Journal of Mental Health Counseling

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Putting Health back into Clinical
Mental Health Counseling
Presented by:
Jim Messina, Ph.D. , NCC, CCMHC
At: Utah Mental Health Counselors Association
Date: May 10, 2013
From Dream to Reality in 1976
On an impulsive whim Nancy and Jim:
• Coined term “Mental Health Counselor”
• Coined Association Title: The American Mental
Health Counselor’s Association
As the process caught fire
• Established the Profession of Mental Health
Counseling
• Set out to create its “Hallmarks of a Profession”
What are the Hallmarks
of a Profession?
1.
2.
3.
4.
5.
Professional Membership Organization
Code of Ethics
Certification and Licensure
Accreditation
Research into Effectiveness of Service
Delivery
History Timeline of Creation of
Mental Health Counseling Profession
• 1976 – Coining of term Mental Health Counselor and
formation of American Mental Health Counselor’s
Association as Division of ACA
• 1979 – Creation of the National Academy of Certified
Clinical Mental Health Counselors
• 1981 – First State Law to license Mental Health
Counselors put into effect in Florida
• 1985 – AMHCA had over 12,000 members
• 2011 – AMHCA put out its newest Standards of
Practice in Mental Health Counseling-Helping to put
Health back into Clinical Mental Health Counseling
• 2013 – AMHCA has over 7,000 members
The National Professional Association
of Clinical Mental Health Counselors
American Mental Health
Counselors Association
Founded in 1976 when term Mental Health Counselor was coined
Initial Definition of Scope of
CMHC Practice
The 1979’s initial AMHCA’s Journal of Mental Health
Counseling included first published definition of
mental health counseling as:
“an interdisciplinary, multifaceted, holistic process of:
1. Promotion of healthy lifestyles
2. Identification of individual stressors & personal
levels of functioning
3. Preservation or restoration of mental health”
(Seiler & Messina, 1979)
AMHCA’s Revised Scope of
Practice in 1986
The 1986 AMHCA Board of Directors adopted:
“Clinical mental health counseling is the provision of
professional counseling services involving the application of
principles of:
1. Psychotherapy
2. Human Development
3. Learning Theory
4. Group Dynamics
5. Etiology of mental illness & dysfunctional behavior
to individuals, couples, families and groups, for the purpose of
promoting optimal mental health, dealing with normal
problems of living and treating psychopathology…
1986 Scope of Practice (2)
The practice of clinical mental health counseling
includes, but is not limited to:
1. Diagnosis & treatment of mental & emotional
disorders
2. Psycho‐educational techniques aimed at the
prevention of Mental & emotional disorders
3. Consultations to individuals, couples, families,
groups, organizations & communities
4. Clinical research into more effective
psychotherapeutic treatment modalities.”
State Chapters of AMHCA
Regional Chapters of State MHCA’s
AMHCA Belongs to
American Counseling Association
Was known as APGA-American Personnel and Guidance Association
in1976 and in 1983 as AACD American Association of Counseling
and Development until 1992 when it changed to ACA
CODES OF ETHICS
Governing
Clinical Mental Health Counselors
National Certification
NBCC’s National Certifications for
Mental Health Counselors
• NCC: National Certified Counselor – Over
48,000
• CCMHC: Founded 1979- Certified Clinical
Mental Health Counselor – Today only 1,000 +
are CCMHC’s which needs to change if we are to
put Health back into the professional identity of
Clinical Mental Health Counseling
State Licensure for Counselors and
Related Fields
In USA
• 120,429 Licensed Professional Counselors
• 54,785 Licensed Marriage & Family Therapists
• 202,924 Licensed Social Workers
All 50 States have Licensed Professional
Counselors but only 15 have Mental Health
Counseling in their Title (Major way of taking
Health out of Clinical Mental Health Counseling!)
15 States with MHC’s in Title
•
•
•
•
•
•
•
•
•
•
•
•
•
Delaware-License Professional Counselor of Mental Health (LPCMH)
Florida-Licensed Mental Health Counselor (LMHC) First Licensed 1981
Hawaii-Licensed Mental Health Counselor (LMHC)
Indiana-Licensed Mental Health Counselor (LMHC)
Iowa-Licensed Mental Health Counselor (LMHC)
Massachusetts-Licensed Mental Health Counselor (LMHC)
Nebraska-Licensed Independent Mental Health Practitioner (LMHP)
New Hampshire- Licensed Clinical Mental Health Counselor (LCMHC)
New Mexico-Licensed Mental Health Counselor (LMHC)
New York-Licensed Mental Health Counselor (LMHC)
Rhode Island-Licensed Clinical Mental Health Counselor (LCMHC)
South Dakota-Licensed Professional Counselor-Mental Health (LP-MH)
Tennessee-Licensed Professional Counselor-Mental Health Service
Provider (LPC/MHSP)
• Utah-Licensed Clinical Mental Health Counselors (LCMHC) as of 2012
• Vermont-Licensed Clinical Mental Health Counselor (LCMHC)
• Washington-Licensed Mental Health Counselor (LMHC)
Major Recommendation to Promote
Professional Identity of CMHC’s
Given only 15 out 50 states licensed CMHC’s, it is
imperative that we who have LMHC licensure
encourage the LPC’s in the other 35 states to gain
Certified Clinical Mental Health Counselor
(CCMHC) status through the NBCC which would
be a clear way of putting HEALTH into Clinical
Mental Health Counseling and a way to get
counselors in all 50 states enabled to call
themselves Clinical Mental Health Counselor
AMHCA’s Online Newsletter
Research in the field is Reported in
AMHCA’s Journal
Accreditation: Standards for
Training of CMHC
CACREP (The Council for Accreditation of
Counseling & Related Educational Programs)
1988 CACREP set out its first Standards for
accreditation of CMHC Programs using 60 hour
requirement put out in 1979 by AMHCA – But it
also had Community Counseling Programs with up
to 48 hours – Most went Community Counseling
2009 CACREP adopted standards for CMHC
which included 60 hour requirement
2009 CACREP Standards for CMHC
Required both core CACREP areas & specialized
training in clinical mental health
Core CACREP areas include:
1.
2.
3.
4.
5.
6.
7.
8.
Professional Orientation and Ethical Practice
Social and Cultural Diversity
Human Growth and Development across the lifespan
Career Development
Helping Relationships
Group Work
Assessment
Research and Program Evaluation
2009 CACREP Standards for CMHC
Specialized CMHC Training:
1.
2.
3.
4.
5.
Ethical, Legal & Practice Foundations of CMHC
Prevention & Clinical Intervention
Clinical Assessment
Diagnosis & Treatment of Mental Disorders
Diversity & Advocacy in Clinical Mental Health
Counseling
6. Clinical Mental Health Counseling Research & Outcome
Evaluation
These areas of CMHC preparation address clinical mental
health needs across the lifespan (children, adolescents,
adults and older adults) & across socially & culturally diverse
populations.
AMHCA 2011 Standard Additional
Requirement for CMHC Training
The 2011 AMHCA standards also recommend
these additional areas of training for CMHC
Training programs:
1. Biological Bases of Behavior (including
psychopathology and psychopharmacology)
2. Specialized Clinical Assessment
3. Trauma
4. Co-Occurring Disorders (mental disorders and
substance abuse)
Implications of AMHCA’s 2011 Expanded
Clinical Standards for Training of CMHC’s
1. Evidenced-Based Practices
a. Diagnosis and Treatment Planning using EBP’s
b. Diagnosis of Co-Occurring Disorders & Trauma
2. Biological Basis of Behaviors
a. Knowledge of Central Nervous System
b. Lifespan Plasticity of the Brain
3. Psychopharmacology
4. Behavioral Medicine
a. Neurobiology of Thinking, Emotion & Memory
b. Neurobiology of mental health disorders (mood,
anxiety, psychosis) over life span
c. Promotion of optimal mental health over the lifespan
Accreditation-CACREP in 2009:74
Clinical Mental Health Counseling
In Florida they are:
1.
Argosy Sarasota
2.
Barry University
3.
Florida Atlantic University
4.
Florida Gulf Coast University
5.
Florida International University
6.
Florida State University
7.
Rollins College
8.
Troy University Southeast Region
9.
University of Central Florida
10. University of Florida
11. University of North Florida
12. University of South Florida
Online:
1.
Cappella University
2.
Walden University
In Utah:
University of Phoenix-Mental
Health Counseling
NOTE: things will change now
that Utah has in 2012
implemented the LCMHC
CACREP 2016 Standards for CMHC
1. FOUNDATIONS
A. development of mental health counseling
B. theories and models related to mental health counseling
C. principles of mental health counseling, including prevention, intervention,
consultation, education, and advocacy, and networks that promote mental health
D. medical foundation and etiology of addiction and co-occurring disorders
E. principles, models, and documentation formats of biopsychosocial case
conceptualization and treatment planning
2. CONTEXTUAL DIMENSIONS
F. etiology, process, nomenclature, treatment, referral, and prevention of mental and
emotional disorders
G. mental health service delivery modalities such as inpatient, outpatient, partial treatment
and aftercare and the mental health counseling services networks
H. diagnostic process, including differential diagnosis, and the use of current diagnostic
tools, such as the current edition of the (DSM)
I. potential for substance use disorders to mimic and/or co-occur with a variety of medical
and psychological disorders
J. impact of crisis on individuals diagnosed with mental illness
K. classifications, indications, and contraindications of commonly prescribed
psychopharmacological medications for appropriate medical referral and consultation
L. public policy and government relations on local, state, and national level to enhance
equity funding and promote programs that affect the practice of mental health counseling
M. cultural factors relevant to mental health counseling
N. professional organizations, preparation standards, and credentials relevant to the practice
of mental health counseling
O. legal and ethical considerations specific to mental health counseling
P. record keeping, third party reimbursement, and other practice and management issues in
mental health counseling
3. PRACTICE
Q. intake interview, mental status evaluation,
biopsychosocial history, mental health history,
and psychological assessment for treatment planning and
caseload management
R. strategies for interfacing with the legal system regarding
court referred clients
S. techniques and interventions related to a broad range of
mental health issues
• What does this tell us? Little change is being
recommended for the next round of CACREP Standards &
AMHCA’s 2011 Standards have had little impact on what is
being proposed at the current time.
• Let’s see if this will matter based on future trends.
The Growth of Mental Health
Counseling as a Profession
• In 2008, according to US Department of Labor:
120,000 Mental Health Counselors were employed
& only 6.7% of them were self-employed
• By 2018 43,000 jobs will be added (for a for a total
of 163,000), representing a 36.3% growth
• Median annual wages in 2008 for Mental Health
Counselors was $38,150. This is High when
compared to other jobs.
Parity with the Other Mental
Health Professions
The median reimbursable fee for service:
• Clinical Mental Health Counselors is $63
• Psychologists is $75 for psychologists
• Clinical Social Workers & Marriage and Family
Therapists is $60
(January 2006 study by Psychotherapy Finances)
SO! What do Mental Health
Counselors Currently Do?
Mental Health Counselors offer full range of services:
• Assessment & diagnosis
• Treatment planning and utilization review
• Psychotherapy
• Brief and solution-focused therapy
• Alcoholism and substance abuse treatment
• Psycho-educational & prevention programs
• Crisis management
• Trauma Intervention
ACA’s 20/20 Commission’s
Definition of Counseling
Counseling is a professional relationship that
empowers diverse individuals, families and groups
to accomplish mental health, wellness, education
and career goals
They also established:
The counseling profession shall establish uniform
licensing standards with LPC as an entry-level title
for counselor licensure.
BUT THINGS ARE GOING
TO CHANGE!
The emerging health needs of Americans is
changing and as a result the roles and function
of mental health practitioners will be changing
as well
New AMHCA Clinical Standards Help CMHC
to Get Ready for Changes in System
The Affordable Care behavioral medicine interventions
1. ACA calls for the coordination and integration of medical services
through the primary care provider for a “whole person orientation” to
medical treatment - model currently implemented at some level in VA &
Federally Qualified Health Centers (FQHC’s)
2. The ACA calls for creation of Affordable Care Organizations (ACO’s) to
provide comprehensive services to Medicare recipients with a strong
primary care basis
3. The ACA model includes integration of mental & behavioral health
services into the Patient-centered medical home (PCMH) which can
enhance patient outcomes
4. The ACA model integrates mental, behavioral and medical services
under one roof with potential of controlling the costs for patients
5. The ACA integrated behavioral medical approach opens a massive
opportunity for clinical mental health counselors
6. To be prepared to fill this evolving behavioral medicine role, it is
imperative that clinical mental health counseling training programs
establish training for future practitioners in these integrated medical
settings.
The Affordable Care Act (ACA)
• Beginning 2014 ACA increases access to quality
health care including coverage for mental health
& substance use disorder services
• All new small group & individual private market
plans will be required to cover mental health &
substance use disorder services as part of the
health care law's “Essential Health Benefits”
categories
The Affordable Care Act (ACA)
• Behavioral health benefits will be covered at
parity with medical & surgical benefits
• Insurers will no longer be able to deny anyone
coverage because of a pre-existing behavioral
health condition
• ACA already ensures that new health plans cover
recommended preventive benefits without cost
sharing, including depression screening for
adults & adolescents as well as behavioral
assessments for children
Results of the Affordable Care Act
• Primary care providers receive 10% Medicare
bonus payment for primary care services
• A new Medicaid state option is created to permit
certain Medicaid enrollees to designate a
provider as a health home & states taking up the
option receive 90% federal matching payments
for two years for health home-related services.
• Small employers receive grants for up to five
years to establish wellness programs
Results of the ACA continued:
• The Center for Medicare & Medicaid Innovation launches
the Accountable Care Organization (ACO) Model &
Advance Payment ACO Model, which offers shared savings
& other payment incentives for selected organizations that
provide efficient, coordinated, patient-centered care
• Some States established American Health Benefit
Exchanges & Small Business Health Options Program
Exchanges to facilitate purchase of insurance by
individuals & small employers
• Teaching Health Centers are established
to provide payments for primary care residency programs
in community-based ambulatory patient care centers
Two Healthcare Organizational
Models which are Driving Change
Two New Medicare/Medicaid models are driving a
change in healthcare delivery:
1. Patient Centered Medical Homes
2. Accountable Care Organizations (ACO’s)
Medical Homes
1. Patient Centered - Empowers them with
Information and Understanding
2. Comprehensive - Co-location of care providers
in physical and behavioral health
3. Coordinated Care - Through Health
Information Technology all providers are kept in
touch
4. Accessible – same day appointment & 24/7
availability through technology online
5. Committed to Quality & Safety – Quality
Improvement Goals which are tracked
Benefits of Medical Homes
1. Patients seek out the right care which is neededwhich is often behavioral vs. physical
2. Less use of ER’s or delays in seeking care
3. Less duplication of tests, labs & procedures
4. Better control of chronic diseases & other illnesses
improving health outcomes
5. Focus on wellness & prevention – reduce
incidence & severity of chronic disease or illnesses
6. Cost savings less use of ER’s & Hospitals
What is moving the Patient
Centered Home Health Model
In April 2013 the Patient-Centered Primary Care Collaborative
Pointed out on it website these factors driving the Home
Health Model
1. Unsustainable cost increases in health care
delivery
2. Growing availability of data
3. Vast change in the way we communicate
Example: In Denmark, more than 80 percent of health-care
encounters & transactions are electronically based & vastly
different method of communicating is coming online and
it's coming fast, driven by younger generations of patients
and physicians.
Potential Role of Mental Health
Counselors in Medical Homes
• Address the stressors which lead folks to seek
out medical attention in the first place
• Assist in increasing compliance of patients with
the medical directives given them by primary
care staff
• Wellness educational programming to help ward
off chronic or severe illnesses
• Assisting clients to cope with the medical
conditions for which they are receiving medical
attention
Primary and Behavioral Health
Integration Grants based on
Medical Home Model in ACA
In Utah:
Weber Human Services-Ogden, Utah
In Florida:
1. Apalachee Center–Tallahassee
2. Community Rehabilitation Center-Jacksonville
3. LifeStream Behavioral Center-Leesburg
4. Lakeside Behavioral Center–Orlando
5. Coastal Behavioral Health Care-Sarasota
6. Miami Behavioral Health Center-Miami
Accountable Care Organizations
• Have a look at the CMS video which overviews the
ACO model:
http://innovation.cms.gov/initiatives/aco/
• Now let’s look at the announcement of the Role
Out of the ACO rules in 2011 to see what is hoped
for in this model:
http://www.healthcare.gov/news/factsheets
/2011/03/accountablecare03312011a.html
Goal of ACO’s
The goal of coordinated care is to ensure that
patients, especially the chronically ill, get the
right care at the right time, while avoiding
unnecessary duplication of services and
preventing medical errors.
So what are ACO’s
1. ACO assumes financial risk rather than 3rd party payers
(government, business or insurance companies) for group
of patients assigned to it
2. Consists of more than one hospital & number of primary
care clinics with full array of medical & health specialistswho self-refer to their own specialists
3. Control costs by being responsible for full care of patients
4. Integration of mental & behavioral health services into
Patient-centered medical homes
5. Enhance patient outcomes through emphasis on
prevention, compliance, and immediate 24/7 attention
6. Utilize an integrated behavioral medical approach
How will ACO’s Work?
The Affordable Care Organizations (ACO’s) is a large local health
system
1. It usually includes more than one hospital and a number of
primary care clinics.
2. It is this whole system which is in charge of the care of its
patients
3. The providers refer to other specialists inside of their own
system
4. These ACO’s have their own group of providers (which could
include Clinical Mental Health Counselors) & by referring
within the system controls costs
5. ACO’s are then responsible not only for their costs but also for
the quality of their services to their patients
6. Providers are paid a flat fee that is risk adjusted for the severity
of the issues facing the patients
7. The ACO organization assumes the financial risk rather than the
government, business or insurance companies
8. Where Clinical Mental Health Counselors work and how they
will be paid may change greatly in the future as these ACO’s
become reality after full implementation of the ACA in 2014
Utah’s Efforts under ACA
• Utah is one of 16 states which proposes to design an
innovative statewide initiative to facilitate improved
physician/patient communication & care coordination
• Goal of improving health care quality & lowering costs
• The state will convene a multi-stakeholder group that
will address strategies for healthcare transformation in
five key areas:
1. Expanded health information technology
2. Adequate healthcare workforce
3. Wellness & healthy lifestyle promotion
4. Payment reform
5. Medical malpractice & dispute resolution.
Key Players in Utah working on
ACA innovations
Organizations
1. IHC Health Services (Intermountain Health Care)
2. Trustees Of Dartmouth College
3. State of Utah
Hospital working on ACA innovation
Salt Lake Regional Medical Center
Utah’s Innovation Advisors
1. Nancy Murphy MD
2. Victoria Wilkins MPH, MD
3. Sarah Woolsey MD,
Accountable Care Organizations
Current Utah ACO’s
• Health Choice at http://www.healthchoiceutah.com/
• Healthy U at University of Utah at
http://uhealthplan.utah.edu/healthyu/index.html
• Molina at
http://www.molinahealthcare.com/medicaid/providers/ut
/pages/home.aspx
• SelectHealth at http://selecthealth.org/Pages/new.aspx
• Central Utah Clinic, P.C. (Provo, Utah)
• IASIS Health Care Org at http://www.iasishealthcare.com very
open to creation of ACO’s in their hospital localities:
• IASIS Utah Hospitals
Davis Hospital and Medical Center, Layton, UT
Jordan Valley Medical Center, West Jordan, UT
Pioneer Valley Hospital, West Valley City, UT
Salt Lake Regional Medical Center, Salt Lake City, UT Health Choice
Utah Accountable Care LLC
Prevention Services Mandated by ACA
After September 23, 2010, the following preventive services must be
covered without policy holder having to pay copayment or co-insurance
or meet deductible but only applies when these services are delivered by
a network provider:
1. Alcohol Misuse: screening & counseling
2. Alcohol and Drug Use: assessment for adolescents
3. Behavioral Assessment for children of all ages
4. Depression: screening for adults & adolescents
5. Developmental screening: for children under age 3 & surveillance
throughout childhood
6. Diet: counseling for adults at higher risk for chronic disease
7. Obesity: Screening & counseling for adults & children
8. Sexually Transmitted Infection (STI): prevention counseling for
adults & adolescents at higher risk who are sexually active
9. Tobacco Use: screening for all male & female adults & cessation
interventions for tobacco users & expanded counseling for pregnant
tobacco users
10. Domestic & interpersonal violence: screening & counseling for all
women
11. Well-woman visits: to obtain recommended preventive services for
women under 65
Potential Clinical Setting Openings for
CMHC’s with ACA Implementation
Clinical Mental Health Counselors will be
ideally situated to provide Behavioral Medical
Interventions based on their expanded training
and implementation of AMHCA’s Clinical
Standards. They will then need to promote
themselves in the following settings:
 General Practice: Family Practice & Internal
Medicine Clinics
 Rehabilitation In-patient and out-patient Centers
 General and Specialized Hospitals
 Senior Citizen’s Independent housing, Assisted
Living & Nursing Homes
What are the future prospects
for the profession?
• Recognized for VA Positions in VA Hospitals and
Field Agencies which is good given the OIF and
OEF veterans complex health issues
• AMHCA hopes to soon be recognized for Medicare
Services
• Increased work in Behavioral Medicine in
Hospitals, Rehab Centers & Primary Care
Physicians’ Offices
• Increased work in Substance Abuse & Alcohol
Treatment Facilities
Mental Health Needs of
OEF & OIF Vets
• The invisible wounds which our OIF and OEF vets
return with are staggering
• PTSD and TBI along with Combat Depression are
staggering disorders which are impacting from 1/3
to 2/3’s of these vets. The Mental Health system
over the next 5 to 10 years will become
overwhelmed in meeting their individual as well as
marital and family needs.
• CMHC’s need to be ready to serve this population
Baby Boomer Generation are Aging
• The increase in Boomers aging and their impact
on the medical and mental health field cannot be
ignored or underestimated
• It is imperative that CMHC’s be armed with
Behavioral Medicine techniques to address the
needs of this geriatric population to address
their chronic health issues, disabilities and
cognitive decline needs
What Skills Do Mental Health
Counselors Need?
• Ability to understand dynamics of Human
Development to capture good psychosocial history
of clients
• Diagnosis of and treatment for behavioral pathology
• Evidenced based practices in psychotherapy to
provide credible treatment to clients
• Understanding of basic neuroscience of brain and
nervous system to understand roots of emotional
responses to life’s stressors
• Understanding of psychopharmacological treatment
of psychopathology
SO what’s Up in Utah?
Related to all these Changes?
State of Utah, UT (DCFS,DJJS) Diagnostic
and/or Rehabilitative Mental Health
This multi-step procurement is issued on behalf of the State of Utah,
Department of Human Services for the purpose of identifying and
contracting with all qualified Offerors interested in
providing Diagnostic and/or Rehabilitative Mental Health
Services for clients in the custody of DHS, DHS/DCFS, or
DHS/DJJS (Outpatient Mental Health)
The initial submission date for Responses is:
Monday, May 13, 2013 on or before 3:00pm
Submissions end: September 30, 2014 3:00 pm
Some Requirements for Contractors
1.
2.
3.
4.
5.
Use of Evidenced Based Practices with targeted youth
Use of SMART Goals: Specific, Measurable, Attainable, Realistic and
Timely
Responsivity Principle: varying treatment according to the relevant
characteristics of Client such as gender, culture, developmental stages,
trauma, IQ, motivation, mental disorders, & psychopathy
“Telehealth” practice of mental health care delivery through interactive
video communications when distance or other hardships create difficulty
with consistent access to services. Telehealth occurs in real-time or near
real-time.
Trauma Informed Care: providers must assess childhood maltreatment
& may need to modify treatment based on understanding of
neurological, biological, psychological & social effects of trauma.
Evidence Based or EvidenceInformed Treatment – Utah Model
1. The treatment regimen shall be individualized based on the
Client’s age, diagnosis & circumstances. This includes, but is
not limited to, addressing grief, loss, trauma, and criminogenic
factors affecting Client.
2. Maintain fidelity of the approved evidence-based or evidence
informed treatment program through monitoring effectiveness
of program.
3. Maintain documentation of staff training received and/or
skills in t evidence based treatment for which Client will be
engaged to restore the highest possible level of function.
CMHC Tools Needed to Put Health
Back into Clinical Mental Health
1.
2.
3.
4.
5.
6.
7.
Evidenced Based Practices
Apps that Work
Neuroscience
Psychopharmacology
Behavioral Medicine
Military Focus Materials
Multicultural Perspective as a Mental
Health Counselors
8. Focus on the Military
Evidenced-Base Practices
http://coping.us/evidencedbasedpractices.html
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Overview of Evidenced Based Practices
Anxiety Disorder
Obsessive-Compulsive Disorder (OCD)
PTSD
Phobias
Depressive Disorders
Bipolar Disorder
Alcohol Dependence
Substance Abuse
Anorexia
Bulimia
Autism
ADHD
Guidebooks for EBPs
Resources on Evidenced Based Practices
Apps that Work
• For Clients
• For Practitioners
• Moving the concept of Telehealth to new levels
http://coping.us/evidencedbasedpractices/
appsthatwork.html
Neuroscience
http://coping.us/introtoneuroscience.html
1. Basics of Neuroscience
2. Stress Response of Humans
3. Lectures on Neuroscience
Psychopharmacology
http://coping.us/psychopharmacology.html
Psychopharmacology Chart
Drug Classifications to treat the following conditions:













ADHD
Alcohol Disorder
Schizophrenia and other Psychotic Disorders
Depressive Disorders
Bipolar Disorder
Anxiety Disorders
Eating Disorders
Dementia
Generic names of each drug
Commercial names of each drug
Time to reach clinical level for each drug
Benefits of each drug
Side effects of each drug
Behavioral Medicine
http://coping.us/introbehavioralmedici
ne.html
1. Background on Behavioral Medicine
2. Lectures on Behavioral Medicine
3. Behavioral Medicine Introductory
Bibliography
4. Internet Resources on Behavioral Medicine
Multicultural Competency
http://coping.us/multiculturalcompetency.
html
1.
2.
3.
4.
5.
Why the Need for Multicultural Competency?
Cultural Immersion
Multicultural Self-Assessment
Challenging Your Cultural Biases
Resources for Multicultural Competencies
Focus on the Military &Their Families
http://coping.us/focusonthemilitary.html
1. Virtual Boot Camp for Civilian Mental Health
Practitioners
2. Impact of Deployment on the Military and their
Families
3. Psychological First Aid for Returning Military and
their Families
4. Building Resilience in Tough Times
5. Addressing Compassion Fatigue in the Family
and Workplace
6. Background Resources on the Deployment's Impact
7. Resources for Active and Veteran Military Service
Members and their Families
So far so Good! So what else does
COPING.US have which will help
CMHC’s put health into CMHC which
are Evidence Based Practice oriented
so that they can be trusted to meet
the needs of both the counselors and
their clients?
EBP Tools on www.Coping.us
Tools for Coping: CBT based Client Workbooks
1. SEA’s: 12 Step Program in Self-Esteem Recovery
2. Laying the Foundation: Tools for overcoming
Patterns of Low Self-Esteem
3. Tools for Handling Loss and Grief
4. Tools for Personal Growth
5. Tools for Relationships
6. Tools for Communications
7. Tools for Anger Work-Out
8. Tools for Handling Control Issues
9. Growing Down: Tools for Healing the Inner Child
10. Tools for a Balanced Lifestyle: weight management
program
How can CMHC use Tools for Coping Series
Clinical mental health counselors can utilize these workbooks with their
clients to:
 Expedite their treatment
 Encourage their recovery
 Sustain their well-being
 Identify triggers for & steps to prevent relapse
Tools for Coping Handbooks enable CMHC’s to challenge clients to:
 Maintain personal growth in between sessions by use of:
 Exercises
 Tools for changing behaviors
 Journal writing
These workbooks are cost effective interventions based in clinically
sound principles which have an evidenced based support in Cognitive
Behavior Therapy for their efficacy & positive results
In Summary
Today we looked at How to put Health back into
Clinical Mental Health by reviewing:
1. The implications of the new Affordable Care Act
(ACA) and how available tools can help clinical
mental health counselors prepare themselves to be
better able to present themselves to the medical
community as legitimate partners in the prevention
and treatment of mental illness in the next century
2. The new 2011 AMHCA CMHC Clinical Standards
and how they put Health into CMHC
3. The need for Counselors to become Behavioral
Medicine Specialists armed with understanding of
Neuroscience, Psychopharmacology, Evidenced
Based Practices and the needs of people who have
experienced severe trauma such as the Vets from
OIF and OEF.
THANK YOU ALL!
• Any further questions or clarifications you would
like at this time?
End of Program
ACO’s Announced in 2013 in FL
1. Accountable Care Coalition of North Central
2. American Health Alliance
3. BAROMA Health Partners
4. Central Florida Physicians Trust
5. Collaborative Care of Florida
6. Diagnostic Clinic Walgreens Well Network
7. Integral Healthcare
8. MCM Accountable Care Org
9. Nature Coast ACO
10. Northeast Florida Accountable Care
11. Paradigm
12. Physicians Collaborative Trust ACO
13. Primary Care Alliance
14. ProCare Med
15. South Florida ACO
16. Primary Partners
17. ProCare Med
Accountable Care Organizations
in Florida First announced 2012
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Accountable Care Coalition of Northwest Florida-NW Florida
Accountable Care Partners – Jacksonville
Allcare Options – All Florida
Florida Medical Clinics-Hillsborough & Pasco Counties
FPG Healthcare – All Florida
HealthNet-Dade, Broward & Palm Beach Counties
Integrated Care Alliance-North Central Florida
Medical Practitioners for Affordable Care-Broward County
Meridian Holdings – Florida
Palm Beach ACO–Palm Beach/Broward County
ProHEALTH Accountable Care Medical Group - Florida
Reliance Healthcare Management Solutions-N & C Florida
TP-ACO - Florida
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