Full Course Description
Bipolar Disorders: Essentials for Clinical Practice
- Contrast categorical (DSM-5) and dimensional (spectrum) approaches to unipolar and bipolar disorders, and mixed states. Synthesize these views in assessment of patients’ mood symptoms.
- Utilize up-to-date instruments for identifying bipolarity, including the Bipolar Spectrum Diagnostic Scale, Bipolarity Index, and MoodCheck.
- Compare criteria for PTSD, GAD, and personality disorders with bipolar disorder; and develop a system for managing ambiguous cases, including co-occurrence of two or more of these diagnoses.
- Validate patients’ symptoms using recent literature on causes of bipolar disorder: explaining that while bipolar disorders are highly genetic, there is no biological diagnostic test on the horizon. Why?
- Integrate elements from 5 bipolar-specific psychotherapies, including sleep rhythm regulation, chronotherapies, light and dark management, online CBT programs, and psychoeducation.
- Contrast medications for bipolar depression in terms of their benefits and risks, their value in long-term mood stabilization, and other health effects.
- Interpret guidelines regarding use of antidepressants in bipolar disorder, relative to psychotherapeutic and pharmacologic alternatives.
- Spectrum and DSM approaches
- What is hypomania?
- From obvious to subtle to normal human experiences.
- Using categorical and dimensional approaches simultaneously.
- Non-manic bipolar markers: “How bipolar are you?”
- Family history, age of onset, course of illness, response to treatments.
- Routine assessment to prevent diagnostic confusion
- Efficient screening
- Beyond the MDQ (Mood Disorders Questionnaire)
- Bipolar Spectrum Diagnostic Scale, Bipolarity Index, MoodCheck
- Making assessment routine in clinical practice
- Bipolar or similar?
- Anxiety is a bipolar symptom? Mixed States
- Review from the International Society for Bipolar Disorders
- Evolution of Mixed states: DSM-3 to DSM-5
- From non-existence to remote occurrence to high prevalence
- Differential diagnosis: PTSD, borderline, Generalized Anxiety Disorder
- Extensive overlap of DSM criteria with Mixed States
- Anxious depression with trauma history: PTSD or bipolar?
- How to manage when diagnosis is ambiguous
- What causes bipolar disorder?
- Helping patients reframe their illness
- Genetics; gut inflammation; circadian stress; hormonal effects
- Does trauma cause bipolar disorder?
- Psychotherapy for bipolar disorders
- Common elements of 5 research-tested therapies
- Chronotherapy: focus on sleep
- Using light boxes and dawn simulators
- Dark therapy: simple ways to decrease light exposure
- Social Rhythm Therapy and bipolar CBT-I
- Treating bipolar depression without antidepressants
- 3 generics with international agreement
- Newer medications – expensive, more unknown
- Anti-cycling/anti-manics that are not antipsychotics
- Antipsychotics: grouping by efficacy and risk
- Tapering antidepressants
- The best treatment for bipolar depression?
- Stop the cycling, stop the depressions
- Antidepressants can promote cycling (and mixed states)
- Why slow tapers are essential
- Sample taper schedules for different antidepressants
- Careful patient education
- Implementing what you’ve learned
- Immediate steps to change your practice
- Routine screening
- Routine patient education
- Managing diagnostic ambiguity
- Maximizing non-medication approaches
- Social Rhythm Therapy, bipolar CBT-I, Dark Therapy
- Dawn simulators and light boxes
- Bipolar patient education
- Delivering your help where it’s needed
- Reaching out to primary care providers
The 10 Best-Ever Depression Management Techniques: Managing Depression Across the Lifespan
- Utilize the DSM-5® for diagnosing depression, co-morbid disorders, and determine their treatment implications.
- Differentiate the neurobiological factors of depression in relation to assessment and treatment planning.
- Analyze the role of medications and its relationship with psychotherapeutic interventions for treating depression and co-morbid disorders.
- Employ strategies to enhance motivation and mobilize clients with lethargy and low sense of reward.
- Apply interventions that stop the damage of chronic stress, workaholism, and burnout.
- Construct a model to stop the despair common to the depression of trauma survivors and interrupt self-destructive coping styles.
- Use the healing impact of positivity to minimize perfectionism and pessimism by strengthening networks for positive cognition.
- Prepare an approach that changes negatively biased attention, mood, cognition and hopeless/helpless style depressed thinking.
The Diagnosis of Depression, Including DSM-5® Symptoms and Co-morbid Diagnosis
- The frequent comorbidity with anxiety disorders
- The contribution of personality disorders to complex diagnosis and treatment
- Differentiate grief and loss from depression and explore the interaction between them
The Neurobiological Basis of Depression
- Endogenous depression
- The effects of adult trauma, early childhood adversity, and chronic stress
- Physiological problems such as vitamin deficiencies, diabetes, and sleep disorders
- The impact of hormones including thyroid, testosterone, estrogen, and progesterone
- The principles of neural networking that keep depression in place
- The role of lifestyle in causing and treating depression
The Role of Psychoeducation in Compliance with Treatment
- The role of medication as interactive with psychotherapy
- Burnout and establishing healthy boundaries
Treatment Goals Overview
- Pragmatic view of methods to begin recovery or to manage depression
- Clarify the 4 aspects of imbalance that undermine true wellbeing
- Apply methods that create balance in the areas of attention, goals, cognition, and affect
- Alter imbalance in attention and change cognitions
- Address meta-cognitions
- Interrupt rumination
Behavioral Activation Goals
- Break out of depression-reinforcing isolation
- Shifting attention to positive experience
- Utilizing habit formation and the psychology of compounding habits to increase compliance with other interventions
Positive Psychology Goals
- Creating access to positive affect
- Utilizing realistic hope in balancing affect
- Gratitude Practice
Suicide Assessment and Intervention: Today's Top Challenges for Mental Health Professionals
- Conduct a thorough suicide assessment that includes both risk and protective factors.
- Implement clinical techniques to support clients’ ability to self-regulate, problem solve, and communicate their needs.
- Develop and monitor realistic safety plans that clients will participate in.
- Create accurate and comprehensive documentation of clinical crises to protect all parties involved and minimize liability risks.
Assessment: Your Comprehensive Guide to Identify Suicidal Risk
Suicide Intervention Strategies: Supporting Clients From “Passive” Ideation to Full-Blown Crisis
- Suicide, ideation, plan, means and intent
- Why do people kill themselves?
- Risk and protective factors
- How to identify implicit suicidal intent
- Strategies for asking direct questions (even when it’s uncomfortable)
- How to engage shut down, withdrawn or resistant clients
Other Clinical Considerations
- Psychological interventions
- Problem solving
- Emotional regulation
- Pharmacology: Short and long term interventions
- Why “no harm” contracts are a dangerous idea (and what to do instead)
- When to break client confidentiality
- How and when to involve loved ones/caregivers
- Hospitalization: Why, when, how
- Clinicians inside the ER: When to admit/planning for home
- After the ER: Limiting the risk
- Documentation: Protect your client, protect your license
- Non-suicidal self-injury (NSSI)
- Relationship between suicide, mental illness and trauma
- Tips for managing clinician anxiety around suicidality
15 Must-Have Mindfulness Techniques for Clinicians: Skills to Transform Your Treatment Plans for Stress, Depression, Anxiety, Anger, Trauma, Guilt and Shame
- Motivate clients to engage in treatment with understandable descriptions of the neurological processes that underlie common disorders and easy to follow explanations of how mindfulness can affect these processes.
- Establish how mindfulness practices can be used in therapy to impact the stress reaction and shift clients to a relaxation response.
- Incorporate mindfulness interventions into your treatment plans for depression and anxiety that can counter automatic patterns of thoughts.
- Communicate how mindfulness and breathing techniques that reduce the body’s anger responses can be taught in-session to help clients manage their angered outbursts.
- Analyze the neurobiology of the traumatized brain and calm it with grounding techniques and breathing exercises.
- Appraise the clinical utility of mindfulness-based therapies in regulating shame and guilt.
Reduce Stress with Mindful Coping Skills
Manage Depression and Anxiety with Mindfulness Techniques That Work
- Educate the client about the impact of stress
- Practice makes perfect – transform the stress response
- Strengthen awareness of the stress response
- Shifting to relaxation response: cultivate a foundation of groundedness, settledness, and ease
- Mindful transitions
Mindfulness as the Antidote to Anger
- The downward spiral and the brain’s default mode
- Cultivate motivation and action
- Witness the anxious mind
- Get unstuck from anxious rumination
- Self-regulation practices for anxiety
Calm the Traumatized Brain
- Understand the sources of anger
- The body’s anger response
- Identify early signs of the anger forest fire
- Clarify the practice: What am I trying to remember?
- Rehearsal of the Stop-Breathe-Reflect-Choose practice
Transform the Inner Critic: Mindfully Deal with Guilt and Shame
- Proceed with caution – avoid retriggering and retraumatizing
- Retrain the dysregulated nervous system
- Cultivate safety
- Grounding techniques
- Breathing techniques
- Positive visualization
- Identifying primary core negative belief
- Cultivating a healthy and true vision of self
- The protective quality of mantras
- Exercises that promote self-forgiveness