Department of Psychiatry

Penn Behavioral Health

Workshop Agenda

Day 1
8:30 - 9:00am Registration and continental breakfast
9:00 - 10:30am

Prolonged Exposure Therapy for PTSD: Edna B. Foa, Ph.D.

  • Diagnosis of PTSD
  • Theory and empirical support for cognitive behavioral treatment approaches
10:30 - 10:45am Break
10:45 - 12:30pm Overview of Prolonged Exposure (PE) Therapy
12:30 - 1:30pm Lunch on your own
1:30 - 3:00pm Assessment of PTSD and other trauma-related psychopathology
3:00 - 3:15pm Break
3:15 - 5:00pm

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

  • How to present the PE program to clients
  • Establishing therapeutic alliance
  • Breathing retraining
  • Psychoeducation - common reactions to trauma

Break into pairs to practice delivery of treatment overview/rationale

Day 2
8:30 - 9:00am Check-in and continental breakfast
9:00 - 10:30am

Imaginal Exposure

  • Rationale for imaginal exposure (recounting the trauma)
  • Procedure for imaginal exposure
  • Videotape illustrations of progressive sessions of imaginal exposure
10:30 - 10:45am Break
10:45 - 12:30pm

Imaginal Exposure (con’t):

  • Assignment of imaginal exposure homework
  • Hot spot procedure for imaginal exposure

Break into pairs to practice the procedures

12:30 - 1:30pm 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 - 9:00am Check-in and continental breakfast
9:00 - 10:30am

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 - 10:45am Break
10:45 - 12:30pm

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 - 1:30pm Lunch on your own
1:30 - 3:00pm

Special issues (con’t):

  • Maintaining focus on PTSD
  • Anger
  • Working with clients with co-morbid alcohol abuse/dependence
  • Obstacles to homework compliance
3:00 - 3:15pm Break
3:15 - 5:00pm

Procedural modifications of imaginal exposure in order to titrate emotional engagement:

  • Over-engagement in exposure
Day 4
8:30 - 9:00am Check-in and continental breakfast
9:00 - 10:30am

Procedural modifications (con’t):

  • Under-engagement in exposure
10:30 - 10:45am Break
10:45 - 12:00pm Break into pairs to role-play exposure rationales, procedures, breathing training; observation and feedback from faculty
12:00 - 1:00pm Lunch on your own
1:00 - 2:30pm

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 - 2:45pm Break
2:45 - 4:00pm

Wrap-up

  • Discussion period
  • Suggested readings and literature
  • Wrap-up and questions from participants

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