Mental Health Care for Providers on Front Lines

Posted on by Dana Schatz

Clinical Mental Health Counseling Student Blog

By: Kyle Zaber, EdD-CMHC, SP specialization student

First responder mental health

The COVID-19 pandemic has impacted us all. Through stay-at-home orders, lack of sporting events and opportunities to participate, modifications in workload and work location, to becoming parent-teachers, or social interaction via technology only, we’ve all been asked to adjust to a new “normal.” This demand on our time, energy and emotions has impacted none more so than those within the health care industry. Care providers around the world are being thrust into an extraordinary demand unlike any we’ve experienced in modern medical history. As an adviser of workforce engagement, I partner with leaders in hospitals and hospital systems across the country to help reduce patient suffering by enhancing and sustaining an engaged and resilient workforce. The COVID-19 outbreak has demonstrated the best in those that serve our communities as health care professionals. They have risen to the challenge and have been exceptional in their battle to reduce patient-suffering.

While leaders in hospitals and hospital systems are happy to share their praise of their front-line staff, they are also quick to share their concern regarding long-term impacts of the COVID-19 pandemic on their workforce. Many have used words and phrases such as, PTSD, anxiety and depression to describe their fears of the second battle soon to come, that of their workforce’s mental health in a prolonged-pandemic setting. Their fears are justified as a meta-analysis conducted by Brooks et al. (2020) indicated that symptoms of post-traumatic stress disorder (PTSD), anxiety and depression are higher for front-line health care staff in a post-epidemic/pandemic setting (e.g. SARS, Ebola). Furthermore, Brooks et al. (2020) discovered that some health care professionals struggle to recover from the effects brought on by the pandemic and choose to leave the medical profession altogether. The trauma inflicted as a result of this pandemic is not fully known, nor will it be until we are safe to transition back to what more closely resembles “normal,” but l believe a strong commitment to serving those who chose to serve others during this pandemic will be needed immediately.

As a student in the UWS clinical mental health counseling (CMHC) program, I believe my education and training is supporting me to be in a unique position to help mitigate the effects COVID-19 in more ways than one. First, my training as a counseling intern has taught me to listen first, ask questions for context and allow others to share freely. As an adviser of workforce engagement, these skills will be essential in understanding my clients’ needs to foster an engaged and resilient workforce. While many hospitals and hospital systems will share overlapping characteristics as a result of COVID-19, just like the clients I serve through internship, each hospital and each hospital system are unique having been impacted by this pandemic in their own way.

Second, UWS’s unique combination of CMHC training and performance psychology training, have enhanced my ability to help my clients find and utilize strengths to enhance the impact of their services. I believe those in the health care industry come to the field with a desire to help others be and feel better. This pandemic has been a tremendous test of the resolve of front-line health care staff as the virus, at times, has proven too strong for their interventions. I fear these are the memories that will be triggered in the prolonged-pandemic minds of front-line staff. While this is understandable, I believe it will be necessary to help work with my clients to find areas in which their strengths yielded positive outcomes for patients and to process what strengths enhanced their teams’ call to service. Through my Psychology of Performance Excellence course, we were informed how reinforcing one’s strengths can help enhance one’s task engagement.

At this time, as the world responds to the demands of COVID-19, those in the counseling arena will be called upon to help our communities adjust to their new normal. Those of us engaged in our online learning through UWS will be in a unique position to assist through tele-health services while we social distance to beat the spread of the virus. All of us in the counseling field will be positioned to serve our communities and positively impact the mental health of those in need once we are safe to return to face-to-face services. I’d like to conclude by thanking all health care professionals who are working tirelessly to battle COVID-19. As mentioned, I’m in a privileged position to hear about the best of what health care providers, hospital leaders and hospital directors are doing to combat this pandemic. It is their courage and service that enhances my desire to be present for them during and after this difficult period. I hope everyone reading this is safe, healthy and well.

Reference

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395, 912-920. https://doi.org/10.1016/S0140-6736(20)30460-8

Rite of Passage Chiropractic Pinning Ceremony Goes Virtual

Posted on by Dana Schatz

If you’re in the Portland Metro area, please consider scheduling an appointment in the Campus Health Center (503-255-6771) so that you can see the high-caliber clinic interns and UWS graduates!

By: Caitlin Jones, Q9 UWS doctor of chiropractic and sports medicine student

The pinning and white coat ceremony at University of Western States (UWS) is a celebratory event where chiropractic students take their first big step toward becoming chiropractic physicians. It signals the start of working in the Campus Health Center (CHC) with a clinician to help treat patients and pulling all of the knowledge learned the previous two years into practice. Working with a clinician in the CHC helps to solidify a student’s knowledge and shape how they’re going to treat their future patients. 

“The pinning ceremony is a rite of passage and represents the student’s physical entry into the clinic and the continuation of this journey to provide health care,” said Dr. Stanley Ewald, associate dean of clinical internship. “It is time to take an oath to oneself to advance the health of every patient equally and recognize the goodness and value of every single human being.”

The pinning ceremony is more than just the first step into the clinic, it’s a big event where families can celebrate the student’s accomplishments thus far. By this time, students have earned a bachelor’s degree in science and have taken their first national board exam, which is a feat. It’s also a great excuse to get dressed up with your pinned white coat and take pictures with family and friends!

pinning

“As a clinician, it is exciting to have fresh new faces in my treating group,” said Dr. Amanda Armington, attending chiropractic physician and associate professor. “They grow so much over the course of the clinical internship and it is in my opinion the best part of the program (but maybe I’m biased). The clinic intern will begin to piece together all the preclinical knowledge and build on that to provide evidence-informed, quality patient care!”

COVID-19 has affected the school in many ways, including transferring the pinning ceremony from a big, in-person event to a virtual one.  While it is unfortunate that students aren’t able to celebrate in person together, it does still allow for family members to participate and celebrate virtually!

Making it this far into the program and entering clinic is a thing to celebrate.

“Make sure you take time and reflect back on all that you learned up to this point and now prepare to recall this information in a succinct and practical matter,” said Dr. Craig Kawaoka, attending physician and associate professor. “Congratulate yourself on a hard-earned and well-deserved achievement. Also, realize this is only the beginning of a lifelong learning experience and practice.”

Current Quarter 8 or Quarter 9, I hope that you celebrate it in your own way! When I received my pin last quarter, I grabbed my closest friends (who are in my COVID bubble) and took pictures and had a potluck dinner to reminisce on the past two years and speculate what clinic was going to look like. It wasn’t the pinning ceremony of years past, but it was still perfect for me. Now, I look forward to the school’s virtual event and pictures of everyone in their coats and pins!

Incoming Chiropractic Student Blog: Tips from an Upper Quarter Student No. 2 – Moving to Portland

Posted on by Dana Schatz

By: Caitlin Jones, Q9 UWS doctor of chiropractic and sports medicine student

hiking pacific northwest

Being from Virginia and never visiting the Pacific Northwest before applying to UWS, I was a bit terrified to pick up and move across the country. Especially when all I knew about Portland was that it rained a lot. After I took the plunge and made the move, I am so happy that I did. Sure, it rains, but not nearly as much as I thought. The summer is also worth all those dreary days. I have a Jeep Wrangler that’s used to being flooded with a summer downpour at least once a week and I’ve been able to keep the top off all summer without flooding it once! 

As a break from school, I really wanted to get into hiking and between Mount Hood, the Columbia River Gorge and the Oregon Coast – there are hundreds of hikes within two hours or less from Portland. Some even right in the city limits – hello Pittock Mansion and your beautiful views! I’ve had friends that have gone crabbing, skiing, rock climbing and kayaking. Oregon is home to some of the best outdoor activities. During this pandemic, it has been a sanity saver with all the amazing places to stay safe while will getting outside and enjoying yourself.

If you’re joining the UWS student family this fall or winter, you are not required to move to Portland just yet. I’d recommend moving to Portland if you’re able, both financially and with your COVID comfort-level. The first few quarters are tough and having a solid study group can really help you learn the material. There are a ton of on-campus resources that you will have access to such as the library and the UWS Health Center. Having chiropractic treatment in the clinic will help you build relationships with upper quarter students as well as get you familiar with how we treat patients here. 

If you’re wanting to move to Portland, reach out to the admissions department and they can give you some advice on how to find housing. Personally, I found my roommates on our UWS student Facebook page and we found a house close to campus on Zillow. Even as an older student myself, it really helped me to live with other students, because we helped each other through the difficult parts of this program. 

And if you aren’t able to move to Portland quite yet – don’t worry! Admissions is working on setting up some socials for you. There’s also a mentor program, student clubs such as the Student American Chiropractic Association (SACA) and the Student Canadian Chiropractic Association (SCCA) to help you build relationships with other students. It sounds cheesy to say, but we really are a family here at UWS. 

hiking pacific northwest

Dr. Rosalia Messina Elected to Council on Chiropractic Education

Posted on by Dana Schatz
Rosalia Messina CCE
Rosalia Messina, EdD, MPA, executive vice president of University of Western States

Rosalia Messina, EdD, MPA, executive vice president of University of Western States (UWS) has been elected to the Board of Directors of the Council on Chiropractic Education (CCE). CCE is the professional accrediting agency recognized by the United States Department of Education and the Council for Higher Education Accreditation to accredit doctor of chiropractic degree programs and chiropractic residencies.

Immediately following the CCE annual meeting in January 2021, Dr. Messina will be appointed to a three-year term as a CCE councilor. “It’s an honor to be elected to the Council on Chiropractic Education,” said Dr. Messina. “I am delighted to serve as a councilor to help advance the quality and integrity of chiropractic education.”

As a CCE councilor, Dr. Messina will be engaged in establishing accreditation standards and requirements, ensuring compliance with accreditation recognition criteria, reviewing program evaluation reports, and rendering decisions regarding the accreditation status of new and established doctor of chiropractic degree programs and chiropractic residencies.

“We are very proud of Dr. Messina’s election to the CCE,” said Dr. Joseph Brimhall, UWS president and CEO. “University of Western States values the accreditation process and Dr. Messina will be continuing a long-standing tradition of UWS representatives serving on recognized accrediting bodies.”

As UWS executive vice president, Dr. Messina serves as the primary representative for the president in facilitating community and government relations. She provides leadership for the integration of all university operations, including direct oversight of human resources, enrollment management, student services, communications and advancement. Dr. Messina holds a master’s degree in public administration with a focus in health policy from Portland State University, and a doctorate degree in education with a focus in interdisciplinary leadership from Creighton University.

The Council for Higher Education Accreditation (CHEA), the CHEA International Quality Group (CIQG), the Association of Specialized and Professional Accreditors (ASPA), the Federation of Chiropractic Licensing Boards (FCLB), the National Board of Chiropractic Examiners (NBCE), and governmental licensing boards recognize CCE as the accreditor for doctor of chiropractic degree programs and chiropractic residencies. The purpose of CCE is to promote academic excellence and to ensure the quality of chiropractic education.

In Support for H.R. 3654

Posted on by Dana Schatz

By: Caitlin Jones, UWS doctor of chiropractic and sports medicine student

HR3654graphic

My first blog for University of Western States was about my trip this past January to Washington, D.C. with the Student American Chiropractic Association (SACA) to advocate for chiropractic care on the Hill. We usually advocate for multiple bills but this year the American Chiropractic Association (ACA) and SACA focused only on H.R. 3654, because it is so crucial for our Medicare patients to get the chiropractic treatment they need.

We just passed the one-year mark of Rep. Brian Higgins (NY) introducing H.R. 3654 to modernize chiropractic Medicare coverage. The last time Medicare’s chiropractic policy was updated was in 1972!  If you think about our profession, how much has changed in the past decade let alone 48 years? As it stands, a patient with Medicare coverage can only see a chiropractic physician for spinal manipulation.  If your wrist hurts or your chiropractic physician thinks that you need some soft tissue work or an x-ray – you would need to pay out-of-pocket if your insurance is Medicare. For these patients who are on fixed incomes, it is a struggle and they are unable to get the care that they need and are seeking.

Imagine that you go to your chiropractic physician for back pain and they think you may have a compression fracture. They suggest an x-ray but cannot perform or give you a referral, even though it is in their scope of practice. Instead, you need to go to your PCP to get a new physical exam, then a referral to a radiologist for the x-ray and then back to the chiropractic physician for treatment. What could have taken moments now takes weeks. 

Because of this financial and time burden placed on Medicare patients, many chiropractic physicians are opting out of taking Medicare insurance. Medicare patients then go to their PCP for back or hip pain that could have been managed conservatively and instead they are prescribed pain medications. This has contributed to the opioid crisis that we have been struggling to overcome for years.

What the American Chiropractic Association (ACA) and SACA are asking for with H.R. 3654 is not an expansion of Medicare, it is to allow chiropractors to be able to treat their patients under the scope of their license. We want to give our patients the treatment they need for their pain and improve their quality of life.

What we need is for you to get involved! It has taken a little more than a year to get 82 co-sponsors and we need more to give this bill the best chance of going up for a vote. It only takes a moment to write or call your representative, let them know how this affects your patients (present and future!) and their constituents. Make it clear that this is a bi-partisan bill that does not expand coverage but allows chiropractic physicians to treat their patients properly.

Visit the ACA website where you can find FAQs and information about how to find your representative. Be sure to encourage others and reach out to your representative TODAY! 

Alumna Spotlight: Dr. Stephanie Halloran

Posted on by Dana Schatz
Halloran And Brimhall
Dr. Stephanie Halloran and UWS President Dr. Joseph Brimhall at A Fond Farewell event on campus last fall.

Stephanie Halloran, DC, MS (class of 2016) has made her way back to University of Western States (UWS) as a new course facilitator in the human nutrition and functional medicine (HNFM) program. Dr. Halloran is an alumna of both the doctor of chiropractic and HNFM programs.

Currently, Dr. Halloran is also working on her postgraduate research fellowship at Yale Medical School on an integrative team that includes four other chiropractic physicians. The contingency’s project was funded by the U.S. National Institutes of Health (NIH), and National Center for Complementary and Integrative Health (NCCIH).

In addition, Dr. Halloran is also a part of an effort to launch a member directory for medically-integrated DCs called DC Integration.

“Connecting this subset of the profession could lead to increased training opportunities for students, residents or research opportunities in musculoskeletal areas,” said Dr. Halloran. “This effort encompasses more than just the VA, but also DoD (Department of Defense), university and private sector positions.”

Following graduation, Dr. Halloran completed her clinical rotation at the Richard Roudebush VA Medical Center with Christopher Sherman, DC, in Indianapolis and completed a one-year residency program with the VA Connecticut Health Care System with Anthony Lisi, DC.

Dr. Halloran sits on the American Chiropractic Association (ACA) Editorial Review Advisory Board, the National Association of Spine Specialists Legislative and the SpinePAC Committee. She also has served on the ACA planning task force for the annual meeting, ENGAGE (formerly NCLC).