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This is where clinicians and educators come for biofeedback training and to add behavioral medicine techniques to their skill sets.

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Schedule: You can start our courses whenever you purchase them and work at your own pace as long as you complete the course within two years of purchase. Just contact us at contact@behavmedfoundation.org or 800 530 6658 to get started.
Duration of course validity: You must begin the course within one year of the purchase date and complete it within two years of the purchase date. Courses not completed by that time are void and must be repurchased if still available. No refunds are provided for courses not completed within two years of purchase.

CE Credit: These are continuing education, not university accredited, courses. CE credits are given through (1) the state of California’s Board of Behavioral Sciences (Approval # PCE1895); (2) The National Board of Certified Counselors (Provider # 6270), and (3) The American Psychological Association.

BCIA: These courses are accepted by the Biofeedback Certification International Alliance for both certification (in the case of basic courses) and recertification.

Payment, Refund, Scholarship, and cancellation policies: Full payment for each course is required before the course materials can be mailed. Payment is by credit card though our web site’s secure ordering section (www.biofeedback-training.org) or by check in US dollars made out to the Foundation and sent to the letterhead address. Full refund will be made until the CDs are mailed to you. After the CDs are mailed, there is no refund at all as the Foundation has committed its resources to you. A course would only be cancelled due to an extreme emergency on the part of the course instructor or the Foundation. In the highly unlikely event a course is cancelled, you would receive a full refund.

Scholarships: The Foundation gives two types of scholarships.

1. $150 off the cost of any of our 30 CE and up courses for (a) students and clinicians from emerging nations and (b) full time students in developed nations who meet our criteria for financial need.

2. Full scholarship covering the cost of registration to the Association for Applied Psychophysiology’s annual meeting to one student per year who is not yet a member of AAPB and has never attended a meeting of this society. The student must have taken or be taking a course from the Foundation and join AAPB as a student member to receive this scholarship.

Multicourse Discounts: People taking a second course through the Foundation pay $100 less than the cost of all subsequent courses earning more than 30 CEs. To arrange your discount, send an e-mail to the Foundation at contact@behavmedfoundation.org when you register for the course.

Shipping course materials: All course materials (normally CDs) are shipped via regular US Mail as part of the cost of the course. If you want some other form of shipment such as second day air, priority mail, or courier service (Fed Ex, etc.) you must arrange to pay for the additional service by sending an e-mail to the Foundation at contact@behavmedfoundation.org when you before purchasing the course.

CD replacement policies: In those rare cases where a CD arrives damaged, it will be replaced for free immediately. There is a $20 charge to replace lost course CDs.

Course updates: Updates to all courses are provided free of charge via regular mail or e-mail during the two years the course is valid or until completion, whichever comes first.

 

 

For additional information, contact us by:
E-mail at: contactbehavmedfoundation.org

Phone with toll from outside the US & Canada: 1 360 452 9528

Phone toll free in the US and Canada:
1 800 530 6658
8:00 AM - 6:00 PM United States
Pacific Time Monday - Friday

Mail at: 6576 Blue Mountain Road,
Port Angeles, WA 98362

Order Behavioral Assessment & Treatment of Pelvic Floor Disorders $550

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F A Q

Who Are Our Courses For?
Clinicians, Educators, & Coaches.
We do not offer training directly to patients.

Can I Get CEC's?
YES! Our courses offer between 35 and 50 CE's. Our  CE courses are approved / accredited by the American Psychological Association (APA), the National Board of Certified Counselors (NBCC), California's Boards of Psychology and Behavioral Sciences, and (for most) BCIA.

How Do I Know These are Quality Courses?
Our Programs, Courses and Instructors are independently evaluated by state and national organizations, such as BCIA, APA, and NBCC so you can be assured of a top notch experience.

Are our Courses Approved by BCIA?
YES! We provide the required training for certification in general biofeedback, EEG biofeedback / neurofeedback, and pelvic floor disorders. You can also use our courses for recertification.

What Education Level Are Our Courses Set At?
Postgraduate (Masters and Doctorate level).
Note that these are difficult courses. They require about the same amount of time, work, and effort as any three credit graduate science class.

How Do I Take (sign-up for / register for) a Course?
These are distance education courses. Just purchase the course here at our web site and use our secure ordering site to pay by credit card or check in US funds. You can start when you wish to and work at your own pace.   

What Are Classes Like?
The courses are very similar to "in-person"¯ courses except that you communicate with your instructor via phone or e-mail. We make sure every student gets personal attention from instructors with decades of experience. You receive CDs containing audiovisual lectures, reading material files, movies, etc. You start the class when you are ready and work at your own pace. For most courses you also read a required text. After you attend each lecture, you answer a set of short essay questions and e-mail them to your instructor. You and your instructor communicate by e-mail or phone to go over any questions you have and to add additional information you may want.

Behavioral Assessment &
Treatment of Pelvic Floor Disorders

(This is the APA and BCIA approved course on biofeedback for urinary incontinence, pelvic pain, etc.)

45 Hours of CE Credit / Course Fee $550

Presented by Richard A. Sherman, Ph.D.

Concept and Objectives: This course is set at the level of a typical 3 credit post-licensure, introductory level course. The course is targeted to licensed / certified clinicians such as psychologists, counselors, physical therapists, social workers, nurses, and physicians as well as to graduate students. Students learn by watching audiovisual lectures provided on CDs, watching several movies, reading assignments both from materials provided on the CD and standard texts, and interacting with their instructor via e-mail. They answer short essay questions after each lecture rather than taking exams. Previous students have found that this course takes between 45 and 95 hours of work to perform.

This course provides a basic understanding of pelvic floor functions and structures along with clinical etiologies of pelvic floor disorders treated by behavioral interventions. Provide sufficient information on research supporting behavioral interventions, and clinical protocols for behavioral interventions to bring health care providers to the point where they have the knowledge base needed to provide these interventions to their clients within their scopes of practice and expertise after the providers gain hands-on experience by working with experienced practitioners. You may wish to contact the Foundation for information about hands-on training.

Pelvic floor disorders are common among all age groups of women. Behavioral interventions such as biofeedback are very effective for stress and urge urinary incontinence, functional constipation, and muscle related pelvic floor pain. If you want to improve the effectiveness of your pelvic floor treatments, consider adding muscle pattern biofeedback. Recordings give you the ability to see exactly what patterns of tension your patients are exhibiting so you can coach them to use optimal patterns as you and your patient watch the display on your monitor. These techniques are simple to learn and teach.”

Learning objectives: The course objective is to provide the depth of knowledge in pelvic area A&P, psychophysiology, biofeedback equipment, and training techniques which clinicians require to perform psychophysiologically oriented assessments and biofeedback and other behaviorally based interventions for pelvic floor disorders. This information is crucial to effectively adding these techniques to a clinician's practice.

This course is designed to help you (the student):

  • Summarize the psychophysiological processes and anatomy underlying each pelvic floor condition covered in the course.
  • Use psychophysiological recording and biofeedback devices record and display psychophysiological information about musculoskeletal functioning of the pelvic floor.
  • Control the biofeedback display to optimize learning to correct patterns of muscle tension in the pelvic floor.
  • Use psychophysiological recording equipment to assess patients with pelvic floor musculoskeletal dysfunctions.
  • Use biofeedback equipment to apply specific interventions tailored to each muscle related pelvic floor condition covered in the course.
  • Use behavioral techniques learned in the course to assist patients in controlling muscle related dysfunction patterns causing specific pelvic floor problems.

Format: Interactive distance based home study supported by e-mail chats after each unit is completed. The CD based lecture portion of the course is presented through a series of audiovisual lectures profusely illustrated by power-point slides. You start the course whenever you wish and work at your own pace. You will receive CDs containing both the audiovisual lectures and a copy of the slide sets upon which the lectures are based so you can make notes on your copy of the slides as you attend the lecture. After watching each lecture and reading the corresponding material in the assigned texts, protocols, and articles, you will answer a brief series of essay questions. The answered questions are then e-mailed to the instructor. You and the instructor will discuss each unit via e-mail chat after your answers are assessed. Ample opportunity for personalized discussion of questions, plans, etc. is available.

Required Reading: (Cost of the texts is not included in the course fee.)

  1. Schwartz M and Andraskik F: Biofeedback a Practitioner's Guide. All of section VIII (elimination disorders), Guilford Press, New York, 2003. ISBN 1-57230-845-1
  2. Laycock J and Haslam J: Therapeutic Management of Incontinence and Pelvic Pain. Springer, New York, 2002. ISBN 1852332247 (soft cover).
  3. Compendium of articles and protocols provided on the course CD.

Optional Reading:

  1. Dorey G: Conservative treatment of male urinary incontinence and erectile dysfunction. Whurr Publishers, Phhiladelphia & London, 2001. ISBN 1-86156-302-7. (Note: If you work with males, it is very worth your while to get this small book!)
  2. Newman D: Managing and treating urinary incontinence. Health Professions Press, Maryland, 2002. ISBN 1-878812-82-3 (Very good book but you can get similar material from the two required texts.)
  3. Brubaker L and Saclarides T: The female pelvic floor. F.A. Davis, Philadelphia, 1996. ISBN 0-8036-0075-5 (Excellent book but you can get similar material from the two required texts.)

Topic Overview:

(A detailed list of subtopics with reading assignments is at the end of this outline.)

  1. Overview of behavioral assessment and intervention for pelvic floor disorders including a brief discussion of credibility.
  2. Anatomy and Physiology of the Pelvic Floor
  3. Principles of applied psychophysiology biofeedback as applied to the pelvic floor
  4. Know what is normal before you try to fix it
  5. Assessments and interventions for urinary incontinence
  6. Assessments and interventions for bowel dysfunctions
  7. Principles of pain assessment and intervention from a psychophysiological perspective
  8. Assessments and interventions for pelvic pain syndromes
  9. Assessments and interventions for erectile dysfunction
  10. Ethical considerations in performing behavioral assessments and interventions for pelvic floor disorders

Getting started:

Purchase the text books on your own (usually on-line book sellers are far less expensive) and purchase the course from the Foundation. Just go to our web site to pay by credit card or send a check in US funds to the above address. See below for discount information. You can begin at your convenience and progress through the course at your own pace.

Payment and discounts: The course costs $550 (exclusive of the texts). You can purchase the course via credit card on our web site (behavmedfoundation.org) or by mailing a check in US funds made out to the Behavioral Medicine Research and Training Foundation to the letterhead address.

Discount for this course if you already took the Foundation's general biofeedback or urinary incontinence courses: People who have taken either the Foundation's general biofeedback or urinary incontinence courses can take this pelvic floor course for half price ($275). People who took general biofeedback courses from other groups can not have a discount because we have no realistic way to judge how much of the information was provided.

Discount for taking the Foundation's general biofeedback course: The Foundation offers a BCIA approved, distancecourse in general biofeedback. Because of the tremendous overlap in information between this and our general biofeedback course, we offer our general biofeedback course to people taking the pelvic floor course at ½ price ($275).

Certificate of Training: The Foundation will issue a certificate of training in behavioral treatments of pelvic floor disorders at the completion of this course only after the participant provides evidence of at least ten hours of hands-on training using a biofeedback device for treatment of urinary incontinence.

Faculty: The course is taught by Richard A. Sherman, Ph.D. Dr. Sherman has been performing behavioral interventions including biofeedback for pelvic floor disorders including fecal and urinary incontinence for over 25 years and has trained dozens of clinicians (including nurses, physical and occupational therapists, and psychologists). He is a professional psychophysiologist with extensive training (his PhD is in biology / physiology) and has over 30 years of experience in the field. He has clinical and research publications in urinary incontinence in addition to over 130 other books and publications. Dr. Sherman is dean of the psychophysiology doctoral program at the University of Natural Medicine and has held numerous positions at the Association for Applied Psychophysiology and Biofeedback (AAPB) including president. His CV is on the course CD and is also available upon request.

Practicum and mentored biofeedback training: This course covers only the didactic portion of the material required to be competent in performing behavioral interventions for pelvic floor disorders. It is crucial that everybody intending to perform behavioral interventions for pelvic floor dysfunctions (1) hands on training in use of the biofeedback devices, (2) observe patients being treated for those dysfunctions of interest, and (3) receive mentoring while performing initial interventions. For BCIA (Biofeedback Certification Institute of America) certification in "pelvic muscle dysfunction biofeedback"¯ in addition to a course in anatomy and physiology, 4 hours of practicum training in use of biofeedback equipment and observation of patient treatment are required along with 48 hours of mentored biofeedback. The mentoring consists of 30 hours of clinical training in EMG and behavioral interventions, 12 hours of direct clinical supervision, and 6 hours of case conference.

You may want to contact us for information about getting this crucial training and mentoring.

Limits to the depth of information provided by this course:

Anatomy and Physiology Course: Anyone intending to perform behavioral treatments of pelvic floor dysfunctions needs to know the basic elements of human anatomy and physiology (A&P). For example, the effects of stress, hormones, bone remodeling, bone disorders, etc on the dysfunctions to be treated can't be covered in sufficient depth in this course. BCIA requires an undergraduate A&P course for certification. We offer a BCIA approved, distance based A&P course which emphasizes the material you need to know to enhance you competence in providing behavioral interventions. Information about the course can be found on our web site.

General Biofeedback Course: This is not a course in general biofeedback. Thus, although you will learn all you need to about the correct application of muscle tension and pneumatic biofeedback to the pelvic floor. But you will not learn (a) how to perform other types of biofeedback such as temperature and breath control training which may be needed if the person is vasoconstricting so much or breathing so incorrectly they can't attend to what you are trying to do due to anxiety, etc. or (2) associated behavioral techniques such as relaxation training which may be needed to reduce levels of anxiety so high the patient can't learn the skills you are trying to teach or may be so tense all over they may not be able to control the pelvic floor. Thus, if you haven't had a general biofeedback course, you may want to take one. The Foundation's general biofeedback course is available at half price to people taking this course.

Pain Course: This is not a general course on pain assessment and intervention from a psychophysiological perspective. This course provides an overview of psychophysiological pain assessment and intervention sufficient for you to do a competent job assessing and providing interventions for simple pelvic floor related pain problems but it doesn't have the depth to give you an overall picture of how pain in other parts of the body relates to the pelvic floor, etc. This means you won't know enough at the end of this course to competently assess pain problems referring to or influencing the pelvic floor. Nor will you know the overall elements of pain assessment and intervention. If you are going to work with pain in the pelvic floor, you should consider taking a course in pain psychophysiology.

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Detailed Contents of each topic with associated audiovisual talks and readings:

1. Overview of behavioral assessment and intervention for pelvic floor disorders

Elimination disorders treated with biofeedback assisted behavioral therapy, history of biofeedback and behavioral modalities used for pelvic floor disorders, assessing credibility of behavioral interventions for pelvic floor disorders, etc.

Audiovisual Lectures 1.1 and 1.2 - Introduction

Audiovisual Lecture 1.3 - Assessing Credibility

(Note that people who have taken the Behavioral Medicine R&T Foundation or UNM's courses in either pain assessment or general biofeedback are exempt from lecture 1.3)

Laycock & Haslam 1

Optional Newman 1 and 2

PFD biofeedback chapter file on CD

2. Anatomy and Physiology of the Pelvic Floor

Audiovisual Lectures 2.1 and 2.2

a. Anatomy and physiology of pelvic floor structures (pelvic floor muscle, bones, diaphragms, sphincters, smooth vs. striated muscle)

Laycock & Haslam 2, 5, 28 - 30

A&P of the male lower urinary tract

Optional Newman 2 and 3

Optional Dorey ch 2

Anatomy of the penis / physiology of erections

b. Urological A&P (urine storage and maturation, bladder anatomy, normal bladder storage and emptying, somatic and autonomic enervation) types of urinary incontinence, dyssynergia

Laycock & Haslam 3, differences between male and female urinary incontinence

Optional Dorey Chapter 5

c. Prostate conditions

Optional Dorey ch 4

d. A&P of digestive structures and processes, stool continence, defecation, somatic and autonomic enervation.

Laycock & Haslam 20 - 22

Optional Newman 5

3. Principles of applied psychophysiology biofeedback as applied to the pelvic floor

Audiovisual Lectures 3.1 - 3.6

(Note: Anyone who took the pain or general biofeedback course given by either the Behavioral Medicine R&T Foundation of the UNM is exempt from this section.)

PFD muscle tension exercise file on CD

a. Introduction to biofeedback (definitions, history, overview of modalities, concepts of feedback and control in biological systems, principles of human learning as applied to biofeedback)

b. Surface EMG Instrumentation (terms and concepts, sources of artifact, sensor placement including skin preparation, distance between sensors and typical sites, EMG factors affecting assessment and interpretation such as fat, posture, etc., signal processing and feedback displays)

c. Biofeedback and distress (stress and the biopsychosocial model of illness, stressful life events and the risk of illness, psychophysiological reactions to stressful events)

d. Neuromuscular relaxation training (techniques assisted by EMG biofeedback such as autogenic training, hypnosis, meditation, etc., integrating relaxation into daily life, overview of other psychophysiological modalities used for neuromuscular relaxation such as heart rate variability, thermal biofeedback, EEG, GSR, etc.)

4. Know what is normal before you try to fix it

Lack of understanding normal levels and patterns of muscle function, patters and rates of urination, defecation, lubrication, erection etc. has led many people to think they are abnormal and many therapists to try changing a normal system resulting in abnormal functioning Audiovisual Lecture 4

5. Assessments and interventions for urinary incontinence

Audiovisual Lectures 5.1, 5.2, 5.4, 5.6, and 5.8

Protocols and patient handouts on CD

a. Overview of physiological basis for and testing for urinary disorders (varieties of bladder disorders such as stress and urge incontinence dyssynergia, etc., overview of medical diagnostic procedures, urodynamics)

Schwartz & Andrasik 26

Laycock & Haslam 4, 6, and 16

Optional Newman 6

b. Physical assessments

c. Urodynamics

d. Surface EMG pelvic floor muscle assessment (vaginal and rectal surface EMG placements, infection control, protocols for evaluation, baselines, phasic and tonic muscle testing, endurance, dyssynergia testing, data interpretation)

e. Exercise and Surface EMG based pelvic floor training

f. Treatment options not involving biofeedback

Laycock & Haslam 8 , 9, 11 - 15, 17 - 19

Optional Newman 7, 8, 9, and 10

Optional Dorey chapter 8

Exercises, Cones / weights, Electrical stimulation, Lifestyle changes, Bladder training for urge incontinence, Medications for urge incontinence, Pads, Appliances, Penile clamps, Prosthetic devices, inserts, Plugs, Surgery, Fluid Control, Skin care for incontinence dermatitis, Intermittent self-catheterization, and Artificial urinary sphincter (d 83/4)

g. EMG instrumentation options (sensors, SEMG instruments, home training devices)

Laycock & Haslam 10

h. Preparation for clinical practice (patient education in biofeedback and relevant A&P, patient intake, communication with other health care providers)

i. Medical and behavioral treatment modalities - urologic (neuromuscular reeducation and exercise assisted by vaginal/rectal SEMG and other SEMG placements for bladder disorders - uptraining, downtraining, coordination training), other behavioral techniques including urge suppression techniques, bladder retraining, electrical stimulation, etc., non-behavioral techniques including drugs, surgery, electrical, physical interventions, etc.)

6. Assessments and interventions for bowel dysfunctions

Audiovisual Lectures 6. and 6.2

Schwartz & Andrasik 27 & 29

Laycock & Haslam 20 - 22

a. Physiological basis for and testing for GI disorders (GI disorders including fecal incontinence, constipation, dyssynergia, irritable bowel syndrome, and colonic inertia, medical diagnostic procedures including manometric and defocograraphic evaluation and transit time studies)

b. GI Medical and behavioral treatment modalities (neuromuscular reeducation and therapeutic exercise assisted by vaginal/rectal surface EMG and other EMG placements for bowel disorders including uptraining, downtraining, coordination training, and bowel sensory awareness training, other behavioral methods specific to bowel disorders, non-behavioral interventions including surgery medications, physical interventions)

7. Principles of pain assessment and intervention from a psychophysiological perspective

Audiovisual Lecture 7.1 - 7.7

(Note: Anyone who took the pain course given by either the Behavioral Medicine R&T Foundation of the UNM is exempt from this section.)

Physiological basis of pelvic pain disorders (psychophysiological basis of pain, basic pain mechanisms related to pelvic pain, pain - stress - muscle tension relationships, trauma)

8. Assessments and interventions for pelvic pain syndromes

Audiovisual Lecture 8.1, 8.2, & 8.3

Schwartz & Andrasik 28

Laycock & Haslam 23 - 27

a. Physiological basis of pain syndromes related to pelvic floor dysfunction (chronic pelvic pain syndromes including vulvodinia, proctalgia fugax, levator ani; co-morbidities including irritable bowel syndrome, fibromyalgia, interstitial cystitis)

b. Pelvic pain syndromes unique (mostly) to males: (prostatitis, orchialgia, penile pain, prostatodynia, perineal pain, testicular cancer related pain, proctalgia fugax)

Optional Dorey ch 6

c. Medical and behavioral treatment modalities for pelvic area pain (neuromuscular reeducation, posture, dietary counseling, drugs, surgery, physical interventions, sexual history taking and counseling)

9. Assessments and interventions for erectile dysfunction: Audiovisual Lecture 9

a. Overview of erectile dysfunction

b. Assessment

c. Treatment

(1) alternative (electrical stimulation, herbs, acupuncture)

(2) drug based (antianxiety, vasodilators)

(3) surgical (repair or replace)

(4) behavioral (education, counseling, fantasizing, exercises, biofeedback, life style)

10. Ethical considerations in performing behavioral assessments and interventions for pelvic floor disorders

Overview of ethical principles of biofeedback as well as practice limitations and referral guidelines. Audiovisual lectures 10.1 and 10.2

Read files on CD entitled "PFD BCIA ethics document" ¯and "additions"¯.

End of course description and outline.

For clinicians who have already had training in some aspects of behavioral treatments of pelvic floor disorders: You can take only the modules of this course you need rather than the entire course. Contact the Foundation's director, Dr. Sherman, at rsherman@nwinet.com to discuss which modules you need and their prices.

Administrative Info:

Please see left sidebar for the followings:

  • Schedule
  • CE Credit
  • BCIA
  • Computer and Computer Knowledge Requirements
  • Refund, Cancellation, & CD Replacement Policies
  • Multicourse Discounts
  • Shipping of course materials
  • Course Updates

Ordering Information: We accept credit cards (only Visa, Master Card, & Discover) and checks in US dollars through our secure shopping cart. All taxes and cost of shipping via regular mail are included in the price.

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