression, anger, anxiety, rumination, and interpersonal hostility. In this presentation we will review the evolutionary adaptive value of envy (dominance hierarchies, social rank theory), the fundamental concern for fairness, schemas related to status, maladaptive "coping" (undermining the "competition" and avoidance of competitors), rumination, complaining, and self-critical thinking. The integrative clinical model includes the following: normalizing envy, validating envy to decrease shame and guilt, relating envy to positive values, focusing on turning envy into admiration and emulation, differentiating the self-concept beyond a focus on one dimension, and acceptance of envy while acting on valued goals. In addition, we will examine how we can modify dysfunctional beliefs about social comparison (Labeling-"He's a winner, I am a loser"; Fortune-telling-"She will continue to advance, I will fall behind"; Dichotomous thinking -"You either win or lose"; Discounting positives -"The only thing that counts is getting ahead"; and Catastrophizing -"It's awful not to be ahead of others). Finally, we will review a case conceptualization of a case of depressive and anxious envy. Participants are encouraged to evaluate their own experience of envy, either as the one who envies or the one who is the target of the envy of others.

At the end of the session, the learner will be able to:

• Identify envy, the emotions entailed in envy, and the unhelpful thoughts related to envy.
• Identify problematic coping strategies underpinning envy.
• Develop a case conceptualization of the client's envy.
• Reverse anger, depression, anxiety, humiliation and rumination associated with envy.
• Use an integrative CBT model to reduce the negative impact of envy and help focus clients on adaptive functioning.

Recommended Readings:

Fiske, S. (2012). Envy up, Scorn down: How status divides us. Russell Sage Foundation.

Leahy, R.L. (2015). Emotional Schema Therapy. Guilford.

Schoeck, H. (1970/ 2010). Envy: A theory of social behaviour. Liberty Fund.

Smith, R. H., & Kim, S. H. (2007). Comprehending envy. Psychological Bulletin, 133(1), 46-64.

Van de Ven, N., Zeelenberg, M., & Pieters, R. (2009). Leveling up and down: The experiences of benign and malicious envy. Emotion, 9, 419-429.

There has been growing interest in addressing disgust as an emotion that motivates avoidance in anxiety and obsessive-compulsive disorders. For close to 30 years, evidence has accumulated to show that disgust is an important contributor to many conditions in these classes of disorders, and more recently, models of intervention have also been proposed. In making the transition from research to treatment, clinicians must disentangle the contributions of fear from disgust, and then craft client-specific evidence-based methods for alleviating disgust. Complicating this further, most practitioners have little formal knowledge of disgust in general or as it specifically relates to psychopathology. This Master Clinician Seminar, therefore, has the following three broad aims. First, this session will provide an overview of the nature of disgust and how it is unique from fear. Second, a systematic approach to assessing disgust in clients will be covered and include a review of measures that are available at no cost and that can be readily integrated into everyday practice. And third, recommendations for treatment to alleviate disgust reactions that prompt avoidance will be covered, including an overview of the current research and illustrative case examples. There will also be activities for attendees to develop skill in integrating disgust in exposure hierarchies. The session will conclude with a discussion of future directions in research evaluating the integration of disgust in evidence-based treatment plans.

At the end of the session, the learner will be able to:

• Distinguish disgust as a motivator of avoidance in anxiety and obsessive-compulsive disorders.
• Identify disgust elicitors, specific classes of stimuli that provoke the emotion.
• Construct hierarchies for use in treatment that incorporate disgust stimuli.
• Separate anxiety from disgust in conceptualizing treatment.
• Conceptualize interventions aimed at alleviating disgust reactions.

Recommended Readings:

Amoroso, C.R., Hanna, E.K., LaBar, K.S., Borg, J.S., Sinnott-Armstrong, W., & Zucker, N.L. (in press). Disgust theory through the lens of psychiatric medicine. Clinical Psychological Science.

Mason, E.C., & Richardson, R. (2012). Treating disgust in anxiety disorders. Clinical Psychology: Science & Practice, 19, 180-194.

McKay, D. (2006). Treating disgust reactions in contamination-based obsessive-compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 37, 53-59.

McKay, D. (2017). Presidential Address: Embracing the repulsive: The case for disgust as a functionally central emotional state in the theory, practice, and dissemination of cognitive-behavior therapy. Behavior Therapy, 48, 731-738.

Olatunji, B.O., & McKay, D. (2009). Disgust and its disorders. Washington, DC: American Psychological Association.

Despite the many advances that have been made in the understanding of psychological disorders and the critical role that mental health experts play in their successful treatment, our field continues to struggle to: (a) reach newer and broader audiences, (b) explain psychological concepts in simple and creative ways, and (c) stand out on the increasingly crowded information superhighway. Complicating matters is the fact that: (a) graduate programs and internship sites tend to focus on ensuring that profession-wide competencies are met, and spend relatively less- and often, no- time preparing their graduates for the challenges involved in branding, marketing, advertising, and other promotional activities that we can use to communicate our messages to the public; and (b) the healthcare landscape continues to change rapidly, with an ever-increasing reliance on, and use of, technology. As a result, typical forums (e.g., journal articles, conference presentations, etc.) for delivering news about advances in our profession have become too narrow, traditional media (e.g., print, radio, television) have lost their centrality, and new platforms are continuously being created (e.g., social media). This seminar will present ways to capitalize on advances in technology to help share psychological concepts with new audiences, while also highlighting the ethics and risks involved in doing so as a psychologist.

At the end of this session the learner will be able to:

• Describe several of the more popular social media platforms.
• Discuss the ethics and risks involved in psychologists' use of social media .
• Demonstrate ways in which use of social media can be done effectively.

Recommended Readings:

At the end of the session, the learner will be able to:

Baier, A. L. (2019). The ethical implications of social media: Issues and recommendations for clinical practice. Ethics & Behavior, 29(5), 341-351.

Kolmes, K. (2012). Social media in the future of professional psychology. Professional Psychology: Research and Practice, 43(6), 606.

Tunick, R. A., Mednick, L., & Conroy, C. (2011). A snapshot of child psychologists' social media activity: Professional and ethical practice implications and recommendations. Professional Psychology: Research and Practice, 42(6), 440-447.

Recent major advances have been made in the psychosocial treatment of children and adolescents with ADHD. Challenges in organization, time management, and planning are among the most prominent problems that impact individual, family, and school adjustment for youth with ADHD. Various forms of Organizational Skills Training (OST) are well-established treatments for children with ADHD (Evans et al., 2018). OST with elementary school children has wide impact in improving organization, time management, and planning, which in turn contributes to improved achievement and to reduced homework problems and family conflict (Abikoff et al., 2013). OST has been fully tested for elementary school children in clinical settings with promising results being found for adaptations for group delivery and in school settings. The manualized treatment is provided two times per week in 20 sessions to intensely alter the ways children respond to school and home demands. Conceptually, OST recognizes how the symptoms of ADHD interfere with practical execution of steps needed during school days and at home. Parents and teachers see these practical executive function deficits as a critical concern. This presentation will review the full protocol (Gallagher et al., 2014) with emphasis on child, parent, and teacher orientation and skills building in five areas: supportive parent behavior management, tracking assignments, managing materials, time management, and planning. In addition to didactics, specific exercises, role-plays, and videos will be used similar to those used to train over 25 research therapists and other clinicians. Participants will learn how to collaboratively engage children so that they feel empowered and how to incorporate positive responses from parents and teachers to effectively motivate children. A substantial portion of the program will review how the individual treatment can be adapted for group delivery and for provision by school personnel with children who do not necessarily meet the criteria for ADHD. The presenters are authors of the clinical intervention, the extension for group delivery, and the team behind a test of an adaptation for school-based delivery being tested in a randomized controlled trial.

At the end of the session, the learner will be able to:

• Describe the skills deficits that over half of children with ADHD demonstrate in organization, time management, and planning.
• Effectively evaluate candidates for treatment and how to implement the components of organizational skills training for children.
• Implement organizational skills treatment for children in clinical settings.
• Adapt the individual treatment for group delivery.
• Guide school personnel in the delivery of the treatment.

Recommended Readings:

Abikoff, H., Gallagher, R., Wells, K. C., Murray, D. W., Huang, L., Lu, F., & Petkova, E. (2013). Remediating organizational functioning in children with ADHD: Immediate and long-term effects from a randomized controlled trial. Journal of Consulting and Clinical Psychology, 81(1), 113-128. doi: 10.1037/a0029648

Bikic, A., Reichow, B., McCauley, S., Ibrahim, K., & Sukhodolsky, D.(2017) Meta-analysis of organizational skills intervention for children and adolescents with ADHD. Clinical Psychology Review, 52, 108-123.

Evans, S., Owens, J., Wymbs, B., & Raisa Ray, A. (2018). Evidence-based psychosocial treatment for children and adolescents with ADHD. Journal of Clinical Child and Adolescent Psychology, 47, 157-198.

Gallagher, R., Abikoff, H., & Spira, E. (2014). Organizational Skills Training for Children with ADHD: An Empirically Supported Treatment. Guilford Press.

Gallagher, R., Spira, E., & Rosenblatt, J. (2018). The organized child: An effective program to maximize your kid's potential - in school and in life. Guilford Press.

Consider the CBT worksheet- a simple clinical tool that some clinicians may brush aside in efforts to ensure that therapy is engaging, skill-based, and tailored to an individual's goals and challenges. These client-focused goals are central to high-quality CBT, and use of CBT worksheets may facilitate, rather than hinder, the clinician and client's success.In this Master Clinician Seminar, Dr. Creed reintroduces CBT worksheets with a three-fold purpose. First, worksheets are framed as a direct clinical tool to help clients scaffold their learning of CBT strategies so that they can ultimately use them fluidly and naturally (i.e., without a worksheet). Discussion will include how to engage clients in this process, how to integrate worksheets in telehealth, and how to support clients in transitioning to a "paperless" version of skill-use. Second, a parallel process is described for training and supervising new CBT therapists, as clinicians rely on CBT worksheets to build their own growing competence and confidence. Finally, Dr. Creed will present a method for rating completed CBT worksheets to evaluate clinician competence, based on preliminary findings from an ongoing NIMH-funded R01 research study (Stirman, PI, Creed, Co-I).

At the end of this session, the learner will be able to:

• Demonstrate strategies for engaging clients in the use of CBT worksheets to help them integrate CBT skills into their daily lives.
• Illustrate ways in which the use of CBT worksheets can scaffold new clinicians in building their confidence and CBT skills.
• Describe a strategy for leveraging CBT worksheets to evaluate clinician competence.

Recommended Readings:

Creed, T.A., Benjamin, C., Feinberg, B., Evans, A.C., & Beck, A.T. (2016). Beyond the Label: Relationship between community therapists' self-report of a cognitive-behavioral therapy orientation and observed skills. Administration and Policy in Mental Health Services Research, 43, 36-43. doi 10.1007/s10488-014-0618-5

Creed, T.A., Frankel, S.A., German, R., Green, K.L., Jager-Hyman, S., Pontoski, K., Adler, A., Wolk, C.B., Stirman, S.W., Waltman, S.H., Williston, M.A., Sherrill, R., Evans, A.C., & Beck. A.T. (2016). Implementation of transdiagnostic cognitive therapy in diverse community settings: The Beck Community Initiative. Journal of Consulting and Clinical Psychology. http://dx.doi.org/10.1037/ccp0000105

Waltman, S.H., Hall, B., McFarr, L., Beck, A.T., & Creed, T.A. (2017). In-session stuck points and pitfalls of community clinicians learning CBT: A qualitative investigation. Cognitive and Behavioral Practice, 24, 256-267 http://doi:10.1016/j.cbpra.2016.04.002 Wiltsey Stirman, S., Marques, L., Creed, T.A., Gutner, C.A., DeRubeis, R., Barnett, P.G., Kuhn, E., Suvak, M., Owen, J., Vogt, ., Schoenwald, S., Johnson, C., Mallard, K., Beristianos, M., & LaBash, H. (2018). Leveraging routine clinical materials and mobile technology to assess CBT fidelity: The Innovative Methods to Assess Psychotherapy Practices (imAPP) study. (2018). Implementation Science, 13, 69. https://doi.org/10.1186/s13012-018-0756-3