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Is gonna pick up if you are in a household where you know you’re in college and
you’ve got four other roommates and all of your your other roommates tend to be
negative and naysayers you’re either probably going to move or you may that
might start wearing off on you a little bit likewise if they are you know all
kinds of go-getters that can wear off on you too so you know there’s going to be
an impact risk factor is peer and family reinforcement of negative or unhealthy
norms and expectations so if your family says you know people suck they’re
always going to take advantage of you what are you going to take away from
that and is that going to contribute to you probably having difficulties with
trusting and maybe developing depression possibly so we want to look at what kind
of messages is the peer group or family sending to the individual that may
contribute to the development of mood or anxiety disorders early sexual activity
among peers could communicate that well this is the norm so everybody’s doing it
ties to deviant peers and gang involvement you know especially at that
particular group there’s a lot of pressure to conform or there’s a
negative consequences family members who don’t spend much time together and this
could be because parents work a lot this could be because everybody’s you know
involved in all kinds of other stuff but they found that
when families are disengaged the parents tend to miss out on subtle cues when
families are disengaged even if they don’t have children in the mix that
there tends to be a weakening of those bonds supportive bonds so people
are at higher risk for development of depression and anxiety because they
don’t have that you know everybody’s behind me sort of feeling parents who
have trouble keeping track of youth can indicate that the youth may be at risk
for developing substance or more mood disorders lack of clear rules and
consequences you think about even just being at work when there’s a lack of
clear rules and consequences you don’t exactly know what you’re supposed to do
I know for me that creates doodles of anxiety I like manuals and to date
pretty much every job I’ve ever taken I’ve walked in and there hasn’t been a
manual and I’ve been like okay there must be a manual written and that’s been
my first thing now I’m kind of on the structured side so I don’t expect
everybody is that way but most of us tend to experience a little bit of
anxiety about failure about acceptance if we don’t know what’s expected so it’s
important whether it’s a family or a job situation to make sure there’s clear
rules and consequences you know what’s expected and what’s going to happen if
you mess up or if you don’t meet this expectation there also needs to be
consistent expectations and limits you know when people especially children but
a lot of us tested our limits when we were kids and even as adults you know I
know you know going back to working in organizations I would have staff who
would test limits and see how long they could go without turning in a progress
note before I’d be knocking on their door going paperwork it’s natural for
people to kind of test limits especially with stuff they don’t want to do stuff
that’s not rewarding family conflict and abuse can cause a high risk of depression
and anxiety whether adults or children I mean if there’s a
a lot of conflict and chaos it’s exhausting and it can cause a lot of
dysphoric emotions and loss of employment that’s kind of
self-explanatory protective factors close family relationships so as
clinicians we can encourage people to identify who they consider their family
it may not be their blood relatives or their family who are there for them
who can they call it 2:00 in the morning and how can they nurture those
relationships encourage people to develop relationships with peers that
are involved in pro-social activities like hiking or volunteering in the
community consistency of parenting is important in terms of producing children
who are who are stronger healthier more resilient encouraging education and
parents who are actively involved can help prevent future depression because
they’re creating children who can join the workforce and have that
individual capital to prevent depression and anxiety and cope with stress
positively and this is a family protective factor and a peer for
protective factor why because we learn from observation so if our peers cope
with stress positively by prayer or exercise or whatever it is they do and
our family has other positive ways of coping with stress and we’re going to
have a greater venue of stuff to choose from supportive relationships with
caring for adults beyond the immediate family is encouraged so we want
children to grow up being able to interact with teachers coaches with
you know Scout leaders whomever and start seeing that people outside of the
nuclear family are trustworthy sharing and family responsibilities including
chores and decision making and that’s true for children teenagers and even
adults you know if you’re living in the same household it
important that everybody feels like they have a say in what’s happening
and participates in the upkeep of the family environment and family
members are nurturing and support each other and this is one where I tend to
stop and I do a love languages little mini class to help people remember that
we don’t always experience nurturance in the same way so understanding one
another’s love language is really important to be able to nurture in a
way that’s meaningful to that other person peer and family interventions are
designed to identify norms goals and expectations in the family foster family
problem-solving skills so there’s not just one person always fixing it develop
structure and consistency within the family unit promote healthy
relationships and engage peers and family of choice in the recovery process
so if somebody’s already depressed we need to be able to hopefully engage
everybody that’s involved in this person’s immediate environment in
helping them move towards recovery and you know preferably not dragging them
back down so we want to engage them and make sure that people have a supportive
others school and work risk factors lack of clear expectations both academic or
performance-wise and behavioral lack of commitment or sense of belonging at
school or at work if you just kind of go and you feel like a number you punch in
punch out that may not make you feel appreciated which can contribute
to depression and you know just bad feelings high numbers of students
failing academically at school and work translates to high amounts of
turnover if you never know who’s going to get laid off it increases stress and
anxiety and parents and community members who are not actively involved
in keeping kids in school and helping make sure that the workforce workforce
is strong but we want to make sure that people have access to how
when it’s needed we want to make sure that people have access to tutoring in
school if they need it to prevent failing school they have access to
transportation to get to work now those are things those are meta concepts that
are more on the community level but it’s important that as a community member you
know we look at different things that we may be able to participate in advocacy
and say you know it’s really important to get a bus system going I live out
about 30 miles east of Nashville and we must have the
the train that goes from my city out to Nashville so people have
access to more jobs so that was important for us to get past the City
Commission protective factors school and work positive attitudes gotta find a
reason why you’re doing this you know and sometimes it’s hard to find a reason
for algebra but we need to help kids find a reason for that we need to help
adults find a reason for why they’re going to work why are they doing what
they’re doing regular attendance shows you know it is associated with higher
mood less less risk of mood or addictive disorders because you’re able to get up
and do it and interface with people and get that social support hopefully from
your colleague’s high expectations are communicated effectively in setting
and positive social development is encouraged you know whether it’s at work
or at school, there are goals there are things you’ve got to accomplish there
are performance objectives but we also want to encourage morale and positive
social bonding whatever the setting having a positive instructional climate
again whether at work or school, I know we learn things when we’re on the
job we learn things and I don’t want people to feel like they’re having
difficulty like they’re stupid I want people to feel like anything that we
teach them as a challenge and something that may be beneficial down the road
leadership and decision-making opportunities are really important again
for students or employees to prevent burnout keep morale up reduce
anxiety and increase a sense of personal empower
and connection and active involvement for everybody is fostered and the school or
organization is responsive to the student’s needs making sure that in
school in the case of school they have access to tutoring resources it’s a safe
environment for them to be in and the children that are going to that school
have enough food in their bellies you know they can’t learn if they’re
hungry all the time workplace is a little bit different but we still need
to be responsive to people’s needs in terms of you know family requirements
whether they need to if they’re going back to school
shifting schedules a little bit we need to try to work with people instead of
being completely rigid and it’s my way or the highway when possible to
promote the best mental health characteristics of settings in which
relationships are often associated with the development of mood disorders and
addictive behaviors so we want to look at the characteristics of schools that are
they safe are they positive environments are they cheering squads or are they
places where people know they’re gonna go and get thrown under the bus
same thing with workplaces you know when you walk into a place you get most of
we get a sense and you’re either like oh this is a cool place to work or oh I
can’t wait til I can get out of here you know we want to go toward the
other end and neighborhoods when you go into a neighborhood – people take care
of their environment do they or do they have trash strewn all over their lawn
all of these things communicate how people feel about their environment and
generally how they feel about themselves and whether they have the energy to take
care of stuff or they just feel completely disenfranchised and don’t
care more about community risk factors no sense of
connection to the community neighborhood disorganization rapid changes high
unemployment a lack of strong social institutions lack of monitoring of youths
activities imbalanced media portrayals of safety health and appropriate
behavior misleading advertising and alcohol or drugs readily available
a lot of stuff we do we’re not going to be able to affect on the community level
so much but we’re gonna hit them real quick we want to improve the climate
process and policies within community schools and workplaces to make it safe and
promote positive health behaviors prevention strategies are designed to
reduce social isolation reduce and address stigma increase awareness of
local recovery models you know who’s out there that has recovered and can serve
as a role model improve economic and housing opportunities so people have a
house a safe roof over their head and they can you know earn money and feel
good about themselves increasing the accuracy and improving the positivity of
media messages and increasing physical and financial ability availability of
recovery so like I said I live in a little town so it’s nice that we have
a community mental health center here so people don’t have to rely on going into
Nashville but also making sure that services are financially available
whether you have a free clinic once a month or you know make sure you’ll you
take Medicaid but there are still a lot of people who have no insurance so where do
they go the socio-ecological model identifies
how the end the individual impacts and is impacted by not only his own
characteristics but also those of family peers community and culture prevention
takes the form of preventing the problem preventing the worsening of the problem and
preventing associated fallout like I said as clinicians a lot of what we’re
going to do is target the individual providing them with resiliency skills to deal
with some of this adversity that might be around them and to help them sort
through some of those media messages and go yeah
that’s not even true you know if I drink this vodka I’m not suddenly going to
have 14 supermodels hanging on me or whatever it is that’s being communicated
so encouraging people to be informed and Wylie consumers any change in the
the system will affect other parts of this system so if it’s a
positive change is probably going to have positive changes negative has
negative changes addressing addictive and mood disorder behaviors require a
the multi-pronged approach we need to look at the individual and you know provide
provide as many skills as possible there because that’s where we’re going to have
a lot of our impact especially in prevention but we also need to
realize that this person resides within a family you know whether they live
alone which sometimes is less problematic or they live in a household
with other people, we need to make sure that where they lay their heads at night
where they spend their non-working hours feel safe and is conducive to recovery
where they work or go to school also needs to feel safe and be conducive to
recovery and that’s part of the community so we need to kind of look at
these areas and if they aren’t safe or they don’t feel safe or aren’t conducive
to recovery, we need to help people how to figure out how they can fix that or
address it like I said they may not be able to move so what can you do to set
some boundaries to create as much safety as you can how can you do this and there
are a lot of different techniques that I’m sure you already have that you used
to help people but it’s important again not to just focus on the individual
because they don’t live in a bubble we need to look at everything right and are
Are there any questions now we have or I have added a Wednesday
class, so you don’t don’t have to come but if you have unlimited
membership same time same station Wednesday so Tuesday Wednesday and
Thursday we have a class from noon. CST 1 p.m. EST 2 for an hour all righty I will talk to y’all maybe
tomorrow maybe on Thursday have a great day if you enjoy this podcast please like
and subscribe either in your podcast player or on YouTube you can attend and
participate in our live webinars with Doctor Snipes by subscribing at all CEUs
comm slash counselor toolbox this episode has been brought to you in part
by all CEUs com providing 24/7 multimedia continuing education and pre
certification training to counselors therapists and nurses since 2006 use
coupon code consular toolbox to get a 20% discount off your order this month.As found on YouTubeI thought my anxiety disorder was for life… $49.⁰⁰ But I Discovered How Hundreds Of Former Anxiety Sufferers Melted Away Their Anxiety And Now Live Relaxed, Happy Lives – With No Trace Of Anxiety Or Depression At All! http://flywait.anxiety4.hop.clickbank.net We’ve seen so many people go anxiety-free that we have no hesitation in guaranteeing this program. So… If at any time within 60 days of you purchasing ‘Overthrowing Anxiety’, your anxiety hasn’t completely evaporated then you can have all your money back. No questions asked! You can do this for yourself today. You can start making a difference in your life right now. Click on the button below and you’ll receive your copy of Overthrowing Anxiety in just a few minutes. It’ll be one of the best decisions you’ve ever made – guaranteed! http://flywait.anxiety4.hop.clickbank.net
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☃in 5-10 Minutes A Day Using Automation Software and our Time-Tested Strategy See How Your New Site Can Be Live In Just 27 Seconds From Now!…It can be incorporated in a lot of various places again where they’re not applying it or ingesting it in any way all they’re doing is smelling it they’ve used it in defusing aromatherapy in hospital emergency rooms and they found that it reduces stress and irritability the people in emergency rooms and I’ve been to enough emergency rooms over the course of the years to know that People who are in emergency rooms typically are not in the best mood so if it can help those people then It’s probably going to have some sort of an effect so psychologically helping clients realize that their body thinks there’s a threat for some reason that’s why it triggered the threat response system which is what they call anxiety, so they need to figure out why is there really a threat You know sometimes it’s like the fire alarm going off in my house it just means that the windows are open and there’s a strong breeze there is no fire there is no problem there’s just a malfunction It’s a false alarm A lot of times clients get this threat reaction they get this stress reaction and it’s not a big deal right now so they can start modifying what their brain responds to and again, those basic fears that a lot of people worry about failure rejection loss of control the unknown and death and loss distress tolerance is one of those cognitive interventions that has taken center stage in anxiety research and it isn’t about controlling your anxiety you know helping people recognize their anxiety acknowledge it and say okay I’m anxious it is what it is How can I improve the next moment instead of saying I’m anxious I shouldn’t be anxious I hate being anxious and slang with that anxiety let it go just accept it is what it is have the client learn to start saying I am feeling anxious okay so distracted don’t react because I explain to them The whole notion of feelings comes in crest and go out in about 20 minutes It’s like a wave so once they acknowledge their feeling if they can distract themselves for twenty or thirty minutes you know Obviously, they figured out there’s no real threat if they can distract themselves for twenty or thirty minutes those emotions can go down and then they can deal with it in their wise mind and encourage them to use distancing techniques instead of saying I am anxious, or I am terrified or whatever Have them say I am having the thought that this is the worst thing in the world I am having the thought that I could not handle this because thoughts come and go and that comes from acceptance and commitment therapy functional analysis makes it possible to specify where and when with what frequency with what intensity and under what circumstances the anxious response is triggered so it’s important that we help clients develop the ability to do functional analyses on their own so when they start feeling anxious, they can stop and say okay where am I what’s going on how intense Is it what are the circumstances, and they start really trying to figure out what causes this for them so they can identify any common themes from their psychoeducation about cognitive distortions and techniques to prevent those circumstances or mitigate them can be provided so if the client knows that they get anxious before they go into a meeting with their boss and it’s usually a high intensity of anxiety okay so we can educate them and help them identify what fears that may be related to techniques to slow their breathing calm their stress reaction and help them figure out times in the past when they’ve handled going in and talking to their boss and it really wasn’t the end of the world you know there’s lots of different things we can do there for them there but the first key and it gives them a lot of a huge sense of empowerment to start becoming detectives in their own life and going okay now under what situations does this happen positive Writing this was another really cool study each day for 30 days the experimental group and this was high school-aged youth in China but you know the experimental group engaged in 20 minutes of writing about positive emotions they felt that day so they’re writing about anything positive that make them happy that made them enthusiastic give them hope whatever long-term expressive writing positive emotions so after 30 days it appeared to help reduce test anxiety by helping them develop insight and use positive emotion words so it got them out of the habit of using the destruction and doom words and encouraged them to get in the habit of looking at the positive things and being more optimistic it’s a really cool activity that clients can try it’s…Look at this… 👀 https://t.co/6ms2fpCzt5https://t.co/cDWKPRGtZS
— Ralph Leaman (@LeRoyMoco) September 1, 2023
The Market WeekSign Up For The Free Newsletter No nonsense, no spam, unsubscribe anytime You can unsubscribe at any time. Read our privacy policy. Financial disclaimer: The Market Week is a general interest newsletter that is not liable for the suitability or future investment performance of any securities or strategies discussed. Readers are advised that the material contained herein should be used solely for informational purposes. As a financial newsletter publisher of general and regular circulation, we cannot tender individual investment advice. Read our full disclaimer. https://is.gd/mycbgenie_The_Market_WeekAs found on YouTubeAFFILIATE MASTERY BONUS: 6-Week LIVE Series Has Begun! FunnelMates $46.⁹⁵ Replays are Instantly Available. Want A Profitable Mailing List But Not Sure Where To Begin? We’ll Guide You, Equip You, and even PAY You Cash To Do It!24 Secret MCU Projects | New Comics This Week | MCU Speculation https://t.co/P8MmSiujtV
— Ralph Leaman (@LeRoyMoco) September 3, 2023
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As found on YouTubeSeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) http://flywait.darekw.hop.clickbank.net/ By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years… often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
Snipes by subscribing
at all CEUs comm slash counselor toolbox, this episode has been brought to you in part by all
CEUs calmly provide 24/7 multimedia continuing education and pre-certification training to
counselors therapists and nurses since 2006 have used coupon code consular toolbox to get
a 20% discount on your order this month.As found on YouTubeBrain Booster | Blue Heron Health News ⇝ I was losing my memory, focus – and mind! And then… I got it all back again. Case study: 
Brian Thompson There’s nothing more terrifying than watching your brain health fail. You can feel it… but you can’t stop it. Over and over I asked myself, where is this going to end? What am I going to end up like? And nobody could tell me. Doesn’t matter now. I’m over it. Completely well. This is how I did it!
Schneider by subscribing at all CEUs
calm / counselor toolbox this episode has been brought to you in part by all
CEUs calm providing 24/7 multimedia continuing education and pre
certification training to counselors therapists and nurses since 2006 use
coupon code consular toolbox to get a 20% discount off your order this month.As found on YouTubeSeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years… often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
So you know focus on what the person has to say and what their heart has to say to engage, and you know likewise, you may not be written off the pages of Vogue either, but try to present yourself well, try to you know, dress appropriately Don’t show up all disheveled and smelly clothes like looking like you haven’t bathed in a week that that’s not helpful so make sure that you’re presenting your best face and you’re dealing with whatever face the client brings And still trying to build that engagement remember the way a client presents. This tells us a lot about what’s contributing to their presenting issues: poor social skills, and ADHD pain. You know there are a variety of things that can contribute to depression, anxiety, and substance use. So try to look at it from that way, even if it’s not your ideal client understand what’s causing this person to be negative and just argumentative and frustrating try to get under there and figure it out. Why is this person so unhappy? What’s motivating is that first impressions impact engagement, so your professional presentation is promptly courteous and smooth handling paperwork. If you walk in there with 15 sheets of paper – and you’re shuffling them around and it seems like you, don’t know what you’re doing. You’re like just a second. I know I had that form around here somewhere, they’re not going to feel very confident in anything. You have to say so and put on a good first impression. Put it together and make sure your paperwork is put together ahead of time. If you have an electronic medical record, make sure you know how to use it because it’s disturbing to people, even though it happens when you’re, using an electronic medical health record to do a screening and you get stuck and you’ve got To call somebody else in to help you figure out how to get on the next screen make sure the environment is calm, clean and comfortable, not too formal or informal like we talked about it, avoids interruptions and provides the appropriate level of privacy. You don’t want clients sitting in the waiting room being able to hear other clients that are in the therapy, rooms or screening rooms. If you’re doing screenings, you may not even be in an office, you may be out at a festival or something so make sure that you’ve got. You know little pull-around screens or something, if appropriate, to give people privacy other people, shouldn’t be hearing their responses to what you are asking them, even if it’s, you know like I said, even if it’s at a Workplace festival or something other people should not hear their answers. So how can you give them privacy if there’s, no way to do that where they can have auditory privacy put as much as possible on check sheets and forms that they can fill out? And then you can point to something and go so help me understand your answer to this right here. Most of the time you want to try to do a screening in a private room. In the initial interview you’re, developing trust and rapport so be empathetic. They’re nervous, probably or they don’t want to be there or maybe they do want to be there and they’re, just hoping that you can help paraphrase that to them whatever vibe you’re getting off of them, paraphrase that and work With it convey warmth and respect and explores the clients, strengths, and skills, you know you’ve been dealing with this depression or this addiction for a long time. I’m wondering how you’ve survived until now. What has helped you deal with it? And keep on keeping on facilitating the clients, understanding the rationale, purpose, and procedures of the screening and assessment exploring the clients, problems, and expectations regarding treatment and recovery, and determining whether a further assessment is needed. That’s your screening. So the definition of screening is the process by which the counselor, client, and significant others, when possible, review the current situation, symptoms, and collateral information to determine the probability of a problem. So we’re going to sit down and we’re going to go okay. What brings you here today? What makes you think you got a problem, you know, and then we’re going to start asking questions or using instruments to try to determine whether we think that there’s a probability that that problem exists screaming is used by all types of Human Service Personnel to determine eligibility and appropriateness of services and needed referrals, so it may be used by a physician by a nurse by a counselor by a caseworker to determine how can we best help this person achieve their goals and their maximum quality of life? It’s not unusual for caseworkers at the Department of Children and Families. If people are coming in to get their food stamps or EBT that month, or they’re enrolling in the process to do a screening to determine how can we best help this person? You know be able to start earning more money, you know, maybe they just need a better job, or maybe they’re not able to maintain employment because their depression is so oppressive. So you can see where screening may be used in a lot of different systems and situations to help people figure out how to help their customers. Screening determines the immediacy of the need. You know you could be doing a screening with somebody who’s like on the fence, or they don’t think they’ve got a problem and it you know there or their problem is minor, so the immediacy may not be great or you could Be screening somebody who is you know heavily intoxicated was just kicked out of his house is facing three DUIs. You know they have a much more immediate need for their safety as well as, hopefully, they’re. More motivated screening needs to be a trance process. We don’t want to sit there with a clipboard and be asking questions and scribbling things down and going uh huh. Well, I think you need to go for an assessment that’s not transparent. The clients like, where did you come up with that I usually use screening instruments, and I talk with people when I’m writing things down. I tell them at the end. If you want to see anything I wrote down, I would encourage you to know I don’t write well, and I’ve got poor penmanship, but I encourage you to read what I wrote and we’re going to talk about these instruments after you Take them so you know you know why were we asking these particular questions? What does it mean to me as a therapist doing your screening, so they understand how you’re arriving at your conclusions? Screening does require informed consent. You know it. Doesn’t have to be a big thing, but it does have to happen before you start screening somebody you need to go. You know I’d like to screen you for depression or anxiety, or this is a wellness screening that your agency is offered, but have them ideally have them sign a sheet acknowledging that they know that they’re being screened for whatever and screening identifies Early warning signs and helps provide early intervention, services and resources, so you know think about high blood pressure or diabetes or any of those physical things doctor screens for that regularly, and if they see that there might be a problem creeping in, they can do something right. Then, to keep it from becoming a full-blown problem. Mental health screening is the same. We notice people are under a lot of stress. We know that that’s probably going to wear them out after a while, and it might lead to depression. So we can start helping them, develop stress management skills, for example. They may not need to go to treatment, maybe they need to go to psychoeducation and learn about stress management, or maybe you’ve got a book. You can let them read or something. But screening is a method of determining what the person needs. Screening is the first opportunity to engage the client in the therapeutic relationship and treatment process, sometimes based on observations or other circumstances. People may be referred directly for assessment, for example, if people come into the detoxification unit we kind of bypass screening. We know there’s a problem and jump straight into assessment, so screening doesn’t always happen, but a lot of times. It does because of that referral source – you know if you’re an Assessor that person came from somewhere. You know their lawyer could have screened them. Their doctor could have screened them whatever, but somebody along the way, probably screen them to determine yeah. You probably need to go over to this facility and talk to an Assessor of the clients. Internal motivation is the primary reason for engaging in treatment. So if they’re there because their wife told them they had to be or their boss or the courts that got them there, but to get them actually engaged in treatment and not just going through the motions they have to have internal motivation. There has to be something in it for them, and that’s, what we want to work on developing throughout the whole process, help them see how this benefits them, what’s in it for them, how can it help them accomplish and get closer to their goals for their life, internal motivation may be fleeting, so rapid engagement is vital. If you see a spark of interest or a spark of willingness, we kind of need to pounce on that spark and go alright. It seems like you know you want to get on with this because you’re sick and tired of being sick and tired. So let’s get you enrolled. Now, if you have to make an appointment for an assessment that’s six weeks out, you may lose the person. You know that engagement doesn’t last for long. The engagement lasts while they’re in your office, and then you know you got to have somebody else, pick it up and keep that momentum going. Screening should be brief. You know twenty-thirty minutes you don’t want to have somebody in there for three hours, that’s the assessment conducted in a variety of settings by a range of professionals on persons deemed to be at risk. Some things we do Universal screenings for like domestic violence, other things you may do selected screenings for – and it also depends on your setting and all that kind of thing. But the take-home point is that screenings are conducted in a variety of settings, whether it be a Health Fair at an employer,’s, a doctor,’s office, sometimes churches will even set up wellness days and do screenings screening represents the first part of a Collaboration among the multidisciplinary team because the screener is going to say, okay, I think I’ve identified that this person probably has an issue with this and needs to be referred to assessment over here, but they also need help with housing and food and affording their Prescriptions, so the screener will kind of link them to other team members in the multidisciplinary team. Screening needs to be sensitive to racial, cultural, socio, economic, and gender-related concerns, so make sure that you’re, culturally responsive and it needs to be developed from information gathered from multiple sources when possible. When you’re doing a screening a lot of times, the only person you’ve got to do. The screening is the person sitting right in front of you, but if you’ve got other information. When I do screenings on people in the criminal justice system, I want to see their criminal records. You know that gives me some objective. Information on you know how many times have they been caught? Dui, whether or not they’ve been convicted? How many times have they been caught DUI, that gives me a little bit more information than just what that person is telling me if they’ve been involved with the Department of Children and Families. I want them to bring their case report, especially if they’ve got an open case going on. Screening assesses signs and symptoms of intoxication and withdrawal. Three key elements: we want to verify that the behavior deviates from the norm and rule out all non-drug related causes. So if somebody is having difficulty focusing or they’re agitated, we want to rule out ADHD and schizophrenia and some other things that might cause that, to rule in, if you will stimulant abuse, for example, you want to verify that there. This is not how they normally behave. You know some people are agitated and a little bit more bouncy or fidgety or whatever you want to say most of the time. If that’s how they are, then you know that’s how they are and it’s not a drug, wants to rule out the drug-related causes, including physical causes. You know if they’re in chronic pain if you know etc. There are a lot of reasons somebody could be excessively sleepy have difficulty concentrating be overly agitated. There are a lot of things that use diagnostic procedures to determine the types of drugs being used. So in screening, we’re going to ask them what they’ve been using. But ideally, you can also do an on-site drug screening. You know having a pee in a cup and the on-site. Screenings are not super reliable, but it gives you something to look at. You know most cases, it’s anywhere between 60 and 70 percent reliability, which is why, if it comes up positive and the person says, I didn’t use that it needs to be sent off to a lab for mass spectrometry. To determine what happened, because you can get false positives and you can get false negatives, they may have used something and it doesn’t show up on the test. So you don’t want to just trust the on sites as being a hundred percent, but it is a good tool to identify whether the person is telling you the truth about how much or what their current, whether they’re currently using or not assess Clients, mental health and trauma history. You’re not going to get deep into the weeds here, just ask them if they have a history of depression, anxiety, or abuse of any sort and move on to their safety or environmental needs. Do they have a safe place to sleep? You know if they have an address, you know, do they feel safe in their home? Do they eat well, how’s their nutrition? Do they have any physical health needs that are not getting met? Do they have any other wraparound needs? If they’ve got kids, do they have access to childcare? Are they having problems with transportation? Are they able to afford the medications that they’re already prescribed, etc? So we want to ask them about some basic things like that, and then we’re going to assess the danger to themselves and others. Are they talking about harming themselves or someone else? And we also want to ask if they’re thinking about hurting themselves or someone else. Screening methods include interviewing the clients and significant others using screening instruments and lab tests like urinalysis that we talked about signs of substance, use disorders or mental health issues. We want to look for number one, the circumstances of contact. If the person was referred by the court, then that’s a pretty good sign that there may be a substance use disorder going on if they’re referred because of a DUI. For example, if they’re referred because of a fight they got into, but they weren’t using at the time their blood alcohol was zero. We want to look maybe for mental health issues and things like intermittent explosive disorder. You want to look at the clients, demeanor, and behavior. Are they acting like they’re under the influence when they come in for the screening? Are they showing signs of acute intoxication or withdrawal? Are there any physical signs of drug use or self-injury? Needle injection marks, if they have a get frequent bloody noses, you know if they get bloody noses, while they’re in your office or if they have signs that they’ve been picking. Those can be all physical signs of drug use. Emaciation and malnutrition are also signed some drugs will cause the pupils to be dilated. Other drugs will cause the pupils to be pinpointed. So you want to know what the signs of different drugs are for drugs of intoxication and different signs that people have been using, especially injection, but, like I said, sometimes, drugs will cause people to pick or itch, and that will show indicate to you that there might Be an underlying issue and information spontaneously offered by the client or significant others can give you information about whether there’s a substance, use or mental health issue, and sometimes the significant other. Let me just kind of back up: there may be the significance the spouse brought the person in and when you go out to meet them you, the person, the person being interviewed. Doesn’t want their spouse in there. They want. They want to go back by themselves, okay, that’s cool, you go out and meet the person and then, if you can, with permission, bring the spouse back after the screening to give them both the results, and at that point the significant other the spouse may Spontaneously say: oh well, why didn’t you tell them about? You know the DUI you had three years ago or whatever. So sometimes spouses will just kind of blurt things out because they suspect that the significant other didn’t already say it during the interview. So if you can get that person in a private place where they have an opportunity to say something wonderful but remember you know you do have to have the client’s permission. Screening instruments can be developed by the agency or use standardized instruments. The cage is a common one and you ask a person: have they tried to cut down unsuccessfully, do they feel annoyed when people talk to them about their substance use, do they feel guilty about the substances about using their substances and do they sometimes have to Use first thing: in the morning to kind of wake up we call it an eye opener if they say yes to one or more of those, there’s a chance that they may have a problem. The gain is another tool that you can use, as is the Michigan alcohol screening test or the Sasi. So all of those are standardized instruments, and some of them cost money. Others, like Kay, don’t, so it may depend on your agency and what kind of budget you’ve got. What instruments you’re using any instruments you do use must detail what action should be taken based on received scores. So if a person takes the cage – and they say yes to one but not any of the others, does that mean they should be sent for a referral if they say yes to two, when at what point should they be sent for a full assessment? You want to screen when screening for mental health you want to screen for acute symptoms such as hallucinations, delusions or depression or anxiety, suicidal thoughts and behaviors, and other mood and thought disturbances. So you’re going to ask them about time, place, purpose, and person. Do you know what time it is? Do you know where you are? Do you know why you’re here and do you know who I am you’re going to ask them about short and long-term memory if they can tell you about something from their childhood great, but you’re also going to ask them If they can tell you about what they had for lunch, another thing you want to assess or another way to assess short term memory is to tell them. I’m going to tell you four words and I want I’m going to. Ask you in a few minutes to recall those four words for me and then tell them four words: make them easy words like dog cat, bird, and fish. You know not something hard to remember and then in five or ten minutes. Ask them what were the four words I told you and see if they can remember you’re going to ask them about prior involvement in mental health treatment. What worked and what didn’t if they have been in treatment? What prescription medications do they use, and this includes all prescriptions because physical health prescriptions can have mental health side effects? Ask them about recent traumas again, don’t get into it, but ask them if they’ve been victimized or experienced any sort of abuse and a family history of mental illness. If they have a family history of mental illness, the chances of them developing mental illness are a little bit greater. When screening for mental health, you’re going to use the modified mini screen, the Mental Status exam, the mini Mental Status exam. The brief symptom inventory, a brief psychiatric rating scale, or the symptom checklist 9 t r. So those are the ones that you’re, typically going to use a lot of times. They’re already in your electronic medical record, so you’re not going to have to figure out what to use in terms of you know, knowing what the instruments are for certification and testing purposes. These are the six that you want to be aware of. So you can google each one of them and find out more about what each screening test can provide. Your screening is the initial contact to decide if a person may need a more in-depth assessment. Screening is brief but requires the person to be engaged in the process to get an accurate result. How well the person is engaged in the screening process is a direct predictor of whether he or she will continue in the process. If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube, you can attend and participate in our live webinars with doctor Snipes by subscribing at all CEUs comm slash counselor toolbox. This episode has been brought to you in part by all CEUs com providing 24 7 multimedia, continuing education, and pre-certification; training to counselors therapists, and nurses, since 2006 use coupon code consular toolbox to get a 20 discount off your order. This month,As found on YouTubeThis solution reverses kidney disease! Guaranteed to be effective or your money back: Beat kidney disease. Just by following a simple treatment plan, you can reverse kidney disease. No matter how old you are! Just listen to what people who have tried this solution have to say. “Thank God I came across your solution by accident! Dad’s kidney function decreased from 36% to 73% in just two months. He’s 90 years old! 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if somebody quits using and maybe you know you are seeing them as a mental health client and
they had an accident or had surgery or something they started using pills they got a couple of
refills then the doctor said no I’m cutting you off and now they’re going through a detox period
detox from opiates is unpleasant but it is rarely life-threatening unless somebody becomes their
electrolytes get imbalanced because of the flu symptoms but we still may see this in private
practice in mental health practice because of the scenario I just told you people can start
taking painkillers as prescribed for something they may get addicted you know take them for
a month or so then when they get off of them not only do they feel like you know really bad
but their pain is also back and it may be they had their wisdom teeth out that pain may be gone
but other aches and pains and everything you feel is probably going to be intensified until the
body kicks back in so educating clients about this is what happens you know it’s not uncommon
if you think it’s too bad go see your doctor helping them make sure they’re getting
good nutrition you know it’s hard if you’ve got flu symptoms to feel like you want to eat or
hold anything down so what can you do to make sure your body has the building blocks to make the
stuff that it needs to help you feel better what can you do to improve your sleep and a lot of our
clients and you know where I used to work we had a methadone clinic and we also had a mother
baby unit and as soon as the mothers would give birth then the doctor would start them on
their detox from methadone and he didn’t believe in the kinder gentler taper he was just like okay
baby’s gone threats gone because you can’t detox from somebody from opiates when they are pregnant
because it can cause the baby to die anyway so as soon as they would stop or as soon as
they weren’t pregnant anymore he would just D see them and they would feel really bad I mean
not only did they just push an 8-pound something out of their body but they also are experiencing
a decreased pain tolerance because they’re not on the opiates anymore and all they want to do is
sleep it’s just like please so understanding that is important in helping people get through
that period even though they may want to sleep all the time helping them understand that it’s
important to maintain their circadian rhythms if they have to take two or three ten-minute
power naps throughout the day to get through the day you know more power to them but if they
can practice good sleep hygiene they’re gonna be way better off in the long run OPD opiate
abuse is also or opiate use is also associated with the treatment of depression but it can cause
depressive symptoms due to its pharmacological properties I mean it slows everything down from
you’re gastrointestinal to your heart rate to your respiration you’re not breathing as much you’re
not getting as much oxygen in you’re gonna have more fatigue you’re gonna have more confusion
you’re going to have more of those symptoms of depression for some people they find it is and
certain opiates they find it is a powerful way to reduce anxiety it makes them feel like they’ve
got a ton of energy because they’re not stressed out anymore and this last one is one of the
The main reason that I find people don’t want to give up opiates is that they finally feel better when
they’re on the eating disorders commonly a coat co-occur with depression and anxiety which can
be caused by nutritional deficiencies you know you’re not giving your body the building blocks
so it can’t make the neurotransmitters it needs and it also probably disrupts your sleep some
and depression anxiety can cause or trigger or whatever you want to say eating disorders because
people with eating disorders may fear becoming fat have low self-esteem have a sense of lack of
self-control or have body dysmorphic disorder so we also want to be aware that there are mental
health stuff that can trigger dysfunctional eating patterns there’s about a 24% prevalence of PTSD
among people with eating disorders so if you’ve got a client with eating disorders especially
bulimia be on the lookout for depression anxiety body dysmorphic disorder alcoholism and PTSD they
maybe smoking too but of the things, I just listed that’s probably the least of their worries it’s
all eating disorders are also associated with alcoholism and smoking I said physical health
issues now you’re seeing somebody with an eating disorder it’s a mild eating disorder you’re seeing
them once a week outpatient so you’re not and you have you know you have training and
working with eating disorders or maybe it’s mild enough that you’re just getting supervision
on treating this issue whatever being aware that people with eating disorders anorexia or bulimia
can have irregular heartbeats and cardiac arrest due to potassium imbalances and electrolyte
imbalances so if they’re not eating or if they are binging and purging in some way shape or
form and that includes excessive exercise which can trigger a lot of heart problems they may have
loss of bone mass and osteoporosis so they may break bones a little bit easier going back up to
the heartbeat not to belabor the point but again heart problems mean a lack of available oxygen
mean confusion fatigue potential difficulty sleeping depressive symptoms and you know cardiac
arrest in and of itself is bad kidney damage from Doretta caboose and low potassium can also
potentially drain damaged the adrenals which are on the kidneys and so it’s important to be
aware of what people are using a lot of people with eating disorders are going to creatively
use stimulants to suppress their appetite think about any of your diet drugs your enter mean I
think it’s one of them the ones they give to help people lose weight they’re stimulants
they’re intense stimulants so people who are struggling with eating disorders are likely to go
towards abusing stimulants or at least using them which can drain the adrenals it can in some
cases have been linked to the development of Addison’s disease liver damage from not eating
or binging and purging causing toxin buildup and possibly pain we can help people deal with it
as much as we can anemia which can cause symptoms of depression in and of itself so goes back to
that nutrition making sure they’re getting enough infertility which in and of itself can be
devastating for young women if they can’t have children anymore or can’t have children
ever that may be a grief issue that we need to help them deal with cathartic: and this is
an important one to be aware of because you don’t have to have somebody who uses laxatives
all the time but people who regularly use or abuse laxatives can become dependent on them so
when they don’t use them they have a feeling of bloating feeling full and abdominal pain which
especially in people with eating disorders or body morphic disorders surrounding just general
body fit bad back body fat can greatly increase anxiety depression hopelessness and in some
cases of suicidality so again educating people is the first step to helping them understand what’s
going on and how dangerous laxatives can be but also if somebody is trying to cut back on their
use of laxatives or just recently stopped using laxatives like when people stopped using
opiates it takes the body a while to get back online but for most people it eventually does
people with eating disorders also have chronic ulcers which are painful and can keep you up at night
As you know gastric reflux and pancreatitis which can flare up at a moment’s notice will is
extraordinarily painful and can cause people to lose time from school or work social activities
feel bad about themselves and also pancreatitis causes a lot of bloating
which in eating disorders is a huge trigger for anxiety and depression pathological gambling
is associated with stimulant abuse especially cocaine methamphetamine and Ritalin to stay
focused disrupted sleep and rebound depression when they quit taking that stuff they wake up and
they’re like oh wow what did I just do alcoholism is also associated with pathological gambling
some people drink to calm their nerves some people drink because it’s the culture if you go
to any of the casinos you know their hand-and-out drinks, they’re trying to get you drunk so you
keep gambling more and there’s as we spoke about earlier rebound depression or anxiety smoking
may help people increase their focus or make them think they can increase their focus so if
you can’t smoke in public places this is more of an issue if you have somebody who does a lot of
online gambling or they gamble at their friend’s house or somebody’s house where there’s poker
games and stuff smoking has some anti-anxiety anti-anxiety properties and may be part of the
the culture I know when my daddy used to have his poker games everybody would smoke cigars and even
the one woman who went there would be smoking a cigar with everybody else and it was just the
culture of being there so there are a lot of different reasons that people may use substances
in addition to gambling mental health issues from gambling anxiety from the stimulant use or from
the tension and release of am I going to you know I’m down $20,000 am I going to make it back ADHD
is also strongly associated with pathological gambling bipolar disorder, especially during manic
phases are associated with pathological gambling generally you see them co-occurring it’s not
like gambling causes it it’s you will see co-occur depression can occur due to losses and
gambling can start because somebody’s depressed because of their financial situation and their
trying to figure out a way to you know borrow from Peter to pay Paul and get ahead you also see
pathological gambling is more strongly associated with people who have obsessive-compulsive
disorder if you’ve got clients with these diagnoses just kind of you know be attentive to
the fact that they are more likely to engage in pathological gambling or if they start gambling
it’s more likely to become a problem than for people who don’t have these issues internet
an addiction that is diagnoseable so you know I’m not just making something up
depending on your resource affects eight point two percent to thirty-eight percent of the
general population now obviously we were looking at you know like games versus you know games plus
Facebook plus shopping or something so depending on the study you looked at their parameters
were a little bit different but either way up to 38 percent of the population has sacrificed
significant personal recreational activities to engage in some sort of internet
behavior Internet addiction can cause anxiety or depression due to eyestrain and chronic headaches
you know if you’re hurting all the time it can make you feel wonky it can also interrupt your
sleep can cause circadian rhythm disorder which can trigger depression fatigue reduced stress
tolerance this is a condition when your body doesn’t know whether it’s supposed to be awake
or asleep because a lot of people who engage in internet-addictive behaviors do so in the dark or
you know they don’t pay attention to whether the lights are on or not they may just sit there kind of
in their cave carpal tunnel contributes to pain and sleep disruption because carpal tunnel does
wake you up at night back ache again may disrupt your sleep and can cause chronic pain during the
a day which can interrupt your daily activities poor nutrition I know a lot of gamers that will sit
there for an entire weekend and not get up to go eat so if it’s not brought to them they don’t eat
they’ll even wear adult diapers so they don’t have to get up to go to the bathroom reduced immunity
due to exhaustion from not sleeping and job or relationship problems I know uh several people
whose marriages ended over a world of warcraft’ so internet addiction is a real thing and it’s
something that we need to be cognizant of because it does cause a lot of problems and a lot of
relationships and it may be one of many problems but it’s something to look at sex addiction
can cause hepatitis and a variety of different STDs which if not treated can cause systemic problems
it’s related to anxiety and depression because sex addiction may begin in order because somebody
wants to feel loved or connected maybe after a breakup or because they never felt loved you’re
connected and then they feel that rush and they’re like oh I like that I want to do that again part
of it could be engaging in that behavior which is so thrilling you know depends on the person
psychological withdrawal from sex addiction people who have been engaging in sex addiction
type behaviors and I include pornography addiction in it for this presentation if they’re not able to
access that may start feeling anxious or depressed they can’t get to that they can’t get to the
the thing that’s gonna cause the dopamine rush and reflection on behaviors that they’ve engaged in
as a part of their sex addiction can also prompt anxiety about a spouse finding out you know am I
going to develop an STD and am I you know how I feel about what I’ve been doing so as clinicians
if we’re working with somebody who has compulsive sexual behaviors even if you know anywhere about that
the spectrum we need to be aware that these things may exist and figure out or help them figure out
how they feel about it and what they need to do to make sure that they’re getting good sleep
that they’re dealing with their depression and their anxiety so that they can have a safe internal
and external environment so back to that global perspective how can we and why is it important
to address chronic illness and disabilities that result from or cause mood disorders or
addictions how can we address depression anxiety and hopelessness that results from or causes
depression anxiety or physical problems how can we address physical problems that are caused
by mood or addictions and how can we address guilt or regret which may accompany addiction
recovery or the realization of a diagnosis of a disease caused by the addiction so while you kind
of ponder those there was a question that came in so question what about robbing Peter to
pay Paul in association with trauma specifically childhood trauma so if you could clarify that
for me a little bit I had mentioned robbing Peter to pay Paul in terms of gambling so I’m just so
mental health issues can be caused by or trigger addictions or physical health issues addictions
can cause or trigger mental health issues or physical health issues that can
be caused by addictions or mental health issues so again chicken-or-egg we don’t necessarily know
which one came first when you have any one of these it’s probably going to or likely impact
each other person or each other area common issues are seen in all three changes in sleeping
changes in nutrition fatigue and grief effective treatment requires addressing the underlying
causes as well as the ripple effects you know so yes after childhood trauma or trauma
of any sort, some people may spend a lot of time feeding the addiction as you put it or
engaging in addictive behaviors to avoid some of the PTSD symptoms to avoid thinking about it
to deal with the grief to deal with the shame so they may engage in something that makes them
feel better or helps them forget to cope with the trauma that happened until they
have other tools so they can come to some sort of terms with it and you know as I
say close that chapter in their book already if there are no other questions tomorrow’s
the presentation I learned a lot creating is on alcohol-related dementia and vascular dementia
and fetal alcohol spectrum disorders all three of which are issues that are caused by substance
use and specifically alcoholism and then I’ll give you a hint about where an acute Korsakoff a
a lot of clients who abuse alcohol but they’re not alcohol dependent who decide to stop drinking can
trigger where Nikki Korsakoff syndrome and causes alcohol-related dementia-type symptoms
so again in mental health, we need to be on the lookout for it if we hear that our clients
are trying to cut down on their alcohol use alrighty everybody and so tomorrow is that
presentation and then Thursday we’re going to look at different models of new bottles of
treatment if you enjoy this podcast please like and subscribe either in your podcast player
or on YouTube, you can attend and participate in our live webinars with doctor Snipes by
subscribing at all CEUs com VirtualBox this episode has been brought to you in part by all
CEUs calmly provide 24/7 multimedia continuing education and pre-certification training to
counselors therapists and nurses since 2006 used coupon code consular toolbox to get
a 20% discount on your order this month 
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