Air Force Suicide Prevention Program Reduces Suicide Rate

U.S. Air Force Photo/ Staff Sgt. Angelita M. LawrenceA U.S. Air Force suicide prevention program is associated with reduced suicide rates among Air Force personnel during times in which the program was rigorously implemented and monitored, according to an NIMH-funded study published online ahead of print May 13, 2010, in the American Journal of Public Health. LCSW CEUs
Background
The Air Force Suicide Prevention Program (AFSPP) was implemented in 1997. Based on the premise that individuals at risk for suicide exhibit early warning signs, AFSPP emphasizes leadership and community involvement in reducing suicide by encouraging Air Force leaders to actively support and get involved with suicide prevention efforts. It trains commanders in how and when to seek out mental health services for their troops, provides training to all military and civilian personnel in suicide prevention, and incorporates other community-based components.

Kerry Knox, Ph.D., of the University of Rochester Medical Center, and colleagues studied the impact of AFSPP in reducing suicide among Air Force personnel from 1997 until 2008. They examined suicide rates from 1981 to 2008 to provide historical context during three military conflicts, and a downsizing of the Air Force that occurred in the 1990s.

Results of the Study
The researchers found that suicide rates were significantly lower after the program was launched than before—an average of two suicides per 100,000 per quarter occurred during the intervention period compared to three suicides per 100,000 per quarter prior to the intervention rollout. During the third quarter of 2004, however, suicide rates increased. Knox and colleagues suggest that the upward spike may have been the result of a diminished implementation of ASFPP due to increased demands from the two ongoing wars in Iraq and Afghanistan. In response, Air Force leadership took steps to strengthen implementation of the program and ensure compliance of its components, according to the authors.

Significance
The results suggest that the program is effective but its success is contingent on continuous implementation efforts and ongoing monitoring. The program cannot be maintained by "inherent momentum," the authors concluded.

What's Next
The authors suggest that the program, if maintained and monitored for compliance, can continue to keep suicide rates low in the Air Force. They also suggest that the program could be implemented in other communities and organizations to prevent suicide and reduce the stigma associated with the mental and psychosocial problems that often precipitate suicide attempts.

Reference
Knox K, Pflanz S, Talcott GW, Campise RL, Lavigne JE, Bajorska A, Tu X, Caine ED. The US Air Force Suicide Prevention Program: Implications for Public Health Policy. American Journal of Public Health. Online ahead of print May 13, 2010.

Brain Emotion Circuit Sparks as Teen Girls Size Up Peers

What is going on in teenagers' brains as their drive for peer approval begins to eclipse their family affiliations? Brain scans of teens sizing each other up reveal an emotion circuit activating more in girls as they grow older, but not in boys. The study by Daniel Pine, M.D., of the National Institute of Mental Health (NIMH), part of National Institutes of Health, and colleagues, shows how emotion circuitry diverges in the male and female brain during a developmental stage in which girls are at increased risk for developing mood and anxiety disorders. LCSW CEUs
"During this time of heightened sensitivity to interpersonal stress and peers' perceptions, girls are becoming increasingly preoccupied with how individual peers view them, while boys tend to become more focused on their status within group pecking orders," explained Pine. "However, in the study, the prospect of interacting with peers activated brain circuitry involved in approaching others, rather than circuitry responsible for withdrawal and fear, which is associated with anxiety and depression."

Pine, Amanda Guyer, Ph.D., Eric Nelson, Ph.D., and colleagues at NIMH and Georgia State University, report on one of the first studies to reveal the workings of the teen brain in a simulated real-world social interaction, in the July, 2009 issue of the Journal Child Development.

Thirty-four psychiatrically healthy males and females, aged 9 to 17, were ostensibly participating in a study of teenagers' communications via Internet chat rooms. They were told that after an fMRI (functional magnetic resonance imaging) scan, which visualizes brain activity, they would chat online with another teen from a collaborating study site. Each participant was asked to rate his or her interest in communicating with each of 40 teens presented on a computer screen, so they could be matched with a high interest participant.

Two weeks later, the teens viewed the same faces while in an fMRI scanner. But this time they were asked to instead rate how interested they surmised each of the other prospective chatters would be in interacting with them.

Only after they exited the scanner did they learn that, in fact, the faces were of actors, not study participants, and that there would be no Internet chat. The scenario was intended to keep the teens engaged –– maintain a high level of anticipation/motivation –– during the tasks. This helped to ensure that the scanner would detect contrasts in brain circuit responses to high interest versus low interest peers.

Although the faces were selected by the researchers for their happy expressions, their attractiveness was random, so that they appeared to be a mix of typical peers encountered by teens.

As expected, the teen participants deemed the same faces they initially chose as high interest to be the peers most interested in interacting with them. Older participants tended to choose more faces of the opposite sex than younger ones. When they appraised anticipated interest from peers of high interest compared with low interest, older females showed more brain activity than younger females in circuitry that processes social emotion.

"This developmental shift suggested a change in socio-emotional calculus from avoidance to approach," noted Pine. The circuit is made up of the nucleus accumbens (reward and motivation), hypothalamus (hormonal activation), hippocampus (social memory) and insula (visceral/subjective feelings).

By contrast, males showed little change in the activity of most of these circuit areas with age, except for a decrease in activation of the insula. This may reflect a waning of interpersonal emotional ties over time in teenage males, as they shift their interest to groups, suggest Pine and colleagues.

"In females, absence of activation in areas associated with mood and anxiety disorders, such as the amygdala, suggests that emotional responses to peers may be driven more by a brain network related to approach than to one related to fear and withdrawal," said Pine. "This reflects resilience to psychosocial stress among healthy female adolescents during this vulnerable period."






Nodes of a brain circuit for social emotion and approach behavior activated more in teenage girls than in boys with age. Functional MRI data (red) superimposed on anatomical MRI images.

Source: NIMH Emotion and Development Branch







Teenage participants were first asked to rate their interest in peers with whom they might communicate in an internet chat room (left). Two weeks later, while in a brain scanner, they were asked to rate how interested the same peers were in interacting with them (right).

Source: NIMH Emotion and Development Branch

Reference
Probing the neural correlates of anticipated peer evaluation in adolescence. Guyer AE, McClure-Tone EB, Shiffrin ND, Pine DS, Nelson EE. July 2009, Child Development.

###
The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit the NIMH website.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit the NIH website.

New Food-Addiction Link Found

Mere sight/smell of food spikes levels of brain “pleasure” chemical
UPTON, NY — Scientists at the U.S. Department of Energy’s Brookhaven National Laboratory have found that the mere display of food — where food-deprived subjects are allowed to smell and taste their favorite foods without actually eating them — causes a significant elevation in brain dopamine, a neurotransmitter associated with feelings of pleasure and reward. This activation of the brain’s dopamine motivation circuits is distinct from the role the brain chemical plays when people actually eat, and may be similar to what addicts experience when craving drugs. LCSW CEUs
“Eating is a highly reinforcing behavior, just like taking illicit drugs,” said psychiatrist Nora Volkow, the study’s lead investigator. “But this is the first time anyone has shown that the dopamine system can be triggered by food when there is no pleasure associated with it since the subjects don’t eat the food. This provides us with new clues about the mechanisms that lead people to eat other than just for the pleasure of eating, and in this respect may help us understand why some people overeat.” The study will appear in the June 1, 2002 issue of Synapse (now available online ).

Brookhaven scientists have done extensive research showing that addictive drugs increase the levels of dopamine in the brain, and that addicts have fewer dopamine receptors than non-addicts. Last year, in an effort to understand the relationship of the dopamine system to obesity, they found that obese individuals also had fewer dopamine receptors than normal control subjects.

In the new study, the scientists investigated the role of dopamine in food intake in healthy, non-obese individuals. The researchers used positron emission tomography (PET), a brain-scanning technique, to measure dopamine levels in 10 food-deprived volunteers. Each volunteer was given an injection containing a radiotracer, a radioactive chemical “tag” designed to bind to dopamine receptors in the brain. The PET camera picks up the radioactive signal to measure the level of tracer. Since the tracer competes with dopamine for binding to the receptor, the amount of bound tracer can be used to infer the concentration of dopamine (more bound tracer = less dopamine).


These brain scans can be used to infer brain dopamine levels in the four experimental conditions (with and without food stimulation, paired with and without an oral dose of Ritalin). Note that the tracer signal in the Ritalin + food scan is significantly lower than the others. This is because the radiotracer competes with natural brain dopamine for binding to the receptor. When there is a lot of tracer bound (the first three conditions), it means there is not as much natural brain dopamine. When there is little tracer bound (as in the Ritalin + food scan), there is more natural brain dopamine occupying the receptor sites. So, it is an inverse relationship (a low tracer signal = a high dopamine level). Hi-res image (300 dpi jpeg).



Study subjects’ brains were scanned four times over a two-day period, with and without food stimulation, paired with and without an oral dose of methylphenidate. Methylphenidate (Ritalin) is known to block the reabsorption of dopamine into nerve cells. The researchers wanted to see if it would amplify any subtle changes in dopamine levels.

For food stimulation, the volunteers were presented with foods they had previously reported as their favorites. The food was warmed to enhance the smell and the subjects were allowed to view and smell it, as well as taste a small portion placed on their tongues with a cotton swab. As a control, during scans when food stimulation was not used, subjects were asked to describe in as much detail as possible their family genealogy. Study participants were also instructed to describe, on a scale of 1 to 10, whether they felt hungry or desired food prior to food stimulation and then at five-minute intervals for a total of 40 minutes.

The researchers found that food stimulation in combination with oral methylphenidate produced a significant increase in extracellular dopamine in the dorsal striatum. There was also a correlation between the increase in dopamine triggered by food stimulation and methylphenidate and the changes in self-reports of ‘hunger’ and ‘desire for food.’ “This suggests the dopamine increases during the food/methylphenidate condition reflect the responses to food stimulation and not the isolated effects of methylphenidate,” Volkow said.

The study demonstrates that methylphenidate, when used at low doses, amplifies weak dopamine signals. It also shows, for the first time, that the dopamine system in the dorsal striatum plays a role in food motivation in the human brain.

This relationship was not observed in the ventral striatum, which includes the nucleus accumbens, the area of the brain thought to be responsible for food reward. “We and others previously thought the nucleus accumbens was the primary brain region associated with regulating food intake by modulating reward and pleasure while eating,” said study coauthor Gene-Jack Wang. “These findings challenge that belief.”

This study was funded by the U.S. Department of Energy, which supports basic research in a variety of scientific fields, and the National Institute on Drug Abuse.

MFT Continuing Education, LCSW Continuing Education, LPC Continuing Education

Alabama
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Alaska
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW) and Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)

Arizona
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Arkansas
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)

California
Approved by the California Board of Behavioral Sciences for licensed Marriage and Family Therapists (MFT, LMFT), Marriage and Family Therapist Interns/Trainee (MFTI), Licensed Clinical Social Workers (LCSW) and Associate Clinical Social Workers (ASW).
Approved by the California Certification Board of Alcohol and Drug Counselors for licensed Drug and Alcohol Abuse Counselors (CADC I & II, CPS, CSS, CADCA)

Colorado
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

Connecticut
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

Delaware
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Meets qualifications in Rule 7.2.5 for licensed Social Workers (LCSW, LSW) (check with state board for further clarification)

Florida
Approved by the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)

Georgia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Hawaii
No continuing education requirements for license renewal for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

Idaho
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Not approved for licensed Social Workers (LCSW, LSW)

Illinois
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)

Indiana
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

Iowa
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Meets requirements stated in Rule 645-281.3 standards of the Iowa Administrative Rules (see state board for further clarification) for licensed Social Workers (LCSW, LSW)

Kansas
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW), Marriage and Family Therapist and Mental Health Counselors (MHC)

Kentucky
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)

Louisiana
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)

Maine
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Check state board for approval requirements for licensed Social Workers (LCSW, LSW)

Maryland
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Check state board for approval requirements for licensed Social Workers (LCSW, LSW)

Massachusetts
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Michigan
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
No continuing education requirements for license renewal for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

Minnesota
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)
Check with board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)

Mississippi
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)

Missouri
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Montana
Approved by the Montana Board of Social Work Examiners, Professional Counselors & Marriage and Family Therapists for licensed Social Workers (LCSW, LSW), Professional Counselors (LPC, LPCC), and licensed Marriage and Family Therapists (MFT, LMFT)

Nebraska
Meets criteria of an approved continuing education program provider for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

Nevada
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapist and Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Social Workers (LCSW, LSW) (check with state board for CE requirements)

New Hampshire
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)

New Jersey
Accepts approval from the National Board for Certified Counselors (NBCC) for Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Not approved for Licensed Social Workers (LCSW, LSW)


New Mexico
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)

New York
No continuing education requirements for license renewal for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

North Carolina
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapists (MFT, LMFT)
Not approved for licensed Social Workers (LCSW, LSW)

North Dakota
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapist and Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Social Workers (LCSW, LSW) (check with state board for CE requirements)

Ohio
Approved by the Counselor, Social Worker and Marriage and Family Therapist Board of Ohio for licensed Marriage and Family Therapists (MFT, LMFT)
Approved by the Counselor, Social Worker and Marriage and Family Therapist Board of Ohio for licensed Mental Health Counselors (MHC)
Not approved for licensed Social Workers (LCSW, LSW)

Oklahoma
Approved by the Oklahoma State Department of Health - Professional Counselor Licensing Board for licensed Marriage and Family Therapists (MFT, LMFT) and Licensed Professional Counselors (LPC)
Not approved for licensed Social Workers (LCSW, LSW)

Oregon
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Pennsylvania
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

Rhode Island
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Not approved for licensed Social Workers (LCSW, LSW)

South Carolina
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

South Dakota
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Tennessee
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Meets requirements stated in Rule 1365-01-.09 for CE credit for licensed Social Workers (LCSW, LSW) (see state board for further clarification)

Texas
Approved by the Texas Board of Examiners of Marriage and Family Therapists (MFT, LMFT) for licensed Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Utah
Meets requirements stated in rule R156-60b-304 for licensed Marriage and Family Therapists (MFT, LMFT) (see state board for further clarification on CE requirements)
Meets requirements stated in rule R156-60c-304 for licensed Professional Counselors (LPC, LPCC) (see state board for further clarification on CE requirements)
Not pre-approved for licensed Social Workers (LCSW, LSW) (see state board for further clarification on CE requirements)

Vermont
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Meets requirements stated in rule 3.3 Formal Activities (2), 3.4(2)(3) for licensed Social Workers (LCSW, LSW) (see state board for further clarification on CE requirements)

Virginia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)

Washington
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)

West Virginia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) (check with state board for CE requirements)
No CE Provider status approval required for Category II (Individual Professional Activities) CE credit for licensed Social Workers (LCSW, LSW)

Wisconsin
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)

Wyoming
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)


MFT Continuing Education

LCSW Continuing Education

LPC Continuing Education Units, Credits, Hours

Drug and Alchohol Counselor Continuing Education CEUs

Common Stress Reactions Following Exposure To Trauma

Common Stress Reactions Following Exposure To Trauma
Psychological and EmotionalInitial euphoria, relief
Guilt about surviving or not having suffered as much as others
Anxiety, fear, insecurity, worry
Pervasive concern about well-being of loved ones
Feelings of helplessness, inadequacy, being overwhelmed
Vulnerability
Loss of sense of power, control, well-being, self-confidence, trust
Shame, anger over vulnerability
Irritability, restlessness, hyperexcitability, impatience, agitation, anger, blaming (anger at source, anger at those exempted, anger at those trying to help, anger “for no apparent reason”)
Outrage, resentment
Frustration
Cynicism, negativity
Mood swings
Despair, grief, sadness
Periods of crying, emotional “attacks” or “pangs”
Feelings of emptiness, loss, hopelessness, depression
Regression
Reawakening of past trauma, painful experiences
Apathy, diminished interest in usual activities
Feelings of isolation, detachment, estrangement, “no one else can understand”
Denial or constriction of feelings; numbness
“Flashbacks,” intrusive memories of the event, illusions, pseudo-hallucinations
Recurrent dreams of the event or other traumas
Cognitive
Poor concentration
Mental confusion, slowness of thinking
Forgetfulness
Amnesia (complete or partial)
Inability to make judgments and decisions
Inability to appreciate importance or meaning of stimuli
Poor judgment
Loss of appropriate sense of reality (denial of reality, fantasies to counteract reality)
Preoccupation with the event
Repetitive, obsessive thoughts and ruminations
Over-generalization, over-association with the event
Loss of objectivity
Rigidity
Confusion regarding religious beliefs/value systems; breakdown of meaning and faith
Self-criticism over things done/not done during trauma
Awareness of own and loved ones’ mortality
http://www.aspirace.com

Autism

What is autism?

Autism, also called autistic disorder, appears in early childhood, usually before age 3 (National Institutes of Health, 2001). Autism prevents children and adolescents from interacting normally with other people and affects almost every aspect of their social and psychological development.

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What are the signs of autism?

Autism has a wide variety of characteristics ranging in intensity from mild to severe. One child with autism does not behave like another child with the same diagnosis. Children and adolescents with autism typically:


Have difficulty communicating with others.
Exhibit repetitious behaviors, such as rocking back and forth, head banging, or touching or twirling objects.
Have a limited range of interests and activities.
May become upset by a small change in their environment or daily routine.
In addition to these characteristics, some children with autism experience hypersensitivity to hearing, touch, smell, or taste. Symptoms of autism can be seen in early infancy, but the condition also may appear after months of normal development. In most cases, however, it is not possible to identify a specific event that triggers the disorder.

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How common is autism?

Studies estimate that as many as 12 in every 10,000 children have autism or a related condition (U.S. Department of Health and Human Services, 1999). Autism is three times more common in boys than in girls (National Institutes of Health, 2001).

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What causes autism?

Researchers are unsure about what causes autism. Several studies suggest that autism might be caused by a combination of biological or environmental factors, or both, including viral exposure before birth, a problem with the immune system, or genetics. Many recently published scientific investigations have examined the possible connection between autism and the measles, mumps, and rubella (MMR) vaccine. At this time, though, the available data do not appear to support a causal link.

Studies of families and twins suggest a genetic basis for the disorder. It is important for scientists to find the genes responsible for autism, if any, because this knowledge would give physicians new tools to diagnose the disorder and help scientists develop gene-based therapies.

Some studies have found that the brains of people with autism may function differently from those that are considered "normal." Research suggests that an abnormal slowing down of brain development before birth may cause autism. Studies also are looking at how autism-related problems in brain development may affect behavior later in childhood. For example, some researchers are investigating the ways in which infants with autism process information and how the disorder may lead to poor development of social skills, knowledge, and awareness.

Chemicals in the brain also may play a role in autism. As a normal brain develops, the level of serotonin, a chemical found in the brain, declines. In some children with autism, however, serotonin levels do not decline. Researchers are investigating whether this happens only to children with autism or whether other factors are involved.

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What help is available for families?

Since brain development can be influenced during early childhood, the treatment of autism has a greater chance of success when initiated as early as possible. In addition, when children with autism are treated early, the cost of long-term care may be reduced. Services and treatments that may benefit children and adolescents with autism and their families include:


Training in communication, social, learning, and self-help skills.
Programs in which other children help to teach children with autism.
Parent training.
Medications to reduce symptoms related to self-injury, seizures, digestive difficulties, and attention problems.
When services are started soon after a child is diagnosed with autism, the child's language, social, and academic skills and abilities may be greatly improved. On the other hand, some children and adolescents do not respond well to treatment or may experience negative side effects from autism medications. Recent data suggest that some of the newer antipsychotic drugs may have fewer side effects than conventional drugs, but more studies are needed before experts can determine any possible safety advantages over traditional treatments.

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What can parents do?

Parents or other caregivers concerned about a child who shows symptoms of autism should:


Talk with a health care provider about their concerns. He or she can help to determine whether the symptoms are caused by autism, a related disorder, or another condition. If necessary, the health care provider can refer the family to a mental health expert who specializes in treating persons with autism.
Get accurate information from libraries, hotlines, or other sources.
Ask questions about treatments and services.
Talk to other families in their communities who are coping with autism.
Find family network organizations.
People who are not satisfied with the mental health care they receive should discuss their concerns with the provider, ask for information, and/or seek help from other sources.

This is one of many fact sheets in a series on children's mental health disorders. All the fact sheets listed below are written in an easy-to-read style. Families, caretakers, and media professionals may find them helpful when researching particular mental health disorders. To obtain free copies, call 1-800-789-2647 or visit http://mentalhealth.samhsa.gov/child.

Mental Health Stigma

Anti-Stigma: Do You Know the Facts?
Stigma is not just a matter of using the wrong word or action. Stigma is about disrespect. It is the use of negative labels to identify a person living with mental illness. Stigma is a barrier. Fear of stigma, and the resulting discrimination, discourages individuals and their families from getting the help they need. An estimated 22 to 23 percent of the U.S. population experience a mental disorder in any given year, but almost half of these individuals do not seek treatment (U.S. Department of Health and Human Services, 2002; U.S. Surgeon General, 2001).

The educational information on this web site encourages the use of positive images to refer to people with mental illness and underscores the reality that mental illness can be successfully treated.

Do you know that an estimated 44 million Americans experience a mental disorder in any given year?

Do you know that stigma is not a matter of using the wrong word or action?

Do you know that stigma is about disrespect and using negative labels to identify a person living with mental illness?

Do you know that stigma is a barrier that discourages individuals and their families from seeking help?

Do you know that many people would rather tell employers they committed a petty crime and served time in jail, than admit to being in a psychiatric hospital?

Do you know that stigma can result in inadequate insurance coverage for mental health services?

Do you know that stigma leads to fear, mistrust, and violence against people living with mental illness and their families?

Do you know that stigma can cause families and friends to turn their backs on people with mental illness?

Do you know that stigma can prevent people from getting access to needed mental health services?

DO'S

Do use respectful language

Do emphasize abilities, not limitations.

Do tell someone if they express a stigmatizing attitude.

DONT'S

Don't portray successful persons with disabilities as super human.

Don't use generic labels such as retarded, or the mentally ill.

Don't use terms like crazy, lunatic, manic depressive, or slow functioning.

Disaster Crisis Counseling Program

Crisis Counseling Programs for the Rural Community
Disaster Crisis Counseling Program
The Nature of Disasters
Definition of a Federal Disaster Declaration

The Federal Emergency Management Agency (FEMA) provides supplemental funding to States for short-term crisis counseling projects to assist survivors/victims of Presidentially declared major disasters. FEMA supplements, but does not supplant, mental health services traditionally provided by State and local mental health agencies. The Crisis Counseling Assistance and Training Program (commonly referred to as the Crisis Counseling Program) was first authorized by the U.S. Congress under the Disaster Relief Act of 1974 (Public Law 93-288) and later modified by the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988 (Public Law 100-707). FEMA is responsible for administering the disaster assistance programs of the Stafford Act, including Federal assistance for crisis counseling services.

A major disaster, as defined by the Stafford Act, is any natural catastrophe, or regardless of cause, any fire, flood, or explosion, which in the determination of the President causes damage of sufficient severity and magnitude to warrant major disaster assistance to supplement efforts and available resources of States, local government, and disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused by the disaster.

Disaster Types

Different types of disasters covered by the Stafford Act that may impact rural areas include: hurricane, tornado, storm, high water, wind driven water, tidal wave, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm, drought, fire, flood, or explosion. Disasters also differ by a number of characteristics including the following:

Origin of disaster (natural versus human-caused)


Length of warning time

Intensity of the event

Extent of property damage

Number of persons impacted

Number of injuries and deaths

Dynamics of the recovery period
Each type of disaster has its own unique pattern of destruction and characteristics that affect the emotional response of disaster victims (NIMH, 1983):

Flood disasters can result in long incident periods and the evacuation of whole communities.

Earthquakes strike without warning and after shocks intensify fright and despair.

Tornadoes randomly choose their victims, skipping one house and striking the next.

Hurricanes can be unpredictable and suddenly change course causing the evacuation of large areas.
Disasters may be classified as either natural or human-caused. The following chart describes the different characteristics of natural and human-caused disasters. Blame is a characteristic that differs significantly for natural and human-caused disasters. Disaster survivors of human-caused disasters may blame and feel anger toward individuals, groups, or organizations they believe caused or contributed to the disaster. In contrast, survivors of natural disasters may blame and feel anger toward themselves, believe it is "God's Will" or a punishment. Survivors of natural disasters may project their anger onto caretakers, disaster workers, or others (CMHS, 1996).


Natural vs. Human-Caused Disasters

Natural Human-Caused
Causes Forces of nature Human error, malfunctioning
Examples Earthquakes, hurricanes, floods Airplane crashes, major chemical leaks, nuclear reactor accidents
Blame No one Person, government, business
Scope Various locations Locations may be inaccessible to rescuers, unfamiliar to survivors, little advance warning
Post-disaster
Distress High Higher, often felt by family members not involved in actual disaster

Source: CMHS. Psychosocial Issues for Children and Families in Disasters. A Guide for the Primary Care Physician. Washington, D.C.: U.S. Department of Health and Human Services; Publication No. (SMA) 96-3077, 1996.


Definition of Crisis Counseling Services
The Crisis Counseling Program, as it has been supported in the past twenty-five years by the Federal government, provides for short-term interventions with individuals and groups experiencing psychological sequelae from Presidentially-declared disasters. This type of intervention involves classic counseling goals of helping people to understand their current situation and reactions, assisting in the review of their options, providing emotional support, and encouraging linkage with other resources and agencies who may assist the individual. The assistance is focused upon helping the person deal with the current situation in which they may find themselves.

It draws upon the assumption, until there are contradictory indications, that the individual can resume a productive and fulfilling life following the disaster experience if given support, assistance, and information at a time and in a manner appropriate to his or her experience, education, developmental stage, and ethnicity (CMHS, 1994.

The Emergency Services and Disaster Relief Branch (ESDRB) of the Center for Mental Health Services (CMHS) will provide technical assistance to states in developing a grant request.
The ESDRB can be reached by phone at (301) 443-4735.
The Crisis Counseling Program is unique in comparison to the mix of Federal programs made available through a Presidential disaster declaration. It is the one program for which virtually anyone qualifies and where the person affected by disaster does not have to recall numbers, estimate damages, or otherwise justify need. The program provides primary assistance in dealing with the emotional sequelae to disaster.

Robert T. Stafford Act

The Stafford Act authorizes the President to provide training and services to alleviate mental health problems caused or aggravated by declared disasters. The Crisis Counseling Program is designed to provide supplemental funding to States for short-term crisis counseling services and is implemented when creating such services are beyond the resources of the State or local providers, given a Presidential disaster declaration.

FEMA may fund two separate portions of the Crisis Counseling Program: Immediate Services (IS) and Regular Services (RS). The IS grant enables the State and its local agency to respond to the immediate mental health needs with crisis counseling services. IS can be funded for up to sixty days after the Presidential declaration. If an RS application has been submitted, the program period for the immediate services may be extended thirty days and additional funding may be awarded. FEMA may approve a longer extension, if the review process of the regular program application exceeds thirty days. Costs incurred from the date of the incident to the date of declaration may be reimbursable under the immediate services program. The RS provides up to nine months of crisis counseling services, community outreach, and consultation and education services to people affected by the disaster. Funding for RS is separate from IS. The State may apply for either or both portions of the Crisis Counseling Program.

Application for IS funding must be completed within fourteen days of the disaster declaration. The application must contain a disaster description, needs assessment, program plan, budget, and budget narrative. The needs assessment is based on the needs of the affected communities and the ability of the current mental health system to respond to those needs. A State must demonstrate that State and local resources are insufficient to provide adequate services.

Differences Between Disaster Mental Health and Traditional Mental Health Programs

Disaster Crisis Counseling Programs are a departure from traditional mental health practice in many ways. The program is designed to address incident specific stress reactions, rather than ongoing or developmental mental health needs (CMHS, 1994). Programs must be structured and implemented according to Federally established guidelines and for a specific period. Emphasis is on serving individuals, families, and groups of people - all of whom share a devastating event that most likely changed the face of their entire community.

CRISIS COUNSELING PROGRAM
Immediate Services
Application due in fourteen days
Sixty-day program
Extension if RS is applied for
Regular Services
Apply within sixty days of declaration
Nine month program
Applications must include
Disaster description
Needs Assessment
Program Plan
Budget
Budget narrative
for more information click below
crisis counseling ceus

Outreach and crisis counseling activities are the core of the Crisis Counseling Program and create a unique set of challenges. Disaster crisis counseling requires breaking out of traditional ways of identifying people in need of services, providing access to those services, maintaining documentation, and determining effectiveness. Mental health professionals will work hand-in-hand with paraprofessionals, volunteers, community leaders, and survivors/victims of the disaster in ways that may be foreign to their clinical training. This publication will focus on the implementation of appropriate crisis counseling services for rural communities across the United States.

LCSW CEU Requirements

LCSW CEU Requirements

The Board of Behavioral Sciences for California has determined that all ceus may be earned by homestudy.

What is the difference between an Online Interactive CE Course and a Homestudy Course?
If you submit a completed course/exam to the CE provider via regular mail, then you have taken a homestudy course. If the course/exam is completed and submitted online, then the hours are approved as regular continuing education. Many state boards, such as the California Board of Behavioral Services, allow all required continuing education to be earned from online interactive continuing education courses. Check with your respective board to determine the amount of hours/units are permitted online.