Continuing Education

Professional development
that changes practice.

Resiliency Technologies, Inc. has been developing award-winning courses for licensed counselors, educators, and school professionals for over 20 years. Built on the same evidence base that powers the Sharpen system, our courses are developed alongside national researchers and feature documentary film testimony from clinicians and individuals in recovery.

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Evidence-based professional development

All Courses

Ten courses.
20 years of evidence base.

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Each course includes a downloadable training certificate indicating hours completed. CE certificate also provided when applicable.

NBCC Accreditation

Resiliency Technologies, Inc. has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7243. Programs that do not qualify for NBCC credit are clearly identified. Resiliency Technologies, Inc. is solely responsible for all aspects of the programs.

Sharpen® Suicide Safety Planning

Instructor: Deirdre DeLeo, MA, LCSW

This one-hour course teaches the Safety Planning Intervention, a brief suicide prevention intervention (Stanley & Brown, 2012). Participants learn the seven components of a safety plan, how protective factors reduce suicide risk, and how to complete a digital safety plan and resiliency toolkit with a client in real time.

1 contact hour · Asynchronous · Continuing education available

Evidence base

Sharpen® draws on twenty years of prevention work in schools, health systems and communities, reaching 87,792 people through live trainings before any of it became digital. The curriculum was written by practitioners who first certified in the field’s gold-standard models, including CONNECT postvention through the South Carolina Office of Suicide Prevention, and it is structured against the four strategic directions of the 2024 National Strategy for Suicide Prevention (U.S. Department of Health and Human Services, 2024).

Led by Deirdre DeLeo, MA, LCSW, of VNS Health Safe Pathways, the course teaches the Safety Planning Intervention, which Stanley and Brown developed while working with veterans in suicidal crisis (Stanley & Brown, 2012). In emergency departments, the Safety Planning Intervention paired with structured follow-up calls was associated with 45% fewer suicidal behaviors over six months than usual care (Stanley et al., 2018).

The course is the professional training component of VNS Health Safe Pathways, a five-year New York State Office of Mental Health suicide prevention initiative, where it has been delivered to 534 participants across 23 cohorts with more than 200 certifications issued. Among trained providers, confidence in suicide risk management improved significantly (p = .001), the proportion reporting high confidence rose from 48.9% to 72.3%, and the low-confidence group was eliminated entirely. Of participants surveyed, 94.8% called the training a good use of their time and 95.5% would recommend it (Rios & Biber, 2024).

Learning objectives

Explain the evidence supporting safety planning as a brief suicide prevention intervention
List the seven components of a safety plan and describe the purpose of each
Describe how protective factors reduce suicide risk and identify at least three to reinforce with a client
Apply a digital safety plan and resiliency toolkit with a client in real time

Sources cited on this page

Rios, I., & Biber, D. (2024). Sharpen® health care worker app data [Program evaluation]. Resiliency Technologies, Inc.

Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256-264. https://doi.org/10.1016/j.cbpra.2011.01.001

Stanley, B., Brown, G. K., Brenner, L. A., Galfalvy, H. C., Currier, G. W., Knox, K. L., Chaudhury, S. R., Bush, A. L., & Green, K. L. (2018). Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry, 75(9), 894-900. https://doi.org/10.1001/jamapsychiatry.2018.1776

U.S. Department of Health and Human Services. (2024). 2024 national strategy for suicide prevention.

$25

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NBCC Accreditation

Sharpen® Suicide Screening

Instructor(s): Alex Karydi, PhD, LMFT and Deirdre DeLeo, MA, LCSW

This one-hour course teaches providers to screen for suicide risk with the Columbia Protocol (C-SSRS), to ask directly about suicidal ideation, intent and plan, and to connect people to the crisis response pathway that fits the level of risk.

1 contact hour · Asynchronous · Continuing education available

Evidence base

Led by Alex Karydi, PhD, LMFT, and Deirdre DeLeo, MA, LCSW, of VNS Health, the course teaches the Columbia-Suicide Severity Rating Scale (Posner et al., 2011), a validated universal screener with versions for clinicians, staff, parents and peers in multiple languages. Participants learn how its two ideation questions and four behavior questions work, why the final behavior question is asked even when ideation is denied, and how low, moderate and high risk levels guide the next step: connection to community services, a mobile crisis team, the 988 Suicide & Crisis Lifeline (988 Suicide & Crisis Lifeline, n.d.), or an emergency department when danger is imminent. The course rests on research showing that asking directly about suicide does not increase suicidal ideation (Dazzi et al., 2014), and it reviews risk factors for suicide among adolescents and young adults, including the elevated risk faced by LGBTQ+ youth.

It is the professional training component of VNS Health Safe Pathways, a five-year New York State Office of Mental Health suicide prevention initiative, where it has been delivered to 534 participants across 23 cohorts with more than 200 certifications issued. Among trained providers, confidence in suicide risk management improved significantly (p = .001), the proportion reporting high confidence rose from 48.9% to 72.3%, and the low-confidence group was eliminated entirely. Of participants surveyed, 94.8% called the training a good use of their time and 95.5% would recommend it (Rios & Biber, 2024).

Learning objectives

Describe the Columbia Protocol (C-SSRS) as a validated universal screening instrument and identify the settings in which it is indicated
Demonstrate how to ask directly about suicidal ideation, intent and plan
Summarize current research on suicide risk factors among the youth and young adult populations you serve
Identify the threshold at which a screening result requires escalation, and name the crisis response pathways available in your setting

Sources cited on this page

988 Suicide & Crisis Lifeline. (n.d.). 988 Suicide & Crisis Lifeline. https://988lifeline.org

Dazzi, T., Gribble, R., Wessely, S., & Fear, N. T. (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine, 44(16), 3361-3363. https://doi.org/10.1017/S0033291714001299

Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., & Mann, J. J. (2011). The Columbia-Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168(12), 1266-1277. https://doi.org/10.1176/appi.ajp.2011.10111704

Rios, I., & Biber, D. (2024). Sharpen® health care worker app data [Program evaluation]. Resiliency Technologies, Inc.

U.S. Department of Health and Human Services. (2024). 2024 national strategy for suicide prevention.

$25

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NBCC Accreditation

Sharpen® Suicide Prevention

Instructor(s): Robyn Hussa Farrell, MFA, E-RYT, MPH Site Preceptor (UC Berkeley, SDSU); Alex Karydi, PhD, LMFT; & Taylor Davis, Ed.S., LPC

This course translates public health evidence on suicide risk and protective factors into practical, strength-based tools for professionals working with youth. Using Sharpen®'s long-form documentary interview format, participants hear directly from national suicidologists and community experts. The curriculum was developed using the same approach as all Sharpen® courses: filmed interviews with experts, modular delivery, and a strength-based framework grounded in published prevention science.

1.5 contact hours · Asynchronous · Continuing education available

Evidence base

Sharpen® draws on twenty years of prevention work in schools, health systems and communities, reaching 87,792 people through live trainings before any of it became digital. The curriculum was written by practitioners who first certified in the field's gold-standard models, including CONNECT postvention through the South Carolina Office of Suicide Prevention, and it is structured against the four strategic directions of the 2024 National Strategy for Suicide Prevention (U.S. Department of Health and Human Services, 2024).

Led by Alex Karydi, PhD, LMFT, and Taylor Davis, Ed.S., LPC, the course teaches the distinction that organizes prevention practice: risk factors are situational events whose weight varies from person to person, while warning signs are changes from an individual's own usual pattern. Participants learn the major public health protective factors drawn from the American Foundation for Suicide Prevention, the Columbia Lighthouse Project and the Suicide Prevention Resource Center. The course grounds its practice guidance in the strengths perspective (Saleebey, 1996), which holds that every individual possesses inherent capacity for growth and change.

The course also maps the gatekeeper training landscape, covering safeTALK and its TALK steps, ASIST, and CONNECT postvention from NAMI New Hampshire, and tells participants how to find a certified trainer for each. Additional subject matter experts appearing on film include Timothy D. Brewerton, MD, DLFAPA, FAED, DFAACAP, CEDS-S; Stephen P. Hinshaw, PhD; Mary Bartlett, PhD; and Nicole Siegfried, PhD, CEDS, alongside contributors speaking from lived experience.

Learning objectives

Differentiate warning signs from risk factors for suicide
Identify evidence-based public health protective factors for suicide
Apply strength-based approaches when working with youth
Describe the four strategic directions of the 2024 National Strategy for Suicide Prevention and explain how a comprehensive approach to prevention is structured
Identify evidence-based gatekeeper training models, including safeTALK, ASIST and CONNECT, and locate a certified trainer
Demonstrate how to start a conversation with someone who may be at risk, and identify the point at which an active threat requires an emergency response

Sources cited on this page

Condron, D. S., Garraza, L. G., Walrath, C. M., McKeon, R., Goldston, D. B., & Heilbron, N. S. (2015). Identifying and referring youths at risk for suicide following participation in school-based gatekeeper training. Suicide and Life-Threatening Behavior, 45(4), 461-476. https://doi.org/10.1111/sltb.12142

Rios, I., & Biber, D. (2024). Sharpen® health care worker app data [Program evaluation]. Resiliency Technologies, Inc.

Saleebey, D. (1996). The strengths perspective in social work practice: Extensions and cautions. Social Work, 41(3), 296-305. https://doi.org/10.1093/sw/41.3.296

Schmelefske, E., Per, M., Khoury, B., & Heath, N. (2022). The effects of mindfulness-based interventions on suicide outcomes: A meta-analysis. Archives of Suicide Research, 26(2), 447-464. https://doi.org/10.1080/13811118.2020.1833796

Suicide Prevention Resource Center. (n.d.). A comprehensive approach to suicide prevention. https://www.sprc.org/effective-prevention/comprehensive-approach

U.S. Department of Health and Human Services. (2024). 2024 national strategy for suicide prevention.

$25

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NBCC Accreditation

Sharpen® Suicide Postvention

Instructor(s): Robyn Hussa Farrell, MFA, E-RYT, MPH Site Preceptor (UC Berkeley, SDSU) and Alex Karydi, PhD, LMFT

Postvention, the organized response following a suicide loss, is an essential and often under-resourced component of community mental health. This 1-hour course prepares professionals to lead compassionate, evidence-based responses that reduce contagion risk and support survivors. Using Sharpen®'s documentary format, participants hear from national suicidologists on safe messaging, contagion risk, and the practical steps organizations must take in the aftermath of a suicide loss.

1 contact hour · Asynchronous · Continuing education available

Evidence base

Sharpen® draws on twenty years of prevention work in schools, health systems and communities, reaching 87,792 people through live trainings before any of it became digital. The curriculum was written by practitioners who first certified in the field's gold-standard models, including CONNECT postvention through the South Carolina Office of Suicide Prevention, and it is structured against the four strategic directions of the 2024 National Strategy for Suicide Prevention (U.S. Department of Health and Human Services, 2024).

The course features Alex Karydi, PhD, LMFT, speaking from her role directing State and Territorial Initiatives at the Suicide Prevention Resource Center (SPRC), the only federally supported resource center dedicated to advancing the implementation of the National Strategy for Suicide Prevention.

This course has been implemented as a professional training component of VNS Health Safe Pathways, a five-year New York State Office of Mental Health suicide prevention initiative, where it has been delivered to 534 participants across 23 cohorts with more than 200 certifications issued. Among trained providers, confidence in suicide risk management improved significantly (p = .001), the proportion reporting high confidence rose from 48.9% to 72.3%, and the low-confidence group was eliminated entirely. Of participants surveyed, 94.8% called the training a good use of their time and 95.5% would recommend it (Rios & Biber, 2024).

Learning objectives

Define postvention and explain its relationship to prevention
Describe the mechanisms of suicide contagion and identify who is at elevated risk following a loss
Apply safe messaging guidelines when communicating about a suicide death
Locate and use national postvention and media guideline resources

Sources cited on this page

American Foundation for Suicide Prevention & Suicide Prevention Resource Center. (2018). After a suicide: A toolkit for schools (2nd ed.). Education Development Center.

Gould, M. S., & Lake, A. M. (2013). The contagion of suicidal behavior. In Forum on Global Violence Prevention, Board on Global Health, Institute of Medicine, & National Research Council, Contagion of violence: Workshop summary. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK207262/

National Action Alliance for Suicide Prevention. (n.d.). Framework for successful messaging. https://suicidepreventionmessaging.org

Reporting on Suicide. (n.d.). Recommendations for reporting on suicide. https://reportingonsuicide.org

Rios, I., & Biber, D. (2024). Sharpen® health care worker app data [Program evaluation]. Resiliency Technologies, Inc.

Survivors of Suicide Loss Task Force. (2015). Responding to grief, trauma, and distress after a suicide: U.S. national guidelines. National Action Alliance for Suicide Prevention.

U.S. Department of Health and Human Services. (2024). 2024 national strategy for suicide prevention.

$25

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NBCC Accreditation

Sharpen® Overcoming Adversity: Trauma and the Developing Brain

Instructor(s): Robyn Hussa Farrell, MFA, E-RYT, MPH Site Preceptor (UC Berkeley, SDSU)

Working alongside 25+ national researchers, clinicians, child welfare professionals, foster parents and adults who grew up in foster care, these experts are featured in more than 35 films throughout the course.

Through expert testimony and personal stories of resilience, participants learn the impact of long-term activation of the stress-response system, how trauma impacts the developing mind, attachment theory, the prevalence of childhood trauma, and research on strategies for breaking cycles of abuse. Participants also receive access to programs suitable for teens ages 14 and up. Recommended companion for Sharpen® Mental Health Literacy, Sharpen® Suicide Prevention / Postvention, and How to Teach 5 Minute Mindfulness™ to Kids.

4.5 contact hours · Asynchronous · Continuing education available

Evidence base

Sharpen® Overcoming Adversity has been in continuous deployment since 2017. The course is built on foundational trauma literature, including the original Adverse Childhood Experiences study (Felitti et al., 1998), van der Kolk's work on the neurobiology of childhood trauma and on developmental trauma disorder (2003, 2005), and the California Surgeon General's report on adverse childhood experiences and toxic stress (Bhushan et al., 2020).

The trauma and child development content in this course is drawn from the Sharpen® library that has been evaluated in multiple settings. Built with more than 20 child welfare agencies and researchers in the area of childhood trauma, relevant modules have been made available to foster parents across South Carolina as a continuing education program through the South Carolina Department of Social Services. Similarly, police officers and health workers have attended training for secondary traumatic stress.

In an IRB-approved single-group pre-post design, 401 foster parents consented and 334 completed both the training and both surveys. Resilience rose from 3.54 to 3.85 on the Brief Resilience Scale (+8.63%, p < .001, d = 0.267) and self-compassion from 3.39 to 3.64 on the Self-Compassion Scale Short Form (+7.35%, p < .001, d = 0.242), with 88.5% mean module completion across 22,475 video views and 525.7 hours of collective watch time (Biber, Hussa Farrell & Farrell, 2026). An earlier pilot with South Carolina foster parents found significant improvement in the same two measures and established the design that study scaled (Biber, 2023).

The veteran reintegration and posttraumatic growth modules were developed as Sharpen® Warrior, built with Upstate Warrior Solution and more than 10 veteran health agencies and led by Craig Burnette, PhD, a psychologist with 40 years in the U.S. Department of Veterans Affairs who also appears on film in this course. The program was featured at the 2019 National Coalition for Homeless Veterans conference in Washington, DC.

The longest-running professional training deployment of Sharpen® Overcoming Adversity is VNS Health Safe Pathways, a five-year New York State Office of Mental Health initiative serving LGBTQI+ and BIPOC youth, families and providers across New York City. A longitudinal evaluation of the provider training, which has reached 534 participants across 23 cohorts from 2022 to 2026, drawing on 750 pooled survey responses, with more than 200 certifications issued to licensed clinicians and health workers (Rios & Biber, 2024).

The trauma and child development material has been presented in professional settings including the Attachment and Trauma Network annual conference (2021, 2022), the South Carolina Foster Parent Association Annual Conference (2023), and the Southeastern School Behavioral Health Conference (2021, 2023, 2025).

Learning objectives

Define Adverse Childhood Experiences and describe their prevalence and clinical presentation
Explain how long-term activation of the stress-response system affects the developing brain and body, and recognize the comorbidities commonly associated with trauma
Describe the dissociative disorders and explain the relationship between early trauma and disrupted identity integration
Apply attachment theory to clinical scenarios, including the role of early caregiving in later relational and emotional functioning
Explain the evidence on intergenerational transmission of abuse and identify strategies for breaking cycles of abuse
Describe typical early childhood development and explain how responsive relationships and positive childhood experiences shape outcomes
Identify evidence-based interventions for children affected by trauma, including play therapy and filial therapy
Describe trauma-informed practice with children in foster care, including recognizing trauma responses and responding appropriately
Identify protective factors and strategies that reduce toxic stress and build resilience in children and families
Describe posttraumatic growth and hardiness, and explain the conditions associated with growth following trauma
Identify challenges associated with reintegration following combat trauma and strategies that support successful transition

Sources cited on this page

Bhushan, D., Kotz, K., McCall, J., Wirtz, S., Gilgoff, R., Dube, S. R., Powers, C., Olson-Morgan, J., Galeste, M., Patterson, K., Harris, L., Mills, A., Bethell, C., & Burke Harris, N. (2020). Roadmap for resilience: The California Surgeon General's report on adverse childhood experiences, toxic stress, and health. Office of the California Surgeon General. https://doi.org/10.48019/PEAM8812

Biber, D. (2023). The impact of an mHealth mental health literacy training for foster parents. Trends in Psychology. https://doi.org/10.1007/s43076-023-00348-x

Biber, D. D., Hussa Farrell, R., & Farrell, T. (2026). Mental health literacy training for foster parents: A three-year implementation and analysis [Preprint]. SSRN. https://doi.org/10.2139/ssrn.6624959

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245-258. https://doi.org/10.1016/S0749-3797(98)00017-8

Huang, C. X., Halfon, N., Sastry, N., Chung, P. J., & Schickedanz, A. (2023). Positive childhood experiences and adult health outcomes. Pediatrics, 152(1), e2022060951. https://doi.org/10.1542/peds.2022-060951

Koenen, K. C., Ratanatharathorn, A., Ng, L., McLaughlin, K. A., Bromet, E. J., Stein, D. J., Karam, E. G., Meron Ruscio, A., Benjet, C., Scott, K., Atwoli, L., Petukhova, M., Lim, C. C. W., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Bunting, B., Ciutan, M., de Girolamo, G., ... Kessler, R. C. (2017). Posttraumatic stress disorder in the World Mental Health Surveys. Psychological Medicine, 47(13), 2260-2274. https://doi.org/10.1017/S0033291717000708

National Scientific Council on the Developing Child. (2015). Supportive relationships and active skill-building strengthen the foundations of resilience (Working Paper No. 13). Center on the Developing Child at Harvard University. https://developingchild.harvard.edu/resources/working-paper/supportive-relationships-and-active-skill-building-strengthen-the-foundations-of-resilience/

New York State Psychiatric Institute. (2025, November 12). OMH suicide prevention program evaluation: Site 4 (VNS Health) debrief [Unpublished evaluation presentation]. New York State Office of Mental Health.

Parker, J., Olson, S., & Bunde, J. (2020). The impact of trauma-based training on educators. Journal of Child and Adolescent Trauma, 13, 217-227. https://doi.org/10.1007/s40653-019-00261-5

Rios, I., & Biber, D. (2024). Sharpen® health care worker app data [Ongoing evaluation]. Resiliency Technologies, Inc.

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18. https://doi.org/10.1207/s15327965pli1501_01

van der Kolk, B. A. (2003). The neurobiology of childhood trauma and abuse. Child and Adolescent Psychiatric Clinics of North America, 12(2), 293-317. https://doi.org/10.1016/S1056-4993(03)00003-8

van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408. https://doi.org/10.3928/00485713-20050501-06

Zhang, Y. (2026). Positive childhood experiences and adult mental health symptoms: A meta-analysis. Development and Psychopathology, 38(2), 766-781. https://doi.org/10.1017/S0954579425100734

$72

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NBCC Accreditation

Sharpen® Mental Health Literacy

Instructor(s): Robyn Hussa Farrell, MFA, E-RYT, MPH Site Preceptor (UC Berkeley, SDSU)

Working alongside more than 15 national researchers and clinicians in mental health, these experts are featured in 100 films throughout the course. Hussa Farrell has implemented this course to undergraduates at a public universities and through various Sharpen® prevention toolkits that have been deployed since 2014. Featured on the Mentalhealthinstruction.org website (vetted through University of Washington SMART Center), the SMHL program has been implemented for high school students, college athletes, parents and professionals.

6 contact hours · Asynchronous · Continuing education available

This six-hour online course covers what mental health literacy is, why stigma has to be addressed directly, how to start a conversation with someone who is struggling, and what to expect from therapy. It then carries those skills into trauma and stress, suicide prevention and disordered eating prevention.

Hussa built the course around 100 documentary films, nearly five hours in all. Learners hear directly from people describing their own experience of anxiety, depression, ADHD, grief, suicidal thoughts and eating disorders, from the families who supported them, and from the researchers and clinicians who treat them.

Evidence base

Sharpen® Mental Health Literacy has evolved over twenty years of development and more than 30 research studies across more than 20 institutions. Its modules were selected using Sharpen® platform data on the most requested and most used content, on top of two decades of community-based participatory research, and they follow the Sharpen® logic model of risk and protective factors (Hussa Farrell & Farrell, 2026).

The program is built against the established mental health literacy literature (Jorm et al., 1997; Kutcher et al., 2016; Sampaio et al., 2022), and it follows the finding that interventions raising knowledge alone may leave stigma untouched, so that stigma has to be addressed directly if literacy gains are to translate into behavior (Martinez & Hinshaw, 2016; Soria-Martinez et al., 2024). The trauma, suicide prevention and disordered eating sections draw on the core literature for each topic, including the Adverse Childhood Experiences study (Felitti et al., 1998), clinical trials of mindfulness-based interventions (Goldberg et al., 2018; Hoge et al., 2023), the 2024 National Strategy for Suicide Prevention (U.S. Department of Health and Human Services, 2024), and a review of eating disorder risk factors across 284 studies (Barakat et al., 2023).

This program has been delivered to foster parents through the South Carolina Foster Parent Association, to medical students at the Edward Via College of Osteopathic Medicine as the branded Mindful MEDS toolkit (Berreta et al., 2023), and to college students and peer mentors (Biber & Rothman, 2024; Hussa Farrell & Abel, 2025). Across three years in which the course was delivered to South Carolina foster parents, 334 completers gained on the Brief Resilience Scale (8.63%) and the Self-Compassion Scale Short Form (7.35%), both p < .001, alongside an 88.5% mean module completion rate (Biber et al., 2026); an earlier pilot with South Carolina foster parents found significant improvement in the same two measures (Biber, 2025). Across four consecutive cohorts of the semester-long college build, 97.4% of respondents recommended the course and 24.7% volunteered unprompted that it should be required of all students; the fourth cohort was independently analyzed by an evaluation team at San Diego State University and has been submitted for publication (Levy et al., 2026).

Learning objectives

As a result of participating in this program, participants will be able to:

Mental Health Literacy
Describe the four components of mental health literacy
Identify the core features, risk factors and protective factors of common mental disorders, including ADHD, depression, anxiety and panic disorders, and PTSD
Describe how public stigma, self-stigma and cultural and family stigma affect help-seeking and engagement in treatment
Describe strategies for starting a supportive conversation with someone who may be struggling, and identify when to connect them to crisis resources
Identify what to expect from therapy, including the types of providers, the limits of confidentiality and the evidence-based treatments
Trauma and Stress
Explain how adverse childhood experiences and chronic stress affect mental and physical health, and identify the role of supportive relationships in resilience
Describe the stress response, including the roles of the sympathetic and parasympathetic nervous systems, and apply evidence-based stress management strategies
Summarize research on mindfulness practices and how they improve health outcomes
Identify mental health stressors and help-seeking barriers specific to athletes, and describe ways to support them
Explain how identifying and naming emotions improves protective factors for coping and help-seeking
Suicide Prevention
Differentiate warning signs from risk factors for suicide
Identify evidence-based protective factors for suicide and apply strength-based approaches when working with youth
Describe the four strategic directions of the 2024 National Strategy for Suicide Prevention and explain how a comprehensive approach is structured
Identify evidence-based gatekeeper training models for suicide prevention
Disordered Eating Prevention
Identify the types of eating disorders, their common risk factors and their medical and psychiatric comorbidities
Explain how weight stigma and internalized weight bias affect self-esteem, and describe strategies, including ending fat talk and mindful eating, that build a partnership with the body

Earning credit: to receive 6.0 NBCC contact hours, complete the module text in all 24 modules and all 100 films, pass the course quiz with a score of 80% or higher (28 of 35 correct), and submit the course evaluation. You may retake the quiz as many times as needed. The downloadable handouts in each module are optional.

Sources cited on this page

Barakat, S., McLean, S. A., Bryant, E., Le, A., Marks, P., National Eating Disorder Research Consortium, Touyz, S., & Maguire, S. (2023). Risk factors for eating disorders: Findings from a rapid review. Journal of Eating Disorders, 11, Article 8. https://doi.org/10.1186/s40337-022-00717-4

Berreta, K., Nguyen, C., Stoner, A. M., Ridgeway, L., Wilson, A., Fadel, N., & Biber, D. (2023). A RE-AIM analysis of a mental health app for undergraduate and medical students during the COVID-19 pandemic: A retrospective cross-sectional study. International Journal of Environmental Research and Public Health, 20(13), Article 6266. https://doi.org/10.3390/ijerph20136266

Biber, D. (2025). The impact of an mHealth mental health literacy training for foster parents. Trends in Psychology, 33(3), 836-849. https://doi.org/10.1007/s43076-023-00348-x

Biber, D., & Rothman, R. (2024). Mental health literacy training for college female peer mentors: A pilot study. Higher Education, Skills and Work-Based Learning, 14(1), 181-191. https://doi.org/10.1108/HESWBL-06-2023-0148

Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Wampold, B. E., Kearney, D. J., & Simpson, T. L. (2018). Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical Psychology Review, 59, 52-60. https://doi.org/10.1016/j.cpr.2017.10.011

Hoge, E. A., Bui, E., Mete, M., Dutton, M. A., Baker, A. W., & Simon, N. M. (2023). Mindfulness-based stress reduction vs escitalopram for the treatment of adults with anxiety disorders: A randomized clinical trial. JAMA Psychiatry, 80(1), 13-21. https://doi.org/10.1001/jamapsychiatry.2022.3679

Hussa Farrell, R., & Abel, C. (2025). Efficacy of mental health literacy training for college peer mentors: Sharpen® MHL impact on Vescent mentors [White paper]. Resiliency Technologies, Inc.

Hussa Farrell, R., & Farrell, T. (2026). The Sharpen® system: Seamless multi-level prevention: Evidence-based logic model validated through server-side engagement data from 9 prevention toolkit implementations (2019-2026) [White paper]. Resiliency Technologies, Inc. https://sharpen.health

Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). "Mental health literacy": A survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166(4), 182-186. https://doi.org/10.5694/j.1326-5377.1997.tb140071.x

Kutcher, S., Wei, Y., & Coniglio, C. (2016). Mental health literacy: Past, present, and future. Canadian Journal of Psychiatry, 61(3), 154-158. https://doi.org/10.1177/0706743715616609

Levy, J., Hussa Farrell, R., Farrell, T., Pish, M., Fassas, J., Reed, E., Hinshaw, S., & Biber, D. (2026). A program evaluation of the Sharpen® Mental Health Literacy (Sharpen® MHL) college course at a southeastern university in the United States [Manuscript submitted for publication].

Martinez, A. G., & Hinshaw, S. P. (2016). Mental health stigma: Theory, developmental issues, and research priorities. In D. Cicchetti (Ed.), Developmental psychopathology: Vol. 4. Risk, resilience, and intervention (3rd ed., pp. 997-1039). Wiley.

Sampaio, F., Gonçalves, P., & Sequeira, C. (2022). Mental health literacy: It is now time to put knowledge into practice. International Journal of Environmental Research and Public Health, 19(12), Article 7030. https://doi.org/10.3390/ijerph19127030

Soria-Martinez, M., Navarro-Pérez, C. F., Pérez-Ardanaz, B., & Martí-García, C. (2024). Conceptual framework of mental health literacy: Results from a scoping review and a Delphi survey. International Journal of Mental Health Nursing, 33(2), 281-296. https://doi.org/10.1111/inm.13249

U.S. Department of Health and Human Services. (2024). 2024 national strategy for suicide prevention. https://www.hhs.gov/programs/prevention-and-wellness/mental-health-substance-use-disorder/national-strategy-suicide-prevention/index.html

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NBCC Accreditation

How to Teach 5 Minute Mindfulness™ to Kids

Instructor(s): Robyn Hussa Farrell, MFA, E-RYT, YACEP, MPH Site Preceptor (UC Berkeley, SDSU)

First written in 2007 by Robyn Hussa Farrell, MFA, E-RYT, How to Teach 5 Minute Mindfulness™ to Kids is an evidence-based, trauma-aware mindfulness curriculum built for people who need to lead a practice for others. It was created inside eating disorder and substance use treatment settings and has been delivered continuously since then across K-12 schools, vocational rehabilitation, early childhood programs, adolescent athletics and healthcare systems. Recommended companion to Overcoming Adversity and Sharpen® Suicide Prevention. The course is Yoga Alliance YACEP approved.

4 contact hours · Asynchronous · Continuing education available · Recommended companion to Overcoming Adversity and Sharpen® Suicide Prevention.

Evidence base

Mindfulness-based interventions are associated with reduced suicide risk and strengthened protective factors across multiple studies and a meta-analysis (Chesin et al., 2023; Collins et al., 2018; Miller & Interian, 2025; Schmelefske et al., 2022), and self-compassion specifically has been linked to reduced suicidal ideation and self-harm (Cleare et al., 2019; Suh & Jeong, 2021). 5 Minute Mindfulness™ has been delivered as suicide prevention training to coalitions in South Carolina and New York, including as part of VNS Health Safe Pathways, a five-year New York State Office of Mental Health suicide prevention initiative. From 2013 to 2019 it ran as a youth-to-youth peer resiliency program in South Carolina, in which high school students were trained to facilitation fidelity and then led sessions for elementary-aged children in K-12 schools.

The program has been evaluated continuously across seventeen years. The National Eating Disorders Association commissioned the original best-practices toolkit, and exercises from the curriculum were published in Yoga and Eating Disorders (Costin & Kelly, 2016). More than 5,000 South Carolina educators received the training through the Compassionate and Resilient Schools initiatives, whose outcomes were published in the Journal of Child and Adolescent Trauma (Parker et al., 2020), with train-the-trainer delivery to more than 1,000 of them. Across eleven documented South Carolina cohorts, 90.4% understood the MBSR evidence base, 90.0% intended to bring the curriculum into their setting, and 93.9% learned something new (Hussa Farrell, 2026). Sixteen adolescent athletes completed an eight-week protocol measured with three validated instruments; sport anxiety fell significantly by week 8, and mindfulness improved (p = .031) (Patrizi et al., 2019). All thirty K-2 students in an early childhood deployment, every one living in housing insecurity, gained across all five literacy dimensions and all six social-emotional domains assessed (Bauer et al., 2020). In New York City healthcare workforce cohorts, confidence rose from 37 to 41 (p = .001), the high-confidence group grew from 48.9% to 72.3%, the low-confidence group was eliminated, and participants' belief that suicide cannot be prevented fell significantly (p = .029, d = 0.51) (Rios & Biber, 2024).

Learning objectives

As a result of participating in this program, participants will be able to:

Apply at least two mindfulness-based stress reduction (MBSR) strategies to support their own wellbeing and the wellbeing of the clients, students or patients they serve
Describe the physiological and psychological mechanisms by which brief, repeated mindfulness practice supports stress regulation, attention and emotion regulation
Demonstrate at least one 5 Minute Mindfulness™ technique using the three-part centering, core practice and cool-down structure (the ARC), suitable for a professional, classroom or clinical setting
Select an appropriate technique from the four categories of mindfulness practice (breathing, gentle movement, meditation and journal writing) for a given population, setting and time constraint, including adapting language to participants' belief systems
Identify trauma-informed adaptations for leading mindfulness with children and adults who have experienced trauma or adversity, including creating a safe environment and responding when a practice brings up strong emotions
Describe how to deliver a 5 Minute Mindfulness™ practice with fidelity inside a two-to-five-minute window, and summarize the research on the benefits and limits of brief, regular practice

Sources cited on this page

Bauer, C., Carson, G., Shirley, L., & Hussa Farrell, R. (2020). After-school resiliency for children ages 4 to 7: LEAP program outcomes [Program evaluation]. Mental Fitness, Inc.

Chesin, M. S., Dave, C. V., & Myers, C. (2023). Using mindfulness-based cognitive therapy to prevent suicide among high suicide-risk patients who also misuse opioids. International Journal of Mental Health and Addiction, 21, 3721-3734. https://doi.org/10.1007/s11469-022-00817-x

Cleare, S., Gumley, A., & O'Connor, R. C. (2019). Self-compassion, self-forgiveness, suicidal ideation, and self-harm: A systematic review. Clinical Psychology & Psychotherapy, 26(5), 511-530. https://doi.org/10.1002/cpp.2372

Collins, K. R. L., Stritzke, W. G. K., Page, A. C., Brown, J. D., & Wylde, T. J. (2018). Mind full of life: Does mindfulness confer resilience to suicide by increasing zest for life? Journal of Affective Disorders, 226, 100-107. https://doi.org/10.1016/j.jad.2017.09.043

Costin, C., & Kelly, J. (Eds.). (2016). Yoga and eating disorders: Ancient healing for modern illness. Routledge.

Hussa Farrell, R. (2026). 5 Minute Mindfulness™: A practice-based evidence review, 2007-2024 [Unpublished manuscript].

Miller, R. B., & Interian, A. (2025). Sitting with suicide: Mindfulness-based cognitive therapy for suicide prevention in military veterans. Clinical Social Work Journal. https://doi.org/10.1007/s10615-025-00994-x

Parker, J., Olson, S., & Bunde, J. (2020). The impact of trauma-based training on educators. Journal of Child & Adolescent Trauma, 13(2), 217-227. https://doi.org/10.1007/s40653-019-00261-5

Patrizi, J., Jones, A., Bishop, B., Stoner, A. M., Fadel, N. M., & Bendyk, H. (2019, May). Courtside mindfulness, keep your head in the game: The effects of 8-week mindfulness training on adolescent volleyball athletes [Poster presentation]. American Psychiatric Association Annual Meeting, San Francisco, CA, United States.

Rios, I., & Biber, D. (2024). Sharpen® health care worker app data [Program evaluation]. Resiliency Technologies, Inc.

Suh, H., & Jeong, J. (2021). Association of self-compassion with suicidal thoughts and behaviors and non-suicidal self-injury: A meta-analysis. Frontiers in Psychology, 12, Article 633482. https://doi.org/10.3389/fpsyg.2021.633482

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NBCC Accreditation

Sharpen® Eating Disorder Awareness and Prevention for Health Professionals

Instructor(s): Robyn Hussa Farrell, MFA, E-RYT, MPH Site Preceptor (UC Berkeley, SDSU)

Developed over 15 years in collaboration with researchers in disordered eating prevention, this 4-hour course features national experts, patients, and family members in over 30 documentary-style films that are incorporated into the learning experience. Hussa has led this training in communities since 2006.

4.0 contact hours · Online · Asynchronous · Continuing education available

Recently updated in collaboration with research teams assembled through Edward Via College of Osteopathic Medicine (VCOM) and Spartanburg Regional Healthcare System (including Timothy D. Brewerton, MD; Natalie Fadel, PsyD; Maggie Gainey, PhD; and Duke Biber, PhD), the course prepares counselors, social workers, nurses, physicians and other health professionals to recognize eating disorders across the diagnostic spectrum, screen with validated tools when symptoms are present, account for trauma, suicidality, and other co-occurring conditions, confront weight bias, understand medical management, and help patients reach the right level of care and treatment team.

Evidence base

An estimated 28.8 million Americans will have an eating disorder in their lifetime, and eating disorders cause about 10,200 deaths each year (Deloitte Access Economics, 2020). LGBTQ youth diagnosed with an eating disorder have nearly four times the odds of a past-year suicide attempt (The Trevor Project, 2022), childhood maltreatment is linked to earlier onset and more severe illness (Molendijk et al., 2017), and weight stigma is associated with depression, dieting and lower self-esteem (Himmelstein et al., 2018).

Eating disorder prevention is the oldest work in the Sharpen® system, in development since 2006 and co-developed with Dr. Brewerton. This training has been evaluated twice in medical settings. At Greenville Health System Children's Hospital, now Prisma Health, 91% of participating pediatricians and residents said it assisted them in diagnosing eating disorders (Haddad et al., 2015). In a 2023 to 2025 pilot with medical students and residents at the Edward Via College of Osteopathic Medicine and Spartanburg Regional Healthcare System, confidence to recognize and treat eating disorders rose and anti-fat attitudes fell (Fadel et al., in peer review). The school-based version of this curriculum produced significant gains in educators' self-efficacy (Anderson et al., 2017), and an adaptation for community health workers is in peer review (Smith et al., in peer review).

Learning objectives

As a result of participating in this program, participants will be able to:

Describe the prevalence, mortality and medical and psychiatric severity of eating disorders, including among males, LGBTQ+ individuals and older adults
Identify risk and protective factors for eating disorders, including genetics, dieting, perfectionism, trauma and weight stigma
Identify the eating disorder diagnoses, including ARFID, and their emotional, behavioral and physical warning signs
Explain how weight stigma and weight bias in health care affect patients' health, help-seeking and treatment, and describe weight-inclusive alternatives
Identify validated eating disorder screening tools and describe when to screen
Describe how trauma and co-occurring conditions, including anxiety, depression, PTSD and suicidality, affect eating disorder development and treatment
Describe the roles of the multidisciplinary treatment team and evidence-based treatments, including family-based treatment and CBT-AR, and the medical risks, such as refeeding syndrome, that require medical management
Identify steps that help patients get the care they need, including levels of care and referrals for medical, psychological, nutritional and peer support

Earning credit: to receive 4.0 NBCC contact hours, complete the module text in all seven modules, all 33 films and three required handouts (Facts About Eating Disorders, the Weight Stigma Fact Sheet and the Guide to Finding an Eating Disorders Specialist), pass the course quiz with a score of 80% or higher (16 of 20 correct), and submit the course evaluation. You may retake the quiz as many times as needed. The other handouts and the Academy for Eating Disorders guide to medical care are optional references.

Sources cited on this page

Anderson, C. N., Holody, K. J., Flynn, M. A., & Hussa-Farrell, R. (2017). An exploratory evaluation of the feasibility, acceptability, and efficacy of the mental fitness disordered eating program in schools. Eating Disorders, 25(3), 230-245. https://doi.org/10.1080/10640266.2017.1289793

Deloitte Access Economics. (2020). The social and economic cost of eating disorders in the United States of America: A report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/

Fadel, N., Estep, C., Stoner, A., Gainey, M., Brewerton, T. D., Biber, D. D., Redden, D., & Hussa Farrell, R. (in peer review). Evaluation of an eating disorder training pilot program for medical students and residents aimed at increasing competency and decreasing weight stigma.

Haddad, G., Farrell, T., & Hussa-Farrell, R. (2015). Increasing awareness of co-morbid mental health conditions among pediatricians and pediatric residents [Program evaluation]. Greenville Health System Children's Hospital.

Himmelstein, M. S., Puhl, R. M., & Quinn, D. M. (2018). Weight stigma and health: The mediating role of coping responses. Health Psychology, 37(2), 139-147. https://doi.org/10.1037/hea0000575

Molendijk, M. L., Hoek, H. W., Brewerton, T. D., & Elzinga, B. M. (2017). Childhood maltreatment and eating disorder pathology: A systematic review and dose-response meta-analysis. Psychological Medicine, 47(8), 1402-1416. https://doi.org/10.1017/S0033291716003561

Smith, H., Fadel, N., Stoner, A., Gainey, M., Brewerton, T. D., Biber, D. D., Redden, D., Farrell, T., & Hussa Farrell, R. (in peer review). Sharpening community health worker skills to combat eating disorders. International Journal of Medical Students.

The Trevor Project. (2022, February 17). Eating disorders among LGBTQ youth [Research brief]. https://www.thetrevorproject.org/research-briefs/eating-disorders-among-lgbtq-youth-feb-2022/

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Continuing Education

This course does not offer NBCC credit. Continuing education for this course is provided by Galen Health.

The Integration of Sylvia the Wood Nymph: A Five-Part Training on Dissociative Identity Disorder

Instructor: Timothy D. Brewerton, MD, DLFAPA, FAED, DFAACAP, CEDS-S

Resiliency Technologies is honored to collaborate with Timothy D. Brewerton, MD on this five-part, five-hour training on Dissociative Identity Disorder. The course begins with an actual therapy session in which Dr. Brewerton discovers that a patient who came to him for depression and binge eating in fact suffered from DID and a history of extensive trauma. Participants view archival video clips taken across years of treatment, observing the dissociative process, the presence of identified alters, and ultimately Sylvia’s full integration.

5 hours · CME/CNE/CEU via Galen Mental Health (APA- and ACCME-approved)

Evidence base

The clinical content in this course is grounded in Dr. Brewerton's decades of peer-reviewed scholarship on dissociation, trauma, and co-occurring eating disorders. His bibliography for this course includes foundational studies on DID epidemiology, neuroimaging, and trauma etiology (Sar, 2011; Dorahy et al., 2014; Reinders et al., 2006, 2012, 2014, 2016, 2018, 2020); the neurobiology of dissociation and state-dependent learning (Blihar et al., 2020; Lebois et al., 2022); phase-based treatment frameworks (International Society for the Study of Trauma and Dissociation, 2011); and the relationship between DID, eating disorders, and PTSD (Brewerton, 2007, 2011, 2018; Brewerton et al., 2019, 2023; Palmisano et al., 2018). The course also draws on Carl Jung's classical archetypes and Carolyn Myss's integral archetypes as interpretive frameworks for understanding the internal landscape of DID.

Epidemiological data presented in the course draws on peer-reviewed studies establishing that the 12-month prevalence of DID is 1–1.5% of the adult population (American Psychiatric Association, 2013), higher than prevalence estimates for anorexia nervosa, and that pathological levels of dissociation are present in approximately 20% of psychiatric inpatients (Foote et al., 2006). Prevalence studies from Turkey, Germany, the Netherlands, and Finland confirm that DID is not a North American phenomenon but a cross-cultural clinical reality (Akyüz et al., 1999; Friedl & Draijer, 2000; Gast et al., 2001; Tutkun et al., 1998).

The course explicitly addresses six empirically-examined myths about DID, including that it is iatrogenic, rare, or culturally specific, drawing on Brand et al. (2016) and Martinez-Taboas et al. (2013). The history of DID in the DSM, from DSM-I through DSM-5, is grounded in the clinical phenomenology literature (Putnam et al., 1986; Dell, 2006).

The Sharpen® system's broader evidence base spans 20 years of development, seven research studies, four peer-reviewed publications and manuscripts, and more than 87,792 people reached through live prevention trainings. The eating disorder and trauma content at the center of this course shares its foundation with the SEDAP curriculum, which has been evaluated in medical, undergraduate, and school-professional settings, and whose clinical films have been used as training tools at more than 500 academic institutions and treatment centers.

Learning objectives

Upon completion of this course, participants will be able to:

Understand the clinical presentation and diagnosis of DID
Recognize the common comorbidities associated with DID, including eating disorders, PTSD, mood disorders, and substance use disorders
Identify the diagnostic criteria for Dissociative Identity Disorder as defined in the DSM-5
Demonstrate improved diagnostic accuracy and treatment approaches associated with DID
Describe the history of dissociation in the psychiatric literature, from ancient references through current DSM classification
Understand the neurobiological basis of dissociation, including findings from brain imaging, cerebral blood flow, and state-dependent learning research
Identify and address common myths about DID using empirical evidence
Apply phase-based treatment frameworks, including the ISSTD Practice Guidelines, to the treatment of DID
Understand the role of trauma, particularly early childhood abuse, in the etiology of DID
Recognize the intersection of DID with eating disorders and PTSD, and implications for integrated treatment
Describe what integration means clinically and what it looks like across a course of treatment

References

Akyüz, G., Doǧan, O., Şar, V., Yargiç, L. İ., & Tutkun, H. (1999). Frequency of dissociative identity disorder in the general population in Turkey. Comprehensive Psychiatry, 40(2), 151–159. https://doi.org/10.1016/s0010-440x(99)90120-7

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Press. https://doi.org/10.1176/appi.books.9780890425596

Blihar, D., Delgado, E., Buryak, M., Gonzalez, M., & Waechter, R. (2020). A systematic review of the neuroanatomy of dissociative identity disorder. European Journal of Trauma & Dissociation, 4(3). https://doi.org/10.1016/j.ejtd.2020.100148

Brand, B. L., Loewenstein, R. J., & Lanius, R. A. (2014). Dissociative Identity Disorder. In Gabbard's Treatments of Psychiatric Disorders. American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9781585625048.gg24

Brand, B. L., Sar, V., Stavropoulos, P., Kruger, C., Korzekwa, M., Martinez-Taboas, A., & Middleton, W. (2016). Separating fact from fiction: An empirical examination of six myths about dissociative identity disorder. Harvard Review of Psychiatry, 24(4), 257–270. https://doi.org/10.1097/HRP.0000000000000100

Brewerton, T. D. (2007). Eating disorders, trauma, and comorbidity: focus on PTSD. Eating Disorders, 15(4), 285–304. https://doi.org/10.1080/10640260701454311

Brewerton, T. D. (2011). Posttraumatic stress disorder and disordered eating: food addiction as self-medication. Journal of Women's Health, 20(8), 1133–1134. https://doi.org/10.1089/jwh.2011.3050

Brewerton, T. D. (2018). An overview of trauma-informed care and practice for eating disorders. Journal of Aggression, Maltreatment & Trauma, 28(4), 445–462. https://doi.org/10.1080/10926771.2018.1532940

Brewerton, T. D., Alexander, J., & Schaefer, J. (2019). Trauma-informed care and practice for eating disorders: personal and professional perspectives of lived experiences. Eating and Weight Disorders, 24(2), 329–338. https://doi.org/10.1007/s40519-018-0628-5

Brewerton, T. D., Perlman, M. M., Gavidia, I., & Suro, G. (2023). The treatment of dissociative identity disorder in an eating disorder residential treatment setting. International Journal of Eating Disorders. https://doi.org/10.1002/eat.24106

Brewerton, T. D., Ralston, M. E., Dean, M., Hand, S., & Hand, L. (2020). Disordered eating attitudes and behaviors in maltreated children and adolescents receiving forensic assessment in a child advocacy center. Journal of Child Sexual Abuse, 29(7), 769–787. https://doi.org/10.1080/10538712.2020.1809047

Calland, R. (2022). Facilitating the emergence of hidden dissociative identity disorder: finding the lost maiden Medusa. Journal of Analytical Psychology, 67(1), 73–87. https://doi.org/10.1111/1468-5922.12750

Chalavi, S., Vissia, E. M., Giesen, M. E., Nijenhuis, E. R., Draijer, N., Cole, J. H., … Reinders, A. A. (2015). Abnormal hippocampal morphology in dissociative identity disorder and post-traumatic stress disorder correlates with childhood trauma and dissociative symptoms. Human Brain Mapping, 36(5), 1692–1704. https://doi.org/10.1002/hbm.22730

Chu, J. A. (2011). Rebuilding Shattered Lives (2nd ed.). John Wiley & Sons. https://doi.org/10.1002/9781118093146

Dell, P. F. (2006). A new model of dissociative identity disorder. Psychiatric Clinics of North America, 29(1), 1–26. https://doi.org/10.1016/j.psc.2005.10.013

Dorahy, M. J., Brand, B. L., Sar, V., Kruger, C., Stavropoulos, P., Martinez-Taboas, A., Lewis-Fernandez, R., & Middleton, W. (2014). Dissociative identity disorder: An empirical overview. Australian and New Zealand Journal of Psychiatry, 48(5), 402–417. https://doi.org/10.1177/0004867414527523

Foote, B., Smolin, Y., Kaplan, M., Legatt, M. E., & Lipschitz, D. (2006). Prevalence of dissociative disorders in psychiatric outpatients. American Journal of Psychiatry, 163(4), 623–629. https://doi.org/10.1176/appi.ajp.163.4.623

Friedl, M. C., & Draijer, N. (2000). Dissociative disorders in Dutch psychiatric inpatients. American Journal of Psychiatry, 157(6), 1012–1013. https://doi.org/10.1176/appi.ajp.157.6.1012

Gast, U., Rodewald, F., Nickel, V., & Emrich, H. M. (2001). Prevalence of dissociative disorders among psychiatric inpatients in a German university clinic. Journal of Nervous and Mental Disease, 189(4), 249–257.

Ginzburg, K., Somer, E., Tamarkin, G., & Kramer, L. (2010). Clandestine psychopathology: unrecognized dissociative disorders in inpatient psychiatry. Journal of Nervous and Mental Disease, 198(5), 378–381. https://doi.org/10.1097/NMD.0b013e3181da4d65

Hyatt-Burkhart, D. (2014). The experience of vicarious posttraumatic growth in mental health workers. Journal of Loss and Trauma, 19(5), 452–461. https://doi.org/10.1080/15325024.2013.797268

International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12(2), 115–187. https://doi.org/10.1080/15299732.2011.537247

Jung, C. G. (2014). The Collected Works of C. G. Jung: Complete Digital Edition (R. F. C. Hull, Trans.). Princeton University Press.

Killeen, T. K., & Brewerton, T. D. (2023). Women with PTSD and substance use disorders in a research treatment study: A comparison of those with and without the dissociative subtype of PTSD. Journal of Trauma & Dissociation, 24(2), 229–240.

Lebois, L. A. M., Ross, D. A., & Kaufman, M. L. (2022). "I am not I": The neuroscience of dissociative identity disorder. Biological Psychiatry, 91(3), e11–e13. https://doi.org/10.1016/j.biopsych.2021.11.004

Li, J. C., Noll, J. G., Bensman, H. E., & Putnam, F. W. (2018). Childhood sexual abuse increases risks for eating disorder symptoms and eating disorder-related health problems in females. In Child Maltreatment Research, Policy, and Practice (pp. 11–26). https://doi.org/10.1007/978-3-030-04561-6_2

Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17(1), 11–21. https://doi.org/10.1023/B:JOTS.0000014671.27856.7e

Lipsanen, T., Korkeila, J., Peltola, P., Jarvinen, J., Langen, K., & Lauerma, H. (2004). Dissociative disorders among psychiatric patients. European Psychiatry, 19(1), 53–55. https://doi.org/10.1016/j.eurpsy.2003.09.004

Lotfinia, S., Soorgi, Z., Mertens, Y., & Daniels, J. (2020). Structural and functional brain alterations in psychiatric patients with dissociative experiences: A systematic review of MRI studies. Journal of Psychiatric Research, 128, 5–15. https://doi.org/10.1016/j.jpsychires.2020.05.006

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Palmisano, G. L., Innamorati, M., Susca, G., Traetta, D., Sarracino, D., & Vanderlinden, J. (2018). Childhood traumatic experiences and dissociative phenomena in eating disorders: Level and association with the severity of binge eating symptoms. Journal of Trauma & Dissociation, 19(1), 88–107. https://doi.org/10.1080/15299732.2017.1304490

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Pugh, M., Waller, G., & Esposito, M. (2018). Childhood trauma, dissociation, and the internal eating disorder 'voice'. Child Abuse & Neglect, 86, 197–205. https://doi.org/10.1016/j.chiabu.2018.10.005

Putnam, F. W., Carlson, E. B., Ross, C. A., Anderson, G., Clark, P., Torem, M., … Braun, B. G. (1996). Patterns of dissociation in clinical and nonclinical samples. Journal of Nervous and Mental Disease, 184(11), 673–679. https://doi.org/10.1097/00005053-199611000-00004

Putnam, F. W., Guroff, J. J., Silberman, E. K., Barban, L., & Post, R. M. (1986). The clinical phenomenology of multiple personality disorder: review of 100 recent cases. Journal of Clinical Psychiatry, 47(6), 285–293.

Reinders, A. A. T. S., Chalavi, S., Schlumpf, Y. R., Vissia, E. M., Nijenhuis, E. R. S., Jancke, L., Veltman, D. J., & Ecker, C. (2018). Neurodevelopmental origins of abnormal cortical morphology in dissociative identity disorder. Acta Psychiatrica Scandinavica, 137(2), 157–170. https://doi.org/10.1111/acps.12839

Reinders, A. A. T. S., & Veltman, D. J. (2020). Dissociative identity disorder: out of the shadows at last? British Journal of Psychiatry, 1–2. https://doi.org/10.1192/bjp.2020.168

Reinders, A. A. T. S., Nijenhuis, E. R. S., Quak, J., Korf, J., Haaksma, J., Paans, A. M., Willemsen, A. T., & den Boer, J. A. (2006). Psychobiological characteristics of dissociative identity disorder: a symptom provocation study. Biological Psychiatry, 60(7), 730–740. https://doi.org/10.1016/j.biopsych.2005.12.019

Reinders, A. A. T. S., Willemsen, A. T., den Boer, J. A., Vos, H. P., Veltman, D. J., & Loewenstein, R. J. (2014). Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: a PET study and neurobiological model. Psychiatry Research, 223(3), 236–243. https://doi.org/10.1016/j.pscychresns.2014.05.005

Reinders, A. A. T. S., Willemsen, A. T., Vissia, E. M., Vos, H. P., den Boer, J. A., & Nijenhuis, E. R. S. (2016). The psychobiology of authentic and simulated dissociative personality states: The full monty. Journal of Nervous and Mental Disease, 204(6), 445–457. https://doi.org/10.1097/NMD.0000000000000522

Reinders, A. A. T. S., Willemsen, A. T., Vos, H. P., den Boer, J. A., & Nijenhuis, E. R. S. (2012). Fact or factitious? A psychobiological study of authentic and simulated dissociative identity states. PLOS ONE, 7(6), e39279. https://doi.org/10.1371/journal.pone.0039279

Ross, C. A. (1991). Epidemiology of multiple personality disorder and dissociation. Psychiatric Clinics of North America, 14(3), 503–517.

Sar, V. (2006). The scope of dissociative disorders: an international perspective. Psychiatric Clinics of North America, 29(1), 227–244. https://doi.org/10.1016/j.psc.2005.10.007

Sar, V. (2011). Epidemiology of dissociative disorders: An overview. Epidemiology Research International, 2011, 1–8. https://doi.org/10.1155/2011/404538

Sar, V., Akyuz, G., & Dogan, O. (2007). Prevalence of dissociative disorders among women in the general population. Psychiatry Research, 149(1–3), 169–176. https://doi.org/10.1016/j.psychres.2006.01.005

Sar, V., Dorahy, M. J., & Kruger, C. (2017). Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective. Psychology Research and Behavior Management, 10, 137–146. https://doi.org/10.2147/PRBM.S113743

Sar, V., Koyuncu, A., Ozturk, E., Yargic, L. I., Kundakci, T., Yazici, A., Kuskonmaz, E., & Aksut, D. (2007). Dissociative disorders in the psychiatric emergency ward. General Hospital Psychiatry, 29(1), 45–50. https://doi.org/10.1016/j.genhosppsych.2006.10.009

Sar, V., Middleton, W., & Dorahy, M. J. (2012). The scientific status of childhood dissociative identity disorder: a review of published research. Psychotherapy and Psychosomatics, 81(3), 183–184. https://doi.org/10.1159/000333361

Sar, V., Onder, C., Kilincaslan, A., Zoroglu, S. S., & Alyanak, B. (2014). Dissociative identity disorder among adolescents: prevalence in a university psychiatric outpatient unit. Journal of Trauma & Dissociation, 15(4), 402–419. https://doi.org/10.1080/15299732.2013.864748

Serra, R., Kiekens, G., Tarsitani, L., Vrieze, E., Bruffaerts, R., Loriedo, C., An, A., & Vanderlinden, J. (2020). The effect of trauma and dissociation on the outcome of cognitive behavioural therapy for binge eating disorder: A 6-month prospective study. European Eating Disorders Review. https://doi.org/10.1002/erv.2722

Simeon, D., Knutelska, M., Yehuda, R., Putnam, F., Schmeidler, J., & Smith, L. M. (2007). Hypothalamic-pituitary-adrenal axis function in dissociative disorders, post-traumatic stress disorder, and healthy volunteers. Biological Psychiatry, 61(8), 966–973. https://doi.org/10.1016/j.biopsych.2006.07.030

Simeon, D., & Putnam, F. (2022). Pathological dissociation in the National Comorbidity Survey Replication (NCS-R): Prevalence, morbidity, comorbidity, and childhood maltreatment. Journal of Trauma & Dissociation(5), 1–14. https://doi.org/10.1080/15299732.2022.2064580

Tedeschi, R., & Calhoun, L. (1995). Trauma & Transformation: Growing in the Aftermath of Suffering. https://doi.org/10.4135/9781483326931

Trim, J. G., Galovski, T., Wagner, A., & Brewerton, T. D. (2017). Treating eating disorder–PTSD patients: A synthesis of the literature and new treatment directions. In L. K. Anderson, S. B. Murray, & W. H. Kaye (Eds.), Clinical Handbook of Complex and Atypical Eating Disorders (pp. 40–59). Oxford University Press.

Tsai, G. E., Condie, D., Wu, M.-T., & Chang, I. W. (1999). Functional magnetic resonance imaging of personality switches in a woman with dissociative identity disorder. Harvard Review of Psychiatry, 7(2), 119–122. https://doi.org/10.3109/hrp.7.2.119

Tutkun, H., Sar, V., Yargic, L. I., Ozpulat, T., Yanik, M., & Kiziltan, E. (1998). Frequency of dissociative disorders among psychiatric inpatients in a Turkish university clinic. American Journal of Psychiatry, 155(6), 800–805. https://doi.org/10.1176/ajp.155.6.800

Vissia, E. M., Giesen, M. E., Chalavi, S., Nijenhuis, E. R. S., Draijer, N., Brand, B. L., & Reinders, A. A. T. S. (2016). Is it trauma- or fantasy-based? Comparing dissociative identity disorder, post-traumatic stress disorder, simulators, and controls. Acta Psychiatrica Scandinavica, 134(2), 111–128. https://doi.org/10.1111/acps.12590

$149

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NBCC Accreditation

Sharpen® Self-Harm and NSSI

Instructor(s): Robyn Hussa Farrell, MFA, E-RYT, MPH Site Preceptor (UC Berkeley, SDSU)

Working alongside national researchers and clinicians in self-harm and suicide prevention, these experts are featured in eight films throughout the course.

Self-harm is one of the most common ways a young person's pain becomes visible to a provider, and one of the most misunderstood. This 1.5-hour online course, in two parts, gives providers a shared, practical framework for recognizing non-suicidal self-injury (NSSI), understanding what the behavior does for the person, asking directly about self-injury and suicide, planning for safety, and connecting youth and families to care. Recommended companion for Sharpen® Suicide Safety Planning / Screening.

1.5 contact hours · Online · Asynchronous · Continuing education available

Evidence base

Self-harm is common, starts young and carries real risk. Between 18% and 23% of adolescents worldwide report NSSI at some point in their lives (Moloney et al., 2024; Xiao et al., 2022), and 9.1% of U.S. children ages 9 to 10 already report it (Burke et al., 2023). A history of self-injury is one of the stronger known predictors of later suicidal thoughts and behaviors (Franklin et al., 2017), which is why the course pairs every question about self-injury with a question about suicide. Digital self-harm roughly doubled among U.S. teens between 2016 and 2021 (Patchin & Hinduja, 2024), and adolescents who see self-harm content online in a given week are more likely to self-injure that same week (Hamilton et al., 2025).

The course teaches providers to assess the function self-harm serves (Klonsky, 2007; Nock, 2010), and it draws on Dr. Ahmad's interviews with young women followed from childhood in the Berkeley Girls with ADHD Longitudinal Study about how self-harm started, continued and stopped (Ahmad & Hinshaw, 2024). Dialectical behavior therapy for adolescents is the most extensively studied treatment for adolescent self-harm and is first-line care (McCauley et al., 2018; Mehlum et al., 2014).

Learning objectives

As a result of participating in this program, participants will be able to:

Part 1: Recognizing self-harm
Differentiate non-suicidal self-injury (NSSI) from suicidal behavior by intent, frequency and lethality
Recognize warning signs of suicide using the FACT framework: feelings, actions, changes and threats
Identify the physical, behavioral and cognitive warning signs of self-harm in youth and young adults
Summarize current prevalence data, the populations at elevated risk, and the protective factors that lower risk
Describe the functions self-harm most often serves and the cycle that maintains it
Describe digital self-harm and how online environments can raise or lower risk
Part 2: Ask, plan and support
Demonstrate how to ask directly about self-injury and about suicidal ideation, intent and plan
Apply the SOARS model and the Inventory of Statements About Self-Injury (ISAS) to document onset, frequency, method, function and stage of change
Identify the criteria that require escalation beyond routine follow-up
Describe how safety planning for self-harm differs from suicide safety planning, including counseling on access to lethal means
Match evidence-based treatments to the clinical picture, with dialectical behavior therapy for adolescents (DBT-A) as first-line care for adolescent NSSI
Respond to a disclosure of self-harm using non-shaming language, coach parents and caregivers, and connect youth and families to care and crisis lines

Earning credit: to receive 1.5 NBCC contact hours, complete the module text in both parts, all eight films and the Understanding Self-Harm clinical reference, pass the course quiz with a score of 80% or higher (12 of 15 correct), and submit the course evaluation. You may retake the quiz as many times as needed. The other downloadable handouts are optional.

Sources cited on this page

Ahmad, S. I., & Hinshaw, S. P. (2024). A qualitative analysis of perspectives on self-directed violence in a prospective longitudinal study of young women with and without childhood ADHD. Journal of Attention Disorders, 28(9), 1255-1266. https://doi.org/10.1177/10870547231221729

Burke, T. A., Bettis, A. H., Walsh, R. F. L., Levin, R. Y., Lawrence, H. R., Sheehan, A. E., Turnamian, M. R., & Liu, R. T. (2023). Nonsuicidal self-injury in preadolescents. Pediatrics, 152(6), Article e2023063918. https://doi.org/10.1542/peds.2023-063918

Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., Musacchio, K. M., Jaroszewski, A. C., Chang, B. P., & Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187-232. https://doi.org/10.1037/bul0000084

Hamilton, J. L., Untawale, S., Dalack, M. N., Thai, A. B., Kleiman, E. M., & Yao, A. (2025). Self-harm content on social media and proximal risk for self-injurious thoughts and behaviors among adolescents. JAACAP Open, 3(3), 431-438. https://doi.org/10.1016/j.jaacop.2024.11.008

Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27(2), 226-239. https://doi.org/10.1016/j.cpr.2006.08.002

McCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., Avina, C., Hughes, J., Harned, M., Gallop, R., & Linehan, M. M. (2018). Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: A randomized clinical trial. JAMA Psychiatry, 75(8), 777-785. https://doi.org/10.1001/jamapsychiatry.2018.1109

Mehlum, L., Tørmoen, A. J., Ramberg, M., Haga, E., Diep, L. M., Laberg, S., Larsson, B. S., Stanley, B. H., Miller, A. L., Sund, A. M., & Grøholt, B. (2014). Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: A randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 53(10), 1082-1091. https://doi.org/10.1016/j.jaac.2014.07.003

Moloney, F., Amini, M., Sinyor, M., Schaffer, A., Lanctôt, K. L., & Mitchell, R. H. B. (2024). Sex differences in the global prevalence of nonsuicidal self-injury in adolescents: A meta-analysis. JAMA Network Open, 7(6), Article e2415436. https://doi.org/10.1001/jamanetworkopen.2024.15436

Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6(1), 339-363. https://doi.org/10.1146/annurev.clinpsy.121208.131258

Patchin, J. W., & Hinduja, S. (2024). Adolescent digital self-harm over time: Prevalence and perspectives. Journal of School Violence, 23(4), 542-554. https://doi.org/10.1080/15388220.2024.2349566

Xiao, Q., Song, X., Huang, L., Hou, D., & Huang, X. (2022). Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis. Frontiers in Psychiatry, 13, Article 912441. https://doi.org/10.3389/fpsyt.2022.912441

$39

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Accommodations & Questions

If you need special accommodations or have questions about any course, please contact us. ADA accommodation requests are welcomed and may be made at any time before or during a course.

Provider Contact

Resiliency Technologies, Inc. · NBCC ACEP No. 7243
Contact us · rfarrell@sharpenminds.com
sharpenminds.com

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Documented Outcomes

Research that holds
across settings.

Sharpen® programs have been evaluated across foster care, K–12 schools, higher education, healthcare systems, and community coalitions. What follows is a representative sample of peer-reviewed and in-press findings.

+8.6%

Resilience improvement, Brief Resilience Scale

p < .001, d = 0.267 · 334 completers

+7.4%

Self-compassion improvement, SCS-SF

p < .001, d = 0.242

Overcoming Adversity

IRB-approved study across South Carolina foster parents

401 foster parents consented; 334 completed both the training and pre/post surveys. Resilience and self-compassion both improved significantly at p < .001, with 88.5% mean module completion across 22,475 video views.

Biber, Hussa Farrell & Farrell, 2026 · SC Department of Social Services · IRB-approved pre-post design

72.3%

High-confidence providers after training

Up from 48.9% · Low-confidence group eliminated

95.5%

Would recommend the training

534 participants · 23 cohorts · p = .001

Suicide Prevention & Postvention

VNS Health Safe Pathways: NYC healthcare workforce

Five-year NYS Office of Mental Health initiative serving LGBTQI+ and BIPOC youth, families and providers. Confidence in suicide risk management improved significantly, the high-confidence cohort grew substantially, and the low-confidence group was eliminated entirely.

Rios & Biber, 2024 · VNS Health Safe Pathways · NYSOMD-funded initiative

97.4%

Recommended the course

4 consecutive cohorts · College setting

91%

Said training assisted them in diagnosing eating disorders

Pediatricians & residents · Prisma Health

Mental Health Literacy & SEDAP

Outcomes across higher education and medical settings

Mental Health Literacy evaluated across four consecutive college cohorts by an independent team at San Diego State University; 24.7% of respondents volunteered unprompted that it should be required of all students (Levy et al., 2026). Eating disorder training evaluated at Greenville Health System Children's Hospital, now Prisma Health (Haddad et al., 2015).

Levy et al., 2026 · Haddad et al., 2015 · Independent evaluations · In review / published

From Participants

What practitioners
are saying.

School Counselor

K–12 Setting · South Carolina

"The films in the Mental Health Literacy course gave me language I could actually use with students, not clinical language, but the kind of honest conversation that changes things."

Licensed Counselor

Community Mental Health · New York

"The suicide prevention course is the most practical training I've taken. Clear, evidence-based, and immediately applicable, I referred two clients to the 988 Lifeline within a week of completing it."

Foster Care Trainer

Child Welfare Agency · Southeast

"Overcoming Adversity changed how our agency talks about trauma. We've integrated the 5MM curriculum into our parent training sessions and seen a real shift in engagement."

Pediatrician

Children's Hospital · Southeast

"I had never received formal training on eating disorder identification. This course gave me concrete screening tools and helped me refer two patients to appropriate care within the month."

Presented At

Peer-reviewed.
Conference-tested.

Sharpen® research and curriculum have been presented at national and regional conferences across child welfare, behavioral health, school counseling, and eating disorder prevention.

2025Southeastern School Behavioral Health Conference

2024National Eating Disorders Association (NEDA) Annual Conference

2023South Carolina Foster Parent Association Annual Conference

2022Attachment and Trauma Network Annual Conference

2021Attachment and Trauma Network Annual Conference

2019National Coalition for Homeless Veterans · Washington, DC

Next Steps

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started?

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Professional developmentthat changes practice.

Ten courses.20 years of evidence base.

Sharpen® Suicide Safety Planning

Evidence base

Learning objectives

Sources cited on this page

Sharpen® Suicide Screening

Evidence base

Learning objectives

Sources cited on this page

Sharpen® Suicide Prevention

Evidence base

Learning objectives

Sources cited on this page

Sharpen® Suicide Postvention

Evidence base

Learning objectives

Sources cited on this page

Sharpen® Overcoming Adversity: Trauma and the Developing Brain

Evidence base

Learning objectives

Sources cited on this page

Sharpen® Mental Health Literacy

Evidence base

Learning objectives

Sources cited on this page

How to Teach 5 Minute Mindfulness™ to Kids

Evidence base

Learning objectives

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Sharpen® Eating Disorder Awareness and Prevention for Health Professionals

Evidence base

Learning objectives

Sources cited on this page

The Integration of Sylvia the Wood Nymph: A Five-Part Training on Dissociative Identity Disorder

Evidence base

Learning objectives

References

Sharpen® Self-Harm and NSSI

Evidence base

Learning objectives

Sources cited on this page

Research that holdsacross settings.

What practitionersare saying.

Peer-reviewed.Conference-tested.

Ready to getstarted?

Professional development
that changes practice.

Ten courses.
20 years of evidence base.

Research that holds
across settings.

What practitioners
are saying.

Peer-reviewed.
Conference-tested.

Ready to get
started?