Doing DBT to Adherence and with Competence: An Advanced Course

Doing DBT to Adherence and with Competence: An Advanced Course The Treatment and Charles Swenson, M.D. are pleased to announce the offering of a new course delivered online and in-person over the span of 4 months. This advanced course is designed to help the DBT therapist bring his or her practice to the next level of adherence, competence, and effectiveness. Instructor: Section One: Charles Swenson, M.D. Online Video-based Classes Wednesday, February 29 - Wednesday, May 23, 2012 (13 weeks) 10:30am-12:00pm (west coast); 1:30pm -3:00pm (east coast) Section Two: 2-day In-person Training June 28-29, 2012; 8am-5pm at Riverview Hospital, Middletown, CT COURSE DESCRIPTION Section One: 13-Week Online Video-based Classes In this 13-week series of 90 minute lectures, the practice of Dialectical Behavior Therapy (DBT) will be taught by the instructor with didactics, power points, clinical examples, and demonstrations where possible. After starting with a coherent review of DBT s three sets of principles and three respective core groups of strategies, the course will proceed to cover, at an advanced level, the practical aspects of targeting; case conceptualization and treatment planning; behavioral chain analysis for assessment and treatment; application of problem-solving, validation, and dialectical strategies; managing suicidal crises; and using mindfulness practice and consultation team to regulate therapist emotions and prevent therapist burnout, Readings from Linehan s manual will be assigned prior to each class so that more experienced participants can review material, while those with less DBT experience can strengthen their grasp of relevant concepts prior to class. The instructor will assume a high level of participant commitment to readings and class participation, which will allow him to focus entirely on advanced clinical applications. At the end of this section, participants will take a quiz to test their knowledge of the topics covered as they ready themselves for the 2-day in-person training section. The audio portion of the online video-based classes will be recorded so missed sessions can be listened to after the class occurs. Section Two: 2-day In-person Training This 2-day in-person training, which will be decidedly experiential in nature, will bring the teachings of section one alive through instructor modeling, participant behavioral rehearsal with instructor feedback, and discussion of the practices including reference to participants clinical cases. While the agenda will systematically move through demonstrations, practices, and discussions of the various DBT interventions and strategy groups, there will be time to address advanced topics of special interest to participants. In addition to the hands-on training in individual therapy, there will be a chance to address problems in participant s consultation teams, using experiential practices and consultation team role-plays as indicated. Extended Training Opportunities Depending on interest, a number of options for further training, consultation, and supervision can be made available to strengthen therapists, skills trainers, team leaders, consultation teams, and DBT programs. These possibilities can be negotiated by individuals or teams, and could be arranged in concert with other individuals and teams to take advantage of inter-team learning and economies of scale. This could include focused assistance and supervision for therapists and skills trainers readying themselves for DBT Certification processes and exams, and consultation to administrators and team Doing DBT to Adherence and with Competence: An Advanced Course :: TIC 2012 Page 1 of 8

leaders preparing for upcoming DBT Program Accreditation processes. Extended individualized and group training opportunities can be discussed at any point during the training sections, and can be finalized by contacting Helen Best at hbest@ticllc.org. COURSE PREREQUISITES This course is open to any individual, team, or group wishing to improve DBT clinical practice and program structure. It is expected that all participants are practicing within the context of an established program and have read Linehan s therapy manual and skills training manual. Books can be purchased at local bookstores or online at. 1. Linehan, M. M. (1993a). Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press. 2. Linehan, M. M. (1993b). Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford Press. TUITION & REGISTRATION Regular rates: 1. Tuition for the full course is $1800. Tuition covers the 13-weeks of online video-based classes (used by an individual or shared by a group using one computer port) and ONE individual ticket to the 2-day inperson training. There is no limit to the number of participants you can have in ONE location, using ONE computer port for the weekly online video-based classes. A group can either sit together in front of a computer monitor or in a conference room with an LCD projecting the computer screen for visibility. 2. Individual tickets for the 2-day in-person training are $295 per person. Teams/groups are encouraged to send two members or an entire team to the 2-day inperson training. Participation in the 13-weeks of online video-based classes is required. Space is limited. 3. Group (4+) Individual tickets for the 2-day in-person training are $265 per person. Members must be from one group (sharing a single computer port for the online videobased classes). Participation in the 13-weeks of online video-based classes is required. Space is limited, please call Helen Best at (206) 251-5134 to register.. Discounted rates for early payment: 1. Tuition for the full course is $1750, if paid before January 31, 2012. 2. Individual tickets for the 2-day in-person training are $275 per person, if paid before January 31, 2012. Registration: Register online at. All registration information and payments are due no later than February 22, 2012. The audio portion of the online video-based classes will be recorded so missed sessions can be listened to after the class occurs. Payment is inclusive of the whole course and no partial refunds are possible once the course begins. Doing DBT to Adherence and with Competence: An Advanced Course :: TIC 2012 Page 2 of 8

DATES & LOCATION Section One: Online Video-based Classes Wednesday, February 29 - Wednesday, May 23, 2012 (13 weeks) 10:30am-12:00pm (west coast); 1:30pm -3:00pm (east coast) Section Two: 2-day In-person Training June 28-29, 2012; 8am-5pm at Riverview Hospital, Middletown, CT Accommodation Option The Inn at Middletown Hotel, Connecticut 70 Main Street Middletown, CT 06457 Reservations: 800-637-9851 Phone: 860-854-6300 http://www.innatmiddletown.com/cromwell-connecticut-hotel.aspx CONTINUING EDUCATION Treatment can offer APA credit for the full course (Section One and Section Two), in collaboration with CONCEPT. Continuing Medical Education, Nursing Education and Social Work CEUs for the 2-day Training (Section Two only), have been applied for by Riverview Hospital. Psychologists APA credit will be provided upon completion of the course. 100% participation is required in order to receive any credit. No partial credit will be given. Record of your participation in the online videobased classes will be documented in addition to sign-in and sign-out sheets at the 2-day in-person training. Continuing Education Credit will be provided by: CONCEPT Consolidated Continuing Education and Professional Training Patricia A. Zapf, PhD Director of Education & Training Web: www.concept-ce.com Phone: 888.709.4448, Fax: 801.846.0608 Email: pzapf@concept-ce.com Continuing Education (CE) credit for psychologists is offered for this program though Consolidated Continuing Education and Professional Training (CONCEPT). A total of 19.5 CE credits can be earned for Section One ($195) and a total of 14 CE credits can be earned for Section Two ($140). Participants may register for Section One CEs (19.5 CEs), Section Two CEs (14 CEs), or both (33.5 CEs). Participants who desire to obtain CE credits for this program can register for credit online at the CONCEPT website (www.concept-ce.com) or by contacting Patricia Zapf, PhD, the Director of Education and Training for CONCEPT at pzapf@concept-ce.com. Payment for CE credit is in addition to payment for course registration and must be completed prior to the completion of the course. CONCEPT is approved by the American Psychological Association and the Canadian Psychological Association to sponsor continuing education for psychologists. CONCEPT maintains responsibility for its programs and their content. Doing DBT to Adherence and with Competence: An Advanced Course :: TIC 2012 Page 3 of 8

Physicians, Nurses, Social Workers Pending approval Educational Credits for the two day training for Physicians, Nurses and Social Workers will be provided by Riverview Hospital. The following applications will be submitted: Riverview Hospital is accredited by the Connecticut State Medical Society to sponsor continuing medical education for physicians. RVH designates this continuing medical education activity for a maximum of 13.5 AMA PRA Category I Credits pending approval. Each physician should claim only those hours actually spent in the activity. The National Association of Social Workers has designated this activity for 13.5 Credit Units pending approval Riverview Hospital for Children and Youth is an Approved Provider of Continuing Nursing Education by the Connecticut Nurses' Association, an Accredited Approver by the American Nurses Credentialing Center's Commission on Accreditation - pending approval 13.5 Contact Hours will be provided. INFORMATION ABOUT THE INSTRUCTOR Charles Swenson, M.D., graduated from Harvard College and Yale Medical School, and during his Psychiatric Residency at Yale he also took part in psychoanalytic training at the Western New England Psychoanalytic Institute. He joined the faculty of Cornell University Medical College, New York Hospital- Westchester Division (in White Plains, New York) in 1982, where for five years he directed the long-term psychoanalytically-oriented inpatient program for patients with personality disorders. Having learned of Dialectical Behavior Therapy (DBT) in 1986, Dr. Swenson then developed the first DBT program in the world outside of Marsha Linehan s program in Seattle. He adapted DBT to an inpatient setting, then a day hospital setting, and went on to train and consult to others as individuals, as programs, and as statewide and provincial treatment systems in the implementation of DBT in the United States, Canada, and Europe. During his fourteen years at New York Hospital Dr. Swenson was twice voted Teacher of the Year by the Cornell psychiatric residents, and in 2001 he was the first recipient of the Cindy Sanderson Outstanding Teaching Award given by the International Society for the Improvement and Teaching of DBT (ISITDBT). In 1996 Dr. Swenson moved to Northampton, Massachusetts, where he became the Area Medical Director for the Western Massachusetts area of the Department of Mental Health, where he was able to spearhead the implementation of DBT throughout the region for adults and adolescents. For the past fifteen years he has continued to train others in DBT, consult to programs and large scale mental health systems, while treating his own private practice patients. He has published widely on the treatment of borderline patients, including articles comparing Kernberg s psychoanalytic approach to DBT (1989), describing the inpatient application of DBT (2001), identifying factors leading to DBT s popularity (2001), identifying the barriers and strategies for implementing DBT in community mental health centers (2002), and a chapter that serves as the primary reference for inpatient applications of DBT (2005). During the past 18 years Dr. Swenson has conducted more than thirty ten-day intensive DBT seminars, has consulted to more than 400 DBT programs, and has supervised dozens of individual DBT therapists. For fourteen years he has been an Associate Professor of Clinical Psychiatry for the University of Massachusetts Medical Center, and has been engaged in the private practice of psychiatry and psychotherapy in Northampton, MA. For more information: http:///charles_swenson.html) Doing DBT to Adherence and with Competence: An Advanced Course :: TIC 2012 Page 4 of 8

COURSE OBJECTIVES Following Section One, the 13-week Online Video-based Classes, the participant will be able to: Articulate the principles of Mindfulness/Behaviorism/Dialectics) and how they interact to create the basis of DBT Specify which DBT strategies are associated with each of the three sets of principles underlying DBT Explain how the DBT therapist derives the prioritized target list for therapy, and how he/she collaborates with the client in doing so Describe how to use DBT s Target Hierarchy to set the agenda of a therapy session and what to do when the therapist and client disagree about the agenda Specify how a DBT therapist arrives at a case conceptualization and how it is transformed into a treatment plan Provide examples of how the case conceptualization keeps the treatment on track when things get difficult Describe how the DBT therapist combines the use of commitment strategies with other DBT strategy groups in trying to get a stronger client commitment to treatment Identify ways to conduct a behavioral chain analysis in a competent manner in sessions to increase the client s learning Explain how the behavioral chain analysis serves as a platform for the conduct of problem-solving in therapy sessions Illustrate how the understanding of the client s particular dialectical dilemmas provides secondary targets to be addressed in therapy sessions Define the contingency procedures of reinforcement, extinction, shaping, and punishment, and provide examples of how each one is used in changing client behaviors in DBT sessions Articulate how the DBT individual therapist effectively moves in and out of skills training in sessions Review the way in which cognitive modification strategies are incorporated in DBT therapy sessions and how that is different than how they are used in cognitive therapy per se Enumerate the principles of exposure as used in DBT, and the difference between how they are used in Stage I versus Stage II of DBT treatment Explain what makes the use of straightforward validation strategies difficult to employ in some clinical situations, and will name some ways to increase the effectiveness of validation Define the difference between functional and explicit verbal validation strategies and explain why functional validation is the more important concept Provide examples in which a DBT therapist uses principles and strategies of dialectics in breaking log-jams in therapy sessions Explain how the shift between reciprocal and irreverent communication styles, even with little change in content, can completely shift the direction in a therapy session, ultimately providing balance Define the two main categories of case management strategies for dealing with the third party in DBT treatment, and the guidelines to use in deciding which category to use at any given time Enumerate the steps in the DBT protocol for managing the highly suicidal client Describe how the DBT therapist s interaction with the Consultation Team can prevent and treat therapist burnout Doing DBT to Adherence and with Competence: An Advanced Course :: TIC 2012 Page 5 of 8

Following Section Two, the 2-day In-person Training, the participant will be able to: Demonstrate how to begin a DBT therapy session by engaging the client in an interesting review of the diary card leading to a collaborative determination of session targets Describe how a DBT therapist uses the dialectical dilemmas and secondary targets to further structure a therapy session Demonstrate how a DBT therapist can use a behavioral chain analysis that is lively, pertinent, and powerful in assessing and treating a client s target behavior Describe how to use contingency procedures to change dysfunctional client behaviors within a therapy session Demonstrate how the DBT therapist effectively weaves a mini-session of skills training into an individual therapy session when a skills deficit becomes apparent Show how a DBT therapist can use exposure principles and cognitive restructuring in a therapy session to reduce avoidance and to increase the capacity to regulate disturbing emotions Demonstrate how the DBT therapist can use validation strategies to promote better client emotion regulation, a stronger therapy relationship, and more effective problem solving Demonstrate how the therapist can use dialectical thinking and dialectical strategies to create movement in a therapy that was otherwise stuck and polarized Demonstrate the use of the DBT crisis protocol in dealing with a suicidal crisis Articulate the most typical problems that emerge in DBT consultation teams and various ways to address them COURSE SCHEDULE Section One: 13-Week Online Video-based Classes Week 1: Understanding DBT s three foundational paradigms (Mindfulness, Behaviorism, Dialectics), the interplay among them, and the strategies associated with each one. Week 2: Working with the client to develop a prioritized list of target behaviors, and using these targets to structure therapy sessions. Week 3: For a given target behavior, developing a case conceptualization and generating a treatment plan from it. Week 4: Getting the client committed to the treatment plan, using commitment strategies (and all other DBT strategies that are needed). Week 5: Using behavioral chain analysis to assess the controlling variables of a target behavior. Week 6: Using behavioral chain analysis as a framework for conducting sessions and a platform for problem-solving. Week 7: Problem-solving I: Applying contingencies, skills, exposure procedures, and cognitive modification to get behavioral change. Week 8: Problem-solving II: Applying contingencies, skills, exposure procedures, and cognitive modification to get behavioral change. Week 9: Using validation strategies to strengthen the treatment alliance, to accept the client, to confirm the client s valid perceptions and behaviors, and to assist with the regulation of emotions. Doing DBT to Adherence and with Competence: An Advanced Course :: TIC 2012 Page 6 of 8

Week 10: Applying dialectical thinking and strategies to achieve balance, negotiate impasses, and maintain speed, movement, and flow. Week 11: Applying dialectics in balancing communication styles in sessions, and in balancing consultation-to-the client with intervening-in-the-environment. Week 12: Assessing suicide risk and managing suicidal crises in DBT. Week 13: Taking care of the therapist: mindfulness practice and consultation team. Section Two: 2-day In-person Training Day 1 8:30-10:15 Mindfulness practice Orientation to the training Getting client commitment when it is difficult 10:15-10:30 Break 10:30-12:00 Using primary and secondary targets to structure sessions 12:00-1:15 Lunch 1:15-2:30 Using behavioral chain analysis in a competent manner 2:30-2:45 Break 2:45-3:45 Using contingency procedures to increase and decrease behaviors 3:45-4:45 Using skills training in therapy sessions to get behavioral change 4:45-5:00 Q&A and evaluations Day 2 8:30-10:15 Mindfulness practice Using exposure procedures and cognitive modification to get behavioral change 10:15-10:30 Break 10:30-12:00 Using validation accurately, compassionately, and effectively 12:00-1:15 Lunch 1:15-2:30 Using dialectics and dialectical strategies to break logjams and maintain speed, movement, and flow 2:30-2:45 Break 2:45-4:00 Assessing and addressing the highly suicidal client 4:00-4:45 Conducting an effective consultation team meeting 4:45-5:00 Q&A and evaluations TECHNICAL REQUIREMENTS The following are technical requirements for the online video-based training section of the course. Every site/computer port must have access to a computer with a video camera/microphone, internet access, and an email address. Minimum requirements for Windows: Windows 98, Me, NT, 2000 SP4, XP SP2, 2003 R2, or Vista Intel x86 (Pentium 400MHZ +) or compatible processor Microsoft Internet Explorer 6.0 or higher, Firefox 1.5 or higher, Mozilla 1.7 or higher,, or Netscape 8.1 or higher JavaScript and cookies must be enabled Recommend ActiveX be enabled for Intenet Explorer 56K or faster Internet connection Minimum requirements for Mac OS: Mac OS 10.3 or 10.4 (Intel or PowerPC processor) Doing DBT to Adherence and with Competence: An Advanced Course :: TIC 2012 Page 7 of 8

Safari 2.0 (Mac OS 10.4) Safari 1.3 (Mac OS 10.3) Firefox 1.5 or higher (2.0 or higher recommended) JavaScript and cookies need to be enabled Requires Java Runtime Environment (JRE) 5.0 or higher 56K or faster Internet connection Minimum requirements for Solaris: Solaris 9 (SPARC), 10 (SPARC/x86) Java Plug-In 1.3.1 or later Firefox 1.5 or higher Mozilla 1.7 or higher JavaScript and cookies need to be enabled Requires Java Runtime Environment (JRE) 5.0 or higher 56K or faster Internet connection Minimum requirements for Linux: Kernel: 2.4.21 or above X Lib: X11R6 or above compatible C++ Lib: libstdc++ 5 Desktop Environment: XFce 4.0 or above, KDE, Ximian, Gnome GDK/GTK+ version: 2.0 or above Glib: 2.0 or above Sun Java 1.5 or above OSS Interface (for Audio) Firefox 1.5 or higher or Mozilla 1.7 or higher JavaScript and cookies need to be enabled 56K or faster Internet connection Doing DBT to Adherence and with Competence: An Advanced Course :: TIC 2012 Page 8 of 8