Sheila A.M. Rauch, Ph.D., ABPP
|
|
- Bertina Fisher
- 6 years ago
- Views:
Transcription
1 Sheila A.M. Rauch, Ph.D., ABPP Atlanta VAMC Emory University School of Medicine Disclaimer: The views expressed in this presentation are solely those of the authors and do not reflect an endorsement by or the official policy of the U.S. Army, the U.S. Air Force, the Department of Defense, the Department of Veterans Affairs, the academic affiliations of the authors, or the U.S. Government.
2 Disclosures Dr. Rauch has received/s DOD and VA funding Dr. Rauch has received fees for consulting from the American Association for Suicidology and Massachusetts General Hospital
3 Preface Lecture is focused solely on neuroscience research and applications to PE True cutting edge with much of this still in development and not yet tested PE is robust and the best course is to follow the manual and stick to the theory behind PE DO the thing you are afraid of over and over and it gets easier If the patient is not fully responding Are you targeting the core fear? Are there avoidances that are interfering with the Doing?
4 Outline BRIEF review of PE and components Emotional Processing Theory and Inhibitory Learning What does this mean for PE? Recent advances from neuroscience of PTSD Safety Learning versus habituation of SUDS Application Future Directions
5 Efficacy of PE Prolonged Exposure (PE) has proven effectiveness (VA/DOD PTSD Treatment Guideline, 2010; Foa, Keane, Friedman, & Cohen, 2008) Reduces PTSD, general anxiety, depression. Reduces guilt and anger (Cahill, Rauch, Hembree, & Foa, 2003; Foa, et al., 2005). Effective in highly comorbid and complex patient populations with PTSD (i.e., van den Berg, et al., 2015; Yuen, et al, 2015) Flexible and used with complex patient presentations Components include imaginal exposure, in vivo exposure, and emotional processing
6 Proposed PE Mechanisms of Action Emotional Processing Theory Emotional Engagement Extinction/habituation Changes in negative thoughts about the self and world Inhibitory Learning/Safety Learning (Craske, et al., 2014) Expectancy violation Deepened extinction Occasional reinforced extinction Removal of safety signals Variability Retrieval cues Multiple contexts Affect labeling
7 Utilizing Imaginal Exposure Increase engagement with sensory probes Assist in organizing the memory and providing context by probing for thoughts and feelings Probing What are you thinking? What are you feeling? during the exposure Once engaged focus on contextual factors influencing behavior What is happening? What are you doing?
8 In Vivo Exposure Exposure to the people, places, and things that remind the patient of the target trauma Hierarchical Patient directed as homework Good tool to drive home self-assessment in the moment Focus on areas most important for this specific patient s function Critical to generalization of benefits
9 Emotional Processing Review of imaginal and in vivo exposures proceeds through: How it went New or changed elements either included or excluded What does that mean about you then? Now? Focus on success and progress Focus on previously discounted context Non-directive reflection of the patients own thoughts
10 Facilitating Processing Open ended questions Focus on reflection allows review of beliefs and opportunity to draw new conclusions Opening processing "How was the exposure for you today?" or "What was different about the exposure experience for you today?" Draws focus in on those previously unattended or discounted elements that are most salient for them following the imaginal exposure Bring focus to neglected elements that may be important Gently point out in processing "I noticed that you did not include.." This will assist the patient in not discounting information or content that needs to be included
11 Creating New Meaning- CONTEXT Reevaluation of actions in context Organizing chaos can allow new understanding Understand why and what this means about him/her then and now. Decide what if anything remains and what he/she wants to do to address it (i.e., making amends, etc.)
12 Emotional Engagement in PE EPT (Rauch & Foa, 2006) Better activation produces better outcome Inhibitory learning (Craske, et al., 2014) Memory activation is necessary Level of activation does not influence outcome Amygdala must be activated in order to effectively learn to inhibit fear (extinction; Milad et al, 2009; Nader et al, 2000). Strength of emotional memories is dependent on catecholamines and glucocorticoids in the brain (de Quervian et al, 2014). Memories can return to a malleable state where new information can become part of the memory (Schwabe et al, 2014) through the process of reconsolidation.
13 Cortisol in Response to Personal Trauma Script Greater cortisol response to a one minute personal trauma script prior to therapy predicted larger symptom reduction in PE but not PCT (Rauch et al, 2015). In PE, both pre-cortisol response and change in cognitions predict change in PTSD. In PCT, only change in cognitions predicted change in PTSD.
14 Enhancing Emotional Engagement Standard PE protocol suggests probes for emotion at points in the imaginal exposure (IE) where emotion is missing Prepatory cues prior to IE olfactory trauma cues auditory trauma cues Physical exercise before IE (Powers et al., 2015) Agents to activate sympathetic nervous system (i.e., yohimbine, etc; Wangelin, et al., 2013)
15 Extinction in PE Extinction refers to learning of a competing safe or inhibitory association for a previously learned fear association Reduction of fear expression when confronted with trauma-related stimuli (either the memory or things associated with the memory) Extinction learning includes contextualization specifically selecting appropriate responses to safety cues and threat cues based on context (Maren, et al., 2013)
16 Evidence: Extinction in PE (cont) Between session habituation more consistently related response than within-session habituation (Sripada & Rauch; Rauch, et al., 2004; dekleine et al, 2015). Improvement can occur without SUDs reduction (Bluett et al, 2014). Possible reasons for inconsistency Waxing and waning of distress based on specific session content. Processing always results in reduced distress
17 Evidence: Extinction in PE (cont) Trauma-potentiated startle increased and then decreased in PE responders, whereas low responders showed a relatively flat response profile (Robison- Andrew, et al, 2014) Medications that enhance extinction learning have had mixed results (Rothbaum et al, 2014; Difede, et al, 2014; dekliene et al, 2014)
18 Enhancing Extinction in PE Increase repetition or duration DCS- for people identified as slower extinguishers prior to treatment Cortisol administration or increase cortisol through other means such as exposure to novel environment or other specific stressor Increasing safety learning that is critical to extinction by making implicit learning explicit
19 Changes in Negative Thoughts in PE Reduction in negative thoughts about the self and world cognitions drives PTSD symptom change (Kumpula, et al., under review; Zalta, et al, 2014).
20 Thoughts and Biology HPA reactivity to traumatic cues prior to treatment predicts response to PTSD treatment (Rauch et al., 2015). Both changes in negative thoughts about the self and the level of HPA reactivity to trauma script uniquely predicted treatment reductions in PTSD (Rauch et al., 2015). Treatment related increased competence to handle negative affect: May reflect changes in the dedicated neurocircuitry, or more general modulation of the hypothalamic pituitary adrenal (HPA) axis, which in turn modulates brain circuitry
21 Enhancing Self Competence for Negative Affect in PE Increase focus on mastery in the trauma and now Change in meaning of trauma to focus on increased function Decrease focus on I wish or what if Enhanced learning of specific safety cues Focused generalization of exposure learning
22 Safety Learning/Inhibitory Learning Focus on tolerance of negative affect NOT reduction of SUDS Large part of exposure and emotional processing making the implicit learning explicit reflection on key meaning elements with the patient Processing is non-directive and focused on reflection Moving the patient from a memory context of personal incompetence to a more flexible or competent context Discriminate safety from threat Modulate attention accordingly Reduce overgeneralization Involves both top-down and bottom-up neurocircuitry.
23 Summary PE is a highly effective and well studied protocol Even beyond RCTs, thousands of clinicians with varied experience currently use the protocol with highly complex and comorbid patients with success. Advances in neuroscience provide direction for how to improve treatment through: Increasing speed of response Augmentation Novel treatments Additional research and neuroscience informed clinical practice can help us continue to improve efficacy and effectiveness of PE
STRONG STAR and the Consortium to Alleviate PTSD (CAP)
STRONG STAR and the Consortium to Alleviate PTSD (CAP) Presentation to: San Antonio Combat PTSD Conference, October 18-19, 2017 Presentation by: Sheila A.M. Rauch, Ph.D. Biological and Symptom Changes
More informationExposures, Flooding, & Desensitization. Anxiety Disorders. History 12/2/2009
Exposures, Flooding, & Desensitization Anxiety Disorders Major advances in treating a wide spectrum of anxiety problems over last 20 years Common thread in effective treatments is hierarchy-based exposure
More informationClinical Relevance of Biological Alterations in PTSD. Rachel Yehuda, PhD Mount Sinai School of Medicine New York, NY
Clinical Relevance of Biological Alterations in PTSD Rachel Yehuda, PhD Mount Sinai School of Medicine New York, NY New developments in PTSD Conceptual shift New findings of prevalence, longitudinal course,
More informationEXAMPLES OF TRAUMA AND DISASTER CONFRONT US EVERYDAY
Disclosure Virtually Better, Inc (VBI), part owner managed under Emory University's Conflict of Interest Policy Virtual Iraq created by Dr. Skip Rizzo at USC, not VBI, but VBI is selling virtual reality
More informationCOGNITIVE PROCESSING THERAPY AND PROLONGED EXPOSURE THERAPY
COGNITIVE PROCESSING THERAPY AND PROLONGED EXPOSURE THERAPY Patricia Resick and colleague s work with rape survivors in the 1990s Social Cognitive Theory based Traumatic Events alter beliefs about the
More informationCOGNITIVE PROCESSING THERAPY AND PROLONGED EXPOSURE THERAPY
COGNITIVE PROCESSING THERAPY AND PROLONGED EXPOSURE THERAPY Patricia Resick and colleague s work with rape survivors in the 1990s Social Cognitive Theory based Traumatic Events alter beliefs about the
More informationPost-Traumatic Stress Disorder (PTSD) Among People Living with HIV
Post-Traumatic Stress Disorder (PTSD) Among People Living with HIV Milton L. Wainberg, M.D. Associate Clinical Professor of Psychiatry College of Physicians and Surgeons Columbia University mlw35@columbia.edu
More informationDr. Kathleen P. Decker, M.D. 1,2
Dr. Kathleen P. Decker, M.D. 1,2 Kathleen.Decker@va.gov Melissa Campbell, M.S., Vanessa Pierce, M.S., Christa Turpin, M.S. & Sarah P. Deaver, Ph.D. 1, 1 Eastern Virginia Medical School 2 Hampton VA Medical
More informationPTSD Ehlers and Clark model
Problem-specific competences describe the knowledge and skills needed when applying CBT principles to specific conditions. They are not a stand-alone description of competences, and should be read as part
More informationpsychological trauma is an experience of a threat to life, body, or sanity so severe as to overwhelm the ordinary process of emotional integration.
Virtual Reality in the Treatment of Combat-Related PTSD with Warfighters Sarah D. Miyahira, Ph.D. Director of Intramural Research Co-Director, VR Behavioral Health Program & Laboratory Department of Veterans
More informationUsing Prolonged Exposure therapy for PTSD. Disclosures. Objectives. APNA 28th Annual Conference Session 3024: October 24, 2014.
Using Prolonged Exposure therapy for PTSD Patricia Hentz, EdD, PMHNP-BC, CRNP Clinical Associate Professor Rutgers School of Nursing Disclosures The speaker has no conflict of interest to disclose. Objectives
More informationEdna B. Foa. Annu. Rev. Clin. Psychol :1-28. Downloaded from
Edna B. Foa ANNUAL REVIEWS Further Click here to view this article's online features: Download figures as PPT slides Navigate linked references Download citations Explore related articles Search keywords
More informationProlonged Exposure Therapy for PTSD. Kirsten DeLambo, Ph.D.
Prolonged Exposure Therapy for PTSD Kirsten DeLambo, Ph.D. To comply with professional boards/associations standards, I declare that I do not have any financial relationship in any amount, occurring in
More informationThe changing face of PTSD in 2013: Proposed Updates & Revised Trauma Response Checklist Quick Screener (Baranowsky, May 2013)
The changing face of PTSD in 2013: Proposed Updates & Revised Trauma Response Checklist Quick Screener (Baranowsky, May 2013) Dr. Anna B.Baranowsky Traumatology Institute http://www.ticlearn.com TRAUMATOLOGY
More informationContact Information. - Please me if you have any questions, are interested in collaborating on research, or would like copies of my materials.
Contact Information Want access to my PTSD materials? Want to discuss the protocol? Email to: MKMooreTX@AOL.COM Subject Line: TPA PTSD Workshop Coming soon: www.drmarlinmoore.com - Please email me if you
More informationTreating Children and Adolescents with PTSD. William Yule Prague March 2014
Treating Children and Adolescents with PTSD William Yule Prague March 2014 In the beginning. When DSM III first identified PTSD, it was thought that children would rarely show it Why did professionals
More informationNeurology and Trauma: Impact and Treatment Implications Damien Dowd, M.A. & Jocelyn Proulx, Ph.D.
Neurology and Trauma: Impact and Treatment Implications Damien Dowd, M.A. & Jocelyn Proulx, Ph.D. Neurological Response to a Stressor Information from the senses goes to the thalamus which sends the information
More informationPTSD: Epidemiology, Course, Co-Morbidity and Treatments
PTSD: Epidemiology, Course, Co-Morbidity and Treatments R. John Sutherland, PhD, LP HealthEast Care System Director for Psychology Training and Certified Nat l PE Trainer for PTSD University of Minnesota
More informationEmotional Memory, PTSD, and Clinical Intervention Updates
Emotional Memory, PTSD, and Clinical Intervention Updates Wen Cai, MD, Ph.D. Chief Medical Officer--La Frontera Arizona Clinical Associate Professor--Psychiatry and Psychology University of Arizona College
More informationNew Criteria for Posttraumatic Stress Disorder in DSM-5: Implications for Causality
New Criteria for Posttraumatic Stress Disorder in DSM-5: Implications for Causality Paul A. Arbisi, Ph.D. ABAP, ABPP. Staff Psychologist Minneapolis VA Medical Center Professor Departments of Psychiatry
More informationACT and Exposure Therapy
UNC School of Social Work Clinical Lecture Series ACT and Exposure Therapy A Combined Approach to Enhance Treatment Engagement Ryan J. Jacoby & Jonathan S. Abramowitz University of North Carolina at Chapel
More informationExposure Review and Troubleshooting. David Valentiner & Simon Jencius Northern Illinois University ADAA 2014 Chicago, IL
Review and Troubleshooting David Valentiner & Simon Jencius orthern Illinois University ADAA 2014 Chicago, IL one Disclosure Method for Reviewing ERP Facilitate adherence Help trainees to learn Aid supervisors
More informationCourage Under Fire Courage After Fire
Courage Under Fire Courage After Fire Assault on the DPD 6 th Precinct How Psychologists Heal Warriors Following Exposure to High Stress Toxic Incidents LaMaurice H. Gardner, Psy.D. Clinical and Police
More informationTrina Hall, Ph.D. Dallas Police Department Lessons Learned: Unfolding the story of PTSD NAMI 2014 Fall Conference
Trina Hall, Ph.D. Dallas Police Department Lessons Learned: Unfolding the story of PTSD NAMI 2014 Fall Conference Loss of career ( unfit for duty ) Embarrassment Label of ill or sick Loss of Confidentiality
More information9/6/17. Enhancing Hope for Change Krista K. Krebs, PhD September (National Center for PTSD: PTSD Monthly Update, Nov 2015)
Enhancing Hope for Change Krista K. Krebs, PhD September 2017 OBJECTIVES To augment confidence/understanding of the neurobiology of PTSD To augment willingness to talk about PTSD with both Veterans and
More informationOBJECTIVES. Enhancing Hope for Change Krista K. Krebs, PhD September 2017
Enhancing Hope for Change Krista K. Krebs, PhD September 2017 OBJECTIVES To augment confidence/understanding of the neurobiology of PTSD To augment willingness to talk about PTSD with both Veterans and
More informationRelationship Between Stress and Substance Use Disorders: Neurobiologic Interface
Relationship Between Stress and Substance Use Disorders: Neurobiologic Interface Kathleen Brady, M.D., Ph.D. Professor of Psychiatry Associate Dean of Clinical and Translational Research Medical University
More informationReview of Research on Post-Traumatic Stress and Current Treatments. published in The San Francisco Psychologist, June 2005 issue, pp 6-7
Review of Research on Post-Traumatic Stress and Current Treatments published in The San Francisco Psychologist, June 2005 issue, pp 6-7 By Shelley F. Diamond, Ph.D. On May 6 th, 2005, approximately 20
More informationA-TIP Acute -Traumatic Incident Procedures Roy Kiessling, LISW, ACSW
A-TIP Acute -Traumatic Incident Procedures Roy Kiessling, LISW, ACSW roykiessling@me.com This brief model (3-6 sessions) contains/restricts the processing for clients who have experienced a recent trauma
More informationProlonged Exposure: An Effective Treatment for PTSD in Military Personnel
Sibiu Alma Mater University Journals Series C. Social Sciences Volume 7, no. 1 / 2014 Prolonged Exposure: An Effective Treatment for PTSD in Military Personnel Erin LOGAN* & Michael STEVENS** Illinois
More informationReactions to Trauma and Clinical Treatment for PTSD
Reactions to Trauma and Clinical Treatment for PTSD Cultural specific concerns and recommendations. Dr. K. Loan Mai AHSSC. October 19, 2012 Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder
More informationEMDR : A therapy for the 21 st century. Polish Psychological Association Warsaw Division September, 2015
EMDR : A therapy for the 21 st century Polish Psychological Association Warsaw Division September, 2015 Udi Oren, Ph.D. Past President, EMDR Europe Association 1 1 Memory Therapy Memory / Memory Network
More informationPTSD does trauma ever really go away? Trauma. Is Trauma Common? 9/29/2010. These types of events can cause Post traumatic Stress Disorder (PTSD).
PTSD does trauma ever really go away? Ch.5 Anxiety Disorders Trauma These types of events can cause Post traumatic Stress Disorder (PTSD). Is Trauma Common? Yes more than two-thirds of people experience
More informationLECTURE 9a CLINICAL INTERVENTIONS
LECTURE 9a CLINICAL INTERVENTIONS PHASE 4: DESENSITIZATION Unrestricted Processing (Chapter 6; Shapiro, 2001) GOAL To fully process the agreed-upon target until SUD = 0 or is ecologically valid (may take
More information4/25/2017 CLINICAL RESEARCH IN PTSD. FH/MCW Level 1 Trauma Center. PTSD with Level 1 Trauma Survivors
CLINICAL RESEARCH IN PTSD TERRI DEROON-CASSINI, PHD ASSOCIATE PROFESSOR MEDICAL COLLEGE OF WISCONSIN DEPARTMENT OF SURGERY TRAUMA & CRITICAL CARE 1 FH/MCW Level 1 Trauma Center 2 PTSD with Level 1 Trauma
More informationPTSD & TBI: The Perfect Storm
PTSD & TBI: The Perfect Storm Part 2 Paul Greenwell MS, LIMHP Lutheran Family Services Inc. At Ease Program Supervisor Purpose The purpose of this activity is to inform the audience of evidence-based treatment
More informationManualized Psychotherapies in the Real World a,b ABSTRACT
Manualized Psychotherapies in the Real World 28 Commentary on Individualizing Exposure Therapy For PTSD: The Case Of Caroline Manualized Psychotherapies in the Real World a,b KATHERINE L. MULLER a,b a
More informationPosttraumatic Stress Disorder in the Occupational Context, Including Military Service
Posttraumatic Stress Disorder in the Occupational Context, Including Military Service John R. McQuaid, PhD Associate Chief of Mental Health, SFVAHCS Professor of Clinical Psychology, UCSF Disclosures I
More informationTHANK YOU! Fear Potentiated Startle (FPS) Fear Potentiated Startle (FPS) 1/30/2015
THANK YOU! Fear Potentiated Startle and Fear Extinction in a Sample of Undergraduate Women Exposed to a Campus Mass Shooting Susan M. Hannan, M.A. Antonia V. Seligowski, M.A. Holly K. Orcutt, Ph.D. Our
More informationMindfulness at HFCS Information in this presentation was adapted from Dr. Bobbi Bennet & Jennifer Cohen Harper
Mindfulness at HFCS 2015-2016 1 WHY Many children today are experiencing an increase in social and academic stress resulting in an over arousal of the sympathetic nervous system and a buildup of stress
More informationPTSD Guide for Veterans, Civilians, Patients and Family
PTSD Guide for Veterans, Civilians, Patients and Family Overview There are a variety of PTSD booklets available, so with ours we wanted to hand-pick the content we felt our audience could use most. We
More informationFirst Responders and PTSD
First Responders and PTSD DR. KENNETH J. COOPER MD, MHSC, FRCPC DR. DION GOODLAND PHD OEMAC CONFERENCE ST. JOHN S NEWFOUNDLAND JUNE 13, 2017 Faculty/Presenter Disclosure Faculty: Dr. Dion Goodland Dr.
More informationUnderstanding the Biopsychosocial Impact of Trauma
Understanding the Biopsychosocial Impact of Trauma Brian R. Sims, M.D., Senior Medical Advisor National Association of State Mental Health Program Directors Module created by Saxe, 2002 2 1 PTSD-RI Score
More informationManual for the Administration and Scoring of the PTSD Symptom Scale Interview (PSS-I)*
Manual for the Administration and Scoring of the PTSD Symptom Scale Interview (PSS-I)* Introduction The PTSD Symptom Scale Interview (PSS-I) was designed as a flexible semi-structured interview to allow
More informationPsychological reaction to real or probable risk of HIV infection
Psychological reaction to real or probable risk of HIV infection Dorota Merecz HIV/AIDS, well-being and mental health problems 1 Critical events in HIV positives diagnosis Disclose HIV diagnosis to family
More informationReducing Risk and Preventing Violence, Trauma, and the Use of Seclusion and Restraint Neurobiological & Psychological Effects of Trauma
Reducing Risk and Preventing Violence, Trauma, and the Use of Seclusion and Restraint Neurobiological & Psychological Effects of Trauma Module created by Glenn Saxe, MD: 2002 revised 2009, 2011, 2013,
More informationNovel Approach to Treating Stigma to Improve Mental Health and HIV Outcomes in Black Gay Men
Novel Approach to Treating Stigma to Improve Mental Health and HIV Outcomes in Black Gay Men LaRon E. Nelson, PhD, RN, FNP, FNAP, FAAN Assistant Professor and Dean s Endowed Fellow in Health Disparities
More informationWhat the heck is PTSD? And what do I do if I have it?
What the heck is PTSD? And what do I do if I have it? Dr. Dion Goodland, Psychologist Goodland Psychology November 2015 Outline for today What is Posttraumatic Stress Disorder (PTSD)? How do I get it?
More informationPROLONGED EXPOSURE. Prolonged Exposure w/ Tiffany Hopkins, PhD 10/18/2018. UNC-CH School of Social Work Clinical Institute 1.
UNC CHAPEL HILL SCHOOL OF SOCIAL WORK CLINICAL INSTITUTE Introductions PROLONGED EXPOSURE Approaching what matters: Prolonged Exposure therapy for PTSD w/ Tiffany Hopkins, Ph.D. Trainees Prior PE experience?
More information"Consolidation theory posits that once a memory is consolidated, it remains consolidated.
"Consolidation theory posits that once a memory is consolidated, it remains consolidated. In contrast to this expectation, we will argue that memory retrieval can return a consolidated/fixed memory to
More informationUnlocking the Emotional Brain: Memory Reconsolidation, Therapeutic Effectiveness, and the Future Evolution of Psychotherapy Bruce Ecker, MA, LMFT
Unlocking the Emotional Brain:, Two Kinds Change Unlocking the Emotional Brain, Therapeutic Effectiveness, and the Further Evolution Psychotherapy Counteractive, incremental change Transformational, liberating,
More informationStress: The Good, Bad, and the Ugly Part One. Catherine Nelson, Ph.D. University of Utah
Stress: The Good, Bad, and the Ugly Part One Catherine Nelson, Ph.D. University of Utah Cathy.nelson@utah.edu Course Overview: Stress Session One Definitions Physiology Toxic Stress Risk factors for experiencing
More informationObjectives. Stressors in Theater. Disclosure statement. The speakers (Drs Fogger & Moore) have no conflict of interest to disclose
Disclosure statement Understanding Non Pharmacological Treatment for Veterans with Post Traumatic Stress Disorder Susanne Fogger DNP, PMHNP BC, CARN AP, FAANP Randy Moore DNP, RN Leah Picket DNP, PMHNP
More informationExposure: Awareness, Tolerance, & Acceptance of Mind & Body
Exposure: Awareness, Tolerance, & Acceptance of Mind & Body Brigette A. Erwin, PhD Director, OCD Program Anxiety and Agoraphobia Treatment Center Bala Cynwyd, PA A presentation conducted at the annual
More informationTheoretical Basis of Memory Reconsolidation In Trauma-Focused Therapy
Theoretical Basis of Memory Reconsolidation In Trauma-Focused Therapy Cerebral Cortex Cortex: Main site of permanent memory, which is very compactly coded. New memories must be filed near similar experiences.
More informationEvidence-Based Treatments for PTSD: Cognitive Processing Therapy
Evidence-Based Treatments for PTSD: Cognitive Processing Therapy Brian L. Meyer, Ph.D. Interim Associate Chief Mental Health Clinical Services McGuire VA Medical Center Richmond, VA May 19, 2015 Disclaimer
More informationPhase 3: Connect the Bottom to the Top
Phase 3: Connect the Bottom to the Top Flow of Treatment Phase 1: Attend to Physiological Reactions Develop rapport, assess, and conceptualize Phase 2: Build the Brain from the Bottom-Up Wave1 intervention
More information2/23/ Transition Conference Harrisburg PA February 23, 2017
2017 Transition Conference Harrisburg PA February 23, 2017 1 ddubovksy@verizon.net 215-694-8450 2 is a spectrum of disorders There is a wide range of intellectual capabilities in individuals with an There
More informationSchool-Based Mental Health Mindfulness Growth Mindset Response to Resiliency
School-Based Mental Health Mindfulness Growth Mindset Response to Resiliency #1: How mindfulness supports well-being from kids who practice. #2: How the three systems in the brain effect emotional self-regulation.
More informationNeuroscience Foundations of ncbt
Neuroscience Foundations of ncbt So much to know! Informed by several neuroscience findings related to: Brain terminology, location, and function Brain development Memory formulation and reconsolidation
More informationThe Role of Campus-based Mindfulness-based Stress Reduction Programs to Increase Resilience to Stress and Promote Retention
The Role of Campus-based Mindfulness-based Stress Reduction Programs to Increase Resilience to Stress and Promote Retention Maren Westphal, Ph.D. & Sophie Kaufman, DPS Pace University Second Annual Retention
More informationMEDICAL ASPECTS OF TRAUMA
MEDICAL ASPECTS OF TRAUMA Toxic Stress and Health Heather C. Forkey, M.D. Foster Children Evaluation Service (FaCES) UMass Children s Medical Center Worcester MA Disclosure slide I have no actual or potential
More informationDavid Yusko, PsyD & Emily Malcoun, PhD
David Yusko, PsyD & Emily Malcoun, PhD Introduce the history, prevalence, and complications this unique comorbidity introduces to clinical practice Discuss two clinical trials that illustrate potential
More informationTSgt Kyle Blair Psychological Health Center of Excellence (PHCoE) 5 DEC Medically Ready Force Ready Medical Force
TSgt Kyle Blair Psychological Health Center of Excellence (PHCoE) 5 DEC 2018 Medically Ready Force Ready Medical Force Disclosure The views expressed in this presentation are those of the presenter and
More informationTrauma FIRST RESPONDERS JADA B. HUDSON M.S., LCPC, CADC
JADA B. HUDSON M.S., LCPC, CADC Trauma FIRST RESPONDERS Jada B. Hudson, M.S. Licensed Clinical Professional Counselor Certified Alcohol and Drug Abuse Counselor Operation Shattered Stars Clinical Consultant
More informationComorbidity Rates. Comorbidity Rates. Males: Females:
Comorbidity Rates Males: Any Diagnosis: 88% Alcoholism 52% Depression 48% Conduct Disorder 43% Drug Abuse 35% Phobia 31% Kessler, et al. (1995) Comorbidity Rates Females: Any Diagnosis 78% Depression 49%
More informationAdolescence: A Visual Summary
1 OCD and Teens/Young Adults: How to Keep Them Engaged in Their Own Treatment, Symptoms, and Lives Martin E. Franklin, Ph.D. Associate Professor of Clinical Psychology in Psychiatry University of Pennsylvania
More informationPost Traumatic Stress Disorder (PTSD) (PTSD)
Post Traumatic Stress Disorder (PTSD) (PTSD) Reference: http://www.psychiatry.org/military Prevalence of PTSD One in five veterans of the Iraq and Afghanistan wars is diagnosed with PTSD. (http://www.psychiatry.org/military
More informationSigns of Acute Stress Disorder Symptom Behavioral Signs Support Needed
APPENDIX G: A GUIDE TO RECOGNIZING ACUTE STRESS DISORDER IN POSTPARTUM WOMEN IN THE HOSPITAL SETTING Michelle Flaum Hall, EdD, LPCC-S, Xavier University INTRODUCTION The Diagnostic and Statistical Manual
More informationComplementary/Integrative Approaches to Treating PTSD & TBI
Complementary/Integrative Approaches to Treating PTSD & TBI Cathy M. St. Pierre, PhD, APRN, FNP- BC, FAANP ENRM VA Hospital Bedford, Massachusetts, USA The purpose To define Post Traumatic Stress Disorder
More information9/3/2014. Which impairs the ability to integrate these experiences in an adaptive manner.
Presented by DaLene Forester Thacker, PhD Licensed Marriage and Family Therapist Licensed Professional Clinical Counselor Director and Trainer with AEI daleneforester@yahoo.com I was not able to use EMDR
More informationHealing after Rape Edna B. Foa. Department of Psychiatry University of Pennsylvania
Healing after Rape Edna B. Foa Department of Psychiatry University of Pennsylvania Outline of Lecture What is a trauma? What are common reactions to trauma? Why some people do not recover? How can we help
More informationAPNA 25th Annual Conference October 19, Session 1022
When Words Are Not Enough The Use of Sensory Modulation Techniques to Replace Self- Injurious Behaviors in Patients with Borderline Personality Disorder General Organization of the Brain Lita Sabonis,
More informationThe doctor will not see you now: therapist-light therapy for PTSD in children as the way ahead? Commentary on:
The doctor will not see you now: therapist-light therapy for PTSD in children as the way ahead? Commentary on: Stepped care versus standard trauma-focused cognitive behavioral therapy for young children
More informationTITLE: Conditioned Fear Extinction and Generalization in Posttraumatic Stress Disorder
AD Award Number: W81XWH-08-2-0170 TITLE: Conditioned Fear Extinction and Generalization in Posttraumatic Stress Disorder PRINCIPAL INVESTIGATOR: Seth D. Norrholm, Ph.D. CONTRACTING ORGANIZATION: Emory
More informationOngoing Research in Cognitive Rehabilitation The SCORE trial
Ongoing Research in Cognitive Rehabilitation The SCORE trial March 16, 2011 Douglas B. Cooper, Ph.D Clinical Neuropsychologist Director, Military Brain Injury Rehabilitation Research Consortium Brooke
More informationBuilding Resilience following Trauma
Building Resilience following Trauma Ferguson Florissant School District Gary U. Behrman, PhD, MSW, M.Div., LCSW Family Support Program Mgr CHADS Coalition George Washington Carver How far you go in life
More informationDefinition. Objectives. PTSD: The Unrecognized Symptom Jorge I. Ramirez, MD, FAAHPM Caroline Schauer, RN, BSN, CHPN
PTSD: The Unrecognized Symptom Jorge I. Ramirez, MD, FAAHPM Caroline Schauer, RN, BSN, CHPN VISN 23 Hospice and Palliative Care Objectives Describe Post Traumatic Stress Disorder (PTSD) and the population
More informationAnnual Insurance Seminar. Tuesday 26 September 2017
Annual Insurance Seminar Tuesday 26 September 2017 Dublin Dublin London London New New York York San San Franscisco Francisco Welcome Emer Gilvarry, Chairperson Dublin Dublin London London New New York
More informationDanni Lapin, LCSW-R Leani Spinner, LCSW-R September 2016 ANDRUS
Danni Lapin, LCSW-R Leani Spinner, LCSW-R September 2016 ANDRUS WHO ARE WE? ANDRUS Private, social sector Mission: ANDRUS nurtures social and emotional wellbeing in children and their families by delivering
More informationChild Victims of Violence: Forging Multidisciplinary Approaches
Child Victims of Violence: Forging Multidisciplinary Approaches Identifying and Caring for Child Victims of Violence, Part II Genevieve Preer, MD Department of Pediatrics Boston Medical Center/ Boston
More informationPosttraumatic Stress Disorder
Posttraumatic Stress Disorder Amanda Smith, Ph.D., & Gretchen H. Wilber, Psy.D. Staff Psychologists, PTSD Program Albany Stratton VAMC Roadmap/Outline for Today s Talk PTSD incidence, symptoms, etiology
More informationAn Experiential Approach to Reliving with Complex Trauma. Dr Jo Billings Berkshire Traumatic Stress Service
An Experiential Approach to Reliving with Complex Trauma Dr Jo Billings Berkshire Traumatic Stress Service A Phase-Based Approach Stabilisation Processing trauma memories Reclaiming life Overview What
More informationTRAUMA INFORMED CARE: THE IMPORTANCE OF THE WORKING ALLIANCE
TRAUMA INFORMED CARE: THE IMPORTANCE OF THE WORKING ALLIANCE Justin Watts PhD. NCC, CRC Assistant Professor, Rehabilitation Health Services The University of North Texas Objectives Upon completion of this
More informationPOST-TRAUMATIC STRESS DISORDER
ISBN: 9780170999809 POST-TRAUMATIC STRESS DISORDER Grant J. Devilly (Swinburne University of Technology) & Jennifer McGrail (University of Melbourne) DSM-IV Criteria for PTSD Information detailing the
More informationLecture 17 (Nov 28 th ): STRESS RESPONSE AND HEALTH Lecture Outline
Lecture 17 (Nov 28 th ): STRESS RESPONSE AND HEALTH Lecture Outline 1) Three Types of Responses to Stress 1) Direct Behavioral 2) Sympathetic System (Branch of Autonomic System) 3) Hormonal ** there is
More informationGlossary for Anxiety Related Assessment and Treatment
Glossary for Anxiety Related Assessment and Treatment While at WayPoint, your child is developing a deeper understanding regarding anxiety along with an expanding vocabulary. Here is a glossary of terms
More informationCONTRACTING ORGANIZATION: Veterans Medical Research Foundation San Diego, CA
Award Number: W81XWH-11-2-0001 TITLE: Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD PRINCIPAL INVESTIGATOR: Victoria Risbrough, PhD CONTRACTING ORGANIZATION:
More informationTrauma Informed Excellence Trauma Informed Care
Trauma Informed Excellence Trauma Informed Care 2012 HEALTH CARE FOR THE HOMELESS REGIONAL TRAINING ORLANDO FLORIDA NOVEMBER 1-2 Diverse Management Solutions, LLC Stay positive www.diversemanagementsolutions.com
More information12/18/2013. Observational Methods. Field Research. Observational Studies. Observational Studies
al Methods Field Research Research involving the direct observation of behavior. Three decisions to make: Will the observation occur in a natural or contrived setting? Will the participants know they are
More informationEffects of Virtual Reality Therapy on Combat-Induced PTSD B Y : M A T T H E W T I N G Z O N
Effects of Virtual Reality Therapy on Combat-Induced PTSD B Y : M A T T H E W T I N G Z O N Facts Due to the past wars in Iraq and Afghanistan: 2.3 million veterans at least 20% of veterans have PTSD over
More informationExecutive Functioning
Executive Functioning What is executive functioning? Executive functioning is a process of higher brain functioning that is involved in goal directed activities. It is the part of the brain that enables
More informationCombat-related PTSD and the Brain
Combat-related PTSD and the Brain Seth J. Gillihan, PhD Visiting Assistant Professor of Psychology, Haverford College Psychologist in Private Practice mail@sethgillihan.com PTSD & Ethics: Guiding Questions
More informationIntegrated Approach to Trauma in Eating Disorders Treatment. Nicole Siegfried, PhD, CEDS Clinical Director
Integrated Approach to Trauma in Eating Disorders Treatment Nicole Siegfried, PhD, CEDS Clinical Director Overview Trauma and Eating Disorders Cognitive Processing Therapy (CPT) Prolonged Exposure Therapy
More informationAttachment: The Antidote to Trauma
Liberty University DigitalCommons@Liberty University Faculty Publications and Presentations Center for Counseling and Family Studies 9-24-2009 Attachment: The Antidote to Trauma Joshua Straub Liberty University,
More informationFunctional Analytic Psychotherapy Basic Principles. Clinically Relevant Behavior (CRB)
Functional Analytic Psychotherapy Basic Principles Clinically Relevant Behavior (CRB) CRB1: In-session instances of daily-life problems CRB2: In-session instances of daily-life improvements CRB3: Client
More informationStress, glucocorticoids and memory: implications for treating fear-related disorders
Stress, glucocorticoids and memory: implications for treating fear-related disorders Dominique de Quervain 1 3, Lars Schwabe 4 and Benno Roozendaal 5,6 Abstract Glucocorticoid stress hormones are crucially
More informationCRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION
CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION In military veterans, what is the effect of virtual reality exposure therapy (VRE) on posttraumatic stress disorder (PTSD) and depressive symptoms, as
More informationCHILD PTSD CHECKLIST PARENT VERSION (CPC P) TRAUMATIC EVENTS
CHILD PTSD CHECKLIST PARENT VERSION (CPC P) 7 18 years. Version May 23, 2014. Name ID Date TRAUMATIC EVENTS TO COUNT AN EVENT, YOUR CHILD MUST HAVE FELT ONE OF THESE: (1) FELT LIKE HE/SHE MIGHT DIE, OR
More information