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Showing posts from November, 2005

Thoughts are Things

Thoughts are Things "There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." Albert Einstein One of the core beliefs of the “new” spirituality is that your thoughts create your reality . What most people don’t realize is that this principle is also core to quantum mechanics . The Spiritual Principle This spiritual principle says that any picture that we hold in our mind’s eye, and become emotionally involved with, is what we attract to ourselves. It’s as if this crystal clear picture, imbued with intense emotion, sends out invisible signals that attract what is in that picture to us. This is like starting a new hobby you’re excited about and suddenly meeting people involved in that hobby everywhere you go, or starting a new project and finding all sorts of synchronicities that help you on your way – things...

Mental Health Triage

Most postings to our blog are formatted as either psychoeducational or experiential in nature. We generally post clinical mental health information based on statistical or fundamental counseling principles guiding the practice of behavioral health. At times we have designed postings to simulate real-life examples of interactions between mental health consumers and clinicians. Both of these formats are meritorious in their own right. But in an ever evolving effort to create additional approaches for educating and entertaining those who frequent our blog (especially our clinical colleagues), we are introducing an additional format-type that will consist of behavioral health case scenarios followed by actual “continuing education”-like Q & A’s that readers can respond to and receive feedback regarding effective DSM-IV case diagnostics and level of care recommendations. It is our intention to promote and enhance the foundations of clinical mental health by assisting mental health pract...

The Road

It is what it is! The Road finds you no matter whether you are looking for it or how aware you are of it. There is no distinction between good and bad. Like a rollercoaster You hold on tight Screaming all the way down Holding on for safety Excitement and adrenaline fill your veins Sometimes letting go with your hands, hair in the wind Feeling the sense of freedom The Road We think we have a plan We think we have control We think we need to know! The Road is the Road It is what it is We are passengers in a car Knowing, questioning, wondering, trusting If we are in alignment The Road will only bring us to the place we have been searching for. Something alittle different for the holiday! Enjoy your Thanksgiving.

The Domestic Violence Caller

Ring...Ring... "How may I help you?" "I only have a little bit of time to talk. My husband has gone out to the store and will be back in about an hour. I really feel like I need to talk to someone. My husband hit me and knocked me down last night. This is only the second time he has struck out at me in 4 years but I told him last time that I would not tolerate physical violence. He really is a good guy. I just make him angry. I know it's my fault. Sometimes I just say the wrong thing. He was really sorry this morning and apologized. He was crying, too. I know he doesn't mean it but he says if I would just listen to him everything would be better. He made me coffee and breakfast this morning. I don't know what to do...I love him and I am really confused." She is crying and tearful throughout her conversation. Thoughts run through my head stay calm, be supportive and non-judgmental of her or her husband, acknowledge that they are in very difficult and scar...

Food for Thought - Service

Car after car after car…..pass as I drive the two lane highway. The cars are filled with people, locked in metal boxes with the illusion of separateness and detachment. We drive, thinking we are alone, with very little interest or awareness of anything else. Being in existence means we are in service to each other. When we breathe, we are in service to the plants as the plants are to us. As we drive in our metal boxes, are we aware that the box is servicing us and we service it with gas, tires, driving safely, etc.? We are often providing service with little awareness. Interface strives to provide Service with intention and awareness to this connectedness that exists. We are profoundly aware how our attitudes, interactions and behaviors affect the Service we provide. There is this continuous giving, assisting, and receiving that occur. Service is the foundation; without service what would there be?

Level of Care Decisions

A 40 year-old female diagnosed with Schizophrenia, Paranoid type, currently receiving Medication Only services through her community mental health provider. This female has required 4 inpatient hospitalizations within the last 12 months , has as long history of chronic mental illness, she has not been compliant on her oral antidepressant and neuroleptic medications, she gave birth to a child recently and she continues to exhibit numerous positive characteristics of her schizophrenia. Based on this information alone it does not appear that this consumer’s treatment plan matches her level of care needs. A consumer such as this could benefit from additional mental health services to assist her in achieving and maintaining some greater stability in her functioning and symptom profile. Medication Only service is not a sufficient level of care intervention for this type of consumer at this time. It is important, perhaps paramount, that the provider continually assesses her psychiat...

The Angry/Hurt Caller

Ring…Ring….Ring… "How may I help you?” “You can start by answering the phone! I have been transferred and put on hold!” “We are sorry to keep you waiting and I realize it must be frustrating waiting for someone to talk to. We as an agency striv…..” “Yeah, Yeah, Yeah…..I heard that all before. I don’t know what you do there but you sure ain’t doin’ nothing for me! Now what are you going to do about my son!” “We would really like to help your son and your family. What are you concerned about with your son?” “My family! WE don’t Neeeeed any help, HE is the one that Needs HELP…I need to put him some place. I can’t deal with him any longer.” “Wow, he seems to be pushing you to your limit and this is the last straw.” “YES! He is going to drive me crazy.” “It really sounds like you care about him and want to see him be successful.” At this point she starts to cry and say, “ yeah…I have really tried I don’t know what to do anymore…He is getting kicked out of school every ot...

Anxiety "The Stepchild"

Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. These disorders fill people's lives with overwhelming anxiety and fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless, and can grow progressively worse if not treated. Considering the prevalence and disabling effects of anxiety disorders, we wanted to devote some energy to this diagnostic category. Subjectively, it seems that anxiety disorders are generally regarded as the stepchild to depression. This seems the case in our clinical experience and in terms of societal awareness. There have been some pharmaceutical advertisements on television promoting Paxil and it’s positive outcomes treating social anxiety and in various medical and mental health trade journals you will find articles touting current research or new medications related to the treatment of anxiety dis...

High Risk Caller - Creative Process

My partner has this format down. The free flowing, anecdotal style of educating, entertaining, training and informing is not usually my teaching approach. I am the analytical writer, the theorist, statistician, process and procedure, policy-minded educator, “just the facts” type. But I too am interested in growing, stretching, learning, and taking new risks as a person, clinician, educator and individual. Mental health seminar and workshop training is the topic most every day with us. Up early, log on, review email and task lists, arouse the creative ideas from the night before and begin crafting those ideas onto paper, PowerPoint and brochures, etc. It is exhilarating sometimes to take that creative energy and begin to form it into something meaningful and useful so colleagues, students, agencies will find value in the content. Some days it flows non-stop; some days there is very little inspiration. Several years ago a suicide triage training project was developed. I remember ...

Crisis in the Afternoon - The Intoxicated Caller

It’s Wednesday and the middle of the week. I have dealt with all the busy pace of a Monday and Tuesday; I am a little more productive, more focused. Wednesday is really the day when I feel like I have settled in to the week, I am energetic and eager. Most calls have been “routine” requests for mental health services. When I say routine I mean non-emergent or high risk callers. I do not mean uninteresting or lacking in uniqueness. Of course, what happens when this is said out loud, a high risk caller presents on the other side of phone. “Good afternoon, how many I help you?” “Yes, I am calling to talk to someone.” “I am sorry I am having a hard understanding you.” He repeats that he is calling but his speech is somewhat slurred and he seems cognitively impaired. He has difficulty focusing. I am trying to figure out if he is developmentally disabled or intoxicated. He says, “I…I…just neeed to talk to yoooou. I am soo depressed. I can’t do anything right. My fami...

The Power of Relationship

What is considered the foundation of healing? The power of relationship is the origin of all treatment modalities, theories and interventions. Carl Rogers the grandfather of this theory says, “ Realness in the facilitator of learning . Perhaps the most basic of these essential attitudes is realness or genuineness. When the facilitator is a real person, being what she is, entering into a relationship with the learner without presenting a front or a façade, she is much more likely to be effective. This means that the feelings that she is experiencing are available to her, available to her awareness, that she is able to live these feelings, be them, and able to communicate if appropriate. It means coming into a direct personal encounter with the learner, meeting her on a person-to-person basis. It means that she is being herself, not denying herself.” I often hear his work being discounted as trivial and ineffective. The relationship is the foundation of all evidenced-based practices. I f...

More Co-occurring Disorders -Mental Illness and Substance Abuse

Persons admitted for treatment with both psychiatric and substance abuse disorders are said to have "co-occurring disorders." Other terms for this are "co-morbidity” and "dual diagnosis." Data on co-occurring problems reported to Substance Abuse and Mental Health Administration’s (SAMHSA’s) Treatment Episode Data Set (TEDS) were provided in the TED Supplemental Data Set which was provided by 29 States and jurisdictions in 2003. Of the approximately 668,000 male admissions in the 29 States that reported presence or absence of co-occurring problems to SAMHSA's Treatment Episode Data Set (TEDS), about 103,000 (15%) were admissions with co-occurring problems. Male admissions with co-occurring problems were more likely to report alcohol as the primary substance of abuse than male admissions for substance abuse alone (48% vs. 43%). There has been an increased awareness of the co-morbidity of mental health and substance abuse disorders and the costs of co-occurrin...

Healing the Healer

When I was in graduate school it was highly recommended, by several of my professors, that anyone going into a helping profession become a patient or client themselves. This was a tremendously valuable experience. I learned what it was like to be vulnerable, to ask for help and to understand my strengths and weaknesses. There was a realization that we are all human! I keep a mirror in my work area still to remind me that whether I am the helper or the one being helped at the moment, we are all the same. Helping professionals are not gods that lack emotion, or the need for nutrition or immune to disease and life’s challenges. There appears to be a growing disconnect from this fundamental understanding that helping professionals are most effective healers when they are healthy. The leadership in some organizations, licensing boards and agencies appear to minimize or ignore the importance of helping professionals caring for themselves physically, emotional, mentally and spiritually. In or...