Asthma Boot Camp Patients with asthma are increasing in number, and will more than likely be encountered by most mental health professionals at some point in their professional practice. Having a basic understanding of asthma will help the health care professional to assist this population of patients in managing their current and future health. Basic epidemiology will be provided to form an understanding of who is most at risk for this problem and how it develops. A description of the gross anatomy of the pulmonary system and a more detailed look at airway constriction (bronchospasm) will enable a fuller understanding of the disease process of asthma. Frontline pharmacological management will be discussed to facilitate an interdisciplinary approach to treatment future. Lastly, since issues of non-compliance with prescribed medical regimes are an inherent part of the disease management process of asthma, these issues will be discussed in detail, along with strategies to facilitate compliance.
Psychosocial Aspects of Asthma Management Psychosocial factors are a vital, but oftentimes overlooked, element in asthma management. This course will help participants understand how the pathophysiology of asthma can be influenced by psychosocial factors. In particular, this course will discuss SES and environmental exposures that significantly impact asthma disease management. Current intervention strategies are reviewed to facilitate the formulation of environment-specific interventions for use with asthmatic patients. Specific information related to the non-compliance component of asthmatic disease is discussed and integrated into the psychosocial focus, and ways to effectively increase compliance in this population are addressed.
CLINICAL INTERVENTIONS
A Review of Behavioral Medicine Treatments of Headaches Approximately 90% of the U.S. population experiences occasional headache pain with 23 million headache sufferers experiencing severe migraines. The experience of headache, especially migraine, often results in pain, disability, and psychological distress for the individual. Among migraine sufferers, over 80% experience some degree of headache-related disability. Migraine alone accounts for an estimated 157 million days lost from work. In addition, there are high rates of co-morbid psychiatric disorders among individuals with headaches such as depression, anxiety, and post-traumatic stress disorder. Mental health professionals can play a key role in the multidisciplinary approach to headache treatment. Behavioral Medicine techniques such as biofeedback, cognitive-behavioral therapy, and relaxation have proven efficacious, either alone or in combination with pharmacotherapy, to manage co-morbid psychiatric disorders, address treatment adherence problems, and modify some risk factors for the progression of headaches. This course provides evidence-based clinical behavioral medicine interventions for this patient population. The principal types of headaches and their causes are described and biobehavioral variables are discussed. Clinical assessment is addressed and elements of nonpharmacological behavioral medicine alternative treatment of headache are presented, along with specific ways to coordinate/integrate care with providers of pharmacological treatment.
An Effective New Model for Lifestyle Change to Promote Health and Wellness: Mind-Body Bridging Health-related behaviors such as poor nutrition, lack of exercise, smoking, excess sun exposure, abuse of alcohol and substances, inadequate stress management, and disturbances in sleep are increasingly being linked to rates of morbidity and mortality. To illustrate, consider that the latest medical research suggests that one third of cancers are caused by controllable lifestyle factors. Mind-Body Bridging, developed by Stanley Block, M.D., is a branch of Mind-Body Medicine that is being well received by both providers and patients as a blueprint for facilitating the adoption and maintenance of health-related behavior change. Mind-Body Bridging techniques enable patients to tap into and constructively override their potentially maladaptive Identity System (I-System), an internal and often unconscious negative feedback loop that automatically maintains a “disconnect” between one’s internal affective state (e.g., historic “story lines”) and the current, external situational demands (e.g., the present/the moment). Mind-Body Bridging has been shown to be efficacious in short circuiting these potentially maladaptive patterns driven by the I-System in a variety of patient populations such as perpetrators/victims of domestic violence, as well as patients with ADHD, chronic pain, depression and anxiety, and more recently, PTSD. Among the benefits of this technique is its rapid effectiveness and resultant enthusiastic acceptance among patients. This online CE course will provide an introduction to the fundamental principle of Mind-Body Bridging, an overview of the relevant literature and a discussion of its powerful experiential aspects and applications for healthcare providers. In addition, an outline for a 3-session Mind-Body Bridging protocol to promote health-related lifestyle change and wellness is provided for use in a variety of clinical settings.
Anger Management: Applications to Healthcare Anger is an affective state with both positive and negative properties. One of the most common emotions involved in detracting from a high quality of life and psychological well-being, pervasive anger has also been associated with a number of deleterious health-related problems including hypertension, cardiac disease, and stroke. Despite its prevalence, clinicians are frequently presented with anger-management issues disguised as substance abuse, depression, and fatigue. In addition, the clinical presentation of anger management problems is frequently masked by gender-specific linguistic usage such as “hurt feelings” and “disappointment.” Taken together, even the most skilled of healthcare professionals may benefit from some guidance in navigating their way through the “anger maze” when helping patients to achieve enhanced mental and physical health. This course will sensitize health professionals to the prevalence of anger-management difficulties and its psychological and physical sequelae in their patients. In addition, strategies to identify, assess, and treat unmanaged anger will be discussed.
Cognitive-Behavioral Therapy for Insomnia. Insomnia is the second most common chronic health problem in the United States, following only behind chronic pain. The elevated prevalence of insomnia, its associated adverse consequences, and dissatisfaction with pharmacotherapy have led to a high level of interest in nonpharmacologic treatments. Cognitive-behavioral therapy for insomnia (CBT-I) is one safe and effective nonpharmacological alternative. As a multimodal approach, CBT-I targets the behavioral and psychological factors that initiate and maintain insomnia. CBT-I has been shown to be effective in treating insomnia in several different populations and with several comorbid medical and psychiatric illnesses. This online course will describe the behavioral and cognitive techniques used in CBT-I, as well as review the current literature on its efficacy. Practitioner considerations will also be addressed.
Mindfulness-based Therapies: A Theory- and Evidence-Based Look at Its Origins and Current Clinical Applications Mindfulness-based interventions, such as Mindfulness-Based Stress Reduction (MBSR) which incorporate Eastern principles and traditional Western approaches, have been shown to influence brain function, immunity, mood, and health-related behavior, and thus have potential to greatly impact emotional as well as physical health. This course will provide an overview of mindfulness-based interventions from a historical and empirical perspective -- from its foundations in Eastern traditional meditation through its progression into Western medicine treatment protocols. The basic tenets and techniques of Mindfulness-based treatments will be presented, including the underlying mechanisms of action and its use alone or in conjunction with other empirically-based treatments. In addition, its current clinical applications such as in the reduction of stress/anxiety, management of chronic pain, adjustment to medical illness, and the treatment of psychological conditions – among them mood disorders, eating disorders, and substance abuse -- will be discussed, along with directives for future research and patient care.
The Principles of Psychological First Aid The theory and practice of crisis response on the part of healthcare providers has passed through a progression of stages during the past century. First developed within a military context, crisis response consisted of an often harsh treatment approach, even on the part of military health care providers, toward personnel suffering from what was called “shell shock” or, later, “battle fatigue.” In the decades since the understanding of stress-related disorders has moved beyond the battlefield, treatment modalities for those disorders evolved as well. The principles of Psychological First Aid represent the most recent chapter in that evolution. The purpose of this course is to acquaint mental health and other healthcare professionals with the factors affecting stress responses in crisis situations, to introduce the principles of Psychological First Aid and to illustrate how these principles can be applied in a crisis response context.
ETHICS
The Patient, Their Doctors, Their Family, and You: The Ethical Role of the Care Provider Reviews the law on confidentiality, privilege, duty to warn, health care proxies, advance directives, and required releases, and how these issues are affected by the data on familial communication, the possibility of genetically transmitted disease/obligate carriers, and how this knowledge will affect standards of ethical practice. Provides a thorough discussion of issues regarding withholding vs. withdrawal of care, terminal sedation, and euthanasia.
NEUROPSYCHOLOGY
Behavior Management Options Following Traumatic Brain Injury There are a wide variety of behavioral “syndromes” that can occur after traumatic injury to the brain (TBI). Depending on the location and extent of brain injury, treatment for these disorders can vary widely from minimal intervention to intensive residential treatment. Many other factors contribute to the behaviorally disabling effects of TBI including pre-injury attributes of the injured person, access to proper neuro-behavioral services after injury, medication management, and long term support services. This course reviews the underlying neuro-pathology of TBI-related behavior disorders, the basic tenants of behavior therapy and it’s application in the treatment of TBI. In addition, state of the art diagnostic and therapeutic options for persons who experience significant neuro-behavioral syndromes after TBI will be presented.
Psychopharmacology and Traumatic Brain Injury: Innovations and Treatment Options Traumatic Brain Injury (TBI) affects approximately 1.5 million persons per year in the United States. When a person sustains a TBI, particularly a severe TBI, the recovery and rehabilitation process can last months and years, and sometimes is incomplete. Medications that were initially developed to help persons with other neurological disorders (e.g. stroke, Parkinsons Disease, dementia) have proven helpful for persons with TBI. That said, many medicines prescribed for persons with TBI can have deleterious side effects and, in some circumstances, can impede the recovery process. This course will present the neuropathology of TBI and the concept of "rational pharmacology” in this context. In addition, a review of emerging treatment options for persons with TBI with a focus on psychopharmacological interventions will be discussed.
PEDIATRIC BEHAVIORAL MEDICINE
Autism Spectrum Disorders (ASD): Understanding, Diagnosing & Treating Asperger's Syndrome, Autism, Pervasive Developmental Disorder NOS and other ASDs With 1 out of every 150 children now being diagnosed with an Autism Spectrum Disorder (ASD), health professionals will increasingly come into contact with these children or parents of children with an ASD. Moreover, health professionals will need to stay informed regarding new advances in understanding the etiology, presentation of, assessment and treatment options for those diagnosed with these disorders. This course will provide an overview of the suspected causes of ASDs. Diagnostic considerations and methods of assessment with be presented. Common biomedical and behavioral treatment recommendations will be reviewed along with the educational needs and rights of these children.
Parental Bereavement Following the Loss of a Child The loss of a child can present many emotional challenges for parents given an underlying assumption that parents will not outlive their offspring. The death of a child may impact the psychological morbidity and overall health of remaining family members. Given their proximity to such events, health care professionals are in a unique position to provide support and facilitate the bereavement process of parents. This course examines parental bereavement patterns based upon the type of loss as well as predictors of complicated parental bereavement. The role of health care professionals in supporting parents is illustrated through review of bereavement follow-up and intervention programs. In addition, specific application of bereavement intervention strategies with case examples will be examined.
Treatment of Young Adults with ADHD: A Mind Body Approach It is estimated that Attention Deficit Hyperactivity Disorder (ADHD) affects about 4.4% of adults between the ages of 18 and 33 in the U.S. Evidence suggests that teens and young adults with ADHD experience considerable impairment in overall quality of life – often noting dysfunction in academic, occupational, and social contexts. Specifically, ADHD core symptoms adversely impact attention (symptoms of focus/management), hyperactivity (symptoms of inattention) and impulsivity (symptoms of acting out/poor impulse control). This online CE course provides a translatable model for supporting clients with the core symptoms of ADHD through the provision of an effective and comprehensive Mind-Body Medicine treatment, known as Mind-Body Bridging. In addition to addressing core symptoms of ADHD, issues relevant to reducing negative self-talk, enhancing stress management, building assertiveness, managing important relationships, facilitating anger management and promoting decision-making will be discussed. A time delimited 4-week protocol to assist young adult clients through the process of reducing unwanted symptoms is presented. The clinical training offered in this course can promote increased self-reliance among ADHD clients and may reduce, or possibly eliminate, the demand for alternative treatments, such as a modified diet, extensive traditional talk therapy and even pharmacological interventions with their unwanted side effects. Qualified health professionals working with teens and young adults who struggle with ADHD will find this training an invaluable resource.
PRIMARY CARE BEHAVIORAL HEALTH
Assessment and Intervention Strategies for the Primary Care Behavioral Health Professional Across the country, and even internationally, behavioral health providers are integrating into primary care clinics to help them better address the many behaviorally-based health problems the clinics encounter. Transitioning to primary care, however, is not easy for most behavioral health professionals, who must learn to adapt to a very different care culture and mission. This course will provide those interested in primary care with the tools needed for effective primary care work. The course starts with an overview of the basic theoretical model for primary care work, and then segues into key clinical strategies. Course participants will learn how to conduct a brief functional assessment and utilize tools and measures designed for use in primary care. They will also learn which clinical interventions are utilized in primary care, and what to document in a primary care chart note. Group visit strategies, including those involving the primary care provider, will also be detailed. Whether new or experienced in primary care, or merely curious about this new field, participants will undoubtedly find much of interest in this course.
Managing Chronic Pain in the Primary Care Clinic One of the most commonly encountered, and resource-consuming, behaviorally-based problems in the primary care context is chronic pain. Owing to insufficient training and a lack of time, primary care providers often have great difficulty helping patients with chronic pain, especially those being treated with narcotic pain medications. Narcotic medications are frequently used, yet they pose many risks and challenges. Given this backdrop, there is much a behavioral health provider can contribute to the care of patients with chronic pain in primary care. This course first describes the challenges of treating chronic pain in primary care and introduces participants to the issues and controversies surrounding the use of narcotic pain medications. It then details the many ways a behavioral health provider in primary care can help with treating and managing these patients, including behavioral strategies to use in individual and group visits, and ways to influence a clinic’s care delivery system. Those working in primary care as well as those interested in chronic pain more generally will find this course informative and unique.
