SAMHSA publishes a TON of resources that can be useful in clinical practice. Many of these Treatment Improvement Protocols of TIPs contain useful forms and assessment instruments in the appendices. Most are available in .pdf for download. There are three main types of publications TIPs which are detailed manuals that discuss current best practices in the field as they relate to a specific problem or population. Quick Guides–These cover the same information as TIPs, but they are the Cliff’s Notes version. They are good for a quick refresher, but, IMHO dangerous to use as a sole source of information. Finally, there are KAP KEYs. These laminated cards highlight what are thought to be the most important points of the TIP. For example, the KAP KEYs for TIP 35: Motivational Enhancement highlighted the FRAMES approach. Each of these tools has a unique place in every treatment center. Link to SAMHSA Publications
DBT is an extremely useful tool for helping people deal with seemingly overwhelming emotions. In early recovery many people experience the double whammy of not only having poor coping skills, but also of having lots of “stuff” (shame, anger, resentment, anxiety, depression) bottled up inside. DBT can help them learn that feelings in and of themselves are just feelings. You can feel them, and then choose how to act and react. Here is a very good set of books by Marsha Linehan and several other authors who can help you learn how to use DBT in your practice with patients with Borderline Personality Disorder, Addictions, Anxiety and much more. Dialectical Behavior Therapy
Well, we do not have an app for that yet, but you can take our courses on your mobile devices now.
We have added 4 more narrated powerpoints to the AllCEUs education channel at: http://www.youtube.com/user/allceuseducation. These presentations are based in part on the wonderful books by Kathryn Zerbe: Integrated Treatment: Beyond The Body Betrayed, and Barbara McFarland: Brief Therapy with Eating Disorders. Each book presents a unique look at methods to help LPCs and addiction counselors work with persons with eating disorders.
We have had many requests to add live CEUs, so…beginning in May, we will be launching a weekly, interactive video podcast. You will be able to watch and participate in the workshop/lecture for free. CEUs will cost $3/credit.
We have added new videos and created an AllCEUsEducationchannel at YouTube
The end of the year is rapidly approaching. Licensed Professional Counselors(LPC), Marriage and Family Therapists (MFT) and Licensed Social Workers (LCSW | LSW) in Alabama, Washington DC, Louisiana, Maryland, Massachusetts, Montana and Tenessee all have renewals approaching.
Don’t wait until the last minute to get your CEUs.
If you do not need 30 CEUs, check out our ala carte page. CEUs for $3 per credit.
Even if you procrastinate, we can help you out. Materials are online. Tests are online and instantly graded. Print your certificate as soon as you pass the exam.
Substance Abuse Counselor, Addictions Counselor, Mental Health Counselor, potato, potAto, what what does it all mean?
The department of labor indicates that the need for counselors and, specifically addictions counselors, will continue to increase at a significantly higher pace than many other professions; however, looking at jobs, it seems that a lot of agencies are seeking counselors that are co-occurring competent. (Oh goody, another term) About 15 years ago, the medical and mental health community began to realize that 1) Not all addictions are chemical, and 2) the majority of people have both a mental health issue and an addiction issue to some degree. That gave rise to the development of certifications by IC & RC and states like Connecticut for persons who were competent in treating co-occurring disorders. That is, who understand the emotional, cognitive, social and physiological interaction between mental health issues and addictive behaviors (alcoholism, drug abuse, eating disorders, sexual addictions etc). After working in community mental health for nearly 15 years, I can tell you that people who are licensed mental health counselors, social workers or marriage and family therapists AND certified as addictions counselors are in much higher demand. This is because they have a broad array of knowledge making them very flexible, and they can supervise services provided to Medicaid clients (big money).
Don’t despair. There are a lot of very talented people who would love to be counselors, but do not have the time or desire to endure three years of graduate school and a two year internship. Thankfully, many states have certifications for addictions counselors that do not require years of graduate school. By getting a certification as a substance abuse counselor first, many people are able to “climb the ladder” at their agency, especially if they seek additional training in mental health counseling. The Florida Certification Board for example has a certification for Mental Health Technicians as well as for Addictions Counselors. Additionally, they have caveats for people who only have a bachelors that enable them to achieve the highest level of addictions certification, the CAP.
The majority of states will also allow people to get their training for addictions certification online. Ensure that the online continuing education provider is accepted in your state though. This usually means they are approved by NAADAC (like AllCEUs is) or are specifically approved by your state (California, Connecticut. and Georgia Certification Boards for example have their own approval process).
To get yourself started, you cal look on our approvals page to find links to the various agencies. You can also Google: Addictions Counselor Certification Board and the name of your state. For example: Addictions Counselor Certification Board Virginia will bring up Virginia’s Department of Health Professions who handles the addictions certification and licensing. From there you can review the process for becoming a certified addictions counselor or mental health technician in your state.
Appropriate responses to the needs of returning veterans will include: • A strength- and recovery-based focus • An empowering, skill-training approach • Careful, individualized, respectful, veteran-specific assessment and treatment planning • A primary emphasis on stabilization and development of internal and external resources • Education for veterans and families on the physical, cognitive and emotional aspects of trauma and substance use disorders • Assertive linkage to ongoing support within the community—and in the larger military and veteran community nationwide Effective responses to the needs of veterans with post-employment stress effects include a consistent approach that integrates trauma-informed addictions and mental health care, but what does that mean? It means that when treating a veteran for mental and/or substance use issues the clinician must realize that the traumas experienced have changed how the person feels, reacts and perceives the world. These changes are normal reactions to abnormal events. Unfortunately, they often persist even when the danger is past. This is the mind’s way of making sure the body survives. In order to help consumers to regain a sense of balance, we must create an environment of safety, trustworthiness, choice, collaboration and empowerment.
Safety means ensuring physical and emotional safety not only in the treatment session, but also in veterans’ daily lives. Even Abraham Maslow believed that safety helped form the foundation of mental health and wellness. When people do not feel safe, they are on guard, and they cannot rest well which negatively impacts their health, mood and relationships which could be supportive. So the next question I am often asked, is “What do they need protection from?” They need places where they are not subject to judgement or evaluation, and are not concerned they will have to defend their actions or the actions of the military in general. If they have been deployed for a while, they need a community that can help them feel less like a stranger in a strange world. They need places where people understand what they are going through, who have survived the nightmares, the insomnia and the feeling of utter isolation, not knowing who they can trust. They need to learn the skills to deal with the flashbacks and the nightmares, and to relaxs at the end of the day.
Trustworthiness is developed in the process of creating safety by maintaining clear, appropriate, consistent boundaries and objectives. Many people—veterans included—will not tell you everything until they believe you are trustworthy. Those things that haunt them at 2am are not things they are going to tell just anybody. Throughout the process that led to the PTSD–whether it be one single incident or years of traumas—the person regularly was stripped of their control, second guessed for every move and, often questioned on their decisions. Trauma informed treatment not only relies on consumers learning to trust their therapists, but also on them learning to trust themselves. Failure to keep promises reinforces the notion that the world is an unpredictable, terrifying place. Failure to help consumers see the logic in what they did, or are doing, reinforces the notion that their behavior is unpredictable and they are out of control. Remember to ask yourself what the benefit is to any behavor. Our brains are programmed to survive. How is the behavior helping the person survive. Substance abuse numbs pain and helps people survive until they develop alternate skills. Fear reactions/fleeing protect the person from imminent danger. Explosive anger can neutralize a perceived threat.
Choice means allowing consumers to prioritize what issues will be dealt with, when and to what extent. The caveat to this merges with collaboration. While it is certainly advised to maximize consumer input and control, there are some things which may need to be negotiated. When consumers are putting themselves at risk, even before treatment starts, the chances of them engaging in highly dangerous behaviors when they are in the midst of a crisis is much greater. For example, if Johnny is drinking a fifth of whisky each night and chasing it with hydrocodone, I would certainly not recommend delving into deep, emotionally charged issues in a traditional outpatient environment. It is likely when the pain increases, so will the desperation to stop the pain. Johnny first needs to get safe—mixing hydrocodone with whisky is just a slow way of committing suicide. If he can create a support plan that includes a drastic reduction in drinking (preferably 100%) and at least 3 people who will be there to support him, then I might consider working with him on the trauma issues in outpatient. My preference is for people with dual disorders (i.e. PTSD and substance abuse) who live alone or do not have a strong support system to enter into either intensive outpatient or a 3-5 day retreat in which they can have 24-hour access to a therapist and have their medication and substance intake monitored.
Finally, empowerment means providing consumers with the tools to help them create safety, trusting them to do the next right thing and encouraging them to make educated choices regarding their recovery and their life. Empowerment means helping them find positive ways to use the energy they are currently using to try and contain their anger and devastation. In PTSD, people often have a lot of “I should haves.” They cannot change the past, but with the knowledge of what they believe they should have done, what can they do now? That is to say, they cannot change the past, but what can they do to prevent it from happening in the future and/or make ammends if they believe they have done something wrong.
Trauma informed care identifies the trauma, and all of the associated mental, emotional, physical and social changes as the primary cause of people’s mental health and substance abuse issues. Likely things will never be like they were before the trauma, but they can get better. The terapists job is to help people define what “better” looks like, provide needed skills to help the person achieve their goals and empower them to start doing the hard work necessary to recover.