MIRECC / CoE

Defining a New Reality in Health Care Delivery and Experience

Presented by Anne Bailey, PharmD, BPCS
Recorded on January 11, 2024 | Expires February 2027

The purpose of this virtual, knowledge-based presentation is to share how VA Immersive is defining a new reality in Veteran healthcare through Virtual Reality (VR) and Augmented Reality (AR), reinforcing why Veterans and staff choose VA. Participants will utilize knowledge gained from this presentation to better implement immersive technology programs across VA. After the training learners should be able to:

• Discuss the current state of Immersive Technology for clinical conditions at VA, as well as staff training and education.
• Discuss the rationale for incorporating Immersive Technology into VA clinical practice.
• Explain the current and future roles that providers could play in leveraging and implementing Immersive Technology.

The Ethics of Professional Boundaries in Rural Communities

Presented by Cynthia Geppert, MD, and Robert Sebesta, LCSW, HEC-C
Recorded on February 15, 2024 | Expires April 2027

This presentation on “Professional Boundaries in Rural Communities” addresses a self-identified knowledge gap in the continuing education needs of rural mental health professionals. Rural mental health professionals specifically requested training be provided on navigating dual relationships in small towns. There is also evidence from the bioethics literature and our National Center for Ethics in Health Care Consultation work that boundary concerns are frequently encountered in these settings. This virtual presentation will improve the knowledge and skill of rural mental health practitioners to identify boundary issues and take proactive and constructive steps to resolve them. The ethical management of boundary questions is expected to provide the mental health care teams with greater comfort and confidence in delivering health care to their patients and communities. After the training learners should be able to:

• Describe the nature and function of boundaries in the health professions.
• Demonstrate the difference between a boundary crossing and a boundary violation.
• Give examples and possible resolutions of common boundary problems encountered in health professions.

Working With and For Native American Veterans

Presented by Charlotte M. McCloskey, PhD
Recorded on January 12, 2023 | Expires March 2026

The purpose of this webinar will be to provide participants with the history of and the current concerns related to the health and well being of Native American Veterans seeking health care in the VHA. This presentation will also provide participants with resources to better serve this population and encourage the use of culturally aware or informed interventions with a focus on family and community involvement. After the training learners should be able to:

• Explain to participants the historical background of Native American/Alaska Native Veterans to provide context to current sociopolitical issues impacting wellness for this population.
• Discuss current events that are impacting the emotional and physical well being of Native American/Alaska Native Veterans.
• Provide resources to the participants to become better aware of culturally safe materials for Native American/Alaska Native Veterans to utilize in patient care.

Darwinian Medicine, Burnout, and Self-Compassion

Presented by Hector A. Garcia, PsyD
Recorded on February 9, 2023 | Expires March 2026

The purpose of this webinar is to use insights gleaned from Darwinian-medicine to grow a deeper understanding of the roots of occupational burnout, the connections between interpersonal predictors of burnout and our survival instincts, and to apply these insights toward greater self-compassion, better working relationships, and greater engagement in the workplace. After the training learners should be able to:

• Articulate a working understanding of the phenomenology of occupational burnout, as defined by the research literature, and describe burnout’s relationship to clinical sequelae such as depression.
• Think critically about burnout’s roots in our survival instincts, as they pertain to leadership behaviors and peer relationships, and self-compassion.
• Use the insights above to propose personal plans for identifying occupation burnout, and to develop burnout reduction/prevention strategies.

A Veteran-guided Approach to Trauma Recovery: The Systematic Reduction of False Safety Aids

Presented by Joseph (Jay) Boffa, PhD
Recorded on March 8, 2023 | Expires April 2026

The purpose of this webinar is to familiarize VA staff with clinical resources available to assist Veterans with a patient-led approach to recovering from trauma and symptoms of post-traumatic stress. It will review common trauma-related symptoms, explain the concept of false safety aids as a maintaining factor of trauma-related symptoms, and introduce a protocol for assisting Veterans with systematically reducing their use of problematic safety aids. After the training learners should be able to:

• Describe the role of avoidance and safety aids in maintaining reactions to trauma.
• Identify common strategies for fading the use of safety aids in the context of trauma cues.
• Explain the steps to help Veterans actively engage in fading safety aids related to trauma cues.

Improving Access to Evidence-Based Psychotherapies: The MyBrief CBT Program

Presented by Jeff Cully, PhD
Recorded on April 13, 2023 | Expires May 2026

The purpose of this webinar is to discuss and identify solutions to challenges faced by providers in their efforts to deliver high quality, evidence-based psychotherapies (EBPs). The training will discuss EBP opportunities and challenges but will focus on a specific EBP program developed in VA to support providers in their efforts to address depression in Veterans. After the training learners should be able to:

• Identify the challenges and opportunities of using evidence-based psychotherapies in frontline practice.
• Describe the evidence for and core features of the MyBrief CBT program for Veterans with depression.
• Describe opportunities for training in the MyBrief CBT program.

Beyond Complicated Grief: A Discussion of Presentations and Interventions Focused on Grief and Loss

Presented by L. Alexis Correll, PsyD
Recorded on May 11, 2023 | Expires June 2026

The purpose of this webinar is to prepare clinicians for the task of supporting Veteran patients and caregivers through grief work. It will present the different types of grief, going beyond the "normative" vs. "complicated" grief dyad. It will also discuss the skills and strategies that can facilitate the grieving process when one is "stuck" in the grieving process following a range of losses. After the training learners should be able to:

• Discuss the different types of grief and their key characteristics.
• Describe the dual process model of grief.
• List factors that influence grief and bereavement.
• Consider how personal and professional loss may impact clinical practice.

Care for Transgender and Gender Diverse Veterans

Presented by Jessica Morris, PhD and Dawnelle Paldino, PhD
Recorded on June 15, 2023 | Expires July 2026

The purpose of this webinar is to provide CBOC mental health providers information about transgender and gender diverse Veteran care, including foundational terminology and information about health disparities that exist for this population. This training will also assist providers in learning methods to create an affirming healthcare environment that counteracts historical discriminatory contextual factors of military and VA history and provide resources for additional education and training. After the training learners should be able to:

• Define common terms used in the care of transgender and gender diverse (TGD) patients.
• Identify health disparities experienced by TGD Veterans.
• Understand how to create an affirming clinical environment for TGD patients.
• List resources for education and training.

Courageous Conversations: Cultural Competence in Mental Health Treatment with Veterans of Color

Presented by Angela D. Moran, MSW, LCSW-BACS; Evelyn M. Webb, MSW, LCSW-BACS; Tamara Richardson, MSW, LCSW-BACS
Recorded on July 13, 2023 | Expires September 2026

The purpose of this live, knowledge-based training is to address the challenges that Veterans of color may face in seeking mental health treatment and to provide insight into aiding in overcoming said barriers in order to provide culturally competent treatment. It will present ethical and cultural considerations for VHA providers in providing effective MH treatment to Veterans from racially diverse populations. After the training learners should be able to:

• Understand the value of cultural competence and humility in ethical mental health treatment of Veterans of color.
• Identify health disparities experienced by TGD Veterans.
• Identify levels of racism and the mental health impacts of racism on BIPOC persons.
• Explore the concepts of microaggressions and institutional racism in the justice system.
• Gain knowledge of barriers to mental health care in communities of color.
• Implement practical strategies to aid clients of color in overcoming barriers to mental health treatment.

Written Exposure Therapy: A Brief PTSD Treatment

Presented by Denise M. Sloan, PhD and Brian P. Marx, PhD
Recorded on August 10, 2023 | Expires September 2026

The purpose of this live, knowledge-based training is to provide training in Written Exposure Therapy (WET), an evidence-based treatment for PTSD. It presents an overview of PTSD among rural veterans, the available treatments for PTSD, the written exposure therapy treatment protocol, empirical support for written exposure therapy, implementation efforts in VA, preparations, logistics, and other considerations, and how to deliver written exposure therapy via telemental health methods. After the training learners should be able to:

• Identify critical elements of written exposure therapy.
• Describe situations when it is appropriate to use written exposure therapy.
• Identify key issues in the delivery of written exposure therapy.
• Describe how to deliver written exposure therapy using telemental health methods.

Anxiety and Panic Disorders

Presented by Kathleen Grubbs, PhD
Recorded on September 14, 2023 | Expires October 2026

The purpose of this live, knowledge-based training is to review the basics of anxiety disorders and their impact on Veterans seeking mental healthcare in VA. It will present information on diagnosis and treatment of anxiety disorders with an emphasis on cognitive behavioral therapy for panic disorder as well as innovations that could improve access to and engagement in care. After the training learners should be able to:

• Discuss diagnosis, prevalence and considerations when working with anxiety disorders.
• Describe common treatment approaches to treating anxiety and panic disorder.
• Identify three innovations that could improve access, engagement, and outcomes for anxiety disorders.

Women's Mental Health - Considerations for Community Based Outpatient Clinics

Presented by Lynette Adams, PhD
Recorded on October 12, 2023 | Expires December 2026

The purpose of this live, knowledge-based training is to raise awareness of considerations for providing mental health care to women Veterans in Community Based Outpatient Clinics (CBOC). It will highlight key demographics of women Veterans and resources that can be utilized by CBOC clinicians. After the training learners should be able to:

• Describe demographic characteristics and utilization care patterns of women Veterans in the VHA.
• Identify at least three gender specific considerations for working with women Veterans in a CBOC setting.
• List at least three resources for clinicians in support of working with women Veterans.

Intimate Partner Violence Assistant Program: Understanding the Health Care Delivery Model for Intimate Partner Violence

Presented by Natalie Peterson, PhD
Recorded on November 9, 2023 | Expires December 2026

The purpose of this live, knowledge-based training is to discuss the prevalence of intimate partner violence amongst the Veteran population as well as introduce available trauma-informed screening and intervention resources for experiencers and users of intimate partner violence. After the training learners should be able to:

• Discuss the Intimate Partner Violence Assistance Program.
• Identify key terms, definitions and signs related to intimate partner violence (IPV) experience and sexual assault (SA) experience.
• Explain key concepts of screening for IPV using a trauma-informed approach.
• List four trauma-informed interventions for IPV and SA.

The State of the Field: Psychedelic Treatments for Mental Health Conditions

Presented by Chris Stauffer, MD and Zach Skiles, PsyD
Recorded on December 14, 2023 | Expires December 2026

The purpose of this grand rounds is to review the use of psychedelic treatments for mental health and substance use disorders among Veteran populations and define the current state of the field with a particular focus on ongoing VA research and possible clinical implementation of psychedelic-assisted therapy. After the training learners should be able to:

• Define current regulatory status and legality of psychedelics in various contexts
• Review study protocols and clinical outcomes from major psychedelic-assisted therapy clinical trials.
• Consider ethical pitfalls and implications of psychedelic-assisted therapy in Veteran populations.
• Explore harm reduction resources, referrals, and provider training.

Virtual Voice and Communication Training for Veterans in Transition: GAPS

Presented by Kimberly Eichhorn and Nan Musson
Recorded on January 13, 2022 | Expires February 2025

Rural transgender Veterans are an underserved population who have limited access to specialized voice and communication interventions to reduce their gender dysphoria. In the general population, approximately 16% of transgender people live in rural areas, but estimates of rurality are higher among transgender Veterans. VHA is currently providing transition-related care to approximately 10,000 transgender Veterans, and Transgender E-consult data suggest that about 40% are living in rural areas. The LGBTQ+ Program Office and the Audiology and Speech Pathology Program Office partnered with the Rural Health Resource Center to develop a standardized protocol to deliver evidence-based voice and communication services for rural Veterans utilizing virtual technology. This course will provide an overview of the Gender Affirming Program with Speech Pathology (GAPS) for transgender Veterans including a review of the implementation, patient reported outcomes, referral process for the program, and recommendations for providers to support patient’s communication goals. After the training learners should be able to:

• Discuss the goals of gender affirming voice and communication interventions for transgender populations.
• Describe the referral process for the Gender Affirming Voice program.
• Outline specific ways to support Communication Goals for Veterans in Transition.

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HeartMath: Building Resilience with the Intelligent Heart

Presented by Hyeji Na, PsyD
Recorded on February 10, 2022 | Expires March 2025

The purpose of this presentation is to provide an overview of the HeartMath system, including scientific research, techniques, and technologies, and how HeartMath may be used in CBOCs and rural areas. After the training learners should be able to:

• Define key concepts presented in the HeartMath interventions, including stress, HRV, and coherence.
• Identify clinical improvement, as well as limitations, related to improving emotional self-regulation through HeartMath techniques.
• Apply three HeartMath techniques for practitioner self-care and for use with clients, with and without the use of biofeedback technology.

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Cultural Competency in Disability: An Ethical Imperative

Presented by Erin E. Andrews, PsyD, ABPP
Recorded on March 10, 2022 | Expires April 2025

The purpose of this virtual training is to address the knowledge gap experienced by mental health providers in providing culturally competent and ethical care to Veterans with disabilities. After the training learners should be able to:

• Explain the ethical imperative of conceptualizing disability as a diversity variable.
• Identify two relevant ethical principles, standards, and conflicts in working with people with disabilities.
• Compare and contrast the pros and cons of a hypothetical ethical case resolution.

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Depression and Pain: Implications for Concurrent Treatment of Symptoms in Veterans

Presented by Joshua Hamer, PhD
Recorded on April 14, 2022 | Expires May 2025

The purpose of this live, knowledge-based training is to understand how behavioral health interventions address psychiatric comorbidities related to depression and pain. It will present a review of the literature regarding pain conditions associated with depressive symptomatology and explore VA treatment options available to support Veterans in improving their qualities of life and functioning. After the training learners should be able to:

• Understand the current state of the evidence-base regarding comorbid manifestations of pain and depression symptoms in Veterans.
• Distinguish effective treatment approaches to address a pain and depression symptoms.
• Describe one team-based approach toward treating Veterans with comorbid pain and depression symptoms in VA.
• Identify how culturally responsive interventions may enhance treatment outcomes for Veterans with comorbid pain and depression symptoms.

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Beyond MST: Using the Mobile App to Support Individuals who Experienced Military Sexual Trauma

Presented by Chris Skidmore, PhD and Amy Street, PhD
Recorded on May 12, 2022 | Expires June 2025

Many Veterans experience military sexual trauma (MST) during military service, and MST is associated with a wide range of physical and mental health conditions and unique care needs. The purpose of this knowledge-based training is to teach attendees about the background for and practical applications of a new mobile mental health app, Beyond MST, designed for MST survivors and those who care for them. After the training learners should be able to:

• Define military sexual trauma (MST).
• Describe at least two features available in Beyond MST, a new mobile mental health app for MST survivors.
• List at least two potential benefits of using a mobile app for MST survivors.

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Infertility and Mental Health

Presented by Laura J. Miller MD
Recorded on July 14, 2022 | Expires August 2025

The purpose of this knowledge-based training is to enhance participants’ knowledge of the mental health consequences of infertility. Participants will learn about factors to include in a mental health assessment of Veterans experiencing infertility, and about how to adapt evidence-based psychotherapies to address infertility-related concerns. An illustrative case will help learners apply this knowledge to clinical situations. Participants will learn about relevant VA resources to assist Veterans and VA clinicians. After the training learners should be able to:

• Explain how infertility can be experienced as a unique stressor.
• Describe the range of potential mental health consequences of experiencing infertility.
• List at least three areas of focus that commonly arise in psychotherapy for people experiencing infertility.

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Caring for Veterans with Psychosis: An Overview of Evidence-Based Pharmacological and Psychosocial Interventions for Veterans with Schizophrenia

Presented by Olaoluwa Okusaga, MD, MScPHR, FAPA and Jared Bernard, PhD
Recorded on August 11, 2022 | Expires September 2025

The purpose of this live, knowledge-based training is to provide an overview of treatments for Veterans with schizophrenia. Information about the need to rule out secondary psychosis, application of the bio-psycho-social model of treatment, discussion of evidence-based somatic treatments and commonly utilized psychosocial interventions, as well as the concept of recovery as it applies to Veterans with schizophrenia will be presented. After the training learners should be able to:

• Explain the importance of ruling out secondary psychosis during the initial assessment of a Veteran presenting with psychosis.
• Describe how to decide on which antipsychotic medication and other somatic treatments to prescribe for a Veteran diagnosed with schizophrenia.
• Describe the concept of recovery as it applies to Veterans with schizophrenia and how its principles are reflected in psychosocial interventions.
• Identify commonly utilized evidence-based psychosocial interventions for Veterans with psychosis.

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Providing Tele-mental Health Care to Older Veterans: Equity and Ethical Considerations

Presented by Jennifer Freytag, PhD, JD
Recorded on September 15, 2022 | Expires October 2025

The purpose of this live, knowledge-based training is to address ethical issues in using tele-mental health as a treatment modality for older Veterans. The training will include a discussion of the barriers and benefits to using tele-mental health with older Veterans, ethical principles that apply to tele-mental health practice, and potential ethical issues rural mental health providers may encounter. After the training learners should be able to:

• Describe barriers to equitable use of tele-mental health with older Veterans.
• Discuss ethical principles to tele-mental health practice with older Veterans.
• Identify potential ethical issues when conducting tele-mental health visits with older Veterans.

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The Great Outdoors: Engaging with Nature for Mental Health

Presented by Austen R. Anderson, PhD
Recorded on October 13, 2022 | Expires November 2025

The purpose of this presentation is to describe a brief nature-focused behavioral intervention for improving Veterans’ mental health and well-being. We will cover the evidence linking nature engagement/exposure with mental health and review the clinician manual and Veteran guide for the intervention. After the training learners should be able to:

• Identify empirical evidence linking nature engagement/exposure to mental health.
• Describe the treatment components of “The Great Outdoors” behavioral intervention.
• Discuss the implementation and delivery of The Great Outdoors behavioral intervention.

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“I Didn’t Really Feel Like a Human Being. I Felt More Like an Ant.”: Veterans’ Experiences Seeking Food Assistance

Presented by Nipa Kamdar, PhD, RN, FNP-BC
Recorded on November 10, 2022 | Expires December 2025

The purpose of this live, knowledge-based training is to share the experiences of Veterans who are food insecure as they try to connect with resources/help. After the training learners should be able to:

• Describe circumstances that contribute to food insecurity.
• Describe experiences of Veterans with screening, finding, and connecting with resources.
• Discuss challenges that Veterans encounter.

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Acceptance and Commitment Therapy for Anxiety and Trauma-Related Problems in Living

Presented by Jeffry Scott Bethay, PhD
Recorded on December 15, 2022 | Expires January 2026

The purpose of this live, knowledge-based training is to describe an ACT model of treatment for anxiety and trauma-related disorders to supplement the VA ACT-D protocol:

• Describe a functional account of clinical anxiety and exposure therapy from an ACT perspective.
• Describe and explain case conceptualization and clinical procedures to address anxiety and trauma-related concerns from an ACT perspective.
• List relevant treatment techniques and exercises corresponding to the 6 core processes of ACT.

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Substance Use Disorder Care in VHA: Updates from National Program Offices

Presented by Joseph Liberto, MD, Tera Moore, PharmD, BCACP, and Ellen L. Edens, MD, MPE
Recorded on May 13, 2021 | Expires June 2024

The purpose of this live, knowledge-based training is to update mental health providers on several national initiatives relevant to the care of Veterans with substance use disorders (SUD). It will present six initiatives dedicated to improving the care of Veterans with SUDs, including how to access services. After the training learners should be able to:

• Recognize the models of care for SUD treatments provided in non-specialty care settings and the importance of risk mitigation.
• Describe the Clinical Pharmacy Specialist (CPS) impact across practice settings for SUD Care.
• Be familiar with available resources for consultation available to providers who treat patients with SUDs.

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Educational and Clinical Tools to Enhance the Delivery of Brief Cognitive Behavioral Therapy

Presented by Darius Dawson, PhD and Jeffrey Cully, PhD
Recorded on July 15, 2021 | Expires August 2024

The purpose of this live, knowledge-based training is to describe advances in providing brief cognitive behavioral therapy (bCBT) and to review several available educational and clinical tools to enhance the delivery of bCBT in frontline practice. The training will focus on the recently released 2nd Edition of the Provider’s Guide to Brief Cognitive Behavioral Therapy but will also provide an overview of various other educational and clinical products available for free download through the South Central MIRECC website. After the training learners should be able to:

• Review the core tenants and empirical support of brief CBT as outlined in the 2nd Edition Provider Guide to Brief CBT for clinical practice.
• Describe relevant use of the provider guide for clinical practice and training purposes using case and diagnostic examples.
• Examine brief CBT through a cultural lens to highlight appropriate adaptations for a variety of patient and clinical populations.
• Discuss appropriate use of the available brief CBT educational and clinical resources available through the VA’s South Central MIRECC for teaching and supervision.

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Expanding the Ability to Conceptualize and Converse About Race in Mental Health Settings

Presented by Angelic Chaison, PhD, Bethany Aiena, PhD, and Quang (Charlie) Nguyen, PhD
Recorded on August 12, 2021 | Expires September 2024

The purpose of this presentation is to enhance mental health providers’ ability to engage in self-education and meaningful conversations about race in order to address racial disparities and inequities in the context of patient care and team interactions. After the training learners should be able to:

• Discuss the necessity of self-education and self-reflection in enhancing one’s ability to provide culturally safe care to Black, Indigenous, and People of Color (BIPOC).
• Identify strategies to engage in courageous conversations about race in mental health settings and beyond.

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Eating Disorders in Male and Female Veterans

Presented by Karen S. Mitchell, PhD
Recorded on September 9, 2021 | Expires October 2024

The purpose of this live, knowledge-based training is to present an overview of eating disorders, including the major diagnoses and clinical criteria, as well as information specific to Veterans with eating disorders. It will provide information regarding associations between trauma and eating disorders, assessment tools, treatment approaches, and referral options. After the training learners should be able to:

• Identify risk factors for eating disorders in male and female Veterans.
• Describe associations between trauma and eating disorders.
• Identify assessment and treatment options for Veterans with eating disorders.

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