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Calm Lake

Information for Doctors

Hello,

My name is Dr. Aleek Karkazian, OTD, OTR/L.

I can help you improve patient outcomes using evidence-based interventions without added stress for you. 
 
I have been an occupational therapist since 2016.  I specialize in health management, lifestyle medicine/ modification, and pain management. 

My past work experiences include school-based pediatrics, community mental health, and community-based adult services. I completed my doctorate in occupational therapy in May 2021. 
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Learn more about me and the services
that we offer.

Click on the boxes to the right.

Calm Lake

Services We Offer

1

Lifestyle Medicine & Health Management

​We will support your patients in incorporating healthy behaviors into sustainable health-promoting habits and routines to improve or maintain health.

We focus on targeted skill development, patient education, and problem-solving barriers to success. Interventions are personalized for the specific needs of each patient.

2

Pain Management Class: Empowered Relief™ 

This is a 2-hour program developed by pain psychologists at Stanford University. It is an evidence-based, single-session pain class that rapidly equips patients with pain management skills.

 

It can be done online or in-person , and both in groups and individually. 

3

Pain Management: Lifestyle Modification

Some patients require a higher level of personalization than offered in group classes and/or  ongoing support to manage pain.

 

 We offer individual or family sessions focused on addressing client-specific lifestyle factors that are contributing to chronic pain.

I specialize in health management & lifestyle modification.

My doctoral dissertation was focused on this topic. My dissertation, "Thriving with Rheumatoid Arthritis (RA): A Self-Management Program for Young and Middle-Aged Adults with RA", explored the unique needs of the young and middle-aged populations in managing chronic health conditions, specifically focusing on RA.

 

As part of my doctorate project, I developed a self-management/ health-management program called "RA Empowerment." RA Empowerment is a program created for young and middle-aged with rheumatoid arthritis that supports them in implementing and sustaining health-promoting habits and routines. The interventions and program elements I researched and developed apply to a wide range of chronic health conditions, not just RA.

My Educational Background

2018- 2021

Doctorate of Occupational Therapy
Boston University

After gaining a few years of work experience, I decided to pursue a Doctorate in Occupational Therapy. The focus of my doctoral project was health management/ self-management. The title is "Thriving with Rheumatoid Arthritis (RA): A Self-Management Program for Young and Middle-Aged Adults with RA"

2013- 2015

Master of Arts
University of Southern California

I obtained my Master's degree in Occupational Therapy from USC, one of the top occupational therapy graduate programs in the country. I passed my board exams and became a licensed occupational therapist in December 2015. 

2009- 2012

Bachelor of Arts
University of California Berkeley

I obtained my Bachelor of Arts degree in Psychology. 

Continuing Education

I prioritize staying up to date on the latest evidence-based interventions to ensure that my clients get high-quality, effective services and treatments when they come to me. 

 

I take courses in multiple areas related to health and wellness because I believe in a holistic approach to health promotion. 

Pain Management

Stanford University Empowered Relief Instructor Certification Workshop- 11 hrs.

Pain Symposium: An Evidence-Based Toolkit to Retrain the Brain- 24 hrs.

-The Fit for Purpose Model of Pain and the Bioplasticity of Recovery

-Empowered Relief™: A Brief and Scalable Solution for Chronic Pain Management

-Knowing Pain Is Not Treating Pain

-PAIN – It’s all in your head, or at least that’s a place to start

-The Hidden Influences and Language of The Nervous System

-Targeted Respiratory Training for Pain and Movement Dysfunction

-Clinical Effectiveness of Mindfulness, Meditation and Mindful Movement Strategies for Chronic Pain

-CBD and Pain: What We Knew Then and Where We Are Going

-"Conscious Caring" for People in Pain

The Latest Integrative Research and Approaches in the Successful Treatment of Chronic Pain Conditions- 6 hrs.

Women's Health

Women’s Health for Rehab Professionals Summit: How to Facilitate Optimal Aging- 10.5 hrs.​​

  • Pelvic Floor Function

  • A Movement Pro’s Guide to Menopause: Training Strategies for Optimal Aging

  • Pelvic Changes Associated with Pregnancy & Menopause: Practical Management Techniques

  • Peri/Menopause: Empow(her)ing the Busy Woman

  • Master Thyroid Function with Nutrition and Lifestyle Optimization

  • Estrogen Dominance: Symptoms, Causes, & Holistic Resolutions to the Ever-Common State of Estrogen Overload

Stress Management

Rejuvenation and Resilience in the Midst of Life Stressors- 6 hrs.

Physical Activity

Pumped: Building a Better Brain Through Exercise and Movement- 6 hrs.

Lifestyle Modification

-Lifestyle Modification & Aging-

I took a semester-long Lifestyle Redesign® course during my Master's program at USC.

  • "Lifestyle Redesign® is an innovative intervention approach developed at USC Chan that has been shown to improve health and wellness by preventing and managing chronic conditions through building healthier lifestyles." (source 8)

 

Lifestyle Modification Badge from the American Occupational Therapy Association- 6 hours

  • Conceptual Foundations of Lifestyle Modification

  • Needs Assessment and Group Leadership to Maintain Occupational Participation

  •  Routine, Occupational Balance and Health in Aging

  • Transportation and Community Mobility to Support Occupational Engagement

  • Stress and Inflammation Reduction for Older Adults.

  • Nutrition, Spirituality, and Sexuality for Productive Aging.

Relevant Courses and Training

Learn More About What We Do:

Overview of Treatment Sessions

Occupational therapy prioritizes:

Using person-centered interventions

Facilitating self-analysis and problem-solving

Assessing performance deficits and strengths

Developing individualized treatment plans

Action planning within the context of patients' daily lives

Returning patients to their most important occupations

Purpose of Sessions

Individual sessions analyze client-specific lifestyle factors and characteristics, allowing for increased patient-centeredness and personalized treatment planning. 

These sessions are focused on targeted skill development, patient education, and problem-solving barriers to success.

 

Areas addressed in sessions include:​ ​​

  • Communication with the healthcare system 

  • Medication management 

  • Physical activity

  • Nutrition management

  • Personal care device management 

  • Environmental modification

  • Pain management 

  • Symptom and condition management 

  • Social and emotional health promotion and maintenance 

Family members are welcome to join any individual sessions, for a portion or the entire session, to improve communication skills and increase social support within the patient's immediate circle.​

Session Format/ Delivery

  • Telehealth: An easy-to-use telehealth platform increases accessibility and attendance by reducing barriers common to this population of patients

    • Lack of transportation 

    • Competing responsibilities

    • Limited Time

    • Low energy

    • Increased symptoms with travel​

  • Convenient Times: Afternoon, evening, and some weekend appointments are available

In-person appointments are available on an as-needed basis in Fresno & Clovis, CA, to support greater generalization of skills to daily life.

Pain Management

Leg Injury

Empowered Relief™  Class
 

Aleek is a certified Empowered Relief™ instructor.

 

Empowered Relief™ is an evidence-based, single-session pain class that rapidly equips patients with pain management skills. It was developed by pain psychologists at Stanford University.(Source: 4,5,6)

 

Benefits of this class include (4): 

  • It requires only ONE live 2-hour class

  • It can be done in-person or online

  • Up to 100 people can be treated in a single class

  • Family members and friends are welcome to attend

  • Can be delivered free of charge or billed to insurance (your choice)

  • Empowers individuals to steer themselves toward pain relief

  • Helps medical treatments work better and works alongside all other medical treatments

  • Addresses a primary goal of the National Pain Strategy to better integrate behavioral treatment broadly into pain care in the U.S. ​

Lifestyle Modification

If patients require a higher level of personalized and ongoing support, we offer individual sessions to address client-specific lifestyle factors contributing to chronic pain.

 

During these sessions, we will collaborate to identify and incorporate self-management strategies into patients' daily routines to reduce pain, increase participation in meaningful occupations, and improve quality of life. (1)

Areas of need we can address are: (1)

  • Education regarding factors that exacerbate or alleviate symptoms

  • Action plan for flare-ups

  • Energy conservation, activity pacing, and fatigue management

  • Eating routine strategies to improve energy management and avoiding dietary triggers 

  • Physical activity: grading physical activity and establishing sustainable routines

  • Academic and work accommodations

  • Strategies to prevent social isolation

  • Environmental modifications

  • Self-advocacy and communication training

  • Education regarding trigger identification and symptom tracking

  • Self-regulation training and stress management

Lifestyle Medicine & Health Management

​We will support your patients in incorporating healthy behaviors into sustainable health-promoting habits and routines to improve or maintain their health.

 

This is accomplished by analyzing activity patterns, problem-solving personal and environmental barriers, facilitating targeted skill development/ education, and action planning within the context of their patients' daily lives and overall health management. (source: 1)

The most common lifestyle changes we can help with are:

  • Establishing healthy eating habits

  • Engaging in regular physical activity

  • Self-regulation and stress management

  • Improving sleep routines and restorative rest

  • Enhancing social support and connections

  • Improving self-advocacy and communication skills

  • Support in reducing the usage of alcohol and smoking

 

Diagnoses I can work with (but are not limited to) are: rheumatoid arthritis, diabetes, fibromyalgia, chronic fatigue, thyroid issues, long COVID, heart disease, headaches/ migraines, etc.

OT's Role in Health Management 

Health Management is defined as "Activities related to developing, managing, and maintaining health and wellness routines, including self-management, with the goal of improving or maintaining health to support participation in other occupations" (AOTA, 2020).  The occupation of "health management" is a new addition to the most recent edition of the Occupational Therapy Practice Framework (AOTA, 2020). 

Occupational therapy is well suited to work in the areas of health promotion and health management. We use a holistic approach to evaluating and addressing the structural, physiological, psychological, environmental, and personal factors that influence the experience of maintaining a healthy lifestyle.
 

Health management is considered well within the scope of occupational therapy practice and purview. It is an occupation for which the profession has distinct tools and techniques to assist clients, such as knowledge and expertise in the therapeutic use of occupation, focus on client-centeredness and function, and application of activity analysis to health management tasks. (source: 3, 7)

Billing & Payments

At this time, we are private pay only. Private pay gives us the flexibility and freedom to create a more valuable experience for our clients. Without the insurance company's restrictions, we can work together to create a treatment plan that suits the patient's unique needs.  

Pain Management Class Costs

It is possible for the Empowered Relief class to have up to 100 people in a single class. Therefore, many offices/ healthcare organizations opt to cover the cost of the class fees and have multiple patients attend the class for free, or a small co-pay paid directly to your office.

According to the AOTA, "Occupational therapy for pain management is a covered service by most insurance companies, including commercial (employee-sponsored and marketplace plans), Workers’ Compensation, Medicare, and Medicaid plans....Occupational therapy treatment is usually billed using the CPT codes depending on the payer source. Depending on state guidelines and payer policy, occupational therapy can also be delivered successfully through telehealth platforms." (Source: 1)

References:

1:https://www.aota.org/practice/practice-essentials/quality/quality-resources/role-of-ot-pain-management 2:https://www.aota.org/~/media/corporate/files/aboutot/professionals/whatisot/hw/facts/factsheet_healthpromotion.pdf 3:Uyeshiro Simon, A., & Collins, C. E. R. (2017). Lifestyle Redesign® for chronic pain management: A retrospective clinical efficacy study. American Journal of Occupational Therapy, 71, 7104190040. https://doi.org/10.5014/ajot.2017.025502 4:https://bethdarnall.com/blog/2019/07/03/empowered-relief-expanding-rapid-access-to-low-cost-evidence-based-pain-care/  5:Darnall BD, Roy A, Chen A, Ziadni MS, Tanner R, You DS, Cook KF, Lorig K, King H, Slater K, Mackey IG, Kao MC, Hong J, Tian L, Mackey SC. Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain: A Randomized Trial. JAMA Netw Open. 2021;4(8):e2113401. doi:10.1001/jamanetworkopen.2021.13401 6:Darnall BD, Sturgeon JA, Hah JM, Kao MC, Mackey SC. ‘From Catastrophizing to Recovery’: A pilot study of a single-session treatment for pain catastrophizing. J Pain Research. 2014; (7):219-226. PMID: 24851056. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008292/ 7:American Occupational Therapy Association. (2020b). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ ajot.2020.74S2001 8:https://chan.usc.edu/about-us/lifestyle-redesign

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