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Sending your client to their Israel gap year: Clinical Risks, Continuity of Care, and What Referring Therapists Need to Know

Tzachi Fried, PhD and Jon Ifrah, MSW and Shevi Slome, LMSW
$29.99 USD

Each year, many adolescents and young adults with significant emotional, relational, psychiatric, or family-system complexity leave their home communities to spend a gap year in Israel. For referring clinicians, this transition can raise important questions: Is the student stable enough to go? What level of support will they need? How should risk be communicated? What happens when a student’s functioning changes once they are far from home, family, and familiar treatment providers? This presentation will help clinicians think more clearly about the clinical risks and opportunities involved in sending higher-complexity clients to Israel for the gap year.

The talk will focus on practical guidance for assessment, preparation, referral, and continuity of care. We will discuss common clinical patterns that emerge during the Israel year, including more complex problems such as emotional dysregulation, safety concerns, personality-related difficulties, substance use, trauma responses, and the impact of program structure and culture. Particular attention will be given to coordinating care between therapists, parents, psychiatrists, and yeshiva/seminary staff while maintaining appropriate boundaries and confidentiality. Clinicians will leave with a clearer framework for deciding when a gap year is clinically appropriate, what supports should be in place, and how to help students transition with greater safety, clarity, and therapeutic continuity.

About the Presenter

Dr. Tzachi Fried is a clinical psychologist and the clinical director of Machon Dvir in Jerusalem, where he leads a coordinated clinical team in working with complex emotional, relational, and personality-related difficulties. His clinical work integrates DBT and RO-DBT with other modalities and trauma-informed approaches. In particular, Machon Dvir focuses on cases involving high distress, high risk, diagnostic complexity, family-system challenges, and difficulties in emotional regulation. In addition to his work at Machon Dvir, Dr. Fried provides psychotherapy, clinical supervision and consultation to therapists working with complex cases. Jon Ifrah and Shevi Slome, co-presentors, are clinicians on Dr. Fried's team

Learning Objectives:

  1. Identify clinical risk factors, destabilization points, and psychosocial variables that may affect a student’s transition to an Israel gap-year program.
  2. Assess the appropriateness of an Israel gap year for adolescents and young adults presenting with emotional, psychiatric, relational, or family-system complexity.
  3. Develop a continuity-of-care plan that coordinates communication and treatment roles among students, parents, referring clinicians, Israeli providers, psychiatrists, and educational staff while maintaining appropriate ethical, confidentiality, and risk-management standards.

Agenda:

Introduction and Overview of the Israel Gap-Year Transition — 10 minutes

• Developmental and psychological aspects of the transition

• Why the Israel year can be both growth-promoting and destabilizing

• Clinical themes commonly seen during the gap year


Destabilization Points During the Transition to Yeshiva/Seminary — 12 minutes

• Separation from family and existing supports

• Religious, social, and identity pressures

• Structure changes, independence, and emotional regulation challenges

• Early warning signs of deterioration


Pre-Gap Year Clinical Assessment: Go, Don’t Go, or Go with Support — 15 minutes

• Assessing emotional stability and readiness

• Evaluating risk factors and protective factors

• Clinical indicators requiring enhanced support or reconsideration

• Determining appropriate levels of care and monitoring


Preparing Students, Parents, and Programs — 10 minutes

• Setting realistic expectations

• Psychoeducation and transition planning

• Communicating concerns appropriately with families and institutions

• Establishing support structures before departure


Common Clinical Patterns and Struggles Emerging in Israel — 15 minutes

• Emotional dysregulation and interpersonal instability

• Trauma responses and attachment-related difficulties

• Substance use and impulsive behaviors

• Anxiety, depression, suicidality, and personality-related presentations


Coordinating Care Across Systems and Countries — 15 minutes

• Collaboration between referring therapists, Israeli clinicians, psychiatrists, and school staff

• Confidentiality and release-of-information considerations

• Managing crises remotely

• Ethical and legal considerations in continuity of care


Case Discussion and Applied Clinical Decision-Making — 8 minutes

• Case-based application of assessment and continuity-of-care principles

• Discussion of intervention planning and clinical judgment


Q&A and Closing Reflections — 5 minutes

• Key takeaways

• Resources and recommendations for clinicians

This presentation is open to:
  • Social Workers
  • Professional Counselors
  • Therapists
  • Psychologists
  • Licensed Mental Health Practitioners
  • Medical Doctors and Other Health Professionals
  • Other professionals interacting with populations engaged in mental health based services
Course Level: intermediate
Level of Clinician: intermediate
  • New practitioners who wish to gain enhanced insight surrounding the topic
  • Experienced practitioners who seek to increase and expand fundamental knowledge surrounding the subject matter
  • Advanced practitioners seeking to review concepts and reinforce practice skills and/or access additional consultation
  • Managers seeking to broaden micro and/or macro perspectives

Participants will receive their certificate electronically upon completion of the webinar and course evaluation form.

Disability Access - If you require ADA accommodations, please contact our office 30 days or more before the event. We cannot ensure accommodations without adequate prior notification. Please Note: Licensing Boards change regulations often, and while we attempt to stay abreast of their most recent changes, if you have questions or concerns about this course meeting your specific board’s approval, we recommend you contact your board directly to obtain a ruling. The grievance policy for trainings provided by NEFESH INTERNATIONAL is available here Satisfactory Completion Participants must have paid the tuition fee, logged in and out each day, attended the entire workshop, and completed an evaluation to receive a certificate (If this is a pre-recorded program, a post-test with a passing grade of 80% to receive a certificate.) Failure to log in or out will result in forfeiture of credit for the entire course. No exceptions will be made. Partial credit is not available. Certificates are available after satisfactory course completion by clicking here.
There is no conflict of interest or commercial support for this program.
Refund Policy:
Full Refund until 48 hours before scheduled date.
48 hours before: full refund less $5.00 processing fee. After event no refund will be given.
*exclusions apply for reasonable need and cause.