AMITA Health Alexian Brothers Behavioral Health Hospital Hoffman

Transcription

AMITA Health Alexian Brothers Behavioral Health Hospital
Hoffman Estates Center for Professional Education
Program Guide
Fall/Winter 2016
1
AMITA Health
Alexian Brothers
Behavioral Health Hospital
Hoffman Estates
Center for
Professional Education
ADVISORY BOARD
Clayton Ciha
President & CEO,
AMITA Health Alexian Brothers
Hoffman Estates
Steve Hunter, LCSW, LMFT
Director, Business Development,
Hoffman Estates
Jason Washburn, PhD, ABPP
Director, Center for
Evidence-Based Practice,
Hoffman Estates;
Director of Education and
Clinical Training,
Northwestern University
Medical Center
Arthur Freeman, EdD, ScD, ABPP
Director, Clinical Psychology Doctoral
Degree Program,
Midwestern University
Dave J. Norton, PhD, LMFT
Founder and Executive Director,
Centennial Counseling
Welcome to our 2016 Fall/Winter
Professional Education Guide
On behalf of AMITA Health Alexian Brothers Behavioral Health Hospital,
we want to thank you for your continued support of our professional
education series. Because of you, we are one of the premier destinations
in the Midwest for continuing education credits in seven different
disciplines. We value the relationships we have created with all of you the
last several years and look forward to a great new season of learning.
The Center for Professional Education will continue to provide CEU
learning for all mental health disciplines including school professionals
(CPDUs) and addiction specialists (CADC/IAODAPCA). Our article by
Dr. Jason Washburn addresses the important topic of Violence: Assessing
Risk for Mental Health Practitioners.
We are thrilled to have special presenter David Sheff joining us in January
to discuss Overcoming Addiction and Ending America’s Greatest Tragedy.
David has written two New York Times bestselling books including the
memoir Beautiful Boy: A Father’s Journey Through His Son’s Addiction.
I am pleased to announce the return of Bill O’Hanlon presenting,
Resolving Trauma Without Drama. Bill is ranked as one of the best
presenters in the country and does only a small handful of live workshops.
For those who need cultural competence CEUs, we have Mark Sanders
discussing spiritualty and psychotherapy. Dr. Ronald Potter-Efron is
making a return appearance to present his material on Healing Toxic and
Hidden Anger. Dr. Rachel Lofton will present a workshop on Sexuality and
Intimacy with Autism Spectrum Clients.
Counseling transgender youth in schools and agencies, one of the most
important topics facing mental health professionals and school staff,
will be addressed with Dr. Toni Tollerud and Matt Liberatore. Finally, we
are proud to present our second edition of Honoring Our Veterans on
November 16, 2016. This workshop, in honor of our Veterans, will feature
three phenomenal speakers and be offered FREE of charge.
As always, we look forward to being your best value in the market for
CEU training. I look forward to seeing you at our upcoming fall events.
Thanks for your partnership.
Please see the latest updates on workshops and trainings at:
AMITAhealth.org/BehavioralMedicine/AB/Professionals
Sincerely,
Steven Hunter, LCSW, LMFT
Director of the Center for Professional Education
Director of Business Development
2
Center for Professional Education:
Fall/Winter 2016 Program Registration Information
Registration
Register online at
AMITAhealth.org/BehavioralMedicine/AB/Register
or call 1.855.MyAMITA (692.6482)
If fees apply, you may pay by credit card online or
over the phone. If your organization is mailing a check
(payable to ABBHH) for your participation, please make
sure the check is mailed to:
AMITA Health Alexian Brothers Behavioral Health
Hospital Hoffman Estates Center for Professional
Education
c/o Steve Hunter, LCSW, LMFT
1650 Moon Lake Blvd.
Hoffman Estates, IL 60169
Check-in and networking begins 30 minutes prior
to each program.
Earn one (1) CEU credit for reading the article:
Assessing Risk for Violence
By Jason Washburn, PhD, ABPP
Pages 4-11
1
Fall/Winter 2016 Training Calendar At-A-Glance
DATE
TOPIC
#
Sept. 16
Current Mental Health Trends and Strategies
for Children and Adolescents
Madelyn “Mandy” Burbank, LCSW
Patrick B. McGrath, PhD
Jackie Rhew, LCPC, CADC
Sarah Briley, EdD, CADC
Kelly Demers, PsyD
12
Sept. 20
Hypersexuality and Dementia: Causes, Behaviors and
Treatment Options
Sachin Bhalerao, MD
13
Sept. 23
Counseling Transgender Youth in Schools and Agencies:
What We Need to Know as Advocates
Toni Tollerud, PhD, LCPC, NCC, NCS, ACS
Matt Liberatore, MA, LCPC
14
Sept. 30
What’s the Latest in ADHD? Strategies and Medication
Amy Davis, PhD
Tricia McKinney, PsyD
Michael Feld, MD
15
Oct. 7
Resolving Trauma Without Drama: New, Brief, Respectful
and Effective Approaches to Treating PTSD
Bill O’Hanlon, MS
16
Oct. 14
Sexuality & Intimacy in Autism Spectrum Disorder:
Rights and Risks
Rachel Lofton, PhD
17
Oct. 15
LCPC Supervision Series: Workshop 1: Effective
Strategies in Supervision
26
Oct. 28
Healing Toxic and Hidden Anger: Treatment for
Passive-Aggressive, Chronically Angry and Impulsively
Angry Clients
Ronald Potter-Efron, PhD, LICSW, CADC III
18
Oct. 29
LCPC Supervision Series Workshop 2: Advanced
Supervision Issues: Psychological Stress, Resistance
and Impairment
26
Nov. 11
Cultural Competence: Integrating Spirituality and
Psychotherapy
Mark Sanders, LCSW
19
Nov. 12
LCPC Supervision Series Workshop 3: Peer, Triadic,
Group and Supervision: Effective Strategies
26
Nov. 16
Honoring Our Veterans: Issues and Challenges
Joseph E. Troiani, PhD, CADC
David Cosio, PhD
20
Dec. 2
When Talk Isn’t Enough: Expressive Therapy
for Emotional Disorders
Linda Cao-Baker, LCPC, BC-DMT
Elizabeth Muckley, LCPC, RDT-BCT
Victoria Storm, BC-MT
Rita Guertin, LPC, ATR
22
Dec. 9
Violence: Assessment of Risk For Mental Health
Practitioners
23
Jan. 26
Overcoming Addiction and Ending America’s
David Sheff, author
24
Greatest Tragedy
2
PRESENTER
Fall/Winter 2016 Webinars Calendar At-A-Glance
DATE
TOPIC
PRESENTER
#
All of our programs are intended for healthcare-related professionals. In some cases, such as our
intensive
advanced
degrees may be required.
Sept. 20 training
A Primercourses,
on Violence
Risk Assessment
27
Oct. 20
Technology and Teen Dating Violence
27
Nov. 10
Non-Suicidal Self-Injury: It’s Not Just Cutting
Denise Styer, PsyD
27
Dec. 6
Petitions for Involuntary Admission:
Colleen Caron, RN
Don Mitckess, LCPC, CRADC
27
Older Adult and Other Special Populations
Continuing Education Information
CEU Grouping
A
B
C
D
E
F
G
LSW/LCSW, LPC/LCPC, LMFT
IAODAPCA (CADC)
Psychologists
CPDU (School Personnel)
Nursing
Dietitians
Nursing Home Administrators
Licensed Social Workers/Licensed Clinical
Social Workers
Approved provider through the Illinois Department
of Financial and Professional Regulation #159.000944
Licensed Professional Counselors/Licensed
Clinical Professional Counselors
Approved provider through the Illinois Department of
Financial and Professional Regulation #159.000944*
*According to IDFPR Professional Counselors/
Administrative Code Section 1375.200 C.1.R, CEUs for
LSW/LCSW are reciprocal for LPC/LCPC
Licensed Marriage and Family Therapists
of Financial and Professional Regulation
#168.000166
CADC/IAODAPCA
For selected programs, we apply for IAODAPCA
Credits. Check each program description for reference
to those credits.
Psychologists
School Personnel/Continuing Professional
Development Unit
For select programs, we will apply for CPDU credits.
Check each program description for reference to these
credits. Approved provider through the Illinois State
Board of Education #080916103644232
Nurses
Dietitians
For select training programs, we will apply for Illinois
Dietetic Association CEUs. Check each program
description for these credits.
Nursing Home Administrators
of Financial and Professional Regulation
#139.000233
Illinois Department of Financial and Professional
Regulation require that participants attend the entire
workshop to receive full credit. AMITA Health recognizes
that our attendees may arrive late or need to leave early.
We will be happy to provide you an amended certificate
based on actual hours in attendance.
3
FEATURE ARTICLE
Assessing Risk for Violence
Mental Illness and Violence
Violence is often paired with mental
illness in popular culture and the
minds of the public. It appears
increasingly common for mental
illness to be the first reason to
be professed for a horrific act of
Jason Washburn
violence.1 Numerous politicians and
PhD, ABPP
media pundits have been quick to
blame mental illness for violence.2
Public opinion general supports a connection between
mental illness and violence.3 After the shooting at the
Sandy Hook Elementary School in Newtown in 2012,
a public opinion poll found that 45.6% of respondents
indicated that they agreed that people with serious
mental illness are, “by far, more dangerous than the
general population”.4
In specific situations, mental illness likely contributes to
violent behavior. This connection between mental illness
and violent behavior is legally recognized in what is
commonly called the “insanity defense.” John Hinckley
Jr., soon to be released, was famously found not guilty
by reason of insanity for the attempted assassination of
President Ronald Reagan in 1981. Although the Hinckley
verdict resulted in legal reform that made the insanity
defense more difficult, the connection between mental
illness and crime remains in legal and public minds.
4
There is some evidence supporting a link between
mental illness and violence. Several studies suggest
that people with severe mental illness, such as
schizophrenia, bipolar disorder, and major depression,
are at a greater risk for violence. For example, in a
total population study in Sweden, depression was
associated with a three-fold increase in violence, even
after controlling for sociodemographic factors.5 A
meta-analysis of 20 studies that included over 18,000
people found an increased risk of violence among those
with schizophrenia and psychosis. In particular, when
compared to the general population, schizophrenia and
psychosis was associated with a 19.5 greater odds of
committing homicide.6
Mental health professionals (MHPs) are likely to
encounter clients who are at risk for violence, and even
to be victims of violence.7 For example, a meta-analytic
study of nearly 24,000 patients across 35 different
studies found that approximately 17% of patients engaged
in at least one violent act while on an inpatient unit.8
Patients on forensic psychiatric units are likely to be the
most at risk for violence. One study found that aggression
from forensic inpatients was nearly universal; 99% of staff
reported verbal conflict with patients and 70% reported
being assaulted in the prior year.9 Violence against
mental health professionals received national attention in
2010 with the murder of a psychiatric technician, Donna
Gross, by a forensic patient at Napa State Hospital.
EARN ONE (1) CEU CREDIT FOR TAKING
THE QUIZ AT THE END OF THIS ARTICLE.
Yet the association of mental illness and violence is more
complex than this horrible incident or the findings from
these studies suggest. In the meta-analysis discussed
above, only one in 300 people with schizophrenia had
committed homicide, a rate similar to that of people with
substance abuse without schizophrenia.6 In another
study, 8.4% of people with bipolar disorder were found
to have committed a violent crime, more than double the
rate in the general population (3.5%). Yet, after controlling
for other non-psychiatric risk factors for violence, there
was no increased risk of violence specifically for bipolar
disorder.10
To be clear, the vast majority of people with mental
illness do not engage in violent behavior.11 For example,
national data indicate that only 5% of the 120,000 gun
deaths between 2001 and 2010 were committed by
people with mental illnesses.2 Even when people with
severe mental illness are violent, the violent behavior is
typically not directly related to their mental illness. For
example, only a small subgroup of people with severe
mental illness appears to be at risk, and typically only
during critical times, such as shortly after a psychiatric
hospitalization.11 Further, a recent study of inpatients with
histories of repeated violence found that psychosis only
preceded 12% of their violent behavior.12 For most people
with mental illness, their risk for violence is increased by
the same factors that increase risk for violence among
people without mental illness.13
It is also important to underscore that people with severe
mental illness are much more likely to be victims of
violence, either from others or by hurting themselves.
One study found people with severe mental illness were
11 times more likely to be victims of violence than those
without mental illness.14 Indeed, across the nation, suicide
accounts for more than half of the deaths associated
with guns.11
In summary, the mere presence of mental illness may
tell us very little about risk for violence. Instead, mental
health professionals must determine the relevance of
mental illness in understanding violence risk.13, 15
Clinical Approaches to Assessing Risk for
Violence
Right or wrong, violence and mental illness is connected
in the mind of the public. As a result, MHPs are often
approached when there is a concern or question about
violence. The typical approach to understanding risk for
violence is to conduct a risk assessment. But what is a
risk assessment? Although the answer to this question
can vary, at a general level, a risk assessment involves
a process in which factors that are expected to increase
risk are evaluated with the goal of determining the
probability that a certain outcome will occur.16
In my professional experience, clinical assessments
of violence risk often looks very similar to suicide risk
assessments. I’ve found that mental health professionals
are likely to ask a variety of questions to obtain
evidence of homicidal ideation, with a particular focus
on understanding the level of detail of those plans,
the means or ability to carry out those intended plans,
and the client’s intent to carry out those plans. I’ve also
found, however, that every MHP handles a violence risk
assessment in different ways. Approaches to violence
risk assessment typically vary because a MHP’s prior
training, experience, and ultimately her or his “gut”
feelings also vary. One MHP may focus on one set of
factors as relevant to violence risk, while another MHP
focuses on a completely different set of factors. Even
when MHPs assess for similar factors, it is unlikely they
will place the same weight or importance on each of the
specific factors.
Assuming two MHPs could develop high reliability in
their assessment of violence risk, it is unclear if their
assessments would even be valid. By relying on intuition,
prior clinical experience, or their memory of important
factors from the research literature, reliance on clinical
judgment often involves the use of irrelevant or even
incorrect risk factors, as well as a failure to attend to the
most critical factors. Indeed, despite evidence to the
contrary, there is a tendency for clinical judgment
5
FEATURE ARTICLE, continued
to overweight symptoms of mental disorders in violence
risk assessment,17 and often overestimate risk in general.18
What about clinical expertise? Unfortunately, even clinical
experience or “expertise” appears to add little to the
accuracy of clinical judgment.17 The major problem with
developing accurate clinical expertise is that most MHPs
have nothing on which to judge the accuracy of their risk
assessment decisions. In contrast to research studies, in
which participants are followed-up to determine if they’ve
become aggressive, MHPs often don’t get to follow-up
on the clients that they assess for risk.17 Indeed, in many
cases, the results of the assessment may fully preclude
the likelihood of an accurate follow-up of the client’s risk.
For example, the client may be sent to an inpatient unit
where risk for violence is contained and managed. It is
impossible to know, however, if a patient that is sent to
the inpatient unit was or was not actually going to be
violent outside of the inpatient unit. Further, expertise of a
specific client, such as a therapist who has been treating
a specific client for many years, may actually interfere
with the assessment of violence risk. MHPs are less likely
to make accurate predictions if they are more familiar
with the client.19 In summary, assessment of violence risk
through clinical judgment raises grave concerns with
reliability and accuracy.20
Because of the high stakes involved in the assessment
of violence risk, it is critical for the assessment to be
as accurate as possible. Accuracy involves being both
sensitive (i.e., identifying those clients who are truly at
risk), as well as specific (i.e., identifying those clients who
are truly not at risk) in risk assessment).21 MHPs often
fear a false negative situation, in which the assessor
concludes that a client is at low risk when the client
is actually at high risk for violent behavior. Yet a false
positive is also problematic: concluding that a client is at
high risk when the client is actually at low risk can result
in unnecessary treatment, stigmatization, and restrictive
interventions that may actually interfere with a client’s
recovery.22
Fortunately, several decades of research have resulted
in the development of increasingly sophisticated tools for
MHPs who find themselves in the position of needing to
conduct a violence assessment.
Actuarial Assessments
At the opposite end of clinical judgment is the actuarial
approach to violence risk assessment. What is actuarial
assessment? Actuarial assessment is a process for
determining, combining, and differentially weighing a set
of previously identified factors to obtain an understanding
of the likelihood or probability that an event will occur in
the future.23 There is an entire profession in the business
world, specifically in the insurance industry that is
devoted to actuarial assessment. These actuaries, as they
Fortunately, several decades of research have resulted in the development of increasingly sophisticated tools
for mental health professionals who find themselves in the position of needing to conduct a violence assessment.
6
are called, are tasked with understanding the financial
implication of uncertainty, using mathematical and
statistical models combined with financial theories
to determine the risk associated with future events.24
Although there are many differences
Although there are many differences between clinical
and actuarial assessments of violence risk, the most
important difference is with the method used to
determine what factors to focus on in the assessment. In
contrast to clinical judgment, which can vary from MHP to
MHP – and even from patient to patient within the same
MHP – actuarial assessments rely on a predetermined,
fixed, and clearly articulated procedure for evaluating,
weighing, and combining information to determine risk.25
An MHP using an actuarial assessment will use it in very
similar, if not nearly exactly way as another MHP, and
each assessment process will be the same across all
clients being assessed.
important difference is with the method
A defining feature of actuarial approaches to violence
assessment is that they are based on findings from the
empirical literature. For example, in constructing the
Violence Risk Appraisal Guide (VRAG) to identify mentally
disordered offenders at risk for violent recidivism, the
test developers started with over 50 different predictor
variables. Like most actuarial violence risk assessments,26
the developers examined sociodemographic factors,
childhood and adult adjustment, criminal history,
characteristics of the initial offense, and psychological
variables in the development of the VRAG. The large
number of initial predictors was identified from the prior
research, from clinicians, and from theories of violent
behavior. The developers then followed 618 mentally
disordered offenders over an average of 81.5 months
to determine who engaged in violent recidivism. Use
various analytic strategies, the authors found that 12
items were most predictive of violent recidivism. Yet,
these items were not all equally predictive. As such, the
developers weighted the tiems based on the rate of
recidivism associated with that item. For example, using
5% increments as a guide, the item “never married”
was weighted at +1 because offenders who were never
married recidivated at a 7% greater rate. In contrast,
being married was weighted at -2 because married
offenders recidivated at a 10% lower rate than the rate of
all offenders combined.27
The actuarial approach has numerous advantages over
clinical judgment. First, the actuarial approach relies
on actual evidence to identify the items that are critical
to violence risk assessment. In clinical judgment, it is
unclear if the factors being used have an empirical basis,
and even more so, if they actually improve prediction.
For inclusion in an actuarial assessment tool, the items
between clinical and actuarial
assessments of violence risk, the most
used to determine what factors to focus on
in the assessment.
must not only be associated with later violent behavior,
but also improve upon the prediction of later violent
behavior.17 Indeed, while many factors are associated
with violent behavior, only a handful of factors actually
improve the prediction of later violence, above and
beyond the other variables.
Second, actuarial approaches provide a clear and
evidence-based way to combine risk factors. Conscious
or not, clinical assessment of violence risk also involves
this step: MHPs determine what factors are particularly
relevant or important to determining risk for a specific
client. In other words, the MHP is applying different
“weights” to different factors in their assessment. In
clinical assessment, however, the application of weights
is idiosyncratic to the MHP and may or may not be based
on any evidence, either clinical or empirical. Indeed, an
MHP may not even be aware that they are weighing
one factor more than another in their determination of
violence risk; it may happen at an intuitive or “gut” level.17
In contrast, actuarial assessments apply weights in a
pre-determined, analytic fashion to determine risk. When
conducted correctly, actuarial assessments remove the
subjectivity and variation involved in a clinical judgment,
taking the guesswork out of risk assessment.23
Third, an actuarial assessment like the VRAG can also
provide a probabilistic conclusion that is very difficult, if
not impossible to obtain with clinical judgment. Clinical
judgment often results in categorization of risk into broad
categories, such as low, medium, and high; however,
categorizing specific clients into these broad ranges
is often idiosyncratic to the specific MHP.18 Using the
samples on which the actuarial assessment was created,
an MHP can identify the number of people who engage
in violent recidivism within a particular range of scores on
the actuarial tool. With the application of item weighting,
the VRAG provides a score from -26 to +38, which can
be further divided into nine risk categories. Take, for
example, a client who scores a 10 on the VRAG. At a
general level, a score of 10 could correspond to a clinical
7
of violence risk. That isn’t the case. In reality, most MHP
have rejected actuarial tools for assessing risk.17 At best,
MHPs use one or more actuarial assessment as part of a
larger clinical assessment. Even among forensic mental
health evaluators, the available evidence suggests
that the VRAG is used sparingly: only 18% of evaluators
reported using the VRAG on their last two assessments
of violence risk.29 Despite their appeal, MHPs, and even
other researchers are concerned with the limitations of
actuarial assessments.30 For example, one of the features
that makes actuarial risk assessments attractive is the
provision of seemingly highly specific and accurate
risk estimates.23 The prior example determined a 44%
change of violent re-offense within the next seven years,
which sounds very specific and very impressive. Yet, it is
important to remember that this estimate is based on a
group of people who happened to have the same score
at the client; it says nothing specifically about the client’s
actual risk. Some have argued that the analytics involved
in determining these risk estimates, specifically the large
margins of error that accompany these estimates, make
the application of group-based statistics to individuals
an imprecise and uncertain practice.25,31 Indeed, actuarial
Despite their appeal, mental health
professionals, and even other researchers
are concerned with the limitations of
actuarial assessments.30
8
judgment of “medium” risk. With an actuarial assessment
like the VRAG, however, it is possible to determine a
more specific risk for violent recidivism. Using the VRAG
normative database, the MHP can conclude that the
client falls within Risk Category 6. Only 28% of offenders
from the normative sample scored higher than this
client on the VRAG. More specifically, because 44% of
offenders in Risk Category 6 had a violent offense within
an average of 7 years, the MHP can conclude that the
risk for violent recidivism is 44%.28 As such, an actuarial
assessment allows the MHP to provide not only a broad
risk categorization, but also a specific risk level with an
empirically-based estimate of risk for violent recidivism.
Fourth, actuarial assessment appears to be superior
to unaided clinical judgment.19 Based on several metaanalytic studies, actuarial assessments improve the
accuracy of violent risk assessment by an average of
a 13% over unaided clinical judgment.18,19 By another
estimate, given 1,000 predictions of violence, actuarial
assessments of violence correctly identify 90 more
clients than clinical judgment.19 There is also some
evidence that actuarial risks assessments are becoming
more accurate over time as researchers identify better
predictors, improve the reliability of those predictors,
and determine improve how they combine and weigh
those predictors.17
Given these findings, it seems reasonable to assume that
nearly every MHP is using actuarial tools for assessment
Weighting is also typically conducted differently in SPJ
than in actuarial assessments. Instead of standard and
empirically-driven weights for items, the weighting of
different factors in SPJ approaches is often left to the
MHP, who determines which items are most relevant
(i.e., more weight) for the specific individual.30 As
such, while the SPJ approach requires the MHP to
determine the presence of a risk factor, it is up to the
MHP to determine the relevance of that risk factor for the
particular individual.
assessments and statistical algorithms for determining
risk are, by their very nature, unable to understand all of
the unique characteristics and circumstances of a given
individual or circumstance.24 Instead, some have argued
that probability estimates of risk for future violence
should be abandoned, and we should instead use
more flexible approach that is grounded in the scientific
literature, but allows for consideration of information
beyond the specific items on an actuarial tool.24
A Blended Approach to Violence Risk
Assessment: Structured Professional
Judgment
Concerns with actuarial assessment have led to
approaches that blend the science of actuarial
approaches with the flexibility and comprehensiveness of
clinical judgment. These approaches, broadly referred to
as Structured Professional Judgment (SPJ), are intended
to guide an MHP towards a decision on violent risk,
allowing greater flexibility and individualization of the
assessment to the specific client.25
SPJ tools share several features. Consistent with
actuarial approaches, the items are determined a priori;
that is, there is a standard set of risk factors that are
used to evaluate all individuals. In contrast to actuarial
approaches, however, SPJ measures select items using a
logical or rational approach, rather than a purely empirical
approach.30 While authors of SPJ tools rely on the
empirical literature to determine the items to include in
their measures, the items they select come from multiple
studies with varying levels of scientific rigor. Some SPJ
tools also include items that may have clinical appeal,
but limited empirical support, or even allow the MHP
to write in their own risk factors. This approach to item
selection allows for a more comprehensive set of items to
be included in SPJ measures than actuarial assessments,
while also making sure that MHPs assess for a standard
set of items.
Further, unlike actuarial approaches which typically rely
on historical factors that do not change, SPJ assessments
integrate dynamic and potentially malleable factors into
their assessments. For example, dynamic risk factors,
such as impulsiveness, anger, negative mood, psychosis,
antisocial attitudes, substance use, interpersonal
relationships, and treatment variables (therapeutic
alliance, adherence), not only provide valuable
information that may influence more immediate risk for
violence, but also opportunities to specify treatment/
management targets.32 By including dynamic factors, SPJ
approaches are more useful for determining treatment
targets and managing risk in a clinical context.33
Consistent with the focus on dynamic risk factors, SPJ
approaches tend to estimate risk over shorter periods of
time. For example, while the VRAG provides estimates
for 7 to 10 years later, some forms of SPJ recommend
reassessment every 3 months, or even earlier if the risk
factors are not adequately addressed through treatment
or management.34
Finally, rather than specific probability estimates, as is
provided with actuarial assessments, SPJ approaches
typically categorize individuals into broad risk levels, such
as low, moderate, and high. When combined with a focus
on malleable factors, the SPJ approaches allow MHPs to
not only identify broad risk categories, but also specific
factors that could be used to reduce risk.
A common example of the SPJ approach to violence risk
assessment is the Historical Clinical Risk Management-20
(HCR-20).15 The HCR-20, now in its third version,
provides guidance to MHPs in assessing the presence of
20 historical, clinical, and risk management items.
The historical scale includes some of the same static
factors found in actuarial assessments, such as
violence history and early maladjustment. The clinical
scale, however, includes factors not found in actuarial
assessments, such as insight, attitudes, impulsivity, active
symptoms of mental disorders, and treatment response.
Finally, the risk management items address social support
and destabilizing influences, feasibility of management
9
plans, and compliance with treatment/management plans.
The HCR-20 manual provides detailed guidance for how
to evaluate each item. The MHP not only determines
the presence of a risk factor, but also the relevance of
the factor for the specific individual being evaluated. For
example, while substance abuse may be rated as present
for an individual who smokes marijuana, the individual
may have never been violent while high, and therefore
the factor may not be relevant.35
There is substantial debate about the comparative
efficacy of actuarial versus SPJ approaches to violence
risk assessment.30 It seems, however, that the SPJ
approach is likely as valid as the actuarial approach. A
recent meta-analysis indicates that the HCR-20 performs
as well as actuarial assessments, like the VRAG.36 Across
six different violence assessment tools, actuarial and
SPJ approaches were found to have similar predictive
validities. Indeed, the tool with the greatest predictive
validity of violence, the the Structured Assessment of
Violence Risk in Youth,37 uses an SPJ approach.
actually rely on the total scores.17 By allowing greater
flexibility in the SPJ approach, MHPs may feel free to
take additional liberties in selecting or modifying factors,
so much so that the SPJ approach begins to look like
unstructured clinical judgment.19 Although MHPs may be
tempted to consider other factors or modify the factors
that are included in an SPJ, there is little data to support
that combining actuarial measures with other measures
improves predictive accuracy.38 Third, as mental health
professionals, it is always temping to overweight
symptoms of mental disorders, increasing the likelihood
of false positives with a mentally ill population.
Recommendations for Practice
Some researchers, such as the developers of the VRAG,
argue that MHPs should use a purely actuarial approach
to violence risk assessment, with no discretion given to
MHPs for modifying or adding to the assessment.23,25
Indeed, there is no evidence that the modification of
numerical risk scores by clinical intuition does anything
to improve the accuracy of violence risk assessment.27
Yet, such a hard line may not be fully necessary. SPJ
approaches, when done correctly, appear to perform
similarly to actuarial approaches.39
It is also important to acknowledge that while the
science of violence assessment has improved
dramatically over the last two decades, there is still
much to discover. For example, a recent meta-analysis
suggests that the scientific literature may be biased by
the authors’ investment in the tools they’ve created.
Specifically, the studies that were authored by the
developer of the tool under evaluation had predictive
validities that were two times higher than the studies
authored by independent investigators.36 Taking all of
these findings together, the jury remains out about the
best approach to take in violence risk assessment.
Much like actuarial approaches, however, there are limits
to the SPJ approach.17 First, not all factors included in SPJ
tools are actually based in the scientific literature. Even
worse, some SPJ measures include factors that have
been shown not to increase risk, such as the severity
of prior violence or psychotic symptoms. Second, while
total scores from SPJ measures appear to perform as well
as many actuarial methods,37 it is not clear that MHPs
10
The lack of consensus in violence risk assessment
is reflected in the practices of MHPs. In a survey of
forensic mental health evaluators reporting on their
two most recent violence risk assessments, 89% used
at least one structured risk assessment tool, with an
average of 3.98 tools per evaluator. Of note, 110 different
structured risk assessment tools were used.29 Most
evaluators used multiple methods in their assessments,
including an interview (99%), record reviews from the
justice (95%), mental health (91%), and educational
(26%) systems, professional (55%) and non-professional
(27%) collateral reviews, additional observations of the
examinee (26%), biological tests (12%), and visits to
places relevant to the examinee or risk of violence (7%).
Although most evaluators used structured assessments
of some kind, the most common reason for not using
them was because they trusted their clinical judgment.29
As such, even among professionals who do forensic
work as their livelihood, there is great variability, and
most evaluators rely on multiple measurements to
conduct risk assessments.
So what is the best approach to assessing for violence
risk? There seems to be enough evidence to suggest that
unstructured clinical judgments should be avoided in favor
of either actuarial or structured professional judgment
tools. Beyond that, Douglas et al. (2014) recommends a six
step process.30 First, gather as much relevant information
from as many sources as possible, especially about past
violent behavior. Sources of information can include record
reviews, as well as interviews with the client, victims,
witnesses, and collaterals. Second, identify the presence
of risk factors and, third, determine the relevance of those
risk factors for your client. The second and third step
of this process are particularly amenable to the use of
actuarial and SPJ tools. Fourth, the MHP must go beyond
just categorizing risk or providing a specific estimate of
risk; the MHP must consider the specific scenarios by
which violence is most likely to occur. The MHP should
consider scenarios in which the client repeats any past
violence, as well as a best-case (i.e., desists violence) and
worst-case (i.e., most serious likely violence) scenarios, and
finally, an evolution of the violence trajectory in a different
or alternative direction. Fifth, develop plans to mediate or
reduce the risk for violence in the four scenarios. Finally,
the MHP should document and communicate the risk.
In all of these approaches, it is important to acknowledge
that clinical skill and judgment is still required, even
with actuarial assessment. Indeed, understanding how
to gather and categorize information, even for actuarial
assessment, is task left best to MHPs; however, MHPs
must be careful to exercise their judgment and skill, as
best as possible, within the tools available.17
See references on page 28.
Earn a CEU Credit
Did You Read the Article?
To obtain one (1) CEU Credit (groups A, C and E), please submit your answers to these
questions here: www.surveymonkey.com/r/assessingviolence
QUESTIONS:
1.
Most gun deaths are committed by people who suffer from mental illness.
True
False
2. Mental health practitioners are less likely to make accurate predictions if they are more familiar
with a client.
True
False
3. Violence Risk Appraisal Guide (VRAG) is used to identify offenders at risk for violent recidivism.
True
4
False
Across different violence assessment tools, actuarial and SPJ approaches were found to have similar
predictive validities.
True
False
11
Current Mental Health
Trends and Strategies
for Children and Adolescents
Program Agenda
Friday, September 16, 2016
9 am – 1 pm
Location
NIU Conference Center, Hoffman Estates Campus
5555 Trillium Blvd., Hoffman Estates, IL 60192
CEUs Offered: 4.0
Groups: A, B, C, D, E
Cost: FREE
Includes program materials, continuing education and
continental breakfast
Reserve a Seat
Register online at
Check-in begins at 8:30 am
Description
This workshop will feature experts from a variety of
programs who will address current and trending issues
with children and adolescents.
Program Objectives
Participants will:
• Learn current mental health trends for children and
adolescents
• Define strategies to intervene in these diagnostic areas
• Examine family dynamics in each diagnostic area
12
Update on Teen Dating Violence
Madelyn “Mandy” Burbank, LCSW, Clinical Navigator
AMITA Violence Prevention Services
Phobias and Panic in Children and Adolescents
Patrick B. McGrath, PhD, Assistant Vice President
AMITA Health Foglia Family Residential Treatment Center
Strategies and Updates for School Anxiety
Jackie Rhew, LCPC, CADC, Clinical Liaison
Current Trends and Strategies in Adolescent
Substance Abuse
Sarah Briley, EdD, CADC,
Stella Wilson, LCSW, Clinical Coordinator, Youth Addictions
Strategies for Working with ASD Population
Kelly Demers, PsyD, Psychologist
AMITA Health Autism Spectrum & Developmental
Disorders Resource Center
Approaches to Working with Dysregulated
Adolescents
Denise Styer, PsyD, Clinical Director
AMITA Health Center for Eating Disorders
School Transition Planning
Jackie Rhew, LCPC, CADC, Clinical Liaison
Kristen Poniatowski, LCSW, School Liaison
Hypersexuality and Dementia:
Causes, Behaviors and
Treatment Options
A Joint Event with the Northern Illinois
Coalition for Mental Health and Aging
Tuesday, September 20, 2016
10 am — noon
Faculty
Sachin Bhalerao, MD
Medical Director, Older Adult Inpatient
AMITA Health Behavioral Medicine Institute
Location
Bridges of Poplar Creek Country Club
1400 Poplar Creek Dr.
CEUs Offered: 3.0
Groups: A, B, E, G
Cost: $20
Description
Sexually inappropriate behavior in the Dementia
population is quite a common and challenging behavioral
issue often encountered in long-term care and hospital
settings. Our goal is to educate and provide a better
understanding of these behaviors and provide both
pharmacological and non-pharmacological treatment
strategies to better serve our patients and empower us
to address the behavioral challenges they may present.
Reserve a Seat
Register online at
Program Objectives
Participants will:
• Learn what constitutes sexually inappropriate behavior
• Discuss the pathophysiology of inappropriate sexual
behavior
• Discuss the treatment and management of sexually
inappropriate behavior
• Discuss novel therapeutic agents
• Discuss ethical issues associated with these kinds of
behaviors
13
Counseling Transgender
Youth in Schools and
Agencies: What We Need
to Know as Advocates
9 am – 3 pm
Guest Faculty & Faculty
Distinguished Teaching Professor
Department of Counseling, Northern Illinois University
Matt Liberatore MA,LCPC
Assistant Principal and Director of Student Services
John Hersey High School
Yumi Terajima, PsyD
Therapist, AMITA Health Center for Self-Injury
Outpatient Program
Location
5555 Trillium Blvd., Hoffman Estates, IL 60192
CEUs Offered: 5.0
Cost: $40
Includes program materials, continuing education,
continental breakfast and snacks
Reserve a Seat
Register online at
Program Objectives
Participants will:
• Review legal, ethical and social justice issues
• Discuss the key developmental factors, social and
emotional barriers
• Learn skills and strategies to enhance safety and
wellness safety and wellness concerns
14
Description
The increase of children and adolescents who are
coming out as transgender and gender-expansive,
requires counselors and educators to become strong
and intentional advocates for these youth. This workshop
will address basic information about transgender and
gender-expansive youth, the challenges they face, and
how professionals can intervene to help contribute to
a safe and healthy environment. It will review school
policies, Title IX, state and national legislation, medical
diagnosis, and other legal and ethical concerns regarding
this population. While exploring the social and emotional
concerns that these youth face in their schools, families,
communities, and peer groups.
Guest Faculty Bios
Dr. Toni R. Tollerud is a professor in the
Department of Counseling, Adult and
Higher Education at Northern Illinois
University (NIU). She is an accomplished
counselor educator and consults all
over the state on issues related to
supervision, career development, and
school counseling.
Matt Liberatore is currently the
Assistant Principal for Student Services
at John Hersey High School located
in District 214. Throughout his time
working in education, Matt has quickly
become a top advocate and ally to
the LGBTQIA community within the
education field. In the past five years,
Matt has presented on “how to create a gender-diverse
safe environment to district, high schools, and Student
Services professionals.
What’s the Latest on ADHD?
Neurobiology, Strategies and
Medication
9 am – 1 pm
Faculty
Michael Feld, MD
Community Liaison Psychiatrist
Amy Davis, PhD
Pediatric Neuropsychologist
AMITA Health Alexian Brothers Neuroscience Institute
Brian Van Meurs, PhD
Pediatric Neuropsychologist Fellow
AMITA Health Alexian Brothers Neuroscience Institute
Tricia McKinney, PsyD
Psychologist/Therapist
Location
Description
This workshop will highlight updates in three major
areas in the diagnosis and treatment of ADHD. Areas
of focus will be neurobiology, medication and strategies
for working with this population. Following the
presentations, participants will have an opportunity
to ask questions during a panel discussion.
Program Objectives
NIU Conference Center
Hoffman Estates Campus
5555 Trillium Blvd.
Participants will:
CEUs Offered: 4.0
• Synthesize strategies for working with ADHD children,
adolescents and young adults
Cost: $30
• Learn to identify the neurobiology of ADHD to further
understand etiology
• Learn to identify new medications and understand
the benefits of these medications
Reserve a Seat
Register online at
15
Resolving Trauma Without
Drama: New, Brief, Respectful
and Effective Approaches
to Treating Post-Traumatic
Stress Disorder
Friday, October 7, 2016
9 am – 4 pm
Guest Faculty
Bill O’Hanlon, MS, LMFT
Author, Psychotherapist
Location
5555 Trillium Blvd.
CEUs Offered: 5.0
Cost: $50
continental breakfast and snacks
Reserve a Seat
People with post-traumatic stress commonly suffer
for years and develop a variety of troubling and often
crippling problems. This workshop will detail a philosophy
and methods of working briefly and effectively with
people who have been traumatized. An array of new
methods has shown that previous conceptions and
methods of working with trauma are unnecessarily longterm and re-traumatizing, rather than creating a sense of
possibilities. Participants will leave equipped with new
tools and ideas to work briefly, effectively and respectfully
with even severe and long-standing trauma. Bill is a
dynamic speaker whose humor and engagement with the
audience makes his presentations fun and enlivening.
Program Objectives
Register online at
Participants will:
• Learn three methods of creating hopeful futures for
trauma survivors
Guest Faculty Bio
• Learn to design therapeutic rituals
Bill O’Hanlon, MS, LMFT, is an
inspirational, professional speaker
and prolific author (over 30 books
so far!), who helps motivate people
and organizations to determine what
they are meant to be doing and to
remove the barriers to succeeding at
those goals. Originally trained as a
psychotherapist, Bill became known for his collaborative,
respectful approach, irreverent humor, storytelling, clear
and accessible presentation style and his infectious
enthusiasm for whatever he is doing. He teaches
seminars, leads trainings, writes books, coaches people
and offers websites, podcasts, blogs, web-based courses
and teleclasses.
16
Description
• Learn four rapid methods for resolving trauma
Sexuality and Intimacy
in Autism Spectrum Disorder:
Rights and Risks
9 am – 1 pm
Description
Intimate relationships and sex are important parts
of the human experience, but both require complex
social skills that may present a challenge to people on
the spectrum. Individuals with ASD are at increased risk
of sexual victimization and may also be at increased
risk of problematic sexual behaviors. This presentation
will discuss the core features of ASD that contribute to
challenges in intimate relationships and sexuality and
describe the ways in which sexuality education can
promote healthy sexuality. Specific teaching tips and
content areas to address will be discussed.
Program Objectives
Participants will:
• Describe key content areas of sexuality education
for people with ASD
• Note core features of ASD that can make intimate
relationships and sexuality challenging
• Learn to identify three strategies for effective sexuality
education instruction
Guest Faculty Bio
Dr. Rachel Lofton is the Clinical Director
for the AARTS Center. She is also on
faculty in the psychiatry departments at
both Rush University Medical Center and
the Yale School of Medicine. Dr. Lofton
specializes in evaluations, consultation
and interventions for children and adults
with Autism Spectrum Disorder (ASD)
and other social challenges. She has an
extensive background in educational, behavioral and social
intervention approaches for individuals with ASD.
Guest Faculty
Rachel Lofton, PhD
Faculty
Rush University Medical Center and Yale University
Faculty Lunch Panel
Shubhrajan Wadyal, MD
Service Line Director
Maria Bellantuono, MA, LCPC, NCC
Clinical Director
AMITA Health Alexian Brothers Autism Spectrum
Disorders Resource Center
Amy Davis, PhD, ABPP
Pediatric Neuropsychologist,
AMITA Health Neuroscience Institute
Location
5555 Trillium Blvd.
CEUs Offered: 3.0
Cost: $45
Includes program materials, continuing education
continental breakfast, and lunch
Reserve a Seat
Register online at
17
Toxic and Hidden Anger:
Approaches for
Passive-Aggressive,
Chronically Angry and
Impulsively Angry Clients
Description
9 am – 4 pm
Guest Faculty
Ronald Potter-Efron, PhD, LICSW, CADC III
Author
Location
5555 Trillium Blvd.
CEUs Offered: 5.0
Groups: A, B, C, E
Cost: $50
Includes program materials, continuing education, and
Reserve a Seat
Register online at
Program Objectives
Participants will:
• Help clients comprehend the interactions between
anxiety and anger in their lives
• Identify separate and distinct forms of anger
• Provide treatment interventions for each of these
forms of anger
18
This workshop is a rare opportunity to participate in a
seminar lead by the international anger expert,
Dr. Ronald Potter-Efron. Dr. Potter-Efron will present
a brand new and powerful workshop full of practical
techniques ready to use immediately. This program will
provide an in-depth look at the issue we’ve all faced but
haven’t always recognized: hidden, chronic and passiveaggressive anger. When people don’t express their
views and feel compelled to conceal their true beliefs,
and emotions, behaving in ways that don’t match what
they honestly think, there can be serious physical and
psychological results for everyone involved.
Dr. Potter-Efron will also provide many useful and practical
interventions for use with a wide range of clients with
other anger problems including clients whose chronic
anger has become habitual, people with impulsive anger
issues, and individuals whose deep distrust of others fuels
their anger.
Guest Faculty Bio
Dr. Ronald Potter-Efron is the author
of 20 books on anger and relationship
communication – exploring the
key factors that lead to passiveaggression and other forms of toxic
anger. Dr. Potter-Efron has studied
for almost 30 years the wide variety
of ways that problematic anger
is displayed. His knowledge of these often subtle
differences in angry behavior, and the corresponding
cognitive distortions that justify problematic anger,
has enabled him to develop individualized treatment
approaches that better meet the widely varied needs
of clients. He is the author of Letting Go of Anger and
Healing the Angry Brain.
Cultural Competence:
Integrating Spirituality and
Psychology
Guest Faculty
Mark Sanders, LCSW, CADC
Lecturer
University of Chicago
Location
5555 Trillium Blvd.
Friday, November 11, 2016
9 am – noon
CEUs Offered: 3.0
Groups: A, B, C, E
Meets state licensure requirement for cultural
competence
Description
Includes program materials, panel, networking, and
Two-thirds of Americans surveyed say they would prefer
to work with a therapist who has a spiritual foundation.
This interactive, skill-building workshop focuses on
strategies to integrate spirituality and psychotherapy.
Topics include:
Reserve a Seat
• Differences between religion and spirituality
Cost: $30
Register online at
Guest Faculty Bio
Mark Sanders, LCSW, CADC, is an
international speaker in the addictions
and mental health fields whose
presentations have reached thousands
throughout the U.S., Europe, Canada,
and the Caribbean Islands. He is the
co-author of Recovery Management
and author of Relationship Detox: How
to Have Healthy Relationships in Recovery, and Slipping
through the Cracks: Intervention Strategies for Clients
with Multiple Addiction and Disorders. Sanders had two
stories published in the New York Times best-selling
book series, Chicken Soup for the Soul. He is also a
lecturer at the University of Chicago.
• Integrating religion and spirituality with traditional
counseling approaches
• Ethics and spirituality
• Issues of diversity in spirituality
• Addressing religious addictions in psychotherapy
Program Objectives
Participants will:
• Understand differences of religion and spirituality
• Synthesize strategies for integrating spirituality into
counseling
• Learn how to conduct a spiritual assessment
• Utilize and understand strategies for addressing
religious addictions in counseling
19
Honoring Our Veterans:
Issues and Challenges
A Joint Event with the Illinois
Psychological Association (IPA)
Military Section
Descriptions & Program Objectives
Friday, November 20, 2016
9 am – 1 pm
Guest Faculty & Faculty
Core Clinical Psychology Faculty
Adler University
Veterans Today
5555 Trillium Blvd.
Historically, our military veterans have
experienced social exclusion within
our society. As a group, their rates of
suicide, homelessness, unemployment,
engagement in the criminal justice
system, physical health, mental health,
and substance abuse problems are
significantly higher than the non-veteran
population. We have to look no further than the largest
veteran population, veterans from the Vietnam War, who
were marginalized often the minute they stepped off the
plane following their tours of duty. Veterans of that war,
as well as the veterans of this, the fifteenth year of what
is now being referred to as the “long war,” continue to
experience alienation and disenfranchisement.
CEUs Offered: 4.0
Participants will:
Patrick B. McGrath, PhD,
Assistant Vice President
AMITA Health Behavioral Medicine Institute Foglia Family
Foundation Residential Treatment Center
David Cosio, PhD,
Psychologist, Anesthesiology/Pain Clinic
Jesse Brown VA Medical Center
Location
Groups: A, B, C, E
Other: Military, Veterans and family member
Cost: Free
Reserve a Seat
Register online at
Check-in begins at 8 am
20
Honoring Our Veterans is a conference for professionals,
active military, veterans and their families. Joseph E.
Troiani, PhD, CADC; Patrick B. Mcgrath, PhD and David
Cosio, PhD will present a follow-up to last year’s soldout Veterans Conference to address new issues and
treatments for our warrior/veteran population.
• Understand the demographics of the current veterans
population in Illinois
• Examine the reported rates of behavioral health issues
with the veteran’s population
• Know the experience of having served in the military.
• Identify the full spectrum of related traumas and injuries
• Discuss the impact of ongoing conflicts on those
currently serving, those who have served, and their
families
IPA and AMITA Health Alexian
Brothers Behavioral Health Hospital
are co-sponsoring this event
to highlight the needs of the
military and veteran communities
for Veterans Day. This conference
is for professionals, active military,
veterans and their families.
Putting Chronic Pain Management into
Veterans’ Hands
David Cosio, PhD
Beyond Nightmares and Flashbacks
Post-traumatic stress (PTS) is no
longer a hidden problem for veterans
and there are now active attempts to
engage veterans in getting help. But
its impact goes beyond the veteran
– their families, friends, occupations,
and academics can also be affected by
PTS. We will discuss the far-reaching
effects of PTS and what treatment providers need to do
to help veterans and their families.
Participants will:
• Understand the impact of PTS on veterans and their
families
• Discuss the specific areas of impact
• Synthesize treatment approaches to PTS
Dr. David Cosio will share basic
principles for relief and prevention,
provide education about conventional
interventions, and introduce services
offering non-pharmacological and
alternative interventions for the relief of
pain and promotion of self-management
strategies. The goal of this seminar is to
empower therapists who work with veterans who suffer
from chronic pain. Participants will leave the seminar
being able to create a comprehensive pain management
plan for their clients.
Participants will:
• Explain the current state of pain management in
the U.S.
• Describe the multi-dispensary approach to pain
management
• Learn how to create a comprehensive pain
management plan
• List the five key coping skills to have more success
when working with veterans suffering from chronic pain
21
When Talk Isn’t Enough:
Expressive Therapy for
Emotional Disorders
Description
Friday, December 2, 2016
9 am – 4 pm
Faculty
Linda Cao-Baker, LCPC, BC-DMT
Clinical Director of Expressive Therapy Services
Elizabeth Muckley, LCPC, RDT-BCT
Expressive Therapist
Victoria Storm, BC-MT
Rita Guertin, LPC, ATR
Location
Bridges of Poplar Creek Country Club
CEUs Offered: 6.0
Cost: $50
continental breakfast and afternoon beverages
Reserve a Seat
Register online at
22
This workshop will present a neuroscience-based
theoretical framework of expressive therapy and clinical
intervention methods from four disciplines (dance
movement therapy, drama therapy, art therapy and
music therapy) as applied to emotional disorders. All
intervention techniques will be presented with case
studies and experiential practice, focusing on specific
symptoms, process of application and the how/why of
change. In this intensive training, you will learn actionoriented, and creative expressive therapeutic skills
to apply in the 1:1 setting. Participants will be able to help
clients to develop their expressive vocabulary, embody
motivation, strengthen self-regulation, increase cognitive
reappraisal skills, and restructure behavior.
Program Objectives
Participants will:
• Acquire key concepts of theoretical framework
of expressive therapy in working with emotional
disorders
• Learn intervention skills of therapeutic movement
dialogue treating poor body image, lacking of
motivation, mood swings and psychosomatic
symptoms
• Acquire intervention techniques of music therapy
treating self-injury, suicidal thought, lacking of
tolerance
• Identify intervention techniques of drama therapy
treating social phobia, impulsivity, and negative
thought frame
Violence: Assessment
of Risk for Mental Health
Practitioners
Friday, December 9, 2016
9 am –noon
Description
This presentation reviews approaches to assessing
for risk of harm to others. Although people with
mental illness are much more likely to be victims than
perpetrators of violence, mental health professionals
invariably encounter situations in which it is necessary
to assess for risk of harm to others. Through a review of
the evidence base and best practices, this presentation
will provide mental health professionals with an
appreciation of the science of violence prediction, the
benefits and limits of various approaches to violence
risk assessment, and an overview of approaches and
available tools for violence assessment.
Program Objectives
Participants will:
• Understand the capacity of mental health professionals
to assess for violence risk
• Become familiar with various approaches to the
assessment of violence risk
• Identify various tools for violence risk and their benefits
and limitations
Faculty
Director, Center for Evidence Based Practice
Director of Education and Clinical Training,
Northwestern University Medical Center
Location
5555 Trillium Blvd.
CEUs Offered: 3.0
Cost: $30
Reserve a Seat
Register online at
Faculty Bio
Jason Washburn is the Director of the
Center for Evidence-Based Practice
at AMITA Health Alexian Brothers
Behavioral Health Hospital Hoffman
Estates. He is a licensed psychologist
and a board-certified specialist in clinical
child and adolescent psychology.
He is also an Associate Professor in
the Department of Psychiatry and Behavioral Sciences
at Northwestern University Feinberg School of Medicine
where he directs the PhD program in Clinical Psychology.
23
Overcoming Addiction
and Ending America’s
Greatest Tragedy
Description: In the Presenter’s Own Words
Thursday, January 26, 2017
9 am – noon
Guest Faculty
David Sheff
Author
Faculty
Gregory Teas, MD
Chief Medical Officer
Sarah Briley, EdD, CADC
Clinical Director, Center for Addiction Medicine
Irfan Syed, MD
Medical Director, Center for Addiction Medicine
Location
5555 Trillium Blvd.
CEUs Offered: 3.0
Cost: $30
continental breakfast and panel
Reserve a Seat
Register online at
24
I know first-hand the pain and terror that comes from
drug use – our own or a loved one’s. When he was
a teenager my son became addicted and almost died.
I learned the hard way that addiction is America’s greatest
challenge – it impacts every other societal problem you
can name. We’ve ignored it because it has been our
great shame. We’ve viewed drug use as a problem of
morals and character, rather than what it is: a health issue.
A health crisis. But we’ve ignored it at our peril. There
are far too many parents like me – desperately trying to
save the lives of their children. And there are far, far too
many suffering even more – they’ve lost their children or
other loved ones. Drugs are now killing more people in
our nation than any other non-natural cause – more than
anything except cancer and heart disease. A person is
dying every 19 minutes.
We are in the midst of an epidemic, and have been
blindsided, but as a nation we’re beginning to wake up
to the fact that our efforts to prevent drug use and cure
addiction have failed. And in addition, we’re learning
that though we’re not preventing it, substance abuse is
preventable, and though we’re not effectively treating it,
addiction is treatable.
We can change the course we’re on, but only when we
reject the status quo. We must acknowledge that we’ve
been looking at the nation’s drug problem in the wrong
way. We’ve focused on drugs, but we must instead focus
on why people use them. When we do, we learn how to
successfully prevent people from using drugs in the first
place; slow or stop use once it’s begun, and save those
who become addicted. When we accept the new paradigm
based on the understanding that addiction is a disease
that’s preventable and treatable, and when we adopt
new proven prevention and treatment strategies, we will
make our cities safer, help families stay together, help our
children grow up healthier, and save countless lives.
Participants will interact with experts Gregory Teas, MD,
Sarah Briley, EdD, CADC and Ifran Syed, MD during the
last hour of the workshop.
Coming Spring 2017
Program Objectives
Participants will:
• Define addiction as a national crisis in need of change
• Learn prevention and treatment for substance abuse
• Discuss treatment options with a panel of experts
Guest Faculty Bio
David Sheff is an American author of
the New York Times best-selling books
Clean: Overcoming Addiction and
Ending America’s Greatest Tragedy
and Beautiful Boy: A Father’s Journey
Through His Son’s Addiction. In
2009, Sheff was included in the Time
Magazine Time 100, The World’s Most
Influential People, and Beautiful Boy was named the best
nonfiction book of the year by Entertainment Weekly.
The book also won the Barnes & Noble “Discover Great
New Writers Award” for nonfiction and was an Amazon
Best Book of the Year (2008).
Beautiful Boy was based on Sheff’s article, “My Addicted
Son,” that first appeared in the New York Times Magazine.
The article won an award for “Outstanding Contribution
to Advancing the Understanding of Addictions” from the
American Psychological Association.
Sheff, a journalist, has written for The New York Times,
Rolling Stone, Playboy, Wired, Fortune, and National Public
Radio’s “All Things Considered.” His interview subjects
have included John Lennon, Frank Zappa, Steve Jobs,
Ai Weiwei, Keith Haring, David Hockney, Jack Nicholson,
Ted Taylor, Carl Sagan, Betty Friedan, Barney Frank,
Fareed Zakaria, and many others.
AMITA Health Behavioral Medicine Institute is excited
to announce the opening of a brand new residential
treatment center in Elk Grove Village, IL. The Foglia
Family Foundation Residential Treatment Center will
specialize in the treatment of Anxiety, ObsessiveCompulsive Disorder and Addictions, for adults ages
18 and up.
· 24-hour supervision
· Latest approaches in evidence-based treatments
· Cutting-edge technological interventions such
as Virtual Reality treatment for PTSD, phobias,
addictions and more
· Individualized treatment plans
· Specialized therapy groups including Mindfulness,
Pain Management, Cognitive Behavioral Therapy,
Relapse Prevention, Forgiveness/12-Step, Hoarding,
Perfectionism, Nutrition and Victim/Survivor
The Foglia Family Foundation Residential Treatment
Center will also provide specialty treatment options
to populations such as Millenials, Veterans and
Professionals.
For more information on the Foglia Family Foundation
Residential Treatment Center, please contact
Scott Naples at [email protected] or
847.230.3581.
AMITAhealth.org/BehavioralMedicine/AB/RTC
25
LCPC Supervision Series:
Keys to Successful Clinical
Supervision Training
Workshop 1, October 15
Effective Strategies in Supervision
Workshop 1: Saturday, October 15, 2016
Workshop 2: Saturday, October 29, 2016
Workshop 3: Saturday, November 12, 2016
This workshop covers the basic strategies necessary
to be an effective supervisor and to engage in the
supervision process. Specific topics include:
• What is supervision?
8:30 am – 3 pm
Guest Faculty
Distinguished Teaching Professor
Department of Counseling
Northern Illinois University
Location
5555 Trillium Blvd.
CEUs Offered: 18.0
Groups: A, B, C, E
Cost: $180
continental breakfast, lunch and snacks
Reserve a Seat
Register online at
Attendees are welcomed to register for workshops
on an individual basis if necessary. Each workshop offers
6.0 CEUs.
Check-in begins at 8 am
26
• Differences in settings, roles, expectations, and
evaluation
• Roles of effective supervisors
• Expectations of supervisor/supervisee
• Selecting a preferred style for supervision and
understanding of the discrimination model as a
starting point
• The supervisor as learner in the discrimination model
• Effective planning for the supervision session
• The art and importance of process in supervision
• Ethical concerns and vignettes pertinent for the
beginning supervisor
Guest Faculty Bio
Dr. Tollerud is a professor in the
Department of Counseling, Adult and
Higher Education at Northern Illinois
University. She received a Presidential
Teaching Professorship Award in
2008. In her 25 years at NIU, she has
coordinated and served as Director of
Internship and the School Counseling
Program. She is an accomplished
counselor educator and consults all over the state on
issues related to supervision, career development, and
school counseling.
Workshop 2, October 29
Advanced Supervision Issues: Psychological
Stress, Resistance and Impairment
This workshop deals with more advanced issues that
arise in the supervisory relationship including:
• Dealing with difficult supervisees
• Prevention strategies to avoid difficulties
• Due process procedures in supervision
•Impairment
• Supervision/supervisee burnout
Webinar Learning
Series
Online learning through AMITA Health
Alexian Brothers Center for Professional
Education is available for your convenience.
Each webinar will be offered on the
specified date from noon – 1 pm. One (1)
CEU credit will be awarded upon
completion of webinar for groups
A and C. Webinar programs are FREE OF
CHARGE! Registration is required.
Register online at
AMITAhealth.org/BehavioralMedicine/
AB/Register
• Transference and countertransference
Opportunities to apply concepts learned will be
experienced through viewing videos of sessions.
Workshop 3, November 12
Peer, Triadic, Group and Supervision:
Effective Strategies
This workshop offers insightful supervision information
utilizing approaches other than the traditional two-person,
face-to-face approach. It will explore the following:
• Differences between consultation and supervision
• Group supervision
• Leadership styles in doing group supervision
• Triadic supervision, the reflective approach model
• Peer supervision
• Ethical and legal issues surrounding these approaches
A Primer on Violence Risk
Assessment
September 20, 2016
Technology and Teen Dating
Violence
October 20, 2016
Non-Suicidal Self-Injury: It’s Not
Just Cutting
November 10, 2016
Denise Styer, PsyD
Petitions for Involuntary
Admission: Older Adult and
Other Special Populations
December 6, 2016
Colleen Caron, RN
Opportunities to apply these concepts learned will be
experienced through both live and video-taped exercises.
27
References from article on page 4:
1. Robillard JM, Illes J. A link in the ink:
mental illness and criminal responsibility
in the media. Journal of Ethics in Mental
Health. 2011;6:1-7.
2. Metzl JM, MacLeish KT. Mental illness,
mass shootings, and the politics of
American firearms. Am J Public Health.
2015;105(2):240-249.
3. Swanson JW, McGinty EE, Fazel S, Mays
VM. Mental illness and reduction of gun
violence and suicide: bringing epidemiologic research to policy. Ann Epidemiol.
2015;25(5):366-376.
4. Barry CL, McGinty EE, Vernick JS,
Webster DW. After Newtown--public
opinion on gun policy and mental illness.
N Engl J Med. 2013;368(12):1077-1081.
5. Fazel S, Wolf A, Chang Z, Larsson H,
Goodwin GM, Lichtenstein P. Depression
and violence: a Swedish population
study. Lancet Psychiatry.
2015;2(3):224-232.
6. Fazel S, Gulati G, Linsell L, Geddes JR,
Grann M. Schizophrenia and violence:
systematic review and meta-analysis.
PLoS Med. 2009;6(8):e1000120.
7. Winer JP, Halgin RP. Assessing and
Responding to Threats of Targeted
Violence by Adolescents: A Guide for
Counselors. Journal of Mental Health
Counseling. 2016;38(3):248-262.
8. Iozzino L, Ferrari C, Large M, Nielssen
O, de Girolamo G. Prevalence and
Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic
Review and Meta-Analysis. PLoS One.
2015;10(6):e0128536.
9. Kelly EL, Subica AM, Fulginiti A, Brekke
JS, Novaco RW. A cross-sectional survey
of factors related to inpatient assault of
staff in a forensic psychiatric hospital.
J Adv Nurs. 2015;71(5):1110-1122.
10. Fazel S, Lichtenstein P, Grann M,
Goodwin GM, Langstrom N. Bipolar
disorder and violent crime: new evidence from population-based longitudinal studies and systematic review.
Arch Gen Psychiatry. 2010;67(9):931-938.
11. McGinty EE, Frattaroli S, Appelbaum
PS, et al. Using research evidence
to reframe the policy debate around
mental illness and guns: process and
recommendations. Am J Public Health.
2014;104(11):e22-26.
12. Skeem J, Kennealy P, Monahan J,
Peterson J, Appelbaum PS. Psychosis
Uncommonly and Inconsistently
Precedes Violence Among High-Risk
Individuals. Clinical Psychological Science. 2016;4(1):40-49.
13. Elbogen EB, Dennis PA, Johnson SC.
Beyond Mental Illness: Targeting
Stronger and More Direct Pathways to
28
Violence. Clinical Psychological Science.
2016:Advance online publication.
14. Teplin LA, McClelland GM, Abram KM,
Weiner DA. Crime victimization in adults
with severe mental illness: comparison with the National Crime Victimization Survey. Arch Gen Psychiatry.
2005;62(8):911-921.
15. Douglas KS, Hart SD, Webster CD,
Belfrage H. HCR-20 (Version 3): Assessing Risk for Violence2013, Burnaby, BC,
Canada.
16. Kraemer HC, Kazdin AE, Offord DR, Kessler RC, Jensen PS, Kupfer DJ. Coming
to terms with the terms of risk. Arch Gen
Psychiatry. 1997;54(4):337-343.
17. Hilton NZ, Harris GT, Rice ME. Sixty-Six
Years of Research on the Clinical Versus
Actuarial Prediction of
Violence. The Counseling Psychologist.
2006;34(3):400-409.
18. Oleson JC, VanBenschoten SW, Robinson CR, Lowenkamp CT. Training to see
risk: Measuring the accuracy of clinical
and actuarial risk assessments among
federal probation officers. Federal
Probation. 2011 75(2).
19. Ægisdóttir S, White MJ, Spengler PM, et
al. The meta-analysis of clinical judgment
project: Fifty-six years of accumulated
research on clinical versus statistical
prediction. The Counseling Psychologist.
2006;34(3):341-382.
20.Lidz CW, Mulvey EP, Gardner W. The
accuracy of predictions of violence to
others. JAMA. 1993;269(8):1007-1011.
21. Dolan M, Doyle M. Violence risk prediction. Clinical and actuarial measures and
the role of the Psychopathy Checklist. Br
J Psychiatry. 2000;177:303-311.
22.Rappaport N, Pollack WS, Flaherty LT,
Schwartz SE, McMickens C. Safety
assessment in schools: beyond risk: the
role of child psychiatrists and other mental health professionals. Child Adolesc
Psychiatr Clin N Am. 2015;24(2):277-289.
23.Mossman D. From group data to useful
probabilities: the relevance of actuarial
risk assessment in individual instances. J
Am Acad Psychiatry Law. 2015;43(1):93102.
24.Bureau of Labor Statistics, U.S.
Department of Labor. Occupational
Outlook Handbook, 2016-17 Edition,
Actuaries. http://www.bls.gov/ooh/math/
actuaries.htm, July 28, 2016.
25.Hart SD, Cooke DJ. Another look at the
(im-)precision of individual risk estimates
made using actuarial risk assessment instruments. Behav Sci Law. 2013;31(1):81102.
26.Yang M, Wong SC, Coid JW. Violence,
mental health and violence risk factors
among community women: an epidemiological study based on two national
household surveys in the UK. BMC
Public Health. 2013;13:1020.
27. Harris GT, Rice ME. Progress in violence
risk assessment and communication:
hypothesis versus evidence. Behav Sci
Law. 2015;33(1):128-145.
28.Harris GT, Rice ME, Quinsey VL, Cormier
CA. Violent offenders: Appraising and
managing risk. Washington, DC: American Psychological Association; 2015.
29.Neal TMS, Grisso T. Assessment Practices and Expert Judgment Methods in
Forensic Psychology and Psychiatry: An
International Snapshot. Criminal Justice
and Behavior. 2014;41:1406-1421.
30.Douglas KS, Hart SD, Groscup JL,
Litwack TR. Assessing violence risk. In:
Weiner IB, Otto RK, eds. The handbook
of forensic psychology 4th ed. Hoboken,
NJ: John Wiley & Sons Inc; 2014:385-441.
31. Hart SD, Michie C, Cooke DJ. Precision
of actuarial risk assessment instruments:
evaluating the ‘margins of error’ of group
v. individual predictions of violence. Br J
Psychiatry Suppl. 2007;49:s60-65.
32.Douglas KS, Skeem J. Violence Risk
Assessment: Getting Specific About
Being Dynamic. Psychology, Public
Policy, and Law. 2005;11(3):347-383.
33.Troquete NA, van den Brink RH,
Beintema H, et al. Predictive validity
of the Short-Term Assessment of Risk
and Treatability for violent behavior in
outpatient forensic psychiatric patients.
Psychol Assess. 2015;27(2):377-391.
34.Dickens GL, O’Shea LE. How short
should short-term risk assessment be?
Determining the optimum interval for
START reassessment in a secure mental
health service. J Psychiatr Ment Health
Nurs. 2015;22(6):397-406.
35.Logan C. The HCR-20 Version 3: A Case
Study in Risk Formulation. International
Journal of Forensic Mental Health.
2014;13:1-9.
36.Singh JP, Grann M, Fazel S. Authorship
bias in violence risk assessment? A
systematic review and meta-analysis.
PLoS One. 2013;8(9):e72484.
37. Borum R, Bartel P, Forth A. Manual for
the structured assessment of violence
risk in youth (SAVRY): Version 1.12003,
Tampa, FL.
38.Seto MC. Is more better? Combining
actuarial risk scales to predict recidivism
among adult sex offenders. Psychol
Assess. 2005;17(2):156-167.
39.Yang M, Wong SC, Coid J. The efficacy
of violence prediction: a meta-analytic
comparison of nine risk assessment
tools. Psychol Bull. 2010;136(5):740-767.
Business Development Staff
Steve Hunter, LCSW, LMFT
Director
847.755.8018
[email protected]
Clinical Liaison, Eating Disorder,
Self-Injury and Forensic Clinic
847.755.8009
[email protected]
Scott Naples
Assistant Director
847.230.3581
[email protected]
Maxine Goldstein, MA
Manager, Business Development
Center for Mental Health,
Arlington Heights
847.952.7464
[email protected]
Colleen Caron, MS, RNC
Older Adult Coordinator, Older Adult
Services and Crisis Intervention
847.755.8324
[email protected]
Jacqueline Rhew, LCPC, CADC
Clinical Liaison
847.668.2842
[email protected]
Dru Lazzara, LCSW
Supervisor, Older Adult Services
630.865.6331
[email protected]
Julie Vadakumpadam
Account Manager, Older Adult Services
214.364.3663
[email protected]
Amy Brooks, LCPC, CADC
Manager, Electronic Marketing and
Physician Recruitment
847.755.8141
[email protected]
Stay Informed!
Sign up for eNews to
receive up-to-date email
announcements on our
training and education
programs.
Sign-up is fast and easy at
AMITAhealth.org/
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Diamond Sutton, BA
Marketing Coordinator
847.755.3245
[email protected]
Two Convenient Professional Education Program Locations
South
Barrington
B
n
59
1
Beverly Rd
Northern Illinois University
5555 Trillium Blvd.
72
Higg
1
ins R
oad
90
2
e Factory Road
Shoe
3
2
Golf Road
Bode Road
Barrington
r
R
Road
59
Bartlett Road
Sutton Ro
Road
58
Hoffman
Estates
72
58
Bridges of Poplar Creek
Country Club
Two great health systems have joined together,
Adventist Midwest Health and
Alexian Brothers Health System.
A new beginning, with opportunity that treasures and respects our faith
traditions, past accomplishments and more profoundly realizes our
sacred missions.
AMITA Health is about open, inclusive and compassionate quality care
for all, inspired by a legacy of faith, delivered with dignity and empathy.
We embrace each person and each family as one of our own.
Call today to schedule an appointment
with one of our top physicians.
1.855.MyAMITA
1.855.692.6482
AMITAhealth.org
© 2016 AMITA Health 15531
back cover ad Center for Professional Education booklet 15531 FINAL.indd 1
Help is closer than you think.
AMITA Health Alexian Brothers Behavioral Health
Hospital has a Centralized Clinical Intake Call Center
for all behavioral health services. A staff of dedicated
Clinical Intake Advisors is available to help patients,
families and behavioral health professionals with
questions while maximizing service and scheduling.
For your convenience, we can assist with:
• Information about referrals and assessments
for mental health and substance use services
• Scheduling of intake assessments
• Information about community resources and
support groups
• Referrals for other mental health related services
To speak to one of our expert
Clinical Intake Advisors, please call:
855.383.2224
© 2016 AMITA Health 160792
8/10/15 9:37 PM

AMITA Health Alexian Brothers Behavioral Health Hospital Hoffman

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