Pre-Meeting Institutes (PMI)

Pre-Meeting Institutes are full or half day sessions that provide opportunities for intensive training on topics integral to the conference program, presented by leaders in the field.

FULL DAY INSTITUTES
8:30 a.m. – Noon, 1:30 – 5:00 p.m.

PMI – 01: Behavioral Sleep Medicine Interventions for Trauma-Related Sleep Disturbances: Cognitive Behavioral Therapy for Insomnia and Exposure, Relaxation, and Rescripting Therapy for Chronic Nightmares


HALF DAY INSTITUTES - MORNING
8:30 a.m. – Noon


PMI – 02: Keeping Traumatic Stress Patients’ Electronic Data and Communication Private and Secure: Ethical and Legal Issues, and Applied Software Applications

PMI – 03: Systematic Delivery of Exposure, Cognitive, and Behavioral Treatments for PTSD with a 16-Week Manualized Group Protocol

PMI – 04:The Interpersonal Paradox of Trauma: Principles and Practice of Treating Trauma in Couple and Family Systems

PMI – 05: Addressing Trauma and Grief in Adolescence: New Models, Measures, and Interventions

PMI – 06: Trauma-Informed Primary Care: A Practical Approach


HALF DAY INSTITUTES - AFTERNOON
1:30 – 5:00 p.m. 


PMI – 07: Ethics for the International Trauma Specialists

PMI – 08: Dropping the Trauma Account: Intro in to Cognitive Processing Therapy-Cognitive Only

PMI – 10: Learning To Effectively Administer and Score the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)

PMI – 11: Working with PTSD in Refugees and Asylum Seekers

 

Wednesday, November 9, 2016
Full Day Institutes
(8:30 a.m. – Noon and 1:30 – 5:00 p.m.)

PMI  - 01                                  

Behavioral Sleep Medicine Interventions for Trauma-Related Sleep Disturbances: Cognitive Behavioral Therapy for Insomnia and Exposure, Relaxation, and Rescripting Therapy for Chronic Nightmares


Keyword: Training/Education/Dissemination
Secondary Keywords: Clinical Practice, Sleep, Training/Education/Dissemination
Population Type: Adult
Presentation Level: Introductory
Region: Global

Pruiksma, Kristi, PhD1; Micol, Rachel, BS2; Taylor, Daniel, PhD3
1University of Texas Health Science Center at San Antonio, Fort Hood, Texas, USA
2The University of Tulsa, Tulsa, Oklahoma, USA
3University of North Texas, Denton, Texas, USA


Nightmares and sleep disturbances are commonly reported following trauma and are considered the hallmark of posttraumatic stress disorder (PTSD). Historically, sleep disturbances have been conceptualized as secondary symptoms that will remit following PTSD treatment. However, coalescing lines of research indicate sleep disturbances are more than just PTSD symptoms, have likely become partially independent, and may be maintaining and exacerbating PTSD. Sleep disturbances may also remain following successful treatment of PTSD and are uniquely related to suicidality, depression, and substance use. There is strong evidence supporting non-medication treatments for insomnia and nightmares, yet many providers have not received adequate training in the implementation of these interventions. Thus the goals of this PMI are to (1) present the evidence base for cognitive behavioral therapy for insomnia (CBT-I) and Exposure, Relaxation, and Rescripting Therapy (ERRT) for nightmares and (2) to provide step-by-step guidance on how to implement these interventions in clinical practice. We will achieve these goals by presenting case examples, providing handouts to be used in clinical practice, video demonstrations as well as audience exercises to further reinforce the utility of these treatments.
 

Wednesday, November 9, 2016
Half-Day Institutes
(8:30 a.m. – Noon)


PMI - 02                                  

Keeping Traumatic Stress Patients’ Electronic Data and Communication Private and Secure: Ethical and Legal Issues, and Applied Software Applications

Keyword: 
Technology
Secondary Keywords: Clinical Practice, Ethics
Population Type: Not Applicable
Presentation Level: Introductory
Region: Global

Elhai, Jon, PhD
University of Toledo, Toledo, Ohio, USA

In recent years, mental health professionals have increasingly incorporated information technology into patient care, including use of smartphones, tablets and laptops for electronic communication, psychological assessment, homework assignment completion and record keeping. Yet weaknesses exist in these technologies that can put patient privacy at risk. This issue is especially salient when working with traumatic stress patients, given the sensitive nature of narrative discussion that happens in trauma-focused psychotherapy (e.g., exposure interventions). In this workshop, issues of ethics, privacy and security of such technology will be discussed in regard to the treatment of traumatic stress patients. Common vulnerabilities empirically found with electronic privacy among mental health clinicians will be detailed. HIPAA regulations related to electronic security will be discussed. An introduction to the concept of “encryption” and its application to traumatic stress practice will be emphasized. I will also explain the relevance of social psychological theory on protection motivation to explaining successful adoption of electronic security practices. Discussion and details are offered on free, easy to use software application solutions for securing patient communication and records. Also discussed are such issues as using encrypted wireless networks, secure email, encrypted messaging and videoconferencing, privacy on social networks, and others. For non-technologically savvy users, this discussion will likely be unfamiliar; though the information will be presented in very basic, non-technical terms. Even for advanced, technologically savvy users, a good deal of this information will likely be unfamiliar and of interest.
 

PMI - 03                                  

Systematic Delivery of Exposure, Cognitive, and Behavioral Treatments for PTSD with a 16-Week Manualized Group Protocol

Keyword: 
Clinical/Intervention Research
Secondary Keywords: Clinical Practice, Cognitive Processes/ Interventions, War – Military/Peacekeepers/Veterans, Gender and Trauma 
Population Type: Adult
Presentation Level: Advanced
Region: Industrialized Nations

Castillo, Diane, PhD1; C'de Baca, Janet, PhD2; Chee, Christine, PhD2; La Bash, Heidi, PhD1
1VA VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, USA
2New Mexico VA Healthcare System, Albuquerque, New Mexico, USA

This is a two-part advanced workshop for clinicians wishing to use a group format to deliver exposure, cognitive, and behavioral treatments for PTSD. The first hour will cover the group literature, challenges to group treatment, and results from a unique 3-member randomized controlled trial with three treatment modules. The manualized 16-week group treatment showed improvement in PTSD (24-point decrease on the CAPS, p<.001, ES=1.72); on functioning (SF-36: Mental: p<.001, ES=1.31; and Physical, p<.001, ES=1.08); and in quality of life (QOLI: p<.001, ES=1.01) in a sample of female OEF/OIF PTSD Veterans. Clinical improvement was comparable to individual PE (Schnurr, et al., 2003), with 77% showing a response to treatment and 52% loss of diagnosis. PCL scores significantly improved for the Exposure (ES=1.42) and Cognitive (ES=0.90) modules, with both superior to the behavioral (Skills) module.
The second part of the workshop will be devoted to providing direction on how to conduct the novel 3-member, 3-module (Exposure, Cognitive, Skills) group treatment protocol. Instruction will include a combination of didactics, instructor demonstrations, and role play for attendees. Most unique to the protocol is conducting imaginal exposure in a 3-member, 90-minute group, with weekly in-session imaginal exposure for each group member. This protocol design addresses the logistic problem of exposure therapy in group. Orientation and Wrap up are conducted in sessions 1 and 16, respectively. Exposure Module (5 sessions). The rationale, identification of safety options, and index trauma are addressed in session 1. Guided imaginal exposure (Keane, et al., 1989; Foa, et al., 2007) is conducted in sessions 2 through 5, with 30 minutes devoted to each member. Cognitive Module (5 sessions). General cognitive restructuring is taught in session 1, with cognitive distortions on 5 themes (safety, trust, power/control, esteem/intimacy) from Cognitive Processing Therapy (Resick & Schnicke, 1993) challenged in sessions 2-5. Skills Module (4 sessions). Behavioral strategies including assertiveness training are implemented in sessions 1 and 2; and videotaped assertiveness roleplay in sessions 3 and 4. Relaxation techniques are reviewed and practiced in the last 30 minutes of each Skills session. Workshop participants will receive a manual describing the group protocol, including handouts for each treatment component. Participants will be encouraged to: actively participate in roleplays as a group facilitator; identify potential issues; and discuss components of successful group treatment. The group protocol is a practical and effective delivery option that systematically includes exposure, cognitive, and behavioral components for PTSD treatment.
 

PMI - 04                                  

The Interpersonal Paradox of Trauma: Principles and Practice of Treating Trauma in Couple and Family Systems

Keyword: 
Clinical Practice
Secondary Keywords: Family Relationship Processes/ Interventions - Theory
Population Type: Both Adult and Child/Adolescent
Presentation Level: Intermediate
Region: Global

Nelson Goff, Briana, PhD1; Oseland, Lauren, MS, PhD Student1; Schwerdtfeger Gallus, Kami, PhD, LMFT2; Kiser, Laurel, PhD MBA3; Dekel, Rachel, PhD4
1Kansas State University, Manhattan, Kansas, USA
2Oklahoma State University, Stillwater, Oklahoma, USA
3University of Maryland School of Medicine, Baltimore, Maryland, USA
4Bar-Ilan University, Ramat Gan, Ramat Gan, Israel


While the study of psychological trauma has traditionally focused on the development of individual symptoms in the person directly exposed to a traumatic event, research over the past 20 years invites a more dynamic conceptualization of the recursive relationship between trauma, interpersonal relationships, and broader contextual factors that influence the expression and duration of traumatic stress (e.g., Figley & Kiser, 2013; Goff & Smith, 2005). Trauma exposure is a multifaceted and complex experience that uniquely impacts individual survivors, their loved ones, and the social systems in which they live. In particular, there appears to be a basic, yet important paradox involved within the interpersonal context of trauma as trauma frequently erodes the strengths of and has a negative impact on the very interpersonal relationships that could promote recovery and posttraumatic growth (Johnson, 2002). Due to the interpersonal nature of trauma, traditional intervention and recovery-focused therapy on an individual level may be inadequate. In Part 1 of this PMI, the presenters will describe models of systemic trauma, based on current theories, research, and clinical experience, including Family Systems Theory, Ecological Systems Theory, and Attachment Theory. Specifically, The Couple Adaptation to Traumatic Stress Model (Goff & Smith, 2005; Oseland, Gallus, & Nelson Goff, 2016) and the Family Adaptation to Trauma Model (Figley & Kiser, 2013) will be reviewed. The presentation will disseminate information regarding the presented models, the primary issues faced by traumatized systems (i.e., couple, family, and community), and methods to apply these models to empirical study of and clinical approaches with traumatized systems. In Part 2 of this PMI, the presenters will describe methods of engaging couple and family systems in trauma-informed systemic treatment approaches. This session will focus on practical skills for working systemically with couple and family systems, recognizing critical ethical issues in working with these groups, and addressing specific challenges that may be unique to trauma-exposed relational systems. Presenters have experience working in industrialized and developing countries with couples, families, and communities coping with traumatic stress. Thus, the aim of this session is to provide applicable knowledge for clinicians from diverse backgrounds to bridge the gap between empirical and clinical approaches to working with trauma survivors and their families.
 

 PMI - 05

Addressing Trauma and Grief in Adolescence: New Models, Measures, and Interventions

Keyword: 
Clinical/Intervention Research
Secondary Keywords: Death/Bereavement - Developmental Processes/ Interventions - Public Health - Traumatic Grief
Population Type: Child/Adolescent
Presentation Level: Intermediate
Region: Global

Saltzman, William, PhD(c)1; Layne, Christopher, PhD2; Kaplow, Julie, PhD, ABPP3; Pynoos, Robert, MD MPH2; Olafson, PhD, PsyD, Erna, PhD, PsyD4; Marrow, Monique, PhD5
1California State University, Long Beach, Long Beach, California, USA
2UCLA - National Center for Child Traumatic Stress, Los Angeles, California, USA
3University of Texas Health Science Center, Houston, Texas, USA
4University of Cincinnati, Cincinnati, Ohio, USA
5University of Kentucky Center for the Study of Violence Against Children, Lexington, KY 40506, Kentucky, USA


Converging developments in basic and applied research suggest that posttraumatic stress and grief reactions are related yet different entities that call for different assessment measures and intervention components. Further, trauma and bereavement often co-occur, especially among adolescents—an age group at highest risk for exposure to violent crime, traumatic injury, and traumatic death. This PMI will cover recent advances in the treatment of the effects of trauma and bereavement in adolescence, including an evidence-based intervention for traumatized and bereaved adolescents—Trauma and Grief Component Therapy for Adolescents (TGCT-A). TGCT-A is an assessment-driven, modularized intervention that can be flexibly tailored according to the exposure histories, needs, strengths, and life circumstances of specific groups and individuals. We will begin with an overview of the developmental tasks, capacities, and needs of adolescents, and the window of opportunity offered by adolescence for intervention. We will then discuss recent advances in conceptualizing, assessing, and treating the interplay between trauma and bereavement as viewed through the lens of multidimensional grief theory. We will then present findings from domestic and international open field trials, qualitative studies, and a large-scale randomized controlled field trial, which show consistent evidence of the effectiveness of TGCT-A in reducing posttraumatic stress and maladaptive grief reactions, and improving academic performance, peer relationships, and pro-social behaviors. We will then discuss how TGCT-A components, paired with properly designed assessment measures, can be tailored to provide universal (broad-spectrum), targeted (specialized), and preventive (resilience-enhancing) services in school, juvenile justice, and child welfare settings. We illustrate methods for providing state-of-the-art treatment for posttraumatic stress and grief reactions to vulnerable adolescents with complex histories of trauma and loss in ways that abide by public health principles—including identifying high-risk groups, stratifying groups by exposure severity and type of need, and improving access to services. Given its utility for juvenile justice, we will review a recently published multi-year evaluation of TGCT-A paired with trauma-informed staff training (Think Trauma) at six residential facilities, which found significant pre-post reductions in posttraumatic stress, depression and anger symptoms, seclusions, and restraints. We will conclude with demonstrations of ways to use TGCT-A’s modularized design to customize intervention for either groups or individuals with different assessment profiles, as well as discussion of next steps in research and program dissemination.
 

PMI - 06                                  

Trauma-Informed Primary Care: A Practical Approach

Keyword: 
Clinical Practice
Secondary Keywords: Health Impact of Trauma - Primary Care
Population Type: Both Adult and Child/Adolescent
Presentation Level: Intermediate
Region: N/A

Ayres, Jennifer, PhD1; Sitterle, Karen, PhD2
1University of Texas at Austin, Austin, Texas, USA
2University of Texas Southwestern, Dallas, Texas, USA

Patients who are reluctant to self-refer for psychotherapy are often more receptive to receiving behavioral health services integrated into medical care. Intervention with patients with histories of recent or past trauma presenting for primary care gives medical and mental health providers an opportunity to address the neurobiological aspects of trauma in an integrated fashion that fosters interdisciplinary collaboration. This pre-meeting institute (PMI) will address (1) the unique challenges and benefits of intervening with trauma survivors in primary care settings, (2) how to provide interdisciplinary trauma training that addresses impact of traumatic life events on patient health, (3) quick and efficient screening for trauma history, intimate partner violence, traumatic grief & loss, trauma due to injury, illness, or medical procedures (4) the continuum of trauma-informed interventions ranging from single session, short-term (EBTs), and patient education, and (5) how to provide linkage to community resources, including outpatient behavioral health, shelter, legal resources.
Providers in primary care settings find themselves addressing the needs of survivors of abuse, natural & manmade disasters, traumatic grief & loss, medical trauma, and intimate partner violence. Interventions need to recognize the common clinical needs of survivors (e.g., coping with emotional & physical pain, grief & loss, finding meaning following painful experiences, and self-identity shifts from trauma victim to survivor) and simultaneously be flexible enough to address trauma-specific needs of survivors (e.g., avoidance issues, preparing for anticipated trigger situations).
This PMI will focus on how to overcome barriers and limitations to providing trauma-informed care in primary care settings (e.g., short appointment slots, busy schedules, lack of resources for mental health services, limited financial and transportation resources, and treatment adherence issues). Case examples will be presented.

 

Wednesday, November 9, 2016
Half-Day Institutes
(1:30 – 5:00 p.m.)

 

PMI - 07         
                         
Ethics for the International Trauma Specialists

Keyword: 
Global Issues
Secondary Keywords: Ethics - Global Issues - War – Civilians in War 
Population Type: Mental-health Professionals 
Presentation Level: Intermediate
Region: Global

Cherepanov, Elena, PhD
Cambridge College, Boston, Massachusetts, USA

An international trauma specialist provides services to highly vulnerable and culturally diverse populations around the world. The unprecedented scale of human suffering, complexity of psychological needs and limited resources create particular professional and personal challenges and puts special demands on making independent, responsible and ethical decisions in extraordinary and often unique circumstances. Adherence to ethical principles sets standards for practice, gives a sense of professional community (Williams, 2012) and ensures a shared framework in every humanitarian response. The international perspective offers a guidance for the competent trauma care based on the international humanitarian principles: humanity, neutrality, impartiality, and independence (UNOCHA, 2012). In the first part of the training, the participants will learn about international humanitarian norms, universal humanitarian values, and limits of humanitarian actions as they apply to the trauma work and research. In the second part, participants will use case scenarios to further explore the role and responsibility of an international trauma specialist in the setting with complex needs; moral, cultural and ethical dilemmas; advocacy, media and communication; and ethically questionable practices: rescue fantasy, imposing moral judgments; fostering psychological dependence; misuse of power, or ignoring survivors’ competency. The review of the signs and consequences of the burnout in the field work highlights the importance of self-awareness and self-care as corner stones of the professionalism, and offers relevant coping skills.  
 

PMI - 08                                  

Dropping the Trauma Account: Intro in to Cognitive Processing Therapy-Cognitive Only

Keyword: 
Clinical Practice
Secondary Keywords: Clinical/Intervention Research - Clinical Practice - Cognitive Processes/ Interventions 
Population Type: Adult 
Presentation Level: Introductory
Region: Industrialized Nations

Dondanville, Katherine, PsyD1; Resick, Patricia, PhD, ABPP2
1University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
2Duke University Medical Center, Durham, North Carolina, USA

CPT is an evidence-based cognitive therapy for PTSD and comorbid symptoms that can be implemented without a written account. For over a decade trainings in Cognitive Processing Therapy (CPT) have exclusively taught CPT including the trauma account as an assignment.  Results from a dismantling study (Resick et al., 2008) indicate the trauma account is a non-essential element for symptom change.  CPT- Cognitive Only (CPT-C) was found to be equally effective and more efficient than utilizing the traditional model.  Most importantly, eliminating the trauma account may prevent patient drop-out.  The purpose of this institute is to provide attendees the basics of cognitive processing therapy – cognitive only (CPT-C) and facilitate a discussion about making the transition for those practicing CPT with the trauma account. Clinicians may be more comfortable with providing the version of CPT that does require writing and reading a trauma account or may have been in the habit of doing so and are unsure of how to conduct the protocol without the written narrative.  CPT-C is a systematic approach to treating PTSD in which participants are encouraged to feel their emotions and learn to think about their traumatic events differently. The institute includes a functional cognitive description of why some people do not recover after traumatization. Following a review of research on CPT-C, participants will receive an overview of the 12-session therapy, with an emphasis on the differences between CPT and CPT-C. The use of Socratic Dialogue to facilitate emotional processing will be reviewed, along with research regarding who may respond better to treatment with or without a trauma narrative. Specific trauma details will be discussed and presented in video-recorded sessions. Role-play and consultation will be included.
 

PMI - 09                        

Use of Expert Evidence on Counterintuitive Victim Behavior in Sexual Assault Prosecution

Keyword: 
Training/Education/ Dissemination
Secondary Keywords: Domestic Violence - Rape/Sexual assault - Social Issues – Public Policy - Gender and Trauma
Population Type: Adult
Presentation Level: Introductory
Region: Industrialized Nations

Mechanic, Mindy, PhD
California State University, Fullerton, Fullerton, California, USA

The goal of the proposed PMI is to provide trauma professionals with education and training on the use of expert testimony on counterintuitive victim behavior in sexual assault prosecutions. Such training will provide trauma professionals with valuable knowledge, enabling them to share their knowledge with judges and juries. The term “counterintuitive victim behavior” (CIVB) refers to behavioral, emotional, or physical responses observed among, or reported by trauma/crime victims that can be understood within the context of that trauma/victimization, but which lay persons fail to understand or misunderstand due to lack of information, myths and stereotypes or other misconceptions held about how ‘real’ victims behave or ought to behave.  It includes actions, behaviors, feelings, and other responses, in addition to failures to respond in expected ways. Courts across the U.S. have admitted CIVB testimony in the prosecution of sexual assault.  When lay persons fail to accurately understand the reality of IPA/sexual assault, they apply their own incorrect assumptions about how ‘real’ victims do or should behave, consequently judging victims as not credible and dismissing their accounts as lacking veracity. Expert testimony on CIVB can help to rebut prevailing myths and misunderstandings about the nature of, and responses to sexual assault, particularly non-stranger sexual assault, in contrast to the prevailing ‘stranger danger’ mythology.  Expert testimony can be used to provide a framework or context, within which to interpret a sexually assaulted woman’s behavior, helping to make sense out of the unimaginable things that simply do not make logical sense when viewed out of the unique context in which they occurred. This is particularly true for acts that defy lay expectations, e.g., compliance perpetrator demands, lack of forceful resistance, and lack of affect post-assault.  CIVB evidence offers jurors a framework for fairly interpreting and evaluating victim accounts without dismissing them as disingenuous.  In addition to myths and misunderstandings about how victims respond to sexual assault or IPSA, many aspects of trauma-related behavior are unfamiliar and counterintuitive to them. Such topics include: traumatic memory; delayed reporting/disclosure; lack of affect when recounting the assault; incomplete or inconsistent statements to the police or other providers; continued contact with the alleged offender, particularly in non-stranger sexual assault cases; returning to life as usual following assault.


 PMI - 10                                  

Learning To Effectively Administer and Score the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)

Keyword: 
Assessment/Diagnosis
Secondary Keywords: Clinical Practice - Research Methodology - Training/Education/ Dissemination
Population Type: N/A
Presentation Level: Intermediate
Region: N/A

Bovin, Michelle, PhD1; Weathers, Frank, PhD2
1VA Boston Healthcare System, National Center for PTSD; Boston University School of Medicine, Boston, Massachusetts, USA
2Auburn University, Auburn, Alabama, USA

Reliable and valid assessment of posttraumatic stress disorder (PTSD) is essential for correctly identifying individuals with this debilitating disorder. Structured diagnostic interviews are considered the “gold standard” for assessing PTSD symptoms and establishing PTSD diagnostic status (Bovin, Marx, & Schnurr, 2015). Since its development in 1990 at the National Center for PTSD, the Clinician-Administered PTSD Scale (CAPS; Blake et al., 1990) has become the most widely used structured interview for PTSD (Bovin & Weathers, 2012). In response to the significant revisions made to the PTSD diagnosis for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013), the CAPS was recently revised to reflect the new criteria. The goals for the revision were to ensure correspondence with DSM-5, retain distinctive features and maximize backward compatibility with earlier versions of the CAPS, and streamline administration and scoring (Weathers, 2014). Initial evaluation of the CAPS-5 indicates that it maintains the excellent psychometric properties of its predecessors (Weathers et al., in preparation).
Because the DSM-5 PTSD criteria constitute the current official definition of PTSD and reflect an updated conceptualization of the disorder, it is essential for clinicians and investigators to begin using DSM-5-compatible measures such as the CAPS-5 as soon as possible -- measures reflecting DSM-IV criteria are now outdated. However, because of the changes made to both the structure and the content of the CAPS-5, careful training on the new version of the instrument is required to ensure that the measure is administered and scored accurately. Accordingly, the purpose of this pre-meeting institute is to provide attendees with an in-depth examination of the CAPS-5 so they can begin to use it effectively in their own clinics and laboratories. This important and timely workshop will review the following topics:
(1) The history of the CAPS and the rationale for the new format for the CAPS-5;
(2) The three versions of the CAPS-5 and when each can be employed effectively;
(3) Guidelines for standard administration and scoring;
(4) Tips for effectively handling common challenges that occur during CAPS-5 interviews.
 
In order to provide a “hands-on” training experience, participants will watch a live mock CAPS-5 interview, score each item in real time, and have the opportunity to ask questions about the rationale behind administration and scoring decisions.
 

PMI - 11                                  

Working with PTSD in Refugees and Asylum Seekers

Keyword: 
Clinical Practice
Secondary Keywords: Culture/Diversity - Refugee/Displacement Experiences - Theory - Torture
Population Type: Adult
Presentation Level: Intermediate
Region: Industrialized Nations

Young, Kerry, PhD
Central and North West London NHS Foundation Trust, London, England, United Kingdom

Many countries across the world have seen a dramatic increase in the number of people seeking asylum. Currently, there are thought to be approximately 19 million official refugees worldwide (UNHCR, 2016). While estimates vary, we expect up to half of those seeking asylum to suffer from PTSD (Bogic et al., 2012; Turner et al., 2001). Thus, there is a pressing need for evidence-based interventions for treating PTSD in this group.
There are well-established protocols for the effective treatment of PTSD using trauma-focused therapies (e.g. Ehlers et al. 2005; McLean and Foa, 2011; Resick et al., 2012). However, there is relatively little information about how to adapt these therapies for PTSD resulting from multiple traumatic events in refugee populations. Currently, the weight of what evidence there is points to the effectiveness of Narrative Exposure Therapy (NET)(Schauer, Neuner & Elbert, 2005) in the treatment of multiply traumatized refugees and asylum seekers (see Robjant and Fazel, 2010 for a review). There has also been some work adapting Cognitive Processing Therapy (CPT) (Kaysen et al., 2011; Bass et al., 2013) and standard Imagery Re-scripting (ImRS) protocols in this population (Arntz et al., 2013).
In this workshop, I will give participants a theoretical and practical framework for the cognitive-behavioural assessment and treatment of refugees and asylum seekers with PTSD, using the aforementioned evidence base as a guide. Topics covered will be:
- Working with interpreters
- Cultural modifications of trauma-focused therapy
- What to consider at assessment
- What theoretical framework to use for formulation
- Treatment planning
- How to do reliving and other evidence-based treatments with people who have experienced multiple traumatic events
- Outcome research in this area 
The workshop will involve formal presentations, case discussion, lots of video role-play of techniques and group discussion.