N. CAL. EMDR Regional Meeting
April 12, 2008 at Oakland's Preservation Park
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Attachment theory and case formulation in the EMDR approach to psychotherapy
This 6-hour workshop provides a model for EMDR case conceptualization integrating attachment theory with the adaptive information-processing model. Participants will gain practical knowledge of when and when not to extend the skills building phase of treatment and how to use RDI or PAT interventions when appropriate.
Attachment theory describes how early dyadic interactions in the first few months of life build essential memory networks shaping each persons working model of self in relationship. These early memory networks shape not only essential perceptions, attitudes and behaviors, but also the organization of the information processing system itself. As a result, attachment theory offers an essential framework for case conceptualization in the EMDR approach to psychotherapy.
This program integrates core concepts from attachment theory with the Adaptive Information Processing model. Clinicians will discover how attachment style can help predict patterns of response to standard EMDR reprocessing and to alternate EMDR interventions that may be needed in the skills building phase such as Resource Development and Installation (RDI) and Positive Affect Tolerance (PAT). Clinicians will learn essential guidelines and review clinical vignettes to be able to decide when patients need (and do not need) these special interventions in the skills building phase of treatment. In addition clinicians will learn practical ways to simplify their effective use of skills building interventions with RDI and PAT to help their patients achieve their treatment goals.
Program Level: Intermediate.
1. Participants will develop a concise framework for recognizing patients attachment style.
2. Participants will develop case conceptualizations and treatment plans that build on patients attachment style.
3. Participants will have clear guidelines for selecting appropriate EMDR interventions in the skills building and reprocessing phases of treatment.
4. Participants will be able to decide when, when not and how to use RDI to address maladaptive tension reduction behaviors when working with borderline spectrum cases where there are symptoms of complex PTSD.
5. Participants will recognize cases where an alternate skills building procedure known as the Positive Affect Tolerance protocol may be needed to help patients learn to tolerate and integrate shared positive affect into their sense of self to foster greater resilience and to tolerate connection with supportive others.
6. Participants will be able to describe a psycho-educational framework for introducing PAT to their patients.
7. Participants will be able to apply the PAT protocol in individual, couple and family sessions.
8. Participants will be able to use feedback from patient written log entries to assess their responses to RDI, PAT and standard EMDR reprocessing.
9:00 9:45 Overview of Attachment Theory research with children and adults
9:45 10:15 Simplified models for clinical assessment of adult attachment style
10:15 10:30 break
10:30 11:15 An overview of case formulation based on history taking and adult attachment style
11:15 11:45 Case vignettes for small group discussion of case formulation and assessment of adult attachment style
11:45 12:15 Three examples of case formulation in cases of complex PTSD with different attachment style followed by large group discussion.
12:15 1:30 Lunch
1:30 2:15 Selection criteria and case examples of when and when not to use RDI
2:15 3:00 Simplified steps for how to use RDI with clinical examples of appropriate use and results.
3:00 3:15 Break
3:15 4:00 Selection criteria and case examples of when to use the Positive Affect Tolerance (PAT) Protocol in individual, couples and families.
4:00 4:45 PM How to offer psycho-education to prepare patients for PAT. How to teach the basic 3-step PAT behavioral exercise for adults and children. How to monitor results of the behavioral exercise with log reports. How to reprocess current stimuli with the PAT protocol to increase tolerance and integration of shared positive affect.
Andrew M. Leeds, Ph.D.
Leeds, Ph.D. is a licensed Psychologist with 33 years of private practice psychotherapy
experience. He practices in
received initial EMDR training in 1991. As an EMDR Institute Senior Trainer he has
conducted EMDR training for 13,000 clinicians at 135 training programs in the
He has presented papers on EMDR for regional, national and international conferences. He is the author of book chapters and a research article on EMDR. From 1996 through 2000 he served as moderator of the EMDR Institute electronic discussion list on the Internet. He served 3 years as a member of the Board of Directors of EMDRIA from 2003-2005. He presently serves as a member of the Editorial Advisory Board of the Journal of EMDR Practice and Research.
Dr. Leeds contributed to the evolution of EMDR by articulating, publishing and teaching the EMDR procedure he named Resource Development and Installation (RDI). In 1999 he received the EMDRIA award for creative innovation in the development of EMDR and the EMDR Institute Ronald A. Martinez, Ph.D. Memorial Award.
Korn, D. L., &
Leeds, A. M. (2001) Principles and procedures for enhancing current functioning in Complex Posttraumatic Stress Disorder with EMDR Resource Development and Installation. The EMDRIA Newsletter Special Edition, December 2001, pp 4-11.