WHAT’S GOING ON AROUND HERE?News from the mental health front lines
But first, a word from our sponsor
Robin Steed, PhD, LOTRwww.robinsteed.pbworks.com
National Alliance on Mental IllnessNorthwest Louisiana Affiliate
www.naminwla.pbworks.com
www.nami.org
Agenda
Keeping All Students Safe Act
Stop Bullying Act
Changes in Mental Health Care in Louisiana
Motivational Interviewing
Stages of Change
KEEP OUR STUDENTS SAFE
Keep Our Students Safe Act
S.2020 in the Senate and H.R. 1381 in the House
Government Accountability Office study: teen hung himselfchild smothered to deathchildren with disabilities
Only 14 states currently restrict use of restraint (Louisiana is not one of them)
What the Act will do:Ban:
physical restraint unless an emergency restraints interfering with breathingchemical restraints
Parents to be notified on same day
What you can do:Email US legislators using NAMI's legislative
action center
Educate school officials, teachers and case workers!
STOP BULLYING
Keeping kids safe from bullyingChildren with disabilities
bullied 2-3x more
Bullied Children:• depressed, lonely, anxious• low self-esteem• headaches, fatigue,
stomachaches, poor appetites
• truant• suicidal
youthviolence.edschool.virginia.edu
School Bullying Prevention Act
House Bill 407 Senate Bill 619
Fills the gaps in meeting federal regulations
Will specifically name at risk groups Identifies process for reportingDefines specific types of bullying
You can help!• Stopbullyinglouisiana.org
• http://www.stopbullyinglouisiana.org/petition
• To find out more, contact Stephanie
Patrick at [email protected] or 1-800-960-7705, ext. 143.
CHANGES IN MENTAL HEALTH CARE IN LOUISIANA
Merger 2011● Office of Mental Health and Office of
Addictive Disease to create Office of Behavioral Health
OMH OAD OBH
Magellan Coordinated System of Care 2,400 children
most severely affected SMO: Service Management Office 50,000 children and 100,000 adults Requires providers re-cert every 14 days
MOTIVATIONAL INTERVIEWING
What for?
Definition of MI• Directive, client-centered• To elicit behavior change• Clients explore and resolve
ambivalence
Concepts of MI• Readiness to change• Ambivalence• Resistance
Principles of MI
1.Express Empathy2.Roll with Resistance3.Support Self-efficacy4.Develop Discrepancy
Empathetic Listening Practice• So, what have you noticed about
the effect of alcohol on your mood?
• How is the new exercise program going for you?
• How do you feel about going back to work?
Self-Motivating StatementsClient: I hate feeling like an old man with this
walker, like I’m weak and frail, but when I don’t use it I’m afraid to go anywhere because I might fall.
Therapist: So you feel like the walker makes you look weak but you’d like to get out more?
Evil Therapist: Well, you really will be frail if you fall again, so you better use the walker.
Silly Therapist: It doesn’t make you look weak!
More self-motivatingClient: It’s not fair! I’ve had to give up
everything- eating sweets is the only thing that makes me feel good anymore. Of course, I don’t like the insulin shots.
Therapist: It seems that eating sugary food comforts you but you would rather not be dependent on insulin?
Pros and Cons ApproachPros Cons
Take meds
Don’t hear voices as muchI can live by myselfI can go to school
Side effectsCost moneyHave to remember
Don’t take meds
No side effectsA little more $
The voices make me feel like killing myself, Can’t take care of myself, Can’t remember anything
Client with MS
Consistent carePT and OT Positive supportCounseling
Scary, bad memoriesHusband madStress increases fatigueFamiliar home
Husband happyEasier
Depend on husband Stressful environmentMiss therapy
In pt.
Out pt.
Pros Cons
Brainstorm Approach1. What exactly is the problem?2. What have you tried so far?3. What are things to try- no
matter how crazy?4. Select one option.5. Select an option to try if the first
one doesn’t work.
What NOT to doArgueAssume expert roleTalk all the timeShould on your clientTell the client they have a problemPrescribe solutions (especially without
listening!)
STAGES OF CHANGE MODEL
What do you want to change?
• Exercise more• Eat healthier• Stop smoking• Stop drinking• Be less co-dependent• Kick that heroin habit once and
for all!
Pre-contemplation
manmeetsscale.blogspot.com
Contemplation
diggingalot.org
Preparation
Action
Maintenance
Know your client’s stage
Mismatch between intervention and client’s readiness for change =
resistance
Transfer to practice• How can you use
motivational interviewing in your practice?• In what stage of change are
your clients?• How can you move them
from one stage to the next?
Resources• Rollnick, S. & Allison, J. (2004).
Motivational interviewing. In The essential handbook of treatment and prevention of alcohol problems (Heather, N. & Stockwell, T. eds.) John Wiley and sons.
• www.robinsteed.pbworks. com