Sessions Descriptions

 

Click a title below to jump to the session's abstract, speakers info, and course outline. Financial disclosures for conference speakers can be found here.

Plenary
Racial and Cultural Mental Health Disparities, Early Psychosis, and the Effects of COVID-19 on Mental Health

  •  Thursday, November 12
  •  Noon - 1:10 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

It is important that every population feels that they have access to receiving proper mental health care and treatment in support of their mental and emotional well-being. This is especially crucial when there is a behavioral health problem. At the time of this writing, there have been several minorities suffering from acute mental health crises (namely psychosis) killed by local law enforcement. There are several minority populations within the U.S. who habitually fail to receive proper access, treatment and quality mental health care service because of their race, ethnicity, socioeconomic status, or other discriminatory reasons. African Americans, Latinos, American Indians/Alaska Native, and Asian Americans are the most vulnerable populations at risk of experiencing a mental health disorder (APA, 2017).

Research over the years has found that there are differences in mental health care disparities for each racial and ethnic minority population depending on their background. When the mental health care services are specialized for understanding minorities, it is likely that their mental health recovery rates will increase with less occurrences of dropouts in recovery programs. Many of the barriers that exist for general mental health care are the same factors which prevent minorities for having access to early psychosis care. Yet, to understand the exact initiatives that should be taken to promote better care for minorities who are experiencing early psychosis is still fully unknown, more longitudinal and qualitative research is needed to better determine those factors. Disparities that existed before COVID-19 are still in effect but with even more barriers because of higher rates of unemployment, evictions, and insecurity, which has made many minorities more vulnerable for getting sick and dying from COVID-19 (Centers for Disease Control and Prevention [CDC], 2020). While many minorities experience a life of poverty and the lack of mental health care access, the two issues are interrelated in they both decrease the quality of life and increase outcomes and risks.

The goal of this session is to address the ongoing and prominent issue of racial and cultural disparities for minorities in receiving mental health care services in the U.S. by discussing the struggles of racial and cultural backgrounds, barriers to care, access to treatment, and the probable solutions for overcoming disparity. Behavioral health disparities refer to the elements that are restricted or minimized in the form of barriers to treatment and access for receiving proper mental health care which will be exemplified more in the session. The topic of early psychosis and how it effects minority groups and the barriers involved for receiving care for early psychosis will also be addressed. This session will also include information on the effects of COVID-19 on mental health.

Instructor

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Maxie L. Gordon, M.D., completed medical school in Nashville, Tennessee and a combined psychiatry and internal medicine residency in Greenville, N.C., where he served as assistant professor and founding director of the medicine/ psychiatry unit. Dr. Gordon moved to Mississippi where he served as a National Health Service Corps scholar. He later joined the faculty of the University of Mississippi. There, he became Associate Professor and Director of Medical Student Education. Dr. Gordon is experienced in both institutional and community psychiatry, where he works as an activist. He reads and speaks widely on health disparities and has a weekly radio show. He has been awarded for teaching and community service. He is board certified.

Learning Objectives

  • Explain the role that lack of financial resources, discrimination and inequalities play in increasing poor health outcomes for minorities.
  • Discuss the role of early intervention in improving outcomes in minority populations.
  • Discuss ways that proper intervention by law enforcement may lead to better strategies in early psychosis.

Course Outline

  • Racial and ethnic minorities: History and health disparities.
  • First Episode Psychosis: Stigma, criminal justice system, and COVID-19.
  • Solutions to improve mental health disparities.
  • Discuss how COVID-19 complicates the treatment of mental illness.

Instructional Level

Introductory

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

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System-Level Improvements
Race, Culture, and Diagnosis of Psychosis

  •  Thursday, November 12
  •  1:15 - 2:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Racial disparities in the diagnosis of schizophrenia have existed for decades in the United States and persist currently. Studies suggest clinicians are more likely to misinterpret and misattribute the clinical presentation of Black individuals due to various factors including lack of attunement to social and cultural context. For example, substantial evidence suggests affective symptoms are given less weight in diagnostic determinations for Black individuals presenting for mental health care, and that this in part contributes to the overdiagnosis of psychotic disorders in this population. This talk will provide an overview of this pattern and how it is tied to sociopolitical movements in the U.S. In addition, I will describe how the social environment of people of color, in large part shaped by systemic racism, is associated with increased vulnerability to psychotic experiences. Accumulating evidence suggests racial discrimination may increase risk for psychotic experiences in Black and Latinx populations—experiences that may or may not lead to a clinical psychotic disorder, but that could contribute to misdiagnosis in these populations. This talk will offer strategies to improve the diagnosis of psychotic disorders in the U.S., especially among Black and Latinx young adults exposed to racial discrimination. Case material from a sample of young adults screened for psychosis risk and later interviewed with the Structural Interview for Prodromal Syndromes (SIPS) will be used to illustrate these strategies.

Instructor

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Deidre M. Anglin, Ph.D., is an Associate Professor of Psychology in the Doctoral Clinical Psychology Program at The City College of the City University of New York (CUNY) with postdoctoral research training in psychiatric epidemiology at Columbia University's Mailman School of Public Health. Dr. Anglin leads several projects and mentors students in her Clinical and Social Epidemiology (CASE) Lab designed to identify social determinants of psychosis risk in populations of color. She has published several papers focused on race, racism, and psychosis and the stigma of mental health service utilization in Black and Asian populations.

Learning Objectives

  • Explain how historical sociopolitical movements in the U.S. have contributed to the overdiagnosis of schizophrenia in Black people.
  • Identify three ways mental health clinicians tend to experience challenges diagnosing people of color accurately.
  • Describe how social factors connected to racial discrimination contribute to vulnerability for psychotic experiences in Black and Latinx people.

Course Outline

  • Role of race in the psychiatric diagnosis of African Americans.
  • Racial disparities in the diagnosis of schizophrenia.
  • Racial disparities in psychotic experiences.
  • The influence of racial discrimination and trauma in the expression of psychotic experiences.
  • Clinical assessment of psychosis in racially minoritized groups.

Instructional Level

Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

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The Human Experience
Culture of Mental Illness: Sensemaking of Psychosis and Recovery

  •  Thursday, November 12
  •  1:15 - 2:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Psychiatry, and healthcare in general, has struggled for decades to address racial inequities, including the dismantling of structural racism, as called for in a series of articles as early as 1970 in the American Journal of Psychiatry, "to create new and powerful antiracism mechanisms that will operate continuously and publicly throughout the country in all aspects of the psychiatric care system," (Sabshin, Wilkerson, 1970). The recommendations of over 50 years ago are still relevant today (Shim, 2020) as global protests and demands to end systemic racism after the killing of George Floyd (Oluwoye, Anglin, 2020) and the increasing evidence that some racial and ethnic minority groups are being disproportionately affected by COVID-19 (CDC, 2020). An area of racial equity work is to improve our understanding of culture as meaning making (Fornäs J. 2017), along with improving our capacity to engage each other's sensemaking of psychosis, recovery, health, and well-being. This is a critical area for those of us with lived experience of extreme states of perception to directly inform. This workshop will offer an opportunity to hear perspectives from three different people diagnosed with psychotic disorders and working with young people in early psychosis programs about the intersections of how they make meaning of psychosis and recovery, and support others, in the context of race, culture, and the COVID-19 pandemic.

Instructors

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Chacku Mathai is an Indian-American who became involved in consumer/survivor/ex-patient advocacy and peer support when he was 15 years old. Chacku's personal experiences with racism, xenophobia, racialized trauma, suicide attempts, and disabling mental health and substance use conditions, including psychosis as a youth and young adult, launched Chacku and his family towards a number of efforts to advocate for improved services, social conditions, and alternative supports in the community. He has since accumulated 35 years of experience in a variety of community service roles as well as international, national, statewide, and local board governance and executive leadership roles.

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Danny Sosa is a certified peer specialist in the early intervention programs for teens and young adults offered by OnTrackNY and Northwell Health. As a former participant, Danny knows the program well. He draws on his personal journey of recovery to support youth who are currently coping with mental health challenges. "I wanted to share my experience if at all it would help other people get through the tough parts,"" he says. Danny routinely strives to combat fears and stigmas, encourage meaningful connections, and build community through one-on-one conversations and groups. Danny supports participants and families in English and Spanish.

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Patrick Kaufmann is currently a Supported Education and Employment Peer Specialist with the Navigate Team at InterAct of Michigan in Kalamazoo. He has served at InterAct for 8 years and worked at a Clubhouse, as a Family Support Partner, and as director of a small non-profit. He has utilized his personal experience as someone in recovery who was diagnosed with a psychosis related illness to support his peers and influence systems. Patrick has experience planning events and conferences, creating and implementing recovery programs, and leading peers in Kalamazoo and nationally in peer-run initiatives.

Learning Objectives

  • Define racism and antiracism as social determinants of health.
  • Identify 1-2 additional social determinants of health that impact racial inequities in health outcomes.
  • Identify 2-3 strategies for engaging a person and family's sensemaking of psychosis and recovery.
  • Identify 1-2 cultural and social factors that may affect a person or family's choices or levels of engagement in early psychosis programs.

Course Outline

  • Social determinants of health
  • Sensemaking of psychosis and recovery
  • Cultural and social factors that impact engagement in care

Instructional Level

Introductory; Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

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Culturally Informed Care
Rural and Frontier CSC Considerations to Address Trauma and Race

  •  Thursday, November 12
  •  1:15 - 2:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

This session will highlight issues related to trauma, race, and Coordinated Specialty Care (CSC) considerations in rural and frontier settings. Using examples from Oregon, Appalachia, and national technical assistance from NAVIGATE, we will aim to increase awareness and offer suggestions on useful ways for attending to these complex care needs in our CSC programs. Content will include reviewing direct care interventions, systemic approaches, and provider considerations.

Instructors

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Katherine Hayden-Lewis, Ph.D., L.P.C., is an educator, licensed psychotherapist, and researcher. She is the Rural Services Director with the EASA Center for Excellence. Katie has led Oregon's work to adapt EASA's fidelity model into the state's rural and frontier community settings. She has worked in the early intervention for psychosis field since 2008 and extensively developed technical assistance materials including rural/frontier practice guidelines and COVID-19 adaptations. Katie holds a M.A. in Transpersonal Psychology (2003), a Ph.D. in Counseling (2015), and is a certified Trauma Center Trauma Sensitive Yoga facilitator. She is on the advisory board for the Laboratory for the American Conversation at Oregon State University, which works to conduct research and develop toolkits to support community's capacity for collaboration when addressing high conflict issues. Katie's practice and research interests include youth identity development, de-centering Whiteness, and body based care practices for CSC.

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Nicholas Breitborde, Ph.D., A.B.P.P., is Professor and Vice Chair for Academic Affairs in the Department of Psychiatry and Behavioral Health at The Ohio State University and Director of the OSU Early Psychosis Intervention Center (EPICENTER). He serves as a Content Area Expert for the Global Burden of Disease Study and is a member of the American Psychological Association Task Force on Serious Mental Illness/Severe Emotional Disturbances. To date, his research has been cited over 34,000 times and has been funded by agencies such as the National Institute for Mental Health (NIMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

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Susan Gingerich, M.S.W., has worked with the NAVIGATE First Episode of Psychosis program since 2009. She is currently the training coordinator for the NAVIGATE Program and has participated in providing training and consultation to teams in 20 states in the U.S., as well as teams in Canada and China. Susan is the co-author with Kim Mueser of several books including The Complete Family Guide to Schizophrenia, Social Skills Training for Schizophrenia, and Illness Management and Recovery (IMR) for Individuals with Serious Mental Illness. She is based in Philadelphia, Pa.

Learning Objectives

  • Analyze useful trauma based approaches that are sensitized to complex trauma, in CSC care.
  • Describe challenges and possible solutions for the dissemination and delivery of CSC in rural communities.
  • Identify the main differences between implementing a first episode team in an urban location versus a rural location.

Course Outline

  • Barriers, challenges, and opportunities for delivery of Coordinated Specialty Care (CSC) in rural settings
  • Implementing training for First Episode Psychosis Teams in rural and frontier settings
  • CSC adaptations and responses due to COVID-19

Instructional Level

Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

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The New Normal
Can We Create Sustainability of Coordinated Specialty Care (CSC)?

  •  Thursday, November 12
  •  1:15 - 2:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Coordinated Specialty Care (CSC) represents a groundbreaking public health approach to early intervention for people with psychosis. The federal block grant has helped to create almost 300 programs nationally; yet even this crucial funding is potentially fragile. This session will discuss how we can ensure coordinated specialty care programs can be sustained. We will review practical strategies to facilitate the creation of private and public funding streams that could promote sustainability.

Instructors

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Ken Duckworth, M.D., serves as the medical director for NAMI, the National Alliance on Mental Illness. He is double board certified in adult and child and adolescent psychiatry. He has also completed a forensic psychiatry fellowship. Dr. Duckworth is currently an Assistant Clinical Professor at Harvard University Medical School and has served as a board member of the American Association of Community Psychiatrists. Dr. Duckworth has held clinical and leadership positions in community mental health, school psychiatry and now also works as Medical Director for Behavioral Health at Blue Cross and Blue Shield of Massachusetts. Prior to joining NAMI in 2003, Dr. Duckworth served as Acting Commissioner of Mental Health and the Medical Director for Department of Mental Health of Massachusetts, as a psychiatrist on a Program of Assertive Community Treatment (PACT) team, and Medical Director of the Massachusetts Mental Health Center. Dr. Duckworth attended the University of Michigan where he graduated with honors and Temple University School of Medicine. Ken won the Patient Advocacy Award from the APA and is a distinguished fellow of that organization.

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Christine M. Crawford, M.D., M.P.H., is the Associate Director of Psychiatry Medical Student Education and an Assistant Professor of Psychiatry at BU School of Medicine. She completed her adult psychiatry residency as well as child and adolescent psychiatry fellowship training at Massachusetts General Hospital/McLean Hospital. She received her M.D. from University of Connecticut and her Masters in Public Health at BU School of Public Health where she concentrated in Social and Behavioral Sciences. During residency, she was the recipient of the MGH Laughlin Award and was selected by the American Psychiatric Association (APA) as an APA/SAMHSA Minority Fellow which provided her funding to develop community based interventions to reduce mental health stigma within the Black community. She has been engaged in a number of community outreach initiatives through the Boys and Girls Club of Boston, NAACP and NAMI. She has authored multiple book chapters on mental health disparities, sociocultural issues in psychiatry as well as peer reviewed publications focusing on major depressive disorder. She has made appearances on PBS, WGBH TV programming as well as provides seminars on mental health and racism at various community based settings.

Learning Objectives

  • Describe the history of the growth of CSC and the future need for licensing or certification.
  • Summarize other models that can offer day rate payment.
  • Describe the elements of private pay services that foster third party payment.

Course Outline

  • Financially sustaining Coordinated Specialty Care (CSC)
  • COVID-19 and underrepresented communities
  • COVID-19 and Serious Mental Illness (SMI)

Instructional Level

Introductory; Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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Plenary
Cultural and Contextual Considerations in the Early Identification of Risk for Psychosis

  •  Thursday, November 12
  •  3:00 - 4:10 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Inspired by the growing recognition that early intervention leads to better outcomes among people along a continuum for psychosis, efforts to identify people at clinical high-risk (CHR) for psychosis have seen exponential growth in the past decade. Gains in identification and assessment have been propelled by advanced statistically derived formulas based on large samples. Although this macro-level process has been productive for many, this approach has focused primarily on white people, evolving from a mental health system grounded in white supremacy. For example, typical CHR interview practices such as those employed with the Structured Interview for Prodromal Syndromes (SIPS) may in some cases not fully honor individual differences of those being evaluated. As a result, existing practices can both fail to identify some individuals from marginalized communities who are at risk for psychosis, while at the same time misdiagnose others. Evidence suggests that conditions associated with marginalized identities such as the stress of immigrant status, being "othered" as an ethnic/racial minority, and exposure to neighborhood crime and trauma increase risk for developing psychosis-spectrum disorders. Simultaneously, contextual or environmental factors can lead to endorsing items – particularly those related to suspiciousness – on CHR assessment tools when the underlying mechanism is unrelated to psychosis. Whether potentiating the development of psychosis, or creating a context where confounds lead to errors of measurement and subsequent over/mis-pathologizing, or both, accurate conceptualization of a person's situation through the use of psychometrically valid strategies across diverse populations is critical.

After briefly describing the field's racially imbued historical context, this talk grapples with contemporary factors related to the disparate assessment of psychosis across racial/ethnic groups, discussing how responses to discrimination, crime, and/or trauma may be causally or concurrently (or concurrently that leads to causality) linked to psychosis risk symptoms. The validity of common assessment measures is described among Black people, and in the context of high-crime neighborhoods, with findings suggesting a need for focused attention towards intercultural and contextual responsivity. Further, assumptions inherent in certain risk assessment questions are scrutinized to assess if behaviors or beliefs considered problematic if observed among white people are equally predictive among minority groups (e.g., belief in superstitions, déjà vu, having special talents, religious convictions). Ultimately, this talk asserts that a lack of cultural/contextual consideration, as well as a lack of validated measures in marginalized groups, can lead to diagnostic confusion, false-positives, and large-scale health disparities, especially in the context of federal funding that is actively encouraging growth to scale in this area. The talk concludes with steps clinicians, researchers, and leaders can take to challenge the status quo in the service of making assessment of risk more inclusive and accurate.

Action recommendations include more explicitly infusing cultural humility into risk assessment training (e.g., the role of clinician bias, considering socially mediated stress as a dynamic factor when establishing risk), increasing access for people of color to become both professionals and leaders in the field, rebuilding trust that has been violated through the marginalization of communities in and outside of the mental health care system, and using structured tools such as the Cultural Formulation Interview to garner a clearer perspective of a given individual's circumstances. Collectively, these steps may help reduce the risk of misdiagnosis as well as enhance detection in those who may be at risk for psychosis.

Instructor

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Jason Schiffman, Ph.D., is Professor of Psychology and Director of Clinical Training at UMBC. Dr. Schiffman co-directs the Maryland Early Intervention Program's Strive for Wellness clinic, a research, training, and services program designed to improve the lives of young people at risk for psychosis and their families. Dr. Schiffman holds numerous grants and has published over 135 scientific articles related to the identification and treatment of early psychosis. His research seeks to refine the identification of, and treatment strategies for, young people at risk for psychosis, while addressing issues of racial inequity and health disparities.

Learning Objectives

  • Identify signs of psychosis-risk symptoms through exposure to risk assessment tools.
  • Demonstrate awareness of psychosis-risk screening and assessment strategies, and recognize how attention to cultural and contextual factors inform these strategies.
  • Describe actions that can be taken to change the status quo with respect to potential biases and health disparities in this field.

Course Outline

  • Psychosis risk symptoms, screening, and assessment
  • Social and cultural factors impact on screening and assessment
  • Addressing potential biases and health disparities

Instructional Level

Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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System-Level Improvements
The Early Psychosis Intervention Network (EPINET) Core Assessment Battery: Tools and Resources for Building an Early Psychosis Learning Health Care Partnership

  •  Thursday, November 12
  •  4:15 - 5:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Initiated in 2019 and sponsored by the National Institute of Mental Health (NIMH), the Early Psychosis Intervention Network (EPINET) is a national learning health care system for early psychosis. EPINET is designed to support practice-based research to improve early identification, diagnosis, clinical assessment, intervention effectiveness, service delivery, and health outcomes in clinics offering evidence-based coordinated specialty care to persons in the early stages of psychotic illness. EPINET includes regional Hubs, first episode psychosis clinics, and the EPINET National Data Coordinating Center (ENDCC). EPINET links clinics that work with individuals with early psychosis through (1) standardized clinical measures, (2) uniform data collection methods, and (3) integration of client-level data across service users and clinics. The session will focus on the EPINET Core Assessment Battery (CAB) that was developed through a consensus process by the EPINET Steering Committee. The Steering Committee is composed of principal investigators from each of the eight regional scientific hubs and the ENDCC. The CAB includes standardized measures and individual items that assess key domains of early psychosis psychopathology, recovery, contextual factors, and treatment that can reasonably be included in the data collection efforts within first episode psychosis programs. The CAB serves as the basis for common data collection across all EPINET clinics. Data aggregated across EPINET clinics will be used to establish a national repository of early psychosis common data elements that will facilitate research to improve early psychosis identification, clinical assessment, intervention effectiveness, and recovery outcomes among individuals experiencing early psychosis. As the database grows, the national repository will be open for analyses to researchers outside of EPINET.

Instructors

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Susan T. Azrin, Ph.D., is Unit Chief of the Early Psychosis Prediction and Prevention research unit at the National Institute of Mental Health, Division of Services and Intervention Research, where she also leads the Early Psychosis Intervention Network (EPINET) initiative. She served as Government Project Officer for the Recovery After an Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) clinical trial, a pioneering study demonstrating the effectiveness of team-based Coordinated Specialty Care for people with early psychosis. Dr. Azrin also leads the NIMH research program on improving health and reducing premature mortality in people with serious mental illness and serves as the Science Officer for the Mental Health Research Network, a learning mental health system.

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Abram Rosenblatt, Ph.D., is Vice President at Westat, where he is sector lead for Child Welfare, Justice and Behavioral Health within the Behavioral Health and Health Policy Practice. Dr. Rosenblatt is currently the Principal Investigator of the NIMH funded Early Psychosis Intervention Network Data Coordinating Center. Previously, Dr. Rosenblatt was a Professor in the Department of Psychiatry at the University of California, San Francisco. He is the author or coauthor of numerous peer-reviewed publications focusing predominantly on the costs and outcomes of multi-faceted systemic and programmatic interventions for children, youth and young adults with behavioral health needs.

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Howard H. Goldman, M.D., Ph.D., is a Professor of Psychiatry at the University of Maryland School of Medicine. He is a mental health policy researcher who has been evaluating demonstration programs for almost 40 years. Recently he has focused on demonstrations on early intervention in mental disorders to prevent disability. Dr. Goldman is the Editor Emeritus of Psychiatric Services, the journal he edited from, 2004 – 2016. He also was the Senior Scientific Editor of the Surgeon General's Report on Mental Health from 1997-1999 for which he was awarded the Surgeon General's Medallion. In 2002 he was elected to the Institute of Medicine.

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Diana Perkins, M.D., M.P.H., is a Professor and Director of OASIS (Outreach and Support Intervention Services) at the University of North Carolina School of Medicine. Dr. Perkins' research activities include psychosis risk prediction, and early intervention, as well as investigations of the genetic basis of schizophrenia. She is in the last year of the NIMH 2.9 million five-year multi-site U01 grant, 5/8-Predictors and Mechanisms of Conversion to Psychosis (NAPLS). She is co-investigator on the NIMH funded Conte Mapping Project (Ayse Belger, PI), which aims to compare the brain development trajectory using MRI and electrophysiology studies of individuals at risk of psychosis due to having an affected first degree family member compared to those with no affected relative.

Learning Objectives

  • Describe research domains important to assessment in early psychosis treatment programs.
  • Explain how the EPINET Core Assessment Battery can be used by EPINET and non-EPINET clinics and researchers.
  • Summarize how EPINET, as a learning health care system, can advance first episode psychosis research and clinical practice.

Course Outline

  • Assessment in early psychosis treatment programs.
  • EPINET Core Assessment Battery.
  • Data and a Learning Healthcare System.
  • QA measures with a recovery focus.

Instructional Level

Introductory

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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The Human Experience
Towards an Inclusive Practice: Creating Safe Spaces in Supervision and Interprofessional Teams to Address Inequities and Optimize the Delivery of Behavioral Health Services

  •  Thursday, November 12
  •  4:15 - 5:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Effective teamwork is the cornerstone of the development and promotion of interprofessional collaboration. When teams come together, their ability to work toward health and wellness for service participants, families, and communities are stronger than any individual efforts. Supervision can further optimize the work of the team. COVID-19 and the ensuing social unrest brought to light the long-standing inequity in access and treatment across all health and behavioral health providers demonstrating all too clearly that BIPOC communities had many more deaths from COVID-19 than white communities. While there is growing interest in understanding how social factors drive poor health outcomes, behavioral health providers responsible for defining and responding to how this impact community of BIPOC, identification of structural racism as a root cause of racial health inequities have largely been neglected.

Clinicians are often trained in treatment models and systems steeped in a long history of white supremacy. Moreover, supervisors along with team members are not exempt from enactments of racial and social injustice, prejudice, power and privilege embedded in our social environment and institutions. Negative consequences impede learning not only between the supervisee and supervisor but also the exchange among team members. As such it can affect clinical understanding of service participant and perpetuate injustice based on power and social locations. Thus, is not an easy task to shift cultural norms entrenched across individual, organizational and institutions and move towards an antiracist practice. During this unpresented time, having difficult and at times uncomfortable conversation presents unique challenges when this dialog have to take place on online platforms.

This presentation will discuss ways in which teams and supervisors can develop brave spaces both physically or online for dialog and critical analysis to identify and alter dynamics of power, privilege, and social oppression. We will present models for constructing facilitated team discussions and supervision dialog, Critical Conversations (CC), to unpack discriminatory beliefs, values, and distribution of resources associated with social, behavioral, and economic outcomes for individuals receiving services. Lessons learned from the ACT Institutes work will be presented.

Instructors

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Helle Thorning, M.S., L.C.S.W., Ph.D., is a Clinical Professor of Psychiatric Social Work (in Psychiatry) Columbia University Vagelos College of Physicians and Surgeons. She serves on the leadership team of the Center for Practice Innovations in the Division of Behavioral Health Services and Policy Research at New York State Psychiatric Institute, Columbia University. She is the Director of the ACT Institute. Dr. Thorning has expertise in addressing practice change through workforce development, transformative learning processes, and quality improvement. Dr. Thorning is a licensed clinical social worker, training clinicians and working with people facing mental health challenges and their families.

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Luis O. Lopez, M.A., M.S., is a counselor, trainer, consultant, and coach. Mr. Lopez is the Coordinator for Fidelity and Best Practices at the ACT Institute and has been at the New York State Psychiatric Institute since 2013. Mr. Lopez has expertise in the areas of Trauma Informed Care, Motivational Interviewing, Dual Recovery, Group Dynamics, Cultural Humility, Stages of Change, Harm Reduction, WRAP, CBT, Wellness Self-Management, and the ACT Model. He has facilitated workshops in these topics at more than 100 conferences nationally and in Canada.

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Pascale Jean-Noel, B.S.W., M.S.W., L.M.S.W., is the Director of Training for the ACT Institute at the Center for Practice Innovations at New York State Psychiatric Institute and Columbia University. In this role, she designs, coordinates and facilitates extensive training curricula in the ACT Model, Person Centered Treatment Planning, and cultural humility and awareness. In collaboration with NY State Office of Mental Health, she oversees training of 108 ACT teams and 1,000 ACT providers. Mrs. Jean-Noel currently serves as a member of the Statewide Multicultural Advisory Committee, advising the New York State Commissioner of Mental Health.

Learning Objectives

  • Identify current social justice issues impacting our work today.
  • Explain challenges and opportunities for teams and in supervision when addressing white supremacy and white privilege.
  • Describe how critical conversations (CC) model provides a framework to illuminate and examine power dynamics in order to produce change with parallel insight and action—across teams, supervisee, supervisor—towards an anti-racist practice.

Course Outline

  • Current social justice issues impacting our work
  • Interprofessional team: Establishing a vision
  • Creating safe spaces: Keeping it real
  • Transforming our programs/agencies

Instructional Level

Introductory; Intermediate; Advanced

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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Culturally Informed Care
The Setup: Pathways to Coordinated Specialty Care for Racial/Ethnic Minorities

  •  Thursday, November 12
  •  4:15 - 5:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Coordinated specialty care services are critical for people with first episode psychosis (FEP), but for historically underserved racial and ethnic minority communities much greater attention is needed to overcome the multiple barriers to receiving these services. Given the barriers that underserved communities face when seeking care for early psychosis, this session will emphasize the importance of understanding individuals and family member experiences. In this session, we will begin by examining the pathways to care for a diverse group of individuals from the onset of a FEP to their entry into coordinated specialty care. We will explore how help seeking decisions were influenced by the misattribution of symptoms, stigma and self-reliance, and how contacts with the health care system was a critical juncture in the pathway to care that expedited or delayed entry into care. We will describe and present data on the experiences of several Black families and their points of contact prior to coordinated specialty care and how that can influence individual outcomes, such as quality of life. We will then review the importance of community outreach and campaigns to promote coordinated specialty care, like the campaign designed for the Spanish-speaking Latinx community in California.

Instructors

Leo-Cabassa.jpg

Leopoldo J. Cabassa, Ph.D., M.S.W., is an Associate Professor and Co-Director of the Center for Mental Health Services Research at the Brown School at Washington University in St. Louis. His research examines physical and mental health disparities in historically underserved minority populations with serious mental illness (SMI). His work blends quantitative and qualitative methods, community engagement, intervention research, and implementation science. His scholarship is making significant contributions in three areas: improving depression literacy and reducing stigma toward mental illness in the Hispanic community; reducing physical health disparities in racial/ethnic minorities with SMI; and 2) improving care for people experiencing first-episode psychosis.

Steven-Lopez.jpg

Steven R. López, Ph.D., is a professor of psychology and social work at the University of Southern California. His longstanding research goal is to improve mental health services for U.S. communities of color, particularly Latinos. This is best illustrated by an NIMH-funded community campaign to reduce the duration of untreated psychosis in a largely Spanish-speaking Latinx community in the Los Angeles area. Dr. Lopez has also served as a mentor for several Latinx psychologists, in part through a 15-year NIH-funded summer research training program in Mexico in which 131 undergraduate and graduate students participated from across the country.

Oladunni-Oluwoye.jpg

Oladunni Oluwoye, Ph.D., is an Assistant Professor in the Elson S. Floyd College of Medicine at Washington State University and the Co-Director of Washington State Center of Excellence in Early Psychosis. Her research is focused on reducing racial and ethnic inequities in mental health service utilization and family engagement in early intervention programs for psychosis.

Learning Objectives

  • Demonstrate ways of exploring individual's and their family's experiences prior to coordinated specialty care.
  • Describe the importance of family involvement and how family member experiences prior to coordinated specialty care can impact individual outcomes.
  • Describe how community outreach and campaigns can be used to reduce the duration of untreated psychosis and encourage people with FEP and their families to seek timely mental health care.

Course Outline

  • Reducing duration of untreated psychosis.
  • Experience and utilization of coordinated specialty care by racial and ethnic minority families.
  • Effective messaging to underserved communities.

Instructional Level

Introductory

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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The New Normal
Providing Crisis and Assessment Services Remotely

  •  Thursday, November 12
  •  4:15 - 5:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Due to the COVID-19 pandemic, services for those experiencing new onset of mental health concerns and psychiatric crises have rapidly shifted to be conducted almost entirely remotely through telehealth. Coordinated Specialty Care (CSC) for early psychosis is a team-based, evidence-based treatment approach for those in the early phases of psychotic disorders, a population associated with increased incidence of emergency service utilization. The CSC approach includes evidence-based assessment and crisis services among other elements. We will present an overview of best practices for early psychosis assessment and crisis services. We will then describe past practices and present recommendations for transitioning to telehealth using examples and data from a well-established and thriving early psychosis clinic: the SacEdapt Clinic in Sacramento, CA. The impact of remote work and the Covid-19 pandemic on these components of CSC care will be discussed in the context of systemic issues in mental health services including early detection, inter-system care coordination, and racial and cultural inequities.

Instructors

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Rachel Loewy, Ph.D., is an Associate Professor of Psychiatry and licensed clinical psychologist. She has been conducting research in the area of early psychosis for over 20 years, with a focus on early detection through screening and assessment. She has also conducted training and supervision of assessment in early psychosis as well as program development in university and community settings.

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Daniel Shapiro, Ph.D., is an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of California Davis and serves as Director of Operations for UC Davis Early Psychosis Programs (EDAPT, SacEDAPT clinics). He is a clinical psychologist specializing in the identification, treatment, and implementation of programming for serious mental illness—particularly in early stage psychotic disorders—and in the teaching and practice of Cognitive Behavioral Therapy for diverse concerns. His research investigates how culture, stress, and the way we understand mental illness/wellness affect pathways to, barriers in, and models of care for early psychosis locally and globally.

Learning Objectives

  • List two evidence-based assessment measures for early psychosis.
  • Describe two recommended adaptations from in-person to remote assessment.
  • Identify two approaches for addressing system issues that have impacted remote assessment and crisis services during the COVID-19 pandemic.

Course Outline

  • Coordinated Specialty Care (CSC) crisis management.
  • Crisis management and telehealth adaptations in the era of COVID-19.
  • Cultural and remote considerations for assessment and screening of early psychosis.

Instructional Level

Introductory; Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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Plenary
Workforce Development: Core Competencies and the Intersection of Criminal Justice, Disparities, and Early Psychosis

  •  Friday, November 13
  •  Noon - 1:10 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

With the significant expansion of early intervention programs for psychosis in the United States has come a demand for a workforce to deliver Coordinated Specialty Care (CSC), particularly in the context of broader workforce challenges in behavioral health. This session will describe core competencies for CSC identified through key informant interviews with early psychosis leaders from around the country. Recruitment, selection, orientation, training, professional development, and retention strategies; and supervision recommendations will be presented.

While many CSC Programs have staff with extensive knowledge of psychosis and experienced in managing risk of violence, they may be less experienced in interacting with the criminal justice system and unfamiliar with the sequential intercept model. Individuals in the early stages of psychosis are at heightened risk of violence and disproportionately likely to experience criminal justice involvement compared to their peers. It is crucial that CSC workforce are aware of opportunities to intervene at the intersection of the mental health and criminal justice systems. Developing these competencies can help reduce the risk of further violence or criminal justice entanglement and thereby optimize long-term outcomes for those in the early stages of psychosis. Transition age youth of color are also disproportionately over-represented in the criminal justice system, representing one third of the youth population in the US but two thirds of incarcerated youth. Workforce of CSC programs will need to be acutely aware of the potential for criminal justice involvement among the individuals they serve with the added layer of racial and ethnic disparities for clients of color and be adept at navigating and advocating within these systems.

This session will review the evidence for heightened risk of criminal justice involvement, racial and ethnic disparities among justice involved youth, and recommendations for intervening effectively.

Instructor

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Jessica Monahan Pollard, Ph.D., is Director of the Office of Behavioral Health, Maine Department of Health and Human Services. Previously, Dr. Pollard was Assistant Professor and Director of Early Psychosis Programs at Yale University School of Medicine. She is Chair of the Mental Health Section of the American Public Health Association. Dr. Pollard earned her Doctorate in Clinical Psychology at the University of Connecticut. She has founded multiple early psychosis programs; and developed resources on workforce development for the National Association of State Mental Health Program Directors (NASMHPD) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Learning Objectives

  • Describe competencies for Coordinated Specialty Care workforce and recruitment, professional development, and retention strategies.
  • Identify opportunities for intervention within the criminal justice system.
  • Summarize the evidence regarding disproportionate justice involvement among youth people with psychosis, including racial and ethnic disparities.

Course Outline

  • Workforce development considerations in Coordinated Specialty Care (CSC).
  • Core competencies in CSC.
  • Knowledge and skills related to criminal justice involvement.
  • Intersection with race and ethnicity.

Instructional Level

Introductory; Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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System-Level Improvements
Building and Retaining an Effective CSC Peer Workforce: The Vision, the Reality, and the Solution

  •  Friday, November 13
  •  1:15 - 2:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Across the U.S., Coordinated Specialty Care (CSC) for a recent onset of psychosis providers are increasingly integrating Peer Support (SAMHSA, 2019). This trend is promising for improving care experiences and outcomes among those with a recent onset of psychosis– and providing meaningful employment opportunities for those in recovery from an onset of psychosis. Peers importantly bring a non-clinical, alternative perspective that disrupts team language, practice, and systems rooted in the more traditional medical model (Deegan, 2017). However, recent research summarized empirically established peer workforce issues in community mental health (e.g., Jones et al., 2020; Mancini, 2018). These include on-the-job stigma and discrimination, low pay and no benefits, isolation, unclear work roles, burnout, limited professional development opportunities, and high turnover. With the proliferation of Peer Support integration into CSC, providers are becoming acquainted with these challenges in building and sustaining a peer workforce. Our presentation compares: (1) the vision for peer support integration into CSC with the (2) current reality facing peers on CSC teams. We propose innovative solutions from CSC Models OnTrackNY and EASA as well as emerging approaches from across the country that target organizational and systemic reforms to improve peer workforce experiences and outcomes.

The Vision: Peer Specialists will work successfully within multidisciplinary teams, support service engagement, influence team culture to be more responsive to young person lived experiences, strategically share their story, document services, maintain wellness and professionalism, role model and coach, provide community support, host groups and social activities and build strong working alliances with CSC participants.

The Reality: The dominant narrative within CSC, and where CSC is implemented, is clinical and does not embrace (and arguably rejects) core Peer Support principles, including mutuality and "nothing about us without us." Most CSC teams operate within adult community mental health or university-based clinics, not peer-run or youth-centric organizations. Other disciplines on CSC teams (e.g., psychiatrists, social workers) are taught to limit self-disclosure and use evidence-based methods that inherently reject alternative illness and healing narratives. Compared to other CSC team members, peers tend to be lower paid, younger, and individuals of color. In a recent study with 25 CSC teams with peers, 84% had only one peer and most were part-time (SAMHSA, 2019). Thus, peers, who are the lowest paid and who have the least power (and presence) on CSC teams, must educate colleagues on the value of their role, challenge the dominant clinical narrative, and speak up "appropriately" when colleagues make discriminatory, racist, sexist, classist, and/or ablest remarks. Peers are subject to tokenism, microaggressions, being ignored, and feeling pressured to advocate or answer uncomfortable questions – and later regretting their responses. Particularly during COVID-19, peers have been leveraged as self-care and virtual technologist experts – educating their colleagues on how to maintain health and wellness when stressed and facing adversity as well as how to best use smartphones and computers to engage CSC participants creatively through video chat platforms.

The Solution: Peers need equitable roles on CSC teams in regards to pay, benefits, responsibilities, support and professional growth opportunities. Peers cannot be solely responsible to be the culture carriers and engagement specialists on CSC teams. CSC Models must value and centralize peer support principles and practices to the extent that they do other treatment modalities. CSC teams must support peers in connecting to national and local peer networks, and professional development opportunities. Team-, program-, and system-level strategies aiming to build and retain peers in CSC must be evaluated.

Instructors

Vanessa-Klodnick.jpg

Vanessa Vorhies Klodnick, Ph.D., L.C.S.W., is the Director of Research & Innovation for Youth & Young Adult Services at Thresholds in Illinois and is affiliated with the UT-Austin Texas Institute for Excellence in Mental Health. Dr. Klodnick's research and consulting focuses on understanding and improving experiences and impact of multidisciplinary community mental health services designed for youth and young adults with emerging mental health conditions. Her work to enhance, blend, and study evidence-based practices has translated into several journal manuscripts, best-practice guidebooks, workforce development activities, and tools for improving peer support and mentoring integration into youth and young adult community mental health services.

Abaigeal-Duke.jpg

Abaigeal Duke is a New York State Certified Peer Specialist and the New York State OnTrackNY and ACT Peer Specialist Trainer with the Center for Practice Innovations. For over a decade, Abbe has held a variety of peer support and advocacy roles within child and adult mental health service divisions. Abbe currently provides training, consulting and technical assistance to 22 OnTrack Coordinated Specialty Care teams across the U.S. Abbe has further refined OnTrack peer role expectations and best-practices, co-facilitates the Stanford PEPPNET Lived Experience Workgroup, and delivers webinars, conferences presentations, and trainings to improve peer professional development and CSC integration.

Nybelle-Caruso.jpg

Nybelle Caruso is a Co-chair of the Early Assessment & Support Alliance (EASA) statewide Young Adult Leadership Council and a Coordinator of Peer Delivered Services at LifeworksNW serving Portland's metro area. Since 2015, Nybelle has supported EASA quality improvement as the EASA Leadership Council Co-chair. Nybelle mentors multiple Peer Support Specialists at LifeworksNW and contributes to peer support program development and expansion. Nybelle has shared her lived experience and contributed to the national discourse on peer values, Coordinated Specialty Care and psychosis through co-authoring multiple journal manuscripts and speaking at national and international conferences on early psychosis.

Learning Objectives

  • Describe aims and promise of effective, sustained peer support integration into CSC teams.
  • Explain the reality of on-the-ground peer support experiences in CSC and community mental health settings.
  • Identify innovative and practical solutions emerging nationally within and beyond CSC to improve CSC workforce experiences, professional development, and impact.

Course Outline

  • Peer support principles and practices
  • Current challenges faced by peer support on CSC teams
  • Solutions for improving team integration, influencing team culture, sustaining professionalism

Instructional Level

Introductory

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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The Human Experience
Compassion-Focused Support for Staff in Early Psychosis Services

  •  Friday, November 13
  •  1:15 - 2:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

The emerging science and practice of Compassion-Focused Therapy (CFT; Gilbert, 2009; 2010), with its roots in evolutionary psychology, attachment theory, and neuroscience, may offer a useful framework for approaching some of the challenges of working in early psychosis services, at each of the personal, professional, and organizational levels. In this presentation, we will start with an understanding of why compassion is important. The reality is that we just find ourselves here, in the flow of life, with a "tricky brain" that can cause all sorts of problems for ourselves, our colleagues and our systems. A lot of what happens in our minds is not our fault, but it is still up to us what we want to do about it. In this presentation, we will explore how our evolved minds can be orientated in certain ways depending on our social motives, and we will consider how orientating our minds towards compassion for self and others can bring a variety of positive benefits for mental health and well-being. We will learn some techniques and practices to help us cultivate compassion in our personal and professional lives, particularly for when things get tough around the issues we face with grief, isolation and loss.

Instructor

Charles-Heriot-Maitland.jpg

Charles Heriot-Maitland, Ph.D., D.ClinPsy., M.A., B.Sc., is a clinical psychologist, researcher and trainer at Balanced Minds (London and Edinburgh, UK). For the last five years, he has been researching the application of Compassion Focused Therapy (CFT) for people in UK NHS services who are experiencing distress in relation to psychosis (as an MRC Research Fellow at King's College London and University of Glasgow, 2014-2019). He provides CFT therapy, supervision, consultation, and training. He has run over a hundred various compassion training workshops both nationally and internationally.

Learning Objectives

  • Describe the concept of 'multiple selves.''
  • List the qualities of the 'compassionate self.''
  • Summarize the techniques for directing compassion to parts of us that are struggling.

Course Outline

  • The compassionate self
  • Compassion and healthcare staff
  • Compassion across the healthcare system

Instructional Level

Introductory

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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Culturally Informed Care
Education and Training to Address Behavioral Health Disparities

  •  Friday, November 13
  •  1:15 - 2:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

The U.S. population is changing. Due to the population aging, the proportion of older adults is increasing. Meanwhile, the population is diversifying; while the population of non-Hispanic Whites is projected to decrease over the next four decades, the population of Hispanics of any race, African Americans, Asian Americans, and multiracial individuals is projected to grow.

While historically underrepresented groups have witnessed population growth since the 1970s, mental health needs have been unattended. Data compiled by the Office of Minority Health (2018) show that historically underrepresented groups are disproportionately affected by mental health needs across the lifespan, but receive mental health treatment with less frequency compared to non-Hispanic Whites. A host of cultural and systemic barriers to accessing care have been identified in the extant literature, while noting the crucial role of mental health service providers in facilitating access to care (Alegria, 2014; Alegria et al., 2016; Surgeon General, 2001).

Social workers represent a large proportion of the behavioral health workforce. In the U.S., there are more than 680,000 social workers, and the Bureau of Labor Statistics (2018) projects the profession to grow 16% from 2016 to 2026. A recent survey of new social work graduates showed 92% of new MSW graduates go into direct practice with individuals, families, and groups, but only 27% reported finding a job primarily addressing issues in mental health or substance abuse (Salzberg, Quigley, Aquaviva, Wyche, & Sliwa, 2018). Challenges to a diverse workforce remain: whereas 60,122 students were enrolled in social work master's degree programs nationally in 2015, only 38.7% of full-time students and 42.3% of part-time students come from historically underrepresented groups (CSWE, 2015).

The smaller number of racial and ethnic master's level social work students available for the behavioral health pipeline is especially significant as the populations most at need for mental health services are often racial/ethnic minority clients. Disparities in access to and use of behavioral health services underline the need for diverse and culturally competent service providers. Since the 1970's, one of the ways that the Council on Social Work Education (CSWE) has addressed the behavioral health needs across the U.S. is through the Minority Fellowship Program (MFP), which targets, but does not limit, recruitment to American Indian/Alaska Natives, Asian Americans, Native Hawaiians and other Pacific Islanders, African Americans, and Hispanics/Latinos. These racial and ethnic groups are historically underrepresented in the delivery of behavioral health services (Substance Abuse and Mental Health Services Administration, 2014; Russell, 2010).

This session reviews the National Academies (2016) framework for educating on social determinants of health. Results from MFP evaluations will be used to highlight successful strategies to engage and support the professional development of masters and doctoral students committed to addressing the behavioral health needs of historically underrepresented groups. Implications and recommendations for behavioral health workforce recruitment and development will be discussed.

Instructor

Duy-Nguyen.jpg

Duy Nguyen, Ph.D., L.C.S.W., M.S.W., is the Director of the Substance Abuse and Mental Health Services Administration-funded Minority Fellowship Program at the Council on Social Work Education. A gerontological mental health services researcher, his grant-funded research has revealed how sociocultural factors, especially differences among Asian ethnic groups and the aging process, affect health and mental health service use. As an educator, he has held faculty appointments at Columbia University, New York University and Temple University, where he has taught courses in research, statistics, and human behavior in the social environment. A Licensed Clinical Social Worker, Dr. Nguyen earned his B.A. and M.S.W. degrees from Washington University in St. Louis, and his Ph.D. from Columbia University. He is a Fellow of the Gerontological Society of America and the Society for Social Work and Research.

Learning Objectives

  • Identify at least one recommendation to implement in behavioral health training that addresses social determinants of health.
  • Describe the 3 key features of the Council on Social Work Education (CSWE) Minority Fellowship Program (MFP) that have supported masters and doctoral fellows.
  • Identify at least one strategy to engage students from historically underrepresented groups to address disparities in behavioral health.

Course Outline

  • Behavioral Health Inequities
  • Social Determinants of Health
  • Minority Fellowship Program
  • Workforce Development

Instructional Level

Introductory; Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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The New Normal
Coordinated Specialty Care: Managing Teams Remotely During Times of Uncertainty and Change

  •  Friday, November 13
  •  1:15 - 2:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Coordinated Specialty Care teams have a unique ability to deliver specialized care for early psychosis utilizing tools that underscore and facilitate client and family engagement. Teams are able to deliver services in a flexible, person-centered, cohesive and culturally competent manner. Typically teams are able to meet with clients and families in the office, their homes, communities and school. The level of coordination across team members to have discussions regarding service delivery, provide joint meetings with several providers, and share information about client interactions that affect treatment decisions, is a fundamental component of the CSC approach.

However, the emergence of COVID-19 led to a rapid shift to the use of telehealth as a primary method for service delivery and technology became the primary vehicle for team communication. Activities that were normally performed in person had to be rapidly adapted to be delivered online and via telephone. Furthermore, the negative social, health and economic impact of COVID-19 on team members and services recipients added another dimension of collective uncertainty, trauma and loss. Team leaders had to grapple with how these issues impacted their team members, and how they impacted the ways in which the team related to program participants. The negative impacts were exponential in communities of color and added a focus on explicitly considering the effects of racism and culture on individual's lives. In parallel, team functioning changed dramatically. Team members had to develop new ways to communicate and coordinate with each other remotely and brainstorm mechanisms for engaging participants and families. Specifically, team meetings, supervision and other forms of team integration were also performed remotely with little preparation or training.

This talk will examine the concrete changes that teams underwent when shifting from in-person to remote service delivery and factors that team leaders had to consider for effectively supporting and promoting a positive team dynamic and effective team functioning. We will describe specific strategies that team leaders implemented to: 1) boost team morale, 2) emphasize self-care and reduce compassion fatigue, 3) facilitate dialogue within the team about trauma, grief and considerations of racial inequities, 4) manage and encourage team communication and cohesion, and 5) supervise role functioning to ensure fidelity to the CSC model during a stressful and rapidly changing environment.

Instructors

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Catherine Adams, L.M.S.W., A.C.S.W., C.A.A.D.C., received her M.S.W. from Michigan State University. She worked for over 30 years for the Clinton-Eaton-Ingham Community Mental Health Board in Lansing, Mich. as a senior clinician and clinical manager serving consumers with mental illness and their families. Ms. Adams has served as Project Director for multiple national research endeavors exploring the benefits of early intervention following a first episode of psychosis. Ms. Adams is also the Co-Owner and Clinical Director of ETCH: Early Treatment and Cognitive Health which provides RAISE-NAVIGATE Coordinated Specialty Care interventions, CBTp and CFT to young adults experiencing a first episode of psychosis and their families. Ms. Adams is the Consultant/Trainer for First Episode Psychosis programs in the state of Michigan. Ms. Adams is a frequent speaker on the topic of early intervention for first episode psychosis.

Iruma-Bello.jpg

Iruma Bello, Ph.D., received her doctorate in clinical psychology from the University of Hawaii at Manoa and completed her clinical internship and post-doctoral training at the Massachusetts General Hospital, Harvard Medical School. She has a broad background in public sector clinical psychology with specialized training in evidence-based practices and CBTp. Her is focused on research and practice aimed at improving outcomes for individuals diagnosed with first episode psychosis and has published on this topic. She is responsible for developing effective implementation strategies to support the dissemination of the OnTrackNY treatment model both in New York and across the United States.

Learning Objectives

  • Describe changes in team functioning associated with 1) the use of technology, 2) managing the impacts of COVID-19, and 3) integrating explicit discussion on race and culture.
  • Identify strategies that team leaders can employ to 1) support team members as they try to deliver coordinated services via telehealth, 2) facilitate dialogue within the team on the impacts of COVID-19, trauma, culture and 3) oversee that team members are utilizing principles of cultural humility when delivering services.
  • Explain supervisory strategies that can help with team building and team cohesion during times of uncertainty and stress.

Course Outline

  • Challenges and context of team functioning during COVID-19
  • Building team cohesion and support around stress, grief, and trauma
  • Cultural humility in Coordinated Specialty Care (CSC) teams

Instructional Level

Advanced

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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Plenary
Harnessing Digital Technology to Bring About Long-Term Recovery in First Episode Psychosis

  •  Friday, November 13
  •  3:00 - 4:10 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Sustained social and vocational recovery is the ultimate goal of specialist first episode psychosis (FEP) services and the most valued outcome by young people and their families. Yet, follow-up studies have indicated that treatment benefits of early psychosis services are not sustained and therefore functional and social recovery is often not fully realised.

The recognition of these limitations has brought about a renewed focus on treatment approaches focused on improving long-term recovery from early psychosis. Along with studies evaluating psychosocial interventions focused on preventing relapse and fostering social and vocational recovery, three recent clinical trials have evaluated the effects of extending the duration of specialist support (by one to three years) compared with the typical timeframe of early intervention services (i.e., 2 years), with mixed findings.

Recent psychological models have proposed self-efficacy, intrinsic motivation and positive emotions as important targets to promote social functioning in psychosis. Strengths- and mindfulness-based interventions have been put forward as key interventions to increase self-efficacy and positive emotions, respectively, with preliminary studies supporting their potential to improve social functioning in psychosis. Similarly, self-determination theory posits that interventions addressing the basic psychological needs of competence, autonomy and relatedness will increase engagement with the intervention and improve overall functioning through increased intrinsic motivation.

A promising and potentially cost-effective alternative to extending the duration of specialist FEP services is to provide lower intensity, maintenance treatment following the initial 2 years of specialist support. Online, mobile and social media-based interventions provide a novel avenue to offer young people lower intensity, effective, sustainable and scalable support beyond discharge from specialist FEP services.

Drawing on our previous interventions in preventing relapse and improving vocational attainment in FEP, combined with novel approaches to social recovery (strengths and mindfulness-based approaches) and the principles of self-determination theory, our team developed a world-first digital intervention (Horyzons) designed to foster long-term recovery in FEP. Horyzons blends evidence-based models of social functioning, relapse prevention and vocational recovery in a wrap-around social media therapeutic environment supported by peer workers as well as clinical and vocational professionals. The effectiveness of Horyzons has now been examined via a single-blind randomised controlled trial (RCT) designed to test whether treatment with both Horyzons and treatment as usual (TAU) for 18 months was more effective than TAU alone.

While we did not find evidence that Horyzons improved social functioning as measured by the Personal and Social Performance Scale (PSP) compared with TAU (social functioning remained high and stable in both groups from baseline to 18-months follow-up), Horyzons was effective in fostering vocational and educational attainment -key aspects of functional recovery- and reducing utilization of emergency services in young people with FEP over 18-month follow-up. Horyzons was also appealing for young people, with almost 50% of participants logging on for at least 9 months.

The implications for the field will be presented and discussed in this session. Horyzons and the MOST platform are now being evaluated and disseminated across Australia and internationally.

Instructor

Mario-Alvarez-Jimenez.jpg

Mario Alvarez-Jimenez, Ph.D., D.Clin.Psy., is Director of Orygen Digital, at Orygen, The University of Melbourne. Over the past 10 years, Professor Alvarez-Jimenez has founded and consolidated Orygen Digital as a large world's leading innovation and research centre (65 researchers and professionals, from 15 different disciplines, more than 25 research projects) developing, evaluating and implementing digital interventions that dovetail with the national and international network of youth mental health services and enhance their accessibility, long-term impact and cost-effectiveness. Orygen Digital's Moderated Online Social Therapy (MOST) platform is now being roll-out across all 41 Victorian Youth Mental Health services. This will constitute the first large network of digitally enhanced youth mental health services anywhere in the world.

Learning Objectives

  • Summarize the state of the early psychosis field in terms of effective interventions/services promoting long-term recovery.
  • Describe new models of digital interventions designed to be linked to clinical services.
  • Identify the pitfalls of existing online mental health interventions.

Course Outline

  • Transforming face-to-face interventions
  • Integrative digital approach to youth mental health services
  • Moderated Online Social Therapy (MOST): Digitally enhanced youth mental health care

Instructional Level

Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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System-Level Improvements
Equitably Financing Coordinated Specialty Care: Strategies for Sustainability

  •  Friday, November 13
  •  4:15 - 5:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology

Abstract

Coordinated Specialty Care (CSC) is an evidence-based practice that has been demonstrated to be effective in successfully engaging and serving individuals experiencing a first episode of psychosis. It involves the use of a multidisciplinary team that actively engages and serves clients and their families using a consumer-centered approach with shared decision making. However, the approach requires a certain amount of service flexibility that does not fit neatly into public or private insurance fee-for-service payment models. In this presentation, we will document the problems with current reimbursement methods and suggest strategies that can be used to address them.

The first strategy involves advancing an argument based on legally required parity in insurance coverage. In 2008, Congress passed and President George W. Bush signed the Mental Health Parity and Addiction Equity Act. This Act prohibits discrimination in insurance coverage for behavioral health services, requiring insurers to cover treatment for mental health and substance use disorders no more restrictively than treatment for illnesses of the body, such as diabetes and cancer. The inability to fully cover the costs of CSC services by both commercial insurance and Medicaid / CHIP is arguably a violation of the Federal Parity Law. In this presentation, we will present this argument and suggest strategies and resources that advocates can use to push for equitable insurance coverage.

A second strategy for assuring equitable access to CSC services involves mandating that a bundled service model and reimbursement rate be used for CSC services in both public/Medicaid and commercial insurance. This is the strategy that Illinois successfully pursued. While Illinois' law excludes commercial insurance coverage of supported education and employment, the law requires that the CSC services be provided with fidelity (meaning providers must use public funds for education and employment components of the model). In this part of the panel, we will both discuss the multi-year process that was involved in the development of the enabling legislation and summarize the implementation process that has been ongoing this year.

Workgroups convened by the Illinois Department of Insurance including treatment providers, insurance companies and advocates have developed program eligibility requirements, continuing treatment and discharge guidelines. Work is underway to choose a reimbursement code and reimbursement rate for the program. Cost-based, bundled reimbursement will be available January 1, 2021. Presenters will also discuss how the Commercial and Medicaid legislation includes mandates for young adult team services beyond CSC, so that young people have services to transition to, and from, during their services journey based on their mental health needs. We will also discuss the challenges of supported employment and education inclusion in the legislation.

Finally, we will review some of the existing approaches that can be used in Medicaid to fully cover the cost of these services We will present data regarding cost effectiveness of CSC services as well as the potential for large public savings if CSC services are properly reimbursed, including significant reductions in severity of illness, physical health care costs, disability, unemployment, homelessness, and early mortality. Not only is coverage the right thing to do to enable access to treatment, but we will also demonstrate that full coverage of every incident case would result in negligible increases in insurance premiums using New York state population data and incidence estimates for both commercial and Medicaid populations.

Instructors

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Heather O'Donnell, J.D., is Senior Vice President of Public Policy & Advocacy at Thresholds. Heather leads the legislative and public policy affairs at Thresholds, a Chicago-based community mental health and substance use treatment provider. She successfully led the passage of Illinois' Early Mental Health and Addictions Treatment Act, the Children and Young Adult Mental Health Crisis Act, and several other legislative efforts aimed at improving access to care. Her expertise extends to Medicaid and affordable housing. Heather also spearheads a statewide coalition of advocacy organizations. Prior to moving into public policy, Heather practiced law in Chicago for many years and also worked in Johannesburg, South Africa for Lawyers for Human Rights.

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Former U.S. Representative Patrick J. Kennedy was the lead author of the groundbreaking Mental Health Parity and Addiction Equity Act (Federal Parity Law), which requires insurers to cover treatment for mental health and substance use disorders no more restrictively than treatment for illnesses of the body, such as diabetes and cancer. In 2013, he founded The Kennedy Forum, a nonprofit that unites mental health advocates, business leaders, and government agencies in support of mental health equity and works to advance evidence-based practices, policies, and programming around treatment and recovery. In 2015, Kennedy co-authored the New York Times Bestseller, "A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction," which details a bold plan for the future of mental health care in America. In 2017, he was appointed to the President's Commission on Combating Drug Addiction and the Opioid Crisis. Kennedy is also the co-founder of One Mind, an organization that pushes for greater global investment in brain research; co-chair of Mental Health for U.S., a nonpartisan initiative designed to elevate mental health and addiction in policy conversations during the 2020 election cycle; and founder of DontDenyMe.org, an educational campaign that empowers consumers and providers to understand parity rights and connects them to essential appeals guidance and resources.

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Marc A. Fagan, Psy.D., is the Vice President of Clinical Operations, Youth and Young Adult Services at Thresholds. Marc has over 18 years of experience in developing, implementing, and sustaining comprehensive programs for youth and young adults, including youth with histories of trauma and system involvement, emerging serious mental health conditions, and at high risk for psychosis. These nationally recognized multidisciplinary programs are featured in several books and journal articles. Locally and nationally, Marc partners with policy makers, researchers, and practitioners to develop effective systems supporting the transition to adulthood. As a consultant and trainer in key evidence-informed practices for young people, including the Transition to Independence Process (TIP) Model, Marc conducts workshops for stakeholders across the country.

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David L. Shern, Ph.D., served as the President and CEO of Mental Health America (MHA) from 2006 to 2012, and on an interim basis in 2014 following the departure of his successor. After leaving MHA, Dr. Shern joined the staff of the National Association of State Mental Health Program Directors as a Senior Public Health Advisor. He also has an appointment in the Department of Mental Health at the Johns Hopkins. Prior to joining MHA, Dr. Shern served as dean of the Louis de la Parte Florida Mental Health Institute (FMHI) at the University of South Florida, one of the largest research and training institutes in behavioral health services in the United States. His work has spanned a variety of mental health services research topics including serving street dwelling individuals with SMI; epidemiological studies of the need for community services; the effects of differing organizational, financing and service delivery strategies on continuity of care and client outcome and the use of alternative service delivery strategies such as peer counseling and self-help on the outcomes of care.

Learning Objectives

  • Describe the major features of the federal Mental Health Parity and Addiction Equity Act and how the law can be used to seek equitable coverage for CSC services.
  • Explain the process of developing and implementing legislation that requires coverage for CSC services in both public and private insurance.
  • Effectively argue that CSC services are affordable relative to other commonly reimbursed medical procedures and meet conventional standards for cost effectiveness.

Course Outline

  • Mental Health Parity and Addiction Equity Law
  • Cost based, bundled rates for CSC services
  • Medicaid strategies to fund CSC services

Instructional Level

Intermediate

Target Audience

Psychologists, Other Mental Health Professionals

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The Human Experience
Telehealth in the Time of COVID-19 for CSC Programs: Opportunities, Suggestions, and Considerations for Working with Diverse Populations

  •  Friday, November 13
  •  4:15 - 5:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

In response to the COVID-19 pandemic, CSC programs have had to modify their services to meet the overwhelming needs of participants and family members. This presentation will provide information, strategies, and suggestions for CSC programs using telehealth during the COVID-19 pandemic focusing on three key areas: (1) common challenges that CSC teams have reported during the COVID-19 pandemic; (2) innovative strategies and solutions from CSC programs to enhance engagement in treatment and telehealth; and (3) suggested telehealth modifications and cultural adaptations to respond to the needs of racially and ethnically diverse populations.

Since the COVID-19 pandemic began, CSC programs have experienced challenges associated with the shift to telehealth and the increased and changing needs of participants. These challenges include difficulties maintaining engagement, participant experiences of increased loneliness and boredom, reports of increases in symptoms and case management needs, and new procedures and protocols to provide ongoing CSC treatment. CSC teams across the world have shared their perspectives on how the COVID-19 pandemic has impacted their ability to provide treatment, and the ongoing concerns of adapting CSC evidence-based interventions from an in-person to a telehealth format.

In response to the pandemic, CSC programs both nationally and internationally have developed strategies to use telehealth in the delivery of treatment. This presentation will focus on providing suggestions, adaptations, and considerations for implementing the CSC treatment model using telehealth delivery methods. Suggestions will include specific strategies for individual therapy, family education, psychopharmacological treatment, peer support, and case management. Many programs have developed innovative solutions to address the unique needs of participants returning to work or school, managing symptoms, engaging and integrating family members in treatment, and avoiding relapses. This presentation will describe strategies CSC teams have used to minimize disruptions in care and expand the use of telehealth services including zoom groups, skills demonstration and practice, integrating family members in treatment, and using interactive materials.

Finally, the presentation will focus on improving engagement using telehealth services for persons from racially and ethnically diverse backgrounds. Suggestions will include strategies to adapt interventions for a telehealth delivery format and considerations to culturally tailor an intervention.

Instructor

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Piper Meyer-Kalos, Ph.D., L.P., holds her doctoral degree in Clinical Rehabilitation Psychology from Purdue University, Indianapolis, Ind. Dr. Meyer-Kalos has specialized in psychiatric rehabilitation and treatment for first episode psychosis with interests in recovery, positive psychology, and psychosocial treatment for people with severe mental illness. Since 2009, Dr. Meyer-Kalos has been part of the psychosocial development team of the Recovery After Initial Schizophrenia Episode (RAISE) project and has co-led the individual therapy component (Individual Resiliency Training). Dr. Meyer-Kalos' current research includes an evaluation of four first episode psychosis programs in Minnesota and the national Early Psychosis Intervention Network (EPINET).

Learning Objectives

  • Describe the common challenges associated with delivering telehealth services in a CSC program.
  • Identify strategies that can be integrated into CSC interventions to improve engagement in telehealth services.
  • List some telehealth modifications and cultural adaptation suggestions to improve engagement with persons from diverse backgrounds.

Course Outline

  • Impact of pandemic on core CSC services
  • Suggested strategies to address challenges
  • Improving approaches to telehealth
  • Addressing the telehealth needs of diverse communities and individuals

Instructional Level

Introductory; Intermediate

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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Culturally Informed Care
Continuity of Care in Coordinated Specialty Care (CSC): Federal and Programmatic Perspectives

  •  Friday, November 13
  •  4:15 - 5:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

Coordinated Specialty Care (CSC) is a treatment program for individuals in the early stages of psychotic illness that focuses on recovery, shared decision making, and employs a team of specialty care providers who work with the client to create and implement and personalized treatment plan. Fueled by Mental Health Block Grant set aside funds, CSC programs have proliferated in the U.S.; a national survey in 2018 found that approximately seventy percent of programs started serving clients in 2014 or later (Westat, 2019). As many of these CSC programs mature, teams are increasingly faced with key decisions, including determining optimal program length, what can be done to facilitate a transition when clients leave the program, and what may be the most appropriate services for ongoing care. In addition, research from outside the U.S. has noted the challenge of sustaining gains achieved in early intervention programs once clients are no longer receiving intensive services.

In response to these issues, some programs have established post-CSC programs, usually at a reduced level of intensity of services or have expanded the duration of CSC services. These "step-down" programs and extended-length models are all designed to provide continuity of care and ease the transition into community-based services, though they vary in many aspects. This session will provide four presentations representing federal and local perspectives on continuity of care following CSC services:

Kristina West will discuss the findings of a research project that examined approaches to continuity of care in nine CSC programs, either through use of a step-down model or an extended length of service. Ms. West will review the scope and structure of programs, integration within larger health systems at local and state level, and policy challenges and opportunities in providing continuing care after CSC.

Michael Birnbaum, MD will discuss the development and implementation of the BOOST program at The Zucker Hillside Hospital. The BOOST program was specifically designed to maintain and enhance gains achieved through early intervention at The Early Treatment Program (ETP), Northwell Health's early psychosis intervention clinic. Dr. Birnbaum will also discuss plans to deploy and study an online CSC step-down program developed by collaborators in Australia.

David Penn, PhD will discuss the implementation of Horyzons, a digital intervention, for first episode psychosis. Horyzons was developed in Melbourne, Australia, by Drs. Mario Alvarez (Orygen) and John Gleeson (Australia Catholic University). It comprises user-friendly therapeutic content and a social network and is moderated by clinicians and peer support specialists. Dr. Penn will review the adaptation of Horyzons for CSC in the US, present preliminary feasibility data, and discuss ongoing efforts to integrate it into CSC.

Nicholas Buekea, PhD will discuss his experience as a CSC client and transitioning out of CSC services in the EASA program. Dr. Buekea participates in the Youth Adult Leadership Council (YALC) where former EASA clients can help guide and support EASA's work. YALC seeks to educate the public on the phenomenon of psychosis and to develop better ways in keeping community members engaged.

Instructors

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Kristina West, M.S., L.L.M., is a policy analyst with the Office of the Assistant Secretary for Planning and Evaluation, Office of Behavioral Health, Disability and Aging Policy. Ms. West was the project officer for the initial review of the Mental Health Block Grant (MHBG) set aside for first episode psychosis and its implementation. Subsequently, Ms. West represented ASPE in a tri-agency effort with SAMHSA and NIMH to evaluate the MHBG set aside. Ms. West is currently collaborating with Westat on a project to review transition services for clients graduating from Coordinated Specialty Care (CSC).

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Michael Birnbaum, M.D., is an attending physician in the Department of Psychiatry at The Zucker Hillside Hospital in New York. He works as the Program Director for Northwell Health's Early Treatment Program (ETP), a clinical and research initiative for adolescents and young adults in the early stages of psychosis. Dr. Birnbaum's research has focused primarily on psychotic disorders with an emphasis on the early stages of illness. He is currently exploring the role of social media and the internet in pathways to care for adolescents and young adults with psychotic disorders.

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David Penn, Ph.D., is the Linda Wagner Martin Distinguished Professor of Psychology and Neuroscience at the University of North Carolina at Chapel Hill. He has published over 200 papers in the areas of social cognition, treatment and stigma in schizophrenia. His work has been supported by NIMH, NARSAD and the Stanley Foundation.

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Nicholas Buekea, Ph.D., is a Doctor of Occupational Therapy. He works with the Early Assessment and Support Alliance (EASA). EASA serves transitional aged youth and young adults who have experienced first episode psychosis. Nicholas is a member of EASA's Young Adult Leadership Council, which aims to guide better services from the point of view of its clients. Nicholas enjoys working with peers and building allies of all walks of life. He enjoys the piano, and dancing.

Learning Objectives

  • Analyze the problems associated with continuity of care for CSC programs.
  • Compare strategies to address continuity of care across nine CSC programs for early psychosis.
  • Summarize future directions for implementing continuity of care for CSC programs.

Course Outline

  • Continuity of care post-coordinated specialty care (CSC).
  • Models of successful transitions.
  • Effective community engagement.

Instructional Level

Introductory

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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The Human Experience
Psychopharmacology Management of Early Psychosis During the COVID-19 Pandemic

  •  Friday, November 13
  •  4:15 - 5:25 p.m.
  •  1.0 AMA PRA Category 1 Credit™  |  1.0 CE credit for Psychology  |  1.0 CE credit for Social Work

Abstract

This session will focus on psychopharmacology management of early psychosis in the COVID-19 era. The changes brought by the pandemic almost overnight had a profound effect on society and psychiatry, including in early psychosis care. We will begin with an overview of the impacts of the COVID-19 pandemic and mitigation efforts on society in general. We will review the potential for elevated psychopathology in the general population and emerging data in this regard. Topics include anxiety, depression, substance use, and suicide and these are all relevant to the early psychosis population as well as other segments of society. We will also review how COVID-19 infection alters pharmacokinetics and pharmacodynamics in the body and what these changes might mean for psychopharmacology management in people with psychotic disorders. We will discuss the possibility of early psychosis patients developing COVID-disease – this has been a relatively minor problem thus far.

Greater concerns have been expressed about isolation, loss of education and employment opportunities, uncertainty regarding health insurance and other impacts from the COVID-19 mitigation efforts on people with early psychosis. We will review the experience thus far in relation to these issues which present formidable challenges for clinicians. Data on outcomes in the early psychosis population in the COVID-19 era are relatively sparse but urgently needed. We will also discuss the impact of rapid conversion to virtual care (access to internet connectivity, trust, and privacy). We will then review recommendations for prescribing in early psychosis clinics during the COVID-19 pandemic.

The basic tenets of psychopharmacology have not changed with COVID-19 but certain topics require more attention and a high level of vigilance is needed to avoid compounding medical problems in patients who become infected. Finally, we will look into the future as screening and vaccination efforts become widespread. People with early psychosis may be at higher risk of refusing preventive care, or unable to access it. A concerted effort will be needed to remove barriers so people in our clinics can receive the care they need and deserve.

Instructors

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Dost Öngür, M.D., Ph.D., is the William P. and Henry B. Test Professor of Psychiatry at Harvard Medical School and Chief of Psychotic Disorders Division at McLean Hospital. His research focuses on clinical trajectories of people with early psychosis as well as neuroimaging studies of brain abnormalities in these conditions. He launched McLean OnTrack, a subspecialty service for early psychosis in 2012. He has received awards for his teaching and mentoring. He is the Editor in Chief of JAMA Psychiatry and a fellow of the APA and ACNP.

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Ann Hackman, M.D., is the Division Director for Community Psychiatry at the University of Maryland School of Medicine. Her career has focused on treatment of people living with schizophrenia. She has spent more than 25 years working on an Assertive Community Treatment team and for the past decade has been the lead psychiatrist on a RAISE Connection model EIP program. Dr. Hackman has received awards for medical student and resident teaching. She serves on the executive committee of the American Association for Community Psychiatry.

Learning Objectives

  • Describe COVID-related changes in physiology and psychopathology that may be seen in people with early psychosis.
  • Outline principles for managing psychopharmacology in early psychosis.
  • Describe potential access and health disparities impacting people with early psychosis in the COVID era.

Course Outline

  • COVID-related changes in those with first episode psychosis
  • Psychopharmacology and first episode psychosis
  • Access and health disparities in the COVID era

Instructional Level

Advanced

Target Audience

Psychologists, Social Workers, Other Mental Health Professionals

Bibliography

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