Although a number of treatment approaches have been investigated in the treatment of pediatric Obsessive-Compulsive Disorder (OCD), cognitive-behavioral therapy with exposure with response prevention has been one of the most effective psychological treatments (Lewin et al., 2005; POTS, 2004), with an average response rate of 60-74% or higher (Connolly & Nanayakkara, 2009; van der Leeden et al., 2011). In order to further improve this treatment-response rate, empirical studies have identified several external and internal factors that are associated with pediatric treatment-resistant OCD (Bystritsky, 2006; Flessner et al., 2011; Franz et al., 2012; Storch et al., 2008). Accordingly, treatment gains can be maximized when mental health practitioners identify and intervene with factors external to the youth while also working directly with youth resistance. In order to improve outcomes and minimize the need for a higher level of care in inpatient and residential settings, there is a need to disseminate and deliver efficacious psychological treatment for pediatric treatment-resistant OCD within an outpatient setting. The complexity of pediatric treatment-resistant OCD typically requires an intensive treatment schedule, flexibility of treatment goals, and the use of a tailored multisystemic evidence-based approach that targets patient-specific external and internal factors (Bystritsky, 2006; Mennin, 2006; Storch et al., 2008). This talk will review basic information regarding the nature and evidence-based treatment of pediatric OCD. This talk will describe the delivery of intensive, multisystemic evidence-based treatment within an outpatient setting for youth with treatment-resistant OCD. Furthermore, the talk will present ways in which exposure with response prevention may be tailored to incorporate internal and external factors that maintain treatment resistance. Lastly, a model will be presented for a comprehensive individualized intensive outpatient treatment program which has the goals of maximizing compliance and treatment response among youth with treatment-resistant OCD.
Following this presentation, participants will be able to:
Dr. Brigette Erwin founded and directs one of the few Philadelphia-area providers of evidence-based treatment for the anxiety and related disorders. The organization’s programs include The Anxiety and OCD Center, Dr. Erwin Consulting, and Coaching for Calm and Confidence™. Distinguished by its use of evidence-based practices and onsite training of all providers, The Anxiety and OCD Center is one of the Philadelphia region’s largest practices specializing in the treatment of the anxiety and related disorders. Dr. Erwin Consulting provides evidence-based strategies to meet and exceed client’s personal, professional, and corporate objectives. Coaching for Calm and Confidence™ delivers in digital format evidence-based strategies for creating calm, confidence, and successful relationships.
Dr. Erwin has close to twenty years of experience as a psychologist, business developer, and business owner. Dr. Erwin received her PhD from Temple University, completed a National Institute of Health postdoctoral fellowship at the University of Pennsylvania School of Medicine, and completed a pre-doctoral internship at the Medical University of South Carolina. Dr. Erwin is Clinical Associate Professor of Psychology at Philadelphia College of Osteopathic Medicine, Public Relations Chair of the Executive Board of the Philadelphia Behavior Therapy Association, and Admissions Board Member and Consultant to Saint Charles Borromeo Seminary. She is honored as a 2017 Woman of Influence by Main Line Today.
Erin Roemer is a licensed psychologist and the Assistant Director at the The Anxiety and OCD Center. Dr. Roemer has a wealth of experience providing evidence-based interventions to children, adolescents, adults, and families. Dr. Roemer received her PsyD in Combined Clinical and School Psychology from Kean University. She completed her postdoctoral fellowship at The Anxiety and OCD Center and completed an APA accredited predoctoral internship at Lincoln Hills/Copper Lake School. Dr. Roemer serves as Clinical Associate Professor of Psychology at Philadelphia College of Osteopathic Medicine and Public Relations Chair of the Philadelphia Behavior Therapy Association Executive Board.
This presentation is intended for mental health professionals, researchers, and graduate students. The instructional level of this presentation is intermediate.
Philadelphia Behavior Therapy Association is approved by the American Psychological Association to sponsor continuing education for psychologists. Philadelphia Behavior Therapy Association maintains responsibility for this program and its content.
This program provides three (3) hours of CE credits. PBTA is also an authorized provider for CE credits for Professional Counselors, Marriage and Family Therapists, and Clinical Social Workers licensed in the state of Pennsylvania.
Full attendance is required to obtain CE credits for this program. APA guidelines do not permit PBTA to issue partial CE credits. No refunds are provided for CE programs. No exceptions allowed.
Dialectical Behavior Therapy (DBT) is a modification of standard Cognitive Behavioral Therapy (CBT) that was designed to treat individuals who meet criteria for Borderline Personality Disorder (BPD). During the treatment development, Linehan’s research demonstrated that that CBT was ineffective with this population. Due to the relentless focus on cognitive change, the scarcity of validation as an active clinical component and the misunderstanding around motivation for change, patients would continued to suffer, continued to engage in problematic behaviors patients and even worse, would drop out of treatment.
In her modification of CBT, she added structures and strategies to attend to the needs of this population. Linehan added acceptance-based principles and her own Zen teaching to help individuals understand that much of their experience in life was valid and made sense even though their behaving was ineffective in building a life worth living. She focused on behaviorism as a technology of change instead of the heavy focus on cognitive restructuring. She conceptualized the development of the pathology in an effective package that both patients and clinicians alike could understand and lock onto as a foundation for transformation. And most important, she introduced the concept of dialectics, which invites the clinician and the patient to begin observing the world and the pathology to conceptualize life as having multiple truths and perspectives to expand our understanding of reality as it is.
In this workshop, PowerPoint presentations, lecture, role-play as well as q/a will be used to teach about the critical migrations away from standard CBT. We will review the DSM-V criteria of BPD and discuss how the diagnostic profile of behavioral, emotional, self, interpersonal and cognitive dysregulation can be understood through the biosocial theory and how DBT was built to meet the skills deficits of these individuals. We will discuss why/how behaviorism makes its way into DBT treatment and how to use these principles to understand, intervene and promote change in these patients. As a counter balance to behaviorist principles and because this is a dialectical treatment, validation strategies must be reviewed and practiced so that the impact of the traumatic invalidation our patients experience can be attended to in the therapy relationship so they can eventually learn how to recover from the chronic invalidation in their lives.
Stephanie Mattei, Psy.D. is a licensed clinical psychologist who earned her doctoral degree from La Salle University in 2003 and has been instructing and supervising in various capacities in the program since graduation Dr. Mattei is Intensively trained in Dialectical Behavior Therapy (Behavioral Tech) and is one of the few clinicians in the state of Pennsylvania to have earned DBT certification through the Dialectical Behavior Therapy-Linehan Board of Certification (DBT-LBC). The only one of it’s kind, the DBT-LBC has taken on the task of identifying what criteria a ‘certified’ clinician would need, and then is ensuring that there is a process by which to credential individuals who meet those criteria.
Dr. Mattei has also co-founded the Center for Acceptance and Change in Bala Cynwyd, PA. Stephanie has a particular interest in treating women who meet criteria for BPD engage in Non-Suicidal Self Injury (NSSI), have suicidal thoughts/experiences and who struggle with eating disorders, trauma and relationship distress. She and her colleagues co-founded the Center for Acceptance and Change in 2005 and have had a consistent consultation team to treat the almost 100 patients we treat. In addition to being a professor/supervisor, treating clinician, and DBT skills trainer, Dr. Mattei has also been a consultant to many area psychotherapy practices who are looking to adopt a DBT program or add DBT principles to their practice.
Lastly, Dr. Mattei also has a small subset of patients that she treats who have been diagnosed with Polycystic Ovary Syndrome (PCOS). Having treated PCOS for over 20 years, she has authored chapters about the topic (Grassi: The Dietician’s Guide to PCOS) and has co-written a workbook to assist women with under-recognized medical disorder (Grassi & Mattei: PCOS Workbook: Your Complete Guide to Physical and Emotional Health).
This presentation is intended for mental health professionals and advanced students with some existing knowledge of psychopathology and CBT. Participants understanding and knowledge of basic psychotherapy principles will be assumed.
This program provides four (4) hours of CE credits. PBTA is also an authorized provider for CE credits for Professional Counselors, Marriage and Family Therapists, and Clinical Social Workers licensed in the state of Pennsylvania.