The following article is a part of conference coverage from the American Psychiatric Nurses Association (APNA) 34th Annual Conference, held online from September 30 to October 4, 2020. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading nurses in psychiatry. Check back for more from APNA 2020.

 

Application of complementary, alternative, and integrative medicine (CAIM) may allow psychiatric mental health nurses (PMHNs) to help improve patients’ stress resiliency and enhance their mood regulation, according to research presented at the American Psychiatric Nurses Association (APNA) 34th Annual Conference, held online from September 30th to October 4th, 2020.

As a complement to best-practice recommendations, author Wendi Koonce Morse, DNP, PMHNP-BC, APRN-C, FNP, reviewed current practices in addressing patient-centered mental health recovery as well as the model guidelines provided by the Federation of State Medical Boards (FSMB) and the National Center for Complementary and Integrative Health (NCCIH) for utilizing CAIM. The researcher considered the use of evidence-based CAIM therapies to complement current practices regarding whole medical systems, biologic supplements, lifestyle factors, variable energies, and mind-body therapies.

Current recommendations from the FSMB for prescribing CAIM include situations in which safety and efficacy research has been published, customary diagnostic procedures have been followed, and informed consent has taken place for documentation in the patient’s medical record. In the case of an acute, severe, or life-threatening illness in which a delay in conventional treatment could result in harm, CAIM should not be offered. When using botanical supplements, it is key to initiate therapy at lower doses before up-titration and to monitor for drug-drug interactions, noted the author.


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A CAIM Assessment Initiation protocol outlines the correct steps the clinician should take before initiating any CAIM therapies. These include questions such as “Is the patient suicidal and/or using or abusing substances?” and “Has the patient tried conventional therapies and been unsuccessful?” The clinician then should determine whether the implantation of CAIM is responsible.

In a second simulation, CAIM for depressive disorders is outlined; examples include exercise and vitamin D for mild cases, psychotherapy for moderate cases, and selective serotonin reuptake inhibitors and psychotherapy for severe cases. Patients with anxiety may benefit from qi gong (also known as chi kung), a form of yoga, and meditation, and those with insomnia should use melatonin, breathing exercises, and lemon balm.

“Health is not linear, and few individuals with altered mental health experience only one psychiatric symptom,” the researcher provided in a purpose statement. “Appropriate, cost-effective, and evidence-based practices can integrate lifestyle behaviors, consumer preference, demand, and keep with the advances in information technology.”

Visit Clinical Advisor’s meetings section for complete coverage of APNA 2020.

Reference

Koonce Morse W. Medication may not meet my needs: unveiling mysteries behind complementary, alternative, and integrative medicines in psychiatry. Presented at: APNA 34th Annual Conference; September 30-October 4, 2020. Poster 85.