InSession Magazine- July 2021

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THE MAGAZINE DEDICATED TO MENTAL HEALTH PROVIDERS

JULY 2021

From Internship to Leadership "This is not what I expected!"

Why Your Values Matter Legislative Update Depression in older adults Rate your mate before its too late

CREATED BY THE FLORIDA MENTAL HEALTH COUNSELORS ASSOCIATION



Your FMHCA Staff You may already know us from our previous in-person Annual Conferences or virtually through our webinars and email conversations; however, we wanted to take this moment to formally introduce ourselves, your FMHCA staff. If you did not know, FMHCA was a 2 woman show led by our Executive Director, Diana and our Executive Administrator, Laura (with support from our awesome board of directors) up until October of 2020. The growth of our Webinar Series and Membership allowed for FMHCA to bring on our newest staff members, Madison and Naomi. We all wear many hats but these ladies mainly work as our creative and social team (emails, social media, webinars, and InSession!). We have a strong mindset and understanding that as the Florida Mental Health Counselors Association, we have the responsibility to continue our work uninterrupted at a level FMHCA has never seen before. It was (and still is) important to us that our community of members and local chapters feel supported and connected. As a team we have been able to revamp our creative strategy, reach a new population, and provide all the resources and benefits to our members that we could get our hands on.

"Run it" is our office motto. We work together weekly on new ideas that typically stem from our visionary Diana who then passes it onto Lauraour voice of reason and logic who then passes it onto Naomi- our figure-it-outer who then passes it on to Madison- who gets the final product to you. We are especially pleased to bring you this issue of FMHCA's InSession Magazine. It is a joy to read through each submission as our publication continues to grow and evolve. Each issue is crafted with you in mind, we read through each email, poll, and evaluation that you send our way and adjust accordingly. Our ultimate goal is to turn InSession into something you must read because of its content and resources (thanks to our incredible authors!).

Diana Huambachano

Laura Giraldo

Madison Borgel

We are grateful for the levels you push us to reach and we hope to see you this upcoming February at our Annual Conference! - Your FMHCA Staff

Naomi Rodriguez


INSESSION

July 2021

6 We Are All Fragile

8 Wondering Out Loud: Creative Reframes for Anxiety in Teletherapy 9 Ask AMHCA

Frequently Asked Questions from The American Mental Health Counselors Association's Code of Ethics

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10 Depression in Older Adults 12 Why Your Values Matter

14 Understanding Regulation Allows for Better Interpretation 16 2021 LIVE Webinar Series Lineup

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18 Mi fe y mi Salud Mental

My Faith and My Mental Health. Why School Based Mental Health Professionals can no longer ignore the role faith, religion, and spirituality have in the Latinx student community and their mental health treatment.

22 Rate Your Mate Before It's Too Late Never Make a Mistake In Love Again

24 FMHCAs Favorites- Summer Edition 26 Pandemic Related Stress, Substance Abuse, and Problem Gambling 28 From Internship to Leadership Halfway through her presidency term at FMHCA, Dr. Deirdra Sanders-Burnett takes us back to her journey from internship to leadership.

32 Listen For The Melodies 2 Is there such a thing as "Closure" from a Traumatic Event?

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MAGAZINE 36 When The Clinician Provides Counseling to Another Clinician

38 Loneliness Hurts Like Hell 40 Childhood: Who Cares? 42 What is Animal Assisted Therapy all about?

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44 Who Helps the Gifted Kids: When will gifted kids ever be enough? 46 How The Power of SelfTalk Improves Self-Care 48 Peace of Mind 50 What I Learned In My Final Year As A Counseling Grad During The Pandemic 52 Balancing Self-Care and Resilience 54 Rites of Passage

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57 Legislative Update & Next Steps with FMHCA Lobbyist, Corinne Mixon 60 Bylaws

Created and published by The Florida Mental Health Counselors Association (FMHCA), InSession Magazine is The Magazine Dedicated to Mental Health Providers. Each issue is crafted with our members in mind.

CONTRIBUTE:

If you would like to write for InSession magazine or purchase Ad space in the next publication, please email: naomi@flmhca.org

DISCLAIMER:

Information in InSession Magazine does not represent an official FMHCA policy or position and the acceptance of advertising does not constitute endorsement or approval by FMHCA of any advertised service or product. FMHCA reserves the right tp edit or reject all copy.

ANTI-DISCRIMINATION POLICY: There shall be no discrimination against any individual on the basis of ethic group, race, religion, gender, sexual orientation, age, or disability.

FMHCA is a chapter of the American Mental Health Counselors Association and is the only organization working exclusively for LMHC's in Florida


We are all Those in helping professions are drawn to careers to help individuals, to fulfill a void of helplessness within their selves. With that, comes a dichotomous flux of emotions where you feel elated and at the top of your game, or worse, devastated and wondering where you went wrong. In the midst of this, as a helping profession, it is vital to have a daily self-care routine, just not from your mental health but your physical health, too. When you feel your mental health being is taking a toll, in the form of stress, fatigue, irritability, burnout, sleeplessness, isolation, headaches, health concerns, etc., listen to your body. As a Registered Mental Health Counselor Intern, I saw the varying tolls my professions was taking on my health and

my mental health, and I dismissed them. Even through the COVID-19 pandemic when my self-care would have been better, I too was subjected to implications that my mental health was taking a toll on me. On a daily basis I was suffering with migraines, relentlessly, as a result of stress. While working from home, I would see clients on tele-health sessions while suffering with vertigo, nausea, light and sound sensitivity. This went on for months, additionally my chronic asthma also became worse. Going to my doctors was not helping, it was a band-aid on a wound. We were treating the symptoms, not the cause. I was advised by my doctors and my therapist that I need to take time off of work for my mental health and my work was not okay with this. In the midst of a global pandemic, where everyone was vulnerable, my needs were nonexistent. After six months of severe migraines and chronic asthma issues, it finally came to a rapid halt when my brain could not take the pressure anymore. Three days after my 27th birthday, I suffered from a stroke. It started out with a throbbing migraine and feeling light-headed, then having difficulty recalling what was going on around me. I have no memory being in the ambulance to the hospital, however, I do remember when they called the code stroke alert on me. Everything after that came in waves of slow motion, like derealization, quite like the sound of the code stroke that still haunts me. I remember trying to communication with the doctors

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that I was a Mental Health Counselor, but I could not. As a counselor who’s core belief is to do no harm, I failed to include that also means to do no harm to myself. I was incredibly preoccupied with my career that when I began to speak again, in my aphasic state, I was more concerned about work and needing them to know what happened. My family informed me that I had other things to worry about and work was not a priority at the moment, that’s when things began to make sense to me. I looked at my hospital room while the nurses began to assess my aphasia, I was petrified. I built a career on being a voice to those in need, I never thought that I would be the one to be voice-less. Going to sleep at night was the hardest thing I have ever done, with the constant fear that I was not going to wake up in the morning. I was truly alone and could not ask for help or reassurance, I made it a point to fight for my life while there. This is what lack of self-care did to me, and it can do it to you. In our world, taking on the role of being a Mental Health Professional, remember that we are fragile and human. Take mental health days, reach out for support when you need it, and be gentle with yourself. Written By: Michelle Moody-Rubino, MS, RMHI Michelle Moody-Rubino is a clinical mental health counselor intern, specializing in dual-diagnosis in the field of mental health. Michelle recently graduated with her Masters of Science degree from Troy University in Tampa campus. As a therapist, Michelle therapeutic approach varies to match the needs of the clients being treated as everyone is an individual.



Wondering Out Loud: Creative Reframes for Anxiety in Teletherapy

D

uring online therapy with two analytical young men presenting with anxiety, I channeled Ericksonian Utilization to pivot their minds toward generating alternate interpretations of their difficulties. In both cases, anxious thoughts were disrupted via therapeutic reframing, providing catalysts for clients to envision hopeful possibilities.

alternative interpretations shifted the client from somatic to intellectual responses to the disturbance, thus reducing his anxiety while increasing his sense of control.

the client had previously shared that he had "dropped out of university due to extreme anxiety,” I asked if the Gremlin was trying to tell the client something important about his

Befriend the Gremlins

studies. Jumping forward in his chair, the client blurted, “Physics is causing me unbelievable stress. Maybe it’s not the field for me.”

An 18 year-old physics major shared that he had been “anxious since he was a child,” and that “anxiety was a part of his DNA.” His parents divorced when he was Hail the Headless Cockroach five, and “his mother had also been anxious as long as he could remember.” An art history educator (24) shared that he was distressed by a reoccurring dream We explored what anxiety looked like in involving cockroaches, finding it difficult his home, and the client expressed to fall back asleep after these nightmares. empathy around his mother’s fears. After I asked what the dream could mean, and providing psychoeducation on anxiety and flow, I wondered out loud if the client the client said, “I really don’t know.” We explored re-writing the end of the dream may have “absorbed” some of his mom’s anxiety because he had previously stated to avert the cockroaches, and surmised that he was a “sensitive” individual. The that even one alternative would reduce client nodded in agreement. his focus on the bugs by fifty percent. When the client mentioned that the Drawing on Narrative externalization, I cockroaches were headless, I said, “Wow. offered another possibility. “What if It sounds like they are dead then – like anxiety isn’t actually a part of your DNA? they have no power. I wonder if this What if there’s a little Menehune that dream means you have conquered a jumps on your shoulder to warn you of difficulty because you have slain the potential danger, and you are perceiving cockroaches.” His eyes lit up and he said, these warnings as internal anxiety? If you “I would have never considered that, but have a strange noise in your car that can’t it totally makes sense. I have been clean be explained, Hawaiians say your car has for three weeks now, and maybe the a Menehune – the Irish have dream is trying to tell me that I’m Leprechauns, Indigenous Peoples have conquering my addiction.” Tricksters, and Harley riders have For homework, I invited the client to generate different meanings and endings for the dream. Opening space for 8

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Gremlins. These are playful but powerful creatures who warn us of danger, or teach us important lessons.” The client smiled. I then speculated that the Gremlin was trying to tell the client something important, but because the client wasn’t listening, the Gremlin became more and more outrageous with its tapping. Since

For homework, I invited the client to imagine what his dream career would look like. Externalizing the client’s anxiety provided a safe space for him to acknowledge his subconscious wisdom, albeit in the form of a wise and playful messenger. Ethics and the Therapeutic Reframe Therapeutic reframing has been evidenced as a positive adaptation tool (Matilla, 2001) and condemned as manipulative spin (Hoffman, 1982). Through an ethics lens, it may be helpful to view reframing as unearthing openings to multiple possibilities, or a “plural realism” (Matilla, 2001, p. 101). As therapists, we have an ethical responsibility to honor client values, goals and preferences during this influential process. Therapists assist clients to expand thinking, whereas clients ultimately determine what resonates. Together, we embark on a shared journey as arbiters of meaning, contextualizing difficulties within the client worldview.


References Hoffman, L. (1982). Foundations of family therapy. New York, NY: Basic Books. Matilla, A. (2001). Seeing things in a new light: Reframing in therapeutic conversation. Helsinki, Finland: Helsinki University Press, 99-103.

Written By: Deborah K. Hurford, MS, MFA, MA, LMFT Deb is a systemic psychotherapist, EMDR therapist, executive coach, multidisciplinary artist and published author. Her book on sexual violence, Running Through the Devil’s Club: A Theatrical Exploration in Healing, was published in 2001 and her work with the expressive arts as a teaching and healing tool has been cited in articles, books and dissertations in Canada, the United Kingdom and the United States. Deb works in private practice with Systemic Solutions Counseling Center (https://systemicsolutionscenter.com/deborah-k-m-hurford-msc-mfa-ma-bed/) in Florida.

Ask AMHCA

Frequently Asked Questions from The American Mental Health Counselors Association's Code of Ethics

disclosing my fee to clients, am I Q Inrequired to inform them concerning my sliding scale or withhold that information until a client asks for it?

Informed consent is intended to be A a transparent process in which information about treatment is disclosed to clients. Accordingly, CMHCs should

disclose billing practices including a sliding scale fee in compliance with I.B.2.a of the Code, which requires disclosure of information to clients including “counselor credentials, issues of confidentiality, the use of tests and inventories, diagnosis, reports billing, and the therapeutic process.” Similarly, CMHC need to comply with section I.E.2, which provides that CMHCs “clearly explain to clients, early in the counseling relationship, all financial arrangements related to counseling.”

have a client who continues to Q Ischedule appointments with me

is no longer benefiting, when services are no longer required, when counseling no longer serves the needs and/or interestsof the client, or when agency or every week, even though I have institution limits do not allow provision of further suggested that she does not need counseling services”. Clients can become dependent on counseling any longer. She says that it counselors and counseling, which is not healthy as it makes her feel better and that she enjoys our interaction. What should I do? does not promote client autonomy. Start by suggesting a decrease in the frequency of sessions, going first to every Code section I.B.5.b applies in this other week and then once a month. This should analysis: “CMHCs may terminate a discourage dependency. Discuss her progress in treatment, and suggest additional community resources counseling relationship when it is that might be helpful. reasonably clear that the client

A

I practice telehealth across Q Can state lines in a jurisdiction where I am not licensed?

is not advisable to practice A Ittherapy in a jurisdiction where you are not licensed. CMHC need to be familiar with state laws and regulations

in both states in which services will be rendered (CMHC Code B.6.f.). In some states, it is a crime to practice as a health care provider or therapist if you are not licensed or approved to provide treatment in that state. Insurance coverage may not apply to claims which involve a criminal act. You may be able to contact the other state to seek approval to provide telehealth across state lines, and you need to document any such authority carefully.


Depression in Older Adults

There are many factors that may lead to depression later in life. Some of these include loss of a spouse, friends and/or pets, retirement (loss of purpose), medical problems, and/or loss of mobility/ independence leading to loss of driving privileges and subsequently a lack of transportation, leaving this population at an increased risk for isolation and loneliness. For these reasons, oftentimes both older adults and medical professionals think that aging and depression go hand-in-hand, and that it is a natural reaction to the many losses and challenges faced by the older population. Not only is this belief wrong, but it can have many ill consequences. It is very important to keep in mind that while depression may be common in older adults, it is NOT a normal part of aging. What do the symptoms of depression look like in the older population? memory problems physical complaints, including pain confusion memory problems trouble sleeping poor hygiene lack of enjoyment in previously enjoyed activities weight loss/loss of appetite irritability delusions hallucinations 10

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Who’s at Risk for Depression? Particularly older women are at greatest risk for depression. Caregiving for an ill spouse, parent, or child, and biological factors such as hormonal changes contributes to a higher rate of depression among women. Given the growing number of persons with Alzheimer’s Disease, caregivers are at an increased risk of depression due to the stress involved in caring for a loved one affected by this chronic and devastating condition. However, white males ages 85 and older have the highest rate of suicide in the U.S. Also at risk are any older adults with a prior history of depression. Treatment Options The good news is that depression is treatable. So what can seniors do to fight off depression? Isolating is a silent killer for the older population. •stay engaged •reach out to others •volunteer •care for a pet •learn a new hobby – Zumba, yoga, painting •join a senior center •exercise Treatment prognosis in this population is high. Usually a combination of medication (such as SSRI’s, NSRI’s, or MAIO’s) and psychotherapy can be very

effective in the treatment of depression in older adults. Electroconvulsive therapy (ECT) can also be used for severe and resistant depression. Building support systems and linking older adults to resources in the community such as senior centers and transportation can also have a positive effect in treating depression as it reduces loneliness and isolation in older adults. Exercise also has many positive mental health benefits. It works as a natural anti-depressant as endorphins – or feel-good hormones – are released during exercise and helps to reduce symptoms of depression and improve sleep. Undiagnosed depression can lead to medical illness as well as cognitive decline in older adults and can be fatal. Seeking treatment is therefore essential.

Written By: Julie (Anne) Galiñanes, LCSW Julie (Anne) Galiñanes has worked worked in the mental health field for over 18 years. She currently works in private practice and specializes in working with older teens and adults experiencing anxiety, grief and loss (including perinatal), self-esteem issues, adjustment issues, marital difficulties, life transitions and every day stress. Julie utilizes an eclectic style to therapy that includes Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Mindfulness, and Solution Focused Therapy.



Matter Why Your Values

Your values are an unequivocal part of who you are, and yet, they’re sometimes hard to identify. Adding to the struggle, different values play different roles in both your personal life and your professional development. Plus, they’re constantly evolving, making regular checkins and adjustments necessary. Some examples of core values include connection, honesty, and commitment to social justice, while professional values may include balance, growth, and integrity. Of course, these values may overlap too. For instance, time with family, although it occurs at home, may be dependent on your career path, making it an important part of the puzzle in both your personal and professional life. In Live LYTE Counseling & Services inaugural blog post, we take a closer look at the importance of knowing your values in both your personal life and your professional development. The Importance of Values in Your Personal Life Before we dive in, let’s look at the difference between goals and values and why you should put an emphasis on values instead of goals. A goal is an achievable task with a focus on the outcome instead of the process. With this type of singular concentration, it’s common to feel let down or disappointed once the goal is (or isn’t) reached). A value is defined as a belief that guides us. Rather than “achieving” our values, we regularly engage with actions that are in line with them, guiding us to act in ways that make us proud and behave in ways that make us feel good. Now that we’ve defined values, it’s easy to see why they’re important, especially for people who are dedicating time to therapy services. Taking that first step and identifying your values can have a positive impact on your relationships, your sense of self, your work — your whole life, really! They help you better understand what matters to you, what makes you tick. You must do more than simply name them though; you need to truly connect to your values and act in ways that bring you closer to them. In doing so, you can find fulfillment and contentment and positively impact your mental health. 12

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Some individuals have been disconnected from their values, so focused on what they believe they ‘should’ value based off of wanting to gain acceptance from others or what they’ve been taught by parents, family, and other influences. Counseling can help to uncover their true values and it can be a pretty liberating experience for them to identify who they are and what matters to them. An example of this would be how values impact how they spend their time and with whom. For many of us, the pandemic has highlighted the importance of connection. By recognizing this value and exploring ways to bring it into your life, you will feel more inspired in other areas of your life too. Maybe this means joining a virtual book club or engaging in zoom theme dinners with friends or family. Values are empowering. Whether you choose to take action or not, your values are still there, playing a role in how you feel and how you act. Acceptance and Commitment Therapy Through Acceptance and Commitment Therapy (ACT), you can learn to accept your inner emotions (rather than avoid or deny them), identify your values, and then live in a way that honors them both. It combines behavioral therapy and mindfulness skills in an effort to help you develop psychological flexibility and embrace challenges rather than running from them. Values in Professional Development Additionally, your values play a major role in your career path and professional development. First, they allow you to be clear about what you want and keep you focused and motivated. Knowing what you stand for ensures that you’ll do your best work, which in turn brings new opportunities (perhaps a big project or promotion) your way. Your values indicate what’s important to you, and by keeping them front of mind, you’re consistently staying true to yourself. Along these same lines, research shows that there’s a strong correlation between your values and job satisfaction. After all, how can you be happy if you don’t know what makes you happy? When you and your employer agree on things that are


important to you — such as contribution to the world or commitment to growth — you’ll feel like your voice is being heard and most likely find fulfillment in your work. On the other hand, if you disagree with your employer’s product or approach, you’ll eventually reach a point where you can no longer behave inauthentically and compromise your values. Lastly, your values play a key role in decision-making. Making decisions, particularly when those choices affect a group of people or even an entire company, is challenging, but having clear values to guide you can make a huge difference. Let’s look at honesty and integrity, two common values that you may experience from employer to employer. One way to ensure that you are integrating these values when making decisions at work is to consider who is being impacted by your choices and how they can partake in the decision-making process. Power-sharing and equity help to live out the values of honesty and integrity in the workplace. Having a clear picture of not only what these values mean but also what they look like in practice makes it

easier to make decisions that have a positive impact. Struggling with identifying and connecting to your values? If you’re ready to live life on your terms, Live LYTE , Counseling & Services can help! For individual therapy or clinical supervision, reach out to Marissa Friedman, LMHC, NCC. For professional development or clinical supervision, contact Carmen Bolivar, LCSW.

Written By: Marissa Friedman, LMHC, NCC Marissa Friedman, MA, LMHC, NCC received her bachelor’s in Psychology from the University of Florida (GO GATORS!) and received her master’s in Marriage and Family Therapy from the University of Central Florida. Marissa is a Licensed Mental Health Counselor and one of the founders of Live LYTE Counseling & Services, LLC. She is passionate about helping adults navigate stress & anxiety, increase self-esteem, and feel empowered and confident through online counseling in Florida.

#FMHCAGivesBack Because of the generosity of our members, FMHCA's Registered Mental Health Intern Licensure Exam Scholarship covered two of our Student Member's Licensure Exam Costs this quarter! Our Registered Mental Health Intern Licensure Exam Scholarship is now open for this quarter and will close September 15th, 2021. If you would like to make a donation to the Registered Mental Health Intern Licensure Exam Fund, please click here.

atkins Demetric W

Demetric is a Master Level Clinician and Registered Mental Health Counselor Intern with the State of Florida currently working towards state licensure and a Ph.D. in Counselor Education & Supervision. Demetric has three years of experience as a mental health professional and currently works with children, adults, and couples in the greater Tampa Bay area and surrounding communities. Demetric specializes in the treatment of anxiety, depression, and other mood disorders. Demetric works closely with persons of color and the LGBTQIA+ community to mitigate cultural and identity concerns. Demetric also serves as the current President for the Hillsborough affiliate for the National Alliance on Mental Illness (NAMI) to support Hillsborough County and those affected by mental illness through advocacy, education, support, and public awareness.

Nicole Esquen is a Registered Mental Health Counselor Intern currently working with the North Miami community by providing individual and group therapy to those with co-occurring disorders. Nicole believes that everyone is capable of overcome any obstacle they may face as long as they have a helping hand through the process; which she is honored to be for her clients. Nicole holds her M.S. from Albizu University and has received training in trauma informed care, substance abuse, and co-occurring disorders. Nicole has been inducted into the Psi Chi Honor Society and passionately advocates for mental health awareness, as she believes it is our duty to stop the stigma.

Nicole E squen


experience a sense of unease. It’s the mobilization piece that has us either fight, flight, or freeze. According to Dana, examples include feelings of escape, being hypervigilant, looking and listening for danger, experiencing a sense of separation, cut off from others, a focus on the predator, missing and misreading signs of safety. When we are fearful, angry, or anxious, we are activating our survival responses, we are in essence fighting back and taking action, (Dana, 2018).

Understanding Regulation Allows for Better Interpretation The polyvagal approach to trauma, offers a way to attune within ourselves, where our very own control and safety center can be our resource, ally, and our aid. Control and a sense of safety are often ripped from us in trauma, yet they are ironically the very options we have within at our disposal to respond to it. The nervous system is continually scanning for cues of threat/danger and cues of safety, under our conscious awareness. This is something Stephen Porges, who discovered the polyvagal, has called neuroception. In neuroception, our nervous system is “listening” inside and outside, between us and other people. According to Dana (2018), our nervous 14

July 2021 InSession | FMHCA.org

system is picking up cues of safety and danger from other’s nervous systems. According to Dana, the ventral vagal state is where we connect and co-regulate with others, experience feelings of wellness, calmness, social engagement, where we are nourished. Through regulation in ventral vagal, we feel healthy, connected, and grounded. It is evidenced in our heart rate, our breathing, our eye gaze, and facial expression. Through our own regulated ventral state, we can bring others to a place of safety within themselves once we have done so for ourselves. We, by this very process, become a place of safety for others. The implicit, subcortical message, according to Dana, is that the “world is safe; what’s valued is protected.” There is havoc on the ANS when ventral regulation can’t be accessed, nor is coregulation possible. We recognize cues of threat/ danger when our nervous system reacts to stimuli. In the sympathetic nervous system, we

Dana further explains in dorsal vagal state, we disconnect and disappear. It is immobilized or collapsed energy. This state includes a conservation mode of being numb, foggy, untethered, alone, lost, abandoned, unreachable, in despair. In dorsal collapse, there’s an inability to take action. Dana describes trauma as a “chronic disruption of connectedness; when it happens, we lose our connection to ourselves. Trauma stories are carried in autonomic dysregulation… not a cognitive experience” (Dana, 2018). This is powerful information. It means healing isn’t solely possible through cognitive techniques. Trauma is stored and trapped in the body and it is worked hard upon by the autonomic nervous system moving through the vagal states. The ANS can inform when the stress is present and it can respond by calming the vagus nerve via regulating the nervous system, mitigating the residual powerlessness and helplessness of trauma. By witnessing our reaction and the states that have consumed us, it is helpful to understand it was a form of protection, of survival. Thus the experience is a process that’s purpose is to keep us safe, from the “insult” to the psyche and or body (Dana, 2018). Thus, regulation and coregulation


between nervous systems becomes very important for healthy social engagement and connection. We are either feeling safe or danger when one is either in coregulation or survival response.” “Without the regulating other, the system is stunned, it cannot connect” (Dana, 2018). When the “ventral vagal goes off line with too much stress, then sympathetic fight flight mode tries to address it; if that doesn’t resolve it, goes to dorsal vagal,” and ultimately immobilization or collapse (Dana, 2018). Tuning inward and listening for the autonomic changes, we can attend and nurture self and get to a sense of regulation and agency. Dana reminds us lovingly to “Honor the wisdom that your nervous system has used to get you to this moment in time… turn towards it, be a friend to it, connect with it.” Dana, has provided practices to help us become aware. She suggests we can bring ourselves back to ventral with breathing awareness and establishing meaningful anchors to call upon to bring us to calmness and safety. She says when you find these anchors, via positive places, people, etc., deepen them in your memory. They are regulating memories.

Being aware of moment to moment experiences and our dysregulation within our nervous systems, we can be mindful of ANS activation and notice and address these changing states… to begin reconnecting, trusting, and establishling a sense of safety (Dana, 2018). This wholehearted attunement within self shifts from a place of danger to a state of safety through mindful regulation, generating the sense of embodied power and control.

to move me out of flight/ fight/ freeze sympathetic mobilized state; and 3) the things I can identify that immobilizes me or makes me feel collapsed in the dorsal state. What can I do with others to either, stay in ventral, or move me out of sympathetic and dorsal states- and name the triggers. Deb Dana (2018). The Polyvagal Theory in Therapy; Engaging the Rhythm of Regulation. W.W. Norton & Company New York.

According to Dana, since we are always asking, even under awareness, “Is it safe to connect?” ….we can ask ourselves “What is happening in this moment to impact connection?” It is also suggested to ask oneself, “Am I anchored in my self regulation? To begin connecting to regulation, find a cue of safety in your body, and find a cue of danger in your body. You can expand the question into the environment and with people in your life, according to Dana. This develops attunement and facilitates integration. Dana further suggests a creating a chart that lists 1) the things I can do on my own that help me stay in the safe and social ventral vagal state; 2) the things I can do

Written By: Annie Flipse, LCSW Annie Flipse is a substance abuse counselor in IOP at, CARF accredited, Breakthroughs Counseling & Recovery, Jacksonville, Fl. She holds a masters degree from Florida State University and is a Licensed Clinical Social Worker (LCSW). Annie is an educator and counselor with a background in human dynamics. She has experience working with teen parents, addicted adults, and her focus is in cognitive behavioral therapy and family systems theory, with emphasis on attachment and the polyvagal theory.

The next 491 Board Meetings are scheduled for August 19,2021 & November 4, 2021 For additional information including: times, locations, and discussion topicsPlease Click Here


2021 Webinar Series Lineup Ethics Update: How to Chat, Post, Follow, Like, Tweet, and Still Sleep Soundly in a Digital Age Presenter: Aaron Norton, LMHC, LMFT, MCAP, CCMHC, CRC Friday, July 9th, 2021 2PM-5PM EST 3 Ethics CE Credits CE Broker Tracking #: 20-765725

Moving from Attachment Trauma Toward Secure Attachment Presenter: Sandra B. Stanford, MS, LMHC Friday, August 27th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-769013

Click Here to Register

Click Here to Register

They Help When Humans Can’t: Understanding Animal-Assisted Crisis Response Presenter: Ariann Robino, Ph.D, LPC, NCC Friday, July 16th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-808672

Complete Mental Status Evaluation - Overview Presenter: Eric Reznik, Psy.D. Friday, September 10th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-769025

Click Here to Register Ethics & Rules: A User Friendly Integrative Approach: Am I doing This Right? Presenter: Michael G Holler, NCC, CFMHE, CCCE, CCMHC, LMHC Friday, July 30th, 2021 2PM-5PM EST 3 Ethics CE Credits CE Broker Tracking #: 20-808682

Click Here to Register Treating Trauma and Eating Disorders (In Person and Via Telementalhealth) Presenter: Elissa Chakoff, M.Ed., Ed.S., LMFT Friday, August 13th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-808892

Click Here to Register Counseling with the Multigenerational Family Presenter: Kathie T Erwin, LMHC, NCC, NCGC Friday, August 20th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-766397

Click Here to Register

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July 2021 InSession | FMHCA.org

Click Here to Register Mental Health in Schools Presenter: Erica N. Wortherly, LCSW Friday, September 24th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-771389

Click Here to Register Understanding Adverse Childhood Experiences (ACEs) and Client Trauma Presenter: Alicia M. Homrich, Ph.D., LPY, LMFT Friday, October 8th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-771449

Click Here to Register Early Recollections and Life Task Assignments: Applying Adlerian Concepts within the Clinical Setting Presenter: Karla L. Sapp, EdD, LPC, LMHC, NCC, CCMHC, CPCS, ACS, CMHFE Friday, October 22nd, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-820548

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I AM MORE THAN ENOUGH: Lessons of Transformation from Adult Children of Alcoholics Presenter: Daniella Jackson, Ph.D., LMHC Friday, November 5th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-839936

Click Here to Register Intimate Partner Violence: Hidden Victims of Sexual, Gender, and Relationship Minorities and Special Populations Presenter: Patsy Evans Ph.D., L.M.H.C., D.O.M. P.H.D. and Nicki Line L.M.H.C., CKAP Friday, November 12th, 2021 2PM-4PM EST 2 Domestic Violence CE Credits CE Broker Tracking #: 20-839940

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FMHCA 2022 WEBINAR SERIES CALL FOR PRESENTERS

DEADLINE TO SUBMIT: NOVEMBER 1ST

FMHCA is looking to webinars that focus on emerging issues in the field of Mental Health Counseling. This is an excellent opportunity to contribute to the profession, further establish yourself as an expert, build your CV, and gain experience in teaching and training.

Integrating Transpersonal Theory and Energy Therapies for Spiritual Clients Presenter: Paty Hernandez, LCSW Friday, December 13th, 2021 2PM-4PM EST 2 General CE Credits CE Broker Tracking #: 20-840196

Our 2021 Webinar Series will begin on January 2021 and conclude on December of 2021. Webinars typically are scheduled on a Friday afternoon and they are 2 hours in duration. Webinars are a great way to market your practice and get your name out in the community. Our average attendance per webinar is about 80-100 attendees. FMHCA offers continuing education credits to licensed professionals who attend the webinars.

Click Here to Register

Come share about an area of our profession that you feel passionate about!

Can't make the time of a webinar? Don't worry! It will be offered in our on-demand series 1-2 weeks after it goes live!

SUBMIT PROPOSAL


Mi fe y Mi Salud Mental My faith and my Mental Health

“Why School Based Mental Health Professionals can no longer ignore the role faith, religion, and spirituality have in the Latinx student community and their mental health treatment.”

Ohio- Jaime Torres a bright, timid, high school senior has been seeing his School Social Worker, Theresa Jones for individual and family therapy for some time now. Jaime struggled for several years with feelings of hopelessness, and panic attacks. It started with palpitations, night sweats, and a feeling like the room was spinning out of control. Jaime also began to experience a sense of desperation, sadness, and hopelessness. He could not take control of his thoughts and started to struggle with suicide ideation. Jaime knew something was wrong and needed help. Yet Mr. Torres was concerned with his parent’s reactions and responses concerning therapy, therefore he chose to not share his decision to engage in psychotherapy at school with anyone at first. Jaime’s parents did not agree with him engaging in therapy, especially his father David Torres. Mr. Torres would often say to Jaime, “tu no eres loco”, “you need to be strong”, “los hombres no lloran”, and “don’t you have faith?” David argued with Jaime that; his faith and religion should be enough to help him get through his struggles with mental illness. Unfortunately for Jaime these attitudes regarding men and mental health are common in the Latinx community. Jaime also received negative feedback from some of his uncles and family members about seeking help for mental illness which validated his concerns about sharing his decision to engage in treatment with his family. Mr. Torres friends at church also agreed that maybe he needed to work on strengthening his faith and should hold off from seeking any treatment, 18

July 2021 InSession | FMHCA.org

perpetuating the idea that lack of faith is what leads to mental disorders. But Jaime disagreed and sought out treatment. He found the help he needed in Theresa his School Social Worker, who was able to integrate Jaime’s faith into his treatment. Jaime never imagined being able to share the struggles confusion, and guilt, associated with his illness, faith, & religion. Guided by Mr. Torres, Theresa had conversations about how these extremely important determinants affected all aspects of Mr. Torres health including his mental health and mental illness. Mrs. Jones treatment plan included an assessment of Jaime’s faith, spirituality & religion. Theresa was aware of the beliefs shared by the Latinx community regarding cultural and religious values. The Research demonstrating the “Latinx community utilize mental health care at a rate that is about half that of non-Hispanic Whites.” Mrs. Jones was sensitive to the Latinx community beliefs and attitudes surrounding mental health which are complex and often misunderstood. She educated herself on religion, faith, and spirituality serving as strong protective factors for the Latinx community, as well the possibility that men share negative perceptions about discussing mental health conditions and seeking treatment. As a result, the Latinx community and Latinx students are struggling with mental illness at alarming rates; many failing to receive treatment because of their religious and cultural values. Mr. Torres is one of the lucky ones, who received treatment because of Mrs. Jones competency in the perception and values of this community in relation to their

religion and faith. Unfortunately, many school based mental health professionals fail to address these values and their contribution to the stigma against mental disorders that contribute to mental health care utilization disparities that currently exist. Jaime hopes school based mental health providers will increase efforts aimed at raising awareness, on the need for competency in integrating faith, religion, and spirituality in treatment in an ethical manner. Mrs. Jones believes this is one of the many ways to make strides in combining faith and psychotherapy. Mr. Torres questioned; If his faith is such a significant part of his life, why would it not be addressed in his mental health treatment? Why are people so afraid to talk about faith, religion, or spirituality? For us “Latinos our faith can define how we see the world, for many of us it is everything.” Everyone is talking about mental health, everywhere he goes Jaime reads, sees, or listens to someone at school talking about the importance of seeking help. He feels however schools need to do a better job at understanding the whole student. School Mental Health staff should be able to apply every aspect of our lives to our illness. According to Jaime, “all they do is talk about it, but can they try to figure out why we are not engaging in treatment?” While Jaime makes an excellent point, school mental health staff often struggle with the dilemma of how to incorporate faith and therapy. Why should schools even consider this, when everyone is so scared of being sued or facing legal action? To consider Jaime’s needs school based mental health professionals will have to figure out how to address the ethical and legal requirements involved in this work. Hence this sensitive and perhaps complex effort school based mental health professionals may choose to not address


spirituality, faith, or religion. It makes perfect sense why we lack research and actions towards school-based curriculums to support school based mental health professionals.

this communities’ perceptions and beliefs with lack of parent engagement in their child’s treatment, or a complete denial that their child/adolescent has a mental health condition.

In New York City, Teachers like Leidy Garay explained that educators and school based mental health staff, as well as administrators are aware religions cannot be forcibly practiced in any public school. Mrs. Garay however believes all students should still have the right to practice their personal beliefs. She has worked alongside school Social Workers, and school Counselors, to become sensitive to her students and families spiritual and religious beliefs. Leidy a Special Education Teacher with over 15years of experience recognizes how faith, spirituality, and religion can provide protective factors for mental health.

According to Leidy “it is not that parents do not want to engage with school based mental health professionals it is more like we are not properly engaging them. If our engagement does not include an assessment of all their determinants, cultural identify, values, and their beliefs as well as family stressors, our assessments are invalid.”

Mrs. Garay believes Latinx students like Jaime exist all over the world. Leidy is correct, as Latinx students struggle with thoughts of suicide up to 8 times higher than their peers. The numbers just keep rising for mental health issues as well as serious mental illness, suicidal thoughts, plans, and attempts. Not to mention that Latinx students are more inclined to mental anguish associated with trauma due to immigration and acculturation. Mrs. Garay has witnessed how often schools fail to assess’ students and families’ various determinants. These students are wonderful, full of light, dreams, and deep-rooted family systems. Latinx students enter into our school system with a multitude of traumas, loss, violence, and extreme poverty. Leidy believes we are missing the opportunity to end the stigmas associated with mental illness within this community. Instead of looking at all aspects of the family’s life and how they will inform their understanding of mental illness and stigmas associated with these conditions the educational system often confuses

Mrs. Jones explained it took time for Jaime’s parents to understand and accept his mental health condition and treatment needs. It involved a genuine desire on both ends to go on a journey that at times was uncomfortable, unknown, and challenging. Constantly requiring Theresa to develop her skills, assess her competency, build her knowledge, examine her own biases, and keep her personal beliefs in check. Mrs. Jones learned from Elena Torres (Jaimes mom) that faith for many Latinx parents is an incredibly strong protective factor and some believe it is they’re faith that “saves” them when struggling with depression and/or mental illness. Holding on to their faith in God, using prayer and meditating on the biblical word are their coping mechanisms. It is their faith and/or religion which gives them strength to get through the bad days and increases their resiliency. Mrs. Jones had to learn about these beliefs, coping mechanisms, and make a decision to respect these as well as how these affected their understanding and treatment of Jaime’s condition. In working with the Latinx community Theresa has found often some students will have gaps in service as it pertains to mental health treatment, or no treatment history at all. This is because the students and families she has served searched for some time before they found a mental

health professional who was competent and knowledgeable in their faith and religious beliefs. A mental health provider who understood and integrated the value and significance of these systems in their life and supported them without judgement or fear. Schools can work towards providing education and increasing professional development on competencies in clinical practices surrounding the integration of faith and the challenges associated with utilizing spirituality in psychotherapy. This will allow for school based mental health providers within their field of discipline to practice this integration in a matter that is ethical, reducing fear, and avoiding legal dilemmas. We will still have schools concerned with not upholding a particular religion. Mrs. Jones understands this as a school Social Worker and Licensed Clinical Social Worker, and she makes clear the ask here is; not for schools to practice religion rather provide students with the opportunity to observe their personal faith and be able to integrate this in combination with their mental health treatment if the student and family desires to do so. Mr. Torres argued that school mental health providers are not practicing with full ethics when they leave out religion and spirituality. According to Jaime, “if you ignore how these inform, influence, and affect my environment and life, ultimately mental health professionals are not fully addressing and breaking down barriers which could lead to me or my family accepting, and understanding treatment of mental disorders.” School Social Workers often use the Biopsychosocial Model, which declares “ interactions between people’s genetic makeup (biology), mental health and personality (psychology), and sociocultural environment (social world) contribute to their experience of health or illness.” School Social Worker Theresa


Jones used this model to gain awareness, and competency on how faith, religion, and spirituality often have correlations with the student’s mental health. The Biopsychosocial model used in her assessment of Jaime, allowed her to develop, and expand her abilities on the spiritual, religious, and faithful facets of her student in a holistic and ethical manner.

that God is first and, it is through him only as the agent we achieve success. He also explained that he believed God wanted those suffering to get help if they need it, there is no shame, guilt, or judgement in that. So why should the Combination Of Faith And Psychotherapy Be Seen As Beneficial?

In combination with the Biopsychosocial Model Mental Health Providers share integrating faith into treatment can begin with: Proper communication and assessment- asking questions about their beliefs and values, the role faith, religion, and spirituality have in the student’s life in the past and at present, how these may affect or influence their values and beliefs and If they desire to discuss these issues with the school based mental health professional. Mr. Torres shared a turning point for his parents occurred when; Theresa allowed them to share their beliefs regarding their faith, talking about the feelings of guilt in the context of their religious background. For example, David and Elena Torres shared they felt as if they were doing something wrong by seeking therapy, that they were putting God second, or that professional help was against Gods will. Mr. David Torres explained they felt validated, understood, and accepted by Mrs. Jones. The Torres family found Theresa allowed their faith, and religion to have the role Jaime choose and the value he desired in treatment. Jaime’s mom: Elena Torres went back to church and told their pastor about their experience. Elena felt it was necessary for her to communicate this journey in an effort to help other mothers who struggled with the decision to integrate faith and therapy. For Jaime, this whole process allowed him to help other students who are suffering. Jaime shared he was able to tell them they do not have to give up on their faith and their belief 20

July 2021 InSession | FMHCA.org

According to the U.S. Department of Health and Human Services Office of Minority Health, In 2017, suicide was the second leading cause of death for Hispanics, ages 15 to 34. While Suicide attempts for Hispanic girls, grades 9-12, were 40 percent higher than for nonHispanic white girls in the same age group, in 2017, and Non-Hispanic whites received mental health treatment twice as often as Hispanics, in 2018. These numbers are disturbing and rising yet we can take actions to reduce the lack of competency and feelings of seeing faith and psychotherapy as separate from psychotherapy and rather combine these in treatment. School Based Mental Health providers can no longer ignore the role faith has in this community. We can no longer decide to not integrate this into treatment because we are fearful or because we lack competency. Some additional strategies school mental health providers can take are to provide education in a manner that is engaging and non-offending. As students and families learn about what

therapy really is, and what it is not, they will be able to see how both their faith and therapy could help them heal and cope with their symptoms if they choose to integrate this in their treatment. As the mental health professionals use the Bio-psychosocial perspective to understand how their student’s faith informs their life, decisions and values they will see why it is beneficial to continue to encourage students and families to continue with the emotional support offered by their church for example. In addition to the coping mechanism offered by the church community, and how this can reduce social isolation. School based mental health professionals can also appreciate how faith provides students with hope — a feeling that everything is going to be okay and that they are going to get through this because God is with them. Jaime for example valued being able to use a Bible passage to help with managing his symptoms. In combination with his faith, Theresa also used some cognitive behavioral techniques, to help Jaime understand his negative thinking patterns. These evidence-based practices provided Jaime with validation and specific ways to cope. How Faith Builds Mental Health Resilience Research suggests that religion and spirituality may build resilience when facing depressive episodes. This has been the experience shared by Jaime and his parents. His spiritual and religious beliefs that God was in control, God was protecting him and would not leave him decreased his feelings of despair and hopelessness. These positive thoughts and strong social supports offered by his religion and spirituality helped Jaime build resilience against the negative feelings of depression and often stopped them right before they started. School based mental health provider such as Social Workers, School


Counselors, and Family Therapist should place emphasis on the positive coping mechanisms that are offered through spiritual practices and the impact of religious and faith-based community supports for people with mental illness. In doing so they can effectively support Latinx families and reduce the stigma associated with mental illness, religion, faith, and treatment. Mrs. Garay knows first-hand about Latino families who are victimized by various forms of trauma such as violence, and immigration trauma. She has found that in working with her students and their school based mental health providers religious views, beliefs, and experiences, can and almost most certainly influenced their acceptance of approaches to treatment and goals. As a result, we must create opportunities for the Latinx community to combine faith and religion in psychotherapy by promoting mental health literacy to allow for this community to create a healthy balance through which they can continue to use their faith and religion as protective factors against mental illness. For school based mental health professionals seeking resources and information on how to integrate faith, religion, and spirituality into psychotherapy the following links may be helpful. Literature/ Workbooks Integrating Spirituality and Religion Into Counseling (3rd ed.) A Guide to Competent Practice by Craig S. Cashwell,

& J. Scott Young Handbook of Religion and Spirituality in Social Work Practice and Research1st ed.by Sana Loue The Therapist's Notebook for Integrating Spirituality in Counseling I: Homework, Handouts, and Activities for Use in Psychotherapy by Karen B. Helmeka, Catherine Ford Sori Incorporating Spirituality Into Core Counseling Courses: Ideas for Classroom Application A Treatment Improvement protocol Improving Cultural Competence Developing Spiritual Competencies in Counseling: A Guide for Supervisors Faith and Field: The Ethical Inclusion of Spirituality within the Pedagogy of Social Work Cultural Competence In Service Delivery The Importance of Faith in Latino Communities Articles https://www.pathways2promise.org/wpcontent/uploads/2017/01/Is-it-aSpiritual-or-a-Mental-Health-Crisis-1.pdf Support https://www.faithandgrief.org/ Webinars https://www.pathways2promise.org/p2pwebinars/ Nami https://www.nami.org/GetInvolved/NAMI-FaithNet/Resources https://www.mhanational.org/para-lamente-para-el-cuerpo-espiritualidad-yreligion https://www.mhanational.org/issues/lati nxhispanic-communities-and-mentalhealth https://www.eurekalert.org/pub_releases /2019-04/ru-mhs040119.php https://www.apa.org/topics/covid19/faith-crisis References Mental Health Research: Latino Family Issues by Amelie Ramirez @SaludAmerica Mental Illness & Families of Faith How Congregations Can Respond

Resource/Study Guide for Clergy and Communities of Faith by Rev. Susan Gregg-Schroeder Coordinator of Mental Health Ministries www.MentalHealthMinistries.net sgschroed@cox.net Intersection of Cultural and Religious Beliefs About Mental Health: Latinos in the Faith-Based Setting, March 2019, Hispanic Health Care International 17(1):4-10DOI: 10.1177/1540415319828265 by, Susan Caplan, University of Northern Illinois Latinx/Hispanic Communities And Mental Health, MHA Understanding Immigrant Trauma, The Immigrant Learning Center, Posted on March 12, 2020 The Biopsychosocial Perspective to Mental Health and Illness, By Julia Cardoso Integrating Spirituality and Religion into Psychotherapy Practice U.S. Department of Health and Human Services Office of Minority Health Against the Stream: religion and mental health – the case for the inclusion of religion and spirituality into psychiatric care, Simon Dein.

Written By: Martha Digna Rodriguez, LCSW Martha Rodriguez, LCSW, received her MSW from the Wurzweiler School of Social Work at Yeshiva University. Rodriguez has more than 15 years of experience in both private and public sectors. She previously served as the Service Manager in Recovery at Marjory Stoneman Douglas High School, facilitating the delivery of mental health services. Currently, her role is Mental Health and Social Work Consultant for the Student Services Project at the University of South Florida.


RATE YOUR MATE before its too late

THE PROBLEM 1. Every day 4 women die in the United States as a result of domestic violence. 2. Every year approximately 132,000 women report that they have been victims of rape or attempted rape. And more than half of them knew their attackers. 3. Every year 1.2 million women are forcibly raped by their current or former male partner. 4. 30% of college students report dating abuse. 5. The divorce rate for first marriages is 48% 6. The divorce rate for second marriages is 67% 7. The divorce rate for third marriages is 73% Despite all of the relationship books, relationship therapists, relationship podcasts, we are continuing to spiral downwards when it comes to finding and maintaining healthy relationships.

Why is this happening? And more importantly, what if anything, are we prepared to do about it? RELATIONSHIPS FAIL FOR 4 REASONS 1. If each person is not emotionally and psychologically healthy, it is not possible to have a healthy long-term relationship with anyone. 2. The majority of people have no idea whatsoever, about what ingredients go into a healthy long-term relationship or marriage. 3. If you don’t know (2), you are in no position to be able to assess who’s right (or wrong) for you. 4. The majority of men and women are unfortunately, lacking in emotional communication and problem-solving skills. OUR CULTURE Just look at the television reality shows like the Bachelor, Marriage at First Sight and the Housewives of New York and Beverly Hills. Or tune into any Life Time movie. Dysfunctional relationships are glamorized in the media. We can’t get enough of the celebrity talk shows that talk endlessly about Angelina and Brad’s on-going drama and Jennifer Aniston’s 22

July 2021 InSession | FMHCA.org

Never Make a Mistake In Love Again

relationship heartbreaks. Just look at the media coverage and attention that Charlie Sheen and Mel Gibson and Lindsay Lohan and others receive describing their abusive and volatile relationships.

and famous clientele are no different from the people who I have treated from the Inner City areas of Montreal, Providence and Manhattan.

Both groups know virtually nothing about what ingredients go into a healthy On the surface, these television shows can relationship, nor have they learned and be viewed as innocent entertainment. developed the emotional communication However, their messages about and problem-solving skills necessary to relationships and marriage make a maintain and sustain a relationship. mockery of what it takes to have a THE SOLUTION healthy, long-lasting relationship. The 10-Step Fail-Safe Formula That Will Also, how many people were fortunate Change the Way You Look at enough to have positive role models for Relationships Forever- It May Even Save parents to teach them about loving Your Life! relationships? And finally, if we haven’t We spend more time researching cars, been taught about what ingredients go into a healthy relationship and if we rely grams of fat and real estate than we do our partners. Think back to how you often on misleading portrayals of love in thought you knew everything there was to movies, television and popular music, how can we then expect people to be able know about your partner. You believed that the person you were in love with was to make healthy choices about their relationships? The reality is that we can’t exactly whom he/she seemed to be. You were sure that you had found your life and we don’t. partner and perfect match. Then Many people believe that the best way to suddenly without warning you realize build stronger families is to attack the that you are headed for disaster. Your barriers keeping people from achieving relationship is in shambles. Your mind is their full potential. Issues like poverty, spinning. What went wrong? Chances are racism, sexism, unemployment t and the signs were there all along. You just addictions are often cited as primary didn’t know what to look for. reasons for the breakdown of But what if I told that there was a 10-step, relationships. And although these are contributing factors to marital and family fail-safe formula, already successfully strife, removing these barriers alone will used by thousands of men and women around the world for assessing who’s not solve the problem. right or wrong for you BEFORE In the past 35 years I have treated some of committing to any serious relationship? the wealthiest, best educated and most Would you not want to know about it? In successful people in Canada and the fact, would you not want to share this United States. And I can definitively say important information with everyone you that the relationship problems of my rich know and love?


The good news is that there is such a formula and you now have an opportunity to educate and empower yourself and others in ways that you never dreamed possible. The formula changes the way that people look at relationships forever. THE FORMULA 1. Predicting the Future: Family Background. Take a close look at your partner’s parent’s relationship to get a good idea of what you might expect from him/her. Family background is the first place to look for relationship programming. What we learned as children we unconsciously play out as adults, UNLESS we learn to acknowledge, address and take whatever steps are necessary to resolve our problems from the past. 2. Lurking Around the Corner: Skeletons in the Closet. The incidence of HPV and genital herpes is skyrocketing and yet most people will not request (and receive) a written clean bill of healthy from their partner’s doctor before engaging in sex. People also need to learn to recognize signs of alcoholism and other kinds of substance abuse, because neither the alcoholic nor the drug abuser is a good candidate for any relationship. Learning how to identify verbal, emotional and physical abuse is critical. Knowledge helps people to EXIT quickly when they are aware that they are at risk. 3. More Skeletons Lurking. People need to learn to identify the signs and symptoms of depression, anxiety and other psychiatric disorders. While the clues are always there, these problems are often invisible to the untrained eye and ear and are major obstacles to a successful love connection. 4. Listening Carefully: Did You Hear What I Said? Everyone talks about the importance of communication. However, the majority of people have simply not learned the necessary skills in order to be able to communicate effectively. How well (or how badly) you and your partner are

able to express emotions like love, fear, disappointment, anger and pain will make or break your relationship. 5. The Art of Compromise: ProblemSolving- Is the most crucial of the key ingredients. Why? Because this skill will help you deal with situations in all other areas of your relationship. Even the most harmonious relationships have conflicts that need to be worked out fairly and openly. It is essential to discover your partner’s attitude and level of skill in dealing with conflict and compromise early on in your relationship. And unless you and your partner are committed to acknowledging, addressing and resolving issues, your partnership will be doomed. 6. Imitating Intimacy: Sexual Illusions. People can have a great sexual connection while at the same time have little or no emotional intimacy. It is very important (especially for women) to learn the difference between lust and love. 7. Lovemaking: the Agony and the Ecstasy. Human sexuality is highly sensitive and oftentimes confusing. Many people are uninformed about their own sexuality as well as their partners. Education, information, communication and chemistry are the key to a successful and exciting sex life. 8. Old Baggage: Past Loves emphasizes that past experience does not necessarily make you (or your significant other) a skilled partner. We unwittingly and unconsciously choose the same kind of partner repeatedly though he/she may look and sound different. Unless your partner (and you) has done his homework on past relationships and truly understands what part he played in why previous relationships were unsuccessful, you may find him reacting to the past rather than to you in the present. 9. Deal Makers, Deal Breakers. When it comes to making a deal with your partner, be honest with yourself. Become aware of silent, unconscious deals. What values can you accept? What can’t you accept? Find out how compatible you are intellectually and educationally. Do you

share similar goals, lifestyles, religious beliefs, interests, money concerns and views about children and careers? 10. Being Realistic: There’s No Such Thing as the Perfect Partner. If your partner is skilled in the most important of the ten key ingredients and you share good chemistry, look carefully at the compromises you might have to make. Certain compromises and trade-offs are okay to make, but certain situations should never be tolerated under any circumstances. FACT A. 450 people participated in my research study. Interestingly, I found that it takes close to 1 year (not a few weeks or months), using my formula, to do a thorough partner evaluation. B. This process cannot be fast-forwarded. C. Also, there is absolutely no correlation whatsoever between socioeconomic status and relationship success and skill. D. The only significant difference between my Inner City patients’ relationships and my rich and famous clientele of the last 20 years; is that the latter can take a week-end trip on their private planes or yachts and take a break from their relationship woes. E. Rich or poor, religious or not, educated or not, black, white or Hispanic, gay, straight or transgender; none of these variables correlate with having a healthy, successful and loving long-term relationship. F. Relationship success is dependent on relationship education. Let’s give people the opportunity to finally “get it right’! Contact Information Beattycohan.msw@gmail.com Website: BeattyCohan.com Written By: Beatty Cohan, MSW, LCSW, AASECT Beatty Cohan is a nationally recognized psychotherapist, sex therapist, author of For Better For Worse Forever: Discover the Path to Lasting Love; columnist, national speaker, national radio and television expert guest and host of THE ASK BEATTY show on the Progressive Radio Network. She has a private practice in New York City and East Hampton.


FMHCA'S FAVORITES

Summer Edition

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1.The Green Monster Smoothie 1 cup dairy or non-dairy milk 1 small sliced frozen banana 1 medium kiwi, peeled and sliced 1 cup lightly packed baby spinach 1/2 small avocado Optional add-ins: 1 tablespoon hemp seeds, 1 teaspoon chia seeds, and/ or 1 to 2 tablespoons nut or seed butter

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July 2021 InSession | FMHCA.org

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PANDEMIC RELATED Stress, Substance Abuse, and Problem Gambling

People have turned to coping with pandemic-related stress, anxiety, and worry in a variety of ways. Numerous reports have emerged indicating alcohol sales have nearly doubled during the pandemic as others have turned to gambling for their “mood altering” experiences to distract themselves from unpleasant or stressful circumstances. Indeed, the pandemic has created additional challenges that extend to mental health issues such as: increased depression, loneliness, or boredom from prolonged isolation anxiety due to loss of employment or not having money to pay for necessities stress related to home-schooling children and balancing work fear about contracting COVID-19, especially among vulnerable populations Psychological stress related to the pandemic should be of particular concern for addiction counselors given the risk of alcohol, drug, and tobacco abuse or relapse in recovery communities. Moreover, the abuse of some substances such as tobacco or cocaine can damage the cardiovascular and respiratory systems thereby increasing risk of mortality associated with COVID-19 infection. [1] In Florida, pandemic-related problem gambling also appears to be on the rise. The Florida Council on Compulsive Gambling (FCCG) has observed many callers to their 1-888-ADMIT helpline number turning to gambling to escape stress, boredom, or depression. Sadly, many also reported using their 26

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unemployment checks to gamble stating, “what have I got to lose, I’ve already lost my job” and in some situations “I’ve lost a loved one to COVID.” Mental health professionals should consider the importance of screening all clients for substance use disorders and behavioral addictions such as gambling disorder during the pandemic. Further, we might consider creating a resource sheet for patients about healthy ways to cope with stress and helpline numbers such as the one offered by the FCCG. The FCCG offers problem gamblers and those with substance-related disorders several suggestions to cope with or reduce stress that are listed below for consideration: 1.Reframing: Changing the way we look at a situation and focusing on some positive aspect. This involves searching for a more favorable understanding of the stressful situation and its implications. For example, job loss might provide opportunities for other employment that will help us learn or grow. Having to home school children, while stressful, might provide an opportunity for a parent to understand more clearly their child’s academic strengths and cultivate a closer relationship. 2.Differentiate Worries with and without Solutions: Worrying and problem solving are different activities. It is helpful to distinguish worries that have practical solutions from those that do not. In other words, focus on worries that have solutions and then focus your attention on problem solving (coming up with a specific plan to solve the things you are worrying about and then executing the

plan). This also requires individuals to let go of the things we cannot control. 3. Containment: Limit time spent worrying to a specific period each day (e.g. at the kitchen table from 3:00 to 3:20 p.m.) so stress or worry don’t eclipse other aspects of life or interfere with activities of daily living. 4.Social Support: Connecting with others can reduce internal stress or worry, especially stress caused from feeling lonely or detached from others.[2] During the current pandemic, social distancing is necessary, however, we don’t have to be emotionally distant from others. Turning to a romantic partner, a friend, family members, religious leaders, co-workers, a therapist, members of a support group (e.g., Gamblers Anonymous), a 12-step sponsor, or neighbors can help us feel less isolated or alone. Looking for ways to volunteer can also help us feel more connected with others. 5.Humor: Finding something humorous or funny about the situation can help relieve stress or tension about difficult situations. We need not look far on social media or elsewhere to find some comic relief. As a caveat, humor should not be in the form of jokes or sarcasm that discriminates or conveys harmful rhetoric towards others. 6.Relaxation Techniques: Several relaxation techniques have been shown to reduce worry and stress. They can include a variety of practices such as progressive relaxation, guided imagery, biofeedback, self-hypnosis, and deep breathing exercises. 7.Mindfulness Meditation: Meditation and mindfulness practices are effective methods to help people manage worry


and stress. [3-4] Like physical exercise, meditation is most effective when it is done regularly. One resource for learning mindfulness meditation strategies can be found online at UCLA’s Mindful Awareness Research Center. Popular meditation “apps” such as Calm, Headspace, or Insight Timer offer meditation exercises. Numerous other resources introduce Mindfulness. [See TedTalk by Dr. Hedy Kober from Yale University, LifeHack, Mindful, VeryWellMind, PsychologyToday Mindfulness, PsychologyToday Mindfulness Practice, New York Times Article, The Wellness Society, and The Free Mindfulness Project.] 8.Calming Music: Research has shown that listening to relaxing music can have a significant impact on reducing levels of stress.[5] This appears to be particularly true of classical music. [6]

9.Gratitude: Several studies have found a relationship between the practice of being grateful; and reduced stress.[7] Most studies have participants pay attention to feelings of gratitude through one or two journal entries daily. 10.Self-Care: This is about putting your own oxygen mask on first by taking a little bit of time each day to help you be your best self. It can include things like exercise, eating nutritiously, adequate rest, journaling, yoga, or going for a walk, all which have been shown to reduce worry, anxiety, stress, and promote more optimal physical and mental health. In summary, pandemic-related stress can increase the risk of addiction. Providers should screen clients for substance use disorders and problem gambling. Finally, there are several empirically supported interventions that providers should

recommend to clients struggling with stress during this difficult time.

Written By: Rory Reid, Ph.D., LCSW, ICGC-II Dr. Reid is an Assistant Professor of Psychiatry and Research Psychologist at UCLA and a Clinical Consultant with the Florida Council on Compulsive Gambling. He has published research articles on behavioral addictions in scientific journals and has worked clinically with hundreds of individuals negatively impacted by various addictions and other mental health issues. His work has been featured in press outlets such as the New York Times, the Wall Street Journal, TIME magazine, as well as TV specials on ABC, CBS and Fox News.

[1] Marsden, J., Darke, S., Hall, W., Hickman, M., Holmes, J., Humphreys, K., Neale, J., tucker, J., & West, R. (2020). Mitigating and learning from the impact of COVID-19 infection on addictive disorders. Addiction. [2] C. Segrin & S. A. Passalacqua (2010). Functions of loneliness, social support, health behaviors, and stress in association with poor health. Health Communications, 25, 312–322. [3] P. R. Goldin & J. J. Gross (2010). Effects of Mindfulness-Based Stress Reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion, 10(1), 83–91. [4] Krusche, A., Cyhlarova, E., King, S., & Williams, J. M. G. (2012). Mindfulness online: A preliminary evaluation of the feasibility of a web-based mindfulness course and the impact on stress. British Medical Journal Open, 2: e000803. [5] C. L. Pelletier (2004). The effect of music on decreasing arousal due to stress: A meta-analysis. Journal of Music Therapy, 41(3), 192–214. [6] P. M. Scheufele (2000). Effects of progressive relaxation and classical music on measurements of attention, relaxation, and stress responses. Journal of Behavioral Medicine, 23(2), 207–228. [7] Nezlek, J. B., Krejtz, I., Rusanowska, M., & Holas, P. (2019). Within-person relationships among daily gratitude, well-being, stress, and positive experiences. Journal of Happiness Studies, 20, 883-898.


FROM INTERNSHIP TO LEADERSHIP Halfway through her presidency term at FMHCA, Dr. Deirdra SandersBurnett takes us back to her journey from internship to leadership.

Meet Deirdra

Society in Education, Delta Epsilon Iato Academic Honor Society.

Deirdra Sanders-Burnett, Ph.D., L.M.H.C., has dedicated her life to assisting others to develop skills needed to live successful lives and make important choices that affect their lives. Dr. Sanders-Burnett is a Licensed Mental Health Counselor, Owner of Faith Counseling, LLC, Certified Professional School Counselor, Certified Teacher, Qualified Supervisor for Mental Health Counselor Interns, Adjunct Instructor for the University of South Florida, Regional Positive Behavior Support Facilitator for Polk County Public Schools, and a Florida Supreme Court Family Mediator.

Deirdra has extensive experience working with children, adolescents, and adults in school, private practice, and community settings. She also possesses a solid background in education which includes teaching, administration, school counseling providing mental health counseling to students in schools, and administration. As an educator, her focus has been on providing students with academic instruction that she believes allows them to develop professionally, personally, and enrich their social/emotional development. Her work experience includes 38 years of service with Polk County Public Schools. Deirdra has 14 years of experience as a Licensed Mental Health Counselor.

Dr. Sanders-Burnett is a member of several non-profit organizations where she served on various committees in the areas of education, advocacy, public health programs and outreach. Her professional and community affiliations include the Florida Mental Health Counselor Association- President 2021, Sun Coast Mental Health Counselor Association- Past President, American Mental Health Counselor Associationmember, American Counseling Association-member, Florida Counseling Association- Membership Chair, Zeta Phi Beta Sorority Incorporated, Gamma Phi Zeta Chapter, The Polk County Chapter of the Charmettes, Inc. Vice President. Kappa Delta PI International Honor 28

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Becoming Dr. SandersBurnett, LMHC Deirdra has always known that she wanted to work the helping profession. Before graduating from BethuneCookman University with a Bachelor of Science in Exceptional Child Education with an Emphasis in Specific Learning Disabilities, Deirdra accepted a position as an Exceptional Student Education Teacher, teaching K-5 students with varying exceptionalities with Polk County Public Schools. After working closely with

the School Counselor and enjoying learning, Deirdra accepted a school counseling position and continued her education resulting in her obtaining a Master of Arts in Special Education and Master of Arts in Guidance & Counselor Education, and a Doctor of Philosophy in Curriculum and Instruction with and emphasis in Counselor Education and Psychology Cognate from the University of South Florida. Deirdra would later work in the capacity of a District level Exceptional Education Staffing Specialist and she now serves her school district as a Regional Positive Behavior Support Facilitator. As Deirdra matriculated at the University of South Florida in College of Education Department of Psychological and Social Foundation of Education Counselor Education Program to become a School Counselor, she was introduced to the field of Mental Health Counseling by Dr. Mary Lou Taylor and Dr. Marti O’Brien. After completing her internship and obtaining licensure, Deirdra accepted a position as the Mental Health Counselor for the Districts’ Alternative Education Program where she later become one of the schools’ Administrators. Deirdra’s passion to serve her community and help people facing mental health issues led her to become a Licensed Mental Health Counselor and open Faith Counseling LLC, her private practice in 2007.


Deirdra's Internship Deirdra’s large involvement in the youth/ intern sector of her community and beyond led us to ask about her own intern experience to which she responded: “I received a rich internship experience providing Mental Health Counseling services to students in a school setting and individuals in a private practice setting.” As she reflects on her Internship, Deirdra stated that she wishes that she would have broadened her experience by collaborating with other experts in the field working with diverse populations, using multiple counseling techniques, and practicing in various community settings. Although Deirdra did not attend 491 Board meetings and engage in advocating for legislative issues that impact the mental health profession, she learned the importance of attending the 491 meetings and encourages her interns

to do the same. Furthermore, through trial and error, attending professional development workshops, and consulting with her colleagues Deirdra learned the business aspects of operating a private practice.

the counseling profession, maintain ethical practices, and avail themselves to continuous professional development opportunities. I urge RMHIs to schedule the time for self-care as they are caring for others” she continued.

Having walked the path that RMHIs are currently walking, she encourages today’s interns to enjoy the journey, discover their passion and their purpose for working in the Mental Health Profession. “I embrace young leadership and continue to let students and interns know that we need emerging mental health counselors to enter the profession. I encourage my students and interns to develop relationships, avoid working in isolation, collaborate and consult with other experts in the field” Deidra states. “I provide them with strategies that will help them advocate for the profession of Mental Health Counseling. Foremost I advise them to know the laws that govern

Meeting FMHCA Dr. Carlos P. Zalaquett (previous President of FMHCA) introduced Deirdra to FMHCA when she was a student pursuing her doctorate at the University of South Florida. During one of their class sessions, Dr. Zalaquett elegantly spoke to the class about the benefits of joining a professional counseling association. He invited Deirdra to attend the monthly professional development training presented by the Suncoast Mental Health Counseling Association. After attending several professional development trainings, Deirdra was invited to become a member of SMHCA and attend a board


meeting. Having a desire to become more active with SMHCA, Deirdra was nominated and elected to serve as Treasurer, then Vice President, and ultimately, became the President of SMHCA. As she attended SMHCA’s monthly professional development trainings and Board meetings she learned about the importance of becoming a member of FMHCA, AMHCA, and attend FMHCA’s Annual Conference. “My curiosity got the best of me and I desired to have the experience of attending this unique conference where I could learn from the experts in the profession of mental health counseling, receive CEUs and additional Certifications” Deirdra stated. While attending the conference, Dr. Zalaguett escorted her around the conference center, introduced her to the Board members, presenters, sponsor, vendors, encouraging her to become a conference volunteer. “He also, invited me to be his guest at the luncheon” Deirdra added. “Having been offered a seat at the tabled surrounded by a room of passionate professionals who cared for empowering each other and the clients they served, I knew that I was in the right place and needed to be a part of moving FMHCA’s vision and Mission forward. I also committed to developing the future direction of FMHCA. When nomination for the office of President-Elect for FMHCA, I gladly accepted the calling” she continued.

me to follow and invested in my personal and professional development. As a child, my parents and ancestors instilled in me the value of helping and giving to others. I was amazed at how my father who traveled throughout the United States would meet people from all walks of life and engage in lengthy conversations with them. He taught me the art of listening and would prompt me to talk by saying, “I’ll give you a penny for your thought.” My mother instilled in me the value of obtaining an education, setting your goals high, and helping others. While attending Bethune-Cookman University the words of Dr. Mary McLeod Bethune was etched in my mind “Enter to learn; depart to serve.” “Invest in the human soul. Who

President of FMHCA and moral responsibility to give back to my profession. To enjoy working collaboratively with FMHCA’s leaders to help grow FMHCA, impact legislation, meet the needs of FMHCA’s members, and contribute to the quality of life of the clients we serve. Marian Anderson once said, “Leadership should be born out of the understanding of the of those who would be affected be it.” As a servant leader of FMHCA, I strive to hear the voices of those I serve and meet their needs. As decisions are made, I constantly focus on the effects of my actions, the actions of the Board Members, and Executive Office staff on the members we serve. I rely on the advice of Robert Putnam who promotes building a sense of community within a larger community, bringing people together, building consensus, developing the physical, human, and social capital of the community. If you attended FMHCA’s 20-day conference and attend FMHCA’s webinars, you are aware that we are enthusiastic about personal growth and professional development, continuing education for ourselves and our members.

I consider it both a privilege and moral responsibility to give back to my profession

Passion Meeting Purpose- A Message from Dr. Sanders-Burnett I am a culmination of the goodwill of people who saw my potential. I am grateful for those who blazed a trail for 30

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Dr. Sanders-Burnett knows, it might be a diamond in the rough.” “We have a powerful potential in our youth.” While attending the University of South Florida, I continued to benefit from learning from master teachers and the time my Professors invested in molding me into the educator and counselor I have grown to be. Thank you, Dr. Herbert Exum, Dr. Tony Tan, Dr. Carlos P. Zalaquett (previous President of FMHCA) just to name a few. As an Adjunct Instructor, I have been blessed to teach at both Universities to pay these gifts forward and invest in the next generation of teachers and counselors. I consider it both a privilege to serve as

COVID Presidency Serving as President of FMHCA has been an experience greater than I could have ever imagined. While serving as President-Elect I enjoyed learning about the culture and operations of FMHCA and its relationship with the regional and national chapters. Attending state and national conferences allows me to experience the passion that my colleagues have for the mental health counseling


profession and establishing our unique identity as Clinical Mental Health Counselors. I am grateful to be a part of a movement to expand mental health counselors’ scope of practice. Moreover, I am thankful to collaboratively work with a team of experienced Mental Health Counselor, leaders, dedicated Board of Directors, and office staff who are committed to advancing the vision and mission of FMHCA. Although the COVID-19 Pandemic created enormous challenges, it also helped us to create new opportunities, think creatively, allowed us to penetrate barriers, expanded our reach using modern technology, and mold our future. As President of FMHCA, I relied on the creative and innovative skills of FMHCA’s Executive Office Staff. They smoothly transitioned the operations of FMHCA into the virtual world. We can conduct virtual board meetings, offer virtual webinars, hosted the Annual Conference virtually increasing our webinar and conference attendance. I have witnessed FMHCA increasing its membership to over 1,200 members. I also heard about the resiliency and dedication of my colleagues as they transitioned their private practices and agencies to telemental health and discovered creative ways to safely provide services to their clients. I view FMHCA not only as an organization but also as a movement. Our founders and past leaders established a solid foundation to build on. As I reflect on and strive to achieve the day-to-day goals of FMHCA, I also invest in plotting the course to accomplish future goals. Within the next five years, I envision FMHCA growing its membership to include the over 13,000 Mental Health Counselors in Florida. I would like to see more Mental Health Counselors advocate for legislation that will expand Licensure Portability and Interstate Compact. I

FMHCA Legislative Advocacy Day Delegation 2020

Deirdra Sanders-Burnett. PhD., LMHC collaborates with Carlos Zalaquett, PHD., LMHC Past President of FMHCA

FMHCA Legislative Advocacy Day Delegation 2020

hope to see Certified and Licensed Clinical Mental Health Counselors recognized as Medicare Providers. I foresee FMHCA developing closer collaborations with AMHCA, FMHCA’s chapters, and other Professional Counseling organizations.

Moving Forward As I continue my term as President, I look forward to working closely with FMHCA’s Regional Directors and committees as they conduct the affairs of the organization at the regional levels and facilitate the organizational structure and well-being of the state chapter. I also plan to collaborate with the leaders in the

Deirdra Sanders-Burnett with Corinne Mixon Lobbyist, Rutledge Ecenia Mixon & Associates at FMHCA's Conference

FMHCA Legislative Advocacy Day Delegation 2020

Regional chapters to identify their needs and ways that FMHCA can support them in meeting their goals. As the American Mental Health Counselors Association (AMHCA) embarks on their new portability initiative, The Counselor Licensure Interstate Portability Endorsement & Reciprocity (CLIPER) Plan, I plan to work closely with FMHCA’s Board of Directors and Stakeholders to support the CLIPER Plan.

Thank You Dr. SandersBurnett for your collaboration on this article. -The FMHCA Office Staff


LISTEN FOR THE MELODIES A side effect of the work I partake in includes the delight of gaining glimpses into the perspectives of others. Therapy fosters a space that allows for a therapist to join with someone on their journey, even if only for a moment. Some days, I feel like I have the secret keys to a time traveling machine, serving as an empathetic perception traveler, weaving in and out of varying realities that grace my office. It’s a neat and often humbling opportunity. Some of the perspectives I find myself uniquely fond of are the realities of those on the Autism Spectrum. These are notoriously some of the most misunderstood perceptions out there. I often normalize the challenges for parents in connecting with their Autistic loved ones. Metaphorically, I have found the particular “key” to use when stepping into the perspective of those on the spectrum have a password that must first be cracked before gaining access to the key. This is where I jump in. Instead of demanding the password, I embrace unconditional positive regard and simply insert myself as an observer. I outwardly recognize the privilege that I have identifying as neurotypical and the honor it is to be invited into their reality. Here, the pressure is alleviated to “mask” and the authentic human that sits before me begins to peek through their defenses that are vital to their internal safety. As this incredible soul begins to peer around their “masks”, I begin to listen for the soft notes of their tempo, their language, the distinctive notes that color 32

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their experiences. Quiet and hesitant at first, I gleefully and humbly listen, cherishing the moments I join with these clients. I hold space for the pain, the loneliness, and the long-held grief that is a side effect of being misunderstood. I empathetically jump into the topics that keep their soul alit despite the mountains of challenges. I immerse myself in the music of their perceptions. Then, ever so magically, I begin to access the password to connection and fostering nonjudgmental spaces. I take these passwords, put it through my therapeutic translator, and later communicate the messages and the experiences my client’s struggled to convey with the world whose tempo just does not make sense. Try as they might, the ability to settle into the neurotypical world escapes them. Now, the tables have turned and suddenly these resilient individuals are now the teachers instead of the students. The empowerment of this unlocking still dazzles my soul when I bare witness to it. There is so much to learn from a perspective that differs from our own.

Something that I listen to often is the silenced plea to have others let those with Autism lead the tempo from time to time. To join in their worlds. To empathically recognize they may never “get it” but their humble recognition of a reality that is different than theirs can still have some good parts. That joy, love, and enjoyment is still very much a reality, it just looks and feels different within the tempo they experience life in. Embrace the many tempos that individual perceptions dance to. Lean into the melodies and recognize that different is just different. Novelty and differences can lead to connection, if only we bare witness to the soft notes that accompany them. Pause. Listen. Embrace the melodies that are different than your own. Then, prepare for the onslaught of connection to those whose tempos can finally find a place in this world.

Different is just different. Not bad. Not broken. Just different. Those on the Autism Spectrum are unabatedly aware of this. While I will not try and speak for anyone, it is typically the tempo of the neurotypical world that colors “different” with negativity. Those with Autism are plagued with the monstrous task of learning to function to the notes of a reality that is far too unfitting and unyielding. They are told from a very young age their “different” is wrong, is sad, is something to be pitied and looked down upon. Where in the world is the empowerment in that?

Written By: Katherine Scott, M.Ed/ Ed.S, LMFT Katherine Scott is a Licensed Marriage and Family Therapist working at a practice lovingly known as Puzzle Peace Counseling in NE Florida. While working with those in all walks of life, she has her niche working with children on the Autism Spectrum and their families. She embraces an experiential approach with her clients in the pursuit of healing.



took to stop the “flashbacks” and the continuous “negative noise” in my head.

Is there such a thing as “closure” from a traumatic event? Many of the therapists I have either supervised or monitored have used the word “closure” when helping clients understand a past trauma. I understand the reason, but it has always been uncomfortable for me to use it when working with client’s past traumas/life events. I personally have never practiced closure in my own past life events. I practiced resolution to where I no longer emotionally react. Is that the same? Is it just another way to say the same thing? Let us discuss it and you can make up your own minds. I was watching a documentary on the “Unabomber” case when a surviving victim who was permanently disabled said, “There’s no such thing as closure. There’s different. There’s better. There’s all kinds of other words. But there’s no closure. Closure means its done. It’s never done. It’s never going to be done, but I don’t believe in being a victim.” Those are very profound words from a victim who went on to forgive the bomber and moved on with his life. In fact, he had befriended the brother of the bomber who reached out to apologize to him. He told the brother, “it’s not your burden to bear” and has maintained a long friendship with him to this day. I was profoundly impacted by this man’s trauma resolution and his entire demeanor. In my 30+ years working with trauma, I have learned to listen to the 34

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language and non-verbal language to assess whether a client has resolved or not resolved his past trauma. In my opinion, this man clearly has reached inner peace with his past. The definition of closure surely backs the referenced victim’s explanation. When I reflect on my own past events I totally agree with the victim’s statements. I still vividly remember the events that have impacted me. The impact and memories are not “closed” by a long shot. The difference, and what I have lectured on in my groups and classes, is I no longer “emotionally react” to a point where it negatively impacts my current state of mind. In my world, that is a little different than closing it. Again, I realize many therapists and people like to use the word “closure” in a more philosophical or figurative manner, but I am saying let’s not, and choose to rephrase it to more accurately portray the client’s process. Over my years, many clients have asked me, “Will my past trauma flashbacks ever stop?”. My answer has always been, “Mine haven’t, but I now just reflect on them without emotionally reacting and causing them to further negatively impact my life”. I would also go on to explain how my memories often keep me humble and strengthen my resolve to continue working as a therapist. In the past, prior to my resolution, my flashbacks and memories would send me down a dark hole. A hole where I would do whatever it

We therapists love to utilize words that attempt to quickly sum up something and sounds good and right. But we can also mislead clients by “word simplifying” and never really processing the client’s perception of what “closure” is. We may quickly reframe their questions regarding their perception as normal and still call it “closure” for our sakes. Many clients may even nod their heads in agreement with us, but it does not necessarily mean they agree with us. They may accept it only because they feel you would not understand why they can’t “close” it. The word “closure” for clients may not necessarily feel right inside. This is not a good resolution, and it may only further the isolation they are already feeling. So, let’s end this article with something I hope we can all agree on. You do not need to use the word “closure” with your clients. Instead, replace it with “resolved” or working toward resolving the past issues that have negatively impacted their lives. It has been successful in my practice and can hopefully help you with your clients. Mind, Body, Spirit….Balance!

Written By: Vincent Strumolo, LMFT Mr. Strumolo is a published author and forward thinker in the field of PTSD. He has developed a framework for therapy called Resolution Focused Therapy (RFT). Mr. Strumolo has been active in developing a comprehensive tracking, utilization management, and performance improvement program for the RFT system of care. Mr. Strumolo has performed various workshops on Trauma, Performance Improvement and Clinical topics at many national and international Conferences.



When The Clinician Provides Counseling to Another Clinician Providing counseling to someone who is a Clinician is something we don’t discuss so often; clearly, not often enough. Clinicians are people too. There may be times when we need therapy. Discussion: It’s important to be aware of some of the nuances that might take place with providing therapy to another Clinician. It’s important to consult with a supervisor, mentor or another colleague. Let’s review some of what we should not be doing when counseling someone in our field of practice. We should not overstep the usual process of informed consent. It should not be assumed because the client is a Clinician they will “know”. It is important for the foundation for the treatment. We should not treat our client as if they are not a therapist. This would not go over well because the client is not accustomed to being a client and would feel as if they were being demeaned. We shouldn’t minimize because they are a Clinician. It’s important to be careful not to work through the real issues and acknowledge the seriousness of their situation because of trying to remain unintrusive, non-confrontational, or polite. We shouldn’t work over the Clinician’s head; meaning that as skilled and knowledgeable as they are, they may not 36

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be able to absorb the complexities of their own issues. This is a balance of language. We shouldn’t become a friend even though the temptation is there. Countertransference issues may be particularly high with this situation and we need to be very aware of it and mindful of it. We shouldn’t become a competitor. This is an opposite type of countertransference that might take place. We shouldn’t treat a known colleague. Assist them with finding someone who is not known to them. Let’s take a look at some of the practices we may want to employ to help the Clinician in counseling. We should discuss any barriers to treatment head on. We should maintain that respect of the Clinical skills honed by the client throughout the counseling process. If we have ever provided Clinical supervision, we would know that we don’t approach first year Clinicians the same as we treat Clinicians with experience. We should allow them to present at their own pace but keep it moving; don’t stagnate. We should try a change in modality.

We should be mindful and inquire how much their issues are impacting their own ability to provide therapy. However, when presenting the question, bear in mind that it probably should be presented empathetically rather than critically. A Clinician may fear repercussions to their own practice and livelihood. We should mindfully use self-disclosure to show understanding or demonstrate examples. If we are comfortable with using self-disclosure as a tool normally and feel we are aware of the pitfalls. It builds teamwork and partnering in the Clinicians journey in the healing process. It also builds and maintains trust. Above all of our counseling techniques, we should keep it real; how would we want to be treated if we were the clinician client? We should keep in mind that we all may be a client at some point throughout the course of our life. The larger question is, will a Clinician seek therapy when needed and would we seek counseling if it were us? It would probably be an easier role to assume when we were younger, less experienced clinicians. However, as a seasoned clinician with many life factors at stake, doesn’t it


become more threatening? The Clinician should feel free to seek help at any point in their lives as any other client, but a Clinician may not. They may feel that they don’t want to reveal themselves to another Clinician, be afraid of their reputation or efficacy as a Clinician, be afraid of threat to their job or position. Clinicians may also think that because they are a Clinician, they “shouldn’t need” another Counselor to help them out.

As an end note, we might also take into consideration, that while this article addresses Clinicians, these same concepts will likely be applicable to

anyone who is in the helping professions and health care fields.

Written By: Dawn M. E. Picone, BCTMH, Psy.D, LCSW Dr Dawn Picone is Board Certified in Telemental Health, holds a Psy.D and is licensed as a Clinical Social Worker in six States. She works exclusively online as a Clinical Consultant for Major Medical venues and provides supervision for MHC and CSW in the State of Florida, New York and New Jersey.

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Loneliness HURTS LIKE HELL To this day, I can clearly remember opening the door to my barely furnished apartment at 16 years old. As the key clicked left, I held my breath to prepare for that sinking feeling of loneliness. It was more like a gut-punch. In the most frank terms, loneliness fucking sucks. And it hurts like hell too. As much as you want to ignore it or deny it, it’s part of our human experience. And for some, like me, it can flare up like a bad case of acne-not so easy to cover up. During my junior year of high school, I was prematurely launched into adulthood when my father decided to live full-time on the other side of the world in Kazakhstan. Tough scenario for a juniorespecially when cell-phones were a luxury item. It was just me, my tv, and homework after school. I still remember eating bags of Rold Gold Pretzel Thins for dinner as a teen, knowing that the emptiness I felt was more unhealthy than the empty carbs. To be honest, it felt so unfair. But I forged through it. Yet, somehow that deep wounding has seemed to follow me into my adulthood. Some call it a “pain point.” To me, it’s more like an old scar- it’s been there for a while, sometimes you forget about it , but it just doesn't go away. Originally, my father was only supposed to work in Kazakhstan for a few months. At first, I moved in with my 20 year old brother in North Carolina and my dad would visit every three months. Then my brother needed to finish college in Florida. I was then given the option of boarding school or living with “Lisa,” a former client from my dad’s hair salon (I guess boundaries or consistency were not necessarily modeled in my childhood). 38

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Lisa was like an adoptive mother between step-moms who in a way found a rent-adaughter in me for the weekends. Let’s just say this relationship can be a bit complicated at times. It’s more of a blurry boundary issue that comes up for me. Regardless, when it was agreed that I would live with Lisa and her husband, Rob (who never wanted kids) I was relieved that I would at least get to live in Texas again. However, that plan quickly turned south after a year. After many marital arguments between Lisa and Rob over having a teen living in their home it was decided for me to move out. The next best option was to live in a small apartment near the high school where all my childhood friends attended. Wait. That's not even nearly half of the truth. What was really going on-was that my dad was living his best life as a single guy in Almaty, being a total narcissist, and selfishly enjoyed not having any kids to worry about. He wanted his freedom after being a single dad for so long. He thought that I would be fine living with family friends. Looking for a proper boarding school never really crossed his mind. So he basically dumped his parental responsibility onto the first person who was volunteering to take over.

experiences and relationships have helped me be a more empathic therapist, mom, and wife. Not always, because I have my “off” days where I regress back to that scared and needy 3 year old or that angry and resentful 16 year-old. Yet, today I see that being exposed to loneliness at various developmental stages of my life, laid out the foundation for this book. Ultimately, I have learned so much more about something so personal yet widely universal. According to a survey conducted by Cigna in 2018, three out of 5 adults in America, or 61%, reported that they sometimes or always feel lonely. Cigna’s survey showed that our loneliest population is our youngest adults, the “Z” generation, ages 18- 22 years old. I would argue that as early as 15, teens are starting to feel their first pangs of loneliness without even understanding what it really is. Most teens and young adults don’t realize that they are lonely.

The worst type of loneliness is when you can’t put your finger on what’s “wrong” while you’re surrounded by people, friends, family, or even strangers. Sometimes you just feel “stuck,” or invisible and disconnected. Like no one really knows you or has a clue of how much you are struggling inside. There are so many masks and personas that we hold I can’t blame Lisa because I’ve changed up to cover our psychological pain. And my narrative and the meaning I give my story. And after years of personal therapy, the more we try to hide it, the more it breeds. grief work, and spiritual healing--I don’t even blame my father anymore. Call it The pandemic magnified the pain of dharma, destiny, fate, or just plain life-loneliness that so many of us have been these early challenges, sense of feeling for a long time. In order to get to abandonment and loss, and early the solution end of this problem, I would introduction to loneliness; were all a part like to first start off by trying to disarm the of my character development. Those life shame that comes with it.


The Shame of Loneliness No one likes to admit that they’re lonely, it’s like a character flaw. For some reason we are quick to blame ourselves that the reason we feel lonely is that we are unlovable or somehow damaged goods, or we just don’t fit it. These are stories we tell ourselves in an attempt to make sense of something that feels so shameful.

emotional hijack, that triggers your amygdala while clicking the offline switch for your prefrontal cortex. What that means is all logical and abstract thinking goes out the door, your emotional brain gets flooded with anxiety and fear, and your amygdala sirens off the alarm to your primitive brain that there’s a real threat detected.

So let’s begin by making more room for the actual emotion of shame. Defined as self-conscious emotion, shame gives us information about an internal state of not feeling enough, unworthiness, regret, or disconnection. Shame is an internal notification that our wellbeing and intrinsic need for connection has been interrupted. Another person or set of circumstances can trigger shame in us, but so can a sense of failure to meet our own expectations or societal standards.

So basically, our human instinct to survive kicks off an automatic urge to hide and protect ourselves when we feel shame. This is a specific kind of stress on the body and mind. It can activate immediate and long-term biological changes. Intense experiences of shame, which some therapists call a “shame attack,” while I call it a “shit storm,” can produce immediate physical changes in your brain associated with a fear response.

However shame grabs you, it’s not a pleasant feeling. I usually get that horrible sinking feeling in the pit of my stomach. My shoulders slouch, my face feels flushed, and I just want to crawl under a huge rock and hide. It sucks.

Experts say shame often leads to a “sunken” body posture, head down, shoulders slouched, and other body language of wanting to disappear. This type of stress response is so immediate that it can also lead to common tell-tale symptoms of sympathetic activation, like blushing cheeks, increased body temperature, sweating, or queasiness.

Research explains this physical urge for self-protection: The experience of shame recruits the same brain circuits that prompt people to hide from physical danger. Shame isn’t really associated with logic or cognition. It’s more of an

One way that you can learn to better manage symptoms of shame and loneliness, while keeping your brain in

shape is using boxed breathing. Think of a four-sided box, and each side you will utilize as a prompt for inhaling and exhaling. Try my brain health tip below: Brain Health Fitness Tip: 4 step box breathing 1. Start by inhaling for 4 seconds, imagining you are tracing the top of the box with your breath. 2. Hold your breath for 4 seconds, as you continue tracing the next side of the box in your imagination. 3. Now, exhale it all out for 4 seconds, as you continue tracing the imaginary box. 4. And then inhaling again for 4 seconds, as you complete tracing the box. Repeat.

Written By: Sylvia Kalicinski LMFT, PhD Dr. Sylvia K is currently the lead clinical therapist at Mount Sinai Medical Center and runs her private practice in Miami Beach where she serves individuals from all backgrounds. As a child of immigrant parents with their own mental health issues, Sylvia understands the uniqueness of each family’s story and the adversities that so many of us face today. Even though loneliness is a personal topic - it’s widely universal. Sylvia’s approach, turns complex human issues into a conversation that we all need to be having right now.


Childhood:

Who Cares?

To heal childhood trauma, is it really necessary to excavate our entire childhoods in psychotherapy? This “deep dive” has always been rather uncomfortably associated with the experience of counseling. Some people can’t abide it. Hate it. They maintain, for example, that “the past is the past”, or another quaint version is “I am who I am”. Others object because they believe implicit in the inquiry is we’ll blame the parents, or one of them, especially the mother. None of this is accurate. But then people keep all manner of irrational beliefs for reasons incomprehensible. It’s been shown, for example, that people will believe a stock pick is a good investment because…wait for it….someone they like told them it was so. Crazy, huh? Well not really. Just inaccurate . And very UNskillful. Talking About It In many sessions, we go slowly and start with symptoms. A woman wanted vaguely to “cure” an incident of sexual molestation, believing that somehow it had made her less of a person. Her husband told that she was somehow damaged, or broken because of her discomfort with intimacy. She believed it for some time and felt awful about herself. In time, we were able to address the anxiety and depression she often experienced around sexuality, and analyze roots of some addictive behaviors like excess wine and dieting. She had an overbearing mother who made her crazy with unrelenting expectations of perfection. She saw how this unrequited 40

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childhood “hunger” for emotional support led her to misjudge the intentions of caregivers. These experiences of loneliness and misplaced trust put her squarely and blindly in the path of a predatory family member who abused her. These memories gradually surfaced. It was hard work for her. Helpful was a gentle path of inquiry and a the emergence of a broader view of herself and her place in the world at 9 years old. From a re-examination of her thoughts and beliefs back then, she was able to embrace her adult self not only as a survivor of a terrible experience, but as a spiritual warrior eager to make meaning of her previous responses to trauma and suffering . A Patient Process Critical to healing is identifying thoughts and feelings associated with beliefs, sometimes severely self-limiting beliefs. Often, after trauma occurs, a person inaccurately believes they are powerless, because in the past experience of trauma, they may have actually been powerless. Sorting out how these limiting beliefs show up in adult behavior is key, especially when self-defeating behavioral patterns emerge. Change is not only possible, but can often take place quickly. Strength, clarity and a sense of renewal can occur after only a few sessions. Often, talking simply makes things clear. Others may see us more clearly than we see ourselves. Our childhoods are treasures of memory and emotion, if we can only courageously UN-earth and find their value.

My practice is John Davis Counseling in Delray Beach, Florida. I see clients live and virtually. If you or someone you love is struggling to feel good and live an optimal life, get in touch. Call or text me at 561-213-8030 or write to me at john@johndaviscounseling.com.

Written By: John Davis, LMHC John Davis is an expert marriage, family and relationship therapist with skill and credentials in addiction and recovery. He is widely renowned for his couples counseling work, getting successful outcomes in most difficult families. He is currently Executive Director of Mental Health Counselor’s Association Palm Beach and a member of Florida Mental Health Counselor’s Association. He maintains a concierge private practice in downtown Delray Beach. Clients come for help with: Couples, family and relationship difficulties, mood disturbances, including anxiety and panic, depression and grief, chronic impulse control issues. John is skilled in trauma resolution and the issues it brings, including PTSD, questions of spirituality and life meaning. John has extensive experience with ADD/ADHD, narcissistic and other personality problems. He offers regular parenting consultation for families .



horse know they want to go for a ride.

What is Animal Assisted Therapy all about? Your dog wags his tail when you walk in the door….. you smile and feel happy. You walk into the pasture and your horse trots over to greet you…..you feel appreciated. Your kitten curls up on your lap…..you feel loved. Such simple acts, but such powerful moments! Every day, people are emotionally affected by the animals that surround them. What if you could channel that power into healing your soul, opening your mind, and increasing awareness of your own behavior towards others? This is what Animal Assisted Therapy does. The concept of Animal Assisted Therapy has gained in popularity over the years. Many people have heard about using animals in therapy and wonder what it’s really all about. It’s about the involvement of animals in the therapy process to provide comfort and to promote personal growth and awareness. Horses, dogs, cats and other animals ASSIST us in increasing our awareness of our own behavior. They look past our words and tune into our body language, which shows our true selves. Animals are very sensitive to our underlying feelings even when we may not personally recognize what we are experiencing. Individuals; families; people with special needs; veterans with PTSD; people struggling with issues such as eating 42

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disorders, grief and addictions; can all benefit from interacting with animals to learn to better understand themselves and to recognize the effects of their behaviors on others. The use of the general term Animal Assisted Therapy actually covers 2 categories which are Animal Assisted Therapy and Animal Assisted Psychotherapy. Animal Assisted Therapy covers a broad range of animal related interactions, such as: providing emotional support by bringing dogs into nursing homes and schools or even into courtrooms to help an anxious witness to testify; providing crisis support by bringing dogs to comfort people in a situation where there has been trauma; providing hippotherapy which consists of riding a horse and strengthening the body; providing horse activities like petting and grooming for those with autism and physical challenges. Petting a dog in the therapist’s office or after a crisis situation can provide a sense of security and calm. Reading to a dog at school can build a child’s self-confidence. Interacting with a horse can help a person feel empowered. For people with physical disabilities, the horse’s motion can help build up muscles and physical strength. For autistic children, getting on a horse can be quite an accomplishment and may even lead to them speaking out loud… even if just to say “go” to the horse so they can let the

Animal Assisted Psychotherapy focuses on the mental health of the client. It includes Equine Assisted Psychotherapy which involves engaging in activities on the ground with horses (usually not riding), and Pet Assisted Psychotherapy which involves engaging in activities with dogs, cats and other animals. An Animal Assisted Psychotherapy session is run by a licensed Mental Health Professional. In sessions with groups and horses or multiple other animals involved, a second person, who is an Animal Specialist, is usually also involved. While the Therapist focuses on the mental health aspects, the Animal Specialist understands the animal’s behaviors and ensures everyone stays safe. The session structure usually consists of a discussion at the beginning to talk about what’s going on with the clients and what issues they are dealing with, followed by a specific activity interacting with the animals. It ends with an opportunity to process what has gone on and what the clients learned from the experience. Each therapist has their own personality and style but the goal is to enable clients to learn from their personal experience and figure things out on their own. The therapist usually has an activity planned that is based on the client’s needs, however it is important to be flexible. Sometimes a client presents with a different situation so the activity may need to be changed and tailored accordingly. I had prepared a specific activity for one Equine Assisted Psychotherapy session but when my client arrived at the barn, she asked me about lifting a horse’s leg. She had heard that it was a trust issue and wanted to try it. So I decided to make lifting the horse’s leg the activity instead of what I had planned. She was scared at first, but built up the confidence and relationship with the horse to finally be successful. This was a more meaningful growth experience for her at that moment in time.


In another Equine Assisted Psychotherapy session the client said people always seem to ignore her. When she tried to walk a horse, he kept putting his head down to eat the grass and ignored her efforts to guide him. When it was pointed out that even the horse ignored her, she realized she had to be more assertive and take control of the situation. This was a metaphor for her taking more control of her life in general. Even clients who are engaged in traditional talk therapy sessions may benefit from a few Equine or Pet Assisted Psychotherapy sessions to deal with behaviors like this that respond to a more experiential approach and provide immediate feedback from the animals. In family therapy situations, a family unfamiliar with horses might be asked to work together to put a saddle on a horse. One family member might take the lead, another may stand back while another may get bossy. Through this activity, the family dynamics become very apparent. This awareness can help them begin to understand each other’s feelings and learn to communicate better. I have a pet snake and also a pet rat that I have brought to group Pet Assisted Psychotherapy sessions, on separate occasions of course! Observing and interacting with both of them has helped some people get over their fears of snakes and rats. They also realize that if they can conquer these fears, they can overcome many other adversities and obstacles. In addition, they may learn about how they

judge others too quickly and don’t give themselves a chance to get to know someone. Corporate environments can also find Animal Assisted Psychotherapy useful to improve leadership skills and encourage cohesiveness in the workplace. For example, bringing a dog to a group session and asking each person to give the dog a treat after teaching the dog a trick can be an eye opener. Some people will just give the treat. Others will try to teach a trick and just give up. Someone else might volunteer to help another group member. Observing and then talking about the different styles may help the group members see each other from a different perspective. It’s an opportunity to discuss such issues as: How do you train someone on the job? How do you help each other learn new tasks? Are your expectations realistic? Think about a personal experience you have had with an animal. Was it positive or negative? How did it make you feel? What effect did it have on you at that time and how has it affected you in the long term? Has it changed you in any way? This thought process will give you more insight into the world of Animal Assisted Therapies. Working through both the positive and negative experiences enables you to look at them from a new perspective. One client shared a story about being pushed by his grandmother’s dog when he was a little boy. When asked how big the dog was he couldn’t remember. We talked about how small he was at the time and how even a little

Chihuahua might have looked big. After laughing at this image, he was able to pet the dog in our session without as much anxiety. You might find that this type of therapy would be helpful for you or for someone you know who is dealing with personal issues. You might decide this is a field of therapy you want to offer as a mental health professional. There are numerous providers of Animal Assisted Therapy worldwide and there are many schools and programs offering training in Animal Assisted Therapy. It’s a great opportunity to combine achieving personal growth with love and respect for animals.

Written By: Carol Tannen, MSW, LCSW Carol has been a Psychotherapist for 45 years & has been providing Animal Assisted Psychotherapy for the last 10 years. She founded “Animals Bring Change” in South Florida & wants to help others understand the therapeutic benefits of involving animals in the therapy process. This prompted her to write an informative & easy to read book called “What is Animal Assisted Therapy? An Overview For Everyone Curious About This Type of Therapy”.


I am a Licensed Mental Health Counselor in Florida who helps gifted kids. Who are these gifted children and teens? These are kids who enjoy expressing themselves through the arts, academics, or in other ways. I consider all children gifted as every child has unique talents, skills, or other characteristics that they may choose to share with the world.

Now, do not get me wrong. We can all evolve as people. However, how do we balance encouraging our kids to do their best while still letting them know that we accept them for who they are now?

I often receive notes of concern from high functioning parents who are worried that their high functioning kids are unmotivated and lack focus. Meanwhile, these “irresponsible children” are participating in demanding academic programs at school, engaging in extracurricular activities, and studying until midnight because they have to get their 92 grade up to a 96. Did I mention that they are also good people who care about others?

My colleague informed me that this usually takes two forms. We may have a young adult who is now a perfectionist striving to overachieve because her worth is dependent on what she accomplishes in life. Or, we may have a young adult who feels completely paralyzed and overwhelmed with the idea that he will never be able to live up to the expectations of others, especially the expectations of his parents.

A good colleague of mine works with young adults with anxiety. She said to me, “Erica, your clients are my future clients.” What did she mean? If kids do not learn to accept Sounds great right? How wonderful it is themselves and their imperfections, then to be so talented! Unfortunately, this these insecurities world of talent can come with a dark side. carry on into adulthood.

So, what do we do? Parents can ask kids what their success goals are versus placing These kids are intrinsically placing a high predetermined goals onto their kids. We can level of pressure on themselves only to be ask our kids if they are happy with the met with a parental message of still not outcomes of their choices. Most being good enough. They could be better. importantly, we can ask our kids to tell us how they would like our support versus imposing support onto them. The goal is that we guide our kids to step into a life that they can be happy and proud to live. So, let’s start creating experiences where gifted kids can feel the selfacceptance they need to become the next generation of innovators and thought leaders.

Who Helps the Gifted Kids: When will gifted kids ever be good enough? 44

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Written By: Erica Whitfield, LMHC, MACP Erica has over 11 years of experience working with children and adolescents and is the Founder of Positive Development. She specializes in providing strengths-based counseling and has helped hundreds of youth unleash their capabilities, transform obstacles into opportunities and find healthy ways to express their energy and creativity.



How the Power of Self-talk Improves Self-care

“Really, I said that?” is what clients often exclaim when I repeat back to them their negative self-talk and put downs. They don’t mean to be mean. They simply want to become the perfect image of who they think they should be. Unfortunately, negative self-talk is exactly what keeps them stuck in destructive self-care patterns. Here’s why. Like the Genie in Aladdin who says, “Your wish is my command,” our brains await instruction to do something via our thoughts and self-talk. Primed for action, they hear them as commands. For example, you say, “I’m so overwhelmed”— or afraid, stressed or miserable—and the brain uptakes that thought and produces that feeling. Tuning into self-talk My first goal in improving clients’ selftalk is to make them aware that what they say to themselves, even unconsciously, may be generating or increasing distressing feelings and dysfunctional behaviors. Many clients don’t think much about self-talk if they even realize they 46

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engage in it. It’s either background noise or they’re so used to speaking negatively to or about themselves that they tune it out. Once clients accept that they engage in self-talk, the goal for them is to remain alert and listen for it, then listen to it and evaluate what they hear. When they’re tuned in, they can decide if what they’re saying to themselves encourages or discourages them from doing what is in their best interest. However, before they can make this assessment, they need to know what constitutes destructive and constructive self-talk. Elements of destructive self-talk ·All or nothing: “If I don’t go to the gym five times a week, why bother going at all?” or “I’m going to diet and be perfect around food from now on.” ·Failure oriented: “I can’t control myself around sweets” or “I give up.” ·Comparative and competitive: “I want to eat as little as my roommate does” or “If my mom was a size 2 at my age, I can be too.”

·Moralistic: “I should go work out like a good girl/boy” or “I’m so bad that I bingewatched TV all weekend.” ·Negative: “I’m such a mess, how will I ever learn to be healthy?” or “What’s wrong with me that I take care of myself for a while then stop?” ·Short-sighted: “I’m full but I’ll just finish off this pie anyway” or “I’ll exercise really hard to lose weight so I’ll look good on next month’s cruise.” Elements of constructive self-talk ·Empowering: “My passion is to nourish my body well” or “I’m getting better and better at self-care.” ·Hopeful: “I’m developing new habits to take care of myself” or “I can do it.” ·Loving: “I do my best and embrace my imperfections” or “I’m so proud of myself.” ·Challenging: “I’ll be brave and take baby steps to change” or “I can learn to do what’s best for me.” ·Inspiring: “Every time I take positive action, I want to do more of it” or “I’m a better cook than I thought I’d be!” ·Intentional: “I will eat mindfully and


slowly” or “I’ll block out an hour a day to relax and do as little as possible.” ·Self-compassionate: “I love myself even when I make poor choices” or “When I overeat, I’ll be especially kind to myself.” Therapists often think they must validate everything clients say they feel. Naturally, we don’t wish to invalidate them, but we also don’t want to encourage self-

deprecation and untruths as when they say, “I’m a hopeless case. Even you can’t change that.” Rather than reinforce their hopelessness, we can respond with, “It sounds as if you’ve been having upsetting feelings. Let’s see what might be making you feel that way,” or “I get that you’ve been troubled by your feelings and want to feel more hopeful.”

We must teach clients that self-talk is foundational to their well-being and that they have the ability and power to talk themselves into becoming healthier, the same way they’ve talked themselves out of it. All it takes is tuning into self-talk and practicing speaking constructively to themselves. Forget willpower. Self-care grows from word-power.

Written By: Karen R. Koenig, LCSW Karen R. Koenig, LCSW, M.Ed. is an eating psychology expert, 8-book award-winning, international author and popular blogger. Her books focus on improving our relationship with food and our bodies via enhancing self-talk, learning life skills, resolving internal conflicts, revamping personality traits, developing rational beliefs, and managing our feelings. In practice for over 30 years, she’s based in Sarasota, FL. Her latest book, "Words to Eat By," is about self-talk, eating, weight, and body image.

22

ANNUAL CONFERENCE

FEB 4-5TH | LAKE MARY, FL

CALL FOR PRESENTERS Deadline to Submit: August 1st 2021

We are now accepting presentation proposals for our FMHCA 2022 InPerson Conference & Virtual Summit. Benefits of Presenting: Presenters will receive a $50 discount on conference registration. Promotion of your name and credentials on our website and in all electronic and print marketing materials, where appropriate. Recognition of your expertise by FMHCA and by other industry professionals. Networking opportunities

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Presenter Eligibility: To be considered, presenters must have professional qualifications in good standing with their professional regulatory board, if applicable, possess the technical expertise necessary to present on a subject effectively, and meet one or more of the following: Have received specialized graduate or post-graduate level training in subject of presentation; and/ or Have extensive experience including at least five years of practical application of research involving subject of presentation.

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SUBMIT


PEACE

change is difficult and may seem even insurmountable. Conceiving the idea of going back to an old way of doing things seems impossible. I believe it is important to validate this concept that going backward to an old way truly is not the answer to instilling true change. Instead, I encourage clients to embrace a new style of life and seek small steps to mold this new life into a new way that includes self care and well many who have been trying to manage a state of “new normal” that initially was to being. Possibly that is a brief routine of being mindful in the morning and evening be a short term inconvenience. when you wake up and go to bed practicing While the impact of the experiences of the pranayama breath. Alternatively, it could be last fourteen months has reached intentionally being present during a walk or unmeasurable levels - one constant exercise routine. Of vital importance is remains. As the Dalai Lama posted on addressing a sleep routine- turn off Twitter May 14, 2021, “Gradually people electronics an hour before sleep, practice are beginning to recognize that peace of relaxation, listen to guided relaxation or mind has an important role to play in our white noise to relax the nervous system. day to day lives. Mental afflictions like Last but very much not least of all, my anger, fear, and frustration detract from clients truly enjoy journaling, whether it’s a our good health, so, all seven billion Gratitude journal to improve negative human beings alive today need peace of thought patterns, a Task journal to write mind here and now.” As a holistic down daily responsibilities and combat practitioner the foundation of my racing thoughts, or a journal to track practice and my own life is built on the patterns of fear and anxiety my clients find overall well being of each individual. It this tool a great resource to begin steps can not be underestimated how sleep, toward well being. Tiny, small and diet, exercise, and mental well being peace of mind impacts each and every one consistent changes in routine that are manageable, attainable, and set us up for of us on a daily basis. I often hear from success are most likely to have profound clients how surprised they are that the lasting effects. slippery slope of the loss of good habits has had a tremendously negative Personal habits are difficult to change, with outcome on their overall functioning, small steps and consistency you can achieve taking away their ability to sleep- focusclarity, generate energy, improve concentrate- taking away their ability to effectiveness and find peace of mind. effectively manage their overall daily Written By: Darcy L. functioning. Coleman, M.Ed., LMHC With all good manners and intent, self Darcy is located in SWFL and care and healthy habits have been specializes in treating Trauma, encouraged and in particular recently in Anxiety and Mood disorders with clients K12 through adulthood both in person and celebration of Mental Health Awareness month across all venues across the globe - through Telehealth private practice. She reminding us these habits are essential to earned her Masters of Education at the overall well being. Yet, for many, once the University of South Florida, Tampa, FL and has been a Licensed Practitioner in the State good habits have been sacrificed for of Florida since 2002, a Qualified Supervisor meeting demands of the ever evolving new way of living life in the “new normal” and Crisis management trainer.

of Mind

Obtaining and maintaining peace of mind is essential to our overall functioning and well being as individuals. Since March 2020 we have been introduced to new challenges, new perspectives, new ways of “doing life”. We have been challenged to compensate, adjust, react, reach out, distance, organize, and reorganize in an ever evolving way. People in all stages of life young to old, student to retiree have made adjustments to their way of living life. Some have been required to distance by staying in the home for work and school or to protect themselves due to pre-existing conditions or age. Others have had to adjust to following CDC guidelines while performing duties in the workplace or school with ever changing demands and challenges. Some who stayed in the home found themselves extending work hours beyond normal boundaries into their personal lives often losing sight of their own needs for self care and rest. Others found themselves isolated from social interaction and support. Some people were actually able to embrace the time to focus on personal health goals and self care. Information being received from various sources began providing conflicting, confusing, and at times misleading, partial or incorrect information that has added stressors to 48

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What I Learned In My Final Year As A Counseling Grad During The Pandemic I am not quite sure where to start this article because, to be honest, last year was a difficult (to say the least) year. We experienced so much emotionally, mentally, and physically on both a global and personal level. When I look back, I see moments where I didn’t feel so alone (like starting Zoom with my family on Sunday nights) and others where I felt quite the opposite (such as going through a divorce). Amidst all this, I was also in the middle of graduate school completing my masters in counseling. For the first time in this field, we were training how to be counselors while facing the same societal issues as our clients. Here are the top three things I learned during a pandemic heading into the World of Mental Health. One, that presence matters over perfection. This seems simple and like basic counselor knowledge, but let’s be real…I was in an intensive program and had spent much of my life trying to “be the best” or “fixer” in my family. Despite learning all the techniques, theories, and achieving “perfect” scores, I felt overwhelmed due to the inability to solve my clients' problems. Was I not supposed to have my life and everyone else’s figured out by now? One of my supervisors, Zac Dodson, told me something that really stuck with me and started to challenge my perspective which was that “perfectionism kills presence”. I remember for weeks questioning how my 50

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clients continued to grow and heal when I felt so helpless with everything going on. I began to realize what I was offering was presence. Even in my own story, I discovered that there was no quick fix to what was happening to me besides finding a safe space to process, truly be seen, and heard. I often wonder how long it would have taken me (if I wasn’t in this vulnerable state) to realize change is less about what I can “do” and more about being human and recognizing another human. Two, that grief is important and everyone processes differently. For someone who tries to see the hope in things, I had a lot of let downs last year. I experienced shock and denial over a marriage slipping out of my fingers, anger at certain leaders’ stand on significant issues, sadness observing death happening all over the world, and bargaining with God over my loved ones health. How could I reconcile all my emotions and thoughts and still have hope to make a tiny dent of difference as a counselor? No matter how much I wanted to or saw my clients trying to avoid grief, I saw how much processing these emotions was necessary, therapeutic, and how each person deals with grief in their own way. Grief has no time limit, is not a linear process, and will only affect our bodies and minds when we do not attend to it. Lao Tzu says that “life is a series of natural and spontaneous changes. Don't resist

them; that only creates sorrow. Let reality be reality. Let things flow naturally forward in whatever way they like.” For my clients and I, the more grief was processed, the more relief and acceptance I saw. After accepting oneself, I saw gratitude over the blessings that were present, a feeling of empowerment over what could be changed versus what could not be, the ability to move forward, and a larger space of acceptance for others. Three, that having a reality perspective can be more positive than positivity. Of course, this is my own perspective but one of the greatest things that has been helpful to myself and clients is reality checking. During this past year, I had clients who would continue to disregard their circumstances, teetering between beating themselves up for not “doing enough” and not being able to “just stay positive”. I was doing it too! It was almost as if we were forgetting that they were in a global crisis and not able to understand why we could not just function as “normal” (whatever that is). We live in a society of “toxic positivity” that states we need to “stay positive” despite unrealistic social media comparisons, mental health illness on the rise, and higher stress demands. As a result, we end up invalidating ourselves and our experiences. Sounds pretty motivating, right? So, I started to ask clients and myself “what is the reality (good and bad)


of the situation” and discussed the idea of knowing first where we are in order to know where we want to go. Numerous times this way of thinking seemed to bring an immediate sense of relief because, instead of being caught up in where someone “should” be, it provided a compassionate space for clients to acknowledge where exactly they are, identify how they got there or what’s preventing them from moving forward, and what smalls steps can be made to reach their goal. Walt Disney said "I always like to look on the optimistic side of life, but I am realistic enough to know that life is a complex matter".

I am thankful to my program at Palm Beach Atlantic University and all the amazing professors for preparing me beyond the classroom into real life circumstances. Though I could never have imagined facing so much in my last year of graduate school, I learned a lot about uncertainty, myself, and others. I realized the true value of sitting with someone when you do not have the answers and are struggling on a personal level yourself. Second, the gift of processing grief and, by doing so, the ability to then be able to walk alongside others in their pain. And lastly, the importance and power in identifying where you are

realistically in this moment in order to process and plan for what’s next. For me, having all the necessary techniques or right answers is not what the essence of therapy is about anymore. It is about being authentic and creating a safe space where clients can be seen, accepted, and heard. Author Rachel Naomi Remen writes “listening creates a holy silence. When you listen generously to people, they can hear the truth in themselves, often for the first time. And in the silence of listening, you can know yourself in everyone.”

Written By: Melissa Buchanan, MS, Registered Mental Health Counseling Intern Melissa Buchanan, MS, is a Registered Mental Health Counseling Intern in the state of Florida and received her Master of Science in Mental Health Counseling from Palm Beach Atlantic University. She works with individuals, couples, and families and has been a part of a variety of settings from nonprofits to crisis centers to private practices. Outside of counseling, she enjoys kayaking, reading, and running around with her Shih Tzu Charlie.

Shop The FMHCA Store Rock fun designs while also supporting your favorite causes. Multiple colors, designs, and styles available in sizes XS-4XL Please note: Each design is made to order and has a campaign deadline. Once the campaign ends, shirts will ship. Do not miss out on your favorite design by waiting!


Balancing Self Care and

RESILIENCE

In my experience during the pandemic period, the terms “self care” and “resilience” have circulated in many discussions in the media, higher education and healthcare settings as strategies to cope and effectively navigate the challenges of this time. As a Licensed Clinical Social Worker and an educator in a clinical social work program, I have been challenged to ensure I am describing these terms and their application in an appropriate manner. In doing this, I challenge students to conceptualize the fact that both constructs need to exist and be at play simultaneously. First, the need for self care does not replace the need to be resilient. I recently had a student inform me that she couldn’t complete her assignment because she needed to engage in self care. I educated 52

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her on the reality that while engaging in self care is a necessary component of surviving graduate school as well as clinical practice it cannot be used as a reason to suspend our normal responsibilities. This is where resiliency needs to be utilized. Since clinical social workers and counselors are often on the “front line” during the pandemic period and other times of community crisis, maintaining resiliency is essential in order to serve our clients during these challenging times. When our disciplines display this resiliency in serving clients it will highlight the importance of our work in community settings and private practice. Additionally, if mental health clinicians demonstrate resilience when working with clients and serving the community this will sustain high standards and a

strong reputation for our professions. Lastly, resiliency lends to our personal and professional success. Conversely, being resilient does not mean self care should be ignored. When I talk to my students about resilience, I stress that being resilient is not the same thing as failing to reach out for help, if needed, and that they should continue to engage in self care, in part, to maintain this resilience. As these conversations continue, I am hopeful that clinical social workers and counselors will recognize that these terms are not black and white but need to be applied with an but need to be applied with an appropriate level of nuance. While resiliency is an essential component in a career as a clinician, it does not overshadow our need to take care of ourselves. As equally important, self care strengthens our resiliency but does not excuse us of our responsibilities. A clear balance of self care and resiliency will allow us optimal functioning. Highlighting this balance in our practice and teaching will provide a strong model for others and help us to remember the importance of these terms in the clinical arena even after the pandemic period has passed.

Written By: Heather Burroughs, MSW, LCSW Heather Burroughs is a Licensed Clinical Social Worker in the state of Florida. Her background includes over 20 years of clinical work in hospice and other healthcare settings. Additionally, she has over ten years of teaching clinical social work and is currently employed as a faculty member in field education in the School of Social Work at the University of Central Florida.



Rites of Passage "I am devastated, I'm a failure!" These are words I often hear when clinicians and counseling students do not pass the National Clinical Mental Health Counseling Exam (NCMHCE). Even when they know about the low passing rate of this exam, therapists conflate their worth and skills with their success on the NCMHCE. After hours of studying, battling anxiety, spending hundreds of dollars in exam fees and study materials, therapists can experience firsthand what so many of their current or future clients describe: disappointment, low selfesteem, shame, rage, anxiety, and even depression. Twenty-two years ago, I designed CounselingExam.com to combat the negative experience of test-taking by prophylactically educating students on the format and expectations of the licensing exam. I often find that realworld experience and the wisdom of seasoned therapists won't help when faced with a textbook-oriented and evidence-based exam. Many graduate students are taught necessary clinical skills and theoretical orientations in graduate school but fall short of being prepared for taking the NCMHCE. I constructed my review program by putting together materials that break down the keywords used by the exam makers, determining what to expect on 54

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exam day, and what mental preparations are necessary to pass the exam. For this unique simulation exam, I found it helpful to reinforce subjects taught by graduate programs: information gathering, decision-making skills, diagnoses found in the DSM-5, theoretical orientations, assessments, and core competencies found in CACREP programs. Students frequently ask me, "How can I deal with my test anxiety? I NEED to pass this exam." I treat them how they are taught to treat their clients in graduate school: with respect and unconditional positive regard. I also provide practical tools and an online relaxation test anxiety program that offers meditation and mindfulness to combat anxiety and stress. Most students don't have access to simulations in graduate school, so I found it essential to provide unlimited practice exams in the format and style of the actual NCMHCE. Students can choose to walk through simulations to practice or use the same format as an actual timed exam. At the end of their study sessions, I provide exam statistics so that students can track their progress and improve the areas where they are falling short. I have dedicated study plans for varying lengths of study times, like seven days, 30 days, 60 days, or 90+ days, where I suggest what areas the students should focus on and

review before their exam. I'm sure you've heard the common idea that physicians ought to experience the same pain their patients experience to know what it is like to undergo a particular procedure or surgery. With the failure rate of the NCMHCE, it is not a far stretch to say that many counseling professionals experience the same kind of pain as a client in therapy. It is devastating to many students when they do not pass the NCMHCE the first time or even after several attempts. I encourage them and remind them that this test is not a measure of their worth. And most importantly, I instill in my students what I know they will also teach their clients: hope, resilience, and self-worth in the face of disappointment and loss. I hope that their struggles with the exam will help them empathize with their clients, improving their compassion in the face of their client's pain. On a practical level, I offer this helpful process to every subscriber: if a student does not pass the NCMHCE, I put them back on the study site at no cost for the length of their original subscription. My goal is for every student to pass the NCMHCE with flying colors, experience renewed confidence, and embrace their newfound resilience in the face of difficulties.


Written By: Linton Hutchinson, Ph.D., LMHC, NCC Linton Hutchinson, Ph.D., LMHC, NCC, has a degree in Counseling Psychology and Mental Health Counseling. He has dedicated his entire career to working with students who are on the road to becoming therapists. Along the way, Linton has taught every counseling course from Principles of Counseling to Research and Assessment and has worked with medical students at St. George’s University School of Medicine in Grenada, West Indies, and taught counseling at the University of the South Pacific in the Fiji Islands. Back in the States, Linton continued his teaching at Nova Southeastern University, University of Central Florida, Troy State, and Rollins College. He was the first Regional Coordinator for Webster University, where he designed and developed their Mental Health Counseling Program in Florida. For the past 22 years, Linton has prepared students for licensure online at CounselingExam.com and currently offers Master Classes covering the DSM-5. His passion is dream analysis, and he has presented seminars worldwide on the use of dreams in the counseling setting.



Legislative Update & Next Steps

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The 2021 legislative session came to a close the first week in April. There are a number of bills that FMHCA monitored and lobbied. Below you’ll find a summary of several bill of interest. Additionally, we have included steps that should be taken by FMHCA members between now and next session to improve our advocacy efforts. COVID liability protections for medical practitioners, including Mental Health Counselors – SB 72 by Sen. Brandes and Rep. McClure 1.The pandemic brought forth many challenges. There were opportunities for health care practitioners to care for Florida’s residents in new ways, such as telehealth, but there were also opportunities for Floridians to be taken advantage of during these difficult situations. 2.The Legislature anticipated that there would be a wave of lawsuits aimed at practitioners who felt called to provide in-person health care services, such as mental health counseling, during the height of the COVID pandemic. Fear of these lawsuits did not keep mental health counselors from providing care for Florida’s families in person when needed; the choice was easy. That said, there were a mounting number of cases arising relating to “imperfect” or “unsafe” practice environments which some attorneys would argue led to additional COVID infections. Problematically, the defending health care practice may have had nothing to do with that person contracting COVID-19. Our COVID tracking systems simply weren’t sophisticated enough to adequately make that determination. 3.The state legislature realized this and passed liability protections for businesses, schools and health care providers. Under the new law, it is nearly impossible to bring a suit against a business on the basis of having contracted COVID-19. 4.FMHCA lobbied to ensure that these protections be extended to mental health counselors. Several versions of the bill language excluded mental health counselors and others and instead only included doctors, nurses, etc. FMHCA is happy to have secured protections for LMHCs. Mental health counseling revisions, SB 818 by Sen. Burgess and Rep. Garrison FMHCA wrote legislative language and met with state senators and representatives to garner support for two priorities aimed toward updating LMHC practice in the state. FMHCA was able to secure strong sponsors, Rep. Sam Garrison and Sen. Danny Burgess, but ultimately, the legislation was controversial and did not pass. It is not unusual for a bill to fail in the first year it’s presented. Most bill concepts take several legislative sessions to pass. FMHCA learned a lot from this experience and plans to bring the bill back in future years. A summary of the bill, which contained two components, follows.


1.Under current law, a licensed mental health professional must be on the premises when clinical services are provided by a registered intern in a private practice setting. This bill would remove the requirement that the supervisor be on the premises, but maintain the requirement that the registered intern must practice under indirect supervision. 2.Additionally, Florida Law states that, for the purpose of administering court appointed forensic evaluations, to the extent possible, the appointed experts shall have completed forensic evaluator training approved by the department, and each shall be a psychiatrist, licensed psychologist, or physician. This bill makes it clear that mental health counselors who have undergone forensic evaluator certification are equally qualified to provide these services to the courts as the groups I listed previously. This change will significantly expedite the judicial process and provide better access to qualified health care professionals. Behavioral Health Care Services Coverage and Access, HB 701 by Rep. Stevenson and Sen. Brodeur Even since mental health care coverage (by insurance) bills passed federally in 2008 and 2010, many Floridians still claim their insurer doesn’t offer behavioral health care or that it is difficult to get information from the insurance company regarding how to receive care. This year, Florida’s legislature passed a measure to increase awareness by policy makers regarding how many Floridians are unable to receive care or are unaware of their options. A description of that bill follows. The bill has already been signed by the Governor. 1.This bill requires the Department of Financial Services (DFS) to submit a report to the Legislature and the Governor regarding complaints submitted by individuals covered by an individual or group health insurance policy or health maintenance organization (HMO) contract about the adequacy of coverage and access to mental health services. 2.The report is due January 31, 2022. Insurers and HMOs are required to provide insureds and subscribers a direct notice regarding the federal and state coverage requirements for mental health services, as well as contact information for the Division of Consumer Services within the DFS. Insurers and HMOs are also required to make this information available on their website. Taking grassroots action between now and next session The legislative session will begin in early January of 2022. Accordingly, bills will be filed and committees will begin to meet as early as September. It’s important that FMHCA’s members maintain contact with legislators and candidates during the “idol” months. This is the time relationships are formed! By the time legislators return to Tallahassee, they are already inundated with meeting requests and policy. 1.Connect with your legislators through in-person or remote meetings— Find your currently elected state representative and state senator by entering your address at https://www.myfloridahouse.gov/Sections/Representatives/myrepresentative.aspx. Email him/her directly as well as the legislative aide whose contact information can also be found on the site. Simply ask for a quick meeting to introduce/reintroduce yourself as a constituent. During the meeting, you can thank them for always looking out for mental health counselors in the aforementioned bills and talk a little bit about the importance of access to quality mental health services. It’s also a great opportunity to talk about the risks and action you took during the COVID-19 pandemic on behalf of Florida’s families – personal stories make a big impact! 2.Contribute to the PAC— Elections occurred in November; however, Florida’s legislators are already fundraising for the 2022 cycle. Half of the Senate seats and all seats in the Florida House of Representatives will be up for grabs in under two years. The FMHCA political action committee is in rebuilding mode. These candidates will never forget your small donation or your service on their behalf…especially during times like these.

Provided By: Florida Mental Health Counselors Association Statewide Lobbyist, Corinne Mixon, DPL Corinne is a registered professional lobbyist with fifteen years of experience representing clients’ state governmental interests. Corinne is now the Senior Director of Government Relations at Rutledge Ecenia, PA where represents a broad client base with a particular emphasis on health care practitioners, education, business and regulated industries. She has been instrumental in passing myriad legislation and killing bills which would have negatively impacted her clients. While earning her BA from the University of Alabama’s School of Communications and Information Sciences, Corinne garnered an internship in the D.C. office of U.S. Senator Richard Shelby, thus igniting her interest in professional lobbying and politics. Corinne began her professional career as a Public Relations Account Coordinator at the Zimmerman Agency where she managed the public relations efforts for a range of major hotels stretching from the Cayman Islands to New York City. Prior to joining Rutledge Ecenia, Corinne was principal shareholder of Mixon & Associates, a lobbying firm operating since 1992 which brought its lobbying business to Rutledge Corinne lobbies across multiple platforms: legislative, executive and state regulatory board. Corinne has managed a large statewide political campaign and been hired as a crisis communication specialist while maintaining her role as a lobbyist. She also has significant experience working in association management, having held positions as executive director and executive vice president at two large statewide associations. During her lobbying career, Corinne has delivered keynote addresses at dozens of events including commencements and conferences. Corinne is board-designated to provide continuing education courses for several regulated professions. In the spring of 2020, Corinne won the “Best Young Lobbyist” competition hosted by the popular Florida Politics news outlet. Corinne was also youngest-ever recipient of the Florida Academy of Physician Assistants’ Lifetime Achievement Award for her role in passing legislation. Corinne is appointed to the Florida Bar Grievance Committee. She serves on the Board of the Florida Association of Professional Lobbyists. She is also a member of the Florida Education Legislative Liaisons. She is an avid runner and Floridian.



BYLAWS, 2020 (Pages 3-6) of the Florida Mental Health Counselors Association A Florida Not-For Profit Corporation Adopted: July 18, 1998 Revised January 29th, 2004; January 1, 2009; February 10, 2012; January 8, 2014; May 17, 2014; September 10, 2014; June 8, 2015 ARTICLE III: Local and Regional Chapters Section 1. Organization of Local Chapters The Association encourages the development of local Chapters to promote local interest and participation in the profession. New chapters may be accepted by the Board of Directors upon meeting the following criteria: • The group must consist of at least 12 members. • There may be no more than one FMHCA local Chapter in any given geographical area. • The Local Chapter will organize in accordance with the Bylaws of FMHCA and develop their own Chapter bylaws to reflect local operations and structure. They will assure that their chapter is in compliance with applicable FMHCA Bylaws concerning local chapters. • All officers of the Local Chapter will be members in good standing of FMHCA. • Charter status is awarded to the Local Chapter by the FMHCA Board of Directors. • The Local Chapter will be free to conduct its affairs at the local level in compliance with the Bylaws of the Association, and • Local chapters must present Chapter Bylaws to the FMHCA Board of Directors for approval to become an official Chapter of FMHCA. Section 2. Reports Each local Chapter will submit a written report annually by September 1 to the Secretary of the FMHCA Board to include 1) a summary of Chapter activities during the past year 2) a current roster of its officers and 3) a list of members. Section 3. Charter Renewal Standards Standards for charter renewal reflect the sound organization and development necessary for a Local Chapter of FMHCA. The Secretary of the FMHCA Board will make recommendations annually to the FMHCA Board of Directors concerning charter renewal for each Local Chapter. Standards and Procedures for Charter Renewal will be established by policy in accordance with the Bylaws. Section 4. Involuntary Revocation of Chapter The Board of Directors will have the power to revoke the charter of a Local Chapter when it is deemed in the best interests of the Association to do so. Procedures for revoking the charter of a local chapter will be established by policy. Section 5. Interest Sections of "Special Interest Groups" ("SIGs") "Special interest Groups" (SIGs) may be organized on a statewide or local basis to promote professional interests not otherwise included in the organizational structure of FMHCA. A group of FMHCA members interested in establishing an interest section may petition the FMHCA Board of Directors for SIG status. The Board of Directors will adopt policies and procedures relative to formation, governance and funding of SIGs. Section 6 Regional Directors (4 positions on the FMHCA Board of Directors) There are four FMHCA Regional District in Florida as follows: 1. Northwest Regional District: which includes all FMHCA Local Chapters (Emerald Coast Mental Health Counselors Association) in the following sub-districts counties and areas in the Northwest Region of Florida • Emerald Coast (5): Counties of Bay, Escambia, Okaloosa, Santa Rosa, and Walton • Big Bend (9): Counties of Franklin, Gadsden, Gulf, Jefferson, Leon, Liberty, Madison, Taylor, and Wakulla, 2. Northeast Regional District: which includes all FMHCA Local Chapters (Mental Health Counselors Association of Central Florida & Northeast Florida Mental Health Counselors Association) in the following sub-districts and counties: • North Central (11): Counties of Alachua, Bradford, Columbia, Gilchrist, Hamilton, Lafayette, Madison, Marion, Putnam, Suwannee and Union 60

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• First Coast (7): Counties of Baker, Clay, Duval, Flagler, Nassau, Putnam and St. Johns • Central Florida (4): Counties of Lake, Orange, Osceola and Seminole 3. Southwest Regional District: which includes all FMHCA Local Chapters (Gulf Coast Mental Health Counselors Association & Suncoast Mental Health Counselors Association) in the following sub-districts counties: • Southwest (6): Counties of Charlotte, Collier, Glades, Hendry and Lee • Suncoast (7): Counties of DeSoto, Hardee, Hillsborough, Manatee, Pinellas, Polk and Sarasota • Nature Coast (6): Counties of Citrus, Dixie, Hernando, Jefferson, Pasco and Levy 4. Southeast Regional District: which includes all FMHCA Local Chapters (Broward Mental Health Counselors Association & DadeMiami Mental Health Counselors Association & Mental Health Counselors Association of Palm Beach County & Space Coast Mental Health Counselors Association) in the following sub-districts counties: • Space Coast (6): Counties of Brevard, Indian River, Martin, Okeechobee, St Lucie and Volusia, • Gold Coast (5): Counties of Broward, Dade, Highlands, Martin, Monroe and Palm Beach Term of Office: There will be one elected Regional Director for each of the District who will serve a 3-year term. Roles and Responsibilities of the Regional Directors: The roles and responsibilities are: 1. To conduct affairs at the regional level in compliance with the Bylaws of the Association. 2. To be the voice on the regional level for FMHCA concerning all of the association activities for its membership including: Chapter Relations and Chapter Formation, Membership, Education, Conferences, Legislation and Ethics 3. To encourage members in their respective Regional District to fully engage in the Membership, Education Programming, Conference Planning and Legislative activities of FMHCA on specific FMHCA committees so that the entire state has its voice in the policies, procedures and activities of the FMHCA. 4. To submit a monthly report on the progress within their respective Regions which is provided to the FMHCA Board of Directors 5. To conduct an annual audit of the Local Chapters and Local Networks in their Region and provide a summary report to the Board of Directors on their activity. 6. To coordinate their activities with the FMHCA Central Office and Executive Director Plan of Staggering Terms of the Regional Directors effective FY2017-2018 On September 13, 2016 the FMHCA Board of Directors adopted the following plan for electing the Regional Directors beginning in Fiscal Year 2017-2018: The Elections of new FMHCA Board Members for FY 2017-2018 that the following staggered terms of office be given for each of the Regional Director positions as follows: 1. Northwest Region: 3-year Term 2. Northeast Region: 2-year Term 3. Southwest Region: 2-year Term 4. Southeast Region: 1-year Term This was done to provide at least two experienced Regional Directors on the Board for the newly elected Regional Directors to provide them peer mentoring and support. Once we assume the 3- year term positions in the following fiscal year elections. This also makes sure that not all 4 positions are opened in the same year, so as not to have to orient four new Board Members at a time and it takes time to get used to being on the FMHCA Board ARTICLE IV: OFFICERS OF THE ASSOCIATION Section 1. Officers 1. The officers of this Association will be President, President-Elect, Past President, Secretary, Treasurer and four (4) At Large members. These officers will comprise the voting members of the Board of Directors of the Association. Only active or retired clinical members may hold office. All officers must be members in good standing of FMHCA and of the American Mental Health Counselors Association. 2. Officers of the Association will be elected at large from among members in good standing of FMHCA. Officers who have had one or more years of service on the FMHCA Board of Directors will be considered first for nomination to the office of President-Elect. In the event that no current or former Board member is available, willing or suitable for nomination, nominees may be sought without regard to prior Board experience. 3. The President, President Elect, Secretary, Treasurer and all At Large members will be elected for one (1) year terms. All officers will assume their elected office on July 1 of each calendar year. The President-Elect will succeed to the office of President of the


Association on July 1 of the year following the commencement of his/her term as President-Elect, or upon the death or resignation of the President 4. Upon conclusion of the President's term of office, he/she will continue as a voting member of the Board of Directors in the office of Past President for a term of one (1) year. 5. All Board vacancies will be filled by a policy established by the Board. Section 2. Nomination and Election of Officers Officers of the Association will be nominated and elected annually consistent with policy established by the board and adhering to the following schedule: February 1: President appoints the Nominations and Elections Committee March 1: Publication of "Call for Nominations" May 1: Publication of list of nominees and a procedure for voting June 1: Deadline for completion of voting procedure July 1: Newly elected officers assume office Publication may be by printed copies sent to members by US mail or by appropriate notice on the FMHCA website. Section 3. Powers and Duties of Officers The President will serve as a voting member and Chairperson of the FMHCA Board of Directors. The President will, with the approval of the Board of Directors, appoint the Chairperson of all Standing and Special Committees except 1) the Finance Committee, the Chair of which will be the Treasurer and 2) the Nominations and Elections Committee, the Chair of which will be the Past President. The President will have the power to act on behalf of FMHCA in legislative and regulatory matters requiring immediate action. The President will perform such other duties as are incidental to the office, or may be properly required by vote of the Board of Directors and/or specified by policy and/or the Board of Directors manual. The President-Elect will serve as a voting member of the Board of Directors; coordinate the Committees and perform such duties as may be directed by the Board and/or as specified in the Board of Directors manual. The Past President will serve as a voting member of the Board of Directors; serve as Chairperson of the Nominations and Elections Committee; and perform duties as may be directed by the President, the Board of Directors and/or by policy and/or the Board of Directors manual. The Treasurer will serve as a voting member of the Board of Directors; serve as Chairperson of the Finance Committee; and perform other duties as may be directed by the President, the Board of Directors and/or by policy and/or the Board of Directors manual. The Secretary will serve as a voting member of the Board of Directors; be responsible for the recording of minutes at all official meetings of the Board of Directors; be responsible for the timely distribution of these minutes to all members of the Board; serve as corresponding Secretary for all officially designated Board business, including receiving reports from local Chapters; and perform other duties as may be directed by the President, the Board of Directors and/or by policy and/or the Board of Directors manual. The At-Large Members will serve as voting members of the Board of Directors, and perform such other duties as may be directed by the President, the Board of Directors and/or by policy and/or the Board of Directors manual. At Large Members may hold an Advisory Board position in addition to serving as an At-Large Member. Section 4. Removal from Office A two-thirds majority of the FMHCA Board of Directors will be required to remove an elected officer from his/her position. Reasons for removal from office are: · Violation of professional, legal or ethical codes; · Failure to carry out duties/responsibilities of office, or · Failure to act in accordance with the established legislative platform or purposes of FMHCA. The procedure for removing an officer from his/her position will be established by policy. A member of the Association must initiate the process of removal from office in writing. Two additional letters from members of the board supporting removal from office must accompany the initial charge. Ethical violations must be dealt with according to procedures detailed in policy relating to such matters as set forth by the Ethics Policy as established in 2020.

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