Clinical Training, Consulting, and Supervision

This overview class will help you to accurately diagnose and treat clients with Bipolar Disorder, separating bipolar symptoms from common co-occurring disorders and misdiagnoses (e.g. Attention-Deficit Hyperactivity Disorder (ADHD), Unipolar Depression, Disruptive Mood Dysregulation Disorder (DMDD), excessive substance use, Schizophrenia, and other mental health problems, as well as evidence-based intervention strategies, and a look at commonly used medications. Through use of lecture, discussion and vignettes to assist you to learn and retain the information, this class will leave you feeling more confident in your work with clients with Bipolar Disorder.

This 7-hour course covers everything from forming a therapeutic alliance and making a proper diagnosis to First Episode Psychosis to evidence-based treatments of the various disorders in inpatient and outpatient settings. The day will be spent (using lecture, discussion, and video) covering the differences between Delusional Disorder, Brief Psychotic Disorder, Schizophreniform Disorder, Schizophrenia, Schizoaffective Disorder, Substance/Medication-Induced Psychotic Disorder, Psychotic Disorder Due to Another Medical Condition, Catatonia. Most emphasis will be on Schizophrenia and Schizoaffective Disorder. Attendees should leave this course confident that they can identify their clients’ type of psychosis and with some useful tools that will assist them to help their clients with these disorders.

Many people are concerned about the impact this powerful stimulant has on our clients, their families, children, and communities. Learn the facts about this drug. This class covers the history and manufacturing of the drug, its impact on drug-endangered children; fetal, youth, adolescent, and adult health and psychiatric effects; gender issues, trauma issues and their impact on treatment; diagnosis and evidence-based treatment strategies, so participants feel prepared to assist a range of clients who have methamphetamine-related problems.

This 2-day 15-hour in-depth pre-licensure class on the assessment and treatment of substance-related disorders was developed for ASWs, AMFTs, and APCCs and meets BBS criteria. It is also appropriate for any other staff members who want simply to learn more about this issue. Topics covered include: commonly used drugs and their effects, current drug use trends, screening and assessment, warning signs, an overview of substance-related disorders as defined in the DSM-5, treatment strategies such as relapse prevention, harm reduction, and motivational interviewing, dual diagnosis/co-occurring disorders, ways for family members to receive help and for them to assist their loved ones who need care, referral information and more. Attendees should leave this training with a solid basic understanding of how recognize and treat people with substance-related problems and how to differentiate them from people who use drugs without significant problems.

Strengthen your capacity to identify and assist your clients who struggle with their relationship with various types of opioids. We will talk about everything from heroin to OxyContin to Vicodin to cough medicine.

Attendees will learn to:

• Describe the scope of the opioid drug epidemic in the United States. 
• Recognize opioid use disorder epidemiology, and the prevalence of co-occurring psychiatric disorders
• Recognize opioid use disorder as a chronic, relapsing, and treatable disease
• Describe effective practices in screening, identification, counseling, and treatment of patients with opioid use disorder
• Compare and contrast physical dependence versus opioid use disorder
• Describe basic neuroscience of opioid use disorder
• Recognize the use of medications including buprenorphine, methadone, and naltrexone as treatment options for opioid use disorder, and in overdose management and prevention
• Identify ways to implement proper use of Naloxone
• Identify psychosocial treatment options for patients with opioid use disorder including harm reduction and relapse prevention
• Identify evidence-based methods for family members to be of assistance
• Examine the need to treat comorbid psychiatric disorders and medical conditions in patients with opioid use disorder
• Examine the importance of reducing related societal stigmas and biases around opioid use disorder, and reducing negative consequences of opioid use

(6-7 hours depending on agreed upon content. 6 with standard content;7 with any specialized content your agency might specify – e.g. “extra focus on meth or adolescents”)

Do you have clients who are currently using drugs and alcohol to excess? Well you’re not alone. Studies have found that well over 90% of people who use substances problematically don’t want to stop – at least not immediately. Learn clinical strategies to engage and treat this population. You can make a difference in engaging with and helping these clients improve their quality of life, even if they decide to continue using drugs.

Learn about: various substances and their effects; current substance use trends; diagnosis of substance-related problems; engagement strategies that work with people who use substances; the history and theory of harm reduction, a bit about motivational interviewing and how/why it is helpful to use with people who use substances, and individual, group, and family treatment strategies. Bring your case examples! While this training builds in many examples, it is always useful when you describe the substance-related struggles your own clients are facing (without names or identifying details of course) so that we can work together during the training on solutions to some of your clinical challenges.

Interested in helping your clients to build and strengthen motivation to change problematic and risky behaviors (e.g. substance use disorders, eating habits, poor treatment engagement and adherence, and tobacco use)? “Motivational interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change.  It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.” (Miller and Rollnick 2013) Bolster your ability to assist your clients to make and maintain positive changes. You will become familiar with the spirit, principles and basic techniques of MI. Through interactive exercises, role-play, practice, and case examples, you will learn to apply MI flexibly and effectively and begin to make it a natural and integrated part of your clinical practice. MI was redesigned in 2013 to include Miller & Rollnick’s four-process model and I include these changes in my trainings as well as other recent updates.

A Brief Introduction to MI: Training Options

Individual Study and Self-Training

Perhaps the most common method by which clinicians explore MI is to study print materials and view training videotapes. Although this can provide some understanding of the basic approach, research by Miller and colleagues found that assigned self-training was not effective in improving clinical skillfulness in MI.

Introduction to Motivational Interviewing (1 hour to 1 day)

Training of up to one day can acquaint the audience with basic concepts and methods of MI, but is unlikely to increase the clinical skilfulness of participants in the practice of MI. The purpose of this type of workshop is to help participants determine how interested they are in learning more about MI.

• A trainer may provide some simple exercises that a practitioner can try with patients to get a “taste” of an MI style.
• The format may be primarily didactic, and may include live or videotaped demonstrations of MI.

Introduction to MI –Training Option (Introductory Workshop of 2-3 days)

With 16-24 hours of training contact time, it is possible to provide participants with an understanding of the spirit and method of MI, and to offer some practical experience in trying out this approach. A reasonable goal for this level of training is not MI proficiency, but rather to “learn how to learn” MI from ongoing practice.

•  Expect a mix of didactic presentation, demonstration, and practice exercises.
• A limited number of participants per trainer allows some opportunity for observation and feedback. Limitations will vary depending on the precise goals and nature of the training, but we recommend no more than 40 participants per trainer.
• Research and experience caution that attendees may leave a one-time introductory workshop overconfident in their mastery of MI. 
• Optimally, this length of training should be provided in blocks of 4 hours or so, with opportunity in between for participants to practice MI and come back with experience and problems (for example, 4/4/4: 4 sessions of 4 hours each spread over 4 months).
• Many organizations choose to contract for full day concurrent workshops. While practical for attendees, this learning option reduces the applicability and retention of MI practice compared to dividing sessions with personal practice in between. Research indicates a reduction in MI skill level within 4 months (Miller & Mount, 2001). 
• Adding opportunities for personal performance feedback (e.g., from practice audiotapes) and/or individual coaching can significantly increase the effectiveness of training in helping participants to improve their clinical proficiency.

Disruptive, impulse-control, and conduct disorders are characterized by disturbances in behavioral and emotional self-regulation. Our society (and respected researchers and clinicians as well as you will see in this class) can have divergent views about the causes of and recommended treatments for these conditions.

This class will review diagnostic criteria for these disorders, will show how to rule out mental health diagnoses with similar clinical presentations, and will teach participants effective evidenced-based treatment strategies for these problems using lecture, video, and vignette-based teaching that brings the material to life.

Relapse Prevention is a cognitive-behavioral approach to relapse intended to identify and prevent high-risk situations such as excessive and harmful substance use. This course will define relapse in the context of recovery, discuss the fundamental concepts of relapse prevention, examine the process of relapse, along with information about recognizing its “warning signs,” or triggers, and the elements of various Relapse Prevention treatment methodologies (including the Gorski model and the Marlatt model), and their treatment recommendations. A true relapse prevention plan must be individualized and evidence-based. It is not simply telling your client to avoid “people, places, and things” that may be triggering. This class will also explore what types of things must be included in your clients’ plans and why according to these models if you want them to have their best chance at recovery.