Dr. Dan said...
Great workshop today! Dr. Suzanne Levy from the Center for Family Intervention Science at the Children’s Hospital of Philadelphia talked about Attachment Based Family Therapy (ABFT). Although her workshops are usually one or two days, she managed to squeeze into three hours, enough information to intrigue me to obtain more education about this topic. Dr. Levy’s presentation was dynamic and she was very knowledgeable. I especially enjoyed her brief explanation of the research and the theory behind this approach to family therapy. As I looked around the room, I noticed several folks whose training began in the 1960’s and early 1970’s, much as mine did. As she spoke, I recalled those early days with Dr. Sal Minuchin at the Child Guidance Clinic and the introduction of “Structured Family Therapy”, with nostalgia. Dr. Levy’s discussion of the research reminded us that family therapy techniques, enhanced with attachment theory etc, have evolved into an “empirically based” treatment approach.
I thought that Dr. Levy did a nice job of presenting the ABFT overview, with both benefits and risks of the family described as factors in the treatment. Although not intending to make the audience experts in ABFT, her presentation of the “Five Tasks” hit the mark to help us appreciate the “guidance” provided by the model, without the “cook-book” approach of other empirically based psychotherapy techniques (Honestly, do you always follow the rules of your “theory” of choice?). Dr. Levy’s emphasis on intentionality at each session to stay focused on the goals, allows use of clinical judgment (and the many years of training) to choose the appropriate strategies to reach the goals. I don’t know about you, but this point helps me feel more like a professional and less like a technician.
Dr. Levy was not trying to “sell” this technique to all. She acknowledged that the research supports success with this approach to a selected, but very large population of families (including single parent, alternate caregivers and other nontraditional families) with adolescents. Research is being conducted with families of younger children. Dr. Levy was quick to acknowledge that this technique is not for everyone. My understanding of her comments excluded adolescents or parents with intellectual disability or other developmental problems, serious mental illness, drug or alcohol addiction, and families where physical abuse is prevalent. In short, this treatment approach appears most effective when both the adolescent and the caregiver are capable of insight. Also, limited to therapists with a tolerance of raw emotions.
I can always tell when the audience is satisfied with a workshop by the quiet attending to the speaker and the appropriateness of questions. The audience was quiet throughout her talk. Questions were relevant and did not detract from her presentation. She responded to all questions thoroughly and checked back with each person to make sure. The audience appeared satisfied with Dr. Levy's Presentation presentation.
March 2, 2011 2:55 PM
Thursday, May 5, 2011
Wednesday, May 4, 2011
Great Pediatric OCD Workshop
This was a great presentation today by Dr. Martin Franklin on Cognitive Behavioral Treatment of Obsessive Compulsive Disorder in children and adolescents. This was his return visit to the Foundations Community Partnership behavioral health lecture series by popular demand. Dr. Franklin presented last fall on “Trichotillomania” in adolescents. Today’s workshop was a full house. He was welcomed back.
Today’s presentation was both enjoyable and informative. This was one of the few times where I’ve seen the audience readily postpone a break in the middle of the three hour workshop, to learn more about the presenters treatment techniques. The 3 hours went by quickly. His workshop included the necessary elements including: Phenomenology and description of the disorder, assessment instruments and strategies, research to support the theory and treatment, and an overview of treatment techniques. He did not simply read his slides, he told humorous but very relevant stories, provided case examples and included research studies. He quickly came back to his point for each item. Overall, I thought that his presentation was well balanced, and all elements were covered. He really knows this stuff!
Sometimes, I attend workshops where the presenter is stilted, defensive, or awkward at handling questions. In some cases, questions from the audience appear as an attempt to “hurry” the presentation, with the presenter saying “I will get to that later.” All questions today appeared relevant and current to the items being presented. Dr. Franklin listened carefully and answered each question fully. He also allowed questions at the end. Questions did not interrupt the flow of his workshop. He was gracious and thorough in response to questions. The audience was satisfied.
As usual, I learned a bunch of things from Dr. Franklin this morning. His focus on the Obsessive Compulsive Cycle (Obsession-Distress-Compulsion-Relief) is important. He reiterated that his treatment will increase obsessive thoughts and distress, while limiting or eliminating compulsive behavior. Tolerating and habituating to the obsessive thoughts and eliminating the compulsion is essential in treatment. He described many creative techniques to increase exposure to the obsessions that need to be challenged without the relief provided by the compulsive behavior. At one point during Dr. Franklins presentation, I almost thought that it would be fun to be a kid with OCD, so I could participate in his treatment (I said almost!). Dr. Franklin pointed out that these techniques also work with children and others who do not have high ability for insight. He said that the clinician must work hard to find creative but concrete opportunities for exposure to obsessions, because the person may not recognize that the obsessions and compulsions are unreasonable. As usual with CBT research, combination of medication (SRI’s) and CBT treatments appear most effective.
Dr. Franklin mentioned that research often explains very complex things in complex ways. He was trying to make it simple in his presentation. As the former college linebacker and current coach, father, Philly sports fan, and everyday guy that he appears, Dr. Franklin did just that. As he stated, his daughter, at age six did better. She described his treatment methods in a couple of sentences.
“Blah, blah blah, do the thing you’re afraid of.
Blah, blah, blah, the more you do it, the easier it gets.”
Any other thoughts?
Today’s presentation was both enjoyable and informative. This was one of the few times where I’ve seen the audience readily postpone a break in the middle of the three hour workshop, to learn more about the presenters treatment techniques. The 3 hours went by quickly. His workshop included the necessary elements including: Phenomenology and description of the disorder, assessment instruments and strategies, research to support the theory and treatment, and an overview of treatment techniques. He did not simply read his slides, he told humorous but very relevant stories, provided case examples and included research studies. He quickly came back to his point for each item. Overall, I thought that his presentation was well balanced, and all elements were covered. He really knows this stuff!
Sometimes, I attend workshops where the presenter is stilted, defensive, or awkward at handling questions. In some cases, questions from the audience appear as an attempt to “hurry” the presentation, with the presenter saying “I will get to that later.” All questions today appeared relevant and current to the items being presented. Dr. Franklin listened carefully and answered each question fully. He also allowed questions at the end. Questions did not interrupt the flow of his workshop. He was gracious and thorough in response to questions. The audience was satisfied.
As usual, I learned a bunch of things from Dr. Franklin this morning. His focus on the Obsessive Compulsive Cycle (Obsession-Distress-Compulsion-Relief) is important. He reiterated that his treatment will increase obsessive thoughts and distress, while limiting or eliminating compulsive behavior. Tolerating and habituating to the obsessive thoughts and eliminating the compulsion is essential in treatment. He described many creative techniques to increase exposure to the obsessions that need to be challenged without the relief provided by the compulsive behavior. At one point during Dr. Franklins presentation, I almost thought that it would be fun to be a kid with OCD, so I could participate in his treatment (I said almost!). Dr. Franklin pointed out that these techniques also work with children and others who do not have high ability for insight. He said that the clinician must work hard to find creative but concrete opportunities for exposure to obsessions, because the person may not recognize that the obsessions and compulsions are unreasonable. As usual with CBT research, combination of medication (SRI’s) and CBT treatments appear most effective.
Dr. Franklin mentioned that research often explains very complex things in complex ways. He was trying to make it simple in his presentation. As the former college linebacker and current coach, father, Philly sports fan, and everyday guy that he appears, Dr. Franklin did just that. As he stated, his daughter, at age six did better. She described his treatment methods in a couple of sentences.
“Blah, blah blah, do the thing you’re afraid of.
Blah, blah, blah, the more you do it, the easier it gets.”
Any other thoughts?
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