MIRECC / CoE

Collaborating with Mental Health Pharmacists to Optimize Multiple Medications

Presented by Austin De La Cruz, PharmD, BCPP
Recorded on January 8, 2025

The purpose of this live, knowledge-based training is to address the challenges and opportunities of managing polypharmacy in Veterans. This training aims to enhance understanding among both prescribers and non-prescribers about the benefits and risks associated with polypharmacy, and to provide practical strategies for managing multiple medications effectively. After the training learners should be able to:

• Define polypharmacy and recognize its significance in the mental health care of Veterans.
• Identify the risks of polypharmacy and its impact on patient outcomes.
• Recognize the role of mental health pharmacists in managing polypharmacy.
• Apply collaborative care strategies to optimize polypharmacy management in mental health treatment.

Assessment and Treatment of Obsessive-Compulsive Disorder in Veterans

Presented by Gabriella T. Ponzini, PhD
Recorded on March 13, 2025

This presentation will provide information and resources regarding the assessment and treatment of obsessive-compulsive disorder (OCD) in Veterans. The use of telehealth to deliver treatment for OCD will also be discussed. After the training learners should be able to:

• Describe rates of OCD and comorbid disorders in Veterans.
• Describe the use of optimal practices for assessing OCD .
• Cite the principles of exposure and response prevention (ERP) for OCD.
• Explain the utility of video telehealth for treating Veterans with OCD

Updated Moral Injury Psychoeducation Group: Introduction to Acceptance and Forgiveness Concepts for Veterans with Moral Injury

Presented by Pat Pernicano, PsyD
Recorded on April 10, 2025

This presentation will address the challenges providers face in offering services for Veteran moral injury (MI). It will review introductory concepts related to MI and a 4-week moral injury program available nationally for education, prevention and early intervention. Will discuss impact of MI, stages of change, and interface with PTSD, substance use disorder, and suicidal ideation. After the training, learners should be able to:

• Raise awareness of Veteran moral injury and the interface with PTSD, substance use disorder, and suicidal ideation.
• Introduce stages of change theory as it applies to moral injury.
• Identify some benefits of prevention and early intervention with Veterans who report guilt, blame, and desire for forgiveness.
• Demonstrate value of metaphor and story in reducing defensiveness and improving readiness to change.

Defining a New Reality in Health Care Delivery and Experience

Presented by Anne Bailey, PharmD, BPCS
Recorded on January 11, 2024

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

This 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.

Sleep Apnea Assessment and Intervention: Recommendations to Optimize Veteran Adherence to PAP

Presented by Earl C. “Chuck” Crew, PhD, DBSM and LeQuan Dang, MD
Recorded on March 14, 2024

The purpose of this knowledge-based training is to provide an overview of sleep-disordered breathing, including challenges and troubleshooting opportunities for Veterans who may struggle to adhere with positive airway pressure (PAP) therapy. Perspectives on medical and behavioral health opportunities for assessment and intervention will be emphasized. A brief overview of the “hub and spoke” model for sleep telemedicine within VA community-based outpatient clinics will also be discussed. After the training learners should be able to:

• Describe the clinical features of sleep-disordered breathing to support screening and potential need for further evaluation by Sleep Medicine.
• Discuss the 4 common barriers for PAP non-adherence (e.g., equipment-related, medical, psychosocial, behavioral) and possible troubleshooting targets.
• Identify 2 effective interventions for increasing PAP adherence.
• Describe the domains supporting health behavior change via motivational enhancement discussions to increase PAP adherence.

Addressing Low Sexual Desire in Rural Women Veterans

Presented by Alexandra Balzer Caloudas, PhD
Recorded on April 11, 2024

The purpose of this live, knowledge-based training is to support VA providers in addressing rural women Veterans’ sexual concerns, emphasizing low sexual desire. It will describe the importance of assessing for low sexual desire in rural women Veterans, provide an overview of common contributors to low sexual desire in rural women Veterans, review approaches to diagnosing low sexual desire, and present a series of research-informed strategies for addressing low sexual desire in clinical settings. A case example will be woven throughout the content and discussions. After the training learners should be able to:

• Explain why it is important to ask rural women Veterans about their sexual concerns including low sexual desire.
• Summarize how low sexual desire is defined.
• Describe at least two potential contributors to low sexual desire in rural women Veterans.
• Identify at least two research-informed strategies for addressing low sexual desire in rural women Veterans.

Whole Health for Complex Patients: Chronic Pain

Presented by Juli Olson, DC
Recorded on May 9, 2024

The purpose of this recorded, knowledge-based virtual training for interprofessional healthcare teams is to address the intersection of mental health and chronic pain co-morbidities. The Whole Health model provides a variety of tools to help the busy provider navigate veteran expectations and needs in the context of complex chronic conditions. After the training learners should be able to:

• Describe the Whole Health System of care as it relates to Veterans with complex presentations;.
• Explain how to access resources for Whole Health and complementary and integrative health (CIH); and
• Identify at least 2 referrals and co-management opportunities of interest for Veterans with co-occurring chronic pain and mental health diagnoses from a WH and CIH perspective.

Guided Self-Help Program

Presented by Maribel Plasencia, PhD
Recorded on June 13, 2024

The purpose of this recorded, knowledge-based virtual training is to provide knowledge around the differences between pure self-help and guided self-help interventions and introduce attendees to the framework for supporting patients who are using self-help tools. It will provide two skills for addressing difficulties patients may face when working with self-help materials. After the training learners should be able to:

• Discuss differences between pure self-help, guided self-help, and traditional therapy.
• Explain the framework used to support patients in their use of self-help.
• Describe two strategies for addressing patient challenges to following self-help materials.

Food Matters: Nutrition Care for Mental Health

Presented by Kerry Gundlach, MS, RD
Recorded on July 11, 2024

The purpose of this recorded, knowledge-based virtual training is to address the connection between nutrition and mental health. It will provide an overview of how nutrition correlates with mental health, specifically focusing on depression and anxiety, discuss supportive dietary patterns, and review emerging evidence on the connection between the gut and mental health (gut-brain-axis) so that providers can integrate this knowledge into patient care. After the training learners should be able to:

• Discuss the connection between nutrition and mental health.
• List evidence-based dietary patterns that support mental health (specifically depression).
• List key nutrients that impact mood-related systems.
• Explain some of the emerging evidence on the gut microbiome and mental health.

Ethical Considerations in Assessing and Treating Moral Injury with Military Veterans

Presented by Brandon Griffin, PhD and Jessica Domino, PhD
Recorded on August 15, 2024

The purpose of this live, knowledge-based training is to address ethical considerations that VA mental health clinicians encounter when assessing and treating veterans seeking care for moral injury. After the training learners should be able to:

• Define moral injury and discuss its impact on Veterans’ well-being.
• Use the moral injury and distress scale to assess probable moral injury in Veterans.
• Discuss ethical issues that may arise when addressing moral injury in clinical practice.

Eye Movement Desensitization and Reprocessing (EMDR) to Treat PTSD

Presented by Marianne Silva, LCSW
Recorded on October 10, 2024

The purpose of this live, knowledge-based virtual training is to provide an overview of Eye Movement Desensitization and Reprocessing (EMDR) including the evidence showing its effectiveness and the protocol and mechanisms of EMDR. Strategies and resources for introducing EMDR within shared decision-making are discussed with attention to VA community-based outpatient clinics and rural mental health providers. After the training learners should be able to:

• Describe the state of the research evaluating the effectiveness of EMDR in the treatment of PTSD.
• Summarize the core components of the EMDR standard protocol.
• Identify at least 3 resources clinicians can use when introducing EMDR as a treatment option in shared decision-making

Unmasking Sexual Acting Out Behaviors: A Brief Overview

Presented by Brad R. Nederostek, PsyD
Recorded on November 14, 2024

The purpose of this educational workshop is to highlight some of the many complexities of Impulsive-Compulsive Sexual Behavior (ICSB). Through examining its medical, psychological, and social underpinnings, attendees will recognize key elements consistent within this clinical population. The goal is to equip providers of various disciplines with sample questions and practical strategies, thereby fostering a nonjudgmental environment aimed at proper assessment, treatment, and/or referral processes. After the training learners should be able to:

• Understand the vast etiologies used to pinpoint these “excessive” behaviors.
• Identify common individual and relational characteristics present within this population.
• Describe the “hidden” ways individuals may present to their provider.
• Discuss the more common clinical presentations of impulsive-compulsive sexual acting out behaviors

Coping with Losing Independence in Aging

Presented by Esi Bentsi-Barnes, MD and Lindsay E. Page, MD
Recorded on December 11, 2024

The purpose of this live, knowledge-based training is to address the challenges faced by older adults in losing independence throughout the aging process. It will present framework for clinicians to support older adults through the aging process. After the training learners should be able to:

• List the 4 M’s in the care of older adults.
• Differentiate the medical, pharmacological, and psychological factors that can affect cognition in older adults.
• Demonstrate strategies for assessing older adults functional and cognitive abilities.

Darwinian Medicine, Burnout, and Self-Compassion

Presented by Hector A. Garcia, PsyD
Recorded on February 9, 2023

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

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

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

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.

Written Exposure Therapy: A Brief PTSD Treatment

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

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

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

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

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

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.

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

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.

Infertility and Mental Health

Presented by Laura J. Miller MD
Recorded on July 14, 2022

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.

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

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.

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

Presented by Jennifer Freytag, PhD, JD
Recorded on September 15, 2022

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.

The Great Outdoors: Engaging with Nature for Mental Health

Presented by Austen R. Anderson, PhD
Recorded on October 13, 2022

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.

“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

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.

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

Presented by Jeffry Scott Bethay, PhD
Recorded on December 15, 2022

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.