Skills for Working with Resistant Clients

A Live, Interactive Webconference
Wednesday, March 8, 2023, via Zoom Interactive Webconference
8:25am-12:35pm

Resistance and defensiveness can be a normal part of the treatment process for behavioral health providers working in the community. Regardless of experience level, clients who present as resistant, defensive, or disengaged can be challenging. In this workshop, common presentations of resistance are identified, as well as the ways each can impact treatment. A framework is provided for understanding what gives rise to client resistance, identifying contextual factors in the therapeutic relationship, as well as what the client brings via their relational history and personality style. This workshop provides approaches and techniques behavioral health providers can use to overcome resistance, repair ruptured alliances, and foster engagement with distrustful clients. Attendees will learn about common defense mechanisms and ways to skillfully deal with them in treatment using evidence-informed, best practice guidelines drawn from Person-Centered Care and Motivational Interviewing. Specific case examples and illustrations will be used to highlight concepts and principles

As a result of participating in this training, attendees will be able to:

Identify three common types of defense mechanisms and give an example of how each can show up and interfere with individual and family therapy.
Identify three or more common sources of resistance and defensiveness in individual and family therapy.
Describe applications of Person-Centered Care to building rapport and repairing therapeutic ruptures
Describe applications of Motivational Interviewing to engagement and buy in, as well as resistance/non-engagement

Agenda

8:25am-10:30am: Focus on Objectives 1 & 2
10:30am-10:40am: Break
10:40am-12:35pm: Focus on Objectives 3 & 4

This is an intermediate level course. The target audience is behavioral health professionals working within an Ecosystemic Family Therapy Model. This is a live synchronous distance learning activity conducted in real time, allowing for simultaneous participation of participants and instructors from different locations.

About The Trainer
Hailey Shafir is a licensed clinical mental health counselor, a licensed addiction specialist, and a board-approved clinical supervisor for newly licensed mental health and addiction counselors. She has more than a decade of experience providing counseling, developing programs for at-risk youth, people struggling with addictions, and providing training and supervision for clinicians. She is the owner of several businesses including Keep Counsel, Plan-it Therapy, IndyWind, and Therapy Cred. Hailey is also a content writer and medical peer reviewer for Addictions.com, the National Drug Helpline, Choosing Therapy, Rehab Adviser, Searchlight, Social Pro Now, and other sites, and has worked to develop online recovery apps and programs for people struggling with addictions and impulse control disorders.

Frequently Asked Questions
Visit our FBMHS Policies & FAQs on Live, Interactive Webconferences for additional information regarding CFBT live interactive workshops, accommodations for disabilities, reporting problems with the training, instructions for registering for a training, etc.

Recognizing Maladaptive Structural Patterns
In Families

A Live, Interactive Webconference
Thursday, 10/26/22, Venango County Human Services via Live Interactive Zoom
8:30am-12:30pm

In systemic therapies, a major focus of assessment when treating children and adolescents with severe emotional and behavioral problems is the relational context of the family. The link between family functioning and the course of child problems is well-established in the empirical literature. This workshop focuses on the use of informal direct clinical observation of family interactions to identify structural patterns related to enmeshment, under organization, and coercive/authoritarian parenting. Implications for family treatment direction is provided for each of the three maladaptive structural patterns described in the training.

Objectives

As a result of participating in this workshop, therapists will be able to:

Explain the nature of family structure
Identify three maladaptive family structures linked to SED in children and adolescence.
Describe interactional patterns that distinguish each maladaptive family structure
Describe how family structure can be used to organize treatment

Agenda
8:30am-12:30pm: Objectives 1-3

This is an intermediate level course. The target audience is behavioral health professionals. This is a live synchronous distance learning activity conducted in real time, allowing for simultaneous participation of participants and instructors from different locations.

Ethical Uses of Power
In the Therapeutic Relationship

A Live, Interactive Webconference
Wednesday, September 14, 2022, via Zoom Interactive Webconference
8:25am-12:35pm

Power is a highly misunderstood and loaded word, but one highly relevant to the therapeutic relationship. A power differential is always present in the therapeutic relationship, and can be used effectively, ineffectively, or even abused. The ‘right’ use of power in the therapeutic relationship involves developing an awareness of the power differential, the implications for clients and families served, and a thoughtful application of our ethical codes.

This training will challenge clinicians to rethink the definition of power and dispel myths and biases around the word that can hinder the ethical, right use of power in therapy. Clinicians will learn about relevant research about power imbalances between counselors and clients and common misuses and abuses of power. Clinicians will be provided with interactive case studies, discussions, and breakout groups to further explore the ‘right’ uses of power in a variety of clinical situations.

As a result of participating in this training, attendees will be able to:

Participants will learn about common myths and biases about power that can undermine the effectiveness of individual and family therapy and develop a more adaptive definition of power
Participants will learn about the research on power differentials in the therapeutic relationship and common ways counselors underuse, overuse, misuse and abuse power with clients and families
Participants will learn about the link between the ‘right’ use of power in relation to strong rapport and therapeutic alliances, engagement in treatment, and positive outcomes in individual and family therapy
Participants will apply the APA and ACA code of ethics to demonstrate the right uses of power in realistic case studies, ethical dilemmas, and clinical situations relevant to family and individual counseling

Agenda

8:25am-8:45am: Introductions & overview of agenda & course format
8:45-10:30am:
– Clarifying what power is, dispelling common biases, myths and misconceptions about power that can undermine treatment, and reviewing research on effective and ineffective uses of power in the therapeutic process
– A review of common myths and biases about power that can undermine outcomes in therapy with individuals and families
– A working definition of power as the ability to influence and direct change and literature on the power differentials present in the therapeutic relationship
– A self-assessment of power aimed at helping attendees identify the power they have in their personal and professional lives
– A review of 9 different types of power and those most relevant and useful to the therapeutic process, with examples and emphasis of effective/ineffective uses of power
10:30-10:40am: Break
10:40-12:00pm:
– Examining power differentials in therapy, common uses, misuses, and abuses of power in the therapeutic relationship, and effective uses of power that are guided by ethical codes and guidelines
– A discussion about the actions and approaches of effective therapists including when, why and how they use their power according to research
– A review of the impact of right uses of power on therapeutic rapport and alliance, engagement in treatment, and outcomes in individual and family therapy
– A review of common misuses and abuses of power in the therapeutic relationship including ethical and boundary violations
– An examination of key components of the APA and ACA code of ethics with interactive discussions on how these apply to the ‘right use of power’ in realistic case studies, ethical dilemmas, and clinical situations
12:20-12:35pm: Wrap up, summary, and Q & A

Helping Clients Overcome FONO (Fear of Normal)

Cost: This program is sponsored by the Catholic Charities Diocese of Harrisburg and is free to all staff

A Live, Interactive Webconference
Wednesday, June 15, 2022, Catholic Charities via Live Interactive Zoom
8:25am-12:35pm

This workshop reviews key recent findings about the widespread mental health effects of the pandemic, providing a big picture perspective on changes in both patients and providers’ current needs that need to be considered in post pandemic lock-down delivery of behavioral health services. An emerging body of research suggests that many Americans report negative mental health effects related to the primary and secondary effects of the COVID-19 pandemic, with a sharp rise in rates of anxiety, depression, addiction, fatal overdoses, and suicide during the pandemic. Unsurprisingly, those most affected are the most vulnerable in our society, including kids, teens, young adults, people with pre-existing mental illnesses or other social, cultural, and economic disadvantages. The demand for counseling has never been greater, behavioral health providers are struggling to meet the increased demand for their services. Higher rates of burnout, vicarious trauma, and personal hardships and impacts related to the direct and indirect effects of the pandemic have further strained our field.

As societies around the world re-open from quarantine, a growing number of people (including providers) are reporting re-entry anxiety, which in public media has been referred to as fear of returning to normal (FONO). These include transitions back into basic socializing, going back to school or into the workplace, attending large public events, traveling, etc. Although too recent a phenomenon to have an established body of empirical studies to determine prevalence and course, this training uses available polls as a rough guide (e.g., APA, 2021). A comprehensive overview of FONO is provided in this training, linking this phenomenon to what we know from established psychological science regarding heightened anxiety in times of uncertainty, particularly for anxiety sensitive people. Implications for supporting and/or treating people reporting FONO are provided based on the current established evidence-based practice related to managing or overcoming anxiety, with the goals of returning to pre-pandemic routines.

Objectives
As a result of participating in this workshop, therapists will be able to:

Describe the most reported mental health effects of the COVID-19 pandemic and which populations are most at risk of being affected
Identify common mental health symptoms which may be related to FONO
Identify the changing needs of patients and the requisite adaptations in the delivery and structure of psychological practice for meeting these needs
Identify evidence-informed methods to support clients and families struggling with post-pandemic transitions

Agenda:

8:25am-8:45am: Introductions & overview of agenda & course format
8:45am-9:30am: Review of direct and indirect effects of the pandemic on mental illness, risk and protective factors, and populations most likely to be affected
9:30am-10:30am: Introduction to the term “FONO”, research and studies that illustrate this phenomena, case examples, and differential diagnosis. Examining key differences between FONO as an adjustment disorder vs chronic mental health conditions including anxiety and mood disorders, OCD, PTSD, and SUD
10:30am-10:40am: Break
10:40am-12:00pm: Implications of post-pandemic societal changes affecting the field of mental health and the role, setting, and structure of individual and family treatment, introduction to a variety of evidence-informed interventions to help clients and families with FONO successfully transition to pre-pandemic routines
12:20-12:35pm: Wrap up, summary, and Q & A

What Didn’t Get to Happen: Understanding & Healing From the Lasting Effects of Childhood Trauma

Cost: This program is sponsored by the Catholic Charities Diocese of Harrisburg and is free to all staff

A Live, Interactive Webconference
Wednesday, March 16, 2022, Catholic Charities via Live Interactive Zoom
8:30am-12:30pm

Extensive research, much of it based on ACE studies has shown that childhood trauma can have many adverse physical, social, and emotional effects that can persist across the lifespan. This training distinguishes between single incident PTSD and chronic exposure to multiple childhood traumas (e.g., neglect, abuse, witness to violence, etc.) associated with complex trauma. Studies related to the latter informs most of the content presented in this training. This workshop provides an in-depth review of the most common effects of complex trauma and provides specific examples of ways these effects can present later in life. Clinicians will also learn about specific relationship patterns, psychiatric problems, and physical health problems that are commonly reported by adults who have experienced early complex trauma.

This training conceptualizes an individual’s response to trauma as dynamic, influenced by the relationship between factors associated with risk, resilience, and aspects of the individual’s social ecology (environment) that promote and protect against the negative impact of exposure to traumatic events. It is in this context that measures of resilience can be useful in treatment. Measures that can be used with children and for adults are described. Protective factors are identified with an eye for helping clients to modify their thinking, actions, and relational environments to build greater resilience and protection from the effects of neglect and mistreatment in childhood. Case studies are provided to stimulate small group discussion about risk and protective factors, and strategies for strengthening and building upon protective factors. Although this training is designed primarily to help therapists remain trauma-informed and strength-focused in their case conceptualizations, a brief description of currently available evidence-based interventions for treating complex trauma in adults are presented.

As a result of participating in this training, participants will be able to:

Identify major findings of the Adverse Childhood Events study about the long-term effects of childhood trauma
Identify common adaptations (e.g., coping styles) associated with early trauma and how they present in later life
Describe the ACES, PCES, and Adult Resilience surveys and how to use them in therapy sessions with clients
Describe evidence informed interventions to help survivors of childhood complex trauma develop more effective coping skills and build resilience

Agenda:

8:30am-8:45 am: Introductions & overview of agenda & course format

8:45-10:30 am: Major findings of the foundational Keisler ACEs study & specific risk factors correlated with high ACE scores. Introduction & review of ACES, PCES and Adult Resilience surveys and how to use them. Overview of attachment wounds and trauma responses and what to look and listen for in sessions. How to provide psychoeducation to clients about ACE scores and childhood trauma

10:30-10:40 am: Break

10:40-12:20 pm: Identifying coping styles & helping clients who experienced childhood trauma heal using Evidence-based treatment interventions. Introduction to the 3 major styles of coping and examples and case studies of each. Examples of interpersonal patterns and conflict and communication styles typical in those who experienced early childhood adversity and trauma.

Review, role-play, and practice of interventions for trauma drawn from: Cognitive Behavioral Therapy (including TF-CBT), Somatic theories (EMDR, SE and EFT), & 3rd wave behavior therapies (including DBT, MBCT, and ACT)

12:20-12:30 pm: Wrap up, summary, and Q&A