Educational Workshops

ED01 PROBLEM SOLVING THERAPY: HOW TO DO IT

Simon Hatcher

Description: Problem solving therapy (PST) is a brief psychological treatment which has been shown to be as effective as antidepressants in the management of depression in primary care. It is a recommended treatment for depression in guidelines in the UK, Australia and Canada. It has also been suggested that it could be an effective treatment for those people who present to hospital after self harm and it has been used in the depressed elderly, as a core component in chronic illness management programmes, in people with medically unexplained symptoms and individuals with cancer. (The author has just finished recruitment into a large randomised controlled trial of problem solving in self harm). PST consists of several steps including problem definition, brainstorming, goal setting and implementation.

At the end of this workshop participants will be able to perform the basic steps of problem solving therapy and have a knowledge of the areas where problem solving is effective.

Outline: The session will start with a brief review of what problem solving is and some of the evidence for it's effectiveness. I'll then describe the components of problem solving therapy illustrated by DVD clips of cases. After this I will ask the attendees to apply problem solving to themselves and to cases supplied by myself and the audience.

ED02 GETTING THE MOST FROM PRIMARY CARE RESEARCH IN MENTAL HEALTH: AN EXAMINATION OF STRENGTHS AND WEAKNESSES

David Clarke, Jane Gunn

Description: Primary care is a major focus for the identification and treatment of people with common mental disorders. Policy changes and research have occurred over the last decade, but with what effect?

This workshop will bring together people from different countries with experience in policy development and research in primary care. In addition to the Chairs from Australia, contributors will include Linda Gask, Andre Tylee, Christopher Dowrick and Tony Kendrick from the UK, Els Licht from the Netherlands, and Tony Dowell from New Zealand. Examples of research will be described, followed by a critique.

At the conclusion of the workshop we aim to have a clear idea about:

What are the key questions we need to answer to take things forward with respect to mental health care in primary care?

What are the best research methodologies to answer these questions?

Outline: The session will run for 3 hours, structured along the following lines:

A short introduction and contextualisation.

Four brief presentations of research.

An analysis of the strengths and weaknesses of this research, including a panel discussion.

Small group work to answer the two key questions.

A plenary session to conclude.

ED03 COGNITIVE THERAPY FOR OVERVALUED IDEAS AND DELUSIONAL DISORDER

Kieron O'Connor

Delusional disorder (DD) is characterized by the presence of one or more delusions which are defined as fixed maladaptive abnormal beliefs. The most prevalent subtype of DD is the persecutory subtype, but other subtypes include somatic delusions, grandiose delusions, erotomania and pathological jealousy. Cognitive behaviour therapy (CBT) has shown success in small scale controlled studies mainly applied to the persecutory subtypes. Overvalued or fixed ideas fall between obsessions and delusions and are generally indicated by a strong investment in a fixed idea not shared by others, where the content of the idea is bizarre (that is, not arising from everyday life experiences).

The aim of this workshop is to present an assessment and treatment package for applying cognitive therapy to OVI and DD. Issues addressed include adapting separate therapeutic components such as: establishing rapport; psycho-education; cognitive restructuring thought challenges and reality testing. Supportive therapy aimed at mood regulation may sometimes improve mood and decrease preoccupation and can be combined with CBT in less specialized settings.

The dimensional structure of fixed beliefs is essential since distinct dimensions may be more accessible to change in some patients. Implementing effective treatment package lies in integrating cognitive change with behaviour modification and emotional regulation.

(1) The workshop will adopt both a didactic and interactive format. (2) Different evaluation instruments such as the current delusional scales, overvalued ideas scales, accommodation measures and daily mood and conviction scales are presented for use at different stages of therapy. (3) Specialized CBT involving addressing cognitive biases specific to each disorder is elaborated. (4) Role play will be used to illustrate specific cognitive techniques step by step. (5) Flexibility in appropriate use of distinct cognitive approaches is illustrated with case examples, and common pitfalls in therapy are outlined.

ED04 PSYCHODYNAMIC PRINCIPLES FOR GENERAL PRACTITIONERS

James Antoniadis

Needs assessment: This workshop was developed on the basis that the understanding of deep psychodynamic principles will orientate the general practitioner dealing with the often difficult to comprehend mental health issues. There is also a need to assist the Mental Health level 2-trained GP to fine tune their particular approach to treatment- CBT, interpersonal therapy and other forms of psychotherapy and counselling. Unfortunately there is not enough ongoing training for these 262 GPs in Victoria. A report run by the GPMHSC PDO (attached) indicates that that only a small percentage are engaging in this training, due to the fact that there is not enough training for them to access. This workshop aims to fill that gap.

Aim: This program aims to impart a detailed understanding of psychodynamic principals and their application in the treatment of common psychological problems via Focused Psychological therapies i.e. CBT & IPT. Knowledge of these principals assists in a deeper understanding of what is actually going on for the patient and how they can be helped. The topics that will be covered include Transference, Counter transference, Addiction, and Depression. This workshop is of particular relevance for GPs offering inter-personal therapy.

ED05 BUILDING THE SYSTEMS FOR HELPING CLIENTS WITH A DUAL DIAGNOSIS

Ken Minkoff, Christie Cline

Dr Ken Minkoff & Dr Christie Cline are internationally recognised for their development of effective integrated systems of care for persons with dual diagnosis. Their Comprehensive Continuous Integrated System of Care model (CCISC) has had a significant international influence in developing the effectiveness of service systems’ responses to the needs of persons with dual diagnosis. They are renowned for their ability to enthuse drug and alcohol and mental health planners and clinicians around the positive outcomes of providing integrated treatment for persons with dual diagnosis.

CCISC is a model, first outlined by Minkoff, to bring the mental health and drug and alcohol treatment systems (and potentially other systems) into an integrated planning process in order to develop a comprehensive, integrated system of care. CCISC is based on an integrated treatment philosophy and is designed around the needs of all cohorts of persons with co-occurring disorders.

Dr's Minkoff and Cline will present the CCISC model. The workshop will be attended mostly by clinicians, managers and policy makers within the Victorian health system. However the workshop will also be open to up to 20 WPA delegates who are interested in the management of dual diagnosis patients and wish to learn more about the CCISC integrated systems model of care.

Dr's Minkoff and Cline will be in Australia in November 2007. The workshop will be a 1-day, two-part, single-site meeting on the 28 November.

The workshop venue will be the Darebin Arts centre in Preston. This venue has a theatre style auditorium which seats up to 350 and smaller rooms.

Part A of the conference, facilitated by Dr Cline, will target key central policy & planning persons across the range of health and human services agencies that provide services to persons with dual diagnosis (30–50 participants).

Part B, facilitated by Dr Minkoff, will target drug and alcohol and mental health managers and clinicians.

Both groups will come together at the end of the day to share experiences and discuss the implementation of the service outcomes.