Displaying items by tag: Clinical Insights
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.
Telepsychiatry is now the second-most used form of telemedicine and has helped clinical professionals (as well as students undergoing graduate school training) utilize video conferencing and digital devices for patient visits and their own self-care (Lavergne & Kennedy, 2021).
In a recent study, Lavergne and Kennedy (2021) explored how willing medical students were to use telepsychiatry during clinical visits—and how well universities supported telepsychiatry learning environments. In their research, Lavergne and Kennedy highlighted the transformative power of telemedicine education. When asked to rate the following statement—that telemedicine and in-person visits were of equal effectiveness—respondents gave this question the lowest confidence score. Students rated this same statement in one of the highest outcome categories after they underwent telemedicine training (Walker et al., 2019; as cited in Lavergne & Kennedy, 2021).
The human spirit and soul are at stake for clients and mental health professionals at the epicenter of the COVID Generation. The surge of medical, physical, and mental health disorders, the stench of death in hospitals and tent cities that are lying on the coronavirus battlefield, reminds us of the frailty of human life. There is no beginning, middle, and end to a viral contagion that can morph into mutant variants and be transmissible within 24 hours. This is because infectious diseases and lethal viruses have been present throughout human history since the beginning of time.
Telehealth Hit its Stride as COVID-19 Raged
Telehealth sprinted from being an underutilized way to deliver healthcare to being a widely used essential service when COVID-19 hit the U.S. in early 2020. Now that vaccines are available and many pandemic restrictions are being lifted - a big push is underway to keep the expanded telehealth services from slowing to a crawl.
Teletherapy Competencies, the What and How
We’re always eager to talk about telemental health competencies and how important they are to teletherapy training programs, but it can be difficult to determine which educational content areas are most useful for you. Universities considering graduate program competencies in telebehavioral health training for their staff and/or students may be seeking guidance in selecting the most effective program. In this article, we describe the course qualities that are often seen in relevant, well-rounded telemental health programs. Using current teletherapy research studies, you’ll see how similar teletherapy competencies are gaining prominence across numerous clinical professions—and why you could benefit from learning them.
In May of 2021, the Association for Play Therapy (APT) released their voluntary practice guidelines for play therapists. This guide outlined key recommendations for conducting safe, effective, and ethically-appropriate therapy sessions. We’ve included our 5 main takeaways from the APT guide, so that you can better assess your level of clinical competence.
When it comes to your telehealth practice, choosing the right technology is quite important! Technology malfunctions can cause hiccups during healthcare appointments and faulty audio devices can cause practitioners to miss critical information. Recently, TCI CEO Raymond Barrett reviewed the pros/cons of various microphones he utilizes while practicing telemental health.
Telehealth is Expected to Get a Big Boost in the Biden Era
Even before he was confirmed as President Joe Biden’s health secretary on March 18, 2021, Xavier Becerra had signaled his support for expanding telehealth. During his confirmation hearings in February, Becerra said, "I wholeheartedly believe we're going to be doing expansion of telehealth."