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 you could never have planned or organized.

Simply wishing for something isn’t enough – you still have to act to receive it. This doesn’t mean mapping out every step of the way. It means being passionately focused on the goal, and taking the first step as a leap of faith, trusting that the second step will appear when you are ready.
The double-edged sword here is that the emotion imprinted on the picture in your mind’s eye can be something engaging like passion or excitement, or it can be defensive, such as fear or anger. Both emotions work just as well. It’s only important that we imbue the picture with emotional intensity.

Napoleon Hill interviewed the 500 most successful people of his time for his book, Think and Grow Rich – people including Thomas Eddison, Henry Ford, and Theodore Roosevelt. He found that these are the absolute laws that built their success, not what is taught in business schools.

So why doesn’t everybody easily get what they want?

1. You have to have an absolute core connection to your purpose to make this principle work.
2. Many people are focused on what they fear or don’t want, as opposed to what they want, and keep attracting that.
3. You have to be almost obsessively focused on your goal – a ‘burning desire’ as Napoleon Hill put it. Most people flit from thought to thought without a single clear sense of what they want. They may desire one thing on the drive to work, another at lunch and others later in the day. There’s no consistent focus.
4. It’s critical that you focus on what you give in exchange for your goal, not just on what you want. Most people focus on what they want, not on how they will serve/give value to others to obtain it.
5. You have to take the first step, not plan out the whole route. At the heart of this principle is the belief that you will attract to you resources you could never have coordinated to attain your goal.

This principle can seem pretty "out there", but it’s actually quite congruent with the principles of quantum mechanics. Unfortunately, most people are ‘programmed’ with an earlier understanding of how the universe works, based on primitive principles such as Newton’s understanding of physics. This old system of ‘determinism’ goes back hundreds of years and so has pervaded our culture and understanding of how we think things work. It’s quite wrong, but the discoveries from quantum mechanics are less than a century old, and haven’t yet pervaded our everyday understanding.

When you start to examine smaller and smaller components of matter, such as subatomic elementary particles, Newtonian physics and determinism fall apart and don’t work. Late in 1927, the world’s leading physicists gathered at the 5th Solvay Conference to develop the Copenhagen Interpretation of Quantum Mechanics, the root of quantum physics. This is when the world changed.

Quantum physics governs the particles that make up every part of you and of the universe. Some of the core principles are:

1. You simply cannot know everything – in fact, it is impossible to do so. The more absolutely you know one thing, the less certain you are about others.
2. You cannot predict individual events – you can only predict probabilities of events happening.
3. Conscious attention (i.e.: the scientist/observer watching) changes the results.
   Many subatomic particles only appear when the scientist looks for them. The rest of the time, the universe acts as if they exist, but they’re really not there.

As Gary Zukav wrote in The Dancing Wu Li Masters, "according to quantum mechanics, there is no such thing as objectivity. We cannot eliminate ourselves from the picture… Physics is the study of the structure of consciousness."

Chrysalis Performance Strategies 2002. www.Teamchrysalis.com

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 practitioners with information and ways to increase their professional skills and confidence.

With that being said……

Scenario #1:
A 36 year-old female presents at your outpatient clinic. She reports she is coming to therapy due to relationship problems with her husband of 5 years. She indicates she thinks her husband may be having an affair and she is worried he may be planning to divorce her. She reports she has 2 children and is also worried for them. Her parents divorce when she was 8 years old and she does not want her children to go through what she did.

She describes that she has been struggling at work to concentrate and complete her assignments for the last 6 months, her boss has noticed and has been lenient at this point but she is worried this could lead to termination. She says her thoughts are constantly focused on her marriage, what her husband is doing, who he is with and why he seems more distant from her. She thinks she is not as attractive since having her children and that he is probably “turned off” by her appearance, saying “I don’t blame him for not being attracted to me anymore, men have needs you know”. In addition, she explains that her sleeping has become more disrupted and at times she lies awake worrying about everything; she says she is so tired during the day she can hardly keep her head up at work some days and on the weekends does not feel like showering or eating sometimes. On top of that, she says she worries about thyroid disease because her mother had that problem about her age.

When asked about history of depression or any thoughts of suicide, she says she does not want to end her life because of her kids but does reveal she fantasizes at times about running away or maybe having her own affair to get back at her husband. As far as depression, she says “I think I am really depressed” and says it’s hard to find anything to look forward to, she feels she is distancing herself from her family and friends and that nothing makes her feel happy anymore.
What really brought her to therapy now is that she says last week, she was in the store and she started feeling dizzy, sweaty, and nauseous and scared feeling. She does not know why this happened, “it just came over me and really freaked me out”. She says she is now worrying about that and about having another “attack”.

She says she is just overwhelmed with how she feels physical, mentally and emotionally and does not know what to do. She says when she went off to college at age 18 she had some similar feelings of loneliness and “problems adjusting” but said this did not last long and she regarded this as merely transitioning from home to college. She says she did meet with a health center counselor briefly, felt it helped some but did not feel the need to continue very long.

She says she wonders if she needs “an antidepressant or something” to make her feel better. Says she has seen a lot of commercials on TV for Zoloft, Paxil and other drugs and thinks she may have some of those symptoms. Sometimes she does drink some alcohol, couple times a week and has noticed drinking “a little more” on the weekends especially when her husband is around. She says, “you know, my husband drinks beer on the weekends, I thought that maybe if I drink a little with him he will want to be around me more”, “it also relaxes me”.

Q & A:
1. Give Axis I-V from DSM-IV (each axis can have multiple diagnoses)
2. Identify the least restrictive yet most clinically suitable level of care for this case, i.e. outpatient only, outpatient w/ medication management, inpatient, etc

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 scary situation, and communicate concern for her safety.

"It really sounds like a scary and confusing situation you are in. I am a little concerned about your safety and the nature of your relationship. I am concerned that you may become more isolated and more at risk of being harmed."

"I'm ok now...He is really sorry but I'm afraid that something might happen in the future. He really doesn't want me spending time with anyone else and it seems that he wants to know where I am at all the time. I think it's getting worse. I'm scared."

"I would like you to see someone who specializes in domestic violence."

"I am not a victim of domestic violence."

"I know those words seem extreme but some of the dynamics in your relationship are patterns of domestic violence. He has been physically violent to you at least twice in the past 4 years and it appears there are other dynamics in your relationship that demonstrate the cycle of violence. Would you being willing to talk with someone who could help you figure out what to do and understand your husband and relationship better?"

"Okay..."

"It also appears that last night was very scary and I would like to talk with you about a plan for safety. Here is the phone number for the domestic violence hotline, 911 and the number to the confidential shelter. Talk to a friend or family member about the possibility of needing to stay with them on short notice, let's talk tomorrow to see how the connection with the domestic violence program went and don't hesitate to call me anytime for further support and direction."

• 1 out of 3 women around the world have been beaten, coerced into sex or otherwise abused during her lifetime.
• 37% of all women who sought care in hospital emergency rooms for violence–related injuries were injured by a current or former spouse, boyfriend or girlfriend.
• Some estimates say almost 1 million incidents of violence occur against a current or former spouse, boyfriend or girlfriend per year.

Once again, this was not the entire discussion but some highlights of a high risk caller.

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 psychiatric status and mobilizes other services on her behalf. The mental health system’s responsiveness to their consumer’s changing clinical profile requires an objective and effective process of decision-making that includes awareness of changes, comprehension of guidelines and flexibility in assigning alternative or additional services; as the consumer’s condition improves then the intensity of services lessens; their condition worsens then the service interventions increase. In theory this is how it works. In practice, it only works when all the agency providers understand the level of care criteria and the services selection guidelines while at the same time are willing to mobilize those services as necessary.

As mental health consultants, providing telephone Triage and mental health benefits preauthorization, we are embedded in the process that involves making level of care assessments and assignments based on clinical criteria and services selection guidelines established by mental health boards. This decision-making requires a clear understanding of the various services offered and the criteria particular to each. Service Excellence is the goal; the Right service at the Right time for the Right cost. We strive to link consumers to the correct service (s) that are most clinically appropriate to meet the consumer’s needs as well as most cost-effective to the agency and community as a whole. Now, we understand that mental health assessment, treatment and outcome are not an exact science, nor are always assigning the correct services. Triage, for instance, is a consumer-initiated and self-report process that relies on consumer provided information in making the disposition. This information often changes, the consumer’s condition changes, reported information is intended to mean something different, is incomplete or, unfortunate to say, is at times fabricated to affect a certain outcome. So we understand that the accuracy in making level of care assignments is a variable and fluid phenomenon. At times it is a complicated process although skilled telemental health clinicians can provide accurate level of care decisions with a 15 to 20 minute phone call.

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 other day. He doesn’t listen at school or at home. He does not want to do his school work. He is often angry. He has been lashing out at everyone around here since his father left four years ago. It’s just gotten worse. I thought he would feel better as time went on but his father comes around once in a while or calls and promises to come but ever shows up…..I can’t deal with the school anymore…they keep calling me at my job. I am about to lose my job and I can’t supervise him at home when he has been kicked out of school.”

“It sounds like his school problems are causing the most disruption. We have a mental health worker at his school. I would recommend that we contact her and see if she can meet with him, his teachers and yourself to come up with a plan to help him be more successful in school. She can also provide psychotherapy for your son to address some of his feelings regarding his father and assist him with some coping skills to manage these feelings.”

She sniffles and says, “I am willing to try anything!”

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 disorders, but in the larger scope of increasing public-awareness clearly much more is written about depression, the symptoms, the individual and social effects and the various and emerging treatments for that illness. Not to minimize the seriousness of depression; in any given 1-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from a depressive illness. And to that end, we applaud all that is and has been done to understand and combat this illness.

NIMH (National Institute of Mental Health) compiles statistics on illness such as depression and anxiety. On face value, the statistical prevalence of anxiety disorders vs. depressive disorders is nearly equal (19 million vs. 18.8 million), respectively. If we “breakdown” the larger category of anxiety disorders, not unlike depressive disorders, we can begin to see more specifically the types and significance of each.

Specific phobias affect an estimated 6.3 million adult Americans and are twice as common in women as in men. A specific phobia is an intense fear of something that poses little or no actual danger. Some of the more common specific phobias are centered on closed-in places, heights, escalators, tunnels, highway driving, water, flying, dogs, and injuries involving blood.

Social phobias affect about 5.3 million adult Americans. Women and men are equally likely to develop social phobia. Social phobia, also called social anxiety disorder, involves overwhelming anxiety and excessive self-consciousness in everyday social situations.

Post-Traumatic Stress Disorder (PTSD) affects about 5.2 million adult Americans. Women are more likely than men to develop PTSD. Post-traumatic stress disorder is a debilitating condition that can develop following a terrifying event. Often, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to.

Generalized Anxiety Disorder (GAD) affects about 4 million adult Americans and about twice as many women as men. Generalized anxiety disorder is much more than the normal anxiety people experience day to day. It's chronic and fills one's day with exaggerated worry and tension, even though there is little or nothing to provoke it.

Obsession-Compulsive Disorder (OCD) afflicts about 3.3 million adult Americans. It strikes men and women in approximately equal number. Obsessive-compulsive disorder, or OCD, involves anxious thoughts or rituals you feel you can't control. If you have OCD, you may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals.

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 Stephanie saying “this is way ahead of it’s time”. I put little stock in what she said at the time; I tried a little marketing but was easily thwarted. After all, I am a clinician by trade not a marketing specialist. The project lay dormant for the last few years until more recently, for whatever reason, we blew the dust off it and started breathing life back into it. Funny how things work; how things have a time, a place, and a purpose. The idea of developing a telemental health seminar, designed to assist medical and/or mental health providers in dealing with High Risk Callers, came out of the old creation and has started evolving into something even better.

Now we are giving of ourselves so others may benefit from this cutting edge, telemental health evolution in both the medical and mental health arenas. Creating educational, interesting, thought-provoking and inspiring seminars is both challenging and exciting. High Risk Callers will change the way the healthcare system will assess and assist these individuals so they are appropriately serviced; in the past these callers generally “slipped through the cracks” as we say in the mental healthcare industry. These callers are the suicidal, paranoid, threatening/hostile, child abuse, intoxicated and domestic violence callers. They are the outliers; the challenging types; the ones that bring out our insecurities as professionals.

Well its 8:00 am and time to get busy. Hope today brings with it more creative thoughts and ideas how to organize our information in a way our colleagues will connect to us and our message. Getting the information to them is vital so that they might use it to benefit others. Hope we can make a difference.

“Where your talents and the world’s needs cross, there lies your vocation” - Aristotle

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 family doesn’t care about me. I can’t keep a job and now, my own mother is threatening to kick me out..out...”
“Wow, it seems that you are struggling with multiple stressors in your life and I am wondering if alcohol is one of them.” My voice is steady, gentle and unassuming. He becomes immediately defense and short, “Why does everyone say I am a drunk?! It’s always about my drinking.”
“When do you drink, what triggers your drinking?” “When I am depressed and something bad happens in my life. Alcohol makes me feel better.”
“You have mentioned your feelings of depression several times and with all the stressors in your life, I was wondering if you had been thinking about harming yourself?” “Aahhh, nah, I…I...just need to talk, talk…..now where am I calling?”
“Tell me about you past self harmful behavior?”
“I drink…it is killing me but I don’t know what to do.”

He is tearful and crying on the phone. I talked with him about coming in to see someone and getting involved in treatment and attending meetings. He is afraid to stop using. We discussed other ways of coping exercise, meditative practice, support groups, etc. He agreed to come in for an appointment. I encouraged him to call back and walk-in if needed. He agreed to let me talk with his mother. She was aware of the appointment and seemed happy that he was trying to get some help.

The intoxicated caller can be very high risk. Even though this patient was intoxicated at the time of call it was important to assess risk factors to self and others and history of these. I also asked to talk with his mother, who was sober and appeared to be one of the only supports he had at the time. With her we discussed the importance of treatment, a crisis intervention plan, access to services and referrals.

Phew…..ok again this was not all of the conversation, assessment or intervention but a glimpse……so much for saying things out loud!....

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 find myself at training seminars with renown speakers touting “new innovative” techniques and interventions. There is generally a significant focus on how to connect with people at the core of these treatment modalites.

The power of relationship and the correlation to healing is greater than we give it credit for. How do we make these connections with others? It seems that a fundamental belief that we are all connected opens the door for this healing. A connection with someone does not need to take weeks, months or years. Have we not all experienced a time when we have met someone and in the first 10 minutes we have found a warmth and feeling of relatedness? Relationships are not developed only in what we say but in our attitudes, gestures and how we carry ourselves in the world. Do we walk by “stranger” on the street with no eye contact or gesture of acknowledgement of their being?

The power of relationship is imperative in a therapeutic relationship with clients and patients in order for healing to occur. It is also imperative for all healthful living. How is your relationship to yourself? We are part of the world we live in, so connect and embrace it. Healing will be present.

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-occurring disorders. It has been clear for a long time that these patients have fallen through the cracks of our systems mostly due to the complications of providers attempting to prioritize one disorder over the other disorder while working withing a framented service system. Providers are becoming crosstrained so that we are able to provide one point of entry for these patients and one provider who is able to meet their needs. With this increased awareness there has been a paradigm shift and a movement to provide integrated treatment for these patients that are at high risk for homelessness, loss of primary support systems, and/or death accidentally or intentionally.

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 order to effectively and compassionately care for others, we must care for our own well-being. We are promoting health. Health starts with us. The wisdom of our leadership and organizations to support this healthy balance is essential for real healing and healthful communities.