Sunday, October 28, 2007

Promoting Recovery




According to a recent article in Psychiatric News to make a significant contribution for patient's recovery inspite of their suffering a mental illness we need to,

1. Establish more standardized training on the principles of recovery for medical students, residents, and practicing psychiatrists.

2. Expose psychiatry residents and practicing psychiatrists more consistently to patients who have achieved recovery.

3. Redefine the role of community psychiatrists to emphasize their importance in supporting recovery to ensure that they have more time to spend with patients working on recovery issues and reintegrating them into the community.

4. Contribute to the development of best-practice guidelines that describe a range of approaches that support recovery goals.

5. Specify recovery-oriented outcomes within federal, state, and local mental health systems to ensure that psychiatrists focus on practical recovery-oriented goals.

6. Continue to establish partnerships with consumer mental health advocates and groups to further policies that support recovery-oriented systems of care.

7. Transform the public mental health system to emphasize recovery and principles of integrated community care.

8. Advocate for increased funding for a wide range of services in community settings for people with serious mental illness.

9. Lead community education campaigns to highlight the discrimination and stigma encountered by those with serious mental illness.

10. Advocate for elimination of discriminatory policies such as zoning exclusions and custody arrangements that penalize people with mental illness and for increased public funding for services that help to eliminate stigma-based policies.


references:
Promoting Recovery: Recommendations for Psychiatrists, Psychiatric News September 7, 2007 Volume 42, Number 17, page 10, American Psychiatric Association.

Two-Way Street Crucial to Fostering Recovery, Eve Bender, Psychiatr News 2007 42: 10.

Saturday, October 27, 2007

Proyecto de tanatologia en Puerto Rico


El Velorio de Francisco Oller 1893



Napoleon en su lecho de muerte.










El comite de legislacion de la Puerto Rico Psychiatric Society ha estudiado el Proyecto de la Camara 2386 presentado por la representante Rivera Ramírez (Por Petición) y referida a la Comisión de Gobierno. Este proyecto se radico durante la 15ta. Asamblea, 3ra. Sesión Legislativa Ordinaria de la CAMARA DE REPRESENTANTES.

Este proyecto tiene el proposito de crear la Ley para Reglamentar la Práctica de la Tanatología en Puerto Rico, establecer una Junta Examinadora establecer sus facultades y deberes, imponer penalidades y para otros fines relacionados.

Tenemos una opinion para la Camara de Representantes sobre este proyecto de ley. Los detalles de nuestra opinion no estan publicados aqui todavia.

Algunas referencias y notas relevantes siguen abajo.

Reference 1.
Proyecto de la Camara 2386 para crear la Ley para Reglamentar la Práctica de la Tanatología en Puerto Rico

Reference 2.
American Psychiatric Association
Precepts on Palliative Care 2001


"Palliative care has become an area of special expertise within medicine, nursing, social work, pharmacy,chaplaincy and other disciplines. However, advances in palliative care have not yet been integrated effectively into standard clinical practice. The fundamental precepts of palliation should be a basic component of the attitudes, knowledge base and practice skills of all clinicians".

Reference 3.
"On death and dying", Kubler-Ross

Reference 4.
La rueda de la vida, Kubler-Ross
La rueda de la vida puede considerarse el testamento espiritual de Elisabeth Kübler-Ross. Es un libro tan singular como lo fue la vida de la autora, una existencia dedicada al alivio del sufrimiento de los enfermos y de todos los que sufren la pérdida de un ser querido.

No hay que temer a la muerte; la muerte no existe, es solo una transición", solía afirmar Elisabeth Kubler-Ross, una mujer que fue considerada por el Times como una de los 100 pensadores más importantes de nuestro siglo. Fue pionera en el movimiento de cuidados paliativos y del estudio de la muerte. Fue una de las voces que desde el mundo científico defendió con más vehemencia la idea de que la conciencia sobrevive al fin del cuerpo.

"Morir es trasladarse a una casa más bella, «se trata sencillamente de abandonar el cuerpo físico como una mariposa abandona su capullo de seda". Estas palabras de gozo son las que pronunciaba cada día la doctora Elisabeth Kübler-Ross junto a la cabecera de sus enfermos.

Doctor honoris causa de varias universidades, fue reconocida mundialmente como una autoridad en materia de tanatología.

Las experiencias científicas de la doctora Kübler-Ross permiten confirmar la existencia de una vida después de la muerte. Sólo se trata del pasaje a un nuevo estado de consciencia en el que se continúa existiendo, comprendiendo, y en el que el espíritu tiene la posibilidad de proseguir su crecimiento.

Ella ha comprendido que los seres que están en el umbral de la muerte no «alucinan» cuando ven a personas que ya murieron venir a buscarlos.
------------------------------
However, the question is very relevant to the psychological health of those involved in the dying process: individuals, families, communities, and cultures. Thanatology explores how the question affects those involved, not the question itself.
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As an interdisciplinary study, thanatology relies on collaboration with many different fields of study.
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Reference 5.
ADEC, Association for death education and couNseling

ADEC Headquarters
60 Revere Drive, Suite 500
Northbrook, IL 60062 USA
Phone or Fax:
Phone 847-509-0403
Fax: 847-480-9282

Certification in Thanatology (CT) is a foundation certification that enhances the professional designation established by the academic discipline of each certificate holder. It recognizes the specific educational background in dying, death and bereavement. Thus, a counselor/therapist or educator is defined by his/her education and work experience. The certification will note the special educational training in the field.

Requirements for Certification in Thanatology (CT)
To apply to take the certification exam, applicants must have:

* A bachelor’s degree (include transcript) and two years of verified related experience*
* Or a master’s or doctorate (include transcript) and one year of verified related experience
* 60 documented contact hours** in thanatology and related topics
* 2 letters of support from supervisors or colleagues.

Related experience is self-defined.
The 60 documented contact hours are defined as education in thanatology or specific topics identified in the CT Content Outline in the CT Handbook. You must provide documentation for these hours.

Educational Experience Requirement
The 60 documented contact hours may be earned through university courses (one three-credit semester course is equivalent to 45 contact hours) or workshops. Educational experiences from any accredited institution will be accepted if they are independently documented by letter or certificate. Courses or workshops by various organizations will also be accepted. ADEC offers workshops and courses as pre-conference activities at its annual conference. See the Educational Events page for listings of courses and conferences in thanatology.
For more information or to prepare for the Certification Exam, read the CT Handbook Ethics



Reference 6
National Center for Death education
777 Dedham St. Newton, MA 02459. Tel: 617.928.4500



Certificate in Thanatology
The National Center for Death Education offers a certificate in the field of Thanatology. To earn it, an applicant must complete 60 hours or CEU equivalents of NCDE workshops, in residence or online and then complete a scholarly project.



Reference 7.
Centennial College
P.O. Box 631, Station A
Toronto, Ontario
Canada M1K 5E9

Sample courses
Introduction to Thanatology
CETH-102 Religious Beliefs, Traditions and Rituals of Death
CETH-103 Mourning, Grief, & Bereavement: Reactions & Responses to Death
CETH-104 Coping with Death: Counselling/Support Groups & Alternative Therapies
CETH-105 Communication Strategies and Support of the Terminally ill

OBJECTIVES:
1. Expose students to various aspects of death and dying from the view of the dying and bereaved.
2. Generate an awareness of and respect for the dying and bereaved.
3. Improve communication skills for those involved with the dying and bereaved.
4. Introduce students to various practical and philosophical approaches to death and dying.


Reference 8.
Brooklyn College
M.A. in community health
HEGIS code 1214
Certificate in thanatology requires studies in bereavement, health crisis intervention, health counseling, health and medical dilemmas, thanatological counseling, care of the terminally ill, and other topics.
Thirty-three to thirty-six credits are required for the degree.
Students must complete one of the following two concentrations of study: Community Health Education (33-36 credits) or Thanatology (33 credits).

Community health education concentration. Required courses (27 credits): Health and Nutrition Sciences 758X, 759X, 761X, 764X, 771X, 772.2X, 775.1X, 777X, and 791.1X.

Elective courses (3-12 credits): Students must complete 3-12 credits chosen from 700-level courses after consultation with the deputy chairperson.
Thanatology concentration. Required courses (24 credits):
Health and Nutrition Sciences 744.5X, 754X, 760X, 762X, 773X, 774.5X, 784.5X, 791.1X.


Reference 9.
Breyers State University Alabama online degree Program

Bachelor Level Courses
1. GRF 151 Introduction to Death & Dying 6 hrs
2. GRF 201 Psychosocial Aspects of Death & Dying 6 hrs
3. PTH 250 Needs of the Dying 8 hrs
4. PTH 360 Death & Mourning 8 hrs
5. PTH 490 Sociology of Death and Dying 8 hrs
6. PTH 550 Ministry to the Dying 10 hrs
7. PTH 570 End of Life Issues 10 hrs
8. PTH 590 Dying and Spirituality 10 hrs
9. PTH 630 Advanced Issues in Death and Dying 10 hrs
10. PTH 680 Spiritual Pastoral Care for the Dying 10 hrs
Master Level Courses
11. PTH 690 Cultural Issues in Death and Dying 10 hrs
12. PTH 700 Ethics in Pastoral Care 10 hrs
13. PTH 735 Pastoral Care of Families 10 hrs
14. PTH 750 Spirituality in Pastoral Counseling 10 hrs
15. PTH 790 Pastoral Care of the Dying Practicum 20 hrs
TOTAL: 146 Semester Hours

Friday, October 26, 2007

Touch points: PARADIGM SHIFT IN CHILD PSYCHIATRY

News from the American Association of Child and Adolescent Psychiatry Annual meeting.

(as reported by Medscape)


"Dr. Berry Brazelton, age 89, noted that during the 1950s, society "blamed the victim," and, for example, if a child had autistic spectrum disorder it was believed to be the mother's fault. "We really thought babies were lumps of clay and it was up to the parents to shape them. This was the dominant thinking at that point."


"Reaching out to new parents and capturing their passion is magical," said Dr. Brazelton, who illustrated his talk with several video clips that captured "magical" moments as he or a parent interacted with an infant. "It is very important to get the family involved," he said. ....

He recommends a paradigm shift from a deficit model taught in medical school to a positive model. "If we give the mother understanding that regression is a time for reorganization, you're reinforcing her success rather than failure."

Touch points is the term Dr. Brazelton uses to describe a temporary regression in conduct of a child before a major landmark occurs in development.

Wednesday, October 24, 2007

Convencion de psiquiatras 2007


VIOLENCIA EN PUERTO RICO
CRISIS Y ALTERNATIVAS DESDE UNA PERSPECTIVA BIOPSICOSOCIAL


La Academia de Psiquiatria es una coalicion de tres organizaciones psiquiatricas tradicionales en Puerto Rico:

la Asociacion de Psiquiatras de Ninos y Adolescentes,
la Seccion de Psiquiatria de la Asociacion Medica de Puerto Rico y
el Capitulo en Puerto Rico de la Asociacion Psiquiatrica Americana.(Puerto Rico Psychiatric Society, Inc)


Programa cientifico
Viernes, 16 de noviembre

1:00 p.m. – 2:30 p. m. Registro
2:45 Bienvenida [ Dra. Dalila Aguilú, Presidenta

Moderador Dra. Lelis Nazario
3:00 Trastornos de Sustancias y Manifestaciones de Violencia [
Dr. Richard Camino

4:00 Agresión en la Sexualidad [ Dra. Diana Díaz


7:00 Cena


Sábado, 17 de noviembre
Moderador [ Dra. María Sánchez Bonilla

8:00 Revirtiendo el Impacto neuronal en el cerebro: rutas alternas a los medicamentos [ Dr. Emir Rivera

9:15 Violence and Altruism: Intertwining of Developmental Pathways [ Dr. Donald Gair

10:30 Receso & Sesión de Posters de Investigación
11:15 Neuropsychiatric Approach to Aggressive Behavior [ Dr. Sheldon Benjamin


12:15 Maltrato de Envejecientes [Dra. Sara Aravanis, Directora NCEA y Lic. Rosa Rodriguez, Directora Division Legal Procurador Envejecientes
1:15 Almuerzo

2:15 Dinámica y comunicación familiar, manifestaciones de violencia [ Dr. Raúl Ríos

3:15 La violencia en los medios de comunicación y la educación para la recepción crítica: una necesidad urgente[ Dra. Aileen Estrada
4:15 Psicofarmacología de la Agresión [ Dr. Jorge Tamayo

8:oo Cena


Domingo, 18 de noviembre
Moderador [ Dr. Juan Fumero

9:00 El Efecto de la Negligencia y Abuso Infantil en el Desarrollo del Sistema Límbico Durante el Primer Año de Vida: Implicaciones Para el Desarrollo de la Agresión [ Dr. Ricardo Vela

10:15 Reframing Partner Abuse as Coercive Control: Implications for Identification, Assessment and Treatment [ Evan Stark, PhD, MSW

11:30 Receso

11:45 Trastornos de Impulso y Conducta Autodestructiva, trasfondo neurobiológico y psicofarmacológico [ Dr. Víctor Sierra


1:00 Premios/Almuerzo/Clausura

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Credit Designation

This activity is planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Escuela de Medicina de PR and the Academia de Psiquiatria de PR. The Escuela de Medicina de PR is accredited by the Puerto Rico Medical Association to provide continuing medical education for physicians.

The Escuela de Medicina de Puerto Rico designates this activity for a máximum of 12 hours in Category I credit towards the AMA Physicians Recognition Award. Each physician should claim only hours of credit that he/she actually spent in the educational activity.

Thursday, October 18, 2007


Puerto Rico Psychiatric Society


Criterios para conceder el Premio Eugenio Maria de Hostos segun decidimos en la reuniòn ordinaria de la Directiva el martes 16 de octubre del 2007.





1. Haber trabajado por la salud mental de los puertorriqueños

2. Haber contribuido al bienestar de la comunidad más allá de lo usual

3. Haber perseverado con una conducta moral y ética excelente

4. Haber sido un ejemplo para otros seguir

5. Estar en la academia, la práctica clínica privada o pública o en investigaciones

6. El candidato usualmente es un medico-psiquiatra. Este no es un criterio absoluto.

7. Este premio se puede conceder a mas de una persona o entidad cada año.



Nestor J Galarza, MD, DFAPA

Presidente

Saturday, October 13, 2007

no a la demencia

No fumar, no beber en exceso, mantener la presion, el azucar y el colesterol malo bajos, hacer ejercicio fisico y mental y ser menor de 30 anos de edad y ........cruzar los dedos.

Son cosas que podemos hacer para que no "conozcamos personas nuevas todos los dias" como dijo el ex-presidente Reagan luego de su diagnostico de demencia.

Vean este articulo sobre alguna otra cosa que podemos hacer:

High Conscientiousness Linked to Decreased Risk for AD CME

News Author: Pauline Anderson
CME Author: Hien T. Nghiem, MD

Arch Gen Psychiatry. October 2007;64:1204-1212.)
Medscape Medical News


http://www.medscape.com/viewarticle/564124?sssdmh=dm1.309771&src=nldne