Dec 19, 2018

There's No Place Like Home

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Having a stable place to live and a sense of security is important to developing resilience. Home is the foundation from which individuals build their lives ( Therefore, creating a space that fosters stability is essential to help clients begin their recovery.



Creating Safety and Security at Home:


  • Nurture stability by encouraging clients to develop a daily routine (e.g. sleeping, eating, school, errands, household chores and hobbies).

  • Encourage clients to create a soothing space to help calm intense feelings. Consider ways the lighting, decorations and activities (e.g. journaling) can have a comforting effect.

  • For clients that are minors, build predictability in the home by setting clear house rules and expectations for behavior.





New Posts
  • The Bills, H.R. 2874 and S. 1576 , which are being reintroduced to congress, includes a requirement for insurance providers to disclose the analysis and criteria used to make decisions about covering or denying treatment. Back in 2008 The Mental Health Parity and Addiction Equality Act was originally intended to established parity between the coverage of behavioral health and medical/surgical benefits. While the law made significant strides forward for behavioral health coverage, the lack of parity of coverage still exists. The National Alliance on Mental Illness found in a survey that the rate of denials for mental health care was nearly twice the rate of denials for general medical care. Coincidentally, the bill’s reintroduction comes on the heels of a federal judge’s ruling that found that the nation’s largest insurer, United Health, unlawfully denied beneficiaries access to mental health and substance use disorders treatment in an effort to cut costs. The Behavioral Health Coverage Transparency Act (H.R. 2874/S. 1576) would require insurance providers to disclose the analysis they utilize in making parity determinations as well as the rates and reasons for mental health/SUD (Substance Use Disorders) claims denials versus medical/surgical denials. It also would require the Department of Health and Human Services, the Department of Labor and the Department of Treasury to undertake a minimum of 12 random audits of health plans per year to discourage noncompliance with existing parity laws. The results of these audits would be made public. Finally, it would establish a Consumer Parity Unit, giving individuals a centralized online clearinghouse to get information about their rights and to submit complaints with assurance of timely responses. In a statement from Senator Elizabeth Warren, who reintroduced the bill, she notes “Patients with behavioral health concerns deserve the same access to care as patients with physical health conditions, but for far too long, insurance companies have unfairly denied behavioral health care services to cut costs. Our bill would put a stop to these discriminatory practices and make sure patients get the treatment they need.” I believe that this type of legislation is much needed and long overdue. Over the course of my career in mental health, I have enjoyed watching the evolution of the popular opinion surrounding mental health and the growing acceptance of mental health as a legitimate concern. There is absolutely no reason why mental health treatment shouldn’t get the same kind of coverage that physical health treatment does. It will be interesting to see how this bill does as it works its way through our chaotic system. It will be a huge victory for everyone if it is passed and it is able to be carried out as it is intended. What are your thoughts the possibility of parity? Would you be more likely to seek mental health services if it was covered in the same way that flu shots are? Let’s hear it OOTers!
  • Sometimes, even providers need to switch things up in sessions, to make sure we are able to maintain our clients' and our own engagement. Practicing adaptive skills in session can help clients to be able to transfer these skills to their daily routine, in a less intimidating way. Most of these interventions work with all ages, with some adaptations, which is a good place for conversation with your client to see what fits them and their needs. Vision Boards and Motivation Vision boards are a great way to practice the miracle question, identify short term and long term goals, dreams, and aspirations. Being able to identify what you want to do in your life, without immediately thinking about barriers, can be eye-opening and liberating. Using a piece of paper or a poster board, you can help your client explore aspects of their lives (travel, education, family, home, hobbies, etc) and use paint, collage or other art supplies to help this project come to life, and foster meaningful communication throughout the process. This project usually takes more than one session Coping Skills Box (or toolkit for little ones) Helping clients to develop a box that has relaxation techniques in one place can empower clients to use skills more effectively when dysregulated. This intervention is customizable for each client and can include grounding/mindfulness techniques (essential oils, journal, bubbles, favorite photos, stress ball, smooth rock, feathers, bubble wrap, etc). This is another intervention that can take more than one session to include planning, identifying what would be helpful for the client to include, practicing each skill, and developing a plan for how and when to use skills. Community Outings Practicing skills in vivo can be extremely beneficial for clients to see how to use the skills in real life situations. Whether it is modeling use of community resources, or identifying triggers and body responses, or practicing how/when to use skills in specific situations, clients and therapists can benefit from changing the scenery. Some examples include going to a park, walking around the office, volunteering in the community, etc. Discussing confidentiality, and what to say if someone asks how you know each other before the outing is important.
  • Let’s take a moment to celebrate our uniqueness. As a husband and father of twins I am constantly reminded how each and every one of us is so different; from head to toe, inside to out. I have quickly learned that I cannot parent my children the same way because they are different people and respond differently to different things. I am also constantly reminded that I cannot assume that my wife will like what I like or see things the same way as I do. When I say “find your bliss” (those of you familiar with Joseph Campbell’s writings may recognize this phrase), I am very acutely aware that this phrase will mean different things to everyone. For example, if you follow me on Instagram you may have seen that I posted a picture of the underside of my car’s engine followed by the caption “There’s something about being under a car that is extremely calming”. When I try to explain this to my wife she cannot wrap her head around it. To her, being under a car is anything BUT calming. She would likely replace “calming” with any of the following: dangerous, dirty, scary, greasy, claustrophobic, waste of time, ………. For me, I could meditate or probably even take a nap under my car. There are a few places or tasks that I am able to loose myself in and just be in the moment and wrenching on my car is one of them. It is extremely important to our mental health to have these places or activities that allow us to let go of all the daily noise that rattles around in our brain and reconnect with ourselves and re-center. When I engage in these kinds of activities I can clear my head, mull over questions that I have been trying to solve or just be. My challenge to all of the OOTers out there is to find your bliss…..or find a way to find your bliss??? I’m sure many of you already have these activities that become meditative, but I’m willing to bet that a lot of you don’t….. or you have forgotten about them. Let me know, what your strategies are for finding your bliss and reconnecting with yourself.

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