2011 LAMFT Advanced Registration Form

2011 LAMFT Annual Conference

Hypnosis, Personal Growth, & Spirituality in Family
Therapy

Advanced Registration Form

(Must be received by January 31, 2011 to take advantage of special
rate)

Thursday, March 10 – Saturday, March 12, 2011
Hilton Baton Rouge Capitol Center Hotel

Baton Rouge, LA

Registration and Badge Information (Please print or type)

Name: _______________________________________________________
First Last

Address: _____________________________________________________

Number Street City State Zip

Home Phone: (___) ____________________

Daytime Phone:(___) ____________________

Email Address: _______________________________________________

LAMFT member? Yes____ (Member # ____________) No_____

If Yes, be sure to INCLUDE AAMFT MEMBER NUMBER and note member category:

Clinical_____ Associate _____ Affiliate_____ Student______

Note: In order to assist planning in workshop room assignments, presenter handouts, and
coordination of CEU certificates, please indicate your session preferences on the following pages.
For detailed program descriptions, go to www.lamft.org. Be sure to check the website for
conference updates, news, and other information.

Continuing Education

This program has been approved for 20 contact hours of continuing education for LAMFT (LMFT),
NBCC (LPC), and ADRA (BCSAC). Review/Approval is being sought from National Association of
Social Workers, Louisiana Chapter (NASW-LA). Please visit the Continuing Education page of the
LAMFT website @ www.lamft.org for updates and additional information.

Thursday March 10, 2011

Morning Sessions – Circle your preference(s)

9:00 – 12:15
100 (3 hours) Jana P. Sutton Ph.D. & Bradford P. Keeney, Ph.D.: AAMFT Approved Supervisor

Refresher Course, Part 1
* This course is for AAMFT Approved Supervisors Only. To receive full credit, you must attend both
parts—Sessions 100 & 200. Session 200 will be offered Saturday, March 12th from 9:00-11:15AM.

101 (3 hours) Frank Thomas, Ph.D. & David Cross, Ph.D.: Patterns that Connect: Systemic Being and
Acting in MFT Practice

9:00 – 10:30
102 (1.5 hours) Amy Yates, Ph.D., Katherine Wilson, Ph.D., & Kelly Barnett, Ph.D.: Growing from an

Individual to a Systemic Therapist: A Primer
103 (1.5 hours) Marvin Clifford, Ph.D.: Taking Care of Yourself: Personal Growth, Changes, and

Identifying your Own Blind Spots and Achilles Heels

10:45 – 12:15
104 (1.5 hours) Justin Levitov, Ph.D., Thomas, W. Foster, Ph.D., & Caitlyn Galjour: Philosophical and

Theoretical Foundations of Relationships: A Guide to Personal Growth
105 (1.5 hours) Kelly Tyner, M.A.: Sexually Based Communication between Parent and Adolescent
106 (1.5 hours) Sherry Richmond-Frank, M.S.: Living Outside the Box: Individuals with Disabilities and

Their Families Invite You In

Lunch

12:30 – 2:00
LMFT/LPC/MFTAC Board Update: Lunch will be provided (1.5 hours)

Heidelberg Ballroom

Plenary Address 2:15-5:30 (3 hours)

Lewis L. Moore, Ph.D.:
Breaking Free of Problemology’s Assertion of Pars Pro Toto

Keynote Address 5:45 – 7:15 (1.5 hours)

Tom Moore, M.A.: Why the Witchdoctor Lives at the Edge of Town—A
Perspective on Professional Identity

Friday March 11, 2011

Morning Plenary Address 9:00 – 12:15 (3 hours)

Betty Alice Erickson, M.S.: Constructing a ‘More-Conscious’ Marriage

Lunch: On your own

Afternoon Plenary Address 2:00 – 5:15 (3 hours)

Betty Alice Erickson, M.S., Lewis L. Moore, Ph.D., Tom Moore, M.A., and
Bradford P. Keeney Ph.D.:

Personal Growth, Spirituality, & Hypnosis: Becoming Awake in Therapy

Saturday March 12, 2011

Poster Session and Competition 8:00 – 9:00 (1 hour)

Morning Sessions – Circle your preference(s)

9:00 – 11:15
200 (2 hours) Jana P. Sutton Ph.D. & Bradford P. Keeney, Ph.D.: AAMFT Approved Supervisor

Refresher Course, Part 2
*This course is for AAMFT Approved Supervisors Only. To receive full credit, you must attend both
parts—Sessions 100 & 200. Session 100 will be offered Thursday, March 10th from 9:00AM-12:15PM.

9:00 – 12:15
201 (3 hours) Brian S. Canfield, Ed.D.: Confidentiality and Privileged Communication Issues in

Working with Couples and Families
Note I: Ethics satisfies the MFT Ethics required for MFT licensure.

9:00 – 10:30
202 (1.5 hours) Amy Yates, Ph.D., Katherine Wilson, Ph.D., & Kelly Barnett, Ph.D.: Designing Systemic

Interventions: A Primer
203 (1.5 hours) Scott Shelby, Ph.D. & Bethany Sartori, M.A.: Creative Strategies When Working with

Students and Families

10:45 – 12:15
204 (1.5 hours) Peggy Buffington, M.A., Robyn Jardine-Randel, M.A., & Bethany Simmons, Ph.D.:

Wait, I Didn’t Come to College to Die: College Students and Suicide
205 (1.5 hours) Catherine Estis, Ph.D.: Securing External Funding for your Research
206 (1.5 hours) Jessica Baudoin, Ph.D., Allison Lux, M.A., & Quinton Jones, M.A.: Experiencing

Change: Moments of Hope from the Supervisors’ Perspectives

12:30 – 1:30
LAMFT General Business Meeting (1 hour): Riverview A

Special Assistance
I need Special Assistance: Yes ___ No ___ If yes, please specify: _______________________
______________________________________________________________________________

Fees: Full Conference

LAMFT Membership Status Regular Advanced Registration Rate
Price (Must be received by 1/31/11)

Non-member $280 $255
LAMFT Member $250 $225
LAMFT Student Member $110 $100
Student Non-Member $130 $110

Fees: Thursday or Friday Only

Advanced Please circle the one

Membership Status Regular Registration Rate day you plan to attend
Price
Non-Member Full Conference (Must be received
LAMFT Member
LAMFT Student Member by 1/31/11)
Student Non-Member
$195 $ 175 Thursday or Friday

$175 $ 155 Thursday or Friday

$ 90 $ 75 Thursday or Friday

$110 $ 90 Thursday or Friday

Fees: Saturday Only

Saturday Only Regular Price Advanced Registration Rate
(Must be received by 1/31/11)
All
LAMFT Student Member $110 $ 100
Student Non-Member
$ 50 $ 40

$ 70 $ 60

Fees and Registration: …………………………………………………... $ __________

Cancellation Policy - Requests for refunds must be made in writing and postmarked by February 1,
2011. All refund requests are subject to cancellation fees in the following amounts: Full conference
registrants ~ $100; Thursday or Friday only conference registrants ~ $60.00; and Saturday only
conference registrants ~ $40.00. There will be no refunds after February 1, 2011.
Returned Check Policy - An administrative charge of $35 will be assessed for any check returned to
LAMFT marked NSF.

Changes in Workshops/Presenter Policy - In case of circumstances beyond its control, LAMFT
reserves the right to make necessary changes in presenters and content without prior notification.
Sponsoring/Exhibiting - For more information on exhibiting or sponsoring at the conference, please
contact Dr. Jessica Baudoin at [email protected] or Dr. Eddie Parish at [email protected].

Payment Information:

___ I have enclosed a check/money order payable to LAMFT in the amount of $_______

___ I authorize LAMFT to charge my credit card in the amount of $_______

Check One:
___ Visa ___ MasterCard ___ Discover ____ American Express

Card Number ____________________________________ Exp. Date _______________

Card Holder’s Name ______________________________ CVN (3 digit # on back) ____

Cardholder’s Billing Address _______________________________________________

Cardholder's Signature _____________________________________________________

Telephone Number (including area code): _____________________________________

Type of ceus requested:

____ LMFT ____ NBCC (LPC) _____BCSAC (Lic. # ____) ____ NASW

Mail this form and payment to:

LAMFT Treasurer, Dr. Jessica Baudoin
P.O. Box 131
Erath, LA 70533

Be Sure to Make Your Hotel Reservations Soon!

Hilton Baton Rouge Capitol Center
201 Lafayette Street, Baton Rouge, Louisiana, United States 70801
Phone: 1-225-344-5866

*Book your rooms early!! Attendees who reserve their rooms by February 7, 2011 will receive a special
group rate of $139 per night until the group block is sold out.

See www.lamft.org for additional hotel and conference information.