Wednesday, February 21, 2018 | 1:00 p.m. ET, 12:00 p.m. CT, 11:00 a.m. MT
This presentation will provide a neuroscience-informed overview of what pain is, including nociceptive pain, neuropathic pain, and pain for psychological reasons. We will build on that foundation in a discussion on how to talk to your patients about pain in a way that engages them in appropriate care. At the end of the session we will take a step back from the addiction narrative, challenge the assumptions that underlie our current approach to the opioid crisis, and build on the first segment of the session to recast the opioid crisis as a trauma crisis, requiring somewhat different resources and a different approach.
Upon completion of this webinar, attendees will be able to:
- Distinguish pain for psychological reasons from nociceptive and neuropathic pain.
- Describe to their patients the cause of their pain and how treatment flows form the cause, in a way that does not suggest “it’s in your head” but rather engages and empowers patients to participate in treatment.
- Recognize and know what to do about high risk prescribing of opioid.
About the Speaker
Bennet E. Davis, MD
Director of Pain Recovery Program
Bennet E. Davis, MD, is the director of the Pain Recovery Program at Sierra Tucson. He is board certified in anesthesiology and pain medicine. Dr. Davis completed his undergraduate work at Stanford University in Stanford, CA, and received his medical degree from Case Western Reserve University in Cleveland, OH. He then trained in orthopedic surgery and anesthesiology at the University of New Mexico and University of California, Irvine. He completed his fellowship in Manchester, England, after finishing residency training.
Dr. Davis served as founder and director of the University of Arizona Pain Center from 1995 to 2002, where he was also director of the Pain Fellowship Program and co-founding faculty of the Arizona Cancer Center. In 2002, he and his colleagues founded Arizona’s first and only adult pain clinic to achieve American Pain Society Center of Excellence, The Integrative Pain Center of Arizona, which operated as one of the nation’s few models for interdisciplinary pain care until November 2017.
He is involved in organized medicine as past president of the Pima County Medical Society, and is active on a national level in teaching as medical director for CHC Pain ECHO, a telemedicine teaching program for primary care providers across the nation. He serves on numerous advisory boards for health policy. His latest article, “A New Paradigm for Pain?” was featured in The Journal of Family Practice and provides an updated definition of pain.
Optimizing Treatment for Major Depressive Disorder: An Integrative Approach Utilizing Brain Stimulation Therapy
Major depression is a serious medical illness affecting more than 14 million American adults every year. Often a debilitating disorder, depression results in a persistent state of sadness that interferes with an individual’s thoughts, behavior, mood, and physical health. It is important to recognize the symptoms and seek treatment as soon as possible.
Antidepressant medications and psychotherapy are the first line treatments for major depression. These treatments, however, do not work for all patients. Patients who have failed to achieve an adequate response from psychotherapy and antidepressants, or who are unable to tolerate medications, may benefit from Transcranial Magnetic Stimulation, or TMS; an FDA-cleared, non-invasive, non-systemic treatment indicated for MDD.
This webinar will discuss how health care providers are in the optimal position to address depression that has not adequately responded to first-line treatments, and explore the benefits of incorporating TMS therapy to the treatment regimen.
- Identify the prevelence and significance of Major Depressive Disorder (MDD)
- Discuss the role of TMS in the treatment of depression, including current American Psychiatric Association recommendations
- Identify qualified candidates for TMS therapy
- Discuss the healthcare provider's role in screening, treatment and referral
About the Speaker
Michelle Chacon, RN
TMS Clinical Operator
Michelle Chacon, RN, is a certified TMS clinical operator and has been with Sierra Tucson since 2015. In her 20 years as a nurse, Michelle has worked in a wide variety of clinical settings. Early in her career, she worked in neurological and medical/surgical hospital units. In the neurointensive care unit, she was part of the Neuro Acute Response Team. Michelle also spent time as a home health care and hospice nurse for several years, and enjoyed being self-employed as an independent clinical case manager. In 2010, Michelle found her niche in behavioral health, with work in an acute inpatient detox facility. Her recent work has included outpatient and residential behavioral health and she is passionate about the importance of mental health and wellness for all individuals.
Michelle graduated with honors and received special recognition for academic excellence with degrees in nursing and health services administration from University of Central Florida, Orlando in 1996.
Michelle is a Tucson native, and spends her free time in her rose garden with her calico cat, ‘Kitty’, or tending her Koi pond.
The lifetime prevalence of Post-Traumatic Stress Disorder (PTSD) ranges from 5-20% of Iraq and Afghanistan war veterans, and it is the third most prevalent psychiatric diagnosis among veterans using the Veterans Affairs (VA) hospitals. PTSD is a complex disorder with frequent co-morbidities of depression, substance use disorders, and traumatic brain injury, which often has a catastrophic effect for the veteran and his or her loved ones.
November 11 marks Veterans Day, a celebration in honor of America's veterans for their patriotism, love of country, and the selfless sacrifice they have offered this nation. This webinar will focus on the etiology, recognition, and treatment modalities available to treat PTSD in our veterans. Lieutenant Commander Reynolds, a retired member of the US Navy, will discuss how mental health providers are in the optimal position to address the important mental health needs of our veterans and mitigate the potentially disastrous effects of PTSD.
- Identify the prevelence and significance of PTSD among our military veterans
- Discuss the impact of PTSD on the veteran and their family unit
- Identify various integrative modalities of evidence-based treatment for PTSD
- Discuss the healthcare/mental healthcare provider's role in screening, treatment and referral
About the Speaker
Bill Reynolds, PA-C
Associate Director of The Addiction Recovery Program
Bill Reynolds, PA-C, is a U.S. Navy-trained physician assistant and served on active duty for 30 years, retiring as a Lieutenant Commander in 2012. He has several years of psychiatry and addiction medicine experience, in addition to his family medicine background. Bill has a keen interest in working with trauma survivors due to his experience working with Marines and Sailors adversely affected by wartime stress. Additionally, he has an affinity for Sierra Tucson’s addiction medicine clients and is a strong proponent of recovery-oriented modalities to help individuals achieve sobriety. In 2017, Bill was awarded a specialty credential called a Certificate of Added Qualifications (CAQ) from the National Commission on Certification of Physician Assistants (NCCPA). He is one of only 15 certified PAs in Arizona to earn a CAQ in Psychiatry since the NCCPA’s inception in 2011.
The Gut, Brain Pain Connection
- Identify the connection between the enteric nervous system and central nervous system as it relates to mental health and pain
- Assess effects of the GI microbiome on mental health and pain
- Identify strategies to improve patient outcomes by optimizing digestion
- Explain how common medications affect digestion
About the Speaker
Maureen Schwehr, NMD
Director of Integrative Services
Maureen Schwehr, NMD, serves as Sierra Tucson’s Director of Integrative Services. Her department provides a unique combination of physical and mental health support for residents. Dr. Schwehr oversees a team of experienced and talented staff whose services includes naturopathic medical consults, acupuncture, physical therapy, chiropractic services, massage therapy, shiatsu, zero balancing, somato-emotional release, and craniosacral therapy.
In addition to supervising staff, she works one-on-one with residents to help them determine the root cause of their problems. Focus is given to nutritional status and hormonal balance, supporting biochemical pathways that help the body function more effectively. Dr. Schwehr holds a doctorate in Naturopathic Medicine from Bastyr University in Seattle, Washington. Past experience includes a position as the medical director at Mirasol, a residential eating disorder facility. As part of the Sierra Tucson staff, she has the opportunity to be part of a truly integrative team that provides a unique, empowering perspective for residents.
This webinar will approach eating disorders and disordered eating from the perspective of developmental, attachment and polyvagal considerations. Eating disorders, for the most part, represent very early disruptions in primary care-giver relationships and challenges to early developmental processes of both autonomy and attachment. The range and types of insults vary widely but the common denominator is that, for some reason, the experience of “feeding” and the meaning of “food” become distorted for the patient/client to the degree that tremendous intrapsychic conflicts are manifested through the behaviors and beliefs with which ED patients often present. An additional factor may be unresolved issues around body and sexuality which is often why these disorders accelerate and/or initially present during adolescence. Finally, the development of Polyvagal Theory concurrent with increased understanding of the effects of relational and attachment trauma can help us understand that these behavioral disorders help solve the problem of activation of archaic parts of the nervous system that are related to basic survival imperatives.
Topics covered in this webinar will include overviews of normal development (both physical and psychological), attachment theory and polyvagal theory. We will explore how specific types of experiential insults can disrupt the normal intrapsychic development of our patients/clients resulting in maladaptive behaviors that are highly valuable as affective coping strategies. Furthermore, we will look at the importance of the relationship between patient/client and provider - both transference and countertransference - in helping resolve the EDO behavior.
- Describe the process and consequences of unresolved sympathetic nervous system activation and how this might present clinically
- Describe how a “psychological wound” during a given point in development can be manifested in later behavioral maladies
- Discuss how family systems and early relationships/roles impact later behavioral and psychiatric presentation. Additionally, the participant will be able to discuss how those relational templates will impact the therapeutic and recovery experience
- Understand that “maladaptive behaviors” are, in fact, very adaptive and valuable even if they are not healthy
ABOUT THE SPEAKER
Tena Moyer, M.D.
Associate Medical Director
Dr. Moyer, M.D., serves as the Associate Medical Director for Sierra Tucson, with primary focus on the development of the Eating Recovery program and addressing acute clinical patient concerns. Dr. Moyer completed her undergraduate degree at Occidental College in Los Angeles and received a BA in Independent Studies. This degree was tailored for Dr. Moyer and combined majors in art and biology, resulting in her work as a medical illustrator prior to attending medical school. In the continuation of her education, Dr. Moyer attended University of Southern California Keck School of Medicine and did an Internal Medicine internship at USC-Los Angeles County Hospital. After working several years as a general practitioner, Dr. Moyer realized that she was particularly fascinated by psychiatric illness and returned to a psychiatry residency at University of Arizona.