Clinical Mental Health Counselors’ Evidence Based Practice Tools

1. Clinical Mental Health Counselors’ Evidence Based Practice Tools Presented by Jim Messina, Ph.D., CCMHC, NCC Troy University-Tampa Bay Site

2. Goals of Presentation • Review the new 2011 AMHCA CMHC Clinical Standards and existing resources to help and expand clinical competency to meet or exceed the new standards • Demonstrate the use of free online Clinical Workbooks- Tools for Coping Series available on www.coping.us • Demonstrate the use of free online Mental Health Counselor resources on www.coping.us • Review the implications of the new Affordable Care Act (ACA) and how the tools available on www.coping.us 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

3. Now for a SwitchLet’s take our last objective first to help motivate you all to recognize why it is important for all CMHC’s to support and embrace the new 2011 AMHCA Standards for CMHC’s and to learn and update oneself in the skills needed in to Meet these standards!

4. Why CMHC’s Need to Catch Up with the 2011 AMHCA Clinical Standards • The Affordable Care Act (ACT) mandates preventive behavioral medicine interventions • 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) • The ACA calls for creation of Affordable Care Organizations (ACO’s) to provide comprehensive services to Medicare recipients with a strong primary care basis • The ACA model includes integration of mental &behavioral health services into the Patient-centered medical home (PCMH) which can enhance patient outcomes • The ACA model integrates mental, behavioral and medical services under one roof with potential of controlling the costs for patients • The ACA integrated behavioral medical approach opens a massive opportunity for clinical mental health counselors • 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.

5. What are ACO’s • The Affordable Care Organizations (ACO’s) is a large local health system • It usually includes more than one hospital and a number of primary care clinics. Examples in Florida would be Bay Care on the West Coast and the Florida Hospital System in Central Florida • It is this whole system which is in charge of the care of its patients • The providers refer to other specialists inside of their own system • These ACO’s have their own group of providers (which could include Clinical Mental Health Counselors) &by referring within the system controls costs • ACO’s are then responsible not only for their costs but also for the quality of their services to their patients • Providers are paid a flat fee that is risk adjusted for the severity of the issues facing the patients • The ACO organization assumes the financial risk rather than the government, business or insurance companies • 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

6. Prevention Services Mandated by ACA If a person has a new health insurance plan or insurance policy after September 23, 2010, the following preventive services must be covered without policy holder having to pay copayment or co-insurance or meet deductiblebut only applies when these services are delivered by a network provider: • Alcohol Misuse: screening & counseling • Alcohol and Drug Use: assessment for adolescents • Behavioral Assessment for children of all ages • Depression: screening for adults & adolescents • Developmental screening: for children under age 3 & surveillance throughout childhood • Diet: counseling for adults at higher risk for chronic disease • Obesity: Screening & counseling for adults & children • Sexually Transmitted Infection (STI): prevention counseling for adults & adolescents at higher risk who are sexually active • Tobacco Use: screening for all male &female adults & cessation interventions for tobacco users &expanded counseling for pregnant tobacco users • Domestic &interpersonal violence: screening & counseling for all women • Well-woman visits: to obtain recommended preventive services for women under 65

7. 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

8. So What are the AMHCA Standards which CMHC’s need to adapt to?

9. AMHCA’s 2011 Expanded Clinical Standards for Training of CMHC’s • Evidenced-Based Practices • Diagnosis and Treatment Planning using EBP’s • Diagnosis of Co-Occurring Disorders & Trauma • Biological Basis of Behaviors • Knowledge of Central Nervous System • Lifespan Plasticity of the Brain • Psychopharmacology • Behavioral Medicine • Neurobiology of Thinking, Emotion & Memory • Neurobiology of mental health disorders (mood, anxiety, psychosis) over life span • Promotion of optimal mental health over the lifespan

10. So What Does www.Coping.us have which CMHC’s can use to upgrade their knowledge and Skills to comply with the 2011 AMHCA Clinical Standards?

11. CMHC Tools on www.Coping.us • Evidenced Based Practices • Neuroscience • Psychopharmacology • Behavioral Medicine • Military Focus Materials • Multicultural Perspective as a Mental Health Counselors • Focus on the Military

12. Evidenced-Base Practices http://coping.us/evidencedbasedpractices.html • 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

13. Neuroscience http://coping.us/introtoneuroscience.html • Basics of Neuroscience • Stress Response of Humans • Lectures on Neuroscience

14. Psychopharmacology http://coping.us/psychopharmacology.html Psychopharmacology Chart http://emedicine.medscape.com/ • 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

15. Behavioral Medicine http://coping.us/introbehavioralmedicine.html • Background on Behavioral Medicine • Lectures on Behavioral Medicine • Behavioral Medicine Introductory Bibliography • Internet Resources on Behavioral Medicine

16. Multicultural Competency http://coping.us/multiculturalcompetency.html • Why the Need for Multicultural Competency? • Cultural Immersion • Multicultural Self-Assessment • Challenging Your Cultural Biases • Resources for Multicultural Competencies

17. Focus on the Military and Their Families http://coping.us/focusonthemilitary.html • Virtual Boot Camp for Civilian Mental Health Practitioners • Impact of Deployment on the Military and their Families • Psychological First Aid for Returning Military and their Families • Building Resilience in Tough Times • Addressing Compassion Fatigue in the Family and Workplace • Background Resources on the Deployment's Impact • Resources for Active and Veteran Military Service Members and their Families

18. So far so Good! So what else does COPING.US have which will help CMHC’s and which are Evidence Based Practice oriented so that they can be trusted to meet the needs of both the counselors and their clients?

19. EBP Tools on www.Coping.us Tools for Coping: CBT based Client Workbooks • SEA’s: 12 Step Program in Self-Esteem Recovery • Laying the Foundation: Tools for overcoming Patterns of Low Self-Esteem • Tools for Handling Loss and Grief • Tools for Personal Growth • Tools for Relationships • Tools for Communications • Tools for Anger Work-Out • Tools for Handling Control Issues • Growing Down: Tools for Healing the Inner Child • Tools for a Balanced Lifestyle: weight management program

20. How can CMHC use the 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

21. In Summary Today we looked at: • The implications of the new Affordable Care Act (ACA) and how the tools available on www.coping.us 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 • The new 2011 AMHCA CMHC Clinical Standards • The free online Mental Health Counselor resources to help CMHC get up to date on the AMHCA Standards on www.coping.us • The free online EBP Based Clinical Workbooks- Tools for Coping Series available on www.coping.us

22. THANK YOU ALL! • Any further questions or clarifications you would like at this time?