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

Ethics: Beneficence & Non-Malfeasance Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Objectives ~    Define beneficence and non-malfeasance ~    Explore common violations of this practice CEs can be earned for this presentation at https://www.allceus.com/member/cart?c=11 Beneficence ~    Beneficence is PROACTIVE action that is done for the benefit of others. ~    Beneficent actions can be taken to ~    Prevent or remove harms ~    Improve the situation of others. ~    The goal of counseling is to promote the welfare of patients ~    Due to the nature of the relationship between clinicians and patients, clinicians have an obligation to: ~    Prevent and remove harms ~    Weigh and balance possible benefits against possible risks of an action. Beneficence ~    Beneficence can also include: ~    Protecting and defending the rights of others (Advocacy) ~    Ensuring the use of a culturally sensitive, trauma informed approach ~    Ensuring the availability of effective referral sources to meet the needs and preferences of clients for whom you are not a good fit ~    Timely advocacy for them with their insurance company for additional session authorization ~    Advocate for patient with treating physician /be an effective member of a multidisciplinary team Beneficence ~    Beneficence can also include: ~    Helping individuals struggling with mental health or addictive disorders find effective treatment based on their readiness for change ~    Increasing awareness of the problems of co-occurring disorders and their treatment ~    Getting continuing education to ensure awareness of current best practices for treatment ~    Providing patient educational videos or handouts in the waiting room or on your website to help them take charge of their health ~    Ensuring a signed release and provision of necessary information to referral sources BEFORE the patient arrives Non-Malfeasance ~    Non-maleficence means to “do no harm.” ~    Refrain from providing ineffective treatments ~    Avoid acting with malice toward patients. ~    Assist patients in making the best treatment decision for them, not one that provides you the most benefit. ~    With all interventions, ensure benefits outweigh the risks. ~    Ensure the patient is provided with all treatment options and can make choose the least restrictive environment ~    Do not provide a treatment that has not been shown to be effective. ~    Do not make blind referrals when possible ~    Ensure referral sources are competent (i.e. licensed, certified etc.) Non-Malfeasance ~    Non-maleficence means to “do no harm.” ~    Don’t encourage clients to collude in insurance fraud ~    Diagnosing them with a disorder they don’t have in order to get reimbursed ~    Changing diagnoses when benefits for one run out ~    Discharge clients when they have met maximal gains at that level of care ~    Do not bill for services under a therapist that were provided by an intern ~    Avoid, when possible, referring a patient back to the same treatment program they have already been through multiple times and relapsed Non-Malfeasance ~    Making referrals to other providers who provide “rewards” for referrals ~    F.S. 491.009 (1) (j) Paying a kickback, rebate, bonus, or other remuneration for receiving a patient or client, or receiving a kickback, rebate, bonus, or other remuneration for referring a patient or client to another provider of mental health care services or to a provider of health care services or goods; or entering into a reciprocal referral agreement. ~    F.S. 456.054 ickbacks prohibited.—(1)As used in this sec

Child Development 101: The Toddler Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Continuing Education (CE) credits can be earned for this presentation at  https://www.allceus.com/member/cart/index/search?q=child+development Objectives ~    Examine how the child is starting to develop self esteem through initiative and independence ~    Explore what can go wrong in each stage and what can be done to repair damages now. Maslow ~    In addition to biological and safety needs… ~    The toddler is now developing ~    Self-Esteem ~    I am lovable for who I am ~    I am loveable even when I make a mistake ~    Self-Efficacy ~    I am capable of trying new things ~    If I make a mistake, my caregiver is there to help me Psychosocial Development Will: Autonomy vs. Shame & Doubt (Toddlers, 2 to 3 years) “Can I do things myself or am I reliant on others?” ~    Interferences ~    Overly permissive or overly strict parents ~    Lack of praise for exploration and experimentation ~    Manifestations ~    Low self-esteem/need for external validation ~    Lack of motivation ~    Establishment/Re-Establishment ~    Encourage child/yourself to explore and experiment ~    Praise child/yourself for trying even if he fails ~    Reassure child/yourself that he/she is loved as it Psychosocial Development cont… Purpose: Initiative vs. Guilt (Preschool, 4 to 6 years) Children begin asserting control and power ~    Interferences ~    Overly strict/enmeshed parents ~    Lack of encouragement to take risks ~    Manifestations ~    Low self-esteem/need for external validation ~    Difficulty making or maintaining friends ~    Unclear what he likes, wants, feels ~    Guilt for having own needs Psychosocial Development cont… Purpose: Initiative vs. Guilt (Preschool, 4 to 6 years) Children begin asserting control and power ~    Establishment ~    Explore and experiment ~    Praise child for trying even if he fails ~    Reassure child that you love him for who he is ~    Encourage children to develop friendships with a variety of people ~    Re-Establishment ~    Explore and experiment ~    Praise yourself even if you don’t succeed ~    Remind yourself why you are lovable for who you are ~    Develop effective goal setting skills Piaget ~    2-6 years early childhood (Preoperational) ~    Preschoolers live in a magical world where inanimate objects are alive (animism) and dreams are real. ~    Parenting challenge: ~    Truth vs. Fiction ~    Creativity vs. Reality ~    They have trouble distinguishing between appearances and reality. ~    Parenting challenge ~    Safe vs. Danger ~    Truth vs. Fiction Piaget ~    Children of this age typically love to play make-believe. ~    Parenting challenge ~    Finding your make believe ~    Understanding what they are communicating through their play Piaget ~    They focus on one aspect of a situation (centration) and struggle to see other vantage points (egocentrism) ~     Parenting challenge ~    Finding their voice vs. Being a bully ~    Helping them learn to make good choices ~    Accepting their part vs. Taking total responsibility ~    Accepting that everything isn’t necessarily their fault or doing ~    Interventions ~    Effective communication skills ~    Explore the notion of responsibility ~    Explore all aspects of a situation including other vantage points Early Childhood cont… ~    They often have difficulty

We are launching a new podcast on March 1, 2017 directed at the general public called Happiness Isn’t Brain Surgery with Doc Snipes.  Each week I will provide tips, tools and tricks to help people better manage anxiety, anger, depression and addiction or just live a happier, healthier life. If you are interested in CEs on Opiates, you can find them here https://www.allceus.com/member/cart/index/product/id/344/c/ Or the Treatment Improvement Protocol on Opiate Treatment: https://www.allceus.com/member/cart/index/search?q=opiate  

Child Development 101: The Infant Stage Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Continuing Education (CE) credits can be earned for this presentation at  https://www.allceus.com/member/cart/index/search?q=child+development Objectives ~    Explore the developmental tasks and needs of the infant stage (0-2 years old) ~    Maslow (Biological and safety needs) ~    Erickson (Trust vs. Mistrust) ~    Bowlby (Attachment) ~    Piaget (Cognition/schema formation) ~    Discuss how failure to get these needs met can result in later mental health issues ~    Discuss how failure to resolve the trust vs. mistrust crisis results in later mental health issues ~    Discuss how infant’s primitive cognitive abilities develop dysfunctional schemas for later in life Maslow—What Infants Need ~    Biological Needs ~    Food when hungry ~    Shelter/Physical comfort ~    Protection from overstimulation ~    Sleep when sleepy ~    Contact ~    Safety ~    Consistent presence vs. Abandonment (no object permanence) ~    Startle / loud noises / pain Erickson’s Stages Psychosocial Development: Trust Needs Will Be Met Success ~    Ability to interpret, trust and act on own feelings (self-confidence) ~    Belief that others will help fulfil needs (hope) ~    Self reliance ~    Comfortable with attention ~    Ability to be “alone” ~    Contentment Failure ~    Inability to trust own instincts/urges/feelings ~    Reliance on others to tell them what they need ~    Inability to trust others will be supportive ~    Discomfort with and craving of attention (Abandonment fears) ~    Irritability/anxiety Piaget– Cognitive Development ~    Piaget (Cognition/schema formation) ~    Sensorimotor: ~    Children do not yet have object permanence ~    Children do not yet have much of a frame of reference so they rely on parental feedback ~    Schemas formed during this time rely heavily on ~    Were needs adequately met (empowered vs. powerless) ~    Parental reaction (stress-level/attentiveness/consistency) John Bowlby–Attachment ~    Securely-Attached Infants ~    Easily soothed by the attachment figure when upset. ~    Caregiver is sensitive to their signals, and responds appropriately to their needs. ~    Insecure-Avoidant Infants ~    Very independent of the attachment figure both physically and emotionally ~    Do not seek contact with the attachment figure when distressed. ~    These caregivers are insensitive and rejecting of their needs and are often unavailable during times of emotional distress. John Bowlby–Attachment ~    Insecure-Ambivalent children ~    Exhibit clingy and dependent behavior, but are rejecting of the attachment figure when they engage in interaction. ~    The child fails to develop any feelings of security from the attachment figure. ~    Exhibit difficulty moving away from the attachment figure to explore novel surroundings. ~    When distressed they are difficult to soothe and are not comforted by interaction with the attachment figure. ~    This behavior results from an inconsistent level of response to their needs from the primary caregiver. Mindful Parenting ~    Be attentive to the baby’s cries and cues before they become hysterical ~    Accept the baby’s needs as they are/Validating environment ~    Be consistent ~    Calm yourself ~    Stressed parent  stressed baby ~    Calm parent  calm-able baby ~    Keep a routine to help set baby’s circadian rhythms ~    Feeding ~    Sleeping ~  

Relationship Saboteurs Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Counseling CEs for this topic can be earned at https://www.allceus.com/member/cart/index/search?q=relationship Objectives ~    Identify the causes, consequences and interventions for some of the most common saboteurs ~    Identify interventions for issues that are commonly seen in relationship sabotage. Fears ~    Most saboteurs are protecting themselves from their basic fears ~    Most sabotagees end up experiencing these same basic fears ~    Fears ~    Isolation ~    Rejection ~    Loss of control ~    The unknown ~    Failure Insecurity Effects on the Saboteur ~    Constantly anxious ~    Hypervigilant to cues of abandonment ~    Untrusting ~    May constantly question/attack partner ~    Constant reassurance from partner prevents feelings of failure, rejection, isolation Effects on the Sabotagee ~    Can feel smothered/isolated ~    Exhausting having to constantly reassure ~    Can feel a lack of trust ~    May feel like he/she is walking on eggshells afraid of the unknown…what will set him/her off next? Needing to Control Effects on the Saboteur ~    Exhausting having to always be in control ~    Exhausting always worrying about loss of control ~    Relationship failures due to inability to trust partners to not abandon or reject them ~    Relationship failures due to trying to control another person ~    Involvement in relationships with dependent, insecure others ~    Can distract from relationship problems (The Hero, The Enabler) Effects on the Sabotagee ~    Often feel invalidated/disempowered/loss of control ~    May not feel heard or appreciated / Rejection ~    May not get needs met ~    May fear failure if he/she does not meet the saboteur’s needs (if you can’t/don’t…then we are done) Fear of Intimacy Effects on the Saboteur ~    Inability to develop a meaningful connection based on your authentic self (Fear of rejection due to low self-esteem) ~    Untenable anxiety when placed in a vulnerable situation ~    Maintain walls to prevent from getting hurt ~    Push people away when feeling vulnerable, emotional, close. (Prior abandonment issues) Effects on the Sabotagee ~    Inability to really get to know and trust the other person ~    Gets pushed away or lashed out on if he/she gets too close (Isolation) ~    Often ends up getting hurt and pushed away because his/her authenticity is too much for the saboteur (Rejection, failure, loss of control) Pessimism Effects on the Saboteur ~    Prevents him/her from getting hurt. ~    Prior experiences create a self-fulfilling prophecy ~    Allows easier relationship termination and “I told you so” face saving ~    Creates an aura of negativity Effects on the Sabotagee ~    Prevents him/her from feeling secure, confident and happy ~    Can draw an otherwise happy person into the abyss anticipating failure ~    Can lead the sabotagee to feel powerless to meet the saboteur’s needs  relationship termination, loss of control, rejection, isolation Needing to Be Center Stage Effects on the Saboteur ~    Ensures the other person is always attentive to them. (Helps maintain control) ~    Provides a sense of self-worth/external validation if always the object of attention (Avoiding rejection or isolation) ~    Can be devastating if the person fails at something. “If I am not the best, then I am nothing” (Failure) ~    Distracts from any other problems in the relationship (The mascot, the Hero) Effects on the Sabotage