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On the Healing Connections Podcast, Mandy Chamberlain, MOTR/L was interviewed about “Aging Well” by Emmy Vadnais, OTR/L.

"Aging Well" with Mandy Chamberlain, MOTR/L - YouTube

Watch or Listen to Full Interview Here

Mandy is an occupational therapist with a passion for working with the older adult population and the founder of SeniorsFlourish.com and the membership site, The Learning Lab. Both are dedicated to helping other geriatric OT’s be the best they can be through education, resources, tips and videos.

Her varied clinical background includes working with geriatrics through long term care, home health services, home modification consultation, assisted living, inpatient critical access and outpatient therapy services.

The book mentioned about preventing and reversing Alzheimer’s is: “The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline.” Music by Steven C. Anderson: “First Touch” from album “Healing Piano.” Please visit SeniorsFlourish.com.

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Emmy Vadnais, OTR/L was interviewed about “Spirituality and Intuition in Occupational Therapy” by Mandy Chamberlain, MOTR/L on her Seniors Flourish Podcast. Listen to Podcast Here

Description from the show:

“Even though there is a large percentage of the US population that affiliates with some level of spirituality or God, our current healthcare system does not often put a priority on spirituality and intuition outside of a typical hospital chaplain. Because occupational therapy looks at the “whole person,” it is an important aspect of people’s lives that we sometimes don’t address. Some areas of OT practice integrate this more easily, such as roles in hospice and palliative care, but given the fact that spirituality affects the health, healing and well-being of our patients, it is a necessary aspect of a person’s identity as a person.

Spirituality is included in the Occupational Therapy Practice Framework, implying the necessity of addressing this in client-centered practice. Guest Emmy Vadnais OTR/L, BCTMB, ARCB discusses how we can integrate spirituality and intuition into our practice, no matter what your affiliation is (or is not).”

Free Resources from the show here.

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Holistic Practice Class Audio Recording 1/2 Off for Full Members – July and August
Instructor: Emmy Vadnais, OTR/L
$99, $49 for Full Holistic OT Members and Holistic Healing Certificate Program Students
Register Here

Begin or expand your Holistic Practice in this Holistic Practice Class. Receive support and guidance from a Holistic Health Practitioner with 20 years in Holistic/Integrative Medicine and private practice.

In this Class you will receive support with:

  • Creating or Expanding Your Holistic Practice
  • Increasing Your Confidence
  • Creating a Business Plan
  • Marketing – How to Grow and Attract Your Clients
  • Referral Sources
  • Holistic Assessments/Evaluations
  • Reimbursement, Billing, and Documentation
Continuing Education – 3 CEUS

Health Care Professionals will receive a Certificate of Completion for completing the class that may be submitted to your professional board for professional development credits. A completed course evaluation is required within 30 days of taking the class to receive a Certificate of Completion. This course meets the NBCOT requirement as a Professional Development Activity.

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Presenter: Amber Ramseyer, MS, OTR/L, SWC, CYT  Host: Kim Reese OTD, MOTR/L, RYT
December 12-17th, 2019 (5 online seminars throughout 2020)
Island Yoga in Aruba
$2750 shared villa, $2995 private room

Come learn and live life with us! Boutique Learning Experience presents Sensory Integrative Approach to Yoga Retreat. This course is endorsed by the World Federation of Occupational Therapy! Dive deep into the neurophysiology of the body and how yoga postures, breath work and meditation impact the body and mind as a whole. Help children (can be applied to adults) be active participants in increasing awareness of their bodies, ability to focus, calm, attend, and learn to respond to their self  and the environment rather than react. Learning modalities include videos, case studies, lectures, positioning & alignment labs, adaption and modification labs and small group activities. This 6 day 5 night retreat is balanced with enriching your mind body and spirit by including optional mindfulness activities for you the practitioner, networking, nutritious food, adventures and relaxation time by the pool or pristine ocean. Start each day with yoga or other mindfulness practices followed by 3-5 hours of continuing education a day for total of 20 hours onsite! Find your life balance on a work trip with us! Continue learning collaboratively over the following year with 5 online seminars with the group discussing new ideas, what worked, what did not, what’s new in the research… The possibilities are endless!  Reserve your spot now with only $500 deposit! Mention HolisticOT and we will provide an additional $100 savings when booked in July! Please note the greatest savings is to book with a friend (save 10%) this special ends August 5th! To reserve your spot, more information, details, FAQs and daily schedule: https://boutiquelearningexperience.com/sensory-integration-and-yoga/

Objectives: 
1. Identify and differentiate sensory integration philosophy and history  
2. Identify and differentiate yoga philosophy and history  
3. Recognize the relationship between sensory integration and yoga
4. Identify mindfulness intervention and breathing techniques, and recognize the impact on the brain and body  
5. Differentiate positioning and alignment to safely use yoga as a modality  
6. Knowledge of adaptions and modifications to allow for every child to access poses  
7. Demonstrate sensory-based yoga intervention technique

Amber Ramseyer is an occupational therapist who currently works at Pediatric Therapy Network (PTN) in Torrance CA, an internationally renowned pediatric clinic specializing in sensory integration theory and intervention as originated by A. Jean Ayres. She has advanced training and certification in sensory integration and administration of the Sensory Integration and Praxis Tests as well as advanced certification in swallowing assessment and intervention.  Amber is a published author of the book;  A Therapist’s Guide to Yoga in Pediatrics: A Sensory Based Approach. Amber has completed her 200 hour yoga certification and is certified to teach yoga for children with special needs. She received her Bachelor of Science degree from Grand Valley State University and her Master of Science degree from Western Michigan University. Amber was born in the midwest and currently resides in Redondo Beach, CA. She loves being active, yoga, hiking, paddle-boarding, and spending time with her dog, Tait.

BLE is a company created by OT’s for OT’s and practitioners! We value your wellbeing & life balance, we strive to address you, the therapist, from a holistic perspective while learning key strategies to help the people with whom we have the privilege of helping. Retreat is hosted by Kim Reese OTD, MOTR/L, RYT, CEO and founder of Boutique Learning Experience. https://boutiquelearningexperience.com

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On the Healing Connections Podcast Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness. 

Whole Person Care

"Whole Person Care" with Kelly Clancy, OTR/L - YouTube

Episode 14 – Emmy Vadnais, OTR/L interviews Kelly Clancy, OTR/L, CHT about “Whole Person Care.” She is an Occupational Therapist, Certified Hand Therapist, a board-certified Structural Integrator, Senior Instructor for the Bowen Academy of Australia, a Holistic Health Counselor, and a nationally board-certified Massage Therapist. She teaches nationally and internationally on the therapeutic approach that she developed called Tensegrity Medicine.

Kelly has been practicing in the field of Occupational Therapy for over 32 years. She uses her skills as a manual therapist and ergonomist to address the postural components that contribute to pain and dysfunction. Her focus is not only on the physical issues that may be present, but also on the relationship of stress, cognitive belief patterns and emotions and their impact on the physical body. Her expertise is in using the biotensegrity model in teaching assessment, manual therapy, and movement interventions to create three dimensional global balance in the global structure.

Kelly is on clinical faculty at the University of Washington’s rehabilitation department where she lectures on the topics of ergonomics, fascia, hand therapy, innovative manual therapy, and whole body medicine. Music by Steven C. Anderson: “Embraced” from album “Heart Strings.” Please visit KellyClancy.com.

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By Tauni Malmgren, OT/S and Emmy Vadnais, OTR/L

Backround

People have used cannabis for medical purposes for at least 3,000 years according to the National Center for Complementary and Integrative Health.1 Currently, medical cannabis (MC) is becoming legalized in many parts of the United States. MC simply refers to cannabis that is used medically. Cannabidiol (CBD) has also gained attention for its medical benefits. As this article will explain, all cannabis has CBD in it, but CBD is not cannabis. Recently, an article from the American Occupational Therapy Association (AOTA) addressed the importance of understanding MC to provide client education and support medication management to increase occupational performance.2

How Cannabis Works

Cannabis contains hundreds of chemicals called cannabinoids. The most well-known cannabinoids are Δ9-tetrahydrocannabinol (THC) and CBD. While THC has psychoactive agents that lead to intoxication, CBD does not have these agents. A report from the World Health Organization states that CBD has no addictive properties and is not a public health risk. CBD is an option for people wanting the benefits of MC without the psychoactive effects or risk for addiction.3

The Legality of Cannabis and CBD

In some states, cannabis is now legal and does not require a prescription, making it more accessible to the public. MC is also legal in some states after some researched benefits. As time goes on, with more people turning to MC, how it may benefit people as well as the risks and benefits may become more apparent. Here is a helpful map showing the legality of cannabis by state.  

CBD oil has become more readily available in the states where it is legal and that does not require a prescription. For more up to date details on the legality of CBD oil, see this helpful map. Even though CBD exists in a legal gray area, CBD oil is ubiquitously sold as a supplement, and the FDA does not regulate the safety or purity of these medication. There are no set guidelines to know if a CBD product is labeled with accurate active ingredients or dosages. What’s more, it is unknown to the medical community currently what the most effective therapeutic dosage of CBD for a particular medical condition. There may be more clear guidelines and research about the possible benefits for CBD oil in the future. Until then, occupational therapy practitioners can pay close attention to companies and distributors of CBD and look out for indicators of better quality such as third party testing and more research. 

CBD Benefits 

In 2018, the U.S. Food and Drug Administration (FDA) approved a pharmaceutical grade CBD medication, Epidolex, for the treatment for two severe and drug-resistant pediatric seizure disorders, Lennox-Gastaut syndrome and Dravet syndrome. However, according to CBD Project, much of what our clients have access to are off market CBD oils that are widely accessible and largely unregulated.4 The project suggests that health professionals learn more about MC and CBD to adequately provide client education about dosages, modes of administration, cannabinoid synergies, risk factors, and drug interactions. 

Some members of the Holistic OT Community have observed benefits for their clients who have used CBD in clinical practice where the CBD was prescribed by a primary practitioner or taken autonomously by the clients themselves. They have reported that CBD alleviated many symptoms and conditions including chronic pain, anxiety, post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), autism, and overall brain function. They also observed that CBD has helped with epilepsy, cerebral palsy, viral infections, seizures, muscle spasms, soft tissue repair, and cancer, and more generally improved sleep, digestion, skincare, and generalized inflammation.5

What Does the Research Say?

AOTA states that federal restrictions place major restrictions on the study of MC resulting in a lack of high quality clinical trials.2 Study limitations include small sample sizes, inconsistent outcome measures, and variable doses, types of cannabinoids, and methods for drug administration. While clinical trials are lacking, literature reviews have found evidence showing that MC can help adults with chronic pain, symptoms from chemotherapy, and muscle spasticity from multiple sclerosis (MS). Moreover, reports show that MC can help with epilepsy, PTSD, and side effects from HIV/AIDS. 

Project CBD has a breakdown of the positive benefits of CBD and THC that are supported by scientific evidence.4 A study found that CBD and THC are neuroprotective agents with antioxidative properties that block neurotoxins, or poisons that act on the nervous system.6 Another study found that THC and CBD can facilitate the growth of new brain cells in adult mammals.7  

A study explains the endocannabinoid system as regulatory system in the body impacting health and disease through the peripheral and central nervous systems and peripheral organs. This study states that modulating the activity of the endocannabinoid system through MC can positively impact a wide range of disparate diseases and pathological conditions including mental health disorders, biomechanical disorders, and much more.8 Another study explores more deeply the effects of MC on the endocannabinoid system.9

Methods of Cannabis and CBD Administration

Research says that MC can be inhaled (e.g., smoking cigarettes, pipes, water pipes, and vaporizing), taken orally (e.g., edibles, juice, tea, oils, capsules, tinctures, and lozenges), oromucosally (e.g., spray), and topically (e.g., creams and suppositories).10 The effects of inhalation have a maximum effect for 15-30 minutes and last for 2-3 hours. The oral route has a maximum effect for 1-3 hours and last for 6-8 hours. The oromucosal route has a maximum effect in 15-45 minutes and lasts for 6-8 hours. The topical route has variable, localized effects.

Potential Side Effects of Cannabis and CBD

An AOTA article states that “like many medication, cannabis has documented adverse effects.”2 These include impaired cognition, perception, and motor skills, increased risk for myocardial infarction, and increased risk of motor vehicle accidents. Long term adverse effects include impaired verbal learning memory, impaired attention, and if smoked, poor respiratory function. Moreover, heavy users are likely to report suicidal thoughts and regular users have increased risk of social anxiety disorders. However, the article notes that this sample was of people who used cannabis heavily for recreation. People who use MC report fewer adverse effects. However, according to the National Center for Complementary and Integrative Health, it is unknown whether the benefits outweigh the risks.11 

When evaluating clients, the article states that acute MC may impair balance, so practitioners should monitor clients for fall risks and provide fall prevention strategies if necessary. Practitioners should also evaluate and monitor effects on cognition and mood through clinical observation and formal screens. While MC can help with spasticity, the Modified Ashworth Scale (MAS) doesn’t pick up on effects. Therefore, client-specific evaluations should be used.  

MC impacts memory, learning, and attention. Keeping this in mind, when practitioners plan interventions, they should take impaired cognitive skills into account and possible schedule treatments outside of acute use.2 The article notes that people who use MC say that they develop a tolerance and claim limited or no impairing side effects. Moreover, people who use MC should avoid driving for four hours after inhalation and six hours after ingestion, so community mobility may be impacted. Lastly, since MC can increase blood pressure and heart rate, vital signs should be monitored during exercise because of an increased risk for acute myocardial infarction.  

A blog post from Harvard Medical School says that side effects from CBD include nausea, fatigue, and irritability. It can also increase the efficacy of certain medications “by the exact same mechanism that grapefruit juice does.”12 The Medline Plus website has some helpful information about potential drug interactions as well as recommended dosages for Epidolex.13 The National Center for Complementary and Integrative Health says that more research needs to be done to develop a comprehensive understanding of the health effects of MC and that steps should be taken to overcome regulatory barriers to research.11 

What is the Role of OT?

An OT, alongside the health care team or with an individual client, may be able to help address and assess the whole person – mind, body, and spirit, and look at the root cause of symptoms, client factors, or interferences to optimal occupational performance. An OT may be able to assist determining what approaches may be helpful instead of or in addition to cannabis products when all other means have been considered.

For example, if a client is experiencing pain or anxiety an OT can assess, alongside other health professionals, what may be at the root cause of these symptoms and support a client with integrative health approaches that are efficacy-based to lower pain and anxiety, through a comprehensive OT plan of care.

OTs may be able to provide education and help clients improve medication management skills. It is not in OT scope of practice to recommend medications or supplements. If educated, an OT may be able to share with clients and the medical team the risks and benefits of cannabis or support a client with cannabis when and if appropriate within state laws.

Over time, as cannabis laws may change to include accessibility in additional states more research for potential risks and benefits and the role of OT will likely become more clear. Know your state laws and refer the client back to a physician or referring practitioner for medical evaluation and prescription recommendations.

References
  1. Marijuana and Cannabinoids. (2018, October 25). Retrieved May 14, 2019, from https://nccih.nih.gov/health/marijuana 
  2. Bell, A. (2018, December 10). An Introduction to Medical Cannabis and Occupational Therapy. Retrieved May 14, 2019, from https://www.aota.org/Publications-News/otp/Archive/2018/medical-cannabis.aspx 
  3. World Health Organization. (2017, November 10). Cannabidiol (CBD): Pre-Review Report [PDF]. Geneva.Expert Committee on Drug Dependence Thirty-ninth Meeting. Retrieved June 16, 2019 from https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf
  4. CBD Project. (n.d.). What is CBD? Retrieved from https://www.projectcbd.org/cbd-101/what-is-cbd 
  5. Holistic Occupational Therapy. (n.d.). In Facebook [Group Page]. Retrieved June 16, 2019 from https://www.facebook.com/groups/holisticoccupationaltherapy/
  6. Hampson, A. J., Grimaldi, M., Axelrod, J., & Wink, D. (1998). Cannabidiol and (2)D9-tetrahydrocannabinol are neuroprotective antioxidants. Proceedings of the National Academy of Sciences of the United States of America, 95(14): 8268-8273.
  7. Wolf, S. A., Bick-Sander, A., Fabel, K., Leal-Galicia, P., Tauber, S., Ramirez-Rodriguez, G… & Kempermann, G. (2010). Research Cannabinoid receptor CB1 mediates baseline and activity-induced survival of new neurons in adult hippocampal neurogenesis. Cell Communication and Signaling, 8(12).
  8. Pacher, P., Bátkai, S., & Kunos, G. (2006). The endocannabinoid system as an emerging target of pharmacotherapy. Pharmacological Reviews, 58(3): 389-462.
  9. Pacher, P., & Kunos, G. (2013). Modulating the endocannabinoid system in human health and disease: successes and failures. The FEBS Journal, 280(9): 1918-1943. doi: 10.1111/febs.12260 
  10. MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12–19. doi: 10.1016/j.ejim.2018.01.004 
  11. Marijuana and Cannabinoids. (2018, October 25). Retrieved June 16, 2019, from https://nccih.nih.gov/health/marijuana
  12. Grinspoon, P., MD. (2018, August 24). Cannabidiol (CBD) – what we know and what we don’t. Retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 
  13. Cannabidiol: MedlinePlus Supplements. (2018, October 29). Retrieved June 16, 2019, from https://medlineplus.gov/druginfo/natural/1439.html
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Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness. 

How Tarot Benefits the Health of Society

"How Tarot Benefits the Health of Society" with Pamela Eakins, PhD - YouTube

Episode 13 – Emmy Vadnais, OTR/L  interviews Pamela Eakins, PhD about “How Tarot Benefits the Health of Society.” Dr. Pamela Eakins is a Sociologist and Visionary Cosmologist.

She has taught at Stanford University, the University of Colorado, and the California Institute of Integral Studies. She is the author of several books including Tarot of the Spirit, Priestess, and Visionary Cosmology. Currently, she teaches in the San Francisco Bay Area as well as online. Music by Steven C. Anderson: “Raindrops and Rainbows” from album “Past to Presence – Mellow.” Please visit PamelaEakins.net and TarotoftheSpirit.com.

Watch full episode here.

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New Recording – Mindfulness Meditation “Loving Yourself” By Emmy Vadnais, OTR/L

Listen Here 

Here’s a new 10-minute guided mindfulness meditation easily accessible on YouTube that you can listen to for your own self-care, play for clients, or a tool they can use in between sessions or after discharge.

Read the researched benefits of meditation here

* Do not listen to this recording while driving a car. Once practiced enough you can bring these concepts into your activities of daily living – ADLs.

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Emmy Vadnais, OTR/L
Topic: Getting Started with OT and Integrative Health
July 17, 2019 
6:30 – 7:30 p.m. Central Time
Live Phone Call (calls are not recorded)
Register Here $25
CEUs are not available for group coaching.

Are you an OT who would like to learn more about how to utilize OT and Integrative Health?

Receive support and have your questions answered such as:

  • How to combine OT and Integrative Health
  • What is the best way to receive education OT and Integrative Health
  • How to bill for OT and Integrative Health

Bring your questions to the next Holistic OT Group Coaching!

Join the group coaching with Emmy Vadnais, OTR/L who has been utilizing holistic/integrative health, wellness, and prevention approaches for 20 years. Learn more about Emmy here

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The Holistic OT Community offers many free resources for OTs interested in learning about OT and Integrative Health, whether you are new to the topic or an advanced practitioner. We suggest you begin here to learn the answers to commonly asked questions.

Would you like individual support learning how to incorporate integrative health, wellness & prevention into your practice, whether you are employed or self-employed?

Coaching and mentoring sessions are half-off all summer for full members with Emmy Vadnais, OTR/L – the founder of the Holistic OT Community. Once you become a full member you can have access to the members only page with monthly tips and suggestions and create your own Directory Listing on our Holistic OT Practitioner Directory.

Contact Emmy to schedule your individual session that is only $75/hr., normally $150/hr. at emmy@emmyvadnais.com.

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