TRAINING AND CONSULTATION Training and consultation are the foundation for a solid clinical framework.  Good training can enhance client care, foster therapist skill, reduce burnout, facilitate good risk management and add to an agency’s reputation. Portland DBT offers everything your agency needs to learn Dialectical Behavior Therapy - the evidence-based treatment that most effectively helps multi-diagnostic, difficult-to-treat clients.  Whether you are looking for introductory workshops or more advanced consultation, Portland DBT has offerings by experienced clinicians who blend DBT knowledge and skill with in-the-trenches experience.  With over a dozen years in Portland specializing in DBT, we pride ourselves on providing training and consultation services that emphasize full-fildelity DBT and at the same time, are sensitive to cost, systemic, and follow-up/continuity issues that impact successful implementation in the model. Trainings are offered at our John's Landing site and run from 8:30 a.m. to 4 p.m. Trainings include materials, continental breakfast, snacks, and CEUs. CURRENT SCHEDULED TRAININGS DBT with Teens and Families Sept. 10 & 11, 2010 Darcy Norling DBT Overview and Skills Sept. 17 & 18, 2010 Kirsten McAteer DBT Individual Therapy Sept. 24 & 25, 2010 Mark Schorr Please download a registration form by clicking here. Please contact Tracy Jendritza at 503-290-3282 or training@PortlandDBT.com for more information. INTRODUCTORY PRESENTATION A didactic presentation that can be from two to four hours depending upon your agency’s needs.  Topics covered include: - Biosocial theory of BPD - Dialectics in treatment - DBT components & functions - Stages and targets INTRODUCTORY WORKSHOP A one-day introductory workshop that covers: - Biosocial theory - Dialectics: Balancing change and acceptance - Assumptions about clients and therapy - DBT components, stages and targets - Overview of treatment strategies Also available is a two-day workshop that adds a second day devoted to skills training (see description). SKILLS TRAINING WORKSHOP A one-day introductory workshop that covers: - Understanding skills in the context of DBT as a comprehensive treatment - Structuring the group and teaching skills - Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness, and Problem-solving INDIVIDUAL THERAPY WORKSHOP A two-day intermediate workshop that covers: - Overview of DBT theory as it pertains to individual therapy - Function & goals of individual therapy - Structuring the individual DBT session - Individual DBT treatment strategies - Treating therapy interfering behavior/in-session dysfunctional behavior - The “four C’s” of telephone consultation - Treating life-threatening behavior/managing risk Prerequisite:  Completion of Introductory Workshop including skills training component.  Beginning to intermediate level psychotherapy experience. ADAPTATIONS TO DBT One-day, introductory workshops focusing on the application of DBT to: - Teen and Families - Eating Disorders - Substance Abuse Disorders OTHER TRAININGS DBT & Trauma: A Biosocial Approach This one-day workshop covers: - Brief overview of trauma disorders and research supported treatments - Treating trauma in the context of DBT - Exposure protocols for trauma related memories, cues and relational trauma - Integrating somatic methods into trauma treatment DBT in the Milieu Setting A one-day workshop that covers: - DBT principles and practices as applied in a milieu setting - DBT components and functions modified for a milieu setting - Discharge planning: Promoting continuity of care and generalization of treatment effects - Obstacles to implementing DBT in a milieu setting and ways to overcome them DBT Integrated Care Workshop This workshop is designed to train community providers to assess and refer clients to DBT, as well as in two community-based groups: 1) Prep and Practice: A group for clients who are concurrently receiving treatment at Portland DBT and in the community and 2) Advanced DBT: A group for graduates of Portland DBT who have transitioned back to community treatment. DBT protocols for managing crises (including hospital protocols) and dealing with set-backs, will be provided. CONSULTATION After formal DBT training, clinical consultation is strongly recommended to generalize and refine new knowledge and skill.  Individual and small group consultation services are available on a one-time only, on-going, or as needed  basis.   The consultant helps with team development, building on therapist knowledge and skill, continued program development and evaluation, risk management, case consultation and DBT adherence. ADVANCED TOPICS CONSULTATION GROUP An intermediate level consultation group conducted on site at the Portland DBT Program. The group is designed for individuals with DBT training looking for more individualized consultation in how to apply and refine new knowledge and skill. Through case presentation, practice exercises, feedback and discussion particpants will learn how to: • Conceptualize and solve problems according to theory • Get unstuck from power struggles and treatment impasses • Use informal exposure strategies in the therapeutic relationship • Treat life-threatening/crisis behavior without reinforcing it PROGRAM DEVELOPMENT Phase I:  Assessment and Recommendations The assessment process includes meeting with DBT service providers including interviewing existing DBT therapists, observation of relevant groups, interviews with clients appropriate for DBT or who are currently receiving DBT services, and review of relevant materials in current use.  Interviewing case managers or psychiatrists who refer to and concurrently treat DBT appropriate clients are also conducted if appropriate.  Meetings with administrative staff, program managers and supervisors are scheduled to assess setting, staffing, payor, and population specific variables that will influence program development.  After the assessment process the consultant will provide a written report.  Phase II:  Program and Material Development Examples of program and material development: Obtain exit material in use with specific population (e.g. teens, incarcerated, elderly). Review and revise. Develop entrance and exit criteria.  Structure and format different types of group (e.g., Motivation Group, Skills Training Group, Problem-solving Group, Relapse Prevention Group). Develop orientation phase – procedures and material. Coordinate with researchers on program evaluation procedures and measures. Phase III:  Staff Training Examples of staff training: Train DBT staff in new materials and program implementation. Train all staff in the basics of the model including:  Assumptions about clients and treatment, the biosocial model, learning theory and a self-management paradigm, dialectics and dialectical dilemmas (for staff and for clients), and the “A-A-A” model. Train DBT staff in how to conduct chain and solution analyses, in the levels and use of validation, in how to intervene with “in-session dysfunctional behavior”, in commitment and stylistic strategies, in how to conceptualize and respond to crises and life-threatening behavior. Train ancillary service providers including milieu staff in the “on-the-spot coaching” procedure and the skills. Train prescribers in DBT compatible medication management strategies.   Train case managers and other relevant individuals in how to assess and refer. Phase IV: Team Consultation After training and program implementation, on-going clinical consultation is provided.  A senior consultant sits in on DBT team meetings and helps in team development, refinement of therapist knowledge and skill, continued program development and evaluation, risk management, case consultation and DBT adherence. For those interested in developing a program, large or small group training, or our consultation services, please feel free to download any of the following files or call Tracy Jendritza at (503) 290-3282.  You can also e-mail us at training@portlanddbt.com.