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Putting Health back into Clinical Mental Health Counseling

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Putting Health back into Clinical Mental Health Counseling Presented by: Jim Messina, Ph.D. , NCC, CCMHC At: Utah Mental Health Counselors Association – PowerPoint PPT presentation

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Title: Putting Health back into Clinical Mental Health Counseling


1
Putting Health back into Clinical Mental Health
Counseling
  • Presented by
  • Jim Messina, Ph.D. , NCC, CCMHC
  • At Utah Mental Health Counselors Association
  • Date May 10, 2013

2
From Dream to Reality in 1976
  • On an impulsive whim Nancy and Jim
  • Coined term Mental Health Counselor
  • Coined Association Title The American Mental
    Health Counselors Association
  • As the process caught fire
  • Established the Profession of Mental Health
    Counseling
  • Set out to create its Hallmarks of a Profession

3
What are the Hallmarks of a Profession?
  1. Professional Membership Organization
  2. Code of Ethics
  3. Certification and Licensure
  4. Accreditation
  5. Research into Effectiveness of Service Delivery

4
History Timeline of Creation of Mental Health
Counseling Profession
  • 1976 Coining of term Mental Health Counselor
    and formation of American Mental Health
    Counselors Association as Division of ACA
  • 1979 Creation of the National Academy of
    Certified Clinical Mental Health Counselors
  • 1981 First State Law to license Mental Health
    Counselors put into effect in Florida
  • 1985 AMHCA had over 12,000 members
  • 2011  AMHCA put out its newest Standards of
    Practice in Mental Health Counseling-Helping to
    put Health back into Clinical Mental Health
    Counseling
  • 2013 AMHCA has over 7,000 members

5
The National Professional Association of Clinical
Mental Health Counselors
American Mental Health Counselors
Association Founded in 1976 when term Mental
Health Counselor was coined
6
Initial Definition of Scope of CMHC Practice
  • The 1979s initial AMHCAs Journal of Mental
    Health Counseling included first published
    definition of mental health counseling as
  • an interdisciplinary, multifaceted, holistic
    process of
  • Promotion of healthy lifestyles
  • Identification of individual stressors personal
    levels of functioning
  • Preservation or restoration of mental health
    (Seiler Messina, 1979)

7
AMHCAs Revised Scope of Practice in 1986
  • The 1986 AMHCA Board of Directors adopted
  • Clinical mental health counseling is the
    provision of professional counseling services
    involving the application of principles of
  • Psychotherapy
  • Human Development
  • Learning Theory
  • Group Dynamics
  • Etiology of mental illness dysfunctional
    behavior
  • to individuals, couples, families and groups, for
    the purpose of promoting optimal mental health,
    dealing with normal problems of living and
    treating psychopathology

8
1986 Scope of Practice (2)
  • The practice of clinical mental health counseling
    includes, but is not limited to
  • Diagnosis treatment of mental emotional
    disorders
  • Psycho-educational techniques aimed at the
    prevention of Mental emotional disorders
  • Consultations to individuals, couples, families,
    groups, organizations communities
  • Clinical research into more effective
    psychotherapeutic treatment modalities.

9
Regional Chapters of State MHCAs
State Chapters of AMHCA
10
AMHCA Belongs to
American Counseling Association Was known as
APGA-American Personnel and Guidance Association
in1976 and in 1983 as AACD American Association
of Counseling and Development until 1992 when it
changed to ACA
11
CODES OF ETHICS GoverningClinical Mental Health
Counselors
12
National Certification
13
NBCCs National Certifications for Mental Health
Counselors
  • NCC National Certified Counselor Over 48,000
  • CCMHC Founded 1979- Certified Clinical Mental
    Health Counselor Today only 1,000 are CCMHCs
    which needs to change if we are to put Health
    back into the professional identity of Clinical
    Mental Health Counseling

14
State Licensure for Counselors and Related Fields
  • In USA
  • 120,429 Licensed Professional Counselors
  • 54,785 Licensed Marriage Family Therapists
  • 202,924 Licensed Social Workers
  • All 50 States have Licensed Professional
    Counselors but only 15 have Mental Health
    Counseling in their Title (Major way of taking
    Health out of Clinical Mental Health Counseling!)

15
15 States with MHCs in Title
  • Delaware-License Professional Counselor of Mental
    Health (LPCMH)
  • Florida-Licensed Mental Health Counselor (LMHC)
    First Licensed 1981
  • Hawaii-Licensed Mental Health Counselor (LMHC)
  • Indiana-Licensed Mental Health Counselor (LMHC)
  • Iowa-Licensed Mental Health Counselor (LMHC)
  • Massachusetts-Licensed Mental Health Counselor
    (LMHC)
  • Nebraska-Licensed Independent Mental Health
    Practitioner (LMHP)
  • New Hampshire- Licensed Clinical Mental Health
    Counselor (LCMHC)
  • New Mexico-Licensed Mental Health Counselor
    (LMHC)
  • New York-Licensed Mental Health Counselor (LMHC)
  • Rhode Island-Licensed Clinical Mental Health
    Counselor (LCMHC)
  • South Dakota-Licensed Professional
    Counselor-Mental Health (LP-MH)
  • Tennessee-Licensed Professional Counselor-Mental
    Health Service Provider (LPC/MHSP)
  • Utah-Licensed Clinical Mental Health Counselors
    (LCMHC) as of 2012
  • Vermont-Licensed Clinical Mental Health Counselor
    (LCMHC)
  • Washington-Licensed Mental Health Counselor
    (LMHC)

16
Major Recommendation to Promote Professional
Identity of CMHCs
  • Given only 15 out 50 states licensed CMHCs, it
    is imperative that we who have LMHC licensure
    encourage the LPCs in the other 35 states to
    gain Certified Clinical Mental Health Counselor
    (CCMHC) status through the NBCC which would be a
    clear way of putting HEALTH into Clinical Mental
    Health Counseling and a way to get counselors in
    all 50 states enabled to call themselves Clinical
    Mental Health Counselor

17
AMHCAs Online Newsletter
18
Research in the field is Reported in AMHCAs
Journal
19
Accreditation Standards for Training of CMHC
  • CACREP (The Council for Accreditation of
    Counseling Related Educational Programs)
  • 1988 CACREP set out its first Standards for
    accreditation of CMHC Programs using 60 hour
    requirement put out in 1979 by AMHCA But it
    also had Community Counseling Programs with up to
    48 hours Most went Community Counseling
  • 2009 CACREP adopted standards for CMHC which
    included 60 hour requirement

20
2009 CACREP Standards for CMHC
  • Required both core CACREP areas specialized
    training in clinical mental health
  • Core CACREP areas include
  • Professional Orientation and Ethical Practice
  • Social and Cultural Diversity
  • Human Growth and Development across the lifespan
  • Career Development
  • Helping Relationships
  • Group Work
  • Assessment
  • Research and Program Evaluation

21
2009 CACREP Standards for CMHC Specialized CMHC
Training
  • Ethical, Legal Practice Foundations of CMHC
  • Prevention Clinical Intervention
  • Clinical Assessment
  • Diagnosis Treatment of Mental Disorders
  • Diversity Advocacy in Clinical Mental Health
    Counseling
  • Clinical Mental Health Counseling Research
    Outcome Evaluation
  • These areas of CMHC preparation address clinical
    mental health needs across the lifespan
    (children, adolescents, adults and older adults)
    across socially culturally diverse
    populations.

22
AMHCA 2011 Standard Additional Requirement for
CMHC Training
  • The 2011 AMHCA standards also recommend these
    additional areas of training for CMHC Training
    programs
  • Biological Bases of Behavior (including
    psychopathology and psychopharmacology)
  • Specialized Clinical Assessment
  • Trauma
  • Co-Occurring Disorders (mental disorders and
    substance abuse)

23
Implications of AMHCAs 2011 Expanded Clinical
Standards for Training of CMHCs
  • Evidenced-Based Practices
  • Diagnosis and Treatment Planning using EBPs
  • Diagnosis of Co-Occurring Disorders Trauma
  • Biological Basis of Behaviors
  • Knowledge of Central Nervous System
  • Lifespan Plasticity of the Brain
  • Psychopharmacology
  • Behavioral Medicine
  • Neurobiology of Thinking, Emotion Memory
  • Neurobiology of mental health disorders (mood,
    anxiety, psychosis) over life span
  • Promotion of optimal mental health over the
    lifespan

24
Accreditation-CACREP in 200974 Clinical Mental
Health Counseling
  • In Florida they are
  • Argosy Sarasota
  • Barry University
  • Florida Atlantic University
  • Florida Gulf Coast University
  • Florida International University
  • Florida State University
  • Rollins College
  • Troy University Southeast Region
  • University of Central Florida
  • University of Florida
  • University of North Florida
  • University of South Florida
  • Online
  • Cappella University
  • Walden University
  • In Utah
  • University of Phoenix-Mental Health Counseling
  • NOTE things will change now that Utah has in
    2012 implemented the LCMHC

25
CACREP 2016 Standards for CMHC
  • 1. FOUNDATIONS
  • A. development of mental health counseling
  • B. theories and models related to mental health
    counseling
  • C. principles of mental health counseling,
    including prevention, intervention,
  • consultation, education, and advocacy, and
    networks that promote mental health
  • D. medical foundation and etiology of addiction
    and co-occurring disorders
  • E. principles, models, and documentation formats
    of biopsychosocial case
  • conceptualization and treatment planning

26
  • 2. CONTEXTUAL DIMENSIONS
  • F. etiology, process, nomenclature, treatment,
    referral, and prevention of mental and
  • emotional disorders
  • G. mental health service delivery modalities such
    as inpatient, outpatient, partial treatment
  • and aftercare and the mental health counseling
    services networks
  • H. diagnostic process, including differential
    diagnosis, and the use of current diagnostic
  • tools, such as the current edition of the (DSM)
  • I. potential for substance use disorders to mimic
    and/or co-occur with a variety of medical
  • and psychological disorders
  • J. impact of crisis on individuals diagnosed with
    mental illness
  • K. classifications, indications, and
    contraindications of commonly prescribed
  • psychopharmacological medications for appropriate
    medical referral and consultation
  • L. public policy and government relations on
    local, state, and national level to enhance
  • equity funding and promote programs that affect
    the practice of mental health counseling
  • M. cultural factors relevant to mental health
    counseling
  • N. professional organizations, preparation
    standards, and credentials relevant to the
    practice
  • of mental health counseling
  • O. legal and ethical considerations specific to
    mental health counseling
  • P. record keeping, third party reimbursement, and
    other practice and management issues in

27
  • 3. PRACTICE
  • Q. intake interview, mental status evaluation,
  • biopsychosocial history, mental health history,
  • and psychological assessment for treatment
    planning and
  • caseload management
  • R. strategies for interfacing with the legal
    system regarding
  • court referred clients
  • S. techniques and interventions related to a
    broad range of
  • mental health issues
  • What does this tell us? Little change is being
    recommended for the next round of CACREP
    Standards AMHCAs 2011 Standards have had
    little impact on what is being proposed at the
    current time.
  • Lets see if this will matter based on future
    trends.

28
The Growth of Mental Health Counseling as a
Profession
  • In 2008, according to US Department of Labor
    120,000 Mental Health Counselors were employed
    only 6.7 of them were self-employed
  • By 2018 43,000 jobs will be added (for a for a
    total of 163,000), representing a 36.3 growth
  •  Median annual wages in 2008 for Mental Health
    Counselors was 38,150. This is High when
    compared to other jobs.

29
Parity with the Other Mental Health Professions
  • The median reimbursable fee for service
  • Clinical Mental Health Counselors is 63
  • Psychologists is 75 for psychologists
  • Clinical Social Workers Marriage and Family
    Therapists is 60
  • (January 2006 study by Psychotherapy Finances)

30
SO! What do Mental Health Counselors Currently Do?
  • Mental Health Counselors offer full range of
    services
  • Assessment diagnosis
  • Treatment planning and utilization review
  • Psychotherapy
  • Brief and solution-focused therapy
  • Alcoholism and substance abuse treatment
  • Psycho-educational prevention programs
  • Crisis management
  • Trauma Intervention

31
ACAs 20/20 Commissions Definition of Counseling
  • Counseling is a professional relationship that
    empowers diverse individuals, families and groups
    to accomplish mental health, wellness, education
    and career goals
  • They also established
  • The counseling profession shall establish uniform
    licensing standards with LPC as an entry-level
    title for counselor licensure.

32
BUT THINGS ARE GOING TO CHANGE!
  • The emerging health needs of Americans is
    changing and as a result the roles and function
    of mental health practitioners will be changing
    as well

33
New AMHCA Clinical Standards Help CMHC to Get
Ready for Changes in System
  • The Affordable Care behavioral medicine
    interventions
  • 1. ACA calls for the coordination and integration
    of medical services through the primary care
    provider for a whole person orientation to
    medical treatment - model currently implemented
    at some level in VA Federally Qualified Health
    Centers (FQHCs)
  • 2. The ACA calls for creation of Affordable Care
    Organizations (ACOs) to provide comprehensive
    services to Medicare recipients with a strong
    primary care basis
  • 3. The ACA model includes integration of mental
    behavioral health services into the
    Patient-centered medical home (PCMH) which can
    enhance patient outcomes
  • 4. The ACA model integrates mental, behavioral
    and medical services under one roof with
    potential of controlling the costs for patients
  • 5. The ACA integrated behavioral medical
    approach opens a massive opportunity for clinical
    mental health counselors
  • 6. To be prepared to fill this evolving
    behavioral medicine role, it is imperative that
    clinical mental health counseling training
    programs establish training for future
    practitioners in these integrated medical
    settings.

34
The Affordable Care Act (ACA)
  • Beginning 2014 ACA increases access to quality
    health care including coverage for mental health
    substance use disorder services
  • All new small group individual private market
    plans will be required to cover mental health
    substance use disorder services as part of the
    health care law's Essential Health Benefits
    categories

35
The Affordable Care Act (ACA)
  • Behavioral health benefits will be covered at
    parity with medical surgical benefits
  • Insurers will no longer be able to deny anyone
    coverage because of a pre-existing behavioral
    health condition
  • ACA already ensures that new health plans cover
    recommended preventive benefits without cost
    sharing, including depression screening for
    adults adolescents as well as behavioral
    assessments for children

36
Results of the Affordable Care Act
  • Primary care providers receive 10 Medicare bonus
    payment for primary care services
  • A new Medicaid state option is created to permit
    certain Medicaid enrollees to designate a
    provider as a health home states taking up the
    option receive 90 federal matching payments for
    two years for health home-related services.
  • Small employers receive grants for up to five
    years to establish wellness programs

37
Results of the ACA continued
  • The Center for Medicare Medicaid Innovation
    launches the Accountable Care Organization (ACO)
    Model Advance Payment ACO Model, which offers
    shared savings other payment incentives for
    selected organizations that provide efficient, coo
    rdinated, patient-centered care
  • Some States established American Health Benefit
    Exchanges Small Business Health Options Program
    Exchanges to facilitate purchase of insurance by
    individuals small employers
  • Teaching Health Centers are established
    to provide payments for primary care residency
    programs in community-based ambulatory patient
    care centers

38
Two Healthcare Organizational Models which are
Driving Change
  • Two New Medicare/Medicaid models are driving a
    change in healthcare delivery
  • Patient Centered Medical Homes
  • Accountable Care Organizations (ACOs)

39
Medical Homes
  1. Patient Centered - Empowers them with Information
    and Understanding
  2. Comprehensive - Co-location of care providers in
    physical and behavioral health
  3. Coordinated Care - Through Health Information
    Technology all providers are kept in touch
  4. Accessible same day appointment 24/7
    availability through technology online
  5. Committed to Quality Safety Quality
    Improvement Goals which are tracked

40
Benefits of Medical Homes
  1. Patients seek out the right care which is
    needed-which is often behavioral vs. physical
  2. Less use of ERs or delays in seeking care
  3. Less duplication of tests, labs procedures
  4. Better control of chronic diseases other
    illnesses improving health outcomes
  5. Focus on wellness prevention reduce incidence
    severity of chronic disease or illnesses
  6. Cost savings less use of ERs Hospitals

41
What is moving the Patient Centered Home Health
Model
  • In April 2013 the Patient-Centered Primary Care
    Collaborative Pointed out on it website these
    factors driving the Home Health Model
  • Unsustainable cost increases in health care
    delivery
  • Growing availability of data
  • Vast change in the way we communicate
  • Example In Denmark, more than 80 percent of
    health-care encounters transactions are
    electronically based vastly different method of
    communicating is coming online and it's coming
    fast, driven by younger generations of patients
    and physicians.

42
(No Transcript)
43
Potential Role of Mental Health Counselors in
Medical Homes
  • Address the stressors which lead folks to seek
    out medical attention in the first place
  • Assist in increasing compliance of patients with
    the medical directives given them by primary care
    staff
  • Wellness educational programming to help ward off
    chronic or severe illnesses
  • Assisting clients to cope with the medical
    conditions for which they are receiving medical
    attention

44
Primary and Behavioral Health Integration Grants
based on Medical Home Model in ACA
  • In Utah
  • Weber Human Services-Ogden, Utah
  • In Florida
  • Apalachee CenterTallahassee
  • Community Rehabilitation Center-Jacksonville
  • LifeStream Behavioral Center-Leesburg
  • Lakeside Behavioral CenterOrlando
  • Coastal Behavioral Health Care-Sarasota
  • Miami Behavioral Health Center-Miami

45
Accountable Care Organizations
  • Have a look at the CMS video which overviews the
    ACO model
  • http//innovation.cms.gov/initiatives/aco/
  • Now lets look at the announcement of the Role
    Out of the ACO rules in 2011 to see what is hoped
    for in this model
  • http//www.healthcare.gov/news/factsheets/2011/03/
    accountablecare03312011a.html

46
Goal of ACOs
  • The goal of coordinated care is to ensure that
    patients, especially the chronically ill, get the
    right care at the right time, while avoiding
    unnecessary duplication of services and
    preventing medical errors.

47
So what are ACOs
  1. ACO assumes financial risk rather than 3rd party
    payers (government, business or insurance
    companies) for group of patients assigned to it
  2. Consists of more than one hospital number of
    primary care clinics with full array of medical
    health specialists-who self-refer to their own
    specialists
  3. Control costs by being responsible for full care
    of patients
  4. Integration of mental behavioral health
    services into Patient-centered medical homes
  5. Enhance patient outcomes through emphasis on
    prevention, compliance, and immediate 24/7
    attention
  6. Utilize an integrated behavioral medical approach

48
How will ACOs Work?
  • The Affordable Care Organizations (ACOs) is a
    large local health system
  • It usually includes more than one hospital and a
    number of primary care clinics.
  • It is this whole system which is in charge of the
    care of its patients
  • The providers refer to other specialists inside
    of their own system
  • These ACOs have their own group of providers
    (which could include Clinical Mental Health
    Counselors) by referring within the system
    controls costs
  • ACOs are then responsible not only for their
    costs but also for the quality of their services
    to their patients
  • Providers are paid a flat fee that is risk
    adjusted for the severity of the issues facing
    the patients
  • The ACO organization assumes the financial risk
    rather than the government, business or insurance
    companies
  • Where Clinical Mental Health Counselors work and
    how they will be paid may change greatly in the
    future as these ACOs become reality after full
    implementation of the ACA in 2014

49
Utahs Efforts under ACA
  • Utah is one of 16 states which proposes to design
    an innovative statewide initiative to facilitate
    improved physician/patient communication care
    coordination
  • Goal of improving health care quality lowering
    costs
  • The state will convene a multi-stakeholder group
    that will address strategies for healthcare
    transformation in five key areas
  • Expanded health information technology
  • Adequate healthcare workforce
  • Wellness healthy lifestyle promotion
  • Payment reform
  • Medical malpractice dispute resolution.

50
Key Players in Utah working on ACA innovations
  • Organizations
  • IHC Health Services (Intermountain Health Care)
  • Trustees Of Dartmouth College
  • State of Utah
  • Hospital working on ACA innovation
  • Salt Lake Regional Medical Center
  • Utahs Innovation Advisors
  • Nancy Murphy MD
  • Victoria Wilkins MPH, MD
  • Sarah Woolsey MD,

51
Accountable Care Organizations
  • Current Utah ACOs
  • Health Choice at http//www.healthchoiceutah.com/
  • Healthy U at University of Utah at
    http//uhealthplan.utah.edu/healthyu/index.html
  • Molina at http//www.molinahealthcare.com/medicaid
    /providers/ut/pages/home.aspx
  • SelectHealth at http//selecthealth.org/Pages/new.
    aspx
  • Central Utah Clinic, P.C. (Provo, Utah)
  • IASIS Health Care Org at http//www.iasishealthcar
    e.com very open to creation of ACOs in their
    hospital localities
  • IASIS Utah Hospitals Davis Hospital and Medical
    Center, Layton, UTJordan Valley Medical Center,
    West Jordan, UTPioneer Valley Hospital, West
    Valley City, UTSalt Lake Regional Medical
    Center, Salt Lake City, UT Health Choice Utah
    Accountable Care LLC

52
Prevention Services Mandated by ACA
  • After September 23, 2010, the following
    preventive services must be covered without
    policy holder having to pay copayment or
    co-insurance or meet deductible but only applies
    when these services are delivered by a network
    provider
  • Alcohol Misuse screening counseling
  • Alcohol and Drug Use assessment for adolescents
  • Behavioral Assessment for children of all ages
  • Depression screening for adults adolescents
  • Developmental screening for children under age 3
    surveillance throughout childhood
  • Diet counseling for adults at higher risk for
    chronic disease
  • Obesity Screening counseling for adults
    children
  • Sexually Transmitted Infection (STI) prevention
    counseling for adults adolescents at higher
    risk who are sexually active
  • Tobacco Use screening for all male female
    adults cessation interventions for tobacco
    users expanded counseling for pregnant tobacco
    users
  • Domestic interpersonal violence screening
    counseling for all women
  • Well-woman visits to obtain recommended
    preventive services for women under 65

53
Potential Clinical Setting Openings for CMHCs
with ACA Implementation
  • Clinical Mental Health Counselors will be ideally
    situated to provide Behavioral Medical
    Interventions based on their expanded training
    and implementation of AMHCAs Clinical Standards.
    They will then need to promote themselves in the
    following settings
  • General Practice Family Practice Internal
    Medicine Clinics
  • Rehabilitation In-patient and out-patient Centers
  • General and Specialized Hospitals
  • Senior Citizens Independent housing, Assisted
    Living Nursing Homes

54
What are the future prospects for the
profession?
  • Recognized for VA Positions in VA Hospitals and
    Field Agencies which is good given the OIF and
    OEF veterans complex health issues
  • AMHCA hopes to soon be recognized for Medicare
    Services
  • Increased work in Behavioral Medicine in
    Hospitals, Rehab Centers Primary Care
    Physicians Offices
  • Increased work in Substance Abuse Alcohol
    Treatment Facilities

55
Mental Health Needs of OEF OIF Vets
  • The invisible wounds which our OIF and OEF vets
    return with are staggering
  • PTSD and TBI along with Combat Depression are
    staggering disorders which are impacting from 1/3
    to 2/3s of these vets. The Mental Health system
    over the next 5 to 10 years will become
    overwhelmed in meeting their individual as well
    as marital and family needs.
  • CMHCs need to be ready to serve this population

56
Baby Boomer Generation are Aging
  • The increase in Boomers aging and their impact on
    the medical and mental health field cannot be
    ignored or underestimated
  • It is imperative that CMHCs be armed with
    Behavioral Medicine techniques to address the
    needs of this geriatric population to address
    their chronic health issues, disabilities and
    cognitive decline needs

57
What Skills Do Mental Health Counselors Need?
  • Ability to understand dynamics of Human
    Development to capture good psychosocial history
    of clients
  • Diagnosis of and treatment for behavioral
    pathology
  • Evidenced based practices in psychotherapy to
    provide credible treatment to clients
  • Understanding of basic neuroscience of brain and
    nervous system to understand roots of emotional
    responses to lifes stressors
  • Understanding of psychopharmacological treatment
    of psychopathology

58
SO whats Up in Utah? Related to all these
Changes?
  • State of Utah, UT (DCFS,DJJS) Diagnostic and/or
    Rehabilitative Mental Health
  • This multi-step procurement is issued on behalf
    of the State of Utah, Department of Human
    Services for the purpose of identifying and
    contracting with all qualified Offerors
    interested in providing Diagnostic and/or
    Rehabilitative Mental Health Services for clients
    in the custody of DHS, DHS/DCFS, or
    DHS/DJJS   (Outpatient Mental Health)
  • The initial submission date for Responses is
    Monday, May 13, 2013 on or before 300pm
  • Submissions end September 30, 2014 300 pm

59
Some Requirements for Contractors
  1. Use of Evidenced Based Practices with targeted
    youth
  2. Use of SMART Goals Specific, Measurable,
    Attainable, Realistic and Timely
  3. Responsivity Principle varying treatment
    according to the relevant characteristics of
    Client such as gender, culture, developmental
    stages, trauma, IQ, motivation, mental disorders,
    psychopathy
  4. Telehealth practice of mental health care
    delivery through interactive video communications
    when distance or other hardships create
    difficulty with consistent access to services.
    Telehealth occurs in real-time or near real-time.
  5. Trauma Informed Care providers must assess
    childhood maltreatment may need to modify
    treatment based on understanding of neurological,
    biological, psychological social effects of
    trauma.

60
Evidence Based or Evidence-Informed Treatment
Utah Model
  • 1. The treatment regimen shall be individualized
    based on the Clients age, diagnosis
    circumstances. This includes, but is not limited
    to, addressing grief, loss, trauma, and
    criminogenic factors affecting Client.
  • 2. Maintain fidelity of the approved
    evidence-based or evidence informed treatment
    program through monitoring effectiveness of
    program.
  • 3. Maintain documentation of staff training
    received and/or skills in t evidence based
    treatment for which Client will be engaged to
    restore the highest possible level of function.

61
CMHC Tools Needed to Put Health Back into
Clinical Mental Health
  • Evidenced Based Practices
  • Apps that Work
  • Neuroscience
  • Psychopharmacology
  • Behavioral Medicine
  • Military Focus Materials
  • Multicultural Perspective as a Mental Health
    Counselors
  • Focus on the Military

62
Evidenced-Base Practices
  • http//coping.us/evidencedbasedpractices.html
  • Overview of Evidenced Based Practices
  • Anxiety Disorder
  • Obsessive-Compulsive Disorder (OCD)
  • PTSD
  • Phobias
  • Depressive Disorders
  • Bipolar Disorder
  • Alcohol Dependence
  • Substance Abuse
  • Anorexia
  • Bulimia
  • Autism
  • ADHD
  • Guidebooks for EBPs
  • Resources on Evidenced Based Practices

63
Apps that Work
  • For Clients
  • For Practitioners
  • Moving the concept of Telehealth to new levels
  • http//coping.us/evidencedbasedpractices/appsthatw
    ork.html

64
Neuroscience
  • http//coping.us/introtoneuroscience.html
  • Basics of Neuroscience
  • Stress Response of Humans
  • Lectures on Neuroscience

65
Psychopharmacology
  • http//coping.us/psychopharmacology.html
  • Psychopharmacology Chart
  • Drug Classifications to treat the following
    conditions
  • ADHD
  • Alcohol Disorder
  • Schizophrenia and other Psychotic Disorders
  • Depressive Disorders
  • Bipolar Disorder
  • Anxiety Disorders
  • Eating Disorders
  • Dementia
  • Generic names of each drug
  • Commercial names of each drug
  • Time to reach clinical level for each drug
  • Benefits of each drug
  • Side effects of each drug

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Behavioral Medicine
  • http//coping.us/introbehavioralmedicine.html
  • Background on Behavioral Medicine
  • Lectures on Behavioral Medicine
  • Behavioral Medicine Introductory Bibliography
  • Internet Resources on Behavioral Medicine

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Multicultural Competency
  • http//coping.us/multiculturalcompetency.html
  • Why the Need for Multicultural Competency?
  • Cultural Immersion
  • Multicultural Self-Assessment
  • Challenging Your Cultural Biases
  • Resources for Multicultural Competencies

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Focus on the Military Their Families
  • http//coping.us/focusonthemilitary.html
  • Virtual Boot Camp for Civilian Mental Health
    Practitioners
  • Impact of Deployment on the Military and their
    Families
  • Psychological First Aid for Returning Military
    and their Families
  • Building Resilience in Tough Times
  • Addressing Compassion Fatigue in the Family
    and Workplace
  • Background Resources on the Deployment's Impact
  • Resources for Active and Veteran Military Service
    Members and their Families

69
So far so Good! So what else does COPING.US have
which will help CMHCs put health into CMHC which
are Evidence Based Practice oriented so that they
can be trusted to meet the needs of both the
counselors and their clients?
70
EBP Tools on www.Coping.us
  • Tools for Coping CBT based Client Workbooks
  • SEAs 12 Step Program in Self-Esteem Recovery
  • Laying the Foundation Tools for overcoming
    Patterns of Low Self-Esteem
  • Tools for Handling Loss and Grief
  • Tools for Personal Growth
  • Tools for Relationships
  • Tools for Communications
  • Tools for Anger Work-Out
  • Tools for Handling Control Issues
  • Growing Down Tools for Healing the Inner Child
  • Tools for a Balanced Lifestyle weight management
    program

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How can CMHC use Tools for Coping Series
  • Clinical mental health counselors can utilize
    these workbooks with their clients to
  • Expedite their treatment
  • Encourage their recovery
  • Sustain their well-being
  • Identify triggers for steps to prevent relapse
  • Tools for Coping Handbooks enable CMHCs to
    challenge clients to
  • Maintain personal growth in between sessions by
    use of
  • Exercises
  • Tools for changing behaviors
  • Journal writing
  • These workbooks are cost effective interventions
    based in clinically sound principles which have
    an evidenced based support in Cognitive Behavior
    Therapy for their efficacy positive results

72
In Summary
  • Today we looked at How to put Health back into
    Clinical Mental Health by reviewing
  • The implications of the new Affordable Care Act
    (ACA) and how available tools can help clinical
    mental health counselors prepare themselves to be
    better able to present themselves to the medical
    community as legitimate partners in the
    prevention and treatment of mental illness in the
    next century
  • The new 2011 AMHCA CMHC Clinical Standards and
    how they put Health into CMHC
  • The need for Counselors to become Behavioral
    Medicine Specialists armed with understanding of
    Neuroscience, Psychopharmacology, Evidenced Based
    Practices and the needs of people who have
    experienced severe trauma such as the Vets from
    OIF and OEF.

73
THANK YOU ALL!
  • Any further questions or clarifications you would
    like at this time?
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