Sage Institute

Course Descriptions

DSM-5: ARE YOU READY?

The new edition of DSM contains significant changes important for users including removal and replacement of the multiaxial system, introduction of a spectrum-approach to diagnosis, updating and reconceptualization of important categories. Some conditions have been promoted into separate chapter headings, such as Trauma and Stressor-Related Disorders. A number of DSM-specific assessment instruments have been included in the updated Appendices. Change of this magnitude has not been without controversy. This workshop will cover the FAQ’s about DSM-5 and will prepare participants for changes in the world’s most-used behavioral-health nomenclature system including CPT codes changes due to go into effect October 2015.

THE FATE OF MOOD DISORDERS IN DSM-5

These disorders have arguably been the most researched and debated within the DSM-5 universe. There is considerable agreement that many diagnostic entities are more accurately described as dimensional, rather than categorical. Dimensional implies that everyone lies somewhere on a continuum and that each diagnostic category may consist of more than one continuum. For instance, depression almost always overlaps with anxiety. An extensive body of research is looking at the neurochemistry and distinguishing features of the two symptom-pictures. Questions undertaken include: Is anxiety simply a sub-set of depression. Is anxiety one of the drivers in bipolar-spectrum disorders? What is the relationship between stress and depression? This opens up a Pandora’s-box of questions about whether AOD providers need to update treatment protocols to include assessment and education and education on the role and impact of stress in recovery process. This one-day training will also cover the neurological connections between mood, food, stress, exercise and sleep. Included will be how the mind can heal the body and how the body heals the mind.

SUBSTANCE USE AND ADDICTIVE DISORDERS: HOW DID THEY FARE IN DSM- 5?

This presentation includes the important updates, additions and background considerations that went into the new updated chapter on AOD disorders The most notable change in DSM-5 has been the reorganization and placement of the abuse and dependence categories into an over-arching continuum, rather than discrete categories. Gambling disorders and compulsive use of electronic media have been added. Criteria for craving and marijuana dependence have been added. Other considerations that went into the making of this chapter include the question of whether abuse inevitably leads to dependence and the need to clarify “addiction” vs dependence especially with regard to use of prescription drugs about which program managers will want to be aware.

MOTIVATIONAL INTERVIEWING: PREPARING PEOPLE FOR BEHAVIOR CHANGE

Traditional models of intervention assume the client will come into the office motivated for change. Motivational Interviewing is the only model that assumes the client will arrive in a state of ambivalence, an element that can significantly impede the efficacy of service delivery. It is also the most-researched model of treatment to date, with over 180 clinical trials of its efficacy. This workshop will prepare students to make management of ambivalence center-stage in the treatment experience through its attention to process elements in the interview and in the therapeutic alliance that have been shown to correlate with positive outcomes. Motivational Interviewing is an approach that will show you how to avoid working harder than the client and how to manage the clinical interview with precision and elegance! Come to this summer class prepared to transform your approach to your most difficult cases! This workshop can be tailored to beginning-advanced students of MI as well as specific client populations.

MANAGING THE GROUP PROCESS

Working with groups is more challenging than individual treatment in significant ways. In a group setting, the leader must be attentive to multiple domains of group functioning including the individual in the group, interpersonal dynamics between group members, as well as dynamics of the group as a whole. The group leader operates on the assumption that healthy groups produce healing environments and healthy individuals. Rather than simply conduct 1:1 conversations with individuals in the group, the group leader is able to surface unspoken agendas in the group (living-room elephants), knows how to manage and titrate levels of intimacy in the group, and can model healthy interpersonal functioning. This is a three-day experiential workshop for intermediate-advanced group leaders.

BRIEF TREATMENT OF THE PERSONALITY DISORDERS: THE POSSIBLE AND THE IMPOSSIBLE

Most clients with a diagnosis of personality disorder would prefer therapy to be briefer rather than longer. Honoring the nature of the client’s commitment for change requires understanding that the client’s construction of reality may be quite different from that of the therapist. As if matters were not difficult enough, counter-transference reactions are inevitable when working with these clients. In spite of this, effective and efficient treatment of the client with a personality disorder is possible, provided the therapist is armed with the tools necessary to disentangle the spoken and unspoken narratives embedded in the client’s presenting material. A video case presentation will be provided to elucidate the various therapeutic choice points necessary to determine the nature of the client’s readiness-for-change. Participants will be shown three easy questions that help assess the manner in which the client’s motivational structure lies embedded within the presenting issue, whether the client is motivated to work on Axis I or Axis II material, hidden obstacles that impede change, how to maintain an attitude of compassion on a bumpy day, how to use manage the client’s energy for change with energy and precision and how to enjoy rather than be overwhelmed working with these clients!

ADVANCED ISSUES IN RECOVERY MAINTENANCE: THE KEY TO SUCCESSFUL TREATMENT

Research on the nature of change across a number of health-behaviors has shown that as hard as it is to initiate behavior change, it is even harder to maintain change over time. Many of today’s clients have had multiple treatment experiences and subsequent failures. In spite of this, addictions treatment programs continue to propagandize rather than involve the client and their family system in any significant way. Initial assessment is too often considered pro forma rather than a collection of data that helps explain the client’s life narrative to the point of intake. The research is now showing that increasing focus on treatment processes, rather than treatment content, enriches the client’s experience and improves treatment outcomes. This one-day intensive workshop will identify patterns of recovery as well factors within the treatment experience and in the client’s naturalistic environment that have been shown to be significant predictors of behavior maintenance over time. Participants will be provided with an evidence-based Relapse Risk Checklist that can be used to guide treatment efforts.

Cognitive-Behavioral Treatment of Substance Use Disorders

The goal of cognitive-behavior therapy is to unpack values, attitudes and beliefs that motivate addictive behaviors. We know that the factors that shape development of an addictive disorder are different from the factors that perpetuate the behavior. Understanding that there is a family history of alcohol and drug use problems (genetic component) is illuminating, and can help relieve guilt, but it does not help the person know what to do next. A CBT treatment plan aims to identify motivational, behavioral and environmental components that shape and maintain the problem, as well as uncovering which factors need to be modified in recovery.

Michele Packard PhD

TO SCHEDULE A TRAINING, CONTACT US:
Sage Institute for Training
Michele A. Packard PhD
Ph 303.443-3920 Fx 303.413-8140
e-mail: sageinstitute@comcast.net
4410 Arapahoe, Suite 140 Boulder, CO 80301

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