Western Psychiatric Institute & Clinic

of UPMC Presbyterian Shadyside

Office of Education & Regional Programming

Comprehensive Crisis Management Train the Trainer Recertification

December 3-4, 2009 8:00 am – 4:30 pm each day Program Code: PP30 UPMC Presbyterian Hospital Classroom B Pittsburgh, PA 15213
Presenters:
David V. Julian, MEd Program Coordinator, Crisis Management Training Programs Office of Education and Regional Programming Western Psychiatric Institute and Clinic		Michael J. Boland, MSEd Clinical Educator/Crisis Specialist Office of Education and Regional Programming Western Psychiatric Institute and Clinic
Program Description:
The Comprehensive Crisis Management Trainer Recertification program is a 16-hour training designed to give trainers updated knowledge, skills, and information needed to instruct the Comprehensive Crisis Management (CCM) training program. The CCM Trainer Recertification class is required annually for instructors to maintain their CCM instructor certification. CCM is an 8 hour program consisting of two components: 1) The lecture and discussion component focuses on assessment and prevention techniques as well as crisis management skills. It helps employees to assess whether a potentially dangerous situation is developing and how to prevent a crisis. 2) A physical demonstration and practice component teaches physical techniques for movement, escape, and emergency safety interventions that are effective and safe for staff and the aggressor. These techniques do not rely on speed, strength or surprise; instead, participants learn to use natural body movement in effective ways.
Educational Objectives:
At the conclusion of this program, participants should be able to: 1. Identify a variety of reasons for challenging behaviors to occur 2. Understand the impact of emotional trauma and the importance of providing Trauma Informed Care 3. Recognize the importance of ongoing self assessment 4. Understand the importance of developing a therapeutic relationship 5. Identify key factors in the prevention of crisis situations 6. Discuss responsibilities necessary in the safe resolution of crisis situations 7. Perform appropriate physical escape and emergency safety intervention techniques
Target Audience:
Individuals with significant clinical experience who will provide the physical and verbal CCM training to their staff members. This program is for individuals who have already been certified as CCM trainers.
Continuing Education Credits:
PSYCHOLOGISTS – 14.0	NBCC – 14.0		CEU – 1.4
ACT 48 – 14.0	SW/LPC/LMFT – 14.0		CPRP – 14.0
Tuition: $350.00 Tuition includes all registration and workshop materials and continuing education credits. Full tuition must accompany the registration form. A $50.00 administrative fee will be deducted from any cancellation received less than two weeks before the session. No refunds can be issued once the program has begun.
To register: Please complete the attached registration form and contract information form and return them via fax, mail or email. For questions regarding this program, please contact Kyessa L. Brian by phone at 412-802-6905 or via email at briankl@upmc.edu.

Continuing Education Credit

Each program is offered for the designated number of continuing education credits

COUNSELORS: NBCC

Western Psychiatric Institute and Clinic is recognized by the National Board for Certified Counselors to offer continuing education for National Certified Counselors. Western Psychiatric Institute and Clinic adheres to the NBCC Continuing Education Guidelines.

EDUCATORS: ACT 48

Western Psychiatric Institute and Clinic is recognized by the Pennsylvania Department of Education to offer continuing education credits under Act 48 guidelines. Western Psychiatric Institute and Clinic adheres to the Act 48 Continuing Education Guidelines.

MENTAL HEALTH PROFESSIONALS: CEU

Nurses and other health care professionals are awarded the designated number of Continuing Education Units (CEU). One CEU is equal to 10 contact hours.

PSYCHOLOGISTS:

Western Psychiatric Institute and Clinic is approved by the American Psychological Association to offer continuing education for psychologists. Western Psychiatric Institute and Clinic maintains responsibility for these programs and their content. Please see each flyer for the number of credit hours being offered.

CERTIFIED PSYCHIATRIC REHABILITATION PRACTITIONERS: CPRP

The announced credit hours for each program can be applied to your training hours for the Certified Psychiatric Rehabilitation Practitioners (CPRP).

LICENSED/CLINICAL SOCIAL WORKERS, LICENSED PROFESSIONAL COUNSELORS, LICENSED MARRIAGE AND FAMILY THERAPISTS: LSW/LCSW/LPC/LMFT
The indicated number of clock hours of continuing education is provided through co-sponsorship of the University of Pittsburgh School of Social Work, a PA-approved provider of social work continuing education in accordance with all the applicable educational and professional standards of the Council on Social Work Education.  These clock hours satisfy requirements for LSW/LCSW, LPC and LMFT renewal.  For information of social work continuing education, call (412) 624-3711.

DIRECTIONS:

UPMC PRESBYTERIAN HOSPITAL

200 Lothrop St., Pittsburgh, PA 15213

Via the PA Turnpike and Interstate 376: Take exit 57, Pittsburgh/Monroeville, to Interstate 376 West. Follow the interstate to Exit 7A, Oakland (Bates Street). Follow Bates Street to the second stoplight; turn left onto Atwood Street. Follow Atwood to the second stoplight (Fifth Ave.) and turn left, then immediately get into the far right lane. Turn right onto Lothrop Street. Near the top of the hill there are signs for Presby Garage on the left. This garage is open for public use. Take the elevators to level “D.” The elevators will open into the Biomedical Science Tower Lobby and the room is off the lobby.

Via Interstates 79/279 from the North: Take Interstate 79 south to Interstate 279 south (two miles south of Wexford/Route 910). Near downtown, take exit 8A to Interstate 579, and follow signs to Interstate 376 east via the Boulevard of the Allies. Take Forbes Avenue/Oakland exit left; do not continue on Interstate 376 east. Bear right onto the Forbes Avenue access ramp, and follow Forbes to Atwood Street; turn left onto Atwood Street. Follow Atwood to the next stoplight (Fifth Ave.) and turn left, then immediately get into the far right lane. Turn right onto Lothrop Street. Near the top of the hill there are signs for Presby Garage on the left. This garage is open for public use. Take the elevators to level “D.” The elevators will open into the Biomedical Science Tower Lobby and the room is off the lobby.

Via Interstates 79/279 from the South: Take Interstate 79 north to Exit 59A. Take Interstate 279 North, following signs to Interstate 376 east. Take 376 east and exit at Forbes Avenue/Oakland (Exit 5). Follow Forbes to Atwood Street. Turn left onto Atwood Street. Follow Atwood to the next stoplight (Fifth Ave.) and turn left, then immediately get into the far right lane. Turn right onto Lothrop Street. Near the top of the hill there are signs for Presby Garage on the left. This garage is open for public use. Take the elevators to level “D.” The elevators will open into the Biomedical Science Tower Lobby and the room is off the lobby.

PARKING:

All Non-UPMC staff who chooses to drive their own vehicle should park at the University Center Garage which is located on Bigelow Blvd (between Lytton Ave and Tennyson Ave). I have attached a map of the Oakland area that shows the location (http://forms.infonet.upmc.com/MapOaklandAppt.pdf). There is a UPMC shuttle that will pick you up from the Bigelow lot which is the large open air lot adjacent to the University Center Garage. I am also attaching a shuttle schedule that shows pick up times from the Bigelow lot and drop off time at WPIC (http://parking.infonet.upmc.com/Schedules/Bigelow.pdf). I can validate parking at the University Center Garage for NON-UPMC STAFF ONLY. If you have any questions regarding where to park, please contact me. *Please be aware that only patients, family members, and visitors are permitted to park in the UPMC Presbyterian parking garage located on Lothrop St.*

DRESS:

Please plan to dress casual for the entire week (jeans, sweats, etc).  Everyday of the week will be divided between the lecture and physical portions of the program, so please be comfortable.  It is also a good idea to bring a sweatshirt or light jacket as the rooms tend to be a little on the chilly side.  Also, the restrictive procedures portion of the program does require spending some time on the floor so it is advisable to bring a small towel or handkerchief as well.

CCM TRAINER RECERTIFICATION PROGRAM REQUIREMENT:

Prior to attending the Comprehensive Crisis Management trainer program, a memorandum of understanding must be agreed to and signed by both Western Psychiatric Institute and Clinic, and a representative of the participant’s agency. This understanding will outline the terms and agreements that must be accepted by the participant’s agency. The memorandum of understanding must be returned to The Office of Education and Regional Programming of the Western Psychiatric Institute and Clinic prior to the start of the program.

Registration Form FOR THE CRISIS TRAINING INSTITUTE
Please duplicate this registration form as needed PLEASE NOTE: Pre-registration is REQUIRED Telephone registrations CANNOT be accepted. Please register NO LATER THAN TWO WEEKS BEFORE THE COURSE(S) YOU WISH TO ATTEND as space may be limited.				Please MAIL or FAX this registration form to: Kyessa L. Brian WPIC/OERP 4601 Baum Blvd, Room 178 3811 O’Hara Street Pittsburgh, PA 15213 FAX: (412) 802-6910 / Phone: (412) 802-6905
Registration forms and information on our upcoming programs are available on the WPIC/OERP website at: http://www.wpic.pitt.edu/oerp
Social Security# (last 5 digits):			DISCIPLINE 01 Psychology 02 Psychiatry 03 Professional/Technical 04 Medicine 05 Social Work 06 Nursing, RN 07 Nursing, LPN 08 Education 09 Related Therapies 10 Social Sciences 11 Administrative /Business 12 Other			DEGREE 01 High School 02 Associate Degree 03 Nursing Degree 04 Bachelor's Degree 05 Master's Degree 06 Doctoral Degree 07 M.D. 08 Other
Name (Last, First):
Agency:
Address:
City:
State:		Zip code:
County
Day Telephone: ( )			JOB TITLE 01 Executive Director 02 County MH/MR Admin 03 Unit/Program Director 04 Unit Program Coord 05 Clinical Supervisor 06 Team Leader 07 Psychologist-Supervisor 08 Psychiatrist-Supervisor 09 Physician-Supervisor 10 Accountant 11 Medical Records 12 Clerical 13 Psychotherapist 14 Therapist		15 Caseworker 16 Case Manager 17 Counselor 18 Consultant 19 Intake/Assessment 20 Residential Program 21 Aide 22 Psychologist 23 Psychiatrist 24 Other Physician 25 Clergy/Chaplain 26 Staff Nurse
Email:
FOR CONTINUING EDUCATION PURPOSES, PLEASE INDICATE YOUR CERTIFICATION NEEDS:
q NBCC COUNSELOR	NBCC NUMBER ____________
q NURSE	q PSYCHOLOGIST
q CPRP
q SW/LPC/LMFT	q ACT 48 ID NUMBER______________
Are you a WPIC employee? □ yes □ no
Crisis Training Institute
PLEASE INDICATE WITH AN “X” WHICH PROGRAM(S) YOU WISH TO ATTEND Comprehensive Crisis Management Trainer Recertification (PP30) December 3-4, 2009 – Pittsburgh, PA TUITION: Total Enclosed: $_____________ Method of Payment: o Check (Make payable to OERP/WPIC) Check #_____________ o American Express o MasterCard o Discover o Visa To be completed by credit card users only: Card Number:__________________________________________3 digit security code:_________ Expiration Date: _________________ Signature:__________________________________________________________ To be completed for UPMC account transfers only: Business Unit:___________ Account #:_____________ Dept. ID:__________ Administrator’s Signature_____________________________________________ PLEASE TURN TO NEXT PAGE FOR CONTRACT AND BILLING INFORMATION.

Course Requirements:

□ Trainee must have sufficient clinical experience and be physically capable to become a competent trainer.

□ Training must be performed in teams of at least two trainers.

□ Training can only be given to members of your agency.

□ Trainers must be recertified by Western Psychiatric Institute and Clinic annually.

□ A contract provided by Western Psychiatric Institute and Clinic must be signed by the appropriate designee from your agency and returned to the address provided before the training begins.

□ Payment must be received within 30 days from the Train the Trainer course ending date.

□ Trainers must follow the program and instructor requirements which will be distributed during the training.

Please provide the following information:

Agency designee who will be responsible for signing contract of understanding:

Name:

Mailing Address:

Telephone Number:

Fax Number:

E-mail Address:

The contract will be mailed to you within one week of receipt of this document.

Agency designee who will be responsible for processing payment:

Name:

Mailing Address:

Telephone Number:

Fax Number:

E-mail Address:

An invoice will be mailed to you within one week of receipt of this document.

How many individuals from your agency will be attending this training session (please provide their names)? ________________________________________________________________________

________________________________________________________________________

The tuition for all registrants can be billed separately or together. Please indicate which you would prefer.

________________________________________________________________________

Total Cost: Number of attendees _____ X $350 = ____________

If you have any questions, please contact Kyessa L. Brian at 412-802-6905 or briankl@upmc.edu. Thank you for choosing the Crisis Training Institute of Western Psychiatric Institute and Clinic.