TICKETED SESSIONS | Workshops

Transgender and gender-diverse (TGD) individuals are disproportionately burdened by pervasive discrimination, marginalization, and other oppressive social forces (e.g., transphobia). These stressors contribute to well-documented mental health disparities, including elevated rates of suicide, anxiety, and depression. While many mental health professionals and ABCT attendees alike are motivated to use the tools of cognitive-behavioral science to address these disparities, far fewer feel prepared to effectively treat clinical distress in TGD people in a culturally affirming, tailored, and evidence-based manner. This gap maintains disparities for this marginalized group and limits the impact and outcomes of cognitive-behavioral science and practice, particularly as it relates to positive outcomes for TGD people. This workshop is designed to provide basic knowledge of clinical distress in TGD populations along with strategies to conceptualize and intervene in presenting problems, utilizing cognitive-behavioral and minority stress frameworks. Presenters will demonstrate how to effectively apply cognitive-behavioral treatment strategies to directly address presenting problems and symptoms of TGD clients. The workshop aims to develop and/or enhance application of basic cognitive behavioral strategies (e.g., cognitive restructuring, behavioral activation) and third-wave CBT principles (e.g., mindfulness, compassion, acceptance) to the needs of a marginalized community. The workshop is intended for audiences who have some to little knowledge regarding transgender health. In order to enhance participants' engagement and learning, case vignettes, experiential exercises, and role-plays will be embedded throughout this workshop, and will be offered in an affirming, nonjudgmental, and supportive environment. The broader implications and social impact of addressing transgender mental health disparities will be emphasized. Despite high rates of comorbidity between PTSD and substance use problems (SUP) in adolescents and adults, few integrated treatments have been rigorously evaluated to date. This slow pace of scientific advancement has left the state of practice stymied. Reasons for this limited progress include compartmentalized mental health and addiction fields; long-standing clinical lore that it is unsafe to engage a youth or adult with SUP in exposure-based treatment due to concerns that exposure-induced distress will exacerbate SUP; and the challenges of conducting comorbidity treatment outcome research.

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

• Develop case conceptualizations of clinical distress associated with transgender-specific stressors using an integration of cognitive-behavioral and minority stress frameworks.
• Apply and adapt specific cognitive interventions (e.g., cognitive restructuring) to address clinical distress in TGD individuals.
• Apply and adapt specific behavioral interventions (e.g., exposure; behavioral activation) to address clinical distress in TGD individuals.
• Apply third-wave CBT principles to the conceptualization of clinical distress in TGD individuals.
• Apply third-wave CBT intervention strategies to the treatment of clinical distress in TGD individuals.

Recommended Readings:

Austin, A., & Craig, S. L. (2015). Transgender affirmative cognitive behavioral therapy: Clinical considerations and applications. Professional Psychology: Research and Practice, 46(1), 21.

Dickey, l. m., & Singh, A. A. (2016). Training tomorrow's affirmative psychologists: Serving transgender and gender nonconforming people. Psychology of Sexual Orientation and Gender Diversity, 3, 137-139. https://doi.org/10.1037/sgd0000175Hendricks, M. L., & Testa, R. J. (2012). A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the Minority Stress Model. Professional Psychology: Research and Practice, 43(5), 460.

James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.

Sloan, C. A., Berke, D. S., & Shipherd, J. C. (2017). Utilizing a dialectical framework to inform conceptualization and treatment of clinical distress in transgender individuals. Professional Psychology: Research and Practice, 48(5), 301.

Anxiety disorders are remarkably common in adolescence , with 1 in 5 teens experiencing clinically significant anxiety by age 18. Adolescents with anxiety or OCD engage in avoidance behaviors that may provide short-term relief, but that also create a feedback loop resulting in adolescents' increased fear and decreased self-efficacy. Parent accommodation and lack of autonomy-granting behavior play an important role in the persistence of this feedback loop. However, this can be difficult to change for parents who may struggle with their own avoidance behaviors coupled with skill deficits in implementing consistent, effective behavior support strategies. Acceptance and Commitment Therapy (ACT) is a cognitive-behavioral approach to psychopathology derived from basic research on human language processes and verbal behavior. A robust evidence base suggests that ACT compares favorably with CBT. Findings regarding ACT efficacy with anxious youth and parents are encouraging, and represent a compelling rationale for further study, especially in light of recent findings that 48% of youngsters with anxiety who were successfully treated with CBT relapse. An ACT approach views anxiety and OCD disorders as conditions in which individuals unwilling to experience anxiety overrely on attempts to prevent, avoid, or escape this experience. Rigid and inflexible engagement in these avoidance behaviors can knock young people far off their developmental course and pull parents into unhelpful coercive patterns with their teens, or into the role of emotion managers. This workshop will present an evidence-based, manualized approach to using ACT for parents raising children with anxiety and OCD. Using didactic presentation, exercises, role-plays, and demonstrations, presenters will engage clinicians in discussion about parenting children and teens with OCD and support them in parenting flexible, curious, and brave youngsters.

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

• Discuss parenting of adolescents with anxiety and/or OCD and ACT from a behavior analytic perspective.
• Identify ways to develop an alliance with parents that supports their motivation to engage in treatment.
• Use ACT components such as mindfulness, acceptance, and perspective-taking experientially with parents to address psychological inflexibility around parenting practices.
• Use ACT components such as creative hopelessness, valuing, and committed action to increase parental motivation to engage in treatment, identify behavior change targets, and establish goals for treatment.
• Integrate ACT with behavioral parent training approaches to support adaptive, flexible, and developmentally sensitive parenting practice.

Recommended Readings:

Coyne, L. W., & Murrell, A. R. (2009). The joy of parenting: An Acceptance and Commitment Therapy guide to parenting in the early years. New Harbinger

Gould, E. R., Tarbox, J., & Coyne, L. (2018). Evaluating the effects of Acceptance and Commitment Training on the overt behavior of parents of children with autism. Journal of Contextual Behavioral Science, 7, 81-88. https://doi.org/10.1016/j.jcbs.2017.06.003.

Hancock, K. M., Swain, J., Cassandra, J., Hainsworth, A. L. Dixon, S. K., & Munro, K. (2016). Acceptance and commitment therapy versus cognitive behavior therapy for children with anxiety: Outcomes of a randomized controlled trial. Journal of Clinical and Child Adolescent Psychology, 47, 296-311. doi: 10.1080/15374416.2015.1110822

Raftery-Helmer, J. N., Moore, P. S., Coyne, L., & Reed, K. P. (2016). Changing problematic parent-child interaction in child anxiety disorders: The promise of Acceptance and Commitment Therapy. Journal of Contextual Behavioral Science, 5, 64-69. https://doi.org/10.1016/j.jcbs.2015.08.002.

Whittingham, K., & Coyne, L. W. (2019). Acceptance and Commitment Therapy: The clinician's guide to supporting parents. Elsevier.

Successful treatment requires a healthy working alliance between therapist and client. There is increasing evidence in the research literature that problems, or ruptures, in the alliance are common challenges faced by many therapists. When therapists are unable to repair a rupture, the likelihood of premature termination or poor outcome is increased; however, rupture repair is associated with improved outcome. This workshop will equip participants with empirically supported strategies for resolving alliance ruptures by presenting Alliance-Focused Training (AFT). Drawing on our NIMH-funded program of research, which has focused on improving therapists' abilities to identify and repair ruptures with clients with depression, anxiety, and personality disorder diagnoses, we will present examples of confrontation ruptures, where there is movement against the other or the work of therapy, and withdrawal ruptures, where there is movement away from the other or the work of therapy. We will also discuss how therapists can use intrapersonal markers of therapist internal experience to identify ruptures. We will present examples of strategies for repairing ruptures, including both immediate strategies that involve renegotiating the task or goal, and expressive strategies that draw on the use of metacommunication, or communication about the communication process, to collaboratively explore ruptures and understand the relational schemas that underlie them. We will also present findings from our efforts to train therapists to identify and repair ruptures and discuss how alliance-focused training targets emotion regulation as the essential therapist skill. We will present several strategies that therapists can use to enhance their abilities to regulate their emotions in the context of ruptures.

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

• Identify interpersonal markers of alliance ruptures that are commonly observed in CBT.
• Identify intrapersonal markers of alliance ruptures that therapists commonly experience.
• Use mindfulness and awareness-oriented exercises to more effectively regulate their emotions in the context of alliance ruptures.
• Use immediate repair strategies to renegotiate tasks and/or goals in treatment.
• Use metacommunication strategies to collaboratively explore a rupture with a client.

Recommended Readings:

Eubanks, C.F. (2019). Alliance-focused formulation: A work in process. In U. Kramer (Ed.), Case formulation for personality disorders: Tailoring psychotherapy to the individual client (pp. 337-354). Cambridge, MA: Elsevier.

Eubanks, C.F., Muran, J.C., & Safran, J.D. (2018). Alliance rupture repair: A meta-analysis. Psychotherapy, 55, 508-519. doi: 10.1037/pst0000185

Muran, J.C., & Eubanks, C.F. (2020). Performance under pressure: Negotiating emotion, difference, and rupture. American Psychological Association.

Muran, J.C., Safran, J.D., Eubanks, C.F., & Gorman, B.S. (2018). The effect of alliance-focused training on a cognitive-behavioral therapy for personality disorders. Journal of Consulting and Clinical Psychology, 86, 384-397. doi: 10.1037/ccp0000284

Norcross, J.C., & M.J. Lambert (Eds.), Psychotherapy relationships that work: Evidence-based therapist contributions (3rd ed.). Oxford University Press.

Safran, J.D., & Muran, J.C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York: Guilford Press.

Irritable Bowel Syndrome (IBS) is a highly prevalent disorder that is highly comorbid with anxiety and depression and shares conceptual overlap with panic, agoraphobia, and social anxiety. It also leads to considerable disability and distress. Managing these patients requires a good conceptual understanding of the biopsychosocial and cognitive underpinnings of IBS as well as the kinds of avoidance behaviors (both obvious and subtle) that maintain and often exacerbate symptoms and disability. Good CBT skills are essential, but incorporating GI-specific phenomena (like bowel control anxiety and fear of food) are also important. There is significant empirical evidence supporting the use of CBT in treating IBS, including multiple RCTs. The inflammatory bowel diseases (IBDs), such as Crohn's disease and ulcerative colitis, have clear biological pathophysiology, but share some of the same symptoms and can lead to heightened risk for IBS in a subset of patients. In addition, many IBD patients experience shame, avoidance, and social anxiety about their condition. This workshop will cover what is known about the etiology and symptoms of IBS, how IBS patients present in clinical practice, IBS in the context of comorbid panic, agoraphobia and/or social anxiety, formulating appropriate treatment goals and basic cognitive and behavioral strategies for treating IBS, including IBS that is comorbid or secondary to a more serious IBD. The workshop will include pragmatic skills training, as well as information about development of a new CBT for IBS App, and a forthcoming book on CBT for IBD patients and clinicians. Case material reflecting patients along a spectrum of severity will provide for lively discussion and acquisition of new skills and techniques. Audience participation, clinical questions, and role-playing will be welcomed. Application of evidence-based psychotherapies to chronic GI disorders is sometimes referred to as psychogastroenterology. Unfortunately, there are very few providers trained in GI-informed psychotherapy. We desperately need more skilled clinicians to treat this large, underserved population. ABCT's membership is an obvious target audience, since they bring advanced CBT skills and need only acquire an understanding of GI specifics.

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

• Develop a case conceptualization that integrates GI disorders with any comorbid mood or anxiety disorders.
• Describe what unique cognitive distortions and behavioral avoidance strategies (especially fear of incontinence and dietary restrictions) tend to maintain and exacerbate distress and disability in GI disorders.
• Modify the standard CBT approach to anxiety disorders to treat GI patients effectively
• Incorporate evidence-based, empirically supported print and digital media into a course of CBT for GI disorders.
• Collaborate effectively with gastroenterologists in managing these sometimes complex patients.

Recommended Readings:

Cassiday, K. L. (2019). Exposure therapy for functional GI disorders. In W.H. Sobin (Ed.), Management of chronic GI disorders using central neuromodulators and psychologic therapies (pp. 143-174). Springer Nature Switzerland AG.

Hunt, M. (2018). Chronic GI disorders. In A. Maikovitch Editor (Ed.), Handbook of psychosocial interventions for chronic pain. Informa UK Limited.

Hunt, M. (2019). Cognitive Behavioral Therapy for Irritable Bowel Syndrome. In W.H. Sobin (Ed.), Management of Chronic GI Disorders Using Central Neuromodulators and Psychologic Therapies (pp. 95-141). Springer Nature Switzerland AG.

Keefer, L., Palsson, O. S., & Pandolfino, J.E. (2018). Best practice update: Incorporating psychogastroenterology into management of digestive disorders. Gastroenterology, 154 (5), 1249-1257.

Kinsinger, S.W. (2017). Cognitive-behavioral therapy for patients with irritable bowel syndrome: Current insights. Psychology Research and Behavior Management, 10, 231-237.

Cognitive Therapy for Suicide Prevention (CT-SP) is a suicide-specific psychotherapy that is based primarily on the assumption that individuals who are suicidal or who attempt suicide lack specific cognitive or behavioral skills for coping effectively with suicidal crises. The primary focus of CT-SP is on targeting suicide risk directly, rather than focusing on the treatment of other psychiatric disorders. Although there are many motivations and distal risk factors for suicide, the principal aim of this treatment is to identify the specific triggers and proximal risk factors that occur during a suicidal crisis and then to identify specific skills that could be used to help individuals survive future crises. CT-SP has been recognized as one of the few evidence-based psychotherapy interventions specifically for suicide prevention. In a landmark randomized controlled trial CT-SP was found to be efficacious for preventing suicide attempts as well as decreasing other risk factors for suicide such as depression and hopelessness. Specifically, patients who received CT-SP were approximately 50% less likely to make a repeat suicide attempt during the follow-up period than those who did not receive CT-SP (Brown et al., 2005). Recently, CT-SP has been adapted for individuals who have chronic suicidal thoughts but who may not have had recent suicidal behavior. Such adaptations are especially important because some high-risk groups such as older adults make fewer suicide attempts and are more likely to die on their first attempt. Therefore, targeting suicidal ideation is critical for averting suicide in such individuals. This workshop will discuss case conceptualization for individuals with chronic suicidal ideation, as well as adaptations made to the original treatment for this population

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

• Describe the empirical evidence for CT-SP.
• Use the narrative interview to elucidate an individual's suicide risk curve.
• Create a case conceptualization and identify treatment goals to reduce suicide risk for individuals with chronic suicidal ideation.
• Apply suicide-specific CBT strategies to target suicidal ideation and behavior.
• Utilize the Relapse Prevention Task to assess whether a patient is ready to end treatment.

Recommended Readings:

Bhar, S. S., & Brown, G. K. (2012). Treatment of depression and suicide in older adults. Cognitive and Behavioral Practice, 19(1), 116-125.

Brown, G. K., Tenhave, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial. JAMA, 294, 563-570.

Brown, G. K., Wright, J. H., Thase, M. E., & Beck, A. T. (2012). In R. I. Simon & R. E. Hales (Eds.), Cognitive therapy for suicide prevention (2nd ed.) American Psychiatric Publishing.

Green, K. L., & Brown, G. K. (2015). Cognitive therapy for suicide prevention: An illustrative case example. In C. J. Bryan (Ed.), Cognitive behavioral therapy for preventing suicide attempts: A guide to brief treatments across clinical settings. Routledge.

Wenzel, A., Brown, G. K., & Beck, A. T. (2008). Cognitive therapy for suicidal patients: Scientific and clinical applications. APA Books.

School attendance problems are among the most vexing and impairing problem behaviors that affect childhood. An acute episode of school refusal can quickly become chronic and interfere in multiple domains of the youth and family's lives. Anxiety, depressed mood, and intolerance of negative affect are often at the root of school refusal. Successful intervention requires a concerted, coordinated effort involving the child, family, school and therapist/mental health professional. Barriers to successful intervention include family context, caregiver mental health, and school attitudes and priorities that conflict with family/youth goals. Attendees of the workshop will become familiar with the scope of the problem, a mood-based conceptualization of school refusal that focuses on avoidance of negative affect, and intervention strategies that incorporate functional assessment, family problem solving, reward planning, and collaboration with schools. Multiple case studies will be presented and attendees will work in small groups to offer solutions. Attendees may also bring local examples for group consultation. Presenters will moderate a discussion of effective interventions and help attendees tailor established interventions to their local contexts

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

• Describe the theory behind a cognitive-behavioral approach to addressing school refusal that focuses on avoidance of negative affect.
• Apply functional assessment strategies to help parents encourage approach behaviors.
• Apply family problem solving, parent training, and reward planning to decrease conflict and increase approach behaviors.
• Problem-solve graded reentry with schools that balance appropriate supports with healthy challenges.
• Coordinate school refusal treatment with school personnel and collateral health professionals in a way that enhances continuity of care.

Recommended Readings:

Brouwer-Borghuis, M. L., Heyne, D., Sauter, F. M., & Scholte, R. H. (2019). The link: an alternative educational program in the Netherlands to reengage school-refusing adolescents with schooling. Cognitive and Behavioral Practice, 26(1), 75-91.

Chu, B. C., Guarino, D., Mele, C., O'Connell, J., & Coto, P. (2019). Developing an online early detection system for school attendance problems: Results from a research-community partnership. Cognitive and Behavioral Practice, 26(1), 35-45.

Heyne, D., Gren-Landell, M., Melvin, G., & Gentle-Genitty, C. (2019). Differentiation between school attendance problems: Why and how?. Cognitive and Behavioral Practice, 26(1), 8-34.

Kearney, C. A., & Graczyk, P. (2014, February). A response to intervention model to promote school attendance and decrease school absenteeism. In Child & Youth Care Forum (Vol. 43, No. 1, pp. 1-25). Springer.

McKay-Brown, L., McGrath, R., Dalton, L., Graham, L., Smith, A., Ring, J., & Eyre, K. (2019). Reengagement with education: a multidisciplinary home-school-clinic approach developed in Australia for school-refusing youth. Cognitive and Behavioral Practice, 26(1), 92-106.

Psychotherapists credit effective supervision as the single most important contributor to their professional development, and experienced therapists continue to seek supervision and consultation even when they are no longer required to do so. However, as currently practiced, effective supervision is not necessarily common. For example, supervisees report that a large proportion of their supervisors are ineffective and occasionally harmful, and the success of supervision, as evidenced by improved client outcomes, is yet to be convincingly established. In fact, Rousmaniere et al. (2016) found that supervision accounted for less than 1% of the variance in treatment outcomes in one large clinic. Addressing this gap, this workshop aims to improve the effectiveness of CBT supervision and clinical training via a model for using deliberate practice to enhance the trainee's acquisition of core CBT skills. Deliberate practice proffers that the quality of practice is just as important as the quantity-expert-level performance is primarily the result of expert-level practice. Backed by decades of research on a wide range of other professions-from sports to math, medicine, and the arts-deliberate practice may help CBT clinicians achieve higher levels of skill mastery. More specifically, deliberate practice is a highly structured, intentional activity with the specific goal of improving performance through behavioral rehearsal and graded stimuli, combined with immediate feedback (e.g., Rousmaniere, 2016, 2018). As noted, the present workshop centers on deliberate practice exercises to enhance development of CBT skills. These exercises address the two major domains of psychotherapy skills: interpersonal (with the client) and intrapersonal (within the therapist). The exercises are appropriate for supervision, graduate coursework, and career-long professional development. The model is intended to be used throughout the psychologist's career, from beginning trainee to experienced clinician. The workshop is highly experiential, with many opportunities for participants to try deliberate practice themselves.

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

• Describe the research support for, and basic principles of, implementing deliberate practice in CBT training.
• Apply deliberate practice principles in the CBT training and supervision process.
• Demonstrate flexible application of CBT-focused deliberate practice that meets the needs of the individual trainee.
• Utilize observations from the deliberate practice process to inform evaluations of trainee competence.
• Integrate deliberate practice into graduate coursework and clinical supervision.

Recommended Readings:

Boswell, J.F. (2013). Intervention strategies and clinical process in transdiagnostic cognitive behavioral therapy. Psychotherapy, 50, 381-386. doi: 10.1037/a0032157

Persons, J.B. (2012). The case formulation approach to cognitive-behavior therapy. Guilford Press.

Rousmaniere, T.G. (2016). Deliberate practice for psychotherapists: A guide to improving clinical effectiveness. Routledge Press (Taylor & Francis).

Rousmaniere, T.G. (2019). Mastering the inner skills of psychotherapy: A deliberate practice handbook. Gold Lantern Press.

Tolin, D.F. (2016). Doing CBT: A comprehensive guide to working with behaviors, thoughts, and emotions. Guilford Press.

Teenagers with ADHD rarely self-refer to therapy and those who do experience difficulties following through on behavioral intentions. This workshop will discuss practical strategies that can be integrated into adolescent ADHD treatment to promote engagement among teens and their parents (Sibley & LaCount, 2020). Supporting Teens' Autonomy Daily (STAND) is an evidence-based behavior therapy for adolescent ADHD that is delivered to teens and their parents as a dyad. STAND draws its engagement strategies from a variety of sources: social psychology research on motivation, change-oriented therapies such as Motivational Interviewing (MI), research on therapy homework and habit formation, behavioral principles, and our own trial and error working with families. This presentation will not serve as a full training on STAND-rather, it will specifically focus on the engagement techniques embedded in the treatment, which can be generalized to other therapies. The first hour of this presentation will focus on initial patient engagement. Topics will include how to build and strengthen parent and teen interest in attending therapy, utilize a strength-based approach that builds self-efficacy and optimism, build genuine relationships with and between family members, and tailor intervention to the client's readiness to change. The second hour will discuss how to promote skill practice and behavioral change outside of session. We will discuss how to devise out-of-session practice activities that set the individual up to succeed, increase client choice in therapy homework activities, and how parents can apply age-appropriate behavioral strategies to encourage skill practice at home. We will also discuss therapeutic strategies to utilize when therapy homework is assigned and reviewed to promote consistent completion of weekly practice activities (e.g., imaginal practice, implementation intentions). In the final hour we will discuss how to promote sustained motivation to continue new habits after termination. Attendees will be taught how to self-evaluate their use of these strategies in session to promote application of selected strategies beyond the conference program.

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

• Structure, assign, and review therapy homework assignments using principles that promote consistent home skill practice.
• Integrate principles of social psychology, motivational interviewing, and behavior management into therapy with adolescents with ADHD.
• Engage parents in therapy in an age-appropriate manner that promotes adolescent autonomy with accountability.
• Guide parents and teens through the creation of a behavioral contract that satisfies both members of the dyad.
• Apply the skills learned in this session to additional evidence-based practices for youth and families.

Recommended Readings:

Becker, S. (2020). ADHD in adolescence: Development, assessment, and treatment. Guilford Press.

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change. Guilford Press.

Sibley, M.H., (2016). Parent-teen therapy for executive function deficits and ADHD: Building skills and motivation. Guilford.

Sibley, M.H., & LaCount, P.A. (2020). Enhancing engagement and motivation with adolescents and parents: The Supporting Teens' Autonomy Daily (STAND) Model. In J. Allen, D. Hawes, & C. Essau (Eds.), Family-based intervention for child and adolescent mental health: A core competencies approach. Cambridge University Press.

Sibley, M.H., Rodriguez, L.M., Coxe, S.J., Page, T., & Espinal, K. (2019). Parent-Teen Group versus Dyadic Treatment for Adolescent ADHD: What Works for Whom? Journal of Clinical Child and Adolescent Psychology.

Prolonged Grief Disorder (PGD) is now an official diagnosis in the 11th revision of the International Classification of Diseases (ICD-11). Its key features are persistent and pervasive yearning, longing, and/or preoccupation with the deceased, accompanied by intense emotional pain. The emotional pain can take different forms, e.g., sadness, guilt, anger, denial, blame; difficulty accepting the death, feeling one has lost a part of one's self, an inability to experience positive mood, emotional numbness, difficulty in engaging with social or other activities. To meet criteria for PGD the symptoms have to persist for an abnormally long period of time (more than 6 months at a minimum) and clearly exceed expected social, cultural, or religious norms for the individual's culture and context. The disturbance has to cause significant impairment in an important area of functioning. PGD is estimated to affect 1 in 10 bereaved people and clinicians are likely to come across such individuals in their practice. Complicated Grief Treatment (CGT) is a rigorously tested psychotherapy treatment for this condition with a 70% response rate across three NIMH-funded studies. CGT targets adaptation to loss. It was derived using a modification of prolonged exposure that incorporates strategies and techniques from interpersonal psychotherapy, motivational interviewing, and psychodynamic psychotherapy. Therapists focus on helping clients to accept grief, manage emotional pain, imagine a promising future, strengthen relationships, tell the story of the death, learn to live with reminders and feel a connection to memories of the deceased. Using case examples and data from clinical research studies, Drs. Skritskaya and Shear will describe the treatment, and use video and experiential exercise to illustrate how to use it in practice.

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

• Describe grief using an attachment theory perspective.
• Explain what it means to adapt to loss of someone close and how adaptation can be derailed.
• Describe ICD-11 prolonged grief disorder.
• Analyze how work with the main themes of Complicated Grief Treatment can be used to address derailers and facilitate adaptation to loss.
• Apply CGT procedures in their practice.

Recommended Readings:

Mauro, C., Reynolds, C. F., Maercker, A., Skritskaya, N., Simon, N., Zisook, S., ... Shear, M. K. (2019). Prolonged grief disorder: Clinical utility of ICD-11 diagnostic guidelines. Psychological Medicine, 49(5), 861-867.

Shear, M. K., & Bloom, C. G. (2017). Complicated grief treatment: An evidence-based approach to grief therapy. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 35(1), 6-25.

Shear, M. K., Reynolds C. F. III, Simon N.M., Zisook S., Wang, Y., Mauro, C., Duan, N., Lebowitz, B., & Skritskaya, N. (2016). Optimizing treatment of complicated grief: A multicenter randomized clinical trial. JAMA Psychiatry, 73(7), 685-694.

Shear, K., & Shair, H. (2005). Attachment, loss, and complicated grief. Developmental Psychobiology. Journal of the International Society for Developmental Psychobiology, 47(3), 253-267.

Skritskaya, N. A., Mauro, C., Garcia de la Garza, A., Meichsner, F., Lebowitz, B., Reynolds, C. F., ... & Shear, M. K. (2020). Changes in typical beliefs in response to complicated grief treatment. Depression and Anxiety.

Bipolar disorder affects 1-2% of the population, is a potentially lifelong condition, and is associated with increased risks of self-harm, suicide, substance use problems, and anxiety. NICE guidance recommends access to psychological therapies for people with bipolar and highlights the importance of taking a recovery-focused approach to care. A range of psychological therapies have shown promise in improving mood and relapse outcomes in bipolar disorder. However, there is much less evidence indicating how to improve personal recovery and other functional outcomes in this condition. Personal recovery, the ability to live a personally satisfying and engaged life, is a valued outcome among service users, including people living with bipolar disorder. Recovery-focused therapy is an evidence-based approach developed to work in partnership with clients to identify and work towards their personal recovery goals, considering functional, social, and work outcomes as well as mood. This workshop will highlight developments in understanding and treating bipolar disorder from a personal recovery perspective. This will include assessment of personal recovery, key components of the intervention, applications in clinical practice, and adaptations for specific groups

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

• Describe the key clinical recommendations from current NICE guidelines for psychological therapy for bipolar disorder.
• Explain differences between clinical and personals recovery approaches in bipolar disorder.
• Demonstrate effective use of the Bipolar Recovery Questionnaire to assess and monitor personal recovery.
• Utilize techniques for improving recovery outcomes in bipolar disorder including the application of behavioral experiments.
• Revise RfT for use with older adults.

Recommended Readings:

Jones, S. H., Lobban, F., Cooke, A. (Eds.). (2010). Understanding bipolar disorder: Why some people experience extreme mood states and what can help. British Psychological Society. https://storage.googleapis.com/quantumunitsed-com/materials/3451_Understanding_Bipolar_Disorder.pdf

Jones, S. H., Smith, G., Mulligan, L., Lobban, F., Law, H., Dunn, G., Welford, M., Kelly, J., Mulligan, J., Morrison, A. (2014). Recovery focused CBT for individuals with recent onset bipolar disorder: A randomised controlled pilot trial. British Journal of Psychiatry, 206, 58-66.

Lobban, F. , Taylor, K., Murray, C., Jones, S. (2012). Bipolar Disorder is a two-edged sword: A qualitative study to understand the positive edge. Journal of Affective Disorders. 141, 204-212

NICE. (2014). Bipolar Disorder: The assessment and management of bipolar disorder in adults, children and young people in primary and secondary care. National Clinical Guideline Number 185. NICE: London.

Tyler, E., Lobban, F., Sutton, C., Depp, C., Laidlaw, K., Johnson, S & Jones, S. (2016). A feasibility randomised controlled trial of recovery focused CBT for older adults with bipolar disorder: Study protocol. BMJ Open, 6:e010590 doi:10.1136/bmjopen-2015-010590.

By the time clients attend treatment for dysregulated behavior, they have likely suffered substantial negative consequences-and yet they still often feel as though the behavior is impossible to resist. As a result, clients often display ambivalence about treatment, difficulty with treatment engagement, trouble completing therapy tasks, and less than optimal outcomes. These treatment barriers can leave both clients and therapists feeling overwhelmed and even hopeless. Therapists treating these clients need a targeted therapy that can address not just the presenting addictive/impulsive behavior, but also the host of other dysregulated behaviors that can impede treatment progress. Mindfulness and Modification Therapy (MMT) is a transdiagnostic therapy that can be customized to address (a) specific dysregulated behaviors; (b) related difficulties with motivation, engagement, and retention; and (c) psychological constructs underlying this spectrum of behaviors. MMT targets dysregulated behavior by integrating guided mindfulness with key elements from Motivational Interviewing, Dialectical Behavior Therapy, Acceptance and Commitment Therapy, and other evidence-based treatments. Pilot trials have shown decreases in alcohol use, drug use, binge eating, physical aggression, and verbal aggression in self- and court-referred clients. Retention has consistently been greater than 80%. Case studies have shown decreases in trichotillomania, skin picking, smoking, compulsive shopping, and other behaviors. Participants in this workshop will gain skills to (a) conceptualize and address dysregulated behaviors in ways that improve engagement and decrease treatment obstacles, (b) customize treatment to fit diverse client needs, and (c) help clients begin moving toward lives that feel more fulfilling. Topics include: improving home-practice completion, evoking change behaviors when feeling stuck, improving attendance/retention, and eliciting values. Implementation will be demonstrated through case vignettes, videos, experiential exercises, and discussion of therapy procedures. Instructions for integrating strategies into existing treatments will be presented along with sample handouts that can be modified to fit client and provider needs.

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

• Describe a method of conceptualizing dysregulated behaviors that can improve treatment engagement.
• Utilize strategies and techniques that can be customized to fit diverse client needs and treatment plans.
• Apply strategies to improve home-practice completion and attendance.
• Describe strategies to evoke change even when feeling stuck and frustrated.
• Discuss empirically supported methods of helping clients move toward lives that feel more fulfilling.

Recommended Readings:

Cassin, S. E., & Geller, J. (2015). Motivational interviewing in the treatment of disordered eating. In H. Arkowitz, W. R. Miller, & S. Rollnick (Eds.), Motivational interviewing in the treatment of psychological problems (2nd ed., pp. 344-364). The Guilford Press.

Miller, W. R. (2015). Motivational interviewing in treating addictions. In H. Arkowitz, W. R. Miller, & S. Rollnick (Eds.), Motivational interviewing in the treatment of psychological problems (2nd ed., pp. 249-270). The Guilford Press.

Witkiewitz, K., Lustyk, M. K. B., & Bowen, S. (2013). Retraining the addicted brain: A review of hypothesized neurobiological mechanisms of mindfulness-based relapse prevention. Psychology of Addictive Behaviors, 27(2), 351-365. https://doi-org.ez.lib.jjay.cuny.edu/10.1037/a0029258

Wupperman, P. (April 2019). Treating impulsive, addictive, and self-destructive behaviors: Mindfulness and modification therapy. Guilford Press.

Wupperman, P., Gintoft-Cohen, M., Haller, D.L., Flom, P., Litt, L.C., & Rounsaville, B.J. (2015). Mindfulness and Modification Therapy for behavior dysregulation: A comparison trial focused on substance use and aggression. Journal of Clinical Psychology, 71, 964-978.

This workshop is specifically for clinicians who want to be more effective in their use of evidence-based practices with people of color and sexual and gender minorities. Given the increasing diversity of clients seeking mental health care, there is a growing need to enhance the sensitivity of therapeutic interventions. Many marginalized groups experience large disparities in access and utilization of mental health care. These disparities have multiple causes, but they do exist in part from well-intentioned clinicians who have not yet acquired the skills and knowledge necessary to effectively engage diverse clients. Microaggressions have been identified as a common and troubling cause for poor retention and inadequate treatment outcomes for people of color. Additionally, microaggressions in the everyday lives of people from stigmatized groups have been linked to numerous negative mental health outcomes. Repeated exposure to microaggressions can cause psychological unwellness and even trauma symptoms. Thus, all clinicians can benefit from a better understanding of microaggressions to improve their work with clients and to help clients navigate microaggressions in their daily lives. We will discuss the theoretical basis of the problem (microaggressions), the cognitive-behavioral mechanisms by which the problem is maintained, and how to address this using CBT principles, with a focus on the role of the therapist. Therapists will learn how to effectively support clients who may be experiencing microaggressions in their daily lives. We will also discuss new research surrounding the impact of microaggressions and review assessment strategies for uncovering the effects of stigma-related stress and trauma in clients. The workshop will include examples, discussion, and Q&A.

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

• Identify microaggressions in interpersonal interactions and the environment.
• Define microaggressions and explain how they are connected to bias and stereotypes.
• Address ruptures in the therapeutic alliance due to microaggressions.
• Support clients coping with distress or impairment due to microaggressions.
• List various (at least 5) types of psychopathologies connected to experiences of microaggressions.

Recommended Readings:

Nadal, K. L. (2013). Contemporary perspectives on lesbian, gay, and bisexual psychology. That's so gay! Microaggressions and the lesbian, gay, bisexual, and transgender community. American Psychological Association. do: 10.1037/14093-000

Williams, M. T. (2020). Managing microaggressions: Addressing everyday racism in therapeutic spaces. ABCT Series on Implementation of Clinical Approaches. Oxford University Press

Williams, M. T. (2020). Microaggressions: Clarification, evidence, and impact. Perspectives on Psychological Science, 15(1), 3-26. doi: 10.1177/1745691619827499

Williams, M. & Halstead, M. (2019). Racial microaggressions as barriers to treatment in clinical care. Directions in Psychiatry, 39(4), 265-280.

Sue, D. W., Alsaidi, S., Awad, M. N., Glaeser, E., Calle, C. Z., & Mendez, N. (2019). Disarming racial microaggressions: Microintervention strategies for targets, White allies, and bystanders. American Psychologist, 74(1), 128-142.

This 3-hour workshop is intended for faculty who teach or seek to teach evidence-based practice for youth in their classes or practica. It will introduce participants to the Managing and Adapting Practice (MAP) system and its "Instructor Model," which supports faculty with ready-to-use instructional materials (e.g., annotated slides, exercises, online learning resources, and clinical tools and guides) and the ability to award credentialing hours to students. Regularly updated content includes practices and clinical algorithms distilled from over 1,000 randomized trials for treatments targeting 11 problem areas (e.g., anxiety, disruptive behavior, suicidality, substance use), supported by easy-to-use guides, spreadsheets, and online tools. Specifically, this workshop will: (a) introduce attendees to the MAP system and resources, (b) demonstrate how curricula can be tailored for a diversity of learners and support their learning over time (e.g., undergraduate, graduate; psychology, social work, psychiatry; classroom and field settings), (c) demonstrate how to meet educational and clinical objectives related to practice delivery, real-time measurement, and integrative reasoning and clinical decision-making, and (d) cover best practices in instruction and training (e.g., use of role play in classes). With an expanded format, this year's MAP presentation will have attendees participate in activities intended to support the development of syllabi, in-class and homework assignments, experiential exercises, and student evaluation methods tailored to their specific learners. Whether you wish to incorporate material into an existing curriculum or to develop an entire course, whether you are giving undergraduates a didactic overview or supervising graduate practicum, whether you are redesigning your entire clinical training model or simply updating a single lecture, this workshop will provide ideas and resources to make your teaching easier and more effective, helping you build the evidence-based thinkers, practitioners, and treatment developers of the future.

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

• Describe the MAP system and how it meets educational objectives related to practice delivery, real-time measurement, and clinical decision-making.
• Identify how the MAP curriculum can be tailored for a diversity of learners and support their learning over time.
• Identify how the MAP curriculum can be incorporated within one course or across multiple courses.
• Recognize empirically supported practices in instruction and training of youth mental health treatments.
• Select activities for rehearsing MAP resources in the classroom.

Recommended Readings:

Chorpita, B. F., & Daleiden, E. L. (2014). Structuring the collaboration of science and service in pursuit of a shared vision. Journal of Clinical Child and Adolescent Psychology, 43, 323-338.

Chorpita, B. F., & Daleiden, E. L. (2018). Coordinated strategic action: Aspiring to wisdom in mental health service systems. Clinical Psychology: Science and Practice, 25, e12264. https://doi-org.pallas2.tcl.sc.edu/10.1111/cpsp.12264

Chorpita, B. F., Daleiden, E. L., & Collins, K. S. (2014). Managing and adapting practice: A system for applying evidence in clinical care with youth and families. Clinical Social Work Journal, 42, 134-142.

Kataoka, S. H., Podell, J. L., Zima, B. T., Best, K., Sidhu, S., & Jura, M. B. (2014). MAP as a model for practice-based learning and improvement in child psychiatry training. Journal of Clinical Child and Adolescent Psychology, 43(2), 312-322. DOI:10.1080/15374416.2013.848773

Mennen, F. E., Cederbaum, J., Chorpita, B. F., Becker, K., Lopez, O., & Sela-Amit, M. (2018). The large-scale implementation of evidence-informed practice into a specialized MSW curriculum. Journal of Social Work Education, 54(sup1), S56-S64.

Cognitive-behavioral therapy for eating disorders (CBT-ED) has traditionally failed to use exposure therapy methods to best effect. Some CBT-ED interventions have recommended approaches that do not reflect the true potential of exposure (e.g., mistaking "white knuckling" for true learning experiences), and some advocate what are effectively avoidant and safety behaviors (e.g., use of "alternative" safety strategies to help patients tolerate anxiety). Moreover, in practice, many clinicians omit key exposure-based techniques completely (e.g., openly weighing the patient; use of mirror exposure). Advocates of CBT for EDs also have done a relatively poor job of articulating when clinicians should conceptualize a strategy as exposure and when they should not. Finally, only recently has the field of eating disorders begun to catch up with the implementation of the inhibitory learning approach to exposure. This workshop will outline how exposure theories have developed and how they fit our understanding of how to treat eating disorders. The presenters will then detail and demonstrate key ways in which exposure therapy can be used to enhance CBT-ED in practice. They will focus on the use of an inhibitory learning approach, where exposure can be delivered more rapidly and with more pervasive benefits. Drawing on their new ABCT-affiliated book, which is the first of its kind to guide clinicians in evidence-based exposure therapy for eating disorders, the presenters will use case examples and role-playing to demonstrate how to implement exposure. This will be used to address a range of symptoms across the range of eating disorder diagnoses (e.g., food/eating-related fears, body image disturbance, recurrent binge-eating, etc.). Finally, the workshop will consider the contexts in which we can use exposure therapy in eating disorder services. This part of the workshop will include: a range of levels of treatment (in-patient; intensive day-patient; out-patient); working with families; addressing clinician reluctance to use exp osure therapy; and working with service settings that are structured to make exposure difficult to implement.

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

• Identify appropriate eating disorder symptoms that could benefit from the use of exposure therapy techniques.
• Identify the avoidant and safety behaviors underpinning eating disorder symptoms.
• Explain the principles of effective exposure therapy.
• Describe how to implement exposure-based methods for eating disorder symptoms, using inhibitory learning principles.
• Identify and address clinicians' avoidance of exposure therapy.

Recommended Readings:

Becker, C. B., Farrell, N. R., & Waller, G. (2019). Exposure therapy for eating disorders. Oxford University Press.

Jansen, A. (1998). A learning model of binge eating: Cue reactivity and cue exposure. Behaviour Research and Therapy, 36, 257-272.

Murray, S. B., Treanor, M., Liao, B., Loeb, K. L., Griffiths, S., & Le Grange, D. (2016). Extinction theory and anorexia nervosa: Deepening therapeutic mechanisms. Behaviour Research and Therapy, 87, 1-10.

Reilly, E. R., Anderson, L. M., Gorrell, S., Schaumberg, K., & Anderson, D. A. (2017). Expanding exposure-based interventions for eating disorders. International Journal of Eating Disorders, 50, 1137-1141.

Waller, G., & Raykos, B. (2019). Behavioral Interventions in the treatment of eating disorders. Psychiatric Clinics of North America, 42, 181-191.

When treating posttraumatic stress disorder (PTSD), it's easy to become overwhelmed by your clients' erroneous beliefs, not knowing where to start or where focus your efforts to gain the most benefit. Consistent with this year's conference theme of enhancing the effectiveness of evidence-based therapies, this workshop will go beyond the session-by-session "how-to's" of Cognitive Processing Therapy (CPT) and focus on harnessing the skill of case conceptualization to better target CPT's key mechanisms to improve effectiveness. Presented by a CPT trainer and CPT expert consultants, this workshop will address how to get more out of CPT by sharpening your skills to identify, formulate, prioritize, and target key beliefs that are most central to unraveling your clients' PTSD. How do people think before trauma, and what ways of thinking do we develop to protect those pretrauma beliefs or avoid painful emotions? Why do patients struggle to stop blaming themselves or others not responsible for their trauma even though it keeps them stuck in guilt, shame, and anger? This workshop will provide a framework for conceptualizing common patient thinking resulting from trauma that will allow you to anticipate and skillfully address your clients' beliefs. In addition to identifying "keystone" beliefs, this workshop will investigate beliefs that clients struggle to let go of and strategies to explore for the function of these beliefs, which, when not addressed, may prevent your client from making progress in treatment. Finally, we will cover effective strategies to target keystone beliefs to unravel your clients' PTSD. The session, appropriate for both those new to CPT as well as advanced CPT therapists, will be interactive and include numerous case examples, video demonstrations, and experiential exercises.

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

• Describe how traumatic events may shatter or strengthen prior beliefs.
• Utilize various sources of information in treatment to conceptualize patient beliefs.
• Identify and prioritize key trauma-related beliefs.
• Explore the function of difficult-to-resolve patient beliefs.
• Demonstrate Socratic questioning techniques to challenge high-priority beliefs.

Recommended Readings:

Farmer, C. C., Mitchell, K. S., Parker-Guilbert, K., & Galovski, T. E. (2016). Fidelity to the cognitive processing therapy protocol: Evaluation of critical elements. Behavior Therapy, doi:10.1016/j.beth.2016.02.009

Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social Cognition, 7(2), 113-136.

Padesky, C.A. (1993). Socratic questioning: Changing minds or guiding discovery? Keynote address European Congress of Behavioural and Cognitive Therapies, London, September 24, 1993. (Available online: http://padesky.com/newpad/wp-content/uploads/2012/11/socquest.pdf)

Resick, P. A., Monson, C. M., Chard, K. M. (2017). Cognitive Processing Therapy for PTSD: A comprehensive manual. Guilford Publications.

Schumm, J. A., Dickstein, B. D., Walter, K. H., Owens, G. P., & Chard, K. M. (2015). Changes in posttraumatic cognitions predict changes in posttraumatic stress disorder symptoms during cognitive processing therapy. Journal of Consulting and Clinical Psychology, 83(6), 1161.