Mini Workshop 13 - Integrating the Menstrual Cycle into Assessment and Treatment: A Practical Overview

While the majority of female/assigned female at birth individuals do not experience significant menstrual cycle effects on their mood, approximately 5% experience intense and debilitating changes (i.e., premenstrual dysphoric disorder, PMDD) and at least 50% of those with mood disorders and other forms of psychopathology experience cycle-based worsening of their symptoms (i.e., premenstrual exacerbation, PME). These cyclical disorders are not caused by hormonal abnormalities, but rather by abnormal neural sensitivity to normal hormone changes. Accordingly, it is imperative that clinicians understand how to assess and treat menstrual cycle-related effects on mood and psychopathology. Our workshop, led by two licensed clinical psychologists and an advanced trainee with expertise in conducting assessments and treatment with this population, will cover the following topics:

Psychoeducation: Overview of the menstrual cycle, including how changes in hormones can affect mood and behavior and the difference between PMDD and PME. We will also highlight both irritability and suicide risk as symptoms that commonly fluctuate across the cycle. Participants will learn how to provide psychoeducation and a broad range of resources to clients.

Assessment: Participants will be taught how to validly assess menstrual cycle effects, including reviewing the rationale behind prospective assessment. We will present available tools for easy tracking and calculation of clinically significant cycle effects.

Outline:
• Overview of the menstrual cycle and the basic mechanisms of its effects on mood and behavior
• Introduction to techniques for providing psychoeducation and a broad range of resources to clients
• Presentation of available tools for easy tracking and calculation of clinically significant cycle effects
• Exploration of strategies for establishing relationships and collaborating with other types of treatment providers
• Discussion of CBT strategies for managing the cyclicity of symptoms and integrating them into existing therapy approaches such as DBT

Interdisciplinary Treatment Collaboration: Participants will be introduced to strategies for establishing relationships and collaborating with other types of treatment providers (e.g., psychiatry, gynecology) who specialize in pharmacological, medical, and surgical treatments of evidence-based treatment of PMDD/PME.

Skills Training: Introduce CBT strategies for management of PMDD/PME, and how to integrate into existing therapy approaches like DBT. Topics include how to utilize increased awareness of symptom flux and applying specific distress tolerance and interpersonal skills to perimenstrual irritability and suicidality.

The session will conclude with Q&A about the menstrual cycle and PMDD/PME.