In the early 2000s, I worked in community mental health in Portland, Oregon. I had the privilege of working with this amazing psychiatrist, Dr. Phil Shapiro, on an Assertive Community Treatment team. You can read an article about him here (on his website) or here (an article from the Oregonian, 2010).
At the time, he was working on this book called Healing Power: Ten Steps to Pain Management and Spiritual Evolution. He had groups that he did with clients in both community mental health and in the regular community (I attended!), all based on the program he outlined in his book.
He recently shared that his book and the subsequent workbook he published, are available for FREE from his new website. The books are available for download in text or audio format. What a gift! Please check out his new website to take a look and download these gems.
Thank you Dr. Shapiro, for your years of service and for making this work available to everyone!
The election is over. I'm sure that most of us are glad about that, regardless of how we feel about the outcome. I'm sure that many of us are trying to process what this campaign stirred up for us, and wondering if and how this nation can heal.
As a social worker, I love that I have a professional Code of Ethics to guide me. This Code of Ethics includes core values that guide me in my work and in my personal life. Social work's core values include service, social justice, dignity and worth of the person, the importance of relationships, integrity, and competence.
What might social work have to say about all of these current events?
The National Association of Social Workers just put out a statement on the election of Mr. Trump. I post it here.
My final thought is a quote that I often remember, "We are here to awaken from the illusion of our separateness." by Thich Nhat Hanh
NASW Statement on Donald J. Trump Election as 45th U.S. President
Association urges President-Elect to help heal divisiveness, trauma from his campaign
WASHINGTON, D.C. -- The National Association of Social Workers (NASW) congratulates Donald J. Trump on his election to become the 45th president of the United States.
The Association is deeply concerned by statements Mr. Trump has made regarding women, people of color and immigrants. At the same time, we acknowledge we must work with the new administration to address pressing issues of the day, including justice reforms, racial and gender inequality, access to health care for all, and helping more Americans achieve economic self-sufficiency and stability.
The NASW Code of Ethics makes clear the importance of social justice. We cannot support any efforts to marginalize or oppress any group of people, and will always work to assure that human rights extend to everyone. Social workers continue to strongly advocate for our country’s most vulnerable populations.
President-Elect Trump has said he is committed to restoring economic prosperity to the United States, helping more Americans afford care for their children and relatives who are older adults, and providing more services to our nation’s brave veterans and their families. We hope to build on these commonalities to move our country forward and will hold Mr. Trump accountable for his promises.
We also urge Mr. Trump and his administration to help heal the divisiveness and trauma his campaign has caused among some communities and populations. NASW, the largest professional social work association in the world with more than 125,000 members, is ready to help ensure these actions are done in a socially responsible and unifying manner.
NASW firmly supports our nation’s efforts to move forward in a positive way that acknowledges the inherent dignity and worth of all people. Specifically, NASW will work to ensure that President-Elect Trump appoints justices to the U.S. Supreme Court and judges to the Circuit Courts of Appeals and lower Federal District Courts who come from diverse gender and ethnic backgrounds and will protect the rights of all citizens.
Lastly, NASW congratulates Democrat nominee Hillary Rodham Clinton for her years of service. Mrs. Clinton has a long history of working for positive social change in areas of importance to social workers, including health care reform; the Children’s Health Insurance Program (CHIP); HIV/AIDS prevention and treatment; reproductive rights for women; racial justice and equal rights for people who are LGBT.
We share Mrs. Clinton’s hope for the future. Everyone deserves the chance to pursue and achieve their dreams.
As Mrs. Clinton said in her concession speech, “let’s do all we can to keep advancing the causes and values we all hold dear; making our economy work for everyone not just those at the top, protecting our country and protecting our planet and breaking down all the barriers that hold any American back from achieving their dreams.”
I recently came across this article, and thought I would share it here. It provides a breakdown on what each campaign in the presidential election has to say about mental health, and how they would address it.
When I started my private practice in 2013, I was somewhat "in the closet" when it came to providing online therapy. I knew that I wanted to offer it, but there were very few social workers offering online therapy and our professional organization, the National Association of Social Workers, offered little guidance as to how to provide it. Often, when I shared with others that I offered online therapy, eyebrows would raise.
In four years, a lot has changed. Online therapy has become more accepted. Insurance companies are starting to cover it. People are recognizing that there are many benefits to online therapy, including making mental health services available to those who otherwise would not have access.
But what are the outcomes? Is online therapy "as good" as face to face? It depends on the issue to be addressed. Here are some recent articles that I have come across.
Online Counseling Can be Your Best Option
Online Therapy Effective at Treating Anxiety and Depression
Postnatal Treatment: Online Therapy Produces Outstanding Outcomes
Internet Based Psychotherapy Actually Works (and its effects may even last longer)
If you are in an area where mental health services are lacking, if you are in another country and looking for an English speaking counselor, if you are looking for anonymity, or if online therapy is simply more convenient or comfortable for you, it may be worth looking into seeing someone online. With the advent of online counseling, it means one less barrier to getting help.
We all probably recently heard that a politician indicated that veterans who come back home with PTSD are weak. Why would one suggest such a thing? Because sadly, this is the view that many hold.
The stigmas surrounding mental health challenges, including PTSD, depression, and suicide (among others) are alive and well. All that you have to do is search for hashtags #stopthestigma or #endstigma to see how many people experience stigma.
Stigma is a problem not only because it prevents people from reaching out for help but also because it results in isolation, poor self-esteem, and poor treatment outcomes. You can read more about the prevalence, causes, and effects of stigma here.
If you are a veteran reading this, please know this. You are STRONG. Whatever you experienced and whatever you continue to experience wasn't and isn't your fault. YOU ARE STRONG. THIS ISN'T YOUR FAULT. Help is available, and you are worth it.
Here is a directory of therapists. You can apply many filters, to narrow down who might be a good match for you.
You Are Not Alone. You Are Strong.
Following up on my last post on harm reduction, I've been hearing a lot on the radio lately about harm reduction efforts happening in Seattle. In particular, stories about creating "Safe Consumption Sites" across King County. Here are a few links in case you have missed the discussion.
Research shows that these kinds of programs have worked in places such as Vancouver, BC, and several countries in Europe. The programs reduce harm by
* reducing the number of overdose deaths
* providing a safe, clean, and secure space for people to use, while reducing the visibility of use to the community
* reducing HIV and Hepatitis C transmission, thereby saving not only people's health but also taxpayer money
* providing an opportunity for people who are using drugs to have multiple contacts with health professionals, who can help users move towards treatment options, healthcare, housing, and other services
Opponents say that these programs encourage drug use and increase crime. The research does not support this. In fact, research indicates that those who use safe consumption sites actually get help and/or enter treatment sooner than those who do not use the sites.
For people who do not want a drug consumption site in their backyard, I wonder...Would you rather wake up to dirty needles outside of your doorstep? Would you rather have less people in your neighborhood contracting HIV and Hep C? Would you rather pay more or less in taxes for the costs associated with arresting and housing homeless people on drug charges, hospitalizing those who have overdoses, and paying for treatment for those who have contracted HIV and Hep C through dirty needles? Would you rather see people injecting drugs in your neighborhood, or have them do it indoors, out of sight?
What would you rather have?
I'd love to hear your thoughts!
For a long time, those who struggled with addictions had only one model of treatment and it centered around the idea of abstinence only. While 12 steps and abstinence only have certainly helped many people, they aren't for everyone.
What is harm reduction? In short, harm reduction refers to programs, policies, and practices that aim to the reduce the harms associated with substance use or other risky behaviors.
One of the first harm reduction ideas started with IV drug users and the concern of spreading HIV through dirty needles. At the time, it was controversial to be handing out clean needles to people who used IV drugs. Now needle exchange programs are commonplace, and the evidence supports that these programs reduce various harms (HIV, Hepatitis C, skin infections, etc.).
Some harm reduction ideas are so commonplace that many people don't realize they are participating in harm reduction--for example using condoms to prevent sexually transmitted infections, or using designated drivers while drinking.
Opioid Replacement Therapy, methadone maintenance programs, safe injection sites, and Naloxone distribution are among many other examples harm reduction.
Have you tried an abstinence only or 12 step approach and found difficulty with it? Don't give up hope--there are other options!
Harm reduction can be different for everyone. If you are using alcohol or other drugs, harm reduction may look like using less, using in different ways, using at different times, not driving while using, etc. Anything that reduces harm is part of harm reduction.
If you are interested in trying a harm reduction approach, whether it be with your alcohol use, gambling, or other drugs or risky behaviors, feel free to contact me. I'd love to help.
What have your experiences been with harm reduction and/or abstinence only approaches?
People who struggle with mental health challenges are more likely to smoke. Check out this article about the correlation and why we need to care about this problem. If you smoke, chances are you have thought about or tried quitting. Here's an interesting infographic on what happens in your body, when you actually quit. Are you ready to try quitting? If you have tried quitting or have successfully quit, please leave us a note and let us know what worked for you!
My friend Sunny recently posted about her experience with depression on Facebook. What she had to say was so real, so authentic, and so moving, that I asked her if I could post it here. So many of us deal with this. As Sunny says,
You are not alone!
Thank you, Sunny Jones, for your willingness to share your experience, strength, and hope with others.
"Those of you who know me closely and/or have lived with me know I struggle with depression. It's mostly cyclical and a part of me always "knows" that it's not real but in the moment it feels very, very real. Much of what I deal with is self-esteem/self-image issues. I'm too fat, I'm not good enough, I'm not enough period, etc. You know...the stories.I'm not sharing this to ask for pity or a hand. I'm sharing because I want to tell you its no joke. Its real. So many of us deal with it. I'm grateful that for me it mostly isn't full time and that I get some relief. I can't imagine what it would feel like if it was 24/7.
Self-care helps. Yet, I struggle with knowing when I need self-care or even what that self-care is. Meditation, eating right, exercising, reaching out to those that love you and don't judge you helps, medication can help (although this last round it didn't...it made it much, much worse), counseling can help.
If you are struggling with this and it feels like the end of the road please, please reach out! People love you! If you are person that someone reaches out to...don't try to rationalize them back into reality. Certainly do share the good things in their life with them. But, remember many of us get it but those "mental gremlins" as my girlfriend calls them cannot be rationalized. They are a black hole that don't want to listen.
I'm at the tail-end (hopefully) of one of the worst experiences I have had with this so I'm not sure my rambling above makes sense but I've felt compelled to share.
So many of us are struggling and feel shame or are afraid to tell those around us...afraid to be vulnerable in our greatest time of desperation...especially when it feels like life isn't worth living...and we know it's not true but it certainly feels that way.
Reach out if you need it. Reach out if you know someone else needs it. Sometimes it's as simple as a hug at lunch when you are feeling overwhelmed. And, sometimes it takes much, much more. That's okay too."
Amber is a Licensed Independent Clinical Social Worker. She offers counseling for individual adults and clinical supervision for social workers. For fun, she enjoys spending time with her family, traveling, researching genealogy, reading, and dragon boating.
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