Fall 2011 – Spring 2012

The following are the workshops from the School of Social Work’s eighth year of the Clinical Lecture Series, where area practitioners, students, and faculty learn together from esteemed and innovative clinicians. The CLS offers monthly lectures enhance the clinical curriculum for students and offer continuing education for graduates and practitioners. It also aims to foster and strengthen relationships among clinically-oriented students and the wider clinical community. Selection of topics and speakers come from participant feedback.

All events took place in the Tate-Turner-Kuralt Auditorium of the School of Social Work at the University of North Carolina at Chapel Hill located at 325 Pittsboro Street, and met on Mondays from 12 noon to 2:00 pm.

Schedule of Events

1. Monday, September 19, 2011 – Where do we draw the line? The ethics of diagnosing dementia, presented by Dan G. Blazer MD, MPH, Ph.D. || SLIDES | printable Handouts

link to video

The development of DSM-V has engendered much controversy over the ethics of diagnosis, including the potential for pathologizing otherwise normative experience or life transitions. In this workshop, Dr. Blazer draws from his extensive experience, including committee work on the DSM-V, to discuss the ethical issues involved in introducing new diagnostic categories and widening existing ones. He focuses on dementia as an illustrative battleground with far-reaching consequences. On one hand, neurocognitive disorders have clear biological markers of brain pathology—even in early or mild cases—yet, treatment is largely ineffective. This workshop challenges us to consider potential implications of diagnosing “mild neurocognitive disorders,” which may be predictive but not disabling or treatable. Advocates see these new diagnoses as opportunities for early detection of progressive disease; while critics see a bonanza for the pharmaceutical companies with little benefit for the diagnosed. In this provocative workshop, Dr. Blazer invites us to consider evidence on both sides of this argument and their implications.

Dan G. Blazer, MD, MPH, Ph.D., is former Dean of Medical Education and currently J.P. Gibbons Professor of Psychiatry and Behavioral Sciences and Vice Chair for Academic Development at Duke University Medical Center. He also serves as adjunct professor in the Epidemiology and the School of Public Health at the University of North Carolina. According to ISI listings, Dr. Blazer is among the most highly cited authors in psychiatry and the social sciences, with his contribution of more than 30 books, 180 book chapters,  and 400 peer-reviewed articles, on topics of depression, epidemiology, and spirituality, especially with the elderly. Dr. Blazer has won numerous distinguished awards for his contributions to psychiatry and excellence in teaching and mentorship. In 1995, he was elected to the Institute of Medicine, National Academy of Sciences, where he has chaired the membership committee. He currently serves on the editorial board of the Archives of General Psychiatry, is acting chair of the Neurocognitive Workgroup, and a member of the Scientific Review Committee for DSM-5.

2. Monday, October 17, 2011 – The many faces of postpartum depression (PPD): Assessment, diagnosis and treatment, presented by William S. Meyer, MSW, BCD || SLIDES || printable Handouts || Edinburgh Scale || Letter to Accompany Edinburgh Scale || For New Mothers

link to video
As most new parents will tell you, caring for an infant is much harder than they had ever imagined; and pregnancy and post-partum periods are especially vulnerable times in a woman’s life. Consequently, the prevalence of new mothers who develop substantial postpartum anxiety and depression may be as high as twenty percent. Yet, many of these women never disclose their experience, in part due to shame and associated stigma, and in part because many health care providers are unsuccessful in eliciting a mother’s genuine feelings about her pregnancy and baby. As clinicians, it is essential that we are well informed about the subtle signs of PPD and that we continue to refine our interviewing skills so that new mothers feel safe to speak freely. In this workshop, William Meyer draws from his years of clinical experience to deepen our understanding of the complex interplay of hormonal, developmental, familial, and cultural factors that affect a new mother’s wellbeing. In addition to identifying risk factors for distress, he will discuss strategies that foster safety and why this makes all the difference for successful interviewing, diagnosing, and intervening.

William S. Meyer, MSW, BCD is an associate clinical professor in the Department of Psychiatry and the Ob/Gyn at Duke University Medical Center, where he has worked for 30 years, 15 of which in the high-risk obstetrics clinic. He has facilitated support groups for 20 years with distressed pregnant and postpartum women (where he has by now worked with hundreds of women in group and individual consultation). He has lectured extensively on postpartum emotional disorders and is a featured speaker for expectant parents on preventing postpartum depression in Duke’s mid-pregnancy series. He has also published clinical papers on a variety of mental health topics and received awards for his teaching and clinical work, including the Day-Garrett Award by the Smith College School for Social Work (2010) and the Lifetime Achievement award from the American Association for Psychoanalysis in Clinical Social Work (2011).

3. Monday, November 14, 2011 – Functional subgrouping: An innovative method for resolving conflict, presented by Norma Safransky, MD & Susan Beren, Ph.D.  || SLIDES ||  printable Handouts || Transcript  

link to more material

Differences can be challenging, whether they are differences in opinions, beliefs, ideas, wishes, or feelings that we have with others or experience within ourselves. Common responses to differences include ignoring, avoiding, judging, scapegoating, getting into conflict with or trying to change or convert others, all which can interfere with effective communication and integration of information. In this workshop, Drs. Safransky and Beren present the innovative method developed by Yvonne Agazarian in Systems-Centered Therapy, which aids in the integration of differences so that conflict is reduced and differences can be treated as resources for growth and development. The presenters will use case examples to illustrate how deeply exploring similarities through “functional subgroups” can lead to growth producing and enriching outcomes.

Norma Safransky, MD is a board certified psychiatrist and a certified group psychotherapist. She is co-director of Triangle Area Dialectical Behavior Therapy (TADBiT). She has been in private practice since 1992. For the past decade she has been studying Systems Centered Therapy.

Susan Beren, Ph.D. is a licensed psychologist who has been in private practice in New York City for the last 13 years, working with individuals, couples and groups.  She also provides consultation to the Pediatrics Department at Maimonides Medical Center in Brooklyn, NY and the Surgery Department at Beth Israel Medical Center in Manhattan. Dr. Beren trained with the Systems-Centered Training and Research Institute (SCTRI®) program and is a licensed SCT practitioner.

4. Monday, January 23, 2012 – Cognitive behavioral approaches to pediatric anxiety disorders, presented by Scott Compton, Ph.D. ||  Slides 

link to more material

Children commonly exhibit signs of anxiety at different phases of development. However, approximately one in five children experience fear, nervousness, and shyness that significantly interfere with normative developmental tasks. If left untreated, anxiety disorders can significantly affect their ability to succeed in school, maintain healthy interpersonal relationships, and increases the risk of mental health problems as adults. In this workshop, Dr. Compton will present a brief overview of the current empirical evidence for the treatment of pediatric anxiety disorders. He will also describe cognitive behavioral interventions that help children successfully manage symptoms of anxiety and use case examples from his clinical work to illustrate the process.

Scott N. Compton, Ph.D. is an assistant professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center. He has been active for more than 15 years in the Program in Child Affective and Anxiety Disorders at Duke, where his research interests have focused broadly on child and adolescent psychotherapy treatment development and evaluation; anxiety and depressive disorders in children and adolescents; chronic tic disorders; behavioral and interpersonal approaches to the treatment of adolescent depressive disorders; translating efficacious treatments into community settings; and multi-site pediatric and adolescent comparative treatment trials. He has received multiple grants from NIMH among others, awards for his research and writing, and is currently associate editor for the Journal of Consulting and Clinical Psychology and Journal of Child and Adolescent Psychopharmacology.

5. Monday, February 13, 2012 – Mindfulness approach to eating disorders and everyday eating, presented by
Katherine Prakken, Ph.D.  || SLIDES || printable Handouts | Bibliography

link to video

Mindfulness has been shown to be a powerful tool in facilitating self-regulation. In this workshop, Katherine Prakken focuses on ways that mindful eating practices can transform people’s relationship with food, whether they suffer from eating disorders or more “everyday” struggles with eating and body image. Dr. Prakken describes strategies that can help individuals identify different kinds of hunger, create the ability to “feed” the self without food, cultivate “bodyfulness” as well as mindfulness, and understand how mood and cognitions can undermine mindful eating. These mindfulness practices have been shown to decrease emotional and unconscious eating; increase enjoyment and satisfaction with food, eating, and the body; and lead a more consistently aware approach to eating and living. Dr. Prakken will present case examples to illustrate their use with clients with bulimia, binge eating, and restricting disorders.

Katherine A. Prakken, Ph.D. is a clinical psychologist in private practice in Chapel Hill, NC, who works with individuals, couples, and families. Her specialty areas are eating disorders, particularly bulimia and binge eating disorder, and sexual abuse and women’s issues. She was trained psychoanalytically and has since incorporated a diverse array of approaches including cognitive behavioral therapy and mindfulness skills. She has a particular interest in countertransference and has presented locally and nationally on the role of countertransference in work with individuals with disordered eating. Dr. Prakken, long interested in mindfulness practices, has recently pursued additional training on the art of combining traditional psychodynamic psychotherapy with mindfulness principles.

6. Monday, March 19, 2012 – Ethical conflicts in advance care planning, presented by Marvin Swartz, M.D. ||  SLIDES || printable Handouts

link to video

Psychiatric advance directives (PADs) are legal documents that allow individuals to express their wishes for future psychiatric care and authorize a legally appointed proxy to make decisions on their behalf during incapacitating crises. PADs promote self determination, autonomy, and offer an alternative to coercive interventions that sometimes accompany crises for people with mental illness. In this workshop, Marvin Swartz will provide information on PADs, including their use, importance, and ethical issues that arise with their use.  Among these is the “Ulysses contract,” which raises questions of identifying the “authentic client.” Should PADs honor decisions made by the person when considering eventualities or the person he or she has become on account of dementia or an episode of mental illness? Using case vignettes, Dr. Swartz will help us explore ethical conflicts that emerge in practice.

Marvin Swartz, M.D, is professor and head of the Division of Social and Community Psychiatry at the Duke University School of Medicine, Vice Chair for Clinical Services, Director of the Duke AHEC Program and Director of the National Resource Center on Psychiatric Advance Directives. He has written extensively on the psychiatric advance directives, mental health services for persons with severe mental illness, mandated community treatment, outpatient commitment, and the effectiveness of involuntary outpatient commitment, psychiatric advance directives, and antipsychotic medications.  Dr. Swartz has served as a member of the MacArthur Foundation Research Network on Mandated Community Treatment, in which he participated in discussions on the role of legal tools such as Psychiatric Advance Directives in improving outcomes for persons with severe mental illness.  Dr. Swartz was a CO-PI of the NIMH Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) for Schizophrenia. He was won numerous awards for his teaching, research and patient advocacy. He maintains an active NC list serve among mental health practitioners on salient news items.

7. April 16, 2012 – New frontiers in the addictions: Recent developments in the treatment of behavioral addictions, presented by Matthew Howard, Ph.D.  ||  SLIDES || printable Handouts || Reading List  

link to video

Despite the notable prevalence of substance abuse and associated conditions, practitioners sometimes have difficulty identifying with this group of clients, potentially affecting treatment.  Yet, recent discoveries on the biomedical bases of substance dependence may reframe practitioners’ approaches to these disorders.  Matthew Howard explores recent findings related to the neurobiology of addiction and examines how these processes may be involved in areas as diverse as binge eating, exercise dependence, pathological gambling, sexual compulsivity, and TV watching.  His talk will examine the prevalence, clinical presentation, assessment, and treatment of these behavioral addictions and their co-occurrence with substance use disorders.

Matthew Owen Howard, Ph.D., Frank Daniels Professor of Human Services Policy Information in the School of Social Work at UNC-Chapel Hill, has forged a path-breaking career advancing the understanding of substance abuse and addiction.  Prior to his academic career, he worked in mental health and substance abuse.  Dr. Howard has since published more than 200 articles, book reviews, and governmental reports and received three grants from the National Institute on Drug Abuse.  He currently serves as Editor-in-Chief of Social Work Research, was formerly editor of the Journal of Social Service Research, and serves on the editorial boards of many other journals.  At UNC, he mentors MSW and doctoral students and teaches a wide variety of courses.  Dr. Howard has won numerous awards for his excellence in teaching, scholarship, and his professional contributions.