Improving Older Adults’ Mental and Emotional Well-Being with Home Health Care

Seniors go through a lot of changes that can impact their mental and emotional health. Some of these changes are minor and occur gradually, while others are significant and abrupt.

Below are some of the challenges older adults face that may compromise their psychological well-being.

Challenges That Impact Seniors’ Emotional and Mental Health

Isolation and Loneliness

Different factors can fuel feelings of loneliness and isolation among older adults. These include:

– the death of their spouse, relatives, or close friends
– losing their jobs
– retiring from careers that defined their identity and gave them a sense of purpose and self-worth
– the absence of people they can regularly talk to and confide in
– mobility and transportation challenges that also lead to decreased social activities

Prolonged loneliness can have detrimental effects on seniors’ health. It can weaken their immune system and put them at higher risk of chronic diseases.

Loss of independence

As their health continues to decline, older adults find themselves unable to do things on their own. They may need help cleaning the house, rely on others for transportation, or require assistance when using the toilet or taking a bath. Others may be suffering from chronic illnesses or recovering from injuries that keep them in bed for weeks or months.

All these may leave your elderly loved one feeling helpless and frustrated. They may fear losing their independence and having less control over their lives.

Memory issues

Occasional memory lapses are a normal part of aging. But factors like illnesses, lack of sleep, or depression may worsen older adults’ forgetfulness.

These memory issues can frustrate older adults and even pose threats to their health and safety. They may forget to take medications on time, or accidentally leave stoves and ovens on.

Vulnerability to stress and mental health concerns

Aside from the changes mentioned above, other challenges can increase stress among the elderly.

Their fear of slipping or getting injured can make them more anxious to go to the bathroom alone or leave the house without a companion.

Financial concerns may also weigh them down. They may be worried about not being able to pay for growing medical and living costs or long-term care.

Chronic stress can increase the risk of mental health issues among seniors. According to the World Health Organization, 7 percent of adults over 60 years are suffering from depression and 3.8 percent from anxiety disorders. Data from the Centers for Disease Control and Prevention also revealed that men 85 years or older had the highest suicide rate of any age group.

Chronic illnesses also leave seniors more vulnerable to depression and other mental health concerns. These mental health issues can further impact their physical health and recovery. For instance, seniors suffering from loneliness and depression have higher mortality rates. Depression also affects the success and duration of cardiovascular treatment in older adults. It can even aggravate insomnia and memory loss.

Augmenting Psychosocial Support for the Elderly Through Home Health Care

The benefits home care workers provide go beyond physical assistance. They become additional sources of psychosocial support, helping seniors navigate challenges that come with aging.

Regular emotional support

Having someone to talk to may help older adults manage difficult emotions like loneliness, fear, and frustration. Moreover, having constant emotional support can help reduce their risk of developing mental and physical issues.

Companionship and socialization

The companionship home care workers provide can alleviate chronic loneliness among seniors. They can also help older adults maintain an active social life by:

– driving them to community activities or visits to family and friends
– accompanying them during walks
– helping them use video chat tools to keep in touch with relatives and friends

These activities help seniors stay connected, keeping feelings of isolation and loneliness at bay. Participating in social activities gives them something to look forward to and allows them to create new memories and connections.

Supporting healthy routines

Healthy eating and exercise keep seniors strong and improve their balance. These also keep their memory sharp, boost their mood and help them relax and manage stress.

In-home senior caregivers and home health aides can help older adults stay fit and stick to healthy routines. For example, they can prepare nutritious meals and ensure these meet seniors’ dietary requirements. They assist them during light exercises, accompany them during walks, and inspire them to resume their hobbies.

Physical support to maintain their independence and quality of life

Aging in place allows seniors to retain their sense of independence and control over decisions that affect their lives. Living in a familiar place, surrounded by things that bring them comfort, may also give them a sense of security amidst the changes they are going through.

Home care workers help seniors stay independent while reducing the risks and difficulties that come with aging in place. They help older adults keep their homes clean and safe by handling light housekeeping tasks and removing hazards like electrical cords and rugs. They help them maintain personal hygiene by assisting them with bathing and dressing.

Home health care agencies provide seniors and their loved ones with cost-effective home care options. This flexibility in terms of the type of care and cost can reduce seniors’ financial stress. Clients can decide how often to request these services and what tasks they need help with. Older adults who are recovering from injuries or illnesses can also save on hospitalization costs through in-home skilled nursing care.

Promoting Holistic Health for Seniors

Changes that come with aging can hurt your elderly loved one’s mental and emotional well-being.

This is an area where home care can help. Home care workers become constant sources of social support for seniors, helping them experience healthy aging and a better quality of life.

How Does Sex Therapy Rescue Your Love Life? – 6 Incredible Ways

It is not a great topic to reveal that many people suffer from various sexual issues. Sex is an important aspect of people’s lives, and dealing with it may be challenging at times.

There are a variety of sexual disorders that make it difficult for people to connect with others. Certain sexual dysfunctions can disrupt relationships and negatively impact an individual’s overall happiness.

Many sexual problems are linked to mental health problems. Some of these challenges will be physical, but knowing how to approach things differently from a mental perspective can help improve the situation. If you’re concerned about your sexual life, a sex therapist may be able to help.

Understanding Sex Therapy

Sex therapy is a form of counseling in which couples or individuals can talk to a mental health professional like a sex therapist, marriage and family counselor, social worker, psychologist, or healthcare practitioner about their sexual health difficulties.

Practitioners of sex therapy aim to assist their clients in identifying and treating issues relating to their sexual health and dysfunction. Contemporary sex therapy tends to stress a few different directions:
• Being mindful (being aware of your thoughts, feelings, sensations, and emotions)
• Psychotherapy (using talk therapy, not just medication)
• Inclusiveness (adapting sex therapy to be more inclusive of different sexualities)
• Couples-oriented (looking at the role of partners, not just the individual)
• Attitude-shifting (changing an individual’s perception of sex)

How does a Sex Therapist Improve Your Life?

There are a variety of issues that counseling may assist with. Many sexual disorders are resolved with the proper use of therapy, and people will move on toward a more fulfilling sexual life.

Sex is an important aspect of people’s lives, and dealing with it may be challenging at times. There are a variety of sexual disorders that make it difficult for people to connect with others. Certain sexual dysfunctions can disrupt relationships and negatively impact an individual’s overall happiness. These include:

1- Problem With Sexual Arousal

Many people seek sex therapy because they are experiencing sexual arousal issues. For people in committed relationships, sexual arousal disorders may be quite challenging, and it might be frustrating not to perform sexually for someone you care deeply about.

A sex therapist can assist with male erectile dysfunction or female painful intercourse problems. Collaboration with a sex therapist is an effective strategy for figuring out what’s causing these issues. A person’s ability to experience arousal is frequently affected by a condition.

2- Conflicted About the Relationship

A partner who is suffering sexual dissatisfaction is a common example. In this case, it’s best to go to counseling on your own first to understand yourself and your sexual concerns better, then invite your partner in.

3- Lack of Desire

A person who is suffering sexual boredom is a frequent example. In this instance, it’s best to go to counseling on your own to understand yourself better and your sexual difficulties, then bring your partner in.

4- Lack of Motivation

An increasingly frequent condition happens when people lack interest in sexual fantasies or behavior and suffer pain or relationship troubles. Treatment entails several steps.

Therapists help clients recognize negative attitudes toward sex, investigate the causes of such attitudes, and develop new perspectives on sex. Clients may be asked to keep journals of their sexual thoughts, view romantic videos, or construct fantasies when the focus switches to conduct.
Therapists also address any relationship problems.

5- Traumatic Sexual Experiences From The Past

Patients benefit significantly from sex therapists’ ability to help them come to terms with prior sexual events that may be affecting their sexual desire or performance.

Sex therapists have expertise in working with rape and sexual assault victims. It can be a difficult journey, but various therapeutic strategies can help. It will take time to talk about the issues and re-establish your comfort level.

6- Intimacy Issues

Another prevalent sexual condition that prevents people from getting close to one another is intimacy difficulties. During sexual intercourse, some people seek an intimate sexual engagement yet have difficulties doing it. Many people are ashamed of getting intimate with another person to avoid having sexual relations altogether. It can make the individual with whom they interact feel incompetent, resulting in general discontent.

A qualified therapist may help persons with physical difficulties and other concerns interfering with intimacy between two adults in a relationship. It may include individual treatment and also couples counseling.

Maintaining a deep and emotionally intimate sexual connection with one’s partner as the relationship progresses and changes may be a big issue for certain relationships. However, with the right treatment and skilled sex therapists, some sexual issues are quickly resolved.

Frequently Asked Questions (FAQs)

1- What does a sex therapist deal with?

Generally, sex therapists listen to concerns and offer therapy and instruction. They assess if the issue is psychological, physical, or both. They also collaborate with other medical and surgical experts to treat the medical causes of sexual problems.

2- What are the four critical principles of sex therapy?

The new sex therapy’s basic foundations include:
• A solid understanding of physiology, endocrinology, and metabolic function.
• Psychotherapy should be used only when organic factors have been excluded or identified
• Treatment of couples as a unit by dual-sex therapy teams,
• An intensive short-term program

3- Is sex therapy regulated?

Sex therapy requires no additional regulation since the language of the existing practices acts in marriage and family counseling and psychology cover most of the activities now constituting sex therapy and thereby limit the practice to licensed counselors.

For more information and how to locate a licensed sex therapist, use the search directory on Psychology Today.

6 Useful Tips to Keep Your Mind and Body Healthy

People these days are often so busy with work and their responsibilities that sometimes they forget to take care of their mental and physical health. 

However, if you keep this up, you risk your chances of burning out and developing certain illnesses that may be hard to treat later on. This is why it is important to take the necessary steps to ensure that your mind and body stay in top condition, especially during these troubling times when the world is currently under a global health crisis. 

Apart from avoiding the development of serious ailments and conditions, one of the benefits of keeping yourself strong and healthy includes saving yourself the trouble of paying for expensive hospital and doctors’ fees. 

With this in mind, you can do more activities while prolonging your life expectancy in the process. Read on to learn more about how you can ensure that you stay healthy. 

De-Stress

Stress can come from an abundance of factors that you face in your everyday life. If you do not find ways to remove stress from your body, it can contribute to the development of serious medical conditions like high blood pressure and heart disease. 

Luckily, there are many ways you can try to de-stress, such as listening to relaxing music, lighting a scented candle, meditating every night, or even treating yourself to a massage. 

Exercise regularly

Breaking a sweat regularly keeps your body in good shape and allows you keep your muscles from going stiff. At the same time, you can maintain a healthy weight range and boost your strength, which can affect your overall appearance as you age. 

Watch your diet 

A healthy diet is one of the best ways to ensure that your body stays healthy and gains the necessary nutrients to function properly. Eating a variety of foods that are right in minerals and vitamins can be beneficial, especially for those at a higher risk of developing genetic illnesses such as diabetes. 

Take a break

Overworking yourself will do you no good and only put your health at risk. Always remember to take a few short breaks during the day to refresh your mind and stretch out your body. By doing so, you also allow yourself to perform better and reduce the amount of time you need to recover at the end of your shift. 

Get checked 

Apart from maintaining a good diet and exercising regularly, make it a habit to regularly get yourself checked out by your doctor. While you may feel fine, this is a good way to know if your body has developed any early signs of complications that can be prevented quickly. In most cases, going for a check-up annually or bi-annually is recommended. 

Talk to a counselor

Keeping yourself mentally healthy is another way to look out for yourself and prevent problems from escalating. When certain situations seem to be too difficult for you to handle, seek out a professional counselor to talk to about your concerns and gain guidance on what you can do to reduce your stress and anxiety. 

Don’t Wait Until It’s Too Late

The majority of people today find that regularly keeping up with an exercise routine and a balanced diet is too tedious. In most cases, people succumb to the convenience of modern-day creations such as instant-cooked foods filled with unhealthy preservatives while spending most of the day sitting down on the couch glued to the television or our phones. 

If you do not change your lifestyle into a healthier one, you risk major consequences later on in life that you may regret. Never wait until a doctor tells you that you need to exercise more and keep a good diet. Start taking care of your health today. 

When Giving Thanks, Don’t Forget Yourself

As we give thanks at the holidays, it’s easy to overlook someone important: your past self.

While it’s well documented that gratitude toward others can improve wellbeing, two University of Florida scientists find that gratitude toward your past self also has benefits.

Does thanking yourself seem a bit…selfish? The researchers, UF psychology professor Matt Baldwin, Ph.D., and undergraduate student Samantha Zaw, think not.

“Despite the fact that past gratitude is self-focused, it reminds people that they’re part of a bigger story and that they have the power to grow,” Baldwin said. “It’s possible this promotes a pay-it-forward type of mentality.”

Gratitude is what psychologists call a self-transcendent emotion, one that lifts us out of the everyday and expands our perspective, which can help us get along with each other better. In a recent experiment, Baldwin and Zaw asked participants to write brief gratitude letters. The first group thanked someone else, the second thanked themselves, while a third, the control condition, wrote about a positive experience they’d had. Zaw and Baldwin then surveyed the participants about their self-perception after writing the letter. Although the results are not yet published, early analysis shows that the exercise gave the other- and self-focused gratitude groups a sense of redemption and helped them feel they were morally good people. However, the group that wrote to themselves scored higher on both measures.

The past-self group also saw a benefit the others didn’t: an increase in the self-awareness measures of clarity, authenticity and connectedness.

“Unlike gratitude toward others, being appreciative of ourselves carries an added benefit of truly understanding who we are and feeling connected to ourselves,” said Zaw, a McNair Scholar who has been working with Baldwin since her freshman year as part of UF’s Emerging Scholars Program.

Zaw and Baldwin’s research — the first known data gathered on past-self gratitude — was inspired by a Reese’s cup. When Baldwin’s co-worker, boredom researcher Erin Westgate, returned to the office after pandemic lockdown, she was delighted to discover a peanut butter cup she had squirreled away in her desk.

“She texted me like, ‘Oh my gosh, my past self left my future self a Reese’s,’” Baldwin recalled. “I was like, ‘Wait a second. You’re expressing gratitude towards something your past self had done. We have to study this.’”

As Zaw and Baldwin dug into previous studies, they found plenty on gratitude toward others and a few on self-compassion, but nothing on past-self gratitude. They designed the letter-writing experiment to test its effects, presenting their findings at the Society of Southeastern Social Psychologists in October and at the upcoming meeting of the Society for Personality and Social Psychology in February.

If you’re curious about the benefits of self-gratitude, Zaw offered a way to try the experiment at home, maybe as a new Thanksgiving tradition. Take a few minutes to write a thank you message to someone else, and another to yourself for something you did in the past. Sharing what you wrote could foster connections between loved ones, she said, but the exercise can also pay dividends if you try it on your own.

“At Thanksgiving and Christmas, we focus on other people, but self-care is really needed too, especially if we want to feel more clear about ourselves,” she said. “Maybe it can even lead to a better vision for ourselves for the next year.”

A Lifeline for Primary Care Amid a Crisis in Youth Mental Health

Most mental health care in America doesn’t happen in psychiatrists’ offices – especially when it comes to children, teens and young adults.

Instead, young people with depression, anxiety and more turn to the same people they already go to for all kinds of other health issues: their pediatricians, family doctors, school-based clinics and other primary care providers.

But where do those providers turn when they need more help in handling the mental health concerns of their patients – especially more serious issues that they’re not trained to handle?

If they’re anywhere in Michigan, they can turn to the team at MC3.

For nearly a decade, the MC3 program has helped thousands of primary care providers throughout the state care for the mental health needs of young people up to age 26. It also aids providers caring for pregnant women and new mothers of any age who have mental health needs.

More than 16,000 times since 2012, MC3’s psychiatrists and pediatric behavior specialists from the University of Michigan have connected directly with more than 1,800 primary care providers by phone, for consultations about their patients.

Together, they’ve mapped out plans for handling ADHD in young children, suicide-prevention safety planning for teens and symptoms that might signal schizophrenia in young adults.

There’s no charge to providers or their patients, thanks to the program’s funding from state and federal grants.

For providers whose patients recently had a mental health emergency or are waiting for an appointment with a child psychiatrist or a psychiatric inpatient bed, the service can literally be a lifeline: one in five of the consults involve a patient who has expressed suicidal thoughts or harmed themselves.

How it Works

MC3 also offers video-based telehealth appointments to connect patients of participating providers with psychiatrists. U-M and Michigan State University experts have also created a wide range of training options for professionals available on the MC3 website.

Though the demand has grown in recent years thanks to the pandemic, the program has room for more Michigan providers to join the network and get access to its services.

Each connection starts by contacting one of the trained professionals in MC3’s network of Behavioral Health Consultants, located throughout the state. MC3 also works closely with the state-funded Community Mental Health agencies across the state.

“Only about 3% of the children, teens, young adults and moms that our participating providers have consulted with us about are in treatment with a psychiatrist. We’re providing access to specialist-informed care to young people who wouldn’t otherwise have it,” said Sheila Marcus, M.D., who heads the pediatric component of MC3 and is a professor of psychiatry at Michigan Medicine, the University of Michigan’s academic medical center.

“The reality is that no matter where they live and no matter what their family’s income level, most of these patients would not have easy access to a specialist because of the critical shortage of such providers,” she added. “In some counties, there are no local providers trained to provide this level of care.”

Primary care providers inside and outside Michigan can also access MC3’s free online resources, even if they’re not enrolled in the program.

These include prescribing guides for mental health medications and online provider education, to equip them to provide diagnosis and care that might not have been part of their formal professional training. Much of that training offers continuing education credits that can help physicians, nurse practitioners, physician assistants and certified nurse midwives keep up their license.

“For me, MC3 has been a game changer,” said Lia Gaggino, M.D., who first interacted with the MC3 team through her pediatrics practice in Portage, Michigan and now is the team’s consulting pediatrician. “Since its inception I have used their services for children and teens who presented with very complicated mental health concerns. I wished I had had a psychiatrist to help me and then MC3 appeared and offered me a lifeline. Their services changed my prescribing practices and improved my skills and I am so grateful for their advice and support. I encourage my colleagues to sign up and call –MC3 is there to help us!”

Local Care Amid a National Emergency

As the nation grapples with a national emergency of rising mental health concerns among young people, MC3 and similar programs in other states are expanding access to critical psychiatric services at a time when demand is soaring.

The national organizations that declared that emergency in October called for more support of mental health care in primary care settings, as well as efforts to overcome the national shortage of mental health specialists for young people, especially in rural and low-income areas.

That shortage is what drove the creation of MC3 in the first place.

Michigan is third from the bottom among all states in supply of mental health professionals for young people. Only Washtenaw County, where the University of Michigan is located, meets national population-based criteria for having enough mental health providers specializing in children and teens.

The pandemic has made matters worse across Michigan and the United States. A national report from November 2020 showed that anxiety and depression in pregnant women have more than doubled, and emergency department visits for mental health concerns in children had risen by double digits since the pandemic began.

Joanna Quigley, M.D., another MC3 consulting psychiatrist from Michigan Medicine, recently presented data at a national meeting showing that 30% of MC3 consults during 2020 focused on pandemic-related concerns.  

The pandemic has prompted MC3’s team to plan to offer extra training to help providers identify the needs and handle the concerns of children traumatized by experiences they or their families have had during COVID-19.

Trauma-informed care is also important for children who even before the pandemic experienced very disruptive life events.

Terri Rosel, NP-C, a nurse practitioner at Cherry Health in northern Michigan, wrote to the MC3 team: “I work in a small student health center in Cedar Springs and am the sole provider in the office. Since starting this job four years ago I have had the pleasure of seeing so many students with mental health concerns. I felt ill-equipped at times to help them with my degree as a family practice nurse practitioner. I would utilize MC3 often to help with treatment plans for these wonderful kids who needed help but could not get into psychiatric services soon enough.”

As the program continues to grow, it will partner more with schools through a direct connection with the TRAILS program that offers mental health awareness and support services.

Positive Feedback from Providers

The MC3 team has surveyed participating providers and found that 99% agreed with the statement that “following phone consultation(s) I felt more confident that I could effectively treat patients’ behavioral health problems.”

The team published other findings from its survey of providers, and responded to feedback by making changes.

The quotes they received from providers are equally compelling.

“This service has been absolutely ‘practice- changing’,” said one. “As we have more and more patients with mental health issues and limited local resources- we are essentially the only option for these kids. Having MC3 support helps us make good treatment decisions and is also ‘on the job training’ which we can apply to future patients.”

In fact, MC3 data show that 25% of the interactions help the patient avoid a higher-level of care that may be difficult to access, such as a psychiatric hospital bed or emergency psychiatric visit.

One of the maternal health providers who joined MC3 recently said, “I can’t even express how this service has enhanced the care I can provide. In the past, we’d screen and diagnose and then send moms out. We’d place referrals and hope that folks could navigate the complex system. Now, with MC3, I can collaborate with psychiatry, start meds or treatment, and access community resources that I am confident they will be able to access. It’s really been invaluable.”

America Has an Anger Problem – Can Better “Mental Nutrition” Fix It?

America is a pretty angry place these days. Formerly respectful spaces like school board meetings have become bitter battlegrounds. Some people are harassing healthcare workers and threatening restaurant staff for enforcing COVID protocols. Others are openly furious with the vaccine-hesitant. Everyone, wherever they stand on the (deeply divided) political playing field, is outraged about something.

Sure, anger is part of the human condition, but have things always been this bad? Elaine Parke thinks not—and she has a plan to get America the anger management tools it needs.

“We’ve stopped listening to one another because we’ve become addicted to our own narrow and sometimes selfish points of view,” says Parke, author of “The Habits of Unity: 12 Months to a Stronger America…one citizen at a time” (Outskirts Press, 2021, ISBN: 978-1-9772-4276-1, $21.95, www.12habits4allofus.org). “And we seem to have lost sight of the notion that we’re personally responsible for our own behavior.

“It’s way past time for us to take a collective deep breath and treat others with dignity, respect, and civility—and listen to them—whether we agree or not,” she adds. “It’s urgent that we make this shift now.”

Dialing down our ire is easier said than done. We are living in extraordinarily stressful times. But there’s more at play. Parke says we are shaped by the messages we consistently consume—and in today’s connected world, a lot of those messages come from our digital diet.

“Social media isn’t solely to blame for stoking our emotional flames—in fact, it was designed to be a source of information and to bring people together,” Parke clarifies. “But if your newsfeed is making you an angrier person, it’s on you to either log off for a few days or reassess the kind of content you’re engaging with. When we choose to focus on stories that are positive and nourishing, we go a long way toward resetting our emotional equilibrium.”

Parke’s “The Habits of Unity” is her attempt to help people take charge of what she calls their “Mental Nutrition.” Much in the same way that we (hopefully) approach the food we eat, we need to develop the discipline to make more nutritious mental choices every day. Her book’s 365 “one-magic-minute-a-day” motivationals make it easy to hardwire these choices into habit.

With her simple, doable framework for uplifting ourselves, boosting our mental health, and practicing unity, Parke hopes to get everyone focused on the same branded behavior each month. The idea is that the sheer force of all that concentrated positive energy sparks a unity revolution that rises from the ground up and sweeps the nation.

Yet, until that happens, we can leverage the power of  “The Habits of Unity” on a personal level by forming one good habit per month:

January: Help Others

February: You Count

March: Resolve Conflicts

April: Take Care of Our Environment

May: Be Grateful

June: Reach Higher

July: Become Involved

August: Know Who You Are

September: Do Your Best

October: Be Patient and Listen

November: Show a Positive Attitude

December: Celebrate Community, Family, and Friends

Those who’ve tried it say the plan is easy to put into practice. It feels good, so you’ll want to keep doing it. And there’s a ripple effect. As you become more positive, centered, and respectful, others will be drawn to you and your relationships will improve.

“As these ripples expand, they will improve the emotional climate in our country and make it easier to seek common ground, instead of lashing out,” says Parke. “But we can’t sit around waiting for others to take action. Each American must recommit to making our country a welcoming, affirming melting pot—instead of a stewing pot.”

The Importance of Self-Reflection

We’ve all heard of self-reflection, and I’d wager most of us would feel comfortable defining it. But generally, self-reflection exists more as a concept that’s understood in theory rather than in practice. How many of us genuinely self-reflect consistently? And how could we? Why should we? Today’s world is full of information, activity, and resources; it’s hard to find the time or sufficient justification for why self-reflection is needed in the first place. Yet, it’s that abundance that makes self-reflection all the more essential right now. In the following, we’ll take a look at what self-reflection is, why we all need it now more than ever, and the value it can bring into our lives.

What is Self-Reflection?

In the simplest terms, self-reflection is setting time aside to evaluate and give serious thought to your emotions, behavior, motivation, thoughts, perspective, and desires. It’s about going beyond the surface level to find the “why” behind these elements of ourselves and the experiences we have. The idea of self-reflection is to gain a more profound, rawer understanding of yourself. And for those unfamiliar, you’ll find that with that understanding comes empowerment and clarity that simply cannot be captured otherwise.

Today’s world is more advanced than it’s ever been and constantly reminds us of what’s out there and available to us. But within this environment can lie a trap. A trap that convinces us that the answers we need to the hardest questions are out in the world for us to find, rather than within ourselves waiting to be unveiled. With that being said, let’s dive into the reasons why self-reflection is more vital than it’s ever been.

Why Now?

Covid & the Climate of Uncertainty and Hostility 

We start with a somewhat obvious one: the present state of society. Over the last year and a half, we’ve all likely felt like we’ve been carrying extra weight around. The air of uncertainty combined with what seems to be growing polarization and hostility has placed a lot on us personally and societally. In times like these, in particular, self-reflection can be a great friend to us. It can help us stay grounded and sharpen our ability not to lose perspective. Just because you engage in self-reflection doesn’t mean the world will change or problems will go away, but it can certainly help in your ability to manage said problems and stay true to what brings you fulfillment in life.

The Modern, Digital Age

Let’s be clear; this piece is not intended to portray our modern advancement as a negative. There are certainly great benefits to it. However, there are legitimate downsides we’ve all likely experienced. Whether it be social media, the internet as a whole, the many gadgets we use, etc., the point is that there have never been more distractions in the world that make it incredibly hard to stay within ourselves. Every day, we’re constantly reminded of what else is out in the world, what others have that we don’t, and people’s perceptions of us. A failure to keep these reminders in check is a recipe for all kinds of negative mental repercussions. Self-reflection can help you in this regard. It’s an incredible tool for staying focused on what you have in life, what matters most to you, and understanding your true identity, no matter what others may think.

Mental Health Crisis

It’s no secret that mental health issues have become a national, if not a worldwide, concern. More and more young people report suffering from mental health problems, and of course, the issue has only been exacerbated by the COVID-19 pandemic. And while we’ve evolved tremendously in our acceptance of mental health struggles, we still have a long way to go, particularly with helping people navigate these difficult times. Self-reflection is not a cure-all approach, but it certainly won’t hurt in managing mental health issues. As mentioned before, when done right, self-reflection ultimately can be empowering and fulfilling. And as we’ll see next, there’s a lot of value it can bring into your life, whether mental health has been a problem area or not.

The Value of Self-Reflection 

Tool for Learning & Growth

We naturally tend to believe we know ourselves well, which is a fair assumption. However, you’d be surprised how much you don’t know about yourself if you don’t self-reflect often. Not everything is always as it seems on the surface. Sometimes our emotions are driven by something else deep within ourselves, or perhaps our behavior was motivated by a force we had never considered before. We’re far more complicated creatures than we give ourselves credit for, and it can often be hard to keep up without taking the extra time to retrace and reconsider. Self-reflection opens up doors that perhaps have never been seen before, let alone opened. And with that knowledge comes the power to learn, evolve, and grow as a person.

Vessel for Self-Peace

This builds off that understanding touched on before. By having a more authentic conception of yourself, you can make better decisions and engage in behavior that you know will ultimately be rewarding to you. For example, not everything we enjoy doing is necessarily beneficial for us in the long run. Sometimes we engage in behavior that gives us what we need at the moment but leaves us empty in the long haul. It can be hard to truly realize what’s good for us and what’s not until we take that time to dive deep within. And once we do, we have more control over our ability to feel at peace with who we are, where we’re going, and what matters most to us in life.

Your Life GPS

Where those previous points lead you is here, a conceptualized roadmap for life. Now, let’s be clear, a big part of life is the unknown, taking chances, learning from experience, and simply “living.” However, most of us often have an overwhelming feeling that we have no idea where our life is going, what we want from it, and where to go next. And that’s precisely where self-reflection and that understanding of self can help. You’ll be able to better understand what fulfills you the most, what you want to get out of your time here, where you want to go next, and how you might be able to do that. Self-reflection will not give you all the answers or allow you to map your entire life step-by-step, nor should that be desired anyway; that’s what living is for. But it can help you on your journey towards getting those answers, learning from your experiences, growing as a person, and finding your purpose in life.

Conclusion

It’s important to know, value can only be experienced if you approach self-reflection with discipline, legitimate intent, and consistent action. Self-reflection also requires a willingness to be honest with yourself and possibly confront areas you may have been reluctant to in the past. But, what you get from self-reflection and how you do it is really just up to you. Below, I’ve included a few resources to help you get started. If you’re new to this, try different ones out and see what sticks for you. Don’t look at self-reflection as a daunting task; it’s meant to be helpful, not stressful. You have to find what brings the most value to you. And hopefully, this journey will leave you feeling empowered, more connected with yourself, and more clear on what you want from this life.

Resources to Get Started:

https://positivepsychology.com/introspection-self-reflection/

https://www.minimalismmadesimple.com/home/self-reflection/

https://www.wikihow.com/Self-Reflect

Public Health and Art

The Rutgers School of Public Health and the Mason Gross School of the Arts have launched a collaboration to support community-engagedarts-integrated research projects that will result in performances or productions of art.

The projects, led by teams made up of faculty from both schools, include Pilates workshops, photo series, and oral history performances.

Devin English, assistant professor in the Department of Urban-Global Public Health, and Frederick Curry, associate professor and interim chair in the Department of Dance, will examine the psychosocial impact of Polestar Pilates classes in three socioeconomically diverse public high schools in New Jersey. English and Curry hope that their intervention will help address anxiety and depression, which is experienced by nearly 70 percent of U.S. teens.

To address HIV-related stigma, Ashley Grosso, assistant professor in the Department of Urban-Global Public Health, and Jacqueline Thaw, associate professor and director of the Master of Fine Arts program in design in the Department of Art & Design, will use Photovoice, a research method that engages people to create, discuss, and share photographs of their own lived experience. This approach is meant to raise awareness about the complex realities that marginalized populations confront. The team will focus on gay, bisexual, and other men who have sex with men, who bear a disproportionate burden of HIV, and who HIV-related stigma often hinders from seeking, or from receiving, treatment and preventative care.

Resilience and HIV/AIDS researchers Kristen Krause, instructor in the Department of Urban-Global Public Health, and Stephanie Shiau, assistant professor in the Department of Biostatistics and Epidemiology, will work with Jeff Friedman, associate professor in the Department of Dance, to develop an oral history workshop and performance by people living with HIV/AIDS. Their project aims to explore biopsychosocial health outcomes and resilience in both oral history documentary interviews and via a performance of dance or movement.

“These collaborative projects exemplify how the arts and humanities can work effectively with public health to advance the work in each of these disciplines,” says Perry N. Halkitis, dean of the Rutgers School of Public Health. “The work that Rutgers School of Public Health faculty are enacting with Mason Gross School of Arts faculty are indicative of the inter-and multidisciplinary efforts that must define all of our work if we are to have maximum effectiveness in our endeavors to advance health equity and the well-being of all people and populations.”

The projects will aim to address some of the five urgent public health issues, which include social exclusion and isolation, chronic disease, racism, mental health, and collective trauma, identified as priorities for cross-sector work in ae report issued by the Creating Healthy Communities: Arts + Public Health in America Initiative.

“These projects illustrate the power of collaboration and highlight the role that the arts can play in helping shape public health outcomes,” says Jason Geary, dean of the Mason Gross School of the Arts. “The challenges that we face as a global society are so profound and interconnected that they demand insights from every perspective, and that’s where the arts can be transformative in so many ways.”

“The Rutgers School of Public Health is excited to provide seed funding in support of interdisciplinary cross-university collaboration to promote public health through artistic mediums,” says Katie Zapert, director of research at the Rutgers School of Public Health, who developed the call for project proposals.

Trigger Warning: A Chinese Father Saved More Than 300 People at Nanjing Yangtze River Bridge

“I understand these people. I know they are tired of living here. They have had difficulties. They have no one to help them.” – Chen Si

Since the Nanjing Yangtze River Bridge was first built in 1968, an estimated 2,000 people have died from suicide involving the bridge. According to data from 1995-99, in China’s first national survey in 2002, death from suicide accounted for 3.6 percent of the country’s total deaths. During that period of time, 287,000 Chinese people died from suicide every year, putting the average suicide rate at 23 per 100,000 people.

Chen Si, also known as The Angel of Nanjing, has been patrolling this bridge every Saturday for more than 20 years and has managed to save more than 300 people from death by suicide. He is a 52-year-old father from Nanjing, the capital of Jiangsu province of the People’s Republic of China. Following the loss of a close relative to suicide, Chen Si has taken up this cause because someone needs to.

A Long History

The relationship between mental illness and suicide is controversial in China. Those who follow traditional Chinese philosophy are not encouraged to express their feelings, nor are they encouraged to expect their environment to change to suit their needs. Therefore, intense misery and feelings of despair may go unrecognized, and suicidal symptoms are not easily detected by Chinese medical professionals. In fact, many doctors working in rural areas do not understand the symptoms of depression and often receive low salaries, which discourages more doctors from entering the mental-health field.

Gender Differences

According to the World Health Organization (WHO) statistics, China’s suicide rate in the 1990s was 20 per 100,000 people. In the 1990s, female suicides were higher than male suicides by a factor of three. While China remains one of the few countries with a higher suicide rate among women than men, recent data shows that these disparities have evened out. In 2016, suicide rates among Chinese men and women came up almost even at 9.1 per 100,000 men and 10.3 per 100,000 women. Overall, China’s suicide rate in 2016 was 9.7 per 100,000 people, which was among the lowest globally.

A 2002 survey also revealed that 88 percent of females who died from suicide used agricultural pesticides or rat poison. Although China initially eliminated highly toxic pesticides to improve the safety of its farm produce, the elimination also had a substantial impact on the reduction of deaths from suicide among women. Research shows that men tend to attempt suicide through violent means such as hanging, whereas women tend to attempt suicide with medication. Overall, most studies indicate a decline in suicide rates among all gender and regional categories in China. The studies also recommended targeted suicide prevention programs, particularly for people in rural areas.

Shifting Tide

Women’s freedom, urbanization, and decreased access to toxic pesticides are key reasons behind the decline in suicide rates. According to Jing Jun, a professor at Tsinghua University in Beijing, “female independence has saved a lot of women.” The founding of New China in 1949 in combination with the opening-up policy in the late 1970s and the continuous growth of China’s economy has led to more equitable opportunities for women. Additionally, urbanization removed certain social constraints leading to more freedom for women. For instance, escaping an abusive partner or household may be easier in a city than in a small village.

Despite a decline in death by suicide rates in China, this is an area that we should pay more attention to. Chen Si acts as an angel, but he cannot do this work alone. He hopes that officials consider building a net across the Nanjing Yangtze River Bridge to prevent deaths by suicide. 

Resources Available

The Crisis Intervention Centre, the first of its kind in China, was established by Nanjing Brain Hospital to provide psychological advice and support to Chinese people. The Centre also has a hotline, which can be reached at 862583712977.

The Lifeline Shanghai at (400) 821 1215 is a free, confidential, and anonymous support service that is open 365 days a year from 10am-10pm GMT+8. 

Facebook and other social media platforms also offer many virtual support groups for individuals experiencing hardship. The National Suicide Prevention Lifeline at 1-800-273-8255 is a 27/4, free and confidential resource to support people in distress, prevention, or in an active crisis. Users should utilize the translate function on these web pages to adjust for language barriers, if necessary.

Can I Ask My Therapist About My Diagnosis?

“I don’t know if I did the right thing. Maybe I shouldn’t have.”

Power differentials are present within the helping profession and may cause the helpee to feel inferior to the helper, particularly in a client-therapist relationship. Oftentimes, clients are in a position where they feel reliant on guidance from their therapist. If there is a significant power imbalance, clients may be hesitant to ask questions and unsure of their role in the reciprocal helping relationship.

On a Reddit social media post, a female client with obsessive-compulsive disorder (OCD) posed this question: “Can I ask my therapist about my diagnosis?” The client has been working with her therapist who is a psychiatrist. The relationship between the therapist and client is fairly new. During one of their sessions, the therapist mentioned that the client might be autistic but they were unsure. The client was previously tested as a child, but the results did not confirm autism or autistic traits. Because the therapist has not confirmed the client’s diagnosis, the lack of uncertainty is creating terrible chaos in the client’s head, as she would like to know if she is or is not autistic. The client is thinking about repeating this question in her next session but is unsure whether it would be rude, pointless, or wrong. Unsure whether or not her therapist is capable of diagnosing autism, the client has tried to persuade her therapist into revealing a diagnosis, but the therapist redirected the conversation.

This is something I’ve brought up with reluctant therapists as well. I understand the reasons they may not want to disclose that info to a client, but at a certain point it’s like if you had to go to the doctor every week to get an MRI and they just told you they’re just concerned with working on your symptoms.” – u/HyaAlphard

Informed Consent

An article on Informed Consent written by Annette Johns discusses how the Canadian Association of Social Workers (CASW) Code of Ethics (2005) defines informed consent as “a voluntary agreement reached by a capable client based on information about foreseeable risks and benefits associated with the agreement.” Social workers have an ethical responsibility to seek informed consent from their clients at the beginning of the therapist-client relationship. Clients also have the right to refuse or withdraw consent and to have an opportunity to ask questions.

It is also important for clients to be engaged in the decision-making processes throughout the duration of the therapist-client relationship. In fact, informed consent and full transparency are integral to the relationship between a client and therapist and ensures the client’s right to self-determination, autonomy, dignity, and confidentiality. Social workers should use clear and understandable language to inform clients of the purpose, risks, limits, and reasonable alternatives to services.

Receiving a Diagnosis

Clients should be a part of the decision about whether to be assessed for a diagnosis. If the client is willing, the therapist has a responsibility to disclose the advantages and disadvantages of receiving a diagnosis. One advantage is that receiving a diagnosis can be comforting to clients who have been struggling with symptoms. Some clients find relief and feelings of validation when they can put a name to it, as well as decreased guilt, shame, and feelings of isolation. Receiving a diagnosis can also open up resources for the client and strengthen the relationship between the therapist and the client. However, clients should also be informed that diagnoses can stick with people, following them to and beyond adulthood even if they were misdiagnosed.

Suggested Questions to Ask

The client should feel comfortable to ask their therapist questions and express their needs throughout the duration of the therapist-client relationship. When the therapist suggests a “working diagnosis,” it should also be understood that the client is the most important member of the diagnostic process and has the right to obtain clarity by asking questions, taking notes, and being actively involved. Although the questions below are based in the medical profession, they are relevant to all clients. Out of seven questions posed by Helene Epstein, here are four relatable key questions:

What kind of test(s) will I have?

It is important for the client to know what kind of tests the therapist plans to administer. There are many different types of tests and ways to identify the source of a client’s concern.

 Why do you think I need this test?

It is important for the client to understand why their therapist is even recommending the test in the first place, as not every test is essential, and some may be invasive or expensive. The client has the right to ask whether there’s an alternative, if it is costly, or if the test is necessary.

What do I need to do to prepare for this test?

While not every test requires specific planning, some might. If this is not communicated in advance, the client may have to reschedule.

When will I get the results?

Depending on the test and other extenuating factors, waiting times for results may vary. Clients should consult with their therapist for more details.

Clients have the right to be fully informed and fully engaged. Although asking questions may seem rude or wrong, it is not. It is important for clients to be informed about decisions being made on their behalf.

Start with these questions and see if they help give you the answers you need. It’s important you use your voice in client-therapist relationships and prioritize your needs. At the end of the day, the treatment your seeking is for you, so do what feels right.

Social Worker Mental Health: An Ethical Dilemma?

Social work can be an incredibly personal profession- exposing social workers not only to others’ traumas but often forcing them to face triggering experiences from their own pasts while on the job. The personal experience that a social worker brings to the table can often be one of their greatest strengths. It can increase their capacity to connect with clients and to express empathy. Yet, from an ethical perspective, at what point do a social workers’ personal history or struggle negatively impact their client? What should they do if they ever find themselves in this situation?

The Dilemma

These are the exact questions that this MSW student finds himself or herself asking on Reddit. Working with parents at a community clinic in the final year of their internship, this student has quickly realized that their own childhood was riddled with significantly more trauma than they had originally thought. Still in the process of coming to terms with a childhood of neglect and emotional abuse, they are exposed to constant reminders of these experiences on the job and it is greatly affecting their mental health. Though currently in therapy to help address this trauma, this student’s situation still brings to light ethical dilemmas surrounding their ability to cope within this profession, properly distance themselves from clients and ethically serve in the social work profession.  

When examining any ethical dilemma within the social work field, it is important to use the NASW Code of Ethics as a guideline to protect both one’s professional career and clients. In this Reddit user’s case, it is important to consult the Impairment standard under Standard 4, which covers “Social Workers’ Ethical Responsibilities as Professionals.” According to the this standard, “Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of the people for whom they have a professional responsibility.” This ethical standard does not imply that it is unethical for social workers to experience these difficulties, as they are bound to happen simply by nature of being human, but rather stresses the importance that these problems do not effect the social worker’s decisions or professional capability.

Deeper Issues

When examining Impairment in this case, there are a few elements of possible concern. For example, this student explains that when observing clients they make “comparisons between what they are going through and what (they) went through” and even find themselves jealous of the families that were not abusive. These feelings raise concerns about whether or not the student is able to exert enough distance to provide unbiased and informed client care. This student also experiences physical symptoms that could be indicative of a further mental health issue such as feeling drained, sad and in a bad mood upon returning home. While these symptoms or a mental health issue alone do not indicate one’s job performance, it is important to examine whether these symptoms themselves could impair decision-making capacity or the ability to consistently show up for clients. 

It is the responsibility of this social worker to look critically at whether or not these personal or mental health components allow them to ethically practice their internship. They should do this by reviewing their supervisors’ feedback, consulting with their therapist and using a significant amount of introspection. If they feel comfortable approaching their supervisor to review these concerns, they should do so, however approaching their supervisor does pose risk for potential unintended career consequences. An academic or field placement advisor could also serve as a good resource to review ethical concerns and explore solutions. If these steps do indicate an unethical situation which is not able to be controlled by the resources at hand, this student must adhere to the social work standard of impairment by “seeking professional help, making adjustments in the workload, terminating practice or taking other necessary steps to protect clients and others.” 

Widespread Problem

Unfortunately, this student is not alone, mental health struggles in the social work field pose a widespread issue both for practitioners and clients that needs to be addressed. According to a UK Community Care survey, “96% of social workers feel either moderately stressed or very stressed,” which has resulted in 76% of social work professionals considering leaving their job within the past year. These mental health difficulties are not unique to social workers in the field full time, but also apply to social work students. The University School of Social Work found that “34% of the students indicated high levels of depressive symptoms and were at high risk of clinical depression, while 6% met criteria for posttraumatic stress disorder (PTSD).” Thus, further preventions must be put in place within the profession as a whole.

Solutions

When looking at possible preventions from a student perspective, it is important that mental health care is regularly discussed in a transparent manner and that high quality mental health resources are available. According to a study published in The Journal of Social Work Education, 23% of social work students had fear or distrust of mental health and 22% were concerned to seek services due to the quality available. Overcoming these mental health barriers are critical in creating a safe an ethical student population. Some programs might even consider the idea of mandating a certain number of therapy hours for students, so that they may explore triggering topics before they come up in field, as well as give students greater appreciation for their clients. 

Increasing internship autonomy for students could also be beneficial in allowing students to avoid triggering populations. At Boston University School of Social Work, students are able to list populations that they would be interested in working with, as well as populations that they do not feel as comfortable working with. While it is important to expose students to many different populations throughout their internship experience, allowing social work students to avoid select populations could minimize triggering social work experiences and help to prevent social work burnout. In the full time professional world, social workers are often able to choose to work with populations that do not trigger them, and students should be allowed this same opportunity. 

If you are a student in the social work field that struggles with mental health during your internship, you can use your voice to advocate for some of these changes to be enacted by getting faculty and student organizations involved. Until these preventative measures are in place, it is important that you maintain strong mental health care practices, seek support and use the NASW Code of Ethics to guide your social work practice. 

How Social Workers and Mental Health Providers Can Help Clients Adjust to the Pandemic

Over the last year and a half, there has been no shortage of media coverage about the mental health implications of the pandemic. Generally, these articles fell into one of two broad categories: those which warned of an impending large-scale mental health crisis and those which sought to help the public cope with whatever they were going through during the heart of the pandemic be it the loss of a job, a loved one, or simply cherished routines. Now, we seem to find ourselves in an in-between moment. While the pandemic is certainly not over, and we are seeing surges of the Delta variant in areas throughout the country, those who are vaccinated and not immunocompromised may have already returned to varying degrees of their pre-pandemic lifestyles.

As people have done so, however, they may have noticed a sense that all was still not well with themselves. Since the most urgent task for many of them in the earlier parts of the pandemic was simply to keep their heads above water, it’s normal and to be expected that they would only now be noticing certain mental health symptoms such as lingering anxiety, depression, burnout, or physical symptoms resulting from chronic stress. Meanwhile, from the mental health providers’ perspective, we seem to have arrived at a point in which there is a collective sense of, “What now?

A Period of Psychological Adjustment

One of the challenges that people commonly face in the wake of a disaster or traumatic event is adjustment. This isn’t the kind of practical adjustments made in the early stages of the pandemic—such as working remotely or having to accommodate for children being at home—but rather psychological adjustment. After a disaster, people feel confused, displaced (physically, emotionally, or both), have a hard time making sense of things, finding purpose, or just generally feeling like something is “off.” In fact, “Something just feels a bit off,” is a common way that people tend to characterize what they are feeling after a disaster. In the case of the Covid-19 pandemic, people’s confusion may be amplified by the lack of situational clarity: Are we still in the disaster? Are we out of it? Something in-between?

Helping clients through this period of vagueness, confusion, and adjustment is, and will be, one of the key tasks of social workers, therapists, and mental health providers right now and in the months ahead.

Being Direct to Assess People’s Needs   

While it’s safe to say that most people, if not everyone, maybe feeling a bit “off,” we also don’t want to make the mistake of assuming that everyone has had a similar experience or is currently in the same place. Because of this, social workers and mental health care providers will want to systematically assess the particular needs of new clients seeking services, of which there has been a significant increase in recent months. This may be particularly important for clients from communities of color since their experiences are going to be magnified due to the various disparities in how their communities have experienced the pandemic.

There are different ways that mental health professionals can go about this. It could be incorporated into the standard questionnaires and self-assessments that are typically used to assess the needs of new clients. Or, perhaps, some professionals may prefer a more direct and personal method by asking targeted yet open-ended questions as part of the initial rapport-building with clients. For instance, during a first session, a social worker or therapist can ask, “This has been a very strange, difficult year for many people. What might be contributing to your added stress levels, currently?”

This is one of the most important components of doing trauma work, which is unless you ask specifically, it can take a very long time until you get around to why a client has come into your office, or until they’re able to make the connections of what’s really causing all the problems. While typically this is allowed to gradually unfold over several sessions, now may be a time when it’s useful, or even necessary, to begin with new clients in a more direct way.

Incorporating a Disaster Crisis Counseling Model

Another reason why it may be useful to be direct right now, and to help clients address their most immediate problems, is that social workers and mental health providers may only be able to see new clients for one, two, or just a few sessions. While greater numbers of people are seeking mental health services, many of them may not be ready or able, for various possible reasons, to delve into deeper or preexisting mental health issues. While the hope is always to be able to do that, after disasters it’s common for people to seek just one or two sessions. Fortunately, even these limited sessions can be helpful when clients are given specific and concrete tools—for example, the six Skills for Psychological Recovery (SPR).

Mental health providers may therefore find themselves, in many cases, having to adhere closer to a disaster crisis counseling model, rather than a long-term therapy. In this scenario, the best way to help clients is to provide them with positive coping methods and strategies that can be immediately applied, especially since many of them may have come to rely on unhealthy coping mechanisms throughout the pandemic. For mental health professionals who haven’t been trained in disaster response, it will almost undoubtedly be useful to look up disaster response methods and incorporate them if possible since they may be what many of their clients need most right now.

The aforementioned lack of situational clarity regarding the ongoing nature of the pandemic, and the global scope of it, may preclude the kind of organized mental health outreach efforts we saw after localized disasters such as Hurricane Katrina and the Gulf oil spill which have been found to be effective. In the current absence of such programs, we will likely continue to see more people seek out mental health services on their own. By keeping in mind the principles covered in this article, and by being flexible with the way we might normally prefer to work with new clients in non-pandemic times, social workers, therapists, and mental health providers will be able to help their clients in the ways that they need it most during this period of psychological adjustment.

Treating Teen Addiction With Compassion and Empathy

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Teen substance abuse and addiction to drugs are all too dangerous epidemics occurring across the United States. The most recent national data gathered by the Centers for Disease Control and Prevention indicate that 3.7 adolescents (ages 15 to 19) per 100,000 died from a drug overdose in 2015. To put that statistic in perspective, that’s a 130 percent increase in teenage drug overdoses compared with 1999. Additionally, according to the U.S. Department of Health and Human Services’ Office of Adolescent Health, opioid misuse is one of the most accelerated drug problems, as 3.6 percent of adolescents between 12 and 17 reported misusing opioids in 2016, and that percentage doubled for adults ages 18 to 25.

Unfortunately, in addition to drug abuse, teenage addiction to other substances is also ruining lives. Cigarette smoking, tobacco use and alcohol consumption have deleterious effects on adolescents nationally. The HHS reports the following 2017 statistics regarding teen substance abuse:

  • 9 percent of high school students smoked at least once a month.
  • 5 percent of high school students used tobacco, snuff or dip monthly.
  • 30 percent of high school students drank alcohol monthly.
  • 13 percent of high school students drank at least five alcoholic drinks in one day monthly.

Teen drug addiction and substance abuse can cause anything from mild impairment to serious health problems or even death. Too many teens do not receive the help they need to break their addictions and avoid relapse. Some may be too embarrassed or scared to ask for help, while others can’t pay for it. Some simply don’t believe they have a problem.

Profitability vs. Patient Health

There is no single solution when it comes to treating a teenager who is battling an addiction to an illicit drug or substance. Teen drug abuse is a complex problem that requires the expertise and guidance of different types of health and wellness professionals. All too often, however, the focus is on how the healthcare system can benefit in terms of market share, revenue and profitability. Many healthcare professionals are now looking for other ways to provide care to people in need.

Instead of focusing on costs, many medical professionals are championing value-based care, which prioritizes patient health. Value-based care could have widespread positive effects on teenage addiction success rates and continued abstinence by providing a more compassionate and empathetic road to recovery. Below is an examination of the value-based care model, followed by a look at how taking this approach could potentially improve the way healthcare professionals treat addicted adolescents.

Value-Based Care Basics

Put simply, value-based care is accomplished when providers, such as doctors and healthcare facilities, are paid “based on patient health outcomes,” according to the online publication NEJM Catalyst. Providers are paid for improving patient health in any measurable way.
The value-based care methodology is in direct opposition to the commonly used fee-for-service methods, which are based on paying per number of services rendered, not outcome. NEJM Catalyst notes five major benefits that value-based care could entail:

  • Minimized costs and improved results for patients.
  • Boosted patient satisfaction and elevated care efficiencies for providers.
  • Tighter cost control and minimized risks for payers.
  • Balance between treatment costs and patient results for suppliers.
  • Reduced healthcare expenditures and improved national health for society in general.

While it may sound amazing, the entire value-based care methodology boils down to application. Does the value-based care approach improve healthcare in practice? Specifically, does value-based healthcare improve the treatment of teenage addiction?

Treating Teen Addiction With Value-Based Care

Throughout a teen’s journey from addiction to recovery, he or she will meet many healthcare professionals, such as physicians, nurses, therapists and social workers. Practicing value-based care, these professionals would focus on providing the best care for positive health results, rather than on monetary concerns.

Diagnosis: Physicians, Nurse Practitioners and Nurses

When a teen battling drug addiction seeks treatment, a nurse, nurse practitioner or physician will ask questions about the level of use and any dangerous behaviors while under the influence of an illicit substance, such as driving while intoxicated. The nurse, nurse practitioner or physician may also order urine and blood tests for the patient, provide treatment directions, and recommend counseling or therapy from another accredited professional, such as a therapist or social worker.

Through UCF Online’s Master of Science in nursing and healthcare simulation graduate certificate, students learn the importance of working with their medical peers in delivering supportive care.
A nurse can often spend more time with a patient than the physician and strongly influence how well that patient responds to treatment. Fostering this relationship is crucial, considering many teens battling drug addiction may not continue treatment due to the fear of fighting the battle alone. Doctors will be the ones, though, who suggest a specific form of treatment regarding teen substance abuse or provide a reference to another health professional. “Interprofessional education is the key to the future of health care,” says UCF Professor Desiree Diaz and nursing simulation expert. Her research focuses on improving care for vulnerable patient populations by incorporating simulation technology with real human emotions to educate health care professionals.

At this diagnosis stage, the teen may be worried about costs, results and the length of time any treatments or referrals may take. Teens may not have the money or time to deal with extraneous steps. With value-based care, their necessary tests, such as urine and blood tests, would be included, while extra tests that may not be relevant to directly improving health may not, saving them time and money. Additionally, because of the faster diagnosis and more efficient treatment timeline, teen patients may experience less frustration with the healthcare system — and may even be more satisfied with the care they receive.

Treatment: Mental Health Workers

During the teen drug abuse treatment process, a patient will meet with a psychiatrist when there is a suggestion or referral from a doctor. A psychiatrist or therapist can work with the teen to discover mental and emotional motivators behind the drug or substance use. Psychiatrists can diagnose specific mental health disorders as well as prescribe medication. Helping patients to understand their physical and mental ailments and that addiction is an illness, without passing judgment, can help teens successfully treat their conditions.

At this stage, basing the pay system on patient health may significantly improve the care that teen addicts receive from mental health workers. For instance, additional medications that don’t work would be ceased, and therapies without benefit would be cut. As a result, patients wouldn’t pay for further treatment that doesn’t work for them. It’s that sense of empathy for the specific situation that might make possible a teen’s long-lasting recovery.

Rehabilitation: Social Workers

Social workers can engage in therapy with patients as psychiatrists and therapists do and provide resources for self-help and teen substance-abuse programs like nurses do. Social workers are also fundamental in the discharge-planning process, helping to ensure teens battling drug abuse have additional health resources that complement scheduled treatments or prescribed medications. Social workers can also help identify harmful social or environmental situations that may be contributing to a teen’s drug abuse and can develop solutions to remove the teen from those negative influences.

In the rehabilitation stage, social workers can play a key role in lending a compassionate ear and providing relevant resources for their clients. Social workers may work with healthcare providers to minimize medication or therapy costs, streamline processes, run cost control, and also analyze risks that teens or their benefactors would be taking on. Value-based care would allow healthcare professionals to work fully with social workers — to the ultimate benefit of addicted teens.

Treating Addicted Teens With Care

Drug and substance addictions are impacting thousands of teens across the United States each year. For example, according to the National Institute on Drug Abuse for Teens, a total of 5,455 overdose deaths occurred in people ages 15 to 24 in 2017 alone — 99 alcohol overdoses and 5,356 drug overdoses. Teenage addiction is a complicated matter, and teens need all the compassion and empathy that healthcare professionals can provide.

Alternative-care methods, such as value-based care systems, may help improve patient outcomes, minimize prices, and improve efficiencies for both patients and healthcare systems. According to the Center for Health Care Strategies, value-based care is one of the “tools that policymakers and payers can use to encourage greater access to [substance-use disorder] treatment in primary care.” Healthcare may be taking a step in a more client-compassionate direction.

Making Your Mental Health a Priority in 2020

As we begin a new decade, 2020 is testing the mental health of humanity. After the world mourned the loss of Kobe Bryant to start the new year,  we are now in the midst of a global corona virus pandemic with looming public health and economic consequences so severe experts are unable to quantify its impact. With social distancing, stay at home orders, and a host of economic challenges, humanity’s resolve is being stretched past our normal limits. Maybe you made a list of resolutions or life changes you wanted to make in 2020. But, one the is for sure, collectively we must be more diligent in protecting our mental health and develop coping mechanisms to help us endure these turbulent times. 

Based on surveying individuals, it was estimated that, in 2018, 19.1 percent of Americans 18 years old and up had a mental illness in the last year. Maybe you have a mental illness, maybe you don’t. Either way, your mental health is important. So what are some practical things you can work on?

Get sufficient sleep.

The Centers for Disease Control and Prevention (CDC) conveys that a person might have an elevated likelihood of poor mental health, some physical health problems, and dying prematurely if the person regularly doesn’t sleep for sufficient time. They indicate that it is advised for individuals ages 18 to 60 to sleep at least 7 hours a night.

If you’re not making enough time for sleep, now is the time to start. As hard as it may be, tell yourself you’ll finish that television show or those household chores tomorrow.

If you’re having trouble sleeping, there are things you can try. Commit yourself to a regular sleep schedule, going to bed and waking up at the same time every day (yes, even on the weekends). Don’t drink too much caffeine, especially later in the day. Stop using devices that produce blue light (like your smartphone, laptop, and television) at least an hour before bed. Practice relaxation techniques, such as deep breathing exercises.

Exercise.

One of the many reasons to exercise is that it might improve your mental health. Try to find something that you’ll enjoy, so you’ll actually stick with exercising. You might decide to start regularly playing a sport with friends, going to a fitness class, or enthusiastically dancing to some of your favorite music. 

If you have any health conditions that might be made worse by exercising, make sure to talk with your healthcare provider first. Together you can develop a plan that is right for you.

Plan ways to reduce stress.

The National Institute of Mental Health (NIMH) conveys that being stressed long-term could be detrimental: it might play a part in mental and physical illnesses, for instance anxiety, heart disease, and depression. Some things that stress us out are beyond our control. A family member might fall ill or a car might suddenly break down. However, some stressful situations can be avoided with better planning. 

If you find it stressful to do all of your household cleaning on Saturday, make time to do a little bit at a time during the week. If you are stressed as soon as you start reading those class syllabi, sit down with a planner and figure out when you will allot time to work on each thing you need to do (maybe you can start working on that final paper a little earlier so you then have time to focus on studying for exams). Yes, it takes some upfront time investment to plan, and it takes commitment to stick to the plan. However, it might help you feel less stressed (and maybe you’ll do better on those exams too!).

Another important thing to plan? Time to do things that you enjoy. Maybe its hiking or crafting or reading. Determine when you are going to do these things, whether it’s planning to do a specific activity or simply planning to do something enjoyable. Make sure it’s a plan that’s reasonable for your life, and then stick to it.

What about those things that are out of your control, or times when you’re working on what is in your control but still stressed? Relaxation techniques, such as deep breathing exercises, progressive muscle relaxation, or mindfulness, might be helpful for you. Research how to do these things, and practice them when you are not feeling stressed.

Take care of your physical health.

Mental health and physical health are connected. Physical health conditions can affect a person’s mental health. For instance, hypothyroidism might make a person feel depressed, and hyperthyroidism might make a person feel anxious. Low vitamin D levels could contribute to feeling depressed.

If it’s been a while since you’ve seen a healthcare provider for a physical, schedule one now. Even if you feel good physically and mentally, a healthcare provider might detect a health concern before it starts causing issues, and some conditions are easily treatable.

Assess your substance use.

For persons who don’t consume alcohol, beginning is not advised by the Dietary Guidelines for Americans 2015-2020. If a person is going to drink and is old enough to do so legally, for men they advise two drinks or less a day and for women they advise one drink or less a day.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides limits for “low-risk” drinking. Low-risk drinking is drinking 7 or fewer drinks in a week as well as drinking 3 or fewer in a day for women. For men, it’s drinking 14 or fewer drinks in a week as well as 4 or fewer in a day. It is recommended that men older than 65 do not exceed 7 drinks a week and 3 a day. For some individuals, it is recommended to not drink at all.

If you are drinking more than these limits, it’s time to reduce how much you drink or quit drinking entirely. However, NIAAA conveys that you shouldn’t try to quit drinking on your own if you might have a dependence on alcohol, as withdrawal could be deadly. Talk with a healthcare provider if you think you might be dependent.

If you are using any illegal substances or misusing any medications, talk with a healthcare provider. It’s important to stop using/misusing these, but stopping without supervision may be dangerous, depending on the substance and other factors.

Seek help.

If you think you might have a mental illness, reach out for help. You can talk with your primary care provider or schedule an appointment with a mental healthcare provider, such as a therapist, psychologist, psychiatrist, or psychiatric nurse practitioner.

A healthcare provider can talk to you about your symptoms and work with you to develop a plan. Therapy and/or medication might be beneficial for you. 

If you are having thoughts of suicide, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

How Being Kind to Others Make You Feel Better

You know that being kind to others is good for the recipient (obviously), but did you know that it’s also good for the giver, too? Yep, that’s right. Being kind to others will improve your mental, emotional and physical well-being. Here are six reasons that being kind to others makes you feel better, plus ideas for acts of kindness:

It boosts your positive emotions.

Being kind to others releases feel-good hormones like dopamine. Part of the brain’s reward system, these hormones make us feel happy and satisfied and are associated with pleasurable activities such as sex and eating good food. It also makes you more alert, focused and motivated, so being nice to a coworker could be the boost that you need to make it through a tough day at work.

It lowers your stress levels.

Helping others can create an emotional buffer that protects you from stressful events. One study of 77 adults found that those who reported higher-than-normal helping behaviors showed no dips in positive emotion or mental health, and they had lower increases in negative emotion in response to high daily stress. This is probably tied to the release of dopamine as well as the social connections that being kind creates.

It helps you build relationships.

Humans follow a behavior pattern called the norm of reciprocity, whereby we tend to reciprocate similar actions. If someone is kind to us, we’re inclined to be kind back—but if they’re mean, we’ll act in a similarly snippy way. Of course, no one follows the norm of reciprocity in all interactions, but being kind to others does increase the chances that they’ll be kind to you in return. Since it’s pretty hard to build a relationship on trading insults, this helps you shore up your friendships and acquaintances.

It reduces anxiety and depression.

Both the release of dopamine and building social connections have been shown to reduce or prevent signs of mental illness like depression and anxiety. Stress can be another trigger for these conditions, especially anxiety, so being kind helps to address them from another angle, too. While being kind to others is no substitute for going to therapy or taking necessary medications, it can be another tool in your toolbox to manage depression and anxiety.

It can improve your physical health.

Being kind isn’t just good for you physically and mentally. It’s also good for your body. In one study, writing small notes of affection to loved ones was found to lower levels of “bad” cholesterol in college students. Other research has indicated that people who devote more time to meaningfully helping others have less inflammation. Not only that, their immune system is also better able to fight off infections. Who knows? Maybe being kind to your coworkers will help you ward off that office cold!

It creates a positive feedback loop.

Being kind to others doesn’t just make both them and you feel good. Thanks to the norm of reciprocity, it also makes them more likely to be kind to you back, which makes you more likely to be kind to them again–and on and on in a cycle of positivity. Your act of kindness may have positive ripple effects that you can’t even conceive of.

At this point, you’re probably wondering about different ways to be kind to others. Here are some of our favorite ideas:

  • Volunteering. Find a charitable organization that champions a cause that means a lot to you and offer to donate your time to them. Even if you’ve never volunteered before, it doesn’t take a lot of skill to hand out meals at a soup kitchen or clear trash from the local river. If you do have more professional talents you’d like to put to use, you can offer to provide them pro bono. Many nonprofits often need help in business areas such as finance and marketing.
  • Give gifts. A small gift such as a scented candle or a potted plant can really make someone’s day. The gift doesn’t have to be expensive, just thoughtful. For example, give someone who loves books a candle that smells like a library. You can also make them something by hand, or simply drop a card in the mail with a heartfelt note. 
  • Do extra chores. Almost nobody likes doing chores, so your family, friends and coworkers are sure to appreciate it when you take care of their tasks for them. Even if it’s not your turn, offer to do the dishes, take out the trash and recycling, vacuum the floors, clean out the fridge, mow the lawn or whatever needs to be done. Or better yet, don’t tell them you’re going to do it so they get a nice surprise.
  • Offer emotional support. Sometimes what your loved one needs the most is a listening ear as they vent or cry. Do your best to listen attentively to them without interrupting. Offer validation when appropriate, but otherwise just let them talk instead of butting in with advice or a relevant anecdote from your life. Your loved one probably needs to emotionally process things before they can receive that kind of information.
  • Express yourself. On the flipside, sometimes we don’t communicate our love and appreciation for people enough. You know in your head that you’re thankful for your friends helping you move. But did you actually tell them? It’s very easy to say “thank you” or compliment someone, and it will mean a lot to them–so do it!
  • Donate money. Of course, donating to a charitable cause or nonprofit organization is a great way to be kind. However, you don’t have to be so formal about it. For instance, you can send money via Patreon to an artist whose work you admire, or Venmo a friend who needs a little cash to tide them over until their first paycheck arrives.

Helping others will make you and others feel better–a win-win situation. If you’re feeling down, try being kind to your coworkers or helping out a friend, and odds are that it will help cheer you up as well.

New App Could Help Panic Attack Sufferers During Coronavirus Pandemic

Displaying the app are co-developers Ellen and Ryan McGinnis of the University of Vermont. PanicMechanic uses the camera on a cell phone to display the panic attack sufferer’s heart rate in real time.

For the nearly 36 million Americans who experience panic attacks, the coronavirus pandemic is a potentially significant new trigger, a recent story in the Washington Post reported.

For panic attack sufferers facing these new anxieties, there is little recourse. Medication is minimally effective and has side effects. Cognitive behavioral therapy doesn’t work for nearly two-thirds of panic sufferers. And bio-feedback, which has shown promise, is cumbersome and impractical to use outside a laboratory or clinical setting.

A new app developed by faculty at the University of Vermont, PanicMechanic, may be part of a solution. The app adapts biofeedback-like monitoring so it can be used on a mobile phone. The app can work at any time and in any location, the first technology to do so for panic.

PanicMechanic is meant to be used as a supplement to professional clinical care.

“The challenge with panic attacks is that they’re episodic,” said one of the app’s developers, Ellen McGinnis, an assistant professor at the University of Vermont’s Center for Children, Youth and Families at the University of Vermont and a trained clinical psychologist.

“That means they’re not only difficult to treat in a traditional therapy setting, because a panic attack is hard to induce, but also that the one intervention that does seem to work for people—biofeedback—isn’t available when it’s needed.”

PanicMechanic uses the camera on a cell phone to measure the body’s panic response, using an approach similar to photoplethysmography

“Activating the app, then holding your finger against the flash can give you an objective measure of your reaction to stress,” said Ryan McGinnis, assistant professor of Electrical and Biomedical Engineering at the University of Vermont, and a co-developer of the app.

The concept for the app is grounded both in decades of research showing that enabling panic sufferers to observe their body’s reaction to stress reduces panic, and in the clinical practice of Ellen McGinnis.

“I’ve used a low tech version of this technique with a dozen patients,” she said. ‘The panic attack sufferer used just a pen, paper and timer to take their own heart rate and plot it on paper during the panic attack. It was very effective in helping patients manage, take control of and overcome their panic.”

The explanation? Intervening with objective information targets a driving dynamic of panic, she says.

“Panic takes hold and you feel like you’re out of control of your body. By showing someone their patterns of physiological arousal, it helps them gain a sense of mastery over their panic response.”

The app also works because it gives the panic sufferer something to do during an episode.

“One of the worst aspects of a panic attack is that you feel helpless,” Ellen McGinnis said.

In addition to displaying an objective measure of the body’s panic response, the app also asks, in a sequence of screens, “how much sleep and exercise you’ve had, what you ate, what your anxiety level is, and if you’ve consumed drugs or alcohol,” she said.

The screens both occupy the panic sufferer and serve a useful purpose, providing data on behaviors and triggers associated with the attack that could be avoided in the future.

The app also predicts how long the panic attack will last, based on past attacks.

That’s key, Ellen McGinnis said, because one of the most frightening aspects of a panic attack is that “it seems like it will never end.”

PanicMechanic employs machine learning to make sure the data gathered by the user on heart is accurate.

“Our beta testing showed that people can’t always put their finger on their cell phone in free living settings and get an accurate reading of their heart rate,” Ryan McGinnis said. The machine learning functionality corrects for faulty finger placement. In a study that will be published later this year, Ellen and Ryan McGinnis and their collaborators demonstrate that data obtained by the app was as accurate as that obtained in a lab setting.

“PanicMechanic helps panic attack sufferers learn to understand their panic attacks,” Ellen McGinnis said. “When they do that, working in partnership with their therapist, they’ve gone a long way toward stopping them.”

The team that developed PanicMechanic includes Steve DiCristofaro of Synbrix Software, LLC., in addition to Ellen and Ryan McGinnis.

The PanicMechanic app is available at the Apple App store.

How Social Workers Play A Role In Disaster Relief

Federally declared disasters have increased by 40% over the last 15 years, according to the Clinical Social Work Journal, and internationally, those numbers are higher. Over just the last two decades, natural disasters have doubled.

In the past, the term “disaster” was poorly defined, leading to emergency response plans that were a one-size-fits-all solution to multifaceted problems. This approach left survivors with fewer options for critical care, especially in the area of mental health.

The National Center for PTSD recently redefined disaster as “a sudden event that has the potential to terrify, horrify, or engender substantial losses for many people simultaneously.” It went on to further define disasters based on type, differentiating between natural and man-made disasters. If more widely accepted, this definition opens the door to opportunities for mental health care in these urgent situations, giving social workers a vital role in relief, recovery, and community resiliency.

Responses in Disaster Relief Social Work

Social workers can offer a variety of mental health services in the immediate aftermath of disasters. Traditional psychotherapy performed by therapists is known for its long-term approach involving session work and trust building, allowing patients to share their trauma narratives. However, when social workers are called up for active disaster relief, their critical and immediate intervention skills are far more necessary for psychological triage. Among them are:

  • Psychological first aid (PFA): PFA assists those in crisis in the aftermath of disaster. It relieves initial distress in an effort to promote short- and long-term coping. This sometimes includes crisis intervention and counseling.
  • Family care: Family social workers help families during crisis. They aid survivors in locating the services they need to overcome post-disaster challenges and repair their lives.
  • Mental health media communications: This field provides voices and vital points of view for under-represented or disadvantaged populations.
  • Resilient community capacity building: This includes creating response plans for various groups.

Above all, the pledge to “do no harm” is the first aspect of every skill.

Assistance During Disaster

Disaster relief programs typically consider the short-term needs of survivors in order to identify the best allocation of resources and promote beneficial coping in the aftermath of tragedy. Social workers assist in these programs in a number of ways, including:

  • Case management: Social workers locate appropriate resources for clients, making sure they receive the services they most require.
  • Case finding: Case finding involves providing survivors with information about the programs available to them. Many are unaware that such services are available or fear stigmatization for participating in them.
  • Outreach: Social workers performing outreach increase program locations in order to allow services to be more accessible.
  • Advocacy: Using connections within various relief organizations, social workers advocate on behalf of clients to qualify them for additional services.
  • Brokering: When acting as a broker, social workers link client systems to the resources they need, fulfilling client needs throughout a multiplicity of programs.

Ultimately, all these methods allow social workers to disseminate information, refer clients to services, and assist them in qualifying for resources in disasters.

Disaster Relief Social Work in Practice

In the U.S., the American Red Cross and the Crisis Counseling Assistance and Training Program have provided almost half of all social workers participating in disaster relief programs. Depending on the type, duration, and severity of disaster, the challenges and requirements of social work change. When preparing ahead of an impending calamity, social workers may be identifying and organizing supplies, assisting with area and hospital evacuations, or even determining which patients can or should be moved.

During an actual emergency, the needs of the afflicted tend to take precedence over one’s own needs. Moment-to-moment changes in operational requirements contribute to the notion that social workers must remain flexible. They must be able to go where they are needed when they are needed there. The following are some real-world examples of social workers in the midst of disaster.

HURRICANE HARVEY

The residents of Beaumont, Texas, were witness to devastation on a massive scale. In the fall of 2017, Hurricane Harvey descended on Texas and Louisiana, and with it came ruined homes and wrecked lives.

In the end, the storm caused over $125 billion in damage and took 107 lives. The end of the storm was nowhere near the end of the damage. Long-term psychological trauma is a reality for many survivors, especially children. According to a recent survey in the aftermath of a hurricane, nearly 3.4% of respondents were found to have suicidal thoughts. The assessment, response, and counseling of suicidal behaviors were critical concerns that social workers on the ground were able to address.

HURRICANE MARIA

In September 2017, the USNS Comfort, a hospital ship, was deployed to Puerto Rico in the wake of Hurricane Maria. The crew included social workers and mental health providers for inpatient and outpatient mental health services. These providers developed protocols to educate the ship’s staff in treating psychiatric patients in addition to treating patients on board.

NORTHERN CALIFORNIA WILDFIRES

The Wildfire Mental Health Collaborative was established in Sonoma County after the devastating Tubbs fire to offer survivors tools for dealing with trauma. In the wake of the fires, The Guardian reported that many social workers were funded by grants from FEMA, which allowed them to connect with nearly 70,000 people in Sonoma County alone. These social workers were able to identify and refer thousands to much-needed mental health services.

Research Applications

Further study of the impact of disasters on the mental health of survivors is critical to the practice of disaster relief social work. The National Association of School Psychologists (NASP) has emphasized that children are especially vulnerable in disaster conditions, as they take their emotional and behavioral cues from adults.

Anxiety and startle responses, typical symptoms in children that have survived hurricanes, require therapeutic activities to help them cope in healthy ways. According to NASP, other disasters can prompt separate trauma responses. Tornadoes can cause survivor’s guilt due to their suddenness, whereas wildfires, given their advance warning, can cause anxiety. Negative effects stem from displacement, property destruction, and the concerns associated with biological threats to one’s health.

$2 Trillion Coronavirus Relief Package Will Support Social Workers, Clients They Serve

WASHINGTON, D.C. – The National Association of Social Workers (NASW) commends Congress and the White House for passing into law the $2.2 trillion economic relief package that will provide aid to individuals, families and communities.

“Our nation is experiencing unprecedented levels of psychological and economic devastation as a result of this public health crisis” said NASW CEO Angelo McClain, PhD, LICSW. “We applaud lawmakers and the Trump Administration for working quickly in a bipartisan way to bring relief to working class and middle-class Americans, many of whom are struggling to afford housing, food and health care during this pandemic.”

The Coronavirus Aid, Relief and Economic Security (CARES) Act, the third COVID-19 relief package that Congress has enacted in as many weeks, includes extended and increased unemployment insurance, coronavirus testing at no cost to patients (including people who are uninsured), and a $1,200 rebate for all U.S. residents with an adjusted gross income of up to $75,000 ($150,000 if married). It also contains a number of other provisions that will go a long way towards helping people as they cope with this crisis. This includes:

Economic Security

  • $1 billion for the Community Services Block Grant to help communities address the consequences of increased unemployment and economic disruption.

Mental Health

  • Extending the Medicaid Community Mental Health Services demonstration that provides coordinated care to patients with mental health and substance use disorders, through November 30, 2020.
  • Providing $425 million for the Substance Abuse and Mental Health Services Administration to increase access to mental health services in communities, provide suicide prevention services and care for people who are homeless. The bill also includes $45 million to respond to family and domestic violence, including providing services or shelter.

Food Security

  • Waiving nutrition requirements for Older Americans Act (OAA) meal programs to ensure older adults can get meals in case certain food options are not available.
  • Increasing the budget for the Supplemental Nutrition Assistance Program (SNAP) by $15.5 billion, and $8.8 billion in additional funding for Child Nutrition Programs in order to ensure children receive meals while school is not in session.
  • Providing $200 million for food assistance to Puerto Rico and the territories to ensure these citizens receive more support during the pandemic.

Child Care and Development

  • $3.5 billion for the Child Care Development Block Grant. This funding will allow childcare programs to maintain critical operations and ensure first responders and health care workers can access childcare during the pandemic.
  •  $750 million for Head Start to meet emergency staffing needs.

Housing

  • Providing $3 billion in rental assistance protections for low-income Americans.
  • Including $900 million in Low Income Home Energy Assistance Program (LIHEAP) funds to help lower income households heat and cool their homes.

Despite being the largest stimulus package in the nation’s history, more relief will be needed due to the scope and severity of the pandemic. The legislation comes amid record-breaking unemployment claims. While there are funds in the bill for unemployment insurance coverage, that benefit is time-limited and does not cover workers’ full salaries. Further, low-income and other marginalized communities will disproportionately experience the impact of this public health crisis.

In terms of food security, despite the increase in the SNAP budget, the package does not include a 15 percent increase in the SNAP maximum benefit.  Also, COVID-19 prevention and intervention services among vulnerable populations such as those in prisons, jail, juvenile detention and immigration detention and people who are homeless was also only partially funded.

We are also disappointed that only 20 percent ($400 million) of the $2 billion needed to ensure an inclusive and fair voting process for primary and general elections was provided and allows discretion by states. NASW along with 200 organizations called for full funding of this effort in order to remove all barriers to maximum participation in the 2020 election for communities of color and marginalized communities.

Despite these gaps, which NASW will be working to address in anticipated subsequent COVI-19 relief packages, the legislation does include provisions that are helpful to social workers. Employers may provide a student loan repayment benefit to employees on a tax-free basis. An employer may contribute up to $5,250 annually toward an employee’s student loans, and such payment would be excluded from the employee’s taxable income. Also, the Secretary of Education is authorized to postpone student loan payments, principal and interest for six months, through Sept. 30, 2020, without penalty to the borrower for all federally owned loans.

The package will also facilitate even greater regulatory flexibility in telehealth than has already been implemented through prior COVID-19 policy actions. The bill gives the Centers for Medicare and Medicaid Services (CMS) authority to waive requirements so that enrolled providers, including clinical social workers, can provide telehealth services using audio-only devices (such as telephone landlines). Under recent CMS guidance, clinical social workers and other eligible providers can, during this public health emergency, use smartphones with video chat apps such as Skype and Apple Facetime to provide services. They can also continue to use HIPAA-compliant video conferencing platforms, which was permissible prior to the pandemic. NASW will continue its advocacy to ensure that audio-only access is permitted by Medicare, which is already allowed in a number of states.

“This economic stimulus plan is an important step in helping our nation cope with this crisis,” McClain said. “We are also glad it will give social workers some of the supports that they need, such as greater flexibility to practice telehealth as they continue doing the hard work of ensuring clients access to services, including health care and mental health care they need as our nation contends with this pandemic.”

The National Association of Social Workers (NASW), in Washington, DC, is the largest membership organization of professional social workers. It promotes, develops, and protects the practice of social work and social workers. NASW also seeks to enhance the well-being of individuals, families, and communities through its advocacy.

6 Tips for Navigating Political Discussions at the Holiday Table

As families gear up to celebrate the winter holiday season together, a course of politics is likely their least favorite topic to dish up at the dinner table.

But two University of Nevada, Las Vegas professors say requests to pass the salt don’t have to quickly escalate into spirited debates over climate change, impeachment or immigration reform.

Katherine M. Hertlein, a professor with the Couple and Family Therapy Program in UNLV’s School of Medicine, works with clients to process their feelings and figure out how to tactfully parse through opposing views on a variety of sensitive issues — skills that may be particularly handy during the holiday season. Emma Frances Bloomfield, an assistant professor of communication studies at UNLV, has researched how people can better tailor their communication strategies when engaging on issues of the environment and climate change.

Below, they offer a few strategies for navigating potential political discord at this year’s family table.

Have realistic expectations

One of the aspects of family conversation that dysregulates us is the unrealistic expectation that family members will share our viewpoints. Part of reducing your reactivity to your family is to recognize what you can reasonably expect rather than setting yourself up for disappointment in expecting something unrealistic.

Don’t start the conversation from a point of contention

You don’t want to view your dialogue partner as inferior. It can be problematic when environmentalists or climate scientists are dismissive, or potentially patronizing to climate skeptics. That kind of dialogue can lead to climate skeptics feeling isolated and silenced. You may not agree with the skeptic, but you should still respect the person who holds the beliefs. We must listen, not just for a talking point to jump in on, but to understand the perspective they’re coming from, and what values or identities they feel are threatened by environmentalism.

Go into the conversation with a knowledge-gaining mindset, rather than a persuasive goal.

Adopt a stance of curiosity

Most people expressing their views are not doing so to purposely cause harm. Be curious about one’s stance and ask questions to fully understand their view rather than making statements yourself to keep the conversation going. This will enable you to find areas of commonality, agreement, and potential for feeling and expressing empathy.

We must listen, not just for a talking point to jump in on, but to understand the perspective they’re coming from.

Buy yourself some time

When people express views contradictory to your own, we may have a tendency to respond from an emotional rather than a balanced position. Phrases such as “I need some time to think about that; I’ll get back to you” provide you a chance to reflect on how to communicate your message in a balanced and respectful way.

Recognize the value system from which the comments originate

Part of what bonds a family is the shared set of values. While the people around the table may not agree about the way in which something should proceed, you may find that their rationale for their decision is rooted in a shared value, such as concern for children, concern for health care, etc. It may also help to consider the motivation behind one’s statements, recognizing that they are not likely intended to create harm but instead reflect good intention.

When in doubt, find a way out

If you anticipate a conversation will move you away from building a relationship and you are unable to maintain a level of psychological distance, consider using physical distance. Develop an exit plan prior to any conversation where you may anticipate difficulties. Having a plan ahead of time that you may or may not choose to use returns you to feeling like you are in a sense of control, and reduces the likelihood that you will seek to obtain control through increasing the volume or intensity of your voice.

Loneliness May Be Due to Increasing Aging Population

Lonely workaholic with alcohol problem

Despite some claims that Americans are in the midst of a “loneliness epidemic,” older people today may not be any lonelier than their counterparts from previous generations – there just might be more of them, according to a pair of studies published by the American Psychological Association.

“We found no evidence that older adults have become any lonelier than those of a similar age were a decade before,” said Louise C. Hawkley, PhD, of NORC at the University of Chicago, lead author of one of the studies. “However, average reported loneliness begins to increase beyond age 75, and therefore, the total number of older adults who are lonely may increase once the baby boomers reach their late 70s and 80s.”

The studies were published in the journal Psychology and Aging.

Hawkley and her colleagues used data from the National Social Life, Health and Aging Project and the Health and Retirement Study, two national surveys of older adults that compared three groups of U.S. adults born in different periods throughout the 20th century. They first analyzed data in 2005 to 2006 from 3,005 adults born between 1920 and 1947 and a second time in 2010 to 2011 from 3,377 people, which included those from the previous survey who were still alive, and their spouses or partners. The third survey, in 2015 to 2016, comprised 4,777 adults, which included an additional sample of adults born between 1948 and 1965 to the surviving respondents from the previous two surveys.

The authors examined participants’ level of loneliness, educational attainment, overall health on a scale from poor to excellent, marital status and number of family members, relatives and friends they felt close to. They found that loneliness decreased between the ages of 50 and 74, but increased after age 75, yet there was no difference in loneliness between baby boomers and similar-aged adults of earlier generations.

“Loneliness levels may have decreased for adults between 50 and 74 because they had better educational opportunities, health care and social relationships than previous generations,” said Hawkley.

Adults over 75 were more susceptible to becoming lonely, possibly due to life factors such as declining health or the loss of a spouse or significant other, according to Hawkley.

“Our research suggests that older adults who remain in good health and maintain social relationships with a spouse, family or friends tend to be less lonely,” said Hawkley.

In a similar study, researchers in the Netherlands found that older adults were less lonely than their counterparts from previous generations.

These researchers used data from the Longitudinal Aging Study Amsterdam, a long-term study of the social, physical, cognitive and emotional functioning of older adults. A total of 4,880 people, born between 1908 and 1957, participated.

The study measured peoples’ loneliness, control over situations and life in general and goal achievement. For example, participants rated loneliness on a scale from 0 (no loneliness) to 11 (severe loneliness) based on feelings such as, “I miss having people around.”

Older adults born in later generations were actually less lonely, because they felt more in control and thus most likely managed their lives better, according to Bianca Suanet, PhD, of Vrije Universiteit Amsterdam and lead author of the study.

“In contrast to assuming a loneliness epidemic exists, we found that older adults who felt more in control and therefore managed certain aspects of their lives well, such as maintaining a positive attitude, and set goals, such as going to the gym, were less lonely,” said Suanet. “Additionally, as is well-known in loneliness research, participants who had a significant other and/or larger and more diverse networks were also less lonely.”

Suanet recommended that older adults take personal initiative to better nurture their social ties, such as making friends to help them overcome increasing loneliness as they age. Also, interventions to reduce loneliness should focus more on bolstering older adults’ feelings of control, instead of only offering social activities.

“People must manage their social lives better today than ever before because traditional communities, which provided social outlets, such as neighborhoods, churches and extended families, have lost strength in recent decades,” said Suanet. “Therefore, older adults today need to develop problem-solving and goal-setting skills to sustain satisfying relationships and to reduce loneliness.”

Seniors may also want to make use of modern technology to maintain meaningful social connections, according to Hawkley.

“Video chatting platforms and the Internet may help preserve their social relationships,” said Hawkley. “These tools can help older adults stay mobile and engaged in their communities.”

Articles: “Are U.S. Older Adults Getting Lonelier? Age, Period and Cohort Differences,” by Louise C. Hawkley, PhD, NORC at the University of Chicago; Kristen Wroblewski, MS, L. Philip Schumm, MA, University of Chicago; Till Kaiser, PhD; and Maike Luhmann, PhD, Ruhr University Bochum. Psychology and Aging. Published Dec. 10, 2019.

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