Counselor Toolbox Podcast

- Learn about bariatric surgery - Explore reasons for the surgery and increase in popularity - Identify the psychosocial outcomes of bariatric surgery - Identify common presenting issues in persons seeking bariatric surgery - Explore current recommendations for assessment protocols and presurgical preparation for bariatric surgery - Identify postoperative mental and physical health issues which may occur and need to be addressed Types of Bariatric Surgery

Summary • There are many unknowns with the current coronavirus situation • The flu is widespread and catastrophic for tens of thousands of people in the US each year and we do not panic. • High levels of stress and anxiety however will reduce immunity and make people more susceptible to all types of illnesses • Steps to reduce anxiety • Get accurate information • Limit your exposure to negative media • Practice mindful acceptance of your reactions • Use belly breathing to help de-escalate the physical anxiety reactions • Identify proactive, positive ways to cope with the situation • Regularly evaluate your beliefs against the FACTS at that time

Coronavirus, election anxiety and financial stress is getting to people right now. This is the audio version of a three part series just released on YouTube on dealing with that stress.

Summary • End of life care often involves multiple providers, the client and caregivers • It is essential to consider all biopsychosocial needs with a focus on integrative care • “Stress” and distress will increase HPA-Axis activation, impair sleep and immunity and contribute to worsening of health and wellbeing of both the patient and caregivers. • Children will need different approaches depending on their developmental level.

Every event is an opportunity to choose thoughts and behaviors that will help you use your energy to move toward your goals and values. Using the Flexibility Activity or worksheet youth can apply this on a daily basis. CEUs/OPDs are available for this podcast at allceus.com/counselortoolbox or if you are in Australia, Australia.allceus.com/counselortoolbox

Summary • People can have millions of automatic cognitive distortions. Addressing each one may not be possible. • Becoming aware of thought patterns, their function, their usefulness and alternatives underlies MCT. • MCT moves from addressing the content of thoughts (What is being thought?) to the function of those thoughts (Why are the thoughts occurring and are they helpful?

Summary • 46% of people in the US are exposed to adverse childhood experiences. (Early Intervention) • Instruction in skills to handle emotional dysregulation • Mindfulness • Vulnerability prevention and awareness • Emotion Regulation • Distress Tolerance • Problem Solving • Of those exposed to trauma, education about and normalization of heightened emotional reactivity and susceptibility to PTSD in the future may be helpful

Summary ~ Information is key; people who are quarantined need to understand the situation ~ Effective and rapid communication is essential ~ Supplies (both general and medical) need to be provided or available (i.e. online shopping) ~ The quarantine period should be short and the duration should not be changed unless in extreme circumstances ~ Most of the adverse effects come from the imposition of a restriction of freedom ~ Voluntary quarantine is associated with less distress and fewer long-term complications ~ Public health officials should emphasise the altruistic choice of self-isolating

Summary – Consistency: Rules, routines, reactions – Responsiveness: To individual needs and preferences – Attention: For being lovable and positive behaviors – Validation: Of their thoughts, feelings and way of being in the world – Empathy: For how their sensory and neurological differences impact them emotionally, cognitively, interpersonally, physically – Solutions: – To help them become more mindful and mitigate or prevent triggers for unwanted behaviors. – To help them develop the skills needed to engage with a neurotypical world.

Summary ~ Once clients are mindfully aware of their thoughts, sensations and urges and willing to accept the moment, they need skills to tolerate that distress ~ Help clients develop a menu of options which they can select from when they are in crisis. ~ They feel how they feel ~ Help them tolerate the distress until the intense emotions subside and they can get into their wise mind.

Summary • Depression is the cluster of symptoms created when there is a neurochemical imbalance in the brain. • What causes the imbalance can be emotional, cognitive, physical, interpersonal, environmental or some combination of the above. • Part of the strengths based approach means helping people see what they already are doing to prevent or deal with the symptoms • Biopsychosocial means • Examining all causative factors • Recognizing that all factors are reciprocal in nature.

Summary • Anger and anxiety are normal emotions that help people survive. • Answers can often be found by asking: “What happened to this person that would trigger this reaction?” • Situations that trigger anger and anxiety often involve a sense of being unsafe, a loss of something, emotions that are unable to be handled effectively, and an alteration of how that person envisions the future. • Problems arise when anger and anxiety are misinterpreted or the person does not have the skills to deal with the problem • Anger is not a simple emotion, it often covers up shame, embarrassment, guilt and/or anxiety. • By helping people identify the roots of their anger and more effective strategies, they can be empowered to reduce the frequency and intensity of these emotions and more effectively cope when they do arise.

Summary • There are many similarities between Pain, mood and addictive disorders • Integrated, concurrent, biopsychosocial treatment is vital • Mood impacts pain which impacts life satisfaction • Recovery supports realistic beliefs and identifies controllable factors àenhanced outcomes • Patients with current addictions or mental health issues need concurrent treatment

Summary • Self esteem begins in childhood • Being aware of self helps people identify their strengths and develop their “me” identity. • Part of self esteem development includes • Values identification • Understanding wants vs. needs • Addressing cognitive distortions • Being aware of sensations, feelings and thoughts • Helps choose behaviors which are in unison with values • Helps support people through the difficult moments • Silences the critics • Clarifies who people are and what people want

Summary • Losses encompass more than death or a person or loss of property • Failure to acknowledge losses can cause unhelpful reactions in similar future situations • It is important to explore feelings and reactions in terms of their functionality---how are they benefitting the person • It takes at least a year to deal with significant losses • Many times there are multiple ancillary losses that need to be addressed • How people deal with grief and loss varies widely. • Grieving is a form of crisis • The body is on high alert which likely impacts sleep, eating and energy to work or socialize • Minimizing vulnerabilities is important to reduce unnecessary frustration and avoid confirming helplessness • Ultimately it is hoped that the person can identify how they are stronger or better off from the experience