This course is entirely recorded. The agenda for this online course is below.

MODULE ONE: The Building Blocks of a Skilled TIST Therapist

Agenda

9:00-9:30:  Review of TIST Level 1 skills

9:30-10:30:  Attuning to the clients’ parts:  becoming a ‘parts whisperer’

10:30-10:45:   Break

10:45-11:00:  Increasing client empathy and self-compassion

11:00-11:30:  Becoming a voice for the parts

11:30-12:00:  Questions, *video, and case application

*Video clip of therapist demonstrating attunement and speaking on behalf of the parts (approximately 10 minutes)

MODULE TWO: The Art of Working with Protector Parts

Agenda

9:00-10:00:  Understanding the defensive role of protector parts 

10:30-10:30:  Increasing client ability to negotiate more flexible defensive strategies

10:30-10:45:   Break

10:45-11:00:  Trauma-related phobias of vulnerability

11:00-11:30:  Using NUCA, a tool for working with protector parts

11:30-12:00:  Questions, video* and case application

*Video clip of work with a protector part (approximately 10 minutes)

MODULE THREE: The Do’s and Don’ts of TIST

Agenda

 10:00-10:30:  Focus on mindful differentiation from parts’ impulses and emotions

10:30-11:30:  Prioritizing client relationships to their parts, not the therapist’s

11:30-11:45:   Break

11:45-12:00:  Emphasizing internal communication and negotiation

12:00-12:30:  The therapist’s role in facilitating internal attachment

 12:30-1:00:  Questions, *video, and case application

*Video clip of client learning to differentiate herself from parts (approx. 10 minutes)

MODULE FOUR: Challenges of Implementing the TIST Model with DID Clients

Agenda:

11:00-11:30:  Differentiating DID from other trauma-related disorders

11:30-12:30:  Facilitating continuous co-consciousness

12:30-12:45:   Break

12:45-1:00:  Dissociation-related complications in memory processing 

1:00-1:30:  Increasing the client’s ability to stay present

 1:30-2:00:  Questions, *video, and case application

*Video clip of DID client working with tendency to dissociate (approx. 10 minutes)

MODULE FIVE: Working with Sadistic and Malevolent Trauma

Agenda:

11:00-11:30:  Organized malevolent and sadistic abuse (eg, human trafficking)

11:30-12:30:  Effect of extreme abuse on brain and nervous system

12:30-12:45:   Break

12:45-1:00:  Focus on stabilization and implicit memory rather than event memory

1:00-1:30:  Role of psychoeducation in treating extreme abuse

 1:30-2:00:  Questions, *video, and case application

*Video clip of psychoeducation with client (approx. 10 minutes)

MODULE SIX: Resolution of Traumatic Memory

Agenda:

11:00-11:30:  A neurobiological approach to understanding memory work

11:30-12:30:  Special challenges posed by dissociation and splitting

12:30-12:45:   Break

12:45-1:00:  Processing requires prefrontal cortical activity

1:00-1:30:  A protocol for memory processing with fragmented clients

1:30-2:00:  Questions, *video, and case application

*Video clip of memory work with a fragmented client (approx. 10 minutes)

JANINA FISHER, Ph.D.

Licensed Psychologist, License #6468, MA

5665 College Avenue, Suite 220C

Oakland, California 94611

510-891-1809

DrJJFisher@aol.com

www.janinafisher.com

Job Description: Consultant, Advisory Board, Trauma Research Foundation

Janina Fisher, Ph.D. is a licensed Clinical Psychologist and Instructor at the Trauma Center, an outpatient clinic and research center founded by Bessel van der Kolk. Known for her expertise as both a therapist and consultant, she is also a past president of the New England Society for the Treatment of Trauma and Dissociation, an EMDR International Association Credit Provider, a faculty member of the Sensorimotor Psychotherapy Institute, and a former Instructor, Harvard Medical School. Dr. Fisher has been an invited speaker at the Cape Cod Institute, Harvard Medical School Conference Series, the EMDR International Association Annual Conference, University of Wisconsin, University of Westminster in London, the Psychotraumatology Institute of Europe, and the Esalen Institute. Dr. Fisher lectures and teaches nationally and internationally on topics related to the integration of research and treatment and how to introduce these newer trauma treatment paradigms in traditional therapeutic approaches.

With TIST Level 1, professionals learned the concepts of the TIST model and how to apply it. When creating TIST Level 2, professionals indicated a need for applicable skills and techniques as well as more clarity on using this technique with highly traumatized clients.

Overall

• Discuss the basic skills and techniques of the TIST model.
• Apply TIST model skills in the therapy room, to help clients understand themselves and their behaviors through the framework of TIST.

Module 1

• Define the basic skills of TIST:  mindfulness, naming signs of parts, identifying blending, and differentiating adult self from part
• Describe techniques for helping clients attune to their parts
• Identify ways of increasing self- and parts-compassion

Module 2

• Detect signs and symptoms of protector parts and their defenses
• Discuss the role of phobias of emotion and vulnerability in trauma treatment
• Explain interventions that build trust and collaboration with protectors

Module 3

• Name the order of priority in using TIST interventions
• Recite the steps of the NULAA protocol for clients
• Differentiate signs of clients’ adult selves from signs of child parts

Module 4

• Indicate the symptoms that differentiate DID from DDNOS or CPTSD
• Summarize TIST interventions for time loss and dissociative fugue experiences
• Describe three ways of addressing dissociative switching in the therapy hour

Module 5

• Explain the traumatic impact of organized group abuse
• Identify the complications in therapist countertransference posed by these clients
• Discuss the challenges of resolving traumatic memory for sadistic malevolent abuse

Module 6

• Name the most common challenges in successful memory work with fragmented, dissociative clients
• Differentiate “memory repair” techniques from “memory processing” techniques
• Express the role of self-compassion in resolving traumatic memory

Mental Health Professionals including Psychologists, Social Workers, LPCs, and LMFTs.

Module 1: The Building Blocks of a Skilled TIST Therapist

The ‘building blocks’ of the TIST approach are necessary for success in using it.  It can be stabilizing for clients to understand and apply the model to themselves, and it prepares clients for addressing the underlying wounds of the child parts at the appropriate time.  In this module, we review the basic skills and describe the skills needed to help clients begin to listen to their parts and to give them a voice by speaking on their behalf.  As we increase our ability as therapists to tune into the parts and resonate with them, we can also stimulate the client’s attunement to them and role model compassionate understanding.  By becoming vocal advocates for the parts, we teach clients to relate to themselves like the ingenious, brave, resilient children they once were.

Module 2: The Art of Working with Protector Parts

Without a way of working with protector parts, client and therapist often find themselves stuck therapeutically.  Access to the wounded child parts requires building trust with parts that defend against emotion, vulnerability and even acknowledgement of the trauma.  In TIST, we assume that all resistance, stuckness, and difficulties in collaboration reflect the protectors’ inherent distrust of and defenses against the therapist and therapy.  Rather than trying to work around these parts, clients can be helped to appreciate and respect their roles in survival and their protective intentions, no matter how destructive the behavior.   In this module, we will cover the steps and skills needed for clients to be able to validate the protectors, earn their trust, and negotiate agreements that support safety and stabilization.

Module 3: The Do’s and Don’ts of TIST

Learning any new model requires simplification and constant repetition, especially when we are treating clients with C-PTSD.  Having a structured guide to the use of TIST decreases the number of decisions the therapist must make and keeps the approach consistent.  This module covers the simple “Do’s and Don’ts” of working with TIST—from what we should ‘always’ do to what we should ‘never’ do.   Participants will learn to avoid certain therapeutic interventions and to consistently emphasize others.  This module will help therapists to focus and prioritize their efforts so that the work is more effective.  We will also discuss pacing so that clients can effectively move from overwhelming symptoms, emotions and beliefs of defectiveness to a more regulated, organized state in which they can appreciate their resilience and the parts that support that.  

Module 4: Challenges of Implementing the TIST Model with DID Clients

Clients with DID or Dissociative Identity Disorder pose a special set of challenges for the therapist.  The independence of the different parts, losses of consciousness and time, the impulsive and self-destructive behavior of parts acting ‘behind the back’ of the client’s adult consciousness.  In the therapy, parts of DID clients often ‘come out’ to make a relational connection to the therapist followed by other parts that push the therapist away or sabotage the therapy.   Learning how to use TIST to navigate the additional complexities posed by DID symptoms is essential to the therapist’s skill set for working with these clients.

Module 5: Extreme Cases: Ritual Abuse, Trafficking, Sadistic and Malevolent Abuse

Many complex fragmented or dissociative clients come to therapy to deal with the effects of sadistic malevolent traumatic experiences, such as ritual abuse, satanic cult abuse, human trafficking, mind control practices, or other organized group traumas.   These clients are generally highly symptomatic, more fragmented, and more easily overwhelmed by extreme parts adapted to extreme circumstances. Following these experiences, post-hypnotic suggestion and future threats stimulate anticipatory terror on top of immediate aftermath fears, instill beliefs that the victim is complicit and therefore ‘bad,’ and condition negative cognitions meant to keep the client compliant for years to come.   The result is an extremely dysregulated nervous system, shattered self-esteem, and the potential for self-destructive behavior, including return to the cult or slave trafficking ring.   Being able to help these clients requires therapist understanding of the nature and effects of these extreme experiences.

Module 6: Resolution of Traumatic Memory

The assumption that the goal of trauma treatment should be the processing of traumatic events has been unquestioned for many decades.  Now, advances in our understanding of trauma have directed us toward a somewhat different goal:  the resolution of implicit and explicit components of memory that continue to intrude on the client’s present experience.  In TIST, treating implicit memory is seen as more important to the resolution of trauma than treating explicit memory.  To further complicate the issue of addressing memory, fragmentation of the personality also results in fragmentation of implicit and explicit memory and increases internal conflicts between parts that block disclosure and parts that are desperate to tell someone.  Each part anxiously anticipates a repetition of the past without any sense that ‘it’ is over.   How do we help clients resolve the past when the past is still present for the parts?

In support of improving patient care, this activity has been planned and implemented by CME Outfitters, LLC and Authentic Presence dba the Academy of Therapy Wisdom. CME Outfitters, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

This educational activity is approved for 18.0 CE contact hours.

Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs.

As a Jointly Accredited Organization, CME Outfitters, LLC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. CME Outfitters, LLC maintains responsibility for this course. Social workers completing this course receive 18.0 Live continuing education credits.

Please Note: Licensing Boards change regulations often and while we attempt to stay abreast of their most recent changes, if you have questions or concerns about this course meeting your specific board’s approval, we recommend you contact your board directly to obtain a ruling.

Instructions will be sent to each participant after the conclusion of the course with instructions on how to obtain the CE Certificate. You must indicate that you have viewed and completed each module by clicking on the "Mark as Complete" button located to the right of the videos.

Activity evaluations must be completed online (requires free account activation), and participants can print their certificate or statement of credit immediately following the end of the course.

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Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Martana Rybnicek, Janina Fisher, Brian Spielmann and Scott J. Hershman, MD, FACEHP, CHCP have nothing to disclose.

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Unlabeled Use Disclosure

Faculty of this CME/CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices. CME Outfitters, LLC, the faculty, and Sunovion do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

This course is $997.

If you for some reason are not satisfied with the course you have 7 days from your purchase date to request a cancellation and a refund. Please refer to the policy section for details on how to cancel.

The CEs are included in the cost of the course. You will be notified by email at the end of the program with instructions on how to obtain CEs.

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