Podcasts about behavioral practice

In this episode we look at neurospicy approved approaches to intervention for ARFID - Avoidant Restrictive Food Intake Disorder. For more info see: Białek-Dratwa, A., Szymańska, D., Grajek, M., Krupa-Kotara, K., Szczepańska, E., & Kowalski, O. (2022). ARFID—Strategies for dietary management in children. Nutrients, 14(9), 1739. https://doi.org/10.3390/nu14091739 Brown, M., & Hildebrandt, T. (2020). Parent-facilitated behavioral treatment for avoidant/restrictive food intake disorder: a case report. Cognitive and Behavioral Practice, 27(2), 231-251. https://doi.org/10.1016/j.cbpra.2019.05.002Fisher, M., Zimmerman, J., Bucher, C., & Yadlosky, L. (2023). ARFID at 10 years: A Review of Medical, Nutritional and Psychological Evaluation and Management. Current gastroenterology reports, 25(12), 421-429. https://doi.org/10.1007/s11894-023-00900-w

Guests: Professor Nikki Rickard is a professor of Wellbeing Science in the Faculty of Education, University of Melbourne, with a focus on digital mental health and emotional regulation. Dr David Bakkar is a clinical psychologist, researcher and the Founding Director of MoodMission. Description: In this episode, Professor Nikki Rickard and Dr David Backer explore the effects of digital technologies on student mental health. They discuss the risks and benefits of apps, gaming, and social media, emphasising the need for balance. With a focus on digital hygiene education and teacher training, they call for a collaborative approach, including young people, in shaping healthier digital environments for students. Helpful Links for Teachers and Parents: Mood Mission - an evidence-based app designed to empower you to overcome feelings of depression and anxiety by discovering new and better ways of coping MoodPrism - a mood tracking app with advanced data collection abilities Beacon (created for parents, easy to use, lots of info in a digestible format, recommends safe apps kids and family, developed by Telethon Kids Institute and Dolly's Dream)  MIND (M-Health Index and Navigation Database) – searchable data base with practitioner reviews  Mindtools.io – smaller database, includes ratings and reviews­­ Reachout/tools-and-apps Research: Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2018). A randomized controlled trial of three smartphone apps for enhancing public mental health. Behaviour Research and Therapy, 109, 76-83. https://doi.org/10.1016/j.brat.2018.08.003 Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2018). Development and Pilot Evaluation of Smartphone-Delivered Cognitive Behavior Therapy Strategies for Mood- and Anxiety-Related Problems: MoodMission. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2018.07.002 Bakker, D., & Rickard, N. (2017). Engagement in mobile phone app for self-monitoring of emotional wellbeing predicts changes in mental health: MoodPrism. Journal of Affective Disorders. Bakker, D., & Rickard, N. (2019). Engagement with a cognitive behavioural therapy mobile phone app predicts changes in mental health and wellbeing: MoodMission. Australian Psychologist, 54, 245-260. https://doi.org/10.1111/ap.12383

This episode we speak with Georgie Paulik White, an associate professor clinical psychology based in Perth who specialises in the treatment of voice hearing. Here's some papers of Georgie's work: Strachan, L. P., Paulik, G., Roberts, L., & McEvoy, P. M. (2023). Voice hearers' explanations of trauma-related voices and processes of change throughout imagery rescripting: A qualitative exploration. Psychology and Psychotherapy: Theory, Research and Practice, 96, 982–998. https://doi.org/10.1111/papt.12491Paulik, G., Maloney, G., Arntz, A., Bachrach, N., Koppeschaar, A., & McEvoy, P. (2021). Delivering Imagery Rescripting Via Telehealth: Clinical Concerns, Benefits, and Recommendations. Current Psychiatry Reports, 23(5):24. Http://doi.org/10.1007/s11920-021-01238-8 Paulik, G., Newman-Taylor, K., Steel, C., Arntz, A. (2020). Managing dissociation in imagery rescripting for voice hearers with trauma: Lessons from a case series. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2020.06.009Paulik, G., Steel, C., & Arntz, A. (2019). Imagery rescripting for the treatment of trauma in voice hearers: A case series. Behavioural and Cognitive Psychotherapy, 1-7. Http://doi.org/10.1017/S1352465819000237

Interviewer info Lyssa Rome is a speech-language pathologist in the San Francisco Bay Area. She is on staff at the Aphasia Center of California, where she facilitates groups for people with aphasia and their care partners. She owns an LPAA-focused private practice and specializes in working with people with aphasia, dysarthria, and other neurogenic conditions. She has worked in acute hospital, skilled nursing, and continuum of care settings. Prior to becoming an SLP, Lyssa was a public radio journalist, editor, and podcast producer. In this episode, Lyssa Rome interviews Kristin Schaffer Mendez about her work on counseling for people with primary progressive aphasia and their families.   Gap Areas This episode focuses on Gap Area #6, insufficient attention to depression and low mood for people with aphasia across the continuum of care.   Guest info   Dr. Kristin Schaffer Mendez is a speech-language pathologist and assistant professor at the University of St. Augustine in Austin, Texas. Prior to entering academia, she worked in several clinical settings, including inpatient rehabilitation, home health, and private practice. Dr. Mendez's experience as a clinician has inspired her research, which is centered upon examining and addressing psychosocial factors in acquired neurogenic communication disorders through patient-centered and care partner-inclusive treatment paradigms, including counseling, support groups, and the use of telerehabilitation platforms.   Listener Take-aways In today's episode you will: Learn about some of the psychosocial factors that people with primary progressive aphasia may face. Understand how speech-language pathologists can provide both educational and personal adjustment counseling for people with PPA. Describe a cognitive behavioral approach to personal adjustment counseling for people with PPA. Edited show notes Lyssa Rome Welcome to the Aphasia Access Aphasia Conversations podcast. I'm Lyssa Rome. I'm a speech language pathologist on staff at the Aphasia Center of California, and I see clients with aphasia and other neurogenic communication impairments in my LPAA-focused private practice. I'm also a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources.   I'm today's host for an episode that will feature Dr. Kristin Shaffer Mendez. Dr. Schaffer Mendez is a speech language pathologist and assistant professor at the University of St. Augustine in Austin, Texas. Prior to entering academia, she worked in several clinical settings, including inpatient rehabilitation, home health, and private practice.   Dr. Schaffer Mendez his experience as a clinician has inspired her research, which is focused on examining and addressing psychosocial factors in acquired neurogenic communication disorders through patient-centered and care partner-inclusive treatment paradigms, including counseling support groups, and the use of telerehabilitation platforms. In this episode, we'll be focusing on her research on counseling for people with primary progressive aphasia.   Dr. Kristin Shaffer Mendez, welcome to the Aphasia Access podcast. It's great to have you here.   Kristin Shaffer Mendez  Thank you so much for having me. It's wonderful to be here.   Lyssa Rome  So I wanted to get started by asking you a question that we often start with, which is whether you have any “aha” moments, so experiences that were pivotal for you in your work as a clinician or as a researcher?   Kristin Shaffer Mendez Yeah, you know, I think throughout my career, there have been a series of “aha” moments. If I think through my career, I've had several different stages. So initially working clinically, as a speech language pathologist, as I was partnering with patients with all different types of communication disorders and their families, I quickly realized that we weren't going to address the specific speech language goals if I didn't first acknowledge and check in with these individuals and get a sense of their general wellbeing, and a sense of if they were suffering, if they were grieving, if they were going through or processing something specific. I did have some didactic training as a student and counseling—not a lot—and I noticed when I would try to find evidence-based resources, I wasn't finding a lot of disorder-specific counseling information.   Fast forward a few years later, I was working as a research speech language pathologist at the Aphasia Research and Treatment Lab in Austin, Texas. And I was working primarily with individuals with PPA, and sometimes I would notice, and in the midst of a speech language treatment session, they would say something maybe under their breath, or maybe in frustration, like, “Oh, my dumb brain,” or “ I'm such an idiot.” And I was thinking, oh, goodness, if this is what's coming out of their mouth, I only wonder what what's happening behind the curtain. And if we were to look at the inner workings of their mind, what their self talk would look like, and how critical it might be. Then I was thinking, “Okay, now what what types of tools might I be able to provide for these individuals so that they can minimize that critical voice, and be more positive, be more adaptive.” And so that leads me to to my line of research.   Lyssa Rome And that also leads, I think, straight into the gap areas. So in this podcast, we've been highlighting those gap areas that were identified in the State of Aphasia Report by Nina Simmons Mackie, which was published in 2018. And I think, in this episode, what you've described so far, and what we're going to be talking about, really focuses in on gap area number six, which is insufficient attention to depression and low mood for people with aphasia across the continuum of care.   You described some of the kinds of self-talk that you were hearing people say. I'm wondering if you could tell us a little bit more about the kinds of psychosocial issues that people with primary progressive aphasia typically experience. And I guess I also wonder if this differs at all from what people with post-stroke aphasia experience?   Kristin Shaffer Mendez So individuals with primary progressive aphasia, the psychosocial factors that they're facing can range from feelings of low confidence, to social isolation, withdrawal, reduced participation in life activities to a diagnosis of mood and or anxiety disorder. So similar in many ways to what individuals with stroke-induced aphasia may be facing. But the difference here is that when we look at the prognosis and the trajectory of life for individuals with PPA, in contrast to individuals with stroke-induced aphasia, who can look at a future of improved communication functioning, or maybe an plateau in communication status, for individuals with primary progressive aphasia, their trajectory is that of decline. And so these individuals are at particular risk for facing these psychosocial threats and for these factors to change over time as well.   Lyssa Rome  So given some of these needs that you've just described and the risks that you've described, how can we as speech language pathologists provide counseling in our treatment for people with PPA?   Kristin Shaffer Mendez   Yeah, so there's there lots of different avenues that we can go down in terms of providing counseling, and really what I'll say is, this is going to be person-specific, and we'll tailor our counseling to the needs of an individual, session by session.   There are two main camps in terms of counseling within our field more broadly, in communication sciences and disorders. And this I follow from Dr. David Luterman, of course, one of the long-standing advocates and pioneers for the integration of counseling in our field. He cites two main forms of counseling. One is informational counseling, otherwise known as psychoeducation, or educational counseling. This is where we're providing disease-related information. And then there's personal adjustment counseling. This is going to be more emotion-centered. This is where we are directly addressing those thoughts, feelings, and behaviors underlying the diagnosis. So I really do believe that we can toggle between the two, and that our patients can and may benefit from both forms of counseling.   As a field, research has shown that speech language pathologists tend to feel more comfortable in providing the educational or the informational counseling relative to personal adjustment counseling, and they're also more likely to have been provided with didactic education in that information-centered counseling. But this is this is where my work comes in. And this is where I'm really motivated and invested in in making changes.   I'll talk some more about personal adjustment counseling. So this can range from micro-counseling skills, that are more general, and that are those soft skills that will help to foster a strong therapeutic alliance with our patients. So actively listening, listening without having an agenda of what we're going to say next, or thinking about the time and redirecting back to the speech language treatment task. Having moments of therapeutic silence, where again, we're not jumping in to fill empty space, but pausing a beat, and letting the patient continue to talk, or sit for a moment and process. Paying attention to our body language, the nonverbal way that we're communicating, leaning in, nodding, validating, affirming through the way that we are presenting. And then listening to what our patients are saying, and then thoughtfully summarizing. So letting our patients know that they are seen and heard and validated.   So those are, those are microcounseling approaches, and we can provide that anytime with any of our patients or our care partners. But then there are also specialized counseling approaches, and that's where my research really delves into further that are going to require more training and a specialized set of skills.   But really, in terms of our opportunities to provide counseling that can really be organically woven into our interactions from the very initial assessment throughout treatment, checking in with our patients at the beginning of sessions, at the end of sessions, and just being being aware, being observant, and noticing if there are moments when our patients seem to be undergoing a moment where they want to talk and where we might need to pause. And use that moment as as a teachable counseling opportunity. And not feel as though we need to stringently adhere to our speech language treatment sessions, or that we have to have some formal time in our sessions that's set aside for counseling.   Lyssa Rome    It almost sounds like you're describing approaching our treatment sessions with a counseling mindset that sort of is woven throughout. And you alluded to more specialized programs that we can also use. I know you've developed a cognitive behavioral therapy program for people with PPA, and I'm curious about that program, and about why you selected CBT. And maybe if you could define it a little bit?    Kristin Shaffer Mendez Absolutely. Yes. So cognitive behavioral therapy, or CBT, is one of the most widely researched and popular forms of psychotherapy. And it trains individuals to examine the connection amongst thoughts, feelings, and behaviors in order to identify, assess, and respond to maladaptive or unhelpful thoughts to optimize mood and behavior more broadly. And also CBT has been modified for individuals with a variety of diagnoses, including those with neurodegenerative disorders, such as Alzheimer's dementia. So when I was considering different psychotherapeutic approaches to adapt, it really seems like CBT could could be a great starting point. There's really limited research in general about adapting counseling approaches for this population.   So within this treatment program, there were both opportunities for dedicated counseling, and that counseling closely followed the traditional form of CBT. However, the sessions were oriented towards communication-centered challenges. And so within that, there's opportunities to check in on an individual's mood, and talk through a home practice exercises from the last week, check in on that, and talk through, “Okay, so what what types of communication difficulties came up this week? And then how we should we prioritize our time together? What do we need to work through?” Then working through specific challenges using aphasia-modified CBT approaches and, and then ending with a feedback component as well. So that's basically the gist of a traditional CBT approach, as a CBT session. So there was that component, but also, these sessions were aphasia-modified in that aphasia-friendly written and visual supports were provided as needed to ensure comprehension of these key CBT concepts that could be new new terminology for any individual who's entering a counseling dynamic. We just wanted to make sure that these individuals were provided with that support.   But so in addition to the more structured counseling, there were also opportunities organically within the speech-language portion of the treatment sessions, where if an individual was demonstrating frustration or emotional distress, or they were saying statements that were maladaptive in nature, then these were teachable counseling moments where CBT techniques were used within the session.   Lyssa Rome So can you tell us a little bit more about the clients goals and also about what you found?   Kristin Shaffer Mendez Yes, absolutely. So, first, I want to contextualize this research and mention that it is considered pilot research. So this is early phase, early stage research, where we are looking at answering the question: Is this novel intervention feasible and is it acceptable to patients? So we're obtaining information to see if patients were satisfied by the treatment, if this was feasible for a speech language pathologist to implement. What we're finding with a small cohort of individuals, so we've published one paper in the American Journal of Speech Language Pathology with our very first pilot participants, that was just a single case experimental design. We have nine additional individuals, three per PPA variant, who have participated in our second phase of pilot research and we have a manuscript in preparation for that stage. But what we're finding today is that this intervention is acceptable. And it's it's feasible. We were also really intentional in selecting and recruiting and enrolling individuals who did endorse that, in light of their PPA, of their communication challenges, that they were facing threats to their emotional well-being and that they were interested in participating in an intervention that included counseling.   So I think that's one important point to make when looking at the individuals who have undergone this intervention. Then with regard to goals, that was really individual for each person. It ranged from participating more in prayer groups to calling family members or friends instead of emailing them or not picking up the phone out of a sense of a fear of what would happen during the conversation. And yes, so these goals were all created collaboratively with with me as the clinician and with the participant, to really determine what was going to be meaningful and valuable in these individuals lives and what to work towards, collectively and in our time together.   Lyssa Rome That makes so much sense and I can imagine how addressing some of the psychosocial challenges, as you have described them, would would allow people to participate in the ways that you were just detailing.   I'm curious about.. you mentioned earlier on, that we don't always get a lot of training as SLPs in specific counseling approaches, and often are more comfortable, I think, with the educational counseling piece of things. So what kind of training would clinicians need—both future clinicians and current clinicians—in order to use this type of approach with our clients?   Kristin Shaffer Mendez Yeah, that's, that's a great question. And that's what we're continuing to examine, as we continue to move through our phases of research and so we've now completed pilot research and in the future we're looking at efficacy research and and later on down the line, I can say more generally, what I envision is that these types of counseling approaches and the evidence base wherein, that we discover, will then be incorporated more universally in graduate school education. But not so that, necessarily, students are going to graduate being able to implement and provide these specialized counseling approaches, but so that they have a sense of the theoretical underpinnings and the basic constructs of these approaches, and even thinking about patient candidacy—who might be appropriate and who might benefit from these approaches. But then in the future, I can see there being continuing education opportunities similar to LSVT, the Lee Silverman approach, where maybe it's a two-day training, for example, and intensive training where individuals are provided with a lot of hands-on experiential learning, so that they are equipped with those tools that they can then implement with patients.   Lyssa Rome  It brings to mind another question that I have, which I think is often on my mind anyway, when I think about counseling approaches, which is: We know that a lot as you've been describing, a lot of anxiety or mood related challenges are directly related to communication-specific disorders, in this case, PPA. So as we think about the needs, the psychosocial needs of people with PPA, given that so many of those needs are directly related to this progressive communication disorder, how do we know what's within our scope, and when we might consider referring to a mental health professional, for example, if the needs are greater than what we are able to meet on our own?   Kristin Schaffer Mendez That's a great question. And I do believe as speech language pathologists we're uniquely equipped to providing counseling. We are the communication experts. And we possess specialized skills in understanding individuals with communication impairments, and helping them express themselves. And this is something that a lot of licensed mental health professionals may not have the background training and experience in.   So with regards to determining when to potentially refer, so it's completely normal, we would argue, that individuals facing a neurogenic communication disorder, such as PPA will, will likely experience grief and loss and suffering as they're processing their diagnosis and navigating their days. But if we have a sense that they are presenting with a mood and or anxiety disorder that may be undiagnosed, then certainly the first step is to administer a mental health screening or an anxiety disorder screening, there are several available online that are free—the Personal Health Questionnaire, the Generalized Anxiety Disorder Scale, for instance. And then if the results do show that there is the potential presence of mood or anxiety disorder, then having having a conversation and coming from a place of care and concern and letting our patient know that we do have concerns that these individuals may be presenting with challenges that go beyond what we are able and equipped to provide. And then from there, looking into finding mental health professionals within the community, so that we can give that warm handoff and engage in interprofessional collaboration, if need be, if the mental health professionals maybe don't have experience in treating a client with PPA or aphasia, for example.   Lyssa Rome  And that's, I think, a perpetual challenge, right? It's finding those people who can support clients with mental health needs beyond what we're able to help them with—people who have those those kinds of communication skills and experience.   Kristin Schaffer Mendez And if I could just say one other thing as well. When I said a warm handoff, I don't necessarily mean that we stop treating our patient or that we don't continue to provide counseling. It's just we want to make sure that we're staying in our lane and providing counseling as it relates to the communication challenges. But not going beyond and stepping outside, especially if there's some type of mental health disorder that needs to be treated and managed more broadly.   Lyssa Rome That totally makes sense to me. It's working with the mental health counselor and not instead of.   So we know that people with PPA will continue to experience declines in their language functioning as their disease progresses. I'm wondering about how the counseling needs change over time and how we can meet their needs over time, as their disease progresses?   Kristin Shaffer Mendez   Yes, that's that's a great question. And that's really important too, is that we demonstrate flexibility, both in the counseling that we provide and in the speech language interventions we provide that's really yoked to and sensitive to a person's presentation.   So Dr. Ian Kneebone has published work pertaining to the provision of CBT for individuals who have survived a stroke. And I think that the principles that he discusses would be really applicable for individuals with PPA or other communication impairments as well, in that we must demonstrate flexibility, that is yoked to an individual's cognitive and communication presentation. And so if, for example, an individual, we'll say with PPA, is presenting with a more progressed clinical profile, then we would consider using language that's more concrete versus more abstract. We would also consider the provision of additional environmental supports, or multimodal communication, for example. And we would also want to include our care partners, if they are amenable to participating, as that can then help to ensure facilitation and implementation of the strategies outside of the therapy sessions.   Lyssa Rome    That brings me to another question, which is that you had mentioned earlier in a study that hasn't been published yet, you had people with each variant of PPA involved in your research. And I'm curious about sort of, in addition to thinking about disease progression, if there are also aspects of the variants that clinicians should be aware of in terms of their neuropsychological or behavioral features. And how would we want to think about sort of varying strategies based on those features? Or what to expect even based on those features?   Kristin Shaffer Mendez Absolutely, yes, that's a great question. And I think that being aware of the potential presence of these neuropsychiatric and behavioral features is important in general, because this can also influence the speech-language interventions we provide. There has been research that have has shown some general patterns that we might expect to see across the PPA variants. So for example, apathy has been found in some research studies, and then other other features that are more specific to a specific PPA variant. So, for example, with the semantic variant of PPA, we may see loss of empathy, mental rigidity, compulsive behaviors, disinhibition. With the logopenic variant, we may see agitation, anxiety, irritability, and with the nonfluent, agrammatic variant, we might also see irritability, and these individuals also often may present with depression. So you know, those are those are some some general trends that we've seen. But again, we have to look at each person as an individual.   But in terms of the counseling that we provide, yes, I think that if we have an individual that, for example, has the semantic variant of PPA, and they're presenting with mental rigidity, then thinking about what types of counseling may resonate with them, or what types of counseling may need to be provided to family members and care partners will be important to consider. So for example, with with cognitive behavioral therapy, which is really hinged upon cognitive restructuring, and taking thoughts that are unhelpful or maladaptive and monitoring and adjusting them so that they become more helpful and adaptive. If somebody presents with mental rigidity, then this type of intervention may be met with resistance.   That said, for the very small sample size of individuals I've worked with, that hasn't always necessarily been the case that that these individuals were not open to engaging in a counseling approach like this. Really small sample sizes—we really can't make any sweeping statements at this point in time. But I think that the key is that we are aware of these features, and that we are providing counseling and educational support and that we are flexible. And sometimes, an approach may not work in general, sometimes it may not work a specific day, and so this really requires trialing and error and experimentation and openness on the part of both the clinician and the client.   Lyssa Rome That leads me actually directly into a question that I wanted to ask as we wrap up. I think it is so important to meet people where they are on a specific day, and to be really aware of who they are and what they're experiencing as an individual—I think that's pretty core to many of our, all of our practices as speech language pathologists. I wanted to wrap up by taking a step back and asking you a little bit more about why this is so important. You touched on it in the beginning, but how does counseling support a life participation approach for our care for people with PPA?   Kristin Shaffer Mendez Yes, so the orientation with counseling is within the context of a whole person who lives a rich, dynamic life. And these individuals are unique, and they have different values and goals. And they do have a communication impairment, but that's just one part of their life, and doesn't define them as a person. And so within the work that we do, in providing counseling, we are honoring these individuals and and that full landscape of their life. And we're equipping them with skills so that they can cope with the challenges that they are facing with their communication challenges. So that they can continue to live a meaningful life that aligns with their values and their goals for their time on this earth.   Lyssa Rome What I'm moving and beautiful way to wrap this up. Dr. Kristin Shaffer Mendez, thank you so much for talking with us. I really appreciate it. It's been a pleasure.   Kristin Shaffer Mendez Oh, it's been a pleasure as well. Thank you so much for the opportunity.   Lyssa Rome Thanks also to our listeners. For the references and resources mentioned in today's show, please see our show notes. They're available on our website, www,aphasiaaccess.org. There, you can also become a member of our organization, browse our growing library of materials and find out at the Aphasia Access Academy. If you have an idea for a future podcast episode, email us at info@aphasiaaccess.org. Thanks again for your ongoing support of Aphasia Access. For Aphasia Access Conversations, I'm Lyssa Rome.       Twitter: @Schaffer_SLP References and Resources Twitter: @Schaffer_SLP   Luterman, D. (2020). On teaching counseling: Getting beyond informational counseling. American Journal of Speech-Language Pathology, 29(2), 903–908. https://doi.org/10.1044/2019_AJSLP-19-00013 Schaffer, K. M., Evans, W. S., Dutcher, C. D., Philburn, C., & Henry, M. L. (2021). Embedding aphasia-modified cognitive behavioral therapy in script training for primary progressive aphasia: A single-case pilot study. American Journal of Speech- Language Pathology, 30(5), 2053–2068. https://doi.org/10.1044/2021_AJSLP-20-00361 Kneebone, I. I. (2016a). A framework to support cognitive behavior therapy for emotional disorder after stroke. Cognitive and Behavioral Practice, 23(1), 99–109. http://doi.org/10.1016/j.cbpra.2015.02.001   Screening tools and citations: PHQ-9: K. Kroenke, R.L. Splitzer, J.B. Williams. “The PHQ-9: validity of a brief depression severity measure.” Journal of General Internal Medicine. 16(9): 606-13. September 2001. Retrieved July 9 2018. https://www.ncbi.nlm.nih.gov/pubmed/11556941.   GAD-7: Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of International Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092  

In Episode 77, Ben chats with Dr. Nissa Intarachote Van Etten. Nissa has worked tirelessly in the area of culturally responsive compassionate care. We dig into popular early intervention skills assessments like the ABLLS and the AFLS in terms of how we can adapt these tools to meet the individual needs of families. Nissa offers a great selection of literature to support cultural diversity in behavior analysis and incorporate it into the assessment process.   Continuing Education Units (CEUs): https://cbiconsultants.com/shop BACB: 1.5 Learning IBAO: 1.5 Cultural QABA: 1.5 DEI   Contact: Dr. Nissa Intarachote Van Etten https://centralreach.com/resources/the-behavioral-view/nissa-van-etten   Links: Dr. Intarachote Van Etten's Dissertation https://www.proquest.com/openview/91926304788a09999dc5c8a752e3a14a/1?pq-origsite=gscholar&cbl=18750&diss=y Combined ABLLS and AFLS https://assessments.centralreach.com/?fbclid=IwAR1PHQ-oeDdxlidfryBsJ3HBRxuXifjfcNidtaBJ31zmhJyRMNVIT8H-uo8 FREE CEU on Cultural Responsiveness in Assessment https://institute.centralreach.com/courses/assessment-mentoring-cohort-week-5-cultural-responsiveness-in-assessment?fbclid=IwAR2e-PM6EN-3q8ft7ZeeHRFi_dGRRDt81ZNZg1zUH_645vFIFyN0UyUCsjo The Behavioral View Podcast https://centralreachtbv.libsyn.com   Research Referenced: Biglan, A. and Hayes, S.C. (2015). Functional Contextualism and Contextual Behavioral Science. In The Wiley Handbook of Contextual Behavioral Science (eds R.D. Zettle, S.C. Hayes, D. Barnes-Holmes and A. Biglan). https://doi.org/10.1002/9781118489857.ch4 Conners, B.M., & Capell, S.T. (Eds.). (2020). Multiculturalism and Diversity in Applied Behavior Analysis: Bridging Theory and Application (1st ed.). Routledge. https://doi.org/10.4324/9780429263873 Fong, E. H., & Tanaka, S. (2013). Multicultural alliance of behavior analysis standards for cultural competence in behavior analysis. International Journal of Behavioral Consultation and Therapy, 8(2), 17–19. https://doi.org/10.1037/h0100970 Rohrer, J. L., Marshall, K. B., Suzio, C., & Weiss, M. J. (2021). Soft Skills: The Case for Compassionate Approaches or How Behavior Analysis Keeps Finding Its Heart. Behavior analysis in practice, 14(4), 1135–1143. https://doi.org/10.1007/s40617-021-00563-x Tanaka-Matsumi, J., Seiden, D. Y., & Lam, K. N. (1996). The Culturally Informed Functional Assessment (CIFA) Interview: A strategy for cross-cultural behavioral practice. Cognitive and Behavioral Practice, 3(2), 215–233. https://doi.org/10.1016/S1077-7229(96)80015-0 Taylor, B.A., LeBlanc, L.A. & Nosik, M.R. (2019). Compassionate Care in Behavior Analytic Treatment: Can Outcomes be Enhanced by Attending to Relationships with Caregivers?. Behav Analysis Practice, 12, 654–666. https://doi.org/10.1007/s40617-018-00289-3 Wright P. I. (2019). Cultural Humility in the Practice of Applied Behavior Analysis. Behavior analysis in practice, 12(4), 805–809. https://doi.org/10.1007/s40617-019-00343-8  

          Welcome to the Aphasia Access Aphasia Conversations Podcast. I'm Katie Strong and I'm a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources. I'm today's host for an episode that will feature Dr. Debra Meyerson and Steve Zuckerman. We'll be talking about their bike ride across the country, Stroke Across America, as well as the importance of identity and storytelling in a person's journey with aphasia. Before we get into the conversation, let me tell you a bit about our guests. Debra Meyerson was, until her stroke in 2010, a tenured professor of organizational behavior at Stanford University's School of Education.  Debra's most significant contribution from that period was Tempered Radicals:  How Everyday Leaders Inspire Change at Work (HBS Press, 2001). More recently, she authored  Identity Theft: Rediscovering Ourselves After Stroke (Andrews McMeel Publishing, 2019) and is co-founder and co-chair, with her husband Steve Zuckerman, of Stroke Onward, a nonprofit working to ensure stroke survivors and their supporters have the resources needed to rebuild identities and rewarding lives.    Steve Zuckerman is, along with Debra, co-founder and co-chair of Stroke Onward; he has been Debra's care partner since her stroke in 2010.  He has held leadership roles at Self-Help, a nationally recognized economic justice nonprofit, since 2006 and still serves part time as a Senior Advisor.  Before that, he was a managing director at a private equity firm.      In the summer of 2022, Debra and Steve led Stroke Across America – a 100-day cross country bike ride, from Oregon to Boston, to raise awareness for stroke, aphasia, and the importance of the emotional journey in recovery.   In this episode you will: be inspired learning about the bike ride, Stroke Across America, and its effort to raise awareness about the emotional journal of living with stroke and aphasia. learn about the power of story in reconstructing identity in people living with aphasia. become aware of Stroke Onward's mission to support the emotional journey of rebuilding identities and rewarding lives.   Katie: Welcome Debra and Steve. I'm so happy that you are here with me today. Debra: Thank you so much, Katie. Steve: It's great to be here. Katie: Well, I'm just so excited for our listeners to be able to hear about what you've got going on, and I'd love to start with what you were up to last summer. You did an amazing bike ride across the U.S. called Stroke Across America. Congratulations! I mean it was a big deal! Can you tell us about it? Debra: Sure. Stroke Across America was a bike ride across the US and Canada to raise awareness about stroke, brain injury and aphasia. We wanted to spotlight the emotional journey after stroke. How do we rebuild our identities and live meaningful lives? We rode 4,500 miles over 100 days, traveling from Oregon to Boston. There was a core team of six riders and others who joined us for portions of the ride. We became a family. I didn't expect that. Katie: That's fantastic. Tell me about who rode with you and became family. Steve: As Deb said, we had six core riders most of the way across the country. In addition to the two of us, a woman named Whitney Hardy, who's actually a close family friend. She's a young woman in her thirties who unfortunately suffered a traumatic brain injury about four years after she graduated from college and suffers no ongoing physical disabilities but has some cognitive issues and memory issues. She rode with us from the beginning to the end. Another stroke survivor was Michael Obel-Omia, who I know is an active participant in Aphasia Access. Michael is a stroke survivor who also lives with aphasia. He joined us about 15 days late because his son was graduating from college, so he joined us in Missoula, Montana. We had two wonderful summer interns, Emily and Alex. We met Emily through her grandfather, who was a stroke survivor and hoped to ride with us but didn't end up riding with us. Emily and Alex are both students at Washington University, St. Louis. They traded off, one rode and one worked, every other day. We can't say enough about the wonderful, not just competent and great work they did, but the energy they brought. They really helped make it special. I guess our seventh team member was our then roughly one-and-a-half-year-old golden doodle named Rusty who was along for the ride. Sometimes she rode in a trailer behind our bike and sometimes in one of the support vehicles. We had a group called Bike Eternity, a gentleman named Arlen Hall, who really arranged all the on-road logistics and the route. He and his team were just fabulous in terms of just making everything work. That was our family. Katie: It's quite a crew. Fantastic. I was wondering if you could tell us about a favorite experience from the ride. Debra: We hosted sixteen community events across the country. They brought together survivors, families, friends, stroke care professionals, and more. It was really inspiring to be with all these people. Building community and collaborating with others is the only path to real change. And you were at the Ann Arbor event? Katie: Absolutely. Yeah. My friend Becca and I came down to the Ann Arbor event. I think it was Dexter or something. Debra: Yeah Katie: Boy, did we show you how we can have rain in Michigan! Debra: I know. Oh, yeah. Katie: Oh, my goodness. Yeah, it was great. Even though we had rain, there was so much great energy around the event. I can feel what you're talking about. Steve: I think the events were kind of really the most powerful experience. But Deb, you were going to talk about one particular ride you loved. Debra: I loved riding past Cameron Pass in Colorado for 30 miles up and 40 miles down. Katie: Wow! Steve: Yeah, so just to add a little bit to that, because I think that one day of riding really, I mean, every day was fantastic. We just loved the riding. But this one stood out for all of us. It was from a town called Walden in Colorado, a bit east of Fort Collins to a campground called Stove Prairie Landing. The pass we rode over was about 10,276 feet, so we were up there. And as Deb said, we rode up for 30 Miles about 2000 feet, but then got to come down 4000 feet. The whole ride was in a canyon with dramatic mountains and a river that we happened to catch at the right time of the year because the snow was melting. So, it was just a rushing river where we got the sound, the sights, and sometimes the spray of rapids as we're cruising downhill. And then there was just a perfect riverside campground at the end. It was just sort of a magical day. Katie: Yeah. As you were describing it, I wanted to use the word magical! So, I agree. Yeah. Fantastic. I'm sure it wasn't all easy street. I was wondering if you could tell us one of the hardest things about planning such a big activity. I mean, this was a big event. You had several events along the way, but you know, tell us a little bit about the planning. Debra: Organizing this event was so hard, but it was so important and so impactful. We had sixteen events: three events before we started riding in Palo Alto, Bend, and Portland, eleven along the way, and two in Boston after we finished. We had so much to do after the rides and after dinner, such as PR, social media, Stroke Onward, events, and a documentary film. There was so much to do! We are really tired. Steve: Yeah, I think the biking certainly was a lot, but we weren't trying to ride fast. You know, one thing I say about biking is, if you want to ride long distances, you just have to ride long distances. You get used to it. So, that didn't really feel like a strain for us. And the organizing of the route, particularly with the help of Arlen, kind of got done ahead of time. It was a lot of work, but he's a pro and we put it together. But it was really, I guess we're “Type As” who can't get out of our own way. We built so much into the trip that it really was those evenings and our theoretical “rest days,” which were nonriding days. We renamed them “stress days.” We felt like we had to get everything done. So, you know, that was the hardest part of the trip. It was just how much we packed in. We jokingly say, but it may not be a joke, “that someday we want to ride across the country where we have absolutely nothing to do but ride across the country.” That way, we can enjoy the evenings and the rest days, do a little more touristing, and spend time meeting people along the way. Katie: Yeah, it was very focused. You were very intentional about gaining awareness and supporting community. And I'm sure that it sounds like there was lots to do beyond just pedaling. You mentioned earlier about a campground, but I'm curious, where did you stay along the way? Steve: Our main support vehicle was an RV, pulling a trailer with a lot of gear. We organized mostly around staying in campgrounds. Partly to keep the cost down and partly because we didn't want to have to stay rooted to where the hotels and motels were. And so, Deb and I got the privilege of sleeping in the RV. It was a small RV, but very comfortable. And the rest of the group was camping, so we had tents and cots, and all you would need for relatively comfortable camping. About one or two nights a week, we would end up staying in a motel, partly just to give the folks who are camping a little bit of a break. We actually came to enjoy the RV so much; we almost preferred it to the hotels. Then, one of the real highlights of the trip was we were able to see a lot of friends going across the country. Particularly in the cities where we held events. We almost, with maybe one exception, always had a rest day connected to the event. Probably at about half of those we ended up staying with friends. That was really special to be able to involve more people in our lives in the journey. Katie: Yeah, I was thinking when you were in Ann Arbor. Deb, you had a number of colleagues and friends that came to the Dexter event. Debra: Yes, in Detroit, two days later, we met with my middle school buddies, Debbie and Debbie and Debbie. Katie: I love that, fantastic! That's great! Well, riding across the country is a huge endeavor. What made you decide to do it? Debra: Steve. Steve: Deb would say, “Steve made me decide to do it.” Well, actually, it is true. I had a close friend from college who rode across the country right after we graduated from college. From that day, I always said, “that's something I want to do”. As I got older and older and hadn't done it, it was kind of rising to the top of the proverbial bucket list. But cycling really has been a huge part of our recovery from Deb's stroke. It has been the best way that we can continue to do a lot of the things we love - exercise, adventuring, seeing new places, and spending time with friends. We had never ridden a tandem before Deb's stroke, we rode individual bikes. It was a bit of a challenge for Deb to give up control, understandably. But when we saw the opportunity to do it with a purpose, that's what kind of got us really excited. We were just starting to build Stroke Onward, we wanted to build awareness for the importance of the emotional journey, and events create good opportunities to attract attention. So, what better thing than to do something you've always wanted to do and do it with a purpose? That's kind of how we got going. Katie: Well, it is inspirational, and I know a big focus of the trip was to raise awareness about stroke and aphasia. Debra, for people who might not know, could you share a little bit about your life story. Debra: Of course. My life story started earlier. In 2010, I was a professor at Stanford. I studied, taught, and wrote about feminism, diversity, and identity. Then, I had a severe stroke. For three years, I did therapy almost full time. I had to get my old life back, but I couldn't. My disabilities, especially aphasia, forced me to leave my job at Stanford. Giving up tenure was like a second punch in the gut. It was a huge trauma on top of my stroke trauma that started my identity crisis. Who am I now? Katie: So, Debra, I think that's what sparked you writing a book called Identity Theft. Can you tell us a little more about that? Debra: I had written two books before my stroke. I decided to write another book after my stroke, Identity Theft. Writing Identity Theft became my learning journey. It has helped me rebuild my identity. It took me five years, and I learned to accept lots of help. No one told me rebuilding identity is so central to recovery. I learned firsthand that it's so important. While researching Identity Theft, I learned that other survivors think so too. They had no advice and support for this.  Steve: Maybe I'll add. Deb mentioned doing research for Identity Theft. From the very beginning when Deb decided to write a book, she didn't just want to write about her story. She was an academic, she wanted to bring in other people's points of view. And so, Deb interviewed twenty-five other survivors and probably another thirty-five people who were care partners, friends, families, and professional caregivers. Kind of the idea being that she wanted to be able to write about a diversity of people and stroke experiences because that would make the book more relatable and more accessible to more people. And that really kind of gets at one of the things that really struck me about Deb writing Identity Theft. In many ways, the writing of the book really reflected her personal journey. That at the beginning, she was kind of writing it to prove she could, she didn't want to let go of that identity as an academic. But very quickly, she realized that the process of writing it, as Deb said, was kind of her journey. She was able to turn her knowledge of identity and the lens on herself to really help rebuild her identity and her life. But along the way, she realized, “Man, there are so many other people out there who aren't being told about this and need resources.” I say this all the time, choosing to write a book when you have aphasia has got to be one of the bravest decisions because it puts you face to face with your frustrating disability every day. And there were a few times when Deb came downstairs and said, “I'm done,” “I'm not finishing the book,” “This is too frustrating,” and “I can't stand it”. But it was that knowledge that it could help other people that got her to push through that frustration. And that gets to kind of one of the big themes of our work, which is about finding purpose and having purpose and how that's often our biggest motivator in life, what we can give. So, that's kind of a little bit of the history of the book. Katie: I appreciate you sharing that. And as you were both talking, you were talking about this journey. And you know, thinking about the story and the writing and the rewriting of your identity. It really isn't about the product, not necessarily the book, which maybe initially that's what you were interested in Deb. But really, the journey is where all the work and the reintegration of who you are and who you're going to be is. very powerful. Very powerful. It's such a great read. I've enjoyed the book very much. So, you have even moved forward beyond a book, and you've started a nonprofit. It's been established for a little bit now. Can you tell us about your nonprofit, Stroke Onward? Debra: Yes. I created it three, no, four years ago? Our mission is to ensure stroke survivors and their supporters have those tools necessary to rebuild identities and rewarding lives. The vision is a stroke system of care that fully supports every survivor's emotional journey and recovery. Steve: Maybe I'll add. I think, clearly, the issues of critical care and helping people survive a stroke, and then all the work on rehabilitation is critical. What we saw is that a lot of people don't get all their capabilities back. It's almost like, well, if recovery means rehabilitation, then does that mean everybody who doesn't fully recover their capabilities, has a failed recovery? And we were just unwilling to accept that. Recovery had to mean more than just capabilities. That's why we decided to really focus on that next step in recovery, which is the emotional journey. So, we really think about our work around three areas. One is raising awareness, just that this whole issue of the emotional journey is really important and doesn't get enough attention. Even if people realize it's important and say, “Well, gosh, where can I get help with this?” There aren't enough resources out there. You know, at the end of the day, as Deb said, “it's about system change.” That we would hope that 10 years from now, a person who suffers a stroke and their family enters a system that not only provides good critical care and points them in the direction of good rehab, but also creates a framework and resources for this part of recovery, for the emotional journey. I won't go through all the actual things we do. Hopefully, you'll be able to post the website and people can go and see more about stroke onward, www.strokeonward.org, easy to remember. Katie: Absolutely.  Debra: And there's the book discussion guides. Steve: Yeah, well, one of the places in that the speech therapy community has been so supportive and such a wonderful partner is with the creation of our book discussion guides. Our colleague, Jodi Kravitz, led the creation so that the book can be more accessible. There's a guide, you know, with the idea being a group of people with aphasia can read the book together and have a facilitated discussion with a guide. But also, we created separate guides for families, speech therapists, and other health care workers. Just again, the whole idea of trying to make the material accessible, digestible, and useful for people who are going through what we went through, which was the identity crisis and having to rebuild our lives. Katie: Absolutely, we use the resources for our local book club here at Central Michigan University and our Lansing Area Aphasia Support Group. The materials were great, but the book just brought forth so much rich discussion. Debra: Yeah. Katie: You know, not all of it was easy to read. There is some tough stuff; you don't skirt the issues. I think it really was a very meaningful experience for our members and the students that were a part of the group to be able to hear the journey, to hear what maybe hadn't been addressed, to hear how people had moved forward with things, and the areas where we really do need to be thinking more about as healthcare providers. It is important that we can support the whole person and not just fix the physical or the language. It's a whole emotional journey that you're moving forward with, which in Stroke Onward is really important. Well, as you know, a lot of my work is about the importance of storytelling. Deb, I was wondering if you could talk about how storytelling impacts your work. Maybe even share a few stories from your work. Debra: Sure. Storytelling is so important. We are always changing, and our stories evolve over time. Storytelling helps us navigate the emotional journey after a stroke. And in my book, Identity Theft, I share my story and the stories of others so that survivors don't feel alone. I would like to share one story that helped me recognize that life could be good after my stroke. Seven months after my stroke, my friend Ann invited me to her 50th birthday weekend in Palm Springs with tennis, hiking, talking, and biking. I said, “No...no, no, no.” I would need so much help, and most of all, I could barely talk at all. Conversations would be loud and lively. I would feel frustrated, jealous, and sad. Kim, my friend, said she would help with everything. She said she would help me have fun. She was there for me. I was nervous, but I decided to give it a try. At first, I was determined to be the “old Deb” at the party, but the frustrations were constant. Conversations were too fast, and the friends trying to help did not give me time to find the words. I was frustrated constantly, but I decided to enjoy myself anyway. The night of the birthday party, I danced a lot! Great music, so fun. I was not the “old Deb” anymore, I was a newer version of myself. I could spend my time with my friends dancing, laughing, and enjoying what is essential in my life: friends, community, and fun. It is so hard, but it is so important. Pushing myself to be social and telling stories about it has been so important to my recovery. Katie: Thanks for sharing, it's a great story. And well, I mean, you sound like you have fabulous friends, but it sounds like Kim really was one that stuck around and was willing to help you through some of that change. Steve: And if I can add one other story, which kind of gets to how Deb reclaimed some of her old identity. In this case, her identity as a mom, and Deb tells the story in the book. When our daughter Sarah, who at the time of Deb's stroke was 15 and was not a big dater in high school. But about a year and a half after Deb's stroke, she got invited to the prom her senior year and she started going out with this guy. And I kind of said to Deb, you know, you never had that mother daughter talk with Sarah. And Deb hadn't been too active in parenting for that year, year and a half because she was you know, fighting for her recovery. I said, “You know, maybe you should be the one, as her mom, to have the talk.” And so, we kind of told Sarah that we wanted to talk to her. We were all standing around the island in the kitchen. Sarah kind of knew something was coming but didn't quite know what. And you know Deb's speech was nothing like as good as it is now back then. You could just see the concentration on her face trying to figure out what she was going to say. And she kind of slowly said, “Boyfriend? Yes. Pregnant, no!” And that has been dubbed by all of our friends for the world's most efficient and effective mother daughter talk. It was funny; we all just burst out laughing. It was really a great kind of wake up for us that Deb could reclaim a lot of aspects of her identity, but she would just have to live them out differently. And that just because they had to be different didn't mean she couldn't live them out. That was one of our favorites. Katie: That is a good story. What I love about your sharing of the stories and where your work brings storytelling to life. One of the things that's happening in the literature that's coming into practice, particularly in the UK, and over in Australia, and hopefully maybe over here in the U.S. sometime, is this idea of step psychological care for aphasia. We'll put something in the show notes if listeners want to check this out a little bit more. This idea consists of different tiers to support mental health and particularly depression in people with stroke and aphasia. At that bottom tier, which is supposed to be accessible to every stroke survivor, one of the level one interventions is storytelling. So, it's that powerful, you know. It's not just fun to tell stories; it's very important to who we are as people and integrating our mental and emotional health into who we are. Steve: Deb, did you want to mention somebody you interviewed for the book that particularly talked about storytelling? Debra: Yes. Randy enjoys storytelling, and he is a stroke survivor from St. Louis who I interviewed for the book. Randy and his wife, Rose, started their own aphasia meetup group. Social connections were really important to him. Steve: And he talked a lot about how he gradually got more and more comfortable telling his story and how much that helped him. He spoke at our community event in St. Louis, and I thought he kind of stole the show when he said, “My stroke changed my life, but it will not hold me back.” I just kind of well up because that's what it's all about. And he said it so eloquently. Katie: Powerful, powerful. Well, Debra, can you tell us a little more about this idea of identity? Debra: Sure. Barbara Shadden and you, Katie Strong, I am so thankful. Identity is our narrative about ourselves over time. We have not one static identity, we have multiple identities. We are always changing. Relationships like friends, family, colleagues, and others are a big part of making who we are. Identity is a choice. Instead of asking, “Who am I now?” ask “Who do I want to be now?”. Katie: Powerful. I like it. Debra, could you talk about aphasia specifically, and how that plays into your views on identity and your recovery? Debra: Yeah. Communication is so central to everything we do and to my identity. Having communication challenges just makes everything harder. Steve: And I'll just add that sometimes in recovery, the physical stuff, you know, trying to walk better or get use of a right arm back, would tend to be the focus. But in reality, the aphasia is really the thing that has challenged her identity the most because it was the communication that forced her from a career she worked so hard to achieve. Also, friends and interaction are so central to who Deb is, and that has just gotten so much more challenging. So, not to diminish the impact of physical disabilities, but aphasia is big and really central to the recovery process. Katie: And I think you know, you mentioned Barbara Shadden earlier, but you know her idea of identity theft. We are the stories that we tell and when we have trouble with the that one thing that we use for story, that tool of language that is impaired, or changed or broken, or, you know, smaller, or however we want to view it with having aphasia, it really makes a significant impact on how you view yourself and how you can connect with other people that are important to you. Debra: Yeah. I agree completely, and I am so lucky to have friends and family to support me. Steve: And I think what you said, Katie, is so powerful, and it's why we talk a lot about how few people really know and understand what aphasia is. I think that's because there's this, whatever the opposite of a virtual cycle is, it's the doom loop cycle of aphasia. Aphasia impacts people's identity so that they don't want to speak if they have aphasia because it's not consistent with who they think they are. But because people don't want to speak with aphasia, nobody knows what it is. And so that, you know, makes it that much harder to speak with aphasia. And I think, you know, that gets to this notion of purpose sometimes driving people through what's hard and what's uncomfortable. That was true for Deb and played a role in making a decision that “Yeah, I really wish I could speak the same way I used to.” We've had so many arguments about Deb saying, “I was terrible," because she was evaluating her speaking performance against the way she would have done it before her stroke. Yet, Deb's been willing to push through that, to be out there. You know, that's part of our work of trying to network with other people and encourage people to get out there and tell their stories because that's the only way the world is going to learn. Katie: And that you're doing, which is so appreciated and inspirational. Steve, I know your work is as much about supporting care partners and other family members as it is about supporting survivors. Can you share a bit about your journey through all of this? Steve: Oof, it feels like that could be a podcast in and of itself. But you know, I think maybe the nugget that I'll share is it's pretty obvious that people who are close to somebody who has a stroke or aphasia, our lives are going to change. Things we used to do; we can't do. Help we didn't used to have to provide, we do have to provide. I think the real “aha” for me personally, was that I needed to focus on my identity change as well. It wasn't just Deb's identity. And for me personally, and I've talked to a lot of care partners about this, really embracing “care partner” as part of my identity. Not just something I had to do to support Deb, but part of who I now am. This was really important to me because that mind shift actually helped me resent some of the changes in my life less. It was just, like Deb said, our identities change, our lives change, this is just another change. If I can embrace that as a change in who I am, then those just become part of life. Not that they're not frustrating sometimes, but it's a lot better. So I think, you know, Sarah, our daughter, is when you talk about the impact on family. And again, this story is in the book as well. But again, not just the impact on her life, but the impact on her and who she was. About two years after Deb's stroke, she gave a talk to her whole school community. Sarah talked about the experience of watching her mom have a stroke, and how she wanted to be like her mother and be strong and tough it out. People were offering to help, and she said “No.” She was going to soccer practice, she was doing all of her assignments, and she was visiting Deb in the hospital; she was going to tough it out because she wanted to be strong. Then, she started to see Deb accept more help and she started wondering, well, maybe I can accept some help. She started to let her friends in and let herself be vulnerable. She kind of realized that real strength isn't about toughing it out, real strength is about being vulnerable and using your relationships. Sarah's an athlete, and she ended the talk with, “Even the world's strongest person needs a spotter.” I well up just telling the story. When she told it, we went through boxes of tissues. But that changed her as a person in ways that actually, you know, maybe she would have gotten there eventually, but not when she was 17. I think that's what we talked to a lot of the families and care partners about. Allow yourself to think about how this experience can change you as a person and try to embrace some of that change where you can. Katie: Powerful. Debra: And the families, Danny, Adam, and Sarah. The families are affected. Katie: Yeah. Aphasia just doesn't happen to the person who has it. Well, Deb, you mentioned that there is one part in your book that sums up a lot of what you were trying to share with other survivors and their families. Maybe we can end with you reading from that paragraph. Deb: Faced with a trauma like stroke, the opportunities for both challenge and growth are great. We can clarify what we value most in life, set goals that will help us meet them, and achieve repeated small wins in pursuit of them. In this way, we can achieve not just recovery, but satisfying growth and fundamental meanings in our lives. Katie: I love it. Yeah. Challenge and adversity, thinking forward into the future, and having goals, purpose, and meaning. It's what life is about. Well, this has just been a fabulous conversation. Thank you both for taking time to share with us a little bit about what you've been up to over the summer and inspire us with some of your stories. Debra: Thank you. Steve: Thank you. Well, that wraps up this episode. Thank you for listening. For references and resources mentioned in today's show, please see our show notes. They're available on our website, www.aphasiaaccess.org. There you can also become a member of our organization, browse our growing library of materials, and find out about the Aphasia Access Academy. If you have an idea for a future podcast episode, email us at info@aphasiaaccess.org. For Aphasia Access Conversations, I'm Katie Strong. Thanks again for your ongoing support of Aphasia Access.   Information about Stroke Onward   https://strokeonward.org/  Stroke Onward website Instagram Facebook Twitter YouTube Identity Theft Book Club Materials developed by Jodi Kravitz, Ellen Bernstein-Ellis, Liz Hoover and Stroke Onward https://strokeonward.org/bookguides/   Resources Related to Identity and Aphasia   Meyerson, D., E., (2003). Tempered Radicals: How Everyday Leaders Inspire Change at Work. Boston, MA: Harvard Business School Press. Meyerson, D. & Zuckerman, D. (2019). Identity theft: Rediscovering Ourselves After Stroke. Andrews McMeel Publishing. www.identitytheftbook.org Shadden, B. (2005). Aphasia as identity theft: Theory and practice. Aphasiology, 19(3-5), 211-223. https://doi.org/10.1080/02687930444000697 Strong, K., & Shadden, B. (2020). The power of story in identity renegotiation: Clinical approaches to supporting persons living with aphasia. Perspectives of the ASHA Special Interest Groups. https://doi.org/10.1044/2019_PERSP-19-00145 Listen to Episode #5 of Aphasia Access Conversations Podcast featuring a conversation between Katie Strong and Barbara Shadden about the important role story has in supporting identity in people who are impacted by living with aphasia. https://aphasiaaccess.libsyn.com/insights-and-aha-moments-about-aphasia-care-with-professor-emeriti-barbara-shadden   Resources Related to Stepped Psychological Care Listen to Episode #34 of Aphasia Access Conversations Podcast featuring a conversation between Jerry Hoepner and Ian Kneebone about stepped psychological care and other research related to supporting the emotional journey of living with stroke and aphasia. https://aphasiaaccess.libsyn.com/34-in-conversation-with-ian-keebone Kneebone, I. I. (2016). A framework to support Cognitive Behavior Therapy for emotional disorder after stroke. Cognitive and Behavioral Practice, 23(1), 99-109. https://doi.org/10.1016/j.cbpra.2015.02.001 Ryan, B., Worrall, L., Sekhon, J., Baker, C., Carragher, M., Bohan, J., Power, E., Rose, M., Simmons-Mackie, N., Togher, L., & Kneebone, I. (2020). Time to step up: A call for the speech pathology profession to utilise stepped psychological care for people with aphasia post stroke. In K. H. Meredith & G. N. Yeates (Eds.), Psychotherapy and aphasia: Interventions for emotional wellbeing and relationships (pp. 1-16). Routledge.    Acknowledgements – A special thank you to Amanda Zalucki and Emma Keilen from the Strong Story Lab at Central Michigan University for their assistance in the transcription of this episode. Cite as: Bertram, M., Isaksen, J., Toft, L. E., Olsen, A. M., & Breckling, M. (2021). Evaluering af projekt Forløb for borgere med afasi samt afrapportering af implementeringsopfølgningen KomTil – fra udvikling til drift. Unpublished report from University of Southern Denmark.

Join us for this invigorating talk about the selection and use of measurements in ABA practice. We discuss the philosophic thought and scientific process behind the BHCOE's whitepaper on this topic, as well as tips for behavior analysts who want to incorporate multiple levels of measurement into their work with clients. To earn CEUs for listening, click here, log in or sign up, pay the CEU fee, + take the attendance verification to generate your certificate! Don't forget to subscribe and follow and leave us a rating and review Show Notes References Behavioral Health Center of Excellence (Ed.). (2021). Selecting appropriate assessment instruments to measure treatment outcomes for individuals with autism spectrum disorder. Author. https://www.bhcoe.org/project/bhcoe-aba-outcomes-framework/  Johnson, K., & Street, E. M. (2004). The Morningside model of generative instruction. Cambridge Center for Behavioral Studies.   Johnson, K., & Street, E. M. (2013). Response to intervention and precision teaching: Creating synergy in the classroom. Guilford Press.  Kubina, R. M.(2019) The precision teaching implementation manual. Greatness Achieved Publishing Company.  Tanaka-Matsumi, J., Seiden, D. Y., & Lam, K. N. (1996). The culturally informed functional assessment (CIFA) interview: A strategy for cross-cultural behavioral practice. Cognitive and Behavioral Practice, 3(2), 215–233. https://doi.org/10.1016/S1077-7229(96)80015-0    Resources BHCOE's Assessment Workshop Series: https://learning.bhcoe.org/  CentralReach Assessment Mentoring Cohort Series: Assessment Cohort  Parenting Stress Index: https://www.parinc.com/products/pkey/333 

What Therapists Should Actually Do for Suicidal Clients: Assessment, safety planning, and least intrusive intervention Curt and Katie chat about suicide assessment, safety planning, and how to keep clients out of the hospital. We reviewed the Integrated Motivational Volitional Model for Suicide, we talked about what therapists should be assessing for in every session, what strong assessment looks like (and suggested suicide assessment protocols), and why the least restrictive environment is so important when you are designing interventions and safety planning. This is a continuing education podcourse. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about suicide assessment, safety planning, and intervention We continue our conversation on suicide, progressing from risk factors (from last week's episode) to how to assess and safety plan with the least intrusive interventions at the earliest stages.   Review of the Suicide Model: Integrated Motivational Volitional Model by O'Connor and Kirtley   Continued to review the IMV model (graphic in the show notes at mtsgpodcast.com) What should therapists assess for in every session, related to suicide? “When clinicians are burnt out, when we have caseloads that are too big, when we aren't taking care of ourselves, we tend to [think], “Okay, this client is at a six, they can live at a six for a while,” which is absolutely true. And if they can [live with this level of suicidality], and they have the good factors that allow them to live there – great. It's just how close are they to that 7, 8, 9?” – Curt Widhalm, LMFT Moderating motivational factors, which move clients from passive to more active suicidality (or the reverse) Looking at what is keeping someone from being at risk for suicide (protective factors) The importance of knowing our clients well before they move into the volitional phase Understanding the clinician factors and putting structure around assessment Assessment for Suicide “Assessment is intervention.” – Curt Widhalm, LMFT SAMHSA's GATE protocol Gather information using a structured assessment tool (Columbia Scale, LRAMP) Looking at intention, means, plan as well as risk and protective factors Moving into a safety plan The importance of recognizing the human during the assessment (versus focusing only on the protocol or your liability) Seeking supervision or consultation – don't do this alone The importance of using the least restrictive intervention for suicide “There is a rupture in the therapeutic relationship when you are sending your client or facilitating a hospitalization against their will. It can save their lives …but that may not always be the case.” – Katie Vernoy, LMFT The idea of “responsible” action The range of options for keeping a client safe Having a conversation with the client on how to avoid attempting suicide The potential impacts of hospitalization, including trauma The danger of hospitalizing someone who does not need this level of intervention Additional intervention between sessions The practicalities to set up your schedule and your practice to support your clients and your self Additional risk factors (transition phases between providers) Our Generous Sponsors for this episode of the Modern Therapist's Survival Guide: Thrizer Thrizer is a new modern billing platform for therapists that was built on the belief that therapy should be accessible AND clinicians should earn what they are worth. Their platform automatically gets clients reimbursed by their insurance after every session. Just by billing your clients through Thrizer, you can potentially save them hundreds every month, with no extra work on your end. Every time you bill a client through Thrizer, an insurance claim is automatically generated and sent directly to the client's insurance. From there, Thrizer provides concierge support to ensure clients get their reimbursement quickly, directly into their bank account. By eliminating reimbursement by check, confusion around benefits, and obscurity with reimbursement status, they allow your clients to focus on what actually matters rather than worrying about their money. It is very quick to get set up and it works great in completement with EHR systems. Their team is super helpful and responsive, and the founder is actually a long-time therapy client who grew frustrated with his reimbursement times The best part is you don't need to give up your rate. They charge a standard 3% payment processing fee! Thrizer lets you become more accessible while remaining in complete control of your practice. A better experience for your clients during therapy means higher retention. Money won't be the reason they quit on therapy. Sign up using bit.ly/moderntherapists if you want to test Thrizer completely risk free! Sign up for Thrizer with code 'moderntherapists' for 1 month of no credit card fees or payment processing fees! That's right - you will get one month of no payment processing fees, meaning you earn 100% of your cash rate during that time. Simplified SEO Consulting Have you spent countless hours trying to get your website just right and yet, it's not showing up on Google and it doesn't seem like anyone's able to find it? Simplified SEO Consulting has a unique solution. They've been training therapists to optimize their websites, so they show up better on Google for the past 4 years. But let's face it, with the busy schedules we all keep it can be hard to find the time to optimize your website even when you learn how. So, they are hosting a 16 day cruise in July 2023 going from LA to Hawaii and back. When you join them, you'll get intensive SEO education and coaching during the 10 days at sea. Most importantly, you'll have plenty of time to sit next to the pool and implement everything you've learned and then ask their team for feedback. Yes, it's the perfect excuse for a Hawaii vacation. But it's also a time to both learn about SEO and actually implement what you learn. The upcoming cruise is a unique opportunity to learn to optimize your own website, have time to practice what you learn and the ability to get feedback from leading SEO professionals in our field. To reserve your spot before it fills up, go to https://simplifiedseoconsulting.com/training-cruise-for-better-seo/    Receive Continuing Education for this Episode of the Modern Therapist's Survival Guide Hey modern therapists, we're so excited to offer the opportunity for 1 unit of continuing education for this podcast episode – Therapy Reimagined is bringing you the Modern Therapist Learning Community!  Once you've listened to this episode, to get CE credit you just need to go to moderntherapistcommunity.com/podcourse, register for your free profile, purchase this course, pass the post-test, and complete the evaluation! Once that's all completed - you'll get a CE certificate in your profile or you can download it for your records. For our current list of CE approvals, check out moderntherapistcommunity.com. You can find this full course (including handouts and resources) here: https://moderntherapistcommunity.com/podcourse/ Continuing Education Approvals: When we are airing this podcast episode, we have the following CE approval. Please check back as we add other approval bodies: Continuing Education Information CAMFT CEPA: Therapy Reimagined is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LPCCs, LCSWs, and LEPs (CAMFT CEPA provider #132270). Therapy Reimagined maintains responsibility for this program and its content. Courses meet the qualifications for the listed hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences. We are working on additional provider approvals, but solely are able to provide CAMFT CEs at this time. Please check with your licensing body to ensure that they will accept this as an equivalent learning credit. Resources for Modern Therapists mentioned in this Podcast Episode: We've pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! SAMHSA's TIP with the GATE Protocol COLUMBIA-SUICIDE SEVERITY RATING SCALE LINEHAN RISK ASSESSMENT AND MANAGEMENT PROTOCOL (LRAMP) References mentioned in this continuing education podcast: Carmel, A., Templeton, E., Sorenson, S. M., & Logvinenko, E. (2018). Using the Linehan Risk Assessment and Management Protocol with a chronically suicidal patient: A case report. Cognitive and Behavioral Practice, 25(4), 449-459. Goldman-Mellor S, Olfson M, Lidon-Moyano C, Schoenbaum M. Association of suicide and other mortality with emergency department presentation. JAMA Netw Open. 2019; 2(12):e1917571. Interian, A., Chesin, M., Kline, A., Miller, R., St. Hill, L., Latorre, M., ... & Stanley, B. (2018). Use of the Columbia-Suicide Severity Rating Scale (C-SSRS) to classify suicidal behaviors. Archives of suicide research, 22(2), 278-294. Linehan, M. M., Comtois, K. A., & Ward-Ciesielski, E. F. (2012). Assessing and managing risk with suicidal individuals. Cognitive and Behavioral Practice, 19(2), 218-232.   Pinals, D. A. (2019). Liability and patient suicide. Focus, 17(4), 349-354. Posner, K., Brent, D., Lucas, C., Gould, M., Stanley, B., Brown, G., ... & Mann, J. (2008). Columbia-suicide severity rating scale (C-SSRS). New York, NY: Columbia University Medical Center, 10. Substance Abuse and Mental Health Services Administration (US); (2009. Addressing Suicidal Thoughts And Behaviors in Substance Abuse Treatment [Internet]. Rockville (MD): (Treatment Improvement Protocol (TIP) Series, No. 50.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK64022/ *The full reference list can be found in the course on our learning platform.   Relevant Episodes of MTSG Podcast: Part 1: Risk Factors for Suicide: What therapists should know when treating teens and adults Rage and Client Self-Harm: An interview with Angela Caldwell Work Harder Than Your Clients   Who we are: Curt Widhalm, LMFT Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at: www.curtwidhalm.com Katie Vernoy, LMFT Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at: www.katievernoy.com A Quick Note: Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We're working on it. Our guests are also only speaking for themselves and have their own opinions. We aren't trying to take their voice, and no one speaks for us either. Mostly because they don't want to, but hey. Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement: Patreon Buy Me A Coffee Podcast Homepage Therapy Reimagined Homepage Facebook Twitter Instagram YouTube   Consultation services with Curt Widhalm or Katie Vernoy: The Fifty-Minute Hour Connect with the Modern Therapist Community: Our Facebook Group – The Modern Therapists Group   Modern Therapist's Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

Prolonged Exposure (PE) therapy is among the most effective, empirically supported treatments for posttrauamtic stress disorder.  Importantly, there is a growing literature around the neuroscience of PE which has important implications for the delivery of PE.  Drs. Sheila Rauch & Carmen McLean, join us for a review of some of the core themes in their book Retraining the Brain: Applied Neuroscience in Exposure Therapy for PTSD.  In this discussion we cover:   why Drs. Rauch & McLean wanted to write this booka brief overview of Prolonged Exposure (PE) therapycomparing & contrasting the theoretical mechanism underlying PE vs. research findingsconsidering the window of tolerance in PE through the lens of applied neuroscienceimpact of length of session on treatment from a brain lensthe relative (and interactive) impact of in vivo &. imaginal exposurewhether tailoring the clinical approach (e.g., PE vs CPT) is necessary depending on the client's presentation the potential utility for PE in addressing moral injurya consideration of whether PE could be experienced differently within the brain depending on the client's stance to the treatment i.e., high vs. low willingnessthe provision of PE through virtual platforms best practices around combining medications with PEPsychedelic/MDMA assisted psychotherapy - caveats and opportunitiesnovel augmentation methods for PE avoiding clinician burnout/vicarious traumatization in the context of PE Comments or feedback?  Email the show: oicbtpodcast@gmail.com.  If you are finding value in the podcast, please leave us a rating (or even better, a review!) at Apple podcasts. Thank you!  Sheila A.M. Rauch, Ph.D., ABPP, is Deputy Director of the Emory Healthcare Veterans Program and Director of Mental Health Research and Program Evaluation at the Atlanta VA Healthcare System. She has published scholarly articles, chapters, and books on anxiety disorders and posttraumatic stress disorder (PTSD) focusing on neurobiology and factors involved in the development, maintenance, and treatment of anxiety disorders, psychosocial factors in medical settings, and the relation between physical health and anxiety. She is an author of the second edition of the Prolonged Exposure manual and patient workbook as well as the PE for Intensive outpatient programs manuals.  She is a fellow of the Association of Behavioral and Cognitive Therapy (ABCT), was granted membership in the American College of Neuropsychopharmacology, and serves as a member of the Board of Directors and Scientific Council of the Anxiety and Depression Association of America.  Dr. Carmen McLean is a licensed clinical psychologist and researcher with the Dissemination and Training Division of the National Center for PTSD at the Palo Alto VA Health Care System and a Clinical Associate Professor (Affiliate) at the Department of Psychiatry and Behavioral Sciences at Stanford University. Her research examines ways to increase the reach of exposure therapy for PTSD by addressing implementation barriers and testing eHealth interventions. She is currently Co-PI of a DoD-funded study testing a tailored process improvement approach to increasing the use of evidence-based treatment for PTSD in the U.S. military health system. She is PI of a FEMA-funded trial testing an intensive, integrated treatment for PTSD, insomnia, and nightmares in firefighters.  Dr. McLean serves on several journal editorial boards and is currently Associate Editor of the Journal of Anxiety Disorders and Cognitive and Behavioral Practice. She has over 125 scholarly publications including a book on applied neuroscience in exposure therapy for PTSD co-authored with Dr. Sheila Rauch and published by APA.

While the general consensus in marketing today is to be data-driven in all that we do, there's a problem inherent in the data… …it's all about the past. But if we're trying to pitch a client on a marketing idea, that's about something in the future. We need to be able to predict consumer behavior, behavior that's often illogical and non-sensical. That's exactly what Rory Sutherland is going to talk to us about. Rory is the Vice Chairman of Ogilvy and the founder of their Behavioral Practice, an arm of the globally recognized ad agency that explores the psychology and ‘unseen opportunities' in consumer behaviour. Agency Accelerated host Stephanie Liu will be talking with Rory about: ✴️  why we can't be 100% data-driven 100% of the time ✴️  when agencies need to be completely illogical with clients ✴️  how to present, and sell, crazy ideas Think of it as your fun – and free! – consultation for your agency. Agency Accelerated Calendar - https://www.agorapulse.com/calendar How To Add Agency Revenue With Social Media Services - https://bit.ly/AddAgencyRevenue Agency Accelerated is the marketing agency podcast for you! Powered by Agorapulse. Hosted by Stephanie Liu. Produced by Mike Allton.

Jaké pohnutky vedou lidi k páchání sexuálního násilí? Jak do toho zasahuje osobnost? Jak do to zasahuje psychosexuální nevyzrálost? A kam se můžete obrátit, pokud máte potíže s ovládáním vlastní sexuality? Nejen tomu se věnuje tato epizoda. psychologickypodcast@gmail.com IG: @evapsycholog Zdroje: Parafilik.cz Násilná sexuální kriminalita – téma pro experty i veřejnost: http://bit.ly/krcze418 EUROPEAN INSTITUTE FOR GENDER EQUALITY. Sexism at work: how can we stop it? Handbook for the EU institutions and agencies [online]. LU: Publications Office, 2020. DOI: 10.2839/290396 Kolářová K., Pavlík P., Smetáčková I. (2009). Co je sexuální obtěžování a jak se mu bránit: příručka pro studující vysokých škol. Praha: Fakulta humanitních studií Univerzity Karlovy v Praze. ISBN 978-80-87398-10-4. Delcea C. (2008). Sexual Offenders–Psychological Approaches. In Proceedings Of The International Conference on Legal Medicine from Cluj, 3rd edition Vol 2, 9-20, 2020. https://www.researchgate.net/publication/347911195_Sexual_Offenders_-Psychological_Approaches/link/5fe7062ca6fdccdcb800bfdf/download Vella-Zarb R. A., Cohen J. N., McCabe R. E., Rowa K. (2017). Differentiating Sexual Thoughts in Obsessive-Compulsive Disorder From Paraphilias and Nonparaphilic Sexual Disorders. In Cognitive and Behavioral Practice. Volume 24, Issue 3. Pages 342-352, ISSN 1077-7229. https://doi.org/10.1016/j.cbpra.2016.06.007

https://www.linkedin.com/in/muhammad-tifak-877428168/ What do you want to change in the world, or impact by your own hands? --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/maker-nation/message Support this podcast: https://anchor.fm/maker-nation/support

Well, how nice of you to stop by the ol’ campfire. Pull up a log, why dontcha? We’re just swappin’ stories, stories about our favorite research topics. Care for a marshmallow with chocolate and graham crackers? You can make one of those, whaddya call ‘em. S’mores? Do you have a favorite research article to spin a yarn about? Something to keep the dark and cold away? Here, why don’t I start…   Articles discussed this episode: Bowman, L.G., Hardesty, S.L., Sigurdsson, S.O., McIvor, M., Orchowitz, P.M., Wagner, L.L., & Hagopian, L.P. (2019). Utilizing group-based contingencies to increase hand washing in a large human service setting. Behavior Analysis in Practice, 12, 600-611. doi: 10.1007/s40617-018-00328-z Sheply, C. & Grisham-Brown, J. (2019). Applied behavior analysis in early childhood education: An overview of policies, research, blended practices, and the curriculum framework. Behavior Analysis in Practice, 12, 235-246. doi: 10.1007/s40617-018-0236-x Ingul, J.M., Havik, T., & Heyne, D. (2019). Emerging school refusal: A school-based framework for identifying early signs and risk factors. Cognitive and Behavioral Practice, 26, 46-62. doi: 10.1016/j.cbpra.2018.03.005 If you're interested in ordering CEs for listening to this episode, click here to go to the store page. You'll need to enter your name, BCBA #, and the two episode secret code words to complete the purchase. Email us at abainsidetrack@gmail.com for further assistance.

In this conversation, we are joined by social justice behaviorist/ rockstar Megan Kirby. Megan gets candid about the history of behaviorism and its role in seeing equity in the world. She also discusses discomfort and pain associated with speaking up and out against injustice. We hope that you enjoy the conversation, as much as we enjoyed recording it. Megan Sullivan Kirby, co-founder of UncomfortableX, has over a decade of experience as a professional working in the fields of special education and outpatient ABA therapy services. She is presently a PhD student at the University of South Florida, studying narrative language interventions and the application of behavior analysis to issues related to social justice, education and human rights, part. Please follow us on FB @BeautifulHumansCast or IG @BeautifulHumansChange Follow Megan on FB and IG @UncomfortableBCBA and visit the website. Resources shared during this conversation: https://www.apa.org/monitor/features/king-challenge Goldiamond, I. (2002). Toward a constructional approach to social problems: ethical and constitutional issues raised by applied behavior analysis. Behavior and Social Issues, 11(2), 108–197. Mattaini, M. A. (1996). Envisioning cultural practices. The Behavior Analyst, 19(2), 257-272. Mattaini, M., & Aspholm, R. (2016). Contributions of a behavioral systems science to leadership for a new progressive movement. The Behavior Analyst, 39, 109-121. Metzl, J. M., Petty, J., & Olowojoba, O. V. (2018). Using a structural competency framework to teach structural racism in pre-health education. Social Science & Medicine, 199, 189-201. National Association of Social Workers. (2001). NASW standards for cultural competency in social work practice. Washington, DC: Author. Nevin, J. A. (2005). The inertia of affluence. Behavior and Social Issues, 14, 7–20. Rakos, R. (1983). Behavior analysis as a framework for a multidisciplinary approach to social change. Behaviorists for Social Action, 4(1), 8-16. Slocum, T. A., Detrich, R., Wilczynski, S. M., Spencer, T. D., Lewis, T., & Wolfe, K. (2014). The evidence-based practice of applied behavior analysis. The Behavior Analyst, 37(1), 41-56. Tanaka-Matsumi, J., Seiden, D. Y., & Lam, K. N. (1996). The Culturally Informed Functional Assessment (CIFA) interview: A strategy for cross- cultural behavioral practice. Cognitive and Behavioral Practice, 3, 215-233. Wyatt, W. J. (2000). Behavioral science in the crosshairs: The FBI File on B.F. Skinner. Behavior and Social Issues, 10, 101-109.

With so much holiday shopping to do, we’re keeping our topics fun and light this month. First up we’ll be talking with Dr. Adel Najdowski all about executive functioning. Seriously, all about it. Then we’ll dive into the old grab bag for three topics totally unrelated to each other. And, on December 25th, everybody gets a special bonus episode Christmas present! Articles for December 2019 Executive Functioning w/ Dr. Adel Najdowski Najdowski, A.C. (2017). Flexible and focused. San Diego, CA: Academic Press.   Grab Bag IX: Research S’Mores Bowman, L.G., Hardesty, S.L., Sigurdsson, S.O., McIvor, M., Orchowitz, P.M., Wagner, L.L., & Hagopian, L.P. (2019). Utilizing group-based contingencies to increase hand washing in a large human service setting. Behavior Analysis in Practice, 12, 600-611. doi: 10.1007/s40617-018-00328-z Sheply, C. & Grisham-Brown, J. (2019). Applied behavior analysis in early childhood education: An overview of policies, research, blended practices, and the curriculum framework. Behavior Analysis in Practice, 12, 235-246. doi: 10.1007/s40617-018-0236-x Ingul, J.M., Havik, T., & Heyne, D. (2019). Emerging school refusal: A school-based framework for identifying early signs and risk factors. Cognitive and Behavioral Practice, 26, 46-62. doi: 10.1016/j.cbpra.2018.03.005  

If you thought behavior assessment was hard, how much harder does it get when you add in the challenges of working with individuals from a different cultural background? We pose the question to special guest Dr. Liz Hughes-Fong and find out just how much more we have to learn about improving our cultural competence. Articles discussed this episode: Mandell, D.S. & Novak, M. (2005). The role of culture in families’ treatment decisions for children with autism spectrum disorders. Mental Retardation and Developmental Disabilities, 11, 110-115. doi:10.1002/mrdd.20061 Salend, S.J. & Taylor, L.S. (2002). Cultural perspectives: Missing pieces in the functional assessment process. Intervention in School and Clinic, 38, 104-112. doi: 10.1177/10534512020380020601 Tanaka-Matsumi, J., Seiden, D.Y., Lam, K.N. (1996). The culturally informed functional assessment (CIFA) interview: A strategy for cross-cultural behavioral practice. Cognitive and Behavioral Practice, 3, 215-233. doi: 10.1016/S1077-7229(96)80015-0 If you're interested in ordering CEs for listening to this episode, click here to go to the store page. You'll need to enter your name, BCBA #, and the two episode secret code words to complete the purchase. Email us at abainsidetrack@gmail.com for further assistance.

Pay attention, because we’re only telling you once. This November, we’re thankful for all of our awesome guests! First, Dr. Liz Hughes-Fong joins us to share all of her knowledge on developing cultural competence in the area of assessment. Then, Dr. Darren Sush calls in to judge our ethical answers to his ethical scenarios for almost 2 HOURS!! Finally, we take it easy with a review of research all about attending. What are you thankful for in behavior analysis? Articles for November 2019 Culturally Competent Assessment w/ Dr. Elizabeth Hughes-Fong Mandell, D.S. & Novak, M. (2005). The role of culture in families’ treatment decisions for children with autism spectrum disorders. Mental Retardation and Developmental Disabilities, 11, 110-115. doi:10.1002/mrdd.20061 Salend, S.J. & Taylor, L.S. (2002). Cultural perspectives: Missing pieces in the functional assessment process. Intervention in School and Clinic, 38, 104-112. doi: 10.1177/10534512020380020601 Tanaka-Matsumi, J., Seiden, D.Y., Lam, K.N. (1996). The culturally informed functional assessment (CIFA) interview: A strategy for cross-cultural behavioral practice. Cognitive and Behavioral Practice, 3, 215-233. doi: 10.1016/S1077-7229(96)80015-0   Ethics Mailbag w/ Dr. Darren Sush Sush, D.J. & Najdowski, A.C. (2019). A workbook of ethical case scenarios in applied behavior analysis. San Diego, CA: Academic Press.   Attending Broden, M., Bruce, C., Mitchell, M.A., Carter, V., & Hall, R.V. (1970). Effects of teacher attention on attending behavior of two boys at adjacent desks. Journal of Applied Behavior Analysis, 3, 205-211. doi: 10.1901/jaba.1970.3-199. Walpole, C.W., Roscoe, E.M., & Dube, W.V. (2007). Use of a differential observing response to expand restricted stimulus control. Journal of Applied Behavior Analysis, 40, 707-712. doi: 10.1901/jaba.2007.707-712 Holifield, C., Goodman, J., Hazelkorn, M., & Heflin, L.J. (2010). Using self-monitoring to increase attending to task and academic accuracy in children with autism. Focus on Autism and Other Developmental Disabilities, 25, 230-238. doi: 10.1177/1088357610380137  

Elizabeth Conti, Ph. D. Dr. Conti is staff Psychologist at the Michael E. DeBakey VA Medical Center, and Assistant Professor at Baylor College of Medicine. She is licensed psychologist in the state of Texas and the embedded psychologist in the Cancer Center and outpatient palliative care at the Houston VA. She is passionate about suicide prevention (particularly for older Veterans), late life mental health, and improving the well-being of medically ill populations. Her post-doctoral training included health services research and quality improvement in large healthcare systems.   References: U. S. Surgeon General Report;"2012 National Strategy for Suicide Prevention: Goals and Objectives for Action", PubMed, 2012. Stanley, B., et. al. "Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk", Cognitive and Behavioral Practice, May, 2012. Choy, C., "Suicide in palliative care setting", Annals of Palliative Medicine, Dec. 2017. Mezuk, B., PhD., et. al."Suicide Among Older Adults Living in or Transitioning to Residential Long-term Care, 2003 to 2015", JAMA, June, 2019. Miller, D, “When a Patient Dies by Suicide—The Physician’s Silent Sorrow”, NEJM, 2019 VA / Mental Illness Research, Education and Clinical Centers * Opinions expressed are solely the responsibility of Dr. Conti and do not necessarily represent the views of the Department of Veterans Affairs or the U.S. government.

Ah, the beautiful summer weather is finally upon us.  And what better time to talk about how hard it is for some students to attend school.  Is it bad teaching? Permissive parents? School anxiety? How the heck are we supposed to find out the function of school refusal behavior? Fortunately, Dr. Christopher Kearney and colleagues have been studying the assessment and treatment of school refusal behavior since the early 90's.  And your pals here at ABA Inside Track are here to disseminate their research with our brand of deep discussion and tangents about Jackie's history of poor attendance due to Sailor Moon. Articles for next episode: Kearney, C.A. & Silverman, W.K.  (1990).  A preliminary analysis of a functional model of assessment and treatment for school refusal behavior.  Behavior Modification, 14, 340-366.  doi: 10.1177/01454455900143007 Kearney, C.A., Pursell, C., & Alvarez, K.  (2001).  Treatment of school refusal behavior in children with mixed functional profiles.  Cognitive and Behavioral Practice, 8, 3-11.  doi: 10.1016/S1077-7229(01)80037-7 Kearney, C.A., Chapman, G., & Cook, L.C.  (2005).  Moving from assessment to treatment of school refusal behavior in youth.  INternational Journal of Behavioral Consultation and Therapy, 1, 46-51. Kearney, C.A.  (2008).  School absenteeism and school refusal behavior in youth: A contemporary review.  Clinical Psychology Review, 28, 451-471.  doi: 10.1016/j.cpr.2007.07.012 If you're interested in ordering CEs for listening to this episode, click here to go to the store page. You'll need to enter your name, BCBA #, and the two episode secret code words to complete the purchase. Email us at abainsidetrack@gmail.com for further assistance.

So, when does, "Mommy, I don't wanna go to school" move beyond a frustrating way to start the day to a serious problem? Next week, we're talking all about the phenomenon of school-refusal behavior and what you can do to help.  In the meantime we bring up some life-affirming quotes and get a glimpse at Rob's most prized possession. Articles for next episode: Kearney, C.A. & Silverman, W.K.  (1990).  A preliminary analysis of a functional model of assessment and treatment for school refusal behavior.  Behavior Modification, 14, 340-366.  doi: 10.1177/01454455900143007 Kearney, C.A., Pursell, C., & Alvarez, K.  (2001).  Treatment of school refusal behavior in children with mixed functional profiles.  Cognitive and Behavioral Practice, 8, 3-11.  doi: 10.1016/S1077-7229(01)80037-7 Kearney, C.A., Chapman, G., & Cook, L.C.  (2005).  Moving from assessment to treatment of school refusal behavior in youth.  INternational Journal of Behavioral Consultation and Therapy, 1, 46-51. Kearney, C.A.  (2008).  School absenteeism and school refusal behavior in youth: A contemporary review.  Clinical Psychology Review, 28, 451-471.  doi: 10.1016/j.cpr.2007.07.012

Do You Overeat, Chronically Diet, Or Feel Loss Of Control Over Food? Have You Lost Connection With Your Body's Internal Signals Of Hunger And Fullness? Do You Want To Eat As Naturally As You Did As A Child? Then Listen To This Episode With Dr. Linda Craighead About Appetite Awareness Training! Appetite Awareness Training (AAT) is a method of self monitoring developed by Dr. Linda Craighead to teach individuals how to tune into internal signals of hunger and fullness and use this heightened awareness to make conscious decisions about eating. Unlike dieting or monitoring calories/food, which increase preoccupation with food, AAT teaches you how to use your appetite cues and mindful eating to reestablish a normal relationship with food. About Linda Craighead: Dr. Linda Wilcoxon Craighead, Ph.D. is Professor of Psychology at Emory University in Atlanta and  has published extensively in the areas of eating disorders and weight concerns. In her book, The Appetite Awareness Workbook: How to listen to your body and overcome binge eating, overeating and preoccupation with food, Dr. Craighead guides you how to develop appetite awareness and mindful eating as a cognitive behavioral approach to eating and weight problems. Dr. Craighead teaches workshops, nationally and internationally, providing training in the application of appetite awareness to a range of problems related to eating and weight. Dr. Craighead is currently working on modifying and applying appetite awareness for children and adolescents, particularly as a tool to prevent or intervene early in the development of obesity. Dr. Craighead has extended her interest in mindfulness through collaboration with the Emory Cognitively-Based Compassion Training (CBCT).  AAT Resources to Explore: Appetite Awareness Workbook: How to listen to your body and overcome binge eating, overeating and preoccupation with food by Linda Craighead Appetite Monitoring Forms(click here to download) The Mindful Eating Coach App Link to the Healthy Eating and Weight Support Laboratory at Emory University  Resources for Disordered Eating and Body Image Treatment: National Association of Anorexia and Associated Disorders (ANAD)  offers free support groups in your area National Eating Disorders Association (NEDA) offers information about eating disorders, screening tools, and free help line Selected Appetite Awareness Publications: Allen, H. N., & Craighead, L. W. (1999) Appetite monitoring in the treatment of binge eating disorder. Behavior Therapy, 30, 253-272.  Brown, A. J., Smith, L. T., & Craighead, L. W. (2010). Appetite awareness as a mediator in an eating disorders prevention program. Eating Disorders:     The Journal of Treatment & Prevention, 18(4), 286-301. Craighead, L. W., & Allen, H. N. (1995). Appetite Awareness Training: A cognitive behavioral intervention for binge eating. Cognitive and Behavioral Practice, 2(2) 249-270.  Dicker, S. & Craighead, L. W. (2004). Appetite-focused cognitive behavioral therapy in the treatment of binge eating with purging. Cognitive and Behavioral Practice, 11(2), 213-221. Hill, D. M., Craighead, L. W., Safer,  D. L. (2011). Appetite-focused dialectical behavior therapy for the treatment of binge eating with purging: a preliminary trial. International Journal of Eating Disorders, 44(3), 249-261.

Episode # 45   Running Time: 48:52   Podcast relevance: Professionals   In this episode, R. Trent Codd, III, Ed.S. speaks with Thomas Ellis, PsyD about the treatment of suicidal patients. Some of the items discussed in this episode include: Whether no-suicide contracts are efficacious and whether they reduce liability Whether suicidality is best seen as a symptom of another illness Developments in the suicidology literature Our ability to predict suicide on an individual basis The important distinction between risk factors and warning signs Minimum competency standards for treating suicidal patients And, more!   Thomas Ellis, PsyD Bio   Thomas E. Ellis, PsyD, ABPP, is Senior Psychologist and past Director of Psychology at the Menninger Clinic, and Professor of Psychiatry in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston, Texas. He earned his bachelor’s degree at the University of Texas at Austin and his doctorate at Baylor University. He is a Fellow of the American Psychological Association (Clinical and Psychotherapy Divisions) and Diplomate of the American Board of Professional Psychology (Cognitive Behavior Therapy). He is a Founding Fellow of the Academy of Cognitive Therapy and Associate Fellow and Supervisor at the Albert Ellis Institute. His research and publications focus primarily on the problem of suicide, including cognitive characteristics of suicidal individuals and the effectiveness of suicide-specific therapeutic interventions. His books include Suicide Risk: Assessment and Response Guidelines (with W. Fremouw and M. dePerczel, 1990), Choosing to Live: How to Defeat Suicide through Cognitive Therapy (with C. Newman, 1996), and Cognition and Suicide: Theory, Research, and Practice (2006). He is the 2011 recipient of the Roger J. Tierney Award from the American Association of Suicidology, in recognition of distinguished contributions to the organization and the field of suicidology.   Episode-related links and resources   New Harbingerpublications has graciously offered a 35% discount to our colleagues and friends. If you'd like the discount simply follow this link: http://www.newharbinger.com/behavior-therapist   Ellis, T.E., & Newman, C.F. (1996). Choosing to Live: How to Defeat Suicide through Cognitive Therapy. Oakland, CA: New Harbinger. Ellis, T. E., & Rufino, K. A. (2015). A psychometric study of the Suicide Cognitions Scale with psychiatric inpatients. Psychological Assessment, 27(1), 82–89. doi:10.1037/pas0000028 Ellis, T. E., Rufino, K. A., Allen, J. G., Fowler, J. C., & Jobes, D. A. (2015). Impact of a suicide-specific intervention within inpatient psychiatric care: the collaborative assessment and management of suicidality. Suicide and Life-Threatening Behavior, 45(5), 556–566. doi:10.1111/sltb.12151 Jobes, D. A. (2016). Managing suicidal risk: A collaborative approach (2nd ed.). New York: Guilford. Joiner, T. E. J. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press. doi:10.1037/13748-018 May, A. M., & Klonsky, E. D. (2015). “Impulsive” Suicide Attempts: What Do We Really Mean? Personality Disorders: Theory, Research, and Treatment, (August). doi:10.1037/per0000160 Nadorff, M. R., Ellis, T. E., Allen, J. G., Winer, E. S., & Herrera, S. (2014). Presence and persistence of sleep-related symptoms and suicidal ideation in psychiatric inpatients. Crisis, 35(6), 398–405. doi:10.1027/0227-5910/a000279 Rudd, M. D., Berman, A. L., Joiner, T. E., Nock, M. K., Silverman, M. M., Mandrusiak, M., … Witte, T. (2006). Warning Signs for Suicide : Theory , Research , and Clinical Applications. Suicide and Life-Threatening Behavior, 36(3), 255–262. Shea, S. C. (2002). The Practical Art of Suicide Assessment: A guide for mental health professionals and substance abuse counselors. New York: Wiley. Stanley, B., & Brown, G. K. (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cognitive and Behavioral Practice, 19(2), 256–264. doi:10.1016/j.cbpra.2011.01.001 Wenzel, A., Brown, G. K., & Beck, A. T. (2009). Cognitive Therapy for Suicidal Patients: Scientific and Clinical Applications. New York: Guilford. www.suicidology.org www.afsp.org www.abct.org

School Struggles with Dr Richard Selznick  Dr. Elizabeth Gosch is Director of the MS Program in Counseling and Clinical Health Psychology and a core faculty member of the PsyD program in Clinical Psychology. A licensed clinical psychologist, she is board certified by the American Board of Clinical Child and Adolescent Psychology and serves as a diplomate examiner for this board. Dr. Gosch received her BA in 1987 from Grinnell College and her doctorate in clinical psychology in 1997 from Temple University. She employs an interactive teaching style, seeking to incorporate discussions of theoretical issues with real-world experience to help students master course material. She has taught doctoral courses in Behavior Therapy, Learning Theories, Practicum, and Child & Adolescent Therapy, among others. Dr. Gosch is a nationally recognized expert on clinical child psychology, anxiety disorders, and cognitive behavioral therapy (CBT) with youth. She has published on several topics but is best known for co-editing Anxiety Disorders: A Practioner's Guide to Comparative Treatments and articles on the treatment of internalizing disorders in children. Dr. Gosch is currently on the editorial board of Clinical Psychology: Science and Practice. She serves as a reviewer for the Journal of Consulting and Clinical Psychology, Cognitive and Behavioral Practice, and the Behavior Therapist. She has served on the Publications Committee of the Association for Behavioral and Cognitive Therapies. She was a co-principal investigator of an NIMH-funded study (NIMH-64484-01A1) of therapeutic process and alliance in the treatment of children with anxiety disorders.

This episode is primarily relevant to consumers. In this episode, R. Trent Codd, III, Ed.S., interviews Anne Marie Albano, PhD about Child Anxiety Disorders. In this episode they discuss: The major child and adolescent anxiety disorders  Whether parents should be concerned about shyness  Steps parents can take to prevent the onset of anxiety disorders in their children  Risk factors for the development of anxiety disorders  When parents should consider seeking professional help and where they might go to locate appropriate help ANNE MARIE ALBANO, PhD BIOGRAPHY Dr. Anne Marie Albano is associate professor of clinical psychology in psychiatry within the Division of Child and Adolescent Psychiatry at the Columbia University College of Physicians and Surgeons, and Director of the Columbia University Clinic for Anxiety and Related Disorders. Dr. Albano received her Ph.D. in clinical psychology from the University of Mississippi and completed a postdoctoral fellowship at the Phobia and Anxiety Disorders Clinic of the Center for Stress and Anxiety Disorders at SUNY-Albany, under the mentorship of David H. Barlow, Ph.D. She has held past positions as the Assistant Director of the SUNY Phobia Clinic, Assistant Professor of Psychology at the University of Louisville, and the Recanati Family Assistant Professor of Psychiatry at the New York University School of Medicine. Among her professional activities, Dr. Albano is past president of the Society for Clinical Child and Adolescent Psychology of the American Psychological Association and past president of the Association for Behavioral and Cognitive Therapies. She is Associate Editor of the Journal of Consulting and Clinical Psychology and a past Editor of the journal Cognitive and Behavioral Practice. Dr. Albano is a Founding Fellow of the Academy of Cognitive Therapy and a Beck Institute Scholar. She is board certified in Clinical Child and Adolescent Psychology. Dr. Albano devotes her career to the study of anxiety and mood disorders in children, adolescents, and young adults. She has been a principal investigator on two of the largest clinical studies funded by the National Institutes of Mental Health, examining treatments for children and adolescents with anxiety and depression. In the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS), 488 children ages 7 to 17 years with separation anxiety, social anxiety, and generalized anxiety disorders were treated with either cognitive behavioral therapy, medication, their combination, or pill placebo. Results indicated that all three active treatments were superior to pill placebo, with the combination treatment having the greatest advantage. These results tell us that anxiety in children and adolescents is highly treatable and that children do not need to suffer with these disorders. Dr. Albano is also a member of the Treatments for Adolescents with Depression Study (TADS) Team, having served as a contributor to the TADS Cognitive Behavioral Therapy manual and also as a principal investigator for this monumental research study. The TADS results found that for adolescents ages 12 to 17, the combination of cognitive behavioral therapy and medication results the greatest response rate in recovery from moderate to severe depression, followed by medication alone. Cognitive behavioral therapy alone takes several weeks longer to reach an effect, suggesting that use of CBT alone in milder cases is indicated. Overall, Dr. Albano's clinical and research careers have centered on developing and disseminating effective treatments for anxiety and depression in children, adolescents, and young adults.