Full Course Description


Bipolar Disorders: Essentials for Clinical Practice

Program Information

Objectives

  • 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.

Outline

  • Diagnosis
    • 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?
  • Treatment
    • 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
    • Pills
      • 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
        • A systematic connection? 

Copyright : 07/16/2019

The 10 Best-Ever Depression Management Techniques: Managing Depression Across the Lifespan

Program Information

Objectives

  1. Utilize the DSM-5® for diagnosing depression, co-morbid disorders, and determine their treatment implications.
  2. Differentiate the neurobiological factors of depression in relation to assessment and treatment planning.
  3. Analyze the role of medications and its relationship with psychotherapeutic interventions for treating depression and co-morbid disorders.
  4. Employ strategies to enhance motivation and mobilize clients with lethargy and low sense of reward.
  5. Apply interventions that stop the damage of chronic stress, workaholism, and burnout.
  6. Construct a model to stop the despair common to the depression of trauma survivors and interrupt self-destructive coping styles.
  7. Use the healing impact of positivity to minimize perfectionism and pessimism by strengthening networks for positive cognition.
  8. Prepare an approach that changes negatively biased attention, mood, cognition and hopeless/helpless style depressed thinking.

Outline

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

Immediate Interventions

  • The role of lifestyle in causing and treating depression
  • Sleep
  • Exercise
  • Nutrition

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

CBT Goals

  • 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

Copyright : 10/14/2019

Suicide Assessment and Intervention: Today's Top Challenges for Mental Health Professionals

Program Information

Objectives

  1. Conduct a thorough suicide assessment that includes both risk and protective factors.
  2. Implement clinical techniques to support clients’ ability to self-regulate, problem solve, and communicate their needs.
  3. Develop and monitor realistic safety plans that clients will participate in.
  4. Create accurate and comprehensive documentation of clinical crises to protect all parties involved and minimize liability risks.

Outline

Assessment: Your Comprehensive Guide to Identify Suicidal Risk

  • 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
Suicide Intervention Strategies: Supporting Clients From “Passive” Ideation to Full-Blown Crisis
  • Psychological interventions
  • Problem solving
  • Emotional regulation
  • Communication
  • 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
Other Clinical Considerations
  • Non-suicidal self-injury (NSSI)
  • Relationship between suicide, mental illness and trauma
  • Tips for managing clinician anxiety around suicidality

Copyright : 09/27/2019

15 Must-Have Mindfulness Techniques for Clinicians: Skills to Transform Your Treatment Plans for Stress, Depression, Anxiety, Anger, Trauma, Guilt and Shame

Program Information

Objectives

  1. Assess the neurological processes and how mindfulness can to increase client’s motivation.
  2. Determine how mindfulness practices can be used to shift clients to a relaxation response. 
  3. Integrate mindfulness interventions into your treatment plans to counter automatic patterns of negative thoughts. 
  4. Demonstrate how mindfulness and breathing techniques can be practiced in-session to increase emotion regulation. 
  5. Analyze the neurobiology of the traumatized brain and implement grounding techniques and breathing exercises. 
  6. Appraise the clinical utility of mindfulness-based therapies in regulating shame and guilt.

Outline

Reduce Stress with Mindful Coping Skills

  • Educate the client about the impact of stress
  • Practice makes perfect – transform the stress response
  • Exercises
    • Strengthen awareness of the stress response
    • Shifting to relaxation response: cultivate a foundation of groundedness, settledness, and ease
    • Mindful transitions
  • Treatment limitations, risks and research
Manage Depression and Anxiety with Mindfulness Techniques That Work
  • The downward spiral and the brain’s default mode
  • Cultivate motivation and action
  • Witness the anxious mind
  • Get unstuck from anxious rumination
  • Exercise:
    • Self-regulation practices for anxiety
Mindfulness as the Antidote to Anger
  • 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?
  • Exercise:
    • Rehearsal of the Stop-Breathe-Reflect-Choose practice
Calm the Traumatized Brain
  • Proceed with caution – avoid retriggering and retraumatizing
  • Retrain the dysregulated nervous system
  • Cultivate safety
  • Exercises:
    • Grounding techniques
    • Breathing techniques
    • Positive visualization
Transform the Inner Critic: Mindfully Deal with Guilt and Shame
  • Identifying primary core negative belief
  • Cultivating a healthy and true vision of self
  • Exercises:
    • The protective quality of mantras
    • Exercises that promote self-forgiveness

Copyright : 07/24/2018