Group Therapy - Highly Experiential Training

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Facilitators: Dawn McBride, Registered Psychologist and Associate Professor and Gabrielle Korell, AMFT, Registered Psychologis

Training Style: Experiential. No powerpoints! We sit in a large circle – no lectures! Very active, integrative learning that is safe, empowering, supportive, and highly instructional. References can be provided that speak to our dynamic, engaging, safe, highly valuable training style.

Size Limit: 20 participants. Beginner therapists to advance group therapists are welcome.

Training Time: 16 hours spread over 2 or more days (open to various arrangements).

Sample Objectives

1. Refresher of group counselling skills, for example: (a) Discuss how facilitator’s dynamics enhance and limit group process and identify at least 10 processing questions to designed to deepen group process, meaning of group activities/topics, and/or interpersonal awareness.

2. Ethical issues in group counselling, for example, identify documentation issues and solutions related to recording group session material.

3. Marketing group programs, for example, identify some solutions to transitioning individual clients into a group service

4. Gain strategies to handle difficult client behaviours in a group setting, for example, (a) explore how therapists underlining needs can influence how they work with group clients who are challenging, triggering, etc., and (b) explore and practice strategies to manage group clients who story tell, are super quiet clients, high “red” activation, the passive-aggressive client, etc.

5. Group activities to process “content” (e.g., family violence topics, depression, stress mgmt) and increase interpersonal awareness (e.g., setting boundaries, empowerment, self-esteem, affect communication, etc.)

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Trauma: Therapeutic Assessment

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This is a workshop that describes what is trauma and how to assess it from a variety of perspectives. There will be ample demonstrations and practice sessions, using non-copyright forms (i.e. no cost) that will enhance informal assessment skills as well as a discussion on how to use these assessment tools as interventions.

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Trauma: Helping Victims of Trauma and Accidents Heal - 4 Options

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This workshop contains many objectives including, for example: WORKSHOP 1: Trauma Informed Care –
Core Issues, Assess Impact, and Frameworks 1.Define and explain the “3 E’s”, as it relates to what is trauma. 2.Describe the common symptoms and difficulties related to experiencing trauma. 3.Describe three frameworks to understand traumatic reactions (acute & chronic) and/or the impact of trauma. 4.List at least three, no-cost, self-report assessment measures to learn more about the impact of trauma on a person’s life and to measure recovery from the trauma. 5.From an organizational perspective, describe what is trauma informed care by identifying four (4) guiding assumptions (the 4Rs) and six (6) guiding principles. In addition, provide examples of how trauma informed care can help develop trauma sensitive practices (e.g., schools, medical offices, counselling sites). WORKSHOP 2: Trauma Healing -Resourcing, Emotional Regulation, & Post Traumatic Growth 1.Describe two trauma counselling frameworks (i.e., emotional regulation model drawing upon sympathetic/parasympathetic theory & the three-stage model of treatment). 2.Describe the critical importance and ethical necessity to focus on stabilization, crisis management, and emotional regulation prior to debriefing the trauma story. 3.Describe several core counselling activities to help the client re-establish a sense of safety and positive resource states. 4.List three self-report (no cost) to assess and promote post-traumatic growth. 5.Identify several issues and questions to consider when implementing a trauma informed approach to care. WORKSHOP 3: Resourcing Positive States & Managing Traumatic Arousal 1.Identify emerging practice standards when working with people who have experienced trauma. 2.List several qualities/characteristics that are essential helpers demonstrate when working with people affected by trauma, including the necessity of having a calm, regulated state when helping a traumatized client who is in highly-activated state (e.g., highly anxious, judgemental, irritable) 3.Describe several strategies to help clients stay in or return to their window of tolerance when they are participating in intake sessions and debriefing their trauma experiences. 4.Describe various trauma tools to reduce traumatic arousal symptoms (e.g., body memories, nightmares, flashbacks). 5.List several strategies helpers can do to reduce and/or manage the impact of trauma exposure on themselves. WORKSHOP 4: Specific Treatment Strategies & Issues
(After Achieving Stabilization, Resourcing Positive States, & Managing Traumatic Arousal) 1.Identify several trauma healing practices when working with First Nations. 2.Identify why guided breathing practices, mindfulness exercises, and yoga can sometimes be highly activating for those who have experienced trauma, and list several strategies to reduce these risks. 3.Describe several counselling approaches/strategies to promote post-traumatic growth. 4.List several strategies teachers, parents, and/or spouses can use to help those who have been impacted by trauma. 5.Describe several counselling approaches/strategies to address and promote healing around the specific trauma event(s).

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Maximizing Compassion Satisfaction and Avoiding Compassion Fatigue / Burn-out - Meeting Our Ethical Duty to Care For Ourselves

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An experiential workshop, using metaphors, discussion questions, PPT material, and creative expressive art to reduce the impact of listening to stories of pain. Sample topics include: (a) assessing counsellor wellness (b) discussing common symptoms for stress-related exhaustion & when it becomes too much (c) "hemorrhaging of the self" - examining burnout (Maslach & Leiter's work) (d) naming the demands that can put our emotional well-being at risk (e) completing and debriefing various assessment measures (f) reviewing self-care activities: before, during, and after shifts (g) enhancing compassion satisfaction (h) being emotional regulated (around staff, clients, and family) means (i) rebuilding our compassion (j) knowing our arousal states and how these impact our work with our clients (k) expanding our window of tolerance to stay compassionate and curious with "red" clients (l) learning to regulate your nervous system so you are not a prisoner to someone else's nervous system (Rothschild) (m) developing an action plan to enhance and protect the "helping" spirit

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The Most Important Session - The First Session

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The first session: what works? This is a very practical session on how to build the working alliance in a short period of time. The workshop objectives are developed in consultation with the agency. Handout packages are available.

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Introduction to Ego-State Therapy via Transactional Analysis

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A dynamic, interactive presentation on my most used modality when working with clients. Sample topics include: •Describe three psychological ego states •Describe what mental health is in relation to ego states •Describe various dynamics and interactions between these 3 ego states •Describe three psychological roles people can take when under stress or in conflict (when in a “drama”) •Describe how these 3 roles interact – causing a drama •Describe strategies to hop off the drama triangle •Process this learning

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Expanding your Counselling Tool Box - Assessment & Treatment Ideas

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This is an experiential workshop customized to the agency's needs – many demonstrations and practice sessions are offered designed to expand a therapist's toolbox with creative and innovative interventions. The focus can be on youth, adults, group therapy, or with couples.

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Powerful resources: EMDR and TAPPING: What really are these new techniques? How can these techniques help me? Help others? Try some experiential tapping activities you can use the next day on yourself and with others!

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There seems to be many myths about EMDR and some poorly trained therapists using EMDR so there have been some horror stories. EMDR training in the USA seems superior to what is offered in Canada. This workshop can focus on:

(a) how to prepare a client (employee) for EMDR,

(b) clarifying what good EMDR sessions should look like,

(c) learn about the prep work therapists can do before being referred for EMDR or before starting any EMDR.

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Best Practice in Ethics -1A: Foundational Issues (for all staff)

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1. Describe why professional conduct and ethical practice is much more than just following a set rules (this sets the stage for the ‘why’ be ethical, e.g., increase one’s moral stages of development)
2. Describe your role power, and provide an example of power dynamics in the helping field, such as power over, power under, and power shared.
3. Describe how moral principles can guide ethical behavior. Provide an example of how these principles can be utilized at work (e.g., you disagree with a client’s beliefs or actions).
4. Identify ethical tests to ascertain the best ethical course of action.
5. Analyze a case where the worker is in tough spot, ethically, by using an ethics decision-making model that is recognized in our field (this is a very simple, easy to remember model).
6. Explain how the above three tasks can be actively integrated into supervision and consultation meetings, so these meetings are efficient and are focused on problem solving not problem talk.

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Best Practice in Ethics -1B: Client Privacy, Consent, and Documentation

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1. Identify the need and value for privacy in the helping field.
2. Describe via a case study, the many strategies agency staff can take to ensure clients’ identity and information are kept private, now and in the future.
3. What are the challenges associated with honouring clients’ privacy: (a) staff issues (e.g., gossip), (b) office set up, (c) legal requirements, (d) release of information forms, etc.
4. Note some of the basic differences between consent, assent, & informed consent.
5. What are 5 of the most important topics in the consent process? E.g., What are the 5 words clients have a right to use anytime?
6. In a sentence or two, describe the FOIP Act, the Limitations Act, and the Adult Guardian & Trustee Act – as it relates to consent and protection of client information.
7. Describe the relational consent process – to ensure clients remember what is in your informed consent document.
8. Identify the 3 Rs for good ethical behaviour.

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Best Practice in Ethics -2: Unpacking The Consent Process & Writing Session Notes

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1. Identify some of the documents therapists/agencies may need to produce to help defend against an ethical complaint – these documents need to showcase a degree of high ethical conduct, offer protection of client’s rights, & meet the ‘reasonable patient’ standard.
2. Describe the differences between consent, assent, and informed consent.
3. List what clients must be informed about to qualify that they make an “informed” choice to seek services at your agency.
4. Identity various strategies to ensure the client gave consent for services, and how to document that consent was obtained in “informed” manner.
5. List examples when a consent is invalid.
6. Describe and practice the relational consent process to ensure clients know the information in your document.
7. Draw a concept map of the 9 core topics to include in contact/session notes that offer enough substance to document the service and promote continuation of care all while taking great care to protect clients’ privacy and dignity, now and into the distance future.
8. Identify the risks associated with having unstructured/venting sessions including the dangers of creating client dependency and failing to focus on change – in session and in the notes.
9. Identify the value of theme based notes, and how to document interventions and the change process.
10. Practice themed based notes.
11. Examine Dr. Dawn's template for completing succinct session/contact notes – in under 5 minutes!
12. Identify at least three questions to ask in every session to inquire about change, learn what is working/not working in the counselling process, and to determine the focus of the session.
13. Identify the 3 Rs for good ethical behaviour.

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Best Practice in Ethics -3: Refresher and Advance Skill Development for Consent and Session Notes

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1. Review and refine the ethical decision-making process by analyzing a case study that requires the use of one or more of: moral principles, the ethical tests, and the previously taught decision-making model. [*if requested]
2. Review and refine the key elements of informed consent by completing an interactive quiz with critical reflection questions.
3. Further refine and enhance the 9+ core topics to include in contact/session notes to ensure there is enough substance to document the service provided and promote continuation of care - all while taking great care to protect clients’ privacy and dignity, now and into the distance future.
4. Participate in an active discussion of therapist’s success and struggles associated with seeking consent and writing ‘smarter’ session notes – exploring what is working, what is not working, and engage in problem-solving the challenges.
5. Describe how to document high risk situations, including how to document suicide, high-risk behaviours including conflict between clients, and youth disclosures of abuse.
6. Identify some of the major challenges of seeking consent from parents and guardians, as well as recommended solutions that may work with these challenges. Offer ample Q & A time.
7. Describe what mature minor is and why it is very unlikely a minor, who is in psychological distress, can be awarded the adult right to consent to service.
8. Identify and discuss the legal implications of certain Acts (in Alberta) that compile providers to release information about a client that violates a client’s privacy, and recommendations to protect client privacy under these Acts.
9. Watch at least one video of a client session (mock) to completing a session note and/or critically examine one or more sample session notes [depends on the time available].
10. Court orders/Subpoenas: Discuss several strategies to use to delay or prevent a release of a file (e.g., when you have a file that has been requested by a lawyer (informally) or a file ordered to be released by the courts). *If time.
11. Provide open Q & A time for problem solving complex ethical situations in the workplace.

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Deepening Therapy by Shifting Away From Content and Managing Strong Emotions in Therapy

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A dynamic, interactive workshop focused on how to process heavy feelings in a session. An example would be learning how to use the SIBAM processing model and increasing the “inside awareness” to facilitate resourcing and change.

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CBT Refresher

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Making CBT come alive without the therapist being a "teacher".

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Making Sense of Clients' Struggles

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This workshop focuses on theory and practice. Here, we aim to review various counselling orientations and how to apply counselling theories to make sense of why clients are struggling; and determine what is needed for growth. Many audience members report this workshop has ample application to their work with 1:1 clients, as well as with families/couples. In addition, comments from the audience speak to how much easier it is to be a therapist if one uses process rather than rely on managing content and/or being a “teacher” in a session.

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Filial Play Therapy

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This workshop focuses on increasing the bond between the child and their parent/guardian. The content of the workshop can be curated to your agency's preference.

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Who Is Driving Your Car? A Powerful Counselling Strategy Adapted From Transactional Analysis

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Learn about a practical, easy-to-understand, powerful therapeutic counselling intervention that focuses on using a metaphor of a car (drawn from transactional analysis theory). This culturally adaptable tool can be used to help clients (e.g., couples, families, individuals) gain insight into how their thoughts, feelings, and actions may be contributing to their depression, anxiety, anger, or interpersonal conflict. Examples will be used to foster deeper learning of this highly effective change tool. In addition, tips and strategies will be offered on how to use this counselling intervention in a way that engages clients.

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Reducing the Spiral of Anxiety: Creative and Innovative Counselling Strategies
to Treat Anxiety

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A full day will be devoted to exploring and practicing a wide and rich variety of interventions to help clients (of all ages) tolerate, manage, and reduce their anxiety symptoms. Anxiety will be conceptualized, in client-friendly terms, as having roots in poor regulation of the nervous system (e.g., in the brain the amygdala is easily hijacked promoting defense responses such as fight, flee, and freeze actions), poor tolerance of affect states, and faulty belief systems that limit insight and cognitive reflection. Since there are many contributions to what feeds chronic anxiety, it is important counsellors know a variety of interventions to reduce these symptoms. As a result, this interactive workshop will focus on interventions that address brain and nervous system regulation, affect tolerance and change of affect states, positive inner resource development, and cognitive reframing. For example, some of the interventions include, but are not limited to, expressive art therapies (e.g., therapeutic art, use of metaphors), pendulation and titration activities, the 3B wheel to promote cognitive awareness, and externalization narratives. The presentation will be suitable to help clients of all ages, but special attention will be focused on youth who suffer from anxiety. The presentation will include video clips, lectures, demonstrations, practice sessions, and an extensive handout.
Objectives:

1. Explain what is anxiety from a variety of perspectives, including how anxiety has roots in: (a) poor regulation of the nervous system (e.g., the role of the amygdala; 3F defense responses), (b) restricted window of tolerance for affect, and (c) distorted belief systems.
2. Provide a rationale for the value of using creative-based and brain-based interventions to reduce chronic symptoms of anxiety.
3. Identify interventions appropriate to reduce anxiety by promoting: (a) affect tolerance, (b) affect state change, (c) cognitive insight, and (d) grounding activities to address the ABCs of regulation.
4. Describe various protocols on how to use creative expressive interventions (e.g., art, poetry, metaphors).
5. Practice some of the interventions before trying them with clients.

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Making the Most of Supervision: Strategies with Supervisees

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This training is offered 1:1 in the form of coaching. However, a workshop can be created. Feel free to see the articles Dr. Dawn has written on providing competent and comprehensive supervision.

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Emotional Regulation and Self-Harm Across the Lifespan (those who hurt themselves on purpose): Understanding It, Assessing It, and Treating It. Part I of II

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1. Identify the range and function of the types of self-harm behavior (e.g., cutting, overeating, picking skin, taking unnecessary risks with one’s life).
2. Distinguish between a suicide threat and self-injury.
3. Explain why self-harm is used – from an emotional regulation perspective, using at least 2 different frameworks (e.g., cycle of self-injury & the 3Fs). Some of the material may be applied to gaining a deeper understanding of why people abuse substances and may hurt others on purpose.
4. Explore the rational and range of creative expressive strategies suitable for those who need help with emotional regulation – such as those who engage in self-harm - especially in the early stages of treatment.
5. Describe the 4 Cs approach when responding to disclosures from those who hurt oneself on purpose. *very valuable for parents and teachers.

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Emotional Regulation and Self-Harm Across the Lifespan (those who hurt themselves on purpose): Understanding It, Assessing It, and Treating It. Part II of II

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1. List the guiding principles of treatment including a bill of rights – re: self-harm.
2. Identify assessment questions, across three different domains, to understand and learn about the person’s need to hurt themselves on purpose. In addition, explain how purposeful assessment questions can help clients gain insight into their behaviour and how they can gain skills to predict and control their behaviour.
3. Describe several counselling interventions within four different counselling domains - affective, somatic, cognitive, creative, and behavioural - that are designed to help clients’:
   1. increase their emotional awareness,
   2. express themselves without having to engage in traditional “talk” therapy such as the use of props,
   3. build their tolerance for emotional & cognitive distress,
   4. gain a solid understanding how the connection between thoughts, feelings and actions, using the user-friendly, visual 3BE model by McBride.
   5. reduce the frequency and/or the intensity of their self-injuries.
4. Describe some strategies to engage parents when working with a youth who engages in self-harm behaviour.

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Customized Training - Will Design A Training To Suit Your Needs

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Customized Training – In active consultation with the agency (at no charge) will develop training objectives that fit your staff’s learning needs.

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