APNA 30th Annual Conference Session 4022: October 22, 2016 National Organization of Nurse Practitioner Faculties (NONPF): 2016 Survey of PMH NP Programs ENHANCING CHILD AND (Vanderhoef & Delaney, in press) ADOLESCENT CONTENT & ■ Current state of PMH NP graduate CLINICAL TRAINING IN ADVANCED education PRACTICE PSYCHIATRIC NURSING ■ Particular focus on two challenges: PROGRAMS: – Alignment with APRN Consensus Model (lifespan curriculum) A JOINT WORKSHOP FROM THE APNA CHILD/ – Suggested transition of APRN ADOLESCENT COUNCIL AND THE APNA education to the Doctor of Nursing GRADUATE EDUCATION COUNCIL Practice (DNP) NONPF 2016 Survey of PMH NP Programs: ■ Present Presenters: rs: Session #4022 Results – Program Descriptors (Vanderhoef & Delaney, in press) ■ Jason Earle PhD, RN, PMHNP-BC ■ 118 program directors ■ Erin Ellington, DNP, RN, PMHNP-BC – 75 responded (64% response rate) ■ Pam Lusk, DNP, RN, PMHNP-BC, FAANP ■ Lifespan curriculum – all but 1 program (transitioning) ■ Total student enrollment: 2,802 ■ Average number of PMH NP graduates/program ■ The presenters, Jason Earle, Erin Ellington, Pam Lusk – 12 (1-50) have no financial conflicts of interest to disclose ■ MSN PMH NP post-graduation position: 96% clinical ■ DNP post-graduation position: 46% clinical (remainder applying for dual roles – practice- academic or practice-administration) NONPF 2016 Survey of PMH NP Learning Outcomes Programs: Results – Curriculum and Clinical Practicum ■ Discuss the basic knowledge, skills, and attitudes (Vanderhoef & Delaney, in press) needed by the PMHNP to provide evidence based Re Regulato tory Re Requirement: Classroom curricula and clinical practica psychiatric mental health care to children and across the lifespan adolescents. ■ Difficulty finding child placements and preceptors ■ 2 programs have closed; 1 new program being developed ■ Identify various child/adolescent teaching strategies and clinical training opportunities that Regulato Re tory Re Requirement: Education in 2 psychotherapy modalities can be employed in PMHNP programs (individual, family, group) ■ 10 programs offer separate theory of psychotherapy course ■ Create a forum where teaching strategies for ■ 38 programs offer separate family therapy course child/adolescent content and PMHNP learning opportunities can be shared. ■ Psychotherapy content frequently integrated into other courses ■ 53 programs require psychotherapy clinical practicum hours (similar to 2008 finding: 50%) Lusk 1
APNA 30th Annual Conference Session 4022: October 22, 2016 Mor More In In ‐ Dep Depth Teaching hing on on the the Re References Common Com on Psy Psychiatric Di Disor sorder ers Vanderhoef, D. M. & Delaney, K. R. (in press). National Organization of Nurse Practitioner Faculties: 2016 Survey • Neuropathophysiology: A Lifespan of Psychiatric Mental Health Nurse Practitioner Programs. Approach Journal of the American Psychiatric Nurses Association . • Psychopharmacology DNP Clinical • Major Psychopathological Disorders Practica • Psychiatric Assessment Across the Lifespan (Integration into • Evidence ‐ Based Treatment Clinical Practice) • Group Therapy and Complex Care (Pediatric ADHD, Anxiety, Depressive, and Disruptive Behavior Disorders) Progr ogressiv ssively ly De Deepening epening Kn Knowledge Through a Sequ Thr Sequence of of Cour Courses ses Rush University Evidence ‐ Based Treatment Pediatric Anxiety and Development Dan Siegel’s Interpersonal College of Nursing Neurobiology Perspective Psychopharmacology Mind Pediatric Anxiety Brain Molecular/Cellular Processes Relationships Neurotransmitters Neuropathophysiology Receptors JASON EA JA EARLE PHD PHD, PMHNP PMHNP ‐ BC BC Signaling the Nucleus Pediatric Anxiety Neurocircuity JA JASON_ N_EARL RLE@RUS E@RUSH.EDU Emotion Generation Circuit Emotion Regulation Circuit Over Ov erview of of Rus Rush’s Psy Psych DNP DNP Popula pulation/R ion/Role Cogna Cognates es and and Pra Practica ca University of Missouri-Kansas City Curriculum Curriculum Erin Ellington, DNP, RN, PMHNP-BC PMHNP Track Coordinator • Neuropathophysiology: A ellingtone@umkc.edu Lifespan Approach • Psychopharmacology DNP Clinical • Major Psychopathological Practica Disorders • Psychiatric Assessment Across the Lifespan • Evidence ‐ Based Treatment • Group Therapy and Complex Care Lusk 2
APNA 30th Annual Conference Session 4022: October 22, 2016 Enhancing Child and Adolescent UMKC PMHNP Program Content • 53 credit hours • 660+ psychiatric clinical hours • Pediatric Behavioral Health Integration • Full ‐ time, part ‐ time, post ‐ MSN • Adolescent SBIRT • Cognitive Behavioral Therapy • Seamless entry to DNP if desired • Clinical Training Sites • 4 core psychiatric courses (16 hrs) – Didactic & clinical – Full lifespan Child and Adolescent Content Pediatric Behavioral Health Integration • Didactic • Reading – Pediatric primary care • Case studies – Advantages/disadvantages • Discussion board – Collaborative Care vs Integrated Care • Exam questions – SAMHSA Levels of Integration and Competencies • Lectures • http://www.integration.samhsa.gov/ • Clinical training • Case examples • Therapy & medication management • Clinical training Enhancing Child and Adolescent Adolescent SBIRT Content • Grant – HRSA Behavioral Health Workforce Education and Training for Professionals – Develop and expand the substance abuse and mental health workforce who will focus on children, adolescents, and transitional ‐ age youth – Emphasis is on prevention and clinical intervention This work supported by grant G02HP27985 from the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration http://www.nattc.org/regional ‐ centers/content.aspx?rc=midamerica&content=STCUSTOM5 Lusk 3
APNA 30th Annual Conference Session 4022: October 22, 2016 Adolescent SBIRT Clinical Training Site • Local Kansas City sites – Inpatient – Outpatient – Residential – Primary care • Distance sites – Student ‐ led search; faculty ‐ assisted recruitment Cognitive Behavioral Therapy Future Plans • Enhanced pediatric psychopharmacology • Workshop: 8 ‐ hour training session with an Beck trainer modules – Lecture, video, roleplays, Q&A • CBT basics: cognitive model, cognitive case • Pediatric telepsychiatry didactic and conceptualization, session structure, treatment experiential training • Emphasis: depression and anxiety disorders • Educational integration with PNP students – Cognitive restructuring, exposure exercises for anxiety, and behavioral activation for depression • Expand CBT for younger children, play therapy, • Population: adolescent, transitional age, young adult and family therapy • Considerations: brief CBT services & E/M add ‐ on • Child/adolescent content for Adult PMHNP Cognitive Behavioral Therapy References • Beck, J. (2011). Cognitive therapy: Basics and beyond. New York, NY: • 1 ‐ hr initial assessment on a transitional age Guilford Press. standardized patient • Heath B, Wise Romero P, and Reynolds K. (2013, March). A Standard • Complete the Beck Cognitive Case Writeup Framework for Levels of Integrated Healthcare. Washington, D.C.: SAMHSA ‐ HRSA Center for Integrated Health Solutions. – (Beck, 2011) • Overwhelmingly positive student feedback • Hoge M.A., Morris J.A., Laraia M., Pomerantz A., & Farley, T. (2014). Core Competencies for Integrated Behavioral Health and Primary Care . Washington, DC: SAMHSA ‐ HRSA Center for Integrated Health – Increased understanding of and confidence in their Solutions. ability to provide CBT – Some interest in post ‐ graduation training in CBT • Mid ‐ America ATTC. (n.d.) Screening, Brief Intervention and Referral to Treatment (SBIRT) Resources. Retrieved from – Students were better ‐ equipped to participate more http://www.nattc.org/regional ‐ centers/content.aspx?rc= effectively in their psychotherapy preceptorships midamerica&content=STCUSTOM5 Lusk 4
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