ESI Conference - Wyoming State Board of Nursing

ISSUED JULY 2015 • AN ANNUAL PUBLICATION
Interventions, Treatments & Networking for professionals working with
Critical Issues
Facing Children
& Adolescents
All new 1, 2 & 3 day options with seminars and
intensive workshops to fill your continuing
education requirements – including new licensure
mandates in ethics and suicide
October 7-9, 2015
Hilton Salt Lake City Center
255 South West Temple
Salt Lake City, Utah
Join your colleagues at this
19th annual, highly revered CE/CME
program for professionals working with
youth and families facing behavioral
health / addiction issues
PROUDLY SPONSORED BY:
ESI Management Group in partnership with –
University of Utah Neuropsychiatric Institute
Primary Children’s Medical Center
5770 South 1500 West • Salt Lake City, UT 84123
W
hat is a child and what is an adult?
The official age defined by society for a
child to launch into adulthood is 18. The legal
drinking age is 21 in many states. But the
reality is that adults are people who can
responsibly handle themselves independently
and manage relationships with some degree
of maturity.
Join Us in October
The rocket carrying that child, does not
suddenly take off with an adult aboard at a
certain, pre-determined birthday. The
launchpad of the family, values, security, love
and acceptance must work in partnership with
the rocket and its developing young
passenger’s confidence, autonomy, life skills,
education and identity for years to insure a
successful launch.
This conference, in its emerging new format, will help clinicians work on
the mechanics of preparing for launch. It will provide all levels of clinicians the
tools needed to work with youth and their families. The intensive pre-conference
workshops will offer skill-building in areas of Family Therapy, Dialectical Behavior Therapy (DBT) and Autism. The central two-day program will offer its popularly requested potpourri of education around the issues presenting in schools
and treatment settings today along with multi-session foci on issues such as
group therapy, suicide, ethics and LGBTQ topics. Additionally, two dynamic and
exclusive tracks will be offered – Advanced Behavior by the University of Utah
Neurobehavior HOME Program and Trauma Treatment by The Children’s Center.
All this, with one, two and three day registration options wrapped into one of the
most economical, highest quality professional conferences around. So step
away from the internet and on-line training to stand out and connect live with a
broadband of professional colleagues and make new contacts; expand your
referral and resource pools; and, benefit from one of the most respected
educational programs. No need to travel far or pay high costs.
• Boost your knowledge in a wide variety of areas
• Fuel & sharpen your clinical skills and expand your toolbox
• Fill your continuing education and new licensure requirements
• Discover new things from nationally renowned speakers
• Revel in varied and interactive programs focused on interventions
• Speed up your practice’s readiness for the changing healthcare landscape
• Advance your client care, outcomes & quality of life
More specifically, you will learn how to:
• Employ techniques of specific approaches such as Dialectical Behavioral Therapy,
Group & Family Therapy, ACT, Resiliency & more
• Relate to your clients & work with even the most difficult family members
• Work more effectively with those who have autism or other special population needs
• Gain insights into ‘the system’ & help prevent youth from ‘falling thru the cracks’
• Conduct effective screenings / assessments around commonly faced issues such
as anger and other ‘problem’ behaviors, substance use / abuse, family functioning,
trauma, executive function, and more
• Work effectively with treatment teams – including medical providers and school
personnel
• Stay up with youth trends, culture & risks
• Apply effective suicide prevention and intervention skills
• Safeguard yourself emotionally, ethically & legally
• Treat common mental health and/or substance use disorders
• Communicate with, and treat various populations
• Access needed resources & referral sources
Overall, this conference will help improve your clinical life and your client care quality
& outcomes by facilitating you to:
• Increase your awareness and knowledge of critical behavioral health issues facing youth;
• Gain effective prevention and intervention working tools to properly intervene with
youth facing behavioral/mental health and/or substance use disorder issues;
• Develop strategies to more effectively promote healthy growth and development of
youth; and,
• Raise familiarity with current resources that will benefit your practice and learn
ways to navigate around existing gaps.
The content and benefits of this program have been expressly created for
professionals in:
Counseling
Family Practice
Marriage & Family Therapy
Paramedical Fields
Primary Care
Social Work
Education
Health Education
Medicine
Pediatrics
Psychiatry
Substance Abuse
Treatment
Family Life Education
Judicial / Corrections
Nursing
Pharmacy
Psychology
Other Health & Mental
Health Professions
conference code CI-1007.
The meritorious standing of this conference draws sizeable crowds. To
insure everyone’s comfort and full benefits, the number of registrants will
be limited. Registrations will not be accepted once a comfortable
capacity is reached.
Your registration includes:
• Continental breakfasts, Thursday lunch & plentiful breaks
• Complete syllabus with faculty handouts
• Broad range of clinically-focused sessions
• Entry into all sessions and special tracks
• Sizeable continuing education & required licensure credits
• Leading national & local faculty
• Open forums for networking, idea exchanges & referral building
• Skill-building sessions & comprehensive workshops
• Discounted hotel rates
• Assorted resource exhibits & materials
• Other bonuses
In the event of unforeseen circumstances, cancellations must be received
in writing by September 9th for a full refund or September 21st for a 50%
refund. No refunds will be granted after September 21st.
GUARANTEE YOUR SEAT!
REGISTER
TODAY by simply returning the attached ‘Registration
Form’ or registering with a credit card on-line at www.esimgt.org using
Continuing Education
This program offers up to 20.5 hours of course work for continuing
education / continuing medical education credit in most fields. (6.75
Wednesday; 6.75 Thursday; and 7.0 Friday)
ETHICS & SUICIDE:
Recent legislative changes have expanded licensure and
continuing education requirements in many health, mental health and addiction
treatment professions. These changes include requirements for inclusion of
ethics and suicide education as part of yearly CE/CME. These requirements
are offered in Critical Issues Facing Children & Adolescents 2015 to help you
fill your needs in your next renewal period.*
PROFESSIONAL CREDIT: For most disciplines, the Division of Occupational &
Professional Licensing (DOPL) does NOT require the educational program to
be pre-approved. Proving your attendance at an educational program
pertinent to your field IS required. (This may be done by showing your conference syllabus as proof of attendance and program applicability to your
field). Certificates are also available if you prefer.
In some states, CME programs like this may be used for re-licensure
credit in other fields. It is your responsibility to record and report
attendance to your licensing organizations and to check with
Boards to determine reciprocity, licensure credit, and specific
requirements (i.e. ethics, suicide).
For your additional convenience, this program has been submitted
to and/or already approved by:
• National Association of Alcohol and Drug Abuse Counselors (NAADAC)
• National Association of Social Workers (NASW), Utah Chapter
• Nevada Nurses Association
• Peace Officers Standards & Training (POST)
• University of Utah Department of Special Education (Approved BACB ACE Provider)
• Utah Association for Marriage & Family Therapy (UAMFT)
• Utah Psychological Association (UPA)
˚AMA Credit: ESI Management Group designates this live activity for a maximum of
20.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit
commensurate with the extent of their participation in the activity.
˚Accreditation: ESI Management Group is accredited by the Utah Medical
Association to provide continuing medical education for physicians.
Approval by any of the listed organizations does not imply their endorsement of any
commercial interests, sponsorship or research. The same holds true for conference planner,
organizers, partners, and other parties involved with this event.
CERTIFICATES: Individuals wishing more compact or formal proof of attendance than
their syllabus and self-reports may register to receive a certificate verifying their
attendance. Attendees may register to receive certificates for verification of attendance
with employers, accrediting organizations and others. (See “Registration Form”).
PARKING: For your convenience and in support of a clean environment, carpooling and
the use of TRAX are encouraged. The Main Street stop is just one block east of the
Hilton. If you prefer to drive, you may park in the Hilton’s underground self-parking lot for
$5/car for up to a 16 hour period or $15/car/24 hours for overnight guests. Feel free to use
any of the three hotel parking entrances – one on West Temple just north of the hotel’s
main entrance or one of the “American Plaza” entrances on 200 South or 300 South.
Guests of the Peery Hotel may park at Capitol Parking around the hotel for $12/24
hours or $8/10 hours. This is a convenient option for those not wishing to park
underground. The entrance to this lot, just west of the Peery’s main entrance on
300 South, is also where you will find the payment kiosk.
HOTEL ACCOMMODATIONS:
Two great and different options in the heart of
downtown and on the city’s light rail system are available for those wishing
overnight accommodations. Hilton Salt Lake City Center, the conference base,
has a variety of guest room options and is offering single/double occupancy
rates of $179 to conference attendees. You may book your hotel reservation
conveniently on line at https://resweb.passkey.com/Resweb.do?mode=welcome_ei_new&eventID=13962564 or call 801-328-2000. If you prefer the
quaintness of a boutique hotel, you may reserve your room, just across the
street, at the Peery Hotel for a special conference rate of $109 or $129
for a king suite. You may reach the Peery via 801-521-4300.
If you wish to extend your stay and enjoy Salt Lake, both hotels will
honor these special rates before and after the conference based on
availability. These rates and reservations made after September
6th cannot be guaranteed. Due to events in the city during this time,
it is suggested that you book your room early!
SALT LAKE ACTIVITIES & EVENTS:
Located in the heart of downtown
Salt Lake City - in both the entertainment and business district, this conference
is a short walk from City Creek and surrounded by over sixty restaurants, bars and
nightclubs. You’re sure to find options to fill your cravings from sun up to sun down.
It is also steps away from the Utah Jazz home, Capital Theatre and TRAX Light Rail.
You can easily venture out to Gateway Shopping Center, Hogle Zoo, Family History
Center, Temple Square, Clark Planetarium, Utah Museum of Natural History and Utah
Olympic Park. For information on Salt Lake City events during your stay, call the Salt
Lake Convention & Visitors Bureau at 800-541-4955. Even locals may want to plan
some fun activities around the conference!
AIRPORT TRANSPORATION: Transportation to and from the airport is available via
Express Shuttle (801-596-1600) for $8 per person each way (advance reservations
welcome) or TRAX public transportation for $2.50 per person each way.
ADA:
Conference founders and coordinators comply with the requirements of the
Americans with Disabilities Act. If you need special accommodations based on ADA,
contact ESI Management Group with your requests at least two weeks in advance.
QUESTIONS? For questions, further information or additional brochures, call ESI
Management Group at 801-501-9446 or 877-501-9446.
2015 Critical Issues Facing Children & Adolescents
Blastoff with this program of top-ranked faculty who have been directed
to avoid introductory programs and, instead, impart the latest data and
hands-on tools for you to take back and apply in your own practice.
Featured Pre-Conference Workshops
WEDNESDAY, OCTOBER 7, 2015
Family Therapy for Familes in Crisis
This special workshop will bring together top experts in a variety of family therapy
models. Their combined expertise, experience and insights will create a unique,
entertaining and practical experience for all who participate. Enjoy the humor and leave
with skills to improve your clinical practice for years to come. Whether its techniques
from the Functional Family Therapy (FFT) Model, a nationally and internationally
acclaimed and evidence-based intervention model for a range of juvenile dysfunctional,
emotional, and behavioral problems, developed by Dr. James F; Alexander or strategies
pulled from one of the other top models presented by this brain-trust of faculty members,
you and your clients are guaranteed to benefit!
FAMILY THERAPY, also referred to as couple & family therapy, marriage & family
therapy, family systems therapy, and family counseling – all which work with families and
couples in intimate relationships to nurture change and development. It tends to view
change in terms of the systems of interaction between family members and emphasizes
family relationships as an important factor in psychological health. Family therapy is
often short term, involves all family members or just those able and willing to participate,
and can be a crucial component of healing individuals and families, deepening family
connections and getting the family through stressful times for long-term success.
The various models of family therapy have a common belief that, regardless of the origin
of the problem, and regardless of whether the clients consider it an “individual” or
“family” issue, involving families in solutions often benefit the entire family. The skills
required of the therapist include the ability to influence conversations in ways that
catalyze the strengths, wisdom, and support of the wider system.
7:00 – 8:00 REGISTRATION, EXHIBITS & CONTINENTAL BREAKFAST
8:00 – 5:00 ALL-DAY FAMILY THERAPY SKILLS WORKSHOP
FAMILY THERAPY FOR FAMILIES IN CRISIS
James F. Alexander, PhD – Functional Family Therapy
O. Kent Allen, LMFT – Owner, Allen Therapy Associates: CEO, Previdence [Program
Coordinator and Facilitator]
Marriage and Family Therapists – Panel
4:15 CERTIFICATES OF COMPLETION (6.75 Hours)
Available on-site to those who pre-registered for this document.
Incorporating Dialectical Behavioral Therapy (DBT)
Into Your Workplace
Identify client strengths and help them identify thoughts, beliefs and assumptions that
make life harder. Dialectical Behavior Therapy (DBT), a cognitive behavioral treatment
originally developed to treat chronically suicidal individuals diagnosed with borderline
personality disorder, is now recognized as an effective treatment for a wide range of
other disorders such as substance dependence, depression, post-traumatic stress
disorder and eating disorders. Research has show DBT to be effective in reducing
suicide behavior, non-suicidal self-injury, psychiatric hospitalization, treatment dropout,
substance use, anger and depression and improving social and global functioning.
Some research, as well as anecdotal results from clinicians around the globe demonstrate more effectiveness with incorporation of some DBT skills, short of full model use,
than without inclusion of such techniques.
For some time, this conference on Critical Issues Facing Children & Adolescents has
provided multiple sessions on DBT Skills. Now, to better meet requests for more intense
training that leaves participants with the confidence, knowledge, and ability to incorporate DBT skills into their own practice without attending costly, multi-day events of
intense training, Critical Issues 2015 is offering a special day-long pre-conference
workshop conducted by certified DBT clinicians that will focus on skills such as
• Mindfulness,
• Distress Tolerance,
• Emotion Regulation and
• Interpersonal Effectiveness.
These skills, together with the latest updates published in October 2014, can be used in
most practices with a variety of clients. The effectiveness is evidenced in many publications. After attending this special workshop, not only will you be able to immediately
implement these DBT skills effectively in your own practices, you may also count this
training as a first step towards eventual certification in DBT.
7:00 – 8:00 REGISTRATION, EXHIBITS & CONTINENTAL BREAKFAST
8:00 – 5:00 ALL-DAY DBT SKILLS WORKSHOP
INCORPORATING DIALECTICAL BEHAVIORAL THERAPY (DBT) INTO YOUR PRACTICE
DBT Intensively Trained Clinicians From:
University of Utah College of Social Work;
Utah Center for Evidence Based Treatment;
Willow Springs Center
4:15 CERTIFICATES OF COMPLETION (6.75 Hours)
Available on-site to those who pre-registered for this document
Autism: Assessment To Interventions—
Concrete Tools For Your Practice
AUTISM - Is the incidence rising? Are we more diagnostically savvy or are we misdiagnosing? Do we have the services and trained professionals to deal with this growing
concern? Are YOU prepared? Join professional colleagues from multi-disciplines –
together in one forum, to learn the facts, increase your knowledge and sharpen your
clinical skills to deal with Autism Spectrum Disorders in your own practice. No more
debates – ascertain the skills to improve services you provide to clients and families –
from differential diagnoses to tertiary interventions.
7:00 – 8:00 REGISTRATION, POSTERS & CONTINENTAL BREAKFAST
8:00 – 9:15 WELCOME
KEYNOTE ADDRESS: AUTISM ACROSS THE NATION – TRANSLATING
RESEARCH INTO PRACTICE & POLICY
David S. Mandell, ScD – Director, University of Pennsylvania,
Perelman School of Medicine Center for Mental Health Policy &
Services Research
David S. Mandell, ScD, University of Pennsylvania, Associate
Professor of Psychiatry and Pediatrics, directs the Center for
Mental Health Policy and Services Research. Dr. Mandell is also
Associate Director of the Center for Autism Research at The
Children’s Hospital of Philadelphia. The goal of his research is to improve the quality of
care individuals with autism receive in their communities. This research is of two types.
The first examines, at the state and national level, the effects of different strategies to
organize, finance and deliver services on service use patterns and outcomes. The second,
and the one more closely connected to what he will be addressing at this special pre-conference program, consists of experimental studies designed to determine the best
strategies to successfully implement proven-efficacious practices in community settings.
Dr. Mandell holds a bachelor of arts in psychology from Columbia University and a
doctorate of science from the Johns Hopkins School of Hygiene and Public Health.
9:15 – 9:30 EXHIBITS & BREAK
9:30 – 10:30 CONCURRENT SESSIONS
BRIDGING THE GAP BETWEEEN CLINICAL DIAGNOSIS & SCHOOL SERVICES:
HOW DO WE WORK TOGETHER TO SUPPORT FAMILIES
Julia Hood, PhD, NCSP – Director, Carmen B. Pingree Autism Center of Learning
DO THEY REALLY NEED THE KITCHEN SINK? IDENTIFYING NEEDS AND
TARGETING RESOURCES
Adam Schwebach, PhD – Director & Neuropsychologist, Neuropsychology Center of Utah
EVIDENCE-BASED INTERVENTIONS FOR AUTISM IN YOUTH
Blake D. Hansen, PhD – Assistant Professor, Brigham Young University Department of
Counseling, Psychology and Special Education
HOW YOUNG CAN WE GO? DIAGNOSING AUTISM IN INFANTS AND TODDLERS
Natalie Roth, PhD – Licensed Psychologist, Alternative Behavior Strategies
TEACHING SOCIAL & EMOTIONAL REGULATION SKILLS TO TEENS WITH ASD:
IDEAS FOR YOUR TOOLBOX [BCBA]
Heidi Block, PhD – Licensed Psychologist, Primary Children’s Medical Center Wasatch
Canyons Adolescent Residential & Day Treatment Programs; School Psychologist,
Davis School District
TEEN SEXUALITY ATOP AUTISM
Danielle Watson, LPN – School Nurse, Carmen B. Pingree Autism Center of Learning
10:30 – 10:45 POSTERS & BREAK
10:45 – 12:00 CONCURRENT SESSIONS
AUTISM SPECTRUM DISORDER & THE PRE-SCHOOL POPULATION: DIAGNOSTIC
& FAMILY CONSIDERATIONS
Sean D. Cunningham, PhD – Assistant Professor, University of Utah School of Medicine
Division of Pediatrics; Psychology Director, Developmental Assessment Center
COMMON DIFFICULTIES & INTERVENTIONS FOR STUDENTS WITH AUTISM
SPECTRUM DISORDERS IN THE SCHOOLS
Julia Connelly, PhD – Clinical Director, University of Utah Autism Spectrum Disorder
Clinic; Psychiatric Assistant Professor, University of Utah Department of Psychiatry
DEALING WITH AUTISM IN RTC’S AND OTHER OUT-OF-HOME SETTINGS
Pending final faculty confirmation
DEALING WITH SEVERE BEHAVIOR ISSUES IN AUTISM: FOCUS ON THE
INDIVIDUAL & FAMILY
Chad Shubin, LMFT – Supervisor, Wasatch Mental Health STRIDE & XCEL
LESSONS & SKILLS FROM THE UTAH BEHAVIORAL SERVICES EARLY
INTERVENTION PROGRAM [BCBA]
Sarah E. Sanders, MEd, BCBA – Director, Utah Behavioral Services
TEACHING LIFE SKILLS TO CHILDREN WITH AUTISM – KEEPING IT SIMPLE & EFFECTIVE
Heidi Woolley, OTD, OTR/L – Assistant Professor & Director, University of Utah Life Skills Clinic
12:00 – 1:00 POSTERS & LUNCHEON – On your own
1:00 – 2:15 CONCURRENT SESSIONS
AS IF AUTISM ISN’T ENOUGH….COMMON MEDICAL AND MENTAL HEALTH
COMORBIDITIES ASSOICATED WITH ASD
Scott R. Stiefel, MD – Pediatric/Adolescent & Adult Psychiatrist
COME PLAY! AN INTRODUCTION TO PLAY AUTISM INTERVENTION
Crystal Emery, BS – Training & Development Specialist, Easter Seals-Goodwill Northern Rocky Mountain
COMMUNICATION INTERVENTIONS FOR MINIMALLY VERBAL YOUTH WITH AUTISM
Pamela Mathy, PhD, CCC-SLP – Associate Clinical Professor & Director, Speech-Language-Hearing Clinic, University of Utah Department of Communication Sciences & Disorders
DIFFERENTIAL DIAGNOSIS OF AUTISM SPECTRUM DISORDER IN LATENCY AGE
& ADOLESCENT YOUTH
Sam Goldstein, PhD – Director / Owner, Neurology, Learning & Behavior Center; Adjunct
Assistant Professor, University of Utah School of Medicine Department of Psychiatry
FINDING THE FIT: INCORPORATING A DEVELOPMENTAL PERSPECTIVE WHEN
WORKING WITH YOUNG CHILDREN & FAMILIES WITH ASD
Lori Krasny, MS, CCC-SLP – Director of Autism Services, The Children’s Center
TWO APPROACHES TO MANAGE SELF-INJURIOUS BEHAVIORS [BCBA]
Joe Dixon, BCBA – Clinical Director, Alternative Behavior Strategies
2:15 – 2:30 EXHIBITS & BREAK
2:30 – 3:30 CONCURRENT SESSIONS
A SPOONFUL OF REMEDIES FOR PEDIATRIC FEEDING PROBLEMS IN CHLDREN
& ADOLESCENTS WITH AUTISM SPECTRUM DISORDER [BCBA]
Aaron J. Fischer, PhD, BCBA-D – Assistant Professor of School Psychology & Adjunct
Assistant Professor of Psychiatry, University of Utah
DIAGNOSING AUTISM: GENTLY DELIVERING THE NEWS TO PARENTS
Douglas Goldsmith, PhD – Executive Director, The Children’s Center
NEURO-VERSITY: EVIDENCE-SUPPORTED TECHNOLOGY FOR INDIVIDUALS ON
THE AUTISM SPECTRUM
Cheryl Wright, PhD – Associate Professor & Chair, University of Utah Family &
Consumer Studies
Scott Wright, PhD – Associate Professor, University of Utah College of Nursing;
Adjunct Associate Professor, University of Utah Family & Consumer Studies
PROMOTING THE USE OF RESEARCH-BASED INTERVENTIONS FOR YOUNG
CHILDREN WITH AUTISM IN UTAH [BCBA]
Thomas S Higbee, PhD, BCBA-D – Professor of Special Education & Director of Autism
Support Services: Education, Research & Training (ASSERT) Program, Utah State University
WHAT THE SIBLING WORLD IS LIKE WHEN YOU OR YOUR SIBLING HAS AUTISM
Catherin M. Johnson, LCSW – Youth & Family Services Director, Wasatch Mental Health
[Panel Coordinator & Moderator]
Autists & Sibling Panel
YOUR SENSORY TOOLBOX: PRACTICAL INTERVENTIONS FOR INDIVIDUALS
WITH AUTISM
Krisanne Lewis, MOT, OTR/L – Occupational Therapist, Spectrum Academy
3:30 – 3:45 EXHIBITS & BREAK
3:45 – 5:00 PLENARY SESSION
FUTURE DIRECTIONS & HOPE: WHAT’S AHEAD FOR UTAH
William M. McMahon, MD – Chair, 2015 IMFAR Meeting; Former Chair, University of
Utah Department of Psychiatry
4:15 CERTIFICATES OF COMPLETION (6.75 Hours)
Available on-site to those who pre-registered for this document.
THURSDAY - OCTOBER 8, 2015
7:00 – 8:00 REGISTRATION, EXHIBITS & CONTINENTAL BREAKFAST
8:00 – 9:15 WELCOME
KEYNOTE ADDRESS: ENVIRONMENTAL DETERMINANTS OF PROBLEM
BEHAVIOR: SELF-INJURY AS A CASE IN POINT [BT / BCBA]
Brian A. Iwata, PhD – Distinguished Professor, University of
Florida Departments of Psychology & Psychiatry
Brian Iwata, PhD, is a Professor of Psychology and Psychiatry at
the University of Florida. He formerly held faculty appointments at
Western Michigan University and at Johns Hopkins University
School of Medicine. He has been the leading developer of the first functional (experimental) analysis model for assessing severe problem behavior, regarded as the
standard in the field for both clinical research and practice. The former editor of Journal
of Applied Behavior Analysis, Dr. Iwata has served as president of the Association for
Behavior Analysis, the Society for the Advancement of Behavior Analysis, and the
Society for the Experimental Analysis of Behavior. His primary area of interest is
disorders of learning and behavior. He has authored more than 225 chapters and
articles on these subjects and has received numerous awards for his work.
9:15 – 9:30 EXHIBITS & BREAK
9:30 – 10:30 CONCURRENT SESSIONS
ACT & ITS APPLICATION IN YOUR PRACTICE
Elizabeth Thomas, CSW – Center for Change
DATA SHEETS AND FAMILY TREATMENT PLANNING [BT / BCBA]
UNI HOME Program - TBD
DSM-5 AND ICD-10 – WILL THEY TALK TO EACH OTHER?
David S. Wood, PhD – Brigham Young University
INVASION OF THE ‘CHILDHOOD’ SNATCHERS: WORKING WITH PREMATURE
PARENTIFICATION & DEVELOPMENTAL ‘SKIPS’ DUE TO ROLE REVERSAL IN
FAMILY DYNAMICS
Randy K. Moss, PhD – Psychologist, Integrated Counseling & Consulting, LLC
SEXUALITY – THE SPECTRUM FROM ‘NORMAL’ TO ‘PROBLEMATIC’
Kathy Daniels Ockey, LCSW – Counseling Manager, LDS Family Services
TREATMENT INTERVENTIONS FOR CHILDREN OF DOMESTIC VIOLENCE
Karen W. Malm, PhD – Executive Director, Summit Community Counseling
WHEN PATIENTS DON’T GET BETTER: THINKING THROUGH THE DIAGNOSIS &
TREATMENT OF DEPRESSION, ADHD, ANXIETY & BIPOLAR DISORDER
Douglas Kondo, MD – Associate Professor of Psychiatry, USTAR Faculty, Veterans
Adminstration Rocky Mountain MIRECC Investigator
10:30 – 10:45 EXHIBITS & BREAK
10:45 – 12:00 CONCURRENT SESSIONS
FUNCTIONAL BEHAVIOR ASSESSMENT: PRINCIPLES & PROCEDURES
[BT / BCBA]
Brian A. Iwata, PhD – Distinguished Professor, University of Florida Departments of
Psychology & Psychiatry
HOW PORNOGRAPHY IS CHANGING AN ENTIRE GENERATION
Clay Olsen – Chief Executive Officer & Co-Founder, Fight the New Drug
LIFE AFTER AN RTC STAY
Trina Packard, MEd – Executive Director, Youth Care [Panel Coordinator & Moderator]
Youth & Family Panel
SOCIAL MEDIA, BEHAVIORAL ADDICTIONS & ETHICS [EC]
Craig Georgianna, PhD, LMFT – Clinical Director, Therapia
WHAT HAPPENED TO THEM IS MORE VITAL THAN WHAT THEY DID: SHIFTING
THE VISION, SEEING THE INJURIES, REMOVING THE PUNISHMENT – TRANSFORMING JUVENILE JUSTICE TO TRAUMA-INFORMED CARE MODELS FOR
INCREASED RE-INTRODUCTION SUCCESS
Randy K. Moss, PhD – Psychologist, Integrated Counseling & Consulting, LLC
12:00 – 1:00 LUNCHEON – Included with registration
1:00 – 2:15 CONCURRENT SESSIONS
ACTION SPEAKS LOUDER: EXPERIENTIAL GROUP THERAPY ACTIVITIES FOR
YOUTH – PART I
Mark E. Beecher, PhD – Licensed Psychologist, Brigham Young University Counseling
& Psychological Services
Anna Packard, PhD – Licensed Psychologist, Brigham Young University
EATING DISORDERS – UNVEILING THE TRUTHS
Kristin Francis, MD – Associate Professor, University of Utah Department of Psychiatry;
Child & Adolescent Psychiatrist, University of Utah Neuropsychiatric Institute
Rachele McCarthey, MD – Assistant Professor, University of Utah Department of
Psychiatry; Medical Director, University of Utah Behavioral Health Clinics
REINFORCEMENT-BASED APPROACHES TO REDUCE PROBLEM BEHAVIORS
[BT / BCBA]
Brian A. Iwata, PhD – Distinguished Professor, University of Florida Departments of
Psychology & Psychiatry
RISK ASSESSMENT – RISK MANAGEMENT: WHAT TO DO WHEN YOUTH MAKE
THREATS
Kim Brady, LCSW – School Social Worker & Behavioral Interventionist, Weber
School District
Stephanie Grotzky, MSW – School Social Worker, Weber School District
Dawn Winter, LCSW – School Social Worker & Behavioral Interventionist, Weber District
STRENGTHENING FAMILIES COPING RESOURCES: TREATING FAMILIES WITH
COMPLEX TRAUMA
Kami Chambers, LCMHC – The Children’s Center
2:15 – 2:30 EXHIBITS & BREAK
2:30 – 3:30 CONCURRENT SESSIONS
A SPOONFUL OF REMEDIES FOR PEDIATRIC FEEDING PROBLEMS IN SPECIAL
POPULATIONS OF CHLDREN & ADOLESCENTS [BT]
Aaron J. Fischer, PhD, BCBA-D – Assistant Professor of School Psychology &
Adjunct Assistant Professor of Psychiatry, University of Utah
ACTION SPEAKS LOUDER: EXPERIENTIAL GROUP THERAPY ACTIVITIES FOR
YOUTH – PART II
Mark E. Beecher, PhD – Licensed Psychologist, Brigham Young University Counseling
& Psychological Services
Anna Packard, PhD – Licensed Psychologist, Brigham Young University
MARIJUANA – IT’S NOT THE SIXTIES ANYMORE
Terry L. Sellers, MD – Provo Canyon Behavioral Hospital
REBOOTING RESILIENCY IN YOUR CLIENTS
Tammy Colvin, TSgt
Vjollca Martinson, PhD, LMFT – Clinical Director, Provo Canyon School
Brianne Wolfgramm, BA – Marketing & Outreach Manager, Provo Canyon School
SOCIAL EMOTIONAL LEARNING SKILLS & FUN WAYS TO TEACH THEM TO YOUTH
Valerie Liggett, LCSW – School Social Worker, Granite School District
Kimberly Sommers, LCSW – School Social Worker, Granite School District
Sara Lyon Spencer, LCSW – School Social Worker, Granite School District
TRANSITIONING FROM ADOLESCENCE TO ADULTHOOD
Crystal Emery, BS – Training & Development Specialist, Easter Seals-Goodwill
Northern Rocky Mountain [Panel Coordinator & Moderator]
Adolescent & Young Adult Panel
UNDERSTANDING THE THEORETICAL FOUNDATION OF EMDR THERAPY & THE
IMPLICATIONS FOR TREATING CHILDREN & ADOLESCENTS
Leslie L. Brown, LMHC – EMDR Consultant & Trauma Recovery Facilitator, EMDRIA,
EMDR Humanitarian Assistance Program / Trauma Recovery
WHAT NON-PRESCRIBERS NEED TO KNOW ABOUT THE LATEST PSYCHOPHARMACOLOGY FOR YOUTH
Allison Nitsche, MD, MPH – Child Psychiatrist, University of Utah Neuropsychiatric Institute
3:30 – 3:45 EXHIBITS & BREAK
3:45 – 5:00 CONCURRENT SESSIONS
A PRIMER ON INTERPERSONAL PSYCHOTHERAPY FOR DEPRESSION – ADOLESCENT VERSION (IPT-A)
Michael W. Tragakis, PhD – Staff Psychologist, VA Salt Lake City Health Care System
BIONEURO FEEDBACK – CATCHING THE WAVE AMONG ADOLESCENTS
Brent Talbot, PhD – Psychological Services Director, Provo Canyon School
BREAKING THE CHAINS OF FAMILY SILENCE VIA FAMILY THERAPY
Marcie Remington, LCSW, CPM – Mental Health Program Administrator, Utah Department of Corrections
ETHICS IN PRACTICE [EC]
Brent M. Kious, MD, PhD – Chief Resident, University of Utah Department of Psychiatry
GHOSTS IN THE ATTIC – ART, TRAUMA AND THE BRAIN
Malissa Morrell, LMFT, ATR-BC – Expressive Therapies Director, La Europa Academy
Mary C. Stanley, ACMHC, ATR-BC, ATCS – Clinical Director & Art Psychotherapist,
The Healing Group
INCREASING MEDICAL COMPLIANCE [BT]
UNI HOME Program - TBD
“THE VOICE HEARING EXPERIENCE” – GAINING EMPATHY FOR THOSE WITH PSYCHOSIS
Dallas Earnshaw, APRN, CNS-BC – Superintendent, Utah State Hospital
UNDERSTANDING UNPLANNED PREGNANCY WITHIN THE LDS CHURCH &
RECENT CHANGES TO THEIR ADOPTION PROGRAM
Kevin Theriot, PhD, LCSW – Program Manager, LDS Family Services
4:15 CERTIFICATES OF COMPLETION (6.75 Hours)
Available on-site to those who pre-registered for this document & are not attending Friday.
FRIDAY – OCTOBER 9, 2015
7:00 – 8:00 CHECK-IN, EXHIBITS & CONTINENTAL BREAKFAST
8:00 – 9:15 KEYNOTE ADDRESS
THE CRITICAL ROLE OF FAMILY SUPPORT IN PREVENTING
RISK & PROMOTING WELL-BEING FOR LGBTQ YOUTH
Caitlin C. Ryan, PhD, ACSW – Director, San Francisco State
University Family Acceptance Project
Caitlin Ryan, PhD, ACSW, is a clinical social worker who has worked
on LGBT health and mental health issues for more than 35 years. She
directs the Family Acceptance Project at San Francisco State University–
the first research, intervention, education, and policy initiative to increase
family support, decrease risk, and promote well-being for LGBT children and adolescents. Dr. Ryan and her team are developing a new family model of wellness, prevention, and
care for LGBT children and adolescents, based on this research. Her work has been
recognized by many groups, including the American Psychological Association, that gave
her the Distinguished Scientific Contribution Award for groundbreaking research on LGBT
youth and families, and the National Association of Social Workers that named her "Social
Worker of the Year" in 1988. Her book, Lesbian & Gay Youth: Care & Counseling is the
first comprehensive guide to health and mental healthcare for lesbian and gay youth.
She was appointed as a member of the Committee on LGBT Health by the Institute of
Medicine to study the research needs, gaps, and opportunities for LGBT people. She
serves on the LGBT Youth Suicide Prevention Task Force of the National Action Alliance
for Suicide Prevention and is a Purpose Prize Fellow. Dr. Ryan received her MSW from
Smith College in Northampton, Massachusetts and her PhD in Public Policy/Health Policy
from Virginia Commonwealth University. She is a member of the Academy of Certified
Social Workers.
9:15 – 9:30 EXHIBITS & BREAK
9:30 – 10:30 CONCURRENT SESSIONS
AN UPDATE ON YOUTH DRUG TRENDS – WHAT YOU NEED TO KNOW
Susie Wiet, MD – Addictionologist; Founder, Trauma Resilience Collaborative
ATTACHMENT AND COMPLEX TRAUMA [TT]
Douglas Goldsmith, PhD – Executive Director, The Children’s Center
EVIDENCE-BASED PRACTICE, PRACTICE-BASED EVIDENCE & IMPLEMENTATION
SCIENCE: WHAT REALLY WORKS?
Joanne Yaffe, PhD, ACSW – Professor of Social Work & Adjunct Professor of Psychiatry, University of Utah
FEAR OF THE QUEER CHILD: LEGAL AND MEDICAL ISSUES CONFRONTED BY
LGBTQ YOUTH
Clifford Rosky, JD – Professor, University of Utah College of Law
FITTING THE PIECES TOGETHER – DECODING PSYCHOLOGICAL TESTING
Britt Holmes, PsyD – Adjunct Instructor, University of Utah Department of Psychiatry;
University of Utah Neuropsychiatric Institute
MAKING SOCIAL SKILLS TRAINING EFFECTIVE & BENEFICIAL
Julia Hood, PhD, NCSP – Director, Carmen B. Pingree Autism Center of Learning
TOOLS & TRICKS FOR EXECUTIVE FUNCTION SKILL DEVELOPMENT
Parth Gandhi, PhD – Neuropsychologist, Psych Testing, Inc.
UNDERSTANDING & ADDRESSING SELF-INJURY: EXAMINING THE SPECTRUM
FROM NON-SUICIDAL SELF-INJURY TO SUICIDE FINALITY [SC]
Michael Riquino, LCSW – Therapist, Counseling & Treatment Center of Utah
10:30 – 10:45 EXHIBITS & BREAK
10:45 – 12:00 CONCURRENT SESSIONS
FAMILY ENGAGEMENT AND THERAPY WHEN KIDS ‘COME OUT’
Caitlin C. Ryan, PhD, ACSW – Director, San Francisco State Family Acceptance Project
GETTING THROUGH THE SCHOOL MAZE UNSCATHED!
Maureen James, LCSW – School Social Work Coordinator, Granite School District
Michelle Murphey, BA – Parent Consultant, Utah Parent Center
Jeffrey Sherwin, LCSW – Special Education Coordinator, Granite School District
MORE THAN A WHACK ON THE HEAD – CONCUSSIONS, TBI’S AND OTHER
NEURO-INSULTS AS THEY PRESENT AND CHALLENGE YOU IN YOUR PRACTICE
Adam Schwebach, PhD – Director & Neuropsychologist, Neuropsychology Center
of Utah
NEGOTIATING THE MINEFIELD OF THIRD PARTY REIMBURSEMENT FOR
THERAPEUTIC / EDUCATIONAL SERVICES
Jared Balmer, PhD, MFT – Executive Director / CEO, WayPoint Academy
REACTIVE ATTACHMENT DISORDER? REALLY? WHAT ARE WE ACTUALLY
SEEING IN CHILDREN WHO ARE ADOPTED OR NOT OTHERWISE WITH THEIR
BIOLOGICAL FAMILIES?
Douglas Goldsmith, PhD – Executive Director, The Children’s Center
THE VALUE OF A COMMUNITY BEHAVIORAL HEALTH CRISIS RESPONSE
SYSTEM: LESSONS LEARNED OVER THE LAST 4 YEARS
Barry Rose, LCSW – UNI/Salt Lake County Crisis Services Manager, University of Utah
Neuropsychiatric Institute
TRAUMA-FOCUSD CBT ADAPTATIONS FOR PRE-SCHOOLERS [TT]
Kristina Hindert, MD – Medical Director, The Children’s Center
WALKING THE LOSS & GRIEF PATH - HELPING CHILDREN & FAMILIES MOVE
FORWARD
Valerie Lambert, LCSW – The Bradley Center
Carrie Moore, MS – Founder, Executive Director & Chaplain, The Bradley Center
12:00 - 1:00 LUNCHEON – On your own
1:00 - 2:15 CONCURRENT SESSIONS
ADDRESSING AND COPING WITH THE SUICIDE OF A PATIENT AND/OR COLLEAGUE [SC]
Geniel Armstrong, PhD – Clinical Psychologist, Hawaii Department of Education
Sandra Whitehouse, PhD – Director of Psychology, University of Utah Neuropsychiatric
Institute
EMOTIONAL RACING MOTORCYCLES: A METAPHOR FOR TALKING ABOUT THE
RISKS AND REWARDS OF BEING HIGHLY EMOTIONALLY SENSITIVE
CJ Powers, PhD – Staff Psychologist, University of Utah Neuropsychiatric Institute
EMPOWERING 10-12 YEAR OLD CHILDREN TO UNDERSTAND & WITHSTAND ABUSE
Carrie Jensen, SSW – Associate Director, Prevent Child Abuse Utah
Patrick A. Leytham, PhD – Assistant Professor of Special Education, Weber State
University
ETHICAL & LEGAL ENTANGLEMENTS IN THE TREATMENT OF YOUTH [EC]
Mary Burris, MD – Assistant Clinical Professor, University of Utah Division of Child &
Adolescent Psychiatry
Robert Denton, JD – Senior Attorney, Disability Law Center
Kirsten Hansen, PhD – President Elect, Salt Lake County NAMI Affiliate Board
Suzanne Jasper – Division of Child & Family Services
FAMILY-FOCUSED TRAUMA TREATMENT [TT]
Sandra Meyer, LCSW - The Children’s Center
JUVENILE COMPETENCY WITHIN THE DEPARTMENT OF HUMAN SERVICES’
INTEGRATED MODEL
Amanda Alkema, LCSW – Juvenile Competency Program Administrator, Utah Department of Human Service
Ruth Wilson, MSW – System of Care Director, Utah Department of Human Services
LIFE BEFORE AND AFTER THE TRANSGENDER EXPERIENCE
Alex Miller – T of Utah
Transition Team Providers
SHAME ON YOU – TECHNIQUES TO PROMOTE SHAME RESILIENCE
Victoria Delheimer, LCMHC, CDWF – Clinical Director, Journey Healing Centers
John Walters, LCSW – IOP Manager, Journey Healing Centers
2:15 – 2:30 EXHIBITS & BREAK
2:30 – 3:30 CONCURRENT SESSIONS
CLINICAL & ETHICAL STRATEGIES WHEN WORKING WITH LGBTQ YOUTH [EC]
Josh Bytendorp, CMHC – Therapist, Fourth Street Clinic
ENGAGING YOUTH IN TREATMENT
Mauria Tanner, CTRS, CMHC – Recreational Therapist, University of Utah Neuropsychiatric Institute
John Webb, CMHC, TRS, CTRS – Expressive Therapy Manager, University of Utah
Neuropsychiatric Institute
FOCUS ON THE FAMILY: SUPPORTING PARENTS OF CHILDREN WITH LANGUAGE DELAYS
Kristen Ipson, CCC-SLP – Easter Seals-Goodwill Provo Early Intervention Program
ElBea Stonier, CCC-SLP – Program Practice Manager, Easter Seals-Goodwill
HUMAN TRAFFICKING: THE FACTS & HOW IT DOES EFFECT YOU!
Sean D. Reyes, JD – Attorney General, State of Utah
SECONDARY TRAUMA AND THE NEWEST KNOWLEDGE [TT]
Brian Miller, PhD –Director, The Children’s Center Safety Net Program
UNDERSTANDING THE DYNAMICS OF BULLYING: HELP KIDS BOUNCE BACK
INSTEAD OF CRACK
Verne C. Larsen, BS – Education Specialist, Utah State Office of Education
WHY POLYPHARMACOLOGY IN YOUTH?
Julie H. Oldroyd, MD – University of Utah Neuropsychiatric Institute
3:30 – 3:40 EXHIBITS & BREAK
3:40 – 5:00 CLOSING KEYNOTE ADDRESS
LIFE HAPPENS, PLANS CHANGE. I’M POSSIBLE!
Jeffrey A. Griffin, MEd – Griffin Motivation
4:15 CERTIFICATES OF COMPLETION
Available on-site to those who pre-registered for this document and attended both
Thursday & Friday (13.75 hours) or only Friday (7.0 hours)
*Minor program changes may occur.
[BT] Behavior Track hosted by the University of Utah Neurobehavior HOME Program
[TT] Trauma Track hosted by The Children’s Center • [EC] Ethics Content included
[SC] Suicide Specific Content included • [BCBA] Session approved for BCBA Credit
Program Committee
Amanda Alkema, LCSW – Juvenile Competency &
Attainment Program Manager, Utah Department of
Human Services
Pat S. Berckman, LCSW - Director, Salt Lake
County Youth Services; UBJJ Rep
Thomas Conover, MD - Child & Adolescent
Psychiatrist, University of Utah Neuropsychiatric
Institute [Course Director]
Victoria Delheimer, LCMHC, LPC, LMFT – Clinical
Director, Journey Healing Centers
Brent H. Esplin, LMFT – Intake Director, Provo
Canyon Behavioral Hospital
Rebecca Giles, MPH – Asthma Program Manager &
Autism Projects Coordinator, Utah Department of Health
Kyle Goodart, LCSW, DE – Intake Coordinator, St.
Mark’s Hospital
Maureen James, LCSW – School Social Work
Coordinator, Granite School District
Catherine M. Johnson, LCSW – Youth & Family
Services Division Director, Wasatch Mental Health
Korey Larsen, LCSW, DE – Children’s Unit
Administrative Director, Utah State Hospital
Krisanne Lewis, MOT, OTR/L – Student Services
Coordinator, Spectrum Academy
Dorann C. Mitchell, LCSW – Assistant Professor &
PACE Director, University of Utah College of Social
Work
Rob O’Neill, PhD, BCBA-D – Professor & Chair,
University of Utah Department of Special Education
Trina Packard, MEd – Executive Director, YouthCare
Amy M. Peters, MEd, CCC-SLP, BCBA – Owner &
Therapist, Private Practice; Behavior Specialist,
Weber School District
Harper Randall, MD – Medical Director, Children with
Special Health Care Needs, Utah Department of Health
Kenneth D. Roach, EdD, LCMHC – Clinical
Director, University of Phoenix
Daniel Scholz, LCSW – Clinical Director, LifeLine
Cheryl C. Smith, BS – Executive Director, Autism
Council of Utah
Eric Tadehara, LCSW, MPA – Children & Youth
Services Program Manager, Utah Division of
Substance Abuse & Mental Health
Kevin Theriot, PhD – Program Manager, LDS
Family Services
Brianne M. Wolfgramm – Marketing & Outreach
Manager, Provo Canyon School; Reboot
Sandra Whitehouse, PhD – Psychology Services
Director, University of Utah Neuropsychiatric Institute
Tia D. Korologos, BSN, RN - President, ESI
Management Group [Facilitator]
PROGRAM SUPPORT
Mary Burris, MD – University of Utah Neuropsychiatric Institute
Cathy Davis – Suicide Prevention Specialist,
Utah State Office of Education
Sherlene T. Dean, APRN – Founder, Matt’s
Place; University of Utah HOME Clinic
Douglas Goldsmith, PhD – Executive Director,
The Children’s Center
Adam Schwebach, PhD – Director & Neuropsychologist, Neuropsychology Center of Utah
Poonam Soni, MD – Valley Behavioral Health &
Private Practice
Ernie Taylor, LCSW – Former Clinical Director,
Heritage Schools Residential Treatment Center
Debora Wawro – Juvenile Justice Services
Dean Weedon, MSc – Director, University of Utah
Neurobehavior HOME Program
Conference Partners
Special appreciation is extended to the following partners offering unrestricted
educational grants and other financial contributions which allow the conference
to provide consistent, economical registration*:
FOUNDERS
Primary Children’s Medical Center
University of Utah Neuropsychiatric Institute
SUPER HERO ($5,000)
Autism Council of Utah
Generations Conference
Willow Springs Center
HERO ($3,000)
Utah Division of Substance
Abuse & Mental Health
STARS ($1,500)
Copper Hills Youth Center
Provo Canyon Behavioral Hospital
Provo Canyon School
Utah Youth Village
Youth Care
EXHIBITORS ($750)
Affinity Guidance Services
Easter Seals – Northern Rocky Mountain &
Utah Association for Infant Mental Health
Highland Ridge Hospital
Highland Springs Specialty Clinic
Odyssey House of Utah
St. George Detox Hospital
ROYALTY ($2,500)
LifeLine for Youth
COMBINING PARTNERS
The Children’s Center
University of Utah
Neurobehavior HOME
Program
Summit Community Counseling
University of Utah College of
Social Work
Utah Addiction Center / Central
Rockies ATTC
Valley Behavioral Health
West Ridge Academy
*Due to an early print date, additional partners, awaiting final confirmation, are not
noted here but will be included in future promotions and/or conference materials.
REGISTER
EASILY BY
REGISTRATION FORM
• Mailing this registration form with billing information or a check/
money order payable to “Critical Issues- ESI” or
• Paying on-line with credit card via www.esimgt.org using conference
code “CI-1007”
Name: _____________________________________
Title: (if any) _____________________
Address:
Degree: _____________________
Organization (if any): _______________________
___________________________________________________________________
City/State/Zip: _______________________________________________________________
Daytime Phone: (______) ________________
Email: _____________________________
* Substitutions will not be accepted after September 30th. After this date, substitutions may be
made on-site for a $20 processing fee.
EARLY-BIRD REGISTRATION (must be postmarked by August 26, 2015)
 $175 Pre-Conference Intensive on ___ Autism ___ DBT or ___ Family Therapy
 $150 Thursday, October 8th
 $150 Friday, October 9th
 $275 Thursday & Friday, October 8th & 9th
GENERAL REGISTRATION (must be postmarked by September 30, 2015)
 $210 Pre-Conference Intensive on ___ Autism ___ DBT or ___ Family Therapy
 $180 Thursday, October 8th
 $180 Friday, October 9th
 $325 Thursday & Friday, October 8th & 9th
ON-SITE REGISTRATION (space available only / call for availability)
 $275 Pre-Conference Intensive on ___ Autism ___ DBT or ___ Family Therapy
 $225 Thursday, October 8th
 $225 Friday, October 9th
 $375 Thursday & Friday, October 8th & 9th
CERTIFICATE OF ATTENDANCE (optional)
 $ 10 Certificate of Attendance (May be used for CEU/CME, employer, record, etc. verification)
 $TBD Certificate for BCBA ($5 per BCBA accredited training hour. This fee will be
calculated and collected on-site.)
$ _______ TOTAL AMOUNT ENCLOSED WITH THIS FORM
 Please bill my agency as noted below. I have obtained approval for such billing using:
Purchase Order # _________________________
Contact: _________________________________ Title: _____________________________
Organization: ___________________________ Daytime Phone: (_____) ________________
Address: _____________________________________
City/State/Zip: _________________
MAIL COMPLETED FORM WITH PAYMENT TO:
Critical Issues 2015 • ESI Management Group
Post Office Box 1734 • Draper, UT 84020-1734
Primary Children’s Medical Center
5770 South 1500 West
Salt Lake City, UT 84123
NON-PROFIT
ORGANIZATION
US POSTAGE
PAID
Salt Lake City, UT
Permit No. 571