This course, developed by the American Association of Psychiatric Administration and Leadership (AAPAL), is geared towards early career psychiatrists who may be interested in administrative roles for the first time or experienced psychiatrists interested in growing their leadership skills. This program will introduce learners to important elements of leadership training in a practical and pragmatic manner as it applies to the field of psychiatry. The course will cover several important topics within leadership, including career development, the role of influence, negotiation, quality improvement and fiscal management. Faculty presenters will also review the benefits and challenges of leadership roles. Participants will be given an opportunity to consider and participate in case-based discussion considering nuanced challenges of psychiatric leadership and to have ample opportunity to engage faculty presenters to further explore their individual questions.

Learning Objectives

• Identify various components of leadership in psychiatry
• Outline important career dynamics to consider when presented with leadership opportunities in psychiatry
• Improve capacity to function as a psychiatric leader
• Identify avenues for further career development
• Apply physician leadership techniques, including negotiation, quality improvement, financial management, and leadership theory to daily work and future career as a physician in leadership

Supportive psychotherapy has a long tradition and is widely practiced. It has acquired an undeservedly poor reputation as a mediocre treatment and the term has been loosely used in psychotherapy research as a weak control condition. Years ago we defined Brief Supportive Psychotherapy (BSP) in a manual as a time-limited, affect-focused, “common factors” treatment for depression research studies. In testing it we found, to our surprise, that in nine successive studies it generally worked as well as the fancier therapies to which it was compared. In other words, BSP is a powerful brief treatment for major depression. The common factors of psychotherapy, defined decades ago by Carl Rogers and Jerome Frank, comprise factors like emotional arousal, helping a patient to feel understood, building a strong treatment alliance through therapeutic ritual and communication of expertise, realistic optimism, and success experiences. A stripped down, elemental therapy, BSP focuses on the patient’s emotional life, helping the patient to tolerate and understand feelings rather than viewing them as problems. The therapist sketches an emotional portrait of the patient and uses this as a therapeutic guide. This approach is simple in concept yet can be hard to do well. Patients like and benefit from it, and dropout rates have been low. This course rehabilitates supportive psychotherapy for attendees, reviewing its checkered history, shabby reputation, and contrastingly potent research performance. The bulk of the course focuses on describing and using its “common factor” elements and particularly its affect focus. Participants will learn not only the use of brief supportive psychotherapy as a focused treatment but also its role as the basis of all good common factor psychotherapies. Particularly in an era when therapy risks becoming too mechanical and intellectualized, awareness of emotional techniques hones psychotherapeutic skills. Course participants may want to but are not required to read the newly published BSP manual, Brief Supportive Psychotherapy, published by Oxford University Press.

Learning Objectives

• Distinguish the common factors of psychotherapy
• Understand how to use affect and emotion in psychotherapy
• Evaluate the evidence base for brief supportive psychotherapy

This update of Mind-Body & Breath Techniques for Stress, Anxiety, Depression, and PTSD focuses on Stress Reduction for Healthcare Providers and on international, cross-cultural trauma recovery for survivors of mass disasters. Neurophysiology, Research, Clinical Integration: Breath-Body-Mind (BBM) uses simple practices, mainly voluntarily regulated breathing practices (VRBPs) with movement, mindfulness, and attention focus derived from yoga, qigong, martial arts, and neuropsychiatry. Easily learned, evidence-based techniques help relieve stress, anxiety, depression, and PTSD; are accepted across cultures; and can be modified for office, hospital, family and group therapy, schools, military bases, or disaster settings. Evolving neurophysiological theory shows how VRBPs may improve sympathy-vagal balance and emotion regulation, and incorporates polyvagal theory (Stephen Porges), GABA pathways, respiratory entrainment of EEG patterns, neuroendocrine response, and social engagement networks. Specific mind-body practices reduce defensive reactions while restoring capacities for emotion regulation, better cognitive function, and meaningful connectedness with self and others. Dr. Patricia Gerbarg updates evidence that VRBPs and related practices improvement stress symptoms in caregivers as well as stress, trauma, and exhaustion in disasters survivors. We discuss current, highly effective Breath-Body-Mind programs for Ukrainian mental healthcare providers and for Rwandan genocide survivors. Experiential Training: Dr. Richard Brown leads rounds of gentle movement (standing or sitting), VRBPs, and open focus attention training. Awareness/mindfulness of breath and psychophysiological state are cultivated. Group interaction with Q & A enhance learning. Attendees learn a short set of mind-body practices for self-care and stress reduction. Dr. Brown & Dr. Gerbarg: During the last hour attendees will learn how to teach Coherent Breathing to their patients and will practice this skill with co-attendees. This training will include discussion of risks, benefits, and adaptations of practices for individuals with physical and psychological conditions.

Learning Objectives

• List four advantages for using simple, effective, evidence-based mind-body programs to support the emotional recovery of populations affected by mass disasters.
• Apply Polyvagal Theory to understanding how Voluntarily Regulated Breathing Practices (VRPs) help shift the organism from states of defensive disconnection towards a state of safety and connectedness.
• Describe initiatives using mind-body techniques to relieve stress and trauma among survivors of war and terrorism in Ukraine and Rwanda.
• Practice Coherent Breathing and other Voluntarily Regulated Breathing Practices (VRPs) for self-care and to reduce stress, anxiety, insomnia, depression, and symptoms of trauma.
• Access resources for learning how to integrate breath and movement techniques experienced in this course into clinical practice.

While most psychiatrists agree that lifestyle factors play an important role in mental health, many are unprepared to address these in the clinical encounter. This course will provide a foundational review of the science, literature, and practical tools for the clinician both as primary interventions and in conjunction with psychopharmacology and/or psychotherapy. This course will review exercise, nutrition, yoga, sleep health, and social connectivity. We begin with a review of the neuroscience of physical exercise and impact on brain health. The impact of active or sedentary behavior on risk for psychiatric disorders and evidence on use of exercise interventions to manage psychiatric disorders with be discussed. A case presentation with highlight the strategies for supporting people in developing a physical exercise routine in clinical care. The role of diet and nutritional psychiatry on mood disorders and cognitive disorders will be presented. The proposed expansion of the bio-psycho-social model to the bio-psycho-social-lifestyle model will be presented (Royal Australian and New Zealand College of Psychiatry). The strategies to incorporate nutritional psychiatry science in clinical practice will be addressed in a case presentation. Next, we presented the growing research on the therapeutic application of yoga for people with psychiatric disorders. Yoga is theorized to exert its effects through regulation of the autonomic nervous system and hypothalamic pituitary axis. Yoga is recommended as second-line adjunctive therapy for mild to moderate Major Depressive Disorder, and there is evidence for yoga as an intervention for anxiety, schizophrenia spectrum disorders, eating disorders, trauma, and substance use disorders, and for child and adolescent populations. Actionable clinical recommendations for yoga and applications for general psychiatrists based on the existing literature will be highlighted. Our course then addresses the impact of sleep on health including cognition, mental health, immune function, physical performance, and injury risk stressing the importance of healthy sleep as a lifestyle anchor. The concept of accumulated sleep debt and ways to pay it back through sleep extension will be discussed. We will provide practical strategies for improving sleep duration, sleep quality, and sleep timing. Through professional athlete sleep success stories, we will illustrate the impact of improving sleep and how it can significantly improve performance. We will end the course with a review of the science of social connectivity including the recent literature and practical applications for clinical practice. The attendees will engage in a small group exercise to practice the power of social connection. Multiple question and answer sessions with active audience engagement will be present during the course and special consideration for diversity, equity, and inclusion through lifestyle interventions will be presented throughout the course.

Learning Objectives

• Summarize iterative behavioral reinforcement strategies to support patients in achieving sustained independent exercise.
• Evaluate the evidence for the efficacy of yoga for people with psychiatric disorders.
• Describe how global dietary changes improve mood and enhance remission rates from depression, and may prevent the risk of cognitive disorders.
• Apply the science of accumulated sleep debt and the benefits of sleep extension to clinical practice.
• Identify evidence-based social connectivity strategies that support mental health.

Repetitive transcranial magnetic stimulation (rTMS) was FDA-approved in 2008 for treating depression. 5 years later it is emerging as an important new approach for the practicing psychiatrist. There are over 7 FDA-approved TMS devices, and new FDA indications emerge each year. This course is geared toward the practicing psychiatrist who wants to understand who to refer for TMS, and what outcomes to expect. As in many areas of medicine and science, there are many who claim more than TMS can deliver.

Learning Objectives

• Understand the current FDA approved indications for rTMS
• Be aware of studies using TMS in adolescents and children
• Know about methods combining TMS with cognitive behavioral therapy
• Recognize recent advances and trends in using TMS for treating depression

Psychiatrists in general practice are often required to engage with the legal system. For example, it is common for inpatient practitioners to petition the courts for treatment over objection, and testify in court, in support of the petition. Many in this position do not have specialized training in forensic psychiatry. This course is designed to address what psychiatrists in general practice need to know in order to engage effectively with the legal system. Through case presentations, interactive roleplay sessions, and didactics, the participants will learn the core practical skill and knowledge needed to better interact with the courts in these matters. The topics addressed will include Treatment Over Objection, hospital retention, report writing and testifying in court.

Learning Objectives

• Improve expertise in common psychiatric evaluations that lead to court involvement, including treatment over objection and hospital retention
• Understand the core fundamentals required to effectively write reports for court submission
• Better understand the proper role(s) and limitations, thereof, when psychiatrists interact with the legal system