WCBCT 2010 Boston | World Congress of Behavioral and Cognitive Therapies

Aaron T. Beck (University of Pennsylvania, USA)

TITLE: A Conversation Period with Dr. David M. Clark

INSTITUTION: Department of Psychiatry, University of Pennsylvania

ABSTRACT BODY:
Description: New advances in cognitive therapy in the United States and Europe. Drs. Beck and Clark will discuss the latest applications of cognitive therapy, recent work on the neurophysiological correlates of the cognitive model, and the empirical evidence for the more recent modifications of cognitive therapy and cognitive behavior therapy.

Biography: Aaron T. Beck, M.D.
University Professor of Psychiatry
University of Pennsylvania
Department of Psychiatry

Paula Barrett (The University of Queensland, Australia)

TITLE: Building Resilience in Families and School Communities - Quo Vadis?

INSTITUTION: Educational Psychology, University of Queensland

ABSTRACT BODY:
Description: For over two decades research on preventative mental health interventions has shown an overall long-term positive impact on the lives of thousands of children and adults worldwide. The long-term societal benefits of early intervention and resilience building have been demonstrated by Nobel Laureates for Economics. Nevertheless, models of early intervention and prevention are not readily embraced by mental health or educational professionals; and resistance to positive psychology and empowering philosophies in clinical settings is the norm.
 Resilience and preventative evidence-based strategies can be taught both at community/group level, and at an individual level in a clinic setting. It only requires a change in philosophical approach of client work and we can use standard CBT and other evidence-based skills (exercise, diet, mindfulness, healthy sleep education amongst others) for the design of our interventions and relapse prevention plans.
 Measurement of intervention outcomes is also increasingly encompassing a multitude of both deficit measures to ascertain levels of psychopathology across a variety of domains, as well as strength-based measures of happiness, coping, peer support, resilience and others. The latter and newer measures are better equipped psychometrically to deal with changes at a population level when we are aiming to produce positive changes in all participants in terms of acquisition of strength-based attributes.
 We all know that prevention is better than cure: Why do we not apply this basic principle in our day-to-day practice as mental health professionals? Why do we not incorporate ?Resilience and Prevention? as part of the curriculum of our pre, primary and high schools as well as university training courses?
 Much needs to be done as there is so much promise in terms of the number of lives we can positively change, from a very young age, using a preventative, resilience building community approach in the next few decades ? Quo Vadis?

Biography: Professor Paula Barrett is one of Australia?s leading scholars in the area child psychology and education. Supported by the World Health Organization Paula?s FRIENDS for Life programs for the prevention and treatment of anxiety and prevention are available in 12 languages and used in over 18 countries around the world. Amongst other top-ranking international and peer-review journals, Professor Paula Barrett?s research and programs have been recognised by The Cochrane Collaboration, The Cochrane Library, 2007. Paula was the 2010 recipient of The Highly Commended Certificate in the Human Rights Medal, awarded by the Human Rights Commission.

David H. Barlow (Boston University, USA)

Opening Address:

TITLE: Cognitive Behavior Therapy in 2010: An Interim Report and Future Directions
INSTITUTION: Center for Anxiety & Related Disorders at Boston University, Boston, MA, United States.
ABSTRACT BODY:
Description: In 1952, Hans Eysenck published ?The Effects of Psychotherapy,? in which he pointed out that there was no evidence that the widespread practice of psychotherapy had any positive effects. In the firestorm of controversy following this paper, behavioral therapy was born with an overarching emphasis on building effective behavior change procedures based on principles of behavioral and cognitive science. Subsequent developments drawn from an ever-increasing array of scientific findings from diverse areas of basic science brings us to the present where cognitive-behavioral therapy best represents evidence-based psychological approaches to alleviating psychopathology and enhancing functioning. In this presentation, we will suggest major trends in the future development of cognitive-behavioral therapy including: a focus on competencies in training, new dimensional approaches to psychopathology, a new emphasis on clinical outcomes assessment with a simultaneous return to a more idiographic focus, the replacement of single-diagnosis treatment manuals with modular transdiagnostic interventions, the continued discovery of new pharmacological agents with known mechanisms of action that specifically bolster the effectiveness of psychological treatment, and a new emphasis on technology-based service delivery.

Invited Address:

TITLE: Dissemination: The (Multi) Billion Dollar Challenge: Are We Getting It Right?

ABSTRACT BODY:
Description: Governments and health care policymakers around the world have recognized the efficacy and effectiveness of psychological, particularly cognitive-behavioral, treatments for a variety of behavioral disorders. As a result, policy has been established and several billion dollars committed to facilitate dissemination of these treatments through a series of financial and regulatory incentives and mandates. But most of these dissemination and implementation programs were created with a distinct sense of urgency which precluded the deliberate development of a consensus on how best to implement the dissemination process. In the context of dissemination science and the study of knowledge diffusion, various barriers that must be overcome for successful dissemination will be presented as well as a checklist of procedural steps that may serve as a guide for future dissemination and implementation efforts.

Biography: David H. Barlow is Professor of Psychology and Psychiatry and Founder and Director of the Center for Anxiety and Related Disorders at Boston University. He received his Ph.D. from the University of Vermont in 1969 and has published over 500 articles and chapters and over 60 books mostly in the area of the nature and treatment of emotional disorders. He is the recipient of numerous awards, including the Distinguished Scientific Award for Applications of Psychology from the American Psychological Association.

Susan Bögels (University of Maastricht, the Netherlands)

TITLE: The Role of Fathers in the Aetiology and Treatment of Childhood Anxiety
INSTITUTION: Child Development and Education, UvA, Amsterdam, Netherlands.
ABSTRACT BODY:
Description: Fathers have been ignored in the research and treatment of children with anxiety disorders. In this keynote a novel, evolutionary-based theory is introduced concerning the role of the father in the development of children?s fear. From an evolutionary perspective, fathers have specialized in external environments (confronting dangerous animals, fighting strangers, exploring new territory) while mothers specialized in the internal environment (feeding and comforting the child). Given this evolutionary-based comparative advantage of fathers, infants might overvalue the signal of their father compared to their mother to decide whether the external environment represents threat or opportunity. From this, it follows that anxious fathers may have a stronger influence on the aetiology of child anxiety than anxious mothers. Put differently, children may learn to overcome their fears by the example of a confident, courageous, and risk-taking fathers. Also, it can be hypothesized that involving fathers in the treatment of anxious children may be an effective strategy to help children overcome anxieties.
I will review the research literature providing direct and indirect evidence for a particular role of the father in child anxiety development. Then, I will present new data from our own lab in which 140 first-born children have been followed from their birth until the age of 2.5 to examine the effect of their fathers and mothers anxiety disorders and parenting on their children?s anxiety symptoms. Video-examples or typical differences between paternal and maternal interactions with their baby are shown. Furthermore, results from our clinical research on the relative effectiveness of involving fathers versus mothers in helping children overcome their anxiety disorders are reviewed. Also, data from our experimental research on how children weigh their fathers? and mothers? signals in the face of potential danger are given.
The potential implications of this new theory on the role of the father for research, prevention and treatment of child anxiety is discussed. Also, societal implications, such as father involvement in parenting after divorce, and the involvement of men in child care and primary education, is discussed.
Biography : Susan Bögels, psychotherapist, is professor in Developmental Psychopathology at the University of Amsterdam, and director of the academic clinic for treatment of parents and children in Amsterdam. Her main research themes concern the intergenerational transmission of anxiety disorders, family treatment, and the role of attention in the aetiology and treatment of psychopathology, including mindfulness. She has started a baby lab to investigate the early aetiology of anxiety in interaction with parenting. She is a member of the DSM-V workgroup on anxiety disorders.

Kelly Brownell (Yale University, USA)

TITLE: Is There The Courage to Change the World?s Diet?
INSTITUTION: Rudd Center, Yale University, New Haven, CT, United States.
ABSTRACT BODY:
Description: Obesity, diabetes and other diseases related to overnutrition take a great toll on the world?s health. These problems do not yield to traditional medicine and its accompanying focus on treatment, nor do weak government attempts at education and calls for personal responsibility show any signs of success. This argues for bold government policies that change conditions that drive the world?s diet. Altering defaults in this way requires research as its basis, but research is seldom designed to help in the policy arena. A model of strategic research will be presented in which science can better link with public policy and the concept of impact moves beyond citations. The model includes input from key government officials (e.g., members of Congress, Attorneys General), identification of goals and target audiences, and a plan for making the results known among those in a position to create social change. Policy victories in the obesity/nutrition arena will be analyzed and prediction of where the field will be moving will be attempted.
Biography: Kelly D. Brownell, Ph.D. is Professor of Psychology, Professor of Epidemiology and Public Health, and Director of the Rudd Center for Food Policy and Obesity at Yale University.

Dianne Chambless (University of Pennsylvania, USA)

TITLE: Marriage and Anxiety Disorders: For Better or for Worse
INSTITUTION: Psychology, University of Pennsylvania, Philadelphia, PA, United States.
ABSTRACT BODY:
Description: The relationship between the quality of intimate relationships and depression has long been established. However, other than a flurry of papers in the 1970s and 1980s on marital aspects of agoraphobia, little research has focused on the important interpersonal relationships of patients with anxiety disorders. In the last decade researchers have picked up the thread again but have concentrated less on overall marital satisfaction and more on specific aspects of anxious patients? relationships with their partners, in particular expressed emotion (the partner?s hostility and criticism of and emotional overinvolvement with the patient), perceived criticism (the patients? perception of how critical their relatives are of them), and the spouse?s excessive accommodation to the patient?s anxiety. Expressed emotion and perceived criticism have proved to be important predictors of treatment outcomes for patients with schizophrenia, bipolar disorder, eating disorders, major depression, and substance use disorders. The topic of this lecture will be the prediction of outcome of cognitive-behavioral treatment of anxiety disorders by these variables and by over-accommodation, as well as elucidation of factors that lead relatives to be high in expressed emotion and to over-accommodate to the patient?s disorder and lead patients to perceive their relatives as critical of them. Possible mechanisms for the effects of expressed emotion, perceived criticism, and over-accommodation on patients will be considered, along with their implications for development of treatment approaches that take these findings into account with the goal of improving treatment outcomes for people with anxiety disorders.
Biography: Dianne L. Chambless is the Merriam Term Professor of Psychology and Director of Clinical Training at the University of Pennsylvania. She has been recognized for her research on anxiety disorders, particularly panic disorder with agoraphobia, and for her pioneering work on identification and dissemination of empirically supported treatments. Dr. Chambless has long been interested in the intimate relationships of people with anxiety disorders and their spouses, beginning with her 1978 publication with Alan Goldstein of a ?Reanalysis of Agoraphobia? in the journal Behavior Therapy.

David A. Clark (University of New Brunswick, Canada)

TITLE: Too Much in the Head: A Paradoxical Look at Obsessions
INSTITUTION: Psychology, University of new Brunswick, Fredericton, NB, Canada.
ABSTRACT BODY:
Description: Obsessions are one of the most difficult clinical phenomena to treat effectively. For decades we have known that exposure and response prevention (ERP), the most effective psychological treatment for obsessive compulsive disorder (OCD), is less efficacious for obsessions than for overt compulsions. In part these disappointing outcomes led to a call for more cognitively oriented intervention strategies in the treatment protocol for OCD. However these newer cognitive behavioral treatments have also not lived up to their promise. Obsessions continue to remain relatively treatment-resistant despite the introduction of more innovative therapeutic approaches. So, what is it about obsessions that make them so difficult to treat? In this address it is proposed that the paradoxical nature of mental control is a major contributor to the remarkable persistence of obsessional thoughts, images and impulses. The lecture begins with a review of the cognitive research on intentional, effortful control in OCD. This will include a critical evaluation of research on thought control beliefs and appraisals, reliance on faulty control strategies, and the metacognitive appraisal of failed thought control. In addition, the role of thought suppression will be considered, with particular attention given to experimental work conducted in our lab as well as other relevant published research. In light of the research findings on effortful control, more innovative approaches to the treatment of obsessions are considered. A model for the persistence of uncontrollable obsessions is proposed and evaluated in relation to relevant experimental findings. The address concludes with recommendations for a more refined, empirically derived and targeted approach to the treatment of obsessions. As well, we consider whether some of these intervention modifications might be generalizable to other persistent, uncontrollable anxious cognition like worry, ruminations and trauma re-experiencing symptoms.
Biography: David A. Clark, Professor, Department of Psychology, University of New Brunswick, Canada received his Ph.D. from the Institute of Psychiatry, University of London, England. His research and writing focus on ognitive aspects to OCD and vulnerability to depression. His most recent publications include Cognitive Therapy for Anxiety Disorders: Science and Practice with co-author Aaron T. Beck (Guilford, 2010), Cognitive Behavioral Therapy for OCD (Guilford, 2004), and the Clark-Beck Obsessive Compulsive Inventory (Harcourt Assessment, 2002). He is a Fellow of the Canadian Psychological Association, Founding Fellow of the Academy of Cognitive Therapy, and recipient of the 2008 Aaron T. Beck Award for Significant and Enduring Contributions to Cognitive Therapy.

David M. Clark (Institute of Psychiatry at Kings College London, UK)

TITLE: Social Anxiety Disorder: from theory to therapy
INSTITUTION: Institute of Psychiatry, Kings College London, London, United Kingdom.
ABSTRACT BODY:
Description: Social anxiety disorder is common and disabling. Longditudinal studies show it has a particularly low natural recovery rate, emphasizing the need for effective treatment. Clark & Wells (1995) proposed a model of the maintenance of the disorder and, with colleagues, developed a specialized form of cognitive therapy which targets the hypothesized maintenance processes. This presentation outlines the model and its empirical status, describes the treatment and the way it has evolved over time with particular emphasis on its novel features, and also highlights surprising research findings. Relevant randomized controlled trials are reviewed. Together these indicate that the individual CT program is highly effective and compares favourably with group CT, exposure therapy, interpersonal therapy and treatment with SSRIs. Mediation analyses and single session therapy experiments to determine the mechanism therapeutic change are described, along with recent developments in novel ways of delivering the treatment (self-study assisted therapy, internet etc). Finally, a brief overview of UK's large scale initiative for Improving Access to Psychological Treatments for Anxiety and Depression (including social anxiety disorder) is provided.
Biography: David M Clark is the Professor of Psychology at the Institute of Psychiatry, Kings College London, UK and a Past President of the International Association of Cognitive Therapy and of the British Association of Behavioural and Cognitive Therapies. His research focuses on cognitive processes in the maintenance and treatment of anxiety disorders. With colleagues he has developed effective cognitive therapy programmes for social anxiety disorder, panic disorder, hypochondriasis and PTSD.

Francesco Colom (Bipolar Disorders Program, Clinical Institute of Neuroscience, Spain)

TITLE: ?Psychotherapy: from iatrogenia to an evidence-based medical treatment?
INSTITUTION: Bipolar Disorders Program -Institute of Neurosciences, IDIBAPS-CIBERSAM-Hospital Clinic, Barcelona, Spain.
ABSTRACT BODY:
Description: The practice of psychotherapy is, and should be, constantly evolving. Our understanding of psychiatric disorders has dramatically grown in the last twenty years thanks to some key findings on their biological basis but also some key developments on our clinical knowledge. Moreover, a vast majority of severe psychiatric conditions that used to be considered as untreatable are today properly addressed thanks to the skyrocketing success of brand new drugs which allow our patients to reach some wellbeing, better quality of life and reduce suffering.
Psychological treatments for severe psychiatric disorders have also evolved dramatically during the last decade. It has been a troublesome and winding road but, finally, psychological treatments have a central role ?most of the times as an add-on to pharmacological treatment- in the daily management of severe psychiatric disorders.
Psychotherapy is, nowadays, an evidence-based treatment which follows roughly the same rules and experiments which apply to other treatment modalities (medication, biophysical treatments). Models based on inspiration or subjectivity are left far beyond. Iatrogenia is over. The era of scientific psychotherapy has begun.
The present lecture will review the evidence-based psychological treatments which have shown prophylactic efficacy on bipolar disorders, focusing mostly in psychoeducation. The lecture also includes a view on the limitations of psychological treatments for bipolar disorder and how this may lead future developments.
Biography: Francesc Colom, PsyD, MSc, PhD is the Head of the Psychoeducation and Psychological Treatments Area at the Barcelona Bipolar Disorders Program. He has lectured all over the world and published near to a hundred indexed papers. He is part of the Nomenclature Committee of the International Society for Bipolar Disorders, chairs the ISBD Website Education Committee for the same society and is member of the Scientific Advisory Pannel of the ECNP. In June 2007, Francesc Colom was awarded with the prestigious ?Mogens Schou Award? for the quality of his research.

Michelle Craske (University of California, Los Angeles, USA)

TITLE: Optimizing Learning during Exposure Therapy for Anxiety Disorders
INSTITUTION: Psychology, UCLA, Los Angeles, CA, United States.
ABSTRACT BODY:
Description: Prevailing models of exposure therapy for phobias and anxiety disorders construe level of fear throughout exposure trials as an index of corrective learning. However, the evidence indicates that neither the degree by which fear reduces nor the ending fear level predict therapeutic outcome. Developments in the theory and science of fear extinction, and learning and memory, indicate that ?performance during training? is not commensurate with learning at the process level. Inhibitory learning is recognized as being central to extinction and access to secondary inhibitory associations is subject to influences such as context and time, rather than fear during extinction training. The current presentation will focus on evidence pertaining to methods for enhancing inhibitory learning during exposure therapy (through mismatches with associative expectancies, weaning safety signals, and medial prefrontal cortex activation), and retrieval of inhibitory learning over time and context (through variability, spacing, and retrieval cues to offset context renewal).
Biography: Michelle G. Craske has published extensively in the area of etiology and treatment of anxiety disorders. She is currently investigating risk factors for anxiety disorders and depression among children and adolescents, the cognitive and physiological aspects of anxiety and panic attacks, neural mediators of behavioral treatments for anxiety disorders, fear extinction mechanisms of exposure therapy, and the development and dissemination of treatments for anxiety and related disorders. She is associate editor for Behaviour Research and Therapy, scientific board member for the Anxiety Disorders Association of America, and Chair of the DSM-V Anxiety Disorders Subworkgroup.

Michael Davis (Emory University, USA)

TITLE: Lack of Safety Signal Learning in PTSD and Role of NMDA Receptors in Fear Extinction and Psychotherapy
INSTITUTION: Emory University, Atlanta, GA, United States.

ABSTRACT BODY:
Description: Many forms of anxiety disorders are characterized by excessive levels of fear and anxiety. Thus, it is extremely important to understand normal processes of fear inhibition and how these might be dysregulated in anxiety disorders. This address will describe two experimental areas involved in inhibition of fear: Safety signal learning; and Extinction. I will describe a new way to measure safety signal learning in rats, monkeys and humans and ideas about how this can be studied in rhesus monkeys. I will then describe our work with D-cycloserine and fear extinction and how this has led to the use of D-cycloserine as an adjunct to psychotherapy.
Safety signal learning: One of the core symptoms of PTSD is an inability to feel safe under conditions that unaffected individuals do feel safe. For example, a woman who was raped at night may no longer feel safe in her own home with her husband in bed. Experimentally, safety signal learning has been successfully studied in animals, such as rats and mice. In the typical experiment, one cue, such as a light is paired with a shock, and a second cue, such as a tone, in compound with the light, signals that no shock will occur. So, the tone is a safety signal, even in the presence of the dangerous light, the shock does not occur. One can measure a fear reaction to the light and a reduction of fear in the presence of a tone. Moreover, this ?transfers? to inhibit fear to yet another cue paired with the shock. This procedure has been very successful in rats but has failed miserably in humans, because they do not show transfer of fear to other cues. We have developed a variant of this procedure to allow it to work in humans and have found in three independent studies that patients with PTSD have deficits in safety signal learning or expression. Based on normal safety signal learning in major depression and other disorders we believe this may be a fundamental biomarker for PTSD.
Extinction: Extinction of fear (a reduction of a fear response when an aversive cue is presented repetitively in the absence of an aversive event) is not an erasure of the original fear memory, but a new form of learning that depends on the N-methyl-D-aspartate (NMDA) receptor. Fear extinction can be facilitated by the NMDA partial agonist D-cycloserine as well as in psychotherapy in six independent studies in simple and social phobia, obsessive compulsive disorder, and panic disorder.

Biography: Dr. Michael Davis was appointed the Robert W. Woodruff Professor of Psychiatry and Behavioral Sciences in the Department of Psychiatry at Emory University, September 1, 1998. Prior to this, Dr. Davis was on the faculty at Yale University for 29 years in the Departments of Psychiatry and Psychology. His faculty appointment began immediately after he received his Ph.D. in Experimental Psychology at Yale in 1969. Dr. Davis is world renown for his work on the neural basis of fear, the role of the amygdala in conditioned fear and memory, and the acoustic startle reflex. He held an NIMH Career Development and Research Scientist Award for 25 years, and has had generous support from the National Science Foundation and National Institute of Mental Health (NIMH), including two consecutive 10-year NIMH MERIT Awards. Currently he has about 350 publications and is exploring intracellular processes in the amygdala in connection with the formation and storage of long term fear memories as well as studying brain systems involved in the reduction of fear and anxiety.

Peter de Jong (University of Groningen, the Netherlands)

TITLE: The ?Unconscious? and Psychopathology: New insights from implicit
cognition research and their clinical implications.
INSTITUTION: University of Groningen, Groningen, Netherlands.
ABSTRACT BODY:
Description: Current cognitive models of psychopathology assume that emotional and behavioral symptoms are maintained through dysfunctional representations (cognitive schemas). Until recently, most research that focused on these models relied on self-report measures. Yet, by now there is a wide consensus that most of our behaviors and cognitions transpire very quickly, and are ?unconscious? in the sense that they occur outside conscious control or awareness. Accordingly, there is an increased interest in using implicit measures of automatic, ?unconscious? associations in addition to routinely used self-report measures. Following recent dual process models, implicit and explicit measures tap different systems. Explicit (reflective) beliefs would stem from the weighting of propositions and their corresponding ?truth? values, while automatic (reflexive) associations would reflect more simple associations in memory. Both types of associations may be differentially involved in psychopathology. Perhaps most important, automatic associations have been shown to have differential predictive validity for more uncontrollable behaviors such as autonomic responding and nonverbal behaviours. Hence automatic associations may well play an important role in guiding relatively spontaneous, uncontrollable behaviors that are critically involved in psychopathology (such as substance misuse, suicidal thoughts, craving for food, defensive reflexes, etc.). Especially important from a therapeutical stance, one may question whether automatic associations are similarly malleable via routine CBT approaches as reflective beliefs. Accordingly, the presence of residual dysfunctional ?unconscious? associations may be one explanation of the return of symptoms following initially successful treatment. Building on this I will argue that insight in the role of automatic associations may provide important complementory information that may help improving our understanding of how disorders are maintained and how they may be treated efficiently. The theoretical and clinical utility of differentiating between automatic associations and reflective beliefs will be illustrated and discussed by drawing from recent evidence related to several forms of psychopathology such as anxiety disorders, depression, substance misuse, and sexual dysfunctions. Special attention will be paid to the role of dispositional factors (such as the ability to exert cognitive control) in shifting the weight between automatic associations and more reflective beliefs in guiding people?s behaviors. Implications for clinical interventions will be discussed.
Biography: Received his PhD in 1994 at Maastricht University and is currently full professor of Experimental Psychopathology at the University of Groningen. Main research focus is on implicit cognition and psychopathology.

Anke Ehlers (Institute of Psychiatry, Kings College London, UK)

TITLE: A Cognitive Approach to Understanding and Treating Posttraumatic Stress Disorder
INSTITUTION: Psychology PO77, King's College London, Institute of Psychiatry, London, England, United Kingdom.
ABSTRACT BODY:
Description: Ehlers and Clark's (2000) cognitive model suggests that chronic posttraumatic stress disorder (PTSD) develops if trauma survivors process the traumatic event in a way that poses a serious current threat. The perceived threat has two sources: First, people with chronic PTSD show excessively negative appraisals of the trauma and / or its sequelae including the initial PTSD symptoms. Second, the nature of the trauma memory leads to easy cue-driven trauma memories that lack the awareness of the self in the past. Furthermore, the patients? appraisals motivate a series of dysfunctional behaviors and cognitive strategies that are intended to reduce the sense of current threat, but maintain the disorder (e.g., thought suppression, rumination, safety behaviors).
A series of prospective longitudinal studies of trauma survivors and laboratory experiments supported the role of the maintaining factors suggested in the model. Recent prospective studies also supported specificity of the proposed factors for PTSD versus depression (e.g., Ehring et al., 2008).
The model has led to the development of a psychological treatment program, Cognitive Therapy for PTSD (Ehlers & Clark, 2000; Ehlers et al., 2005). Five randomized controlled trials showed that the treatment is highly acceptable, and more effective than wait list, self-help or an equally credible psychological treatment (Ehlers et al., 2003; 2005; submitted; Duffy et al., 2007; Smith et al., 2007). Comparable treatment effect sizes were achieved by trained clinicians in a community setting (Gillespie et al., 2002). Further studies showed that the treatment is also effective when given as a 1-week intensive treatment, and that is effective in very chronic PTSD following terrorist violence (Duffy et al., 2007) and in children (Smith et al., 2007). Mediation analyses suggested that the effects of CT are mediated by changes in the three maintaining factors suggested by Ehlers and Clark's (2000) model, memory characteristics, appraisals, and maintaining cognitive and behavioral strategies.
Biography: Anke Ehlers is Professor of Experimental Psychopathology and Wellcome Trust Principal Research Fellow at the Department of Psychology, Institute of Psychiatry, King?s College London, UK. She is Co-Director of the Centre for Anxiety Disorders and Trauma, Maudsley Hospital, London, UK. Her research focuses on anxiety disorders, in particular posttraumatic stress disorder (PTSD), panic disorder, and social phobia.

Paul Emmelkamp (University of Amsterdam, the Netherlands)

TITLE: Cognitive-Behavioral Treatment of Obsessive Compulsive Disorder: The State of the Art
INSTITUTION: University of Amsterdam, Amsterdam, Netherlands.
ABSTRACT BODY:
Description: In this presentation I will review the role of theory in the historical course of behavioral and cognitive therapy of OCD, which has increased and decreased over the years. It is generally assumed that treatment innovations develop nicely from sound empirically supported theoretical approaches to their application in treatment. However, in OCD this has never been the case. In OCD most innovations in CBT interventions have emerged from clinical practice rather than being the result of theoretically driven experimental work. Further, in treatment studies on OCD, there has been a surprising lack of interest for studying mediational factors in treatment. Therefore, a stronger emphasis on the development and empirical testing of theories of behavioral and cognitive change appears timely.
On the other hand, it will be argued that many theoretical developments in recent years/decades with respect to OCD have not led to any innovation in clinical practice. While research into experimental psychopathology of OCD has certainly improved our theoretical understanding of OCD, to the best of my knowledge it has had no real clinical impact on diagnosis, treatment planning or innovations of treatment of patients suffering from OCD. Comparing effect sizes of treatment of OCD in the seventies of the last century with effect sizes of treatment in the past few years reveals that there has not been any improvement in the result achieved.
The evidence-based approach, which is the currently prevailing view on CBT therapists is based on disorder-specific thinking; it assumes that qualitatively distinct groups can be defined by shared symptoms. This approach assumes that patients with OCD respond in a uniform way to a certain treatment. However, there might be important differences within this patient group, which have largely been neglected in research. Bridging the gaps between basic science, treatment development, treatment process research and everyday clinical practice remains an important challenge for future CBT research in OCD.
Biography: Paul M.G. Emmelkamp (17-02-1949) is a licensed psychotherapist and clinical psychologist and full professor of clinical psychology at the University of Amsterdam. He attended Utrecht University where he received his PhD in 1975. Before moving to Amsterdam he held positions at the University of Groningen, where he was appointed as full professor in Clinical Psychology in 1986. Paul Emmelkamp has contributed to a number of areas in clinical psychology, psychopathology and psychiatry. He has written and co-edited many books on research into a variety of clinical subjects. Further, he has written over 350 publications in peer reviewed journals or books. He is Co-Editor in chief of Clinical Psychology & Psychotherapy and serves on the editorial board or advisory board of a number of journals in psychology and psychiatry, including Applied and Preventive Psychology, Journal of Anxiety Disorders, and Psychotherapy & Psychosomatics. Paul Emmelkamp has received anumber of honours and awards, including membership of the Royal Academy of Arts and Sciences, an honorary membership of the Dutch Association of Behaviour and Cognitive Therapy, and the Senior Heijmans award for his lifetime achievements from the Dutch Institute of Psychologists (NIP). In 2006 he was awarded a distinguished professorship ('academy professor') by the Royal Academy of Arts and Sciences.

Christopher Fairburn (Oxford University, UK)

TITLE: ?TRANSDIAGNOSTIC? THEORY AND PRACTICE
INSTITUTION: Psychiatry, Oxford University, Oxford, United Kingdom.
ABSTRACT BODY:
Description: There has been recent interest in adopting a transdiagnostic perspective on psychopathology and treatment. This has been particularly well developed in the eating disorder field where there appear to be transdiagnostic mechanisms that lock people into having an eating disorder but not a particular eating disorder. Accordingly a transdiagnostic form of CBT has been developed and it has been shown to be suitable for all forms of eating disorder.
In this presentation the case for transdiagnostic conceptualization and practice will be argued with reference to various classes of psychiatric disorder. It will be proposed that not everything that is ?transdiagnostic? is of interest and that a distinction needs to be drawn between transdiagnostic trivia and transdiagnostic process of clinical importance.
Biography: Professor Christopher Fairburn is Wellcome Principal Research Fellow and Professor of Psychiatry at the University of Oxford. He has a well established international reputation for his research on the nature and treatment of eating disorders. He has a particular interest in the development and evaluation of psychological treatments and is especially well known for his development of the cognitive behavioural approach to the treatment of eating disorders.

Mark Freeston (Newcastle University, UK)

Clinical Supervision - Art or Science?

Philippa Garety (Institute of Psychiatry, UK)

TITLE: The future of CBT for psychosis: Theory, research findings and implications for new therapy developments
INSTITUTION: 1. Department of Psychology, Institute of Psychiatry, King's College London, London, United Kingdom.
2. South London & Maudsley NHS Foundation Trust, London, United Kingdom.
ABSTRACT BODY:
Description: Cognitive models of the positive symptoms of psychosis specify the cognitive, emotional and social processes held to contribute to their occurrence and persistence. These models are multi-factorial and take account of social adversity and biological vulnerabilities in the development of psychotic experiences. They also specify the key cognitive processes by which psychotic experiences are converted into psychotic symptoms. In common with all cognitive models of psychological disorders, the role of the appraisals made by the individual of their experiences and of events is central. It is proposed that biases in appraisal are risk factors in the pathway to symptom development and persistence. Factors which contribute to making these biased appraisals are discussed. This includes biases in reasoning and emotional processes.
The latest evidence concerning the efficacy of cognitive behavioural therapy for psychosis (CBTp) will also be reviewed. New data from the Psychological Prevention of Relapse in Psychosis (PRP) trial will be presented on the differential effects of types of therapy technique on outcome in subgroups of participants. It will be argued that CBTp can be made more effective if it is targeted at key cognitive processes and if it is personalized to those processes active in the individual case. Cognitive models have highlighted biases in emotional processes arising from trauma histories and recent CBTp approaches have consequently particularly emphasized work on emotional processes, schemas and traumatic experiences. This is likely to be particularly effective for certain sub-groups of patients and further development of CBTp approaches tailored to this group is recommended. Therapy development has, however, somewhat neglected reasoning biases. About 50% of people with delusions show the jumping to conclusions (JTC) reasoning bias. There is evidence which suggests this bias plays a role in both the development and the persistence of psychosis. New research will be presented which suggests JTC is more common in certain delusion sub-types. Therefore a new promising target for personalized CBTp development is the JTC bias. A reasoning training intervention, directly targeting this hypothesised causal processes, will be described, together with preliminary evidence of its effects on reasoning and delusions.
Biography: Philippa is Professor of Clinical Psychology at the Institute of Psychiatry, King?s College London and Head of Psychology, South London & Maudsley NHS Foundation Trust. She was awarded her first degree in Philosophy and Psychology (Natural Sciences) by Cambridge University. She then qualified as a clinical psychologist in 1981 at the Institute of Psychiatry, followed by completing a PhD on cognitive processes in delusions. Since then she has combined research with clinical practice and service development. Her main focus of research has been the investigation of cognitive and emotional processes in psychosis, particularly reasoning in delusions, together with the therapy development. In the early 1990s she worked closely with David Fowler and Elizabeth Kuipers to develop and evaluate CBT for Psychosis. She has continued to translate the findings of theoretical and empirical research into improvements in treatments and service provision, setting up with colleagues, one of the first Early Intervention services for people with psychosis (LEO) in the late 1990s. She continues to work with her colleagues (E Kuipers, D Fowler, D Freeman, P Bebbington, G Dunn and a research team; funded by the Wellcome Trust) on experimental studies testing cognitive theories of psychosis and on psychological treatment research, including randomised controlled trials. She was awarded the Shapiro lifetime achievement award in 2002 by the Division of Clinical Psychology of the British Psychology Society, and in 2007 was selected as a Senior Investigator of the National Institute of Health Research.

Kurt Hahlweg (Technical University of Braunschweig, Germany)

TITLE: Strengthening Couples: Dissemination of Interventions for the Treatment and Prevention of Couple Distress
INSTITUTION: 1. Clinical Psychology, TU Braunschweig, Braunschweig, Germany.
2. Clinical Psychology, TU Braunschweig, Braunschweig, Germany.

Steven C. Hayes (University of Nevada, USA)

TITLE: How Do We Create a More Progressive Discipline? Turtles, Hares, and Transdiagnostic Processes
INSTITUTION: Psychology, University of Nevada, Reno, NV, United States.
ABSTRACT BODY:
Description: Empirical clinical psychology and CBT has been more successful in generating reasonably successful technologies than progressive scientific theories. The future of our field requires this to change. In this talk I argue that it is a positive step to focus on empirically supported processes and procedures, but that this change requires a different development strategy than the one we have been following for decades. I recommend an elaborated version of the development approach underlying behavior analysis, which we term a "contextual behavioral science" approach, and show why it will help us create a more progressive and broadly useful discipline.
Biography: Steven C. Hayes is a Foundation Professor of Psychology at the University of Nevada, Reno. An author of 32 books and more than 425 scientific articles, he has focused his work on the basic behavioral analysis of language and cognition (Relational Frame Theory), and the extension of that knowledge into clinical and other applied domains (Acceptance and Commitment Therapy). An author of best selling popular books, and past-President of this association, in 2007 he received the Lifetime Achievement Award from ABCT.

Steven Hollon (Vanderbilt University, USA)

TITLE: Cognitive Behavior Therapy in the Treatment and Prevention of Depression
INSTITUTION: psychology, vanderbilt university, Nashville, TN, United States.
ABSTRACT BODY:
Description: Cognitive behavior therapy has emerged as a major alternative to medications in the treatment of depression. Although some studies suggested that drugs might be superior in the treatment of more severe depressions, a recent placebo-controlled trial indicates that when cognitive therapy is adequately implemented it can be as efficacious as medications. Moreover, cognitive therapy appears to have an enduring effect that lasts beyond the end of treatment. Patients who respond to cognitive therapy are about half as likely as patients treated with medication to relapse following treatment termination and no more likely than patients continued on drugs. Given this enduring effect, cognitive therapy is likely to prove more cost-efficient than medication treatment. Cognitive therapy appears to be superior to medications for depressed patients without personality disorders and for patients with more prior negative life events. It also appears to be superior for patients who are unemployed and helping those patients find jobs. Adherence to specific components of cognitive therapy drives subsequent symptom change, whereas the quality of the nonspecific working alliance appears to be largely a consequence of prior improvement. Competence predicts subsequent symptom change and can be enhanced by training. Patients who can best perform specific skills taught in cognitive therapy are least likely to relapse following treatment termination and insight into the role of cognition in the maintenance of depression precedes sudden gains in treatment which in turn predicts freedom from relapse. Cognitive change mediates subsequent change in depression in cognitive therapy but not in pharmacotherapy and change in attributional style is both specific to cognitive therapy and predictive of subsequent freedom from relapse. Adding cognitive therapy to medications appears to enhance response for patients with more severe or nonchronic depressions and a more purely behavioral intervention may be as efficacious as medications and as enduring as cognitive therapy. The incidence of severe adverse events and risk for suicide both are reduced for patients treated with cognitive and behavioral interventions relative to medication alone. There are even indications that a cognitive behavioral intervention can prevent episode onset in at-risk adolescents. Taken in aggregate, these findings suggest that cognitive behavior therapy may be a viable alternative to medications in the treatment of major depression and that it works through specific mechanisms for somewhat different patients.

Terry Keane (National Center for PTSD, Boston VA Healthcare System and Boston University, USA)

Trauma, War, and Terrorism: Recent Findings in the Treatment of PTSD

ABSTRACT BODY:

Description: Treatment of Posttraumatic Stress Disorder (PTSD) has progressed rapidly over the course of the past three decades. A condition that affects millions of people worldwide, PTSD represents a major challenge to the individuals affected, their families, their communities and to the countries they inhabit. Scientific studies suggest that there are now five distinct evidence based approaches to treating those with this condition. The purpose of this presentation will be to characterize these treatments; to identify the key treatment components that lead to behavior change; and to discuss new models and methods for disseminating these treatments across the world.

Biography: Terence M. Keane, Ph.D. is the Director of the Behavioral Science Division of the National Center for PTSD and Professor of Psychiatry and Psychology at Boston University. An early leader in studying this disorder, he pioneered the use of exposure therapy in the treatment of PTSD while developing many of the most widely used assessment methods for evaluating and assessing PTSD. He's received many honors and awards recognizing his contributions and he's lectured internationally on these topics. His research program has been continuously funded by the NIH, VA, and Department of Defense for thirty years.

Marsha Linehan (University of Washington, USA)

TITLE: Dialectical Behavior Therapy for BPD: an overview of the data
INSTITUTIONS: Dept of Psychology, University of Washington, Seattle, WA, United States.
ABSTRACT BODY:
Description: Borderline Personality Disorder (BPD) is a persistent and severe mental disorder. Traditional community treatments, even when intensively applied, have been marginally effective at best. Dialectical Behavior Therapy (DBT) is a cognitive-behavioral treatment developed specifically for treatment of BPD. DBT combines the basic strategies of behavior therapy with eastern mindfulness practices, residing within an overarching dialectical worldview that emphasizes the synthesis of opposites. Acceptance procedures in DBT include mindfulness and a variety of validation and acceptance-based stylistic strategies. Change strategies include behavioral analysis of maladaptive response patterns and problem-solving techniques, including skills training, contingency management (i.e., reinforcers, punishment), cognitive modification, and exposure-based strategies. This talk will summarize the outcomes of the randomized controlled trials of DBT as well as recent research on mechanisms of action in DBT.
Biography: Marsha Linehan is a Professor of Psychology and adjunct Professor of Psychiatry and Behavioral Sciences at the University of Washington and is Director of the Behavioral Research and Therapy Clinics, a consortium of research projects developing new treatments and evaluating their efficacy for severely disordered and multi-diagnostic and suicidal populations. Her primary research is in the application of behavioral models to suicidal behaviors, drug abuse, and borderline personality disorder. She is also working to develop effective models for transferring science-based treatments to the clinical community.

G. Alan Marlatt (University of Washington, USA)

TITLE: Mindfulness-Based Relapse Prevention in the Treatment of Addictive Behaviors
INSTITUTION: Psychology, University of Washington, Seattle, WA, United States.
ABSTRACT BODY:
Description: The purpose of this talk is to provide an overview of Mindfulness-Based Relapse Prevention(MBRP), a group therapy program that meets weekly for 8 sessions for clients with addictive behavior problems. MBRP combines cognitive-behavioral relapse prevention with mindfulness meditation as a meta-cognitive coping skill. In addition to practicing various meditation skills (including breath and body-scan meditation, urge-surfing and breathing-space breaks), participants will learn how to develop coping skills to deal with urges and craving and other triggers for relapse.
Learning Objectives: (1) To learn how to apply MBRP interventions to work with clients with addictive behavior problems. (2) To practice various meditation skills that are a central component of MBRP. (3) To gain knowledge about
treatment outcome research showing that MBRP is an evidence-based clinical practice.
Biography: : To gain access to my bio and photo online, they are available online: http:/depts.washington.edu/abrc/marlatt.html

Richard McNally (Harvard University, USA)

TITLE: Experimental Exploration
of the Frontiers of Psychopathology
INSTITUTION: Dept of Psychology, Harvard University, Cambridge, MA, United States.
ABSTRACT BODY:
Description: Experimental psychopathologists have used laboratory methods to elucidate the mechanisms mediating symptoms of anxiety disorders and other syndromes. In addition to doing this work, our research group has also used these methods to explore phenomena at the frontiers of psychopathology. Specifically, we have addressed why sincere, normal individuals come to believe bizarre things about themselves. In my talk, I will present findings from two groups of people. One group comprises individuals who do not merely believe in reincarnation, but who claim to have recovered actual memories from their previous lives. A second group comprises people who believe they have experienced abduction by space aliens. The purpose of my presentation is to present what we have learned about the motives and mechanisms driving people to conclude that they have lived previous lives or have experienced kidnapping at the hands of extraterrestrials.
Biography: Richard J. McNally is Professor and Director of Clinical Training in the Department of Psychology at Harvard University. His is the author of more than 320 publications, many concerning anxiety disorders, including the books "Panic Disorder: A Critical Analysis" and "Remembering Trauma."

Charles Morin (Laval University, Canada)

TITLE: Cognitive Behavioral Therapy for Chronic Insomnia:  New Trends in Treatment Development and Dissemination
INSTITUTION: Psychology, Laval University, Quebec, QC, Canada.
ABSTRACT BODY:
Description: Insomnia is a prevalent public health problem that may present as a primary condition or comorbid with another psychological or medical disorder. Chronic insomnia produces a significant burden for the individual and for society, as evidenced by reduced quality of life, increased risk of depression, higher absenteeism and reduced productivity at work, and higher health-care costs. Despite its negative impacts, insomnia often remains untreated and when therapy is initiated, it is usually limited to medication, an option that is not acceptable to many patients with insomnia. There is extensive evidence that psychological approaches, primarily cognitive behavioral therapy, are effective, produce durable and generalizable outcomes, are well accepted by patients, and should be the first line therapy for chronic insomnia. Nonetheless, these approaches are not widely available and remain under utilized by health care practitioners. Several innovative and cost-effective treatment delivery models (e.g., telephone consultations, internet-based treatment) have yielded promising results but despite these advances, there remains a problem of supply. A significant challenge for the future will be to disseminate more efficiently evidenced-based therapies and practice guidelines and increase their use in clinical practice. Additional training opportunities are also needed for practitioners to develop expertise in a new emerging subspecialty called behavioral sleep medicine.
Biography: Charles Morin is Professor of Psychology and Director of the Sleep Research Center at the Université Laval in Quebec City. He holds a Canada Research Chair on Sleep Disorders and is past President of the Canadian Sleep Society. He is Associate Editor for the journals Sleep and Behavioral Sleep Medicine and is on the editorial board of several other journals. He has published five books and over 160 articles and chapters. His main contributions have been in the development, validation, and dissemination of psychological and behavioral approaches for treating insomnia.

Ricardo F. Muñoz (University of California, San Francisco, USA)

TITLE: Using behavioral and cognitive approaches to reduce health disparities worldwide:
From individual therapy to evidence-based Internet interventions.
INSTITUTION: 1. Psychiatry, University of California, San Francisco, San Francisco, CA, United States.
2. Chief Psychologist, San Francisco General Hospital, San Francisco, CA, United States.
ABSTRACT BODY:
Description: In 1978, Christensen, Miller, and Muñoz published ?Paraprofessionals, partners, peers, paraphernalia, and print: Expanding mental health service delivery? in Professional Psychology. They proposed a framework for the expansion of mental health services to include prevention, treatment, and maintenance interventions. The paper also proposed the development and testing of interventions provided by five levels of adjuncts. These were: paraprofessionals (individuals trained and paid to administer well-defined interventions under the direction of a professional), partners (volunteers in helping roles, such as Big Brothers or Big Sisters), peers (individuals in mutual help programs, as in Alcoholics Anonymous), paraphernalia (equipment, electronic media, automated devices to assist in behavior change efforts), and print (written intervention materials). This presentation will describe work done at the University of California, San Francisco (UCSF)/San Francisco General Hospital (SFGH) to develop and test cognitive-behavioral interventions in many of the cells defined by the intersection of level of intervention and type of provider. The resulting intervention manuals and other materials are available in English, Spanish, and some other languages for downloading at no charge from the UCSF/SFGH Latino Mental Health Research Program site: http://www.medschool.ucsf.edu/latino/. Colleagues, especially those serving public sector patients, are invited to use these materials. Many of these interventions have been implemented and subjected to treatment outcome studies with diverse populations in varied national and international settings, with good results. The development of personal computers in the 1980s and the World Wide Web in the 1990s has made it possible to adapt these interventions to online versions. The UCSF/SFGH Internet World Health Research Center (www.health.ucsf.edu) has been conducting international randomized control trials of evidence-based Internet interventions. The advantage of automated self-help Web interventions is that, unlike traditional methods of intervention, they are not consumable. This creates the potential of sharing them throughout the world at no cost to the users, even in places where there are no providers or no providers who speak the languages of those in need. The systematic development of Internet interventions for the most burdensome health problems in the most commonly used languages could expand the reach of behavioral and cognitive approaches and significantly contribute to reducing health disparities worldwide.

Tom Ollendick (Virginia Polytechnic Institute and State University, USA)

TITLE: Treatment of Phobic Anxiety Disorders in Children and Adolescents: Where To From Here?
INSTITUTION: Psychology, VirginiaTech, Blacksburg, VA, United States.
ABSTRACT BODY:
Description:
Although CBT has been found to be effective with the phobic and anxiety disorders of youth and enjoys evidence-based status, as many as 25% to 40% of youth with these disorders do not respond to these interventions. In this address, new and exciting developments will be reviewed that show promise for addressing some of these treatment non-responders. Innovations including computer-assisted interventions, virtual reality interventions, attention retraining strategies, and intensive treatment modalities will be highlighted. In addition, it will be argued that some non-responders or difficult-to-treat youth will require interventions that benefit from an idiographic approach to case formulation and treatment. In many respects, this approach invites us to return to our roots in behavior therapy and clinical science. This idiographic approach will be illustrated in the treatment of non-responders to evidence-based treatments using controlled single case design methodologies. Implications for these findings and intervention science will be highlighted.
Biography: Dr. Ollendick is University Distinguished Professor and Director of the Child Study Center at Virginia Tech. The past president of ABCT (1995), he is the current editor of Behavior Therapy and serves on the Editorial Boards of several other journals. He is is the author of several books, book chapters, refereed papers, and professional presentations at national and international conferences. His research interests cut across divese child behavior disorders and are informed by social learning theory.

Jacqueline B. Persons (San Francisco Bay Area Center for Cognitive Therapy, USA)

TITLE: Case Formulation-driven Cognitive-behavior Therapy
INSTITUTION: 1. San Francisco Bay Area Center for Cognitive Therapy, Oakland, CA, United States.
2. Psychology Department, University of California at Berkeley, Berkeley, CA, United States.

Michael Petronko (Rutgers University, USA)

TITLE: Developmental Disabilities: In Search of Practice Based on Evidence: a 40 Year Sojourn
INSTITUTION: Rutgers University, Piscataway, NJ, United States.
ABSTRACT BODY:
Description: Individuals with developmental disabilities have long suffered from misunderstanding, ignorance, bias, and neglect; not only from society at large, but from the professionals practicing therein. This address will chronicle the progress made in developing effective treatments for psychological and/or behavioral disorders in persons with intellectual disabilities during the last forty years - specifically, evidence-based treatments. After presenting a brief historical perspective, a current state-of-affairs will be discussed.
The recently published Diagnostic Manual- Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability (DM-ID) will be described as a ?sine qua non? first step, leading toward treatment parity. Obstacles associated with achieving full parity will be presented in some detail and include the difficult iatrogenic challenge of possessing cognitive deficits-self determination. The various methods associated with determining the presence of a developmental disability will also be discussed as they effect treatment. It then becomes critical that people providing the necessary compensatory supports for our clients (i.e. direct support staff, professionals, parents, administrators) be included in the treatment process. Treatment fidelity and access therefore presents unique variables when treating these groups that are often neglected in the literature.
The presentation will conclude with suggestions regarding strategies our field might use in addressing these aforementioned challenges. Most noteworthy among them is how to improve the professional and clinical infrastructure of the field through the active recruitment and training of students and young professionals.
Biography: Dr. Petronko pioneered the development of Natural Setting Therapeutic Management (NSTM), a community-based multiple-
Dr. Petronko pioneered the development of Natural Setting Therapeutic Management (NSTM), a community-based multiple-model service delivery program for persons with developmental disabilities and their families. This program, serving the behaviorally/cognitively challenged, has been adopted as a prototype of evidence-based service delivery for state and national mental health care. His research and practice in developmental disabilities has spanned 40 years during which time he maintained a singular interest in attracting graduate students into working with this population.

Antonio Pinto (Department of Mental Health of the Province of Naples, Italy)

TITLE: CBT of Psychosis: Historical Evolution and Current Approaches
INSTITUTION: Psychiatry, Columbia University, New York, NY, United States.

Gregory Quirk (University of Puerto Rico School of Medicine, Puerto Rico)

TITLE: Overcoming our fears: Neural mechanisms of extinction
INSTITUTION: Dept. of Psychiatry, University of Puerto Rico School of Medicine, San Juan, PR, United States.
ABSTRACT BODY:
Description: Most anxiety disorders involve a conditioned component. Decades of psychological research have taught us that extinction of classical conditioning reduces the expression of the conditioned response, but does not eliminate the conditioning memory, suggesting that extinction is inhibitory learning. Recent advances in rodent research have delineated the neural circuits involved in the acquisition and expression of fear extinction. While the basolateral amygdala (BLA) is a site of inhibitory learning in extinction, the medial prefrontal cortex modulates the expression of extinction memory, via projections to the amygdala. Converging lines of evidence indicate that the infralimbic (IL) prefrontal cortex inhibits the expression of conditioned fear by inhibiting amygdala output. Extinction induced plasticity in IL occurs via both synaptic and intrinsic mechanisms. Manipulations of the prelimbic (PL) prefrontal cortex have the opposite effect, suggesting that this area works with the amygdala to activate fear. Thus, PL and IL serve as ?on? and ?off? switches for fear expression. Extinction failure is associated with over and under activity in PL and IL respectively, suggesting that the ability to retrieve extinction is governed by prefrontal cortex, in conjunction with hippocampal and amygdala inputs. Human homologues of rodent IL and PL show predicted changes in activity levels in people undergoing extinction, as well as extinction failure in PTSD patients. New strategies to treat anxiety disorders could involve regulating the prefrontal network, for example increasing or decreasing activity in IL or PL, respectively.
Biography: Gregory J. Quirk, PhD, is a Professor of Psychiatry and Director of the Laboratory of Fear Learning at the University of Puerto Rico. Dr. Quirk carried out his doctoral and post-doctoral work in New York City and started his laboratory in Puerto Rico in 1997, focusing on the topic of extinction. A former Fulbright Scholar, Dr. Quirk is interested in promoting neuroscience in developing countries. His research is funded by the NIMH and the UPR.

Winfried Rief (Phillips University-Marburg, Germany)

TITLE: Behavioral medicine: Achievements, pitfalls, and new frontiers of applying CBT to physical problems
INSTITUTION: University of Marburg, Marburg, Germany.
ABSTRACT BODY:
Description: This lecture will provide evidence how psychological factors determine aspects of physical health, and how these pathways can be used to improve treatment programs for medical problems. Furthermore, the achievements, but also the pitfalls of applying psychological approaches to medical problems will be summarized.
Subjective illness beliefs predict outcome in costly illness aspects such as disability and workers compensation. This has been shown for various disorders, such as heart attacks, patients undergoing heart surgery, psoriasis, multiple sclerosis, or whiplash syndrome. Depression predicts re-infarction rate in post-MI-patients. Psychological factors are not only associated with behavioral outcome variables of medical problems, but also with actions of biological systems. Learning process influence immune activity, current mood determines the nocturnal recovery of biological systems, etc.
Despite this clear evidence for a link of psychological processes and physical health, the application of CBT techniques in medical conditions was only partially successful. CBT has been shown to be an essential ingredient of pain management programs, but also of chronic somatic symptoms in general. Conditions like hypertension or migraine respond well on biofeedback treatment. On the other hand, long lasting and substantial benefits were not shown for CBT treatments of obesity. Myocardial re-infarction rates were not significantly reduced in a trial using psychological prevention strategies. In contrast, subjective well-being in most chronic illness conditions can be improved using CBT techniques. Reasons for pitfalls, like insufficient consideration of motivational factors, will be highlighted.
After summarizing examples of successful and less successful CBT interventions in medical fields, a special emphasis will be on designing pathways to new frontiers of behavioral medicine. CBT treatment for tinnitus has been shown to be successful, and has to be disseminated. The need for psychological intervention in cancer patients is highly recognized, but the development and evaluation of corresponding programs has to be improved. Moreover, new fields of medicine such as coping with side effects of challenging medication (e.g., chemotherapy) as well as providing evidence based programs to support end-of-life problems should be conquered. Finally, new techniques like real-time fMRI feedback could lead to completely new insights and CBT applications.
Biography : Behavioral medicine deals with the application of CBT techniques in medical fields. This has been shown to be highly effective for various medical conditions, such as pain, hypertension, or tinnitus. New pathways will be outlined how current CBT approaches for medical conditions can be improved, and how new fields for the application of CBT techniques in medicine can be entered.

Jeffrey Young (Cognitive Therapy Center of New York, USA)

TITLE: New Advances in Schema Therapy for Personality Disorders
INSTITUTION: Psychiatry, Columbia University, New York, NY, United States.
2. Schema Therapy Institute, New York, NY, United States.
ABSTRACT BODY:
Description: Schema therapy represents a significant expansion of cognitive therapy to treat personality disorders and other chronic, difficult patients.
ST is an integrative approach, combining CBT with elements of emotion-focused therapies, attachment theory, and psychodynamic concepts. This address will describe new developments, including a revised theory & treatment that place major emphasis on unmet childhood needs, "limited reparenting", and the schema mode concept.
Schema modes -- related to mood or ego states -- will be presented in the context of Borderline Personality Disorder. This model hypothesizes that patients with BPD flip rapidly among four modes: the Detached Protector, Abandoned Child, Angry Child, & Punitive Parent. Treatment techniques for modes will be discussed.
Finally, the address will summarize the results of recent outcome studies demonstrating the efficacy of schmea therapy for BPD patients.
Learning Objective #1 (approx. 125 characters): Participants will learn how CBT has been expanded into an integrated therapy with emotion-focused, attachment, and psychodynamic concepts.
Learning Objective #2 (approx. 125 characters): Participants will learn how the original schema model has been expanded based on the concept of a schema mode, how modes relate to BPD, and the use of limited reparenting to treat modes.
Learning Objective #3 (approx. 125 characters): Participants will learn about recent outcome research validating schema therapy for BPD.
Who should attend?: Attendees interested in the expansion of CBT to understand and treat more complex patients, especially those with personality disorders such as BPD and other chronic disorders.
Recommended Readings: 1. Young, J.E., Klosko, J.S., & Weishaar, M. (2003). Schema Therapy: A Practitioner?s Guide. Guilford Publications: New York.
2. Young, J.E. & Klosko, J.S. (1993, 1999). Reinventing your life. New York: Plume Books.
3. Arntz, A., van Genderen, H. (2009) Schema therapy for borderline personality disorder. John Wiley: New York
Biography: Dr. Young is Founder and Director of the Schema Therapy Institute and Cognitive Therapy Center of New York. He is also on the faculty in the Department of Psychiatry at Columbia University College of Physicians and Surgeons.
Dr. Young received his undergraduate training at Yale University and his graduate degree at the University of Pennsylvania. He then completed a postdoctoral fellowship at the Center for Cognitive Therapy at the University of Pennsylvania with Dr. Aaron Beck, and went on to serve there as Director of Research and Training.
Dr. Young has lectured on cognitive and schema therapies internationally for over 20 years. He has trained thousands of mental health professionals, and is widely acclaimed for his outstanding teaching skills. Dr. Young was awarded the prestigious NEEI Mental Health Educator of the Year award.
Dr. Young is the founder of Schema Therapy, an integrative approach for personality disorders and treatment-resistant patients. He has published widely in the fields of both cognitive and schema therapies.
He has also served as consultant on many cognitive and schema therapy research grants, including the NIMH Collaborative Study of Depression, and was on the editorial boards of journals including Cognitive Therapy and Research and Cognitive & Behavioral Practice. Dr. Young is the co-founder of the International Society for Schema Therapy, and is a Founding Fellow of the Academy of Cognitive Therapy.

Antonette M. Zeiss (VA Central Office in Washington, DC, USA)

TITLE: Integrated Health Care for an Aging Population: CBT As a Component of Comprehensive Care for Older Adults
INSTITUTION: VA Central Office, Washington, DC, United States.
ABSTRACT BODY:
Description: The demographics of aging demonstrate the growing importance of older adults as a vital component of the world?s population; this presentation focuses on the need to ensure that this growing segment of our population receives the best possible holistic health care. Basic interdisciplinary care models are presented, including how they differ from multidisciplinary care models and how interdisciplinary care is especially suited to the health care needs of older adults. Interdisciplinary health care is characterized by sensitivity to diversity and collaboration among health professionals; the model for an interprofessional team approach presented can guide Cognitive Behavioral (CBT) therapists in working to enhance interdisciplinary collaboration while also delivering specific evidence-based services to older adults. The presentation will cover recommendations from the report of the 2007 American Psychological Association Presidential Task Force on Integrated Health Care for Older Adults. The fragmented care of our current health delivery systems too often results in a lack of preventive care, family stress, diminished quality of life, and poor medical outcomes for this population. Cognitive Behavioral therapists can contribute to integrated health care and demonstrate the importance of their approach in treating mental health problems of older adults and in delivering CBT-based Health Psychology interventions for many symptoms of chronic illness in older adults.
Biography: Antonette M. Zeiss, Ph.D. is Deputy Chief Consultant, Office of Mental Health Services, U.S. Department of Veterans Affairs. She has served as former President of the Association for Advancement of Behavior Therapy; the Society for a Science of Clinical Psychology; and Section II (Clinical Geropsychology), APA Division 12. She is former Chair of the APA Committee on Aging and a current member of the APA Board for Advancement of Psychology in the Public Interest. Her professional interests focus on implementation of evidence-based practices in mental health on a broad, systemic basis.

Jonathan Abramowitz (University of North Carolina, USA)

Treating OCD: How to Supercharge Exposure Therapy with the Latest Cognitive Techniques (with Maureen Whittal)

Donald H. Baucom (University of North Carolina-Chapel Hill, USA)

Cognitive-Behavioral Couple Therapy: Attending to the Relationship and the Individual
University of North Carolina, Chapel Hill, NC, United States.
 
Cognitive-behavioral couple therapy has focused primarily on the couple?s relationship with little attention to the two partners as individuals. This workshop will focus on developing and using couple-based interventions when (a) a couple is struggling because of ?normal? individual differences or competing needs between two healthy partners and (b) one partner is experiencing individual psychopathology, both within healthy and distressed relationships. This will include in-depth discussion and demonstrations of couple-based interventions for psychopathology, using anxiety disorders and eating disorders as examples. These interventions involve the integration of empirically supported interventions for individual psychopathology with cognitive-behavioral approaches to working with couples. A primary goal of the workshop is helping clinicians understand how these approaches can be applied in their own practices.
You will learn:
- To nderstand central individual differences between healthy partners that contribute to relationship distress
- To understand the framework for integrating individual psychopathology and relationship functioning
- To be able to develop couple-based interventions that target individual psychopathology and contribute to relationship well-being
Who should attend?: This workshop is appropriate for individuals who want to increase and broaden their couple intervention skills to address the two partners' functioning.
Recommended Readings: Epstein, N., & Baucom, D. H. (2002). Enhanced cognitive-behavioral therapy for couples: A contextual approach. Washington, DC: American Psychological Association.

Robert J. DeRubeis (University of Pennsylvania, USA)

Maximizing the Impact of Cognitive Therapy for Depression:  Insights from Clinical Practice, Supervision and Research
University of Pennsylvania, Philadelphia, PA, United States.

Cognitive therapy (CT) for depression has been well-described, extensively tested, and shown to engender powerful relapse-prevention effects, making it an ideal candidate for dissemination. However, clinicians in mental health practice environments may experience difficulties delivering CT effectively, often due to common misperceptions of CT techniques and the cognitive model. The goal of the workshop is to provide participants with tools they need to implement CT effectively and to address their concerns about the limits of the cognitive approach.
After reviewing the core principles of CT, we will examine how they can best be adapted to individuals who come for therapy. Using case examples, videotape vignettes, and role-plays with participants, Dr. DeRubeis will illustrate solutions for common problems in the conduct of CT. Topics will include: the integration of behavioral techniques with the cognitive model; dealing with clients? beliefs about the primacy of the neural over the cognitive, and the implication clients draw about their need for medical rather than psychological treatment; maximizing the synergy between medications and CT; and avoiding the use of advice-giving in favor of guided discovery.
You will learn:
-The three functions of behavioral techniques, and how to design behavioral interventions and experiments to capture all three;
- How to address common conflicts between medications and CT, and how to capitalize on a client's belief that medications have changed his or her mood.
- Reasons therapists employ advice-giving rather than guided discovery (Socratic questioning), and exercises that enhance Socratic questioning skills.
Who should attend?: Practitioners who have encountered roadblocks in the application of CT with depressed clients, and CT supervisors who wish to augment their teaching and training methods.
Recommended Readings: Young, P.R., Grant, P., & DeRubeis, R.J. (2003). Some lessons from group supervision of cognitive therapy for depression. Cognitive & Behavioral Practice,10,30-40.  Strunk, D.R., DeRubeis R.J., Chiu, A.W., & Alvarez, J. (2007). Patients? competence in and performance of cognitive therapy skills: Relation to the reduction of relapse risk following treatment for depression. Journal of Consulting and Clinical Psychology,75,523-530.

Christopher Fairburn (Oxford University, UK)

Transdiagnostic CBT: Potential Strengths and Weaknesses
Oxford University, Oxford, United Kingdom.

In this one-day workshop Professor Fairburn will describe a new transdiagnostic cognitive behavioural approach to the treatment of the full range of eating disorders seen in clinical practice (including anorexia nervosa, bulimia nervosa and the various forms of eating disorder NOS).
The workshop will open with a brief account of the current standing of CBT for eating disorders. For the rest of the workshop Professor Fairburn will focus on certain practical aspects of the new ?enhanced? transdiagnostic treatment (CBT-E). Particular emphasis will be placed on novel methods for addressing patients? concerns about shape and weight. Extensive use will be made of illustrative clinical material. This will include recorded demonstrations of key interventions. Participants will be encouraged to present their own cases for discussion.
You will learn:

To acquire good knowledge of the strategies and procedures used in CBT-E to achieve the following:
- Engagement and preparation for CBT-E
- Early behavior change
- The designing of the treatment to suit the individual patient, rather than the DSM diagnosis
- Modification of the over-evaluation of controlling shape and weight and its various expressions (e.g., body checking, feeling fat)
- Acquire up-to-date knowledge of the standing of CBT for eating disorders
- Understand the basis for CBT-E being ?transdiagnostic? in its scope
Who should attend?: The workshop will be suitable for all those interested in the treatment of patients with eating disorders.
Recommended Readings: 1. Fairburn CG. Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press, 2008. 2. Fairburn CG, Cooper Z, Shafran R. Cognitive behaviour therapy for eating disorders: A ?transdiagnostic? theory and treatment. Behaviour Research and Therapy 2003; 41: 509-528.
3. Fairburn, C.G., Cooper, Z., Doll, H.A., O?Connor, M.E., Bohn, K., Hawker, D.M., Wales, J.A., & Palmer, R.L. (2009). Transdiagnostic cognitive behavioral therapy for patients with eating disorders: A two-site trial with 60-week follow-up. American Journal of Psychiatry, 166, 311-319.

Joseph Greer (Williams College; Mass. General Hospital and Harvard Medical School, USA)

Applications of CBT for Depression and Anxiety in Medically-ill Populations (with Steven Safren)

Sheri Johnson (UC Berkeley, USA)

Empirically Supported Interventions for Bipolar Disorder: Psychoeducational and Cognitive Strategies

University of California Berkeley, Berkeley, CA, United States.

Bipolar disorder is a severe and recurrent disorder, even with currently available medications. Most treatment guidelines now suggest adding psychological treatment to medications to enhance outcomes, and a variety of manuals have been shown to be helpful in improving symptoms, hospitalization rates, and social outcomes. This workshop is designed to help clinicians learn strategies for mania prevention. More specifically, you will learn techniques of psychoeducation, as well as strategies for identifying psychological and social triggers. More specifically, we will cover motivational interviewing skills to promote diagnostic acceptance, tools for helping clients develop and implement skills for symptom monitoring, and strategies for identifying and controlling triggers using reviews of life history and ongoing monitoring. This workshop will use a combination of didactic material and role plays to illustrate the details of techniques.
You will learn:
- How to present psychoeducation for bipolar disorder within a motivational interviewing framework.
- How to develop and implement personalized symptom monitoring strategies with your clients.
- How to help clients identify psychological and social triggers for their bipolar episodes.
Who should attend?: Clinical psychologists, nurses, social workers, and other therapists working with or planning to work with clients with bipolar disorder.
Recommended Readings: Colom, F., & Vieta, E. (2006). Psychoeducation Manual for Bipolar Disorder. Cambridge, England: Cambridge University Press.

Philip C. Kendall (Temple University, USA)

Treating Anxiety Disorders in Youth:  Clinical Procedures Informed by Developmental, Cognitive, Behavioral, and Family Literatures
Temple University, Philadelphia, PA, United States.

This workshop will provide a brief initial description of the theory that guides the intervention and a brief overview of the nature, symptoms, and experience of anxiety in youth.
We will consider when anxiety is developmentally reasonable and when it is disordered.   The bulk of the workshop will address specific intervention strategies that comprise CBT: the strategies will be described and illustrated with case examples and with illustrations from the Coping Cat workbook and treatment manuals.   Research outcomes will be noted and used to inform decisions made in the provision of clinical services. We will consider both what we know and what we do not yet know about the treatment of anxiety disorders in youth. At the end of the day, time permitting, we will preview samples from the computer-assisted treatment entitled Camp Cope-A-Lot.
Who should attend?: Those interested in learning about cognitive behavioral interventions for youth with anxiety disorders.

Robert L. Leahy (American Institute for Cognitive Therapy, USA)

Using the Therapeutic Relationship in Cognitive Behavioral Therapy

American Institute for Cognitive Therapy, New York City, NY, United States.  

Therapists are not ?blank slates? that ?rationally? implement a technology and patients are not reducible to ?diagnostic categories? onto which ?interventions? are implemented. Patients? schemas may focus on threats of abandonment, humiliation, or loss of autonomy, while therapists may have schemas reflecting demanding standards, need for control, and approval seeking. Both may have ?emotional schemas? where emotions may be viewed as threatening, overwhelming, needing ?regulation? or incomprehensible. ?Schema mismatches? may lead the therapist to view emotions as a waste of time, ?complaining? or a sign of ?rumination? and make it difficult for the therapy to elicit emotionally significant material or to allow for important experiential exposure. We will identify and modify self-fulfilling "interpersonal strategies" where personal and emotional schemas are continually confirmed (or never disconfirmed) in the therapeutic relationship. Resistance and non-compliance can be viewed as a window into the past, present and future interpersonal world of the patient and a variety of cognitive, behavioral and experiential strategies can be used to overcome these roadblocks. Finally, the therapist?s own dysfunctional beliefs and strategies are amendable to CBT strategies that can enhance therapeutic effectiveness and reduce the risk of burnout.
You will learn:
 How to avoid falling into ?schema traps? where you inadvertently confirm the patient?s worst fears;   
How to identify your own dysfunctional personal and emotional schemas in therapy. 
How to examine and use relationships where the patient and your schemas are matched or mismatched;
How to use the mismatches in relationships as a way to gain insight into the patient?s relationship problems outside of therapy.
Who should attend?: Clinicians who recognize that there are significant impasses in therapy that result in non-compliance, misunderstanding and premature dropout and who want to go beyond ?technique? therapy.
Recommended reading:
Leahy, R.L. Schematic mismatch in the therapeutic relationship: A social-cognitive model (pp.229-254) In Gilbert, Paul and Leahy, R.L. (2007) (Editors), The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies. Routledge, London.  Leahy, R.L. (2001) Overcoming Resistance in Cognitive Therapy. New York: Guilford
Leahy, R.L. (2003) Roadblocks in Cognitive-Behavioral Therapy: Transforming Challenges into Opportunities for Change. New York: Guilford. Leahy, R.L. (2005). A social-cognitive model of validation: In, P. Gilbert (ed). Compassion: Conceptualisations: Research and Use in Psychotherapy. (p. 195-217) London: Brunner- Routledge.
Leahy, R.L. . Resistance: An emotional schema therapy (EST) approach. In Simos, Gregoris (Ed). (2009). Cognitive behaviour therapy: A guide for the practising clinician, Vol 2. (pp. 187-204). New York, NY, US: Routledge/Taylor & Francis Group.

Marsha Linehan (University of Washington, USA)

Mindfulness, Willingness and Radical Acceptance: Translating Zen Practices into Behavioral Skills

University of Washington, Seattle, WA, United States.

Peter Monti (Brown University, USA)

Craving and Cue Exposure Treatment: Where Have We Been? Where Are We Going?
Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States.

Craving is a hallmark of addictive behavior and can be a significant threat to successful treatment.Cue exposure treatment (CET) is a clinical approach that uses behavioral and cognitive-behavioral methods for attenuating craving.It was developed based on extensive evidence indicating that craving can be acutely elicited via situational variables, such as environmental cues or affective experiences, and attempts to extinguish such responses in both animal and human models.In clinical trials,it has been supported independently and as part of a multi-component approach, as well as toward abstinence-based and controlled drinking goals.This workshop will review the construct of craving across a variety of addictive disorders and will review its relationship with drug use, with particular emphasis on methodological issues in assessing the construct.Next,advances in the scientific study of craving will be reviewed.The workshop will provide a comprehensive overview of the theoretical basis and empirical support for CET.Moreover,it will provide all the necessary methods and tools for effective clinical implementation of the approach.Particular attention will be paid to valid assessment of craving and individual difference variables, such as genetic predisposition, that may be related to treatment benefit.Limitations of the cue exposure approach will be discussed as will differences in response patterns across addictive behaviors. Innovative applications of the cue exposure model (such as to food as an addiction) will be discussed.
You will learn:

Alina Morawska (University of Queensland, Australia)

A multilevel system of evidence parenting interventions for children and adolescents with conduct problems (with Matthew Sanders)

Christine Padesky (Center for Cognitive Therapy, USA)

From Chaos to Clarity: A New Step-by-Step Model for Complex Cases
Center for Cognitive Therapy, Huntington Beach, CA, United States

When clients come to therapy with a single psychological difficulty, there is often a clear-cut, evidence-based treatment approach to follow. But what is a therapist to do when clients experience multiple mood disorders accompanied by other difficulties such as eating disorders and relationship problems? What should be treated first? What treatment protocol(s) should be used?
Padesky presents a step-by-step model to guide therapists? treatment planning with complex cases, derived from her most recent book (Kuyken, Padesky & Dudley, 2009). She demonstrates the three guiding principles of this new approach:  (1) Clients can be engaged to collaboratively co-create conceptualization models that explain presenting issues. Padesky explains why it is important for clients to help construct their conceptualizations and shows how this collaborative process resolves common treatment challenges. (2) Conceptualization is not static; instead it evolves over the course of therapy from descriptive to explanatory models. Participants learn simple interview methods that help clients co-develop models to understand presenting issues, their triggers, and what maintains them.  (3) Client strengths can easily be incorporated into conceptualizations. Doing so helps clients build resilience as they resolve their distress.  Aaron T. Beck calls this new approach ?a gold standard for how to develop individualized case conceptualizations.?
You will learn:
- To practice collaborative case conceptualization and differentiate between three levels of case conceptualization; Identify triggers and maintenance factors to form explanatory conceptualizations;  
- To incorporate strengths into conceptualizations;  Learn when a longitudinal conceptualization is not necessary
Who should attend?: Clinicians from all areas of psychology
Recommended Readings: Kuyken, W., Padesky, C.A., & Dudley, R. (2009). Collaborative Case Conceptualization: Working effectively with clients in cognitive-behavior therapy. New York: Guilford Press.

John Piacentini (University of California, Los Angeles, USA)

Comprehensive Behavioral Intervention for Tics in Children and Adolescents (with Douglas Woods)

Patricia A. Resick (National Center for PTSD, Boston VA Healthcare System and Boston University, USA)

Treating Posttraumatic Stress Disorder with Cognitive Processing Therapy
National Center for PTSD, Boston, MA, United States. and Boston University, Boston, MA, United States.

 The purpose of this workshop will be to train participants in the implementation of cognitive processing therapy (CPT), an evidence-based treatment for PTSD. CPT is a 12-session protocol that has been demonstrated to be effective for the treatment of PTSD and comorbid symptoms resulting from a range of traumatic events and can be implemented as an individual or group treatment. CPT consists of trauma-focused cognitive therapy with or without account writing, arranged as a systematic and progressive series of skills and assignments. After an introduction to the theoretical underpinnings, participants will learn how to treat clients with CPT session by session. In addition to didactic information, CPT will be demonstrated with videotaped examples. Participants will also work with the therapy materials and may engage in role play. Common problems encountered with clients will be discussed. Prior to attending, please complete the online CPT training at http://cpt.musc.edu in order to facilitate learning at a higher level at this workshop.
You will learn:
- To be able to describe the theory underlying CPT.
- To be able list and consider pre-treatment issues and recommended assessment measures for CPT.
Be able to demonstrate knowledge and skills required to implement CPT, an evidence-based psychotherapy for PTSD.
Who should attend?: Therapists interested in learning CPT.
Recommended Readings: Resick, P.A., Monson, C.M., & Chard, K.M. (2007, revised in 2008). Cognitive processing therapy: Veteran/military version. Washington, DC: Department of Veterans? Affairs (available from Resick at [email protected]).

Steven A. Safren (Massachusetts General Hospital and Harvard Medical School, USA)

Applications of CBT for Depression and Anxiety in Medically-ill Populations
MGH / Harvard Medical, Boston, MA, United States and J. Grerr,  MGH / Harvard Medical, Boston, MA, United States and Williams College, North Adams, MA, United States.

CBT is the most widely studied psychosocial treatment. Most protocol-based treatments, however, have been tested in circumscribed samples, and real-world applicability has been questioned. Individuals who suffer from a medical illness are at increased risk for mood and anxiety disorders, and represent a population of individuals for whom typical CBT interventions require adaptation to address the disability associated with disease, side effects from treatments, and self-care behaviors. This workshop will focus on how to apply state-of-the-art CBT for individuals with depression and anxiety who are medically ill.
First, we will provide an overview of ways to address concerns clinicians experience when doing CBT with medical illness, such as questions regarding differential diagnosis and collaborating with medical teams. Examples will be provided for various illnesses including HIV, diabetes, cancer, and neurological diseases. Second, we will focus on a novel, evidenced based intervention, ?Cognitive Behavioral Therapy for Adherence and Depression?. Third, we will focus on CBT for anxiety in medically-ill patients, which we are studying in individuals with advanced cancer, with a particular emphasis on helping patients cope with realistic worries about disease progression and survival. Throughout the workshop, clinical interventions will be demonstrated through case examples and role-play exercises using the two presenters as client and therapist, followed by group discussion.
You will learn:
Ways to address concerns clinicians experience when devloping CBT case conceptualizations and treatment plans with medical illness.
 To understand the components of ?Cognitive Behavioral Therapy for Adherence and Depression."
 To understand how to adapt CBT for anxiety in medically-ill patients.
Who Should Attend: Clinicians with some familiarity of CBT.
Recommended Readings: Safren SA, Gonzalez JS, Soroudi N (2008). Coping with Chronic Illness: A cognitive behavioral appraoch for Adherence and Depression. Therapist Guide. Oxford University Press.  Safren SA, Gonzalez JS, Soroudi N (2008). Coping with Chronic Illness: A cognitive behavioral appraoch for Adherence and Depression. Client Workbook. Oxford University Press.

Paul Salkovskis (Institute of Psychiatry, Kings College London, UK)

Treating Health Anxiety Using CBT: Not the Worried Well, Rather the Walking Wounded
King's College Institute of Psychiatry, London , United Kingdom.

This workshop aims to provide practical clinical grounding in cognitive-behavioural treatment as applied to health anxiety, (hypochondriasis). The cognitive behavioural theory suggests that for hypochondriasis patients' problems lie not in the physical symptoms and other bodily variations they experience but rather in the way they interpret and react to these symptoms. A particular pattern of misinterpretation and reactions are involved in the maintenance of health worries, and therefore need to be modified in the course of treatment.
A crucial difference from problems such as panic disorderlies in the time course of the interpretations which are characteristic of health anxiety and hypochondriasis. This means that the emphasis in CBT has to be somewhat distinct from cognitive-behavioural treatments for anxiety disorders such as panic, with more in common with treatment for OCD. The importance of helping the patient to develop alternative, non-catastrophic interpretations of the problems they are experiencing is emphasised. Such an approach also needs to avoid the pitfalls involved in the provision of ?reassurance?.
The workshop will highlight clinical strategies for: assessment of anxiety and health related triggers, the way these are interpreted; engagement in psychological treatment; formulation and reaching a shared understanding; re-attribution; behavioural experiments; helping the patient stop seeking reassurance and unnecessary medical investigations; dealing with anxiety in the therapist and the patient's physicians; and relapse prevention
You will learn: 

To understand the unique characteristics of health anxiety;
To understand engagement and treatment issues;
To understand how to deal with reassurance.
Who should attend?: Cognitive behavioural therapists, clinical psychlogists, psychiatrists, physicians.
Recommended Readings: Salkovskis P, Warwick HM, Deale AC (2003). Cognitive-Behavioural Treatment for Severe and Persistent Health Anxiety (Hypochondriasis), Brief Treatment and Crisis Intervention 3, 353-367.

Matthew Sanders (University of Queensland, Australia)

A multilevel system of evidence parenting interventins for children and adolescents with conduct problems (with Alina Morawska)
University of Queensland, Brisbane, QLD, Australia.

This workshop provides an overview of a flexible, mult-level system of evidence based parenting and family interventions targeting children from infancy through to the adolescent years. The approach blends "light touch" universal parenting programs with more intensive targeted interventions for complex high-risk families. The inervention, known as the Triple P-Positive Parenting Program, has 20 differnet program variants targeting parents of children with a variety of behavioural or emotional problems or specific family situaitons. This includes parents of children with conduct or emotional problems, parents who have separated or divorced, parents of children with a disability or where parenting problems are complicated by mental health problems in the parent. Apart from providing an overview of how the multilevel system operates and its evidence base, the workshop will illustrate the key consulation processes used and how a self-regulatory framework for working with families is infused throughout the entire system. Principles and strategies of flexible tailoring will be discussed so that the program remains responsive to the assessed needs of families.
You will learn:
An overview of the Triple P system of parenting and family interventions.
Key clinical procedures and processes used in working with complex family situations.
How to avoid and/or manage barriers that get in the road of parents learning new skills or completing the program (including parent resistance).
Various clinical tools and materials that are used at different levels of the program.
Who should attend?: Multidisciplinary; familiarity with behavioral approach to parent training would be useful.
Recommended Readings: Sanders, M.R (2008). Triple P-Positive Parenting Program as a public health approach to strengthening parenting. Journal of Family Psychology, 22, 508-517.

Zindel V. Segal (University of Toronto, Canada)

Mindfulness and Relapse Prophylaxis in Mood Disorders
Centre for Addiction and Mental Health, Toronto, ON, Canada.

The chronic, recurrent nature of depression and anxiety presents an enormous challenge to sufferers and treatment providers. This workshop introduces participants to Mindfulness-Based Cognitive Therapy, an innovative, clinically proven treatment that encourages patients to play an active role in preventing the return of depression by integrating elements of Mindfulness-based meditative practice with Cognitive Therapy. It draws upon recent research to show how sustaining recovery from depression and anxiety depends upon learning how to keep mild states of sadness or fear from spiraling out of control. This type of learning is experiential in nature and often involves developing a capacity to allow distressing feelings, thoughts and sensations to occupy awareness, without trying to change them, replace them with other thoughts or fix anything about them. Training in mindfulness fosters a ?decentered? relationship to experience in which depression or anxiety-inducing thoughts or feelings can be viewed from a wider perspective as passing events in the mind, rather than as 'self' or as necessarily true. A central focus in this work is how to create a space that enables the therapist?s own mindfulness practice to inform their psychotherapy of clients suffering from depression, anxiety and worry. In this workshop, we will review the 8 week program, highlight its evidence base and experience the mindfulness practices that are featured in MBCT.

Adrian Wells (University of Manchester, UK)

Metacognitive Therapy: Applications to Treating Generalized Anxiety Disorder and Post-Traumatic Stress
University of Manchester, Manchester, United Kingdom.

Metacognitive Therapy (MCT) is an evidence-based treatment applicable to a wide range of disorders. It is based on the metacognitive model that identifies a common set of metacognitive factors and processes in all forms of pathology. It specifically focuses on formulating and modifying a Cognitive Attentional Syndrome consisting of worry and rumination, threat monitoring and unhelpful coping strategies that escalate and maintain disorder. The syndrome is a consequence of the effect that metacognition has on mental control, which leads to a failure to terminate extended thinking. In this workshop the specific models of PTSD and GAD will be described and illustrated with clinical case material. The process of case conceptualisation will be explained and the course and content of treatment for these two disorders will be described in detail.  Website: www.mct-institute.com
You will learn:
Metacognitive theory and how the models of PTSD and GAD work;
How to generate metacognitive case conceptualisations for PTSD and GAD;
How to socialise patients in treatment;
The structure and content of MCT.
Techniques for modifying the Cognitive Attentional Syndrome.
Techniques for modifying metacognitive beliefs and building metacognitive skills.
Who should attend?: The workshop is suitable for therapists and researchers at all levels.
Recommended Readings: Wells, A. (2008). Metacognitive Therapy for Anxiety and Depression. New York: uilford Press.

Maureen Whittal (University of British Columbia, Canada)

Treating OCD: How to Supercharge Exposure Therapy with the Latest Cognitive Techniques
University of British Columbia, Vancouver, BC, Canada and Jonathan  Abramowitz, University of North Carolina, Chapel Hill, United States

Exposure and response prevention (ERP) is the gold standard psychological treatment for obsessive compulsive disorder (OCD). For those who complete treatment, 80-90% receive benefit. The average decline in symptoms is approximately 50%-60%, with relapse rates of less than 10%. Nevertheless, doing ERP can be difficult for some patients, and individuals with covert compulsions may pose a particular challenge for exposure-based treatments. Cognitive therapy (CT) strategies address some of the limitations of ERP, and appear to also be effective in reducing OCD symptoms. This workshop will focus on how to integrate ERP and CT strategies for the different types of OCD symptoms (e.g., contamination, checking, severe obsessions, mental rituals, ordering rituals, etc.). Case studies and video examples will demonstrate the nuts and bolts of planning and implementing the treatments. Common obstacles to treatment, such as arguments and motivational problems, will be reviewed, and methods for addressing such problems will be provided. The continuity of clinical practice with clinical science will be emphasized throughout this workshop.
You will learn:
The latest cognitive theory, assessment and treatment strategies for addressing Obsessive Compulsive Disorder;
How to plan and implement exposure-based treatments for OCD and integrate them with cognitive strategies;   
How to address special populations (e.g., primary obsessions with few to no overt compulsions) and pitfalls in treatment (e.g., motivation and how to avoid arguments);
Who should attend?: Those with an intermediate level of familiarity with OCD treatment
Recommended Readings: Whittal, M.L. & Robichaud, M (2009). Cognitive Behavioral Treatment of Obsessive-Compulsive Disorder. In. M. Reinecke & S. Hofmann (Eds.). Cognitive-behavioral therapy with adults. London: Cambridge University Press. Abramowitz, J. S. (2006). The psychological treatment of obsessive-compulsive disorder. Canadian Journal of Psychiatry, 51, 407-416. McKay, D., Taylor, S., & Abramowitz, J. S. (2009). Obsessive-compulsive disorder. In D. McKay, J.S. Abramowitz, & S. Taylor (eds.). Cognitive-behavioral therapy for refractory cases: Turning failure into success (pp. 89- 109). Washington DC, American Psychological Association. Abramowitz, J. S. (2006). Understanding and treating obsessive-compulsive disorder: A cognitive-behavioral approach. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Douglas W. Woods (University of Wisconsin-Milwaukee, USA)

Comprehensive Behavioral Intervention for Tics in Children and Adolescents (with John Piacentini)
University of Wisconsin-Milwaukee, Milwaukee, WI, United States and John Piacentini, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, United States.

Tourette Syndrome (TS) is a neurological condition consisting of multiple motor and vocal tics. In recent years, there has been a growing recognition about the utility of behavior therapy procedures in managing the symptoms of Tourette Syndrome. Recently, the NIMH funded a multi-site group of researchers working with the Tourette Syndrome Association to conduct two parallel randomized clinical trials investigating the efficacy of these procedures in adults and children with TS. The procedures being tested in the study combine elements of habit reversal training with psychoeducation and function-based behavioral interventions, yielding a Comprehensive Behavioral Intervention for Tics (CBIT). In the current workshop, the presenters will describe CBIT and other relevant interventions used in the treatment of children with Tourette Syndrome. In addition to learning the general therapeutic techniques, attendees will learn to appreciate the diagnostic complexities associated with tic disorders, and will learn about the underlying theory for behavioral intervention, the data supporting the model, and data on the efficacy of the treatment. Various instructional technologies will be employed including didactic instructions, videotaped samples of actual treatment, and role-play demonstrations.
You will learn:
To distinguish between Tourette Syndrome and other tic disorders and their Comorbidities;   
To understand the behavioral model of tic disorders;  the core elements of behavior therapy for tic disorders including habit reversal training and function-based interventions;

Jeffrey Young (Cognitive Therapy Center of New York, USA)

Schema Therapy for Borderline Personality Disorder
Columbia University, New York, NY, United States.
 
Dr. Young will present the schema therapy approach for working with Borderline Personality Disorder. This model places primary emphasis on ?limited reparenting? within the therapy relationship, and the extensive use of emotion-focused techniques.  Schema therapy has been evaluated in outcome studies for BPD and demonstrated high levels of efficacy. The schema therapy model for BPD is based on the concept of a schema mode (similar to mood or ego states. Borderline patients typically ?flip? among four modes: the Detached Protector, the Abandoned/Abused Child, the Angry/Impulsive Child, and the Punitive Parent.  Dr. Young will discuss specific strategies for identifying and responding to modes, such as: extensive use of self-disclosure, schema mode imagery and dialogues, and limited reparenting.  The workshop will include patient video segments.
You will learn:
To conceptualize Borderline Personality Disorder in terms of four schema modes: the Detached Protector, Abandoned/Abused Child, Angry/Impulsive Child, and Punitive Parent.
About "Limited Reparenting" as one of the central foci in the ST approach to BPD.
The results of a major outcome study comparing Schema Therapy with Transference-Focused Psychotherapy (TFP) for outpatient BPD.
An overview of a range of schema therapy interventions for BPD, including mode dialogues, imagery, and cognitive restructuring.
Who should attend?: Workshop is open to all attendees interested in an integrative, longer-term therapy for BPD that places strong emphasis on the therapy relationship and emotion-focused strategies. Presenter will assume that attendees are already familiar with BPD as a diagnostic category & its associated symptoms.
Recommended Readings: Young, J.E., Klosko, J.S., & Weishaar, M. (2003). Schema Therapy: A Practitioner?s Guide. Guilford Publications: New York. Arntz, A. & van Genderen, H. (2009). Schema therapy for borderline personality disorder. John Wiley: New York.

Nader Amir (San Diego State University, USA)

Attention Modification Program: An Effective and Efficient Treatment for Anxiety

Saturday, June 5 9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 16

Nader Amir, San Diego State University, San Diego, California, United States

Anxious individuals tend to pay particular attention to negative information. CBT is designed to change this thinking pattern using Socratic questioning. However, it would be more efficient if these biases could be changed experimentally. In this talk I will present data from a number of randomized placebo controlled trials as well as open trials demonstrating the efficacy of a computerized attention modification program (AMP) in reducing anxiety symptoms. These studies use variations of the probe detection task to modify attention as well as assess change in attention bias over the course of training in individuals with generalized social phobia (GSP), GAD, PTSD, and OCD. These studies, using diverse methodologies and samples, attest to the ability of AMP to relieve anxiety and point to the potential for developing more efficient, empirically based treatments for these individuals.

You will learn:

·     About treating anxiety disorders;

·     About attention bias and anxiety;

·     About translational research; and

·     About cross diagnostic treatments.
Who should attend? People interested in learning about new treatment modalities 
Recommended Readings: Amir, N., et al (2009). Attention training in individuals with generalized social phobia: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 77 (5), 961-973.

Arnoud Arntz (University of Maastricht, the Netherlands)

Group Schema Therapy for Borderline Personality: Catalyzing Change

Friday, June 4  9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 8

Arnoud Arntz, Maastricht University, and Maastricht Community Mental Health Center, Maastricht, Netherlands, and J. Farrell, Indiana University School of Medicine, and Larue D. Carter Memorial Hospital, Indianapolis, Indiana, United States

This presentation gives a short introduction to the schema mode model of Borderline Personality Disorder (BPD) treatment, and demonstrates and describes a group schema therapy (GST) model for BPD and a way to combine individual and group. GST has empirical validation from a randomized controlled trial (RCT) and pilot studies, and a large multisite international RCT is in progress. The possibility of catalyzing interactions between ST techniques and the curative factors specific to group treatment are discussed. GST targets key criteria of BPD including: impairments in stability of self and relationships and the negative impact of stormy relationships and fear of abandonment on social, family, and occupational functioning. The GST experience provides a closer analogue to the family of origin, with a large array of schema change and relationship experiences to learn from. A peer group provides opportunities to identify and remediate unmet adolescent needs for mastery, autonomy, healthy validation of sexuality and exploration of life?s meaning. Group acceptance can undo emotional damage from critical or rejecting family groups and/or childhood peer groups. The experience of a supportive, validating group can directly impact and help heal key BPD schemas of abandonment, defectiveness, emotional deprivation, social isolation and mistrust/abuse. The adaptation of ST the group modality requires are presented and the interventions are demonstrated by video segments from BPD groups. These include: the co-therapy model used, limited re-parenting, group imagery re-scripting, mode-specific group role-plays and other experiential and cognitive group work.

You will learn:

·     How to recognize three defining aspects of group schema therapy;

·     How to observe demonstrations of group schema therapy; and

·     To summarize briefly the basic schema mode model of BPD.
Who should attend? Anyone interested in treatment of BPD, Schema therapy or group psychotherapy.  
Recommended Readings: Arntz, A. & van Genderen, H (2009) Schema Therapy for Borderline Personality Disorder. New York: John Wiley & Sons. Arntz, A.; Weertman, A. (1999). Treatment of childhood memories; theory and practice. Behaviour Research and Therapy, 37, 715-740. Farrell, J.M., Shaw, I.A. & Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: A randomized controlled trial. Journal of Behavior Therapy & Experimental Psychiatry, 40(2), 317-328. Farrell, J.M. & Shaw, I.A. (2010). Schema therapy groups for borderline personality disorder patients: the best of both worlds of group psychotherapy. In E. Roediger & G. Jacobs (Eds.) Fortschritte der Schematherapie. Göttingen: Hogrefe. Retrieved from http://www.bpd-home-base.org  

Judith S. Beck (University of Pennsylvania, USA)

A Cognitive Behavioral Approach to Weight Loss and Maintenance

Saturday, June 5 9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 15

Judith Beck, Beck Institute for Cognitive Therapy and Research and University of Pennsylvania, Philadelphia, Pennsylvania, United States

This seminar is designed help you teach clients a specific set of cognitive and behavioral skills, including how to motivate themselves every day, respond to interfering cognitions, create time for exercise, discipline themselves to use good eating habits, decatastrophize hunger, cope with craving and emotional eating, and get back on track immediately. Clients master these skills before learning how to plan and monitor their food intake and eat on a regular basis. Then they finally change what they eat. Later skills include learning how to eat flexibly, incorporate their favorite foods, deal with difficult real-life situations, cope with special occasions and food pushers, develop a lifelong eating plan, motivate themselves for life, and prevent relapse. Skills will be demonstrated through volunteer role-plays.

You will learn:

·     How to identify dysfunctional cognitions that interfere with weight loss;

·     How to apply cognitive and behavioral strategies to help patients tolerate hunger and cravings;

·     How to identify and ameliorate common diet-interfering problems; and

·     How to employ relapse prevention techniques to facilitate maintenance of weight loss.

Who should attend? Clinicians who work with clients on weight loss and maintenance.

Recommended Readings: Beck, J. S. (2007). The Beck Diet Solution. New York: Guilford Press. Klem, M. L. et al. (1998). Psychological symptoms in individuals successful at long-term maintenance of weight loss. Health Psychology, 17, 336-345. Thomas, J. G., & Wing, R. R. (2009). Maintenance of Long-Term Weight Loss. Medicine and Health, 92, 53-57. Wing, R. R et al (2006). A self-regulation program for maintenance of weight Loss. New England Journal of Medicine, 355, 1563-1571.

Thomas Borkovec (Pennsylvania State University, USA)

Miracle Cures Do Happen: Two Examples from a Cognitive Therapy Session and an Interpersonal/Emotional Processing Session

Thursday, June 3 2:00 p.m. ? 4:00 p.m.

Master Clinician Seminar 7

Thomas Borkovec, Penn State University, University Park, Pennsylvania, United States

Sudden and dramatic changes during a therapy session are rare, but their periodic occurrence indicates that powerful causal mechanisms do indeed exist. In the course of twenty years of clinical trials on psychotherapy for generalized anxiety disorder, two such events were captured on videotape. In the first case, the therapist was using traditional cognitive therapy interventions which, during a 10-minute segment, resulted in the complete and long-lasting elimination of a client?s severe, comorbid contamination phobia. In the second case, the therapist was working with the client using interpersonal and emotional processing techniques which, during a 30-minute segment, resulted in a dramatic change in the client?s subsequent interpersonal and emotional life, the elimination of GAD diagnostic status, and reductions in anxiety and worry levels to within normal limits. Both videotapes will be shown and discussed with attention to how such dramatic change may have taken place on the basis of technique and client readiness for change.

You will learn:

·     About some of the kinds of client behavior that suggest openness for change;

·     How to observe examples of precise and potent therapist administration of CBT and Interpersonal/Experiential techniques; and

·     What client, therapist, and technique variables may have combined in these sessions to create dramatic change.

Who should attend? Open to any level of expertise in CBT and Interpersonal/Experiential Therapy

Recommended Readings: Borkovec, T. D., Hazlett-Stevens, H. & Diaz, M. L. (1999). The role of positive beliefs about worry in generalized anxiety disorder and its treatment. Clinical Psychology and Psychotherapy, 6, 126-138. Newman, M. G., Castonguay, L. G., Borkovec, T. D., & Molnar, C. (2004). Integrative therapy for generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 320-350). New York: Guilford Press.

Andrew Christensen (University of California, Los Angeles, USA)

Acceptance and Change in Couple Therapy

Friday, June 4  9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 9

Andrew Christensen, UCLA, Los Angeles, California, United States

In this Master Clinician Seminar, I will give an overview of the theoretical background, assessment methods, and treatment strategies of Integrative Behavioral Couple Therapy (IBCT), illustrating treatment strategies with videotaped examples of couples in therapy. Developed by Andrew Christensen and Neil Jacobson, IBCT is a ?third wave? behavioral approach to couples, based in part on traditional behavioral approaches but including an emphasis on emotional acceptance rather than an exclusive focus on change and a focus on experiential, contingency shaped change rather than rule-governed, didactic change. IBCT has been the focus of three clinical trials, including a large scale, two site clinical trial comparing Traditional Behavioral Couple Therapy with IBCT (Christensen et al., 2004). The latter study has included 2 year follow-up data (Christensen et al., 2006), 5 year follow-up data (Christensen et al., in press), prediction studies (Atkins et al., 2005; Baucom et al, 2009) and mechanism studies (Cordova et al., 1998; Doss et al., 2005). These studies have all supported the efficacy of IBCT and provide a strong empirical base for its use. In this seminar I will first provide a conceptual overview of IBCT, emphasizing its theoretical distinction from Traditional Behavioral Couple Therapy and from Cognitive Behavioral Couple Therapy. Then I will describe assessment and case formulation in IBCT, which serves as the basis for a feedback session at the end of the assessment period. Finally, I will describe three essential treatment strategies in IBCT and provide videotape demonstration of some of these interventions.

You will learn:

·     How to describe the central theoretical foundations of IBCT;

·     How to describe case formulations in IBCT; and

·     How to describe and illustrated treatment strategies in IBCT.

Who should attend? Those interested in couple therapy who have some knowledge of behavioral approaches to couple therapy. 
Recommended Readings: Christensen, A., & Jacobson, N. S. (2000). Reconcilable differences. New York: Guilford Press. Jacobson, N. S., & Christensen, A. (1998). Acceptance and change in couple therapy: A therapist?s guide to transforming relationships. New York: W. W. Norton. 

Mark Dadds (University of New South Wales, Australia)

Beyond Behavioral Parent Training: Making Family Interventions Really Work for Young Conduct Problem Children.

Saturday, June 5 2:00 p.m. ? 4:00 p.m.

Master Clinician Seminar 21

Mark Dadds, University of New South Wales, Sydney, New South Wales, Australia

A range of family intervention techniques can promote positive change in children with conduct problems and their families, however, engaging such families can be difficult, drop rates are high, and change can be hard to achieve when the parent?s own issues dominate. This seminar will focus on strategies that can be used to maximize parental engagement, reduce dropout, and facilitate positive change in difficult families. First principals theories and a process model of consultation that is utilizable across a range of child and family problems will be presented. The structure of the workshop will be: 1) Theoretical tools: behavioral, attachment, structural, and cognitive tools. 2) Assessing the causes of child and family problems: didactic presentation of content advances and a process model for family therapy and empowerment. 3) Therapy Process: work through the process phases using a videotaped example of a family in therapy. Structured but playful behavior rehearsals will be used for skill development.

You will learn:

·     To understand and communicate the major models of child and family functioning;

·     To understand common parent-child problems in terms of the major models of child and family functioning;

·     To translate these models into a therapeutic process that maximizes parental engagement in treatment; and

·     To be able to identify, prevent and remediate difficult process events in working with parents.

Who should attend? Clinicians who work with the parents of children with behavioral and emotional problems.

Recommended Readings: Dadds, M. R., & Hawes, D. (2006). Integrative Family Intervention for Child Conduct Disorders. Brisbane, Australian Academic Press.

Raymond DiGiuseppe (St. John?s University, USA)

A Comprehensive Treatment for Anger Problems with Adolescents

Saturday, June 5 9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 18

Raymond DiGiuseppe, St. John's University, Queens, New York, United States

Anger is a common problem for which we have few successful treatments. This presentation will review characteristics of anger that interfere with the development of a therapeutic alliance. Understanding these characteristics can lead to the construction of successful treatment programs. Anger is an emotion that most people do not wish to change. Thoughts concerning other blame and justification of one?s anger fuel the anger experience. Anger usually involves rumination of these thoughts. Angry clients frequently engage in selective abstraction errors that result in their focusing on the benefits of anger and underestimating the costs. Also, anger frequently arouses the motivation for revenge, which is highly reinforcing. As a result, angry clients often have low motivation for change because they blame others for their problems, believe they are justified in their rage, and feel positively reinforced by vengeful fantasies. This presentation will focus on how to increase the motivation for change by using decisional analysis and changing the beliefs and cognitions that allow the person to view their anger as a positive experience. Cognitive, problem solving, and imaginal strategies will be suggested.

You will learn:

·     How to assess the characteristics of disturbed anger;

·     How to assess the elements of anger that block motivation for change;

·     How to intervene to change the selective abstraction errors that lead to clients? overestimation of the benefits of anger; and

·     How to intervene to change clients' external attributions for blame and justification beliefs and replace their desire for revenge with acceptance or forgiveness.
Who should attend? Professions who treat, supervise or teach interventions for adolescents and young adults with externalizing disorders, anger , and aggression problems. 
Recommended Readings: DiGiuseppe, R., & Tafrate, R. (2007). Understand anger disorders. New York: Oxford University Press. Tafrate, R., & Kassinove, H. (2010). Anger management for everyone: seven proven ways to control anger and live a happier life. Atascadero, California: Impact Publishers. DiGiuseppe, R. & Tafrate, R. C. (2003). Anger treatment for adults: a meta-analytic review. Clinical Psychology, 10, 70-84. Lachmund, E., DiGiuseppe, R., & Fuller, J. R. (2005). Clinicians? diagnosis of a case with anger problems. Journal of Psychiatric Research, 39(4), 439-447. DiGiuseppe, R. & Tafrate, R. C. (2001). A comprehensive treatment model for anger disorders. Psychotherapy, 28(3), 262-271.  

Keith Dobson (University of Calgary, Canada)

Working with Negative Cognitions in Depression: Evidence-based and Utility-based Strategies for Cognitive Change

Thursday, June 3 2:00 p.m. ? 4:00 p.m.

Master Clinician Seminar 6

Keith Dobson, University of Calgary, Calgary, Alberta, Canada

Although the presence of negative cognitions in depression is well recognized, not all such cognitions will be the focus of clinical work in CBT. Further, even when negative thoughts are targeted for assessment and possible change, different strategies can be employed. Two of the most challenging tasks for therapists are to determine which thoughts to work with, and how to approach these in practice. In this Master Clinician session, the presenter will discuss two broad classes of thoughts, and the range of potential strategies that can be used for each of these classes. In particular, it will be suggested that negative and possibly distorted thoughts warrant evidence-based interventions, whereas negative but potentially realistic thoughts will respond better to utility-based interventions. Examples of these two types of thoughts, and specific interventions for each, will be presented. The presentation will blend didactic presentation and video presentation.

You will learn:

·     To distinguish between different types of negative cognitions in depression;

·     To recognize effective strategies for two types of negative cognition in depression; and

·     To be able to name and provide examples of reality-based and utility-based interventions for negative thoughts in depression.
Who should attend? Clinicians with some familiarity with the use of CBT in depression, or trainees in CBT. 
Recommended Readings: Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press. 
Dobson, D. J. G., & Dobson, K. S. (2009). Evidence-based practice of cognitive-behavioral therapy. New York: Guilford Press.

Joan Farrell (Indiana University, USA)

Group Schema Therapy for Borderline Personality: Catalyzing Change

Friday, June 4  9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 8

Arnoud Arntz, Maastricht University, and Maastricht Community Mental Health Center, Maastricht, Netherlands, and J. Farrell, Indiana University School of Medicine, and Larue D. Carter Memorial Hospital, Indianapolis, Indiana, United States

This presentation gives a short introduction to the schema mode model of Borderline Personality Disorder (BPD) treatment, and demonstrates and describes a group schema therapy (GST) model for BPD and a way to combine individual and group. GST has empirical validation from a randomized controlled trial (RCT) and pilot studies, and a large multisite international RCT is in progress. The possibility of catalyzing interactions between ST techniques and the curative factors specific to group treatment are discussed. GST targets key criteria of BPD including: impairments in stability of self and relationships and the negative impact of stormy relationships and fear of abandonment on social, family, and occupational functioning. The GST experience provides a closer analogue to the family of origin, with a large array of schema change and relationship experiences to learn from. A peer group provides opportunities to identify and remediate unmet adolescent needs for mastery, autonomy, healthy validation of sexuality and exploration of life?s meaning. Group acceptance can undo emotional damage from critical or rejecting family groups and/or childhood peer groups. The experience of a supportive, validating group can directly impact and help heal key BPD schemas of abandonment, defectiveness, emotional deprivation, social isolation and mistrust/abuse. The adaptation of ST the group modality requires are presented and the interventions are demonstrated by video segments from BPD groups. These include: the co-therapy model used, limited re-parenting, group imagery re-scripting, mode-specific group role-plays and other experiential and cognitive group work.

You will learn:

·     How to recognize three defining aspects of group schema therapy;

·     How to observe demonstrations of group schema therapy; and

·     To summarize briefly the basic schema mode model of BPD.
Who should attend? Anyone interested in treatment of BPD, Schema therapy or group psychotherapy.  
Recommended Readings: Arntz, A. & van Genderen, H (2009) Schema Therapy for Borderline Personality Disorder. New York: John Wiley & Sons. Arntz, A.; Weertman, A. (1999). Treatment of childhood memories; theory and practice. Behaviour Research and Therapy, 37, 715-740. Farrell, J.M., Shaw, I.A. & Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: A randomized controlled trial. Journal of Behavior Therapy & Experimental Psychiatry, 40(2), 317-328. Farrell, J.M. & Shaw, I.A. (2010). Schema therapy groups for borderline personality disorder patients: the best of both worlds of group psychotherapy. In E. Roediger & G. Jacobs (Eds.) Fortschritte der Schematherapie. Göttingen: Hogrefe. Retrieved from http://www.bpd-home-base.org

Philippa Garety (Institute of Psychiatry, UK)

New Ways of Working with Delusions

Thursday, June 3 9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 4

Philippa Garety, King's College London, and South London & Maudsley NHS Foundation Trust, London, United Kingdom

A high proportion of people with psychosis have persisting and distressing delusions that present a challenge in cognitive behavioral therapy for psychosis (CBTp). Recent meta-analyses suggest that although CBTp is effective in reducing overall symptoms and may have positive effects for hallucinations, the evidence for beneficial changes in distressing delusions is lacking. This session will address questions about the different causes of delusion persistence and discuss a variety of ways the clinician might adopt for working with delusions. The importance of both emotional processes, in particular anxiety related processes, and reasoning biases will be discussed. The concepts of jumping to conclusions and belief flexibility will be introduced. New ways of working to promote adaptive reasoning and greater belief flexibility will be presented. The session will use video material and case examples, together with a demonstration of new computerized reasoning training material and a discussion of its place in therapy practice.

You will learn:

·     To summarize different causes of delusion persistence and to learn different approaches to adopt when working with persistent delusions;

·     About the evidence for the role of emotional processes and reasoning biases as causes of persistence of delusions;

·     To understand the concepts of jumping to conclusions and belief flexibility and to learn how they are assessed and their importance in therapy; and

·     To learn and practice new ways of working to promote adaptive reasoning and greater belief flexibility.

Who should attend? Clinical psychologists, cognitive behavior therapists and other mental health professionals with some expertise in working, using CBT, with people with psychosis. 
Recommended Readings: Freeman, D., Garety, P. A., Fowler, D., Kuipers, E., Bebbington, P. E., & Dunn, G. (2004). Why do people with delusions fail to choose more realistic explanations for their experiences? An empirical investigation. Journal of Consulting and Clinical Psychology, 72: 671-680. Garety, P., Freeman, D., Jolley, S., Dunn G., Bebbington, P. E., Fowler, D., . . . & Dudley, R. (2005). Reasoning, emotions and delusional conviction in psychosis. Journal of Abnormal Psychology, 114: 373-384. 

W. Kim Halford (University of Queensland, Australia)

Four New Ways to Make Behavioral Couple Therapy Work Better

Thursday, June 3 9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 2

W. Kim Halford, University of Queensland, St. Lucia, Queensland, Australia

Couple therapy has some challenges distinctive from individual therapy. In this presentation I will describe four challenges that commonly arise that can compromise couple therapy effectiveness, and describe and demonstrate four exciting new approaches to address these challenges. The challenges to be discussed are: the common experience of partners blaming each other for relationship problems, and lacking a way of understanding relationship challenges that facilitates change; ambivalence about the future of the relationship that leads to lack of change effort by many distressed couples; the challenge of managing a constructive process when attempting to develop couple relationship skills like communication; and how to identify when the couple therapy approach being tried is not working and what needs to change.

You will learn:

·     To describe four common challenges to making couples therapy effective;

·     To describe and demonstrate the use of structured assessment incorporating internet-based assessment systems, combined with motivational interviewing procedures, to help couples develop a dyadic conceptualization of their relationship difficulties, and to build the partner's commitment to personal change to enhance relationship functioning;

·     To describe the use of structured audiovisual materials and self-directed learning processes to enhance distressed couple's development of key relationship skills; and

·     To describe a brief, practical system for monitoring client progress during couple therapy and detecting couples that are at risk of not benefiting from therapy.
Who should attend? Psychologists, psychiatrists and mental health professionals who have an interest in working effectively with distressed couples.  
Recommended Readings: Halford, W. K. ( 2001). Brief Couple Therapy. New York: Guilford. Halford, W K., Moore, E. M., Wilson, K., Dyer, C., Farrugia, C., & Judge, K. (2006). Couple commitment and relationship enhancement program [Guidebooks, leaders manual, and audiovisual DVD production available from www.couplecare.info]. Brisbane: Australian Academic Press. Slade, K., Lambert, M. J., Harmon, S. C., Smart, D. W., & Bailey, R. (2008). Improving psychotherapy outcome: the use of immediate electronic feedback and revised clinical support tools. Clinical Psychology and Psychotherapy, 15, 287-303.

Philip C. Kendall (Temple University, USA)

The Clinical Side of CBT for Anxious Youth: Tips from the Trenches

Friday, June 4  2:00 p.m. ? 4:00 p.m.

Master Clinician Seminar 14

Philip Kendall, Temple University, Philadelphia, Pennsylvania, United States

This presentation will provide a brief run-through of the sessions used in the Coping cat workbook and treatment manual. Following the overview, matters of assessment, screening, diagnosis, treatment conceptualization and planning, and evaluations of outcomes will be considered. Throughout, input that has been received from over 40 therapists who have implemented the program will be summarized and discussed. The format will be an initial presentation followed by audience participation and discussion. At the end of our allotted time, time permitting, we will preview samples from the computer-assisted treatment entitled Camp Cope-A-Lot.

You will learn:

·     Assessment, screening, and diagnosis; and

·     Treatment conceptualization and planning.

Who should attend? Those interested in learning about cognitive behavioral interventions for youth with anxiety disorders.

David J. Miklowitz (University of Colorado at Boulder, USA)

Bipolar Disorder: A Family Intervention Approach

Saturday, June 5 2:00 p.m. ? 4:00 p.m.

Master Clinician Seminar 19

David Miklowitz, University of California, Los Angeles, CA, United States

Early-onset bipolar disorder, defined as onset of mania before age 18, is a highly treatment-refractory form of the disorder marked by frequent recurrences, substantial symptom burden between episodes, social and academic dysfunction, and high suicide risk. This seminar describes an outpatient program of family-focused treatment (FFT) as an adjunct to pharmacotherapy for teenage bipolar patients (ages 13-17) who have just had an episode of mania, depression, or mixed disorder. After a brief summary of empirical findings on the efficacy of FFT for adults and bipolar teens, the talk will focus on key therapeutic objectives and techniques: assisting families in (1) mood monitoring and identifying early warning signs of mood cycles; (2) implementing strategies to prevent full recurrences, (3) promoting consistent sleep/wake habits, (4) encouraging medication adherence, and (5) developing effective family communication and problem-solving skills to address irritability, oppositionality, and family conflict. The developmental transitions made by families in coming to accept the realities of the teen?s disorder will be discussed.

You will learn:

The research background pertinent to family-focused treatment for adolescent and adult bipolar patients; 
To become acquainted with the clinical methods of family-focused treatment ; and 
Ways to apply this treatment within clinical-community settings.
Who should attend? Those interested in treatment for bipolar disorder 
 

Kim T. Mueser (Dartmouth Medical School, USA)

Illness/Wellness Management and Recovery for Severe Mental Illness: Current Status and Future Directions?

Friday, June 4  2:00 p.m. ? 4:00 p.m.

Master Clinician 13

Kim Mueser, Dartmouth Medical School, Concord, New Hampshire, United States

The Illness Management and Recovery (IMR) program is a standardized, curriculum-based intervention in the public domain designed to teach people with severe mental illness how to manage their psychiatric disorder in the service of achieving personally meaningful, recovery goals. This presentation will begin with a brief review of the concept of recovery, including new definitions that emphasize the subjective experience of coming to grips with having a mental illness, the process of developing a meaningful life, and personal growth. Next, the development of the IMR program will be described, followed by a summary of the core components of the intervention. Then, research evaluating the effectiveness of the IMR program will be reviewed, as well as research examining its implementation in routine community mental health treatment settings. Finally, future directions for research on IMR program will be considered, including special populations (e.g., forensic, intellectually disabled) and special problems (e.g., addressing comorbid health problems).

You will learn:

·     To describe the 10 curriculum modules that are taught in the Illness Management and Recovery program;

·     To describe the three different teaching strategies used to teach information and skills in the Illness Management and Recovery program;

·     To define the term "recovery" as it is used in the Illness Management and Recovery program; and

·     To identify the five evidence-based practices incorporated in the Illness Management and Recovery program.

Who should attend? People who are familiar with severe mental illness (e.g., schizophrenia, bipolar disorder, severe major depression) should attend the presentation. 
Recommended Readings: Hasson-Ohayon, I., Roe, D., & Kravetz, S. (2007). A randomized controlled trial of the effectiveness of the Illness Management and Recovery program. Psychiatric Services, 58, 1461-1466. Levitt, A., Mueser, K. T., DeGenova, J., Lorenzo, J., Bradford-Watt, D., Barbosa, A., . . . & Chernick, M. (2009). A randomized controlled trial of Illness Management and Recovery in multi-unit supported housing. Psychiatric Services, 60, 1629-1636. Mueser, K. T., Corrigan, P. W., Hilton, D., Tanzman, B., Schaub, A., Gingerich, S.,  
. . . & Herz, M. I. (2002). Illness Management and Recovery for severe mental illness: A review of the research. Psychiatric Services, 53, 1272-1284. Mueser, K. T., Meyer, P. S., Penn, D. L., Clancy, R., Clancy, D. M., & Salyers, M. P. (2006). The Illness Management and Recovery program: rationale, development, and preliminary findings. Schizophrenia Bulletin, 32 (Suppl. 1), S32-S43. Salyers, M. P., Godfrey, J. L., McGuire, A. B., Gearhart, T., Rollins, A. L., & Boyle, C. (2009). Implementing Illness Management and Recovery for consumers with severe mental illness. Psychiatric Services, 60, 483-490. Whitley, R. E., Gingerich, S., Lutz, W. J., & Mueser, K. T. (2009). Implementing the Illness Management and Recovery program in community mental health settings: facilitators and barriers. Psychiatric Services, 60, 202-209.

Lars-Göran Öst (Stockholm University, Sweden)

Rapid and Effective Treatment of Specific Phobias 

Thursday, June 3 9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 3

Lars-Göran ÖstStockholm University, Stockholm, Sweden

Specific phobia is the most prevalent of all psychiatric disorders in the general population with a lifetime prevalence of about 12%. However, few people suffering from specific phobia apply for treatment, mainly because they are not aware of the treatment possibilities, or they are afraid that the treatment itself will be worse than having the phobia. I have developed a rapid treatment that is carried out in one single session, which is maximized to 3 hours. The treatment is based on a cognitive behavior analysis of the catastrophic beliefs the patient has in relation to a possible confrontation with the phobic object or situation. Prolonged exposure is done as a series of behavioral experiments to help the patient test the catastrophic beliefs they have. In animal phobias, modeling is used as an adjunct. During the last decade I have done 12 randomized clinical studies on phobias of spiders, snakes, blood-injury, injections, dental care, flying and enclosed places in adults and 2 studies on various specific phobias in children and adolescents. The mean treatment time varies between 2 and 3 hours and the proportion of clinically significant improvement between 80-94%. The effects are maintained, or furthered, at the 1-year follow-up. These results have been replicated in at least 12 RCTs carried out in Holland, Great Britain, Germany, Norway, USA, Canada, and Australia. The presentation will include a description of the one-session treatment and a review of the research published on this treatment.

You will learn:

·     About a rapid treatment based on cognitive behavior analysis; and

·     About clinically significant research on this treatment

Who should attend? Clinicians interested in treatment of specific phobias. 

Jacqueline B. Persons (San Francisco Bay Area Center for Cognitive Therapy, USA)

Developing and Using a Case Formulation to Guide Treatment

Thursday, 9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 1

Jacqueline B. Persons, San Francisco Bay Area Center for Cognitive Therapy, Oakland, CA, and University of California, Berkeley, CA, United States

A case formulation identifies a particular patient?s symptoms, problems, and disorders and proposes some hypotheses about mechanisms (e.g., distorted schemas, emotion dysregulation, experiential avoidance) that cause and maintain the problems. The formulation guides treatment planning and clinical decision-making. A formulation is especially helpful when treating multiple-problem patients, patients for whom multiple ESTs are available, those who have problems that interfere with treatment, and those who fail the ESTs. Dr. Persons describes strategies for developing a case formulation, using the formulation to guide clinical decision-making, and collecting data to test the formulation and evaluate the effectiveness of the treatment based on the formulation. She illustrates these strategies using audio and video material from therapy sessions and provides extensive handouts. 
You will learn:  
Assessment tools and strategies that are useful in the process of developing a case formulation when working with anxious and depressed outpatients; 
Strategies for using the formulation to guide clinical decision-making; and 
Ways to use progress monitoring to evaluate the effectiveness of the interventions that flow from the formulation and (indirectly) the formulation itself. 
Who should attend? Beginning and intermediate-level clinicians 
Recommended Readings: Persons, J. B. (2008). The case formulation approach to cognitive-behavior therapy. New York: Guilford.  Persons, J. B. (2005). Empiricism, mechanism, and the practice of cognitive-behavior therapy. Behavior Therapy, 36, 107-118. Kazdin, A. E. (1993). Evaluation in clinical practice: Clinically sensitive and systematic methods of treatment delivery. Behavior Therapy, 24, 11-45.

Ron Rapee (Macquarie University, Australia)

Group Treatment of Anxiety Disorders in Children and Adolescents: The Cool Kids Program

Friday, June 4  9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 11

Ronald Rapee, Macquarie University, Sydney, New South Wales, Australia

For some years we have been conducting the Cool Kids treatment programs for anxious children and adolescents at Macquarie University. Treatment is commonly conducted in group format over approximately 10 sessions, and both parents and children attend all sessions for children. A similar but slightly different program, involving some parental input, is run for adolescents. The treatment components include education, cognitive restructuring, parent management strategies, approach to feared situations, and rewards. Variations to the delivery of the program have allowed it to be used in individual presentation, school early intervention presentation, self-help format, parent-only format, and distance delivery. Data from these and similar programs indicate a high degree of success with most children, showing moderate to marked change, and results maintaining for several years. In this presentation we will discuss the details and delivery of the Cool Kids treatment program for young people. Application to individual cases will be described and there will be ample time for questions and group discussion.

You will learn:

·     How to identify anxiety disorders in children and adolescents and understand some of the primary maintaining mechanisms;

·     To develop a detailed understanding of a manualized treatment package for the management of child and adolescent anxiety; and

·     To understand the role of parents in the maintenance of child anxiety and their inclusion in anxiety management.

Who should attend? Anyone working clinically with anxious children and adolescents. This includes practicing clinical psychologists, psychiatrists and other mental health workers, educators, and school counselors.  
Recommended Readings: Rapee, R. M., Wignall, A., Spence, S. H., Cobham, V. E., & Lyneham, H. (2008). Helping your anxious child: A step-by-step guide for parents (2nd ed.). Oakland, California: New Harbinger. Rapee, R. M., Schniering, C. A., & Hudson, J. L. (2009). Anxiety disorders during childhood and adolescence: Origins and treatment. Annual Review of Clinical Psychology, 5, 311-341.

Patricia A. Resick (National Center for PTSD, Boston VA Healthcare System and Boston University, USA)

The Anatomy of a Stuck Point: Challenging Specific PTSD Beliefs within Cognitive Processing Therapy

Saturday, June 5 9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 17

Patricia Resick, Boston University, Boston, Massachusetts, United States

This master clinician seminar will illustrate how to think through the series of Socratic questions one might ask in the process of challenging a distorted cognition related to one?s role in a traumatic event or the conclusion one draws about self, others, or world in the aftermath of trauma. Socratic dialog is the underpinning of intervention for cognitive processing therapy (CPT) for PTSD and requires a particular frame of reference in order to successfully challenge the client?s reasoning and assumptions. This presentation will walk participants through several common assimilated or over-accommodated stuck points and illustrate how a therapist might work with the client to challenge these assumptions. Videotaped examples of a client at several points in therapy will be used to demonstrate the logic and style of Socratic dialog within the context of CPT.

You will learn:

·     How to clarify general statements into specific thoughts that are more easily challenged;

·     To generate a series of questions designed to guide clients to examine the accuracy of their beliefs about their traumatic events and the implications for themselves and others; and

·     To draw a diagram of the logic behind Socratic dialog as a means of giving direction to their challenging questions.
Who should attend? Participants should have been trained in cognitive processing therapy for PTSD. 
Recommended Readings: Medical University of South Carolina, CPT Web-A web-based learning course for cognitive processing therapy. Retrieved from http://cpt.musc.edu. Resick, P. A., Monson, C. M., & Chard, K. M. (2007, revised in 2008). Cognitive processing therapy: veteran/military version. Washington, DC: Department of Veterans Affairs (available from: [email protected])

Juan Jose Sanchez-Sosa (National University of Mexico, Mexico)

Cognitive-Behavioral Interventions for Disadvantaged Participants with Chronic Medical Conditions

Thursday, 2:00 p.m. ? 4:00 p.m.

Master Clinician Seminar 5

Juan J. Sanchez-Sosa, National University of Mexico, Mexico City, DF, Mexico.

Chronic conditions such as diabetes, cancer, hypertension, etc., represent a serious psychological burden. In addition to the suffering caused by the medical condition itself, most patients with chronic diseases tend to show poor mastery of adaptive behaviors, more feelings of loneliness, less self-efficacy, and smaller social support networks. In addition, frequent psychological factors associated with poor care and control of chronic conditions include: defective coping strategies, distorted or biased beliefs about the disease or its treatment, lack of self-care skills, and interfering emotional reactions such as anxiety and depression. These problems are, in turn, naturally aggravated by such conditions as very low income, little or no schooling, risky environments, and deficiencies derived from certain characteristics of healthcare services themselves. These variables will be addressed as will some instances of successful interventions with patients with chronic conditions under severe socio-economic restrictions.

You will learn: 
To identify the main medical conditions for which successful interventions have shown benefits in socially disadvantaged patients;  
To identify at least three of the various cognitive-behavioral areas susceptible of improvement in patients with chronic medical conditions; 
To describe the main cognitive-behavioral intervention procedures leading to improved quality of life and therapeutic adherence; and  
To describe two cost-benefit implications of successful cognitive-behavioral interventions for institutional (hospital, health systems, etc.) settings. 

Jason Satterfield (University of California, San Francisco, School of Medicine, USA)

Cognitive-Behavioral Therapy for the Beginning of the End of Life: Interventions for Chronic, Progressive Illness

Saturday, June 5 2:00 p.m. ? 4:00 p.m.

Master Clinician Seminar 20

Jason Satterfield, University of California, San Francisco, California, United States

Over 130 million Americans currently suffer from a chronic disease accounting for 7 out of every 10 deaths. Co-morbid stress, depression, and anxiety amplify psychosocial impairment and hasten disease progression. With changing disease demographics, it is now critical to develop adjunctive psychosocial treatments for chronic disease management and progression toward end of life. As with birth, death requires preparation and presents difficult medical, psychosocial, emotional, and spiritual challenges. Patients with progressive disease have the opportunity to prepare for death and exert some control over the rate of their decline. Patients may maximize quality of life by alleviating unnecessary suffering and facilitating the achievement of a ?good death.? Psychotherapy ? especially more structured approaches such as cognitive therapy ? could provide an important toolkit to assist patients and families. Using patient videos, group exercises, and didactics, a cognitive therapy-based end of life treatment will be demonstrated. This evidence-based program is divided into 4 flexible modules: (1) Stress, Appraisals, and Coping, (2) Emotion Management, (3) Relationships, and (4) Quality of Life. Special therapeutic issues considered will include treatment delivery formats, defining boundaries, confidentiality, inclusion of family, working with a medical team, requests for hastened death, and the spiritual and existential issues activated for the caregiver.

You will learn:

·     To describe common psychosocial challenges that emerge with progressive disease;

·     To discuss how current medical care falls short;

·     To apply CBT to the challenges faced at the end of life including the management of emotions, relationships, and quality of life; and

·     To integrate CBT structure with spiritual and existential interventions more commonly seen in end of life care.

Who should attend? Health care providers interested in chronic disease management and/or end of life. Participants should be familiar with cognitive therapy. 
Recommended Readings: Rabow, M. W., Hauser, J. M., & Adams, J. (2004). Supporting family caregivers at the end of life: ?They don?t know what they don?t know.? Journal of the American Medical Association, 291(4), 483?491. Satterfield, J.M. (2008). A cognitive-behavioral approach to the beginning of the end of life: minding the body. New York: Oxford University Press. Satterfield, J.M. (2008). Minding the body: workbook. New York: Oxford University Press. Werth, D., & Blevins, J. W. (Eds.) (2005). Psychosocial issues near the end of life: A resource for professional care providers. Washington, DC: American Psychological Association.

Bonnie Spring (Northwestern University, Feinberg School of Medicine, USA)

Treatment of Multiple Health Risk Behaviors: Poor Quality Diet, Inactivity, Smoking

Friday, June 4  2:00 p.m. ? 4:00 p.m.

Master Clinician Seminar 12

Bonnie Spring, Northwestern University, Chicago, Illinois, United States

Unhealthy lifestyle behaviors account for as much as 40% of premature mortality from cardiovascular disease and cancers. Smoking still marginally outstrips obesity as the most potent preventable cause of morbidity. Four risk behaviors are so prevalent that they could be said to characterize a westernized lifestyle: eating a high-fat diet, consuming few fruits and vegetables, extensive television viewing, and low moderate-vigorous intensity physical activity. Public health guidelines advise correcting all of these unhealthy behaviors, but little is known about the best approach. Because risk behaviors usually co-occur, questions arise about how many behaviors to treat and in what order. A further complication is that changing one unhealthy behavior often yields parallel (complementary) or opposite (substitute) change in other behaviors. Bonnie Spring will present lessons learned from two decades of research and practice spent developing interventions to treat lifestyle risk behaviors. She will describe interventions to prevent weight gain after quitting smoking. Then she will discuss the treatment that maximized healthy lifestyle change in head-to-head comparison of four different interventions to correct diet and activity risk behaviors. She will also discuss including technology when intervening with special populations, including the elderly.

You will learn:

·     To describe how to help a client quit smoking and minimize weight gain while staying abstinent;

·     To explain which behaviors you would advise changing if your client has a high fat diet, low fruit and vegetable diet, high screen time, and low physical activity; and

·     How to analyze what barriers can be anticipated when implementing a technology-supported behavior change intervention with an elderly population.
Who should attend? Clinical psychologists or other health professionals who work with adults that would benefit from adopting a healthier lifestyle.  
Recommended Readings: Prochaska, J., Spring, B., & Nigg, C. (2008). Multiple health behavior change research: an introduction and overview. Preventive Medicine, 46(3), 181-188. Spring, B., Pagoto, S., Pingitore, R., Doran, N., Schneider, K., & Hedeker, D. (2004). Randomized controlled trial for behavioral smoking and weight control treatment: effect of concurrent versus sequential intervention. Journal of Consulting and Clinical Psychology, 72(5), 785-796.

Adrian Wells (University of Manchester, UK)

Metacognitive Therapy with Adult Anxiety: Case Formulation and Meta-Level Change Strategies

Friday, June 4  9:00 a.m. ? 11:00 a.m.

Master Clinician Seminar 10

Adrian Wells, University of Manchester, Manchester, United Kingdom

Metacognitive Therapy (MCT) focuses on mapping out and modifying the underlying factors controlling thinking. It is based on the finding that psychological disorder is linked to hard to control perseverative cycles of worry, rumination and fixation on threat. It changes these processes by modifying the metacognitions giving rise to them. Treatment does not focus on reality-testing the content of worry and ruminations and does not require traditional exposure methods. Patients are helped to develop new styles of metacognitive control, new ways of metacognitively experiencing inner thoughts, and erroneous metacognitive beliefs are modified. Evidence from both uncontrolled and randomized controlled studies indicates that this treatment approach is efficient and highly effective. In this presentation basic principles and methods of metacognitive case formulation will be described and illustrated in generalized anxiety disorder, PTSD and OCD. The key techniques of metacognitive change used in the treatment of these disorders will be described. This presentation will give participants a greater knowledge of the metacognitive therapy approach and how this contrasts with standard CBT. It will offer an understanding of meta-level formulation and common change techniques.

You will learn:

·     A basic knowledge of metacognitive therapy(MCT) and how it is distinct from CBT;

·     An understanding of the disorder-specific models and how to use them to generate case formulations;

·     To develop a knowledge of some of the common metacognitive change techniques; and

·     To understand the application of MCT to GAD, PTSD and OCD.

Who should attend? Anyone with an interest in learning more about metacognitive therapy and basic techniques. It is suitable for researchers and practitioners at all CBT levels. 
Recommended Readings: Wells, A. (2008). Metacognitive therapy for anxiety and depression. New York: Guilford Press.