Department of Psychiatry
Penn Behavioral Health

Center for the Treatment and Study of Anxiety

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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

              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

              • 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

              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