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2016 Conference Presentations

Table of contents


Thursday August 18 Preconference

Full Day Workshop

FxnMed4US - Functional Medicine for the Underserved

Arti Chandra MD, Kara Parker MD and Connie Basch, MD
Chronic disease has exploded in epidemic proportions across the developed world. Disease states labeled as diabetes, hypertension, depression, ADHD, chronic fatigue, fibromyalgia and autoimmune diseases, to name a few, have increased exponentially in the last century. The current conventional medical model of medicine does not provide the tools needed to diagnose, reverse and heal chronic disease.
Functional medicine provides a conceptual paradigm which both subsumes and enhances our current system of disease classification and understanding. It is a cognitive approach which emphasizes identification of underlying imbalances and their correction as opposed to conventional medicine’s emphasis on symptom suppression. Often seen as requiring numerous expensive and esoteric laboratory tests and supplements, in fact the tools of functional medicine are very applicable to underserved populations, who often gain tremendous benefits from simple interventions. In the long run, identifying and correcting underlying issues is much less expensive than trying to control their downstream sequelae. Tools which will be reviewed include:
  • Sidney Baker’s Rules of Tacks
  • The Antecedents, Triggers, and Mediators Model
  • The Functional Medicine Timeline
  • The Functional Medicine Matrix
  • Food First and lifestyle approaches to addressing imbalances in digestion, inflammation, detoxification, and energy production
  • Low cost and accessible “kitchen herbs” and strategies for obtaining lower-cost dietary supplements for your patients
  • Group medical visits as a strategy to facilitate the patient education required for this approach
Concrete patient cases will be used to demonstrate this approach. A CD with useful materials (recipes, forms, handouts) will be provided.

Morning Presentations

Advanced Group Medical Visit Facilitation and Management

Jeff Geller, MD
Group Medical Visits are growing rapidly as a mechanism to provide medical care. They particularly excel at treatment of chronic illness and conditions, while addressing mental well being. Often group medical visits have more time for participants to freely exchange ideas and best practices. Groups need good facilitation to help participants feel engaged and connected to one another. We will be sharing some facilitation basic and advanced skills to help groups flourish .

Nervines for Body Mind &Spirit: Materia Medica and Clinical Applications and Bitters & Carminatives: The Art& Science of Herbal Digestive Aids

Ingrid Bauer, MD, MS and Benjamin Zappin, LAc
Nervines refer to a broad range of herbs that act on the nervous system. This workshop will introduce participants to the major Western "herbal action types" as well as basic concepts of qi-regulating and shen-calming from Traditional Chinese Medicine. It will then dive in to explore approximately 12 common herbs, their pharmacology, applications, and relevant evidence-base in scientific literature. It will conclude with a discussion of formulations to address common nervous system and mental health conditions.
It is commonly proposed that bitters stimulate digestion by increasing gastric secretions, and that carminatives alleviate gas and bloating. But can we improve upon our understanding of how these herbs actually act upon the gastrointestinal system? In this class we will briefly review the physiology of the gastrointestinal system, comparing and contrasting Western biomedical and folk perspectives. We will then explore traditional and scientific perspectives on how bitters and carminatives affect the body, including digestive, hepatic, cardiovascular, and nervous system function, and how we can use organoleptics and biochemistry to help understand individual herbs’ actions. Specific herbs as well as formulas and culinary strategies for treating common GI problems will be explored through tasting and discussing clinical cases.

Healing Community Trauma with Acupuncture

Carla Cassler, DAOM
Unresolved psychological-emotional trauma is often at the root of physical and mental illness experienced by people in underserved communities. The trauma stems from experiencing life-threatening events, such as natural disasters, sexual violence, torture, or physical abuse. It can be passed through generations, leading to significant suffering for individuals, families, communities and nations. People cannot heal unless their brains and nervous systems are able to handle the processing of trauma. Acupuncture is a somatic treatment that can help achieve this along with psychological support and processing. This workshop prepares acupuncturists, MD acupuncturists, and other health professionals to provide community style ear acupuncture for people affected by trauma. with a goal of reducing and preventing post-traumatic stress.

Afternoon Presentations

Mind Your Pain

Jill Frank, FNPC and Robert Laguna, MSOM, L.Ac
This presentation will offer participants the opportunity to experience the Living Well with Pain model as developed by the Seton McCarthy Community Health Center, AOMA Graduate School of Integrative Medicine and other members of the Austin community. This is a shared medical visit format for delivery of pain related education, mindfulness and movement practices by patients willing to utilize self- management strategies. Methods will include the NADA protocol, qigong, mindfulness exercises and shared experience discussion. The aim is to optimize and balance long term opioid management with self-management strategies, improve functional outcomes with decreased ER visits and hospitalizations related to ineffective chronic disease management.

Herbal Medicine and Somatic Practices for Stress, Trauma and Resilience

Larken Bunce, MS, Herbalist
While stress and trauma often lead us to mistrust or abandon our bodies out of fear, pain or overwhelm, it is our bodies that remember--even the stories long-buried by our psyches—and so, it is to our bodies that we must return. A felt sense of physical and emotional safety, of being at home in our skin, is necessary for all other healing to take place, and yet is not present for many of us. Herbs and somatic practices pair powerfully in addressing the dysregulation of the nervous and endocrine systems, while also attending beautifully to the emotional and spiritual realms of stressful and traumatic experiences. Join me for this extended follow-up to last year's brief presentation to deepen your understanding of the pathophysiology of stress and trauma and the effects these have on our various body systems, perceptions, and behaviors. Drawing on psychophysiology, pharmacology and traditional energetic systems, we’ll explore the role herbs can play in modulating the stress response, as well as healing and even preventing further trauma. Simple, broadly applicable and teachable somatic practices will also be shared, along with rationale and indications. You’ll leave with personal experience with the somatic practices, highlighting the need for practitioners to address their own healing and resilience, first and foremost.

An Integrative Wellness Model within a Federally Qualified Health Center - Virtual Tour and Seminar

Connie Earl, DO, Chris Perkowska, PA, CNM, Mary Szecsey, Natalie Dwyer
The Forestville Wellness Center is an independent site among the West County Health Centers (WCHC), a collection of community health centers in west Sonoma County, CA, and a Federally Qualified Health Center (FQHC). We provide only integrative medicine and group visits to the patients of WCHC, primarily Medicaid and Medicare patients. We offer medical acupuncture, Chinese medicine, Osteopathic manipulation, Integrative Health Consults, Western Herbalism, Ayurvedic Medicine, NAET, HeartMath, among other therapies, to our patient population, as well as myriad groups with the purpose of improving nutrition, increasing movement, developing stress management skills, and addressing addiction. In today’s half-day workshop, we will take you on a virtual tour of our clinic, and take you through our services, which are provided by both billable and non-billable providers. We will share our experience with you, and give time during the sessions for you to work on your own Wellness Programming plan. We will take you through our budget and demonstrate how we were able to exceed our productivity goals for the 2015 fiscal year, as well as share some of our tools for programming, group planning, and budget-making. In addition, we will demonstrate an alternative model of productivity as it applies to our wellness center within an FQHC. We will be joined by our Executive Director, Mary Szecsey, who will address administrative support for Wellness Programming.

Friday August 19 Conference Day 1

8-9 am Plenary

Beyond Collective Impact: Why Collaboration?

David Gibbs

9:15-10:15 am Breakout Sessions 1

Quick and Simple Functional Clinical Pearls for Use in an Underserved Community

Hansie Wong, MD
The gut is responsible for 70% of the body's immune function. Therefore, achieving and maintaining gut health is important for overall health and wellness. This presentation will review ways in which poor gut health and absorption may manifest clinically, take a simple functional approach to evaluate gut health, and discuss cheap and easy “alternative” ways to heal the gut in an underserved population. You will learn clinical pearls for using food, diet, and nutrition as medicine for specific conditions. In particular, time will be spent discussing the many benefits of using magnesium as an adjunctive or primary therapy for common complaints.
The clinical pearls and tips discussed will be applicable to the underserved population, requiring little to no extra cost of elaborate testing or expensive supplements.

Integrative Health Coaching: Working Toward Meaningful Behavioral Change in Underserved Communities

Priscilla Abercrombie, RN, NP, PhD
The purpose of this session is to discuss the role of the integrative health coach in promoting health and behavior change in underserved communities. We will explore what integrative health coaching looks like –based on a 4-stages model. An example of a high-level integrative health coaching program will be presented, including educational competencies, training strategies, and ensuring skill attainment through various assessments. During this session the participants will observe health coaching in process and have an opportunity to create their own goal for self-care.

Acupuncture and Trigger Point Dry Needling: Effective, Low-Cost, Low-Risk, Low-Tech Treatment for Myofascial Pain

Jonah Hershowitz, LAc
Myofascial pain is an extremely prevalent, often overlooked, cause of acute and chronic pain for which conventional treatment options are inadequate, entailing significant costs and risks, and demonstrating poor long-term efficacy. For marginalized populations, even these treatment options for pain are often not available. Untreated myofascial pain often causes chronic pain, and sets into motion a downward spiral that adversely affects sleep, physical activity, and overall quality of life, frequently leading to depression and substance abuse.
Acupuncture and trigger point dry needling offer low-risk, low-cost, effective methods in the treatment of myofascial pain that require minimal material resources, and lend themselves to mobile or temporary treatment settings. This presentation will demonstrate why acupuncture and trigger point dry needling are ideal methods to treat myofascial pain in underserved communities, and will explain the methods and mechanisms of action, as well as explore ideas for implementation in free and low-cost clinical settings.

Latino Herbal Medicine: Traditional Use, Safety and Efficacy

David Kiefer, MD
The use of dietary supplements, including herbal medicines, vitamins, and minerals, is common in the United States across all demographics. Our work with Latinos in Madison, Wisconsin, found, in agreement with national studies, a higher incidence of use of herbal medicines than the general population. Focus groups yielded 199 minutes of audio recordings and the mention of 57 medicinal plants. These plants were obtained from gardens, acquaintances, mail order, and ten retail sites, the latter selling 20-150 products per site including medicinal foods. Participants mentioned 35 distinct health and disease categories for which herbal medicines were used, and rarely discussed plant use with their health care provider. When compared with likely Latin binomial taxonomic names, clinically-relevant confusions with the use of common plant names were also identified. The non-disclosure mentioned above, when interfaced with results from national surveys about plant-pharmaceutical interactions, creates a situation of potentially unsafe combinations. Offshoots of these results include the importance of correct plant identification, cross-culturally sensitive clinical approaches, and cross-checking herbal and pharmaceutical use such as through thorough documentation in an electronic medical record. This presentation will also review a sister research site in Ecuador, and related literature, to illustrate the important changes that occur with traditional healing systems in the process of immigration, another factor to be considered as clinicians work with this demographic.

My Experience as an Oncology Nurse

Sangeeta Agarawal
An engaging talk will be given regarding speaker Sangeeta Agarawal’s experience as an Holistic Oncology Nurse. During her time as an Oncology Nurse at The Mayo Clinic, Stanford Hospital, and UCSF Hospital, Sangeeta was able to apply Holistic Medicine principles which allowed her to provide a level of supportive care on top of her oncology care. Her supportive care included patient symptom management, patient education, and in providing emotional support to patients and their families. During her talk, Sangeeta will recount some of her experiences and close with how a Holistic outlook can be applied to other areas of medicine. She will lay out a framework for the instances where various types of Holistic practices such as mindfulness, massage, reflexology, aromatherapy, diet and lifestyle guidance, and music therapy can be applied. She will also discuss the areas to watch out for, the areas to avoid, and the key points to remember when collaborating with a patient’s provider team. During this talk, she will share valuable resources that you can use to understand your patient’s condition so that you can make an informed decision when caring for your patient.

Research Presentations

  • Acceptability of a Mindfulness Based Intervention for Depression Among African-American Women in a Federally Qualified Health Center
Inger Burnett-Zeigler, PhD
  • Improving Cardiovascular Outcomes among Overweight/obese Latino Cancer Survivors using a Culturally Tailored Yoga Program: Preliminary Findings from a Non-Randomized Pilot Study
Bruriah Gutierrez, MeD

10:30-11:30 am Breakout Sessions 2

Your Gut Microbiome: Why and How

Arti Chandra, MD, MPH
Approx. 70 million Americans have digestive problems, prompting nearly 600 million office visits to clinicians for these concerns. There is a burgeoning amount of clinical research indicating that a healthy gut microbiome is a fundamentally critical component of maintaining digestive health as well as overall health. A disturbed gut microbiome has been implicated in IBS, IBD, GI cancers, Diverticulitis, as well as a host of non GI conditions such as Autoimmune Disease, Mental Health Disorders, Dermatologic issues, Atopic Disease, and numerous other conditions. The speakers believe that it is imperative for clinicians and health educators to understand the importance of the health of the gut microbiome to overall health and learn how their decisions can play a role both in promoting disturbances in their patients’ gut flora and also in supporting the growth of beneficial flora. This workshop will include instruction and a demonstration of techniques of in home preparation of fermented foods.

Health Coaching for the Underserved: Case Reports from San Francisco

Meg Jordan PhD, RN, CWP
Integrative health/wellness coaching offers a compassionate and effective intervention for under-represented, marginalized and underserved populations for better management of chronic conditions and general improvement of health-related choices and sense of well-being. However, due to lack of Medicare/Medicaid reimbursement, health coaching has primarily been an out-of-pocket or employer-sponsored activity for those with means and education to pursue it. This presentation reports the findings of a peer-reviewed, published case report, based upon an Aetna Foundation grant, that brought integrative wellness coaching (IWC) to homeless and low-income individuals. The project was undertaken to assess the feasibility of the health coaching model and general responsiveness of the individuals and families who received it. The IWC model is taught within the M.A. degree program in Integrative Health Studies at the California Institute of Integral Studies, an approved program of the National Consortium for Credentialing Health and Wellness Coaches.

How to improve chronic pain care

Sandra Gordon, B.Sc., CEC
Use of prescription painkillers has soared by nearly 400 percent in the past 15 years, yet there has not been an overall change in the amount of chronic pain reported from over 100 million Americans. Stigma for both patients experiencing chronic pain and providers treating pain hinders care in this critical area. We need a new chronic pain care model that places the patient at the center of a personalized, tailored, integrated multi-disciplinary model of self-care and directed care drawing upon all available evidence-based modalities to relieve pain and improve function.
Methods:
In 2015, Samueli Institute conducted a Chronic Pain Breakthrough Collaborative, a learning and action community designed to accelerate education and widespread implementation of best practices in interdisciplinary care for chronic pain. Leading providers in civilian, military and veteran healthcare to addressed four components of chronic pain care: 1) integrative care delivery, 2) patient self-efficacy, 3) reliable systems and processes, and 4) a sustainable business model.
Results:
Participants reported a decrease in the number of patients relying on opioids for chronic pain, an increase in the number of patients using non-pharma and self-care therapies for pain, and an increase in quality of life and patient function. Additionally, improvements in staff communication, multi-disciplinary teamwork and collaboration were reported.
Discussion:
Participating health care leaders illustrated positive change tangibly, with a shared belief that we cannot wait for reimbursement and regulation to catch up to the reality of the over 100 million people who are suffering with chronic pain.

The use of medical cannabis in the treatment of chronic pain

Harry McIlroy, MD
The use of medical cannabis to treat a variety of conditions has been evolving rapidly. While cannabis has long been used as a patient preferred means of self-treating pain, it has emerged as an effective medical treatment for chronic pain, with numerous advantages including: Effective reduction of pain, harm reduction due to decreased reliance on narcotic drugs, flexibility in dosing and delivery methods that improve patient autonomy and self-efficacy in the treatment of their chronic pain.

The Art of Medicine - Developing Therapeutic Presence

Onna Lo, MD, ABIHM
Based on the Osteopathic paradigm that our body is self healing and self regulated, we can use Therapeutic Presence - a provider's ability to hold a healing space for another person, to empower the patients to tune into their own self healing process.

Beyond Food Access: Advancing a Food Systems and Equity Agenda

Jamie Harvie
Beyond Food Deserts - Advancing a Just, Equitable Food System Agenda
Food access is an important consideration for vulnerable food insecure populations. Food access is often defined through a geographic definition by terms such as food deserts. Yet, access is more than geographic and includes culture, influence of marketing, transportation, affordability and other systemic drivers. A variety of studies help us understand the urgency and necessity of a systems approach if we are to successfully advance a just, fair and healthy food system. Thus, as we advance short term strategies to support geographic access to healthy food we must also use a systems lens to secure a long term sustainable and just food system. This presentation will highlight the United Nations "Right to Food", Institutes of Medicine 2015 Food System report, Good Food Purchasing Pledge and various campaigns, tools and strategies that will enable participants to contextualize and catalyze a just and fair food system.

11:30-12:30 pm Lunch/Plenary Single Payer Health Care: An Integrated Delivery System

Bill Skeen, MD, MPH

12:45 - 1:45 pm Breakout Sessions 3

Functional Approaches to Chronic Pain Management

Connie Basch, MD
Functional Approaches to Chronic Pain Management
Chronic pain is a growing and challenging problem in our culture, and the traditional tools for treatment of pain, in particular the opioids, cause a host of secondary problems. On the other hand, the “just say no” approach leaves many patients without relief for their suffering.
Fortunately, functional and Integrative medicine offer some unique tools for addressing these problems, identifying underlying imbalances and treating the whole patient. This presentation will present pearls gleaned from 10 years of caring for hundreds of people living with chronic pain, with many suggestions for implementing these approaches in low-resource settings. Topics covered will range from identification of underlying and treatable causes for chronic pain, to nutritional and exercise tips for people living with pain, to specific mind-body tools and resources for working with the trauma and stress that fuel these symptoms in so many of our patients. The emphasis will be on specific and useful materials, including helpful mnemonics, curriculum for group visits on chronic pain, patient handouts, etc.

Increasing Access to Integrative Cancer Care in a Cancer Center

Ana Maria Lopez
Access to integrative medicine services for cancer patients remains a challenge. Barrier include lack of integration with other time-intense cancer care services, physical distance from the cancer center, cost of integrative services, lack of insurance reimbursement for integrative care, and lack of cancer treatment culture acceptance of integrative services. In this presentation, we will outline our experience with integrative integrative medicine services within the Huntsman Cancer Institute of the University of Utah Health Sciences. We will describe our process of integration, the barriers and facilitators, our experience with solutions, and the development of data collection and assessment to evaluate our efforts consistently and comprehensively.

Building Communities of Support for Extreme States of Consciousness: Involving Integrative Medicine in Spiritual Dimensions of Psychosis

Dina Tyler
Can mental health crises called psychosis be transformational? How can Integrative Medicine illuminate the trauma and spiritual aspects of what so often gets labeled as schizophrenia or bipolar during a mental health crisis? The presenters combine years of clinical work with individuals diagnosed with psychosis and their families, as well as having their own personal journeys of recovery, which inform how they work with clients. They will share how they have created supportive communities for people who experience voices, visions and different realities and how these communities reduce distress associated with symptoms, decrease reliance on hospitals and medication, and improve outcomes such as returning to school and work. They will share a community-building model for how Integrative Medicine Practitioners can become involved in supporting the mind, body and spirit of individuals given a psychiatric diagnosis.

Principal Plants in Herbal First Aid

7song
There are a number of therapeutic categories commonly seen in first aid situations, including, inflammation, pain, infection, and trauma. This class will cover some common and useful plants from these categories such as antispasmodics, anodynes and antimicrobials to give the participants practical tools for these circumstances. Some of the plants included are Willow, Valerian, Skullcap, Eyebright, Propolis, Licorice, Lobelia and others.

Telemedicine Mind-Body Group Therapy in a Public Mental Health Setting: Efficacy, Acceptability, and Best Practices

Chanel Heermann, MD
Telemedicine is becoming an increasingly common solution to issues of mental health service access in many areas. This lecture will discuss a small-scale demonstration project, which was designed to investigate telemedicine as feasible and acceptable means of delivering group therapy services to underserved communities. Our presentation will highlight our experience delivering the 7 Foundations of Health and Happiness (7FHH), a mind-body medicine skills group, via telemedicine. Outcomes discussed will include the Arizona Integrative Outcomes Scale (AIOS), and the overall mental, physical, and spiritual health measures, using the Mental, Physical and Spiritual Well-being Scale (MPS), as well as qualitative feedback from the participants and the facilitator. An overview of “lessons learned” from our project will be presented. In it, we will offer suggestions for best practices pertaining to technology, logistics, and group process, and possible accommodations for the needs of a public mental health population, especially those patients with chronic mental illnesses. Discussion and contribution from participants is welcome. Our hope is to contribute to the ongoing development of best practices in this emerging field.

Hepatitis-Cure: Efficient, Patient-Centered, Holistic Group Visits to Optimize Health Beyond the Liver and Cure Hepatitis C

Fasih Hameed, MD
Chronic Hepatitis C is rampant in underserved communities. The development of direct-acting antivirals has revolutionized treatment. To accommodate the increased demand for treatment, the Petaluma Health Center, an FQHC, designed and successfully implemented a whole-person based group visit model of education, screening, treatment and longitudinal oversight for it's HCV positive population. The program was developed in cooperation with the local coalition of health centers and managed medicaid (Partnership Health Plan) and serves as a model for efficient and effective treatment of chronic Hepatitis C. The multidisciplinary team that developed and oversees the program includes a medical assistant, nurse, two nurse practitioners, referral specialist, and a single prescribing physician. The program relies on active population-based management to prioritize treatment for the sickest patients first but the success of the model has allowed us to open treatment to all patients including the uninsured. The group format allows us to spend a significant amount of time on education around liver-specific as well as general health issues and introduce holistic ways of supporting a person through the transition to renewed health.
In this presentation we will review the Integrative treatment of Hepatitis C. We will discuss the broad-reaching implications of this widespread disease, whose impact is felt far beyond the liver. We will outline the group visit cohort model of treatment and present data from our first 1.5 years. We will discuss population-based management and non-invasive fibrosis evaluation. We will guide attendees through the steps needed to establish similar programs in their home institutions.

2 - 3 pm Breakout Sessions 4

Functional Medicine based Group Visits for the Underserved

Kara Parker, MD
Health statistics show that over 80% of chronic illness is caused by stress, and modifiable by lifestyle. The expansion of Medicaid and ACA are showing that caring for the burden of chronic disease in the underserved is challenging and expensive. Unfortunately, standard medicine treats and bills for downstream care. Underserved patients often lack access to education and support to improve their health at its foundation. Functional Medicine based group visits offer a maximized solution to empower patients to understand and “re-write the story” of their health through a systematic, supportive model.
In this talk in a hands on format we will:
-Offer a structure and “how-to” for Functional Medicine, personalized Lifestyle GV in an underserved population that can be utilized by participants immediately in their practices.
-Share the evidence for important nodes in FM Timeline, Lifestyle and matrix and how they are digested into understandable concepts for a low health literacy population to improve health over time in the context of a supportive, non-judgmental environment.
-Offer resources and practice in mind body and movement exercises that can accompany each GV topic.
-Give ideas and recipes for snacks to accompany each GV session.
-Teach a method of the FM Timeline that includes patient’s owning and re-writing their health history, and future.

Ayurveda in a Community Clinic setting

Chris Perkowska
Ayurveda is a very old system of medicine, born in India, and it is currently in a resurgence of popular use in our culture. Ayurveda is constitutional/elemental medicine and strives towards balance of the elements in the body for greater wellness.
Our community has had a school of Ayurveda for over 20 years, and therefore a culture of Ayurveda exists amongst some of our population. Our integrative medicine clinic, a specialty clinic part of a primary care clinic system located north of San Francisco, has had Ayurveda consultations available for the past 3 1/2 years. This year we started offering group visits for patients to provide them with a deeper understanding of basic concepts in Ayurveda.
This session will introduce Ayurveda in its most basic form. It will explain the evolution of how we incorporated Ayurveda into our clinic. It will also give participants some concepts of self care remedies to use with their own patients back at their own clinics.

Harm Reduction Approaches to Psychiatric Medication: Using Integrative Medicine as an Alternative Way to Support Mental Health

Benjamin Zappin, LAc and others
This panel of consists of experts who work with people who choose alternatives to the use of psychiatric medications for dealing with mental health issues. Ben Zappin is an acupuncturist and herbalist in Oakland, CA who uses integrative medicine to assist people struggling with emotional and spiritual distress. Dr. Judith Pentz is a Integrative Psychiatrist in New Mexico, who incorporates various modalities including orthomolecular, nutritional options, homeopathy, targeted amino-acid therapy, breathing techniques and meditation, in her work with individuals given a psychiatric diagnosis. Will Hall, DiplPW is an internationally recognized therapist, trainer, advocate and author who wrote the “Harm Reduction Guide to Coming Off Psychiatric Drugs,” and has presented about coming off medications around the world. Dina Tyler is a peer specialist who shares her personal lived experience of the mental health system and alternative approaches with underserved populations in Alameda County, California.

Preconception Care in Underserved Populations: Blueprint to a Healthy Start…and Future

Abigail Aiyepola, ND
Infant and maternal mortality are disproportionately higher in certain populations across the globe. Research has established certain critical periods of development as important considerations related to improved birth outcomes. This course will explore some of the trends related to these statistics, and consider ways in which specific targeting of preconception and fertility awareness programs towards these vulnerable populations may perhaps serve to mitigate or even solve some of the disparities we find within our global healthcare systems.

Breema, The Art of Being Present

Karen Burt-Imira, MD
Breema uses touch and movement based on the body's natural mechanics and rhythms to create a comfortable and balanced experience which is relaxing, nurturing and energizing for both giver and receiver.
Breema uses bodywork, self-care exercises, body-centered meditation, and the Nine Principles of Harmony to foster a tangible connection between mind and body—enabling us to experience being present in our body. This experience supports our ability to become present in any activity of daily life, and becomes the foundation for living in greater connection and harmony within ourselves and with others.
Self-Breema exercises are short and easy to learn. Requiring no special attire or equipment, they can be done at any time to calm and refresh mind, body, and emotions. Simple Breema bodywork can be offered in a clinical setting to patients/clients and co-workers to relax and rejuvenate them and ourselves, or to friends and family members as a mutually supportive and nurturing activity. The Nine Principles of Harmony can be applied in any situation to support tension and stress release, to let go of reactive emotions and see a bigger picture, to help open our hearts to others with well-wishing and compassion, and to move from a scattered to a more focused and clear mind. In short, we become more present in life, and this offers us the possibility of discovering new dimensions of relationship, health and well-being.

It’s About Resilience: Building Personal, Community, Organizational and Societal Resilience

Michael Bennett, NP
In this age of uncertainty, dominated by distractions and distorted debates about apparently controversial issues, like climate change, wealth and income inequality, and an inefficient, expensive and unjust sick-care model, we can’t help but wonder how resilient we really are as a species. An obscure 1970s design science may provide some surprising guidance for building a healthier, more resilient society. This workshop will provide an overview of Permaculture while re-framing our historical context, illustrate examples of resilience, and engage participants in a health-focused Resilience Assessment and Planning exercise for individuals, communities, organizations, and ultimately for society.

3:15 - 4:15 pm Poster Session

4:15 - 4:30 pm Quick IM Activity Self-Massage

Hansie Wong, MD

4:30 - 5:30 pm Plenary Integrative Treatment of Infectious Disease in Underserved Populations: Insights from Three Decades of Researching and Treating A.I.D.s. H.I.V., and Hepatitis C

Misha Cohen, OMD, LAc

Saturday August 20 Conference Day 2

6-7 am Morning Activity: Introduction to Taichi

Hansie Wong, MD
Taichi is an ancient Chinese martial art that exercises the mind and body through slow movements. Practicing taichi regularly can improve balance and coordination, increase energy and stamina, reduce stress, and calm the mind. This workshop will go over the fundamental taichi principles. Participants will have the opportunity to put these principles into practice and learn two basic taichi movements.

7:30 - 7:45 am Opening Remarks Jeff Geller MD

7:45 - 8 am Quick IM Activity: How to Get Unstuck

Chanel Heermann, MD
The Center for Mind-Body Medicine has been teaching a “Shaking and Dancing” active meditation to their practitioners for years, and now we are bringing this simple, effective technique to IM4US. It’s a great way to get “unstuck” – either “shaking loose” mental blocks and worries, or releasing tension held in the body.

8 - 9 am Plenary Addressing Community Health Through the Development of Community Leaders

America Bracho,MD, MPH

9:15 - 10:15 am Breakout Sessions 5

Somatic Complaints in the Primary Care Setting

Elena Rosenbaum, MD
Chronic somatic complaints are frequently seen by primary care physicians. For example, low back pain, headaches and neck pain are among the most common reasons patients seek medical care. Biomedical paradigms emphasize treatment of low back pain and other somatic complaints with medications, physical therapy or modalities that target the localized complaint. Analgesics are the most often prescribed drug class (11.4%) of all medications (CDC National Ambulatory Medical Care Survey 2012). This same study noted that only 1% of all ambulatory visits mentioned stress management as a treatment strategy and only 0.7% of the visits made CAM recommendations despite the fact that psychotherapy and CAM modalities such as acupuncture and osteopathy are included in the Joint Commission pain management standard (PC.01.02.07 Nov 2014). Many chronic somatic complaints are caused by as psychophysiological mechanisms, and the traditional biomedical approach to these has limited effectiveness. This session focuses on an integrative approach to somatic complaints in an underserved primary care setting. The goal of the session is to discuss strategies for evaluation and management that are affordable and possible to implement in an underserved community.

Transforming your 15-minute visit with Mind-Body Medicine

Anuj Khattar, MD
Often times health care providers feel rushed by the time demands of a short clinical visit in a busy and undeserved clinical setting. Mind-body medicine can feel less important than other issues that both the provider and patient want to address during the limited time together, however mind-body medicine can be an important tool to help focus and deepen a clinical visit. This is especially pertinent with patients from underserved backgrounds who experience high levels of social stress and often lack healthy stress management skills. This presentation will review the physiology and importance of mind-body medicine and bring forth ideas and methods of implementing these ideas in a busy clinical practice.

Assimilating Integrative Medicine within the Education System

Sanaz Demehry, PA-C, MS
The education system is a tool that can be used to reach children within communities, including the underserved. The various components of Integrative Medicine (IM) can be woven within schools to educate, inspire and pave the path for better health. An empowering instrument with great potential to prevent illness, manage common medical conditions, expand compassion, and create a healthier society that is aware and in charge of their health. Planting the seeds of the different components of IM: nutrition, mind-body, herbal supplements and environmental toxins in the youth has the potential to decrease health care utilization, heath care costs and prescription drug use among children. The result is the positive ripple effect in the health system and underserved communities that will pay forward for future generations.

An Osteopathic Approach to Headaches and Integrating Essential Oils in the Clinic Setting

Josephine Conte, DO
The osteopathic model is a philosophy founded in 1874 by A.T. Still, MD that treats the whole person: body, mind and spirit. We recognize that structure and function are interrelated. The body has self healing and self regulating mechanisms and rational treatment is based on the prior three principles. Aspects of headache treatment distinctly osteopathic will be addressed here.
Aromatherapy is the use of essential oils, all of which are derived from plants. The judicious application of essential oils can enhance manual treatment, can calm the nervous system and add a dimension of beauty to the clinic room. This session is designed to share one way a family medicine residency is treating the underserved in a rural clinic setting while integrating multiple modalities to promote wellness primarily through stress reduction.

Direct Care, Education, Research and Partnerships: Anatomy of a Comprehensive Integrative Medicine Program at a Community Clinic

Myles Spar, MD, MPH
In 2006, the Venice Family Clinic, then the largest free clinic in the United States, established a multidisciplinary health, wellness and Integrative Medicine program. Housed at the renamed Simms/Mann Health and Wellness Center, this program has continued to grow to include direct patient care from practitioners of multiple modalities, IRB approved research studies, education of students from various health science programs and self-care programming for providers. This workshop will break down the program explaining the structure, partnerships and finances to enable participants to take all or part of this model back to their home clinics. Assessment tools and MOU’s will be shared with participants.

Research Presentations

"A Fruit and Vegetable Prescription Program at a Federally Qualified Health Center Decreases Hemoglobin A1c among Low-income Diabetics" (Richard Bryce, DO)
"Composition of Integrative Medical Group Visits (IMGV) Randomized Controlled Trial in an Urban Population" (Paula Gardiner, MD)
“Racial Disparities in Use of Chiropractic Services under Medicare in Los Angeles County, California" (James Whedon, DC, MS)

10:30 am - 12 pm Breakout Sessions 6

Incorporating an integrative approach to interprofessional primary healthcare education to meet the needs of the underserved

Patricia Lebensohn, MD
The University of Arizona Center for Integrative Medicine, in collaboration with the Consortium of Academic Health Centers for Integrative Medicine received a HRSA grant to establish the National Center for Integrative Primary Healthcare (NCIPH). The NCIPH supports the incorporation of competency- and evidence-based Integrative Healthcare (IH) curricula into educational programs in a movement toward integrative interprofessional patient care. The goals of the NCIPH include developing competencies, curricula, best practices, healthcare professional resources and patient education materials as they relate to the practice of IH to improve health outcomes, especially in underserved communities. Based on a coordinated set of IH competencies across primary care professions and needs assessment, a 45-hour interprofesssional IH curriculum, Foundations in Integrative Health for primary care was developed and pilot-tested in primary care educational training programs and safety net community clinics providing integrative healthcare to the underserved. One example of a community clinic pilot involves a unique collaboration effort in Orange County, CA to transform the culture, practice and care delivery models of participating Community Health Centers (CHC) to include sustainable Integrative Health approaches centered on whole person care and health creation. This new 3 year program represents a collaboration between the Orange County Coalition of CHC’s, UCI Department of Family Medicine, Samueli Center for Integrative Medicine and a community health funder partnership, and involves a combination of increasing IH knowledge and skills via the NCIPH curriculum augmented by local skill building workshops, together with technical and manpower support for individualized clinic adoption of new practice models.

Mindfulness for Daily Living: Adapting Ancient Practices for a Modern World

Diana Shakarian, PhD
Mindfulness. Nowadays you see the term everywhere. Articles in Time Magazine, Huffington Post, The Los Angeles Times, WebMD, The National Center for Complementary and Alternative Medicine (NCCAM), and research studies from universities world-wide repeatedly address how mindfulness is being used by hospitals, health care professionals, mental health workers, professional sports teams, K-12 teachers, college professors, and Fortune 500 companies. These institutions are using mindfulness practices to improve performance, concentration and creativity, to help manage stress, pain, fear, anxiety, depression and addiction, to improve memory, immune response, self-healing and to boost feelings of well-being and improve quality of life.
Learn about the power of mindfulness to not only change our lives, but also change our brains, and in the process, gain a first-hand experience of mindfulness itself. In this seminar, former university professor and UCLA certified mindfulness instructor, Dr. Diana Shakarian will provide a general introduction to mindfulness from both a scientific and experiential perspective. Learn what mindfulness is and how it can positively impact your physical, mental and psychological health. Experience the benefits of mindfulness through a guided meditation practice designed to reduce stress and anxiety while cultivating states of inner calm, clarity and compassion. In essence, learn how these ancient practices can help us reclaim our lives, bringing a sense of peace and tranquility to our overly-stressed, always hectic modern life.

Pediatric obesity group visits on the Navajo Nation: Collaboration with national and local partners

Maryclaire O'Neill, DO
Overview on using pediatric obesity group visits at a Navajo Nation clinic as the format for implementing the CDC REACH (Racial & Ethnic Approaches to Community Health) grant and Wholesome Wave fruit & veggie prescription program (FVRx), through coordination with dietitians, community health workers, local trading post owner, and the elementary school on the Navajo Nation.
The narrative of implementing this program will be the basis for discussion on: 1) The value of group visits for both patient and practitioner; and 2) considerations in establishing group visits, including venue, partnerships, and billing.

Osteopathic Manipulative Medicine 101- a practical experiential workshop

Connie Earl, DO, ABIHM
This session is a hands-on intro into Osteopathic Manipulative Medicine (OMM), and is intended to leave participants with practical skills that they can start using right away. In this half-day workshop, we will discuss the philosophy and principles of Osteopathic Medicine, review supporting evidence for OMM, practice palpation skills and discuss the principles of several forms of OMM. We will apply osteopathic technique and principles in the review of case studies, and practice these techniques on each other in the workshop. I have selected some of the highest yield and most-used techniques to allow participants to apply them to a wide base of patients on return to their practice.

Making it Easy, Combining Modalities for Effective Treatment

Bonney Lynch, LAc, CMT
Demonstration and guided practice of combining manual therapy, touch, acupuncture, breath work to treat chronic pain, trauma, and people with sensitive nervous systems.
Body based therapies, including positional release, acupressure and acupuncture can help people better integrate sensory input and traumatic experiences. Awareness of breath, use of image, and relaxation approaches can help with our awareness, ability to focus and also support the healing process. Principals of alignment, use of breath and ergonomic skills to help support provider well being and efficiency will be emphasized.
Case studies, differentiation of clinical choices, and creative ways to combine modalities based on criteria of provider and patient needs and resources will be discussed.
Guided practice in partners or small groups.

Returning to Normal

Andrea Lee, MD, FACOG
What is normal? As doctors and caregivers we want to treat problems. But what happens when we start making problems out of normal events.
Birth, majority of the time, is a normal, healthy event in a women’s life. Birth, historically occurred in the home, attended by women of the community and midwives. It was not until the 1900s that more women have doctors than midwives attend their birth with majority now in the hospital. With this movement into hospitals we started to see more and more use of technology with birth than ever before. We did see a decrease in maternal and infant mortality but with stabilizing of these numbers we have continued to see an increase in interventions, the most significant being cesarean sections. We have also seen a significant decrease in breastfeeding rates. What are the consequences of this?
WE, as a community of providers must help to shift our approach to birth. The first step is understanding what is normal. Second is creating a space for birth to happen that minimizes the risk of unnecessary intervention. Understanding normal birth happens when we help to educate and empower women to be their own guide through labor and birth with the support of a team of caregivers. The ideal space for a healthy, low risk pregnant women is a birth center.
This talk will reintroduce normal and describe the birth center model of care, the visits, the delivery, the team and the excellent outcomes.

1 - 2 pm Breakout Sessions 7

Back to wellness basics- for ourselves, our patients, our learners

Andrea Gordon, MD
Back to wellness basics- for ourselves, our patients, our learners
As the term “Integrative Medicine” becomes more familiar, many associate it with expensive or new techniques.
In reality much of wellness comes down to a few factors: nutrition, exercise, meaning and community. This session reviews how to attend to these factors for ourselves and how to teach others how to implement them with limited time and financial resources.
Food can be seen not just as fuel, but as a possible cause of either inflammation in the body or as supporting resilience. Activity need not mean time at a fancy gym. There are ways to become more active that organically fit into one’s life and become more sustainable. Finally, meaning and community have been shown to correlate with longevity, lower disease burden and even with higher rates of recovery from addiction. As we address each of these factors attendees will experience a small taste of these strategies and learn ways to bring this back to their practice and teaching.

Mindfulness Training: Preventing Burn-out and Increasing Resiliency for Providers and Staff

Lisa Hardmeyer Gray
Recent studies are concluding that healthcare professionals are at higher risk for professional burn-out. Burn-out is characterized by a loss of mental, physical and emotional energy from continued job-related stress and has been linked to poorer quality of care, patient dissatisfaction, medical errors, lawsuits and increased costs to medical organizations in staff-turnover. Burn-out also seems to have adverse personal consequences including contributions to broken relationships, problematic substance abuse, and suicidal ideation. To reduce professional burn-out, improve retention and promote employee morale, administrators must implement strategies to reduce burn-out while also promoting productivity. There is a need to offer innovative resiliency skills for all health care workers to adapt to a dynamically changing practice environment. There is mounting evidence that Mindfulness skills are an effective means of preventing burn-out and developing resiliency skills.
Supported by evidence-based research reported in in JAMA and the Annals of Family Medicine, this 2-part workshop the presenter will offer discuss her professional experience and expertise in Mindfulness training for health care providers, staff and patients and draw from recent evidence-based research reportedhese studies have concluded that Mindfulness programs are a low-cost practical tool in decreasing burn-out and increasing short-term and sustained patient-centered care. Providers and staff report they are more present, attentive and empathic with their patients resulting in better care, greater job satisfaction and well-being. In addition, as health care moves from fee-for-services to value-based outcomes, there is also mounting evidence that Mindfulness programs have beneficial, low-cost outcomes for health and well-being for patients.

Adverse Childhood Experiences (ACEs) and Risk for Chronic Disease. Creating A Trauma Informed Community Network to build Resilience

Anu French, MD, FAAP ABOIM
Experiencing stress in childhood changes one’s set point of wellbeing for decades to come. The brain undergoes epigenetic changes because of early adversity and an inflammation-promoting state of fight-flight/freeze-appease is turned on. The endocrine and immune systems produce damaging inflammatory neurochemicals in response to even small stressors which sets the stage for chronic disease down the road. The landmark study by Vincent Felitti on ACEs in the 1990’s brought attention to ACEs (Adverse Childhood Events and Experiences) and prospective data continues to show how the effects of these can be very toxic and long lasting. The ACE Score is used to assess the total amount of stress during childhood and has demonstrated that as the number of ACEs increase, the risk for chronic disease increases in a strong and graded fashion. Recognizing that chronic childhood stress can play a role in developing adult illnesses and relationship challenges, can be enormously freeing and empowering. We now know that we can become neuro-biologically resilient. Resilience is not a trait that people either have or do not have. It involves behaviors, thoughts and actions that can be learned and developed in anyone. This presentation will review the latest literature on ACEs, risk for chronic disease and practical tools to build resilience. And how the Trauma Informed Community Network of St Louis was formed, to connect a multidisciplinary team of professionals and healers, who serve populations living in poverty with toxic stress and complex trauma, to help promote the science behind Resilience.

Clinical Pearls and Walking Alongside: Lessons from Naturopathic Community and Global Health

Sean Hesler, ND
Integrative health practices vary widely between fields and practitioners, necessitating the sharing of successes and failures on the clinical, community, and global levels. The community and global health lessons learned at Southwest College of Naturopathic Medicine’s community clinics and Naturopaths Without Borders’ sites have wide applicability for integrative practitioners in low-resource settings for the underserved.
In particular, this talk will focus on broadly apply a set of high-yield Naturopathic treatments, using a multidisciplinary approach to improve common health concerns, and empowering patients to take charge of their health with tested methods. This toolkit approach allows participants to broaden their therapeutic perspectives while choosing lessons within their scopes of practice. Attendees will also learn a hands-on, easily-disseminated soft tissue technique for relieving headaches and neck pain.

A Tale of Two Cities: Bringing Loma Linda's Lifestyle Medicine to a Free Clinic in San Bernardino

Christina Miller, MD, MPH
Loma Linda is a designated “blue zone” where individuals are ten times more likely to reach 100 years of life than those living in the rest of the world. This predominantly educated, affluent, and active Seventh Day Adventist community is home to nationally-recognized training programs for Lifestyle Medicine, which teach how plant-based diets and exercise can reverse chronic disease. However, Loma Linda is only streets away from San Bernardino, a city which went bankrupt in 2012, was named the worst run city in America in 2013, became part of the poorest large metropolitan area in the nation in 2014, and made national headlines with a tragic shooting of civil servants in 2015. It should come as no surprise that measures of lifestyle health in San Bernardino (fast food consumption, fruit and vegetable consumption, and exercise) were among the lowest in California. This lecture reviews the methods which providers from Loma Linda employed to bring Lifestyle Medicine to underserved individuals in San Bernardino. Activities included: 1) partnering with a local food pantry and church, 2) incorporating a nonprofit organization to create free clinic structural support, 3) obtaining grants focused on lifestyle measures, and 4) implementing screening and counseling into acute visits. These steps taken to bring Loma Linda’s Lifestyle Medicine to a Free Clinic in San Bernardino will be explained in a narrative fashion focusing on lessons learned and techniques that other providers can implement in their own journey to bring health to their underserved neighbors.

Re-Organizational Healing vs Restorative Healing Restructuring the way we assess our patients

Laura Polak, DC
Wholeness: New quantitative tools for measuring health in our patients.
What does it mean to be well? If we get rid of a problem or symptom does it mean that we have succeed it with the patient? The answer is no. This presentation will look at how to measure progress across 5 areas that allow you to quantify progress of wellness with your patients; 1. Physical State, 2. Mental emotional state, 3. Stress, 4. Life Enjoyment, 5. Overall quality of life. Furthermore, you will learn how to access the areas that are working optimally, and are energy rich to assist the areas that are less effective or energy poor. This helps both doctors and patients to move out of the "traditional" bio-mechanical medical model to a integrative model that assesses the whole being.

2:15 - 3:15 pm Breakout Sessions 8

Health Disparities and the Social Determinants of Health

Donna Odierna, DrpH, MS, CH(AHG)
In this seminar, we will examine patterns of disease and the social determinants of health disparities in diverse populations. We will focus primarily on health effects of such factors as discrimination, poverty, disability, meaningful access to healthcare, social and environmental justice, and systemic inequality on health, and their relevance to health practice and policy. We will discuss structural social injustice, margianalization, intersectionality of multiple oppressions (e.g., classism, racism, sexism, ableism, etc.) and specific effects on health in socially disadvantaged populations. We will brainstorm about the resources and information we need to be able to recognize and address these large, systemic problems in our everyday lives. Participants bring their training and experience to this seminar, which will include lecture interspersed with small- and full-group co-learning activities, and discussion. The goals of the seminar are to increase our understanding of the issues that lead to inequities in health and to develop tools and creative approaches to that we can use in our work and clinical practice.

Mindfulness For the Clinician: Dismantling Systemic Bias in Health Care Delivery

Elizabeth Adler
Snap judgments, distracted attention, and inadvertent stereotypes run rampant on hospital wards because there are few cultural or cognitive systems in place to prevent these components of unjust healthcare delivery systems. Systemic bias disproportionally affects underserved communities. For example, a black patient is half as likely as a white patient to receive pain medication during an emergency room assessment of a broken bone. Bringing mindful attention to our thought patterns can help us as care providers avoid the biases that have likely been engrained in our cognitive flowchart of diagnostic and care algorithms. This special interest discussion group on reducing inequities in our healthcare delivery system will use the tools of mindful awareness to help participants identify bias and practice strategies for re-wiring our habitual thought patterns. The overall goal is to add mindfulness as a tool to dismantle barriers to care for the underserved.

Medicinal Mushrooms: Clinical Insights and Practice

Renee Davis, MA RH(AHG)
Medicinal mushrooms have much to offer for immune health and are very cost effective. But their mechanisms of action, preparation and clinical use remain elusive. This class will focus on 5 key mushrooms: Reishi, Lion's Mane, Maitake, Chaga, and Turkey Tail. We'll discuss their pharmacology and preparation, demystify the mechanisms of fungal polysaccharide immunomodulation, and clarify common areas of confusion (yeast overgrowth, long-term use, autoimmunity).

Naturopathic Primary Care at an FQHC - Politics, Policy and Practice

Bill Walter, ND
Oregon's Medicaid expansion created access for patients to receive care from licensed CAM/IM professionals (ND, DC, LAc). Under Medicaid expansion, Naturopathic Physician Dr. Bill Walter has been hired by his County's Federally-Qualified Health Center to serve as a primary care provider for the Medicaid population.

Integrative Nutrition: A Collaborative Community-based Approach

Michelle Steinberg, MS
Nutrition counseling in underserved communities can be challenging as food access poses major obstacles in many populations. Street Level Health Project, a multilingual clinic and day laborer workers’ organization in Oakland, CA, addresses nutrition in Latino/a and other immigrant communities through unique multi-faceted programing that engages the social determinants of health while providing clients with holistic nutrition counseling. The clinic’s nutritionist/herbalist meets with individual clients, utilizing a culturally sensitive, harm reduction approach to nutrition and lifestyle changes. She also leads group “charlas” in the clinic’s waiting room, promoting an interactive exchange around nutrition and wellness. She collaborates with a promotora de salud and a cook from the community who lead mealtime discussions on nutrition, do street outreach on basic wellness, and prepare healthy, free community meals on site. This combination of strategies not only reinforces healthy food choices, but models nutritious meal preparation and provides sustenance to the community. In this presentation, Michelle Steinberg, M.S. the clinic’s nutritionist/herbalist, will detail the approaches used, focusing on both models of care delivery and nutritional protocols tailored towards low-income immigrant populations. Hermelinda Aguiar and Maria Dolores Rios will then outline their roles and strategies as community-based promotoras de salud. This will be followed by a Q&A and facilitated audience discussion to brainstorm techniques and support participants in identifying applicable strategies for their own communities.

Listening to Ourselves and Each Other; Healing the Negative Health Impacts of Racism, Sexism and Poverty

Elizabeth Rocco, MD
The cumulative chronic negative health impacts of racism, poverty, sexism and trauma have resulted in an epidemic of mental and physical health needs in under served communities in the United States. In addition to the elimination of widespread racial, gender and class inequities, our society needs a new sustainable health model to heal complex trauma caused by these negative impacts. Potential models must both address how societal oppression leads to illness and have the toolkit to heal complex trauma, the cumulative effects of generations of racism, poverty, sexism and trauma on humans. Practitioners and clients alike will need to deepen their awareness and connectedness with themselves and each other to create optimal conditions for inherent emotional healing processes. The development of a culture of listening to ourselves and each other in a deep connected way is key as our society relearns the art of holding space for healing. Any sustainable model will offer clients a toolkit of self empowering practices to foster attention, human connection, compassion and empathetic listening as each of us take charge of our healing and healing of our world.
During this workshop we will discuss how societal oppression leads to complex trauma and manifests as illness and how alternative models with an integrative toolkit can promote societal healing by cultivating a culture of listening to ourselves and each other in a deep connected way. Throughout the workshop, participants will practice a variety of techniques drawn from emerging sustainable models: empowerment groups, mindfulness and listening communities.

3:30 - 4:30 pm Plenary The Global Integrative Health and Medicine Movement: What Every Clinician Should Know

Tabatha Parker, ND

Toolkit