ISTSS 29th Annual Meeting Resilience After Trauma: From Surviving to Thriving Session Abstracts The largest gathering of professionals November 7-9, 2013 dedicated to trauma treatment, education, research and prevention Pre-Meeting Institutes and Opening Keynote, November 6 Philadelphia Marriott Downtown Philadelphia, PA USA Jointly Sponsored by Boston University School of Medicine and Visit the International Society for www.istss.org Traumatic Stress Studies for the latest meeting information ISTSS 29th Annual Meeting Session Abstracts Table of Contents Wednesday, November 6 Pages Pre-Meeting Institutes 2 – 10 Keynote Address 11 Thursday, November 7 Keynote Panel 12 Concurrent Session 1 13 – 36 Lunch Movie 37 Special Journalist Panel 37 Concurrent Session 2 38 – 62 Concurrent Session 3 63 – 88 Concurrent Session 4 89 – 115 Friday, November 8 Concurrent Session 5 116 – 142 Concurrent Session 6 143 – 170 Lunch Movie 171 Concurrent Session 7 172 – 191 Concurrent Session 8 192 – 216 Concurrent Session 9 217 – 241 Saturday, November 9 Keynote Address 242 Concurrent Session 10 243 – 269 Lunch Movie 270 Concurrent Session 11 271 – 304 Concurrent Session 12 305 – 332 Concurrent Session 13 333 – 356 th 1 ISTSS 29 Annual Meeting Session Abstracts Wednesday, November 6 Pre-Meeting Institute (PMI) #1 Wednesday, November 6 8:30 a.m. to 5:00 p.m. Grand Ballroom A Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) (Practice/Child/Adol/I/Global) Cohen, Judith , MD1, Mannarino, Anthony, PhD2 1Allegheny General Hospital, Pittsburgh, Pennsylvania, USA 2Allegheny General Hospital/Drexel University College of Medicine, Pittsburgh, Pennsylvania, USA OBJECTIVE: This PMI provides a brief introduction to Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for child mental health professionals. METHODS: Drs. Anthony Mannarino and Judith Cohen, two of the TF-CBT developers, describe three underlying principles of TF-CBT: that this is a components-and phase-based model; the use of gradual exposure throughout TF-CBT; and the importance of proportionality throughout treatment. They describe the TF-CBT phases (stabilization, trauma narration and consolidation) and components, summarized by the acronym "PRACTICE" that includes Psychoeducation; Parenting component; Relaxation skills; Affective modulation skills; Cognitive processing skills; Trauma narrative; In vivo mastery of trauma reminders; Conjoint child-parent sessions; and Enhancing safety. Case examples are included throughout to illustrate how TF-CBT helps children and families gain resilience after trauma, including complex trauma experiences. RESULTS: TF-CBT has been tested in 13 randomized controlled trials including for children who have experienced sexual abuse, domestic violence, war, commercial sexual exploitation, and multiple traumas. In these studies TF-CBT was superior to comparison or control conditions in improving children's PTSD symptoms and a variety of other difficulties. CONCLUSIONS: TF-CBT is an evidence-based treatment for treating traumatized children. Pre-Meeting Institute (PMI) #2 Wednesday, November 6 8:30 a.m. to 5:00 p.m. Grand Ballroom B Taking Your Prolonged Exposure (PE) Practice to the Next Level: How and When to Use PE with Complicated PTSD Patients (Practice/Violence/M/Global) Yusko, David, PsyD1, Foa, Edna, PhD1, Nacasch, Nitsa, MD2 1University of Pennsylvania, Philadelphia, Pennsylvania, USA 2Tel-Aviv Brull Community Mental Health Center, Tel Aviv, Israel, Despite the comprehensive research that exists using prolonged exposure therapy (PE) there are still questions about it being a potentially harmful treatment for certain patients with PTSD. Even though PE is the most widely studied therapy for PTSD, with the most evidence supporting its efficacy in a broad range of PTSD populations (e.g. th 2 ISTSS 29 Annual Meeting Session Abstracts variety of target traumas, demographic diversity, various types of comorbidity, and wide dissemination), there is still more to learn. This institute will begin with a brief review of the evidence supporting the efficacy and effectiveness of PE. From there, a review of the basic components involved in PE, followed by a combination of actual treatment videos and real case vignettes that illustrate how PE experts have implemented PE in these complicated treatment cases. Case presentations will demonstrate the use of PE with the following populations: comorbid substance dependence, comorbid borderline personality, early childhood sexual abuse, repeated and/or prolonged traumas, and comorbid OCD. The institute encourages participants to present their own difficult PTSD cases for consultation. In summary, the institute will focus on the following aspects: 1) an overview of PE treatment literature, 2) a review of PE treatment components; 3) actual patient illustrations of PE being used in difficult trauma populations, 4) institute participants bringing in their own case material for consultation from PE experts, and 5) instruction on when and how to modify PE procedures in complicated PTSD populations. Pre-Meeting Institute (PMI) #3 Wednesday, November 6 8:30 a.m. to 5:00 p.m. Grand Ballroom C Acceptance and Commitment Therapy: Mindfulness and Compassion in the Treatment of PTSD (Practice/N/A/M/Industrialized) Walser, Robyn, PhD 1National Center for PTSD – Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA Acceptance and Commitment Therapy (ACT) is a principle-based behavioral intervention that is designed to address human suffering in a mindful and compassionate way. ACT also aims to support individuals in engaging commitments to behavior change that are consistent with personal values and well-being. While ACT has been applied to a wide variety of problems, it is well suited to the treatment of trauma. Individuals who have been diagnosed with PTSD and trauma related problems are often disturbed by traumatic memories, nightmares, unwanted thoughts and painful feelings. They are frequently working to avoid these experiences and the trauma- related situations or cues that occasion them. In addition to the symptoms of PTSD, the painful emotional experience and aftermath of trauma can often lead the traumatized individual to view themselves as “damaged” or “broken” in some important way. These difficult emotions and thoughts are associated with a variety of behavioral problems ranging from substance abuse to relationship problems. ACT seeks to reduce rigid and inflexible attempts to control negative emotions by fostering acceptance through mindfulness and defusion techniques. The client is guided to experience internal events without effort in unworkable control. The ultimate goal is psychological and behavioral flexibility in the service of a more workable life. In this presentation we will briefly explore the theoretical underpinnings of ACT in addition to the six core components of ACT and how they are used to treat experiential avoidance and problematic rule following found in PTSD. A broad overview of the intervention techniques will also be presented. th 3 ISTSS 29 Annual Meeting Session Abstracts Pre-Meeting Institute (PMI) #4 Wednesday, November 6 8:30 a.m. to 5:00 p.m. Grand Ballroom D Treatment of Complex Childhood Trauma: Comparative Application of Case Material to Four Leading Intervention Models (Practice/Child/Adol/M/Industrialized) Brown, Adam, PsyD1, Ford, Julian, PhD2, Blaustein, Margaret , PhD3, Habib, Mandy, PsyD4, Saxe, Glenn, MD5 1New York University School of Medicine, New York, New York, USA 2University of Connecticut Health Center, Farmington, Connecticut, USA 3Trauma Center at Justice Resource Institute, Brookline, Massachusetts, USA 4Adelphi University, Garden City, New York, USA 5New York University Langone Medical Center, New York, New York, USA This full-day pre-meeting workshop will begin with an Introductory-level morning session introducing participants to four leading evidence-based models for complex trauma intervention developed by members of the NCTSN over the past decade: ARC (Attachment, Self-Regulation and Competency), SPARCS (Structured Psychotherapy for Adolescents Responding to Chronic Stress) TARGET (Trauma Affect Regulation: Guide for Education and Therapy) and TST (Trauma Systems Therapy). Model developers will describe key facets of each model, including the processes and techniques through which each model addresses the core components of complex trauma intervention. The afternoon session will feature an Intermediate-level application of each intervention model to the same case, the "James" clinical vignette from the NCTSN's Core Concepts Curriculum. Presentations will be followed by integrative comments from the Program Chair from a Core Components perspective. Ensuing panel discussion will be audience-driven, and will focus on examination of the shared and unique elements of each treatment model, and consider model fit based on client-specific and contextual factors, including developmental stage, treatment setting, care-giving system and cultural considerations. Pre-Meeting Institute (PMI) #5 Wednesday, November 6 8:30 a.m. to 5:00 p.m. Franklin 6 Problem-Solving Therapy to Enhance Recovery and Resilience (Practice/Mil/Vets/I/N/A) Nezu, Arthur, PhD, ABPP, Nezu, Christine, PhD, ABPP 1Drexel University, Philadelphia, Pennsylvania, USA Problem-Solving Therapy (PST) is an evidenced-based, cognitive-behavioral intervention, based on research demonstrating the mediating and moderating role of social problem solving (SPS) regarding stress and