New Approaches in the Treatment of Mental Illness and Chronic Disease

This workshop has been approved for six hours of continuing education credit, i.e.,, six CEs for psychologists (through SIAP); six CMEs for physicians (through MMC). These continuing education accreditations are also recognized for nurses, counselors, social workers, and marriage and family therapists. 

SIAP is approved by the American Psychological Association to sponsor continuing education for psychologists. SIAP maintains responsibility for the program and its content. 

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the New Mexico Medical Society (NMMS) through the joint providership of Memorial Medical Center (MMC) and Restoring Meaning:Alternatives to Biomedical Reductionism in the Art and Science of Healing. Memorial Medical Center is accredited by the NMMS to provide continuing medical education for physicians. Memorial Medical Center designates this live activity for a maximum of 6 hours AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 To register for the event, please go to: RestoringMeaning.com.

 DESCRIPTION

 New Approaches in the Treatment of Mental Illness and Chronic Disease

The medical model has yielded miraculous gains in our understanding and treatment of serious diseases and conditions. However, research focused almost exclusively on easily measured variables often leaves out important dimensions of illness and health, both physical and psychological.

This workshop looks at new approaches to treating mental illness and chronic disease. How do mind and body interact when responding to placebo effects? How best to treat chronic disease while considering the whole person? What treatments of schizophrenia become available when the (unproven) assumption of a chronic brain defect is rejected?

Although uncomfortable to admit, sometimes we see that an approach works without being able to discern exactly why. Sometimes effective approaches - whether applied to parenting, to teaching, or to the healing arts - flow from values and attitudes in addition to empirical knowledge.

 

CE SPEAKERS

 Stuart Kelter, Psy.D., Licensed Psychologist, Certified Prescribing Psychologist, private practice, Las Cruces

Arthur Berkson, MD, Family Physician, Integrative Medicine, private practice, Las Cruces

Al Galves, Ph.D., Licensed Psychologist, private practice, Las Cruces

Kevin Hennelly, MA, MS, JD, LPCC, Psychotherapist and Substance Abuse Counselor, Founder and Clinical Director of the Santa Fe Hearing Voices Treatment Center

 

LOCATION AND TIME

 Saturday, April 13, 2019, 9:00 – 5:15 p.m.

NMSU Corbett Center, Student Union, Room 302 (Senate Gallery)

 

 

 

WORKSHOP SCHEDULE

 

9:00-10:00     Introduction: Biomedical reductionism:The good,the bad,and the debatable.

                        Stuart Kelter; PsyD

 

10:00- 10:45  It's all in your mind. Or is it?Placebo and Nocebo Effects.

                        Stuart Kelter; PsyD

 

10:45-11:00    Break

 

11:00-12:00   A case study using an integrative approach to patient care.

                        Arthur Berkson, MD

 

12:00-1:30     Lunch (on your own)

 

1:30-2:30       Three innovative treatments for schizophrenia:implications for understanding

                        serious mental illness and its treatment.

                        Al Galves, PhD

 

2:30-2:45        Break

 

2:45-3:45        Support groups and psychotherapy with voice hearers: a clinical perspective.

                        Kevin Hennelly, MA, MS, JD, LPCC

 

3:45-4:00        Break

 

4:00-5:00       Panel Discussion (all presenters)

5:00- 5:15      Evaluation and feedback

LEARNING OBJECTIVES AND REFERENCES FOR EACH PRESENTER

 

 INTRODUCTION:  BIOMEDICAL REDUCTIONISM: THE GOOD, THE BAD, AND  THE DEBATABLE.

            Stuart Kelter, PsyD

 

Participants will be able to:

 

·    Define the meaning/mechanism duality as applied to physical ailments,such as hypertension and pain syndromes.

 

·     Explain the meaning/mechanism duality as applied to at least two psychiatric disorders.

 

·     Name two clinical situations in which biomedical reductionism is helpful and two in which it is unhelpful.

 

REFERENCES:

 Ahn A.C., Tewari, M., Poon C.S., &Phillips, R.S. 2006. The limits of reductionism in medicine: Could systems biology offer an alternative PLOS Medicine 3(6),  709-713. doi: 10.1371/journal. Pmed 0030208.

Angermyer M.C., Holzinger A.,  Carta M.G., & Schomerus G. 2011. Biogenetic explanations and public acceptance of mental illness: systematic review of population studies. British Journal of Psychiatry, 199 5,367-72.

Beresford M.J. 2010. Medical reductionism: lessons from the great philosophers. QJM: International Journal of Medicine 103 (9) 721-724.

 

Gold, I. 2009. Reduction in Psychiatry . The Canadian Journal of Psychiatry, 54, (8),

 

Turnwald B.P., Goyer J.P., Boles D.Z., Silder A., Delp, S.L. & Crum A. J. 2018. Learning one's genetic risk changes physiology independent of actual genetic risk. Nature Human Behavior, 3, 48-56

 

Zahrt O.H. & Crum A.J.  Perceived Physical Activity and Mortality: Evidence From Three Nationally Representative U.S. Samples.  Stanford University. Health Psychology, doi: 10.1037/hea0000531. 

 

IT’S ALL IN YOUR MIND. OR IS IT? PLACEBO AND NOCEBO EFFECTS.

            Stuart Kelter, PsyD

 

Participants will be able to:

 

·     Explain the difference between apparent and real placebo/nocebo effects.

·     Evaluate the relative contribution of the placebo component to medication efficacy for  antidepressants.

·     Define three possible ways of harnessing the placebo effect in the act of prescribing medications.

·     Identify two ethical dilemmas raised by knowingly prescribing placebos and medications whose efficacy derives mostly from placebo effects.

·     Identify  two ethical dilemmas raised by disclosing possible side-effects.

 

REFERENCES

*Likely to be discussed during the presentation

*Benedetti F., Mayberg F., Wager T.D., Stohler C.S., & Zubieta J.K. 2005. Neurobiological mechanisms of the placebo effect. The Journal of Neuroscience,2545:10390-10402

Bradford A., & Meston C. 2011. Behavior and symptom change among women treated with placebo for sexual dysfunction. Journal of Sexual Medicine,8 1, 191-201.

Fournier J.C., DeRubeis R.J., Hollon S.D., Dimidjian S., Amsterdam J.D., Shelton R.C., & Fawett J. 2010. Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis.JAMA3031, 47-53. 

Ford A.C., & Moayyedi P.  2010. Meta-analysis: factors affecting placebo response rate in irritable bowel syndrome. Ailment Pharmacological Therapeutic.  322 144-58.

*Kirsch I. 2010.The Emperor’s New Drugs. UK: Random House.

Leigh R., McQueen G., Tougas G., Hargreave F.E., & Bienenstock J. 2003. Change in forced expiratory volume in 1 second after sham bronchoconstrictor in suggestible but not suggestion-resistant asthmatic subjects: a pilot study. Psychosomatic Medicine65, 791-795.

Lidstone S.C., Schulzer M., Dinelle K., Mak E., Sossi V. Ruth T.J., de lat Fuente-Fernandez R., Philips AG., & Stoessi A.J. 2010. Effects of expectation on placebo-induced dopamine release in Parkinson disease. Archives of General Psychiatry. 678, 857-865.

Leuchter A.F., Cook A., Witte E.A., Morgan A., & Abrams M. 2002. Change in brain function of depressed subjects during treatment with placebo. American Journal of Psychiatry159:122-129. 

Levine M.E., Stern R.M., & Koch K.L. 2006. The effects of manipulating expectations through placebo and nocebo adminstration on gastric tachyarrhythmia and motion-induced nausea. Psychosomatic Medicine,68,478-486.

Lidstone S.C., & Stoessl A.J. 2007.Understanding the placebo effect: contributions from neuroimaging. Mol Imaging Biol,94,176-85.

Mayberg H.S. 2002. The functional neuroanatomy of the placebo effect. American Journal of Psychiatry,159, 728-737.

Miller F.J., & Kaptchuk T.J. 2008. The power of context: reconceptualizing the placebo effect. J Royal Society of Medicine.1015,222-225

Levine J.D., Gordon N.C.,&Fields H.L. 1978. The mechanism of placebo analgesia. Lancet,2,654-7.

Moerman D.E. 2002. Meaning, Medicine and the ‘Placebo Effect’. Cambridge, UK: Cambridge University Press.

Petrovic P., Dietrich T., Fransson P., Andersson J, Carlsson K., & Ingvar K. 2005. Placebo in emotional processing—induced expectations of anxiety relief activate a generalized modulatory network. Neuron 466, 957-69.

Pollo A., Torre E., Lopiano L, Rizzone M., Lanotte M., Cavanna A., Bergamasco B, & Benedetti F. 2002. Expectation modulates the response to subtahlamic nucleus stimulation in Parkinsonian patients. NeuroReport13: 1383-1386.

*Rutherford B.R., Wall, M.M., Brown P.J., Choo T., Wager T.D., Peterson B.S., Chung S., Kirsch I., & Roose S.P. 2017. Patient Expectancy as a Mediator of Placebo Effect in Anti­depressant Clinical Trials. American Journal of Psychiatry1742 135-143.

Storms M.D., & Nisbette R.E. 1970. Insomnia and the attribution process. Journal of Personality and Social Psychology,162, 319-28.

Wechsler M.E., Kelley J.M., Boyd I.O., Dutile S., Marigowda G., Kirsch I., Israel E., & Kaptchuk T.J. 2011. Active albuterol or placebo, sham acupuncture, or no intervention in asthma. New England Journal of Medicine365 2,119-26.

Yanofski, J. 2011. The Dopamine Dilemma—Part II: Could Stimulants Cause Tolerance, Dependence, and Paradoxical Decompensation? Innovative Clinical Neuroscience.81,47–53.

 

A CASE STUDY USING AN INTEGRATIVE APPROACH TO PATIENT CARE. 

                         Arthur Berkson, MD

Participants will be able to:

 

·    Name the main components of an integrative medicine perspective to a complicated patient.

 

·    Identify at least one clinical criteria for the clinical use of low dose naltrexone.

 

·    Identify at least two supplements, including alpha-lipoic acid, and their clinical use.

 

·    Name the  basic components of the anti-inflammatory diet.

 

·    Identify at least two basic concepts pertaining to the inividualizing of mind-body medicine modalities

REFERENCES

 

B.M. Berkson, D.M. Rubin, & A.J. Berkson. 2009. Revisiting the ALA/N alpha-lipoic acid/low-dose naltrexone protocol for people with metastatic and nonmetastatic pancreatic cancer: a report of 3 new cases.Integrative Cancer Therapies, 84, 416-22.

 

B.M. Berkson, D.M. Rubin, & A.J. Berkson. 2007. Reversal of Signs and Symptoms of a B-Cell Lymphoma in a Patient Using Only Low-Dose Naltrexone.  Integrative Cancer Therapies, 63, 293-296

 

B.M. Berkson, D.M. Rubin, & A.J. Berkson. 2006. The Long-term Survival of a Patient with Pancreatic Cancer with Metastases to the Liver after Treatment with Intravenous Alpha-Lipoic Acid/Low-Dose Naltrexone Protocol.  Integrative Cancer Therapies, 51, 83-89

 

THREE INNOVATIVE TREATMENTS FOR SCHIZOPHRENIA: IMPLICATIONS FOR UNDERSTANDING SERIOUS MENTAL ILLNESS AND ITS TREATMENT

        Al Galves, PhD

 

Participants will be able to:

 

·     List three innovative treatments for schizophrenia that invoke the self-healing powers of patients.

 

·     Identify the distinguishing characteristics of the three innovative treatments for schizophrenia.

·     List at least four implications of the three innovative treatments for schizophrenia for treatment of other mental disorders.

REFERENCES

 

Bola J., & Mosher, L. 2003 treatment of acute psychosis without neuroleptics: two year outcomes from the Soteria Project. Journal of Nervous and Mental Disease, 1914. 219-229.

 

Seikkula J., Aaltonen J., Alakare B., Haarakangas K, Keranen J., & Lehtinen K. 2006 Five-year experience of first episode non-affective psychosis in open dialogue approach: Treatment principles, follow-up outcomes and two case studies. Psychotherapy Research, 162, 214-228.

 

SUPPORT GROUPS AND PSYCHOTHERAPY WITH VOICE HEARERS: A CLINICAL PERSPECTIVE

             Kevin Hennelly, MA, MS, JD, LPCC

 

·  Participants will be able to name the three major theoretical models that explain voice hearing.

 

·  Participants will be able to list three major impediments to establishing and maintaining a therapeutic relationship with voice hearers.

 

·  Participants will be able to name three clinical interventions that help voice hearers to maintain control of their thoughts and actions.

 

·  Participants will identify three specific strategies to prevent voice hearing from interfering with treating co-occurring disorders such as PTSD, depression, and anxiety.

 

·  Participants will name four core principles for facilitating support groups for voice hearers.

 

REFERENCES

 

Longden E., Read J., & Dillon J. 2017. Assessing the impact and effectiveness of hearing voices network self-help groups. Community Mental Health Journal, 542, 184-188, doi: 10.1007/s10597-017-0148-1

 

Marino C., & Hansen M.C. 2015. The hearing voices movement in the United States: Findings from a national survey of group facilitators.Psychosis, 1-12. http://dx.doi.org/10.1080/17522439.2015.1105282

 

de Jager A., Rhodes P., Beavan V., Holmes D., McCabe K. Thoma N., McCarthy-Jones S., Lampshire D. & Hayward M. 2016 Investigating the lived experience of recovery in people who hear voices. Qualitative Health Research, 2610, 1409-23. doi 101177/1049732315581602.