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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 Individual and Group Exercises for Anger and Anxiety | File Type: audio/mpeg | Duration: 52:23

468 – Individual and Group Exercises for Anger and Anxiety https://www.allceus.com/member/cart/index/product/id/969/c/ Journey to Recovery Individual and Group Exercises for Anger and Anxiety Objectives What is the Purpose • Anger (Fight) and anxiety (Flee) protect you from perceived threats by alerting you there MIGHT be a problem • Have you ever gotten angry or stressed out about something just to find out that it wasn’t a big deal? • Problems • Based on prior learning experiences (but life changes) • Unsafe situations • Need for someone’s approval • May be overgeneralized (all or nothing) • Dogs barking • Semis What is the Purpose • Problems • May be the result of transference • First love • Worst boss • May simply be inaccurate (Fire alarm) • Car backfiring • Sean’s “paint” Effects • How does anger or anxiety affect you: • Physically: Sleep, pain, GI, immunity • Emotionally: Regret, guilt, feeling helpless • Socially: Fear vs. respect, negative impact on relationships • Occupationally: How you work with others, customer service • Spiritually: Your sense of contectedness to and impact within the world, karma • Environmentally: Break stuff, holes in walls, throw out things impulsively Anger • Since anger protects people and it often results from application of prior knowledge or experiences, then it can be supposed that people with a lot of anger may have been exposed to significant threats (traumas) in their past • When you have a hammer, every problem looks like a nail Anger and Anxiety Triggers • The Alphabet List • A= Attitude • B= Bullying • C= Creating drama • D= Disagreeing • E= Expecting too much • F= Failing to keep a promise • G= … Anger and Anxiety Interventions • Recognize anger and anxiety as a protective response based on that persons experiences and worldview. • In what way did the current situation make the person feel unsafe emotionally, interpersonally, physically or remind them of a time he or she was unsafe? • What emotions were triggered by this event and what vulnerabilities or skill deficits contributed to the event? • In what way did the situation trigger a sense or memory of loss? • How does the persons experience of the event alter his/her future? Anger and Anxiety Interventions • The Alphabet List • A= Acceptance • B= Breathing • C= Compassion, Challenge • D= Dispute, Distract, Distress Tolerance • E= Express myself • F= Friend’s support • G= Gratitude • H= Higher Power/Hope • I=… Anger and Anxiety Interventions • Identify 2 ways you could deal with the following symptoms, why they might occur and why it is important to recovery • Beach ball • Jenga (card draw) • Hat draw (same cards from Jenga) • Symptoms • Always feeling worried or stressed out • Insomnia • Fatigue • Shortness of breath • Muscle tension • Headaches • Irritability Anger and Anxiety Interventions • Anxiety/Anger graphic novel or skit • Anxiety/Anger says… • Evidence for and against • Anger/anxiety thermometer • Vulnerability predictor/prevention • Handling criticism (role play) • Worry stone or beads • Worry box • Positive writing • Anger “Onion” Anger and Anxiety Interventions • Hidden Heart • Fill a ziplock baggie with slips that tell about all of your hurts and anger (This is your heart) • Put the little bag inside of a paper lunch bag. Write on the outside all the ways they present themselves to the world to hide what is hidden on the inside. • For kids: Anger Tornado • RELAX Jar: Using beads with the letters R-E-L-A-X and other small beads and sequins, fill a small jar with rice. Leave a little air at the top so as it is rotated, the rice will slide around inside revealing the letter beads and sequins.  When the person gets angry, she/he can turn the jar until finding all the letters that spell relax. (more resources here https://www.creativecounseling101.com/anger-management.html) Anger and Anxiety Interventions • Hidden Heart • Fill a ziplock baggie with slips that tell about all of your hurts and anger (This is your

 Case Management for Chronic Pain | File Type: audio/mpeg | Duration: 59:29

467 – Case Management for Chronic Pain Dr. Dawn-Elise Snipes PhD, LPC, LMHC https://www.allceus.com/member/cart/index/product/id/1265/c/ Executive Director, AllCEUs Objectives • Define the problem • Examine the similarities between CNCP, mental health issues and addiction • Identify the impact of CNCP on patients • Explore biopsychosocial resource needs for secondary and tertiary prevention. Introduction • Historically, pain without an apparent anatomical or neurophysiological origin was labeled as psychopathological. This approach is damaging to the patient and provider alike. It pollutes the therapeutic relationship by introducing an element of mutual distrust. It is demoralizing to the patient who feels at fault, disbelieved, and alone. • Moreover, many medically unexplained pains are now understood to involve an interplay between peripheral and central neurophysiological mechanisms that have gone awry. • Adjustment disorder remains the most appropriate, accurate, and acceptable diagnosis for people who are overly concerned about their pain. Facts • CNCP patients with addictive disorders 32% • People >20 with pain lasting >3 months 56% • People with disabling pain in the previous year 36% • Children with chronic pain 11%-38% • Pain may have a long course with multiple episodes • Chronic pain can be highly stressful for patients and families • Care for people with chronic pain is increasingly done in outpatient • Untreated mood and addictive disorders in individuals with chronic pain increases morbidity and mortality rates and reduces the capacity for self-management Facts • Chronic pain due to one condition can cause increases in systemic inflammation and widespread pain • Across CP conditions there is generally a shift away from brain regions engaged in processing the sensory component of pain toward regions that encode emotional and motivational subjective states • Experiences of physical and social pain (ie, social rejection, exclusion, bullying, negative social evaluation, loss of a close relationship), share neurochemical and neural substrates • Young people with comorbid depression and CP are at an increased risk of suicide Pain and Mental Health • CNCP and addiction or mood disorders frequently co-occur and fluctuate in intensity over time and under different circumstances • They share neurophysiological patterns including • Increased inflammatory cytokines • Altered levels of dopamine, serotonin and norepinephrine • Hyperactive HPA-Axis Effective pain management in patients with comorbid issues must address all conditions simultaneously. Similarities– Pain, MH and SUD • Treatment of one condition can support or conflict with treatment for the other. • A medication appropriately prescribed for a particular chronic pain condition may be inappropriate, given the patient’s SUD or mental health history. • Are mediated by genetics and environment. Biopsychosocial Impact of Pain • Sleep • Pain • Medication side effects • Fatigue • Circadian rhythm disruption • Physical changes (weight changes, ports, pumps, hair loss) • Loss of mobility • Depression • Anxiety • Anger/Irritability • Grief/Adjustment • Jealousy or resentment • Withdrawal • Self Esteem changes • Loss of social support or paternalism • Inability to engage in prior important activities • Loss of independence • Vocational problems • Financial hardships (Medical expenses, job loss, environmental modifications) • Access to nutritious food • Physical, sexual and emotional relationship problems Common Chronic Pain Conditions • Low Back Pain • Neck Pain • Upper Back Pain • Arthritis • Fibromyalgia • TMJ • Chron’s Disease • Migraines Assessing for Chronic Pain • Assessment instruments include the McGill Pain Questionnaire For a list of additional assessment tools, see TIP 54 • Assessment of CNCP should document: • Pain onset, quality, and severity • Results of investigations into etiology • Pain-related functional impairment • Emotional changes (e.g., anx

 Developing Self-Esteem and Self-Efficacy | File Type: audio/mpeg | Duration: 42:02

466 – Developing Self-Esteem and Self-Efficacy Developing Self-Esteem and Self-Efficacy Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Counseling Continuing Education Podcast Host: Counselor Toolbox, Case Management Toolbox https://www.allceus.com/member/cart/index/product/id/1030/c/ Objectives • Understand what self esteem and self-efficacy are, why they are important and how to develop them The Nature of Self-Esteem • How people feel about theirself in contrast to who people think people “should” be • The more rejecting people are of theirself, the more • Distress people experience • people seek external validation or withdraw • In order to develop healthy relationships people need to • Feel good about theirself • Get in touch with theirself and their true values • Believe people are a lovable and worthwhile person • Choose actions in harmony with their true self The Gift of Mindfulness • Teaches people to live in the moment • Not stuck in guilt or resentment of the past • Not paralyzed by fear of the future • Putting one foot in front of the other • Cornerstone of mindfulness is acceptance • Nonjudgmental • Letting be • Patient • Mindfulness teaches that when people trust theirself and act with awareness and purpose people become more self reliant Note: The book will give people access to online, recorded versions of several meditations Impact of Mindlessness • Ignoring or invalidating how people feel • Failing to integrate feelings, thoughts, sensations and urges • Running on autopilot and not making time for the things that are important (getting us closer to our ideal selves) • Blindly adopting mainstream messages of who/what we should be • Not in harmony with who we really want to be • Not achievable or realistic Developing a Self-Concept and Efficacy • You are more than your accomplishments or your bank account. • What do you want to stand for (values)? • Download a values list and circle the ones that are important to you. • Identify how you CURRENTLY demonstrate those. • Identify other ways you could demonstrate those. • What things do you do that go against your values? (i.e. impatience) • What could you start doing today to address one of those? Developing a Self-Concept • What things are you good at, and what are your accomplishments? • What traits/values do those accomplishments and strengths represent? Success, courage, determination, creativity, compassion • How would your friends describe you? • Loyal, compassionate, caring, honest… • How do you demonstrate those? • Self Esteem Acronym (THINK) Breathing and the Body • The constant noise often keeps people from addressing the underlying issues of emotional turmoil • Life becomes focused on treading water • Forward goals are exchanged for just surviving • This reduces self-efficacy • Mindfulness and self-awareness help people quiet their thoughts • By making contact with the present moment people can: • Find their strength • Learn to grow • Choose how people wish to respond Activities • A Deep Full Breath • Abdominal breathing signals the brain to slow down and relax. “Rest and digest” • Simply paying attention to breath often causes it to slow down • Feel the loving touch (their Breath) • Life begins and ends with breath • Breathing helps relax the body and move Qi • Add visual and auditory breathing reminders Activities cont… • In and Out • Do a body scan and yay attention to what their body is trying to tell them • Inhale and take in positive affirmations • Make a list of 1-3 affirmations • Exhale and let go of stress and negative energy • Envision stress leaving like a wave/cloud/balloon • Note: This can also be done with bubbles • Practice noticing points of tension/tightness/heaviness and feel them relax or loosen as they exhale • Develop confidence that they can feel feelings and not have to impulsively act. Thinking and the Mind • An Impartial Witness (Fly on the wall) • Stop Sorting (into good and bad) • See the Whole Room, Not J

 Grief | File Type: audio/mpeg | Duration: 56:35

465 – Grief Purchase Link: https://www.allceus.com/member/cart/index/product/id/582/c/ Grief Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs Objectives • Define grief • Conceptualize grief in terms of any loss • Identify how failure to deal with grief can impact a person • Explore the stages of grief What is Grief • Grief is a label assigned to all of the emotions associated with dealing with any kind of loss • Physical (Things, abilities, freedoms) • Self-concept (Roles, values, labels) • Worldview (Innocence, safety) • Dreams (How things should be) • Social (Loss of relationships…) Stages of Grief • Denial: Numbness, dream, alternate explanations) • Anger: The unknown, loss of control, death, isolation, failure—(shouldas and couldas) • Bargaining: If I … then I will wake up and realize this was only a really bad dream • Depression: Helpless, hopeless • Acceptance: Radical acceptance that the loss occurred and determining how to proceed from there BioPsychoSocial Impact of Grief • Biological • Sleep disturbances • Changes in weight • Increased blood pressure • Increased cortisol and other endocrine changes • Muscle weakness • Social • Withdrawal/Isolation • Enmeshment • Psychological • Depression • Anxiety • Relief • Changes in worldview • Guilt • Anger • Difficulty concentrating • Difficulty making decisions • Avoidance of triggers Exacerbating & Mitigating factors • How people react in a crisis depends • How close the situation was to them (physical and emotional proximity) • How many other stressors them experienced in the last year • Mental health issues/Effective coping skills • Social supports • Understanding of the loss • How much control/responsibility they feel like they had in the situation • Type of loss and predictability • Age of the bereaved Impact of Unresolved Grief • Most people get stuck in either anger (including guilt)or depression • Anger (shoulda, couldas and if onlys) • At self • At others • At higher power • Depression (Hopelessness, Helplessness—I don’t now how to go on) Denial • Denial is the mind’s way of protecting people from what lies ahead. • Denial can start before the actual loss as in the case of terminal illness (anticipatory grief) • Therapist Activities • Assess level of acceptance and denial of each person in the support system • Discuss hope and acceptance • Action strategies • Shore up resources • Gather accurate information • Facing the loss: Narrative therapy Anger • Anger is the power play • Push people away to avoid getting hurt again • Blame others as an outlet for helplessness—somebody somewhere could have prevented this • Blame self to try to regain some control/prevent it from happening again, make themselves suffer • Question belief system and world schema • Guilt is a form of anger Anger • Action steps • Identifying primary and secondary losses • Explore what the losses mean to the person (Ex. Job, Parent, Victimization) and how they feel about it • Angry (other losses) • Scared (which fears and why?) • Depressed (I feel helpless to… ; I feel hopeless to…) • Ventilation and Validation Anger • Action steps • Examine the stated beliefs for • All or nothing thinking • Emotional reasoning • Fallacy of fairness • Emotional Reasoning (I feel angry therefore someone must be to blame) • Begin exploring solutions to fears and issues (What is within their control) Bargaining • If I do x, y and z, maybe I can wake up and it will have been a nightmare • Contributes to depression because the person wakes up everyday hoping the reality is different • Hope is squelched every morning • Develop hope for the new reality • I can grief

 Complicated Grief and Attachment | File Type: audio/mpeg | Duration: 59:52

460 – Complicated Grief and Attachment Purchase Link: https://www.allceus.com/member/cart/index/product/id/995/c/ Complicated Grief and Attachment Dr. Dawn-Elise Snipes PhD, LPC-MHSP Podcast Host: Counselor Toolbox and Happiness Isn't Brain Surgery Objectives ~ Define Complicated Grief ~ Identify how loss of or lack of an attachment relationship may represent a loss that needs to be grieved. ~ Explore the overlap between complicated grief and trauma ~ Identify risk factors for CG ~ Explore tasks for successful grief resolution Definitions: ~ Loss: Change that includes being without someone or something in this case the primary attachment relationship ~ Secondary loss: Other losses as a result of a primary loss. Example, loss of security when rejected by primary caregiver ~ Grief: Reaction or response to loss; includes physical, social, emotional, cognitive and spiritual dimensions. ~ Trauma: Any situation that causes the individual to experience extreme distress Attachment ~ Attachment ~ Attachment is the quality of the relationship with the caregiver characterized by trust, safety and security. ~ The quality of the infant-parent attachment is a powerful predictor of a child's later social and emotional outcome ~ Determined by the caregiver's response to the infant and toddler when the child's attachment system is ‘activated' Internal Working Model ~ Children's attachment with their primary caregiver leads to the development of an internal working model which guides future interactions with others. ~ 3 main features of the internal working model ~ a model of others as being trustworthy (what is the loss here?) ~ a model of the self as valuable (what is the loss here?) ~ a model of the self as effective when interacting with others. (what is the loss here?) ~ Secure attachments also help children ~ Feel loved and accepted ~ Learn to manage their emotions ~ Address dichotomous thinking and cognitive distortions Bowlby on Attachment and Grief ~ Attachment Relationships Help Regulate Psychological And Biological Functions Including: ~ Mastery and performance success ~ Learning and performing ~ Relationships with others (and future attachment) ~ Cognitive functioning ~ Coping and problem solving skills ~ Self-esteem ~ Emotion regulation ~ Sleep quality ~ Pain intensity (physical and emotional) Bowlby ~ Attachment and safety stimulate a desire to learn, grow and explore ~ Caregivers provide support and reassurance (Safe haven) ~ Encouragement and pleasure (secure base) Feeney J Pers Soc Psych 631 -648 2004 Bowlby ~ Loss of an attachment relationship ~ Disrupts attachment, caregiving and exploratory systems ~ Attachment: Activates separation response and impacts restorative emotional, social and biological processes ~ Exploratory system: Inhibits exploration with a loss of a sense of confidence and agency. ~ Caregiving: Produces a sense of failure and can include self blame and survivor guilt Trauma ~ Trauma is any event that is distressing or disturbing ~ How do we know what is distressing or disturbing ~ Erodes a sense of safety (Triggers fight or flight) ~ Emotional (including dysregulation) ~ Mental (interpretations and schemas) ~ Physical (object permanence, darkness, pain, prior experiences) ~ Adverse Childhood Experiences that may disrupt primary attachment ~ Immediate family member with a mental health or addiction issue ~ Immediate family member who is incarcerated ~ Divorce ~ Abuse (child or DV) ~ Neglect How Can Disrupted Attachment ïƒ Trauma ~ The primary attachment figure remains crucial for approximately the first 5 years of life ~ Trust/mistrust (Ages 0-2) ~ Object Permanence ~ Autonomy/shame (Ages 2-7) ~ Egocentrism: children assume that other people see, hear, and feel exactly the same as they do ~ Children's moral sense in this phase of development is rigid and believe that a punishment is invariable, irrespective of the circumstances. ~ They regard bad things that happen as a consequence for misdee

 Contextual Cognitive Behavioral Therapy | File Type: audio/mpeg | Duration: 54:49

464 – Contextual Cognitive Behavioral Therapy Purchase Link: https://www.allceus.com/member/cart/index/product/id/1001/c/ Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director: AllCEUs Counselor Education Host: Counselor Toolbox Podcast Objectives • Define and review the concepts of contextual cognitive behavioral therapy • Explore the impact of context on people’s phenomenological reality • Explore how addiction and mental health issues can be influenced by context • Explore how acceptance, awareness, mindfulness and psychological flexibility can be used transdiagnostically. Why Contextual • Addiction and mental health issues are often intergenerational • Addiction and Mental Health issues are strongly correlated with: • Each other • Adverse childhood experiences (history of and children with) • Impaired occupational and social functioning • Health problems Contextual Approaches • Encourage mindfulness in the present moment • Accept each person’s “truth” is constructed from their schema and the resulting interpretation of the current moment • The goal is to consider the context and function of the past and present issue and empower the person to make a conscious choice toward their valued goals • Remember that the prefix RE means to do again • REpeat • REdo • REgress • RElapse • REaction Childhood Context and Development • The family context can be a preventative or risk factor for the development of issues • Children develop schema about themselves, others and the world through these early interactions • In later life people continue to develop schema influenced by their past learning. Caregiver Requirements for Secure Attachment and Healthy Development • Consistent Age-Appropriate Responsiveness • Trust • Autonomy • Industry • Identity • Empathy • Compassion • Effective Communication Skills • Unconditional Love Think About It • What is it like for a child growing up in a house in which one or both parents has: • An addiction • A mental health issue Common Addicted Characteristics • Difficulty dealing with life on life’s terms • Difficulty dealing with distress (poor coping) • Impulsivity / lack of patience and distress tolerance • Neglectfulness • Hostility • Defensiveness • Blaming • Manipulation • Withdrawal • From others/disconnected • No pleasure in other activities • Justification/minimization/denial • Low self-esteem • Guilt and shame Common Characteristics in People with Mental Health Issues • Difficulty dealing with life on life’s terms • Difficulty dealing with distress (poor coping) • Impulsivity / lack of patience and distress tolerance • Neglectfulness • Hostility • Irritability • Withdrawal • From others/disconnected • Apathy • Low self-esteem • Guilt and shame • Fatigue • Sense of hopelessness or helplessness The End Product • People’s REactions to things are based on prior learning + present moment. • Bridges • Stress • Depression • Self-esteem Core Concepts in Contextual CBT Mindfulness • Improves people’s ability to be present in the present • Shift from automatically reacting to thoughts and feelings based on schema to being aware of ALL experiences in the present to provide more flexibility Encouraging Acceptance of Internal Experiences • Accepting thoughts, feelings, sensations without having to act on them • Radical Acceptance • Unhooking • Dialectics • I can be a good person AND be divorced • I can be happy AND grieving • I can stay sober AND be stressed Acceptance of Internal Experiences • Accepting thoughts, feelings, sensations without having to act on them • Distress Tolerance • ACCEPTS • Activities • Contributing • Comparisons • Emotions (opposite)

 Understanding Anxiety through a Child’s Eyes | File Type: audio/mpeg | Duration: 53:41

462 – Understanding Anxiety Through a Child’s Eyes Purchase Link: https://www.allceus.com/member/cart/index/product/id/1033/c/ Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director, AllCEUs Counselor Education Host: Counselor Toolbox Podcast Objectives – Identify symptoms of anxiety in children – Review common misdiagnoses – Explain how children’s developmental stage impacts their fears – Propose interventions to help children deal with anxiety Symptoms of Anxiety in Children – Emotional Signs of Anxiety – Is extremely sensitive – Irritable – Is afraid of making even minor mistakes including test anxiety – Panic attacks – Has phobias (about bees, dogs, etc.) and exaggerated fears (about things like natural disasters, etc.) – Worries about things that are far in the future – Has frequent nightmares – Gets distracted from playing by his worries – Has compulsive, repetitive behaviors Symptoms of Anxiety in Children – Behavioral Signs of Anxiety – Starts having meltdowns or tantrums. – Asks “what if-” constantly. – Avoids participating in group activities. – Remains silent or preoccupied during group work – Refuses to go to school. – Avoids social situations with peers after school or on weekends – Becomes emotional or angry when separated from parents – Constantly seeks approval – Low self-esteem and efficacy – Overly concerned about negative evaluations Symptoms of Anxiety in Children – Physical Signs of Anxiety – Frequently complains of head or stomachaches – Refuses to eat snacks or lunch at school – Can become restless, fidgety, hyperactive – Difficulty concentrating – Starts to shake or sweat in intimidating situations. – Dizziness – Frequent urge to urinate – Constantly tenses muscles – Exaggerated startle response – Has trouble falling or staying asleep – Falls asleep in school – Repetitive activities (tapping, leg shaking…) – Nail biting / skin picking – Rigid routines Not Little Adults – How do children think differently – 0-2: Object permanence; personal agency (crying, “Uh Oh,” Ask for drinks) – When you are overtired, startled, too hot/cold, or have low blood sugar, the HPA-Axis is activated –> Threat Response (Anxiety) – 2-7: Egocentric, personalized, concrete/dichotomous, mystical – Daddy yelled at me. Daddy left. Daddy hates me. It is my fault. – I told Mommy I hated her. She got sick. It is my fault. – I didn’t say my prayers last night. We got into a car accident because God is mad at me. – The neighbor’s dog always charges the fence and wants to bite me. This makes me scared. Dogs are dangerous. Not Little Adults – How do children think differently – 7-11: Inductive (Start making global attributions from specifics) – I didn’t make the team. I got a C on my spelling test. I must be a failure – 11+: More advanced reasoning but little life experience and often have not questioned prior faulty schema What is Anxiety – Anxiety is fear which is the flee part of the fight or flight (stress) response – What do we/children fear – Death (Biological Needs/Safety(self & others)) – Rejection/Isolation/Abandonment (Biological Needs, Safety, Love and Belonging) – The Unknown (Biological Needs, Safety, Love) – Loss of Control (Parental, older children) What is Causing the Anxiety – Cognitive – Unhelpful thoughts – Lack of knowledge – Physical – Lack of sleep – Poor nutrition or hunger – Hormones (sex, thyroid) – Emotional – Highly sensitive child – Environmental/social – Bullies – Teacher pressure – Parental enmeshment or disengagement – Chaotic home environment (mental heal

 Internal Family Systems Theory | File Type: audio/mpeg | Duration: 46:18

461 – Internal Family Systems Theory Purchase Link: https://www.allceus.com/member/cart/index/product/id/1034/c/ Dr. Dawn-Elise Snipes Objectives ~ Define Internal Family Systems Theory ~ Identify when it is used ~ Explore guiding principles ~ For more information and training programs in IFS, go to https://www.selfleadership.org/ Overview ~ IFS was developed in the 1990s by family therapist Richard Schwartz, Ph.D., ~ It is based on the concept that an undamaged core Self is the essence of who you are, and identifies three different types of sub-personalities or “families” that reside within each person, in addition to the Self. ~ Wounded and suppressed parts called exiles (lost child) ~ Managers, that keep the exiled parts suppressed (enabler) ~ Firefighters, that distract the Self from the pain of exiled parts. (hero/mascot/scapegoat) ~ The Internal Family Systems Center for Self-Leadership conducts training programs Basic Assumptions ~ The mind is subdivided into an indeterminate number of subpersonalities or parts. ~ Everyone has a Self which can lead the individual's internal system. ~ The non-extreme intention of each part (exile, manager and firefighter) is something positive for the individual. ~ There are no “bad” parts ~ The goal of therapy is not to eliminate parts but instead to help them find their non-extreme roles. ~ As we develop, our parts develop and form a complex system of interactions among themselves ~ When the system is reorganized, parts can change rapidly. ~ Changes in the internal system will affect changes in the external system and vice versa. Parts ~ Subpersonalities are aspects of our personality that interact internally in sequences and styles that are similar to the ways in which people interact. (exile and the manager or the firefighter and the Self) ~ Parts may be experienced in any number of ways — thoughts, feelings, sensations, images, and more. ~ All parts want something positive for the individual and will use a variety of strategies to gain influence within the internal system. ~ Parts that become extreme are carrying “burdens” — energies that are not helpful, such as extreme beliefs, emotions, or fantasies. ~ Parts can be helped to “unburden” or recognize their role and return to their natural balance. ~ Parts that have lost trust in the leadership of the Self will “blend” with or take over the Self. Exiles ~ Young parts that have experienced trauma and become isolated or suppressed in an effort to protect the individual from feeling the pain, terror, fear, and so on, of these parts ~ Exiles are often young parts holding extreme feelings and/or beliefs that become isolated from the rest of the system (such as “I’m worthless,” “I must be successful to be lovable,” “I am a failure”) ~ Exiles become increasingly extreme and desperate as they look for opportunities to emerge and tell their stories ~ Want to be cared for and loved and constantly seek someone to rescue and redeem them ~ Can leave the individual feeling fragile and vulnerable Managers ~ Managers are proactive and try to avoid interactions or situations that might activate an exile’s attempts to break out or leak feelings, sensations, or memories into consciousness. ~ Different managers adopt different strategies controlling, perfectionism, co-dependency ~ The primary function of all mangers is to keep the exiles exiled…. ~ Common managerial behaviors: controlling, perfectionism, high criticism, narcissism, people pleasing, avoiding risks, being pessimistic, constantly striving to achieve ~ Ask…What would trigger the exiles and how can that be prevented? ~ Common managerial symptoms: Emotional detachment, panic attacks, somatic complaints, depressive episodes, hypervigilance Firefighters ~ Have the same goals as managers (to keep exiles away) but different strategies ~ Managers want you to look good and be approved of, FFs only care about distracting from the p

 Art Therapy Part 2 | File Type: audio/mpeg | Duration: 42:06

30 Art Therapy Activities for Individual or Group CEUs are available for this presentation at AllCEUs https://www.allceus.com/member/cart/index/product/id/1229/c// Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director: AllCEUs Counselor Education Host: Counselor Toolbox Podcast Objectives • Identify 30 art therapy activities and the goals and benefits for each 1. Collage • Medium (2 or 3-D) • Picture • Bulletin Board • Book or Notebook Cover • Scrapbook • Photo Blanket • Quilt • Website (Canva, MineCraft) • Materials • Odds and ends (buttons, keys, material, yarn) • Nature • Pictures from magazines, online, wrapping paper, greeting cards, food bags/boxes • Paint • Stamps • Macaroni/Beans • Benefits • Fine motor coordination • IRL: Scissor use, turning pages, gluing • Virtual: Typing, mousing, photoediting • Visual expression • Problem solving/creativity “How can I depict…” 1. Collage • Uses • Before and After • Layered with Goals • Most Important • Happiness (or other emotions) • My Accomplishments • Tribute/Memory • Nature (with leaves, feathers, sticks…) • Positive Affirmations • Superhero (anxiety) • Friendship • My Happy Place 2. Sculpture • Medium • Clay • Playdough or salt dough • Paper Mache • Pinata / Piggy Bank • Wadded Newspaper • Scarecrow • Multimedia (jars, foam balls, felt, popsicle sticks, pipecleaners, paper towel tubes, plastic shopping bags, cardboard from boxes) 2. Sculpture • Benefits • Fine motor skills • Creativity and problem solving • Visual self expression • Uses • Superhero • Family • Memory • Self-Portrait • Emotion 3. Puppets • Material • Socks • Felt finger puppets • Pipe cleaner finger puppets • Popsicle stick puppets • Brown paper bag • Toilet paper roll • Benefits • Fine motor skills • Verbal communication • Creativity • Uses • Giving a voice (What I wish I could say) • Addressing the anger/monster • Observation (What does the alien see) • Angel vs. Devil • Teach interpersonal skills (Sally is sad, what should Sammy do???) • Team work 4. Gratitude Tree • Medium • On the wall • On paper • With sticks and tags • Materials • Paper cutouts • Paint (finger, brush, pens) • Sticks and gift tags or cardboard “leaves” • Uses • Remember things that are going right (depression, frustration) • Help remembering to focus on the good (negativity) • Gratitude in grief 5. Wind chime • Materials • Keys • Buttons • Beads • Silverware • Bamboo pipes • Shells • Chandelier crystals • Bells • Terracotta pots • Feathers (and bells) • Cookie cutters • Decorated soda or tin cans • Soda bottle tops (metal) • Benefits • Fine motor skills • Creative expression • Uses • Grief • Favorite things • Happy memories • Mindfulness 6. “Stained Glass” • Materials • Shrinkable plastic sheets or ornaments (Shrinky Dinks) • Benefits • Find motor skills • Creative expression • Uses • Mindfulness • Memory window or attach to LED Christmas light strand to make a garland • Things that make me feel… • Things that remind me of (grief) • Things that inspire me (goals) 7. Flag • Medium • Solid color nylon flag (~$8) • Cut a king sheet and sew or glue edges • Large piece of cardboard (large shipping box or appliance box). Fortify edges with colored duct tape • Hint: Take a picture of the flag and print it out or have it added to water bottles for each person to have a miniature version • Benefits • Fine motor skills • Encourage communication and discussion • Visual expression 7. Flag • Uses • Identify common and complimentary attributes

 Art Therapy Part 1 | File Type: audio/mpeg | Duration: 56:17

30 Art Therapy Activities for Individual or Group CEUs are available for this presentation at AllCEUs https://www.allceus.com/member/cart/index/product/id/1229/c/ Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director: AllCEUs Counselor Education Host: Counselor Toolbox Podcast Objectives • Identify 30 art therapy activities and the goals and benefits for each 1. Collage • Medium (2 or 3-D) • Picture • Bulletin Board • Book or Notebook Cover • Scrapbook • Photo Blanket • Quilt • Website (Canva, MineCraft) • Materials • Odds and ends (buttons, keys, material, yarn) • Nature • Pictures from magazines, online, wrapping paper, greeting cards, food bags/boxes • Paint • Stamps • Macaroni/Beans • Benefits • Fine motor coordination • IRL: Scissor use, turning pages, gluing • Virtual: Typing, mousing, photoediting • Visual expression • Problem solving/creativity “How can I depict…” 1. Collage • Uses • Before and After • Layered with Goals • Most Important • Happiness (or other emotions) • My Accomplishments • Tribute/Memory • Nature (with leaves, feathers, sticks…) • Positive Affirmations • Superhero (anxiety) • Friendship • My Happy Place 2. Sculpture • Medium • Clay • Playdough or salt dough • Paper Mache • Pinata / Piggy Bank • Wadded Newspaper • Scarecrow • Multimedia (jars, foam balls, felt, popsicle sticks, pipecleaners, paper towel tubes, plastic shopping bags, cardboard from boxes) 2. Sculpture • Benefits • Fine motor skills • Creativity and problem solving • Visual self expression • Uses • Superhero • Family • Memory • Self-Portrait • Emotion 3. Puppets • Material • Socks • Felt finger puppets • Pipe cleaner finger puppets • Popsicle stick puppets • Brown paper bag • Toilet paper roll • Benefits • Fine motor skills • Verbal communication • Creativity • Uses • Giving a voice (What I wish I could say) • Addressing the anger/monster • Observation (What does the alien see) • Angel vs. Devil • Teach interpersonal skills (Sally is sad, what should Sammy do???) • Team work 4. Gratitude Tree • Medium • On the wall • On paper • With sticks and tags • Materials • Paper cutouts • Paint (finger, brush, pens) • Sticks and gift tags or cardboard “leaves” • Uses • Remember things that are going right (depression, frustration) • Help remembering to focus on the good (negativity) • Gratitude in grief 5. Wind chime • Materials • Keys • Buttons • Beads • Silverware • Bamboo pipes • Shells • Chandelier crystals • Bells • Terracotta pots • Feathers (and bells) • Cookie cutters • Decorated soda or tin cans • Soda bottle tops (metal) • Benefits • Fine motor skills • Creative expression • Uses • Grief • Favorite things • Happy memories • Mindfulness 6. “Stained Glass” • Materials • Shrinkable plastic sheets or ornaments (Shrinky Dinks) • Benefits • Find motor skills • Creative expression • Uses • Mindfulness • Memory window or attach to LED Christmas light strand to make a garland • Things that make me feel… • Things that remind me of (grief) • Things that inspire me (goals) 7. Flag • Medium • Solid color nylon flag (~$8) • Cut a king sheet and sew or glue edges • Large piece of cardboard (large shipping box or appliance box). Fortify edges with colored duct tape • Hint: Take a picture of the flag and print it out or have it added to water bottles for each person to have a miniature version • Benefits • Fine motor skills • Encourage communication and discussion • Visual expression 7. Flag • Uses • Identify common and complimentary attributes

 Biopsychosocial Impact of Depression and Strategies for Prevention and Intervention | File Type: audio/mpeg | Duration: 56:46

459 – Biopsychosocial Impact of Depression and Strategies for Prevention and Intervention CEUs are available for this presentation at AllCEUs https://www.allceus.com/member/cart/index/product/id/1227/c/  Biopsychosocial Impact of Depression and Strategies for Prevention and Intervention Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC Executive Director, AllCEUs Podcast Host: Counselor Toolbox, Case Management Toolbox, NCMHCE Exam Review Objectives • Define depression (symptoms) • Explore the biopsychosocial impact • Learn how to ask strengths-based assessment questions • Identify a range of potential causes for depression • Explore activities and interventions that can help people address some of the underlying causes Depression • Depression represents a cluster of symptoms • Diagnosis with depression only requires people to have a few of the symptoms • A variety of different things can cause and be caused by depression • Emotions: Anger, anxiety, grief, guilt, shame • Thoughts: Cognitive distortions • Relationships: Poor self-esteem, unhealthy/unsupportive relationships, need for extremal validation • Physical: Neurochemical imbalances, poor nutrition, exhaustion, insufficient sleep, medication side effects • Environmental: High stress environments that prevent relaxation/rest and increase hopelessness/helplessness Strengths-Based Assessment • What does this mean to you? (apathy, sadness, mood swings) • Which symptoms are most bothersome for you and why? • For each symptom • What makes depression worse? • What makes depression better? • How was life more pleasurable prior to getting depressed? • What is different during times when you are NOT depressed? • How do you expect life to be different when your depression is gone? Neurotransmitter Imbalances • Ability to feel pleasure/Apathy/Emotional Flatness • Memory issues • Difficulty concentrating • Sleep issues • Lack of motivation • Fatigue • Pain • Irritability/Agitation • Fight or flight stress symptoms Neurotransmitters • Get quality sleep • Create a routine • Address pain and apnea • Improve the sleep environment • Other factors: Shift work, time zones, daylight savings time • Relaxation • Biofeedback • Progressive muscular relaxation • Address medication side effects • Psychotropics • Opioids Neurotransmitters • Improve Nutrition • Address addictive behaviors • Address chronic or extreme stress • Refresher • Both of these increase the amount of neurotransmitters flooding the synapses. • To protect the body from overload, the brain shuts down some of the receptors so the body does not overload (tolerance/desensitization) • When the neurotransmitters return to a normal level, the receptors are still shut down, so not enough neurotransmitter gets sent out. • Things that normally caused a reaction, no longer are strong enough to cause a reaction Hormones • Thyroid • Are altered in response to chronic stress • Impacts mood, libido and energy levels • Estrogen • Boosts neurotransmitters that affect sleep, mood, memory, libido, pain perception, learning and attention span. • Increased estrogen may increase the availability of serotonin • Testosterone • Low testosterone may be implicated in reducing the availability of serotonin • Testosterone is manufactured by the adrenal glands, • Enhances libido, improves stamina and sleep, assists brain function, and is associated with assertive behavior and a sense of well-being. Hormones • Cortisol • Cortisol is made by the adrenal glands. • Helps the body adapt to stress by increasing heart rate, respiration, and blood pressure. • Cortisol levels increase early in the morning to prepare to meet the demands of the day, and gradually decrease throughout the day (“circadian rhythm”). •

 Assisting Families Through Transitions | File Type: audio/mpeg | Duration: 48:01

Assisting Families Through Life Transitions CEUs are available for this presentation at AllCEUs https://www.allceus.com/member/cart/index/product/id/81/c/ Dr. Dawn-Elise Snipes PhD, LMHC Executive Director, AllCEUs.com Podcast Host: Counselor Toolbox and Case Management Toolbox Flower Empower • A comprehensive approach • The core of the flower is the clinician-family partnership • Assess need • Sustain a caring environment • Educate • Identify and link to resources • The stem symbolizes advocacy activities • The leaves symbolize vision, values and principles • The roots feed the flower (partnership): • Responsibility and accountability • Recognition of the value of the partnership • Respect uniqueness • Resource identification for emerging needs • Results monitoring Clinician – Family Partnership • Recognize family assessment of the situation as essential • Respect the important role of family • Determine the desired degree of family involvement • Negotiate the roles of clinician and family within the partnership • Listen • Engage in participatory dialog • Recognize patterns • Highlight family strengths Assessment • Within the context of the family • Identify if assistance is required to strengthen the family • Information • Family structure and composition • Culture • Power and Role Structures • Communication • Access to Resources • Environmental characteristics • Family strengths • Family supports • Family perception of events • Degree of involvement desired by family Sample Questions • Who would you like us to share information with and who not? • How can we be most helpful to you and your family or friends during this transition? (Clarifies expectations, increased collaboration) • What has been most/least helpful to you in past times of crisis? (Identifies past strengths, problems to avoid and successes to repeat) • What is the greatest challenge facing your family right now? (Indicates actual/potential suffering, roles, and beliefs) • What do you need to best prepare you/your family member for dealing with this issue?(Assists with early discharge planning) • Who do you believe is suffering the most in your family at this time? (Identifies which family member requires the greatest support and intervention) • What is the one question you would most like to have answered right now? (Explores the most pressing issue or concern) • How have I been most helpful to you? How could I improve? (Demonstrates a willingness to learn and work collaboratively) Support • Sources of Resources and Support • Intrafamilial (within) • Extrafamilial (outside) such as community services, training programs • Interfamilial (between) like support groups Values and Principles • Recognize personal assumptions and values about families and cultural beliefs and to adjust their care accordingly. • Families are unique, diverse, and change over time • Families in transition can make informed decisions • Families have expert knowledge and skills that help them determine their own needs and respond to expected and unexpected life events. • Partnerships with families are built upon mutual trust, honesty, and collaboration • Partnerships support and strengthen families • Families should be supported in their choices • Family members and the client may have different and conflicting needs Outreach • Target groups • Clinicians • Families • Policymakers • The public • Provide pre-emptive information to assist families in managing expected or unexpected life events Workplace environment • Ensure staff is oriented to family-centered care • Ensure clinicians can effectively access resources • Provide ongoing opportunities for professional development Implementation • Ensure appropriate staffing levels

 Developing Positive Self-Talk in People of All Ages | File Type: audio/mpeg | Duration: 52:48

456 – Building Positive Self Talk for Confidence and Self-Esteem CEUs are available for this presentation at AllCEUs https://www.allceus.com/member/cart/index/product/id/1030/c/ Dr. Dawn-Elise Snipes Executive Director: AllCEUs Counselor Education Host: Counselor Toolbox Podcast Objectives – Identify the function of negative self talk – Explain the benefits of positive self talk – Describe 15 methods for teaching positive self talk to people of all ages Function of Negative Self Talk – Protection from threats and failure – I can't do this. – I'm not smart enough to… – I cannot find a decent partner – Nobody wants to be my friend – I am ugly – I could lost my job at any moment – Attention (See UFD Game…) Ugly, Fat and Dumb Game – The ugly, fat, and dumb game is a method of attaining attention by the individual in any given group whom needs the most attention (not necessarily the individual with the lowest self-esteem). – An individual draws attention to their own (perceived or real) flaws in order to get others to announce their own in an attempt to make the first person feel better and subsequently, lowering their own self-esteem – For example: – While eating dinner, Sally announces her weight to the table and calls herself fat causing all the other girls at the table (who nearly all clearly weigh more) to announce their weight in an attempt to make Sally feel better about herself. – If someone at the table isn't of lower weight, they find another deprecating thing to say about themselves- “But you are so pretty. I would kill to have your hair. Mine is like a rats nest.” Benefits of Positive Self Talk – Reduced cortisol and HPA-Axis activation – Reduced pain – Improved physical health (Less stress-related disease) – Increased energy – Greater life satisfaction – Improved immunity Unconditional Positive Regard – From attachment figures who teach positive talk – From self – Encourage the use of the phrase – “I love you even if…” Self Awareness – Who you are – I have the ability to… (things you do) – I am… (inner qualities) – Keep a daily journal or account of your successes, good qualities and accomplishments – What you say to yourself – Journaling Mantras – Don't wait until you are stressed. Practice positive self talk throughout the day-Every day (Positive Thinking Apps) – Mantras – I am capable. – I am lovable. – Today is going to be an awesome day. – I choose to be present in all that I do. – I feel energetic and alive. – I can achieve my goals. – I love challenges and what I learn from overcoming them. – I've got this Visualization – Visualization helps people's brains “see” how they can succeed (or fail) – Negative self talk “teaches” the brain that negative things will happen which increases anxiety and distress, reduces concentration and increases a sense of helplessness. – Positive self-talk helps people's brains “see” that – Success is possible – Happiness is possible – The person has power Visualization – Visualizations combined with desensitization help reduce anxiety and distress around… – Public speaking – Tryouts or job interviews – Driving – Starting a new school/job – Taking a test – … – Have people watch others who are successful and/or role play then use that data to visualize. Environments – Surround yourself with positivity – Parents model positivity – Listen to positive songs – Have family members bring a positive quote or song (lyrics) with them to dinner once a week and put it on the fridge. – Give yourself a pep talk every morning. &

 Biopsychosocial Impact of Guilt and Strategies for Prevention and Intervention | File Type: audio/mpeg | Duration: 54:36

457 – Biopsychosocial Impact of Guilt and Strategies for Prevention and Intervention CEUs are available for this presentation at AllCEUs https://www.allceus.com/member/cart/index/product/id/1228/c/ Dr. Dawn-Elise Snipes Executive Director AllCEUs.com Podcast Host: Counselor Toolbox, Case Management Toolbox Objectives • Define guilt • Explore the impact of guilt • Identify activities to help people deal with guilt What is it? • Guilt is anger at yourself, and comes from an Old English word that means “delinquency.” Today Merriam-Webster’s Collegiate Dictionary defines it as “feelings of culpability, especially for imagined offenses or from a sense of inadequacy; self-reproach.” • Note: Nowhere does it say that guilt is related to things you actually did wrong What Can Guilt Do? • Make you become over responsible trying to fix everything to atone for perceived sins • Make you over-conscientious • Make you overly sensitive • Immobilize you and interfere with decision making • Co-dependency • Overshadow other feelings • Mislead you (Shoulda, coulda, woulda) • Motivate change • Sometimes guilt is necessary otherwise people would not know how to exercise self-control or have a conscience. Where does it come from • Autonomy vs. Shame • Major Question: “Can I do things myself or am I reliant on the help of others?” • Will, Efficacy • When criticized, overly controlled, or not given the opportunity to assert themselves, people begin to feel inadequate in their ability to survive, and may then become overly dependent upon others Where does it come from • Initiative vs. guilt • Major Question: “Am I good or bad?” • Purpose, Acceptability • When efforts to engage in activities are stifled by significant others, people begin to feel that their self-initiated efforts are a source of embarrassment. • If the person’s questions are treated as a nuisance or embarrassing then the person may feel like a nuisance. • People who are over-directed by others may struggle to develop a sense of initiative and confidence in their own abilities. Sources of Guilt • The following things can cause guilt in the actor or their significant others • Addiction • Abuse • Relationship issues – infidelity and divorce • Parenting – non supportive or absent parenting • Crime – by the perpetrator and the victim • Trauma – survivor guilt • Cultural expectations – family or religious demands on our behavior Sources of Guilt • Toxic guilt • A nagging feeling of pervasive but nonspecific badness, as if your whole life has something wrong with it • Often has roots in early childhood: mistakes that your parents or teachers treated as a big deal, for example, or religious training • Gluttony vs. Abstinence (Moderation) • Sloth vs. Diligence (Balance) • Greed vs. Generosity (Benevolence) • Lust vs. Chastity (Moderation) • Anger vs. Passivity (Assertiveness) • Pride vs. Humility (Authenticity) • Envy vs. Rejection (Respect, contentment) Other Sources of Guilt • Existential Guilt • Guilt you feel for having a negative impact • Guilt you feel for having more than someone else • Guilt you feel for surviving • When toxic guilt gets mixed up with existential guilt, people often suffer from a feeling that they are responsible for everyone else's pain Other Sources of Guilt • Shoulda, Coulda, Woulda Game • I shoulda, coulda, woulda…but didn’t • Go to the gym • Call my friend • Finish my report • I shouldn’t have…but did • Have that second piece of cake • Lie • Call in sick • Go out drinking all night Questions • How does guilt impact your attitude, optimism and emotions? • How does guilt impact your self-esteem? • How does guilt impact your health? • How does guilt impact your energy? • How does guilt impact all other ar

 Arlene Englander Interview – Author of “Let Go Of Emotional Overeating and Love Your Food” | File Type: audio/mpeg | Duration: 48:07

Let Go of Emotional Overeating and Love Your Food This book is for anyone who would like to eat whatever they like, yet stop just at the point of satisfaction without overeating. Written by a Columbia University trained psychotherapist and former emotional overeater, Let Go of Emotional Overeating and Love Your Food offers psychologically sound techniques for recognizing the symptoms of emotional overeating and methods for addressing it in ways that are both effective and enjoyable. You can learn more about the author and book at: https://arleneenglander.com The book is available for purchase via Amazon: https://amzn.to/36D9zfp

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