Full Course Description


Rewire the Anxious Brain: Applied Neuroscience for Treating Anxiety, Panic and Worry

Program Information

Objectives

  1. Demonstrate to clients the neurological processes underlying anxiety in a clearly understandable manner that enhances client motivation.
  2. Incorporate personalized goals to increase client engagement and focus client efforts on making lasting changes in the brain.
  3. Characterize the differences between amygdala-based and cortex-based anxiety symptoms in order to select the most effective treatment interventions.
  4. Individualize practical and evidence-based methods to resist anxiety and improve symptom management in clients.
  5. Demonstrate strategies for calming the amygdala without use of medication to improve client level of functioning.
  6. Recommend exposure-based strategies that change the amygdala responses to triggers to reduce anxiety symptoms.
  7. Employ a variety of strategies to improve clinical outcomes utilizing evidence-based strategies that target cortex-based responding, including cognitive restructuring, psychoeducation, cognitive defusion, distraction, and mindfulness.
  8. Differentiate symptom-producing cognitions characteristic of specific disorders, including Obsessive Compulsive Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, and Post-Traumatic Stress Disorder as it relates to case conceptualization.
  9. Analyze the clinical implications of how SSRIs and SNRIs promote the process of treating anxiety.
  10. Determine detrimental effects of benzodiazepines as it relates to anxiety treatment outcomes.
  11. Differentiate between rebound anxiety and relapse symptoms to inform the clinician’s choice of treatment interventions.
  12. Breakdown the key elements of mindfulness practices in managing symptoms of anxiety.
  13. Present client education exercises that can be utilized in session to train clients in the use of mindfulness techniques.
  14. Appraise common reactions to aversion and utilize clinical strategies to replace them with mindfulness.
  15. Reframe exposure as an opportunity to teach the amygdala new responses in order to improve client engagement and treatment compliance.
  16. Utilize clinical strategies for exposure that reduce avoidance and train clients to push through anxiety.
  17. Employ effective strategies for reducing anxiety symptoms utilizing imaginal and in vivo exposure, including use of SUDS and attention to interceptive triggers.
  18. Provide clinical strategies for managing comorbid depression that reduce worry, rumination, and common cognitive errors while promoting positive thinking and social interaction.
  19. Use cognitive restructuring and cognitive strategies for managing symptoms of OCD and GAD that focus on scheduling obsession/worries and promote client acceptance of uncertainty.
  20. Implement interventions in a clinical setting that use a reconsolidation approach to reactivate a symptom-producing memory and disconfirm it.

Outline

Module 1: Using Neuroscience in the Treatment of Anxiety

  • Using Neuroscience in the Treatment of Anxiety
    • Positives: We know more about anxiety-based disorders than any other disorders
    • Science gives explanations, evidence, authority, destigmatizes difficulties
    • Concerns: How to effectively explain neuroscience and answer questions
    • Clients may feel a lack of responsibility
    • Oversimplification is inevitable - The proper level of detail is essential
  • Enhancing the Engagement of Anxious or Avoidant Clients in Treatment
    • Don’t neglect therapeutic relationship!
    • Empathy before explanations
    • Addressing the challenges of anxious, worried, obsessive, and avoidant clients
    • Assist anxious clients in understanding their own symptoms, feelings, interpretations, beliefs
    • Treatment strategies for anxiety are effortful and produce anxiety
    • Use the goal of changing the brain rather than the goal of reducing anxiety
    • Focus on client’s personalized goals in guiding the process
    • Agreement on goals between therapist and client is predictive of improvement
    • Case Example
  • The Promise of Neuroplasticity
    • Defining Neuroplasticity in everyday language
    • Therapy is about creating a new self
    • Focusing on neuroplasticity makes the brain more resistant to anxiety
    • Clients are more willing to undergo anxiety when they expect it will create improved circuitry
    • Explaining re-consolidation: the modification of emotional memories
  • Identifying Two Neural Pathways to Anxiety
    • Amygdala - Bottom-up triggering of emotion, physicality of anxiety
    • Cortex - Top-down emotion generation based in cognition
    • Simplified techniques for explaining the two pathways and their differences to clients
    • How anxiety is initiated in each pathway and how pathways influence each other
    • Different pathways respond to different types of treatment
Module 2: Working with the Amygdala
  • Explaining the Amygdala’s Role in Anxiety
    • The protective, evolutionary role of the amygdala
    • The amygdala and the stress/fear/anxiety response
    • The role of the amygdala in forming emotional memories
    • Explaining the Fight/Flight/Freeze response to clients
    • Teaching the amygdala
    • The language of the amygdala - communicating alarms and relying on pairings
    • Why the amygdala needs experience to learn
    • How “Triggers” are created in the amygdala
  • Managing the Amygdala
    • Essential for all Anxiety Disorders, PTSD, OCD, Depression
    • Symptomatic behavior is often a response to amygdala activation
    • Interventions that impact the amygdala
    • The Vagus nerve’s role in recovery from the activation of the sympathetic nervous system
    • Interventions that reduce activation in the amygdala over time
    • Communicating with your client to enhance treatment compliance
    • Exposure: activating the fear circuitry created in the amygdala to generate new connections
    • Tips for effective exposure strategies
    • Exposure with response prevention is essential when treating OCD
  • Limitations and Risks in Neuroscience-Informed Treatment of Anxiety
    • The efficacy of evidence based treatments differ by individual and context
    • Research is constantly evolving
    • Using analogies and other psychoeducation communication
    • Medication information and interaction with interventions
    • More studies needed to support some observed clinical outcomes
Module 3: Managing the Cortex
  • Explaining the Cortex’s Role in Anxiety
    • How the cortex constructs reality for us
    • Describing the cortex and its functions in understandable terms
    • The fear/anxiety response comes from the amygdala, but the cortex can initiate the response
    • Using the concept “Don’t scare your amygdala”
    • Understanding and resisting the detrimental effects of anticipation
    • Teaching the appropriate use of worry to minimize its detrimental effects
  • Managing the Cortex
    • Cortex management is essential for GAD, SAD, OCD, PTSD, and Depression
    • Identifying specific cognitions, beliefs, attitudes, associated with specific anxiety disorders
    • “Survival of the busiest” - understanding how to modify the cortex
    • Changes in cortex responses can occur through education, logic, argument, and experience
    • “You can’t erase: You must replace.”
    • Modifying interpretations and using coping thoughts to manage anxiety
    • The appropriate use of distraction
    • Right vs. left hemisphere interventions
    • Cognitive Therapy - modifying the cognitions mediating emotional responses
    • Cognitive fusion - recognizing the problem and how to use cognitive defusion
    • CBT cognitive restructuring approaches for targeting cortex-based processes
    • Mindfulness approaches to reducing anxiety, and their effect on the cortex
    • A cognitive model for approaching OCD
Module 4: Medications in the Treatment of Anxiety
  • Medications Overview
    • The role of therapists regarding medications
    • Anxiety management, not anxiety elimination, is the goal
    • Beneficial effects of Medications
    • Assessing and addressing medication during the initial intake
    • Respecting the relationship between the prescriber and client
    • Educating clients about the role of medication in treating anxiety
    • What are the approved Medications for treating anxiety?
  • Medications and Anxiety Treatments
    • SSRIs and SNRIs
    • Benzodiazepines
      • The impact of benzodiazepines on therapeutic interventions
      • The problem of rebound from benzodiazepine use
    • Buspirone
    • Beta blockers
    • Sedatives/hypnotics/z-drugs
    • Choosing the right medication for specific anxiety disorders
    • Mechanisms of Action: How these drugs work
    • Explaining the effects to clients
    • Benefits, disadvantages, and risks of medications
    • Factors that influence the usefulness of medications
    • Monitoring therapeutic effects
    • CBT vs. Medications: Comparing effectiveness and durability
Module 5: Exposure Strategies for Teaching the Amygdala
  • Teaching the Amygdala
    • Exposure interventions allow new emotional learning
    • Emotional learning is based on associations or pairings
    • The amygdala is not always “correct” - it needs experience to learn new reactions
    • Training clients in exposure strategies can change client relationship with anxiety
    • Clients are motivated by idea that they are “teaching the amygdala”
    • Learning to reduce avoidance and push through anxiety
    • Preparation for exposure: psychoeducation, breathing training, cognitive restructuring
  • Exposure Strategies
    • In vivo vs. imaginal exposure approaches
    • Interoceptive triggers and methods for exposure
    • Training client for independent exposures
    • Use of the term “trigger” and providing examples for client
    • Understanding the brain changes underlying successful exposure experiences
    • Use of Subjective Units of Distress/Discomfort Scale (SUDS)
    • Examining advantages of graphing SUDS ratings
    • Concerns associated with safety signals, medications, distraction
    • Tips for constructing hierarchies
    • Therapist’s role in exposure
    • Troubleshooting problems
    • Case Examples
Module 6: Mindfulness in the Anxious Brain
  • Introducing mindfulness to clients
    • Defining basic emotional reactions: Attachment, Aversion, Indifference
    • Key elements to mindfulness: Being aware, present, and focused
    • The detrimental effect of judgment and how to practice self-acceptance
    • Exploring thoughts, sensations, and emotional reactions
    • Using breath in connecting to the present moment
    • Learning how to savor the moment
  • Incorporating mindfulness as a tool in treatment
    • The neuroscience of mindfulness: Examining the evidence
    • Teaching clients to focus more deliberately
    • Mindfulness as training to determine focus
    • Using the power of intention to focus thoughts in new directions
    • Coping with common reactions to aversion using mindfulness
    • “Mind wandering” is not failed experience!
    • The role of practice and evidence for brain change
    • Helpful hints in mindfulness training
  • Mindfulness exercises for the anxious brain
    • Focus on the breath
    • Train the brain to focus
    • Mindfulness of sound and thoughts
    • Fingers Exercise
    • GLAD technique to resist depressive thinking
    • Becoming Embodied: The experience of the body
Module 7: Neuropsychologically Informed CBT
  • Neuropsychologically Informed CBT approaches
    • CBT strategies used to effectively treat anxiety
    • Advantages of the strategic use of neuroscience in CBT
    • Focus on expectancy of client has benefits in CBT
    • Evidence supports CBT and neurological knowledge can strengthen client engagement
    • Not all assumptions of CBT are consistent with current neurological knowledge
    • Focusing on logic and disputing has limits - some circuitry is not logical
    • Emotional centers of the brain are not mediated by cognitive processes
    • Skills based approaches in CBT provides the brain experiences to learn
    • Neurology of anxiety supports many CBT tenets:
      • Psychoeducation
      • Focus on the present
      • Exposure techniques
      • Importance of going beyond talk to experience
Module 8: Treating Comorbid Depression
  • Treating Comorbid Depression
    • The link between chronic anxiety and depression
    • How the hippocampus impacts negative thinking
    • Exercises to help clients focus on the positive
    • Addressing worry, rumination, and common cognitive errors in depression
    • Benefits of goal setting and behavioral activation
    • Key role of social support and social interaction
    • Benefits of adequate sleep and regular exercise
  • Case Example

Module 9: Cognitive Restructuring Interventions

  • Cognitive Restructuring: Interventions for OCD and GAD
    • Steps in cognitive restructuring:
      • Guided discovery
      • Exploring the relationship between thoughts and amygdala activation
      • How to challenge distorted cognitions
      • Tools for generating alternative perspectives
    • Identify and stop anxiety-igniting thoughts common in OCD and GAD
    • Strategies for embracing uncertainty
    • Making OCD or worry the adversary: Don’t be bullied!
    • Scheduling obsessions or worries to bring them under control
    • Strategies to avoid counter transference
    • Mindfulness tools for OCD and GAD
    • Myths about working with anxious thoughts

Module 10: Using Reconsolidation Approaches

  • Using Reconsolidation Approaches
    • Explaining implicit emotional learning and identifying examples
    • Reconsolidation: Deleting/modifying unwanted memories
    • How to lay the groundwork for reconsolidation:
      • Guided discovery
      • Assisting the client to experience the memory structure in the present moment
      • Promoting client’s experiential learning of emotional truth
      • Disconfirming the emotional memory with “mismatching” information that invalidates it
    • Case Example

Copyright : 06/30/2018

Telehealth for Mental Health Professionals: Distance Therapy Training

Program Information

Objectives

  1. Appraise the legal and ethical challenges posed by telehealth for mental health professionals in a clinical setting.
  2. Analyze the evidence supporting the effectiveness of telemental health as it relates to clinical treatment.
  3. Inspect the unique policies and procedures considerations for telehealth and the clinical implications.
  4. Evaluate adaptions with telemental health for various populations to improve clinical outcomes.
  5. Investigate the privacy, security and confidentiality concerns related to technology use in clinical practice.
  6. Differentiate how client expectations differ for telehealth as compared to in-person therapy and what that means for clinical treatment.
  7. Distinguish unique boundary issues that arise in a telemental health setting.
  8. Utilize specific adaptations that are recommended for various disorders and modalities to improve clinical outcomes.
  9. Appraise text messaging and email complications as it relates to privacy in a clinical setting.
  10. Apply best ethical practices regarding referrals and advertising concerns as it relates to clinical practice.
  11. Articulate the legalities of practicing across state lines via telemental health sessions.
  12. Specify the HIPAA compliance challenges associated with telemental health and its clinical implications.

Outline

Telehealth for Mental Health Professionals: What You Need to Know Before You Get Started

  • The Types of Telehealth
    • Synchronous Format – Live Interaction via Video
    • Asynchronous Format – Transfers of Information Electronically
  • Evidence Supporting the Effectiveness of Telehealth for Clients and Various Populations
  • The Benefits and Risk for Telehealth
  • Recent Trends in Telehealth
Legal & Ethical Issues
  • Following a Code of Ethics
  • Legal Implications of Practicing Across State Lines
  • Privacy & Security
    • HIPAA Compliance Concerns
    • Documentation & Paperwork Issues
    • Ensure Data Protection & Avoid Unintended Access/Disclosure
    • The Client’s Perception of Privacy via Videoconferencing
  • Boundary Issues More Likely to Arise in Telehealth
  • Multicultural Issues in Telehealth
  • Technology Competence of the Clinician and Client
How to Start Your Mental Health Telepractice
  • Offering Your Telehealth Services – Where to Begin?
  • How to Introduce the Concept to Clients
  • Who is a Good Fit for Telehealth? Who is Not?
  • Administrative Responsibilities
  • Policies & Procedures Consideration – Protect Yourself and Your License
    • Informed Consent – Unique Concerns & Best Practices
    • Intake Process – Tips You Need to Know
    • Emergency Plan for Telehealth
  • Client Interviewing & Assessment Techniques
  • Videoconferencing vs. Telephone
  • Best Practices for Professionalism
    • Camera Placement, Background, Proximity & Dress Attire
    • Handling Technical Issues
Important Business Aspects to Consider
  • Marketing Concerns with Telehealth Practice
  • Billing & Reimbursement Strategies – Is This Covered Under My Client’s Insurance Policy?
  • Payment Fee Structure Considerations
  • Communication of Payment Structure to Client
  • Professional Liability Insurance – Telehealth Covered?
  • Client Expectations & How They Differ Versus In-Person Therapy
  • Financial, Accounting & Tax Concerns
  • Giving and Getting Referrals – Issues for Telepractice
Choosing a Platform – What Technology is Right for You and Your Clients?
  • An Overview of the Various Platforms Available
  • Demonstrations of Key Features
  • How to Assess What Features are Important for You
  • Cost Comparisons
  • What Legal Assurances Do I Need from A Platform Provider?
  • Client Considerations When Choosing a Platform
    • What Technology is My Client Using & Where From?
Demonstrations of Telehealth in Practice
  • A Guided Tour of How to Begin a Telehealth Videoconferencing Session
  • What Videoconferencing Looks Like in Practice
  • Key Techniques to Enhance the Telehealth In-Session Experience
  • Presentation Skills & Tips
Additional Technology Considerations
  • Text Message & Email Telehealth – Security, Privacy & Expectations
  • Cloud Storage – What are the legal issues?
  • Virtual Reality – What You Need to Know
Treatment Adaptations to Consider for Telehealth
  • Disorders
    • Discuss Key Adjustments Recommended for Practicing Telehealth for Different Disorders
  • Populations
    • Evidence & Best Practices for Tailoring Telehealth to a Variety of Clients
    • Important Adaptations for Groups or Couples
  • Modalities
    • Which Modalities Most Easily Apply to Telehealth & Which Could Use Adaptions
Case Studies of Telehealth Successes & Failures
  • Examples of the Do’s and Don’ts That Can Make or Break Your Telepractice
The Future of Telehealth for Mental Health Professionals
  • Possible Future New Rules & Regulations
  • Up & Coming Technology Trends to Be Aware Of
  • What Distance Therapy Might Look Like in 10 years

Copyright : 02/20/2020