1. Balancing CMHC Job Responsibilities: A Look at Promising Practices from Various Job Corps Centers

2. M.I.N.O.R.S! A 6-Week Skill-Building Process Group for Minors Karyn Felder Moore, PhD, LCPC Woodstock JCC

3. MINORS Support Group Participants: All Woodstock JC students ages 16.0 – 17.9 years. Purpose: To create a safe, supportive environment for self expression and development of essential social and life skills; namely: Mentoring/Modeling, Independent living skills, Nurturing self, Opportunities, Respect/Responsibility, and Success!

4. Group Goals Each student will attend a minimum of 6 encounters to address each of the primary objectives (M.I.N.O.R.S!). Each student will actively participate in discussion and sharing of personal experiences, suggestions and ideas. Each student will get to know at least one new person. Each student will be prepared to “mentor” another new minor by the time s/he has completed the 6 sessions (fulfillment is optional).

5. M.I.N.O.R.S. Mentoring/Modeling – week 1 –Each student is encouraged to identify a suitable mentor on center and to model appropriate (i.e., employable) behavior. Independent Living Skills – week 2 –We discuss what it means to be “independent” and practical steps they can take now in preparation for life after JC (i.e., savings account, avg. rent, budgeting).

6. M.I.N.O.R.S. Nurturing self – week 3 –Student is encouraged to take pride in themselves, set goals and reward (goals: self care, sense of accomplishment). Opportunity – week 4 –Discover what opportunities await you at JC. Make a point to pursue at least 3 during your tenure (i.e., joining a club, drivers ed., volunteer service).

7. M.I.N.O.R.S. Respect/Responsibility– week 5 –Webster defines respect as the special esteem or consideration in which one holds another person or thing, the state or quality of being esteemed, to feel or show consideration to. Success – week 6 –Students define what it means to be successful – at JC, in life.

8. Certificate After each student has completed the 6 components, they receive a Certificate of Completion. Some students are recommended as “student mentors” or “buddies.” Some students are recommended for monthly student awards. Students needing additional support and/or not suited for group will meet 1:1 with CMHC.

9. Career Preparation Period (CPP) Sonja Depratt, LCSW Joliet Job Corps

10. CPP Objectives Introduction to CMHC services Assessment Report building Introduction to emotion regulation concepts Education Skill building GETTING STUDENTS TO THINK

11. CPP 1: Intro to Emotions What causes emotions? “analogy of the traffic jam” –Emotional hijacking “we can amp it up or amp it down” Introducing self awareness concepts –Self awareness is a high predictor of success –First step in emotion regulation Skills to develop –Tune in, learning internal focus 30-second meditation “pay attention to your breath” –Notice “feelings have an energy” Your body gives you clues –Name and describe what you notice –Be curious –“Just because you believe something it does mean its true”—Disputing internal negative beliefs Understanding emotions are not “YOU” they are an aspect of you –Think about your “first mind, your inner wisdom” –

12. CPP 2: Anger Management Review from previous week What emotion is difficult to deal with? (they always say anger) Hijacked by anger! Now what? –How to talk yourself “Down” Learning about anger without judgment

13. CPP 3: Mental Health Education Review of skills –Emotional learning skills –What have they noticed? Questions and answers Seeking support –Homesick –Depression –Anxiety –Mood swings CMHC as a resource

14. A Description of a Mental Health Clinical and Consultation Intern Program: A Win-Win-Win for the San Jose Job Corps Janet Negley, PhD San Jose JCC

15. The Basics Mental Health Intern Programs are a win-win-win: We can provide more and varied services to our trainees, the MHC has more time for creative program development and the interns have a challenging, unforgettable professional training opportunity. Five clinical interns work two days each, providing ten clinical hours, co-leading two groups in addition to occasional assessments and staff trainings. Our clinic provides 74 hours of mental health services a week.

16. The Basics Interns co-lead eight rotating groups, six groups per week: Anger Management, Positive Psychology, Healthy Relationships, LGBT Support Group, An Introduction to Mental Health Issues in the Workplace, Chill Group (alternative mindfulness techniques), Community Engagement Group (volunteer work to build new self narratives), and Coping with Stress (anxiety interventions). We assess 15-20 trainees per year for learning disabilities, allowing accommodations for GED testing, classroom work and potential 504 plans.

17. Steps To Building An Intern Program Assess your center’s needs. Are you able to see at risk students in a reasonable amount of time? Do you have mental health coverage all days of the week? Do you have adequate places to refer students who need acute or on-going care? Do you need assessments for LD students? Group support? Find a school within driving distance from your center with a Master’s or Doctoral level graduate program in Clinical Psychology or Social Work. Contact the Director of Clinical Training (the DCT) or the Practicum Coordinator to find out practicum requirements of that school. Find out your state’s rules on supervision: number of clinical hours per supervision hour. Licensing requirements of the supervisor? Try to keep interns for a minimum of six months as less time than that reduces your “output of energy/gain” proportion.

18. Other Pragmatics Determine their interview windows. Get your paperwork in order. Attend their practicum fair. Talk up your program. Hand out brochures. Volunteer to teach a class in multi-culturalism, adolescent psychology, anything you think will attract the student’s attention. Interview, select and set a start date. Develop training for orientation. Set expectations for interns. Start slow and then, build one intern at a time.

19. Paperwork Contract with graduate school (most schools have their own form they require) MOU between your JC site and graduate school Due process description (seems extreme, but allows all involved to have clear steps towards remediation if there are problems) Informed consent for interns to add to your Informed Consent forms, explaining their role

20. The Mental Health Consultation Practicum Using three graduate students who have their clinical requirements being taken care of elsewhere, this allows consulting projects to take place on center even as our clinical population increases in severity and challenges. We develop one large scale project per year in which an area is assessed, interventions researched and results reported; for instance, starting an SGA program for LGBTQQ trainees, researching how our center is servicing our LD trainees and assessing our pregnancy rates and anti-pregnancy programs.

21. The Mental Health Consultation Practicum Our team has consulted with the center as a whole, with departments and with individual staff. Mental health consultant teams helps with center wide trainings bringing fresh faces, new ideas and the ability to break into smaller discussion groups to regularly scheduled all staff trainings.

22. Top Ten Questions About The Intern Program Who are they? –Third and fourth year graduate students from a program about 18 miles away. Why does the MHC do this? –To provide more services with the resources allotted to the mental health budget. What do the interns do? –Crisis intervention, caseload of ten clients per week, co-lead two groups, assessment. What does having practicum interns require from me? –One hour of private supervision per intern per week, one hour of didactic/group supervision, 24-hour access by phone, patience.

23. More of the Top Ten Questions Can the interns be trusted? –Interns need to be carefully selected and then trained about issues of safety first. Interns are required to check in by phone every time there are critical issues, such as suicidal ideation. Our staff has had good experiences with interns and so treat them with respect and as equals and they, in turn, step up. How do I have time for this? –For every hour of supervision I give an intern, the organization receives ten hours of clinical work. Although the set-up and maintenance time for the program is significant, it makes my week much easier overall. Initially, as in all new creative endeavors, there are some extra hours. Later, there are less demands on your time and more time to offer services/programs you could only imagine before!

24. More of the Top Ten Questions How much do you need to supervise them? –One hour of 1 to 1 for each intern per ten clinical hours of their work, one hour of didactic/group supervision per week. Lots of phone calls in the beginning of the rotation, then, not very many later. What kind of malpractice insurance is needed? –The graduate school covers malpractice for all students in the field, but you have to be extra careful that contract paperwork is in before clinical work starts. I add interns in the “also named insured” category of my personal malpractice, but I am already covered. This is not expensive. How does the staff accept the interns? –Very well. You do need to build a reputation that interns provide excellent service for our trainees. Once the staff sees that, they accept them whole- heartedly.

25. What are the pitfalls and challenges? We only have two dedicated Mental Health rooms, so space is an issue. There are at least two interns each day, six of us on Friday.. We use conference rooms, rooms of employees who start late or don’t work on one day a week, closets…. There are four challenging months out of the year. (Remember, that means eight easy ones.) February in which the interviews for the following year take place (reviewed 52 applications, interviewed 28 for six slots). July, in which the old interns leave and the new interns start. They need a few days for orientation, a slow start up and much extra attention. By September, we are up to full speed. October is minimally stressful if all six interns need letters of recommendation for their next year’s placement. January, in years in which most the interns are fourth years because they have interviews all over the country for their fifth year internships and are gone for the month. Phone calls and emails are commonplace. I require interns to check in by phone any time they have done an assessment for suicide, homicide or CPS reporting. It doesn’t take long. At the beginning of the rotation, I encourage phone calls about any issue and in a few months, everyone knows what to do.

26. Teaching Anger Control And Conflict Resolution On A Job Corps Center Mike Neidig, LCSW, LCAS Oconaluftee JCC

27. Topics For Anger Control Classes The way you behave when angry is not inherited, it's learned Anger is an emotion and how you react is behavior Managing your anger is a learned skill that anyone is capable of learning The extent to which you get angry and how long you stay angry depends on your thoughts

28. Topics (cont’d) Individualized distracting behaviors and self- calming techniques help control both level of anger and behavior. Improving behavior control when angry improves employability. Being explosive might had been adaptive behavior back home but is not appropriate on-the-job behavior. Externally imposed consequences do not control your behavior. You control your behavior by making "decision" on what is in your best interest (reward vs consequences).

29. Developing An Anger Control Program Referral sources-CSO, counseling and residential living Class size-the smaller the better Length of Sessions: 30 to 45 minutes Psychoeducational or group therapy? Mostly educational but can become group like some sessions when students start giving each other feedback constructively Using anger logs is a key part of the program Role playing is very powerful where students demonstrate both good and poor anger responses to the same situation

30. Miscellaneous Length of "treatment”: Students should attend sessions until they start demonstrating some behavioral improvement. Some students want to continue longer than it seems indicated and some see participation as punishment and want out as soon as possible. Rarely are students so regressed that they need individual sessions before joking the group. It is often a good idea to have the referring staff member determine when the student is ready to finish the group. Handling angry eruptions during the sessions is an important skill for the presenter.

31. Managing Disruptive Behavior In Class Having a roomful of explosive students is sometimes a challenge but the more they see the content as relevant in their life, the more they are likely to control themselves. Often the students who have been in the sessions longer are good at setting the norm of appropriate behavior in the class for the newer, more disruptive students. When it starts to escalate become more didactic. When the class is more subdued more role playing and student-to-student interactions are possible. Great learning takes place when the skill being covered is relevant to a real life situation on center. Therefore, role playing current anger situation displaying the skill for that class is the best learning possible.

32. Log 1 Date/TimeIncidentLevel of (0-100) Automatic Thoughts Outcome

33. Applicant File Review Hillary Walsh, LPC Old Dominion JCC

34. Tools that Help! The tools that are made available to us and can also help make the process easier are Appendix 610: Health Care Needs Assessment an Appendix 609: Individualized Assessment of Possible Direct Threat, and the Center Recommendation for Denial Forms.

35. Although time consuming, the forms allow us the opportunity to make decisions for our recommendations based on facts. By following the guidelines for the three forms, the decisions have a better chance of being upheld by the region because they are being provided factual information that supports our recommendations. Less time consuming after you become familiar with the forms and process

36. IEP I read every IEP even if there are no indications that mental health issues are present. I can possibly gain additional insight into the history of the applicant through the IEP that may not be documented in the applicant file.

37. ASK JAN (Job Accommodation Network), then ask the FRT (File Review Team) Can we meet the accommodation needs of this applicant? –JAN can provide accommodation suggestions –You can also find them at the end of the Mental Health Chronic Care Management Plans or in the Mental Health Desk Reference Guide. If applicant does not accept accommodations, then you do not need to consider in Appendix 609 or 610 assessments.

38. Interviewing the Applicant Conduct clinical interview/mini mental health status exams. Ask specific questions that will give insight into areas of concern. Document the interview in clear clinical and behavioral terms –Not only non-compliant with medication but what has been behavior in past and what behavior is a concern now while not taking meds –What has the applicant being doing since leaving school? Any evidence of adaptive behaviors? Use this information for justification of recommending denial. This is really the “meat” of the assessment along with a review of information in the file.

39. Contact the Physician, Psychologist, Therapist, or Counselor We are only required to contact providers if we have contradictory recommendations. –I contact each person who has provided information that indicates significant issues that could lead to a denial. With the applicant’s permission, I also have someone from the FRT present on the calls. I put the call with both the provider and the applicant on speaker phone so that all answers can be heard by the other person present. Before doing so I state that they are on speaker phone, introduce the other person or individuals and tell who are on the call and their job title.

40. Reasons for Denial Center cannot meet the health care needs of the applicant. Applicants behavior is too dangerous creating a direct threat to their safety or the safety of other students and/or staff on center. –Sexually inappropriate behaviors such as sexual assault or exposing themselves to others. –Recent harm to self or others

41. Helpful Hints 1.Develop relationship with your ACs to get as much information ahead of time as you can. 2.Use the Word version of the forms, so you can type directly on the form. 3.Call your Regional Mental Health Specialist and send your first few assessments ahead of time for feedback before submitting to the RO. 4.Document the calls, who was on the call, and when the call was conducted. –Applicant interview –Calls with Providers or ACs 5.Ask for new health documentation with a deadline as its existence is discovered during the applicant interview. Document this request in the file. –If documentation not received make recommendation based on applicant interview and what you have in the file.

42. Sexual Consent: Educating Students April O’Grady, PhD Penobscot JCC

43. Who and How Initially done at a full assembly Then weekly CPP1 CMHC orientation Reviewed with staff periodically as needed

44. Why? Forensic work with juveniles and sexual charges Psychoeducation component of treatment beneficial to all PJCA students

45. Student Reaction Initially some are attentive and some bored Once begin sexual consent portion, have everyone’s attention

46. State of Maine Age Laws <14 y/o – cannot legally consent 16 & older – can legally consent to any older person 14 & 15 y/o – can consent within 4 year age range

47. Power Differential “If you are larger than your partner, you are likely stronger than your partner.” Important in a range of contacts from “bear hugs” and horsing around to serious sexual situations. Partners may pretend not to mind, so ensure you are not restricting.

48. Other Consent Points Consenting to lower level of activity does not mean you have consented to a higher level activity. Both males and females have the right to say no. Agreeing to a relationship does not equal consent for sex.

49. Substance Use and Consent Maine law is vague. A person under the influence of substances may not be able to fully consent to sexual activity.

50. Questions?