"Stress" is a common patient complaint and chronic stress related symptoms can directly or indirectly account for a substantial proportion of primary care office visits. Adapting to excess stress may give rise to negative coping strategies such as poor diet, smoking and increased alcohol consumption. A NEJM review article on the damaging effect of stress mediators notes that these significant lifestyle changes can in turn worsen the medical effects of chronic stress [McEwen BS. Seminars in medicine of the Beth Israel Deaconess Medical Center: protective and damaging effects of stress mediators. N Engl J Med 1998;338(3):171-179]. In addition, positive lifestyle factors such as exercise, sleep and social connectivity are often negatively impacted when individuals feel overwhelmed. Therefore, via several pathways, unmitigated chronic stress can put the individual at significantly increased risk for stress related medical conditions such as obesity, cardiovascular disease, alcohol abuse or depression.

Simple and effective office based behavioural interventions and resources for stress management are available for primary care physicians but are often under utilized.

Via an engaging and interactive case study, this course seeks to train physicians to effectively coach their patients toward positive stress management choices. The case study takes place over several office visits with each encounter presenting a common stress related problem.

NUMBER OF CREDIT HOURS: The Harvard Medical School designates this educational activity for a maximum of 1 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

COST: $20.00
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OVERALL LEARNING OBJECTIVES:

1. Train physicians to effectively recommend stress management and lifestyle medicine interventions for their patients.
2. Assess key issues in the patient’s presentation.
3. Identify current positive and negative lifestyle factors influencing an individual’s response to a significant stressor.

CLINICAL LEARNING OBJECTIVES:

1. Identify screening tools for common psychiatric disorders that may present with stress-related symptoms.
2. Understand the significance of negative coping mechanisms and their implications for treatment planning.
3. Formulate appropriate initial and long-term behavioral treatment plans.
4. Review the role of pharmacological treatments in stress management.
5. Understand and identify significant patient adherence factors in lifestyle and behavior interventions.

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EDWARD M. PHILLIPS, MD Course Co-Director

Edward M. Phillips, MD, is Assistant Professor of Physical Medicine and Rehabilitation at Harvard Medical School. He is Director of Outpatient Medical Services of the Spaulding Rehabilitation Hospital Network in Boston, Massachusetts. Dr. Phillips’s clinical and academic work at the intersection of exercise physiology and mental health spawned his interest in Lifestyle Medicine. He is founder and director of The Institute of Lifestyle Medicine in the Department of Physical Medicine and Rehabilitation at Harvard Medical School, www.instituteoflifestylemedicine.org. Additionally, Phillips serves on the American College of Sports Medicine task force that has initiated and developed the Exercise is Medicine™ program. His book on the topic, Exercise is Medicine™, The Clinician's Guide to the Exercise Prescription will be published by Lippincott, Williams and Wilkins in early 2009. DISCLOSURE:

CHRIS STEWART-PATTERSON, Course Co-Director

Dr. Stewart-Patterson has practiced Occupational Medicine since 1989. He provided occupational medical services to multiple employers including Royal Canadian Mounted Police and Canadian Armed Forces among other organizations. Dr. Stewart-Patterson has provided stress assessment and treatment services to employees in high stress vocations such as enforcement personnel and corporate executives. He has written extensively on stress for the public and has provided stress management program services to both corporations and government. He provides psychiatric and substance use disorder evaluations for safety sensitive employees such as police, fire fighters, correction officers, sheriffs, coast guard and railway personnel. He has frequently instructed for the American College of Occupational and Environmental Medicine and Harvard Medical School Dubai Center lecturing on occupational psychiatric and substance use disorder assessment. Dr Stewart-Patterson is a clinical instructor in the Faculty of Medicine, University of British Columbia and an honorary senior clinical lecturer in occupational medicine at Wellington School of Medicine, University of Otago. DISCLOSURE:

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ERIC LESKOWITZ, MD, ABHM Reviewer

Eric (Rick) Leskowitz MD, ABHM is a consultant psychiatrist to the Pain Management Program at Spaulding Rehabilitation Hospital in Boston. A board-certified psychiatrist, he holds appointments with the Departments of Psychiatry at Harvard and Tufts Medical Schools. He has studied energy healing, meditation and hypnosis for over 20 years, and has presented workshops nationally and internationally on the integration of subtle energy techniques and theories with the allopathic medical model. He serves on the Advisory Boards of three journals, and has written widely for medical and lay journals; a collection of his papers entitled Energy Medicine: The Dynamics of Subtle Energy in Health and Disease is available from the author. He has also edited two textbooks: Transpersonal Hypnosis: Gateway to Body, Mind and Spirit (CRC Press, 2000) and Complementary and Alternative Medicine in Rehabilitation (Churchill Livingstone, 2003). His documentary film, “The Joy of Sox: Weird Science and the Power of Intention” is now in production. DISCLOSURE: No Disclosures

SUSAN PARKS, PHD Reviewer

Dr. Parks is a Harvard trained clinical psychologist and neuropsychologist and works as a clinician and post doctoral neuropsychology training director at McLean Hospital. She completed her graduate work at the University of Pittsburgh. She has a private practice offering psychotherapy, evaluation and personal coaching services to people with a wide variety of needs. Dr. Parks has special interests in healing and motivation through personal coaching. In 2006 she traveled through India with a Lifestyle Medicine Conference serving as a Harvard Medical School faculty member. She taught Indian health professionals about the power of using the principles of personal coaching and Cognitive Behavioral Therapy in their practice to motivate patients to lead healthier lives. Dr. Parks is on the Advisory Board of a newly formed nonprofit organization, There and Back Again: Navigating life after war, a privately funded group offering reintegration support services to veterans of Iraq and Afghanistan. DISCLOSURE:

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NUMBER OF CREDITS: 1 

Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Harvard Medical School designates this educational activity for a maximum of 1 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Upon completion of the course you will get a certificate via e-mail within 2 weeks.

Click the image to view a sample of the certificate

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