BMW Practitioner Confidence Form – Train-the-Trainer BMW Practitioner Confidence Form - Train-the-Trainer Your Name: Residency Program Name: Email Address Confidence Measured: * Before Train-the-Trainer Session After Train-the-Trainer December 2016 May 2017 Practitioner Role: * Faculty Fellow Nurse Practitioner Physician's Assistant PGY-1 PGY-2 PGY-3 PGY-4 Other Please rate your CURRENT confident in using the strategies below to build a therapeutic relationship with children and families affected by emotional, developmental, and behavioral concerns: Manage situations when patients seem to be talking too long. Very Confident Somewhat Confident Not Very Confident Not at All Confident Collaboratively prioritize patient concerns and set an agenda for a visit. Very Confident Somewhat Confident Not Very Confident Not at All Confident Identify possibilities when patients feel there is nothing left to try. Very Confident Somewhat Confident Not Very Confident Not at All Confident Respond to patients' reluctance to try a treatment or consider a diagnosis. Very Confident Somewhat Confident Not Very Confident Not at All Confident Ask for permission to talk about possible diagnoses or treatments. Very Confident Somewhat Confident Not Very Confident Not at All Confident Please rate your CURRENT level of confidence in your ability to use each of the following in treating the symptom clusters outlined below: ANXIETY: Using graded exposure to feared situations. Very Confident Somewhat Confident Not Very Confident Not at All Confident ANXIETY: Using modeling of brave behavior and active coping with fears. Very Confident Somewhat Confident Not Very Confident Not at All Confident DISRUPTIVE BEHAVIOR PROBLEMS: Helping parents provide tangible rewards for good behavior. Very Confident Somewhat Confident Not Very Confident Not at All Confident DISRUPTIVE BEHAVIOR PROBLEMS: Helping parents give specific, descriptive praise. Very Confident Somewhat Confident Not Very Confident Not at All Confident DISRUPTIVE BEHAVIOR PROBLEMS: Counseling parents about monitoring children's behavior. Very Confident Somewhat Confident Not Very Confident Not at All Confident DISRUPTIVE BEHAVIOR PROBLEMS: Explaining to parents how to use time out. Very Confident Somewhat Confident Not Very Confident Not at All Confident DISRUPTIVE BEHAVIOR PROBLEMS: Explaining to parents how to give effective commands. Very Confident Somewhat Confident Not Very Confident Not at All Confident DISRUPTIVE BEHAVIOR PROBLEMS: Explaining to parents how to set limits. Very Confident Somewhat Confident Not Very Confident Not at All Confident DISRUPTIVE BEHAVIOR PROBLEMS: Providing parents psychoeducation about causes of behavior problems. Very Confident Somewhat Confident Not Very Confident Not at All Confident DISRUPTIVE BEHAVIOR PROBLEMS: Explaining to parents how to use response costs for behavior change. Very Confident Somewhat Confident Not Very Confident Not at All Confident LOW MOOD: Assessing the extent of suicidal thoughts. Very Confident Somewhat Confident Not Very Confident Not at All Confident LOW MOOD: Safety counseling for youth with depressive symptoms. Very Confident Somewhat Confident Not Very Confident Not at All Confident FIRST LINE ADVICE: Teaching how to use cognitive coping methods. Very Confident Somewhat Confident Not Very Confident Not at All Confident FIRST LINE ADVICE: Developing a plan for behavioral activation. Very Confident Somewhat Confident Not Very Confident Not at All Confident FIRST LINE ADVICE: Working with families on reducing burdens/problem solving strategies. Very Confident Somewhat Confident Not Very Confident Not at All Confident FIRST LINE ADVICE: Teaching patients how to identify and rehearse responses to situations that trigger depression. Very Confident Somewhat Confident Not Very Confident Not at All Confident Please feel free to add any additional comments.
