2021 Spring Training Institute Schedule

Speaker(s):

William Kellibrew

Presentation:

At age 10, William witnessed the murders of his mother, Jacqueline and 12-year-old brother, Tony, in their family living room on July 2, 1984, by his mom’s ex-boyfriend. The killer died by suicide that day, but not before making William beg for his life at gunpoint.

In this presentation, William shares his personal and professional journey of healing.  From experiencing multiple childhood traumas including child sexual abuse, domestic and gun violence, bullying, and other victimizations, William has emerged as a global advocate and respected authority on addressing violence and trauma throughout multiple systems and settings. His synergy with the audience is inspiring and motivating as he provides a practical trauma-sensitive healing-centered approach to supporting individuals, families, and communities impacted by violence and trauma.

Objectives:

1. Identify key elements in healing after being impacted by childhood trauma.
2. Use William’s story as a catalyst to continue the conversation on supporting children and families affected by violence and trauma in multiple systems and settings.

Slides and Handouts:

KELLIBREW_APBSpeakers_MissouriConference_May2021

Speaker(s):

Jacob Lee, MD

Presentation:

Climate change is the central crisis of the Anthropocene, a species-level threat which is part of a short list of dangers to offer true existential threat to Humans. When the Intergovernmental Panel on Climate Change released their groundbreaking Global Warming of 1.5°C Special Report in 2018 they built upon the undeniable body of evidence which had propelled 195 nations to enact the Paris Climate Accords two years earlier. Climate change threatens to become the greatest source of human misery over the next one or two human lifetimes. Natural disasters like wildfires and heatwaves, hurricanes and floods have displaced many, while desertification causes countless climate refugees. Weather-related events displace more than 20,000,000 globally each year. Disasters also cause a different kind of psychological distress than seasonal weather patterns, and cause more disruption to normal life patterns. But the implications of climate change can be more direct, with associations with the above conditions increasingly coming to light.

Rates of PTSD, depression and anxiety are found to rise sharply following flooding, another natural disaster of increasing prevalence due to anthropomorphic climate change. Heat waves have been found to directly contribute to mood disorders and anxiety, and people with mental illness are at three times increased risk to die from a heat wave than neuro-typical controls. Extreme heat’s associations with suicide attempts and heat-related violence may also be of direct interest to the psychiatrist. Thanks to an expanding body of evidence linking environmental factors to psychiatric outcomes through mechanisms including epigenetics, congenital defects, or impaired neurodevelopment, the importance of these considerations will continue to grow within psychiatry.

Objectives:

1. Briefly outline critical milestones and projections for earth’s climate
2. Identify direct and indirect associations between classical psychiatric conditions and rising temperatures, natural disasters, and other climate outcomes.
   1. PTSD
   2. Depression
   3. Suicidality
   4. Anxiety
   5. Substance use disorders
3. Discuss climate-related anxiety

Slides and Handouts:

LEE_VERSION 2_Grand Rounds Climate Change STI

Speaker(s):

Nancy Ellis-Ordway, MSW, PhD

Presentation:

Weight stigma is a challenging, pervasive and overlooked difficulty that affects individual and public health, with substantial ethical implications. This program addresses the current research on the topic through the lens of social justice. As mental health professionals, we have an ethical responsibility to address the social justice impact of weight stigma in our society and in our clinical practices.

Objectives:

1. Articulate the risks of focusing on weight loss and the benefits of questioning accepted assumptions.
2. Define acceptable and unacceptable discrimination.
3. Delineate the relationship among body image, self-esteem and quality of life.
4. Review the ways that weight stigma interferes with ethical practice according to different professional codes of ethics.
5. Identify cultural influences in the development of disturbances in eating and body image.
6. Specify effective treatment approaches.

Slides and Handouts:

ELLIS-ORDWAY_MIMH2021PP

Speaker(s):

David Lynde, MSW, LICSW

Presentation:

The national pandemic in the US has forced mental health services delivery approaches to change rapidly and continuously.  We know a good deal about what works for Supported Employment & Education outside of this national health emergency, however, we do not have research to tell us what works in the current situation for Missouri and nationally.

People whose lives are affected by mental illness are still working, still furthering their educations and still pursuing their economic independence during the presence of COVID-19.  This presentation will provide a forum to learn, explore and share strategies, techniques, and service delivery options as well as supports for Transition Aged Youth who are receiving services related to their employment and / or educational goals.

Objectives:

1. Identify the evidence-based principles of Supported Employment and Education Services
2. Identify potential concerns of people in services regarding employment and education during the pandemic
3. Describe creative engagement strategies for people in services regarding education and employment goals during the pandemic
4. Identify and describe strategies and interventions as part of SEE services to assist people with education and employment goals during the pandemic

Slides and Handouts:

LYNDE_MO_STI_TAY_SEE_dwl_FINAL

Speaker(s):

Mark Sanders, LCSW, CADC

Presentation:

The great majority of clients with substance use disorders have a concurrent mental Illness. In this skill building presentation you will learn 10 evidence based approaches to co-occurring disorders recovery, including: integrated co-occurring disorders treatment, feedback informed treatment, motivational interviewing, the use of motivational incentives; 12 step facilitation; medication assisted treatment; supportive employment; supportive housing and intensive family case management. Emphasis will also be placed upon the person centered recovery movement, how to build recovery capital; trauma informed care and the use of peers to help support recovery.

Objectives:

1. Define 10 Evidence Based Approaches to Co-occurring Disorders Treatment.
2. Discuss the Person Centered Recovery Movement.
3. Identify how peers can help support recovery.

Slides and Handouts:

Speaker(s):

Apurva Bhatt, MD

Presentation:

In 2017, Missouri ranked 4th in the nation in death by firearm (CDC). In 2017, firearm related deaths were the second leading cause of death in Missouri children ages 1-17 (CDC). According to the Gifford Law Center in 2020, Missouri received a scorecard grade F in terms of its current firearm laws. In 2017, Missouri saw a near doubling of the rates of suicide by firearms in 15-24-year-olds (the highest rate reported since data collection began in 1999). In 2015, Missouri experienced the highest firearm homicide rate in 15-24 year olds since 1999. This presentation will zoom in on changes in Missouri firearm law which occurred from 1999-2018, discuss the existing scientific literature on the effects of changes in Missouri’s firearm laws on suicide/homicide by firearms, and will elaborate on Dr. Bhatt’s work in this area.

Objectives:

1. Recall the timeline of changes in Missouri firearm policy
2. Describe the current state of affairs regarding Missouri firearm law
3. Review the scientific literature on the effects of Missouri’s firearm laws on suicide and homicide by firearms in the state
4. Learn how firearm status impacts suicide by firearms/suicide risk
5. Describe future preventive strategies to mitigate adolescent and young adult suicide by firearms in the state

Slides and Handouts:

BHATT_Spring Training Institute Bhatt slides

Speaker(s):

Rachel Hanks, MSW, LCSW, RPT

Presentation:

In 2016, the National Survey of Children’s Health reported that 46% of children under the age of 17 have experienced at least one traumatic event. A single traumatic event is understood to be inherently complex in the most stable of children. However, chronic stress and trauma during those crucial early years of brain development may adversely impact a child’s ability to function and self-regulate. Presenting behaviors of developmental trauma may include aggression, intolerable feelings of distress, attachment issues, developmental delays, dissociation, depression, and sensory processing issues. These issues increase a child’s risk factors for mental illness, poor health outcomes, lowered educational attainment, involvement in the criminal justice system, and can even lower their life expectancy.       

When working with young children, it is important to understand the pervasiveness and complexities of these presenting issues in a variety of settings. The principles of play therapy, attachment, and brain development can help a child’s team and family better understand a child’s behavior. From the case management team to home to school, developmentally-appropriate interventions and support can help increase a young child’s ability to self-regulate, attach, heal, and even thrive.

Objectives:

1. Identify the effects of chronic trauma and maltreatment on a young child’s development.
2. Understand the role attachment plays in self-regulation and development.
3. Identify appropriate interventions for young children with high levels of dysregulation.

Slides and Handouts:

HANKS_RACHEL_2021_Lessons Learned_participant copy_Hanks

Speaker(s):

Alex, Barajas-Munoz, Ph.D.

Presentation:

This workshop focuses on how culture and cultural change affects Latinos and their substance use. Cultural factors in treatment and clinical issues related to culture are explored, and approaches to integrating culture into therapy are proposed

Objectives:

1. Interpret how culture changes affect Latinos and their substance use
2. Identify problems faced by individuals around access and readiness for treatment, and sustaining a course of recovery
3. Describe cultural factors in treatment, and clinical issues
4. Outline approaches to integrating culture into therapy

Slides and Handouts:

BARAJAS-MUNOZ_Cultural Considerations for Hispanics STI 2021

Speaker(s):

Jeanna Moschenrose, M.Ed., Ph.D.

James Belman, Psy.D

Presentation:

Parts of my book will be used to emphasize the effectiveness of helping offenders to find identity, purpose, strengths, values, and goals. Focus will be on the present and the future based on their individual choices to change outcomes and achieve personal goals. Self-forgiveness is important as well as making cognitive and behavioral changes. Establishing a new direction begins with an inner change. Empowerment comes through the realization of one’s power to make choices and through education, counseling, and encouragement from well-trained, caring professionals

Objectives:

1. Understand the power of giving positive encouragement and direction.
2. Help offenders be empowered by realizing choices create the future
3. Gain skills in teaching how to overcome disappointments and crises
4. Help offenders break repetitious dysfunctional cycles of addiction
5. Identify mind prisons that hinder success
6. Describe the four main differences in a positive motivational treatment program

Slides and Handouts:

MOSCHENROSE_The Power Of Positive Motivation In Healing The

Speaker(s):

Mark Sanders, LCSW, CADC

Presentation:

In this presentation you will learn strategies to help break intergenerational patterns of addictions, trauma and dark secrets in families. We will discuss the role of treatment providers, persons in recovery and families in breaking these patterns. Other topics include: the unique risk and protective factors for children of parents with substance use disorders; fetal alcohol syndrome as a risk factor and intervention strategies; the impact of siblings on the intergenerational transmission of addiction; addressing generational dark secrets and traumatic stress disorders in families.

Objectives:

1. Define six risk factors for intergenerational patterns of addiction in families
2. Identify the role of treatment providers in breaking intergenerational patterns of addiction, trauma and dark secrets.
3. Discuss the roles of persons in recovery and families in breaking intergenerational patterns.
4. Reveal the risk and protective factors for children with parents with substance use disorders.
5. Review how to address dark family secrets which can foster addiction
6. Discuss how to address intergenerational trauma in families

Slides and Handouts:

Speaker(s):

Drew E. Murray, MD

Presentation:

This presentation is a side by side case comparison demonstrating the significance of a patient’s insight and includes a relevant literature review. 

Objectives:

1. Discuss two patients in forensic psychiatry with similar symptom complexes
2. Explore the role of insight in psychosis, including its definition and how we can improve upon it. 
3. Apply measures of insight to two forensic patients and compare their respective hospital courses. 

Slides and Handouts:

MURRAY_DREW_Insights on insight

Speaker(s):

Adriatik Likcani, PhD

Ryan Peterson, PhD

Amanda McCullough, MS, SMFT, CRADC

Emily Brown, MS, CRADC

Presentation:

This presentation on ethics is beyond the ‘typical’ topics of dual relationships and abuse of power with clients. It is about us as professionals and our personal worldview and professional acculturation. Why do ethical codes exist? What do I do when my values and morals conflict with ethical codes? How to deal with ethical dilemmas? What is wrong with faith-based approaches? What is wrong with evidence-based treatment? What is wrong with recovery support services? This session will help you find the answers to any of those questions!

This is a session about ethics, values, morals, personal worldview and professional acculturation in the practice of treatment and recovery support for opioid use disorders and other substance use disorders. Participants will learn about the ecology of substance use treatment and recovery support and issues that arise with scientific discovery such as evidence-based practices and effective interventions, medication assisted treatment/recovery, integration of faith-based approaches, etc. Such contemporary issues tend to challenge the stability of any professional and require of them to affirm or resist change. They will learn models of working through dissonance and finding a new stability. They will identify external and internal influences that impact their emerging worldview, personal and professional acculturation.

Discussion with participants will be based on morals, values, sources of power and influence in the acculturation process, and the ethics of providing value-sensitive care and due care to individuals and families struggling with opioid use disorder and other substance use disorders.

Objectives:

1. Discuss how participants can use existing Codes of Ethics, including AAMFT, NBCC and NASW, to inform and reflect upon their personal worldview and professional acculturation
2. Identify personal lenses that cause dissonance among professionals in their practice
3. Recognize professional acculturation process through the ecology of substance use treatment and recovery support approaches
4. Identify issues that threaten status quo of the helper, prompt resistance or create dissonance, and require them to find a new professional stability
5. Learn and utilize models to apply in their professional development when facing contemporary ethical issues

Slides and Handouts:

Speaker(s):

Jacalyn Leake, MS, CCTP, CFTP

Jaimee Hartenstein, MS, PhD

Presentation:

This presentation explores the experiences of transgender, non-binary, and genderqueer individuals’ identity and the outcomes in relation to the adverse childhood experiences of abuse, neglect, and household dysfunctions like domestic violence using the lenses of intersectionality and minority stress. Archival research found in the published record is reviewed to explore the current literature relating to the trans and gender variant population, identity development, and adverse childhood experiences outcomes. The presentation discusses recent professional experiences relevant to the topic and future research needs.

Objectives:

1. Define key concepts and terms surrounding trans and gender variant identities, the theories of minority stress and intersectionality, and adverse childhood experiences.
2. Describe the current literature surrounding trans and gender variant individuals and adverse childhood experiences.
3. Identify future academic research areas and needs.

Slides and Handouts:

LEAKE_HARTENSTEIN_MO STI_Trans Dev ACEs

LEAKE HARTENSTEIN_MO STI_Trans Dev ACE

Speaker(s):

Anchana Dominic, MD

Presentation:

According to the World Health Organization, an estimated 800,000 people died in 2016 due to suicide. In this era of technological advances, social media’s role in suicide and suicide prevention has often been questioned. Highly publicized media reports of celebrity suicide and TV shows romanticizing the topic may also have effects on subsequent trends in suicide rates among the general population. Data suggests that social media may have a negative impact on mental health through cyber-bullying of vulnerable individuals and by promoting comparative feelings of inadequacy. However, harnessing the unique strengths of social media can contribute to the spread and reach of suicide prevention efforts among users.

Social media platforms can encourage suicide prevention by identifying individuals who are at acute risk of suicide, reaching them anonymously and providing them with resources. It can also spread mental health awareness of appropriate prevention efforts and treatment interventions.

In this presentation, the impact of social media on mental health and recent trends in suicide rates will be teased out. The assessment of suicidal risk by identifying specific tell signs of acute suicidal ideation as expressed through social media will be discussed. How to effectively use social media as a suicide intervention tool and promotion of mental health will also be discussed.

Objectives:

1. Identify ways different social media platforms can be used to promote suicide prevention
2. Discuss the link between media reports on suicide and subsequent trends in suicide rates
3. Identify ways social media can identify, reach, or promote seeking treatment among individuals at risk of suicide

Slides and Handouts:

Speaker(s):

Melissa Palmer, PharmD, BCPS, BCPP

Presentation:

Methamphetamine use disorder has no current FDA-approved medications for treatment, although it is an increasingly prevalent concern. In 2016, the National Survey on Drug Use and Health reported that there were 684,000 people ages 12 and older with a methamphetamine use disorder. Data from the Substance Abuse and Mental Health Services Administration reported that treatment for methamphetamine use increased by 52% from 2012 to 2016. Several medications have been studied in an off-label manner, although the 2015 VA/DoD Clinical Practice Guidelines for the Management of Substance Use Disorders has opined that there is insufficient evidence to recommend for or against the use of any pharmacologic agents for methamphetamine use. Medications that have been researched include disulfiram, topiramate, modafinil, bupropion, agonist replacement, and baclofen. Evidence supporting the use of these agents will be reviewed and discussed, including application to clinical care.

Objectives:

1. Compare and contrast pharmacologic agents used in the treatment of methamphetamine use disorder.
2. Identify patients who could benefit from medication therapy.
3. Develop a patient-centered treatment plan considering patient-specific factors such as co-morbidities and socioeconomic parameters.

Slides and Handouts:

PALMER_Methamphetamine Use Disorder 5.6

Speaker(s):

Beth Orns, MSW, LCSW

Presentation:

Objectives:

1. Define the diagnostic criteria of autism

2. Define the diagnostic criteria of mental health issues that commonly co-occur with autism

3. Understand ways to support clients who have co-occurring issues in the community and in an inpatient setting

4. Understand evidence based treatment approaches for treating mental health issues that co-occur with autism

Slides and Handouts:

ORNS_BETH_Autism and Mental Health for SI_FINAL

Speaker(s):

Heather Allen, BSW

Bianca Farr, MSW, LCSW, MARS

Presentation:

Objectives:

1. Define Special Needs Trusts and ABLE accounts and understand their benefits 
2. Identify who in their care may benefit from a Special Needs Trust or ABLE Account
3. Utilize the knowledge gained to refer constituents to appropriate parties for consultation on their unique circumstances

Slides and Handouts:

ALLEN_HEATHER_Spring Training Presentation 2021 FINAL

Speaker(s):

Burgess, Doug, MD

Presentation:

Participants will gain an appreciation for the biological underpinnings of addiction and use this knowledge to identify inherent biases and barriers to care within traditional addiction treatment models.

Objectives:

1. List 3 similarities between substance use disorders and other chronic diseases.
2. Identify 3 neuroadaptations associated with transition to drug addiction.
3. Describe the general principles of a Medication First, Low Threshold model of care

Speaker(s):

Chris Lawrence, Ph.D. SEP

Kiko Ha, M.Ed., LPC

Presentation:

Advances in brain development research have demonstrated the physical, physiological and emotional impact of chronic and situational stress and trauma on individuals. Individuals with a history of trauma have been found to be at much higher risk for a variety of medical and mental health complications. It is essential that we search for creative, non-invasive and non-pharmacological interventions to address the CAUSES of the physical, mental and behavioral health symptoms associated with trauma and stress.       

HeartSpace Clinic has been offering two technology based interventions, HeartMath and The Safe and Sound Protocol for the past 18 months. The focus of these interventions is improved regulation and resilience in the nervous system and they are both effective with children, adolescents and adults. HeartMath is a biofeedback program that teaches individuals certain thought patterns and breathing techniques affect their HeartRate Variability (HRV). HRV has been found to be a significant factor in physical and mental resilience. HeartMath is easily taught and can be generalized to home by using a device that works with a phone.       

The Safe and Sound Protocol (SSP) was developed by Stephen Porges, author of the Polyvagal Theory. The SSP addresses an auditory adaptation that contributes to hypervigilance (in other words, anxiety). The intervention was first used with children on the autism spectrum, with remarkable results in their social engagement abilities. It is now being used by HeartSpace Clinic, as well as by others around the world, with individuals who have a history of trauma or traumatic stress, with similarly amazing results in terms of anxiety, depression, social engagement and trauma symptoms.   

The most recent group of patients to receive the benefits of SSP has been cats and dogs with severe anxiety and avoidance symptoms.       

This workshop will introduce these two unique interventions, share anecdotes and data from our ongoing study of their impact on adults, children and pets, and discuss lessons learned.

Objectives:

1. Introduce two technology assisted interventions – HeartMath and the Safe and Sound Protocol.
2. Provide rationale for utilizing both interventions with clients who have a history of trauma.
3. Share data gathered through the Technology Enhanced Trauma Treatment Project.
4. Discuss the use of the Safe and Sound Protocol with pets.
5. Discuss clinical indicators and cautions for the use of both interventions.

Slides and Handouts:

LAWRENCE_Spring Institute (2)

Speaker(s):

Terri Cooley-Bennett, MSW, LCSW, LSCSW, CCDP-D, TTS

Presentation:

Professionals in Behavioral Health and Healthcare often function in a variety of roles. These include being key members of interdisciplinary teams, providing clinical oversight and supervision, and delivering services to vulnerable populations. Because of the unique challenges experienced, opportunities for ethical dilemmas and vicarious liability are not uncommon. As professionals, we are accountable not only for our own ethical behavior, but for the behavior of others including colleagues and supervisees. This continuing education program will provide an overview of common ethical principles with a special emphasis on Vicarious Liability or the doctrine of “imputed negligence”. As an important aspect of practice, resources for identifying, managing, and preventing ethical violations will be provided with the goal being excellent customer service to our clients, supervisees, colleagues, and agencies.

Objectives:

1. Participants will be provided with an understanding and overview of common ethical principles

2. Participants will define Vicarious Liability and will discuss the variety of ways that professionals and clinicians can be held accountable for Vicarious Liability or “imputed negligence”

3. Participants will describe Interdisciplinary Team Collaboration as it relates to Ethics and Liability

4. Potential Ethical Dilemmas which are common in a healthcare setting that arise from Vicarious Liability will be considered and options for managing the dilemma will be introduced

5. Participants will examine strategies that will aide in the prevention of ethical violations and will determine how to address good, better, and best responses to common dilemmas

Slides and Handouts:

COOLEY-BENNETT_2021 Vicarious Liability and Ethics In Health Care

Speaker(s):

Timothy Dellenbaugh,MD

Presentation:

This session with provide an interactive introduction to genetics in psychiatry. We will review and define the terminology and concepts that are necessary for understanding the potential role of genetic testing in psychiatry. We will review the current status of genetic factors related to risk of developing psychiatric illness, drug response and side effects. Finally, we will discuss implications of direct-to-consumer genetic testing. This presentation will be oriented to a nonscientific audience. The only prerequisite is knowing that DNA is the genetic material in humans.

Objectives:

1. Define basic genetic terms
2. Recognize some genetic factors related to risk of developing psychiatric illness, drug response and side effects
3. Discuss implications of direct-to-consumer genetic tests

Slides and Handouts:

DELLENBAUGH_TIMOTHY_2021 Psychiatric Genetics Dellenbaugh Spring Final

Speaker(s):

Emily Brown, MS, CRADC

Adriatik Likcani, PhD

Amanda McCullough, MS, SMFT, CRADC

Palmer, Megan, BS

Presentation:

The presentation will focus on specific interventions on how to engage families and how to partner with them when they have a loved one struggling with Opioid Use Disorder and other substances. Presenters will talk about findings of the pilot program funded through SOR grant to develop and test family systems-based interventions and introduce participants to specific interventions for support groups and psychoeducational groups for families and caring others, and family therapy intervention specific to OUD treatment. The program goals were to: a) educate families on resources for them and their loved one struggling with opioid use disorder to enable engagement in treatment and recovery support services; b) educate families on family dynamics during addiction and the recovery process; c) provide open forums / workshops for families in the most non-stigmatizing and sensitive manner possible in the community to increase participation; d) offer family sessions to families with or without their loved one present to assist them in getting their loved one into treatment; e) enable engagement in treatment for the individual family member/s struggling with opioid and other substance use disorder; f) link the family and the individual members with substance use disorder with resources in their community to assist them in 5 major domain: basic needs, health and sobriety, secure safe and stable housing; develop a purpose; and to establish safe and supportive networks in their community.

Objectives:

1. Identify strategies how to engage and partner with families
2. Take away concrete ideas and modules for support groups and psychoeducational groups with families
3. Integrate family systems-based interventions in their programming

Speaker(s):

Angela Gray, MSW, EdS

Presentation:

Black girls often go through life feeling invisible, like they do not exist or are not important. They are victimized by being suspended from school, sexually exploited and sent to juvenile detention centers at a higher rate than other girls from other races their own age. They often combat negative stereotypes of the Angry Black Girl/Woman syndrome often depicted on television and social media. Developmental consequences of Trauma and Trauma Informed Interventions will be explored to help Black girls heal and restore.

Objectives:

1. Define what it means to be invisible as a Black girl.
2. Examine how invisibility and victimization impacts preschool and elementary Black girls.
3. Examine how out of school suspensions, expulsions, and poor attendance contributes to the invisibility and victimization of Black girls.
4. Examine how everyday practices at school such as dress codes and hairstyles contribute to the victimization of Black girls.
5. Explore how the media promotes sexual exploitation and objectification of Black girls.
6. Explore the history of colorism and how it was devised to create division among Black girls.

Slides and Handouts:

Speaker(s):

Stephanie Foo

Presentation:

Mental health professionals are trained to spot destructive symptoms and pathologize their client’s mental illness. But what we often forget is that what we think of as “mental illness” can often potentially be a collection of adaptive skills that have value during tough times. During the COVID-19 crisis, for example, many people with OCD and PTSD have found their former “disabilities” to be helpful traits that keep them alive. 

Objectives:

1. To recognize the power of stigma and shame, and to engage in conversation about how to alleviate that stigma and shame through nuanced storytelling
2. To talk about how we can alleviate stigma and shame in sessions with clients, especially during diagnosis, instead empowering them to see their talents
3. To acknowledge the adaptive and positive power of some mental illnesses

The Department of Mental Health, Division of Behavioral Health, is recognizing three Outstanding Performers for Housing, Supported Employment, and Recovery Support Services.  These awards go to agencies that exemplify the DMH Vision of Hope – Opportunity – Community Inclusion: Missourians receiving mental health services will have the opportunity to pursue their dreams and live their lives as valued members of their communities.

Speaker(s):

Felix Vincenz, PhD

Presentation:

Objectives:

1. Identifying the qualities that describe effective Crisis Leaders
2. Understanding the key concepts the underlie effective Crisis Leadership
3. Developing an overall plan for effective Crisis Leadership, for current and future crises

Slides and Handouts:

VINCENZ_FELIX_Leadership in Times of Crisis NEW

Speaker(s):

James Reynolds, MD

Ron Smith, Ph.D., J.D.

Presentation:

The appointment of a substitute decision-maker is a legal matter decided by a Judge or Jury, but initiated by a health care provider. Depriving a person of their autonomy is an awesome responsibility, matched only by the equally awesome responsibility placed upon a caregiver to act in the best interests of a consumer who is not competent to manage their own affairs. Knowing when that time has come can be trying for the consumer and caregiver. Dr. Reynolds has evaluated many consumers for Guardianship and testified in court hearings and jury trials on the issue. Mr. Smith is an experienced attorney with the Office of the Missouri Attorney-General who has tried numerous cases of Guardianship on behalf of the State.       

Dr. Reynolds will speak on the decision-making process in determining the need for a Guardian, and some practical and ethical considerations inherent in this important decision. He will cover recent changes in Guardianship law concerning specific questions required by the law, including the rights to marry, vote, and drive a car. Mr. Smith will speak to the process of testifying in court on these matters, the information your attorney will need to demonstrate to the Court through testimony, and what to expect from cross-examination. Caregivers who are anxious about appearing in court will particularly find his advice helpful.

Objectives:

1. Define factors to consider when proposing Guardianship
2. Review recent changes in Guardianship law and questions to address in detail.
3. Identify the importance of a good working relationship with the attorney and the issues that will arise in court

Slides and Handouts:

REYNOLDS AND SMITH_When Your Consumer Needs A Guardian-final

Speaker(s):

Stephen Finzo, Psy.D

Presentation:

This training will provide an overview of the establishment and development of SFBT, its uses for appropriate populations, and skills and nuances for application. We will explore the tenets of the treatment as related to addressing the client’s need in the present and with the focus on the future. We will explore the Needs and Change model addressing motivation, respectful curiosity, and the preferred future. We will determine and define interventions and skills readily available to the participant.

Objectives:

1. Review the development of SFBT
2. Gain a practical knowledge of the interventions of SFBT
3. Learn a viable tool for intervention with clients

Slides and Handouts:

FINZO – SFBT PPT MIMH 5-2021-final

Speaker(s):

Kirsti Millar, M.S.

Michelle Alvarado, BSW

Bryan Gourley, BS

Rachel Morelan, BA, MPA

Heather White, BS

Presentation:

The Missouri Department of Mental Health was awarded a five-year SAMHSA youth suicide prevention grant in 2016. The Show Me Zero Youth Suicide Initiative aims to expand intervention services and prevent suicide in youth aged 10-24 in the greater Kansas City area. This initiative is being implemented by two local Community Mental Health Centers. The program diverts youth who are admitted to hospital emergency department and in-patient psychiatric departments to mental health services at these two centers. Program staff also work with Kansas City area schools to identify and refer youth at risk of suicide. This presentation will describe the key interventions, provide data on the ongoing program effectiveness and discussing ways for ongoing sustainability.

Objectives:

1. Describe the Kansas City youth suicide prevention initiative and its effectiveness in reducing suicide and suicidal ideation
2. Offer “Lessons Learned” from implementation of this youth suicide prevention initiative
3. Discuss potential for replication in other locations and sustainability

Speaker(s):

Brian Ouellette, MA, LPC

Presentation:

This presentation looks at Moral Injury and how it contributes to the development of PTSD. Part of this presentation will look at the overlapping symptoms of PTSD and Moral Injury.  This presentation will look at the development of a person’s moral code, how combat trauma has the potential to create cognitive dissonance with someone’s moral code.

The presentation will also cite examples of quotes by various veterans from books such as, “What Have We Done”, and “Soul Repair”, as well as having a collaborative discussion with the participants.

Objectives:

1. Review how we develop morals.
2. Discuss cognitive dissonance as it relates to war and morals

Slides and Handouts:

OUELETTE_Moral injury and the Development of PTSD

Speaker(s):

Steven Sewell, BACEED, CPS

Presentation:

Fears, misconceptions, doubts, and other barriers to healthy communication play a large part of what we do as end of life professionals. Working with children and teenagers who are grieving through the loss of their loved one or as a patient can be even more challenging. In this seminar, Steve will provide encouraging hope to you, in whatever discipline you serve in, to support, provide empathy, and create a high, open relationship with these precious young people. If you have direct contact with family members (especially kids), this session is for you.

Objectives:

1. Reflect on what we know about grief and loss with children and adolescents
2. Differentiate age level appropriate grief support for a variety of end of life clinicians
3. Observe general tips for caregivers who offer care to kids and teens as it relates to grief and loss.

Speaker(s):

Shari Scott, M.A., LPC

Presentation:

Youth suicide frequently graces the covers of magazines, social media, and local news channels.  It’s a topic that increases in coverage as the statistics for suicide deaths among youth simultaneously climb upward.  Suicide ranks as the second leading cause of death for persons aged 10-24 and the rates increase yearly.  The victims left in its path are perplexed and dig through social media posts and the personal belongings of the deceased looking for answers. 

Published research and post-mortem analysis of completed suicides in youth point to highly correlative factors such as the presence of psychosocial, mental health, and substance abuse issues.  But what happens to the loved ones after someone dies a death by suicide?  What can one expect from the grief journey and how can professionals support the grieving child, teen, or adult? 

This presentation covers a post-mortem analysis of nearly 3000 youth suicide deaths to uncover pre-existing and contributing factors in the lives of those who died by suicide.  It also provides tips on how to support the bereaved child, teen, or adult on their grief journey.

Objectives:

1. Examine nearly 3000 youth suicide deaths to determine underlying causes
2. Explore statistics related to youth suicide deaths
3. Define risk factors and red flags in suicidal youth
4. Discuss ways to talk to youth about suicide
5. Review the psychosocial, mental health, and substance abuse/use factors in suicidal youth

Slides and Handouts:

SCOTT_Pediatric Suicide and Loss MIMH 2021

Speaker(s):

Eddie McCaskill, MSW, EdD

Anthony Bass, MEd, MA, MSW, RADC, MARS, CCATP, AMTP, CCTP, CDBT, EMDR, LPC

Presentation:

This workshop will examine the impact of adverse childhood experiences and depression on Black males. Black males who are exposed to adverse childhood experiences before age eighteen may be at an increased risk for depressive disorders as adults. There is minimum research on the impact of adverse childhood experiences on the health and well-being of Black males. Adverse childhood experiences have shown to have a severe negative impact on children as well as poor outcomes in their adult lives (Salinas-Miranda et al., 2015). The victims are at increased risk of being homeless, misusing drugs, suicidal, post-traumatic stress, depression, and anxiety at a higher rate than the regular population (Al-Shawi & Lafta, 2015).   

The Center for Behavioral Health Statistics and Quality (2016) data analysis indicated that more than half of all adults in the United States have suffered from adverse childhood experiences. The exposures to adverse childhood experiences have been connected to health problems in adults. Adverse events experienced in childhood may impact the individual for a lifetime. Felitti et al., (1998) identified the ten indicators of adverse childhood experiences as; physical and emotional abuse; physical and emotional neglect; sexual assault; parent treated violently; substance misuse in the home; mental illness in the home; parental separation or divorce; and an incarcerated household member. The Philadelphia Urban ACE Study included additional experiences such as neighborhood violence and racial discrimination. Adverse childhood experiences have been linked to depression in adults (Crouch, Strompolis, Bennett, Morse, and Radcliff, 2017).

Objectives:

1. Identify the ten indicators of adverse childhood experiences.
2. Raise level of awareness regarding the impact of adverse childhood experiences and depression on Black males.
3. Learn psychological, emotional and behavioral symptoms that may present in Black males who have experienced adverse childhood experiences.

Slides and Handouts:

MCCASKILL AND BASS_Bass Formatted DMH Presentation 2021 (2)

Speaker(s):

Amy Shoffner, Psy.D.

Damalye Barclay-Debi, M.A.

Presentation:

Emotional regulation is one of the most important skills in addressing mental health issues. The topic of emotional regulation is often over-complicated which can be overwhelming for those trying to learn emotion regulation skills and for professionals trying to teach emotion regulation skills. This presentation will teach participants the basics of emotional regulation. It will take the mystery out of emotions and help participants understand their own emotional regulation system. Further, this presentation will consider ways to teach emotional regulation to a diverse diagnostic population.

Objectives:

1. Understand the basics associated with emotional regulation.
2. Understand one’s own emotional regulation system, including how to use coping skills to lessen the intensity of unwanted emotions.
3. Teach this model of emotional regulation to diverse diagnostic populations.

Slides and Handouts:

SHOFFNER AND BARCLAY-DEBI_Emotional Regulation_2021

Speaker(s):

Rhiannon Evans, M.S., BCBA, LBA

Lucas Evans, M.A., BCBA, LBA

Teresa Rodgers, PhD, BCBA, LBA

Presentation:

Staff working in high-stress environments are often faced with poor staffing ratios, competing job tasks and burnout. This creates a barrier to providing quality social opportunities and leads to environments where only challenging behavior results in meaningful social interactions. There is no magic fix to overcome these barriers; however, a whole-systems approach with active supervision can help sustain implementation of programs. The Missouri Department of Mental Health (DMH), Division of Developmental Disabilities calls this approach Tiered Supports.

Presenters will discuss how to use this approach and the results which have demonstrated significant reduction in severe problem behavior and increased quality of life in five separate applied settings in a forensic psychiatric facility serving individuals between the ages of 17-100. Similar results were found when applied to multiple community settings where residential services are provided and similar barriers exist. Furthermore, staff participating in the approach reported increased job satisfaction, including a better relationship with their supervisor, team, and the people they serve. Presenters will share applied examples from each setting.

Objectives:

1. Discuss common implementation barriers both in institutions and in community settings
2. Review a universal approach, in Missouri’s Department of Mental Health – Division of Developmental Disabilities, which focuses on active supervision and regular feedback
3. Examine data regarding the supervisors, DSPs, and people participating in the program across multiple applied settings within DMH
4. Learn how to implement a whole-systems, Tiered Supports, approach to increase sustainability of programs

Slides and Handouts:

EVANS_RHI_Spring Institute RE.LE.TR. 2021

Speaker(s):

Shawn Anderson, PhD

Aishah Augusta-Parham, MA

Alexis Humenik, MA, MSCP

Kristin Neville, MA

Presentation:

Expanding the role of evidence-based psychotherapy is critical to effective and efficient competency restoration treatment. Although pharmacological treatment is widely accepted as the primary intervention for competency attainment, for some patients, medications alone are not sufficient to achieve this goal. Certain psychotherapeutic treatments have been empirically established to successfully address particular psychiatric symptoms, which underlie the legal deficits and/or contribute to the psycho-legal deficits of many incompetent defendants.  This presentation will: review different manualized psychotherapeutic approaches that can be used to address specific competency deficits; describe the process for identifying patients whose competency deficits would benefit from psychotherapeutic treatments; and provide case examples using Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Dialectical Behavior Therapy.

Objectives:

1. Learn how psychotherapy fits into a competency restoration program.
2. Learn to identify patients with competency-related deficits appropriate for psychotherapy treatment.
3. Learn how three evidence-based therapies can be applied in competency restoration treatment by addressing specific interfering symptoms and building psycho-legal skills.

Slides and Handouts:

ANDERSON_SHAWN_Spring Training Institute_2021

Speaker(s):

David Strabala, MSW

Presentation:

Hero stories are gaining more attention in culture, through superhero movies, focus on the hero’s journey, and even Trauma-Informed-Care asking, “What happened to you?” as a healing element. All alone, such healing focus on a hero’s power can become imbalanced, however, leading to narrow vision, hyper-masculinity and estrangement from community. Who can help? None other than the misunderstood character known as the trickster. A disruptor, fool, and seemingly evil, the trickster is also a creator. The trickster ways can be especially important today as many problems don’t respond well to typical forceful means.       

Using a djembe drum, the presenter will tell stories of heroes and tricksters from many cultures. He will compare heroes and tricksters to show how they complement each other in healing. The feminine in story will also be discussed, in the form of female protagonists and helpers and in action that balances masculine energy. The audience will learn the value of stories as containers for healing in three ways: through deeper, meaningful connections to self and others; through emergent insight and creativity; and as a guide to embracing non-violent conflict resolution. Focus will be placed on populations within the presenter’s specialties, primarily troubled teens and veterans with PTS.    

Objectives:

1. Discover how stories connect us more deeply to ourselves and the world
2. Experience how stories yield insights and creativity
3. Open up non-violent conflict resolutions through stories

Slides and Handouts:

STRABALA – -Trickster webinar 2021 Strabaladoc

Speaker(s):

Justin Puch, M.A., LPC

Presentation:

Anxiety has increased significantly in children and adolescents over the past decade. A study found that our children have the level of anxiety that inpatient psychiatric patients had two decades ago. In this presentation you will learn how anxiety presents in children and adolescents, how to treat anxiety in your office, and how to help parents help their children cope more effectively.

Objectives:

1. Learn what anxiety is and how it presents in children.
2. Develop and learn counseling techniques to use in sessions.
3. Learn about tried and true coping skills for children and how to teach them so they are utilized.
4. Learn how to coach parents to help kids cope more efficiently.

Speaker(s):

Rachel Colwick, M.A., LPC

Mark Moore, M.A., LPC

Presentation:

This presentation will consist of an overview of the empirically supported treatment models and theories associated with persons who have committed sexual abusive acts such as Good Lives Model, Risk Needs Responsivity Model, Relapse Prevention, Self-Regulation Model-Revised, Motivation-Facilitation Model of Sexual Offending, Cognitive Behavioral Therapy and Rational Emotive Behavior Therapy. The presenters will explain the dynamic risk factors related to this population as well as the protective factors, or features that have been shown to help lower rate of recidivism. Further, characteristics of patterns regarding the sexual offense progression will be depicted within this presentation. Additionally, case examples will be illustrated to increase conceptualization of the offense motivations, goals, and behaviors. Finally, an emphasis of evidence based treatment strategies or tools will be exemplified to audience members.

Objectives:

1. Discuss the empirical based models associated with sexual offending
2. Explain the dynamic risk factors associated with sexual offending including the protective factors (or features shown to help lower recidivism rates)
3. Describe the primary characteristics or patterns (offense goals, motivations, and behavior) related to the offense progression
4. Identify treatment targets and interventions or strategies

Slides and Handouts:

COLWICK AND MOORE_STI2021FinalDraft

Speaker(s):

Ken McManus, M.Ed., LPC

Jason Klaus, B.S.

Presentation: 

In 2018, for the third year in a row, the national total of police officer deaths by suicide exceeded the number of officer deaths in the line of duty. While every such tragedy has its own story, there are patterns of toxicity unique in law enforcement careers that significantly contribute to the risks for relationship implosion, isolation, depression and suicide. Some law enforcement agencies are responding to these trends by providing officer wellness initiatives and supports; others are not. By either path, clinicians may find themselves confronted with law enforcement personnel, or their family members, seeking effective intervention in what may be the later stages of a mental health crisis. And, these individuals can be “treatment reluctant” as a function of their culture. This presentation will provide research-based insights into individual and organizational police culture and specific strategies clinicians can incorporate to increase the efficacy of their treatment efforts.

Objectives:

1. Identify specific dynamics within police culture that increase risks for crisis
2. Identify specific dynamics within police officer experience that enable despair and isolation
3. Describe the neurology that underlies the intensity of officer experience, e.g. the hypervigilance rollercoaster, and increased risk for harm
4. Identify strategies to enhance clinician effectiveness with this unique population

Slides and Handouts:

MCMANUS – Understanding Cop Culture May3rd

Speaker(s):

Keith Neuber, M.S.

Presentation:

Generational diversity is more pronounced in the workplace than at any other time in history. The challenge is in blending the distinct talents and potentials of Boomers, Generation X, Millennials and Generation Z to create a productive, harmonious workplace.    The presentation examines factors which contribute to generational ideology and the potentials each generation bring to a work environment. The presentation will also explore the similarities in human dynamics which exist across generations and how these similarities can facilitate a common collaborative focus. With a refinement of standard business practices to accentuate individual strengths a diverse work force can become an inclusive, thriving enterprise.    

Objectives:

1. Provide a framework for understanding generational differences and ideology
2. Examine the impact of generational difference has on workplace productivity
3. Identify human characteristics that are common to all generations and how they can be used to create collaboration   
4. Provide a model that re-structures common business practices to maximize productivity through a shared perspective

Slides and Handouts:

NEUBER_Conquering the Generational Challenge

Speaker(s):

John Carpenter, MSW, LCSW

Presentation:

When any two people seek to have a meaningful, loving relationship, there are many factors which can interfere, distract, or deteriorate their efforts to succeed. Couples face interfering relatives, cultural differences, strong but often different values, blended family challenges, the dividing effect of manipulative children, addictions, and emotional distractions — not to forget the individual needs and personality dynamics of each individual. Sound too complicated or overwhelming?

This presentation will clearly illustrate nine classic formations of couples with their challenges based upon emotional distance caused by the types of interference just mentioned. Using wonderful illustrations, role plays, and visual props to demonstrate their dynamics. The ways to rebalance or treat these relationships will become very clear and easy to adopt. These nine types of couples should encompass every possible relationship you can imagine — including your own!

Objectives:

1. Identify and comprehend each type of the nine couples
2. Understand what forces / factors interfere with each type of couple
3. Describe the basic treatment needs of each couple
4. Learn visual and experiential techniques to assess and help each couple

Slides and Handouts:

CARPENTER_MIMH 2021

Speaker(s):

Doug Burgess, MD

Evan Schwarz, MD

Dayana Arteaga, DO

Percy Menzies, M. Pharm.

Drew Shoemaker, MD

Angeline Stanislaus, MD

Presentation:

The ECHO model has been recognized as an effective method for distributing and supporting the implementation of evidence based practices to rural areas. This model utilizes teleconferencing technology to link experts in the treatment of opioid use disorder with clinicians interested in learning and implementing evidence based practices in the treatment of a particular condition. This presentation will consist of a live session of the Opioid Use Disorder ECHO. There will be a 20 min didactic on a topic pertaining to the treatment of individuals with opioid use disorder followed by a case presentation and discussion. The didactic covered during this presentation will be management of acute pain in patients being treated for opioid use disorder.

Objectives:

1. Utilize the ECHO model as a tool to help implement evidence based treatment of Opioid Use Disorder
2. Describe 1 strategy for addressing acute pain management in patients treated with methadone, buprenorphine and naltrexone
3. Understand the potential for synergistic pain control when combining buprenorphine with full agonist opioids

Slides and Handouts:

BURGESS_Management of Acute Pain in Patients with Opioid Use Disorder STI

Speaker(s):

Angela Gray, MSW, EdS

Presentation:

Teen girls from urban backgrounds often display challenging attitudes as defense mechanisms to hide the pain or trauma that has impacted their lives. Girls in pain are often misunderstood as simply “trouble makers,” without unpacking the root causes of the behaviors.

This interactive workshop will provide a lens to better understand teen girls’ urban experience. We discuss both internal and external factors-including low self-esteem, depression and anxiety, bullying, and the pressures they absorb from social media, music videos, and explicit songs. The workshop includes lecture, role play, and group sharing to enhance participants’ skills to empower teen girls. 

Objectives:

1.   Define attitude and how it relates to teen girls from urban backgrounds   

2.   Explore how self-esteem impacts teen girls   

3.   Explore the correlation of stress and poverty affects teen girls   

4.   Explore negative self-talk and negative thinking of teen girls   

5.   Examine internal and external factors in today’s society  

6.   Explore the attitudes of professionals and how they could impact teen girls   

7.   Discuss strategies that administrators, social workers, and counselors can use to help teen girls

Slides and Handouts:

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