Dr. Martina Moore already knew quite a bit about being resilient before COVID-19 hit in early 2020. Her practice, along with thousands of other behavioral health organizations, therapists, and professional associations all had to quickly pivot to telehealth.
This fast switch meant having a special quality that therapists often talk about with their clients - resiliency. This was a quality that Dr. Moore came by the hard way. Her father was an alcoholic. And he had a behavioral health problem.
“I grew up with a father that was an alcoholic, Dr. Moore told Raymond Barrett, CEO, and founder of the Telehealth Certification Institute (TCI). “He got sober when I was in high school - in my senior year. I walked that journey with him - of recovery. My father had what we call co-occurring disorders. He had behavioral health and substance use disorders. I saw him navigate through the process of recovery with not as many options as we have now. By the grace of God, he's still sober some 30 years later.”
Kathryn Cates-Wessel, the Chief Executive Officer at the American Academy of Addiction Psychiatry (AAAP), joins Ray Barrett in a conversation about how AAAP is supporting health professionals who treat clients suffering from substance-use disorders in primary care and psychiatric settings. She offers tips for finding resources, explains why specialist knowledge is imperative for providers, and what service gaps are preventing effective treatment.
Kathryn shares 30 years of experience in the substance-used field with roles in administration, medical education, and policy. Prior to working with AAAP, Kathryn was the Associate Director for Brown University’s Center for Alcohol and Addiction Studies, as well as the Executive Director of Physicians and Lawyers for National Drug Policy.
Dr. DJ Ida, the Executive Director for the National Asian American Pacific Islander Mental Health Association (NAAPIMHA), agreed to talk with us at the Telehealth Certification Institute about the importance of cultural competence in the mental health field. Part of Dr. Ida’s long-term vision for NAAPIMHA is to establish a national center for cultural competence where clinicians, medical professionals, students, and paraprofessionals can come together for training and supervision.
Dr. Ida envisions that the center would move beyond talk therapy and consider additional community-based interventions, since the traditional therapy model “is not the only way to heal.” At NAAPIMHA, Asian American and Pacific Islander paraprofessionals are recognized for the distinct value they can bring to their communities, even if they lack the clinical skills one might learn in the classroom.
When COVID-19 hit, people worldwide faced isolation, loneliness, anxiety, and depression as quarantines and lockdowns were implemented. Mental health professionals were on the front lines of helping people cope with the pandemic, but clinicians faced their own struggles. Most closed their offices and shifted their practices to telehealth. They had to quickly learn new skills and ethics. They found themselves isolated - no longer seeing clients in person, or interacting with colleagues between sessions.
Many clinicians turned to their professional organizations for guidance, including the American Mental Health Counselors Association (AMHCA). AMHCA President Dr. Beverly Smith said it was hard for some clinicians to make that shift to telehealth.
Cognitive enhancement therapy (CET) is an evidence-based practice that uses brain games to target specific cognitive domains, such as attention, memory, and executive functioning. This intervention is particularly valuable for clients who have early course schizophrenia, schizophrenia-spectrum disorders, or neurocognitive conditions. CET’s effectiveness may be most evident when helping clients with social cognition—being able to get the gist of what someone says, understanding emotional cues, or employing flexible thinking, among other skills.
In a phone interview with the Telehealth Certification Institute, Christa Crohurst—a Licensed Professional Counselor in Arizona—describes her experience of using CET with clients. Christa explains why CET is an option for telehealth and what practitioners should watch out for before they begin offering sessions. Although Christa says that many of her clients have made huge strides with CET, there are a few challenges that practitioners can expect to encounter.
Jill Cook, the Executive Director of the American School Counselor Association (ASCA), spoke with Raymond Barrett, the CEO of the Telehealth Certification Institute, about the professional role of school counselors. In addition to being the Executive Director of ASCA, Cook is also a Certified Association Executive (CAE) and a former chair and member of multiple national organizations. Cook assisted in the development of the School Counselor of the Year program and the Recognized ASCA Model Program (RAMP) at ASCA.
According to Cook, there are over 120,000 counselors in K-12 schools who assist students with academic development, social-emotional development, and all types of post-secondary professional and educational goals.
Dr. Bradley Conner, Associate Professor and Director of Addiction Counseling at Colorado State University (CSU), talks with the CEO of the Telehealth Certification Institute about his university’s innovative approach to training addiction specialists. As a researcher, Dr. Conner studies the etiology and negative outcomes of sensation seeking, emotion dysregulation, and impulsivity across the lifespan. He looks at how personality types influence the course of disorders and engagement with risky behaviors. In the interview, Dr. Conner uses his expertise to describe the unique addiction training model at CSU.
In this interview, Dr. Kathryn Krase shares her professional advice on mandated reporting with Ray Barrett, the CEO of the Telehealth Certification Institute. Dr. Krase is a lawyer, social worker, and an expert in preparing professionals in the ethical reporting of suspected child maltreatment. She is the co-author of two books: Child Welfare: Preparing Social Workers for Practice in the Field (2021), and, Mandated Reporting of Child Abuse and Neglect: A Practical Guide for Social Workers (2009). Over the past decade, the main subject of her research and writing has been the disproportionate representation of BIPOC children in reports to child protective services, and the role that bias plays in the making of those reports. As an expert in mandated reporting bias, Dr. Krase examines how bias disproportionately affects families who identify as Black, Indigenous, and People of Color (BIPOC). For example, according to Dr. Krase, 25% of the 4 million yearly reports are made against Black children, while only 15% of the U.S. child population is Black.
Dr. Krase’s holistic orientation on reporting stems from her early work experience at the New York Society for the Prevention of Cruelty to Children—the first child advocacy organization in the world—and her role as a practitioner at the family level. By using current research studies, Dr. Krase presents key topics such as overreporting consequences, mandated reporter requirements, and the legal protections that help clinicians make ethical decisions.
Dr. Krase encourages practitioners of all levels to use self-reflection as they confront their own backgrounds. Since beliefs or assumptions as a reporter can impact who is reported, familiarizing yourself with circumstances that have bias potential can prepare you for tough situations. You can listen now to learn more about this much-needed professional practice area!
Resilience, Self Care, and ‘Battle Buddies’ for Behavioral Health Professionals
A community coming together to rebuild after a devastating tornado; homeless veterans learning to reclaim their lives and dignity; addicts struggling to set aside drugs.
All of these people have something in common: resilience, and a need for self care.
Dr. Stephanie Felder, PhD, LCSW, has witnessed this resilience over and over again in her multiple roles in social work and public service. She is a Commander (CDR) in the Commissioned Corps of the U.S. Public Health Service (USPHS), and recently transitioned to the Office of the Surgeon General where she is the lead licensed clinical social worker for the public health emergency response strike team.
In all of her roles, she has seen resilience among people in all stations in life, and she has watched them learn that self care is key to surviving and thriving.
She also learned that resilience and self care are important for herself - and for all behavioral health professionals.
“I started my career in social services in North Carolina and then moved to a state position as a
licensed clinical social worker in a residential treatment program. Shortly after that, I moved to a position as the health care coordinator for homeless veterans in Fayetteville, North Carolina. That position was pretty amazing. I learned a lot about homeless veterans
and their needs.”
Dr. Felder was so inspired by those veterans that she became active duty herself. She took a position with the Substance Abuse and Mental Health Services Administration (SAMHSA).
“When I became active duty I entered into the public health service - that was the start of all of my deployments - and the start of my understanding of the real importance of self-care.”
“I started to deploy around 2017 and that's when the tempo really picked up for me. Hurricane Harvey - I went out for that. Then in 2018 I went out for Hurricane Florence which was in Clayton, North Carolina.”
Felder recalled the stress of receiving a field promotion - she was sent out to do a job, then get a new assignment when she was in the field.
“That was pretty intense and scary - anxiety-provoking for me because it was a true leadership position in the field, and it was also in North Carolina. The people I was seeing felt like family because I'm from South Carolina, and I had lived in North Carolina. It was personal and self-care was definitely important during that mission - trying to manage the job, but also to manage my own emotions.”
“I also saw the resilience in communities when I went out to Oklahoma after some major tornadoes. Just seeing that community come back together and build, and the support that you saw just coming from all other states and all around - that is when I realized the true importance of resilience and self-care.”
Dr. Felder also worked at the Health Resources & Services Administration (HRSA) managing HIV AIDS grants. “I realized the importance of self-care and resilience among these communities. The people work really hard in the Ryan White program. They provide services to people that are underserved and otherwise wouldn't receive that high level of medical care.”
When COVID-19 hit in 2020, Dr. Felder was in New York as the behavioral health officer in charge. “Seeing everything that was happening - it was just...it was definitely life-changing.”
During emergencies, social workers, Dr. Felder said, are expected to put the interest of others and the community ahead of their own interests.
“You serve,” she said. “We're helping people find family members, or we're helping people find a new living place.”
But often, the emergency responders and social workers need help, too.
“It can become overwhelming when you're out there, and you're trying to keep all the balls in the air.”
Dr. Felder had some tips for mental health professionals responding to a crisis:
- Be aware of your environment - whether it's a disaster environment or a domestic dispute.
- Walk in with an open mind and be observant of your surroundings.
- Build rapport and mutual respect by listening and understanding.
- Establish with the person or the community that this is a safe space and that you are there to listen.
Dr. Felder said self-care is vital during a crisis, but she acknowledged it is something she still is working on for herself. “It's easy to say it, but it's hard to practice what you preach.”
At some point, though, you have to realize you must take care of your own needs. “It's hard to help others and give to others when there's nothing left for you,” she said.
What does Dr. Felder do to recharge?
“I do yoga and meditation. I try to make sure that I have regular exercise. All of those help me to ground myself and decompress.”
When she’s deployed, Dr. Felder also has a very important resource - “battle buddies.” A battle buddy is a trusted colleague that will call her out if they see her in distress. That is the person that comes to her to say, “hey, you know you're not headed in the right direction.”
“The idea is that with your battle buddy you don't become defensive. You say, ‘Let me let me take a moment and evaluate this - yes you're right,’” Dr. Felder said.
If she does get angry, the battle buddy knows it’s their job to be the calm one. “The battle buddy - they do not back down. They stand their ground,” she said.
All of us in behavioral health might take a cue from Dr. Felder and find our own battle buddies, and then be a battle buddy for someone else.
By Amanda Barnett, LPC, EdS, NCC
The Center for Disease Control and Prevention (CDC), and other major public health organizations, have recognized the mental health effects of COVID-19 on youth—consequences that can be seen in virtually every aspect of teenage life.
Knowing how to help struggling young adults is not always so easy. Luckily, there are proactive steps that you can take to improve student wellbeing as they navigate the pandemic. Encouraging self-expression, providing accurate information, teaching ways to stay healthy, and noticing changes in behavior—such as unhealthy eating habits, poor sleep schedules, or variations in activity levels—are just a few ways to reassure young adults that they’re safe.