PRESENT:
LEAP TRAINING
June 26, 2015
United Methodist Church
304 Egan Ave. N. Madison, SD
8:30- Registration 4 p.m.-Conclusion Lunch on your own
LEAP Institute
LEAP Practitioner Training
Listen * Empathize * Agree * Partner
The LEAP (Listen-Empathize-Agree-Partner) training programs teach participants a set of evidence-based practices to strengthen mutual respect and trust with the aim of developing effective partnerships among a range of persons in a variety of settings.
The LP-I training helps persons with mental illness that are either non-adherent, or only partially adherent, become fully engaged in treatment and services (medication, psychotherapy, psychosocial programs, peer-support, supervised housing, etc.) and to cooperate with persons who are trying to help them (with accepting treatment and services and/or in law enforcement/corrections settings, with de-escalation and following requests/directions).
***CEU’s approved by SD Boards of Licensed Professional Counselors, Social Workers, and Addiction Professionals.
The LEAP® Company
888.801.LEAP
631.980.7876
Educational Division
LEAP Institute
LEAP Practitioner Level-I (LP-I) Training
Objectives
The LEAP (Listen-Empathize-Agree-Partner) training programs teach participants a set of evidence-based practices to strengthen mutual respect and trust with the aim of developing effective partnerships among a range of persons in a variety of settings.
The LP-I training helps persons with mental illness that are either non-adherent, or only partially adherent, become fully engaged in treatment and services (medication, psychotherapy, psychosocial programs, peer-support, supervised housing, etc.) and to cooperate with persons who are trying to help them (with accepting treatment and services and/or in law enforcement/corrections settings, with de-escalation and following requests/directions).
The LP-I training is completed over the course of one day and involves didactic, experiential and role-play workshops. The workshops are unique in that the same evidence-based practices are taught to:
- MENTAL HEALTH PROVIDERS (psychiatrists, social workers, nurses, psychologists, case managers, crisis workers, consumer peer counselors, occupational therapists, etc.),
- FAMILY CAREGIVERS AND FRIENDS (of persons with mental illness), and
- LAW ENFORCEMENT, CORRECTIONS, JUDGES, AND ATTORNEYS (i.e., others who regularly work with persons with serious mental illnesses). * Poor and partial-adherence to treatment[1] presents staggering obstacles to recovery. It is associated with a poorer course of illness, increased involuntary hospitalizations, suicide, poorer subsequent response to treatment, estrangement and discord with caregivers and providers, criminal behavior, and failure to reach optimal levels of recovery. In light of the tremendous advances made in the treatment of schizophrenia and bipolar disorder, the tragedy of both untreated, and inadequately treated, mental illness is compounded. The urgency to implement strategies that optimize adherence and recovery has never been greater. Deficits in insight (a.k.a. “anosognosia” see DSM IV-TR, American Psychiatric Association Press, 2000, page 304) are very common. Not surprisingly, anosognosia[2] predicts poor and partial-adherence. After all, who would want to take medication for an illness they did not believe they had? Research shows that poor insight is among the top predictors of poor adherence, far more predictive than the person’s experience of side effects. Although recent innovations in drugs used to treat these disorders have addressed many of the limitations of traditional antipsychotic medications (e.g., severity of side effects, aspects of cognitive dysfunction), they still do not deal with the problem of poor adherence to treatment. Improving insight and adherence Because of poor insight into the illness and poor adherence to treatment many persons with schizophrenia and bipolar disorder exist at the margins of society and are unable, or oftentimes unwilling, to utilize available drug therapies and services. A set of communication and problem solving skills that can be used by mental health providers, care-givers and other stakeholders can be readily learned by participating in the LEAP training program. Below, we describe LEAP training in more detail.
- Summary
- Unfortunately, medications do not appear to impact significantly on level of insight, on the other hand, various forms of cognitive therapy and motivational interviewing have been found to improve adherence dramatically. More recently, studies testing the efficacy of such interventions using psychiatric nurses and family members in patents with schizophrenia suggest that extensive professional background is not needed to be effective. Indeed, training caregivers in the LEAP approach is especially effective as there are many more opportunities for interaction than is afforded providers. Furthermore, maladaptive communication patterns in the family are usually improved reducing expressed emotion, discord, and estrang
- Non-adherence rates in schizophrenia and bipolar disorder continue to hover around 50% while partial adherence rates are even higher (75%). Considering that millions of people either flat out refuse to participate in treatment, or if they do, practice only partial-adherence, the “real-world” effectiveness of both the older, and more promising newer treatments, is abysmal.
- Scope of the Problem
- * Although the general LP-I training is appropriate for this audience and we encourage it, a more tailored and in depth LEAP Level I program is available for law enforcement officers involved in Crisis Intervention Teams (CIT), corrections staff and hostage negotiators. It provides a strategy and specific tactical plan–communication tools–proven to quickly deescalate and obtain voluntary compliance.
LEAP LP-I Training.
The success of the LEAP approach rests on three pillars:
- Consumer Focus: Developing a new relationship with the mentally ill person that focuses exclusively on problems that the “patient” perceives.
- Treatment Team: Breaking down the barriers that keep the provider, family, other stakeholders (law enforcement, judges, attorneys), and consumer from functioning as an effective team.
- Common goals: Finding common ground between team members and the consumer, that can be shaped into goals that will be worked on together.
A brief description of the workshops for mental health providers and family caregivers[3] and a typical training day schedule is given below. Copies of the worksheets provided for workshops A and C follow this. The worksheets provide content, structure for the session, and specific exercises to be completed.
REGISTER HERE – pre-registration is required.
Please email: brolson@ccs-sd.org
Name:
Organization:
Address:
Phone:
and that you will be attending the 6/26/15 session in Madison.
Research on Poor Insight and Engagement in Treatment.
Dr. Xavier Amador (see: www.XavierAmador.com for biography) gives a presentation of the empirical research on the prevalence, etiology and treatment of both poor insight and poor adherence. Although largely didactic, the workshop is interactive in that participants are repeatedly queried to assess and highlight misconceptions they hold about the causes and treatment of poor insight and poor adherence. The evidence base supporting the LEAP technique is reviewed.
Learning Objectives: 1. Participants will learn that the top two predictors of good adherence to treatment are: good insight into how treatment can help one to achieve his/her goals; and a relationship with one person (either provider, friend or relative) in which the mentally ill person feels respected, trusts the other person, and this person is of the opinion that treatment would be beneficial. 2. Severe problems with insight into illness are most often a consequence of the disorder (schizophrenia or bipolar disorder) stemming from brain dysfunction (i.e., anosognosia) rather than defensiveness and/or personality factors. 3. Contrary to popular belief, treatment with antipsychotic medications and/or mood stabilizers rarely results in significant improvements in insight. 4. Motivational interviewing and cognitive therapy (e.g., LEAP) have demonstrated efficacy in improving specific aspects of poor insight associated with poor adherence. These psychological interventions have been shown to be effective whether delivered by providers (at all levels), family members, or consumer peer counselors/educators.
SUMMARY
The goal of the LP-I Training is to give attendees the knowledge and skills needed to build a collaborative relationship with the mentally ill person(s) they want to engage in treatment and services. A set of 7 evidence-based communication tools are taught and practiced during the training day.
Learning objectives: Participants will learn to 1) listen without opining, 2) to empathize without reality-testing, 3) identify areas of agreement, 4) apologize for words and actions that harmed the relationship, 5) respectfully delay giving contrary opinions, 6) give recommendations/opinions in a manner that increases trust and communicates respect, and 7) quickly form partnerships to achieve common goals that are linked to treatment and/or requests. Participants will learn that we rarely win on the strength of our arguments and instead, win on the strength of our relationships.
[1]From this point forward “poor adherence” refers to both complete noncompliance as well as partial compliance, unless otherwise stated.
[2] See also: http://www.xavieramador.com/wordpress/wp-content/uploads/schiz-digest-winter-07.pdf
[3] Description of trainings for law enforcement, judges and attorneys are available upon request at www.LEAPInstitute.org
Sponsorsed by and and
To print off a flier and post – click here: LEAP madison pdf
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