Intensive Training in Prolonged Exposure Therapy for PTSD
Workshop Agenda
Day 1
8:30 am - 9:00 Registration and continental breakfast
9:00 am - 10:30 Prolonged Exposure Therapy for PTSD: Edna B. Foa, Ph.D.
- Diagnosis of PTSD
- Theory and empirical support for cognitive behavioral treatment approaches
- How to present the PE program to clients
- Establishing therapeutic alliance
- Breathing retraining
- Psychoeducation - common reactions to trauma
10:30 - 10:45 break
10:45 - 12:30 Overview of Prolonged Exposure (PE) Therapy
12:30 - 1:30 Lunch on your own
1:30 - 3:00 Assessment of PTSD and other trauma-related psychopathology
3:00 - 3:15 break
3:15 - 5:00 Instruction in the individual treatment components through description of intervention, videotapes of therapy sessions, role-plays among participants with observation and feedback from faculty
Prolonged Exposure Therapy Program
Break into pairs to practice delivery of treatment overview/rationale
5:00 pm end
Day 2
8:30 - 9:00 check-in and continental breakfast
9:00 - 10:30 Imaginal Exposure
- Rationale for imaginal exposure (recounting the trauma)
- Procedure for imaginal exposure
- Videotape illustrations of progressive sessions of imaginal exposure
10:30 - 10:45 break
10:45 - 12:30 Imaginal Exposure (con’t):
- Assignment of imaginal exposure homework
- Hot spot procedure for imaginal exposure
Break into pairs to practice the procedures
12:30 - 1:30 Lunch on your own
1:30 - 3:00 In-Vivo Exposure
- Rationale for in-vivo exposure
- Use of Subjective Units of Distress Scale (SUDS)
Break into pairs to practice these procedures
3:00 - 3:15 break
3:15 - 5:00 In-vivo exposure (con’t):
- Construction of in-vivo hierarchy (approaching safe situations)
- Safety guidelines for in-vivo exposure
- Assignment of in-vivo homework
Break into pairs to practice the procedures
Day 3
8:30 - 9:00 check-in and continental breakfast
9:00 - 10:30 Treatment components (continued):
Final Session
- Reassessing SUDS for in-vivo hierarchy; discussion of what has changed; relapse prevention; planning on-going exposure work
- Final Session summaries - video illustrations
Break into pairs to practice the procedures as needed
10:30 - 10:45 break
10:45 - 12:30 Special issues: Case presentations (description and excerpts from videotaped sessions) illustrating procedural modifications, therapist response to client behavior:
Avoidance
- reluctance to do in-vivo or imaginal exposure
- avoidance of homework (including listening to tapes)
- missing therapy sessions
12:30 - 1:30 Lunch on your own
1:30 - 5:00 Special issues (con’t):
- Maintaining focus on PTSD
- Anger
- Working with clients with co-morbid alcohol abuse/dependence
- Obstacles to homework compliance
3:00 - 3:15 break
3:15 - 5:00 Procedural modifications of imaginal exposure in order to titrate emotional engagement:
- Over-engagement in exposure
Day 4
8:30 - 9:00 check-in and continental breakfast
9:00 - 10:30 Procedural modifications (con’t):
- Under-engagement in exposure
10:30 - 10:45 break
10:45 - 12:00 Break into pairs to role-play exposure rationales, procedures, breathing training; observation and feedback from faculty
12:00 - 1:00 Lunch on your own
1:00 - 2:30 Important considerations in providing Prolonged Exposure therapy to trauma survivors
- Using the theoretical model of the treatment to guide therapists’ decision-making
- Developing tolerance for client’s emotional distress
- Flexibility in applying this treatment
- Importance of supervision and peer consultation
- How to begin using the therapy
- 60 vs. 90-minute therapy sessions
2:30 - 2:45 break
2:45 - 4:00 Wrap-up
- Discussion period
- Suggested readings and literature
- Wrap-up and questions from participants
