About the Event
Cognitive Behavior Institute is excited to welcome David Yusko, Psy.D, Christina DiChiara, Psy.D, Steve Tsao, Ph.D, and Shannon Murphy, PhD, for a live interactive webinar on: Prolonged Exposure for PTSD
04/19/2023 9am-5pm EST
04/20/2023 9am-5pm EST
4/21/2023 9am-5pm EST
Credit Hours: 19.5 Clinical CEs
Globally, the approximately lifetime prevalence of PTSD is 3.4% overall and 8% among those exposed to trauma (Shein et al., 2021). Half of those who have experienced PTSD report persistent symptoms (Koenen et al., 2017). There are several empirically-based treatments for PTSD, one of which is prolonged exposure (Blankenship, 2017). PE is a manualized treatment for survivors of trauma, multiple studies demonstrating reductions in PTSD over time (Hendriks, et al., 2018; Zoellner, Roy-Byrne, Mavissakalian, and Feeny, 2019). PE is a clinical best practice and is strongly recommended by the American Psychological Association for the treatment of PTSD (APA, 2017; Schnurr et al., 2022). PE also has comparable efficacy when delivered in person versus through telehealth (Wells et al., 2020).
This training will provide intensive instruction in the use of Prolonged Exposure Therapy (PE) for survivors of trauma, covering the basics of all components of PE and how to modify PE procedures in order to tailor the treatment to the client’s response to exposure. Maintaining focus on treatment of PTSD while maintaining flexibility in following the PE treatment manual (Foa et al., 2019) will be emphasized. Lecture, discussion, videotaped therapy sessions, and participant role plays with feedback from faculty trainers are used to accomplish the goals of the workshop.
9:00-12:30 Prolonged Exposure Therapy for PTSD
● Emotional processing theory
● PE Treatment Research
12:30-1:30 Lunch on your own
1:30-2:30 Overview of PE Therapy
● Description of PE/Overview of Sessions 1-12
3:45-4:30 Break into pairs to practice delivery of treatment
4:30-5:00 Session 1: Trauma Interview and Breathing Retraining
Session 2: Psychoeducation
8:45-9:00 Zoom Check-In
9:00-11:15 Session 2: In Vivo Exposure
● Use of Subjective Units of Distress (SUDs) scale
● Construction of in vivo hierarchy
● Safety guidelines for in vivo exposure
● Assignment of in vivo homework
11:15-12:30 Break into pairs to practice rationale and procedure for in vivo
exposure and hierarchy construction
12:30-1:30 Lunch on your own
1:30-3:00 Session 3: Imaginal Exposure
● Procedure for imaginal exposure
3:15-4:15 Imaginal Exposure Processing – Anger/Guilt/Shame
4:15-5:00 Break into pairs to practice delivery of imaginal exposure rationale
8:45-9:00 Zoom Check-In
9:00-9:45 Session 4-6
Sessions 6-11: Hot Spots Procedure for Imaginal Exposure
9:45-10:30 Session 12: Final Session
10:45-12:30 Factors that impair effective emotional engagement in exposure:
1:00-2:30 Factors that impair effective emotional engagement in exposure:
2:30-3:30 Factors that impair effective emotional engagement in exposure:
3:45-5:00 Review of Treatment/Forms; Special Topics; Open Discussion Q&A
- Participants will describe the diagnosis of PTSD
- Participants will describe psychopathology of PTSD
- Participants will describe emotional processing theory as it relates to Prolonged Exposure Therapy for PTSD
- Participants will describe empirically-supported, psychotherapeutic treatments for chronic PTSD
- Participants will compare the efficacy of these treatment approaches empirically-supported, psychotherapeutic treatments for chronic PTSD
- Participants will explain considerations in deciding whether or not to use PE with a patient
- Participants will explain how clients can be helped to emotionally engage in and process traumatic memories, with the aim of reducing trauma-related symptoms and difficulties
- Participants will use psychoeducational treatment components of Prolonged Exposure Therapy for PTSD
- Participants will construct an in-vivo exposure hierarchy that includes a range of situations that safely and effectively promote learning while expanding the client’s world.
- Participants will use in-vivo exposure to safe but avoided trauma reminders with patients
- Participants will demonstrate how to help patients choose an appropriate index trauma to focus on in Prolonged Exposure Therapy for PTSD
- Participants will apply imaginal exposure to memories of traumatic events
- Participants will choose hot spots with patients
- Participants will use hot spots procedures
- Participants will identify avoidance in PE sessions
- Participants will demonstrate how to address avoidance in PE sessions
- Participants will identify over-engagement in imaginal exposure
- Participants will demonstrate how to address over-engagement in imaginal exposure
- Participants will identify under-engagement in imaginal exposure
- Participants will demonstrate how to address under-engagement in imaginal exposure
Dr. Yusko is nationally recognized as an expert in prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) and is a certified PE therapist and supervisor by Dr. Edna Foa. Dr. Yusko is also an expert in anxiety disorders with particular expertise in obsessive compulsive disorder (OCD), panic disorder, social phobia, generalized anxiety disorder, and specific phobias. He is also certified as an exposure and response prevention (EXRP) therapist and supervisor for OCD by Dr. Edna Foa. He received his Psy.D. in clinical psychology from the Graduate School of Applied and Professional Psychology at Rutgers, The State University of New Jersey. As a graduate student, Dr. Yusko was supported by a National Institute on Alcohol Abuse and Alcoholism training grant under the expert mentorship of Dr. Barbara McCrady, a national leader in the field of alcohol use disorders. Dr. Yusko completed his predoctoral internship training at Montefiore Medical Center, a part of Albert Einstein School of Medicine. Upon completing his doctoral studies, Dr. Yusko joined The Center for the Treatment and Study of Anxiety (CTSA) in the Perelman School of Medicine at the University of Pennsylvania. Dr. Yusko joined CTSA in order to coordinate a National Institute on Alcohol Abuse and Alcoholism funded clinical trial examining the sequential versus concurrent treatment of PTSD and alcohol dependence. Dr. Yusko is one of a handful of experts in the world on the concurrent treatment of PTSD and substance use disorders. Dr. Yusko is also a treating clinician for the National Football League for players that violate the league’s substances of abuse rules. He was trained in sports psychology by Dr. Charlie Maher, sports psychologist for the Cleveland Indians baseball organization, and continues to work with athletes of all levels. Dr. Yusko has presented on issues associated with OCD and PTSD at local and national professional organizations, he has appeared on television and been interviewed by multiple media outlets.
Dr. DiChiara is an expert in evidence-based treatments for trauma, anxiety, and obsessive-compulsive disorders. She joined the Center for Anxiety & Behavior Therapy in 2016 and currently serves as the Director of Education, overseeing the local and international training and dissemination of evidence-based treatments for Obsessive-Compulsive Disorder (OCD) and Posttraumatic Stress Disorder (PTSD). Dr. DiChiara has extensive experience with Prolonged Exposure (PE) therapy for PTSD, and is a certified PE therapist and PE supervisor by Dr. Edna Foa, the developer of PE. She is similarly experienced in Cognitive Processing Therapy (CPT) for PTSD, is a certified CPT therapist by the Veteran's Administration (VA), and is a co-investigator in ongoing CPT research at the VA in Philadelphia. Dr. DiChiara developed her expertise in Exposure and Response Prevention (ERP) for OCD during her training, research, and practice at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. She also specializes in cognitive-behavioral and exposure therapies for a broad range of anxiety disorders and obsessive-compulsive related disorders. In addition to her work at CABT, Dr. DiChiara served the veteran population through the VA in Philadelphia, both as a psychologist on the PTSD Clinical Team, as well as the Military Sexual Trauma (MST) Coordinator, the Evidence-Based Psychotherapy (EBP) Coordinator, and as Telemental Health Champion. She has been dedicated to the training and supervision of psychology trainees and licensed mental health professionals worldwide through individual and group supervision and consultation. She received a master’s degree in Counseling and Clinical Health Psychology, as well as her doctoral degree in Clinical Psychology, from the Philadelphia College of Osteopathic Medicine.
Steven D. Tsao, Ph.D.: Dr. Tsao is an expert in exposure and response prevention (EXRP) for obsessive compulsive disorder (OCD), having trained under several internationally-recognized leaders in the field including Dr. Edna Foa, Dr. Michael Jenike, and Dr. Dean McKay. Dr. Tsao has treated hundreds of clients with OCD, given regional and national presentations on OCD, and been featured on several popular media outlets including ABC’s 20/20, The Philadelphia Inquirer, WBUR, WGBH, Prevention Magazine, and Health.com. Dr. Tsao also has extensive experience with prolonged exposure (PE) therapy for posttraumtaic stress disorder (PTSD) and is a certified therapist and supervisor by Dr. Edna Foa, the developer of PE. He has helped train PE therapists both nationally and internationally and provided expert consultation on PE for grants funded by the Department of Defense. Dr. Tsao received his Ph.D. in clinical psychology from Fordham University where he was the recipient of Senior Teaching Fellowship and the Alumni Dissertation Fellowship. Dr. Tsao completed his predoctoral internship at Boston University School of Medicine/Boston VA Medical Center and his postdoctoral fellowship at Harvard Medical School/McLean Hospital. He worked at a residential eating disorders program where he developed and implemented a specialized track for patients with OCD and later, focused exclusively on severe and treatment-resistant OCD and OC-spectrum disorders during his years as a Staff Psychologist at the OCD Institute at McLean Hospital. After relocating to the Philadelphia area, Dr. Tsao joined the Center for the Treatment and Study of Anxiety at the University of Pennsylvania where he most recently served as the Clinic Director. Dr. Tsao also served as the Assistant Clinical Director at Rogers Behavioral Health-Philadelphia, where he helped launch and oversee the delivery of evidence-based treatment for anxiety and mood disorders in an intensive day treatment setting.
Dr. Murphy is a licensed clinical psychologist in private practice at the Center for Anxiety & Behavior Therapy. She has extensive training and experience in evidence-based treatments for OCD, PTSD, and anxiety-related disorders. Her specialty in this area developed during her doctoral training at Temple University where she trained in the Adult Anxiety Clinic of Temple (AACT), under the mentorship of Dr. Richard Heimberg, as well as in the Center for the Treatment and Study of Anxiety (CTSA) in the Perelman School of Medicine at the University of Pennsylvania under Dr. Edna Foa.She completed her pre-doctoral internship at VA Boston Healthcare System in the PTSD and Women’s Trauma Recovery clinics, during which time she became certified in Cognitive Processing Therapy (CPT) for PTSD. She is also a certified therapist in Prolonged Exposure (PE) for PTSD and Exposure and Response Prevention (ERP) for OCD through CTSA.
American Psychological Association (2017). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. https://www.apa.org/ptsd-guideline
Fina, B. A., Wright, E. C., Rauch, S. A., Norman, S. B., Acierno, R., Cuccurullo, L. A. J., ... & Foa, E. B. (2021). Conducting prolonged exposure for PTSD during the COVID-19 pandemic: considerations for treatment. Cognitive and behavioral practice, 28(4), 532-542.
Foa, E. B., Hembree, E. A., Rothbaum, B. O., & Rauch, S. A. M. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences: Therapist guide, 2nd ed. Oxford University Press. https://doi.org/10.1093/med-psych/9780190926939.001.0001
Foa, E. B., Bredemeier, K., Acierno, R., Rosenfield, D., Muzzy, W., Tuerk, P. W., ... & McLean, C. P. (2022). The efficacy of 90-min versus 60-min sessions of prolonged exposure for PTSD: A randomized controlled trial in active-duty military personnel. Journal of consulting and clinical psychology, 90(6), 503.
Schnurr, P. P., Chard, K. M., Ruzek, J. I., Chow, B. K., Resick, P. A., Foa, E. B., Marx, B. P., Friedman, M. J., Bovin, M. J., Caudle, K. L., Castillo, D., Curry, K. T., Hollifield, M., Huang, G. D., Chee, C. L., Astin, M. C., Dickstein, B., Renner, K., Clancy, C. P., Collie, C., … Shih, M. C. (2022). Comparison of Prolonged Exposure vs Cognitive Processing Therapy for Treatment of Posttraumatic Stress Disorder Among US Veterans: A Randomized Clinical Trial. JAMA network open, 5(1), e2136921. https://doi.org/10.1001/jamanetworkopen.2021.3692...
Schein, J., Houle, C., Urganus, A., Cloutier, M., Patterson-Lomba, O., Wang, Y., King, S., Levinson, W., Guérin, A., Lefebvre, P., & Davis, L. L. (2021). Prevalence of post-traumatic stress disorder in the United States: a systematic literature review. Current medical research and opinion, 37(12), 2151–2161. https://doi.org/10.1080/03007995.2021.1978417
Wells, S. Y., Morland, L. A., Wilhite, E. R., Grubbs, K. M., Rauch, S., Acierno, R., & McLean, C. P. (2020). Delivering Prolonged Exposure Therapy via Videoconferencing During the COVID-19 Pandemic: An Overview of the Research and Special Considerations for Providers. Journal of traumatic stress, 33(4), 380–390. https://doi.org/10.1002/jts.22573
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