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Reframing the Complex Patient

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In this 3-part webinar series Sarah and Andra will explore the benefits of an integrative approach to the complex patient that puts understanding stress at the core of caregiving. Part one dives into the science of stress – the nuances of stress physiology, health effects of chronic stress, biobehavioral coping mechanisms, and the social determinants of health. Part two advocates for shifts in PT assessments and interventions that we can implement when we see our patients through the lens of stress science. This approach is aligned with the principles of trauma-informed care and biopsychosocial models. Part three discusses barriers to adopting this approach, opportunities for the PT profession to implement integrative models, and important boundaries and self-care for practitioners taking on comprehensive caregiving.

  • Contains 4 Component(s), Includes Credits

    (LMS-MHS-1) This is Part 1 of a 3-part series exploring the benefits of an integrative approach to the complex patient that puts understanding stress at the core of caregiving. Part one dives into the science of stress - the nuances of stress physiology, health effects of chronic stress, biobehavioral coping mechanisms, and the social determinants of health.

    This 3-part webinar series will explore the benefits of an integrative approach to the complex patient that puts understanding stress at the core of caregiving. Part one dives into the science of stress - the nuances of stress physiology, health effects of chronic stress, biobehavioral coping mechanisms, and the social determinants of health. Part two advocates for shifts in PT assessments and interventions that we can implement when we see our patients through the lens of stress science. This approach is aligned with the principles of trauma-informed care and biopsychosocial models. Part three discusses barriers to adopting this approach, opportunities for the PT profession to implement integrative models, and important boundaries and self-care for practitioners taking on comprehensive caregiving.

    Interested in the whole series - click here.

    Learning Objectives

    1. Construct rationale for an integrative approach to care of the complex patient

    2. Summarize stress physiology and its relevance to clinical PT practice

    3. Evaluate how positive, tolerable, and toxic stress impact clinical PT practice

    4.Analyze protective and risk factors for stress related sequelae

    5. Explore the applicability of the ACEs Study to clinical PT practice

    6. Explain allostatic load and its relevance to clinical PT practice

    Andra DeVoght

    PT, MPH

    Has been a physical therapist since 1995. After a decade working at Harborview Medical Center, Seattle’s level 1 trauma hospital, she was inspired to pursue a master’s degree in public health that radically changed her approach to physical therapy and led her to open a private practice, Insight Physio PLLC. Andra’s clinical practice at Insight Physio focuses on a biopsychosocial approach to chronic pain, women’s health, and pediatrics. She collaborates with mental health professionals for the care of complex patients. She teaches therapeutic yoga and mindfulness classes for people experiencing chronic pain or other chronic illnesses.

    Andra has focused on continuing education course work that integrates a mind-body approach to health care. These include yoga teacher certification with specialty in trauma informed yoga, mindfulness instructor training, NEAR sciences (neuroscience, epigenetics, ACEs and resilience) teacher training, Explain Pain, Postural Restoration Institute courses, Center for Mind Body Medicine facilitator training, and most recently the advanced level course work with the Somatic Experiencing Trauma Institute.

    In addition to clinical practice Andra collaborates on community-based projects teaching about the social determinants of health and a biopsychosocial approach to health and healthcare. She has developed curriculum and guest lectures for teachers/special-ed staff and middle school, high school , and midwifery students. Central to her biopsychosocial model is a deep understanding of the stress response and the health effects of stress and adversity. When we view patient care through the lens of the stress response, we begin to connect important dots between symptoms, beliefs, behavior and life circumstances.

    Sarah Wenger

    PT, DPT

    Dr. Wenger is an associate clinical professor at Drexel University’s College of Nursing and Health Professions. She received her master of physical therapy degree from Arcadia University in 1997 and her doctor of physical therapy degree from Temple University in 2002. She also is a board-certified clinical specialist in orthopaedic physical therapy. She has published and presented on a range of topics related to her areas of expertise in chronic pain, underserved populations, and clinical reasoning, and she provides pro bono services in a community-based clinic. With an interdisciplinary team, Wenger developed a chronic pain clinical reasoning model and psycho-education program called Power Over Pain.

    Course Instructions

    1. Click on the Contents tab to watch the course recording.
    2. Click the Take Quiz button to complete the assessment. Learners will have 3 attempts to pass and must answer at least 70% of questions correctly.
    3. Click Fill Out Survey under the Evaluation listing to provide valuable course feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
    4. Click the View/Print Your Certificate button under the Certificate listing. You can view/print your certificate at any time by visiting the APTA Learning Center and clicking the CEU Certificate/Transcript link on the left-hand side of the page. 

    Need Assistance?

    For assistance logging in, accessing activities, claiming credit, or for other questions or concerns, please e-mail learningcenter@apta.org. 

  • Contains 4 Component(s), Includes Credits

    (LMS-MHS-2) In this 3-part webinar series Sarah and Andra will explore the benefits of an integrative approach to the complex patient that puts understanding stress at the core of caregiving. Part two advocates for shifts in PT assessments and interventions that we can implement when we see our patients through the lens of stress science.

    In this 3-part webinar series Sarah and Andra will explore the benefits of an integrative approach to the complex patient that puts understanding stress at the core of caregiving. Part one dives into the science of stress - the nuances of stress physiology, health effects of chronic stress, biobehavioral coping mechanisms, and the social determinants of health. Part two advocates for shifts in PT assessments and interventions that we can implement when we see our patients through the lens of stress science. This approach is aligned with the principles of trauma-informed care and biopsychosocial models. Part three discusses barriers to adopting this approach, opportunities for the PT profession to implement integrative models, and important boundaries and self-care for practitioners taking on comprehensive caregiving.

    Interested in the full series - click here.

    Learning Objectives:

    1. Construct rationale for an integrative approach to care of the complex patient

    2. Summarize stress physiology and its relevance to clinical PT practice

    3. Evaluate how positive, tolerable, and toxic stress impact clinical PT practice

    4. Analyze protective and risk factors for stress related sequelae

    5. Explore the applicability of the ACEs Study to clinical PT practice

    6. Explain allostatic load and its relevance to clinical PT practice

    Sarah Wenger

    PT, DPT

    Dr. Wenger is an associate clinical professor at Drexel University’s College of Nursing and Health Professions. She received her master of physical therapy degree from Arcadia University in 1997 and her doctor of physical therapy degree from Temple University in 2002. She also is a board-certified clinical specialist in orthopaedic physical therapy. She has published and presented on a range of topics related to her areas of expertise in chronic pain, underserved populations, and clinical reasoning, and she provides pro bono services in a community-based clinic. With an interdisciplinary team, Wenger developed a chronic pain clinical reasoning model and psycho-education program called Power Over Pain.

    Andra DeVoght

    PT, MPH

    Has been a physical therapist since 1995. After a decade working at Harborview Medical Center, Seattle’s level 1 trauma hospital, she was inspired to pursue a master’s degree in public health that radically changed her approach to physical therapy and led her to open a private practice, Insight Physio PLLC. Andra’s clinical practice at Insight Physio focuses on a biopsychosocial approach to chronic pain, women’s health, and pediatrics. She collaborates with mental health professionals for the care of complex patients. She teaches therapeutic yoga and mindfulness classes for people experiencing chronic pain or other chronic illnesses.

    Andra has focused on continuing education course work that integrates a mind-body approach to health care. These include yoga teacher certification with specialty in trauma informed yoga, mindfulness instructor training, NEAR sciences (neuroscience, epigenetics, ACEs and resilience) teacher training, Explain Pain, Postural Restoration Institute courses, Center for Mind Body Medicine facilitator training, and most recently the advanced level course work with the Somatic Experiencing Trauma Institute.

    In addition to clinical practice Andra collaborates on community-based projects teaching about the social determinants of health and a biopsychosocial approach to health and healthcare. She has developed curriculum and guest lectures for teachers/special-ed staff and middle school, high school , and midwifery students. Central to her biopsychosocial model is a deep understanding of the stress response and the health effects of stress and adversity. When we view patient care through the lens of the stress response, we begin to connect important dots between symptoms, beliefs, behavior and life circumstances.

    Course Instructions

    1. Click on the Contents tab to watch the course recording.
    2. Click the Take Quiz button to complete the assessment. Learners will have 3 attempts to pass and must answer at least 70% of questions correctly.
    3. Click Fill Out Survey under the Evaluation listing to provide valuable course feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
    4. Click the View/Print Your Certificate button under the Certificate listing. You can view/print your certificate at any time by visiting the APTA Learning Center and clicking the CEU Certificate/Transcript link on the left-hand side of the page. 

    Need Assistance?

    For assistance logging in, accessing activities, claiming credit, or for other questions or concerns, please e-mail learningcenter@apta.org. 

  • Contains 4 Component(s), Includes Credits

    (LMS-MHS-3) This is part 3 of a 3-part series

    In this 3-part webinar series Sarah and Andra will explore the benefits of an integrative approach to the complex patient that puts understanding stress at the core of caregiving. Part one dives into the science of stress – the nuances of stress physiology, health effects of chronic stress, biobehavioral coping mechanisms, and the social determinants of health. Part two advocates for shifts in PT assessments and interventions that we can implement when we see our patients through the lens of stress science. This approach is aligned with the principles of trauma-informed care and biopsychosocial models. Part three discusses barriers to adopting this approach, opportunities for the PT profession to implement integrative models, and important boundaries and self-care for practitioners taking on comprehensive caregiving.

    Interested in the whole series - click here.

    Learning Objectives:

    1. Document and address adverse societal and social conditions that effect patients' symptoms, health, and outcomes

    2. Effectively document the impact of complexity to facilitate comprehensive care and reimbursement

    3. Perform evaluation tests and measures that capture the full complexity of patient presentations

    4. Select appropriate ICD-10 and CPT codes to describe the complexity of patient's conditions and interventions provided

    5. Identify personal actions to improve complexity care at individual levels

    6. Identify global initiatives to improve complexity care at clinic and systemic levels

    Sarah Wenger

    PT, DPT

    Dr. Wenger is an associate clinical professor at Drexel University’s College of Nursing and Health Professions. She received her master of physical therapy degree from Arcadia University in 1997 and her doctor of physical therapy degree from Temple University in 2002. She also is a board-certified clinical specialist in orthopaedic physical therapy. She has published and presented on a range of topics related to her areas of expertise in chronic pain, underserved populations, and clinical reasoning, and she provides pro bono services in a community-based clinic. With an interdisciplinary team, Wenger developed a chronic pain clinical reasoning model and psycho-education program called Power Over Pain.

    Andra DeVoght

    PT, MPH

    Has been a physical therapist since 1995. After a decade working at Harborview Medical Center, Seattle’s level 1 trauma hospital, she was inspired to pursue a master’s degree in public health that radically changed her approach to physical therapy and led her to open a private practice, Insight Physio PLLC. Andra’s clinical practice at Insight Physio focuses on a biopsychosocial approach to chronic pain, women’s health, and pediatrics. She collaborates with mental health professionals for the care of complex patients. She teaches therapeutic yoga and mindfulness classes for people experiencing chronic pain or other chronic illnesses.

    Andra has focused on continuing education course work that integrates a mind-body approach to health care. These include yoga teacher certification with specialty in trauma informed yoga, mindfulness instructor training, NEAR sciences (neuroscience, epigenetics, ACEs and resilience) teacher training, Explain Pain, Postural Restoration Institute courses, Center for Mind Body Medicine facilitator training, and most recently the advanced level course work with the Somatic Experiencing Trauma Institute.

    In addition to clinical practice Andra collaborates on community-based projects teaching about the social determinants of health and a biopsychosocial approach to health and healthcare. She has developed curriculum and guest lectures for teachers/special-ed staff and middle school, high school , and midwifery students. Central to her biopsychosocial model is a deep understanding of the stress response and the health effects of stress and adversity. When we view patient care through the lens of the stress response, we begin to connect important dots between symptoms, beliefs, behavior and life circumstances.

    Course Instructions

    1. Click on the Contents tab to watch the course recording.
    2. Click the Take Quiz button to complete the assessment. Learners will have 3 attempts to pass and must answer at least 70% of questions correctly.
    3. Click Fill Out Survey under the Evaluation listing to provide valuable course feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
    4. Click the View/Print Your Certificate button under the Certificate listing. You can view/print your certificate at any time by visiting the APTA Learning Center and clicking the CEU Certificate/Transcript link on the left-hand side of the page. 

    Need Assistance?

    For assistance logging in, accessing activities, claiming credit, or for other questions or concerns, please e-mail learningcenter@apta.org.