REGISTRATION
FORM
CISM: Stress
Management for the Trauma Provider (PN68)
(Please type or print; photocopy for
additional registrants; telephone
registrations cannot be accepted.)
SS#: (Last five digits only): __ - __ __ __ __
Name______________________________________
Agency_____________________________________
Address ____________________________________
City ___________________State____ Zip _________
Phone ______________________________________
Email_______________________________________
County______________________________________
Specialty/Degree(s)___________________________
Are you a WPIC employee? □Yes □ No
For Continuing Education Purposes,
please check if you are:
|
□
NBCC
Counselor (NBCC #_________) |
|
|
□
Educator
(ACT 48) |
|
|
□
Nurse |
□
Psychologist |
|
□
SW/LPC/LMFT |
□
|
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□
CPRP |
□
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Tuition: $________ Method
of Payment:
□
UPMC Account
Transfer □American
Express
□ MasterCard □ Discover □Visa □ Check #______
(Payable to OERP/WPIC)
To be completed by credit card users
only:
Card Number _______________________________
Expiration Date: _____________________________
Signature: __________________________________
To be
completed for UPMC account transfers:
Account #__________________________________
Administrator’s Name_________________________
Administrator’s Signature______________________
CISM: Stress Management
for the Trauma Provider (PN68)
OVERVIEW:
Stress Management for the Trauma
Provider is an important workshop for all who work with traumatized people.
This course explores the “Stress Continuum,” the levels of stress including eustress (i.e., beneficial, motivating stress), traumatic
stress, burnout, countertransference, compassion
fatigue or secondary PTSD, and vicarious traumatization
which may occur as a result of helping others. Individual self-report exercises and an
experiential group support session will assist the participating trauma provider
in assessing their own level of stress through sharing personal experiences
with others. Stress management self care techniques will be presented, experienced
and discussed, and attendees will have an opportunity to develop a personal
self care plan.
EDUCATIONAL OBJECTIVES:
At the conclusion of this program,
participants should be able to:
·
Discuss
motivating factors for the work done by trauma providers
·
Recognize
personal signs and symptoms of stress
·
Understand
the impact of working with trauma survivors
·
Discuss
burnout, contertransference, compassion fatigue,
vicarious traumatization, and critical incident
stress
·
Experience
and discuss self care techniques and plans
WHO SHOULD ATTEND:
The audience for this class includes all mental health
professionals, emergency services personnel and peer counselors.
PRESENTERS:
Robert S. Fonte, RN, MEd
ICISF Trainer
Director, Crisis
Training Institute
Office of Education
and Regional Programming
Western Psychiatric
Institute and Clinic
Jeffrey D. Magill, BA
Crisis and Disaster Training Specialist
Office of Education and Regional Programming
Western Psychiatric Institute and Clinic
TUITION:
General …….................................................$200.00
First Responders and Comprehensive Crisis Management
Trainers ……………………. $175.00
Tuition
includes all registration and workshop materials; continental breakfast, lunch
and refreshments; in addition to continuing education credits. Full tuition
must accompany the registration form.
Please make checks out to WPIC/OERP.
A $15.00 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. Please
mail completed registration form and payment to:
ATTN: Kyessa L. Brian
WPIC/OERP
4601
Telephone: 412-802-6905
Fax: 412-802-6910
Email: briankl@upmc.edu
http://www.wpic.pitt.edu/oerp
From
the East
Take the Parkway East (Route 376) to Exit 7 (Edgewood/Swissvale). At the end of
the exit ramp, turn right onto
To park at the
TO RECEIVE THE DISCOUNTED PARKING
RATE, PLEASE PARK IN THE
For
further directions and information on parking, please visit http://shadyside.upmc.com/Locations.htm or contact Kyessa L. Brian at 412-802-6905.
Social Workers: For social workers, 13.0 credit hours
of continuing education are provided through co-sponsorship of the University of
Pittsburgh School of Social Work, a PA-approved provider of social work
continuing education. These clock hours satisfy requirements for
LSW/LCSW, LPC and LMFT renewal. For information of social work
continuing education, call (412) 624-3711.
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.
All Health Care Professionals: Other health care professionals are awarded 1.3 continuing education
units (CEUs).