Professional Development Fall Conference Recap

by Rosemarie Coratola, Psy.D., LMFT
CTAMFT Secretary & Professional Development Committee Chair (profdev@ctamft.org) 

“Wonderful and much-needed presentation.”
“Very informative and current.”
These are some of the comments from participants who attended CTAMFT’s Fall Specialty Conference last month.

The conference included two half-day workshops and was filled with lively and thought-provoking discussion. Ethics and Marriage and Family Therapy was presented by Sebastian Perumbilly, Ph.D., LMFT in the morning session. The afternoon workshop presenter, psychologist Danielle Moreggi, Ph.D., discussed the DSM-5 and changes made to the previous version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), DSM-IV-TR.

Ethics
Ethical guidelines for Marriage and Family Therapists are listed in the form of the American Association for Marriage and Family Therapy (AAMFT) “Code of Ethics,” and are guidelines. However, they do not identify exact methods to carry out each of the guidelines. Ethical principals are developed through thoughtful consideration about the needs of the client(s) and not those of the therapist. Dr. Perumbilly led the workshop participants in lively discussion about case vignettes and ethical dilemmas, which led many in attendance to rethink their current practice procedures.

Specific legal and ethical issues in MFT were reviewed including 1) identifying the client or patient, 2) clinical documentation, 3) confidentiality, 4) communicating with other systems, 5) working with minors, 6) reporting of child abuse and neglect, 7) intimate partner violence, 8) use of technology and 9) therapist values.

The group also discussed managing possible risks and dealing with complaints. Record keeping was cited as an important component in this. The group was encouraged to review the AAMFT Code of Ethics that can be found at AAMFT Code of Ethics . This important topic sparked much discussion and led to many more questions, along with requests for additional information from legal and state administrative authorities.

DSM-5 Overview
Dr. Moreggi reviewed changes to the DSM that will take effect beginning October 2014 with use of the DSM-5. This revised manual is structured into three sections. The first describes how to use the manual. The second is a listing and description of all of the disorders. And the third section identifies assessment measures and conditions for further study. The chapter order better reflects the lifespan, in comparison to the DSM-IV-TR version, and age-related factors were added to the criteria when appropriate.

Some of the highlighted changes include the Global Assessment of Functioning (GAF) of the DSM-III, DSM-IV and IV-TR was eliminated and replaced with a Severity Specifier (e.g., No Impairment, Mild Impairment, Moderate Impairment and Severe Impairment). The Not Otherwise Specified (NOS) specifier was replaced by two options – Other Specified Disorder (OSD) and Unspecified Disorder (USD). The first allows the clinician to indicate the specific reason that the presentation does not meet full criteria, and the second is used when the symptoms cause clinically significant distress or impairment but do not meet the full criteria, or number of symptoms, for the diagnostic class.

Mental Retardation was changed to Intellectual Disability, and is expected to change further to Intellectual Developmental Disorder in the next DSM iteration. Autism Spectrum Disorder (ASD) now includes Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder and Pervasive Developmental Disorder.

A new category of Trauma and Stressor-Related Disorders includes PTSD, Reactive Attachment Disorder (RAD), Disinhibited Social Engagement Disorder, Acute Stress Disorder and Adjustment Disorder. Many other changes were noted during this afternoon session.

Additional DSM-5 resources can be found at www.psych.org, www.DSM5.org, http://psychnews.psychiatryonline.org and www.psychiatry.org/dsm5.

CTAMFT wishes to thank the presenters for their engaging discussions throughout the day, the Courtyard Marriott Shelton and the CTAMFT Professional Development Committee; Normajean Cefarelli, Kristen Cocchia, Erin Cushing, Jessica Floyd, Beth Golden, Roxanne Pomeroy and Alycia Toohey. Of course, this conference could not have flowed smoothly without the hard work of the CTAMFT staff – Wendy Haggerty and Shannon Eterginio, thank you both!

For additional information, or if you are interested in joining the CTAMFT Ethics or Professional Development Committees, contact – ethics@ctamft.org or profdev@ctamft.org. We would love to hear from you.

Earn Up to 6 CEUs: CTAMFT Professional Development Workshop

Earn up to 6 CEUs – October 25, 2013

The CTAMFT Professional Development Committee is proud to bring to you our Fall Workshop this year. We, your friends and colleagues, have worked tirelessly to bring our membership something special, timely and ultimately useful for your continuing education demands. We have created a full-day or half-day – morning or afternoon option – to meet your busy scheduling needs.

Plus, a really cool part, is that lunch is included with every registration!

We, as always, have worked to keep the cost of this yearly offering as accessible as possible. A full day is $90 and EITHER half-day option is $75, and all registrations include lunch.

We hope to see our friends and colleagues on the 25th, to get caught up and to learn about the changes in the DSM-5 that affects every one of our jobs. Plus, if you attend the morning Ethics session, you can claim the credits towards a reduction in your annual Liability Insurance fees.

If you have any questions, please contact Shannon, our new Association Manager.

Date: Friday October 25, 2013

Time: 8:00 AM – 4:30 PM
Location: Shelton, CT – Courtyard Marriott
Cost: $90 full-day; $75 half-day
Schedule:
8:00 AM Registration and Continental Breakfast
*8:30 AM – 12:30 PM Ethics in the MFT Profession with Dr. Sebastian Perumbilly (3 CEUs)
12:30 PM – 1:30 PM Lunch
1:30 PM – 4:30 PM DSM-5 Overview with Dr. Danielle Moreggi (3 CEUs)

CLICK HERE TO REGISTER

Morning Session: “Ethics in the MFT Profession,” Dr. Sebastian Perumbilly

Seb Perumbilly is an assistant professor in the Department of Marriage and Family Therapy Program at Southern Connecticut State University. He is actively involved with academic, clinical and research communities both in the United States and in India. He teaches Research Methods, Ethics and core courses in the field of Marriage and Family Therapy (MFT). He holds an M.A. in Bioethics; and another M.A. and Ph.D. in Human Development and Family Studies with a focus in MFT from the University of Connecticut.

*This workshop is eligible towards liability insurance discount.

Afternoon Session: “DSM-5 Overview,” Dr. Danielle Moreggi

Dr. Danielle Moreggi has been providing psychological services since 1997 and has been a licensed Clinical Psychologist in the state of CT for over 10 years. With a private practice in Milford, CT, she provides psycho-therapy, assessment, and professional consultative services, with an expertise in college student mental health. She continues to serve as full-time faculty at the University of New Haven Psychology Department in West Haven, CT since 2001; and also as a professional trainer for the New England Institute of Addiction Studies (NEIAS) since 1998.

Professional Development Workshop – register TODAY

CTAMFT Professional Development Committee is proud to present to you our Fall Specialty Workshop. We have created an opportunity to meet CEU requirements in a format that also satisfies Ethics training requirements as well as a great opportunity to get comfortable with the new DSM-5 codes. Please choose either a full day, a morning half-day or an afternoon half-day.

This workshop is being held in upper Fairfield County to hopefully capture the largest portion of the state’s MFT professional population. We look forward to seeing you there!

“Ethics in the MFT Profession” with Dr. Sebastian Perumbilly – morning session
and/or
“DSM-5 Overview” with Dr. Danielle Moreggi – afternoon session

When: Friday, October 25, 2013

Location: Shelton Courtyard Marriott

Time: Full Day – 8:30 AM – 4:30 PM – 6 CEUs
AM Half Day – 8:30 AM – 1:00 PM – 3 CEUs
PM Half Day – Noon – 4:30 PM – 3 CEUs

Cost: Full Day – $90 (Early Bird of $75 through 9/30)
Half Day – $75 (Early Bird of $60 through 9/30)

Click here to REGISTER!

AM includes ethics presentation, breakfast & lunch; PM includes DSM-5 Overview, lunch and snack

Letter from the President – Innovations That Work

Innovations That Work

Dorothy Timmermann, LMFT, CTAMFT Board President

2012 CTAMFT Annual Conference

Each and every time I have the opportunity to spend quality time with colleagues in our field, I am always left feeling inspired and motivated by something that I’ve heard or more fully sensed from the interaction. Innovations that work are happening all around us. This was the motivation behind the addition of a Regional Networking Event aimed at Clinical Members as part of this year’s Annual Conference. We have invited colleagues from surrounding Divisions as well as AAMFT to share in this experience with us. Our hope is to create the space for the flow of ideas and shared connections to spark creativity and deepen our work. Consider joining us Thursday evening, April 19th from 6-8 at the Mystic Marriott. Tickets are $25 (drinks and light fare included) and must be reserved in advance. Booking is available online at ctamft.org as part of the conference registration.

Another opportunity provided by this year’s CTAMFT Annual Conference is the time for Self Care. Our venue is not only beautiful and serene, it has a wonderful spa! The Mystic Red Door Spa is extending a warm welcome to us with 20% off all services and complimentary makeup refreshers. Book some time before or after our events for yourself by calling 860-446-2500 and referencing the “warm welcome” special for our group. Discounted rooms are also being held under the group booking code: MNFMNFA ($149/night and available for both Thursday and Friday nights).

As a reminder, Early Pricing on Registration runs through March 1, 2012. If you have any questions at all about the conference please email us.

We hope that you will join us this year for what is sure to be a pleasurable and engaging time!

Saving Couples

Michelle Weiner-Davis

As a Marriage and Family Therapist, what’s your attitude about divorce? Do you take a values-free stance about change, facilitating movement in whatever direction your clients’ choose? Or do you have a default preference for the survival of the couple or for individual fulfillment? How do you define successful treatment for a couple in distress?

This year’s CTAMFT Annual Conference  will provide a forum to grapple with therapeutic assumptions about couple’s therapy. Keynote speaker Michelle Weiner-Davis, author of Divorce Busting, among other works, couldn’t be clearer about her therapeutic endgame. “I hate divorce,” she writes in her blog.  For Weiner-Davis, marriage is a highly valuable human endeavor, and she rarely feels hopeless about a couple’s chance for healing and growth.

From her wealth of experience, Weiner-Davis knows many couples can be saved, even those who present in a highly conflicted state after or during infidelity. Her program for helping couples is an optimistic approach that encourages highlighting small changes. She offers couples concrete strategies for creating change in their relationship. For instance, she coaches folks to try specific tactics, like: Do Something Different, Act As If, Easier Done Than Said, The Medium is In The Message, and Do a 180.

If you work with couples in your practice, this year’s conference will provide a rich opportunity to examine your own assumptions about preferred therapeutic outcome. And whatever you discover about yourself as a couple’s therapist, you will certainly increase your range of interventions in dealing with even the most conflicted couples.

DSM-Depression versus Bereavement
By Macdara MacColl, CTAMFT Editor

Another controversy erupted last month over a proposed revision to one of our field’s most important tomes, the Diagnostic and Statistical Manual (DSM). This time the debate swirls around bereavement and depression.

In the current DSM-IV-TR, the criteria for Major Depressive Episode include an exclusion for bereavement. A client, in other words, is not experiencing a depressive episode if his symptoms are better accounted for by loss-related bereavement (DSM-IV-TR, p. 356). Bereavement is listed as a separate V-code (V62.82). The assumption is that depression-like symptoms are sometimes normal after a significant loss and therefore not a disorder.

In the proposed fifth revision (DSM-5), slated for publication in May 2013, the bereavement exclusion is eliminated from Major Depressive Episode as is the V-code for bereavement. In other words, even if a client’s depressive symptoms are related to a recent loss, the clinician may still diagnose the individual as suffering from a major depressive episode.

But a new article authored by Jerome Wakefield and Michael First of NYU analyzes available studies and challenges the validity of removing the bereavement exception (BE). After examining the studies cited in support of removing the BE and subsequent literature, the authors concluded:

“The claimed evidence for the BE’s invalidity does not exist. The evidence in fact supports the BE’s validity and its retention in DSM-5 to prevent false positive diagnoses. We suggest some improvements to increase validity and mitigate risk of false negatives.”

The debate, as covered in outlets such as the New York Times  and The Daily Beast, raises fundamental questions about our field’s stance on “normal” versus “disordered” emotional behavior. Given that depression is often treated with medication, altering the diagnostic criteria for depression can be especially impactful for clinicians and patients alike.

Visit the DSM website  for more information about the manual, the proposed changes, and the process for offering input.

RELATED NEWS:
Antidepressant Use Linked to Increased Pulmonary Hypertension Risk in Infants
When It Comes To Depression, Serotonin Isn’t the Whole Story

 

BHP Update

Last month, we reported that CTBHP had announced that LMFTs could now receive reimbursement payment for Medicaid FFS clients under the age of 18. Subsequently, BHP sent out a retraction, stating “Changes to Business Effective 1/1/12, has been retracted. A revised Provider Alert on this topic will be forthcoming, therefore, disregard the previous transmittal.”

The original alert covered a range of changes to billing practices and procedures; LMFTs receiving expanded Medicaid reimbursement was one among many changes. The revised alert has not yet been distributed, and we don’t know at this point whether the expanded Medicaid reimbursement issue will be affected or not. We’ll keep you posted via e-News.

DSM-5 Discussion

As the 2013 anticipated release of the DSM-5 approaches, we find information coming to us that reflects the multiple dialogues that are occurring among the various mental health disciples. As your professional organization, we are sharing these views on our blog forum in order to expand this discussion with our membership. We hope that by doing so, we serve as a venue to “grow” our understanding of the complexity and concerns of this important professional issue.

Please watch this video and start the discussion here! What is the consensus of Connecticut MFTs regarding some of the DSM-5 philosophies?

We eagerly await the discussion.