Counselor Toolbox Podcast

Treatment Planning with the MATRS and ASI Instructor; Dr. Dawn-Elise Snipes Executive Director, AllCEUs Counselor Education and Training Podcast Host: Counselor Toolbox, Addiction Counselor Exam Review & Happiness Isn’t Brain Surgery Objectives • Examine how Addiction Severity Index information can be used for clinical applications and assist in program evaluation activities. • Identify differences between program-driven and individualized treatment planning processes. • Gain a familiarization with the process of treatment planning including considerations in writing and prioritizing problem and goal statements and developing measurable, attainable, time-limited, realistic, and specific (M.A.T.R.S./SMART) objectives and interventions. • Define basic guidelines and legal considerations in documenting client status. ASI • Medical Status • Life interference • Due to addiction • Assessed need for medical intervention • Education, Employment, Finances • Level of education • Occupational hx forever and last 30 days • Drivers license/transportation • Sources of financial support • Dependents • Perception of employment / financial issues • Assessed need for employment counseling ASI • Alcohol/Drug Use • Drugs (addictive behaviors) used, pattern and method • Amount of money spent • Which drugs (behaviors) most problematic • Voluntary abstinence – When, for how long, how and what triggered relapse • Hx of medical problems due to use • Treatment Hx • Perception of the need for treatment • Assessed need for treatment ASI • Legal status • Probation or parole • Is treatment court mandated • Are you awaiting trial / pending charges • Catalog charges and frequency • How many charges are addiction related • How many charges resulted in convictions • How many times have you been incarcerated? • How many days in the last 30 have you been in jail • Perception of legal problems • Assessed need for legal services/counseling ASI • Family/Social History • Identify history of addiction or psychiatric issues in 1st and 2nd degree family members • Marital status and satisfaction • Living arrangements and satisfaction (Recovery environment) • Use of alcohol or drugs in the household • With whom do you spend most of your time • Who are your close friends • Have you had serious difficulty getting along with any first degree family member, coworker or friend • Trauma/abuse history • Perception of interpersonal problems • Assessed need for family/social counseling ASI • Psychiatric • How many times hospitalized • Number of times ever and 30 days you have experienced depression, anxiety, hallucinations, cognitive difficulties, suicidal ideation, • Are you on or have you ever been on psychiatric medications • Perception of psychiatric issues • Assessed need for mental health counseling Process Review • An assessment is conducted. • Data and information are collected from the client, collateral sources, and assessment scales. • Problems are identified. • Readiness for change for each problem is identified • Problem statements are prioritized. • Goals are created that address the problems. • Objectives to meet the goals are defined • Interventions are revised or changed based on client response to treatment Treatment Plan Overview • Developed at admission and continually updated • Individualized • Problem statements are • Nonjudgmental • Not jargony “denial” “resistant” “Codependent” • Goals must be • Specific • Measurable (as evidenced by) • Achievable • Relevant • Time limited (achievable by the end of treatment) Treatment Plan Overview • Program-driven plans • Are one-size-fits all • Reflect the components and/or activities and services available in the program • Individualized Treatment Plan is “Sized” to Match Client Needs • Not all clients have the same needs or are in the same situation. • The individualized treatment plan is made to “fit” the client based on her/his unique: • Abilities • Goals • Lifestyle • Socioeconomic realities • Work history • Educa

WRITING EFFECTIVE TREATMENT PLANS: The Pennsylvania CASSP Model Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP Executive Director: AllCEUs.com Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery and Addiction Counselor Exam Review Objectives • Learn the principles of the CASSP model • Review the difference between goals, objectives and interventions • Identify qualities of good goals, objectives and interventions • Services are planned to meet the individual needs of the child, rather than to fit the child into an existing service. • Services • Consider the child’s family and community contexts • What resources are available • What are their capabilities and needs • Are developmentally appropriate and child- specific (not little adults) • Build on the strengths of the child and family to meet the mental health, social, and physical needs of the child. • Services recognize that family is the child’s primary support system • The family is a full partner in all stages of the decision-making and treatment planning process, including implementation, monitoring, and evaluation. • A family may include biological, adoptive, and foster parents, siblings, grandparents and other relatives, and other adults committed to the child. • Examine the people with whom the youth spends the most time. (runaways/homeless youth; youth in boarding school) • What is the family’s perception of: • Functioning • Strengths • Priorities • Cultural values • Whenever possible, services are delivered in the child’s home community, drawing on formal and informal resources to promote the child’s successful participation in the community. • Community resources include not only mental health professionals and provider agencies, but also social, religious, and cultural organization and other natural community support networks • Services are planned in collaboration with all the child-serving systems involved in the child’s life. • Representatives from all these systems and the family collaborate to • Define the goals with the child • Develop a service plan • Develop the necessary resources to implement the plan • Provide appropriate support to the child and family • Evaluate progress. • Culture determines our world view and provides a general design for living and patterns for interpreting reality that are reflected in our behavior. • Services that are culturally competent are provided by individuals who have the skills to recognize and respect the behavior, ideas, attitudes, values, beliefs, customs, language, rituals, ceremonies, and practices characteristic of a particular group of people. • Questions that must be answered • What is the view of the child in this culture? • What are cultural expectations for functioning in this area? • What is the cultural perception for need for help and who from? • What are cultural strengths that can be capitalized on? • What does the culture perceive as the child and family’s strengths? • Services take place in settings that are the • most appropriate and natural for the child • and family and are the least restrictive and • intrusive available to meet the needs of the • child and family. Treatment Plan Characteristics • An effective treatment plan should be both informative and practical. • A person reading a treatment plan should be able to grasp the major concerns and how they are being addressed. • The initial treatment plan identifies the work to be done. • Subsequent treatment plans identify • what is currently being done • what has recently been achieved, • work and services planned for the future. • By defining goals and objectives which can be monitored, the treatment plan becomes an instrument of accountability. • Identified goals, objectives and outcomes can be actively tracked by the team, and modifications in treatment made as needed. Components • Brief Description of the Child • Tony is a thirteen-year-old Caucasian male living with his mother and four sisters in a three bedroom mobile home. Tony i

WRITING EFFECTIVE TREATMENT PLANS: The Pennsylvania CASSP Model Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP Executive Director: AllCEUs.com Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery and Addiction Counselor Exam Review Objectives • Learn the principles of the CASSP model • Review the difference between goals, objectives and interventions • Identify qualities of good goals, objectives and interventions • Services are planned to meet the individual needs of the child, rather than to fit the child into an existing service. • Services • Consider the child’s family and community contexts • What resources are available • What are their capabilities and needs • Are developmentally appropriate and child- specific (not little adults) • Build on the strengths of the child and family to meet the mental health, social, and physical needs of the child. • Services recognize that family is the child’s primary support system • The family is a full partner in all stages of the decision-making and treatment planning process, including implementation, monitoring, and evaluation. • A family may include biological, adoptive, and foster parents, siblings, grandparents and other relatives, and other adults committed to the child. • Examine the people with whom the youth spends the most time. (runaways/homeless youth; youth in boarding school) • What is the family’s perception of: • Functioning • Strengths • Priorities • Cultural values • Whenever possible, services are delivered in the child’s home community, drawing on formal and informal resources to promote the child’s successful participation in the community. • Community resources include not only mental health professionals and provider agencies, but also social, religious, and cultural organization and other natural community support networks • Services are planned in collaboration with all the child-serving systems involved in the child’s life. • Representatives from all these systems and the family collaborate to • Define the goals with the child • Develop a service plan • Develop the necessary resources to implement the plan • Provide appropriate support to the child and family • Evaluate progress. • Culture determines our world view and provides a general design for living and patterns for interpreting reality that are reflected in our behavior. • Services that are culturally competent are provided by individuals who have the skills to recognize and respect the behavior, ideas, attitudes, values, beliefs, customs, language, rituals, ceremonies, and practices characteristic of a particular group of people. • Questions that must be answered • What is the view of the child in this culture? • What are cultural expectations for functioning in this area? • What is the cultural perception for need for help and who from? • What are cultural strengths that can be capitalized on? • What does the culture perceive as the child and family’s strengths? • Services take place in settings that are the • most appropriate and natural for the child • and family and are the least restrictive and • intrusive available to meet the needs of the • child and family. Treatment Plan Characteristics • An effective treatment plan should be both informative and practical. • A person reading a treatment plan should be able to grasp the major concerns and how they are being addressed. • The initial treatment plan identifies the work to be done. • Subsequent treatment plans identify • what is currently being done • what has recently been achieved, • work and services planned for the future. • By defining goals and objectives which can be monitored, the treatment plan becomes an instrument of accountability. • Identified goals, objectives and outcomes can be actively tracked by the team, and modifications in treatment made as needed. Components • Brief Description of the Child • Tony is a thirteen-year-old Caucasian male living with his mother and four sisters in a three bedroom mobile home. Tony i

Treatment Planning with the MATRS and ASI Instructor; Dr. Dawn-Elise Snipes Executive Director, AllCEUs Counselor Education and Training Podcast Host: Counselor Toolbox, Addiction Counselor Exam Review & Happiness Isn’t Brain Surgery Objectives • Examine how Addiction Severity Index information can be used for clinical applications and assist in program evaluation activities. • Identify differences between program-driven and individualized treatment planning processes. • Gain a familiarization with the process of treatment planning including considerations in writing and prioritizing problem and goal statements and developing measurable, attainable, time-limited, realistic, and specific (M.A.T.R.S./SMART) objectives and interventions. • Define basic guidelines and legal considerations in documenting client status. ASI • Medical Status • Life interference • Due to addiction • Assessed need for medical intervention • Education, Employment, Finances • Level of education • Occupational hx forever and last 30 days • Drivers license/transportation • Sources of financial support • Dependents • Perception of employment / financial issues • Assessed need for employment counseling ASI • Alcohol/Drug Use • Drugs (addictive behaviors) used, pattern and method • Amount of money spent • Which drugs (behaviors) most problematic • Voluntary abstinence – When, for how long, how and what triggered relapse • Hx of medical problems due to use • Treatment Hx • Perception of the need for treatment • Assessed need for treatment ASI • Legal status • Probation or parole • Is treatment court mandated • Are you awaiting trial / pending charges • Catalog charges and frequency • How many charges are addiction related • How many charges resulted in convictions • How many times have you been incarcerated? • How many days in the last 30 have you been in jail • Perception of legal problems • Assessed need for legal services/counseling ASI • Family/Social History • Identify history of addiction or psychiatric issues in 1st and 2nd degree family members • Marital status and satisfaction • Living arrangements and satisfaction (Recovery environment) • Use of alcohol or drugs in the household • With whom do you spend most of your time • Who are your close friends • Have you had serious difficulty getting along with any first degree family member, coworker or friend • Trauma/abuse history • Perception of interpersonal problems • Assessed need for family/social counseling ASI • Psychiatric • How many times hospitalized • Number of times ever and 30 days you have experienced depression, anxiety, hallucinations, cognitive difficulties, suicidal ideation, • Are you on or have you ever been on psychiatric medications • Perception of psychiatric issues • Assessed need for mental health counseling Process Review • An assessment is conducted. • Data and information are collected from the client, collateral sources, and assessment scales. • Problems are identified. • Readiness for change for each problem is identified • Problem statements are prioritized. • Goals are created that address the problems. • Objectives to meet the goals are defined • Interventions are revised or changed based on client response to treatment Treatment Plan Overview • Developed at admission and continually updated • Individualized • Problem statements are • Nonjudgmental • Not jargony “denial” “resistant” “Codependent” • Goals must be • Specific • Measurable (as evidenced by) • Achievable • Relevant • Time limited (achievable by the end of treatment) Treatment Plan Overview • Program-driven plans • Are one-size-fits all • Reflect the components and/or activities and services available in the program • Individualized Treatment Plan is “Sized” to Match Client Needs • Not all clients have the same needs or are in the same situation. • The individualized treatment plan is made to “fit” the client based on her/his unique: • Abilities • Goals • Lifestyle • Socioeconomic realities • Work history • Educa

Recovery Oriented Systems of Care Dr. Dawn-Elise Snipes PhD, LPC-MHSP Executive Director: AllCEUs Counselor Continuing Education Podcast Host: Counselor Toolbox, Addiction Counselor Exam Review & Happiness Isn’t Brain Surgery Objectives • Define a Recovery Oriented System of Care • Discuss the 17 Elements of a ROSC • Explore the Guiding Principles of Recovery Recovery Oriented Systems of Care • Affirms the real potential for permanent resolution of behavioral health problems • Offers solutions to behavioral health problems on a community and cultural level • Shift away from risk management and relapse prevention toward encouraging clients to self-define goals and take responsibility for achieving them • A shift from emergency room/acute care model to one of sustained recovery management which include wrap-around recovery support services Recovery Oriented Systems of Care • Emphasis on • Post-treatment monitoring • Stage-appropriate recovery education • Peer recovery coaching • Assertive linkages to recovery communities • Early re-intervention • Maintaining functional ability in all life activities • Recovery in illness instead of recovery from illness Recovery Oriented Systems of Care • Goals • Foster health and resilience activities • Increase permanent housing and sense home/belonging • Ensure gainful employment and access to education to provide a sense of purpose • Enhance communities by increasing availability of necessary supports from and for peers/family/community • Reduce barriers to social inclusion • Counselor functions • Identify gaps in services • Identifying emerging trends and needs • Monitor system effectiveness ROSC Guiding Principles • Recovery emerges from hope and is… • Person-centered – self-efficacy, self-direction • Non-linear, and occurs via many pathways (methods) • Holistic – mind, body, spirit, community • Supported by peers and allies (counselors/case workers) • Supported through relationships and social networks (family, peers, faith groups, community) • Culturally based and influenced • Supported by addressing trauma • Based on respect of individual, family and community strengths and responsibilities ROSC Guiding Principles • Recovery emerges from hope and… • Involves a personal recognition of the need for change and transformation • Involves a process of healing and self-redefinition • Exists on a continuum of improved health and wellness • Involves addressing discrimination and transcending shame and stigma • Involves (re)joining and (re)building a life in the community • Is a reality Elements of a ROSC • Person-centered, strengths-based, individualized providing integrated, comprehensive services across the lifespan • Inclusive of family and other ally involvement • Anchored in the community • Continuity of care • Partnership-consultant relationships • Culturally responsive /Responsive to personal belief systems • Commitment to peer recovery support services for client and families • System-wide education and training • Ongoing monitoring and outreach • Outcomes driven • Research based • Adequately and flexibly financed. Recovery Management • Spans 3 phases • Prerecovery identification and engagement • Recovery initiation and stabilization • Recovery maintenance Recovery Oriented Systems of Care • 3 core components • Collaborative decision making /individual empowerment • Continuity of services and supports • No wrong door • Services available as long as needed • Service quality and responsiveness • Evidence based • Developmentally and culturally appropriate • Gender specific • Trauma informed • Family focused • Stage appropriate Players • Individual • Family • Peers • Community • Transportation • Civic organizations • Community coalitions • Housing • Childcare providers • Business community • Educational system • Veteran’s affairs • Criminal justice (courts, cops, jails, P&P) • Physicians • Counselors • Clergy • Financial counselors • Social services Creating a Recovery Oriented Enviro

Domestic Violence and Mental Health Dr. Dawn-Elise Snipes PhD, LPC-MHSP Executive Director: AllCEUs Counselor Continuing Education Podcast Host: Counselor Toolbox, Addiction Counselor Exam Review & Happiness Isn’t Brain Surgery Objectives • Overview of the prevalence of IPV/DV • Overview of the mental health professional guidelines. • Assessment of those who batter: limits of confidentiality • Treatment Program approaches and goals • Partner contacts • Characteristics of those who batter • Characteristics of victims • Impact of DV on mental health • Treatment issues for victims • Impact of DV on children • What can help children • Buffers against DV Statistics • 1 in 4 women and 1 in 7 men have been victims of severe physical violence by an intimate partner in their lifetime. https://ncadv.org/statistics • 19.3 million women and 5.1 million men in the United States have been stalked in their lifetime. • 63% of males as opposed to 15% of females had a deadly weapon used against them in a domestic violence incident. • In the year 2000, 440 men were killed by their intimate partner. Since then, 4% of male murder victims come from domestic violence incidents. Male Victims of DV • Men find it hard to see themselves as victims. They tend to feel that battering is associated with women and not men. • Men who are bisexual or gay may believe that they deserve the abuse because of their sexual orientation. • Male victims find it hard to seek help because • Help is mainly gender based • According to the National Coalition of Domestic Violence in 2003 and 2004 the state of Tennessee provided shelter to 11 men but was unable to find shelters for 192 men • They feel that they do not have the right to seek help because they have become part of the problem by defending themselves Where Do We Find Victims and Abusers? • Mandated treatment for batterers from the courts • Self referral for domestic violence counseling • In the context of therapy for other concerns (e.g., alcohol or other drug abuse, marital conflict, anger problems, depression, academic or conduct problems of children who witness domestic violence, etc.) • Over fifty percent of clients presenting alcohol or other drug problems also experience domestic violence. • Over fifty percent of those presenting for help with domestic violence also struggle with substance abuse. Important Note • Statistically, women are more likely to be killed by their partners when their partners threaten suicide than when their partners threaten homicide. However, confidentiality laws do not provide for the warning of battered women whose partners contemplate suicide. • Therefore, treatment programs may wish to specify an exception to confidentiality in the program contract for “all threats of harm to self and others.” Concurrent Addiction and DV Treatment • Some domestic violence programs require chemically-dependent batterers to participate in drug treatment programs concurrently. • Many of the treatment issues are the same (e.g., denial, minimization, projection of blame, etc.) • Batterers often blame their use of violence on psychoactive substances • Batterers often blame their partners for “forcing” them into treatment • Violence may become more frequent once the “batterer” is sober • Integrated treatment allows for an examination of the relationship between substance use and violence • Victims remain at higher risk of being abused while their partners go without DV treatment • Postponing DV treatment may imply that stopping the violence is not as important as some other issue such as substance abuse. What About Couples Counseling • Clinicians should question the appropriateness/safety of couples counseling if any of the following conditions exist: • Physical violence within the last several months • Either partner is afraid of the other • Either partner is afraid of reprisal for expressing feelings, needs, concerns, etc. • Either partner does not believe that the other can express feelings other

Addiction Counselor Exam Review Podcast Hosted by Dr. Dawn-Elise Snipes Executive Director: AllCEUS.com Counselor Training Unlimited CEUs $59 and Addiction Counselor Precertification Training $149 Objectives • Examine the counselors function in providing client, family and community education • Identify the benefits of outreach and education • Identify qualities of effective education efforts Client, family and community education • Learning is defined as a change in behavior that can occur at any time or in any place as a result of exposure to environmental stimuli • The teacher and learner jointly perform teaching and learning activities • Counselors are often called upon to teach daily living skills to increase patients’ level of independence • Health educators provide information to individuals and communities on a variety of important topics including biological, medical, and physical aspects of substance use, safety, HIV and STDs, nutrition, General Medical conditions, smoking, pregnancy, and mental health • Success is measured not by how much content has been imparted but how much the person has learned Client, family and community education • Client family and community education is the process of providing client’s families, significant others and community groups with information on a variety of topics • The role of educator encompasses many knowledge and skill sets such as • understanding and applying the principles of learning theory • using specific teaching skills to accommodate individual learning styles • making adaptations for culture, age and linguistic ability among learners • Educational groups help engage the client in treatment and recovery and is much less threatening because it is easier to learn than to change Client, family and community education • Characteristics of adult learners • They are engaged in multiple roles • They have more life experiences • They need a safe environment in which they do not have to be afraid of being wrong • They're self directed and don’t want to be spoon fed • They are relevancy oriented • Their problem solvers and want to know how new information can be applied in a practical setting • They need to feel part of a learning community which provides both encouragement and serves as a sounding board for ideas, anxieties, and concerns • Adults are motivated to learn • In order to cope with specific life changing events • Because they have a use for the knowledge or skill being sought Effective education efforts • Education is provided in a variety of ways including formal classes, handouts and informal meetings • Print electronic and other multimedia educational materials have become increasingly available • A client education program must be sensitive to the following: • Characteristics and needs of the client, their family, and significant others • Physical/environmental • Time/scheduling • Cognitive/learning abilities • Language • Cultural Effective education efforts • Educational sessions are typically offered in 60 to 90 minute blocks • Sessions usually consist of a lecture, an exercise, and are presented with media supplements • Educational topics include: • Addiction as a Biopsychosocial disease • The recovery process • Life skills • Health • Relapse warning signs and triggers • Resources available for clients family’s and community members • Recovery planning Effective education efforts continued • Learning styles • Each learner absorbs and retains information differently • A learning style is the primary way person tends to learn and can be auditory, visual, or kinesthetic • Challenges to learning • Learning and memory deficits attributable to substance use • Consideration should be given to the teaching approach used and the amount of information given at any one time • The matrix model of outpatient treatment illustrates an approach that recognizes impairments and delivers information to the client accordingly • Progress is gradual • The focus is on the present

Psychological Triage and First Aid Objectives CEUs are available for this presentation at https://allceus.com/webinar ~Explore applications for psychological triage and first aid in crisis situations ~Discuss the applicability of this approach for clinicians, reception staff, clergy, teachers and employers Psychological Triage and First Aid ~A method of becoming aware of and providing initial response to a crisis situation Applicability ~Clinicians ~Reception staff ~Clergy ~Teachers ~Employers Activity ~Write one of the following on each of the 7 cards you are given: ~Your best friend ~Your closest family member ~One of your favorite belongings ~Something you enjoy, an activity, or hobby. ~An ability ~Health ~Housing ~Financial Security ~After you have written on each card, place them face down on the table and shuffle them around. Close your eyes and pick three cards… Role of the Lay Person ~Protect from danger ~Be direct and active ~Provide accurate information about what you’re going to do ~Reassure, but do not give false assurances ~Recognize the importance of taking action ~Provide and ensure emotional support Considerations ~People typically rely on past strategies to cope with new stressful situations ~Past coping mechanisms can be functional or dysfunctional. ~Hardiness (resilience) has been identified as a buffer ~Children can be vulnerable because they have no experience or known patterns of actions as a response to the experience. Psychological First Aid promotes and sustains an environment of all of the following EXCEPT:{ ~Safety ~Calm ~Connectedness =Caregiver dependence ~Hope} Summary ~Many people in the community are in a position to provide early identification of someone in crisis. ~Many times people in crisis who receive support, connect with available resources and have adequate coping and health-related behaviors will adjust without professional help ~People who are alert to other people’s distress can easily start experiencing compassion fatigue ~It is vital to remember that for a responder to be responsive, he or she must be healthy. ~Making psychological triage a part of the routine of teachers, clergy, LEO, supervisors can assist in reducing mental illness and substance abuse and increasing individual welfare and economic stability. ~Offering practical assistance is composed of four steps ~Identifying the most immediate needs ~Clarifying the need ~Acting to address the need

Parenting Skills CEUs are available for this presentation at https://allceus.com/webinar Objectives • Identify 6 key areas of child development • Describe characteristics of children in 4 stages of development • Identify key principles to help you effectively work with/parent children. Developmental vs. Chronological • Culture, environment, health and personality impact developmental age. • Maslow 6 Ways Children Grow Piaget in a Nutshell • Thinking, Reasoning and Problem Solving • Pre-operational • Concrete Operational • Formal Operational Erikson in Brief • Love and Belonging, Self-Esteem • Autonomy vs. Shame • Industry vs. Inferiority • Identity vs. Role Confusion Kohlberg’s Theory of Moral Development • Level 1: Preconventional: Focus on the Self • Punishment and Obedience: Can I do it and not get caught? • Personal Benefit: What makes ME happiest? • Level 2: Conventional: Focus on Others • Conforming to the will of the group. What makes others happy/gets me approval? • Authority and Social Order: What does society say I should do? • Level 3: Post-Conventional: Focus on the Principles • Social Contract and Human Rights: Do the rules need to be changed to fit the current culture? • Universal Ethical Principles: What is the most compassionate and ethical choice? Common Observations: Preschool • Biological Needs • Sleep: 10-13 hours quality sleep • Exercise: 30 minutes of structured physical activity and at least 60 minutes of unstructured physical activity daily • Nutrition: ~1400 calories • Piaget–Cognitive Needs: Concrete Operational • Use concrete examples: How would you feel if….? • Egocentric: Help clarify what is and is not the child’s doing… • All or Nothing; Always or Never. Difficulty with sometimes. • Clarify Media: Truth vs. Fiction and Ongoing vs. Reruns Common Observations: Preschool • Love, Belonging and Esteem Needs –Erickson: Initiative vs. Guilt • Love and Belonging Needs (UPR) • Self-Esteem Needs: What can the child do? Dislike behaviors not children. • Kohlberg–Social/Moral Reasoning • Instrumental purpose (good deal) • Safety Needs Common Observations: Preschool • Strong attachment to home and family • Short interest span • Short attention span • Aware of self and own desires • Imaginative (animism) • Curious • Seeks repetition of enjoyable activities • Boys and girls readily play together • Depends on adults for getting needs met • Needs consistency • Thrives on structure Common Observations Elementary • Biological Needs • 9-12 hours of sleep • Nutrition: 1600-2000 calories • Moderately active 60 minutes a day, at least five days a week or have at least 11,000 daily activity steps on a pedometer • Piaget–Cognitive Needs: Concrete operational thought • Still needs concrete examples • Less all-or-nothing thinking • Love, Belonging and Self-Esteem– Erickson: Ability to master and complete tasks/sense of accomplishment • Emphasize goodness of the child • Model positive expectations • Teach acceptance of failures • Encourage calculated risk taking Common Observations Elementary • Kohlberg–Social/Moral Reasoning: Interpersonal Accord and Conformity (Being good and living up to what others expect of you) • Openly communicate about expectations and their rationale • Identify who “others” are • Reward conformity to expectations • Safety Needs • Safe, independent exploration (Scouts, sports teams, hobbies) • Cohesiveness in the environment: A feeling of confidence that one's internal and external environment is predictable and that things will probably work out as well as can be reasonably expected Common Observations Elementary • Longer attention span • Difficulty managing boredom • Provide positive alternatives • Still short interest span • Encourage Exploration • Aware of others and willing to share • Desires acceptance from peers • Expresses self freely in play and art • Help child put words to expressions • Wants everyone to obey rules • Explore feelings related to nonconf

Addiction Counselor Exam Review Models of Treatment Objectives Models of Treatment • Psychological (self-medication) Model • Addiction and mental health issues result from deficits in learning, thinking or emotion regulation • Treatments • Behavioral self-control • Individual and group counseling (Multiple EBPs) • Pharmacotherapy for mental health issues Psychological: Behavioral Self Control • Goals • Strengthen internal mechanisms (self-awareness) • Establish external controls • Coping skills • Goal setting • Behavioral contracting (What would you contract for?) • Trigger management (What are MH triggers) • Functional Analysis (of behaviors NOT diagnosis) • Relapse prevention (What are relapse prevention strategies for MH? Addiction?) Psychological: Psychotherapeutic • Dialectical Behavior Therapy • Why • Clients unintentionally rewarded ineffective treatment while punishing their therapists for effective therapy. • The sheer volume and severity of problems presented by clients made it impossible to use the standard CBT format. • Clients found the focus on change inherent to CBT invalidating. (How might this be true in addiction?) • Clients felt their suffering was being underestimated, and therapists were overestimating their helpfulness • “You are doing it, or feeling incorrectly.” Psychological: Psychotherapeutic • Dialectical Behavior Therapy • Over Riding Themes • Mindfulness (wise  mind) • Distress tolerance • Emotion regulation • Interpersonal effectiveness & problem solving Psychological: Psychotherapeutic • Matrix Model for Stimulant Use • A 45 session treatment program • Goals: • Learn about issues critical to addiction and relapse • Receive direction and support from a trained therapist • Become familiar with self-help programs. • The therapist functions simultaneously as teacher and coach, fostering a positive, encouraging relationship Psychological: Psychotherapeutic • Motivational Enhancement Therapy • Helps resolve ambivalence about treatment & abstinence • This therapy consists of: • Initial assessment battery • Followed by 2-4 individual sessions with a therapist Psychological: Psychotherapeutic • Motivational Enhancement Therapy • This therapy consists of (cont…): • First treatment session (FRAMES) • Feedback about the initial assessment • Responsibility • Elicits self-motivational statements • Strengthens motivation and builds a plan for change • Advice: Coping strategies for high-risk situations are suggested Psychological: Psychotherapeutic • Motivational Enhancement Therapy • This therapy consists of (cont…): • First treatment session • Menu of Options • Empathy • Self-Efficacy • Subsequent sessions: therapist monitors change, reviews change strategies being used, encourages change Psychological: Psychotherapeutic • Family Behavior Therapy (FBT) • Demonstrated positive results in both adults and adolescents • Addresses not only substance use and mental health problems but other co-occurring issues (i.e. conduct disorders, child mistreatment, family conflict, and unemployment) • FBT involves the patient along with at least one significant other such as a cohabiting partner or a parent Psychological: Psychotherapeutic • Family Behavior Therapy (FBT) • FBT combines behavioral contracting with contingency management. • Therapists seek to engage families in applying the behavioral strategies taught in sessions and in acquiring new skills to improve the home environment. Psychotherapeutic • Seeking Safety • Present-focused therapy for trauma/PTSD and addiction • Available as a book, with guidance for clients and clinicians • Can be done in individual or group Psychological: Psychotherapeutic • Introduction/Case Management • Safety, PTSD: Taking Back Your Power • When Substances Control You • Honesty, Asking for Help • Setting Boundaries in Relationships • Getting Others to Support Your Recovery • Healthy Relationships • Community Resources • Compassion • Creating Meaning • Discovery • Integrating the Split S

Preventing Elder Abuse Objectives ~ Define elder abuse ~ Examine the prevalence of elder abuse ~ Identify risk factors for elder abuse ~ Explore prevention strategies A direct link to the counseling CEU course based on this podcast can be found at https://allceus.com/podcastCEUs Definitions ~ “Physical Abuse” means the use of physical force which results or could result in physical injury to an incapacitated adult. ~ “Sexual Abuse” means contact or interaction of a sexual nature involving an incapacitated adult who is being used without his or her informed consent. ~ “Emotional abuse” means the misuse of power, authority or both, verbal harassment, or unreasonable confinement which results or could result in the mental anguish or emotional distress of an incapacitated adult. ~ “Neglect” means an act of omission which results or could result in the deprivation of essential services necessary to maintain the minimum mental, emotional or physical health and safety of an incapacitated adult. Definitions ~ “Self Neglect” refusing to engage in behaviors necessary to maintain his minimum mental, emotional or physical health and safety. ~ “Exploitation” means the illegal use of an incapacitated adult’s person or property for another person’s profit or advantage ~ Domestic violence is a pattern of coercive control that one family member exercises over another. The offender may use physical abuse, emotional abuse, sexual abuse, neglect, financial exploitation, isolation, threats, intimidation, and maltreatment of the loved ones or pets to exert control over the other person. Prevalence ~ Prevalence of elder abuse to be approximately 10% ~ verbal mistreatment (9%) ~ financial mistreatment (3.5%) ~ physical mistreatment (less than 1%) ~ ~260,000 (1 in 13) older adults in New York had been victims of at least one form of elder abuse in the preceding year. ~ Adult Protective Services (APS) agencies show an increasing trend in the reporting of elder abuse. ~ Only about one out of every 14 incidents of elder abuse are reported. ~ Only one out of every 25 cases of financial exploitation are reported. Abuse in Long-Term Care Facilities and Nursing Homes ~ According to the Nursing Home Abuse Center, available research indicates the following: ~ About 3.2 million U.S. citizens lived in nursing facilities in 2009. ~ A study of 2,000 nursing facility residents indicated an abuse rate of 44 percent and a neglect rate of 95 percent. ~ Complaints of abuse, exploitation or neglect accounted for 7 percent of complaints given to Ombudsmen at long-term care facilities. Risk Factors ~ Dementia is a risk factor. A 2009 study revealed that close to 50% of people with dementia experience some kind of abuse. ~ Warning Signs ~ Memory loss that disrupts daily life (typical forgetfulness) ~ Challenges in planning or solving problems (occasional errors) ~ Difficulty completing familiar tasks (occasionally needing help) ~ Confusion with time or place (temporary disorientation) ~ Difficulty reading or judging distance (cataracts) ~ Problems with words in speaking or writing (slower processing) ~ Misplacing things with inability to retrace steps. Accusing people of stealing ~ Increases in poor judgement (occasional lapses) ~ Withdrawal from social activities (being tired) ~ Changes in mood and personality (rigid routines) Risk Factors ~ Low social support / social isolation ~ Experience of previous traumatic events—including interpersonal and domestic violence—has been found to increase the risk for emotional, sexual, and financial mistreatment. ~ Functional impairment and poor physical health are associated with greater risk of abuse and reluctance to report. ~ Living with a large number of household members other than a spouse is associated with an increased risk of abuse, especially financial abuse. ~ Vulnerable due to grief from recent loss Risk Factors ~ Lower income or poverty (physical, verbal) ~ Regular income or accumulated assets (financial) ~ Unfamiliar w

Attachment and Impact on Adult Relationships A direct link to the counseling CEU course based on this podcast can be found at https://allceus.com/podcastCEUs Objectives ~ Briefly define attachment theory ~ Learn about the impact of attachment ~ Identify triggers for attachment behaviors ~ Explore the relationship between ACEs and attachment issues ~ Learn about adult attachment theory ~ Examine how attachment impacts emotional regulation and vice versa ~ Identify ways to help people become more securely attached. What is Attachment Theory? ~ Attachment behaviors, such as crying and searching, were adaptive responses to separation from with a primary attachment figure someone who provides support, protection, and care. ~ Erikson postulated the periods of trust vs. mistrust, and autonomy vs. shame and doubt during this same time period ~ Maintaining proximity to an attachment figure via attachment behaviors increases the chance for survival ~ From this initial relationship we learn ~ How scary or safe the world is. ~ What it is like to be loved. What is Attachment Theory? ~ The attachment system essentially “asks” the following fundamental question: Is the attachment figure nearby, accessible, and attentive? ~ If the answer is “yes,” the person feels loved, secure, and confident, and, behaviorally, is likely to explore his or her environment, interact with others. ~ If the answer is “no,” the person experiences anxiety and, is likely to exhibit attachment behaviors ranging from simple visual searching to active following and vocal signaling on the other ~ These behaviors continue until either ~ The person is able to reestablish a desirable level of physical or psychological proximity to the attachment figure ~ Until the person “wears down.” Impact of Attachment ~ How loved or unloved we feel as children deeply affects the formation of our self-esteem and self-acceptance. It shapes how we seek love and whether we feel part of life or more like an outsider. ~ As we individuate we often again seek approval. Does it Stop After Infancy ~ Maybe yes, maybe no. ~ Consider the child that regularly did not get needs met. ~ Persisted with attachment seeking behaviors ~ Those behaviors were eventually rewarded (so they will happen again) or not, so the child stops seeking comfort from others. ~ How does this impact ~ Self-esteem? ~ Trust in others? ~ Future relationships? Does it Stop After Infancy ~ Maybe yes, maybe no. ~ Consider the adult who got needs met as a child, but in adult relationships regularly does not get needs met. ~ What role do significant others play in the survival of the adult human? ~ Think about Erikson’s stage of intimacy vs. isolation ~ How does not getting needs met impact ~ Self-esteem? ~ Trust in others? ~ Future relationships? Adult Attachment Theory ~ (1987) Hazan and Shaver noted that the relationship between infants and caregivers and the relationship between adult romantic partners share the following features: ~ both feel safe when the other is nearby and responsive ~ both engage in close, intimate, bodily contact ~ both feel insecure when the other is inaccessible ~ both share discoveries with one another ~ both play with one another's facial features and exhibit a mutual fascination and preoccupation with one another ~ both engage in “baby talk” Adult Attachment Theory ~ If adult romantic relationships are attachment relationships, then: ~ We should observe the same kinds of individual differences in adult relationships that Ainsworth observed in infant-caregiver relationships. ~ The way adult relationships “work” should be similar to the way infant-caregiver relationships work. ~ The same kinds of factors that facilitate exploration in children (i.e., Having a responsive caregiver) should facilitate exploration among adults (i.e., Having a responsive partner). ~ Whether an adult is secure or insecure in his or her adult relationship

Review for the Alcohol and Drug Counselor Exam Intake and Orientation Screening and Assessment • Demonstrate verbal and nonverbal skills to establish rapport and promote engagement • Discuss with clients the rationale, purpose and procedures associated with screening and assessment • Assess clients immediate needs including detoxification • Administer evidence based screening and assessment instruments to determine client strengths and needs • Obtain relevant history to establish eligibility and appropriateness of services • Screen for physical needs, medical conditions, co-occurring mental health issues • Interpret results of screening and assessment and integrate information to formulate a diagnostic impression and determine appropriate course of action • Develop a written integrated summary to support diagnostic impressions Intake • Intake • Is the process of enrolling a client in a specific course of treatment • A series of activities designed to organize information about the client and their significant others • Ensures eligibility • Completes basic data collection • Identifies barriers and assets • Establishes a treatment approach • Primarily administrative in nature • Needs to be standardized in nature • It is an extension of the screening and assessment process • Can be used to engage the client in treatment and enhance motivation for change Orientation • Can be conducted in individual, family or group settings • Completed after the intake • Describes specific aspects of treatment • Schedule • Goals • Rules and responsibilities • Hours of service • Medication • Drug testing • Treatment costs • Client rights Client Rights • Florida Statute 381.026 • Individual dignity • Confidentiality • Right to nondiscriminatory services • Standard (Age, race, gender, sexual orientation, disability) • Prior service departures • Number of relapses • Level of psychotropics • Ability to pay (public agencies) Client Rights • Quality services • Communication • With informed consent communication may be limited • Personal effects • unless for to do so would infringe upon the right of another patient or is medically or programmatically contraindicated for documented medical, safety, or programmatic reasons • May be temporarily held by the agency but must be returned at the end of treatment • Minors to be educated • Counsel (involuntary proceedings) • Habeus corpus (full evidence of what is being alleged) Client Rights • (Florida Specific) • A patient has the right to a prompt and reasonable response to a question or request. • A patient receiving care in a health care facility or in a provider’s office has the right to bring any person of his or her choosing to the patient-accessible areas of the health care facility or provider’s office to accompany the patient while the patient is receiving inpatient or outpatient treatment or is consulting with his or her health care provider, unless doing so would risk the safety or health of the patient, other patients, or staff of the facility • A patient has the right to refuse any treatment • A patient has the right to express grievances to a health care provider, a health care facility, or the appropriate state licensing agency regarding alleged violations of patients’ rights. Client Rights • (Florida Specific) • A patient has the right to know the name, function, and qualifications of each health care provider who is providing medical services to the patient. A patient may request such information from his or her responsible provider or the health care facility in which he or she is receiving medical services. • A patient in a health care facility has the right to know what patient support services are available in the facility. • A patient has the right to be given by his or her health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis, unless it is medically inadvisable or impossible to give this information to the patient • A health

Children and Mental Health Instructors: Dr. Dawn-Elise Snipes, Ph.D Course Objectives • To recognize normal developmental stages in children and signs of problems in development. • To list risk factors that negatively affect children’s mental health. • To describe and identify symptoms of childhood mental health disorders. • To name community-based prevention/treatment resources and identify major services offered by these organizations. • To gain knowledge of treating children’s mental health problems. Beginning Notes… • Children are not “little adults.” They have their own unique development and needs. • The definition of mental disorders in children might be best expressed something different than normal developmental expectations for the child. • Estimates for the prevalence of mental disorders in children range from 5% (“severe”) to 21% (“minimum”). • Research indicates that half of all lifetime cases of mental illness begin by age 14. • Additional training ensure increased availability for early intervention in preschools, schools, juvenile justice and medical offices. Normal Development • Theories of Development • Erikson’s Psychosocial Stages • Trust vs. mistrust • Autonomy vs. shame • Initiative vs. guilt • Industry vs. inferiority • Piaget’s Cognitive Development • Bandura’s Social Learning Theory • Kohlberg’s Moral Development • Obedience • Instrumental purpose • Conformity • Individual rights Developmental Psychopathology • Understanding Multiple Sources • Specific characteristics of the child (including biological, psychological, and genetic factors) • His or her environment (including parent, sibling, and family relations, peer and neighborhood factors, school and community factors, and the larger social-cultural context) (Brofenbrenner’s Ecological Systems Theory) • Understanding Adaptability • “self-righting” and “self-organizing” tendencies; namely, that a child within a given context naturally adapts (as much as possible) to a particular ecological niche, or when necessary, modifies that niche to get needs met • i.e. psychopathology may be the result of survival adaptations to a pathological environment. Developmental Psychopathology • Understanding Timing • Is the behavior appropriate at this age? • Understanding Context • The same behavior in one setting or culture might be acceptable and even “normative,” whereas it may be seen as pathological in another. • For this child at this time • Understanding degree • Of impairment in comparison to others in the same age group Risk Factors for Psychopathology • Biological • Genetics • Substance exposure • Low birth weight • Prematurity • Psychosocial • Domestic violence • Abuse • Substance misuse • Household mental illness • Bullying • Parental Depression • Stressful Life Events • Parent separation • Parent incarceration • Parent abandonment • Childhood Maltreatment • Peer and Sibling Influences Adverse Childhood Experiences • Almost two-thirds of surveyed adults report at least one ACE, and more than 20% reported three or more ACEs. • The ACE score, a total sum of the different categories of ACEs reported by participants, is used to assess cumulative childhood stress. • There is a graded dose-response relationship between ACEs and negative health and well-being outcomes across the life course. • As the number of ACEs increases so does the risk for the following: • Heart attack and heart disease • Mental distress, depression • Smoking • Disability • Unemployment • Lowered educational attainment • Stroke • Diabetes Assessment and Treatment • Assessment is more difficult because children can’t verbalize some things, much has to be observed. Also, information on assessment is often gained from adults, whether or not it is appropriate for child diagnosis. • Treatment focuses on psychotherapy, play therapy, and psychopharmacology. Overview of Childhood Mental Disorders • Categories: • Anxiety Disorders • Attention/Disruptive Disorders • Eating Disorders • Mood Disorder

Review for the Alcohol and Drug Counselor Exam • Past 30 Day statistics, According to the 2012 National Survey on Drug Use and Health, • 6.5% of the population over 12 reported heavy drinking • 9.2% reported illicit drug use • The majority of people who use recreationally will not need treatment • Addiction is characterized by compulsive craving for the substance and using that substance despite negative consequences • Cravings and compulsive behavior are caused in large part as a consequence of substance use or addictive behaviors on the brain causing • Emotional • Cognitive • Physical • Behavioral changes Definition of Addiction • Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. • Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations reflected in pathological pursuit of a reward and/or relief by a substance. • Without treatment and/or engagement, addiction is progressive and can result in disability or premature death. (ASAM 2011, NIDA 2007) Characteristics of Chronic Disease • Disrupts normal functioning • Have serious, harmful consequences • Are preventable and treatable • Can last a lifetime • May be fatal if untreated Addiction—A description, not a Diagnosis • Addiction is a description, not a diagnostic term. • Addiction erodes a person’s self-control and ability to make sound decisions • The DSM V has 2 diagnostic categories • Substance abuse • Substance dependence (The medical definition of addiction) • Dependence is always characterized by dependence and withdrawal Factors Influencing Addiction • No single factor is causative • General Categories • Biological/genetic makeup • Gender • Ethnicity • Developmental stage/early use • Social environment • Proximal (neighborhood, school/work, friends, family) • Cultural/Media/Availability • Method of administration Factors Influencing Addiction • Genetic Factors • 40-60 % of a person’s vulnerability is genetic. • Expression of these genes is influenced by: • Effects of the environment • Reactions/effects of addictive behaviors • Genetic predisposition to mental health issues (self-medication) • Social Environment & Peer and School • Access • Social learning of acceptability and use patterns • Exposure to peers/family who engage in criminal behavior • Academic/work failure • Poor social skills / unstable relationships Factors Influencing Addiction • Developmental/Early Use • The earlier the initiation, the greater the likelihood it progresses to addiction • Addictive behaviors have a stronger impact on the developing brain (esp. the prefrontal cortex) • Indicative of a set of vulnerabilities/triggers • Genetics • Mental Illness • Unstable family relationships • Exposure to abuse Factors Influencing Addiction • Method of Administration • Smoking and injection increase addictive potential due to • Rapid transit to the brain (seconds) • Rapid fade of effects (crash) Theories of Causation • Moral Model • Addiction is the result of defects of character • Rejects any biological basis • Focuses on individual choices and values retraining • Disease Model • Addiction is an illness resulting from an impairment of neurochemical or behavioral processes • Presented by Jellinek leading the APA and AMA adopting the disease model • Addiction is a primary disease and not caused by anything else Theories of Causation • Genetic Model • Individuals have a genetic predisposition • Difficult to separate social causes from family and genetic causes • Cultural Model • Cultural attitudes and availability impact which addictions people develop • Blended Model • Addiction develops in each individual as a result of a unique set of factors Continuum of Addiction • Social – risky/problematic –abuse –dependence • Many individuals never progress beyond risky consumption • Recovery from addiction is a multidimensional process which differs between people and changes over time. • Risky/problematic