ISTSS 28th Annual Meeting (International Society for Traumatic Stress Studies)


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ISTSS 28th Annual Meeting (International Society for Traumatic Stress Studies)

  1. 1. ISTSS 28th Annual Meeting Beyond Boundaries: Innovations to Expand Services and Tailor Traumatic Stress Treatments Preliminary ProgramThe largest gathering of professionalsdedicated to the advancement and exchange ofknowledge about traumatic stress. November 1 – 3, 2012 Pre-Meeting Institutes, October 31, 2012 JW Marriott Los Angeles at L.A. LiveJointly Sponsored by Los Angeles, CA USABoston University School of Medicine and theInternational Society for Traumatic Stress Studies
  2. 2. ISTSS 28th Annual MeetingDear Colleagues,The 28th Annual Meeting of the International Society for Traumatic Stress Studies (ISTSS) About thewill be held November 1-3, 2012, at the JW Marriott Los Angeles at L.A. Live in LosAngeles, California, USA. The ISTSS Annual Meeting is the place where professionals International Societyconnect with old friends and colleagues, meet new ones and develop and strengthencollaborative relationships that move the field of traumatic stress forward. It is a forum for for Traumaticsharing research, clinical strategies, public policy concerns and theoretical formulations Stress Studiesof trauma. It is an international assembly of professionals and students representing anarray of disciplines who share a passion for the study and treatment of traumatic stress. ISTSS is an international interdisciplinary professionalThis year’s meeting theme is “Beyond Boundaries: Innovations to Expand Services and organization that promotesTailor Traumatic Stress Treatment.” Major advances have been made in the assessment advancement and exchange ofand treatment of traumatic stress in the past 20 years. Despite these advances, the vast knowledge about traumatic stress.majority of those affected by traumatic stress still do not receive any type of services or This knowledge includes:care. For many, no services are available. Others are reluctant to seek care or do notfind the services offered appealing. In addition, treatments are not effective for some • Understanding the scope andwho receive them. The effectiveness of services or clinical care may be limited if our consequences of traumaticconceptualizations, research methods and practices do not match the clinical realities for exposure,some trauma survivors. • Preventing traumatic events andThis meeting will provide a forum to discuss innovative strategies for outreach, ameliorating their consequences,assessment, treatments and programs that will enable us to deliver services in a wider andvariety of contexts and reach more trauma survivors. A shift in focus from mental disorder • Advocating for the field of traumaticand diagnosis to the promotion of mental health can help reduce stigma and facilitate stress.wider dissemination of information and tools to promote recovery from traumatic stress.Innovations in conceptualization, measurement and clinical methods may help us betterunderstand the diversity of responses to traumatic stress and tailor our services andtreatments to groups and individuals with different post-traumatic presentations.We hope you will be able to join us at the International Society for Traumatic StressStudies 28th Annual Meeting in Los Angeles.For up-to-date information, please visit look forward to welcoming you to this outstanding educational event.Debra Kaysen, PhD, and Wietse Tol, PhD28th Annual Meeting Co-ChairsEve Carlson, PhDISTSS PresidentWhy Attend the ISTSS 28th Target Audience Meeting Attendees ParticipateAnnual Meeting? Who will benefit from this conference? from a Variety of Clinical and• Learn about cutting-edge research • Attorneys Nonclinical Settings Around and clinical work in the field of • Counselors • Drug and alcohol counselors the World... trauma.• Discuss the translation of basic • Educators • Community agencies research into clinical interventions • Journalists/media experts • Government and the benefits of collaboration • Marriage and family therapists • Law enforcement and mutual learning to implement • Nurses • Law firms, legal aid organizations evidence based practice. • Physicians • News organizations• Choose between research, clinical • Policy makers • NGOs and combined tracks, or attend a • Psychiatrists • Nonprofit/private/public social mixture of them. • Psychologists service/health agencies• Participate in formal and informal • Social workers • Private clinical practice networking opportunities. • Victim advocates • Religious institutions• Receive continuing education credits • Research organizations and visit the bookstore and exhibits. • Universities2 Preliminary Program
  3. 3. ISTSS 28th Annual MeetingSchedule at a Glance (subject to change)As of July 19, 2012Tuesday, October 30 Friday, November 24:00 p.m. – 6:00 p.m. Registration Desk Open 8:00 a.m. – 9:00 a.m. Coffee and Tea Service 8:00 a.m. – 6:00 p.m. Registration Desk OpenWednesday, October 31 8:00 a.m. – 6:00 p.m. Exhibits Open7:30 a.m. – 8:30 a.m. Coffee and Tea Service 8:00 a.m. – 7:00 p.m. Bookstore Open7:30 a.m. – 5:00 p.m. Registration Desk Open 9:00 a.m. – 10:15 a.m. Keynote Address (Hanson) and8:30 a.m. – Noon Pre-Meeting Institutes Concurrent Session 610:30 a.m. – 5:00 p.m. Bookstore Open 10:30 a.m. – 11:45 a.m. Concurrent Session 71:30 p.m. – 5:00 p.m. Pre-Meeting Institutes 10:30 a.m. – 6:00 p.m. Poster Viewing 25:15 p.m. – 6:00 p.m. New Members and 11:45 a.m. – 1:30 p.m. Lunch on Your Own First-Time Attendee Gathering 11:45 a.m. – 1:30 p.m. Student Luncheon Meeting8:00 p.m. – 9:30 p.m. Invisible Wounds of War: Breaking 1:30 p.m. – 2:45 p.m. Concurrent Session 8 the Silence: A Documentary About 1:45 p.m. – 3:30 p.m. Internship and Postdoctoral Program Bridging the Gap: Community Based Networking Fair Non-Profit Integrative Intensive Retreats for Service Members and 3:00 p.m. – 4:15 p.m. Concurrent Session 9 Their Families in Collaboration with 4:30 p.m. – 5:45 p.m. Concurrent Session 10 the DOD/VA 6:00 p.m. – 7:00 p.m. Author Attended Poster Session 2 (cash bar)Thursday, November 1 7:00 p.m. – 7:45 p.m. Business Meeting8:00 a.m. – 9:00 a.m. Coffee and Tea Service8:00 a.m. – 6:00 p.m. Registration Desk Open Saturday, November 38:00 a.m. – 6:00 p.m. Exhibits Open 8:00 a.m. – 9:00 a.m. Coffee and Tea Service8:00 a.m. – 7:00 p.m. Bookstore Open 8:00 a.m. – 1:30 p.m. Exhibits Open9:00 a.m. – 10:15 a.m. Keynote Address (Patel) and 8:00 a.m. – 4:30 p.m. Registration Desk Open Concurrent Session 1 8:00 a.m. – 6:00 p.m. Bookstore Open10:30 a.m. – 11:45 a.m. Concurrent Session 2 9:00 a.m. – 10:15 a.m. Keynote Address (Weingardt) and10:30 a.m. – 6:00 p.m. Poster Viewing 1 Concurrent Session 1111:45 a.m. – 1:30 p.m. Lunch on Your Own 10:30 a.m. – 11:45 a.m. Concurrent Session 12Noon – 1:15 p.m. Special Interest Group (SIG) Meetings 11:45 a.m. – 1:30 p.m. Lunch on Your Own1:30 p.m. – 2:45 p.m. Concurrent Session 3 Noon – 1:15 p.m. Special Interest Group (SIG) Meetings3:00 p.m. – 4:15 p.m. Concurrent Session 4 1:30 p.m. – 2:45 p.m. Keynote Address (de Jong) and4:30 p.m. – 5:45 p.m. Concurrent Session 5 Concurrent Session 136:00 p.m. – 7:00 p.m. Author Attended Poster Session 1 3:00 p.m. – 4:15 p.m. Concurrent Session 14 (cash bar) 4:30 p.m. – 5:45 p.m. Concurrent Session 157:15 p.m. – 8:00 p.m. Awards Ceremony 5:45 p.m. Meeting Adjourns8:00 p.m. – 9:30 p.m. Welcome ReceptionTable of ContentsSchedule at a Glance..................................3 Pre-Meeting Institutes.......................13–21 General Information and Meeting Highlights....................................72Keynote Addresses.................................5–8 ISTSS Special Interest Groups.................21 Registration .............................................73z Master Clinicians....................................9 Daily Schedule....................................23–67 Continuing Education................................74A Master Methodologists.....................9–10 Internship and Postdoctoral Program Networking Fair..................................68–70 Registration Form.....................................77O Featured Presentations................. 10–11 Hotel and Travel Information...................71 Pre-Meeting InstituteR Media Presentation..............................12 Registration Form.....................................783 Preliminary Program
  4. 4. ISTSS 28th Annual Meeting The ISTSS 28th Annual Meeting is supported in part by education grants from the following: Platinum Support This event is supported by National Institute of Mental Health Grant Number R13MH07881 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. Silver Supporter ISTSS Exhibit, Support, and Advertising Opportunities We invite commercial, government agencies, and non-profit organizations to take advantage of multiple ways to participate in the ISTSS Annual Meeting. Exhibitors: Contact new prospects, gather leads, introduce your presence in the market and show your appreciation for your existing customers by exhibiting at the ISTSS Annual Meeting. Supporters: Show your support for quality educational content at the ISTSS Annual Meeting or online continuing education program by providing an unrestricted educational grant to ISTSS. Advertisers: Contact us to learn about advertising opportunities at the ISTSS Annual Meeting. For more information, visit the ISTSS website at or reach us at, +1-847-480-9028, ext. 275, or Preliminary Program
  5. 5. ISTSS 28th Annual MeetingKeynote AddressesThursday, November 1, 9:00 a.m. – 10:15 a.mMental Health for All-by-AllPrimary Keyword: Clinical/Intervention Research Dr. Vikram Patel is a professor ofSecondary Keyword: Diverse Populations International Mental Health and WellcomePresentation Level: Intermediate Trust Senior Research Fellow in ClinicalRegion: Global Science at the London School of Hygiene & Tropical Medicine (UK). He is the joint directorVikram Patel, MSc, MRCPsych, PhD, FMedSci of the School’s Centre for Global MentalProfessor of International Mental Health & Wellcome Trust Senior Health.Research Fellow, London School of Hygiene and Tropical MedicineLondon, United Kingdom His primary research spans three themes: investigating theThe scarcity of specialist mental health human resources in social and cultural determinants of mental disorders; describingall countries, but especially in low income countries, is further the inter-relationship of mental disorders with other publiccompounded by their inequitable distribution and inefficient health priorities; and evaluating interventions aimed at improvingutilization. This human resource gap will remain large for the access to effective mental health care in low resource settings.foreseeable future, and is likely to be worsened as populationsgrow in many countries and as specialists immigrate from poorer He serves on a number of committees including the WHO’sto richer areas. Expert Advisory Group for Mental Health and the Technical Steering Committee of the Department of Child & AdolescentIn this context, this presentation considers ‘task-sharing’ as one Health and the World Economic Forum Global Agenda Council onof the most significant advances in improving access to affordable Brain and Cognitive Sciences.and effective mental health care. Task sharing, the strategy ofrational redistribution of tasks among health workforce teams, He is a co-founder of Sangath, a community based NGO in Indiahas become a popular method to address specialist health which won the MacArthur Foundation’s International Prize forhuman resource shortages in other areas of health care such Creative and Effective Institutions in 2008. He is a member ofas HIV/AIDS and maternal and child health. Specific tasks are a group constituted by the Ministry of Health (Government ofmoved, where appropriate, from highly qualified health workers India) tasked with writing India’s first mental health policy andto health workers with shorter training and fewer qualifications designing the National Mental Health Program for the period ofin order to make more efficient use of the available human 2012-2017.resources for health. He was elected a fellow of the Academy of Medical Sciences ofThis presentation will synthesize the growing, and compelling, the UK and won the Chalmers Medal from the Royal Society forbody of evidence on the safety and effectiveness of task-sharing Tropical Medicine & Hygiene in 2009. His book Where There Is Noto improve access to care for a range of mental disorders, by Psychiatrist (Gaskell, 2003) has become a widely used manualunpacking complex psychological treatments and empowering for community mental health in developing countries. He wascommunity and lay health workers to deliver specific treatment an editor of both Lancet Series’ on Global Mental Health (2007 &strategies. Not only are such interventions more affordable and 2011); the PLoS Medicine series on packages of care for mentalaccessible, but they also empower individuals to better manage and neurological disorders in developing countries (2009); andtheir own mental health and care for others who are affected, The Lancet series on promoting universal health care in Indiathereby reducing the large ‘treatment gaps’. (2011). He led the efforts to set up the Movement for Global Mental Health.Such task-sharing interventions are also very relevant to betterresourced settings which also face high levels of ‘treatment He is based in Goa, India where he leads a program of publicgaps’ (in particular for psychological treatments), and spiraling health research and capacity development with Sangath, thecosts of mental health care (mostly driven by the high costs of Public Health Foundation of India and government agenciesspecialist delivered care). The role of mental health specialists focusing on three broad areas: child development, adolescentin such intervention programs needs to expand from providing health and mental clinical care to incorporate a number of additional roles,for example advocacy, training, consultation, evaluation andsupervision. In doing so, the goal of ‘mental health for all’ may berealistically achieved, in partnership ‘with all’.5 Preliminary Program
  6. 6. ISTSS 28th Annual MeetingKeynote AddressesFriday, November 2, 9:00 a.m. – 10:15 a.m.Road Less Traveled? Bringing Effective Trauma Interventions forYouth & Families Into Community SettingsPrimary Keyword: Training/Education/Dissemination Dr. Rochelle Hanson is a professor atSecondary Keyword: Child/Adolescent the National Crime Victims Research andPresentation Level: Introductory Treatment Center (NCVC), DepartmentRegion: Industrialized Countries of Psychiatry and Behavioral Sciences, Medical University of South Carolina. She isRochelle Hanson, PhD a licensed clinical psychologist specializingProfessor and Director of Clinical Operations, National Crime in the treatment of trauma among children,Victims Research and Treatment Center (NCVC) adolescents and adults. Her research focusesCharleston, South Carolina, USA on the prevalence and effects of trauma exposure as well as dissemination of evidence-supported practices forTransporting and implementing efficacious treatments into trauma-exposed youth.communities to reach all individuals who need them is anongoing challenge. Implementation strategies involving She is a former board member of the American Professionalmulti-stakeholder participation have not yet specifically Society on the Abuse of Children. She is a core faculty memberfocused on empirically-supported trauma-focused treatments, of Project BEST, a statewide initiative, funded by the Dukeparticularly those that target youth and their families. As a Endowment, whose longterm goal is to ensure that abused/result, these interventions are still not well-integrated within traumatized children in South Carolina receive appropriate,communities, nor are they yet the standard practice of care empirically supported mental health assessment andthroughout many countries’ mental health and public health psychosocial treatment She is currently serving as director of TLC for DC II, a learningThis presentation will describe some promising examples of collaborative focused on training and implementation of TF-multilevel implementation models designed to promote and CBT in Washington, D.C. Dr. Hanson conducts trainings insupport sustained use of evidence-based, trauma-focused trauma-focused cognitive behavior therapy (TF-CBT) throughoutinterventions in community settings. Research on delivery of the country and maintains a clinical practice. She is the 2010trauma interventions in community settings will be reviewed recipient of the MUSC Teaching Excellence Award, Clinical-with an emphasis on methods to promote adoption, uptake, Professional, Educator-Mentor.and sustained use. Challenges to implementation, particularlyinvolving interventions that target traumatized youth and theirfamilies will be highlighted.The presentation will conclude with a discussion on directions forthe future, including implications for clinicians, administrators,researchers, public policy makers, as well as other keycommunity stakeholders.6 Preliminary Program
  7. 7. ISTSS 28th Annual MeetingKeynote AddressesSaturday, November 3, 9:00 a.m. – 10:15 a.m.Internet and Mobile Technologies to Support the ImplementationEvidence-Based Practices in PTSD TreatmentPrimary Keyword: Technology Dr. Weingardt is national director for MentalSecondary Keyword: Not Applicable Health Web Services in the U.S. DepartmentPresentation Level: Intermediate of Veterans Affairs (VA). He and his team areRegion: Industrialized Countries responsible for coordinating activities across three broad domains: online clinical trainingKenneth R. Weingardt, PhD for VA mental health clinicians, onlineNational Director, Web Services, VA Office of Mental Health Services, self-help and mobile apps for veterans andVeterans Health Administration their families, and websites to support a wideConsulting Assistant Professor, Department of Psychiatry & range of VA stakeholder groups.Behavioral Sciences, Stanford University School of MedicineWashington, District of Columbia, USA He has successfully completed several research projects funded by the National Institute on Drug Abuse (NIDA) and VAWidespread adoption of Internet and mobile technologies is Health Services Research & Development (HSR&D) evaluatingtransforming the way in which we screen, assess, and intervene role of online clinical training in implementing evidence-basedwith clients who have post-traumatic stress disorder (PTSD). This practices such as cognitive behavioral therapy and motivationalpresentation begins with a high level overview of the scientific enhancement therapy for substance use disorders. He servesliterature regarding technologies to support evidence-based as a consultant on a variety of current projects funded by VA,PTSD care, including provider-facing resources such as online NIH and the Wellcome Trust, and provides researchers withclinical training programs and decision support systems, and guidance regarding the design, development, implementationpatient-facing resources such as online self-help programs, and and evaluation of internet and mobile technology applications formobile apps. mental health.Next, the Consolidated Framework for Implementation Research(CFIR) will be reviewed, and its utility in understanding the factorsthat drive the sustained adoption of these technologies in clinicalpractice will be discussed. Case studies of a mobile app and aWeb-based self-help tool will be used to illustrate how the CFIRsframework can help researchers and clinical leaders to attendto the many contextual factors that influence whether a newtechnology is embraced by providers and patients.The presentation concludes with a discussion of the conceptof scalability, and a call for researchers to think about howtechnology interventions can be taken to scale throughoutall stages of their work, rather than waiting until they havecompleted pilot testing and efficacy studies.7 Preliminary Program
  8. 8. ISTSS 28th Annual MeetingKeynote AddressesSaturday, November 3, 1:30 p.m. – 2:45 p.m.Public Mental Health as the Future Paradigm Fourth, public mental health calls for a new research agenda.for our Trauma Societies? We need research on tipping points that convert inaction toPrimary Keyword: Global Issues cooperation and synergy in post-disaster areas and refugeeSecondary Keyword: Disaster/Mass Trauma Survivors camps. We need research on the transformation of stigma andPresentation Level: Intermediate helplessness into connectivity and remoralization of vulnerableRegion: Industrialized Countries populations. We need research to change cycles of violence (e.g. by the use of transitional justice mechanisms into peacefulJoop de Jong, MD, PhD coexistence). We also need research on differential susceptibilityProfessor of Cultural and International Psychiatry, VU University and to traumatic stress transcending the macro-level of ecologicalUniversity of Amsterdam, the Netherlands resilience to the micro-level of epigenetics.Boston University School of MedicineRhodes University South Africa Finally, the public mental paradigm asks for a redefinition ofThe Hague, Netherlands psychological and other competencies in both high and low-income countries. It implies that psychologists and otherHow do we address the psychological needs of large populations mental health professionals become core team players liaisingexposed to severe traumatic stressors? To answer this question, to other professionals involved in health and education, thea public mental health approach is quickly gaining popularity for economy, governance, the military, and human rights.trauma-exposed populations in international settings. Dr. Joop de Jong is professor of CulturalThis presentation will address how this perspective may inform and International Psychiatry at the VUprevention and care with populations exposed to traumatic University and the University of Amsterdam,stressors both in high-income (e.g. in the aftermath of 9/11 or adjunct professor of Psychiatry at BostonKatrina) and in developing countries (e.g. in the context of natural University, and visiting professor at Rhodesdisasters and armed conflicts). University South Africa. He was trained in tropical medicine, public health, psychiatry,Public mental health aims at protecting, promoting and psychotherapy and epidemiology. Herestoring the mental health of a population rather than an established Transcultural Psychosocial Organization (TPO), one ofindividual. The paradigm of public mental health has several the largest relief organizations in mental health and psychosocialimportant implications for the trauma profession in the realms of care of post-conflict and post-disaster populations in over 20prevention, resilience, research and competencies. countries in Africa, Asia, Europe and Latin America.First, both origins and consequences of disasters play at different Over the past decades, Dr. de Jong worked part-time withsystem levels. Hence, primary prevention can become more immigrants and refugees in Amsterdam. He has conductedeffective if it further develops interventions that address these research in post-conflict, post-disaster and multiculturalmultiple system levels. Universal primary prevention has much settings, and co-authored 250 chapters and papers in the fieldto win by distilling and addressing key predictors of ill health that of cultural psychiatry and psychotherapy, epidemiology, publicshow striking similarity with the determinants of disaster and mental health and medical anthropology.war including poverty and marginalization.Second, an ecological approach requires a shift from individualpsychological resilience to ecological resilience involving diverseactors at the level of the community. An ecological approachalso asks for a careful cultural critique of the salience of theneuroscience construct of post-traumatic stress disorder (PTSD)versus other expressions of distress across the globe.Third, dealing with distress in resource-strained settings requirestask sharing and task shifting by mental health professionals tolocally trained paraprofessionals and lay people. It also requires ashift from specialized treatment to selective prevention involvinglocal healers, local practitioners and a range of communityinterventionist from other disciplines.8 Preliminary Program
  9. 9. ISTSS 28th Annual MeetingNote: Discussants are italicized. Presenting authors/co-authors are underlined. Chairs are indicated for symposia and paper sessionsby heading within the daily schedule.z Master CliniciansThursday, November 1, 4:30 p.m. – 5:45 p.m. Saturday, November 3, 4:30 p.m. – 5:45 p.m.Pharmacological Strategies for Trauma-Related Using Empirically Supported MindfulnessMental Health Complaints Techniques to Enhance Trauma TherapyPrimary Keyword: Clinical Practice Primary Keyword: Clinical PracticeSecondary Keyword: Diverse Populations Secondary Keyword: Adult Survivors of ChildhoodPresentation Level: Intermediate Interpersonal Trauma/Region: Global Complex Trauma Presentation Level: IntermediateThomas Mellman, MD Region: Industrialized CountriesHoward University, Washington, District of Columbia, USA John Briere, PhDAccumulation of findings implicating neurobiological LAC+USC Medical Center, Los Angeles, California, USAdysregulations as well as overlapping features and frequentcomorbidity with disorders that respond to pharmacotherapy A number of mindfulness-based interventions includinghave spurred interest in medication treatment for post-traumatic mindfulness-based stress reduction [MBSR], mindfulness-stress disorder (PTSD). While two medications from the selective based cognitive therapy (MBCT), and mindfulness-based relapseserotonin reuptake inhibitor class have U.S. Food & Drug prevention (MBRP) have been successfully applied to theAdministration approval for PTSD, there remains controversy treatment of symptoms and disorders ranging from anxiety andregarding their overall efficacy and population specificity. Other depression to substance abuse, chronic pain, and self-injuriousclasses of medications are widely applied to PTSD treatment behaviors. However, less attention has been paid to mindfulnesswith mixed evidence bases. Medications have also been applied approaches to post-traumatic stress disorder (PTSD) and other,to symptom specific targets (most notably prazosin for sleep more complex, trauma-related difficulties.disturbance), acute intervention for preventing PTSD, andenhancing cognitive behavioral therapy. This session will outline the potential benefits of mindfulness training for both the therapist and the trauma-exposed client,Dr. Mellman brings experience in clinical trials, published highlighting constructs such as settling skills, metacognitivesyntheses and interpretations of the research evidence, and most awareness, equanimity, compassion, acceptance, andnotably, treating patients from both veteran and civilian settings. nonjudgmental attention to—and reduced identification with—He will present relevant clinical pharmacology, review of research ongoing mental processes. Also discussed will be the role andstudies, and respond to questions and facilitate discussion contraindications of meditation for trauma survivors, the useregarding clinical scenarios involving medication treatment of outside mindfulness training classes, and the links between(and consideration of prescribing) and PTSD. The session will mindfulness and established cognitive-behavioral procedures,accommodate the interests of prescribing and non-prescribing including therapeutic exposure, cognitive restructuring, andclinicians. affect regulation training. Other aspects of mindfulness, however, represent unique contributions of Buddhist psychology that potentially offer new pathways to reduced posttraumatic suffering.A Master MethodologistsSaturday, November 3, 9:00 a.m. – 11:45 a.m. and all effects have boundary conditions. Thus, an analysis which attempts to answer only how or when but not both is necessarilyIntegrating Mediation and Moderation Analysis incomplete in significant ways. Recently, methodologists havePrimary Keyword: Research Methodology been describing approaches to integrating moderation andSecondary Keyword: Not Applicable mediation analysis into a single integrated model.Presentation Level: IntermediateRegion: Global This session has four basic objectives: to introduce the audience to the theoretical and substantive rationale for combiningAndrew Hayes, PhD moderation and mediation analysis in a single integratedThe Ohio State University, Columbus, Ohio, USA statistical model, (2) to provide a tutorial on some of the basic statistical concepts including modern approaches to inference,As research in any particular area develops and evolves, attention (3) to illustrate by example how such analytical integration hasnaturally shifts away from establishing the existence of some been undertaken in some existing published research, and (4) tokind of causal effect between two variables to understanding how demonstrate an easy-to-use statistical tool developed for SPSSthe effect operates (mediation) and when the effect exists or is and SAS that makes this analytical approach extremely simple tostrong versus when it is absent or weak (moderation). Few would conduct.dispute that all effects exist through some kind of mechanism,9 Preliminary Program
  10. 10. ISTSS 28th Annual MeetingA Master MethodologistsSaturday, November 3, 3:00 p.m. – 4:15 p.m. and liabilities in survival and genetic analyses, latent response variables with missing data, priors in Bayesian analysis, and asNew Developments in Latent Variable Modeling: counterfactuals and potential outcomes in causal analysis. InMultilevel and Mixture Analysis addition, categorical latent variables appear as latent classes in finite mixture analysis and latent transition analysis (HiddenPrimary Keyword: Research Methodology Markov modeling), latent trajectory classes in growth mixtureSecondary Keyword: Not Applicable modeling, and latent response variables with missing data onPresentation Level: Intermediate categorical variables.Region: Global Understanding the unifying theme of latent variable modelingBengt O. Muthén, PhD provides a way to break down barriers between seeminglyUniversity of California, Los Angeles, California, USA disparate types of analyses. Researchers need to be able to move freely between analysis types to more easily answer their researchThe use of latent variables is a common theme in many statistical questions. To provide answers to the often complex substantiveanalyses. Continuous latent variables appear not only as factors questions, it is also fruitful to use latent variable techniques tomeasured with errors in factor analysis, item response theory, combine different analysis types. This talk discusses examplesand structural equation modeling, but also appear in the form of that use combinations of multilevel, latent class, and longitudinalrandom effects in growth modeling, components of variation in modeling features in the new Mplus Version 7.complex survey data analysis and multilevel modeling, frailtiesO Featured PresentationsFriday, November 2, 10:30 a.m. – 11:45 a.m. Friday, November 2, 1:30 p.m. – 4:15 p.m.Special Workshop: Beyond Significance: Featured Symposia: World Health OrganizationUnderstanding the Old and New Generation of Preparation of ICD-11: Clinical Utility ofEffect Size Statistics Diagnostic Criteria for Trauma-RelatedPrimary Keyword: Research Methodology DisordersSecondary Keyword: Not Applicable Primary Keyword: Assessment/DiagnosisTechnical Level: Intermediate Secondary Keyword: Not ApplicableRegion: Industrialized Countries Presentation Level: Introductory Region: GlobalConstance Dalenberg, PhD1; Paul Frewen, PhD21 Alliant International University, San Diego, California, USA Andreas Maercker, PhD, MD2 Schulich School of Medicine & Dentistry, Western University, University of Zurich & World Health Organization, Geneva,London, Ontario, Canada SwitzerlandGrowing numbers of journals are now either strongly advising Stress-related disorders (such as PTSD, acute stress reaction)or even requiring the use of effect size statistics in the must be differentiated from other mental disorders and frompresentation of results. This workshop is constructed around normal, self-limited stress responses. WHO is aware of concerna brief description and history of the major families of effect about an overuse of certain stress-related diagnoses, especiallysize statistics (zero order and adjusted), including rules of among populations that have been exposed to a natural orcomputation, transformation (how to you turn chi square into r human-made disaster. A tendency to focus on stress-relatedor g into d), and appropriate presentation and use. The workshop diagnoses may be related to the appeal of the simple, externalwill include introduction to the newer “common language” effect explanation for symptoms, which is suggested by names suchsize statistics. as PTSD. There is also significant controversy in the field about some existing or proposed categories that are seen as ‘milder’, such as adjustment disorder or prolonged grief disorder. Some have challenged the validity and utility of these categories. At the same time, there is evidence that some clinical phenomena that have up to now been considered sub-threshold for diagnosis are associated with poor adjustment and a variety of negative mental health outcomes over time. In general, to help countries to reduce disease burden associated with mental disorders, the classification system must be usable and useful for health care workers around the world. With ICD-11, there appears to be a unique opportunity to produce such a system.10 Preliminary Program
  11. 11. ISTSS 28th Annual MeetingO Featured PresentationsFriday, November 2, 4:30 p.m. – 5:45 p.m. Saturday, November 3,10:30 a.m. – 11:45 a.m. Featured Panel: Integrating Biological, Special Workshop: Applications of DialecticalPsychological, and Social Variables in Research Behavior Therapy to the Treatment ofon Risk, Treatment, and Phenomenology of Dissociative Behavior and Other ComplexTraumatic Stress Trauma-Related ProblemsPrimary Keyword: Biological/Medical/Neuroscience Primary Keyword: Clinical PracticeSecondary Keyword: Not Applicable Secondary Keyword: Adult Survivors of ChildhoodPresentation Level: Intermediate Interpersonal Trauma/Region: Global Complex Trauma Presentation Level: IntroductoryAlain Brunet, PhD1; Karestan Koenen, PhD2; Bekh Bradley, Region: Industrialized CountriesPhD3; Susan Borja, PhD41 Douglas Mental Health University Institute, McGill University, Amy Wagner, PhDMontreal, Quebec, Canada Portland VA Medical Center, Portland, Oregon, USA2 Columbia University, New York, New York, USA Individuals who have experienced multiple and/or severe3 Veterans Affairs Medical Center, Decatur, Georgia, USA traumatic experiences during development often present with a4 National Institute of Mental Health, Bethesda, Maryland, USA wide range of problems related to severe emotion dysregulation. The complexity and heterogeneity of this population pose uniqueThis panel discussion will include presentations describing challenges for clinicians, as existing protocol treatments forsome of the research that has successfully integrated biological post-traumatic stress disorder (PTSD) are often insufficientand psychosocial variables in studies of traumatic stress and or existing problems may interfere with the delivery of thesediscussion of ideas for future research. The first presentation treatments (e.g., dissociative or suicidal behavior).by ISTSS President-Elect Dr. Karestan Koenen will focus on theinterplay of genetic variables, including DNA sequence variation Dialectical behavior therapy (DBT) is based on empiricallyand epigenetic markers, and psychosocial variables in risk for supported principles (as opposed to protocols) that lead totraumatic stress over the life course. individualized case formulations and treatment plans to treat the interpersonal, emotional, and behavioral difficulties of individualsIn the second presentation, Dr. Bekh Bradley will describe with severe emotion dysregulation.research on the role of neurohormones in trauma responses andrecovery and the interaction of trauma-related physiological and This workshop will overview the principles of DBT, procedurespsychological processes and how they might inform treatment. for developing individualized case formulations and determiningPresenters will also identify critical questions that need to be empirically-based interventions (based on behavioral analyses),addressed, methods that need to be developed, and potential and key DBT interventions, including DBT skills. Applicationsobstacles to progress in these areas. to the treatment of dissociative behavior and other complex trauma-related problems will be emphasized. ConsiderationsDiscussion of ideas about how the field might expand on this for determining whether to initiate empirically-based (protocol)work and how National Institute on Mental Health (NIMH) treatments for PTSD in this population will be discussed.program priorities can inform that expansion will be led byDr. Susan Borja who is program chief of the DimensionalMeasurement and Intervention Program in the Division of AdultTranslational Research and Treatment Development of the NIMH(U.S.)11 Preliminary Program
  12. 12. ISTSS 28th Annual MeetingR Media PresentationWednesday, October 31, 8:00 p.m. – 9:30 p.m.Invisible Wounds of War: Breaking the SilenceA Documentary About Bridging the Gap: Community Based Non-Profit Integrative IntensiveRetreats for Service Members and Their Families in Collaboration with the DOD/VABruner, Victoria, LCSW, RN, BCETS1; Mantz, Captain Joshua, BA families. The public agrees, though by a less lopsided(Hons)2; Kudler, Harold, MD3 majority-71 percent. Communities and universities have created1 National Veteran’s Wellness and Healing Center, Cabin John, retreat modalities by forming non-profit organizations to bridgeMaryland, USA the gap between service members, their communities and2 U.S. Army, Ft. Riley, Kansas, USA supplement the DoD/VA efforts. Retreats are designed to assist3 VA VISN, Durham, North Carolina, USA warriors/families affected by combat by using holistic, supportive, and educational approaches structured to provide reconnectionPrimary Keyword: Media to self and peers, family and community, thus providing vitalSecondary Keyword: Military/Peacekeepers/Veterans resource information and serve as a pre-clinical, post-clinical andPresentation Level: Intermediate encourage help seeking. The documentary highlights numerousRegion: Global reintegration challenges for both active duty and veterans and their families. A unique requirement of attending is that a spouseThis documentary by Lisa Ling for Oprah Winfrey Network or significant other must accompany the service member. Theexplores an innovative modality, National Wellness and Healing treatment unit is the dyad. The VA Hotline is featured as are aCenters, which utilize empirically supported therapies with Navy couple struggling with post-traumatic stress, depressioncomplementary and alternative interventions in a community and moral injury. Outcomes data will be presented.setting. According to a recent Pew Research Center Studysome 84 percent of post-9/11 veterans say the public does notunderstand the problems faced by those in the military or their12 Preliminary Program
  13. 13. ISTSS 28th Annual MeetingPre-Meeting InstitutesWednesday, October 31 PMI – 2 Full-Day Institutes Training in the Cognitive Behavioral(8:30 a.m. – Noon and 1:30 p.m. – 5:00 p.m.) Intervention for Trauma in Schools (CBITS) PMI – 1 ProgramAn Introduction to Cognitive Processing Therapy Primary Keyword: Clinical Practice Secondary Keyword: Child/AdolescentPrimary Keyword: Clinical Practice Presentation Level: IntermediateSecondary Keyword: Adult Victims of Violence Region: Industrialized CountriesPresentation Level: IntroductoryRegion: Global Lisa Jaycox, PhD1; Audra Langley, PhD2 1 RAND Corporation, Arlington, Virginia, USAPatricia Resick, PhD, ABPP1; Carie Rodgers, PhD2; Richard 2 University of California, Los Angeles, California, USAMonroe, PhD3; Robert Larson, LCSW41 National Center for PTSD, Boston, Massachusetts, USA The Cognitive-Behavioral Intervention for Trauma in Schools2 San Diego VA/University of San Diego, San Diego, California, USA (CBITS) program was developed in the early 1990’s and has3 Hines VA Hospital, Hines, Illinois, USA been being disseminated across the United States over the past4 Bay Pines VA Healthcare System, Bay Pines, Florida, USA decade. Designed with and for schools, it uses proven cognitive- behavioral techniques in a group format for students aged 10-15The purpose of this pre-meeting institute is to provide who have elevated symptoms of post-traumatic stress disorderattendees the basics of cognitive processing therapy (CPT). (PTSD). The program was originally evaluated in two studies andCPT is an evidence-based cognitive therapy for post-traumatic shown to significantly reduce PTSD and depressive symptoms asstress disorder (PTSD) and comorbid symptoms that can be well as some aspects of behavioral problems in Los Angeles forimplemented with or without a written narrative and can be a diverse student body exposed to community violence (Kataokaimplemented as either an individual or group therapy. It has been et al., 1993; Stein et al., 1993). CBITS has since been used anddemonstrated to be effective across a range of traumas as well tested in a variety of other settings (e.g., Native American groups,as very complex trauma histories and symptom presentations. Morsette et al., 2009; faith-based settings, Kataoka et al., 2006)Because it is very difficult to teach CPT in less than two or three and for other types of traumatic events (e.g., following Hurricanesdays, this year we would like to conduct the workshop somewhat Katrina and Rita in New Orleans, Cohen et al., 2009; Jaycox etdifferently than usual and take into account the participants’ al., 2010). The program includes 10 student group sessions,readiness to learn the protocol for implementation. Even when 1-3 individual child sessions, 2 parent sessions, and 1 teacherannouncing advanced workshops, some individuals sign up for education session. A full description can be found on SAMHSA’sa workshop without the requisite skills and both the prepared NREPP website.members of the audience and the workshop presenters must tryto balance basic explanations with more advanced concepts. This training is designed for professionals with clinical training who work in schools or in community agencies partnering withThis year we are proposing to do a basic one-day workshop but schools. Training in this PMI will involve a brief overview of thealso recognize that some attendees will have more advanced CBITS techniques, followed by demonstrations, coaching, andtraining and different goals than other participants. Therefore, role-plays to solidify skills of attendees. Skills taught will includewe are proposing to divide participants into two groups based psycho-education, relaxation, cognitive training, approachingon their pre-conference preparations. One group will be for feared situations, trauma narrative, and social problem-solvingthose participants who intend to implement the protocol and in the student group format as well as trauma narrative in thehave already read the manual and bring it with them (requests individual student format. Training will also include how tocan be made to for a PDF copy) and/or implement parent and teacher sessions. Throughout the PMI,have completed the online CPT course ( and we will discuss implementation issues so that trainees can leavecan provide their completion certificate. The participants in this the training with a firm grasp of how to obtain buy-in from schoolgroup will be taught at a more specific and advanced level how to administration, obtain parental permission, identify children forimplement the therapy protocol, including role plays of Socratic the program, make use of the website,dialogue with feedback and the opportunity to practice therapist and monitor outcomes.skills needed for implementation. This training course is designated as “intermediate” because weThe second group, targeting those who are attending just to strongly encourage all participants to obtain the CBITS manuallearn more about CPT, who sign up at the last minute, or who and take the online web CBITS course at www.cbitsprogram.orgare not sure whether they want to implement the therapy, prior to the PMI. Instructions will be sent to enrollees prior towill be provided a rationale for the therapy, information about the PMI; the web training course is free and provides 5 hours ofeffectiveness, an overview of the protocol, will be shown continuing education credit. Late registrants will be accepted, butvideotaped examples of the therapy, and will be walked through should be well versed in cognitive-behavioral interventions forthe sessions with case examples as well as information about trauma in order to make good use of this training the different formats are conducted. There will be noexpectation that this latter group of attendees will have the skillsby the end of the workshop to implement the therapy.13 Preliminary Program
  14. 14. ISTSS 28th Annual MeetingPre-Meeting Institutes PMI – 3 Wednesday, October 31Acceptance and Commitment Therapy: Half-Day InstitutesMindfulness and Values in the Treatment of (8:30 a.m. – Noon)PTSD PMI – 4 Primary Keyword: Clinical PracticeSecondary Keyword: Not Applicable What Trauma Therapists Should Know AboutPresentation Level: IntermediateRegion: Industrialized Countries Panic, Phobia and OCD Primary Keyword: Clinical PracticeRobyn Walser, PhD Secondary Keyword: Not ApplicableNational Center for PTSD, Dissemination and Training, Menlo Park, Presentation Level: IntermediateCalifornia, USA Region: Industrialized CountriesThe concept of emotional avoidance offers organization to Sally Winston, PsyDthe functional analysis of trauma-related problems and lends Anxiety and Stress Disorders Institute of Maryland, Towson,coherence to understanding the sequelae of trauma. Many Maryland, USAindividuals who have been diagnosed with post-traumaticstress disorder (PTSD) or who have trauma related problems Trauma survivors often present for treatment for overwhelmingare struggling with traumatic memories, painful feelings and symptoms of anxiety disorders other than post-traumatic stressunwanted thoughts and they take great efforts to avoid these disorder (PTSD). At times, the trauma impact has precipitatedprivate experiences. The avoidance or control of private internal symptoms in someone with an underlying predisposition toexperience commonly seems to become the goal of many trauma obsessive-compulsive disorder (OCD), generalized anxietysurvivors and has a powerful impact on individuals diagnosed disorder (GAD), panic or phobia; at other times it exacerbates orwith PTSD or its related problems. re-activates pre-existing disorders. These symptoms can take on a life of their own and become functionally autonomous fromOne therapeutic alternative to emotional or experiential the trauma material, or they can remain intimately tied up withavoidance is acceptance. Acceptance can create a new context trauma sequelae. Trauma-focused treatment may or may notfrom which the trauma survivor may view the world and the alleviate the presenting panic attacks, OCD symptomatology,self. If efforts to control private experience are relinquished as phobic avoidance behaviors or general hyperarousal anda means to mental health, then efforts to take healthy action, vigilance.while still acknowledging emotion and thought without effort tocontrol or change them, can lead to valued and life enhancing This workshop is designed to be an overview of current evidence-behavioural changes. Acceptance and Commitment Therapy based treatment of anxiety disorders other than PTSD as they(ACT) is a structured intervention that applies acceptance apply to people who have experienced high impact or traumatictechniques to internal experience while encouraging positive events. It will be clinically focused, moving from a discussion ofbehaviour change that is consistent with individual values and the particular phenomenology of the different anxiety disordersgoals. The basic theory and ACT’s application to PTSD will be into practical applications. Metacognitive concepts such aspresented. Opportunity for role-play, case formulation and anxiety sensitivity and paradoxical effort will be presented.interactive exercises will be offered. Related issues include distinguishing between panic attacks, flashbacks and feeling panicky, and understanding when addressing the content of obsessions is irrelevant or actually harmful. Knowing the difference between safety behaviours which manage self-destructive urges and safety behaviours which neutralize exposure, maintain obsessions and promote avoidance is essential in choosing treatment strategies. Techniques such as interceptive exposure and breathing retraining will be demonstrated. The presenter integrates concepts from cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), assertive community treatment (ACT), and almost 40 years of clinical practice in the field.14 Preliminary Program
  15. 15. ISTSS 28th Annual MeetingPre-Meeting Institutes PMI – 5 PMI – 6Treating Post-Traumatic Sleep Problems With Beyond Boundaries: The Interpersonal ParadoxCBT for Insomnia of Trauma in Couple and Family SystemsPrimary Keyword: Clinical Practice Primary Keyword: Clinical PracticeSecondary Keyword: Military/Peacekeepers/Veterans Secondary Keyword: Not ApplicablePresentation Level: Advanced Presentation Level: IntermediateRegion: Industrialized Countries Region: Industrialized CountriesJason DeViva, PhD1; Claudia Zayfert, PhD2 Kami Schwerdtfeger, PhD1; Briana Nelson Goff, PhD21 VA Connecticut Health Care System, Newington, Connecticut, USA 1 Oklahoma State University, Stillwater, Oklahoma, USA2 Dartmouth Medical School, Hanover, New Hampshire, USA 2 Kansas State University, Manhattan, Kansas, USADifficulty falling and staying asleep is one of the most common A growing theme in the trauma literature over the past fewsymptoms reported after trauma. Cognitive-behavioral therapy decades is the recognition that psychological trauma hasfor insomnia (CBT-I) is an evidence-based treatment that is a widespread and interpersonal impact. While high qualityrecommended as a first-line intervention by the American attachment systems and interpersonal relationships haveAcademy of Sleep Medicine practice guidelines. Though been found to mediate the duration and severity of a survivor’spreliminary evidence suggests that the specific methods of traumatic stress reaction and the consequential cognitive andCBT-I can be helpful for trauma-related sleep problems, emotional effects, research also suggests that trauma commonlythe use of CBT-I with trauma survivors often is complicated has a negative impact, eroding the strength of the sameby post-traumatic symptoms that interfere with sleep. interpersonal relationships that could potentially assist withIn this institute we will provide participants with specific posttraumatic recovery and growth. This may be due in part torecommendations for improving the treatment of post-traumatic the fact that trauma survivors often engage in self-preservationsleep problems by tailoring CBT-I to the specific presentations of strategies and create boundaries that make routine relationalpatients with post-traumatic stress disorder (PTSD). exchanges (e.g., communication, nurturance, problem-solving, and conflict resolution) difficult.We will first present a model for understanding the precipitationand perpetuation of insomnia that will be used to describe Trauma survivors may also oscillate between uncontrollablehow symptoms of PTSD can contribute to the initiation and outbursts of anger and a desperate need for intimacy. Suchmaintenance of sleep problems. We will then discuss how to discord between these two potentially opposing dynamics ofincorporate trauma-related factors into a CBT-I treatment plan. the interpersonal components of trauma remains a paradox.We will review the core components of CBT for insomnia While the relational dyads of trauma survivors are often(e.g., stimulus control, sleep restriction, sleep hygiene, characterized by secondary traumatization, caregiver burden,cognitive restructuring), highlighting research supporting their and decreased relational functioning, these same interpersonaluse with insomnia and trauma-related sleep difficulties. relationships are crucial to the recovery process and serve as aWe will examine the specific features of PTSD that can interfere key factor in the development of posttraumatic resilience. Duewith the application of CBT-I to trauma-related insomnia and to the interpersonal nature of trauma, traditional interventiondiscuss modifications and additions to standard CBT-I that can and recovery-focused therapy on an individual level may beaddress PTSD-specific sleep problems. Particular attention inadequate. The intense nature of survivors’ symptoms, whichwill be paid to factors affecting the sleep of returning military often lead to hostility and confusion within interpersonalpersonnel and the role of fear of sleep in perpetuating sleep relationships, suggest that recovery lacking systemic focus mayproblems. We will discuss implementing CBT-I within an alienate the survivor and leave recovery stagnant.overarching case formulation of a trauma survivor’s multipleproblems. This will include how CBT-I may be integrated into a The presenters will describe a model of systemic trauma, basedtreatment plan that may include trauma-focused CBT for PTSD on current theories, research, and clinical experience. The(e.g., prolonged exposure or cognitive processing therapy) or Couple Adjustment to Traumatic Stress-Revised (CATS-R) Modelimagery rehearsal treatments for nightmares. includes components related to individual levels of functioning for both partners (primary and secondary trauma) and interpersonalLastly, we will describe methods for determining when CBT functioning factors (e.g., marital satisfaction, power, conflict),for insomnia may be contraindicated in patients with PTSD. as well as predisposing factors and resources that impact theCase material and group activities will be used to illustrate the intrapersonal and relational systems. The presentation willtreatment recommendations made in this institute. disseminate information regarding the presented model, the primary issues faced by traumatized systems, and methods to apply the model to empirical study of and clinical approaches with traumatized systems. In addition, the presenters will describe results from a current model-based, three-phase research project that focuses on the impact of trauma history on current relationship functioning in couples. Quantitative and qualitative data from couples with various trauma experiences indicate both positive and negative effects on the couple15 Preliminary Program
  16. 16. ISTSS 28th Annual MeetingPre-Meeting Institutesrelationship, as well as specific mechanisms that may be unique sessions will demonstrate diverse treatment effects and provideto trauma-exposed couple and family systems participants with comparisons to other research-supported trauma treatments. PMI – 7 PMI – 8 Introduction to EMDR TherapyPrimary Keyword: Clinical Practice Lead User Innovation: Creating a “CommunitySecondary Keyword: Diverse Populations of Innovators” to Develop and DisseminatePresentation Level: Introductory Trauma Informed Treatment for Children andRegion: Global Adolescents Across the Continuum of CareFrancine Shapiro, PhD Primary Keyword: Training/Education/DisseminationMental Research Institute, Palo Alto, California, USA Secondary Keyword: Child/Adolescent Presentation Level: IntermediateThis presentation will introduce the basics of eye movement Region: Industrialized Countriesdesensitization and reprocessing (EMDR) therapy and provide anoverview of individual and group protocols. Both the theoretical Adam Brown, PsyD1; Glenn Saxe, MD2; Heidi Ellis, PhD3; Omarfoundation and recent research findings will be explored. EMDR Gudino, PhD1; Liza Suarez, PhD4; Kelly McCauley, MSW5is an evidence-based psychotherapy supported by more than 20 1 NYU Child Study Center, New York, New York, USArandomized controlled studies. Meta-analyses have indicated 2 New York University School of Medicine, New York, New York, USAthat the effects of EMDR on post-traumatic stress disorder 3 Children’s Hospital Boston, Boston, Massachusetts, USA(PTSD) symptoms are comparable to those of trauma-focused 4 University of Illinois, Chicago, Chicago, Illinois, USAcognitive behavioral therapy. However, EMDR therapy does not 5 KVC Behavioral HealthCare, Lawrence, Kansas, USArequire homework, sustained arousal, detailed descriptions ofthe index trauma, or extended exposure to the event. While the The need for trauma focused, evidence informed practice in childeye movement component has been the subject of controversy, serving settings is clear, yet dissemination of such models isin the past decade an additional 20 randomized trials have fraught with challenges. This pre-meeting institute will describeevaluated the eye movements and demonstrated significantly a unique, cutting edge approach to development, adaptationsuperior effects compared to “exposure-only” conditions. The eye and dissemination of one such model, Trauma Systems Therapymovements have been shown to (a) decrease the emotionality (TST), across various levels of the child serving system.and vividness of memories, (b) create physiological relaxationresponses, (c) facilitate access to associative memories and (d) TST is a comprehensive model for treating traumaticlead to an increase in recognition of correct information. Two stress in children and adolescents that adds to individually-dominant theories regarding the role of the eye movements have based approaches by specifically addressing the child’semerged: (1) disruption of working memory and (2) elicitation of social environment/system of care. Specifically, this modelan orienting response. The research and clinical implications will conceptualizes the development of a ‘Trauma System’, which isbe examined. comprised of two main elements: 1) a traumatized child who is not able to regulate emotional states and 2) a social environment/The goals of this presentation parallel those of the conference system of care that is not sufficiently capable of helping the childitself by allowing participants to evaluate ways in which EMDR contain this dysregulation. A ‘Trauma System’ therefore emergestherapy offers innovations in both conceptualization and clinical when there is an imbalance between the needs of a child andtreatment. These innovations include ways to support therapy their social environment.retention and increase stability for those clients ordinarilyconsidered too fragile to tolerate memory processing. Outreach TST is currently being delivered in diverse service settingsfor underserved populations can also be increased through across the United States and research evidence suggests thatboth the group protocols and the use of consecutive-day trauma children who receive TST demonstrate improved emotional andtreatment. Relevant research will be reported on the use of behavioral functioning as well as reduced trauma symptoms.EMDR therapy with diverse populations. Furthermore, the TST model effectively engages families with multiple problems and children and families also experienceParticipants will learn how the adaptive information improvements in environmental stability. Lastly, implementationprocessing theory that guides EMDR therapy practice offers of TST leads to reduced hospitalizations and lengths of stay,a reconceptualization of (a) psychopathology, (b) therapeutic suggesting improved cost-effectiveness.change, (c) the therapy relationship, (d) preparation forprocessing and (e) the multiple methods included in the therapy. One of the biggest challenges to effective implementation is theThe work of the EMDR Humanitarian Assistance Programs will balance between maintaining model fidelity, while encouragingalso be discussed, including the results of outreach programs improvements and adaptations that will allow the model to beafter natural and manmade disasters. The presentation will effectively implemented in a variety of settings with a varietyprovide participants with the theoretical basis for EMDR therapy, of youth and families. Based on the concepts of “lead useran overview of the eight treatment phases, the three-pronged innovation,” and flexibility within fidelity, TST has created aselection of processing targets, pertinent research, as well as “community of innovators,” in which lead staff in agenciesapplications to the full range of trauma victims. Videotaped implementing TST, in consultation with the model developers,16 Preliminary Program
  17. 17. ISTSS 28th Annual MeetingPre-Meeting Institutesdevelop modifications of the model to best serve clients in their and organizations (e.g., schools and the Medical Reserve Corps),unique setting. These adaptations build on a core platform of developing training standards and different training platformsminimal fidelity, and then become the standard for other similar (online course, Train-the-trainer course, mobile app), addressingsettings implementing TST. implementation barriers, and improving evaluation strategies for PFA. This session will describe the basic goals and interventionThis pre-meeting institute will present: 1. an overview of the strategies of PFA, encourage practice of the core actions throughTST model and its development, 2. challenges of dissemination exercises, and discuss the current efforts to enhance theand implementation, and 3. development of program evaluation evidence-base.methodology to inform adaptation and assess effectiveness.The model developers, as well as “lead users” from real world PMI – 10 settings will describe in detail the process of developing specificadaptations for residential treatment, foster care, substance Beyond Boundaries: Strategies for Enhancingabuse, school based programs, refugee programs, and Resilience in First Responders and Survivorscommunity based prevention settings. Through Cross-Culturally Adaptive Trauma PMI – 9 Treatment Primary Keyword: Global IssuesPsychological First Aid Secondary Keyword: Disaster/Mass Trauma SurvivorsPrimary Keyword: Prevention/Early Intervention Presentation Level: IntermediateSecondary Keyword: Disaster/Mass Trauma Survivors Region: GlobalPresentation Level: IntroductoryRegion: Global Amber Elizabeth Gray, MA, LPC1; John Fawcett, MSW2; Leslie Snider, MD, MPH3; John Ehrenreich, PhD4Melissa Brymer, PhD, PsyD1; Patricia Watson, PhD1; Douglas 1 Restorative Resources Training & Consulting, Santa Fe, NewWalker, PhD2; Gilbert Reyes, PhD3; DeAnna Griffin, MA1 Mexico, USA1 UCLA, Los Angeles, California, USA 2 John Fawcett Consulting, Auckland, New Zealand2 Project Fleur-de-lis, Metarie, Louisiana, USA 3 War Trauma Foundation, Amsterdam, Netherlands3 Fielding Graduate University, Santa Barbara, California, USA 4 State University of New York/Antares Foundation, Old Westbury, New York, USAPsychological First Aid (PFA) has become the standard of practicein the immediate aftermath of mass casualty events, with The provision of trauma services in war-torn and disaster-recommendations issuing from the IASC Guidelines on Mental affected areas includes the simultaneous provision of servicesHealth and Psychosocial Support in Emergency Settings. PFA is to survivors and to those who respond to these acute intervention to help children, adolescents, adults, and Increasingly, the survivors seeking help are not accustomedfamilies in the immediate aftermath of disasters, terrorism and to conventional mental health services, and first respondersother emergencies. PFA is designed to reduce the initial distress represent a truly diverse cross-section of humanity respondingcaused by traumatic events and to foster short- and long-term in a cultural context distinct from their own, and away from theiradaptive functioning and coping. PFA includes basic information- usual support systems. Multiple frameworks for multi-levelgathering techniques to help providers make rapid assessments support of local survivors and responders, such as best practiceof immediate needs and to make flexible interventions; relies on guidelines for managers; train-the-trainers and staff supportfield-tested, evidence-informed strategies that can be provided programs; and psychological crisis support for survivors will bein a variety of settings including shelters, schools, field hospitals presented in this half day PMI.and medical triage areas, family reception and assistancecenters, acute care facilities, respite centers for first responders Recent research on key areas of risk or resilience for bothor other relief workers, emergency operations centers, national and international aid workers will provide a backdropcrisis hotlines, disaster assistance services centers, homes, for a discussion of staff support services. A 2007 mission tobusinesses, and other community settings. the Darfur region of Sudan and Chad to investigate stress levels of humanitarian workers, which were found to be high,Variations of PFA have been promoted for several decades, but catalyzed a management level train the trainers programthe principles and practices of PFA were not fully specified or designed to be globally adaptable, based on the principles ofoperationalized until 2005, when the National Center for Child social support and the sourcing of local culture as a protectiveTraumatic Stress (NCTSN) and the National Center for PTSD factor for humanitarian worker well-being and health. In Haiti,published a comprehensive PFA Field Operations Guide. This an NGO funded staff support program built on survivor toPFA is a modular intervention that includes 8 core actions: 1) survivor support as a foundation of sustainable, culture-centricContact and Engagement; 2) Safety and Comfort; 3) Stabilization; programming became an inter-INGO model for staff support.4) Information Gathering; 5) Practical Assistance; 6) Connection A global initiative to pilot innovations to Psychological First Aidwith Social Supports; 7) Information on Coping; and 8) Linkage (PFA) training programs has been conducted in Sudan and Sriwith Collaborative Services. Since the launch of this field Lanka, with adjustments made for language, context and culture.operations guide, the NCTSN and NCPTSD has dedicated their Training models to bring culturally informed trauma treatmentfocus on developing adaptations for different service settings to survivors, including creative arts and non-clinical approaches,17 Preliminary Program
  18. 18. ISTSS 28th Annual MeetingPre-Meeting Instituteswill be described as innovations to deliver mental health services community to the needs of the vulnerable groups. A focus onin a wider variety of contexts and reach more trauma survivors. individual recovery without changes in the support systems carries potential for re-traumatization. The community-basedThis PMI will provide program participants with ideas to psychological recovery approach views the individual traumaeffectively develop similar services and programs in their recovery process as a part of systemic change, which allows notorganizations and contexts. Concepts, research, rationale, only to support the survivors but also to create the sustainableprinciples, teaching activities, and excerpts from training changes in the community in order to cope with future challengesprogram modules are presented and shared to demonstrate and to support the vulnerable groups after NGOs leave. Thedidactic, experiential, process-focused ways to train in culturally capacity building and the sustainability of the community recoverydiverse, complex emergency settings. Excerpts from trainer’s are achieved by engaging the community members in themanuals, sample handouts and other materials from the recovery efforts, by educating and sensitizing them to the needsmodules of all program curricula are shared so that participants of vulnerable groups. The mental health officers offer education,have some tools to apply the principles, learning, and practices engagement, empowerment, program development, trainings,of these unique, cross-culturally adaptable, context-centric and the on-going support, while the community and the localprograms in their own professional settings. staff have the leading role in the recovery process. In order to assure the sustainability of the recovery process, the strategic programmatic planning from the beginning must include theWednesday, October 31 active involvement of the local structures and staff, and the steps to reduce the reliance on NGOs by working with the localHalf-Day Institutes structure.(1:30 p.m. – 5:00 p.m.) PMI – 12 PMI – 11 An Introduction to the Neurobiology ofThe Mental Health Module in Complex Traumatic StressEmergencies: From Practice to Theory Primary Keyword: Biological/Medical/NeurosciencePrimary Keyword: Global Issues Secondary Keyword: Not ApplicableSecondary Keyword: Civilians in War/Refugees Presentation Level: IntroductoryPresentation Level: Intermediate Region: GlobalRegion: Global Jasmeet P. Hayes, PhD1; Lisa M., Shin, PhD2; Mohammed Milad,Elena Cherepanov, PhD PhD3; Ann Rasmusson, MD1; Ananda Amstadter, PhD4; NicoleCambridge College, Boston, Massachusetts, USA Nugent, PhD5 1 VA Boston Healthcare System, Boston, Massachusetts, USAThe international relief work brought to the trauma field great 2 Tufts University, Medford, Massachusetts, USAappreciation for the importance of attending to the trauma 3 Harvard Medical School, Boston, Massachusetts, USAissues and the experience of dealing with trauma in various 4 Virginia Commonwealth University, Richmond, Virginia, USAcultural contexts. They also raised concerns about a tendency to 5 Warren Alpert Medical School of Brown University, Providence,pathologize the normal human responses. The non-governmental Rhode Island, USAorganizations (NGOs) have been incorporating the formal mentalhealth modules into the relief work since the 1980’s when this Recent advances in neuroimaging, biochemistry, and geneticsidea was so new and invigorating, that only much later the research have paved the way toward a greater understanding ofenthusiastic experimenting with models was confronted with the neurobiology of trauma and stress. As new technologies andboring but unavoidable questions about the standards of care, methods are discovered and applied to neurobiological work,empirical research, measurable outcomes or the quality control. it becomes increasingly important for individuals interested in treating and studying post-traumatic stress disorder (PTSD) toThe expansion and diversification of the field mental health learn the tools necessary to evaluate the latest research findings.programs in complex emergencies highlighted the need in the The purpose of this pre-meeting institute is to provide attendeesconceptual framework, developing the strategic goals and the an introduction to the major biological approaches used to studyevidenced-based practices. The accomplishments are hindered PTSD, including a state-of-the-art review of trauma research andby controversies in understanding the global trauma reactions. the methodological advantages and limitations inherent in theseThe advances in community mental health suggest that the approaches. The target audience will be comprised of clinicians,success of individual recovery is determined by the available researchers, and students with no familiarity or only a basicsupport systems in the community which provides a secure sense knowledge base of the biological aspects of traumatic stress. Weof self, supportive relationships, empowerment, social inclusion, will review the following topics:coping skills, and meaning. (1) Structural and Functional Neuroimaging of PTSD: This topicThe proposed Community-Based Psychological Recovery in will include an overview of how neuroimaging data are collected,Complex Emergency model aims to achieve the sustainable processed, and analyzed, in addition to the limitations andcommunity-level impact by identifying and strengthening the advantages of neuroimaging methods. Furthermore, a summarycommunity resilience and education and sensitization the of the major findings and discoveries in the neuroimaging of18 Preliminary Program