Counselor Toolbox Podcast

Treatment of Persons with Co-Occurring Disorders Based on SAMHSA TIP 42 Part 7 Host: Dr. Dawn-Elise Snipes Executive Director: AllCEUs Counselor Education Podcast Host: Counselor Toolbox and Addiction Counselor Exam Review Objectives ~ Special Settings and Specific Populations ~ Acute Care and Other Medical Settings ~ Providing Treatment to Clients With COD in Acute Care and Other Medical Settings ~ Sustaining Programs for Clients With COD in Acute Care Settings ~ Dual Recovery Mutual Self-Help Programs ~ Dual Recovery Mutual Self-Help Approaches ~ Advocating for Dual Recovery ~ Specific Populations ~ Homeless Persons With COD ~ Criminal Justice Populations ~ Women Providing Tx in Medical Settings ~ Primary care and mental health providers are often not familiar with substance use disorders which can lead to unrealistic expectations or frustrations, which may be directed inappropriately toward the client ~ Education of Clinicians about addictions ~ Services Provided ~ SBIRT ~ Crisis counseling ~ Single session treatment or motivational enhancement ~ Short-term mental health or substance abuse treatment counseling ~ Medication assisted therapy and/or ambulatory detox ~ Psychoeducation as appropriate Medical Settings cont… ~ facilitate linkage to more intensive services ~ Realize that chronically ill clients enter periods of stability when little intervention is required. ~ Episodic use of services by these clients means staff need to be flexible and to realize that these clients are likely to return when in crisis. ~ Critical to incorporate program evaluation activities that examine both process and outcome ~ Are we reaching the clients we wanted to target? ~ Are those clients enrolling and completing services? ~ Are those clients experiencing stability periods? Dual Recovery ~ Why are Dual Recovery Groups needed? ~ Stigma and prejudice ~ Inappropriate advice ~ What are they ~ Double Trouble ~ Dual Recovery Anonymous ~ Dual Disorders Anonymous ~ Dual Diagnosis Anonymous ~ Support Together for Emotional/Mental Serenity and Sobriety (STEMSS) is a supported self-help model for people with co-occurring disorders Specific Populations ~ People who are homeless ~ For most homeless clients with COD, the impact of substance abuse and mental illness bears a direct relationship to their homeless status. ~ The ability to maintain housing is affected profoundly by substance abuse (Hurlburt et al. 1996). ~ Approximately 70 percent of participants in recent NIAAA demonstration projects identified substance abuse problems as the primary reason for their homelessness in both the first and most recent episodes ~ Supportive housing dramatically reduced use of other public systems by people who were homeless and had SMI Specific Populations ~ People who are homeless ~ Providing Housing ~ Housing contingent on treatment and drug free samples ~ Housing integrated with treatment (Shelter/RRs) ~ Other Services ~ Teach clients skills for maintaining housing. ~ Work closely with shelter workers and other providers of services to the homeless. ~ Address real-life issues in addition to housing, such as substance abuse treatment, legal and pending criminal justice issues, Supplemental Security Insurance/entitlement applications, issues related to children, healthcare needs, etc. Specific Populations ~ Criminal Justice ~ aftercare subsequent to prison-based treatment was to ease the abrupt transition ~ Recognize special service needs. ~ Give positive reinforcement for small successes and progress. ~ Clarify expectations regarding response to supervision. ~ Use flexible responses to infractions. ~ Give concrete (i.e., not abstract) directions. ~ Design highly structured activities. ~ Provide ongoing monitoring of symptoms. Specific Populations ~ Women ~ Specialized programs for women with COD have been developed to address pregnancy and childcare issues as well as certain kinds of trauma ~ Women who enter treatment sometimes risk losing public assistance su

Treatment of Persons with Co-Occurring Disorders Based on SAMHSA TIP 42 Part 6 Host: Dr. Dawn-Elise Snipes Executive Director: AllCEUs Counselor Education Podcast Host: Counselor Toolbox and Addiction Counselor Exam Review Objectives ~ Identify essential programming for clients with COD ~ Explore modifications for clients with COD ~ Identify components in successful implementation of programming Essential Programming for Clients With COD ~ Screening, Assessment, and Referral ~ Physical and Mental Health Consultation ~ Prescribing Onsite Psychiatrist ~ Medication and Medication Monitoring ~ Mental Health and Substance Use Disorders ~ Relapse Prevention ~ Psychoeducational Classes ~ Double Trouble Groups (Onsite) ~ Dual Recovery Mutual Self-Help Groups (Offsite) Design and Implementation ~ Designing Outpatient Programs for Clients With COD ~ Group work and modifications ~ Individual work and modifications ~ Recovery support ~ Case management ~ Implementing Outpatient Programs ~ Evaluating Outpatient Programs ~ Sustaining Outpatient Programs Design ~ The population of persons with COD is heterogeneous in terms of motivation for treatment, nature and severity of substance use disorder (e.g., drug of choice, abuse versus dependence, polysubstance abuse), and nature and severity of mental disorder Individual Counseling ~ Variety of approaches ~ Culturally responsive ~ Trauma informed ~ Regularly scheduled ~ Guided by the treatment plan ~ Problem: Depression ~ Goal 1: To self report a mood of 3 or above 6 out of 7 days ~ Objective 1A: Learn about the causes of depression ~ Objective 1B: Identify my symptoms of depression and what might be causing them ~ Objective 1C:… Group Work ~ Working in Groups ~ Group therapy should be augmented by individual counseling ~ Reduce the emotional intensity of interpersonal interaction in COD group sessions ~ Because many clients with COD often have difficulty staying focused ~ Treatment groups usually need stronger direction from staff ~ Group or activity running for no more than 40 minutes. ~ Because of the need for stability, the groups should run regularly and without cancellation ~ In early recovery psychoeducational groups are usually more beneficial (Relapse prevention, PAWS, CBT/DBT Tools…) Groups ~ Because many clients with COD have difficulty in social settings, group sizes may need to be smaller ~ Co-leaders are especially important in these groups, as one leader may need to leave the group with one member ~ Considerable tolerance is needed for varied (and variable) levels of participation depending on the client's level of functioning, stability of symptoms, response to medication, and mental status ~ Affirmation of accomplishments should be emphasized over disapproval or sanctions. ~ Negative behavior should be amended rapidly with a positive learning experience designed to teach the client a correct response to a situation Medication Management ~ Medication Assisted Therapy ~ Opiates ~ Alcohol ~ Nicotine ~ Management of acute and post-acute withdrawal symptoms ~ Psychopharmacology Primary Care ~ Consults or referrals to rule out mood or pain issues caused by ~ Autoimmune disorders (Fibro, Chron’s etc) ~ Liver or kidney issues ~ Diabetes ~ Sex or thyroid hormone issues (Including Low T, PMDD and hypo or hyper thyroid) ~ STDs ~ HIV ~ Musculoskeletal issues Family Education ~ Particularly in cultures that value interdependence and are community and/or family-oriented, a family and community education and support group can be helpful ~ Programs must provide this instruction in an interactive style that allows questions, not in a lecture mode. The essentials of this information include: ~ The name of the disorder ~ Its symptoms, prevalence, cause ~ How it interacts with substance abuse—that is, the implications of having both disorders ~ Treatment options and considerations in choosing the best treatment ~ The likely course of the illness ~ Programs, resources, and individuals who can be he

Treatment of Persons with Co-Occurring Disorders Based on SAMHSA TIP 42 Part 4 Host: Dr. Dawn-Elise Snipes Executive Director: AllCEUs Counselor Education Podcast Host: Counselor Toolbox and Addiction Counselor Exam Review Objectives ~ Define the purpose of screening ~ Define assessment ~ Learn the 12 steps in the assessment process Screening ~ Screening is ~ An initial procedure ~ Can be completed by paraprofessionals ~ A process where counselor, client and SO’s review current information and symptoms ~ Identifies whether the person may be showing signs of a substance abuse or mental health issue ~ Can also assess for related service needs ~ Screening is NOT ~ A diagnostic procedure Guidelines ~ Screening should be conducted on persons who may be at risk in a variety of settings by a range or professionals and paraprofessionals ~ Agencies should collaborate on screening procedures ~ All screening procedures should be culturally responsive and trauma informed ~ Initial screenings are brief and when possible contain information from multiple sources (SOs, criminal history, physician, other therapist, referral source) Common Screening Instruments ~ CAGE ~ Cut down ~ Annoyed ~ Guilty ~ Eye opener ~ GAIN-SI ~ Michigan Alcohol Screening Test MAST ~ Substance Abuse Subtle Screening Inventory SASSI Protocol ~ An effective screening protocol specifies ~ How any screening tools are used and scored ~ What established cutoff scores are ~ What happens when a client scores in the positive range ~ How to document results of the screening and referral ~ How to document seamless referral and service coordination ~ There are a number of circumstances that can affect validity and test responses that may not be obvious ~ The manner in which instructions are given to the client ~ The setting where the screening or assessment takes place, privacy (or the lack thereof) ~ Trust and rapport between the client and counselor ~ Mitigating circumstances (legal, child welfare, custody, employment) Assessment ~ Screening identifies the possibility of the presence of a problem (Doctor, LEO, Judge, PO, DCF case worker) ~ Assessment defines the nature of the problem and develops specific treatment recommendations for addressing the problem (placement) (Intake Counselor or Agency Clinician) ~ A comprehensive assessment serves as the basis for an individualized treatment plan in the client’s treatment setting of choice.(Primary therapist) Dos and Don’ts for Assessment ~ Do keep in mind that assessment is about getting to know a person with complex and individual needs. ~ Do not rely on tools alone for a comprehensive assessment. ~ Do always make every effort to contact all involved parties ~ Don't allow preconceptions about addiction to interfere with learning about what the client really needs ~ Do become familiar with the diagnostic criteria for common mental disorders, including personality disorders, and with the names and indications of common psychiatric medications ~ Most important, do remember that empathy and hope are the most valuable components of your wor ~ Don't assume that there is one correct treatment approach or program Basic Assessment ~ A basic assessment covers the key information required for treatment matching and treatment planning. Specifically, the basic assessment offers a structure with which to obtain ~ Basic demographic and historical information, and identification of established or probable diagnoses and associated impairments ~ General strengths and problem areas ~ Stage of change or stage of treatment for both substance abuse and mental health problems ~ Preliminary determination of the severity of the COD as a guide to final level of care determination ~ Assessment of the client with COD is an ongoing process that should be repeated over time to capture the changing nature of the client's status. ~ Consists of ~ Background—family, trauma history, history of domestic violence (either as a batterer or as a battered person), mari

Treatment of Persons with Co-Occurring Disorders Based on SAMHSA TIP 42 Parts 1&2 Host: Dr. Dawn-Elise Snipes Executive Director: AllCEUs Counselor Education Podcast Host: Counselor Toolbox and Addiction Counselor Exam Review Objectives ~ Define Co-Occurring Disorders ~ Review the relevance of co-occurring disorders research to clinical practice ~ Familiarize with the following terms: Substance Use Disorders, Mental Disorders, Compulsive Behaviors/Behavioral Addictions, Treatment Programs, Systems ~ Co-Occurring Disorders means that the person has a substance use or addictive disorders AND a concurrent mental health issue that is not attributable to the effects of intoxication or withdrawal ~ What challenges do clients with co-d present in treatment settings? To clinicians? ~ Co-Occurring Disorders ~ Create multiple treatment issues ~ Impact treatment due to varying course of both disorders ~ Models and strategies for addressing co-d Prevalence ~ An estimated 10 million Americans have COD in any given year ~ Using only DSM criteria ~ Not including nicotine addiction or eating disorders ~ COD are the expectation, not the exception ~ People with COD are more likely to be hospitalized ~ Rates of mental health issues increase as the rate or substance use disorders increases Principles of COD Treatment ~ No Wrong Door ~ Mutual Self-Help ~ Integrated care ~ Individualized approaches including ~ Psychotherapy ~ Medication Assisted Therapy ~ Peer Support ~ Community Based Resources Mood Disorders ~ Anxiety ~ Social ~ Generalized ~ Depression ~ Persistent Depressive Disorder ~ Major Depression ~ Bipolar Disorder ~ Mania or Hypomania plus Depression or PDD Other Non-Personality Disorders ~ ADD/ADHD ~ Autism Spectrum Disorders ~ PTSD ~ Schizophrenia ~ Alcohol Induced Dementia (Wernicke-Korsakoff’s Syndrome) ~ Obsessive Compulsive Disorder ~ Issues w/Dementia ~ Age-Related Dementia ~ Alzheimer’s Disease ~ Parkinson’s Disease Personality Disorders ~ Cluster A ~ Odd or Eccentric Behavior ~ Paranoid, schizoid, schizotypal ~ Cluster B ~ Dramatic, Emotional or Erratic Behavior ~ Antisocial, borderline, histrionic, narcissistic ~ Cluster C ~ Anxious, fearful behavior ~ Avoidant, dependent, obsessive-compulsive Addictive Disorders ~ In the DSM V ~ Substances ~ Gambling ~ Internet Gaming Disorder (of interest) ~ NOT in the DSM ~ Sex addiction ~ Pornography addiction ~ Shopping addiction ~ Eating disorders and food related issues are not considered addictions Criteria for Addiction ~ Use for longer than intended ~ Spending more money than intended ~ Failed efforts to quit or cut down ~ Giving up important activities ~ Development of a tolerance ~ Physiological or psychological withdrawal ~ Negative consequences in one or more areas of life related to the addiction ASAM Levels of Care Quadrants of Care Recovery Oriented System of Care ~ Comprehensive Continuous Integrated System of Care ~ What types of services would be needed here? ~ Substance Use ~ Mental Health ~ Medical ~ Pain Management ~ Parenting ~ Financial ~ Occupational/Educational ~ Case management Summary ~ Co-Occurring Disorders Treatment means providing concurrent services to meet the mental health as well as addiction needs of individuals ~ Co-Occurring Disorders treatment recognizes the reciprocal impact of each disorder on the other ~ Overlooking the MH or SAB in diagnosis or treatment sets a person up for relapse ~ COD Treatment is integrated and attends to the whole person ~ Clinicians have an ethical responsibility to be educated in both MH as well as SAB issues and treatments even if they are not “skilled” in treating one or the other. More Videos ~ There are 5 more videos in this series. They will all be on the playlist “TIP 42 Co-Occurring Disorders” on our YouTube channel AllCEUs.com/YouTube ~ To earn CEUs for this presentation, go to AllCEUs.com/podcastCEUs where you can find a direct link to the class associated with this presentation

Treatment of Persons with Co-Occurring Disorders Based on SAMHSA TIP 42 Part 3 Host: Dr. Dawn-Elise Snipes Executive Director: AllCEUs Counselor Education Podcast Host: Counselor Toolbox and Addiction Counselor Exam Review Objectives ~ Identify guiding principles in treatment ~ Identify core components in the delivery of services ~ Explore how to improve substance abuse treatment systems and programs Guiding Principles ~ For each component, identify how you do, or could apply this in your program ~ Employ a recovery perspective ~ Adopt a multiproblem viewpoint ~ Develop a phased approach to treatment ~ Address specific real-life problems early in treatment ~ Plan for the client’s cognitive and functional impairments ~ Use support systems to maintain and extend treatment effectiveness ~ Community ~ Family ~ Self-Help Core Components ~ For each component, identify how you do, or could apply this in your program ~ Access ~ Full assessment ~ Appropriate levels of care ~ Integrated treatment ~ Comprehensive Services ~ Continuity of care Access ~ Access occurs in four main ways: ~ Routine access for individuals seeking services who are not in crisis ~ Crisis access for individuals requiring immediate services due to an emergency ~ Outreach, in which agencies target individuals in great need (e.g., people who are homeless) who are not seeking services or cannot access ordinary routine or crisis services ~ Access that is involuntary, coerced, or mandated by the criminal justice system, employers, or the child welfare system Assessment ~ Screening to detect the possible presence of COD in the setting where the client is first seen for treatment ~ Evaluation of background factors (family, trauma history, marital status, health, education and work history), mental disorders, substance abuse, and related medical and psychosocial problems (e.g., living circumstances, employment, family) that are critical to address in treatment planning ~ Diagnosis of the type and severity of substance use and mental disorders ~ Initial matching of individual client to services (often, this must be done before a full assessment is completed and diagnoses clarified; also, the client's motivation to change with regard to one or more of the co-occurring disorders may not be well established) ~ Appraisal of existing social and community support systems ~ Continuous evaluation (that is, re-evaluation over time as needs and symptoms change and as more information becomes available) Appropriate Level of Care ~ A basic program has the capacity to provide treatment for one disorder, but also screens for the other disorder and can access necessary consultations. ~ A program with an intermediate level of capacity tends to focus primarily on one disorder without substantial modification to its usual treatment, but also explicitly addresses some specific needs of the other disorder. ~ A program with an advanced level of capacity provides integrated substance abuse treatment and mental health services for clients with COD. ~ A program that is fully integrated actively combines substance abuse and mental health interventions to treat disorders, related problems, and the whole person more effectively Integrated Treatment ~ Integrated treatment can occur on different levels and through different mechanisms. For example: ~ One clinician delivers a variety of needed services. ~ Two or more clinicians work together to provide needed services. ~ A clinician may consult with other specialties and then integrate that consultation into the care provided. ~ A clinician may coordinate a variety of efforts in an individualized treatment plan that integrates the needed services. ~ Multiple agencies can join together to create a program that will serve a specific population. Integrated Treatment ~ The focus is on preventing anxiety rather than breaking through denial. ~ Emphasis is placed on trust, understanding, and learning. ~ Treatment is characterized by a slow pace and a long-te

This podcast episode is based on Journey to Recovery: A Comprehensive Guide to Recovery from Mental Health and Addiction Issues by Dr. Dawn-Elise Snipes  Read it for free on Amazon Kindle Unlimited. Journey to Recovery Series Goal Setting Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Podcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery CEUs are available for this presentation at https://www.allceus.com/member/cart/index/product/id/924/c/ Objectives ~ Identify the purpose of setting goals ~ Learn about SMART goals and how to set them ~ Explore pitfalls in goal setting Why Do I Care ~ Goal setting is an integral part of behavior change ~ Goal setting is something everyone does every day ~ Ineffective goals can have a negative impact on self esteem ~ Ineffective goals can make people mistakenly think they are helpless to change anything. Activity ~ Identifying pitfalls in goal setting ~ Prepare an authentic Italian meal. ~ Learn what an authentic Italian meal consists of ~ Decide what is going to be in YOUR meal ~ Learn about how to prepare that meal ~ Identify what ingredients you need for that meal (and get what you don’t have) ~ Do you do everything at the same time? (Hint: No, the sauce is made first so the seasonings can blend) SMART Goals ~ Specific ~ Measurable ~ Achievable ~ Realistic ~ Time Limited ~ Think about the last goal you set that was successful… ~ Think about the last goal you set that was unsuccessful. ~ What is the difference between the two? ~ SMART? ~ Motivation? Goals—The Beginning ~ Goals (What & Why)þ ~ I want to…so that I can … ~ Goals are the overarching reason a person begins to do something. ~ Often goals are broad and abstract. “I want to be healthier.” “I want to be happy.” ~ Goals need to be broken down into manageable, meaningful, observable objectives. ~ Phrase goals as adding a positive instead of removing a negative. Start With Problem Definition ~ What are the symptoms of the problem? ~ How are the symptoms impacting your overall functioning? ~ What is your perception of the problem? ~ What are your strengths in relation to solving this problem? Goal Development ~ In general, if the problem is resolved what will you achieve/what will be different? ~ What is the absence of the problem? ~ If I am not ____ then I am ______ ~ How will your best friend know when you have achieved your goal? Miracle Question ~ One way to elicit goals is through the miracle question: ~ If you woke up tomorrow and you were _____ (i.e. your problem was resolved/goal was achieved) what would be different? ~ This provides insight into the symptoms/definition of the problem and motivations for change. Specific ~ Overall Goal for Treatment ~ What is the problem? ~ Example: Depression ~ How will you know when the problem is resolved? ~ Emotionally, I won’t feel as hopeless and helpless. I wont dread getting out of bed. ~ Mentally, I won’t be so foggy headed and will be able to concentrate ~ Physically, I will have more energy and lose some weight ~ Socially, I will enjoy spending time with friends Specific ~ Main Issue ~ Learn about the overall problem (Depression) ~ Learn about your symptoms/causes/triggers of the problem ~ Identify ways to address your specific symptoms/causes/triggers ~ Pick one way to address your specific symptoms (helplessness, difficulty concentrating, no energy, no desire to interact with others) and start doing that. Measurable (Goals) ~ Frequency (#/time) ~ Number of times per day or week ~ i.e. Number of crying episodes/day ~ i.e. Number of eating episodes NOT due to hunger/day ~ i.e. Number of wake-ups/night ~ Duration (How long) ~ Crying ~ Eating ~ Sleeping (How long were you awake) ~ Intensity ~ How bad was it? Likert (1-mild; 2-moderate; 3-intense; 4-excruciating) ~ Number of calories per binge Recommendations ~ When trying to change, aim to increase a positive behavior ~ Instead of crying  laugh ~ Instead of stress eating  crochet ~ Instead of measuring how sa

This podcast episode is based on Journey to Recovery: A Comprehensive Guide to Recovery from Mental Health and Addiction Issues by Dr. Dawn-Elise Snipes  Read it for free on Amazon Kindle Unlimited. Journey to Recovery Series Enhancing Motivation Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs CEUs are available at https://www.allceus.com/member/cart/index/product/id/924/c/ Objectives ~ Define motivation ~ Explore the various types of motivation Definition ~ Motivation is a combination of desire, willingness and ability. It is your ability to keep your eye on the destination, and choose to do things that move you closer to that end point, instead of detouring you ~ Have you ever accomplished something you were not motivated to do? ~ What was it? ~ How did you get yourself motivated? 5 Principles of Motivation ~ Motivation is a key to change. ~ Motivation and people are multidimensional ~ Motivation is dynamic and fluctuating. ~ Motivation is influenced by social interactions. ~ Motivation can be modified. Motivational Process ~ Motivation involves: ~ Recognizing that something needs to be done ~ Identifying the benefits to getting it done ~ Addressing the drawbacks to doing it ~ Creating a plan ~ Implementing that plan Crisis Causes Change ~ Think about a goal you achieved, and complete the following exercise ~ What did you want to change? ~ Why did you want to change it (the crisis) ~ What was uncomfortable about the change (the other crisis) ~ Why was it worth the effort? Types of Motivation ~ Mental Motivators: Wanting to get out of the fog, believing you can do it ~ Emotional Motivators: Depression, anxiety, panic, PTSD ~ Environmental Motivators: Reducing the tension, more money to improve my environment ~ Physical Motivators: Pain, illness, discomfort, fear of contracting a disease ~ Social Motivators: What friends and family want, what you need to do to be accepted, availability of friends, wanting to set a good example for kids ~ Occupational Motivators: Fear of losing a job, desire for a promotion, frustration at own poor work performance. Dimensions of Motivation (MEEPS) ~ How is your “issue” impacting: ~ Your ability to think and concentrate? (Mental) ~ Your mood? (Emotional) ~ Your environment reflects how you feel inside. What is it telling you? (Environmental) ~ Your physical health (including sleep and nutrition)? ~ Your relationships? (social) ~ Your work (including your work product, desire to go to work and sick days)? Activity ~ Part of getting motivated is to understand the benefits and drawbacks of the old behavior and the new behaviors. ~ Example: ~ I want to start eating better. ~ Benefits… ~ Drawbacks ~ Solutions to Drawbacks… ~ If I decide to NOT change my eating habits ~ Benefits… ~ Solutions/Alternative ways to meet the same needs… ~ Drawbacks… Stages of Change ~ Precontemplation ~ Contemplation ~ Preparation ~ Action ~ Maintenance Precontemplation ~ Reluctant precontemplators do not have sufficient knowledge or awareness about the problem, or the personal impact it is having, to think change is necessary. ~ How is your addiction and/or mental health issue impacting you and your family? ~ Rebellious precontemplators are afraid of losing control over their lives. ~ What things are making you feel forced into recovery or change? ~ How can you reframe those things, so you feel less angry/annoyed ? ~ What can you do to make the best of this situation? ~ Resigned precontemplators feel hopeless about change and overwhelmed by all of the energy required. ~ Identify all the times you have tried to change and been successful, even if only for a day. Contemplation ~ Accept that it is normal to be ambivalent ~ “Tip the decisional balance scales” toward change by eliciting and weighing the pros and cons of substance use and change. ~ Visualizing Change ~ GOD collages ~ Drawbacks to staying the same ~ Pretend you have built this awesome community called Recovery Place. It has everythi

Journey to Recovery Series Improving Effectiveness with Different Learning Styles in Group and Individual Work Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Podcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery Objectives ~ Learn why it is important to understand learning style ~ Identify the three components of learning ~ Explore the multiple facets of learning ~ Synthesize the components and facets of learning to understand how you most effectively learn Why Do I Care? ~ You learn every day: ~ Reading/watching the news ~ Developing a new skill or hobby ~ Watching people and life ~ To change a behavior you need to: ~ Learn the function of the old behavior ~ Learn why the old behavior is not meeting your needs ~ Learn about alternate behaviors ~ Develop that knowledge into skills Learning Theory ~ Client-Partnership Model ~ Client and coach identify learning goals and methods ~ New information is linked to prior learning ~ Client undergoes an unlearning process before new information is implemented ~ Information is given over time ~ Information is tailored to the needs of the individual ~ Learning is affective, cognitive, social and behavioral Assumptions about Learners ~ Want to know why they should learn it (Motivation) ~ Intro story you can relate to… ~ Define how this will help you… ~ Are active, responsible, self-directed learners ~ Identify what you might be able to get out of this? ~ Identify how you can apply the material? ~ Bring experience to learning ~ Knowledge of primary and related topics (i.e. depression and treatment) ~ Biases primary and related topics (i.e. depression and treatment) Assumptions cont… ~ Are ready to learn when the need arises ~ How can you make mandatory learning more relevant? ~ How can you increase rewards for learning? ~ Provide Task/Problem-Oriented Learning ~ Identify something you need to learn about in order to improve your recovery or happiness. Context of Learning ~ Positive learning climate ~ How do you create that in your setting? ~ Does it differ for other people? ~ What are some examples of negative learning climates you have been in? ~ Personal characteristics ~ Self-efficacy ~ Expectations ~ Vulnerabilities/confounding issues (crisis, MH, detox) Context cont… ~ Peers ~ Stage of readiness for change ~ Co-occurring issues ~ Culture ~ Community ~ Stigma/attitudes ~ Availability of peer support ~ Significant Other Expectations ~ Identified patient/why aren’t you fixed ~ It’s not me, it’s him Motivating the Adult Learner ~ 6 factors that motivate adult learning: ~ Social relationships: ~ To make new friends and socialize ~ To improve current relationships with friends and family ~ External expectations: ~ Job/School ~ Other authority’s requirement (Doctor, probation officer) ~ Social welfare: ~ To improve ability to serve the community ~ To improve the community Motivating the Adult Learner ~ 6 factors that motivate adult learning: ~ Personal Improvement: ~ Enhance health and wellbeing ~ Professional advancement ~ Stay abreast of competitors ~ Escape/Stimulation: ~ To relieve boredom ~ Change the routine ~ Cognitive interest: To learn for the sake of learning Learning Components ~ Cognition ~ How people acquire knowledge ~ Seeing, hearing or doing ~ Conceptualization ~ How people process information ~ Abstract, specific, memory pathways ~ Affective ~ People’s motivation, decision-making styles, values and emotional preferences ~ How much does this information matter? Cognition: Knowledge Acquisition ~ Active/Reflective (When you process) ~ Processing information in the moment ~ Taking information in and having an ah-ha moment when it is assimilated ~ Action without reflection = Trouble ~ Reflection without action = Inaction Cognition: Knowledge Acquisition ~ Active/Reflective Learner Tips ~ Reflective learners ~ Think it through first ~ Prefer working alone ~ Active learners ~ Difficulty sitting quietly through lectures ~ Like group work ~ Need discussion

Journey to Recovery Series Individualizing Treatment for Temperament Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Podcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery Objectives ~ Review temperament dimensions as defined by the Keirsey ~ Review temperament as defined by the DISC ~ Explore how temperament impacts treatment approaches, interventions and settings ~ Identify common goals for treatment and ways to individualize them. Keirsey/MBTI ~ Extrovert/Introvert ~ Environment ~ Awareness ~ Processing methods ~ Sensing/Intuitive ~ Details vs. Big Picture ~ Thinking vs. Feeling ~ Motivation and Decision making ~ Judging vs. Perceiving ~ Time management Temperament Extrovert ~ Are expansive; less passionate ~ Easy to get to know ~ Like meeting new people ~ Would rather figure things out while they are talking ~ Often enjoy background noise ~ Know what is going on around them rather than inside them ~ Often do not mind interruptions ~ Are often considered good talkers Introvert ~ Are intense and passionate ~ Difficult to get to know ~ Exert effort to meet new people ~ Figure things out before they talk ~ Prefer peace and quiet ~ Are more likely to know what is going on inside them ~ Dislike being interrupted ~ Are often good listeners Temperament Sensing ~ Are practical and realistic ~ Prefer facts and live in the real world ~ Content in general ~ Would rather do than think ~ Focus on practical, concrete problems ~ See the details and may ignore the big picture ~ Want specifics and tend to be very literal ~ May think that those preferring intuition are impractical ~ Believe “if it isn’t broken, don’t fix it” iNtuitive ~ Are imaginative dreamers ~ Prefer abstraction, inspiration, insights ~ Live in the world of possibilities ~ Would rather think than do ~ Focus on complicated abstract problems ~ See the big picture but miss the details ~ Love word games ~ May think that those preferring the practical lack vision ~ Believe anything can be improved ~ Focus on the future and possibilities Temperament Thinking ~ Like words such as principles, justice, standards or analysis ~ Respond most easily to people’s thoughts ~ Want to apply objective principles ~ Value objectivity above sentiment ~ Can assess logical consequences ~ Believe it is more important to be just than merciful ~ Assess reality with a true/false lens ~ May think that those who are sentimental take things too personally ~ May argue both sides of an issue for mental stimulation Feeling ~ Like words such as care, compassion, mercy, intimacy, harmony, devotion ~ Respond most easily to people’s values ~ Want to apply values and ethics from multiple perspectives ~ Value sentiment above objectivity ~ Good at assessing the human impact ~ Believe it is more important to be caring/merciful ~ Assess reality with a good/bad lens ~ Think that those preferring objectivity are insensitive ~ Prefer a to agree with those around them Temperament Judging ~ Plan ahead ~ Self disciplined and purposeful ~ Thrive on order ~ Get things done early. Plan ahead & work steadily. ~ Define and work within limits ~ Maybe hasty in making decisions ~ Time and deadline oriented ~ Thinks those preferring spontaneity are too unpredictable ~ Excellent planners. May not appreciate or make use of things which are not planned or expected Perceiving ~ Adapt as they go ~ Flexible and tolerant ~ Thrive on spontaneity ~ Get things done at the last minute depending on spurt of energy ~ Want more information ~ May fail to make decisions ~ Always think there’s plenty of time ~ Think that those who are not spontaneous are too rigid ~ Good at handling unplanned events, but may not make affective choices among the possibilities. The DISC ~ The DiSC profile is a tool used for discussion of people's behavioral differences. ~ DiSC profiles help clients: ~ Increase self-knowledge of how they respond to conflict, what motivates them, what causes stress and how they solve problems ~ Improve work

This podcast episode is based on Journey to Recovery: A Comprehensive Guide to Recovery from Mental Health and Addiction Issues by Dr. Dawn-Elise Snipes  Read it for free on Amazon Kindle Unlimited. Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Podcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery Author: Journey to Recovery (2015) & Happiness Isn’t Brain Surgery (2017) To get on the pre-release list for Journey to Recovery 2nd Edition and a 50% discount on the digital version, please email support@allceus.com. Publication is expected at the end of October. Objectives ~ Identify the common symptoms for anxiety and depression-based disorders ~ Learn how a positive change in one area or symptom can have positive effects on all symptoms or areas. ~ Explore ~ The function of each of those symptoms ~ The potential causes of each of those symptoms ~ Interventions for each of those symptoms Review ~ Everything you feel, sense, think and do is caused by communication between your nerves with the help of chemical messengers called neurotransmitters. ~ “Higher order” thinking is able to over-ride sensory input and tell us there is a threat when none exists, or that there isn’t a threat when there really is. ~ Think of your brain as a computer processor. It simply does what it is told, based on the information that it has. What are symptoms ~ Symptoms are your physical and emotional reactions to a threat. ~ Symptoms are designed to protect you. ~ They are not bad or good. They just are. ~ Instead of trying to make the symptom go away, it may help to: ~ Understand the function of them ~ Identify alternate, more helpful, ways to deal with the threat Transtheoretical and Transdiagnostic ~ Transtheoretical means approaching a person’s presenting issues/symptoms and considering emotional, cognitive, physical, interpersonal and environmental explanations for it. ~ Transdiagnostic means that many symptoms are common to multiple issues such as sleep changes, appetite changes, irritability, fatigue and lack of pleasure. ~ By examining the WHOLE person and not getting stuck on treating a particular diagnosis we are freed up to really address the individual’s issues Case ~ Sally is a 27 year old mother of 2 and presenting with ~ Lack of pleasure/apathy “blah” ~ Fatigue ~ Irritability ~ Weight gain ~ Sleeping difficulties (waking up a lot) ~ Feelings of guilt ~ Inability to concentrate and indecisiveness ~ Diagnosis Possibilities (some) ~ Depression ~ Anxiety ~ PTSD ~ PCOS ~ Hypothyroid ~ “Stress” (relationship or job) Lack of Pleasure ~ Form/Symptom ~ Lack of pleasure in most things, most days for a period of at least 2 weeks. ~ Cause ~ Neurochemical imbalance (insufficient dopamine, norepinephrine?) caused by: ~ Lack of sleep ~ Excessive stress ~ Drug or medication use ~ Hormone imbalances including thyroid problems Lack of Pleasure ~ Causes ~ HPA-Axis ~ Cortisol ~ Increased norepinepherine and glutamate ~ Reductions in ~ Estrogen ~ Testosterone ~ Serotonin ~ Increased anxiety and depression ~ Reduced melatonin ~ Impaired sleep Lack of Pleasure ~ Function ~ This is your body's way of ~ Signaling that there may be a problem ~ Conserving excitatory neurotransmitters for a “real” crisis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182008/pdf/DialoguesClinNeurosci-13-263.pdf Post-traumatic stress disorder: the neurobiological impact of psychological trauma ~ Forcing you to address it. After all, nobody wants to be depressed for very long. Lack of Pleasure ~ How You Cope ~ Think back over a few times when you have been depressed, even if it was just for a few hours. ~ What did you do to help yourself feel better? ~ What makes the depression/lack of pleasure worse? ~ What can you do to prevent triggering your depression/lack of pleasure? ~ What changed this time that triggered the depression? Lack of Pleasure ~ Simple-ish Interventions ~ Don’t expect exhilaration, but try to do some things that make you mildly happy. ~ Get

Addiction Counselor Exam Review Case Management and Service Coordination Instructor: Dr. Dawn-Elise Snipes Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery & The Addiction Counselor Exam Review Objectives ~ Define referral and service coordination within the context of case management ~ Explore why CM is necessary ~ Identify the different approaches to case management ~ Identify the CM role in service coordination ~ Define service planning ~ Identify challenges and solutions to collaboration Service Coordination: Case Management ~ A client-level collaborative process designed to: ~ Help individuals access needed services ~ Select the most appropriate services ~ Facilitate linkage with those services ~ Promote continued retention in services by monitoring participation ~ Coordination of multiple services when necessary ~ Advocate for continued participation Service Coordination: Case Management ~ Objectives of case management ~ Continuity of care ~ Accessibility: ~ Establish relationships with “gatekeepers” ~ Develop contracts or MOUs which specify ~ Available “slots” ~ Consequences for failure to implement specified activities/procedures ~ Accountability ~ Following up on the referral with client and referral resource ~ Measuring outcomes with ~ Client satisfaction ~ Client outcomes ~ Service system outcomes (i.e. reduction in cost to treat) ~ Efficiency “Know the system and make it work” Service Coordination: Case Management ~ Necessary because of poor service coordination, lack of service continuity and difficulty of clients negotiating the gap between services ~ Structure ~ Case manager who acts as the human link between the client and service providers ~ Core agency ~ Develops contracts with providers for identified services ~ Controls case management funds ~ Acts as a single point of entry for clients ~ Develops missing service elements Service Coordination: Case Management ~ Approaches ~ Intensive/Assertive Community Treatment ~ Comprehensive, multidisciplinary, community based ~ Growth ~ Paternalism ~ Clinical ~ Case manager provides many services including counseling ~ Stabilization ~ Strengths based ~ Focus on strengths and empowerment ~ Growth ~ Empowerment Service Coordination: Case Management ~ Approaches ~ Brokerage ~ Coordinates services and provides few, if any services ~ Stabilization ~ Empowerment ~ Integrated ~ Family-focused, strength-based program that uses an independent facilitator to coordinate all relevant people, including providers, family and natural supports. ~ This team then works in partnership with the family to create a safety-based comprehensive plan addressing the needs of all family members. ~ Growth Service Coordination: Case Management Principles ~ Offers a single point of contact for clients ~ Client-driven and strengths based ~ Involves advocacy ~ Between services with seemingly contradictory requirements to serve the best interests of the client ~ With agencies, families, legal systems and legislative bodies ~ May involve the recommendation of sanctions to encourage client compliance and motivation ~ Community based ~ Pragmatic “Where the client is” ~ Anticipatory based on the natural course of the client’s presenting issues ~ Flexible to individual needs ~ Culturally sensitive Service Coordination: Case Manager’s Role ~ To coordinate, manage, link, advocate and support clients in their quest to maximize their quality of life and achieve as much independence as possible ~ Basic Prerequisites and Competencies ~ Ability to establish rapport ~ Awareness of how to maintain boundaries ~ Willingness to be nonjudgmental ~ Recognize the importance of family, social networks and community in the process ~ Understand the variety of insurance and payment options available ~ Understand culture and respond in a culturally sensitive manner ~ Understand the value of an interdisciplinary approach to treatment ~ Serve as both facilitator of referrals and advocate Service Coordination: Case

This podcast episode is based on Journey to Recovery: A Comprehensive Guide to Recovery from Mental Health and Addiction Issues 2nd Edition by Dr. Dawn-Elise Snipes Journey to Recovery  2nd Edition:  The Mind-Body Connection Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Counselor Education Podcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery To get on the pre-release list for Journey to Recovery 2nd Edition and a 50% discount on the digital version, please email support@allceus.com. Publication is expected at the end of October. Activity: How Do Your Mind & Body Interact? ~ What physical sensations do you have when you are angry? Anxious? Depressed? ~ When you are hungry or your blood sugar is low, what are your physical sensations? How does it affect your mood? ~ If you have been eating like crap, how do you feel? ~ When you drink alcohol or caffeine, does it impact your mood? ~ When you are sleepy or sick, how does it affect your mood? ~ When you are stressed, how does it affect your sleep? What physical aches and pains do you get when you are stressed? ~ When you are overtired, does life seem more stressful and exhausting? ~ When you are in pain, what is your mood like? Objectives ~ Learn about the central control center, the brain ~ What role does it play in ~ Emotions ~ Thoughts ~ Physical Reactions/Sensations ~ How things can go wrong ~ How to fix those things The Brain ~ Your central control center ~ Takes in information ~ Compares it to what it already knows (or thinks it knows) from prior experiences ~ Makes a decision about what to do. ~ Based on that decision it activates action centers which excrete neurotransmitters in order to produce the desired reaction. Neurotransmitters and Mood Creation ~ Chemical messengers take “orders” to and from the brain through the nervous system ~ The Big 5 fall into 2 main categories ~ Excitatory: ~ Dopamine = Pleasure ~ Norepinepherine & Glutamate: Motivation and stimulation (get-up-and-go) ~ Inhibitory: ~ GABA – Relax ~ Serotonin – Calming, contentment Neurotransmitters Function ~ Emotional ~ Happiness ~ Sadness ~ Anger & Fear ~ Mental ~ Concentration ~ Learning ~ Decision Making ~ Physical ~ Sleep behavior ~ Eating behavior ~ Libido ~ Gastrointestinal Functioning/motility ~ Pain perception Think About It ~ When you are… ~ “Afraid” ~ “Angry” ~ “Depressed” ~ What is your body’s response? ~ Are you more optimistic or pessimistic? ~ Do you tend to notice the positive things or the negative ones? Your Senses ~ Thoughts can trigger feelings and physical reactions ~ Feelings can impact thoughts and physical reactions ~ Physical sensations (your senses) can also trigger feelings and thoughts ~ Sight (Happy, Sad, Angry) ~ Smell (Happy, Sad, Angry) ~ Sounds (Happy, Sad, Angry) ~ Touch/comfort (Happy, Irritable) Mood Disorders ~ An imbalance in neurotransmitters will cause emotional, mental, or physical “distress” ~ What causes imbalances ~ Reduced Flow & Insufficiency ~ Too much “stress” for too long ~ Addictive behaviors ~ Medications ~ Poor nutrition ~ Insufficient sleep Neurotransmitters, Addiction & Black Friday ~ Normal day ~ Normal store capacity is 750 people. ~ The store needs a constant 500 to stay open ~ The store has 8 doors to allows for people to easily enter and exit without getting “bunched” ~ Black Friday ~ 1500 people push through the door as soon as it opens ~ Store is destroyed ~ Staff is exhausted ~ Takes time to restock and refresh staff ~ Management closes all but two doors and adds security guards to manage flow Where Does the Information Come From ~ Your Stress Sensor (Security Guard): Peripheral Nervous System ~ Your nervous system continues to feed the brain information about whether the threat is: ~ Continuing and something else needs to be done ~ Continuing but there is no hope ~ Subsiding and your brain can tell your body to relax. ~ How does all this happen? ~ How does the brain “know” what is threatening? Lets fin

Based on Doc Snipes' upcoming book 100+ Practical Tools to Defeat Depression. Read the whole book for FREE with Amazon Kindle Unlimited CEUs are available for this presentation at https://www.allceus.com/member/cart/index/product/id/904/c/ Dr. Dawn-Elise Snipes, PhD, LPC-MHSP, LMHC Executive Director, AllCEUs Counseling Education Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery Objectives ~ Discuss how all of your senses can either help you feel happier or more stressed. ~ Identify happiness triggers and ways to incorporate them into your home, car and office Connectedness ~ Your environment plays a big role in how you feel ~ A soothing environment will trigger calming physiological responses ~ A stressful environment can trigger anxiety or depression ~ If you are stressed or depressed your environment tends to end up reflecting that. ~ When you are happy and energized, your environment often reflects that as well. ~ How is your home different when you are depressed vs. when you are happy? ~ Describe a place that you walked into that had “bad energy” ~ Describe a place you walked into that had “good energy” Sights ~ Extroverts vs. Introverts ~ Sights (pictures, colors, people, things…) ~ How can you improve what you see ~ At home ~ At work ~ In the car ~ Lighting ~ Fluorescents are stressful and can trigger migraines and seizures ~ Too dim or too bright at the wrong times can mess up circadian rhythms. ~ Total room light is not necessary. Focused bright light can be very effective (especially for people with ADD) Smells: Aromatherapy ~ Smells are one of our strongest memory triggers ~ Aromatherapy uses essential oils to trigger physiological responses, but everyday items can also trigger responses ~ Activity: Identify 5 scents that bring back happy memories or feelings of calm ~ Activity: Wax tarts (What does this remind you of?) ~ Baby powder, pine trees, sugar cookies… ~ Activity: Identify 5 scents that help you feel energized and clear headed ~ Activity: Identify 10 ways to distribute fragrances (on a cloth in the sock drawer, on your pillow, in a spray bottle, lightbulb rings, wiped on ceiling fan blades etc…) Order and Organization ~ Declutter ~ 3 box method: Keep it, Give it Away, Trash ~ Hanger Turn ~ Mount Everest ~ Flat surface-itis Make a House a Home ~ Activity: Interior Design ~ Feng Shui for Dummies Cheat Sheet ~ Colors ~ Red/pink ~ Blue ~ Black ~ White ~ Yellow ~ Green ~ Brown Make a House a Home ~ Activity: What can you do to your environment to make it more pleasant? ~ Visually (colors, pictures, organization, plants, furniture placement/mirrors) ~ Smelling ~ Sounding (wind chimes, nature sounds, music, waterfall) ~ Temperature? ~ Smell? ~ Colors? ~ Décor/style? Modern? Farmhouse? English Cottage? Other? ~ Furniture? Clean lines or soft and fluffy? ~ Lighting? Summary ~ Your environment can trigger a variety of different feelings based on your prior experiences and personal preferences ~ Environments that are too noisy, bustling and chaotic can be exhausting for introverts, but environments that are too quite and subdued can make extroverts feel depleted. ~ Environments that trigger memories of happy times can help people feel less alone, more energetic and empowered

Based on Doc Snipes' upcoming book 100+ Practical Tools to Defeat Depression. Read the whole book for FREE with Amazon Kindle Unlimited CEUs are available for this presentation at https://www.allceus.com/member/cart/index/product/id/904/c/ Spiritual Interventions Dr. Dawn-Elise Snipes, PhD, LPC-MHSP, LMHC Executive Director, AllCEUs Counseling Education Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery Objectives ~ Define spirituality ~ Discuss how recovery can be a spiritual journey ~ Explore individual and group activities to help teach concepts of spirituality ~ Purposeful action ~ Living in the present ~ Values ~ Connectedness ~ Honesty and Authenticity ~ Responsibility and Discipline ~ Gratitude What is Spirituality ~ Recovery from depression can be a spiritual journey. It involves getting honest with yourself and others about what you can and cannot change, developing compassion for yourself and others and living mindfully, devoting energy to those things that are important to you. It is a journey that requires you to identify where you want to go, instead of aimlessly wandering through life. Honesty and Authenticity (Self-Connection) ~ That means acting in harmony with those needs, wants and desires. ~ Activity (Jenga, Hat Draw, Beach Ball) What and Why? ~ What is your favorite (food, movie, color, book, place, song…) ~ What is the most important characteristic in a friend? ~ What is one thing you do well? Don’t do well? ~ What makes you a good person? ~ What is one thing you really need right now to feel your best? ~ What is something you wish your best friend would do for you? ~ What is one thing you are proud of? ~ What is one thing you would like to improve? ~ What is one goal you are striving toward? ~ What is one thing holding you back from achieving your goal? Honesty and Authenticity (Self-Connection) ~ Activity ~ If I woke up tomorrow and was happy, what PPTs would be the same and what PPTs would be different? Write a list or description of what you want and need. (Get honest with yourself) You can always shred it. ~ By getting it out there you have the ability to look at it and decide which changes are really what you want and worth making, and which changes are just knee-jerk reactions to stress or despair. (Like changing jobs or ending a relationship) ~ Sometimes you will do things for people that you don’t really want to do. ~ You do it, because they are important to you. ~ In those cases, putting your needs aside serves to enhance something more important to you. ~ The challenge becomes balancing your needs with other people’s. Values Identification ~ Start with the Values Group Activity ~ Write the following values on individual sheets of paper and put them around the room ~ Honest, Loyal, Compassionate, Hard Worker/High Achiever, Humorous, Knowledgeable/Smart, Popular, Powerful/Influential, Respectful, Optimistic, Tidy/Clean ~ Ask each person to stand under the value that is MOST important for them to be known for. ~ Discuss why people chose that one. Who taught them that was important? ~ Ask if anyone has done anything in the past month that went against that value, and if so, how it made him/her feel. Values Identification ~ Discuss ~ Values shape how you view the world, what is important to you and how you define goodness. ~ You cannot live authentically or purposefully without knowing what you value ~ Any of these things can either contribute to a stronger sense of peace and self-worth, or a greater sense of confusion, helplessness, hopelessness and depression. ~ You are encouraged to evaluate: ~ What your values are ~ Where they came from ~ Whether you truly believe them ~ Their impact on your actions and the resulting impact on you and society ~ How you choose which to nurture and which to let go when they conflict. Purposeful Action ~ Everything we do has a purpose, so what is purposeful action? (Hint: Actions that get us closer to those things that are important to a rich and meanin

Addiction Counselor Exam Review Podcast Episode 22 Pharmacology Instructor: Dr. Dawn-Elise Snipes, PhD Executive Director: AllCEUs.com, Counselor Education and Training Podcast Host: Counselor Toolbox & Addiction Counselor Exam Review AllCEUs offers Addiction Counselor Precertification Training for $149 for 400+ hours of multimedia education.  We also are there for you when you need CEUs for as low as $59 for unlimited CEUs. Objectives ~ Review symptoms of intoxication and withdrawal of drugs of abuse ~ Learn about Post Acute Withdrawal Syndrome (PAWS) ~ Identify factors that impact symptomatology General ~ Purity of the drug, hydration levels, route of administration and usage patterns all can impact ~ Speed of the effect ~ Intensity of the effect ~ Range and intensity of negative consequences/side effects ~ Injecting can result in blood infections, collapsed veins, kidney and heart problems (Fastest) ~ Inhaling can result in ulcerated nasal passages ~ Oral ingestion must be filtered through the liver and kidneys and often also irritates the GI tract (Slowest) Drugs of Abuse ~ Alcohol ~ Classified as a sedative-hypnotic, CNS depressant ~ Ethanol/Ethyl alcohol 8 stages of effect as BAC increases ~ Subclinical ~ Euphoria ~ Excitement ~ Excitement/confusion ~ Confusion stupor ~ Coma ~ Death Drugs of Abuse ~ Alcohol ~ Men drink more ~ Women more likely to ~ Develop drinking problems ~ Experience alcohol related organ damage at lower levels ~ Women’s BAC reaches higher levels with same amounts of alcohol as men ~ Alcohol mixes with water and men tend to have more body water Drugs of Abuse ~ Alcohol related medical conditions ~ Loss of control of eye muscles ~ Hypoglycemia ~ Gastritis / Pancreatitis ~ Reduced immunity ~ Cardiac arrhythmia ~ Anemia ~ Constant flushing ~ Peripheral neuritis ~ Fatty liver ~ Cirrhosis ~ Blood pressure increases ~ Wernicke/Korsakoff’s syndrome / Alcohol related dementia Drugs of Abuse ~ Cannabis ~ As of 2016, still considered a schedule 1 by the DEA ~ Schedule 1 substances have no medicinal use and high risk of abuse ~ Legal in 29 states for medical use and in 8 of those states for recreational use ~ 9-17% of occasional users become addicted ~ 25-50% of daily users become addicted ~ Methods of administration ~ Smoked (pipes, bongs, blunts, Dabs) – rapid action ~ Consumed (tea, brownies) –slower action ~ Acts on cannabinoid receptors which influence memory, pleasure, concentration, sensory perception Drugs of Abuse ~ Cannabis ~ Dabs ~ Concentrated doses of cannabis that are made by extracting THC and other cannabinoids using a solvent like butane or carbon dioxide, resulting in sticky oils ~ Even when home extraction goes well, there’s no way to know the quality or purity of your finished product. “Dirty” oil may contain chemical contaminants or excessive amounts of residual solvents that could present health hazards ~ Cannabis extracts often test between 60-90% THC, which means it doesn’t take much to become profoundly high ~ Can be inhaled using a dab-pen or a e-cig with attachments ~ Besides coughing like a maniac, the second most common side-effect associated with dabbing is sweating like you ran a marathon Drugs of Abuse ~ Cannabis ~ Effects ~ Respiratory illness ~ Heightened heart attack risk ~ Neurobehavioral effects on fetus ~ Increased depression, anxiety and suicidal thoughts, esp. in adolescents ~ Loss of motivation ~ Exacerbation of schizophrenia ~ Impaired judgement ~ Impaired motor coordination ~ Reduced life satisfaction ~ Lower academic/career success Drugs of Abuse ~ Synthetic Marijuana (Spice/K2) ~ Synthetic cannabinoids refer to a growing number of man-made mind-altering chemicals sprayed on dried, shredded plant material or vaporized to get high. ~ Synthetic cannabinoids are sometimes misleadingly called “synthetic marijuana” (or “fake weed”) because they act on the same brain cell receptors as THC ~ The effects of synthetic cannabinoids can be unpredictable a