Assessment of Functional Impairment in Children: New Data, New Ideas, and the Rating Scale of Impairment

CE credits: 1.5 (Approved)

Time and Room:  10:50 AM - 12:20 PM; Redmond Room

Learning Objectives:

1. Describe the history and current theories of impairment in school and mental health assessments
2. Utilize the assessment of impairment in treatment planning and intervention

Program Description:

Impairment has become a primary focus of psychological and educational assessments in the community and schools. Qualification of disability status and/or services under multiple legislations, including the Individuals with Disabilities Improvement Education, Americans with Disabilities and the Social Security Acts all require accurate assessment of impairment above and beyond diagnosis and disability determination. This presentation addresses cutting edge research and evidence based practice of the assessment of impairment in children in school and mental health settings. The history of assessment of impairment as part of the diagnostic process will be guided by a discussion of the World Health Organization impairment standards and recommendations from diagnostic protocols (e.g., Diagnostic and Statistical Manual of the American Psychiatric Association - 5^th Edition). The presentation will introduce data from a nationally representative standardization sample of 3,500 children assessing impairment in school, community and home. The Rating Scale of Impairment will be introduced as a valid and reliable means of assessing impairment in the diagnostic process. The presentation will include an overview of integrating impairment data into a comprehensive assessment, treatment, planning and monitoring.

About the Presenter, Samuel Goldstein, Ph.D.

See presenter description above.

The Basics of Opening a Private Practice: Clinical, Ethical, and Management Considerations

CE credits: 1.5 (Approved)

Time and Room:  10:50 AM - 12:20 PM; King County 3

Learning Objectives:

1. Describe the basic steps to create a solo or group practice
2. Demonstrate an awareness of the current models of integrated care
   
3. Increase their knowledge of the ethical considerations of starting a private practice

Program Description:

Thinking about private practice, but not sure where to start? The goal of this presentation is to leave you with more answers than questions. This presentation will cover the important facets of starting and growing a private practice, including the basic steps for start-up or growth, individual versus group practice, the current models of integrated care, and ethical considerations. Attend this presentation if you are new to private practice or considering how to move from institutional work to private practice.

About the Presenter, Samantha Slaughter, Psy.D.:

Dr. Slaughter is a business consultant, licensed psychologist, and CEO of Integrative Psychological Services of Seattle, a group practice integrating physical health with psychological work. She serves as the Director of Professional Affairs for the Washington State Psychological Association. She was honored by WSPA most recently in 2017, receiving the Sustained Service Award in recognition of her contributions to WSPA.

What Was Old is New Again: An Introduction and Update to Biofeedback, Including Neurofeedback and QEEG

CE credits: 1.5 (Approved)

Time and Room:  10:50 AM - 12:20 PM; Kirkland Room

Learning Objectives:

This workshop is designed to help you:

1. Describe the scientific antecedents of applied psychophysiology and biofeedback;
2. Apply integrated biofeedback with psychotherapy concepts to common clinical problems and cite supporting research and efficacy.

Program Description:

This program is intended to introduce the audience to the history, research, mechanisms, applications, and a demonstration of biofeedback for use in a clinical setting. Biofeedback is the process of gaining greater awareness of many physiological functions: brainwaves, muscle tone, skin conductance, heart rate and pain perception. This introductory level program will discuss the old-new in biofeedback with an emphasis on neurofeedback, along with some easy to use methods that clinicians can incorporate into their work with relatively little training. At a high level, the presenters will discuss the most salient research and efficacy in this field, and the more effective applications. The last 30-minutes of the program will show a live demonstration of neurofeedback.

About the Presenters, Richard Packard, Ph.D., and Brian Imber, Ph.D.:

Richard L. Packard, Ph.D. is a licensed psychologist as well as having additional certifications in forensic psychological matters. He earned his B.S. degree from the University of Texas Health Science Center at Dallas in 1976, his M.S. from East Texas State University in 1978, and his Ph.D. from the University of Washington in 1990. He has held research and clinical faculty positions with the Washington State Department of Corrections and the University of Washington Medical School, Department of Psychiatry and Behavioral Sciences.  In his 40-plus years of professional work, Dr. Packard has been involved in a wide variety of clinical and forensic issues as well as maintaining a long-standing interest in furthering effective treatment using a variety of methods. He has worked in numerous settings including inpatient and outpatient, rehabilitation settings, as well as corrections and private practice. Dr. Packard has received professional and academic awards for his research and clinical contributions and is a frequent speaker and presenter at professional and scientific conferences. In recent years, Dr. Packard has returned to an early interest in cognitive neuroscience and the application of these developments in clinical practice.

Dr. Brian L. Imber is a partially licensed practicing clinical psychotherapist at Brain Health Northwest in Seattle Washington. He specializes in integrating multiple psychotherapies with applied biofeedback to treat clinical and non-clinical issues. Dr. Imber received his Ph.D. in Clinical Psychology with a specialization in Applied Psychophysiology from Saybrook University. He also holds a M.A. in Clinical Psychology and an M.B.A. He has clinical research and application interests in the field of Integrative Psychotherapy, particularly applying biofeedback/neurofeedback to treat peripheral and central nervous system dysregulations, and helping individuals optimize performance in business, sports, education, and the arts. Dr. Imber also integrates and applies Virtual Realty technology to help with the treatment of stress, fears, and phobias.

Benefits and Mitigated Risks of the Intensive Treatment Format: Taking Care Ethically

CE credits: 1.5 (Approved)

Time and Room:  2:00 PM - 3:30 PM; Redmond Room

Learning Objectives:

Attendees will be able to :

1. identify whether clients are appropriate for the intensive format.
   
2. describe four parameters of the intensive treatment structure that need to be defined.
   
3. define abandonment and betrayal enactment and how to mitigate it in the intensive format.
   
4. articulate four elements of ergonomics to consider for therapist and client health and safety in the intensive structure.
   

Program Description:

Some therapists offer intensive treatment as an alternative to the conventional therapy structure of regular brief therapy appointments over months or years. This workshop describes considerations for doing intensive work safely and ethically. Advantages include having time to drop into the felt sense of the bodily held unprocessed experience, some wish to avoid treatment in their own town, and some prefer to work briefly and intensively rather than hassle with weekly appointments with all the travel and choppiness of brief sessions.

Hazards include that when working in implicit memory, the therapist's every nuance can trigger an enactment of early relationship trauma. If time in the intensive runs out before the work is complete, there is a risk of triggering early abandonment issues, even as adult states understand. Other ethical considerations include the use of time (e.g., breaks), scheduling, pricing, communication, accommodations, ergonomics, logistics, daily closure procedures, follow up checkpoints. The workshop will address the safety and comfort for both therapist and client in the intensive format.

About the Presenter, Sandra Paulsen, Ph.D.:

Dr. Paulsen is the author of When There Are No Words: Repairing Trauma and Neglect from the Attachment Period, and Looking Through the Eyes of Trauma & Dissociation: An Illustrated Guide for EMDR Therapists and Clients. She co-authored The Neurobiology and Treatment of Traumatic Dissociation: Toward an Embodied Self, and All the Colors of Me: My First Book on Dissociation. A fellow of the ISST&D, she was invited faculty in numerous international venues, and was invited EMDRIA Masters Series Lecturer. She has taught her several workshops in such places as Japan, Russia, Canada, Scotland, Hong Kong, England, Brazil, Norway, Sweden, South Africa and more. Her clinical practice is limited to brief intensive work on a forested island near Seattle. That practice is canine and equine assisted.

Understanding Internet Gaming Disorder

CE credits: 1.5 (Approved)

Time and Room:  2:00 PM - 3:30 PM; King County 3

Learning Objectives:

1. Participants will be able to accurately assess for Internet Gaming Disorder
2. Participants will be able to list 3 common disorders which co-occur with Internet Gaming Disorder

Program Description:

The World Health Organization will be adding Gaming Disorder to its list of mental diseases in the upcoming ICD-11. Many therapists are not familiar with the diagnosis and treatment of Gaming Disorder (also referred to as Internet Gaming Disorder, Internet Addiction Disorder, Gaming Addiction, Problematic Screen Use, etc.), although most are seeing clients suffering from this disorder. Because so few specialists exist, it is important that non-specialists learn how to treat the problem more effectively or refer when appropriate. This program will provide an introduction to the signs and symptoms, the etiology, the co-occurring disorders, the vulnerabilities and the treatment of Internet Gaming Disorder.

About the Presenter, Hilarie Cash, Ph.D., LMHC, CSAT:

Dr. Cash is the cofounder and Chief Clinical Officer of reSTART Life, PLLC, a residential program (first in the US and Canada) designed explicitly for adults and adolescents who are experiencing addiction to the Internet and video games. She began her work in the emerging field of Internet addiction in the mid-90's. By 1999, she had co-founded an outpatient clinic called Internet/Computer Addiction Services (now closed) in Redmond, WA. She is the co-author of the 2008 book, Video Games and Your Kids: How Parents Stay in Control. All of these ongoing endeavors have brought her recognition as one of the nation's leading experts in the growing field of Internet and video game addiction.

Decision-Making Capacity Assessments: Theory to Practice

CE credits: 1.5 (Approved)

Time and Room:  2:00 PM - 3:30 PM; Kirkland Room

Learning Objectives:

1. Apply knowledge of the guiding principles in capacity assessment
2. Identify common DCMA pitfalls
3. Implement a standardized approach to capacity assessment
   

Program Description:

Decision making capacity can be affected by various conditions such as traumatic brain injury, psychiatric illness, and neurodegenerative diseases. As a health care provider, one may be called upon to assess a patient's decision-making capacity. Yet decision-making capacity assessments (DMCA) require a specialized set of skills that are inconsistently taught in the healthcare field. Isolation from inter-disciplinary teams, lack of confidence, uneasiness managing conflict between family and patients, and fear of liability can result in clinicians failing to correctly identify incapacity in patients. Balancing autonomy and independence with patient safety and well-being is delicate and complex, and may include different levels of tolerance for various aspects of decision making. Theory and research can inform effective clinical approaches, interdisciplinary collaboration, and operational documentation for DMCAs. With multiple calls for compulsory training in DMCA for healthcare providers, this presentation aims to provide an introductory overview of the scope of decision-making capacity and practical tools for conducting such assessments as followed through exemplary cases.  Several guides and articles on structured approaches to decision making capacity assessment will also be discussed.

About the Presenters, Christopher J. Graver, Ph.D., ABPP-CN and CPT Fawn A. Walter, MS:

Dr. Graver is the Chief of Neuropsychology at Madigan Army Medical Center and a Board Certified Neuropsychologist. He has published and presented workshops on decision making capacity assessments, therapeutic assessment approaches, and functional somatic syndromes. He also serves as a reviewer for several journals, including The Clinical Neuropsychologist.

CPT Walter is completing her internship at Madigan Army Medical Center and will earn her Ph.D. from Kent State University in 2019. Her research focuses on health behaviors and positive psychology in healthy and unwell populations. She has presented her research at behavioral medicine conferences for the past six years.

Moral Injury: Assessment, Intervention, and Spiritual Dimensions

CE credits: 1.5 (Approved)

Time and Room:  3:50 PM - 5:20 PM; Redmond Room

Learning Objectives:

1. Summarize current research trends in the study of Moral Injury and how this overlaps with and is distinct from Post-Traumatic Stress Disorder
   
2. Identify current assessment measures and recognize ongoing challenges in the assessment/evaluation of moral injury.
   
3.  Be able to provide an overview of the Adaptive Disclosure intervention and other modalities for treating moral injury .
   
4.  Identify ways in which Moral Injury impacts and may be impacted by an individuals religious or spiritual identity.
   

Program Description:

The construct of moral injury has become an area of interest to many clinicians and researchers working with individuals impacted by combat exposure. While there may be an increased awareness of moral injury among professionals working within the U.S. Department of Defense (DOD) and the Department of Veterans Affairs (VA), those working outside of these institutions may have limited access to information on this topic. Since many veterans receive their care outside of the VA system, it is crucial that community providers have access to this burgeoning area of study and clinical intervention. Presenters will provide a definition of moral injury, summarize current research trends in the study of Moral Injury, and describe how this overlaps with and is distinct from Posttraumatic Stress Disorder (PTSD). Current methods of assessment will be introduced, along with the challenges in the area of assessment/evaluation of moral injury. An overview of interventions addressing moral injury will be provided. The final section of the presentation will focus on working with spiritual distress, commonly identified as a core feature of moral injury. Presenters will define this concept and its relationship to moral injury by presenting several theoretical perspectives and discussing corresponding implications for clinical work. Time will also be spent discussing ways of working within a patients spiritual tradition to facilitate healing and growth.

About the Presenters, James Dillon, Ph.D., Julie Johnson Sharrette, Psy.D., and Samuel Rennebohm, MS, MDiv.:

Dr. Dillon received his doctoral degree in Clinical Psychology at the University of Missouri-St. Louis. He completed his pre-doctoral internship at the Jerry L. Pettis Memorial Veterans Medical Center in Loma Linda, CA, and his postdoctoral fellowship in Interdisciplinary Treatment of Substance Abuse at the Puget Sound VA Healthcare System in Seattle, WA. Dr. Dillon has worked in correctional and military settings. Currently, he works in the Veterans Intensive PTSD Program at the Puget Sound VA Healthcare System American Lake Division, and private practice in Seattle. His professional interests include trauma and PTSD, moral injury, the influence of culture on psychological development, gender, and LGBT issues.

Dr. Sharrette is a psychologist specializing in the assessment and treatment of PTSD. She received her doctorate in Clinical Psychology from Nova Southeastern University and completed a pre-doctoral internship at Western State Hospital in Washington State. She has worked with active duty military and veteran populations for the last nine years with most recent employment at the American Lake Division of the VA. Her professional interests include program development, psychological assessment, violence risk assessment and prevention, and treatment of complex trauma and moral injury.

Samuel Rennebohm is completing his pre-doctoral psychology internship at the VA Puget Sound - American Lake Division, and will go on to do a Fellowship in Couples and Family Health at the Puget Sound VA - Seattle Division. Prior to doing his doctoral work in Clinical Psychology at Seattle Pacific University, Samuel also completed a Masters of Divinity Degree from the Pacific School of Religion. His post-doctoral research will be focused on the impact of moral injury on Veteran romantic relationships and social support.

What Can We Gain from the Alternative DSM-5 Model for Personality Disorders?

CE credits: 1.5 (Approved)

Time and Room:  3:50 PM - 5:20 PM; King County 3

Learning Objectives:

1. Participants will be able to compare the alternative DSM-5 diagnosis model for Personality Disorders (Sect. III DSM-5) with the current DSM-5 model (Sect. II DSM-5).
2. Attendants will be able to describe the clinical utility of the alternative DSM-5 model for therapeutic practice and assessment.

Program Description:

The alternative DSM-5 model for personality disorders addresses problematic classification issues and comorbidities that have plagued the DSM-IV and the current DSM-5 classification model for personality disorders (PD), such as co-occurrence of PDs, heterogeneity within categories, and arbitrary diagnostic thresholds. The alternative DSM-5 model offers several advantages over existing models in diagnosing and treating personality disorders: With the incorporation of the Level of Personality Functioning Scale (LPFS) and the Personality Inventory for DSM-5 (PID-5), diagnoses of PDs have largely become objectified and more reliable and valid. Furthermore, clinical decision making and communication with clients are greatly assisted by the identification of the severity level of personality functioning and specific pathological traits. Focusing on relevant areas of personality based on a trait approach also allows more individualized and targeted interventions which will in turn likely lead to better treatment outcomes for personality disorders. Workshop attendees will be familiarized with the alternative DSM-5 model for personality disorders and its development, as well as advantages over previous diagnostic approaches in the DSM. Using case examples,  diagnosing PDs will be exemplified to give practitioners guidelines in the use of the alternative model, determination of the level of personality functioning, and the application of the PID-5 on a trait and dimensional level. The usefulness for treatment planning will also be highlighted.

About the Presenter, Cornelia Kirchhoff, Ph.D.:

Since receiving her Ph.D. in Clinical Psychology from Washington State University in 2015, Cornelia Kirchhoff has since worked as assistant director at the WSU Psychology Clinic. As clinical faculty, she teaches personality assessment and diagnosis at a  graduate level and supervises a wide array of assessment and therapy cases.

Forensic Survival Skills for the Non-Forensic Psychologist

CE credits: 1.5 (Approved)

Time and Room:  3:50 PM - 5:20 PM; Kirkland Room

Learning Objectives:

Participants will be able to:

1. Describe the risks of rapid response or advocacy in cases involving litigation.
2. Apply recommendations to ethically and professionally respond to records requests.
3. Discuss methods for deposition and trial testimony to reduce malpractice risks.

Program Description:

Ethical and practice pitfalls abound when treating or evaluating psychologists encounter litigation situations. Some of those may suddenly appear with an unexpected phone call or letter while more formal contacts such as subpoena or deposition and testimony demands are issued to the psychologist. This can be a frightening and overwhelming event for those who are unprepared. However, with some simple survival skills and basic knowledge, the psychologist can respond in an ethical and methodical fashion to meet those challenges. This workshop will provide such guidance by examining four components: initial contact and requests; deposition and interrogatories; trial testimony parameters; and elements of the art of testifying. Attention to record keeping, documentation of contacts, scope of practice, and basis for opinions represent central domains which will be addressed. Additional information regarding relevant statutory guidelines and limitations will be presented.

About the Presenters, Daniel Rybicki, Psy.D., and G. Andrew Benjamin, JD, Ph.D., ABPP:

Dr. Daniel Rybicki has over 30 years of experience as an expert witness and evaluator for family, criminal, civil, and dependency court cases. He has served in multiple jurisdictions including those in California, Illinois, Indiana, Oregon and Washington, and has testified over 400 times. Dr. Rybicki specializes in complex custody cases such as high conflict or relocation cases and cases where there are allegations of alienation, personality disturbance, sexual abuse, substance abuse, or domestic violence. In addition to extensive experience in psychological assessment (over 8,000 evaluations), Dr. Rybicki continues to provide work product review, consultation and serves as a rebuttal witness or expert witness throughout Washington.

Dr. Benjamin works with families engaged in high-conflict litigation and lawyers suffering from various mental health and drug abuse problems, in various governance positions, and as director of the Parenting Evaluation Training Program at the University of Washington. A Clinical Professor of Psychology and Affiliate Professor of Law at the University of Washington, Dr. Benjamin has published 72 peer-reviewed articles in Psychology, Law, and Psychiatry journals. He is the author of five books published by APA, and one book published by Sage. He has received multiple awards from such groups as the Washington State Bar Association, the Washington State Psychological Association, and the APA.