- Email: [email protected]
Mindfulness: Use in Clinical Practice
EXTENDED WORKSHOPS 1 Trauma-Focused Cognitive-Behavioral Therapy for Interpersonal Violence: Practical Strategies for Child Psychiatrists 2 Meditation/Mindfulness: Use in Clinical Practice 3 Introduction to Motivational Interviewing: Skill-Building Fundamentals 4 Dialectical Behavior Therapy Toolkit for Child Psychiatrists: Targeting SelfInjury and Suicidal Behavior 5 Fundamentals in Mentalization-Based Treatment for Suicidal and SelfInjurious Youth
EXTENDED WORKSHOP 1 TRAUMA-FOCUSED COGNITIVE-BEHAVIORAL THERAPY FOR INTERPERSONAL VIOLENCE: PRACTICAL STRATEGIES FOR CHILD PSYCHIATRISTS Judith A. Cohen, MD, Allegheny Health Network, JCohen1@ wpahs.org; Anthony Mannarino, PhD, Allegheny Health Network, [email protected]; Nathaniel G. Sharon, MD, University of New Mexico School of Medicine, [email protected] Objectives: Interpersonal violence is associated with increased risk for developing PTSD and associated problems (e.g., depression, substance abuse). Lesbian, gay, bisexual, and transgender (LGBT) youth, youth in child welfare, and those in the juvenile justice system experience high rates of interpersonal violence, but PTSD is under recognized in these populations. This extended workshop provides additional time and opportunity for child and adolescent psychiatrists to learn core trauma-focused (TF)-CBT techniques that can improve their ability to care for youth who experience interpersonal violence Methods: The workshop provides training, practice, and expert feedback in TF-CBT techniques of the following: 1) applying gradual exposure to overcome trauma avoidance; 2) psychoeducation about interpersonal violence for caregivers (including those who are nonsupportive of the youth); 3) managing traumatic behavior problems; 4) encouraging adaptive affective expression related to interpersonal violence experiences; and 5) cognitively processing interpersonal violence for youth and caregivers. TF-CBT developers Judith Cohen, MD, and Anthony Mannarino, PhD, provide training, demonstration role plays, videos, and expert feedback in these techniques. Nathan Sharon, MD, a TF-CBT-trained child psychiatrist with recognized expertise in treating gender diverse youth, provides demonstration role plays and expert feedback in applying TF-CBT techniques for traumatized LGBT youth. Participants engage in hands-on practice of each technique during the workshop and receive expert feedback. A DSM-5 PTSD rating scale and technique handouts are provided. Results: Through proven CBT implementation techniques, child psychiatrists gain mastery in implementing core TF-CBT techniques for youth who are traumatized by interpersonal violence. These techniques can be used in a variety of practice settings. Conclusions: Implementing core TF-CBT techniques with increased skill and fidelity can improve child psychiatrists’ quality of care for youth who experience interpersonal violence.
EBP, PTSD, CAN Sponsored by AACAP's Child Maltreatment and Violence Committee and Sexual Orientation and Gender Identity Issues Committee http://dx.doi.org/10.1016/j.jaac.2017.07.497
EXTENDED WORKSHOP 2 MEDITATION/MINDFULNESS: USE IN CLINICAL PRACTICE Deborah R. Simkin, MD, Emory University School of Medicine, [email protected]; James J. Hudziak, MD, University of Vermont and Fletcher Allen Health Care, james.hudziak@ uvm.edu; Basant Pradhan, MD, Cooper Medical School of Rowan Unviersity and Cooper University Hospital, [email protected]
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www.jaacap.org
1.0 — 3.0 Objectives: The goal of this session is to provide a hands-on workshop on mindfulness-based stress therapy (MBST) and a combination of mindfulnessbased cognitive behavioral therapy (MBCT) and yoga called Trauma Interventions using Mindfulness-Based Extinction and Reconsolidation (TIMBERª) Methods: The workshop will be scheduled as follows: 8:00 am to 8:30 am— group-guided, focused-attention meditation with guided imagery (Dr. Simkin); 8:30 am to 9:30 am—discussion of research and methods using MBST in youth (Dr. Hudziak); 9:30 am to 10:30 am—demonstration of MBST (Dr. Hudziak); 10:30 am to 10:45 am—break; 10:45 am to 11:45 am—MBST rehearsal by audience; 11:45 am to 12:00 pm—questions; 12:00 pm to 1:00 pm—lunch; 1:00 pm to 2:00 pm—Dr. Pradhan will present data of efficacy, components of TIMBER, and methods in TIMBER, including standardized scales used in TIMBER (Assessment Scale for Mindfulness Interventions, Arousal Response to Trauma Memory Activation, and PTSD-specific scales); 2:00 pm to 3:15 pm—TIMBER is shown step by step through case examples and TIMBER video; 3:15 pm to 3:30 pm— break; 3:30 pm to 4:30 pm—rehearsal of TIMBER with audience participation; and 4:30 pm to 5:00 pm—questions. Results: Current data on these meditation/mindfulness techniques show promise for treating symptomatic anxiety, depression, and executive function in youth. TIMBER integrates the principles of yoga and MBCT. In TIMBER, the psycho-physical manifestations of the hyperarousal episodes and the reappraisal/modifications of the trauma experiences are being done by cognitiveemotive restructuring using cognitive-behavioral and yoga interventions to induce new learning using combined extinction and reconsolidation approaches. Unlike the extinction-only approaches, which have no effect on the original memories of trauma, the reconsolidation-based approaches have been found to update the trauma memories and thus result in new learning. This technique has been useful in patients with refractory PTSD. Conclusions: At the end of this workshop, clinicians will be able to learn techniques that they can use in their office for patients and their families.
EBP, AD, CAM Sponsored by AACAP's Complementary and Integrative Medicine Committee and Health Promotion and Prevention Committee http://dx.doi.org/10.1016/j.jaac.2017.07.498
EXTENDED WORKSHOP 3 INTRODUCTION TO MOTIVATIONAL INTERVIEWING: SKILL-BUILDING FUNDAMENTALS Joseph S. Lee, MD, Hazelden Betty Ford Foundation, [email protected]; Christian Thurstone, MD, Denver Health and the University of Colorado, Christian.Thurstone@ dhha.org Objectives: There is a critical need to provide evidenced-based psychotherapy training to child and adolescent psychiatrists. Motivational interviewing is a humanistic, client-centered, and evidenced-based psychotherapy that can be adopted for use in almost any clinical setting. This day-long workshop will provide sufficient time for hands-on training in motivational interviewing theory and fundamental skills for residents, faculty, and students Methods: This day-long workshop is designed for participants with beginning and intermediate knowledge of motivational interviewing. The workshop will highlight four essential processes of motivational interviewing as follows: 1) engaging; 2) focusing; 3) evoking; and 4) planning. Emphasis will be placed on core skills such as 1) open-ended questions; 2) affirmations; 3) reflections; and 4) summaries. Instruction will be provided by rotational lecture presentations, interactive exercises, small group experiential exercises, and auditing of video samples. Results: By the end of the workshop day, participants will gain confidence in basic motivational interviewing skills to elicit change in talk within clients and to handle client ambivalence. Moreover, even beginner-level trainees will become inspired by their development to pursue further psychotherapy training. Conclusions: Child and adolescent psychiatrists can become very effective at psychotherapy. Motivational interviewing will be a ubiquitous tool that will foster the adoption of evidenced-based therapy approaches regardless of the clinical setting, thus benefitting physicians, clients, and families alike.
J OURNAL
OF THE
AMERICAN A CADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017
EXTENDED WORKSHOP 1 TRAUMA-FOCUSED COGNITIVE-BEHAVIORAL THERAPY FOR INTERPERSONAL VIOLENCE: PRACTICAL STRATEGIES FOR CHILD PSYCHIATRISTS Judith A. Cohen, MD, Allegheny Health Network, JCohen1@ wpahs.org; Anthony Mannarino, PhD, Allegheny Health Network, [email protected]; Nathaniel G. Sharon, MD, University of New Mexico School of Medicine, [email protected] Objectives: Interpersonal violence is associated with increased risk for developing PTSD and associated problems (e.g., depression, substance abuse). Lesbian, gay, bisexual, and transgender (LGBT) youth, youth in child welfare, and those in the juvenile justice system experience high rates of interpersonal violence, but PTSD is under recognized in these populations. This extended workshop provides additional time and opportunity for child and adolescent psychiatrists to learn core trauma-focused (TF)-CBT techniques that can improve their ability to care for youth who experience interpersonal violence Methods: The workshop provides training, practice, and expert feedback in TF-CBT techniques of the following: 1) applying gradual exposure to overcome trauma avoidance; 2) psychoeducation about interpersonal violence for caregivers (including those who are nonsupportive of the youth); 3) managing traumatic behavior problems; 4) encouraging adaptive affective expression related to interpersonal violence experiences; and 5) cognitively processing interpersonal violence for youth and caregivers. TF-CBT developers Judith Cohen, MD, and Anthony Mannarino, PhD, provide training, demonstration role plays, videos, and expert feedback in these techniques. Nathan Sharon, MD, a TF-CBT-trained child psychiatrist with recognized expertise in treating gender diverse youth, provides demonstration role plays and expert feedback in applying TF-CBT techniques for traumatized LGBT youth. Participants engage in hands-on practice of each technique during the workshop and receive expert feedback. A DSM-5 PTSD rating scale and technique handouts are provided. Results: Through proven CBT implementation techniques, child psychiatrists gain mastery in implementing core TF-CBT techniques for youth who are traumatized by interpersonal violence. These techniques can be used in a variety of practice settings. Conclusions: Implementing core TF-CBT techniques with increased skill and fidelity can improve child psychiatrists’ quality of care for youth who experience interpersonal violence.
EBP, PTSD, CAN Sponsored by AACAP's Child Maltreatment and Violence Committee and Sexual Orientation and Gender Identity Issues Committee http://dx.doi.org/10.1016/j.jaac.2017.07.497
EXTENDED WORKSHOP 2 MEDITATION/MINDFULNESS: USE IN CLINICAL PRACTICE Deborah R. Simkin, MD, Emory University School of Medicine, [email protected]; James J. Hudziak, MD, University of Vermont and Fletcher Allen Health Care, james.hudziak@ uvm.edu; Basant Pradhan, MD, Cooper Medical School of Rowan Unviersity and Cooper University Hospital, [email protected]
S128
www.jaacap.org
1.0 — 3.0 Objectives: The goal of this session is to provide a hands-on workshop on mindfulness-based stress therapy (MBST) and a combination of mindfulnessbased cognitive behavioral therapy (MBCT) and yoga called Trauma Interventions using Mindfulness-Based Extinction and Reconsolidation (TIMBERª) Methods: The workshop will be scheduled as follows: 8:00 am to 8:30 am— group-guided, focused-attention meditation with guided imagery (Dr. Simkin); 8:30 am to 9:30 am—discussion of research and methods using MBST in youth (Dr. Hudziak); 9:30 am to 10:30 am—demonstration of MBST (Dr. Hudziak); 10:30 am to 10:45 am—break; 10:45 am to 11:45 am—MBST rehearsal by audience; 11:45 am to 12:00 pm—questions; 12:00 pm to 1:00 pm—lunch; 1:00 pm to 2:00 pm—Dr. Pradhan will present data of efficacy, components of TIMBER, and methods in TIMBER, including standardized scales used in TIMBER (Assessment Scale for Mindfulness Interventions, Arousal Response to Trauma Memory Activation, and PTSD-specific scales); 2:00 pm to 3:15 pm—TIMBER is shown step by step through case examples and TIMBER video; 3:15 pm to 3:30 pm— break; 3:30 pm to 4:30 pm—rehearsal of TIMBER with audience participation; and 4:30 pm to 5:00 pm—questions. Results: Current data on these meditation/mindfulness techniques show promise for treating symptomatic anxiety, depression, and executive function in youth. TIMBER integrates the principles of yoga and MBCT. In TIMBER, the psycho-physical manifestations of the hyperarousal episodes and the reappraisal/modifications of the trauma experiences are being done by cognitiveemotive restructuring using cognitive-behavioral and yoga interventions to induce new learning using combined extinction and reconsolidation approaches. Unlike the extinction-only approaches, which have no effect on the original memories of trauma, the reconsolidation-based approaches have been found to update the trauma memories and thus result in new learning. This technique has been useful in patients with refractory PTSD. Conclusions: At the end of this workshop, clinicians will be able to learn techniques that they can use in their office for patients and their families.
EBP, AD, CAM Sponsored by AACAP's Complementary and Integrative Medicine Committee and Health Promotion and Prevention Committee http://dx.doi.org/10.1016/j.jaac.2017.07.498
EXTENDED WORKSHOP 3 INTRODUCTION TO MOTIVATIONAL INTERVIEWING: SKILL-BUILDING FUNDAMENTALS Joseph S. Lee, MD, Hazelden Betty Ford Foundation, [email protected]; Christian Thurstone, MD, Denver Health and the University of Colorado, Christian.Thurstone@ dhha.org Objectives: There is a critical need to provide evidenced-based psychotherapy training to child and adolescent psychiatrists. Motivational interviewing is a humanistic, client-centered, and evidenced-based psychotherapy that can be adopted for use in almost any clinical setting. This day-long workshop will provide sufficient time for hands-on training in motivational interviewing theory and fundamental skills for residents, faculty, and students Methods: This day-long workshop is designed for participants with beginning and intermediate knowledge of motivational interviewing. The workshop will highlight four essential processes of motivational interviewing as follows: 1) engaging; 2) focusing; 3) evoking; and 4) planning. Emphasis will be placed on core skills such as 1) open-ended questions; 2) affirmations; 3) reflections; and 4) summaries. Instruction will be provided by rotational lecture presentations, interactive exercises, small group experiential exercises, and auditing of video samples. Results: By the end of the workshop day, participants will gain confidence in basic motivational interviewing skills to elicit change in talk within clients and to handle client ambivalence. Moreover, even beginner-level trainees will become inspired by their development to pursue further psychotherapy training. Conclusions: Child and adolescent psychiatrists can become very effective at psychotherapy. Motivational interviewing will be a ubiquitous tool that will foster the adoption of evidenced-based therapy approaches regardless of the clinical setting, thus benefitting physicians, clients, and families alike.
J OURNAL
OF THE
AMERICAN A CADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017