COVID – 19 CRISIS WORKING TOGETHER Town Hall Meeting: June 10, 2020 5:00pm PDT | 7 PM CDT | 8 PM EDT
COVID – 19 CRISIS
WORKING TOGETHER
Town Hall Meeting:
June 10, 2020 5:00pm PDT | 7 PM CDT | 8 PM EDT
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Presenters
Olivia Friedman, DACM, LAc, Dipl. O.M. (NCCAOM)®
Chair, American Society of Acupuncturists
Yvonne R. Farrell, DAOM, L.Ac.
Diana Fried, M.Ac., M.A., Dipl. Ac. (NCCAOM)®
Founder & Co-Executive Director, Acupuncturists Without Borders
Carla Cassler, DAOM, L.Ac.,
Co-Executive Director Acupuncturists Without Borders
Margaret Chesney, PhD.
Professor of Medicine, School of Medicine, University of California, San Francisco
Special Advisor to IHPC and Former Director UCSF Osher Center for Integrative Medicine
Yvonne R. Farrell, DAOM, L.Ac.
Mental Health: Treating the
Aftermath of Covid19
Diana Fried, M.Ac., M.A., Dipl. Ac.(NCCAOM)®.
Founder & Co-Executive Director,
Acupuncturists Without Borders
Carla Cassler, DAOM, L.Ac.,
Co-Executive Director Acupuncturists Without Borders
Mental Health: Treating the
Aftermath of Covid19
CoVid and Mental Health
• Unresolved trauma – foundational to suffering/conflict
• Disaster of uncertainty-psychological stress increases
• CDC: Long term consequences of collective trauma are mental health
challenges/substance abuse
• Younger people 18-24, people of color, indigenous people, women hardest hit
• CoVid on top of systemic trauma sources
• Healthcare/essential workers carry heavy trauma burden
• Secondary trauma danger among health practitioners as we start working
again
Acupuncture and Trauma
• Threat = Dysregulation of body, mind, emotions
• Somatic intervention needed for emotional processing
• Acupuncture and other somatic therapies regulate
system
• Regulation restored = processing restored
• Hope, problem solving, resilience increases
• Community acupuncture increases regulation
Acupuncture after Nepal earthquake
Pre-Covid treatments for veterans who served in US military, deported to Mexico
Guy Page, left, at his San Diego clinic, The
Inn Spot (before Covid 19)
Treatments after Stoneman Douglas
shooting in Parkland, Florida
Refugee Camps, Greece
New Orleans, 2005
Haiti after 2010 earthquake
Israel
Southern California during wildfires
Matamoros, Mexico Border Refugee
treatments
Margaret Chesney, PhD.
Professor of Medicine, School of Medicine, University of
California, San Francisco
Special Advisor to IHPC and Former Director UCSF Osher
Center for Integrative Medicine
Mental Health: Treating the
Aftermath of Covid19
Overview
• Extensive mental health research in predicts emotional
distress in the populations affected by COVID-19
is ubiquitous
• Most people are resilient and will not succumb to
psychopathology; some may even find new strengths
• But many will experience PTSD, and other psycho-
pathology, particularly depressive and anxiety disorders
• Briefly touch on the current stress and describe some
“Tools you can use”
Overview
• Fear of infection
• Mass home-confinement directives, quarantine
• Losses, from feeling safe, to livelihood, to loved ones . . .
• Depression, anxiety, psychosomatic problems, insomnia,
disorientation, increased substance use, domestic
violence, … suicide ideation
• All health care professionals need to be ready to refer
to mental health professionals or to emergency
psychiatric hospitalization
Stress: Some stress is “good”
• “Good” stress = Challenge
• You perceive the stress,
but it does not exceed your resources
Stress: There is also “bad” stress
• “Bad” stress = Threat
• You perceive the stress,
but exceeds your resources for coping
and endangers your well-being
Stress Management - Maintaining Balance
Many Strategies
• Calm App
• Cognitive Behavior Therapy
• Problem Solving Therapy
• Progressive Muscle Relaxation
• Meditation, including Mindfulness
Based Stress Reduction
MBSR Increases Positive States
• Mindfulness-based Stress Reduction (MBSR)
–an intervention that focus on reducing
distress and enhancing well-being
• N = 60, stressed individuals
• Randomized to MBSR vs. waiting list
• MBSR resulted in significant decreases in
perceived
stress and improved quality of life
(Nyklicek & Kuijpers, 2008)
Stress Reduction Research to
Lower Risk of Chronic Diseases
Min
dfu
lness
Tra
inin
g
Transactional Model of Stress and Coping
General Stressor
Specific Stressors
Unchangeable Stressors
- Hurricane occurred- Aging
- Untreatable disease (HIV)
Changeable Stressors
- Relationship with boss- Long commute to work
- Dispute with neighbor
Transactional Model of Stress and Coping
Coping: Emotional Focused
- Mindfulness- Calm Breathing- Prog. Muscle Relax.
Changeable Stressors
- Relationship with boss- Long commute to work
- Dispute with neighbor
Specific Stressors
Outcome:Increased Illness
Transactional Model of Stress and Coping
Coping: Problem-Focused
- Problem Solving- Cognitive Behav. Ther.
Unchangeable Stressors
- Hurricane occurred- Aging
- Untreatable disease (HIV)
Specific Stressors
Outcome:Increased Illness
Coping Effectiveness Training (CET)
General StressorHIV
Specific Stressor
Changeable Stressors
UnchangeableStressors
Problem-FocusedCoping Strategies
Problem-solvingCognitive Behav.Therapy
Emotion-FocusedCoping Strategies
MindfulnessCalm BreathingPhysical activity
Chesney & Folkman
Positive Education Project
Chesney & Folkman
HIV+ Men(N=149)
CET(N=54)
Coping Effectiveness Training
(3 mo – 10 sessions)
Maintenance
(9 mo – 6 sessions)
HIV-Info(N=51)
HIVInformation Control
(3 mo – 10 sessions)
Maintenance
(9 mo – 6 sessions)
WLC(N=44)
Waiting List Control
(3 mo – no sessions)
Crossed Over to CET Intervention
(in month 4)
Intervention Group Control Groups
Coping Effectiveness Training Reduces
Stress –Perceived Stress Scale
Effective Coping
Changeable Stressors:
Exposure to virusInteraction with others
UnchangeableStressors:
Presence of VirusNo treatmentNo vaccine
Problem-FocusedCoping Strategies
Problem-solvingCognitive behaviortherapy
Emotion-FocusedCoping Strategies
MindfulnessCalm breathingPhysical activity
Coping Effectiveness Training for COVID-19
• Changeable sources of stress:
- For reducing exposure, interacting with others,
problem-solving, using cognition to be attentive,
keep attuned to key information, e.g., masks
• Unchangeable sources of stress:
• - For ongoing strain of presence of COVID- 19
meditation, yoga, tai chi, “apps” like calm
walks outdoors
• Tool you can use to Outsmart Stress
“BREATHE”
Breathe: Take a deep breath, be present
with yourself in the moment
“BREATHE”
Realistic Goals: Set realistic goals for this
moment, this hour and this day
✓ and celebrate meeting them!
“BREATHE”
Everyday events: Notice the positive
moments in everyday life,
sunset, flowers
share these events with others
recognize when things go right
“BREATHE”
Acts of Kindness
Create positive events for others
“BREATHE”
Turn negatives around:
Reframe negative events
Find the silver lining
Power of the positive
“BREATHE”
Humor
“BREATHE”
End each day with gratitude
Note positive steps and all you are thankful for
Do positive
accounting
at the end of
the day
Keep a
Gratitude
Diary
COVID – 19
HELPFUL RESOURCES
COVID – 19
HELPFUL RESOURCES
CERTIFICATES OF COMPLETION FOR TOWN HALL
MEETINGS ARE DISTRIBUTED WITHIN
TWO (2) WEEKS OF THE EVENT DATE
Thank you!Questions and Answers