From Neurons to Thought: Coherent Electrical Patterns Observed Across the Brain

Amidst the background hum of electrical signaling generated by neurons in the brain, scientists have found that local groups of neurons, firing in coordination, sometimes create a signal that is mirrored instantaneously and precisely by other groups of neurons across the brain. These transient episodes of coherence across different parts of the brain may be an electrical signature of thought and actions. MFT CEUs
Background
One of the goals of neuroscience research is to identify how thoughts and actions are encoded in the activity of neurons. A challenge has been to extract meaningful patterns from the ongoing tumult of electrical activity in the brain. This global electrical activity is built from the firing of individual neurons. A single neuron responds to a stimulus in an all or nothing manner—if the stimulus reaches a certain threshold, the neuron “fires” an electrical signal. Groups of neurons firing in a coordinated way create a local electrical field that is in itself a signal that can vary in pattern. These local field potentials (LFPs) have been a target of research.

This Study
In this research, Dietmar Plenz and colleagues at NIMH and Duke University pinpointed LFPs in the cortex that surpassed a minimal size threshold, and then searched the rest of the cortex to see what was occurring at the same time. In each case, they found other answering LFPs across the brain that mimicked each other with high precision: there was no degradation or loss of power (amplitude) in the signal. Unlike what is observed after dropping a stone in a pond—with wavelets getting smaller farther from the stone—the intensity of the LFPs was the same across the brain. The investigators call these LFPs coherence potentials. Although LFPs that occur during these transient episodes of coherence are identical to each other, they are also multidimensional and potentially infinitely diverse, providing a means to encode information. Most LFPs do not reach the threshold that characterizes a coherence potential but with those that do, propagation of the LFPs across the brain is extraordinarily rapid. The authors note that the rapid dispersion of such a signal mimics the spread of ideas and behaviors in social networks; a sufficiently provocative idea can spread very swiftly through a population.

Significance
Coherence potentials simultaneously engage groups of neurons in different parts of the brain with diverse functions. This is consistent with the multi-faceted nature of mental associations and memories—a memory focused on a person or object might conjure various kinds of sensations and thoughts—visual, tactile, auditory, and emotional, for example.

These findings emerged from recent work that demonstrated that, like other systems in nature, the cortex exists at a critical state between stability and instability. A characteristic of this state in the brain is the presence of neuronal avalanches—if a stimulus reaches a certain threshold, it will set off cascades of neuronal firing. This dynamic is analogous to when the slope of a sandpile reaches a point at which adding one more grain will trigger an avalanche. The adherence of the cortex to this critical state ensures that the brain can respond to a wide range of stimuli, but not lapse into a chaos of excess activity (such as the too-synchronous firing during epilepsy). Coherence potentials emerge predominantly when the cortex is critical, that is, when it displays neuronal avalanches. Nudging the cortex away from this point, by inhibiting neuronal signaling with medications for example, disrupts these dynamical patterns.

What’s Next
Coherence potentials were present in cells in culture as well as awake monkeys, a robust demonstration that they occur in the functioning cortex. Future studies will be aimed at monitoring coherence potentials in the context of behavioral function with the ultimate aim of making a connection between specific coherence potentials and behaviors.

Reference
Thiagarajan, T.C., Lebedev, M.A., Nicolelis, M.A., and Plenz, D. Coherence potentials: loss-less, all-or-none network events in the cortex. PLoS Biology 2010, doi:10.1371/journal.pbio.1000278.

Early Mental Health Intervention Reduces Mass Violence Trauma

Early psychological intervention guided by qualified mental health caregivers can reduce the harmful psychological and emotional effects of exposure to mass violence in survivors, according to a national conference report released today. Experts emphasized that although more research is needed, existing data, including studies of other kinds of traumatic events, as well as clinical experience, provide useful guidance to the mental health community in responding to mass violence.

"School violence, shootings in the workplace, and terrorist acts have increased Americans' exposure to mass violence during the past decade, and psychological interventions are increasingly among the first responses to it. It is vital to the health and well-being of the American people that effective interventions reach the people who need them in a timely and efficient manner," said LTC (Dr.) Elspeth C. Ritchie, U.S. Army, chairperson of the planning committee for the conference.

The report calls on the scientific community to develop a national research program to examine the relative effectiveness of early mental health interventions following exposure to mass violence. Early intervention is defined as any form of psychological intervention delivered within the first four weeks following mass violence or disasters. Examples of early interventions include brief, focused psychotherapeutic intervention and selected cognitive behavioral approaches.

The report says that some interventions—including mass education via media outlets—although beneficial, have the potential for unintended harm. The report recommends that the leadership select professionals who have the training, expertise, accountability, and responsibility required to provide these interventions. Also, the report cites some evidence that early intervention in the form of a single one-to-one recital of events and discussion of emotions evoked by a traumatic event does not consistently reduce risk and may even put some survivors at heightened risk for later developing mental health problems.

The report is targeted to those who deliver these interventions to emotionally distressed persons following mass violence, to those who research these issues, and to employers who want to help workers who have experienced this type of emotional trauma. It is also intended to aid officials who must decide what mental health help to include in the local, state, and national responses to survivors of mass violence and terrorism. Prepared by 58 mental health researchers and clinicians from the U.S. and five other countries, the report details what is effective, what is not, and what questions require further research.

The report provides guidance on screening for mass violence trauma-related mental health problems, on follow-up with trauma-exposed persons, and on the expertise, skills, and training for providers of early intervention services. The report also addresses what is known about timing for various types of early interventions.

Participants agreed that it is sensible to expect persons to recover from the trauma of mass violence, although some groups may be more vulnerable, such as those with preexisting mental disorders. They also agreed that most survivors who show no clinically significant symptoms for approximately two months generally do not require follow-up and that participation of survivors in early intervention sessions should be voluntary.

The report includes an outline of a sample training program for an early intervention workforce. Recognizing that persons who arrive first at a scene of mass violence may not be trained to provide early mental health interventions, participants recommended that early response personnel be trained to make appropriate referrals when additional expertise is needed. MFT CEUs
Entitled “Mental Health and Mass Violence: Evidence-Based Early Psychological Intervention for Victims/Survivors of Mass Violence. A Workshop to Reach Consensus on Best Practices," the report was developed by the National Institute of Mental Health (NIMH) at the National Institutes of Health in the U.S. Department of Health and Human Services, the U.S. Departments of Defense, Justice, and Veterans Affairs, and the American Red Cross.

Terrorist Attacks and Children

Jessica Hamblen, Ph.D.
When terrorist attacks occur, our children may witness or learn about these events by
watching TV, talking with people at school, or over hearing adults discussing the events. For
instance, the September 11th, 2001 attacks and the Oklahoma City bombing received
widespread attention and media coverage and many children were exposed. But how should
we speak to our children about these events when they occur? Should we shield them from
such horrors or talk openly about them? How can we help children make sense of a tragedy
that we ourselves cannot understand? How will children react? How can we help our children
recover? Fortunately, there have been relatively few terrorist attacks. One consequence of this is that there is little empirical research to help us answer the above questions.

Information from related events can be used to provide answers.
How do children respond to terrorism?
There is a wide range of emotional, behavioral, and physiological reactions that children may
display following a terrorist attack. From previous research, we know that more severe
reactions are associated with a higher degree of exposure (i.e., life threat, physical injury, witnessing death or injury, hearing screams, etc.), closer proximity to the disaster, a history of prior traumas, being female, poor parental response, and parental mental health problems. There is some research on children from the September 11th, 2001 attacks and the Oklahoma City Bombing. In a national sample of adults surveyed 3-5 days after the September 11th attacks, 35% of parents reported that their children had at least one stress symptom and almost half reported that their children were worried about their own safety or the safety of a loved one. Two factors related to increased stress symptoms were 1) amout of television coverage viewed by the child, and 2) parental distress. Children who watched the most coverage were reported to have more stress symptoms than those who watched less coverage. Similiarly, parents who endorsed more stress symptoms were also more likely to
report that their children were upset, indicating a relationship between parental and child
distress. Findings from a study following the Oklahoma City bombing indicate that more severe
reactions were related to being female, knowing someone injured or killed, and bomb-related
television viewing and media exposure.

Below are some common reactions that children and adolescents may display.
Young Children (1-6 years)
• Helplessness and passivity; lack of usual responsiveness
• Generalized fear
• Heightened arousal and confusion
• Cognitive confusion
• Difficulty talking about event; lack of verbalization
• Difficulty identifying feelings
• Nightmares and other sleep disturbances
• Separation fears and clinging to caregivers
• Regressive symptoms (e.g., bedwetting, loss of acquired speech and motor skills)
• Inability to understand death as permanent
• Anxieties about death
• Grief related to abandonment by caregiver
• Somatic symptoms (e.g., stomach aches, headaches)
• Startle response to loud or unusual noises
• "Freezing" (sudden immobility of body)
• Fussiness, uncharacteristic crying, and neediness
• Avoidance of or alarm response to specific trauma-related reminders involving sights
and physical sensations
School-aged Children (6-11 years)
• Feelings of responsibility and guilt
• Repetitious traumatic play and retelling
• Feeling disturbed by reminders of the event
• Nightmares and other sleep disturbances
• Concerns about safety and preoccupation with danger
• Aggressive behavior and angry outbursts
• Fear of feelings and trauma reactions
• Close attention to parents' anxieties
• School avoidance
• Worry and concern for others
• Changes in behavior, mood, and personality
• Somatic symptoms (complaints about bodily aches and pains)
• Obvious anxiety and fearfulness
• Withdrawal
• Specific trauma-related fears; general fearfulness
• Regression (behaving like a younger child)
• Separation anxiety
• Loss of interest in activities
• Confusion and inadequate understanding of traumatic events (more evident in play
than in discussion)
• Unclear understanding of death and the causes of "bad" events
• Giving magical explanations to fill in gaps in understanding
• Loss of ability to concentrate at school, with lowering of performance
• "Spacey" or distractible behavior
Pre-adolescents and Adolescents (12-18 years)
• Self-consciousness
• Life-threatening reenactment
• Rebellion at home or school
• Abrupt shift in relationships
• Depression and social withdrawal
• Decline in school performance
• Trauma-driven acting out, such as with sexual activity and reckless risk taking
• Effort to distance oneself from feelings of shame, guilt, and humiliation
• Excessive activity and involvement with others, or retreat from others in order to
manage inner turmoil
• Accident proneness
• Wish for revenge and action-oriented responses to trauma
• Increased self-focusing and withdrawal
• Sleep and eating disturbances, including nightmares

Tips for talking with your children about terrorism
Create a safe environment.
One of the most important steps you can take is to help children feel safe. If possible, children should be placed in a familiar environment with people that they feel close to. Keep your child's routine as regular as possible. Children find comfort in having things be consistent and familiar. Provide children with reassurance and extra emotional support.
Adults need to create an environment in which children feel safe enough to ask questions,
express feelings, or just be by themselves. Let your children know they can ask questions. Ask your children what they have heard and how they feel about it. Reassure your child that they are safe and that you will not abandon them. Be honest with children about what happened. Provide accurate information, but make sure it is appropriate to their developmental level. Very young children may be protected because they are not old enough to be aware that something bad has happened. School age children will need help understanding what has happened. You might want to tell them that there has been a terrible accident and that many people have been hurt or killed. Adolescents will have a better idea of what has occurred. It may be appropriate to watch selected news coverage with your adolescent and then discuss it. Tell children what the government is doing. Reassure children that the state and federal government, police, firemen, and hospitals are doing everything possible. Explain that people from all over the country and from other countries offer their services in times of need. Be aware that children will often take on the anxiety of the adults
around them. Parents have difficulty finding a balance between sharing their own feelings with their children and not placing their anxiety on their children. For example, the September 11 th attack on the United States was inconceivable. Our sense of safety and freedom was shattered. Many parents felt scared and fearful of another attack. Others were angry and revengeful. Parents must deal with their own emotional reactions before they can help children understand and label their feelings. Parents who are frightened may want to explain that to their child, but they should also talk about their ability to cope and how family members can help each other. Try to put the event in perspective.
Although you yourself may be anxious or scared, children need to know that attacks are rare
events. They also need to know that the world is generally a safe place.

What can parents do?
(Excerpted from Monahon)
Infancy to two and a half years:
• Maintain child's routines around sleeping and eating.
• Avoid unnecessary separations from important caretakers.
• Provide additional soothing activities.
• Maintain calm atmosphere in child's presence.
• Avoid exposing child to reminders of trauma.
• Expect child's temporary regression; don't panic.
• Help a verbal child to give simple names to big feelings; talk about event in simple
terms during brief chats.
• Give simple play props related to the actual trauma to a child who is trying to play out
the frightening situation (e.g., a doctor's kit, a toy ambulance).
Zero-to-Three has published excellent guidelines for parents whose very young children (ages
0 to 3) might have been exposed to media or conversations about the September 11 th
terroristic attacks.
Two and a half to six years:
• Listen to and tolerate child's retelling of the event.
• Respect child's fears; give child time to cope with fears.
• Protect child from re-exposure to frightening situations and reminders of trauma,
including scary TV programs, movies, stories, and physical or locational reminders of
trauma.
• Accept and help the child to name strong feelings during brief conversations (the child
cannot talk about these feelings or the experience for long).
• Expect and understand child's regression while maintaining basic household rules.
• Expect some difficult or uncharacteristic behavior.
• Set firm limits on hurtful or scary play and behavior.
• If child is fearful, avoid unnecessary separations from important caretakers.
• Maintain household and family routines that comfort child.
• Avoid introducing experiences that are new and challenging for child.
• Provide additional nighttime comforts when possible such as night-lights, stuffed
animals, and physical comfort after nightmares.
• Explain to child that nightmares come from the fears a child has inside, that they
aren't real, and that they will occur less frequently over time.
• Provide opportunities and props for trauma-related play.
• Try to discover what triggers sudden fearfulness or regression.
• Monitor child's coping in school and daycare by expressing concerns and
communicating with teaching staff.
Six to eleven years:
• Listen to and tolerate child's retelling of the event.
• Respect child's fears; give child time to cope with fears.
• Increase monitoring and awareness of child's play which may involve secretive
reenactments of trauma with peers and siblings; set limits on scary or hurtful play.
• Permit child to try out new ways of coping with fearfulness at bedtime: extra reading
time, leaving the radio on, or listening to a tape in the middle of the night to erase the
residue of fear from a nightmare.
• Reassure the older child that feelings of fear and behaviors that feel out of control or
babyish (e.g., bed wetting) are normal after a frightening experience and that he or
she will feel better with time.
Eleven to eighteen years:
• Encourage adolescents of all ages to talk about the traumatic event with family
members.
• Provide opportunities for the young person to spend time with friends who are
supportive.
• Reassure the young person that strong feelings-guilt, shame, embarrassment, or a
wish for revenge-are normal following a trauma.
• Help the young person find activities that offer opportunities to experience mastery,
control, and self-esteem.
• Encourage pleasurable physical activities such as sports and dancing.
How many children develop PTSD after a terrorist attack?
• The above symptoms are normal reactions to trauma and do not necessarily mean
that a child has acquired a disorder. However, a significant minority of children will
develop posttraumatic stress symptoms after a terrorist attack. Findings from
Oklahoma City indicate that:
• Children who lost a friend or relative were more likely to report immediate symptoms
of PTSD than non-bereaved children.
• Arousal and fear presenting seven weeks after the bombing were significant predictors
of PTSD.
• Two years after the bombing, 16% of children who lived approximately 100 miles
away from Oklahoma City reported significant PTSD symptoms related to the event.
This is an important finding because these youths were not directly exposed to the
trauma and were not related to people who had been killed or injured.
• PTSD symptomatology was predicted by media exposure and indirect interpersonal
exposure, such as having a friend who knew someone who was killed or injured.
• No study specifically reported on rates of PTSD in children following the bombing.
However, studies have shown that as many as 100% of children who witness a
parental homicide or sexual assault, 90% of sexually abused children, 77% of children
exposed to a school shooting, and 35% of urban youth exposed to community violence
develop PTSD.
When should you seek professional help for your child?
Many children and adolescents will display some of the symptoms listed above as a result of
terrorist attacks. Most children will likely recover in a few weeks with social support and the
aid of their families. Many of the above suggestions will help children recover more quickly.
Other children, however, may develop PTSD, depression, or anxiety disorders. Parents of
children with prolonged reactions or more severe reactions may want to seek the assistance of
a mental-health counselor. It is important to find a counselor who has experience working with
children as well as with survivors of trauma. Referrals can be obtained through the American
Psychological Association at 1-800-964-2000. Also visit the website of the National Child
Traumatic Stress Network
References
1.Schuster, M.A., Stein, B.D., Jaycox, L.H., Collins, R.L., Marshall, G.N., Elliott, M.N., et al.
(2001). A National Survey of stress reactions after the September 11, 2001 terrorist attacks.
New England Journal Medicine, 345, 1507-1512.
2. Pfefferbaum, B., Nixon, S., Tucker, P., Tivis, R., Moore, V., Gurwitch, R., Pynoos, R., &
Geis, H. (1999). Posttraumatic stress response in bereaved children after Oklahoma City
bombing. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1372-
1379.
3. Pfefferbaum, B., Seale, T., McDonald, N., Brandt, E., Rainwater, S., Maynard, B.,
Meierhoefer, B. & Miller, P. (2000). Posttraumatic stress two years after the Oklahoma City
bombing in youths geographically distant from the explosion. Psychiatry, 63, 358-370.
4. DeWolfe, D. (2001). Mental Health Response to Mass Violence and Terrorism: A Training
Manual for Mental Health Workers and Human Service Workers.
5. Pynoos, R. & Nader, K. (1993). Issues in the treatment of posttraumatic stress in children
and adolescents. In J.P. Wilson & B. Rapheal (Eds.), International Handbook of Traumatic
Stress Syndromes (pp. 535-549). New York: Plenum.
6. Monahon, C. (1997). Children and Trauma: A Guide for Parents and Professionals. San
Francisco: Jossey Bass
MFT CEUs

Thanksgiving Day: Nov. 25, 2010

In the fall of 1621, the Pilgrims, early settlers of Plymouth Colony, held a three-day feast to celebrate a bountiful harvest, an event many regard as the nation's first Thanksgiving. Historians have also recorded ceremonies of thanks among other groups of European settlers in North America, including British colonists in Virginia in 1619. The legacy of thanks and the feast have survived the centuries, as the event became a national holiday in 1863 when President Abraham Lincoln proclaimed the last Thursday of November as a national day of thanksgiving. Later, President Franklin Roosevelt clarified that Thanksgiving should always be celebrated on the fourth Thursday of the month to encourage earlier holiday shopping, never on the occasional fifth Thursday.

242 million
The number of turkeys expected to be raised in the United States in 2010. That's down 2 percent from the number raised during 2009. The turkeys produced in 2009 together weighed 7.1 billion pounds and were valued at $3.6 billion. Source: USDA National Agricultural Statistics Service

Weighing in With a Menu of Culinary Delights
47 million
The preliminary estimate of turkeys Minnesota expected to raise in 2010. The Gopher State was tops in turkey production, followed by North Carolina (31.0 million), Arkansas (28.0 million), Missouri (17.5 million), Indiana (16.0 million) and Virginia (15.5 million). These six states together would probably account for about two-thirds of U.S. turkeys produced in 2010.

735 million pounds
The forecast for U.S. cranberry production in 2010. Wisconsin is expected to lead all states in the production of cranberries, with 435 million pounds, followed by Massachusetts (195 million). New Jersey, Oregon and Washington are also expected to have substantial production, ranging from 14 million to 53 million pounds.

1.9 billion pounds
The total weight of sweet potatoes — another popular Thanksgiving side dish — produced by major sweet potato producing states in 2009. North Carolina (940 million pounds) produced more sweet potatoes than any other state. It was followed by California (592 million pounds) and Louisiana (162 million pounds).

931 million pounds
Total production of pumpkins produced in the major pumpkin-producing states in 2009. Illinois led the country by producing 429 million pounds of the vined orange gourd. Pumpkin patches in California and Ohio also provided lots of pumpkins: Each state produced at least 100 million pounds. The value of all pumpkins produced by major pumpkin-producing states was $103 million.

If you prefer cherry pie, you will be pleased to learn that the nation's forecasted tart cherry production for 2010 totals 195 million pounds, albeit 46 percent below 2009's forecasted total. Of this 2010 total, the overwhelming majority (140 million) will be produced in Michigan.

2.2 billion bushels
The total volume of wheat — the essential ingredient of bread, rolls and pie crust — produced in the United States in 2010. North Dakota and Kansas accounted for 33 percent of the nation's wheat production.

736,680 tons
The 2010 contracted production of snap (green) beans in major snap (green) bean-producing states. Of this total, Wisconsin led all states (326,900 tons). Many Americans consider green bean casserole a traditional Thanksgiving dish.
Source: The previous data came from the USDA National Agricultural Statistics Service .

$7.3 million
The value of U.S. imports of live turkeys from January through July of 2010 — 99.1 percent from Canada. When it comes to sweet potatoes, the Dominican Republic was the source of 62.1 percent ($3.4 million) of total imports ($5.5 million). The United States ran a $3.9 million trade deficit in live turkeys during the period but had a surplus of $31.5 million in sweet potatoes.
Source: Foreign Trade Statistics .

13.8 pounds
The quantity of turkey consumed by the typical American in 2007, with no doubt a hearty helping devoured at Thanksgiving time. Per capita sweet potato consumption was 5.2 pounds.
Source: U.S. Department of Agriculture as cited in the Statistical Abstract of the United States: 2010, Tables 212-213 .

The Turkey Industry
$3.6 billion
The value of turkeys shipped in 2002. Arkansas led the way in turkey shipments, with $581.5 million, followed by Virginia ($544.2 million) and North Carolina ($453 million). In 2002, poultry businesses with a primary product of turkey totaled 35 establishments, employing about 17,000 people.
Source: Poultry Processing: 2002

$4.1 billion
Forecast 2010 receipts to farmers from turkey sales. This exceeds the total receipts from sales of products such as barley, oats, sorghum (combined) and peanuts.
Source: USDA Economic Research Service

The Price is Right
$1.33
Retail cost per pound of a frozen whole turkey in December 2008.
Source: U.S. Bureau of Labor Statistics as cited in the Statistical Abstract of the United States: 2010, Table 717

Where to Feast
3
Number of places in the United States named after the holiday's traditional main course. Turkey, Texas, was the most populous in 2009, with 445 residents, followed by Turkey Creek, La. (362) and Turkey, N.C. (272). There are also nine townships around the country named Turkey, three in Kansas.
Source: Population estimates

5
Number of places and townships in the United States that are named Cranberry or some spelling variation of the red, acidic berry (e.g., Cranbury, N.J.), a popular side dish at Thanksgiving. Cranberry township (Butler County), Pa., was the most populous of these places in 2009, with 27,560 residents. Cranberry township (Venango County), Pa., was next (6,774).
Source: Population estimates

28
Number of places in the United States named Plymouth, as in Plymouth Rock, the landing site of the first Pilgrims. Plymouth, Minn., is the most populous, with 72,849 residents in 2009; Plymouth, Mass., had 56,842. There is just one township in the United States named “Pilgrim.” Located in Dade County, Mo., its population was 126 in 2009. And then there is Mayflower, Ark., whose population was 2,257 in 2009.
Source: Population estimates

117 million
Number of households across the nation — all potential gathering places for people to celebrate the holiday.
Source: Families and Living Arrangements: 2009

NBCC CEUs

Aspira Continuing Education http://www.aspirace.com is NBCC certified.
Mission
The National Board for Certified Counselors (NBCC) is the nation's premier professional certification board devoted to credentialing counselors who meet standards for the general and specialty practices of professional counseling.


History of NBCC

Thomas Clawson, Ed.D.
President and CEOThe National Board for Certified Counselors, Inc. and Affiliates (NBCC), an independent not-for-profit credentialing body for counselors, was incorporated in 1982 to establish and monitor a national certification system, to identify those counselors who have voluntarily sought and obtained certification, and to maintain a register of those counselors.

NBCC's certification program recognizes counselors who have met predetermined standards in their training, experience, and performance on the National Counselor Examination for Licensure and Certification (NCE), the most portable credentialing examination in counseling. NBCC has approximately 42,000 certified counselors. These counselors live and work in the US and over 50 countries. Our examinations are used by more than 48 states, the District of Columbia, and Guam to credential counselors on a state level.

NBCC was initially created after the work of a committee of the American Counseling Association (ACA). The committee created NBCC to be an independent credentialing body. NBCC and ACA have strong historical ties and work together to further the profession of counseling. However, the two organizations are completely separate entities with different goals.

•ACA concentrates on membership association activities such as conferences, professional development, publications, and government relations.
•NBCC focuses on promoting quality counseling through certification. In addition, NBCC promotes professional counseling to private and government organizations.
NBCC's flagship credential is the National Certified Counselor (NCC). NBCC also offers specialty certification in several areas:

•School counseling - The National Certified School Counselor (NCSC)
•Clinical mental health counseling - The Certified Clinical Mental Health Counselor (CCMHC)
•Addictions counseling - The Master Addictions Counselor (MAC)
The NCC is a prerequisite or co-requisite for the specialty credentials.

NBCC's Accreditation
The National Board for Certified Counselors is accredited by the National Commission for Certifying Agencies (NCCA), the accrediting body for the National Organization for Competency Assurance (NOCA). NOCA is the leader in setting quality standards for credentialing organizations.

For confirmation of this accreditation, as well as descriptions of the services and missions of NOCA and NCCA, please feel free to visit NOCA's website at www.noca.org.

Statistics on NCCs
Statistical information based on active certificants as of 12/30/2008
NCC
CCMHC
NCCC
NCGC
NCSC
MAC

43960
1088
540
148
2287
642


NCC - National Certified Counselor
CCMHC - Certified Clinical Mental Health Counselor
MAC - Master Addictions Counselor
NCCC - National Certified Career Counselor
NCGC - National Certified Gerontological Counselor
NCSC - National Certified School Counselor

Benefits of Becoming an NCC
National certification can be a continuing source of career enhancement and pride for you as a counseling professional.

What the NCC Credential Does for You

•Generates client referrals for you through CounselorFind, NBCC's referral service linking potential clients to nearby NCCs.
•Travels with you when you relocate in or outside the US.
•Keeps you in touch with current professional credentialing issues and events through The National Certified Counselor, NBCC's newsletter.
•Advances your professional accountability and visibility.
•Ensures a national standard developed by counselors, not legislators.
•Supports the rights of NCCs to use testing instruments in practice through NBCC’s participation in the National Fair Access Coalition on Testing (FACT).
•Offers, through Lockton Affinity, liability insurance to NCCs at bargain rates.
•Allows online access to verification of national certification through the NBCC Registry.

Trauma and PTSD Continuing Ed

Supporting the Survivor

A guide to understanding the impact of violent trauma on your loved ones and how you can help them

for more information on this topic, visit website below
Trauma and PTSD ceus, mft ceu, lcsw ceu, lpc ceuIn the United States, your odds of falling victim to violence at some point in your lifetime are high. Even if you don’t encounter violence directly, chances are that you know someone who has or will experience trauma. While a victim copes with the direct impact of trauma, those close to the victim also struggle in the aftermath. What do I say? What do I do? Why does my loved one seem so distant?

This brochure is intended to help you begin to understand what happens to many victims of violent crime and what you might do to help them along the healing process.

How Does Trauma Affect Survivors?
Victims of violence often face a wide range of struggles. They often question what has happened or what they may have done to cause or prevent it. Many wonder how they will heal and why they cannot connect with their loved ones as they once did. It is also common for survivors to feel anger or frustration as they ponder whether they will ever feel “normal” again. While every survivor’s experience is unique, violent trauma is almost always a life-changing experience that can affect everything from one’s ability to sleep to his or her ability to concentrate at work.

Understanding the nature and impact of trauma can be key to helping your loved one. Many survivors find themselves in unfamiliar and distressing psychological territory. It is common for them to endure intense feelings of isolation, insecurity, and fear, and their most treasured relationships often suffer as a result. Trauma can also lead to Post Traumatic Stress Disorder (PTSD), which may include both substance abuse and mental health problems.

Violent Trauma, Substance Abuse, and Mental Health Concerns
Many victims turn to alcohol or other substances in an attempt to get some relief from their emotional turmoil and suffering. All trauma survivors manage their experiences in different ways. However, substance abuse is not only ineffective in healing from trauma, but it also can present a host of additional problems that make the healing process even more difficult.

Violence is also a widely recognized catalyst for mental health concerns such as PTSD, a condition that can be caused by experiencing or observing virtually any kind of deep emotional or physical trauma. Millions of people in the United States suffer from PTSD, resulting from many different types of trauma—from enduring years of domestic violence to a single violent attack that lasts but a few seconds. PTSD is characterized by both emotional and physical suffering; many afflicted by it find themselves unintentionally revisiting their trauma through flashbacks or nightmares. PTSD can make a survivor feel isolated, disconnected, and “different” from other people, and it can even begin to affect the most routine activities of everyday life. Psychologists and counselors with experience in treating trauma survivors can be very helpful in working through PTSD, and there are prescription drugs available to help ease PTSD symptoms. PTSD is a potentially serious condition that should not be taken lightly.

According to a recent study conducted by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, the most effective way to combat trauma, substance abuse, and mental health problems is through an integrated, holistic approach, taking into account how each individual problem affects the others. To begin, it can be helpful for a survivor to share experiences and concerns with a service provider who can assist in developing a plan to address these struggles comprehensively.

Many wonder how they will heal and why they cannot connect with their loved ones as they once did.

What Can I Do to Help My Loved One?
Since each individual’s experience is unique, there is no one-size-fits-all remedy for victimized loved ones. For those who care about a person who has experienced a violent trauma, finding ways to be helpful and maintaining a healthy relationship can be challenging. Following are some tips to help your loved one who has been victimized.

Listen . Talking about the experience, when the survivor is ready, will help acknowledge and validate what has happened to him or her and can reduce stress and feelings of isolation. Let your loved one take the lead, and try not to jump in with too many comments or questions right away.

Research . If the victim wants more information, would like to report a crime, or has other questions, you can help find answers and resources.

Reassure . As strange as it may sound, survivors often question whether an incident was their fault or what they could have done to prevent the crime against them. They may need to hear that it was not their fault and be assured that they are not alone.

Empower . Following trauma, victims can feel as though much of their lives is beyond their control. Aiding them in maintaining routines can be helpful, as can offering survivors options or possible solutions.

Be patient . Every journey through the healing process is unique. Try to understand that it will take time, and do what you can to be supportive. The healing process has no pre-determined timeline.

Ask . Your loved one may need help with any number of things or have questions on many different topics. Even a favor as mundane as running a few errands or taking the dog for a walk can be a big help, so consider lending a hand.

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Aging and Long Term Care CEUs

Copyright 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education.

1. Define aging and long term care 2. Become familiar with relevant demographic information. 3. Obtain information that includes but is not limited to, the biological, social, and psychological aspects of aging. 4. Learn the psychological impact of aging 5. Describe the relationship between aging and culture 6. Distinguish between long term and alternative types of care 7. Identify and access relevant resources Table of Contents: 1. Definitions 2. Demographic Information 3. Biological Aging 4. Aging and Culture 5. Long Term Care 6. Psychological Considerations 7. Elder and Dependent Adult Abuse Reporting 8. Resources 9. References

1. Definitions

Aging is defined as “the accumulation of changes in an organism over time.” Aging is also a multidimensional process of physical, psychological, and social change (Masoro E.J. & Austad S.N..eds: Handbook of the Biology of Aging, Sixth Edition. Academic Press. San Diego, CA, USA, 2006). Some dimensions of aging grow and expand over time, while others decline. For example, although reaction time may decrease with age, knowledge of world events and wisdom may increase. Research shows that even late in life potential exists for physical, mental, and social growth and development (Strawbridge, W.J., Wallhagen, M.I. & Cohen, R.D., 2002. Successful aging and well-being: Self-rated compared with Rowe and Kahn. The Gerontologist). Aging is an important part of all human societies which not only reflects the biological changes that occur, but also the cultural and societal conventions (Masoro E.J. & Austad S.N.. eds: Handbook of the Biology of Aging, Sixth Edition. Academic Press. San Diego, CA, USA, 2006).

2. Demographic Information

The number of Americans age 55 and older will almost double between now and the year 2030. This number will grow from 60 million today (21 percent of the total US population) to 107.6 million (31 percent of the population) as the Baby Boomers reach retirement age. During that same period of time, the number of Americans over 65 will more than double, from 34.8 million in 2000 (12 percent of the population) to 70.3 million in 2030 (20 percent of the total population). The next generation of retirees will be the healthiest, longest lived, best educated, and most affluent in history. Americans reaching age 65 today have an average life expectancy of an additional 17.9 years (19.2 years for females and 16.3 years for males).

The likelihood that an American who reaches the age of 65 will survive to the age of 90 has nearly doubled over the past 40 years from just 14 percent of 65-year-olds in 1960 to 25 percent at present. By 2050, 40 percent of 65-year-olds are likely to reach age 90 (Fentleman, D.L., Smith, J. & Peterson, J., 1990. Successful aging in a postretirement society. In P.B. Baltes and M.M. Baltes, Eds. Successful aging: Perspectives from the Behavioural Sciences). Highest level of education achieved is increasing in the older population. Although less than one-third of today’s adults aged 70-74 have at least some college education that percentage will increase to more than 50 percent by the year 2015. Currently, older Americans possess more financial resources compared to previous generations. Households headed by persons age 65 and older reported a median income in 2000 of $32,854 ($33,467 for Caucasians, $27,952 for African-Americans, and $24,330 for Hispanics).

While one of every eight (12.1 percent) households headed by someone age 65 or older had incomes less than $15,000, nearly half (49.2 percent) had annual incomes of $35,000 or more, and nearly three in ten households (29.8 percent) had incomes greater than $50,000 per year (Fentleman, D.L., Smith, J. & Peterson, J., 1990. Successful aging in a postretirement society. In P.B. Baltes and M.M. Baltes Eds. Successful aging: Perspectives from the Behavioural Sciences).

Approximately fifty percent of Americans age 55 and over volunteered at least once in 2002. Even among those aged 75 and older, 43 percent had volunteered at some point in the previous year. Older volunteers devoted the most time to community activities amounting to almost double the national median for all ages. Compared with the U.S. median commitment of 52 volunteer hours annually, those 65 and over contributed 96 hours per year. (U.S. Department of Labor's Bureau of Labor Statistics, Volunteering in the United States, December 2002). It is Older Adults as Volunteers Age 55 to 64 Age 65 to 74 Age 75+ % of age group who volunteer 50.3 % 46.6 % 43.0 % total number of volunteers 11.9 million 8.5 million 7.1 million Avg weekly hours/volunteer 3.3 hours 3.6 hours 3.1 hours Total time volunteered annually 4.8 billion hours 1.6 billion hours 1.1 billion hours estimated that the number of older volunteers would increase significantly if more were asked to volunteer or were offered an incentive. Older Americans now view retirement as an increasingly active, engaged phase of life that includes work and public service. Factors in the Decision to Work in Retirement (%)* Pre-retirees who plan Working to work in retirement retirees Total Desire to stay mentally active 87 68 83 Desire to stay physically active 85 61 80 Desire to remain productive or useful 77 73 76 Desire to do something fun or enjoyable 71 49 66 Need health benefits 66 20 56 Desire to help other people 59 44 56 Desire to be around people 58 47 55 Need the money 54 51 53 Desire to learn new things 50 37 48 Desire to pursue a dream 32 20 29 (Source: AARP, Staying Ahead of the Curve 2003) According to a 2002 survey conducted for Civic Ventures, 59 percent of older Americans view retirement as “a time to be active and involved, to start new activities, and to set new goals.” Just 24 percent see retirement as “a time to enjoy leisure activities and take a much deserved rest.” Retirees who intend to work during their retirement identify the desire to stay active and productive, rather than economic necessity, as the primary reason. More than half of the respondents (56 percent) say civic engagement will be at least a fairly important part of retirement (Peter D. Hart Research Associates, “The New Face of Retirement: An Ongoing Survey of American Attitudes on Aging,” San Francisco: Civic Ventures, 2002).

A 2003 survey conducted for AARP found that many Americans between the ages of 50 and 70 plan to work far into what has traditionally been viewed as their "retirement years": • Nearly half of all pre-retirees (45 percent) expect to continue working into their 70s or later. Of this group, 27 percent said they would work until they were in their 70s, and 18 percent said “80 or older,” “never stop working,” or “as long as they are able to work.” • The most common reasons given by pre-retirees for wanting to continue working in retirement were the desire to stay “mentally active” (87 percent) or “physically active” (85 percent), and the desire “to remain productive or useful” (77 percent). Slightly more than half of the pre-retirees (54 percent) indicated that their motivation was based on "a need for money.” (S. Kathi Brown, “Staying Ahead of the Curve 2003: The AARP Working in Retirement Study,” Washington, DC: AARP, 2003). • The result of these demographic trends is the emergence of a new life-stage between adulthood and true old age – which has been called the “third age” or “midcourse” or “my time.” (Source: AARP, Staying Ahead of the Curve 2003) “The third age is no longer a brief intermezzo between midlife and drastic decline… Instead, it has the potential to become the best stage of all, an age of liberation when individuals combine newfound freedoms with prolonged health and the chance to make some of their most important contributions to life.” Mark Freedman, founder of Civic Ventures, author of PrimeTime: How Baby Boomers Will Revolutionize Retirement and Transform America. “Midcourse connotes the period in which individuals begin to think about, plan for, and actually disengage from their primary career occupations and the raising of children; launch second or third careers; develop new identities and new ways to be productively engaged; establish new patterns of relating to spouses, children, siblings, parents, friends; leave some existing relationships and begin new ones…. The fact that most retirees say that they retired ‘to do other things’ suggests that midcoursers are retiring to move to something else, not simply from boring or demanding jobs.” Phyllis Moen, McKnight Presidential Chair, Sociology, University of Minnesota. “Midcourse: Navigating Retirement and a New Life Stage.” Jeylan Mortimer and Michael J. Shanahan, eds., Handbook of the Life Course. New York: Kluwer Publishers, 2003. “Something huge is happening here… The emergence of an older, more vigorous population is the most significant story of our times.”, Abigail Trafford, Washington Post health columnist and author, My Time: Making the Most of the Rest of Your Life.