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Registration

1 August - 31 August 2017
Early Bird Pricing Available

1 September - 22 September 2017
Regular Pricing Available

Advanced Registration
Through 21 September 2017

Thereafter, On-Site Registration
Available 22 September 2017

Contact the ISSTD office at 703-610-9037 or email info@isst-d.org

continuing education

Continuing Education credits are available for this conference through our CE co-sponsor, CE Learning System. Credits must be purchased before the end of the conference for a separate fee.

Additional information on CE credits is available on the PROGRAM page of the conference website.

TREATING THE INTRICATE TRAUMA CLIENT

Friday, September 22 | 8:30am - 4:30pm

Session 1: Recognizing Dissociation in the Effects of Complex Trauma
8:30am – 10:30am  |  Presenter: Garrett Deckel

Complex trauma is distinguished from trauma more generally by several factors.  It is not single-incident trauma but rather involves repetitive traumatic experiences.  Most characteristically coercive control is exercised over the victim, leading to a variety of psychological adaptations that help the victim survive the trauma but are maladaptive in the long run.  Survivors of complex trauma typical develop a wide array of symptoms in multiple domains including cognitive, affective, physical, and relational, as well as frequent psychiatric and medical co morbidities, including affective disorders, anxiety disorders, substance use disorders, and eating disorders.  They are often misdiagnosed and/ or the primary diagnosis is missed. 

This talk will focus on victims of childhood abuse.   The mind/ brain of a child who is repeatedly abused relies on our innate capacity to dissociate in order to survive.  Dissociative processes are multiple and complex, and include "detaching" from the body that is being harmed, emotional and/ or physical numbness, and forming multiple self-states (most extreme in DID) to hold or manage different aspects of navigating a life in which repeated trauma is inescapable.  These dissociative defenses and structures are then well-established and may become "go-to" ways of managing anxiety/distress, leading to a variety of maladaptive patterns and symptoms. 

Upon completion of this session, participants will be able to:

  • Distinguish complex PTSD from PTSD.
  • Improve understanding of the wide range of symptoms, comorbidities and risk factors related to complex trauma.
  • Increase understanding of dissociative processes, dissociative structure, and dissociative disorders.
  • Name 5 observable signs that suggest your client may be dissociating in your office.

Session 2: Developmental Impact of Trauma and Dissociation
10:45am – 12:00pm  |  Presenter: Robert Slater

Early childhood trauma has the potential to overwhelm the coping ability of children and can create the need for developmental changes in brain structure and function. These changes to the developing mind allow for short term survival and sacrifice long term effective functioning. This workshop will detail some aspects of how the brain copes with overwhelming trauma and impaired or disorganized attachment. Specific case examples will be provided from various causes of C-PTSD and dissociative responses and some basic methods of addressing these changes in order to facilitate more effective functioning will be provided.  

Upon completion of this session, participants will be able to:

  • Identify 3 specific causes of early childhood traumatic stressors and specific examples of possible reactions/coping mechanisms.
  • Identify 3 changes in brain structure and function that contribute to traumatic stress and dissociative reactions.
  • Name 4 observable aspects of dissociation according to the BASC model of dissociation.

Session 3: Eating Disorders and Dissociation: When No Body is Home
1:00pm – 2:15pm  |  Presenter: Deborah Cohen

Many trauma patients have issues with eating and with their body image. Comorbid trauma psychopathology manifested by ED patients can consist of mild PTSD to DID. ED issues may range from compulsively eating in an attempt at modulating levels of distress to refusing to eat or drink because these behaviors can cause intense flashbacks or mimic abusive acts. Often sexually traumatized women consciously or unconsciously keep themselves over- or underweight to try to dull their sexual feelings. They then can feel less sexual while warding off sexual interest. Body image distortion is a dissociative symptom, although it is rarely discussed as such in the eating disorder field. To only consider body image distortion and not trauma theory is limiting and inaccurate.  Conversely, known methods of working with body image distortions can be invaluable.

This workshop will highlight some of the thinking in the trauma and ED literature and then apply these concepts to cases from the presenter’s caseload. This understanding will be translated into how one conceptualizes and actualizes strategies for patients who have both an eating disorder and a history of trauma. This presentation will also discuss how the above issues can complicate the therapeutic relationship.

Upon completion of this session, participants will be able to:

  • Identify the relationship between trauma, dissociation and eating disorder symptoms.
  • Recognize that having both an eating disorder and a traumatic history can cause complications in the therapeutic relationship.
  • Formulate a treatment plan and therapeutic strategies utilizing the relationship between trauma and eating disorders.

Session 4: Treatment of Complex Dissociative Disorders: An Overview of Treatment, Traumatic Transference, and Vicarious Traumatization
2:30pm – 4:30pm  |  Presenter: Deborah Cohen and Garrett Deckel

Psychotherapy is the primary treatment modality for both cPTSD and dissociative disorders.  Current treatment guidelines recommend a multimodal three-phase approach.  Phase one consists of establishing safety, stabilization, and symptom reduction; phase two consists in working through and integrating traumatic memories; and phase three focuses on identity integration and rehabilitation.  These phases do not form a discrete temporal sequence but rather a general treatment trajectory, within which there may be movement back and forth.  Though psychotropic medications do not treat dissociation per se (with one possible exception still being evaluated), they may be useful adjuncts to psychotherapeutic treatment.  Specific medication classes that may be used will be briefly reviewed. 
Psychotherapy in trauma survivors is complicated by trauma-based psychophysical "blueprints" that implicitly guide interpersonal relationships and behavior.  Interpersonal neurobiology teaches that even before infants can speak they begin to form mental maps of basic relationship patterns and "expectancies" concerning how the other person will act in different scenarios.   In survivors of trauma, these core representations involve a variety of dynamics between perpetrator, victim and bystander (Karpman's Triangle), in highly personalized and individually historicized forms.   As a result, the therapist is frequently experienced as, and may be reacted to as if, he or she were a perpetrator or betrayer leading to traumatic transferences (and countertransferences) that may be especially difficult to work through.  Moreover, the therapist may repeatedly be exposed to details of horrific interpersonal violence, a type of exposure recognized in DSM-5 to be a possible precursor of PTSD.  Therapists working with this population must learn to recognize traumatic transferences/ countertransferences, be vigilant about care for self, and seek outside consultation when appropriate.

Upon completion of this session, participants will be able to:

  • Describe the three phase model of psychotherapy for complex PTSD and Dissociative Disorders.
  • Understand how internalized representations of interpersonal interactions serve as guidelines for adult behavior.
  • Describe 3 common transferential dynamics encountered in trauma survivors.
  • Define vicarious traumatization and name 3 strategies for preventing it.

CONTINUING EDUCATION

APA
CE Learning Systems, LLC is approved by American Psychological Association to sponsor continuing education for psychologists. CE Learning Systems maintains responsibility for this program and its content.

ASWB
CE Learning Systems (Provider #1020) is approved as a provider for social work continuing education by the Association of State Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education ACE program. CE Learning Systems LLC maintains responsibility for the program. ASWB Approval Period: 02/23/2016 – 02/23/2019. Social workers should contact their regulatory board to determine course approval. Social workers participating in this course will receive up to 6.5 continuing education clock hours.

New York State Education Department's State Board for Social Work
ISSTD's Co-Sponsor, CE Learning Systems SW CPE is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #0060.

New York Education Department for Licensed Mental Health Counselors
CE Learning Systems, LLC is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0072.

CE Process Info
A continuing education certificate for the event you attended will be obtained using the website, CE-Go. Approximately 3 days after the event, you will receive an email containing a link to CE-Go.   (This link will be sent to the email account you used to register for the event).
Upon accessing the CE-Go website, you will be able to:

  • Complete evaluation forms for the event (Mandatory to receive credit for each session)
  • Download your continuing education certificate in a PDF format

If you have any questions or concerns regarding the CE-Go process, please contact CE-Go at 877 248 6789 ext. 5,  or by email at [email protected]