Fall 2010

Helping Adolescents: Challenges in working with Adolescents and their Families
When: Tuesday October 5, 2010, 12pm-3pm
Where: 2901 Butterfield Road, Oakbrook, IL
Cost: $25.00, includes 3 CEU’s & box lunch.

                                       Spring 2011

Strategies for Maintaining an Ethical Practice
When: Tuesday March 8, 2011, 12pm-3pm
Where: 2901 Butterfield Road, Oakbrook, IL
Cost: $25.00, includes 3 CEU’s & box lunch

(see below for details on each seminar including registration)

 
Fall 2010

Helping Adolescent: Challenges in working with Adolescents and their Families

Adolescence is considered a challenging time by most experts. This presentation examines problems and challenges facing today’s adolescents (and those who are trying to help them). We will focus on common problems that occur in adolescence, ranging from depression to underachievement to conflicts about autonomy. We will discuss the ways in which modern life affects adolescents and families. Finally, we will focus on specific strategies for helping adolescents overcome depression, assume greater responsibility for themselves, and cope with the demands of the transition into adulthood.

Speaker:
Peter Perrotta, PhD, and Centers’ for Family Change staff

Dr. Perrotta is the President of Centers for Family Change. He has specialized in the treatment of Adolescents and their families for over 25 years.

When: Tuesday October 5, 2010, 12pm-3pm
(registration and box lunch pick up 11:30-12pm)

Where: 2901 Butterfield Road, southeast corner of
Butterfield and Meyers. First floor conference room.
Go to: www.centersforfamilychange.com for directions.

Cost: $25.00, includes 3 CEU’s & box lunch.
To register: call 630 586-9991 or email us at cffcfamily@sbcglobal.net. Send payment to: Centers for Family Change, 2907 Butterfield Rd., St 240 Oakbrook, IL 60523.

 Spring 2010

Strategies for Maintaining an Ethical Practice

At first blush, we all are confident that we are ethical clinicians, who know how to avoid the pitfalls that may lead other practitioners into ethical quandaries. However, ethical practice is not that simple or easy. Dilemmas such as balancing the needs of different family members, effectively engaging high risk clients, and balancing the needs of intrusive insurance companies with those of clients, may test us. This presentation examines ethical challenges that we are all likely to encounter, explicates the issues involved, and examines the clinical, ethical and legal issues involved in these dilemmas. Particular emphasis is focused on working with couples and families.

Speakers:
Peter Perrotta, PhD and Centers for Family Change staff

Dr. Perrotta is the President of Centers for Family Change. He is also a member of the Illinois Psychological Association’s Ethics Committee. Dr. Perrotta has a longstanding interest in ethics and risk management.

When: Tuesday March 8th 2011, 12pm-3pm
(registration and box lunch pick up 11:30-12pm)

Where: 2901 Butterfield Road, southeast corner of
Butterfield and Meyers. First floor conference room.
Go to: www.centersforfamilychange.com for directions.

Cost: $25.00, includes 3 CEU’s & box lunch.
To register: call 630 586-9991 or email us at cffcfamily@sbcglobal.net. Send payment to: Centers for Family Change, 2907 Butterfield Rd., St 240 Oakbrook, IL 60523.

Intuvin is a new medication for ADHD, that is being marketed by Shire. Intuvin is an extended release guanfacine. Guanfacine is an anti-hypertensive agent. Shire is touting the benefits of Intuvin and appears to be placing particular emphasis on the fact that it is a non-stimulant and also is offered in extended release form.* However, there are several important things to keep in mind when considering a new ADHD medication such as Intuvin:

1. Limited data on the benefits of Intuvin

The benefits of Intuvin were established based on only two studies (ref. 1), that lasted 8 and 9 weeks respectively.

These studies compared the benefits of Intuvin to placebo. While Intuvin was found to be far more effective than a placebo in reducing ADHD symptoms there is no evidence that Intuvin is more or less effective than other ADHD medications.

There have been other studies of guanfacine (Tenex) in non-extended release form. Three out of four of these studies showed some improvement in ADHD symptoms. However, three of these studies were on small samples (under 20 subjects) and had no control groups. The one study using a control group found benefits for guanfacine relative to placebo (ref. 2.). However, these studies only support the claim that guanfacine is more effective than placebo.

2. How Intuvin (guanfacine) is supposed to work

As Shire notes on their website it is not certain how Intuvin works. The theoretical model suggests that it should increase receptiveness to Norepinephrine in the prefrontal cortext. Coincidently, this is the same neurotransmitter that Strattera (atomoxetine) is hypothesized to increase (albeit in a different manner (ref. 2).

3. Intuvin versus stimulant medications versus Strattera

There is no evidenced that Intuvin is more effective, or even as effective as other ADHD medications. The leading experts on ADHD all recommend that stimulant medication (no one stimulant has shown to be more effective than any other stimulant) be the initial medication of choice for persons with ADHD. Strattera (atomoxetine) is recommended as the second medication treatment option (ref. 4). Until more data is available on Intuvin recommending Intuvin as the medication of choice for ADHD would appear to be questionable.
A similar phenomena occurred several years ago, when Strattera hit the market. However, several studies have suggested that stimulants appear more effective than Strattera (ref. 5). Thus, the recommendation that stimulant medication be the first option in treating ADHD, appears to hold.

References
*Information about Intuvin can be viewed on www.intuvin.com.

Ref. 1. Biederman J, Melmed RD, Patel A, et al. A randomized, double-blind, placebo-controlled study of guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder, Pediatrics, 2008; 121:e73-e84.

Ref. 2. Connor, D. “Other Medications,” in Barkley R. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 3rd ed. Guilford Press, New York, 2006, pp. 666-668.

Ref. 3. Prince J, Wilens T, Spencer T, & Biederman J. “Pharmacotherapy of ADHD in Adults,” in Barkley R. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 3rd ed d. Guilford Press, New York, 2006, p. 717.

Ref. 4. Barkley R, What is the role of Atomoxetine in the Management of ADHD, ADHD Report, April 2009.

Ref. 5. ADHD Report, October 2007, p. 14-15

The group will be offered free of charge.

One hour of CEUs will be available for LCSWs and LCPCs.

Please contact Peter Perrotta, PhD, at cffcfamily@sbcglobal.net for more information.

Exact dates and times, as well as topic areas will be posted in February.

 ”ADHD: The latest findings on evaluation and treatment.”

This conference is for professionals who work with children, adolescents and adults with ADHD.  It will examine the latest findings on ADHD and review the implication of these new findings for evaluation and treatment. Please see the conference flyer, reproduced below,  for details and information on registration:

ADHD: The latest findings on evaluation and treatment

          The volume of research and new information on ADHD can, at times, be overwhelming. This presentation will examine current research and thinking on ADHD and discuss the implications of these findings for understanding ADHD and working with those diagnosed with ADHD. Particular emphasis will be placed on new treatment approaches and strategies for working with children and adolescents with ADHD. The latest research on medication and non-medication based treatments will be examined. The implications of this research for addressing both behavioral and academic difficulties related to ADHD will be discussed.

Speaker:           Peter Perrotta, PhD

 Dr. Perrotta is the President of Centers for Family Change. He has specialized in the evaluation and treatment of ADHD for over 20 years.

 When:             Tuesday February 23rd, 2010, 12pm-3pm

                        (registration and box lunch pick up 11:30-12pm)

Where:            2901 Butterfield Road, southeast corner of  Butterfield and Meyers. First floor conference room.

                        Go to: www.centersforfamilychange.com for directions.

Cost:                $25.00, includes 3 CEU’s  & box lunch.

To register: call 630 586-9991 or email us at cffcfamily@sbcglobal.net. Send payment to: Centers for Family Change, 2907 Butterfield Rd., St 240 Oakbrook, IL 60523.

It is our obligation as therapists to remember that while the services we offer can help people in many ways,  often quite profoundly, that we can cause harm (emotional pain, family conflict etc).  Keeping this in mind when we consider various strategies and interventions is something we all need to be cognizant of. This is not to minimize or downplay the value of therapy. There is a clear and consistent body of research that supports the value of psychotherapy (see http://www.centersforfamilychange.com/faqs.htm for a discussion of this issue and a list of article and studies supporting the value of psychotherapy). Rather, it is to highlight the importance letting those we are working with know that therapy, like all interventions, has risks and rewards.

Informed Consent: A paradigm for reducing risk 

It is also our obligation to let our clients know about these risks. For those who peruse the literature on risk management there is much discussion of the issue of informed consent. Many writers have stressed that informed consent should not be a static, one time proforma event, that it can be in some medical setting. I can think of a number of occasions where I was handed forms to sign, with no active encouragement to read them, but rather with the exceptation that I quickly sign and return them. For those of you who have ever had a stress test you realize that you are giving the hospital permission to perform a wide range of interventions (including heart surgery) if you encounter problems during that test. On other occasions I have had more positive experiences where I have been carefully warned about the potential risks and limits of a procedure. The challenge for all of us as health care professionals is to remember that we can bring about harm as well as benefit, and that it is our obligation to be clear with our clients and patients about this.