Counselor Toolbox Podcast show

Counselor Toolbox Podcast

Summary: Counselors, coaches and sober companions help hundreds of thousands of people affected by Addictions and Mental Health issues each year. Learn about the current research and practical counseling tools to improve your skills and provide the best possible services. Counselor Toolbox targets counselors, coaches and companions, but can also provide useful counseling self-help tools for persons struggling with these issues and their loved ones. AllCEUs is an approved counseling continuing education provider for addiction and mental health counselors in most states. Counseling CEUs are available for each episode.

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  • Artist: Dr. Dawn-Elise Snipes
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Podcasts:

 Nephrology Social Work | File Type: audio/mpeg | Duration: 54:47

423 -Nephrology Social Work Between writing notes, filing insurance claims, and scheduling with clients, it can be hard to stay organized. That’s why I recommend TherapyNotes. Their easy-to-use platform lets you manage your practice securely and efficiently. Visit TherapyNotes.com to get two free months of TherapyNotes by just using the promo code CEU when you sign up for a free trial at TherapyNotes.com. Objectives – Identify the causes of kidney failure – Explore the consequences of kidney failure Facts about CKD – 1 in 7 or 30 million American adults have CKD and 1 in 3 are at increased risk. – Early detection can help prevent the progression of kidney disease to kidney failure. – Heart disease is the major cause of death for all people with CKD. – Hypertension causes CKD and CKD causes hypertension. – High risk groups include – those with diabetes, hypertension and family history of kidney failure. – African Americans (diabetes, HBP), Hispanics, Pacific Islanders, American Indians and Seniors – The progression of CKD can be stopped if caught before stage 4 Causes of Kidney Disease – Diabetes – 30-40% of people with diabetes also have kidney disease (>2% of the adult population) – People with diabetes and CKD are more prone infections and anemia increasing their vulnerability to acute complications – High blood pressure – Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney's filtering units. – Inherited diseases, such as polycystic kidney disease – Malformations that occur as a baby develops – Lupus and other diseases that affect the body's immune system. – Obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men. – Repeated urinary infections. Symptoms – Feel more tired and have less energy – Have trouble concentrating – Have a poor appetite – Have trouble sleeping – Low back pain – Have muscle cramping at night – Have swollen feet and ankles – Have puffiness around your eyes in the morning – Have dry, itchy skin – Need to urinate more often, especially at night – Blood in the urine – Nausea – High blood pressure (headache, blurred vision, pounding in ears) End Stage Renal Disease – End stage renal disease (ESRD) is the point when the kidneys cannot filter waste and excess fluid from the body. – Dialysis mechanically removes waste when the body is no longer able to do so and takes 3-4 hours per session. – In hemodialysis, blood travels through a tube and is filtered by an artificial kidney – In-center hemodialysis is done three times per week in a clinic setting – In peritoneal dialysis, a solution is administered through a catheter in the abdomen and is later removed – Peritoneal dialysis and home hemodialysis can be done at a time and a location chosen by the patient Functions of a Nephrology Social Worker – Psychosocial evaluation and treatment planning – Counseling and conferences with patients, families, and support networks – Discharge planning – Groupwork (education, emotional support, self-help) – Information and referral – Facilitation of community agency referrals – Team care planning and collaboration – Advocacy on patients’ behalf within the setting and with appropriate local, state, and federal agencies and programs – Patient and family education Problems Addressed – Adjustment to chronic illness and treatment as they relate to quality of life – Changes in activities and friendships/ Inability to engage in previous activities – Transportation assistance – Childcare needs – Fatigue – Age, employment and finances were significant predictors of adjustment issues and treatment compliance – The perception of an ill

 Gut Health and Mental Health (Re-Release) | File Type: audio/mpeg | Duration: 57:37

ReRelease Gut Health & Mental Health: The Impact of the Second Brain Dr. Dawn-Elise Snipes PhD, LPC-MHSP, Executive Director: AllCEUs.com CEUs are available for this presentation at AllCEUs https://www.allceus.com/member/cart/index/product/id/959/c/ Between writing notes, filing insurance claims, and scheduling with clients, it can be hard to stay organized. That’s why I recommend TherapyNotes. Their easy-to-use platform lets you manage your practice securely and efficiently. Visit TherapyNotes.com to get two free months of TherapyNotes by just using the promo code CEU when you sign up for a free trial at TherapyNotes.com. Disclaimer ~ This is for educational purposes only and not intended to replace medical advice. Always have clients discuss any nutritional changes or supplements with a Registered Dietician or their primary care physician. Objectives ~ BREIFLY review the findings from the research identifying the connection between the brain and the gut ~ Differentiate gut health from proper nutrition ~ Identify signs and consequences of poor gut health ~ Explore the bidirectional relationship between the brain and the gut (second brain) ~ Identify promising alternative approaches to treating mood (and other) disorders. Overview ~ Depression is the leading cause of disability in the world according to the World Health Organization. The effectiveness of the available antidepressant therapies is limited. ~ Data from the literature suggest that some subtypes of depression may be associated with chronic low grade inflammation. ~ The uncovering of the role of intestinal microbiota in the development of the immune system and its bidirectional communication with the brain have led to growing interest on reciprocal interactions between inflammation, microbiota and depression. ~ The intestinal microbiota: A new player in depression? Encephale. 2018 Feb;44(1):67-74 Overview ~ Gut microbiota appear to influence the development of emotional behavior, stress- and pain-modulation systems, and brain neurotransmitter systems ~ Microbiota changes caused by illness, dietary changes, probiotics and antibiotics impact endocrine and neurocrine pathways (bottom up) ~ The brain can in turn alter microbial composition and behavior via the autonomic nervous system (“stress”) (top down) ~ Even mild stress can change the microbial balance in the gut, making the host more vulnerable to infectious disease and triggering a cascade of molecular reactions that feed back to the central nervous system Overview ~ Exposure to chronic stress decreased the relative abundance of Bacteroides species and increased the Clostridium species in the caecum; and caused activation of the immune system (i.e. inflammation) ~ Children with Autism Spectrum Disorder treated with oral vancomycin —antibiotic to reduce Colostridium– had significant improvement in behavioral, cognitive and GI symptoms ~ Acute and chronic stress increase GI and BBB permeability through activation of mast cells (MCs) Gut Inflammation and Mood ~ Inflammation of the GI Tract places stress on the microbiome through the release of cytokines and neurotransmitters. ~ Coupled with the increase in intestinal permeability, these molecules then travel systemically. ~ Elevated blood levels of cytokines TNF-a and MCP (monocyte chemoattractant protein) increase the permeability of the blood-brain barrier, enhancing the effects of rogue molecules from the permeable gut. ~ Their release influences brain function, leading to anxiety, depression, and memory loss. Gut-Brain Connection ~ The vagus nerve is one of the biggest nerves connecting your gut and brain. It sends signals in both directions ~ In mice it was found that feeding them a probiotic reduced the amount of cortisol in their blood. However, when their vagus nerve was cut, the probiotic had no effect ~ Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad S

 Attachment and Its Impact on Adult Relationships (Re-Release) | File Type: audio/mpeg | Duration: 60:39

422 -Attachment and Impact on Adult Relationships A direct link to the counseling CEU course based on this podcast can be found at https://www.allceus.com/counselortoolbox/ 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 adu

 NCMHCE Exam Review Group and Career Counseling | File Type: audio/mpeg | Duration: 51:38

NCMHCE Exam Review Group and Career Counseling Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director, AllCEUs.com Podcast Host: Counselor Toolbox and NCMHCE Exam Review Objectives – Review – the indications and contraindications for group therapy – types of groups – stages of group formation – Group curative factors – Therapist’s role in group Indicators for Group – Indicators for Group – The primary problem involves affective, behavioral, cognitive or social issues – The client is verbally, cognitively and physically able to participate – The client is motivated to change – The client finds peer support and feedback beneficial – The client has a positive view of group therapy Contraindications for Group Therapy – People who refuse to participate – People who can’t honor group agreements including behavioral (impulsivity) and attendance – People who are unsuitable for group therapy – People in crisis, or who have a low tolerance for anxiety and frustration, or are markedly depressed – People whose defenses would clash with the dynamics of a group. – People who can’t tolerate strong emotions – People who experience severe internal discomfort in groups. Types of Groups – Gender based – Topic based (depression, PTSD, Addiction) – Skill Based (coping, problem solving, interpersonal) – Support – Psychoeducational – Therapy – Open – Closed: Short-term, task oriented Forming a Group – Stages – Forming – Storming – Norming – Performing – Adjourning Group Curative Factors – Social microcosm that allows for multiple transferences – Hope – Universality – Altruism – Self-understanding and insight Therapist’s Role – Explain the phases in the group process – Creating and maintaining cohesion and participation – Culture building – Focus on the here and now, illuminating the processes at work. – Use appropriate self-disclosure – Facilitate resolution of interpersonal conflict – Use linking and blocking – Model giving and receiving of feedback – Use structured activities – Identify and discuss group themes and patterns – Create interventions based on the stage of group development – Challenge harmful behaviors – Address interaction of group members outside of group Career Counseling– Models – Trait and factor model focuses on individual abilities, interests and personalities and work adjustment varies directly with the congruence between characteristics and demands – Client centered model emphasizes self-concept and the existence of choices based on what the client perceives is best in his/her life – Psychodynamic model stresses internal motivations and coping mechanisms and person's belief or knowledge about what he or she is able to do (Efficacy) – Developmental model focuses on career as a developmental, maturational process (Career Maturity Index) Career Counseling– Models – Behavioral career counseling focuses on making realistic career choices (behavior) and eliminating anxiety about making such choices – Values model helps clients choose careers in line with their values – Time: Future, Past, Present, Unconcerned with schedules – Social: Individual, collateral, hierarchical – Activity Value: Active vs. Passive responses – Life Values (Life Values Inventory) Career Choice – Holland/Trait-Factor – Personalities (RIASEC) – Realistic (hands on) – Investigative (problem solving) – Artistic – Social (Helping others) – Enterprising (Leading) – Conventional (Routine/systematic) Career Choice – Holland – Tests – Vocational Preference Inventory (General Holland’s 6-Types by rating 160 jobs) – Self-Directed Search (

 CM -Principles of Case Management.mp3 | File Type: audio/mpeg | Duration: 56:36

Standards of Practice for Case Management Dr. Dawn-Elise Snipes PhD, LPC-MHSP Executive Director, AllCEUs.com Podcast Host: Counselor Toolbox and Case Management Toolbox – Based in part on the Standards of Practice for Case Management by the Case Management Society of America Objectives – Explore the benefits of adding case management to your skill set – Learn how Case Management is financially beneficial – Explain the principles of case management – Identify practice settings – Review risk factors (targets) for case management Why Case Management- – Adjunct to clinical practice – Enhances coaching and clinical services – Can be its own business (High copay/high deductible) – Understanding capitation – It pays the doctor a set amount for each enrolled patient whether a patient seeks care or not. – Compensation is based on the average expected utilization of each patient in the group. – 100,000 people 20% expected to need 10 sessions of brief therapy @ $45/session 20,000*450= 900,000/year – Use it or lose it caveat How Case Management Reduces BH Cost – Ensures wrap-around services (i.e. housing, transportation, medical care, public assistance) – Better health –> Better mental health – Improved health literacy – Better mental health – Reduced stress (financial, interpersonal, occupational) –> Better mental health – Treatment plan compliance – Better mental health – Nonfragmentation of services –> Better mental health – Guidance during service transitions – Better treatment compliance –> Better mental health – Advocacy with community leaders for funding service gaps- improved service access – better mental health – Case managers are less expensive than licensed providers Case Management Principles – It can be applied to individuals or groups of clients, such as in disease management or population health services. – Underage drinking or STD prevention at universities – Diabetes, heart disease, premature birth prevention (Clinical or foundations) – Cancer, diabetes, depression, autism management (Clinics or foundations) – Ageing services (AAA, geriatric physician groups, LTC & STC facilities) – The goal is achieving client wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. Case Management Principles – Services are best offered in a climate that allows direct communication between the case manager, the client, and appropriate service personnel – When an individual reaches the optimum level of functioning, everyone benefits: the client(s), their support systems, health care delivery systems, reimbursement sources, communities. Case Management Process – Assess client resources, needs, goals – Collaborate and Plan – Identify service plan goals and needed resources – Implement – Monitor – Evaluate Primary Case Management Functions – Positive relationship-building – Effective written/verbal communication – Negotiation skills – Knowledge of legal, ethical and risk management issues – Cultural responsiveness – Ability to develop goals, enhance motivation and evaluate progress – Promotion of client autonomy and self-determination – Knowledge of funding sources, health care services, human behavior dynamics, health care delivery and financing systems, and clinical standards and outcomes Guiding Principles – Use a client-centric, comprehensive, holistic approach. – Facilitate self-determination and self-care with advocacy, collaboration, and education. – Remain culturally responsive – Promote the use of evidence-based care – Enhance client safety – Link with community resources. – Assist with navigating the hea

 Mental Health and the Elderly 12 Key Points | File Type: audio/mpeg | Duration: 51:59

421 -Mental Health & the Elderly 12 Key Points Podcast is part of A La Carte Course: https://www.allceus.com/member/cart/index/product/id/112/c/ Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director, AllCEUs.com Podcast Host: Counselor Toolbox & Case Management Toolbox Objectives – Review 12 key issues that either differ or often go overlooked in people over 65 Psychosocial Adjustment to Aging – There are multiple psychosocial aspects to aging – Integrity vs. Despair – Loss of physical functioning – Death of friends – Changes in social relationships – Frequent mental distress (FMD) may interfere with major life activities, such as eating well, maintaining a household, working, or sustaining personal relationships. – Older adults with FMD were more likely to engage in behaviors that can contribute to poor health, such as smoking, not getting recommend amounts of exercise, or eating a diet with few fruits and vegetables (11) Emotional Health – Mood issues are not a consequence of normal aging – Depression – Situational (grief, life transitions) – Vascular – Bidirectional association between depression and cardiovascular diseases – Elderly men have the highest rate of suicide of any age group – When untreated, depression reduces life expectancy, worsens medical illnesses, enhances health care costs and is the primary cause of suicide among older people – Both exercise and dietary interventions can promote mental health – Almost half of older adults who are diagnosed with a major depression also meet the criteria for anxiety Cognitive Decline – It is often partly preventable – Slowing or some loss of other cognitive functions takes place, most notably in: – Information processing – Selective attention – Problem-solving ability – Prevention and early intervention should focus on – Encouraging different problem solving tasks (hobbies, puzzles etc.) – Maintaining physical activity to improve blood flow – Maintaining a good sleep routine (including addressing bladder issues) Cognitive Health – Dementia Risk Factors – Smoking – Alcohol use – Hypertension – Diabetes – TBI from falls – Dementia Interventions – Physical activity – Control of blood pressure – Not smoking – Social engagement – Depression prevention/intervention – Diabetes management Chronic Health Conditions – Medications – Pain – Increased injury risk – Parkinson’s Disease – Frailty Syndrome is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations such as loss of muscle mass and strength, energy and exercise tolerance, and decreased physiological reserve – Malnutrition – Lack of Exercise – Depression – Horticulture Therapy shows great potential in enhancing mental health, cognitive functioning and physical health in the elderly Medication – Age-related physiological changes that can impact drug effects include the following: – absorption: increasing gastric pH, decreasing absorptive surface – distribution: decreasing total body water, lean body mass, and serum albumin – metabolism: decreasing hepatic mass and blood flow – excretion: decreasing renal blood flow, glomerular filtration rate, and tubular secretion. – Some of the most common medicines likely to have adverse effects include anticoagulants, antibiotics, diuretics, hypoglycemic agents, benzodiazepines, opioids, NSAIDs Sexuality – Hormonal changes and other physiological changes associated with aging affect sexual interest. – Erectile dysfunction is a problem in men increasing with age. – Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and d

 Wellness & Illness Prevention, Concepts & Strategies | File Type: audio/mpeg | Duration: 57:09

420 -Wellness & Illness Prevention Concepts & Strategies Buy the A La Carte Course here: https://www.allceus.com/member/cart/index/product/id/1087/c/ Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director, AllCEUs.com Podcast Host: Counselor Toolbox & Case Management Toolbox Objectives – Explain the purpose of wellness and disease prevention – Identify the benefits of it – Define the 3 types of prevention and intervention activities – Describe the steps to initiate a change – Apply knowledge of the principles of effective programs Purpose of Prevention and Early Intervention – Attainment of the highest possible standard of health depends on a comprehensive, holistic approach which goes beyond the traditional curative care, involving communities, health providers and other stakeholders. – This holistic approach should empower individuals and communities to take actions for their own health, foster leadership for public health, promote intersectoral action to build healthy public policies and create sustainable health systems in the society Benefits – Benefits include: – Knowledge about risk factors for developing health problems – Awareness of personal risk factors – Screening to identify whether health conditions may be present – Coaching about how to manage newly identified health problems – Strategies for prevention of future health problems Dimensions Model of Health – The Dimensions Model of Health includes 6 dimensions – Biophysical Dimension – Psychological and Emotional Dimension – Behavioral Dimension – Socio-cultural Dimension – Environmental Dimension – Health Systems Dimension Goals – Reducing Risk Factors – Individual – Microsystem (immediate family, peers) – Exosystem (neighborhood, school, work) – Macrosystem (culture) – Enhancing Protective Factors – Individual – Microsystem (immediate family, peers) – Exosystem (neighborhood, school, work) – Macrosystem (culture) Types of Prevention – Primary prevention (Wellness) aims to prevent problems before they ever occur by reducing risk and enhancing protective factors. (Diabetes, TBI, Smoking, Depression) – Education about healthy and safe habits – Safe schools and communities through effective enforcement of community laws and norms regarding health and mental health behaviors. – Annual, universal screenings for health and mental health issues. – Access to safe housing, nutrition and medical care. – Opportunities for gainful employment to prevent poverty and increase community connection. – Access to parenting education. Types of Prevention – Secondary prevention reduces the impact of problems that have already begun, with the goal of halting and reversing the progression. (Diabetes, TBI, Smoking, Depression) – Access to early intervention, self-help groups and counseling – Access to medication and patient assistance programs – Access to safe, sober housing Types of Prevention – Tertiary prevention prevents additional issues from Diabetes, TBI, Smoking, Depression – Job coaching and advocacy to ensure employment – Financial counseling and assistance to prevent poverty and financial stress – Access to adequate nutrition, medication and healthcare for overall health and wellbeing – Access to safe, sober housing to prevent homelessness Types of Interventions – Universal interventions attempt to reduce specific health problems across all people in a particular population such as children in your county, by reducing risk and promoting protective factors (Prevent TBI) – Selective interventions are aimed at a subgroup determined to be at high-risk due to their exposure to risk factors (football players) – Indicated interventions are targeted to individuals who are

 Case Management of Psychosocial Aspects of Disability and Chronic Illness | File Type: audio/mpeg | Duration: 56:33

008 CM-Psychosocial Aspects of Disability CEUs are available at allceus.com/counselortoolbox Objectives ~ Define Disability ~ Review the phases of disability adjustment ~ Explore the concept of Disability Identity ~ Identify aspects of disabilities which increase stigma ~ Explore the 5 As of intervention ~ Using ecological theory, explore the psychosocial impact of the disability on the individual and family. Define Disability ~ Any mental health, addictive or physical health issue which restrict or alter a person’s regular or desired activities. ~ Examples ~ Addiction ~ HIV ~ Paraplegia ~ Deafness ~ Visual Impairment ~ Down’s Syndrome ~ Schizophrenia ~ Autism ~ Muscular Dystrophy ~ Chron’s Disease Adjustment to Disability ~ Many people experience more than four stages of adjustment to a physical disability: ~ Shock ~ Anxiety ~ Denial ~ Mourning/Depression ~ Withdrawal ~ Internalized anger & Externalized aggression ~ Acknowledgment ~ Acceptance ~ Adjustment Disability Identity ~ The beneficial self-beliefs that PWDs hold regarding their disabilities, as well as any ties they possess to members of the disability community ~ People with “invisible” disabilities often have a low disability identity ~ Disability identity is negatively correlated with mood disorders ~ Identity development is a fundamentally social process, and identities are formed through mirroring, modeling, and recognition through available identity resources, and so it is imperative that professionals working with individuals with disabilities become aware of this developmental process to be able to better support individuals along this journey Disability Identity Development ~ Key Themes ~ Communal attachment—wishes to affiliate with other PWDs ~ Affirmation of disability—Living in the And ~ Self-worth—values the self and feels equal to nondisabled people ~ Pride—feels proud of identity despite recognizing that disabled is often viewed to be a devalued quality ~ Discrimination—aware of prejudicial behavior in daily life ~ Personal meaning—finds significance in, identifies benefits with, and makes sense of disability Stigmatizing Dimensions ~ Source/responsibility for condition—Is a stigma congenital, accidental, or self-inflicted? ~ Aesthetic—Does the stigma distress or otherwise upset other people? (Addiction, amputation, wheelchair…) ~ Apparent or concealable—Is a stigma obvious (e.g., amputation) or invisible (e.g., psychological or mood disorder, chronic pain, diabetes)? ~ Disruptiveness—Does the stigma’s presence hinder or otherwise prevent social interaction or communication? (aesthetics, cognition, verbalization) ~ Perilous—Can the stigma be seen as contagious or even dangerous to others? (HIV, addiction, psychosis, autism…) ~ Course—Is the stigma getting worse or better? Fundamentals ~ Clients must feel empowered to make decisions regarding self-management ~ Educational and empowerment strategies must be individually tailored ~ Information and support should be consistent with current best practices ~ Collaborative relationships with patients and supporters is critical to success 5 As ~ Assess ~ The condition ~ The client’s and SO’s understanding of the condition ~ Their current coping strategies and efficacy ~ The impact of the condition on the client’s (PACER) ~ Physical Health ~ Affect ~ Cognitions ~ Environment and Economic Well-being ~ Relationships and Recreation ~ Advise/educate the client and significant others 5 As ~ Agree/collaborate to develop a workable plan ~ Short term ~ Long term ~ Assist client and supports in identifying and accessing services ~ Arrange for referrals and follow-up as needed ~ Raise awareness of their rights and of the possibilities and services available to them to ~ Enhance their mental and physical ~ Engage in social/recreational activities ~ Act to eliminate discrimination Ecological Systems Individual Dimensions ~ Risk/Mitigating Factors ~ Age ~ Health (concurrent conditions and health behaviors) ~ Mental Health ~

 13 Brief Interventions for Any Client | File Type: audio/mpeg | Duration: 59:47

419 -13 Useful Brief Interventions Instructor: Dr. Dawn-Elise Snipes, PhD, LPC-MHSP, LMHC CEUs are available at allceus.com/counselortoolbox Objectives ~ Review the benefits of brief interventions ~ Identify the goals of brief interventions ~ Explore 13 brief interventions that can be used with most clients Benefits ~ Reduce no-show ~ Increase treatment engagement ~ Increase compliance ~ Increase self-efficacy ~ Reduce aggression and isolation ~ Provide an interim for clients on waiting lists Goals of Brief Interventions ~ Goals should be… ~ Specific ~ Measurable ~ Achievable in 8-10 weeks ~ Relevant ~ Time Limited ~ Purpose: ~ Reduce the likelihood of damage/additional problems from the current issue. (i.e. family, work, health, self-esteem, guilt, anger) ~ Provide rapid measurable change to increase hope and motivation Target Symptoms ~ General Symptoms ~ Depression/anxiety (mood) ~ Muscle tension ~ Sleep disturbances ~ Concentration ~ Irritability ~ Fatigue ~ Lethargy/psychomotor retardation ~ Hopelessness/helplessness (efficacy) ~ Meta Issues ~ Relationship issues ~ Unhealthy habits (smoking, emotional eating etc.) ~ Modern populations are increasingly overfed yet malnourished, sedentary, sunlight-deficient, sleep-deprived, and socially-isolated Assessment for Brief Interventions ~ Identify what the resolution of the problem looks like. ~ Define a starting point to create one measurable change in the client’s behavior ~ Explore the array of causes of the behavior ~ Physical (sleep, nutrition, relaxation, medicine, health, pain, hormones, addiction…) ~ Affect (anxiety, depression, grief) ~ Cognitions (Cognitive distortions) ~ Environment and Employment ~ Social Relationships (quality, boundaries, communication) Assessment cont… ~ Explore Current Strengths/Mitigating Factors ~ Support systems ~ Client strengths ~ Situational advantages (mitigating factors) ~ Previous treatment (What has and has not worked) 1. Backward Chaining ~ Identify triggers and mitigating factors by backward chaining. ~ Ask the client to describe a situation that triggered the problem ~ John came home late and I got angry ~ I had a bad day and came home and drank a bottle of wine ~ It was valentine’s day and I wasn’t in a relationship so I got depressed ~ I didn’t sleep well and everything seemed to make me feel overwhelmed ~ Ask the client to think of a similar situation that did not trigger the problem ~ John came home late but he called and let me know. ~ I had a bad day and decided to go out to dinner with friends from work to commiserate ~ It was valentine’s day and I wasn’t in a relationship so I went out with friends and we celebrated un-valentine’s day together ~ I didn’t sleep well, so I kept my office door closed and reminded myself that I can only do what I can do 2. Forward Chaining ~ Add in triggers for behaviors you want to start doing ~ Push notifications ~ Visual cues ~ Change buddy ~ Rewards ~ Add in obstacles to behaviors you wish to stop ~ Make it more difficult to start ~ Journal ~ Inaccessibility ~ Temporal distance ~ Aversion 3. Positive Reflection ~ Positive Affect Journaling for 20 minutes per day improves depression and anxiety , enhanced resilience, reduced medical visits ~ Alternatives for those who hate journaling ~ Tell someone about the positive things in your day for ~10-20 minutes ~ Mentally reflect on all the positive things in your day and life for ~10-20 minutes ~ Draw a picture about something incredibly awesome in your life 4. Sleep ~ Benefits: Enhances cognition, enhances immunity, reduces depression and reduces anger, anxiety, and fatigue ~ Only quality sleep within normal limits (7-9 hours) is helpful ~ Incorporation into treatment ~ Review sleep hygiene ~ Develop a sleep routine ~ Keep a log of symptom severity and sleep 5. Sunlight and Circadian Rhythms ~ The body uses sunlight to set circadian rhythms and make vitamin D ~ Vitamin D deficiency is implicated in seasonal affective disorder, behavioral withdrawal

 Psychosocial Aspects of Disability and Chronic Illness | File Type: audio/mpeg | Duration: 57:04

418 -Psychosocial Aspects of Disability CEUs are available at allceus.com/counselortoolbox Objectives ~ Define Disability ~ Review the phases of disability adjustment ~ Explore the concept of Disability Identity ~ Identify aspects of disabilities which increase stigma ~ Explore the 5 As of intervention ~ Using ecological theory, explore the psychosocial impact of the disability on the individual and family. Define Disability ~ Any mental health, addictive or physical health issue which restrict or alter a person’s regular or desired activities. ~ Examples ~ Addiction ~ HIV ~ Paraplegia ~ Deafness ~ Visual Impairment ~ Down’s Syndrome ~ Schizophrenia ~ Autism ~ Muscular Dystrophy ~ Chron’s Disease Adjustment to Disability ~ Many people experience more than four stages of adjustment to a physical disability: ~ Shock ~ Anxiety ~ Denial ~ Mourning/Depression ~ Withdrawal ~ Internalized anger & Externalized aggression ~ Acknowledgment ~ Acceptance ~ Adjustment Disability Identity ~ The beneficial self-beliefs that PWDs hold regarding their disabilities, as well as any ties they possess to members of the disability community ~ People with “invisible” disabilities often have a low disability identity ~ Disability identity is negatively correlated with mood disorders ~ Identity development is a fundamentally social process, and identities are formed through mirroring, modeling, and recognition through available identity resources, and so it is imperative that professionals working with individuals with disabilities become aware of this developmental process to be able to better support individuals along this journey Disability Identity Development ~ Key Themes ~ Communal attachment—wishes to affiliate with other PWDs ~ Affirmation of disability—Living in the And ~ Self-worth—values the self and feels equal to nondisabled people ~ Pride—feels proud of identity despite recognizing that disabled is often viewed to be a devalued quality ~ Discrimination—aware of prejudicial behavior in daily life ~ Personal meaning—finds significance in, identifies benefits with, and makes sense of disability Stigmatizing Dimensions ~ Source/responsibility for condition—Is a stigma congenital, accidental, or self-inflicted? ~ Aesthetic—Does the stigma distress or otherwise upset other people? (Addiction, amputation, wheelchair…) ~ Apparent or concealable—Is a stigma obvious (e.g., amputation) or invisible (e.g., psychological or mood disorder, chronic pain, diabetes)? ~ Disruptiveness—Does the stigma’s presence hinder or otherwise prevent social interaction or communication? (aesthetics, cognition, verbalization) ~ Perilous—Can the stigma be seen as contagious or even dangerous to others? (HIV, addiction, psychosis, autism…) ~ Course—Is the stigma getting worse or better? Fundamentals ~ Clients must feel empowered to make decisions regarding self-management ~ Educational and empowerment strategies must be individually tailored ~ Information and support should be consistent with current best practices ~ Collaborative relationships with patients and supporters is critical to success 5 As ~ Assess ~ The condition ~ The client’s and SO’s understanding of the condition ~ Their current coping strategies and efficacy ~ The impact of the condition on the client’s (PACER) ~ Physical Health ~ Affect ~ Cognitions ~ Environment and Economic Well-being ~ Relationships and Recreation ~ Advise/educate the client and significant others 5 As ~ Agree/collaborate to develop a workable plan ~ Short term ~ Long term ~ Assist client and supports in identifying and accessing services ~ Arrange for referrals and follow-up as needed ~ Raise awareness of their rights and of the possibilities and services available to them to ~ Enhance their mental and physical ~ Engage in social/recreational activities ~ Act to eliminate discrimination Ecological Systems Individual Dimensions ~ Risk/Mitigating Factors ~ Age ~ Health (concurrent conditions and health behaviors) ~ Mental Health ~ C

 NCMHCE Stages and Theories of Treatment | File Type: audio/mpeg | Duration: 53:36

NCMHCE Review #9: Stages and Theories of Treatment CEUs are available at https://www.allceus.com/CE/course/view.php?id=1421 Dr. Dawn-Elise Snipes Executive Director, AllCEUs.com Podcast Host: NCMHCE Exam Review and Counselor Toolbox Objectives ~ Review the stages of treatment ~ Review theoretical approaches for individual counseling including ~ CBT ~ Behaviorism ~ Humanistic ~ Developmental Stages ~ Immediate Concerns ~ Evaluate risk factors ~ Establish rapport ~ Enhance motivation and hope ~ Address administrative and policy issues ~ Make a preliminary diagnosis or narrow to a couple Stages ~ Assessment and Goal Setting ~ Ask questions about ~ The perception of the problem ~ Duration ~ Mitigating and Exacerbating factors ~ Hoped for resolution ~ Impact on PSF in multiple dimensions ~ Physical symptoms ~ Make observations ~ Use collateral sources Stages ~ Treatment plan development (specific as possible—SMART) ~ Prioritize goals ~ Identify needs and services to meet those goals ~ Work with client to select interventions ~ Make appropriate referrals ~ Provide psychoeducation Stages ~ Middle stages ~ Consider a systems approach and involving family or at least addressing contributions of family to the problem and/or solution ~ Teach mindfulness, feelings identification, distress tolerance and coping skills to reduce core symptoms ~ Improve social support ~ Enhance self esteem and efficacy ~ Regularly monitor motivation, resistance and unanticipated barriers to change Stages ~ Late Stage ~ Solidifying gains ~ Generalize skills to other areas ~ Mindfulness and coping skills can be used not only for being aware of and addressing depression, but also anxiety, anger ~ Social support is helpful in recovering from depression, but can also be helpful for behavior change or coping with stress or grief. Stages ~ Termination Stage ~ Consolidate gains by reviewing progress and enhancing efficacy. ~ Ensure a support system is in place ~ Develop a relapse prevention plan ~ Identify and address issues related to termination Cognitive ~ Cognitive theories are active, directive and time limited ~ May include ~ REBT (Identify unhelpful thoughts, unhelpful emotions, UPR, anger management) ~ CBT (Identify unhelpful cognitions, and behaviors and choose more helpful ones and alter the cognitive triad—Self-World-Future) ~ DBT (Distress tolerance, emotion regulation, interpersonal, problem solving) ~ ACT (Radical acceptance, mindfulness, commitment to purposeful action, Unhooking/Defusion) ~ CPT (Challenging questions) Cognitive ~ Goals are to ~ Increase self monitoring and awareness ~ Identify unhelpful cognitions ~ Clarify and challenge underlying beliefs ~ Replace unhelpful triggers and behaviors with helpful ones ~ Increase adaptive problem solving ~ Counterindications: Psychotic disorders, dementia, FASD Behavioral Approaches ~ Emphasis on changing or replacing current behaviors by altering the antecedents and/or consequences through ~ Positive and negative reinforcement of alternate behaviors and punishment and lack of reinforcement of target behaviors ~ Social/observational learning ~ Focuses on observable, measurable behaviors not thoughts or emotions ~ Always gather baseline data and conduct a functional analysis ~ Interventions are conducted in the person’s natural setting and involve SOs Behavioral Approaches ~ Techniques in behavioral approaches ~ Systematic desensitization ~ Flooding ~ Assertiveness training ~ Aversion therapy ~ Extinction ~ Token Economy Humanistic Models ~ Seeks to understand people’s subjective experience ~ UPR for people’s uniqueness, wholeness ~ Belief in people’s natural tendency to move toward self actualization ~ View problems as stemming from incongruence between the self and perceived conditions of worth ~ Overall goal is to achieve congruence between the self and experience and an enhanced ability to cope with future problems ~ Rogerian therapy views assessment and diagnosis as detrimental Gestalt ~ Goals ~ Inc

 Communicating with the Cognitively Impaired Alzheimers and Dementias | File Type: audio/mpeg | Duration: 61:11

417 -Communicating with the Cognitively Impaired Instructor: Dr. Dawn-Elise Snipes, PhD Executive Director: AllCEUs.com, Counselor Education and Training Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery Objectives ~ Define cognitive impairment ~ Explore symptoms of cognitive impairment in ~ Alzheimer’s ~ Dementias ~ Fetal Alcohol Spectrum Disorders ~ Review APA Treatment Guidelines for counselors working with persons with Alzheimer’s ~ Identify methods for effective communication ~ Learn how to handle difficult behaviors ~ Identify specific issues and interventions for a person with a FASD Symptoms of Cognitive Impairment ~ The development of multiple cognitive deficits manifested by both ~ (1) memory impairment (impaired ability to learn new information or to recall previously learned information) ~ (2) one (or more) of the following cognitive disturbances: ~ (a) aphasia (language disturbance) ~ (b) apraxia (impaired ability to carry out motor activities despite intact motor function) ~ (c) agnosia (failure to recognize or identify objects despite intact sensory function) ~ (d) disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting) Symptoms of Cognitive Impairment ~ Other Symptoms ~ Attention ~ Perception ~ Insight and judgment ~ Organization ~ Orientation ~ Processing speed ~ Problem solving ~ Reasoning ~ Metacognition Causes of Cognitive Impairment ~ Wernike-Korsakoff’s Syndrome ~ Vascular Dementia ~ Stroke ~ Impeded blood flow to brain ~ Alzheimers ~ Fetal Alcohol Spectrum Disorders ~ Brain Injury (Car accident, football, fall, boxing) ~ (Temporarily) Hyper or Hypo-glycemia Screening for Cognitive Impairment ~ The AD8 (PDF, 1.2M) and Mini-Cog(PDF, 86K) are among many possible tools. ~ Patients should be screened for cognitive impairment if: ~ The person, family members, or others express concerns about changes in his or her memory or thinking ~ You observe problems/changes in the patient’s memory or thinking ~ The patient is age 80 or older(12) ~ Low education (IQ, FASD, stroke…) ~ History of type 2 diabetes ~ Stroke ~ Depression ~ Trouble managing money or medications ~ Episodes of delirium (confusion/disorientation) Important Aspects of Management ~ Important aspects of psychiatric management include ~ Educating patients and families about ~ the illness ~ treatment ~ sources of additional care and support (e.g.,support groups, respite care, nursing homes, and other long-term-care facilities) ~ the need for financial and legal planning due to the patient’s eventual incapacity (e.g., power of attorney for medical and financial decisions, an up-to-date will, and the cost of long-term care) Important Aspects of Management ~ Behavior oriented treatments ~ Identify the antecedents and consequences of problem behaviors ~ Reduce the frequency of behaviors by changing the environment to alter these antecedents and consequences. ~ Stimulation-oriented treatments ~ recreational activity, art therapy, music therapy, and pet therapy, along with other formal and informal means of maximizing pleasurable activities for patients ~ Emotion-oriented treatments ~ supportive psychotherapy can be employed to address issues of loss in the early stages of dementia ~ Reminiscence therapy has some modest research support for improvement of mood and behavior ~ Tolerate, Anticipate, Don’t Agitate Communication ~ Written, oral, body language/signs ~ Let the client write, draw or speak to communicate ~ Use real objects when possible. (i.e. an apple) ~ Use picture books, posted lists ~ Story boards can be utilized to discuss a behavior incident ~ Use assistive devices when needed (glasses, hearing aids, large font) ~ Have spare reading glasses, hearing assistance (~$150) as people may misplace them ~ Get their attention ~ Orient them to who you are and why you are there ~ Establish rapport before jumping into “business” ~ Get the person’s attention by identifying her by name Communication ~ Us

 Supporting Clients on Medication Assisted Therapies | File Type: audio/mpeg | Duration: 56:27

416 -Supporting Clients on Medication Assisted Therapies Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director, AllCEUs Counselor Education Podcast Host: Counselor Toolbox, Case Management Toolbox, NCMHCE Exam Review CEUs at: https://www.allceus.com/member/cart/index/product/id/1123/c/ Objectives – Define MAT – Explore barriers to treatment What is Our Goal – Help people – Reduce symptoms of depression and anxiety – Agitation – Sleep disruption – Anhedonia – Fatigue – Feelings of worthlessness and guilt – Stay alive (not overdose or commit suicide) – Be relatively pain free (bidirectional with depression and anxiety) – Be independent – Improve interpersonal relationships – Be financially secure – Be “productive” members of society to their ability Goals – Pain, financial instability, lack of independence, poor relationships, mood disorders, low self-esteem, lack of effective coping skills are common in people addicted to opioids To Achieve This Goal – Clients must – Enter treatment – Stay in treatment long enough to: – Get through any PAWS syndromes caused by switching to MAT – Enable their neurotransmitters to balance out – Address biopsychosocial issues that trigger or maintain illicit drug use (SPACE) – Social – Physical – Affective – Cognitive – Environmental Question – Do you have biases towards clients who take antidepressants- Benzodiazepines- – Methadone is a serotonin re-uptake inhibitor – Buprenorphine is a partial agonist – Do you have biases toward clients who take opioids or gabapentin for chronic pain- – It is possible to develop physical dependence on gabapentin and experience withdrawal effects for up to 45 days Review of Terms – Agonists–medications that bind with the brain’s receptors and produce opioid-like effects (Methadone, morphine, fentanyl, heroin) – Partial agonists-medications that bind with given receptors and only produce limited opioid-like effects.(Buprenorphine) – Antagonists-medications that block receptors and prohibit opioid-like effects.(Naloxone) – Street and pain-killer opioids are “short acting” – MAT is “long acting” Benefits of MAT – Methadone does not create a pleasurable or euphoric feeling from mu-receptor activation – The medications used in MAT reduce cravings, prevent withdrawal and help normalize brain function so that you can focus on developing the healthy thought and behavior patterns that will sustain recovery. (SAMHSA, 2003) – MAT provides individuals a taper of long-acting opioid medications as a way to wean them off of stronger opioids such as heroin – A minimum of 12 months is required for methadone maintenance to be effective (NIDA, 2009). Benefits of MAT – Reduce overdose risk – Improve the chance of survival – Reduce the risk of relapse – Improve retention in treatment for an adequate period of time to address biopsychosocial issues – Employment – Pain – Other health issues – Relationship problems – Mood disorders (The correct SSRI takes up to 2 months to take effect) – Reduce criminal activities associated with substance use disorders – Reduce negative health outcomes, including HIV and hepatitis infection – Improve birth outcomes among addicted pregnant women Stigma – Stigma is typically a social process characterized by exclusion, rejection, blame or devaluation that results from an adverse social judgment about a person or group – The presence of stigma leads to ongoing discrimination and marginalization with detrimental effects for clients, families and communities including decreased self esteem, increased isolation and vulnerability, and a reduced likelihood of service access. – Associative stigma is the process of being s

 CM -Dementia Case Management | File Type: audio/mpeg | Duration: 91:40

Case Management Toolbox 06 -Dementia Case Management Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director AllCEUs Continuing Education Podcast Host: Case Management Toolbox, Counselor Toolbox CEUs are available for this presentation at https://www.allceus.com/case-management-toolbox-podcast/ Objectives Resources – The Dementia Society of Ottawa and Renfrew Counties – Dementia Australia Symptoms of Dementia – Cognitive and sensory changes: – Memory loss – Difficulty in communication, especially finding the right words to communicate or keeping track of a conversation. – Reduced ability to organize, plan, reason, or solve problems – Difficulty handling complex tasks – Confusion and disorientation (Gets lost in familiar places) – Difficulty with coordination and motor functions – Loss of or reduced visual perception – Metallic taste in mouth, decreased sense of smell – Agnosia: loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective nor is there necessarily any significant memory loss “visual agnosia” “Auditory agnosia” Symptoms of Dementia – Psychological changes: – Changes in personality and behavior – Depression – Anxiety – Hallucinations – Mood swings – Agitation esp. with changes in routine – Apathy – Isolation/withdrawal Dementia vs Normal Aging – Normal Aging – Occasional forgetfulness – Can use notes as reminders – Slower processing – Increased time for complex tasks – Able to follow written and verbal directions – Longer to learn new information – Difficulty finding the right word – Slowed reaction time – Able to complete ADLs* – Some issues with balance* Types of Dementia- Alzheimer’s – Stage 1 means Alzheimer’s has started to develop, but there are no symptoms of memory loss yet — this stage can last up to 20 years. – Stage 2 Mild Cognitive Impairment –MCI) involves mild changes in memory and thinking skills – Stage 3 (Late Stage/Alzheimer’s Dementia) memory and thinking skills are so impaired that a person needs help to complete daily activities of daily living. Types of Dementia- Korsakoff’s Syndrome – Korsakoff’s syndrome and Wernicke/Korsakoff syndrome – Alcohol has a direct toxic effect on the brain cells, or whether the damage is due to lack of thiamine, vitamin B1 – People with anorexia and those who have had bariatric bypass surgery are also at risk. Types of Dementia—AIDS Dementia Complex – 7% in people not taking anti-HIV drugs. Types of Dementia—Vascular Dementia – Vascular Dementia includes a very wide range of symptoms caused by a reduction in blood supply to the brain usually due to strokes or heart attack – Symptoms can develop months after a major stroke – The main symptom of Vascular Dementia is slowness in thinking speed, problems concentrating or difficulty planning and organizing. – It is also common for a person with Vascular Dementia to experience mood changes Types of Dementia- With Lewy Bodies – Dementia with Lewy Bodies is often misdiagnosed as Alzheimer’s Disease – Parkinson’s Disease and Dementia with Lewy Bodies produce similar brain changes – The main symptoms include memory loss, disorientation, visual hallucinations and sleep issues – The disease lasts an average of 5 to 8 years from the time of diagnosis to death, but the time span can range from 2 to 20 years. Types of Dementia–Frontotemporal – The main functions affected by Frontotemporal Dementia are language skills, the ability to focus and the ability to control impulses – More common in those under 65 Other (Reversible-) Causes of Dementia – Clinical hypothyroidism and hyperthyroidism have long been linked with reversible cognitive impairment in patients –

 Relapse Prevention Groups for Addiction and Mental Health Disorders | File Type: audio/mpeg | Duration: 54:53

415 -Relapse Prevention Groups for Addiction and Mental Health Disorders Part of the Co-Occurring Disorders Recovery Coaching Series Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director, AllCEUs Objectives ~ Define Relapse ~ Identify triggers and warning signs of relapse ~ Review Relapse Syndrome and possible interventions ~ Explore the acronym DREAM ~ Define and identify vulnerabilities ~ Define and identify exceptions ~ Develop a relapse prevention plan Types of Relapse ~ Emotional relapse ~ Mental relapse ~ Physical relapse ~ Behavioral Relapse Relapse Warning Signs ~ Emotional Cues ~ Anger and irritability ~ Anxiety ~ Depression ~ Resentment ~ Mood Swings ~ Boredom ~ Mental Cues ~ Negativity ~ All or none thinking ~ Concentration problems ~ Memory problems ~ Rigidity/Problem solving difficulties ~ Physical Cues ~ Sleep problems ~ Appetite problems ~ Medication noncompliance ~ Fatigue ~ Pain ~ Tension ~ Social Cues ~ Unhelpful friends ~ Isolation ~ Not asking for help ~ Secrets ~ Stop meetings/support groups/counseling Relapse Warning Signs ~ Discuss the above relapse warning signs ~ How they are rewarding ~ Best ways to address them Relapse Warning Signs and Triggers ~ Family Feud ~ Preparation ~ There are 4 questions for the first part of the game ~ Name the top 5 emotional relapse warning signs ~ Name the top 5 cognitive relapse warning signs ~ Name the top 5 physical relapse warning signs ~ Name the top 5 social relapse warning signs ~ Write the first letter of each word of the 5 warning signs to guide people (You can make your own warning signs if you want) Name the Top 5 Emotional Relapse Warning Signs Name the Top 5 Emotional Relapse Warning Signs Relapse Warning Signs and Triggers ~ Discussion ~ Have people identify the key questions to address each relapse warning sign ~ How are you feeling? ~ Why are you doing this/feeling this way? ~ Who can help you? ~ What 3 things can you do to change the situation or how you feel about the situation? ~ When will you do it? ~ As you discuss each warning sign, have clients fill out a worksheet with solutions for themselves Recovery Signals ~ Dot Chart (Bingo markers) 10 Most Common Triggers of Relapse ~ Withdrawal symptoms (anxiety, nausea, physical weakness, psychological withdrawal and craving) ~ Post-acute withdrawal symptoms (anxiety, irritability, mood swings, poor sleep) ~ Poor self-care (stress management, eating, sleeping) ~ People ~ Places (where you used or where you used to buy drugs) ~ Things (that were part of your using, or that remind you of using) ~ Uncomfortable emotions (H.A.L.T.: hungry, angry, lonely, tired) ~ Relationships and sex (can be stressful if anything goes wrong) ~ Isolation (gives you too much time to be with your own thoughts) ~ Pride and overconfidence (thinking you don’t have a drug or alcohol problem, or that it is behind you) Recovery Triggers ~ Recovery triggers are things that remind you to do the next right thing to keep moving toward your goals (Design plan (car, home, work)) ~ Mood (Happiness, compassion, gratitude, hope, optimism, courage, determination) ~ People (That inspire you to move forward and support and encourage you) ~ Sights (décor (dishes, pictures, blankets, pillows, framed memories), mobile device) ~ Smells (that trigger a recovery mood or remind you of a goal or to do something) ~ Sounds (That help you relax, get energized or focused) Goal Awareness ~ Recovery is about heading toward a happier, healthier life. ~ Define what that looks like ~ Relationships with… ~ Kids that trust and confide in me and want to spend time with me ~ Pets that are happy ~ Activities ~ Run a marathon ~ Foster rescue animals ~ Health ~ Have ample energy to get through the day ~ Be in good health ~ Things ~ Own my house ~ Be able to comfortably pay my bills Goal Awareness Worksheet PAWRS ~ Hot Potato/Beach Ball OR Small Group Work ~ First write the symptoms on the board and discuss what might cause these symptoms in recovery from depre

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