Presentation on theme: "HN 430 Advocacy for Families and Youth Unit 6 seminar"— Presentation transcript:
1HN 430 Advocacy for Families and Youth Unit 6 seminar
2Unit 6 – Special Populations In this unit, you will examine the needs of special populations, including grief services, emotional and mental health services, and suicide.Special populations – often more than other populations – really need multidisciplinary interventions (collaboration with many resources)
3The bio-psycho-social model Interrelated, integrated roles of biology, psychology, and social/cultural factorsBiological componentsPhysical, biochemical, genetic factorsPsychological componentsPatterns of thinking, coping skills, perceptions, emotional intelligence, temperament, personality characteristicsSocial/cultural componentsFamily relationships, support systems, work relationships, broader cultural environment
4Suicide - scope of the Problem Suicide is the third leading cause of death among adolescents in the United StatesEvery year, 20% of teens contemplate suicide, and between 5% and 8% attempt suicide.While girls are more likely to report attempting suicide, boys are more likely to complete suicideDifferences partly due to lethality of methodsSuicide - scope of the Problem
5Native Americans have the highest teen suicide rate of any ethnic group However, research shows that having a strong ethnic cultural identity has a protective effect on suicide characteristicsLGBT teens are 2 to 3 times more likely to commit suicide than heterosexual peers.Suicide Rates
6Interpersonal and Psychosocial Characteristics Substance AbuseUnder-over achievementCatastrophic WorldviewDisruptive and violent familiesConnectedness and poor communicationGay, lesbian, bisexual and transgender youthLoss and SeparationInterpersonal and Psychosocial Characteristics
7Intrapersonal and Psychological Characteristics Self-ImageAngerLonelinessImpulsivityDepression and hopelessnessThinking patternsIntrapersonal and Psychological Characteristics
8Faulty Thinking of Suicide Cognitive CharacteristicsCognitive ConstrictionThe inability to see options for solving problems; thinking “this will never end”Dichotomous thinkingOnly able to see two solutions to the problem: 1) continue to exist in living hell or 2) find relief through deathCognitive rigidityA rigid style of perceiving and reacting. See the problem as catastrophic “I have no place to live and not one to help me and there’s nothing I can do about it”Cognitive distortionOverestimating the magnitude and insolubility of problems. Difficulties are generalized to the rest of life. Often assume they are the cause. “I didn’t get an A on the test, so I must be stupid and everything in my life is a mess.”Faulty Thinking of Suicide
9Warning Signs of Suicide Suicide MotivationsVerbal messagesBehavioral changesWarning Signs of Suicide
10The reasons that young people attempt suicide can themselves be warning signs a means of self-punishment to deal with guilt or shame (pregnancy, conflict w/sexual orientation)Absolution for past behaviorsPerverted revenge (to get back at someone)Retaliatory abandonmentA cry for help (although not intending to end their lives, these attempts can still be lethal)Suicide Motivations
11Verbal Messages Most children give verbal hints, such as I don’t see how I can go on; I wish I were deadYou’ll be sorry you treated me this wayPretty soon my troubles will be overSuicidal children also talk about death and may also joke about killing themselves.Verbal warning should be taken seriously – if ignored, may be interpreted as confirmation that the child is expendable and unloved.Verbal Messages
12Behavioral Changes Mood swings or fluctuations A change from positive interactions with others to withdrawal and negativityApathy or a lack of activityChanges in sleep or eating patternsGiving away prized possessionsBehavioral Changes
13A person who has considered/attempted suicide will always be suicidal After a suicide crisis has passed, the child is no longer at risk for suicideTalking about suicide can make people more inclined to make an attemptSuicide happens without warningA person who talks about committing suicide never actually does it.Suicidal people are mentally ill or severely depressedSuicide MYTHS
14Interviews for Suicide Lethality The interviewer should attempt to assessThe history of the presenting problem (i.e. loneliness, depression)The family constellation and relationshipsA developmental, medical and academic historyThe status of interpersonal relationshipsVerbal and behavioral warning cuesAny current stressors that may trigger a suicide attemptInterviews for Suicide Lethality
15Interviews for Suicide Lethality Pay special attention to these factorsSymptoms of clinical depression and hopelessnessRecent loss of an important relationship or life goalSerious family problems, such as divorce or abusePersonal history of physical disability, drug abuse or psychiatric treatmentInterpersonal impoverishment, or the absence of friends, family, and other who can provide emotional supportInterviews for Suicide Lethality
16Interviews for Suicide Lethality Severity of threat depends on the specificity and lethality the method of choice.Major red flagsIdeation with a plan, including a time, place and methodA lethal method (such as a gun)Accessibility of a means to commit suicide (such as a loaded gun in the house)A history of previous suicide attemptsInterviews for Suicide Lethality
17Listen an show respect for the feelings a suicidal youth expresses Reinforce the child for seeking helpBe specific about assessing lethalityMake decisions (need to be hospitalized?)Have the youth sign a written contractUse the resources that are availableObtain counseling and psychotherapy for the young personSuicide Treatment
18Grief and LossGrief – the feeling that occurs when one loses someone or somethingLoss – not necessarily a personParent or other family memberFriendPetTerminal IllnessStatus (social status, SES status)Material thingsLoss – can be loss of a parent’s job, parent, pet, friend
19Stages of Grief Denial, numbness, and shock Bargaining Depression “This did not happen. She is not dead, just went away.”Bargaining“I promise I’ll be good if she will come back.”Depression“I really miss her; I feel alone now.”Anger“Why did this have to happen? I hate her! She left me!”Acceptance“Grandma is gone but it is ok.”
20Factors that interfere with the grief process (Worden, 1991) Relational: what type of relationship did the person have with the deceased?Circumstantial: what was the circumstance that surrounded the death? Such as a person who is missing and is there evidence that the person is dead?Historical: did the bereaved person have complicated grief reactions in the past?
21Factors that interfere with the grief process (Worden, 1991) Personality: the bereaved person’s character and how he or she copes with emotional distress.Social: if the nature of the death has any social stigma, such as suicide (“complicated bereavement”). If the bereaved person and those around him or her acts as if the loss did not happen. If the bereaved person does not have a support system.
22Some Signs and Symptoms SadnessAngerWithdrawConfusionGuiltRegressionFear of being alone or dyingPhysical complaintsChanges in sleeping and eating patterns
23DepressionDepression is one of the most common client issues a counselor encounters.Nearly 15 million, or approximately 7%, of adults in the United States experience depression annuallyDepression is characterized by:Persistent feelings of sadness or irritabilityLoss of interest in hobbies, work, and sexual activitySleep disturbanceAppetite increases or decreasesIsolating from family and friendsCrying spellsFeelings of hopelessnessNeglect of personal hygiene
24A study, published in the Archives of General Psychiatry (January 2011), examined evidence from 54 studies that identified a particular gene variant, often referred to as the depression gene, as a possible determinant in who will and who will not suffer from clinical depression.The Depression Gene
25Anxiety Anxiety is another commonly encountered client issue. In the United States, 3% of the adult population experiences Generalized Anxiety Disorder, 3% experiences Panic Disorder, and 7% experiences Social Phobia in their lifetimeAnxiety is characterized by:Excessive or constant worryRestlessnessIrritabilityDisturbed sleep
26Eating DisordersTwo common types of eating disorders are Anorexia Nervosa and Bulimia Nervosa.Anorexia Nervosa is characterized by a client’s refusal to maintain minimally normal body weight, a fear of gaining weight, and distorted perceptions of body size and shape.Bulimia Nervosa involves binge eating and inappropriate compensatory measures to prevent or reduce weight gain.
27Mental Health Treatment Settings Inpatient or hospital-based treatment facilities provide 24-hour care to clients in acute crisis situations, such as:Clients who are suicidal or homicidalClients with mental illnesses such as Schizophrenia or Bipolar Disorder who are dealing with psychosis or manic episodesClients who suffer from severe eating disorders and are at risk medicallyClients with substance dependence issues who need inpatient detoxification to reduce the medical risk associated with withdrawal symptoms
28Mental Health Treatment Settings Intensive outpatient treatment is appropriate for clients who are functioning at a high level but need more intensive treatment than outpatient therapy is able to provide.Outpatient treatment typically consists of weekly or bi-weekly sessions with a professional counselor and the sessions usually are an hour in length.
29Services and interventions include the following: Collaboration with local agenciesWork place supportLife skills trainingSupportive counselingSocialization opportunitiesCommunity InvolvementPlacement and support in community living situations
30Peer Support Peer mentoring/self help approaches Primary agent of change as young people can serve as positive role models"Recovery for Life" (self help program)Enhances decision making skillsImproves overall psychological adaptationPromotes Self Advocacy