Many therapists feel the quiet tremor that arises when a client’s needs begin to stretch beyond the container of traditional outpatient work. This webinar is designed to bring steadiness to that threshold, offering clinicians a clearer understanding of the care continuum and the specific inflection points where stepping up may no longer be optional, but essential. Through a blend of clinical clarity and reflective guidance, participants will learn how to recognize the “arc” where outpatient care reaches its natural limit and where a higher level of support can better protect both client safety, reduce risk and preserve therapeutic integrity.

Clinicians will leave with a more grounded sense of the continuum, an ability to discern acuity with greater confidence, and a framework for communicating referrals with compassion, transparency, and clinical precision. The goal is to help therapists feel less alone at the edge of the bridge, and more capable of guiding clients toward the level of care that can truly hold them.

Learning Objectives:

1. Identify clinical and behavioral indicators that suggest outpatient treatment may no longer be sufficient for client safety or stabilization.

2. Differentiate between levels of care (IOP, PHP, residential, inpatient) and articulate the core functions and treatment goals of each.

3. Describe at least three common barriers that prevent therapists from initiating step-up conversations and learn strategies to navigate them ethically and effectively.

4. Apply a simple decision-making framework to assess acuity and determine when to recommend a transition to a higher level of care.

5. Demonstrate language for compassionate referral conversations, including how to engage clients in the process while maintaining therapeutic alliance and boundaries.

About your trainers:

Led by two therapists with a combined 30+ years of experience with high acuity clients, Livia Budrys and Sarah Buino empower therapists to navigate complex client situations with a deeper sense of confidence.

Livia Budrys, LCSW, C-IAYT, SEP is the former Director of The Meadows Outpatient Center in Atlanta, GA, and the pioneer of Yoga-Informed Psychotherapy®. A Licensed Clinical Social Worker and Certified Yoga Therapist, she integrates neurobiology, somatics, and contemplative practice into trauma treatment and system-wide clinical training. With over two decades of experience in program development and clinician education, Livia is known for advancing trauma-informed, body-centered approaches that bridge evidence-based psychotherapy with embodied healing traditions.

Sarah Buino, LCSW, CADC, RDDP, NMT, is a Licensed Clinical Social Worker, educator, and consultant who helps therapists integrate personal healing with professional practice. Before founding Head/Heart Therapy, she served as a Senior Therapist for Presence Behavioral Health’s Professionals Program (PHP/IOP). Through Head/Heart Business Therapy and Group Practice (R)evolution, she guides practice owners in building relational, trauma-informed organizations. An Adjunct Faculty Member at Loyola University Chicago and host of the podcast Conversations With a Wounded Healer, Sarah was recognized as Professional of the Year (Illinois Certification Board, 2022) and Emerging Leader (NASW Illinois, 2017).

Continuing Education:

Head/Heart Consulting, PLLC is an IDFPR-approved CE Sponsor (#159.001625) for Social Workers (LSW/LCSW) and Professional Counselors (LPC/LCPC) licensed in Illinois. Illinois CEs are often accepted in other states, please check with your licensing board to confirm.

Contact the host of The Arc of Care--When Outpatient Isn't Enough: A 1-hour webinar for psychotherapists