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Understanding & Treating Families
with Complex Developmental Trauma

Published 8/15/20

Histories of adversity and trauma are common among families served in intensive, in-home programs.  Although therapists may know the child’s trauma history, the caregivers’ current and past experience with adversity and trauma too often remains in the background, yet is equally as important for informing clinical decision-making.  The caregivers’ histories of trauma have a major impact on family structure, parenting, and response to treatment.  This training introduces participants to current science and conceptualizations of complex developmental trauma, describing what it is and how it impacts brain development and brain functioning in children and caregivers.  Clinician-friendly concepts from neuroscience (e.g. Siegal’s “hand model” of the brain and Porges’ concept of neuroception) are introduced to help therapists gain a basic understanding of how trauma and chronic adversity shapes emotional availability and parent-child relationships.  Bruce Perry’s neurobiology-informed neurosequential model of therapeutics is described as a useful tool for clinical problem solving.

This strength-based training translates knowledge about the impacts of toxic stress on the brain and body into clinical practice, informing therapists about how best to introduce, structure, and pace interventions.  Special attention is given to the important role of therapists in co-regulating stressed, dysregulated caregivers in family therapy sessions.

This course is comprised of edited segments from three live-streamed Zoom versions of a similarly named didactic presented to therapists working in Pennsylvania’s FBMHS programs in April 2020.  Since break-out rooms were used to foster interaction with the material, the webinars in this course contain a rich balance between lecture and conversation.  These conversations facilitate translation of theory to clinical application.

Objectives:

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

  1. Identify the impacts of chronic adversity and traumatic stress on the brain and body
  2. Describe co-regulation and its critical role in emotion regulation in parenting and in family therapy sessions
  3. Explain the role of neuroception and trauma adaptation in presenting symptoms, as well as in the negative interactions of traumatized children and caregivers
  4. Describe how family therapists can effectively apply the intervention rubric: “regulate, relate, and then reason” with reactive family members.

This is a beginning level course, introducing therapists to complex developmental trauma and its implications for treating families.

Course Outline

  • Unit 1: How Chronic Adversity, Toxic Stress, and Trauma Impact the Brain and Body (75 minutes)
    • Webinar: Adverse Childhood Events (ACES and the Complex Developmental Trauma
    • Webinar: Reframing Challenging Behavior as an Adaption to Toxic Stress
    • Handouts: The ACE Pyramid, Slide Handouts
  • Unit 2: Why It’s Important to View Emotional Reactivity in a Relational Context (60 minutes)
    • Webinar: The Relationship Between Attunement and Emotional Regulation
    • Webinar: Brain Adaptations to Alarm and Safety and the Capacity for Connection
    • Handouts: Model of the Brain, Summary of Science of Neglect, Slide Handouts
  • Unit 3: The Critical Role of Co-Regulation in Family Treatment (75 minutes)
    • Webinar: Regulate, Relate, and Reason
    • Webinar: Becoming a Mindful, Emotionally Regulated Therapist
    • Case Presentation: Helping a Caregiver Remain Calm in the Face of Extreme Persistence
    • Handouts: Autonomic Nervous System, Co-Regulation Strategies with Child, Window of Tolerance, Slide Handouts

About the Presenters

Click here for information on Tara Byers, MS, LPC, NCC.

This course uses an online distance-learning self-paced format.  It includes recorded audio, recorded video-based webinars, and selected readings.  There are post-tests to ensure comprehension of the material. Participants can communicate with the instructors via the online moodle interface. Real-time communication with the instructor in our online, self-paced distance learning courses is not possible. However, participants can send an email to the instructor via the online moodle interface within the course and expect to receive a response within 48 hours. All course content, including post-tests, should take approximately 3.5 hours to complete.

Frequently Asked Questions
Visit our Self-Paced, Online Continuing Education Policies & FAQs for additional information regarding the CFBT online learning center, accommodations for disabilities, reporting problems with the course, instructions for viewing webinars, etc.

Recognizing and Treating Under-Organization in Families

Published 3/1/20

Under-organized families are marked by inconsistency and chaos.  Life in the home can feel random and leaderless.  Children living in these families are at risk for abuse and neglect, and a wide range of behavioral and emotional problems within the family and community.  This workshop provides an eco-systemic framework for understanding under-organized families and the caregivers who head them.  Common traps are identified that helping professionals need to avoid when working with these families. Treatment guidelines are provided for addressing problems of caregiver engagement, maintaining a treatment focus, coordinating with multiple community agencies who may be working at cross purposes, and strengthening the caregivers’ executive functioning.

This is an Intermediate Level course. The target audience is all behavioral health professionals working with children and adolescents.

Objectives

As a result of participating in this online course, you will be able to:

  1. Recognize fragile couple relationships and patterns of family under-organization
  2. Describe the impact of family under-organization on the development of children’s emotional competencies
  3. Describe five important treatment tasks in helping under-organized families
  4. Identify the most common mistakes professionals make when working with under-organized families and how to avoid them

Course Outline

  • Unit 1: The Relationship Between Family Structure and Externalizing Problems (30 minutes)
    • Webinar: A Comparison of four Maladaptive Family Types
    • Webinar: Countering the Troubled Treatment Histories of Children with Externalizing Problems
  • Unit 2: The Core Features of Under-Organization in Families (100 minutes)
    • Webinar: The Structure of Under-Organized Families
    • Webinar: The Impact of Unpredictability and Inconsistency
  • Unit 3: Interventions Focused on Supporting the Ambivalent, Overwhelmed Caregiver (105 minutes)
    • Webinar: Addressing Parental Ambivalence
    • Webinar: Matching Treatment Expectations to Caregiver Capacity
  • Unit 4: Interventions Focused on Strengthening Fragile Relationships (70 minutes)
    • Webinar: Roots of Under-Organization: Fragile Couples
    • Webinar: A Case Study: Building On-Ramps to Parenting

About the Presenters

Click here for information on C. Wayne Jones, PhD.

This course uses an online distance-learning self-paced format.  It includes recorded audio, recorded video-based webinars, and selected readings.  There are post-tests to ensure comprehension of the material. Participants can communicate with the instructors via the online moodle interface. Real-time communication with the instructor in our online, self-paced distance learning courses is not possible. However, participants can send an email to the instructor via the online moodle interface within the course and expect to receive a response within 48 hours. All course content, including post-tests, should take approximately 5.5 hours to complete.

Frequently Asked Questions
Visit our Self-Paced, Online Continuing Education Policies & FAQs for additional information regarding the CFBT online learning center, accommodations for disabilities, reporting problems with the course, instructions for viewing webinars, etc.

Understanding and Treating Enmeshment in Families

Updated 7/8/19

Enmeshment is one of four structural patterns most associated with serious emotional disturbance (SED) in children. This course describes the characteristics of enmeshment and how this interactional pattern shapes children’s development of social-emotional competencies and their response to treatment. Treatment guidelines are highlighted, as well as common clinical traps that therapists are likely to encounter when working with enmeshed relational patterns. This course is an edited version of a live workshop presented for intensive, in-home family-based therapists in February 2019.

This is an Intermediate Level course. The target audience is all behavioral health professionals working with children and adolescents.

Learning Objectives 

  1. Identify the characteristics of enmeshed parenting and enmeshed family structure
  2. Identify four basic emotional competencies and how enmeshment impacts their development
  3. Recognize four maladaptive coping strategies enmeshed families use to minimize conflict
  4. Recognize signs of induction into enmeshment and identify strategies for avoiding it
  5. Identify strategies for pushing the conversation and increasing distress tolerance in enmeshed families

Course Outline

  • Unit 1: Recognizing Enmeshment (100 minutes)
    • Webinar: An Introduction to Enmeshment and Family Structure
    • Webinar: The Characteristics of Enmeshed Relationships
    • Webinar: Differentiating Enmeshment from Co-Dependency and Emotional Fusion
  • Unit 2: ESFT Core Concepts (30 minutes)
    • Webinar: ESFT Case Conceptualization
    • Webinar: How Enmeshment Impacts Development of Core Emotional Competencies
  • Unit 3: Four Faces of Enmeshment (90 minutes)
    • Webinar: The Overly Sensitive Caregiver
    • Webinar: The Anxious, Impulsive Caregiver
    • Webinar: Hostile-Chaotic & Rigid Types
  • Unit 4: Strengthening Family Distress Tolerance (60 minutes)
    • Webinar: Pushing the Conversation: Case Study
    • Webinar: Pushing the Conversation: Case Study 2

About the Presenters

Click here for information on C. Wayne Jones, PhD.

This course uses an online distance-learning self-paced format.  It includes recorded audio, recorded video-based webinars, and selected readings.  There are post-tests to ensure comprehension of the material. Participants can communicate with the instructors via the online moodle interface. Real-time communication with the instructor in our online, self-paced distance learning courses is not possible. However, participants can send an email to the instructor via the online moodle interface within the course and expect to receive a response within 48 hours. All course content, including post-tests, should take approximately 5.0 hours to complete.

Frequently Asked Questions
Visit our Self-Paced, Online Continuing Education Policies & FAQs for additional information regarding the CFBT online learning center, accommodations for disabilities, reporting problems with the course, instructions for viewing webinars, etc.

Preventing Teen Suicide

Despite the best efforts of therapists treating high risk teens in intensive, community based treatment programs, too many are still ending their lives through suicide.  This means that good treatment alone is insufficient to prevent teen suicide.  Also required is a sound knowledge about the nature of suicide, skills in assessing for suicide ideation and acute risk of suicide, and competency in co-developing effective safety plans with teens and their families.  This is the focus of this course.

The content of this course is informed by published national core competencies in assessing and managing suicide risk (Suicide Prevention Resource Center, American Association of Suicidology, and SAMSHA).  The webinars are comprised of excerpts taken from two different live workshops given to Family Based therapists and supervisors.  Dr. Wintersteen’s workshop was sponsored by the Philadelphia Child And Family Therapy Training Center in June, 2016, while Dr. Jones’s workshop was sponsored by the Center for Family Based Training in May, 2016.

This is a Beginning Level course. The target audience is all behavioral health professionals working with children and adolescents.

Course Objectives
At the end of this course, participants will be able to:
  1. Identify eight common myths about teen suicide and describe the corresponding facts for each one
  2. Identify 12 critical suicide risk assessment questions
  3. Describe the six steps of safety planning

Course Outline

  • Unit 1: Understanding Teen Suicide (40 minutes)
    • Webinar: The Scope of Teen Suicide
    • Webinar: Common Myths About Teen Suicide
  • Unit 2: Assessing the Risk of Suicide (70 minutes)
    • Webinar: Barriers to Conversations about Suicide
    • Webinar: Tips for Having Conversations about Suicide
    • Webinars: Generating Valid Data
    • Webinars: The Questions to Ask in Risk Assessment
    • Reading: Uncovering Suicide Intent
  • Unit 3: Creating Effective Safety Plans (60 minutes)
    • Webinar: An Introduction to Safety Plans
    • Webinar: Safety Planning Steps 1-3
    • Webinar: Safety Planning Steps 3-6
    • Safety Plan template
  • Unit 4: Optional Online Resources on Suicide, and Suicide Assessment

About the Presenters

Matthew B. Wintersteen, PhD is a Licensed Psychologist. He received his degree at the University of Tennessee and did his Fellowship at The Children’s Hospital of Philadelphia, in the Division of Child and Adolescent Psychiatry. He currently serves as an Associate Professor at Thomas Jefferson University. His areas of specialty are suicide prevention and intervention for youth and young adults. He is leading a project, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), that focuses on developing and implementing suicide prevention education, policies, and procedures into Pennsylvania’s schools and colleges.

Click here for information on C. Wayne Jones, PhD.

This course uses an online distance-learning self-paced format.  It includes recorded audio, recorded video-based webinars, and selected readings.  There are post-tests to ensure comprehension of the material. Participants can communicate with the instructors via the online moodle interface. Real-time communication with the instructor in our online, self-paced distance learning courses is not possible. However, participants can send an email to the instructor via the online moodle interface within the course and expect to receive a response within 48 hours. All course content, including post-tests, should take approximately 3.0 hours to complete.

Frequently Asked Questions
Visit our Self-Paced, Online Continuing Education Policies & FAQs for additional information regarding the CFBT online learning center, accommodations for disabilities, reporting problems with the course, instructions for viewing webinars, etc.

Crafting Meaningful Treatment Goals and Action Steps

This course focuses on one of the most critical components of treatment success, creating meaningful, measureable goals and action steps that are systemically informed.   A case is made for restricting the number of long term goals in order to achieve “laser focus,” which is important to engagement and motivation in the change process.  Guidance is provided on how to choose the best focus for the overarching treatment goal and how to structure it so it is most effective.  This course demonstrates how to apply the SMART approach to the development of clinical goals in intensive, in-home programs.   For development of more achievable action steps, the power of incremental, tiny habits is described and demonstrated.  Concrete examples of both clinically sound and unsound goals and action steps are provided.   

This is a Beginning Level course. The target audience is all behavioral health professionals working with children and adolescents.

Course Objectives
At the end of this course, participants will be able to:

1. Explain the rationale for a one-goal treatment plan that flows directly from the case conceptualization
2. Demonstrate how to use the SMART format as a rubric for writing and evaluating clinical goals
3. Describe the principle of “tiny habits” and show how to use it in developing achievable action steps

This course uses an online distance-learning self-paced format.  It includes recorded audio, recorded video-based webinars, and selected readings.  There are post-tests to ensure comprehension of the material. Participants can communicate with the instructors via the online moodle interface. Real-time communication with the instructor in our online, self-paced distance learning courses is not possible. However, participants can send an email to the instructor via the online moodle interface within the course and expect to receive a response within 48 hours. All course content, including post-tests, should take approximately two hours to complete.

Frequently Asked Questions
Visit our Online Course Policies for additional information regarding the CFBT online learning center, accommodations for disabilities, reporting problems with the course, instructions for viewing webinars, etc.