FULL-DAY PRE-CONGRESS WORKSHOPS - JUNE 19, 2008

1. Judith Beck: “Cognitive Therapy for Weight Loss and Maintenance”

Why do so many people have difficulty losing weight or maintaining their weight loss? One important element that is often underemphasized in weight loss programs is the role of dysfunctional thoughts and beliefs. While people can change their eating behavior in the short-run, they generally revert back to old eating habits unless they make permanent changes in their cognitions. While choosing a healthy diet, arranging their environments, and learning about good eating habits is essential, these elements are insufficient. This workshop presents a step-by-step approach to teaching people specific skills and to help them respond to negative thoughts that interfere with implementing these skills. 
These skills include: continually motivating themselves, reframing the disadvantages of dieting, planning and monitoring their eating, seeking support, reducing their fear of hunger, increasing their tolerance of hunger and craving, creating sufficient time and energy for dieting, solving problems associated with dieting, and continuing to use these skills indefinitely. Techniques will be presented to help dieters cognitively restructure dysfunctional beliefs related to deprivation, unfairness, discouragement, entitlement, and disappointment, and continually rehearse responses to key automatic thoughts that undermine their motivation and sense of self-efficacy.

2. Frank Dattilio: “Contemporary Cognitive Behaviour Therapy with Couples and families: A schema Enhanced Approach ”

This workshop focuses on the use of cognitive-behavioral strategies when working with couples and families and emphasizes an enhancement approach with the use of schema identification and restructuring. Participants will learn firsthand techniques, such as identification and assessment of schemas and their affect on individual's thoughts, emotions, and behaviors, as well as the cognitive-behavioral strategies that will be used to modify them. Clinical examples will be utilized through DVD presentations, as well as case discussion, and a question and answer period.

You will learn:
1) To identify cognitive-behavioral techniques that are most frequently used with couples and families.
2) How to identify dysfunctional schemas and offer patients' techniques for challenging and restructuring them, particularly when they involve content that is transmitted from family-of-origin.
3) To identify when the use of straight behavioral techniques may be preferred over cognitive techniques.
4) When and how to use homework assignments and out-of-session assignments to augment change during the course of treatment.

3. Christopher Fairburn & Riccardo Dalle Grave: “Transdiagnostic Cognitive Behaviour Therapy for Eating Disorder”

In this workshop Professor Fairburn and Dr Dalle Grave will describe a new "enhanced" cognitive behavioural approach to the treatment of the full range of eating disorders seen in clinical practice (including anorexia nervosa, bulimia nervosa and the various forms of eating disorder NOS).

The workshop will open with a brief account of the current standing of CBT for eating disorders and the theoretical basis for the new treatment. For the rest of the workshop Professor Fairburn and Dr Dalle Grave will focus on the practical aspects of the new “enhanced” cognitive behavioural treatment (CBT-E). Particular emphasis will be placed on novel methods for addressing patients’ concerns about shape and weight. Other topics will include engagement, addressing binge eating and purging, and helping underweight patients regain weight. Extensive use will be made of illustrative clinical material. The workshop will be suitable for all those who work with patients with eating disorders. 

4. Arthur Freeman: “Cognitive Behavioural Treatment of Patients with Narcissistic Personality Disorder”

The patients with Narcissistic Personality Disorder (NPD), are often among the most difficult in the therapist's caseload. They may require more time in therapy and greater therapist energy than other patients while making less progress or change. They usually enter therapy for issues other than the NPD, notably depression and anxiety or at the demand of others. Progress with these clients may be slowed or stopped by the personality problems. These patients can become the individuals that therapists “love to hate,” in that they frequently arouse intense negative countertransference. Often misunderstood or poorly conceptualized, NPD will be discussed through the lenses of several common theoretical models.
This workshop will briefly review the theoretical, conceptual, and developmental issues in the etiology and treatment of NPD described in the Diagnostic and Statistical Manual, 4th Edition-Text Revision (DSM IV-TR, 2000) 
Among the topics to be covered in the workshop will be: assessment and diagnostic criteria; concomitant psychological problems; treatment planning using Freeman's Diagnostic Profile System; issues of non-compliance with therapeutic regimen; treatment success and failure, and therapist response. Assessment and treatment will be illustrated through the use of videotaped examples. Of special interest will be Freeman's revision of the widely used Stages of Change developed by Prochaska & DiClemente.
Teaching techniques will include didactic presentation and videotapes of patients with NPD. 

5. Paul Gilbert: “Working with Shame and Developing Inner Compassion: an Introduction to Compassion Focused Therapy”

Shame and self-criticism are known to play an important role in the causation, formation and maintenance of a range of disorders, (anxiety, depression, eating and personality disorders) and avoidance of help-seeking.
This workshop will explore an evolutionary and safety strategies approach to shame and self-criticism. Participants will learn to distinguish between external shame (thoughts and feelings focused on what one thinks others think about the self) and internal shame (self-focused thoughts and feelings). Key skills include recognising the varied presentations of shame, function analysis of self-critical thinking and use of imagery.
The second part of the workshop focuses on a new and innovative approach, called Compassionate Mind Training (CMT). CMT focuses on developing care-focused motivation, distress tolerance, empathy/acceptance and non-judgement for one’s difficulties. Participants will learn how to help to develop compassionate attention, thinking, behaviour, feeling and imagery.

6. Robert Leahy: “Schema Mismatch in the Therapeutic Relationship: Using Roadblocks as Opportunities for Change”

Therapists are not “blank slates” that “rationally” implement a technology and patients are not reducible to “diagnostic categories” onto which “interventions” are implemented. Patients and therapists each come to the therapeutic relationship with their own conceptualization of what an effective relationship will be and how emotions are to be handled. Patients’ schemas may focus on threats of abandonment, humiliation, or loss of autonomy, while therapists may have schemas reflecting demanding standards, need for control, and approval seeking. Moreover, both patients and therapists may have “emotional schemas” where emotions may be viewed as threatening, overwhelming, needing “regulation” or incomprehensible. These “schema mismatches” may lead the therapist to view emotions as a waste of time, “complaining” or a sign of “rumination” and make it difficult for the therapy to elicit emotionally significant material or to allow for important experiential exposure. 
In this workshop, we will identify and modify mutually self-fulfilling "interpersonal strategies"---where personal and emotional schemas are continually confirmed (or never disconfirmed). Rather than viewing therapy as a set of “simple techniques”, we will see how CBT can provide for meaningful and deeper change. Conceptualization, techniques and strategies for altering these roadblocks will be described.

7. Jeffrey Young: “Schema Therapy for Borderline Personality Disorder”

Dr. Young will present the latest advances in schema therapy for working with Borderline Personality Disorder. This approach places primary emphasis on “limited reparenting” within the therapy relationship, and the extensive use of emotion-focused techniques. Schema therapy was evaluated in a large-scale outcome study for BPD and demonstrated high levels of efficacy.
The schema therapy model for BPD is based on the concept of a schema mode. A schema mode is defined as a facet of the self, or state, that has not been fully integrated with other parts of the self. Borderline patients typically “flip” among four modes: the Detached Protector, the Abandoned/Abused Child, the Angry/Impulsive Child, and the Punitive Parent.
Dr. Young will present an overview of specific strategies for identifying and responding to each mode, including: validation of emotional needs, schema mode imagery and dialogues, limited reparenting, empathic confrontation, and the role of the therapist’s own schemas. 
The workshop will include patient videotape segments and extensive handouts.

8. John Kabat-Zinn: “Mindfulness in medicine and psychology – a first hand taste and clinical applications”

In this workshop, Dr. Kabat-Zinn will present the work his colleagues and he have been engaged in for the past twenty nine years, that has given rise to a range of mindfulness-based interventions, the most widespread of which are mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). He will recount relevant aspects of the history, rationale, structure, and protocol of MBSR and MBCT and their clinical outcomes as documented in a growing number of clinical trials and research studies. The workshop will also be experiential, serving as an introduction to the meditative practices associated with MBSR and MBCT, as first-person engagement is essential for understanding the heart of this approach. Mindfulness is a rigorous meditative discipline -- a gentle but challenging way of being and perceiving and inhabiting one’s life, and cannot be fully understood as a conceptually driven cognitive-behavioral technique deployed in particular circumstances as required. We will practice some aspects of MBSR together, space and time permitting, such as sitting meditation, the body scan, and mindful yoga, and well as mindful eating and mindful walking, and explore in dialogue as a group the experiential dimension of what arises for us during formal mindfulness practice, with an eye to its potential applications in clinical situations in medicine and psychology.