Upload File

stepps to address bpd part 1€¦ · acknowledgements donald black, md bruce pfohl, md patrick o....

  • Home
  • Documents
  • STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA
24
STEPPS to Address BPD Part 1 Presented by Nancee Blum, MSW

Upload: others

Post on 24-Jun-2020

5 views

Category:

Documents


0 download

Report

TRANSCRIPT

Page 1: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

STEPPS to Address BPD

Part 1

Presented by

Nancee Blum, MSW

Page 2: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

STEPPS™ Systems Training for

Emotional Predictability and Problem-Solving

Nancee Blum, MSW, LISW

Norm Bartels, MA, MPH Don St. John, PA-C

Bruce Pfohl, MD

Department of Psychiatry Roy J. and Lucille A.

Carver College of Medicine The University of Iowa

Page 3: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

3

Page 4: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

With special thanks to Donald Black, MD Professor of Psychiatry

Roy J. and Lucille A. Carver College of Medicine

The University of Iowa

4

Page 5: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Disclosures Grant Support: Nellie Ball Trust STEPPS research support - MH 63746 from NIMH (2002-2006) Royalties: LevelOne Publishing LLC - STEPPS, STEPPS UK and STAIRWAYS, Psychiatrie Verlag (German), Cristaldo (Italian) American Psychiatric Press (Blum, Pfohl) Oxford University Press – (Blum)

5

Page 6: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Acknowledgements

Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA Norm Bartels, MPA, MA Stephan Arndt, PhD Brett McCormick, MA Rebecca Hansel

JoAnn Franklin, RN M’Hamed Temkit, MS Peggy Loveless, PhD Jeff Allen, PhD Level1Image Art/Richard

Blum Renee Harvey (UK) Lydia Turner (UK) Christine Openshaw (UK) Barry Wood (UK)

6

Page 7: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Where Is STEPPS?

U.S.- 48 States

Canada-20 Locations

Argentina

Australia

Belgium

Denmark

England France

Germany Italy Japan

Kenya

New Zealand

Norway

Scotland

Singapore

Spain

South Africa

The Netherlands

Puerto Rico

7

Page 8: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Who Uses STEPPS? Outpatient clinics Inpatient units, Partial hospital Day treatment Residential treatment ACT (Assertive Community Treatment) HIV+ patients (for anger control) Corrections (prisons and community) Primarily used with adults

- Adolescent version in preparation

8

Page 9: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

The STEPPS Program for BPD

Group format Psychoeducational approach/manual-based Cognitive behavioral model + skills training Confronts early maladaptive schemas

(cognitive filters) Includes reinforcement team Teaches a common language

9

Page 10: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

STEPPS

A “value-added” (supplemental) treatment

May help to decrease frequency of individual therapy

Supported by managed care Evidence-based practice (NREPP)

10

Page 11: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

STEPPS Focuses on the present Patients learn to manage their disorder

- Move away from being a victim - Do not blame others

Do not expect other people or things to rescue them (e.g., MD, medications)

Teach skills to others in their system High level of patient and therapist

acceptance

11

Page 12: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Selecting Group Members

Two important elements in STEPPS: - Learning to share time with others - Learning to limit discussion of individual

problems to those elements that serve educational goals of STEPPS

Consider motivational interviewing 12

Page 13: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Who Is Not A Good Candidate for STEPPS?

Individuals who are extremely narcissistic Individuals who deal with conflict by

physically threatening or intimidating others (marked ASPD traits*)

Avoid having only one male *ASPD traits did not necessarily predict

poor outcome in RCT

13

Page 14: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Recommended Format Weekly sessions (20 weeks) Two hour sessions Two trainers/6-10 trainees Reinforcement team

- Treatment system personnel - Other providers - Family and friends

May repeat basic group or go on to STAIRWAYS

14

Page 15: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Three Step Program

Awareness of illness - DSM criteria - reframe as emotional intensity

disorder (EID) - identify cognitive filters (schema)

Emotion management skill training Behavior management training

15

Page 16: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Emotion Management Skills

Distancing Communicating Challenging Distracting Managing Problems

16

Page 17: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Behavior Management Skills Goal Setting Eating Sleeping Exercise Leisure Physical Health Abuse Avoidance Interpersonal Relationships

17

Page 18: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

18

Page 19: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

19

Page 20: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

Emotional Intensity Continuum

1 3 5 2 4

1=Baseline 2=Beginning of Intensity 3=Development 4=Pre-blow-up 5=Blow-up

20

Page 21: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

21

Page 22: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

22

Page 23: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

23

Page 24: STEPPS to Address BPD Part 1€¦ · Acknowledgements Donald Black, MD Bruce Pfohl, MD Patrick O. Monahan, PhD Scott Temple, PhD Scott Stuart, MD Wayne Bowers, PhD Don St. John, PA

STEPPS to Address BPD

End - Part 1

Presented by

Nancee Blum, MSW

24


Thrombocytopenia Scott Akin, MD. Thrombocytopenia Scott Akin, MD

Philippine Kiès, MD, Marianne Bootsma, MD, PhD, Jeroen Bax, MD, PhD, Martin J. Schalij, MD, PhD, Ernst E. van der Wall, MD, PhD Arrhythmogenic right ventricular

Scott Schissel, MD, PhD

Laurence de Leval, MD, PhD,* David Waltregny, MD, PhD,w Jacques Boniver, MD, PhD,*

elearning.rcog.org.uk in... · ManagementofCancerDuringPregnancy Donald C. Doll, MD; Q. Scott Ringenberg, MD;JohnW.Yarbro, MD, PhD \s=b\Although cancerduringpregnancyisInfrequent,itsman-agement

D.Bruni, MD; L.Bragonzoni, PhD; M.Gagliardi, MD; M.Bontempi, PhD; Akkawi I, MD; G.Raspugli,MD, Tedi M, MD; S.Patella, MD; Prof. M.Marcacci, MD. Rizzoli

Catheter Ablation of Atrial Fibrillation in the Elderly Burr Hall, MD * Wojciech Zareba, MD, PhD * Scott McNitt, MS * Darren Traub, DO ** James Daubert,

Welcome to Riverhills Neuroscience LOCATIONS · NEUROLOGISTS P. Scott Becker, MD James P. Farrell, MD John H. Feibel, MD Arthur Hughes, MD John P. Kachoris, MD Maureen Li, MD, PhD

Scott Haldeman, MD, PhD, DC Haldeman, MD, PhD, DC Dr. Scott Haldeman, DC, MD, PhD is a foremost international authority on the management of spinal pain. He has served as Chair of

oncologyupdates.ro · Călin Buzea, Phys., PhD Laura Mihalache, MD, PhD Simona Ruxandra Volovă˙, MD, PhD Constantin Volovă˙, MD, PhD ORGANIZING COMMITTEE Mihai Andronic, MD Ana

Scott Hirsch, MD

M. Karan MD P. Vulekovic MD PhD Dj. Jajic MD PhD T. Cigic Md PhD V. Papic MD PhD Dj. Djilvesi MD B. Jelaca MD Neurosurgery Clinic Clinical Centre of Vojvodina,

Osteoporosis Diagnosis and Therapy Veronica Piziak MD, PhD Scott & White Professor of Endocrinology Texas A&M HSC

Burton Scott PhD, MD Duke Movement Disorders Center Durham, NC

Kentucky Lions Eye Center · Guadalupe Mejia, OD Patrick Scott, OD Gary Foulks, MD Research Faculty Cornea Qiutang Li, PhD Brian Ceresa, PhD Genetics Diego Montoya-Durango, PhD Glaucoma

Translational Research Program (TRP) Chair: Adam P. Dicker, MD, PhD Brain Arnab Chakravarti, MD Breast Wendy Woodward, MD, PhD Steven Chimura, MD, PhD

Scott D. Solomon, MD, Janet Wittes, PhD, Ernest Hawk, MD, MPH for the Celecoxib

Molecular Subtypes: Not Quite Ready for Prime Time Scott Kopetz, MD, PhD. Department of GI Medical Oncology MD Anderson Cancer Center

Parallel MR Imaging - Questions and Answers in MRImriquestions.com/uploads/3/4/5/7/34572113/deshane_pi_review.pdf · CME Committee: Scott Nagle, MD, PhD, Pratik Mukher-jee, MD, PhD,

meeting Program - cdn.ymaws.com · Joel gelfand, md spiro getsios, Phd elizabeth grice, Phd John Harris, md/Phd alain Hovnanian, md/Phd akinori Kawakami, md/Phd Heidi Kong, md terry

A.D’Hoore MD PhD , A. Wolthuis MD, F. Penninckx MD PhD

ALPHEUS...2020/11/11  · Guillaume Cayla MD-PhD, Farzin Beygui MD-PhD, Grégoire Rangé MD, Zuzana Motovska MD-PhD, Eric Vicaut MD-PhD and Gilles Montalescot MD-PhD on behalf of the

Truth to Power: Alliance for the Public Good€¦ · Jim Scott, MD -NPA Immediate Past-President • Jean Silver-Isenstadt, MD, PhD . NPA Executive Director • Tobie Smith, MD, MPH

Tendon injuries Robert Spławski MD, PhD Paweł Surdziel MD, PhD Robert Spławski MD, PhD Paweł Surdziel MD, PhD Department of Traumatology and Hand Surgery

XXII International Symposium on Morphological Sciences · Bilhim T, MD PhD, Pisco JM, MD PhD, Campos Pinheiro L, MD PhD, Pais D, MD PhD, Goyri O’Neill JE, MD PhD ..... 7 Distribution

A.D’Hoore MD PhD, A. Wolthuis MD, F. Penninckx MD PhD K. Haustermans MD PhD*, E. Van Cutsem MD PhD** V. Vandecaveye MD PhD*** Department of Abdominal Surgery,

G. Scott Gazelle, MD, MPH, PhD Director, Partners Radiology Partners Radiology Research Retreat February 26, 2010

MD vs MD-PhD vs PhD 2015_slides & handout

Nov. 6, 2015 CFAS Business Meeting Rosemarie Fisher, MD Ann Bonham, PhD Scott Gitlin, MD Vincent Pellegrini, MD

Challenging Cases in Diagnosis and Management … MD, PhD, Luis Aguinaga, MD, PhD, Joseph G. Akar, MD, PhD, Vinay Badhwar, MD, Josep Brugada, MD, PhD, John Camm, MD, Peng-Sheng Chen,

Seth Scott MD

SCOTT ARTHUR WALDMAN, MD, PhD, FCP, FAHA, FNAI - … · Curriculum Vitae: Scott A. Waldman SCOTT ARTHUR WALDMAN, MD, PhD, FCP, FAHA, FNAI CURRICULUM VITAE CURRENT POSITIONS (Thomas

Laura Herrera Scott, MD, MPH Don Shell, MD, MA Russ Montgomery, PhD, MHS Maryland Department of Health and Mental Hygiene Maryland Insurance Association

Viroj Tangcharoensathien, MD PhD Phusit Prakongsai, MD Supon Limwattananon, PhD

TEST UTILIZATION IN AN ACCOUNTABLE AND INTEGRATED ... · Scott Paulson MD, Michelle Shiller MD, Mark Holguin MD, Maria Juarez MD, Robyn Olney MD, Sheila Dobin PhD, and Richard Reuter,