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Past MIRECC Presents Topics | NW Mental Illness Research, Education and Clinical Center
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Past MIRECC Presents Topics | NW Mental Illness Research, Education and Clinical Center
MIRECC Presents :: Past Topics
The Northwest Mental Illness Research, Education and Clinical Center provides continuing education through MIRECC Presents. MIRECC Presents translates current scientific and clinical research into information that can be used by clinicians to enhance the care of Veterans. By integrating cutting-edge treatments and timely research into their daily clinical practices, mental health providers are empowered to provide the highest quality of care for Veterans experiencing mental health challenges. Visit the MIRECC Presents overview page for information about joining the webinar and the current topics and schedule for the latest MIRECC Presents offering.Past MIRECC Presents
Below is a list of past MIRECC Presents webinars. Clicking on the topic will lead to the detailed description of that particular webinar.JUNE 3, 2020: Posttraumatic headaches: Current concepts in pathophysiology, diagnosis, and management
Chronic headaches can occur after trauma and can co-exist with traumatic brain injury and chronic PTSD, causing significant discomfort for patients and impairing optimal functioning. This presentation will summarize the current status of clinical care and research related to posttraumatic headaches and discuss guidelines for assessment and treatment.Presenter: Cynthia Mayer, DO
Cindy Mayer, DO, is a staff physician at the VA Puget Sound in Seattle. Dr. Mayer is Board-certified in neurology and nuclear medicine and completed a clinical research fellowship at the VA VISN 20 Northwest Network MIRECC under the mentorship of Drs. Murray Raskind and Elaine Peskind, Director and Co-Director, respectively, of that program. Her areas of interest include mild traumatic brain injury (mTBI), Gulf War Illness, and neurodegenerative diseases. Dr. Mayer has a particular interest in pathologies underlying these conditions and their comorbidities, and in identifying treatments to alleviate symptoms. Dr. Mayer is currently co-Principal Investigator on a randomized controlled trial evaluating the medication prazosin for prophylactic treatment of posttraumatic headaches in Veterans and active duty Service Members with mTBI. This research has been funded through a VA Career Development Award and a DoD CDMRP grant.
View recording of Posttraumatic headaches: Current concepts in pathophysiology, diagnosis, and management
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APRIL 15, 2020: The role of religion/spirituality in mental health outcomes for PTSD
Religion and spirituality have become increasingly important in psychiatric assessment and treatment. They can be an important part of cultural heritage, and they also can be important in healing and social supports. This presentation discussED the relevance of religion and spirituality in clinical outcomes for mental health conditions, including PTSD.
Presenter: Zhen Cheng, Ph.DZhen Cheng, Ph.D. is a Psychology Postdoctoral Fellow at the VA Portland Health Care System through the Northwest MIRECC. She is also a Clinical Instructor of Psychiatry at the Oregon Health & Science University School of Medicine. Dr. Cheng’s research focuses on the intersection of culture (gender, religion and spirituality, and race/ethnicity) with PTSD and sexual trauma.
Download PowerPoint
View recording of The role of religion/spirituality in mental health outcomes for PTSD
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APRIL 1, 2020: Treatment engagement and retention in patients with PTSD
Despite the development of evidence-based, effective treatments for PTSD within VA, treatment engagement and retention continue to be challenging, but they are essential for effective treatment. This presentation will explore some of the factors that influence engagement and retention and provide clinical suggestions for optimizing treatment engagement and retention.
Presenter: Shannon Kehle-Forbes, Ph.DShannon Kehle-Forbes, Ph.D is a clinical psychologist interested in understanding and treating post-deployment health problems. Specifically, her interests and expertise are in the areas of dissemination and implementation of evidence-based psychotherapies for PTSD, treatment seeking and access, and conditions often comorbid with PTSD (mild traumatic brain injury and substance use disorders).
View recording of Treatment engagement and retention in patients with PTSD
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MARCH 18, 2020: Evidence for glymphatic dysfunction in Alzheimer’s Disease: Sleep, waste, and neurodegeneration at the crossroads of the Central Nervous System
Alzheimer’s Disease continues to be an important contributor to morbidity and mortality among Veterans. The glymphatic system, a brain-wide network that facilitates the clearance of waste products, has been demonstrated to fail in the aging brain and in the young brain after traumatic brain injury. Impairment of glymphatic function may link brain trauma early in life with the development of dementia in later years. This clinically relevant presentation will explore the implications of impairment of glymphatic function for vulnerability to Alzheimer’s Disease.
Presenter: Jeff Iliff, Ph.DJeff Iliff, Ph.D is the Associate Director for Research at the VISN 20 NW Mental Illness, Research, Education and Clinical Center (MIRECC) at the VA Puget Sound Health Care System. He is a Professor in the Departments of Psychiatry and Behavioral Sciences and in Neurology at the University of Washington School of Medicine, where he is the Arthur J. and Marcella McCaffray Professor in Alzheimer’s Disease. Dr. Iliff focuses upon how the different cells of the brain work in concert to maintain whole-brain function. His strongest interest is in the cerebral vasculature, how it functions as a crossroads between the CNS and periphery, different brain regions, fluid compartments and cell types; maintaining appropriate sequestration, exchange and communication. The breakdown of these relationships are a key contributor to many neuological, neurovascular and neurodegenerative diseases.
View recording of Evidence for glymphatic dysfunction in Alzheimer’s Disease: Sleep, waste, and neurodegeneration at the crossroads of the Central Nervous System
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MARCH 4, 2020: Dialectical Behavioral Therapy (DBT) for treating PTSD
Dialectical Behavior Therapy (DBT) was originally developed to treat chronically suicidal and self-injuring individuals with multiple mental disorders and pervasive emotion dysregulation. From its inception, DBT has highlighted the role of trauma as a common etiological factor and posttraumatic stress disorder (PTSD) as an important treatment target for many patients who receive this treatment. In this talk, the basic structure and procedures of the DBT Prolonged Exposure (DBT PE) protocol will be outlined and the clinical challenges encountered during its development will be discussed. In addition, research findings supporting the safety and effectiveness of the integrated DBT and DBT PE protocol treatment will be presented.
Presenter: Melanie S. Harned, Ph.D., ABPPMelanie S. Harned, Ph.D., ABPP, is a Psychologist and Coordinator of the DBT Program at the VA Puget Sound Health Care System and an Associate Professor in the Department of Psychiatry and Behavioral Science and Adjunct Associate Professor in the Department of Psychology at the University of Washington. Dr. Harned has previously worked as the Research Director of Dr. Marsha Linehan’s Behavioral Research and Therapy Clinics at the University of Washington (2006-2018), Director of Research and Development for Behavioral Tech, LLC (2014-2017), and Director of Behavioral Tech Research, Inc. (2013-2016).
Outcome/Objectives: At the conclusion of this educational program, learners will be able to:
1. Understand the rationale for integrating PTSD treatment into DBT.
2. Outline the basic structure and procedures of the DBT Prolonged Exposure protocol for PTSD.
3. Review research findings evaluating the safety and effectiveness of the treatment.
View recording of Dialectical Behavioral Therapy (DBT) for treating PTSD
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FEBRUARY 19, 2020: Dissociation, Somatization, and Other Challenging Presentations of PTSD
Challenging presentations of PTSD, particularly dissociation and somatization trauma reactions, sometimes lead clinicians to hesitate offering evidence-based PTSD treatment. This course will help clinicians identify and understand dissociation and somatization presentations as trauma reactions within a PTSD case conceptualization framework, and will include reviewing clinical suggestions to support first-line evidence-based PTSD treatment for Veterans with these challenging presentations.
Presenter: Abigail Angkaw, PhDAbigail Angkaw is a clinical psychologist and Section Chief overseeing a unit of community-based outpatient mental health clinics at the VA San Diego, PTSD Program Director at the VA San Diego, and an Associate Clinical Professor at the University of California, San Diego. Dr. Angkaw specializes in questions related to treatment, assessment, and clinic administration, including Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Clinician Administered PTSD Scale (CAPS-5), measurement-based care, motivation and engagement, and program improvement.
Outcome/Objectives: At the conclusion of this educational program, learners will be able to:
1. Describe how individuals with PTSD may present with dissociation and somatization;
2. Discuss the rationale for not immediately excluding individuals with PTSD and dissociation or somatization reactions from evidence-based treatments for PTSD;
3. Identify methods to address dissociation and somatization PTSD reactions within evidence-based PTSD treatment.
View recording of Abigail Angkaw, PhD's presentation: Dissociation, Somatization, and Other Challenging Presentations of PTSD
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FEBRUARY 5, 2020: Clinical and administrative applications of the PTSD-Repository Clinical Trials Database
The development and use of evidence-based treatments for PTSD remains an important VA mission. This requires PTSD research that can inform and positively impact patient care. This presentation will highlight the relevance and effective use of the national PTSD repository for VA clinicians, educators, and researchers.Presenters:
- Maya O’Neil, PhD: Dr. Maya O’Neil is an Associate Professor at Oregon Health & Science University and Clinical Neuropsychologist at the Portland VA. She is a VA RR&D Career Development Awardee and an Investigator with the HSR&D CIVIC research center, the VA’s Evidence-based Synthesis Program, and the OHSU Pacific Northwest Evidence-based Practice Center. Her current grants focus on PTSD, TBI, cognitive functioning, and evidence synthesis methods.
- Jessica Hamblen, PhD: Dr. Jessica Hamblen is the Deputy for Education at the National Center for PTSD and an Associate Professor at the Geisel School of Medicine at Dartmouth. Her primary research interests are to develop, evaluate, and disseminate evidence-based treatments for PTSD and to inform and support trauma survivors in understanding and seeking these treatments. She currently has an HSR&D funded randomized controlled trial to examine whether videos of Veterans sharing their experiences with PTSD treatment improves engagement and completion of treatment.
- Tamara Cheney, MD: Research Associate, Oregon Health & Science University’s Pacific Northwest Evidence-based Practice Center
1. Understand the rationale behind developing the PTSD-Repository;
2. Identify key patient, study, and outcome variables included in the PTSD-Repository;
3. Learn how to use the PTSD-Repository for clinical, administrative, educational, or research purposes.
View recording of Clinical and administrative applications of the PTSD-Repository Clinical Trials Database
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JANUARY 15, 2020: Unconventional interventions for PTSD: State of the evidence
Download brochure and registration informationCurrently, several nonpharmacologic biological treatments are being investigated for the treatment of trauma. This presentation will explore the current evidence base for the use of these treatments, such as stellate ganglion block and hyperbaric oxygen, in PTSD treatment.
Presenter: Paul Holtzheimer, MD, MSCRDr. Paul Holtzheimer is Deputy Director for Research at the VA’s National Center for Post-Traumatic Stress Disorder (NCPTSD), Executive Division. He is an Associate Professor of Psychiatry and Surgery at the Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center and a Diplomate of the American Board of Psychiatry and Neurology. Dr. Holtzheimer’s research program focuses on the neurobiology and treatment of mood disorders, primarily using functional and structural neuroimaging (magnetic resonance imaging and electroencephalography) as well as focal neuromodulation (e.g., transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation).
Target Audience: The target audience includes but is not limited to Physicians, Nurses, Psychologists, Social Workers, Healthcare Teams and other professionals supporting Veteran care.
Outcome/Objectives: At the conclusion of this educational program, learners will be able to:
1. describe various proposed non-pharmacologic biological treatements for PTSD
2. discuss the regulatory processes that provide safety oversight for these interventions; and
3. identify the safety and efficay data for focal brain stimulation in PTSD treatment.
View recording of Unconventional interventions for PTSD: State of the evidence
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DECEMBER 18, 2019: Focal Brain Stimulation for PTSD
Currently, several nonpharmacologic biological treatments are being investigated for the treatment of PTSD. This presentation will focus on the current evidence base for a particularly promising clinical treatment, focal brain stimulation, including potential benefits and risks.Presenter: Paul Holtzheimer, MD, MSCRDr. Paul Holtzheimer is Deputy Director for Research at the VA’s National Center for Post-Traumatic Stress Disorder (NCPTSD), Executive Division. He is an Associate Professor of Psychiatry and Surgery at the Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center and a Diplomate of the American Board of Psychiatry and Neurology. Dr. Holtzheimer’s research program focuses on the neurobiology and treatment of mood disorders, primarily using functional and structural neuroimaging (magnetic resonance imaging and electroencephalography) as well as focal neuromodulation (e.g., transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation).
Outcome/Objectives: At the conclusion of this educational program, learners will be able to:
1. describe the neural circuit paradigm that supports the use of focal brain stimulation for PTSD;
2. summarize the rationale for using focal brain stimulation to treat PTSD; and
3. identify the safety and efficay data for focal brain stimulation in PTSD treatment.
View recording of Focal Brain Stimulation for PTSD
Download slides (PDF)
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DECEMBER 4, 2019: Lethal means safety: How clinicians can have the conversation
Lethal means safety is an important part of suicide prevention and risk assessment, one of the highest mental health priorities in VHA. This presentation will provide practical guidelines for clinicians for discussing lethal means safety with their patients in order to lower suicide risk. View the presentation.
Presenter: Bridget Matarazzo, Psy.D Dr. Bridget Matarazzo is the Director for Clinical Services and a Clinical/Research Psychologist at the Veterans Affairs' Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC). Dr. Matarazzo’s primary research interests are related to engaging Veterans at risk for suicide in care, particularly following psychiatric hospitalization. . She is the Principal Investigator of a Military Suicide Research Consortium-funded multi-site interventional trial aimed at studying the effectiveness of the Home-Based Mental Health Evaluation (HOME) Program, which she developed with her colleagues at the Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC).
Outcomes/Objectives:
At the conclusion of this educational program, learners will be able to:
1. Explain the importance of discussing lethal means safety with patients
2. Identify patients with whom providers should discuss lethal means safety
3. Discuss safe storage practices for firearms and medications
Course materials:
1. Slides
2. Therapeutic Risk Management - Risk Stratification Table
3. Suicide Risk Management - Infographic
4. View recording of Lethal Means Safety: How Clinicians Can Have the Conversation
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NOVEMBER 20, 2019: Quality of Care and Patient Outcomes Following Discontinuation of Long-Term Opioid Therapy in High-Risk Patients
The effective treatment of chronic pain is one of the greatest challenges for clinicians. Just as challenging is tapering and discontinuation of long-term opioids. This presentation will discuss these challenges that clinicians face with high-risk patients, and will offer perspectives on clinical outcomes and optimizing quality of care after opioid discontinuation.
Presenter - Travis Lovejoy, PhD: Dr. Travis Lovejoy is staff psychologist at the Portland VA and Associate Professor of Psychiatry at Oregon Health and Science University. Dr. Lovejoy's translational research focuses on the design, rigorous testing, and implementation of clinical and health services interventions that improve health of persons living with chronic illnesses, as well as the communities to which they belong. His current research examines multifaceted treatment approaches for the management of chronic pain in patients with co-morbid substances use disorders, as well as telehelath approaches to improve mental health functioning and reduce HIV transmission risk behavior in persons living with HIV. Outcome/Objectives
At the conclusion of this educational program, learners will be able to:
1. Describe historical trends in opioid prescribing in the U.S.;
2. Identify the consequences of opioid taper and discontinuation among long-term opioid users; and
3. Characterize changes in patients’ pain following discontinuation of long-term opioid therapy.
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NOVEMBER 6, 2019: Diagnosing ADHD in Adults, and Considering Treatment Options
One of the most challenging psychiatric illnesses to diagnose and treat is ADHD. Symptoms can overlap with several other conditions, and accurate diagnosis is dependent on an estimation of patient functioning going back to childhood and adolescence. Moreover, treatment options include the appropriate use of controlled substances with potential for misuse. This presentation will focus on these important clinical issues, and it will include considerations particularly relevant to the care of Veterans and healthcare teams.Presenter - Whitney Black, MD: Dr. Whitney Black is an Assistant Professor of Psychiatry at Oregon Health and Science University. She received her B.A.from University of Missouri Kansas City, her M.D. from University of Missouri Kansas City School of Medicine, and completed her residency in Psychiatry at Oregon Health & Science University.
Outcome/Objectives
At the conclusion of this educational program, learners will be able to:
1. identify evidence-based screening measures when diagnosing ADHD
2. describe strategies for psychostimulant titration trials in adult patients; and
3. describe the role for non-stimulant medications in treatment of adults with ADHD.
View the recording of Diagnosing ADHD in Adults, and Considering Treatment Options
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OCTOBER 16, 2019: The role of psychedelics in modern psychiatry: A review of the evidence base
Presenters:Melissa Buboltz, MD, staff psychiatrist at the Portland Veterans Affairs (VA) and Associate Professor of Psychiatry at Oregon Health and Science University (OHSU)
Aryan Sarparast, MD
Payton Sterba, MD
Jovo Vijanderan, MD
(Drs. Sarparast, Sterba and Vijanderan are residents in the Department of Psychiatry at Oregon Health and Science University.)
View the recording of The role of psychedelics in modern psychiatry: A review of the evidence base | Download the slides (3.35MB)
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MAY 1, 2019: Present-Centered Therapy for Posttraumatic Stress Disorder (PTSD)
The development of evidence-based psychotherapies for PTSD remains an important VA mission. Although trauma-focused treatment has the strongest evidence base as a treatment for PTSD, evidence has emerged showing that Present Centered Therapy is an effective alternative. Present Centered Therapy is a manualized time-limited treatment for PTSD that helps patients focus on addressing their current life problems that are related to past trauma. Present Centered Therapy has not been widely used outside of research, however, and neither the rationale nor the protocol are widely understood. This presentation will help bridge that gap for clinicians by providing information about the development of Present Centered Therapy, the evidence showing its effectiveness, and how to implement the treatment in clinical practice.Presenter: Tracie Shea, PhD, Staff Psychologist, Trauma Recovery Services Clinic, Providence VA Medical Center
Providence, Rhode Island
Outcomes/Objectives: At the conclusion of this educational program, attendees will be able to:
1. Describe the rationale for the development of Present-Centered Therapy
2. Summarize the evidence base for Present-Centered Therapy
3. Identify the core elements of Present-Centered Therapy
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APRIL 17, 2019: Benefits and Harms of Cannabis for the Treatment of Chronic Pain
Management of chronic pain among Veterans remains a significant challenge for clinicians across specialties and professional disciplines. New approaches are being developed, but they need to be systematically tested for efficacy and safety. This presentation will focus on the complex research and clinical issues related to the use of cannabis for chronic pain, and will summarize current practice recommendations based on current research evidence.Presenter: Ben Morasco, PhD, Staff Psychologist and Shannon Nugent, PhD, Staff Psychologist, Department of Veterans Affairs, Portland Health Care System, Portland, Oregon
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Discuss the changing culture related to the use of cannabis for chronic pain
2. Identify demographic and clinical characteristics of patients who use medical cannabis and have concurrent prescriptions for long-term opioid therapy
3. Summarize results from a systematic review examining the benefits and harms of medical cannabis for chronic pain
4. Summarize clinical practice recommendations related to cannabis use among patients with chronic pain
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APRIL 3, 2019: Problem Solving Training for Cognitive Dysfunction After Deployment
David Litke, PhD, Staff Psychologist and Lisa McAndrew, Ph.D., Staff PsychologistWar Related Illness and Injury Study Center (WRIISC), Department of Veterans Affairs New Jersey Health Care System
East Orange, New Jersey
Purpose: One of the cutting-edge treatments for Veteran mental health conditions is Problem-Solving Therapy, which has been found to be efficient and effective. This presentation will describe the essential elements of Problem-Solving Therapy and discuss how it can be particularly effective for cognitive problems after the stresses of deployment.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Describe the theory behind Problem-Solving Therapy
2. Identify Veterans most likely to benefit from Problem-Solving Therapy for cognitive problems
3. Identify resources for further training in Problem-Solving Therapy
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MARCH 20, 2019: Military service and combat deployments: Strengthening the patient-provider alliance in the context of moral injury and institutional betrayal
Kelly McCarron, Psy.D., Clinical Psychologist / Omowunmi Osinubi, M.D., Clinical DirectorWar Related Illness and Injury Study Center (WRIISC), Department of Veterans Affairs New Jersey Health Care System
East Orange, New Jersey
Purpose: Military combat potentially can present moral dilemmas that remain with Veterans long after their military service. These dilemmas can contribute to long-term emotional suffering and complicate recovery from posttraumatic stress disorder. This presentation will address these dilemmas that are encountered on a personal and institutional level, and will provide suggestions for how they can be addressed in the provider-patient relationship during the process of healing and recovery.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Define the concepts of moral injury, betrayal trauma, and institutional betrayal
2. Describe how moral injury, betrayal trauma, and institutional betrayal may impact Veterans’ health care
3. Discuss specific communication techniques that facilitate trauma disclosure in a manner that builds the patient-provider alliance
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MARCH 6, 2019: Suicide Prevention Among Women Veterans
Monireh Moghadam, LCSW, Lead Suicide Prevention CoordinatorDepartment of Veterans Affairs, Portland Health Care System
Portland, Oregon
Purpose: Suicide prevention and risk assessment continue to be important responsibilities for VA clinicians. This includes risk assessment among a variety of special groups who seek VA care, including women Veterans. Therefore, this presentation will particularly focus on practical and effective recommendations for suicide risk assessment among women Veterans, and will discuss important elements of safety plans for enhancing suicide prevention.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. List three examples of gender differences in U.S. suicide rates
2. Describe three suicide risk factors for female Veterans
3. Discuss the six steps of a Suicide Prevention Safety Plan
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FEBRUARY 6, 2019: A Pragmatic Approach to Managing Borderline Personality Disorder within the Busy Outpatient Clinic
Neisha D'Souza, M.D., Assistant Professor of Psychiatry / Sean Stanley, M.D., Assistant Professor of PsychiatryOregon Health and Science University
Portland, Oregon
Purpose: The treatment of major psychiatric disorders sometimes occurs in the context of a patient's underlying personality disorder. Effective comprehensive treatment requires knowledge and skill in managing the co-occurring personality disorder. This presentation will provide clinicians with tools to effectively recognize and treat symptoms and behavior associated specifically with borderline personality disorder in busy clinical settings.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Diagnose borderline personality disorder (BPD) correctly, including differentiation from mood disorders and PTSD
2. Articulate the basic therapeutic approach utilized in Good Psychiatric Management for clients living with BPD
3. Utilize the Model of Interpersonal Coherence to assist clients in understanding their symptomatology
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JANUARY 16, 2019: Flexible Applications in Delivering Evidence-Based Psychotherapies for Posttraumatic Stress Disorder
Tara Galovski, PhD Director, Women's Health Sciences DivisionNational Center for PTSD/Veterans Affairs Boston Healthcare System
Boston, Massachusetts
Purpose: The development and refinement of evidence-based practices for treating posttraumatic stress disorder (PTSD) have proliferated over the last three decades. Following initial, more tightly controlled clinical trials demonstrating the efficacy of evidence-based practices such as Cognitive Processing Therapy (CPT), a host of additional studies have sought to assess the added benefits of more flexible administrations of these efficacious interventions. Given that there is much evidence to suggest that fidelity to the Cognitive Processing Therapy (CPT) protocol is important, but at times greater flexibility is necessary and effective, the goal must be providing clinicians with knowledge and tools to effectively navigate the fine line between fidelity and flexibility. Using Cognitive Processing Therapy (CPT) as an example, this presentation seeks to provide empirically informed guidance to clinicians seeking to optimize outcomes in their administration of evidence-based practices for PTSD.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Describe the rationale for flexibly administering evidence-based practices
2. Summarize the evidence base for modifying interventions to meet patient need
3. Discuss the parameters around therapy modifications while maintaining fidelity to study protocols
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DECEMBER 19, 2018: Neuropsychiatric Issues in Parkinson's Disease
Joel Mack, MD, Staff PsychiatristDepartment of Veterans Affairs, Portland Health Care System
Portland, Oregon
Purpose: A neuropsychiatric condition frequently encountered in VA clinical settings is Parkinson's Disease, and treatment approaches are constantly evolving. Despite increased awareness in recent years of Parkinson's Disease neuropsychiatric symptoms and their impact on quality of life, common issues such as depression, anxiety, psychosis, and impulse control disorders continue to be under-recognized and undertreated in clinical practice. This discussion will provide an overview of the range of neuropsychiatric issues in Parkinson's Disease and highlight recent developments in assessment and treatment of these problems.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Summarize the range of neuropsychiatric symptoms experienced by patients with Parkinson's Disease (PD)
2. List possible neuropsychiatric complications of Parkinson's Disease and its treatments
3. Discuss an interdisciplinary approach to treating neuropsychiatric symptoms in PD, including both medication and non-pharmacological interventions
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DECEMBER 5, 2018: Problem Solving Training for Cognitive Dysfunction After Deployment
David Litke, PhD and Lisa McAndrew, PhD – VA New Jersey HCSGo back to top of page
NOVEMBER 7, 2018: Treating Tobacco Use in Patients with Posttraumatic Stress Disorder (PTSD)
Andy Saxon, MD, DirectorCenter for Excellence in Substance Abuse Treatment and Education (CESATE)
Department of Veterans Affairs, Puget Sound Health Care System
Seattle, Washington
Purpose: Addiction frequently co-exists with many psychiatric disorders. Tobacco use is one of the most common addictions, and its use has significant adverse effects on health. This presentation will examine the prevalent use of tobacco by patients with PTSD and its adverse effects, and describe options for treatment interventions for patients with these co-existing disorders.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Describe the high rates of tobacco use among individuals with psychiatric disorders
2. Summarize the adverse effects of tobacco use on psychiatric disorders and potential improvements with tobacco cessation
3. Discuss characteristics of evidence-based treatment for co-occurring tobacco use and posttraumatic stress disorder
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OCTOBER 3, 2018: Mental Illness and Firearms
Joseph Chien, MD, Staff PsychiatristDepartment of Veterans Affairs, Portland Health Care System
Will Frizzell, MD, Resident in Psychiatry
Oregon Health and Science University
Portland, Oregon
Purpose: In medical care settings such as VA medical centers, and society at large, there continues to be intense discussion about the connection between mental illness and gun violence, including the relationship between firearms and suicide. Adequate data is needed to make policy and clinical decisions about violence prevention and threat assessment. This presentation will discuss the latest data regarding the connections among mental illness, firearms, suicide and violence, and suggest preventative clinical interventions.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Summarize the epidemiologic data regarding mental illness and gun violence
2. Describe the relationship between firearms and suicide
3. Discuss the role of gun violence restraining orders
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MARCH 21, 2018: Exposure, Relaxation and Rescription Therapy – Military (ERRT-M): Treating Trauma-Related Nightmares
Noelle Balliett, PhD, Staff PsychologistSeattle VA Medical Center
Purpose: In combat PTSD, nightmares are one of the prime symptoms that cause distress for Veterans, and are a frequent complaint for Veterans seeking treatment. Therefore, it is important for clinicians to have effective options for treating combat-related nightmares. This presentation will focus on an effective option for decreasing nightmares, thereby improving sleep and overall patient functioning.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Summarize how to differentiate trauma-related nightmares from other common sleep complaints
2. Discuss how to effectively consult with Veterans about treatment for nightmares
3. Describe the core components of ERRT-M
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MARCH 7, 2018: Bipolar Disorder Best Practices
Julie Anderson, MD, Staff PsychiatristDepartment of Veterans Affairs, Portland Health Care System
Portland, Oregon
Purpose: Bipolar disorder is a psychiatric condition with significant adverse impacts on functioning. It is a complex condition that can be improperly diagnosed and treated. In addition, treatment guidelines can change based on new research. This presentation will explore how to accurately diagnose bipolar disorder and implement the most effective evidence-based treatment.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Summarize how to accurately diagnose bipolar disorder and describe diagnostic confidence of the diagnosis in practice
2. Discuss treatment options for bipolar disorder based on the current mood episode
3. Describe how to tailor treatment options for bipolar depression or unipolar depression with mixed features to individual patient needs considering their risk for emergence of mania/hypomania
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FEBRUARY 21, 2018: Addressing Traumatic Guilt in PTSD Treatment
Sonya Norman, PhD, Staff PsychologistSan Diego VA Medical Center
San Diego, California
Purpose: In treating PTSD, one of the most common mental health conditions among combat veterans, clinicians need to be aware of psychological issues, such as guilt, that may influence trauma recovery. To assist clinicians, this presentation will focus on assessing the role of guilt in trauma recovery and various ways to address it in treatment.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Describe the relationship between posttraumatic guilt and common posttraumatic psychopathology
2. List common posttraumatic guilt cognitions
3. Discuss strategies for addressing posttraumatic guilt in PTSD treatment.
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FEBRUARY 7, 2018: Antidepressant Efficacy and Publication Bias
Erick Turner, MD, Staff PhysicianDepartment of Veterans Affairs, Portland Health Care System
Portland, Oregon
Purpose: For optimal patient care it is essential that clinicians can access current and accurate information about new advances in healthcare. This includes the most recent information about the efficacy and safety of medications. Therefore, this presentation will summarize approaches that can help clinicians to evaluate published information about the effectiveness of antidepressant medications so that they can make informed decisions for the best clinical care.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Summarize what placebo-controlled RCTs show about the efficacy of newer, compared to older, antidepressants.
2. Describe how one’s impression of antidepressant efficacy depends on whether one consults the peer-reviewed published literature or FDA review documents.
3. Discuss whether there has been any change in the extent of reporting bias with newer, compared with older, antidepressants.
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JANUARY 17, 2018: Veterans Have Feelings Too: The overlooked emotional world of combat PTSD
Hannah Roggenkamp, MD, MIRECC FellowDepartment of Veterans Affairs, VA Puget Sound Health Care System
Seattle, Washington
Purpose: Posttraumatic Stress Disorder (PTSD) among combat Veterans is a frequently encountered mental health condition. Recognition, discussion, and resolution of emotional experiences are integral to recovery from PTSD. This presentation will discuss the role of emotions in combat PTSD and how this can be addressed by clinicians in their work with Veterans.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Summarize existing research on emotions in combat PTSD
2. Describe the roles of shame, guilt, anger and grief in combat PTSD
3. Discuss methods to facilitate emotional experiences in Veterans
Download PDF of PowerPoint Presentation: Veterans Have Feelings Too: The overlooked emotional world of combat PTSD Go back to top of page
DECEMBER 6, 2017: Treating Anger and Aggression in Populations with Posttraumatic Stress Disorder (PTSD)
Leslie Morland, PhD, Staff PsychologistSan Diego VA Medical Center
San Diego, California
Purpose: Dysregulated anger and heightened levels of aggression are prominent among Veterans with PTSD, so it is important to know how to manage anger and aggression in a trauma population. The primary goal of this presentation is to allow clinicians to learn key principles and tools for working with trauma survivors who struggle with dysregulated anger.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Describe the prevalence of anger and aggression in Veterans with PTSD
2. Discuss current models for understanding the relationship between anger, aggression and PTSD
3. Summarize current treatment models for dysregulated anger in a Veteran population
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NOVEMBER 15, 2017: Posttraumatic Stress Disorder (PTSD) and Suicide: Conceptualization and Assessment
Hal Wortzel, M.D., Director of Neuropsychiatric Services / Ryan Holliday, PhD, Advanced MIRECC FellowDepartment of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center
Denver, Colorado
Purpose: Suicide prevention, including suicide risk assessment, is a key focus in the Department of Veterans Affairs. A number of conditions, including PTSD, are risk factors for Veteran suicide. Therefore, this presentation will help clinicians explore the complex relationship between PTSD and suicide, and will discuss practical recommendations for suicide risk assessment and therapeutic risk management. Implications for effective PTSD treatment for Veterans with suicide risk also will be discussed.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Summarize the elements of suicide risk assessment and therapeutic risk management
2. Discuss the relationship between PTSD and suicide
3. Describe a conceptual model of suicide in the context of PTSD
Download PDF of PowerPoint Presentation: Posttraumatic Stress Disorder (PTSD) and Suicide: Conceptualization and Assessment
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NOVEMBER 1, 2017: Update on Pharmacologic Approaches to Agitation in Dementia
Lucy Wang, MD, Geriatric Psychiatrist
Department of Veterans Affairs, Puget Sound Health Care System, Mental Health Service
Seattle, Washington
Purpose: Control of disruptive agitation in dementia is a continuing challenge for clinicians and caregivers, and is an important determinant of patient safety and humane care. Therefore, this presentation will update attendees on recommended evidence-based pharmacological approaches to agitation in dementia to enhance effective treatment and patient safety.
Outcomes/Objectives: At the conclusion of this educational program, learners will be able to:
1. Discuss basic principles in the management of dementia-related agitation
2. Summarize recent APA guidelines on antipsychotic use in dementia patients with agitation and psychosis
3. Discuss emerging medication treatment options for dementia-related agitation
Download PDF of PowerPoint Presentation: Update on Pharmacologic Approaches to Agitation in Dementia
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