CEs: 6.0, including 4.5 toward pharmacotherapeutic CE requirement (pending)
Join us on Saturday, March 28, 2020, from 8:30 a.m.-4:45 p.m. Stay after the conference for our Member Reception, with award presentations, door prizes, refreshments, and more!
Located on the campus of Bastyr University, 14500 Juanita Dr. NE, Kenmore, WA
Registration fees increase by $30 after March 14.
Join AAPPN today and qualify to receive Member registration rates.
● Members: $190.
● Student Members: $120
● Nonmembers: $250
About the Conference
Your registration includes CEs, all materials, refreshments, and a delicious lunch. You’ll also enjoy a space for networking with your colleagues, exhibitor tables, and a post-conference reception featuring member awards, door prizes, and libations.
Exhibitors: Reserve your exhibit space now. Space available for both commercial and nonprofit/government exhibitors. Download an exhibitor application form.
About the Program
Helping clients struggling with treatment-resistant depression is one of the most difficult challenges in our practice. Despite aggressive pharmacologic and psychotherapy treatment approaches, studies show that 10-15% of patients will remain chronically depressed with a significant psychosocial morbidity and an increased mortality rate by suicide. These patients experience functional impairment, poor quality of life, suicide ideation and attempts, self-injurious behavior, and a high relapse rate.
Explore the full spectrum of treatment considerations and modalities that psychiatric nurse practitioners utilize to treat these clients optimally. Sessions will offer new information, research support, methods, and tools. We will take an in-depth look at this issue from a number of unique perspectives.
“A Multi-Faceted, Person-Centered Approach to ‘Treatment Resistance’”
Susan Caverly, PhD, ARNP, BC
Treatment resistance or failure is a challenge faced by all practitioners. The etiology can sometimes be very complex, involving multiple or rapidly changing prescriptions and often frustration for the patient and the practitioner.
This presentation will consider biopsychosocial elements as well as aspects of the therapeutic relationship or interview that contribute to our struggle to attain success through our interventions. We’ll discuss meeting the individual where they are and working with the goals they present, as well as the value of consultation to overcome obstacles to meeting agreed-upon treatment goals.
Case exemplars will focus on youth, co-occurring disorders (substance and process), interviewing style, goal-setting, and concerns specific to pharmacologic management.
Susan Caverly, PhD, ARNP, BC, is the Director of Psychiatric Services and the Integrated Cognitive Therapies Program at Therapeutic Health Services, and also has a private practice. She is a Clinical Professor at the University of Washington and Adjunct Faculty at Seattle University.
She has worked extensively in clinical and program development roles in Emergency and Community Psychiatry, particularly with disenfranchised or minority populations, individuals with co-occurring disorders and process addictions, school systems, and youth involved with the justice system.
- Identify two techniques for gathering accurate history prior to embarking on a treatment regimen
- Develop increased awareness of the ways in which they partner with patients to achieve identified and mutually agreed upon goals
- Consider three practice approaches that will assist in overcoming or preventing treatment resistance (Meeting the patient where they are and working at the pace they engage with, gathering adequate information for an accurate diagnostic formulation, and assuring that medication trials are fully operationalized)
“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 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.
She 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
This activity has been submitted to Oregon Nurses Association for approval to award contact hours. Oregon Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Upon approval, attendees may earn 6 contact hours, of which 4.5 can be applied toward the pharmacotherapeutic continuing education requirement for advanced practice nurses with prescriptive authority. Participants must be present for all of the educational activity to receive contact hours.
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