Clinical Grand Rounds
Our monthly program brings together recognized experts in the mental health and addiction fields to share insights and best practices from their research and clinical experience.
The series includes both virtual and in-person events, and runs every third Thursday of the month from 12-1:30pm. These presentations are free and open to the public ($10 if requiring CEUs, free CEUs for Root staff). If interested, please register below for each session.
FEATURED SPEAKER
Marilyn Finkelstein, LCSW
Program Manager of Addiction Services at The Institute of Living
“An Introduction to Understanding Motivational Interviewing and How it is Useful in Working with Patients Who Have Substance Use Disorders”
FEBRUARY 16, 2023 · 12:00pm – 1:30pm · ONLINE
Synopsis & objectives:
- What is MI?
- MI is about change and how to help facilitate and NOT DIRECT the change
- The work is collaborative to help increase a person’s motivation for change
- Let’s talk about the foundation:
- Ambivalence around change is common
- Change is not linear
- Readiness to change is not fixed
- Pay close attention to readiness so you can adjust your sessions/engagement with the patient/client
- Fixing patients? No way! Practitioners have to avoid the ‘righting reflex” where you want to fix the problems the patients are presenting because that actually reducing their motivation for change and autonomy (this also doesn’t take into account a patient’s ambivalence)
- Addiction Stages of Change:
- Pre-contemplation, contemplation, preparation, action and maintenance
July 21, 2022
Over two decades ago, we learned that the therapeutic relationship is the largest factor in client change and goal attainment regardless of the technique employed by the professional, yet we often pay less attention to it. Given the power of this relationship, ethical guidelines must be employed to not only create positive change but to protect the vulnerable client from any unintended harm. This presentation will expose attendees to the application of our common ethical principles to the relationship and create an opportunity for clinician self-reflection on the nature in which we relate to those we serve.
Jeffrey Quamme, MS, AADC, CCS
Executive Director, Connecticut Certification Board, Inc.
August 18, 2022
American prisons have become the de facto modern-day asylums. Large proportions of inmates suffer from significant psychiatric and substance related disorders. The laws regulating the practice of prison medicine are guided by both statutes as well as case law precedent. The lecture will provide an overview of the history of prison psychiatry, its legal foundations, and the practical experience of the presenter.
Sohrab Zahedi, MD
Psychiatrist, Centurion Health / Assistant Clinical Professor, UCONN Department of Psychiatry
September 22, 2022
International suicide rates have continued to rise for nearly two decades. Even though the U.S. Centers for Disease Control designated suicide a national epidemic in 2013, we continue to see an unrelenting increase in self-inflicted deaths. Entering into conversations about suicidal thoughts, and even using the word suicide in our clinical interviews, is often met by clinicians with fear and trepidation. This presentation will provide participants with an overview of contemporary risk factors for suicide, and techniques to decrease the clinicians’ fear of engaging with individuals who experience suicidal ideation.
Kirk J. Woodring, MSW, LICSW
Adjunct Professor, Smith College School for Social Work
October 20, 2022
Discussion will include the continued increase in the prevalence of MJ use in U.S. schools since 2007, the report of negative consequences for youth in Colorado following the experience with medicalization and finally, the preparations to implement medical MJ use in CT. At the conclusion of this presentation, participants will:
- Provide behavioral and develop mental perspectives of cannabis HARMFULNESS to teens’ present and future mental, medical, and academic wellbeing.
- Review the changes in MJ use status such as: decriminalization, medicalization and legalization and address their impact on youth wellbeing.
- Discuss how to influence the political and public opinion by maintaining a Utilitarian Approach in order to establish guidelines regarding “the best interest of the adolescent”.
Yifrah Kaminer MD, MBA
Professor Emeritus of Psychiatry & Pediatrics, Alcohol Research Center, University of Connecticut School of Medicine
November 17, 2022
“The Fats of Life: Understanding the Role of Cholesterol in Addiction, Depression, and Suicide”
ONLINE
Synopsis & objectives:
This presentation will investigate the belief that all dietary fat is “bad,” and will highlight the crucial roles that essential fats – cholesterol and essential fatty acids – play in maintaining brain health. This presentation will discuss the research evidence linking deficiencies of essential fats to depression, addiction, and suicide. This presentation will discuss an integrative model of psychiatric treatment that prioritizes the correction of underlying nutritional deficiencies.
- Describe the historical origins of the now-widespread myth that all dietary fad is health-adverse
- Explain some of the critical roles that cholesterol and essential fatty acids play maintaining healthy brain function
- Explain how and why dietary intake alone may be unreliable insofar as predicting a patient’s cholesterol levels
- Identify three or more physical and/or psychiatric outcomes associated with deficiencies of essential fats
- Describe the health implications of imbalances in levels of Omega-3 vs. Omega-6 fatty acids
- Describe how testing for essential fatty acid and cholesterol levels can improve current treatment models for depression and addiction, as well as current suicide prevention models
James Greenblatt, MD
Medical Director, Psychiatry Redefined / Medical Director, TZ Health
December 15, 2022
Synopsis & objectives:
- Illustrate the prevalence of suicide amongst youth in the United States and specifically here in Connecticut
- Review the importance of providing universal suicide screening in your practice and how it is feasible
- Recognize the impact of the pandemic on youth mental health and suicidality.
Steven C. Rogers, MD, MS-CTR
Attending Physician – Division of Emergency Medicine, Medical Director – Emergency Behavioral Health Services
Connecticut Children’s / Research Scientist – Connecticut Children’s Injury Prevention Center / Associate Professor –
University of Connecticut School of Medicine
January 19, 2023
Synopsis & Objectives:
Anxiety disorders are the most common psychiatric disorders. Cognitive-behavioral therapy (CBT) is the first-line treatment of choice for these conditions, yet most sufferers do not receive this treatment. The aim of this presentation is to familiarize attendees with the basic conceptual principles of CBT for anxiety and to clarify the core mechanisms of CBT treatment for each disorder. Specific objectives are:
- Describe the use of imaginal, in vivo, and interoceptive exposure in the treatment of anxiety-related disorders.
- Discuss the use and limitations of relaxation-based strategies in anxiety disorder treatment.
- Describe approaches to maladaptive cognition in anxiety-related disorders, including cognitive restructuring and acceptance.
David Tolin, PhD, ABPP
Director, Anxiety Disorders Center, The Institute of Living / Adjunct Professor of Psychiatry, Yale University School of Medicine
February 16, 2023
“An Introduction to Understanding Motivational Interviewing and How it is Useful in Working with Patients Who Have Substance Use Disorders”
ONLINE
Synopsis & objectives:
- What is MI?
- MI is about change and how to help facilitate and NOT DIRECT the change
- The work is collaborative to help increase a person’s motivation for change
- Let’s talk about the foundation:
- Ambivalence around change is common
- Change is not linear
- Readiness to change is not fixed
- Pay close attention to readiness so you can adjust your sessions/engagement with the patient/client
- Fixing patients? No way! Practitioners have to avoid the ‘righting reflex” where you want to fix the problems the patients are presenting because that actually reducing their motivation for change and autonomy (this also doesn’t take into account a patient’s ambivalence)
- Addiction Stages of Change:
- Pre-contemplation, contemplation, preparation, action and maintenance
Marilyn Finkelstein, LCSW
Program Manager of Addiction Services at The Institute of Living
March 16, 2023
Synopsis & objectives:
Contingency management (CM) is one of the only effective behavioral treatments for persons with stimulant use disorder, but it is rarely offered in community settings. This presentation will describe Project MIMIC, a regional initiative to promote the uptake of contingency management in opioid treatment programs throughout New England.
By the end of this presentation, attendees will be able to:
- Discuss the magnitude of the evidence-to-practice gap for contingency management
- Describe the design of Project MIMIC, a large-scale effort to implement contingency management in opioid treatment programs throughout New England
- Identify the types of support needed to implement contingency management in opioid treatment programs
Sara J. Becker, PhD
Alice Hamilton Professor of Psychiatry, Director of Center for Dissemination and Implementation Science, Northwestern Medical School
April 20, 2023
“Using Technology to Deliver Treatment for Chronic Pain and Opioid Use Disorder (OUD): The IMPACT trial”
ONLINE
Synopsis & objectives:
- Describe the development and testing of a technology-based intervention for chronic musculoskeletal pain
- Describe the integration of two cognitive behavioral therapy (CBT) based treatments, one for opioid use disorder and one for chronic pain
- Describe an ongoing randomized clinical trial of a technology-based CBT intervention for individuals with chronic pain and opioid use disorder receiving medication for opioid use disorder.
Alicia Heapy, PhD
Associate Professor of Psychiatry, Associate Director of the PRIME Center, Yale / VA CT Healthcare System
May 18, 2023
“Can We Harness Technology to Build Trust and Adherence in Opioid Treatment Programs?”
ONLINE
Synopsis & Objectives:
Opioid treatment programs manage patients with severe opioid use disorder under highly regulated conditions. These federal regulations were designed to foster medication adherence and prevent diversion, while also helping patients to control cravings, restore functioning, and reap the benefits of medication-assisted recovery. However, some patients may not respond well to the relatively stringent requirements, either early on in their treatment, or even over time. In March 2020, in response to COVID-19, SAMHSA relaxed take-home dose guidelines for patients. Recent research reveals that the relaxation of take-homes has not led to an increase in methadone overdose deaths or diversion of doses. In this presentation, we describe the development and evaluation of Sonara, an app designed to build trust and support adherence to methadone take-home dosing. Sonara is a smartphone-based app for patient monitoring that combines video-recording with tamper-aware packaging on take-home methadone vials. We describe patient, clinician and clinic leader experiences and outcomes with Sonara from four diverse clinics in California, Massachusetts, New Mexico and Oklahoma. Discussion can focus on the potential application of Sonara in standard opioid treatment program operations.
- Explain how strengthening patient-provider trust leads to improved OTP accessibility
- Describe how asynchronously observed MAT can be used to help patients meet their recovery goals faster
- List SAMHSA’s new, more stringent take-home requirements, set to take-effect after the COVID public health emergency has expired
Michael Giles, MD & Mark McGovern, PhD
Dr. Giles: CEO Sonara Health
Dr. McGovern: Professor / Co-Chief, Division of Public Mental Health & Population Sciences, Department of Psychiatry / Medical Director, Integrated Behavioral Health, Division of Primary Care, Department of Medicine, Stanford University School of Medicine
June 15, 2023
Many individuals with alcohol use disorders (AUD) seek drinking to avoid or otherwise manage painful physical and psychological states. Yet, how the neural processes underlying pain play a role in the maintenance of AUD remains under-explored. This presentation provides recent findings from Dr. Thang Le’s laboratory which examines the neural circuit supporting pain and its involvement in promoting drinking as a coping behavior.
Thang Le, PhD
Postdoctoral Associate, Department of Psychiatry, Yale School of Medicine
