High Risk Adolescents and their Families: Understanding and Treating Borderline Personality Disorder

High Risk Adolescents and their Families:
Understanding and Treating Borderline Personality Disorder

Friday, May 4, 2007
New Haven, Connecticut

Sponsored by:	The National Education Alliance for Borderline Personality Disorder in partnership with NARSADYale University School of Medicine, Department of PsychiatryYale-New Haven Psychiatric Hospital
Course Description	The complex challenges associated with BPD will be addressed in order to inform mental health professionals, families and consumers of the most current diagnostic and treatment options available, and other issues of current interest to those affected by this disorder.
Statement of Need	Diagnosis and treatment interventions of borderline personality disorder should begin as soon as possible Borderline Personality disorder (BPD) is a severe and generally chronic disorder and people who suffer from it are underserved. Friends and families are often bewildered and do not know how to help. Treatment programs for those with BPD need to be more readily available. Families need access to programs such as those already developed for several other mental illnesses. BPD presents patients, their families, clinicians, and researchers with multiple challenges.
Conference Objectives	This conference on borderline personality disorder will address the following objectives and at the end of the conference, attendees will be better able to identify, specify, and describe: Review family systems literature as it relates to high-risk Adolescents Review neurobiology as it relates to trauma and problems of emotion dysregulation Describe medication options for high-risk adolescents Present ‘Family Connections, a program for relatives Describe modified DBT as it is applied to suicidal and self-injurious adolescents and their families Present challenges and research regarding psychiatric hospitalizations, suicidal behavior, and self-injury

Conference Program

Moderator for the day:
Seth R. Axelrod, PhD
Assistant Professor of Psychiatry, Yale University School of Medicine
IOP DBT/DBT ‘S Team Leader, Yale-New Haven Psychiatric Hospital

Welcome & Opening Remarks

Perry D. Hoffman, PhD

President, National Education Alliance for Borderline Personality Disorder

Benjamin S. Bunney, MD

Charles B.G. Murphy Professor
Chairman, Department of Psychiatry
Yale University School of Medicine

BPD and the Family System

To describe Borderline Personality Disorder, including DSM-IV diagnosis.
To review family systems literature as it relates to personality pathology.
To introduce Integrative Relational Psychotherapy (IRP), a dynamic new approach to the diagnosis and treatment of personality disorders.

Jeffrey Magnavita, PhD
Connecticut Center for Short-Term Psychotherapy
Founder, Clinical and Administrative Director
Glastonbury Psychological Associates.

Neurobiology and Childhood Trauma

To understand the range of sequelae associated with a history of child abuse.
To understand the role of genetic and environmental modifiers of child outcome.

Joan Kaufman, PhD
Associate Professor of Psychiatry and Child Study Center Departments of Psychiatry and Child Study Center,
Yale University

Psychopharmacology of BPD

The different types of medication used in treating BPD.
The symptoms and behaviors of BPD that are the targets of biological treatments.
The most common negative effects of the frequently used medications for BPD.

Thomas H. McGlashan, MD
Professor, Department of Psychiatry Yale University School of Medicine

Family Support and Perspectives

Participants will be able to identify the impact of borderline personality disorder on family members.
Participants will identify the influence family members have on their relative with BPD.
Participants will understand the need for a family program.
Participants will identify a set of skills that target family member well being.

Perry D. Hoffman, PhD
President, National Education Alliance for Borderline Personality Disorder

DBT for Adolescents and Their Families

Participants will be able to discuss the basis of DBT and the rationale for adapting it for adolescents.
Participants will be able to discuss the Biosocial Theory of Borderline Personality Disorder.
Participants will be able to discuss the modes/functions, goals, and stages of DBT treatment.

Alec Miller, PsyD
Associate Professor, Director of Clinical Services,
PS8 School-Based Mental Health Program
Dept. of Psychiatry & Behavioral Sciences
Chief, Child and Adolescent Psychology
Albert Einstein College of Medicine/Montefiore Medical Center

Residential Adolescent DBT Modifications and Outcomes

To describe a DBT residential program for adolescents that provides DBT according to protocol, while also modifying certain features for strategic reasons.
To present some basic outcome data regarding psychiatric hospitalizations, suicidal behavior, self-injury, and post-discharge case disposition.
To discuss with other participants the unique challenges and joys of providing DBT with adolescent clients and their families.

Barent Walsh, PhD
Executive Director
The Bridge of Central Massachusetts, Inc., Worcester, MA
Jennifer Eaton, MS
Director of DBT Services
The Bridge of Central Massachusetts, Inc., Worcester, MA

Assessing Adolescent Suicide and Self-injurious Behavior

Present new information about the current prevalence and risk factors for self-injurious behaviors.
Provide detailed information about the evidence-based assessment of self-injurious behaviors among adolescents.
Describe how recent advances in the assessment of self-injurious behaviors might inform and improve clinical assessment, decision-making, and treatment.

Matthew K. Nock, PhD, MD
Assistant Professor of Psychology
Harvard University
Research Scientist
Judge Bake Children’s Center, Harvard University

Case Presentation with Expert Consultation

Describe a composite clinical case of an adolescent psychiatric inpatient presenting with high risk and disruptive behaviors.
Describe challenges that occur with treatment staff working with such patients and their families.
Facilitate consolidation of new learning from this conference through application to this clinical example.

Dwain Fehon, PsyD
Assistant Professor
Department of Psychiatry (Psychology),
Yale University School of Medicine
Co-Service Manager
Adolescent Inpatient and Outpatient Services,
Yale-New Haven Psychiatric Hospital

Alec Miller, PsyD
Matthew Nock, PhD
Barent Walsh, PhD
Jennifer Eaton, MS

High Risk Adolescents and their Families: Understanding and Treating Borderline Personality Disorder – Friday, May 4, 2007