Call for Presentations

Call for Presentations
Submission Deadline: Friday, March 13, 2015
to Steve Wiland at submissions@dwmha.com
This conference offers behavioral healthcare professionals the opportunity to:
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Share new clinical academic knowledge with practicing health professionals
Share practice knowledge and experience addressing complex recovery challenges
Provide an inter-professional educational opportunity eligible for continuing education credits
Showcase Wayne County as a leader in inter-professional collaboration as an important element in
Community Mental Health (CMH) system transformation
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Who should submit workshop presentations?
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Researchers whose findings can contribute to the improvement of the CMH system
University faculty with practice knowledge to enhance the competencies of the CMH workforce
Experienced practitioners with specific expertise in effective program or practice models
Experienced managers or administrators with specific expertise in effectively developing/
implementing program or practice models
Presentations focusing on the following topics are invited:
1) Co-occurring Mental Health and Substance Use Disorders
2) Trauma and Posttraumatic Stress Disorder
3) Better Serving Homeless Populations
4) Better Serving Military Veterans
5) Behavioral Addictions
6) Integrated Behavioral and Physical Healthcare
7) Mental Health First Aid
8) Interfacing with the Criminal Justice System (Specialty Courts, Jail Diversion, etc.)
9) Effective Behavioral Health Crisis Response
10)Using Data/Outcomes to Drive System Improvement
11)Adolescent Suicide Prevention
12)Mental Illness and Youth
13)Cross-System Partnerships (which could encompass a number of the above)
The DWMHA Interdisciplinary Mental Health Conference encourages the
following types of submissions:
Research Papers - Completed research papers in any of the topic areas listed above or related
areas.
Abstracts - Abstracts of completed or proposed research in any of the topic areas listed above, or
related areas. The abstract for proposed research should include the research objectives, proposed
methodology, and a discussion of expected outcomes.
Case Studies - Case studies in any of the topic areas listed above, or related areas.
Work-in-Progress Reports or Proposals for Future Research - Incomplete research or ideas
for future research in order to generate discussion and feedback in any of the topic areas listed
above, or related areas.
Reports on Issues Related to Teaching - Reports related to innovative instruction techniques or
research related to teaching in any of the topic areas listed above or related areas.
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Format of Presentations:
Paper sessions will consist of three to four presentations in a 75 minute session. The session will
be divided equally between the presenters.
Workshop presentations will be given a full 75 minute session.
Panel sessions will provide an opportunity for three or more presenters to speak in a more open
and conversational setting with conference attendees. Submissions for these 75 minute sessions
should include the name, department, affiliation, and email address of each panelist in addition to
a description of the presentation and the title page.
Poster sessions will last 75 minutes and consist of a large number of presenters. Poster sessions
allow attendees to speak with the presenters on a one-to-one basis. The following supplies will be
provided for poster sessions:
• Easel
• Tri-fold display board (48 x 36 inches)
• Markers
• Push pins
• Tape
• Round table
• Chairs
Selection Process:
A limited number of presentation spaces are available and will be reviewed by the conference committee. All
completed proposals must be received by Friday, March 13, 2015. Proposals received after the deadline or
that are incomplete will not be considered.
Presenter Information and Agreement:
In submitting this presentation proposal, I understand and agree to the following on behalf of all presenters
participating in this workshop
• The conference budget does not provide honorariums for workshop presenters.
• All presenters will receive complimentary conference registration.
• Due to the high cost of travel, we are not able to reimburse for travel, lodging, mileage or other
expenses related to presenting at this conference.
• If presenters are not able to participate due to lack of reimbursement, special arrangements may be
made with the conference committee if requested.
• If using handouts, the presenter is responsible for providing a master copy and agrees to allow the
handouts to be made available online in a pdf format.
• I will not promote a specific product or service for personal gain during my presentation.
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Questions and Submissions:
Submit your completed application and all required attachments to the conference planning committee via
Steve Wiland at submissions@dwmha.com. Incomplete submissions will not be considered for the
conference. Receipt of submissions will be acknowledged via email within 48 hours. There is a limit of two
contributed submissions per lead author.
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First Annual DWMHA Interdisciplinary Mental Health Conference:
Raising the Bar
Presentation Proposal Application
Please complete this application – Type directly on document
Do NOT change the font, change the color or formatting
1. Presenter Information: Enter the information below for each presenter in your workshop. The first
(lead) presenter will be the main contact and responsible for communicating all conference related
information to other presenters. There are a maximum number of three presenters allowed.
Lead Presenter
Name and Credentials: ___________________________________________________________
Organization Affiliation: __________________________________________________________
Discipline: ______________________________ Job Title: _______________________________
Email Address: __________________________________________________________________
Mailing Address: ________________________________________________________________
Phone Number: _________________________ Cell Phone: ______________________________
Name and Credentials: ___________________________________________________________
Organization Affiliation: __________________________________________________________
Discipline: ______________________________ Job Title: _______________________________
Email Address: __________________________________________________________________
Mailing Address: ________________________________________________________________
Phone Number: _________________________ Cell Phone: ______________________________
Name and Credentials: ___________________________________________________________
Organization Affiliation: __________________________________________________________
Discipline: ______________________________ Job Title: _______________________________
Email Address: __________________________________________________________________
Mailing Address: ________________________________________________________________
Phone Number: _________________________ Cell Phone: ______________________________
2. Presenter Experience: Identify presentations the LEAD Presenter has previously delivered on this
or related topics:
A. Presentation Title:________________________________________________________
Type of Event and Date:____________________________________________________
B. Presentation Title:________________________________________________________
Type of Event and Date:____________________________________________________
C. Presentation Title:________________________________________________________
Type of Event and Date:____________________________________________________
Do you have any recorded presentations that are available for review online? If yes, please list the
website(s)/direct link:__________________________________________________________
3. Lead Presenter References: Identify at least two presenter references:
Full Name:___________________________________Title:______________________________
Email: ______________________________________ Phone:____________________________
Relationship: _________________________________
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B. Full Name:___________________________________Title:______________________________
Email: ______________________________________ Phone:____________________________
Relationship: _________________________________
Format of presentation:
4. Schedule for workshop – Check all of your availability:
_____ Monday AM
_____ Monday PM
_____ Tuesday AM
_____ Tuesday PM
5. Would you be willing to present your workshop more than once at this conference?
____ Yes
____ No
6. Title of Presentation:
7. Abstract - description of your workshop that includes the theoretical and/or empirical background
of the presentation and the ways in which the presentation will inform either clinical, applied practice
or empirical research. This should be a description of the presentation content and a maximum of
250 words. Insert abstract below:
8. Choose the topic your presentation will focus on (select all that apply)
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Co-occurring Mental Health and Substance Use Disorders
Trauma and Posttraumatic Stress Disorder
Better Serving Homeless Populations
Better Serving Military Veterans
Behavioral Addictions
Integrated Behavioral and Physical Healthcare
Mental Health First Aid
Interfacing with the Criminal Justice System (Specialty Courts, Jail Diversion, etc.)
Effective Behavioral Health Crisis Response
Using Data/Outcomes to Drive System Improvement
Adolescent Suicide Prevention
Mental Illness and Youth
Cross-System Partnerships (which could encompass a number of the above)
9. Each presentation must provide at least three (3) measurable learning objectives. Use such
words as: define, identify, assess, describe, recognize, demonstrate, show, explain, examine. These
will be used in the registration brochure and need to fit the workshop content.
Learning Objective 1:__________________________________________________________
Learning Objective 2:__________________________________________________________
Learning Objective 3:__________________________________________________________
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10. Indicate the presentation format (check all that apply):
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Interactive
Research/Evaluation
Panel Discussion
Other (please specify):
_____ Case Study/Case Presentation
_____ Lecture
_____ Small Group Discussion
11. Please indicate the target audience level:
_____ Entry Level
_____ Intermediate
Social Workers:
_____ Macro
_____ Advanced
______ Micro
12. Each presentation must provide a minimum of three bibliographic references. At least ONE
reference must be current within the last five years.
Reading 1: __________________________________________________________
Reading 2: __________________________________________________________
Reading 3: __________________________________________________________
13. Choose the audio-visual and training equipment needed – select all that apply:
_____ Speakers
_____ Whiteboard and markers
_____ Internet Access
_____ Other – please specify:
Attach the following information for each presenter:
a) Resume/CV (electronic submission only)
b) Brief biographical sketch (used for conference marketing and
introductions)
c) CME Wayne State University School of Medicine Disclosure of
Commercial Relationships Form
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Wayne State University School of Medicine Continuing Medical Education
DISCLOSURE OF COMMERCIAL RELATIONSHIPS
Activity Title:
Activity Date(s):
Name:
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The Wayne State University School of Medicine Division of Continuing Medical Education is accredited by the Accreditation
Council for Continuing Medical Education (ACCME) as a provider of continuing medical education.
Wayne State University School of Medicine requires that all presentations at CME activities be fair, balanced, free of
commercial bias, and fully supported by scientific evidence.
Everyone who is in a position to control the content of an education activity must disclose relevant financial relationships with
any commercial interest.
A commercial interest is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by,
or used on, patients. Providers of clinical service directly to patients are not considered commercial interests.
Planning committee members, moderators, planners and presenters are required to list all financial arrangements or
affiliations with companies or organizations having a relationship to the subject of this educational activity.
Please note: The ACCME considers relationships of the person involved in the CME activity to include financial relationships
of a spouse or partner.
Individuals who refuse to disclose are disqualified from CME planning and implementation.
I. Check one:
I have no relevant personal financial relationships with commercial interests within the past 12 months
I have relevant personal financial relationships within the past 12 months with the following commercial
interests:
Type of Personal Financial
Relationship
Name of the Company(s) Whose Products Will Be Addressed
Consultant
Speaker’s Bureau
Grant/Research Support (Principal
Investigator)
Stock Shareholder (Self-managed)
Other: (must specify)
1. I agree that all the recommendations involving clinical medicine will be based on evidence accepted within the profession of
medicine as adequate justification for their indications and contraindications in patient care.
2. I agree that all scientific and clinical research used to justify patient care recommendations will conform to generally accepted
standards of experimental design, data collection and analysis.
3. I agree to provide a balanced presentation that is free from commercial bias or financial interest for or against any commercial
product or service.
II. Off-Label: Will your presentation or participation involve comments or discussion concerning an FDA nonapproved use of a pharmaceutical or medical device?
Yes
No
Not Applicable (Planner)
If “Yes”, how will you inform the audience that the FDA has not approved this use?
Signature:
Date:
Activity Director or Reviewer:
III. Resolution: If current conflicts of interest are present, the person overseeing CME content completes this
section. To assure independence and balance of content, current conflicts of interest were resolved by the following
process (check one):
Pre-review of presentation slides by Activity Director
Other (describe):
Signature (no relevant relationships):
2013
Pre-review of ppt. slides by CME department
Role:
Date: