Practical for Your Practice

Microaggressions are subtle, covert forms of discrimination that impact marginalized populations. In this episode, Dr. Ryan Warner shares his insights on the importance of recognizing and responding genuinely to microaggressions in a clinical context as well as some of his own experiences of microaggressions.

Ryan C. Warner Ph.D., CRC is a licensed psychologist, researcher, speaker, and consultant. Dr. Warner has conducted talks and trainings at both national and international levels. Additionally, Dr. Warner has held leadership positions across the nation, has been published in various peer-review journals, and has served as a graduate-level instructor.

Resources mentioned in this episode:

• https://www.rcwarnerconsulting.com/
• 8:34: Reference to “Unmasking Microaggressions in Clinical Practice” https://deploymentpsych.org/Microaggressions-Archive
• 22:00 LET UP Model https://cdn.ce21.com/documents/pkfz2numoeewujk0h_zdgg.pdf

Calls-to-action:

Subscribe to the Practical for Your Practice Podcast

Subscribe to The Center for Deployment Psychology Monthly Email

Provider self-care is an important and ethical responsibility for all providers. Our training as behavioral health providers does not render us immune from stress and even symptoms of mood or anxiety difficulties. Many of us found that some of the self-care behaviors we relied on prior to the COVID-19 pandemic were suddenly unavailable. What can be done? Consider creatively applying the advice we give to our clients to ourselves. Listen as Andy discusses with Dr Carin Lefkowitz practical adjustments we can make to our self-care routines in the current environment.

Carin M. Lefkowitz, Psy.D., is a clinical psychologist and Senior Military Behavioral Health Psychologist at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. Dr. Lefkowitz earned her M.A. and Psy.D. in clinical psychology at Widener University, with a concentration in cognitive-behavioral therapy.

Resources mentioned in this episode:

• 13:50 : Steven C. Hayes, Ph.D. “Don’t Feel Motivated? Play the Impossible Game”: https://www.psychologytoday.com/us/blog/get-out-your-mind/201903/don-t-feel-motivated-play-the-impossible-game
• 18:40 : Guided meditation by Kristin Neff -- Self-compassion exercise for therapists : https://self-compassion.org/guided-self-compassion-meditations-mp3-2/
• 28:55 : Self-care for Practitioners free e-booklet by New Harbinger : https://www.newharbinger.com/blog/professional/a-guide-to-self-care-for-practitioners-a-free-e-booklet/

Calls-to-action:

Choose one or two self-care behaviors you can prioritize for self-care

Try the Impossible Game to enhance your motivation

Subscribe to the Practical for Your Practice Podcast

Subscribe to The Center for Deployment Psychology Monthly Email

In this episode, we sit down with Dr. Robyn Walser for a rich discussion on how clinicians can get better at conceptualizing cases on the fly. We talk about moving from technical to functional, from fidelity to competence, the importance of contextual factors, and most importantly, balancing the need to be present with our clients with our hearts as well as our heads. Come hear Dr. Walser’s actionable intel about improving case conceptualization through understanding the purpose of behavior (the clients and ours), the client’s desired trajectory and the importance of understanding the psychological inflexibility processes that keep clients stuck.

Robyn D. Walser, PhD, is a psychologist and Staff, National Center for PTSD, Dissemination and Training Division, at the Veterans Affairs Palo Alto Health Care System.

Dr. Walser is currently developing innovative ways to translate science-into-practice and is responsible for the dissemination of state-of-the-art knowledge and treatment interventions in her position at the VA. She is an expert in Acceptance and Commitment Therapy (ACT) and has been doing ACT trainings both nationally and internationally since 1998. Dr. Walser is also involved in several research projects investigating use of mindfulness and ACT in Veteran populations.

Resources mentioned in this episode:

• (33:25) contextualscience.org (ABCS) “case conceptualization” https://contextualscience.org/search/node/case%20conceptualization
• The Heart of Act: https://contextualscience.org/publications/the_heart_of_act_developing_a_flexible_processbased_and_clientcentered_prac

Calls-to-action: For example:

Subscribe to the Practical for Your Practice Podcast

Subscribe to The Center for Deployment Psychology Monthly Email

Register for an upcoming ACT Workshop: https://deploymentpsych.org/training

Physical pain can be tough to address when it is a focus of psychotherapy, and it can be even tougher when it “shows up” unexpectedly like an unwanted guest. In this podcast, our colleague Dr. Sharon Birman shares some practical, evidence-based tips for responding to comorbid physical pain during the course of therapy for other presenting issues. Dr. Birman’s take-home message… don’t be afraid to engage with chronic pain!

Sharon Birman, Psy.D., is a Military Behavioral Health Psychologist working with the Military Training Programs at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. In this capacity, she develops and presents training on a variety of EBPs and deployment-related topics, as well as providing consultation services. She has traveled widely across the United States and OCONUS providing continuing education to civilian and military behavioral health providers teaching a variety of courses including Cognitive Therapy for Suicide Prevention, Cognitive Behavioral Therapy for Depression, Cognitive Behavioral Therapy for Chronic Pain, Assessment and Management of Opioids in Military-Connected Populations, Assessment of PTSD, Traumatic Brain Injury, Military Sexual Assault and Military Family Resilience.

She joined the CDP in 2014 after completing her postdoctoral fellowship at Harbor-UCLA Medical Center, where she was actively involved in CBT and DBT intervention, supervision, and education. She completed her predoctoral internship at Didi Hirsch Mental Health Center, focusing her training on suicide prevention and evidence-based interventions for the treatment of individuals with severe, chronic mental illness. Dr. Birman received her bachelor’s degree in psychology from the University of Southern California and her master’s and doctorate degrees in clinical psychology from Pepperdine University.

Resources mentioned in this episode:

• https://www.va.gov/painmanagement/docs/cbt-cp_therapist_manual.pdf [20:22]
• https://www.va.gov/painmanagement/ [20:30]
• https://www.abct.org/Information/?m=mInformation&fa=fs_CHRONIC_PAIN [21:03]

Calls-to-action:

• Attend an upcoming CDP training on Understanding and Treating Chronic Pain https://deploymentpsych.org/training
• Subscribe to the Practical for Your Practice Podcast
• Subscribe to The Center for Deployment Psychology Monthly Email

The recent events in Afghanistan have left many military-connected clients (and providers!) reeling, creating a sense of anxiety in clinics about how to best provide support. In this episode we bring lead EBP consultants from VA and DoD together to talk about the importance of examining our own reactions, making room for our client’s grief, anger and other emotions and how to be fully present in the room as our clients struggle to (re)create balance and meaning. We explore how validation serves as the essential substrate across EBP’s, as well as ways providers can support clients to examine values and move with intention through these historical events. Don’t miss this special episode as your colleagues discuss “doom scrolling,” the “EBP police” and much more!

Sonya Norman, Ph.D. is Director of the PTSD Consultation Program through the Executive Branch of the National Center for PTSD, an Associate Professor of Psychiatry at the University of California, San Diego (UCSD), and in the Psychotherapy Unit of the VA Center of Excellence for Stress and Mental Health. She earned her doctorate in Counseling Psychology at Stanford University and completed trauma-focused postdoctoral research fellowships at UCSD. Dr. Norman previously directed the San Diego VA's OEF/OIF/OND PTSD clinic and has served as a consultant on the VA's prolonged exposure therapy roll-out. Dr. Norman's primary areas of research are in psychotherapies that treat co-occurring PTSD and substance use disorders and in treating PTSD in recently deployed Veterans. Dr. Norman has over 50 publications related to trauma and PTSD.

Kelly Chrestman, Ph.D., is a Senior Military Behavioral Health Psychologist at the Center for Deployment Psychology. She provides training, support, and consultation in Cognitive Behavioral Therapy and in the Assessment and Treatment of PTSD. She works with the team at CDP to find new and better ways to link clinicians with both traditional and innovative resources that will help them implement EBPs more effectively. This includes leveraging computer technology and virtual assets to reach professionals that might otherwise have difficulty accessing high-quality training and consultation.

Resources mentioned in this episode:

• 32:20 Apps mentioned Covid coach, mindfulness coach, ptsd coach: https://mobile.va.gov/appstore/mental-health
• 32:45 VA NCPTSD website
  • For Veterans: https://blogs.va.gov/VAntage/category/afghanistan-series/
  • For Providers: https://www.ptsd.va.gov/professional/treat/specific/pro_guide_veterans_reactions.asp

• 33:20 Vet Center Groups and other resources - https://www.va.gov/VE/pressreleases/2021081801.asp

Calls-to-action:

1. Check out the links to the resources mentioned in this episode to include mobile apps, blogs for veterans and providers, and ways to find Veteran social support groups to supplement your support (see resources above)
2. Subscribe to the Practical for Your Practice Podcast
3. Subscribe to The Center for Deployment Psychology Monthly Email

Masks, social distancing and hand sanitizer oh my! This week we are joined by Dr. Kelly Chrestman, one of CDP’s Prolonged Exposure mavens, to talk about practical tips for doing in vivo work during the pandemic. We dig into how assigning in vivo items may or may not have changed in the midst of the pandemic and creative ways to maintain momentum. Not doing PE? There is still actionable intel for you on how to collaborate with clients to get them engaged in meaningful activities despite all the barriers of COVID. This is the time to flex new muscles and think outside the box with us as we talk about doing PE (via telehealth) during the pandemic.

Bios for your guests

Kelly Chrestman, Ph.D., is a Senior Military Behavioral Health Psychologist at the Center for Deployment Psychology. She provides training, support, and consultation in Cognitive Behavioral Therapy and in the Assessment and Treatment of PTSD.

She works with the team at CDP to find new and better ways to link clinicians with both traditional and innovative resources that will help them implement EBPs more effectively. This includes leveraging computer technology and virtual assets to reach professionals that might otherwise have difficulty accessing high-quality training and consultation.

Resources mentioned in this episode:

• https://deploymentpsych.org/system/files/member_resource/In_Vivo_Exposure_While_Sheltering_Final_0.pdf [13:22 ]

• https://deploymentpsych.org/system/files/member_resource/Patient_telehealth_checklist_0.pdf and https://deploymentpsych.org/system/files/member_resource/Moving_PE_to_Telehealth_FINAL_0.pdf [21:56 starts to talk about the forms or 23:08 is where she literally says to add the link]

• [https://deploymentpsych.org/resources/consultation-services [26:09]

Calls-to-action:

Subscribe to the Practical for Your Practice Podcast

Check out CDP’s COVID-19 Behavioral Health Resources page: https://deploymentpsych.org/covid19-bhresources#NEWBHSD

All of us have been to multiple day workshops to learn new clinical skills. Although we might leave with some enthusiasm, new skills, and new information, that doesn’t always mean that we are proficient in applying new learning. In this podcast, Drs. Holloway and Santanello chat about some of the strategies that they have used as EBP practitioners to improve their skills.

Resources mentioned in this episode:

• 7:30 Chow, D. L., Miller, S. D., Seidel, J. A., Kane, R. T., Thornton, J. A., & Andrews, W. P. (2015). The role of deliberate practice in development of highly effective psychotherapists. Psychotherapy, 52(3), 337-345.

• 15:42 (16:58) The first 20 hours - How to Learn Anything, Josh Kaufman https://www.youtube.com/watch?v=5MgBikgcWnY

Calls-to-action: For example:

• Seek out opportunities for consultation (e.g. colleagues, practice groups, consultation calls)
• Carve out protected time in your weekly schedule to focus intentionally to practice/develop skills
• Be honest with yourself about what you’re good at and what you need to improve using criteria other than your own confidence in your skills (e.g. self-rating competence forms, fidelity forms)
• Contact info for Andy and Kevin: [email protected] / [email protected]

Three clinical psychologists and trainers from the Center for Deployment Psychology (CDP) at the Uniformed Services University (USU) come together to talk about the good, the bad, and the ugly of actually implementing Evidence-Based Psychotherapies (EBPs). Practical for your Practice is a bi-weekly podcast featuring stories, ideas, support, and actionable intel to empower providers to keep working toward implementing EBPs with fidelity and effectiveness. In this first episode your hosts Drs. Jenna Ermold, Kevin Holloway, and Andy Santenello share the who, what, where, and why behind this podcast and more importantly how these conversations between colleagues can enhance the work you do.

This podcast is produced by the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences. The views expressed are those of the speakers and do not necessarily reflect the opinions of the Uniformed Services University, the Department of Defense, or the US Government. In addition, reference to any specific company, products, processes, or services does not necessarily constitute or imply endorsement by the Uniformed Services University, the Department of Defense, or the US Government.

Bios:

Jenna Ermold, Ph.D., is a clinical psychologist and working as Assistant Director, Training and Education at the Center for Deployment Psychology (CDP) of the Uniformed Services University of the Health Sciences (USU). She is a trainer and subject matter expert in PTSD, Prolonged Exposure therapy for PTSD, military culture, and the innovative application of technology for augmenting training and dissemination. Dr. Ermold received her Ph.D. in clinical psychology from the University of Vermont, completed her doctoral internship at Malcolm Grow Medical Center, Andrews AFB, and is a Veteran of the United States Air Force.

Andy Santanello, Psy.D. is a clinical psychologist by training and is currently a senior military behavioral health psychologist at the Center for Deployment Psychology (CDP) of the Uniformed Services University of the Health Sciences. Dr. Santanello is a PTSD, Mindfulness, and Acceptance and Commitment Therapy subject matter expert at CDP. In addition to training other clinicians in evidence-based psychotherapeutic protocols and processes, he is passionate about developing new and innovative ways to use technology in training and providing mental health services.

Kevin M. Holloway, Ph.D., is a clinical psychologist working as Director, Training, and Education at the Center for Deployment Psychology (CDP) and Assistant Professor of Medical and Clinical Psychology at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. He is a trainer and subject matter expert in PTSD, Prolonged Exposure therapy for PTSD, Virtual Reality Exposure Therapy, and the innovative application of technology for augmenting training and dissemination. Dr. Holloway received his Ph.D. in clinical psychology from Brigham Young University in 2004 and completed his doctoral internship at the Portland, Oregon Veterans Administration hospital.