1. WHAT’S GOING ON AROUND HERE? News from the mental health front lines

2. But first, a word from our sponsorBut first, a word from our sponsor Robin Steed, PhD, LOTR www.robinsteed.pbworks.com National Alliance on Mental Illness Northwest Louisiana Affiliate www.naminwla.pbworks.com www.nami.org

3. Agenda Keeping All Students Safe Act Stop Bullying Act Changes in Mental Health Care in Louisiana Motivational Interviewing Stages of Change

4. KEEP OUR STUDENTS SAFEKEEP OUR STUDENTS SAFE

5. Keep Our Students Safe ActKeep Our Students Safe Act S.2020 in the Senate and H.R. 1381 in the House Government Accountability Office study:  teen hung himself  child smothered to death  children with disabilities Only 14 states currently restrict use of restraint (Louisiana is not one of them)

6. What the Act will do:What the Act will do: Ban:  physical restraint unless an emergency  restraints interfering with breathing  chemical restraints Parents to be notified on same day

7. What you can do:What you can do: Email US legislators using NAMI's legislative action center Educate school officials, teachers and case workers!

8. STOP BULLYINGSTOP BULLYING

9. Keeping kids safe from bullyingKeeping kids safe from bullying Children with disabilities bullied 2-3x more Bullied Children: depressed, lonely, anxious low self-esteem headaches, fatigue, stomachaches, poor appetites truant suicidal youthviolence.edschool.virginia.edu

10. School Bullying Prevention ActSchool Bullying Prevention Act House Bill 407 Senate Bill 619  Fills the gaps in meeting federal regulations  Will specifically name at risk groups  Identifies process for reporting  Defines specific types of bullying

11. You can help!You can help! Stopbullyinglouisiana.org http://www.stopbullyinglouisiana.org/petition To find out more, contact Stephanie Patrick at spatrick@advocacyla.org or 1-800-960-7705, ext. 143. spatrick@advocacyla.org

12. CHANGES IN MENTAL HEALTH CARE IN LOUISIANA

13. Merger 2011Merger 2011 ● Office of Mental Health and Office of Addictive Disease to create Office of Behavioral Health OMHOADOBH

14. Magellan  Coordinated System of Care 2,400 children most severely affected  SMO: Service Management Office  50,000 children and 100,000 adults  Requires providers re-cert every 14 days

15. MOTIVATIONAL INTERVIEWINGMOTIVATIONAL INTERVIEWING

16. What for?What for?

17. Definition of MIDefinition of MI Directive, client-centered To elicit behavior change Clients explore and resolve ambivalence

18. Concepts of MIConcepts of MI Readiness to change Ambivalence Resistance

19. Principles of MIPrinciples of MI 1.Express Empathy 2.Roll with Resistance 3.Support Self-efficacy 4.Develop Discrepancy

20. Empathetic Listening PracticeEmpathetic Listening Practice So, what have you noticed about the effect of alcohol on your mood? How is the new exercise program going for you? How do you feel about going back to work?

21. Self-Motivating Statements Self-Motivating Statements Client: I hate feeling like an old man with this walker, like I’m weak and frail, but when I don’t use it I’m afraid to go anywhere because I might fall. Therapist: So you feel like the walker makes you look weak but you’d like to get out more? Evil Therapist: Well, you really will be frail if you fall again, so you better use the walker. Silly Therapist: It doesn’t make you look weak!

22. More self-motivatingMore self-motivating Client: It’s not fair! I’ve had to give up everything- eating sweets is the only thing that makes me feel good anymore. Of course, I don’t like the insulin shots. Therapist: It seems that eating sugary food comforts you but you would rather not be dependent on insulin?

23. Pros and Cons ApproachPros and Cons Approach ProsCons Take meds Don’t hear voices as much I can live by myself I can go to school Side effects Cost money Have to remember Don’t take meds No side effects A little more $ The voices make me feel like killing myself, Can’t take care of myself, Can’t remember anything

24. Client with MSClient with MS Consistent care PT and OT Positive support Counseling Scary, bad memories Husband mad Stress increases fatigue Familiar home Husband happy Easier Depend on husband Stressful environment Miss therapy In pt. Out pt. In pt. Out pt. Pros Cons

25. Brainstorm ApproachBrainstorm Approach 1.What exactly is the problem? 2.What have you tried so far? 3.What are things to try- no matter how crazy? 4.Select one option. 5.Select an option to try if the first one doesn’t work.

26. What NOT to doWhat NOT to do  Argue  Assume expert role  Talk all the time  Should on your client  Tell the client they have a problem  Prescribe solutions (especially without listening!)

27. STAGES OF CHANGE MODELSTAGES OF CHANGE MODEL

28. What do you want to change?What do you want to change? Exercise more Eat healthier Stop smoking Stop drinking Be less co-dependent Kick that heroin habit once and for all!

29. Pre-contemplation manmeetsscale.blogspot.com

30. Contemplation diggingalot.org

31. Preparation

32. Action

33. Maintenance

34. Know your client’s stageKnow your client’s stage resistance Mismatch between intervention and client’s readiness for change = resistance

35. Transfer to practiceTransfer to practice How can you use motivational interviewing in your practice? In what stage of change are your clients? How can you move them from one stage to the next?

36. Resources Rollnick, S. & Allison, J. (2004). Motivational interviewing. In The essential handbook of treatment and prevention of alcohol problems (Heather, N. & Stockwell, T. eds.) John Wiley and sons. www.robinsteed.pbworks. com