Session recordings from our 2020 Annual Conference are available in video format, along with session slides and other relevant materials.
- Clinical, Emeritus, and Out-of-State Members – $100.00
- Student Members – $50.00
Non-Members – $150.00.
CEs: 8.00 ANCC-approved contact hours, including 5.58 toward pharmacotherapeutic CE requirement
About the Conference
Contact Hours: This nursing continuing professional development activity was approved by Oregon Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Approval valid through 11/7/2022. OCEAN ID #2020-10
AAPPN is able to award continuing education hours for the entire program. We cannot award partial credit.
About the Program
Helping clients struggling with treatment-resistant depression is one of the most difficult challenges in our profession. Explore the full spectrum of treatment considerations and modalities that psychiatric nurse practitioners can utilize to enhance treatment outcomes.
We are pleased to offer a presentation schedule with the following speakers:
- Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMH
- Saundra Jain, MA, PsyD, LPC; and Rakesh Jain, MD, MPH
- Rebecca M. Allen, MD, MPH
- Virginia Buccola, DNP, PMHNP-BC
- David Dunner, MD
About the Speakers & Topics
Resilience and COVID: The Impact of Isolation on the Provider’s Mental Health
Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMH
The unexpected impacts of COVID have been the result of extended periods of isolation and uncertainty. Telehealth methods allow us to maintain contact with our patients, but at what cost. We will examine the impacts and look for new tools and methods to restore and build our reserves.
Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMH, is Associate Director for Patient Care Services for the San Francisco VA Health Care System. She is also an Associate Clinical Professor at the UCSF School of Nursing. She chairs the APNA Clinical Psychopharmacological Institute and is Lead Coordinator of the Nursing Organizations Alliance.
Nihart is co-editor of Psychiatric Nursing: Contemporary Practice. She received the 2018 John D. Chase Award for Executive Excellence in Health Care, as well as the APNA American Psychiatric Nurse of the Year award.
- Analyze the impact of COVID on their own emotional well-being.
- Consider what aspects of the pandemic are most detrimental for themselves.
- Explore options for self-care and new routines to fill our reserves in the time of COVID.
Out of the Darkness: Mechanisms and Novel Approaches to Treatment-Resistant Depression
Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMH
Many limitations exist in analyzing the science around treatment-resistant depression. It is key for clinicians to logically and systematically approach this special subgroup before choosing one of several novel approaches in treatment of depression.
- Define the use and limitations of research related to treatment-resistant depression.
- Utilize an algorithm for systematic diagnosis of treatment-resistant depression before choosing a novel approach to treatment.
- Describe potential mechanisms of action for Transcranial magnetic stimulation (rTMS), ketamine, esketamine, and other possible glutamatergic augmentations.
“Addressing the Monster in Treatment-Resistant Depression: Facing Down the Pandemic of Wellness Deficit Disorder”
Rakesh Jain, MD, MPH, and Saundra Jain, MA, PsyD, LPC
Treatment-resistant depression is a serious, difficult to treat the condition in psychiatry. It causes considerable damage to human functioning. While pharmacotherapy and ECT have made a dent in it, too many patients continue to suffer from treatment-resistant depression.
Traditional psychotherapy is certainly a valuable addition to medication treatment, yet too many patients remain symptomatic. The “walking wounded” are just too frequent in all psychiatric practices.
Saundra and Rakesh Jain developed a wellness program over a decade ago to augment all types of treatment in psychiatry. They have studied this in treatment-resistant depression and treatment-resistant anxiety, and have found wellness interventions to be useful in such conditions.
This session will address the science behind wellness interventions, as well as practical tips on how to successfully implement it in clinical practice. Plenty of time for Q&A will also be assigned to cover the unique needs of every clinician.
Saundra Jain, MA, PsyD, LPC, is an Adjunct Clinical Affiliate, School of Nursing, at The University of Texas at Austin. She is focused on wellness and the impact of positive psychology on client outcomes. She also maintains a private psychotherapy practice.
Dr. Jain is a co-founder of the WILD 5 Wellness Program, which combines five elements of wellness (exercise, mindfulness, sleep, social connectedness, and nutrition) along with positive psychology practices into a prescriptive, simple wellness program. She is co-author of two well-received workbooks written for those interested in improving their mental wellness: KickStart30: A Proven 30-Day Mental Wellness Program and LiveWell90: A Proven 90-Day Mental Wellness Program.
Rakesh Jain, MD, MPH, is a Clinical Professor at the department of Psychiatry at the Texas Tech University School of Medicine in Midland, Texas, and in private practice in Austin.
Dr. Jain has presented at the World Psychiatric Congress in Prague, and at the Depression and Pain Forum meetings world-wide. He is the author of 55 articles in publications such as Journal of Psychiatric Research, Journal of Clinical Psychiatry. He has co-authored six books ranging from patient education to cutting edge neurobiologic findings in psychiatry and mental health.
- Describe the concept and definitions of wellness and resilience in human functioning and assess its impact on mental health.
- Review the neurobiology of resilience and wellness and appreciate the emerging concept of posttraumatic growth.
- Assess some of the therapeutic options available to enhance wellness and resilience in our patients.
- Describe how combining quality psychopharmacology with wellness interventions may be a good relapse prevention strategy.
“Managing Treatment-Resistant Depression in a Primary Care Setting”
Virginia Buccola, DNP, PMHNP-BC
Collaborative or Integrated Care is opening opportunities for PMHNPs to practice within a primary care setting as Psychiatric Consultants. This model of integration expands access to mental health care, improving both patient and provider experiences.
This session includes a 90-minute video to watch prior to the conference and a Q&A session at the conference. We will discuss Collaborative Care and the role of the PMHNP as a Psychiatric Consultant, presenting new challenges for PMHNPs, including co-management with Primary Care Providers (PCP’s) of complex medical and psychiatric illness in resource-limited situations. Explore the challenges inherent in caring for those who have barriers to accessing specialty mental health care outside of their PCP’s office.
The Biopsychosocial Model of Care will be presented as a framework for holding the distress of the patient, the PCP, and the PMHNP.
Virginia Buccola, DNP, PMHNP-BC, works as a PMHNP in a Primary Care setting, seeing both children and adults for psychiatric medication management, as well as providing psychiatric consultation to her team of Primary Care Providers at Community Health Care in Tacoma.
Dr. Buccola previously worked as a psychiatric prescriber in Community Mental Health and in a private practice focused on the mental health care of pregnant and breastfeeding persons.
- Describe three components of Collaborative Care in Primary Care setting
- Identify three areas of medical co-morbidity most commonly associated with treatment resistant depression
- Identify three social determinants of health that impact effectiveness of most commonly accessible mental health treatments
- Define two components of a Biopsychosocial Model of Care
“The Six D’s of Treatment-Resistant Depression”
David Dunner, MD
Examine the “6 D’s” of treatment-resistant depression: Diagnosis, Dose/Duration of treatment, Drug/Device mechanism of action, Different treatment and Durability of response
We will discuss augmentation strategies, new treatments such as Esketamine nasal spray, and neuromodulation treatments such as transcranial magnetic stimulation, electroconvulsive therapy, and Vagus nerve stimulation therapy.
We will also discuss durability of response to the newer treatments and provide a rationale for when to utilize the newer treatments.
Dr. Dunner has spent several decades treating patients with treatment-resistant mood disorders, as well as conducting research in treatment resistant depression. He is the Director of the Center for Anxiety and Depression on Mercer Island, and is a Professor Emeritus of the Department of Psychiatry and Behavioral Sciences at the University of Washington.
His clinical practice includes treatment with transcranial magnetic stimulation, Esketamine nasal spray, and Vagus nerve stimulation.
- Understand the “6 Ds” of treatment resistant depression
- Understand the concept of “durability of response”
- Develop a rational treatment plan based on diagnosis and prior treatment utilization of the patient
“Brain Stimulation in Psychiatry: ECT, TMS, and Beyond”
Rebecca Allen, MD, MPH
Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are effective, sometimes life-saving interventions for many of the approximately 1/3 of depressed patients who do not achieve remission with multiple medication and psychotherapy trials.
Review the evidence for and clinical use of ECT and TMS, including mechanisms of action, efficacy, tolerability, and when and how to refer. Gain an understanding of the relative risks and benefits of ECT and TMS for common and debilitating treatment-resistant conditions which often pose a significant clinical challenge to manage.
Esketamine, vagal nerve stimulation (VNS) and experimental interventions (DBS, tDCS) will also be briefly reviewed.
Dr. Allen is the Director of Neuropsychiatry and Research at Seattle Neuropsychiatric Treatment Center (SeattleNTC), the largest provider of psychiatric brain stimulation services (ECT, TMS, DBS, VNS) in the Pacific Northwest. As a Clinical Assistant Professor at the UW Department of Psychiatry, Dr. Allen serves as a site training director for the Brain Stimulation Psychiatry elective for UW psychiatry residents.
She is board-certified in Behavioral Neurology and Neuropsychiatry. She is also the President-Elect of the Washington State Psychiatric Association.
- Describe the relative efficacy and rates of side effects of ECT, TMS, and Esketamine
- List at least two disorders effectively treated by ECT and TMS
- Identify typical clinical criteria for consideration of ECT and TMS
To receive contact hours, your evaluation must be completed by November 14, 2022.
2020 Conference Planning Committee
Melanie Kristoferson, MSN, ARNP, PMHNP-BC, Chair
Deborah Eti, PhD, MSN
Bernadette Gilroy, MN, ARNP
Erika Giraldo, DNP, ARNP
Mary Ellen O’Keefe, MN, MBA, PNHCNS-BC, ARNP
Jinn Schladweiler, MN, OEHN, PMHNP, ARNP
Soonja Tyrrell, MSN, ARNP, PMHNP-BC
Patricia Wuertzer, MSN, ARNP-BC, PLLC