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FREE help for Self-Harm | Text CONNECT to 741741 | Crisis Text line. (2020, May 23). Crisis Text Line. https://www.crisistextline.org/help-for-self-harm/

Hodgkinson, S., Beers, L. S., Southammakosane, C., & Lewin, A. (2014). Addressing the mental health needs of pregnant and parenting adolescents. Pediatrics, 133(1), 114–122. https://doi.org/10.1542/peds.2013-0927

Risk management. (n.d.). https://www.counseling.org/knowledge-center/ethics/risk-management

Suicide Prevention Resources | Suicide | CDC. (n.d.). https://www.cdc.gov/suicide/resources/index.html

Texas Administrative Code. (n.d.). https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=22&pt=30&ch=681

Texas Suicide Prevention | Know the signs. Save a Life. (n.d.). https://texassuicideprevention.org/

The Wisdom Of Trauma. (2023, July 6). About the film - The Wisdom Of Trauma. The Wisdom of Trauma -. https://thewisdomoftrauma.com/about-the-film/

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This is my husband, Corey and I. I would not be pursing a LPC without him, so for that I am very thankful!

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These are my 3 beautiful children. Vance 10, Caydsen 4, and Paige 1. They are who motivate me to succeed in this Master's program!

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TX Administrative Code - Professional Counselors

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TX Administrative Code - Professional Counselors

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This includes the SUBCHAPTER A | GENERAL PROVISIONS
SUBCHAPTER B | RULES OF PRACTICE
SUBCHAPTER C | APPLICATION AND LICENSING
SUBCHAPTER D | SCHEDULE OF SANCTIONS

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Hello, my name is Lea-Ann Skiles. I am currently in my 2nd semester in the Mental Health and Wellness program at Angelo State University. Upon graduating, I plan to pursue my education in the LPC Bridge so that I may become a Biblical LPC for adolescents & pregnant women. In my personal life, I am a commission artist, wife, and a stay at home mother of 3 children. One goal that I hope to achieve from this course is to better understand how to properly counsel severe trauma cases such as childhood abuse.

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This resource is a crisis hotline that offers immediate support & resources that includes help resources that I could provide to suffering patients. https://www.crisistextline.org/help-for-self-harm/

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What is Self-Harm?

For some people, when depression and anxiety lead to a tornado of emotions, they turn to self-harm looking for a release. Self-harm and self-injury are any forms of hurting oneself on purpose. Usually, when people self-harm, they do not do so as a suicide attempt. Rather, they self-harm as a way to release painful emotions. But, no fear. There is help for self-harm.

Types of Self-Harm

Self-harm can crop up differently for everyone. And, the ways people may self-harm extend far beyond the usual references to cutting usually in media. Simply, self-harm is anything and everything someone can do to purposely hurt their body.

Here are some of the most common types of self-injury:

Cutting

Scratching

Burning

Carving words or symbols into the skin

Hitting or punching oneself (including banging one's head or other body parts against another surface)

Piercing the skin with sharp objects such as hairpins

Pulling out hair

Picking at existing wounds

Read on for some healthy coping mechanisms to push through, process, and cope with your emotions.

Text to cool down. If you're dealing with painful emotions, we're here to help. Shoot us a text to connect with a real human and strategize healthy coping mechanisms to manage your emotions. Text CONNECT to 741741 to connect with a real human.

Get creative. Studies show that diving into making art can help people process emotions. So, next time you're feeling like self-harming, grab your sharpie and doodle your worries away. A bonus: you can totally suck at it and still reap the same rewards.

Find your zen. Keeping yourself safe from self-harming is all about finding healthy alternatives to work through the hard stuff. Researchers found taking time to re-center through meditation to be a powerful way to find your cool and calm. Try using an app like Headspace to get on the meditation bandwagon.

Talk to a pro. Self-harm is serious. And, while the intention behind self-harm usually is not death, it can still be dangerous-both physically and emotionally. Talking to someone who can help you find alternatives is incredibly important. Of course, you can start by texting us. Also, consider telling someone you know who can help you connect with a professional.

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FREE Help for Self-Harm | Text CONNECT to 741741 | Crisis Text Line

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You don't have to hurt. There is help for self-harm. Text CONNECT for FREE, 24/7 crisis counseling and healthy coping mechanisms.

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Reference Guide for Mental Health Disorders -Unit 1 Assignment 4

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Reference Guide for Mental Health Disorders -Unit 1 Assignment 4

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This assignment is very useful material that I will utilise as a LPC for overall reference to various mental disorders. Within it contains a spreadsheet that includes detailed information over Depression, Anxiety, Psychosis, Substance Use, & Eating Disorder. The spreadsheet is broken up by each mental disorder and includes research based definitions, causes, importance of early intervention, specific types of disorders, & helpful resources. The specific types of disorders are; Depression: Bipolar Disorder, Postpartum Depression, Seasonal Depression, Suicidal Ideation, & NSSI, Anxiety: GAS, Panic Disorder, Phobic Disorder, PTSD, OCD, & Mixed Anxiety, Depression, & Substance Abuse, Psychosis: Schizophrenia, Bipolar Disorder, Psychotic Depression, Schizoaffective Disorder, & Drug-Induced Psychosis, Substance Use: Alcohol, Other Drugs (Marijuana, opiod, cocaine etc. , & Eating Disorders: Anorexia Nervosa, Bulimia Nervosa, & EDNOS.

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This source is from the CDC & offers multiple resources as well as the 988 hotline information that I could utilize for an offered resource to clients. https://www.cdc.gov/suicide/resources/index.html

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Suicide Prevention Resources

Contact the 988 Suicide and Crisis Lifeline if you are experiencing mental health-related distress or are worried about a loved one who may need crisis support.

Connect with a trained crisis counselor. 988 is confidential, free, and available 24/7/365.

Visit the 988 Suicide and Crisis Lifeline for more information at 988lifeline.org .

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CDC provides resources for suicide prevention, including publications, reports, and data sources.

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What I Know & Wish to Learn - Unit 1 Assignment 1

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What I Know & Wish to Learn - Unit 1 Assignment 1

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My prior knowledge of trauma consist of the origins, the versatility, & the effects. I understand that trauma does not discriminate and is experienced among a vast amount of people in all cultures. Trauma can originate from multiple sources of horrendous experiences such as child abuse, neglect, sexual assault, combat exposure, car wrecks, etc. The effects typically result from the individuals inner responses to the traumatic event and can often cause drug addiction, anxiety, PTSD, depression, and chronic illness.

Based on the Channel Kindness Mental Health Awareness Quiz and my own personal experiences in trauma, I have much to learn about mental health statistics. Upon the results for the quiz, it declared that I have very little knowledge of the prevalence of mental health amongst youth groups. And for me personally, I experienced trauma at a young age so in result I developed certain mental health issues that went untreated for over a decade. With that being said, I believe that my knowledge in adolescent mental health recognition & treatment is lacking as proved from the quiz results. Throughout this course, I expect & look forward to gaining this knowledge so that I can better assist the youth and prevent adolescents from going forth in a crucial time of life untreated.

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Pregnant adolescents experience a tremendous amount of depression in comparison to adult mothers. Some compelling statistics that I found to be relative are that “Approximately 19% of all 15- to 19-year-olds report having thoughts of suicide” & that 9% have made suicide attempts (Hodgkinson et al., 2013). This declares a significant and serious concern for my specific role and should be one of my primary focuses as many of my clients will persist of pregnant adolescents.

Resources

Hodgkinson, S., Beers, L. S., Southammakosane, C., & Lewin, A. (2013). Addressing the Mental Health Needs of Pregnant and Parenting Adolescents. Pediatrics, 133(1), 114–122. https://doi.org/10.1542/peds.2013-0927

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Pediatrics. 2014 Jan; 133(1): 114-122.

Abstract

Adolescent parenthood is associated with a range of adverse outcomes for young mothers, including mental health problems such as depression, substance abuse, and posttraumatic stress disorder. Teen mothers are also more likely to be impoverished and reside in communities and families that are socially and economically disadvantaged. These circumstances can adversely affect maternal mental health, parenting, and behavior outcomes for their children. In this report, we provide an overview of the mental health challenges associated with teen parenthood, barriers that often prevent teen mothers from seeking mental health services, and interventions for this vulnerable population that can be integrated into primary care services. Pediatricians in the primary care setting are in a unique position to address the mental health needs of adolescent parents because teens often turn to them first for assistance with emotional and behavioral concerns. Consequently, pediatricians can play a pivotal role in facilitating and encouraging teen parents' engagement in mental health treatment.

Keywords: teen pregnancy, teen parenting, mental health, mental health interventions

This is the 2nd in our series on Adolescent Health.

Adolescent childbearing is a remarkably common occurrence in the United States, seen across all geographic, racial, ethnic, and socioeconomic groups. Medical providers often struggle to provide comprehensive care to young families, many of whom face a wide variety of barriers to optimal health and development. Because teen mothers often face significant environmental and psychosocial stressors and are at risk for a number of mental health concerns that can affect them and their children, primary care for young mothers and their children must include attention to these problems. Indeed, in recent years there has been a growing call for pediatric primary care providers to become more engaged in the early detection and treatment of mental health concerns in the primary care setting, and models of integration have been developed and disseminated.1,2 Additionally, the prevalence and implications of postpartum depression have garnered significant attention in the fields of clinical medicine and public health, leading to advocacy for maternal mental health screening during the infant's well child visits.3⁻6 This increasing attention to the need for mental health awareness, assessment, and management within primary care is very relevant for clinicians caring for adolescent mothers and has driven the development of this review.

This article summarizes the current literature on the prevalence and severity of mental health disorders in adolescent mothers, barriers to care, and recommendations for interventions that address the mental health needs of this vulnerable population. Although the mental health of teen fathers also has an important influence on fathers, mothers, and children, there is little research on the mental health of adolescent fathers. Thus, for the purpose of this review we will focus on teen mothers, but we strongly encourage the field to investigate the mental health needs of young fathers also.

Prevalence of Mental Health Concerns Among Teen Mothers

In addition to navigating the developmental tasks of adolescence, teenage mothers must also adjust to the responsibilities and demands of parenting, often in the context of economic and social disadvantage. Such stressors may contribute to a range of mental health problems that can adversely affect the functioning and parenting behavior of adolescent mothers and increase the risk of behavioral problems in their offspring.

A number of studies suggest that adolescent mothers experience significantly higher rates of depression, both prenatally and postpartum, than adult mothers and their nonpregnant peers.7⁻11 Among adolescent mothers, rates of depression are estimated to be between 16% and 44%. In contrast, the lifetime prevalence of major depression among nonpregnant adolescents and adult women is between 5% and 20%.9 Depression symptoms among young mothers are also more likely to persist well after the birth of their child.12 Although there are few prospective, longitudinal studies on the long-term mental health outcomes of adolescent mothers, 1 study of African American adult women who became mothers during adolescence found a twofold increase in depression 20 years after the birth of their first child.13

Completed suicides are rare among pregnant women, but the few studies that exist in this area suggest that adolescent mothers may be at elevated risk for suicidal ideation. Approximately 19% of all 15- to 19-year-olds report having thoughts of suicide, and ∼9% have made a suicide attempt.14 The few available studies of suicidality in adolescent mothers found rates ranging from 11% to 30%.15,16

Early childbearing is also associated with an elevated risk of substance abuse. Estimates of drug use among pregnant adolescents range from 11% to 52%.17,18 However, these rates may be an underestimate because it is not uncommon for pregnant women to underreport their drug use to medical providers and on self-report surveys.19,20 Studies have found that substance use among pregnant adolescent women often declines during pregnancy but then resumes after delivery and continues well into adulthood,21,22 coinciding with the chronic and persistent mood symptoms described in this population.

Teen mothers are also at risk for developing symptoms of posttraumatic stress disorder, mainly because of their high risk for community and interpersonal violence exposure.23,24 One study found that on average, teenage mothers had experienced >5 traumatic events, including physical attacks by a partner, neglect, abuse by a parent, incarceration, and traumatic loss. Almost 50% of the adolescent parents in this study met full criteria for posttraumatic stress disorder.25 Compared with adult mothers, adolescent mothers are 2 to 3 times more likely to be victimized by their partner, the father of their child, or a family member.26,27

Although adolescent childbearing is associated with an elevated risk of adverse mental health outcomes,28,29 there is significant variability in outcomes for individual families. The majority of teen mothers and their children can have positive outcomes equal to those of their peers who bear children later, particularly when they are provided with strong social and functional supports. Therefore, primary care and other interventions for adolescent families should maintain a strength-based focus.30

Understanding the Relationship Between Teen Motherhood and Mental Health

The direction of causality in the relationship between teen parenthood and mental health problems is complex and not elucidated by existing research. Adolescent mothers are more likely to be poor and disproportionately African American and Latina, live in low-income communities, be born to parents with low educational and employment attainment, have a history of child abuse, reside in chaotic home environments characterized by poor interpersonal relationships, and have limited social support networks.24,31,32 These are also factors that have been strongly and independently associated with adverse mental health outcomes.12,24,31⁻33 Additionally, the stressors of caring for an infant may exacerbate the psychological distress experienced by young mothers. Thus, it is unclear whether the stressors and experiences of early childbearing lead to mental health problems or whether the mental health outcomes among adolescent mothers are a result of the adverse life circumstances that often precede and predict teen pregnancy.

In studies examining the influence of sociodemographic factors on outcomes, the association between early parenting and adverse mental health was either diminished or no longer significant once potentially confounding factors such as socioeconomic status, parental education, and family functioning (eg, abuse history, parental mental health history, single-parent household) were controlled.6,12,28,33 It is important to note that these studies were conducted with aggregated data, and although there is a significantly greater risk for mental health difficulties among adolescent mothers, not all adolescent mothers have mental health problems. Additional research is needed to explain these variations in mental health outcomes among teenage mothers.

Mental Health and Parenting Behavior

Abundant research links maternal depression and other forms of distress to impairments in parenting and to problem behavior in children.34⁻39 The impact of maternal mental health on parenting and child behavior is often understood through the lens of attachment theory,40 which posits that infants develop expectations about the availability and responsiveness of their caregivers based on repeated experiences with them. Numerous studies have found an association between maternal depression and insecure attachment in young children.41⁻45 Because adolescent mothers, more often than adult mothers, may lack the cognitive or social-emotional resources to provide the sensitive and responsive parenting necessary for a secure attachment,46 pediatricians working with adolescent mothers should attempt to assess and foster attachment behaviors in the context of well child care and anticipatory guidance.

A positive and supportive relationship between the teen mom and her mother and the infant's father has been repeatedly found to be a protective factor for teen mothers and their children.28,35,47 Thus, pediatricians may also use their contact with a child's father or grandmother to foster the quality of these important relationships and to talk with teen mothers about these relationships and their potential for support.

Mental Health Service Use Among Teen Mothers

There are few data on mental health service use among pregnant and parenting adolescents. Available data on mental health service use among low-income women in general and families from diverse ethnic backgrounds suggest that vulnerable groups, such as teenage mothers, face significant barriers in accessing mental health services.

Up to 50% of pediatric visits address some behavioral or psychosocial concern.48 However, of the 15 million children and adolescents with a diagnosed mental health disorder, 25% or less receive ongoing mental health services.49 Rates are often much lower for youth who are poor, of ethnic minority status, or from disadvantaged backgrounds.50,51

Youth and families from impoverished communities face many barriers to treatment, which may explain the disparities in access to mental health care. First, mental health services in urban and rural communities are often inadequate or insufficient to meet the mental health needs of low-income youth, particularly those from families that rely on public or community-based health care services. As a result, many youth receive mental health services in the primary care setting; however, primary care providers vary in their expertise and ability to treat mental health disorders in adolescents.50,51 Lack of insurance, time availability, and transportation, which are especially salient issues for teenage parents, may also impede access to mental health services. Although some states allow adolescents to consent for mental health care, teens may still refuse or avoid services out of fear that their parent or guardian will discover their help seeking.52 The structure of mental health appointments may also be a barrier. Teenage parents may be more likely to engage in treatment when appointments are flexible and accommodating to their school schedules and allow them to discuss their problems at their own pace, instead of through an intake process that can appear intrusive and insensitive.25

Given that teenage parents are disproportionately African American or Latino, physicians should consider some of the factors that may affect mental health service use in these groups, particularly African Americans. Available studies suggest that African Americans are at greater risk of underusing mental health services than other racial and ethnic groups. In some studies, African American mothers were half as likely to use mental health services, and when they did engage in mental health treatment, they received fewer sessions and were more likely to terminate services prematurely.53,54 This is consistent with more widespread data on African American disparities in medical care in general.55 In addition to these obstacles to care, there are additional access considerations for African Americans such as trust, privacy and safety concerns, and perceptions of low participation in decision-making. Specific to mental health treatment, greater pessimism about antidepressant and psychotherapeutic efficacy, preference for care by a professional of the same race or ethnicity, greater value of spiritual factors, and greater concern for stigma are also salient factors.56⁻60

Unfortunately, need does not correlate with service use; however, linkage to gateway agencies can be an important facilitator of service access and use.61 Effective gateway agencies include schools, churches, and juvenile justice agencies. For example, many school districts have mental health providers that can serve as critical point people in identifying and treating mental health problems.62 There is evidence for success of 1 school-based program for teen mothers that included access to a school social worker, weekly peer groups, and direct coordination with the teen's primary care provider. Notable mental health outcomes of participants in this program included greater motivation and hopefulness.63

The adolescent parent's pediatrician also has the potential to be an important gateway to mental health care. There is abundant and ongoing evidence for successful mental health integration in the primary care office. Existing models for collaborative care include colocated pediatricians and child psychiatrists or psychologists; telephone mental health consultation services, including telepsychiatry (staffed by child psychiatrists, psychologists, social workers, or mental health coordinators); formal cross-educational sessions between mental health clinicians and pediatricians; and implementation of care managers on site.64⁻71 Pediatricians who do not have colocated mental health services can support teen mothers with mental health needs by facilitating referrals to gateway organizations, such as the department of health, outpatient mental health programs, and community-based organizations with wraparound services that include mental health care.

Although these models of care are not tailored solely to adolescent parents, 1 program described in the literature offers a comprehensive service delivery model. A multidisciplinary team of clinicians (eg, obstetrician-gynecologist, pediatrician, social worker, and health educator) are colocated in a multiservice center that also includes social service agencies.72 Adolescent parent participants had more regular clinic attendance; had better health outcomes (as did their offspring); were more consistent in their use of contraception, with lower repeat pregnancy rates; and had better school attendance and matriculation rates. Expansion of such a program to include mental health services would improve access to mental health care.

Mental Health Screening in Teen Mothers

Although the critical significance of mental health screening in the pediatrician's office has recently gained attention in the field, there is a dearth of literature on mental health screening of adolescent mothers.73 However, the evidence to date suggests the utility of in-office screening of all adolescents with various mental health screening tools (eg, Diagnostic Predictive Scales-8, Columbia Depression Scale, and select items from the Youth Risk Behavior Survey, Center for Epidemiologic Studies Depression Scale for Children, Beck Depression Inventory, and Postpartum Depression Screening Scale).74⁻76 Furthermore, mental health screening of mothers at pediatricians' offices during infants' well child visits is a stated concern of the American Academy of Pediatrics (AAP) Task Force on the Family and Bright Futures and has been found feasible and effective with various mental health screening measures, such as the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire.3⁻6,77⁻79 This emerging evidence suggests the great potential for effective mental health screening of teen mothers.

Mental Health Interventions for Teen Mothers

Mental health interventions targeting adolescent parents are limited. In our review of the literature on mental health interventions relevant to teen mothers, we found that interventions are typically nontraditional and integrated into other settings, primarily primary care or other clinical contexts, home visits, and schools. We focused our review on interventions delivered in the home and in the primary care setting, because they would be most relevant to primary care physicians. Specific interventions discussed in each category were selected if they had empirical support and published findings. Emergent interventions and practice guidelines are also discussed.

Pediatric Primary Care: The Pediatrician's Role

The role of the primary care physician in directly addressing the mental health needs of teen mothers has not been rigorously studied. However, the AAP has highlighted the critical role of pediatric providers and provided practice guidelines. By establishing rapport; assessing mental health concerns, providing individual or group-based counseling around parental stress, positive parenting techniques and infant care and development, and facilitating referrals to services in the community, physicians can help address the mental health concerns of adolescent mothers.80

General Mental Health Interventions in the Medical Setting

Mental health interventions for children and adolescents administered in the general medical setting are scarcely described in the literature; 1 study described mental health training for nurses in a practice over 4 months with additional ongoing supervision. The nurses provided psychoeducation and brief therapy and collaborated with school and community mental health resources.81 The pediatric participants receiving the study intervention experienced greater access to and completion of mental health care compared with control patients receiving usual care. Another successful trial involving adolescent subjects implemented clinician-administered motivational interviewing in the office and referral to an Internet cognitive behavioral therapy program.82 Engagement in the Internet program was substantial, and participants experienced a reduction in thoughts of self-harm, hopelessness, and depression. Yet another study reported the benefits of motivational interviewing in the emergency department to target adolescent alcohol abuse.83 Motivational interviewing is a recent, rapidly expanding intervention focused on increasing motivation for change by working through ambivalence. The interview may be brief, <45 minutes, with a conversational and collaborative approach. The ultimate goal of this intervention is to effect behavioral change.84

With regard to general interventions for teen mothers, 1 study described the benefits of scheduled social work visits during clinical appointments, waiting room education, clinician inquiries into education and family planning, and regular appointment reminder calls and letters. Teen dropout and repeat pregnancy rates and infant immunization rates and emergency department usage were all improved compared to a control group.85 Again, modification of such a program to more specifically include attention to mental health could optimize the psychological well-being of adolescent mothers.

Pediatric Primary Care: The Teen-Tot Model

The core component of the Teen-Tot model is the provision of comprehensive primary care for both teen parents and their children together in the medical home. In this model, case management, social work, and mental health services are also integrated into medical care visits. The interdisciplinary team assists adolescent-headed families in accessing needed community-based services and teaches and empowers them to access such resources themselves. By doing this work in the context of an ongoing relationship, the team is also providing empathy, support, and modeling of parenting and healthy relationships. The team also facilitates the involvement of a mental health professional when more substantial intervention is needed (eg, in cases of trauma or interpersonal partner violence). Ideally, the mental health providers would be colocated in the primary care setting so that they are available during clinic sessions, can interact with families, and can have regular contact with the clinic staff. A rigorous evaluation of the Teen-Tot model, including its effectiveness at addressing the mental health needs of adolescent mothers, is being conducted by the authors. The few preliminary studies of the model have found declines in the number of repeat pregnancies and more positive outcomes in education for teen mothers and infant health.86,87

Home Visiting

As early as 1975, Selma Fraiberg and colleagues88 first described a home-based intervention with mothers and infants in which the mother's own childhood experiences of trauma, deprivation, or conflict limited her ability to psychologically provide competent care to her child. Although mental health services are not a primary focus of most current home visiting interventions, Fraiberg's theory suggests that the relationship between the home visitor and the mother is an important influence on the mother's mental health. The home visitor engages and gains the trust of the teen parent by being empathic and attentive to her emotional and concrete needs, which enables the mother to better attend to those needs in her child. The home visitor also serves as a model for the mother, teaching her experientially and didactically about the importance of empathy, support, and appropriate limit setting.

The best-known and most rigorously evaluated home visitation program was developed and studied by David Olds and colleagues.89 The Nurse Home Visitation Program provided regular home visits by nurses to a group of largely poor unmarried mothers (approximately half were adolescents) before and after the birth of their first child. Fifteen years later the women receiving this intervention had fewer subsequent pregnancies and births, less time on welfare, fewer arrests, fewer problems resulting from substance abuse, and fewer substantiated reports of child abuse and neglect compared with a control group.89⁻92

Numerous other home visiting programs, including Healthy Start and Healthy Families America, have been implemented and evaluated with a range of at-risk mothers and young children, with mixed results. It is noteworthy that these programs have generally demonstrated their greatest benefits for low-income, first-time adolescent mothers.93

Coparenting

Two interventions to strengthen positive coparenting in teen parents have been developed and implemented collaboratively with health care providers. The Young Parenthood Program94 is a 10-session intervention for individual teen parent couples focused on building communication, self-regulation, and other interpersonal skills related to coparenting. More positive parenting was observed among fathers who participated in this intervention than among those in a control condition.94 Strong Foundations95 is an intervention that includes 5 prenatal group sessions for expectant adolescent couples followed by 9 individual postpartum sessions integrated into well child pediatric visits during the child's first year. Sessions teach communication and conflict management skills and work toward developing an identity as a coparenting team. Strong Foundations outcome data have not yet been published. Because resources such as these are rare in most communities, providers should be alert to the coparenting relationship and sensitive to ways in which they can provide support and encouragement for young parents to work together, regardless of the status of their romantic relationship.

Conclusions and Recommendations for Pediatric Providers

The pediatric primary care setting is a universal, nonstigmatizing source of services to teen mothers and their children. As such, it is likely to be the first place teen mothers turn for assistance with mental health concerns, and there are a number of ways in which pediatricians can facilitate or directly address mental health needs. Not all young mothers will be able to articulate their experiences and concerns directly to providers. Therefore, pediatricians must also spend time during primary care visits to assess the psychological and emotional well-being of both mother and child. Such an assessment does not have to be a lengthy, formal clinical evaluation. Rather, regular use of brief and effective screening tools is an efficient means of eliciting information and initiating conversations about mothers' stressors, symptoms of depression, history of trauma, and experiences in parenting.

The pediatrician's ability to establish relationships with teen mothers and appropriately refer to community mental health agencies, including home visiting programs, schools, and other agencies providing services to adolescent parents, is critical to service use and optimization of care for adolescent mothers and their children. Furthermore, when pediatricians directly facilitate and encourage access to mental health services, mothers are more likely to use them.50

Perhaps the best method for engaging teen mothers in behavioral health services is to integrate them directly into a primary care setting with a multidisciplinary treatment team. Mothers who are reluctant to seek services for themselves might be more amenable to dyadic work with a focus on their child. If mothers are not interested in meeting with a mental health professional or one is not available in a community, pediatric providers who do not have specific mental health training can provide important assistance and meaningful support to young mothers who are isolated or lack models of positive coping skills. Primary care providers can offer parent coaching and education and facilitate mothers' ability to seek positive support from others in their lives and community.

This article is intended to augment the AAP's "Clinical Report: Care of Adolescent Parents and Their Children," which highlights the responsibilities of the pediatrician in the medical home to include anticipatory guidance, knowledge of community resources, mental health screening, and advocacy.80 Because a full review and discussion of the pediatrician's role in mental health care are beyond the scope of this article, the reader is also directed to the AAP for resources and practice parameters on improving mental health care in pediatric practice.80,96⁻101

There remains a need for a broad range of research to more fully elucidate how pediatricians can contribute to improved mental health outcomes for teen mothers and their children. In addition, other factors influencing mental health warrant investigation. The role of grandmothers, other family members, and young fathers in the lives of teen mothers and their children is complex and not well understood. Future research should specifically work to clarify causal relationships and identify modifiable factors that influence outcomes. Finally, research is needed to elucidate the effectiveness of different forms of intervention for this population. Standards of care for teen parents and their children have not been established.

Glossary

AAP

American Academy of Pediatrics

Footnotes

Dr Hodgkinson drafted sections of the manuscript and arranged and edited contributions prepared by the coauthors; Drs Beers and Southammakosane drafted sections of the manuscript and reviewed and revised the manuscript; Dr Lewin drafted sections of the manuscript and critically reviewed and edited the manuscript; and all authors approved the final manuscript as submitted.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this manuscript to disclose.

FUNDING: The preparation of this manuscript was supported by the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health, under award 5P20MD000198. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funded by the National Institutes of Health (NIH).

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

References

36. Knoche LL, Givens JE, Sheridan SM. Risk and protective factors for children of adolescents: maternal depression and parental sense of competence. J Child Fam Stud. 2007;16:684-695 [ Google Scholar]

55. Institute of Medicine Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington, DC: Institute of Medicine; 2002 [[ PMC free article] [ PubMed] Google Scholar]

97. Addressing mental health concerns in primary care: a clinician's toolkit (CD-ROM) [computer program]. Elk Grove Village, IL: American Academy of Pediatrics; 2010

Articles from Pediatrics are provided here courtesy of American Academy of Pediatrics

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Addressing the Mental Health Needs of Pregnant and Parenting Adolescents

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Adolescent parenthood is associated with a range of adverse outcomes for young mothers, including mental health problems such as depression, substance abuse, and posttraumatic stress disorder. Teen mothers are also more likely to be impoverished and reside ...

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Developmental Discussion on Trauma - Unit 2 Assignment 2

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Developmental Discussion on Trauma - Unit 2 Assignment 2

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This assignment was broken up into 4 discussion posts over the review and analysis of a chosen documentary. The documentary I chose was an educational one called "The Wisdom of Trauma" featuring Dr. Gabor Mate. His overall view is that trauma is an internal response to traumatic events and that anxiety, substance abuse, and chronic illness all have correlations to each other. Within this documentary, it is displayed that every individual suffers and responds differently to trauma and that trauma is much more an epidemic issue within the western world that ultimately needs to be addressed. Dr. Mate's solution to this problem is through educational awareness from an informed-trauma society and through intervention for current suffering individuals.

I found that this documentary did paint a very clear understanding for how relevant trauma truly is. This was done through the expression that every individual, no matter walk of life, all had the same suffering caused from prior traumatic events. Another highly interesting theory made was over chronic illness in which the trauma becomes a physical manifestation to inner pain. Dr. Mate backs this by declaring the highly and over prescribed steroid medications. In other words, stress hormones better called Cortisol. It makes one question if the solution is stress hormones then perhaps the cause could potentially be stress itself?

Attached is a rough draft of my initial discussion posts through out this series of assignments.

Resources
The Wisdom Of Trauma. (2023, July 6). About the film - The Wisdom Of Trauma. The Wisdom of Trauma -. https://thewisdomoftrauma.com/about-the-film/

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“Trauma is not what happens to you. Trauma is what happens inside you, as a result of what happens to you.” - Dr. Gabor Mate

“The interconnected epidemics of anxiety, chronic illness and substance abuse are, according to Dr Gabor Maté, normal.” (The Wisdom Of Trauma, 2023)

“Suicide is the second most common cause of death in the US for youth aged 15-24 [2], and kills over 700,000 people a year globally [3] and 48,300 in the USA [4] Drug overdose kills 81,000 in the USA annually [5]. The autoimmunity epidemic affects 24 million people in the USA [6].

“The abnormality does not reside in the pathology of individuals, but in the very culture that drives people into suffering and dysfunction."” (The Wisdom Of Trauma, 2023)

Resource
The Wisdom Of Trauma. (2023, July 6). About the film - The Wisdom Of Trauma. The Wisdom of Trauma -. https://thewisdomoftrauma.com/about-the-film/

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About the film Watch trailer The interconnected epidemics of anxiety, chronic illness and substance abuse are, according to Dr Gabor Maté, normal. But not in the way you might think. One in five Americans are diagnosed with mental illness in any given year [1].

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The American Counseling Association (ACA) is no longer offering risk management services.

Risk management is a very complex area. ACA believes that, whenever questions arise, counselors should consult with a lawyer licensed in the jurisdiction in which they practice.

Recommended Risk Management Resources

One resource, recommended by Nancy Wheeler, former ACA Risk Management Consultant, is Martindale.com, an online legal portal that can be used to search for attorneys. ACA has no affiliation with Martindale and does not endorse the attorneys listed on the company's website. ACA members should keep in mind that it is important to verify the credentials and past work of all prospective legal advisers.

In addition, professional counselors should use all of the services available to them through their liability insurance provider. In the event of a license protection or professional liability incident or notice of complaint, ACA members insured through HPSO should call HPSO for support at 800-982-9491, or go to hpso.com for more information.

ACA Risk Management Resources

ACA offers a variety of resources to counselors looking for information about risk management.
Books
The Counselor and the Law: A Guide to Legal and Ethical Practice, Eighth Edition
Anne Marie "Nancy" Wheeler and Burt Bertram

This eighth edition provides a current and comprehensive discussion of counselors' legal and ethical responsibilities, an examination of state and federal laws as they relate to practice, and helpful risk management strategies. Attorney Nancy Wheeler and Burt Bertram, a private practitioner and counselor educator, offer real-world practical tips to help navigate professional risks while providing competent clinical care. New or updated topics include matters surrounding informed consent, current case law on duty to warn/protect and issues surrounding suicide in college/university settings, electronic records and ransomware concerns, and updates on state licensure board data regarding boundary violations. The authors' legal and ethical decision-making model will assist counselors and students with processing their own legal and ethical dilemmas, and the ACA Code of Ethics is included as a handy reference.

Risk Management for Counselors Columns

The following documents are risk management columns by Anne Marie "Nancy" Wheeler, J.D., an attorney licensed in Maryland and the District of Columbia., published monthly in Counseling Today.

Some of the columns below references ACA's ethics consultation services, however the contact information is not up to date. To contact the ACA Ethics and Professional Standards Department please call (800) 347 6647, ext. 321 or fill out the online Ethics Contact Form.

Please note that these documents are a member-only benefit. Please login to view these documents.

Technology:

Health Information Hackers (12/14)
Apple Watch and Privacy (5/15)
Potential privacy problems with cloud-based storage (10/15)
Preparing for your 'digital afterlife' (5/16)
Ensuring cloud service providers comply with HIPAA (12/16)
Phishing email targets HIPAA covered entities (2/17)
Protecting against ransomware (3/17)
Artificial intelligence raises new questions for counselors (3/18)

Confidentiality, Privileged Communication, and Privacy:

Do proposed regulations properly protect client privacy? (4/16)
Does opioid crisis change thinking on confidentiality? (1/18)
Of software patches and privacy breaches (10/18)

Privacy breaches and group counseling (9/19)

Children:

Balancing child rights with parental rights (9/16)
Providing services with the consent of one parent (10/16)
Criminal case could hold lessons for teens and counselors (5/18)
Student suicides raise concerns about potential counselor liability (12/18)
Digital communications, bullying and suicide (6/19)

HIPAA (1/14)
HIPAA (5/13)
HIPAA HITECH Law Changes (2/13)
New HIPAA Privacy Rule (7/2014)
HIPPA/HITECH enforcement unlikely to abate (4/17)
Protected health information and the HIPAA breach portal (10/17) Know your state's data breach reporting law (11/18)

HIPAA violations and civil monetary penalties (8/19)

Records:

Electronic Health Records Risks (1/15)
Records Custodian Appointment (6/14)
Participating in the exchange of electronic health information (8/17)

General:

Clients (9/13)
Subpoenas (8/13)
Fee-Splitting (3/13)
Minimizing High Liability Risk (2/15)
Subpoenas, HIPAA, HITECH, LLCs (3/14)
National Practitioner Data Bank (11/14)
Title IX (4/15)
Clear and Present Danger (6/15)
Determining proper insurance coverage (9/15)
When can non clients sue counselors? (11/15)
Payment for serving as a witness in court (12/15)
Providing access to counseling for those with limited English proficiency (2/16)
Using ACA's ethics and risk management services (6/16)
Settling on the proper form for your practice (7/16)
Client is secretly recording counseling sessions (8/16)
Seeking payment in bankruptcy cases (11/16)
Handling a subpoena for client records (1/17)
State courts filing could influence future duty to warn decisions (6/17)
Sexual reassignment surgery and letters of support (7/17)
Insurance issues for counselors heading into retirement (9/17)
The pitfalls of serving as both treating counselor and expert witness 11/17)
The wisdom of finding a local attorney (12/17)
Discussing advance health care planning with clients (2/18) Finding legal representation for undocumented immigrants (4/18) Assessing the risk potential of a new supervisory position (6/18)
Providing input on client marijuana use (7/18)
Hiring independent contractors vs. hiring employees (8/18)
Planning in advance for disasters and emergencies (5/19)
The importance of using decision-making models (7/19)

Professional Responsibility: Intervening with Counselor Colleagues(3/15)
Coordination of Care (8/14)
Fees and antitrust laws (8/15)
Banning weapons in private office (6/15)
Promoting or selling dietary supplements as a counselor (1/16)
Supervisors inherently assume more risk (3/16)

Reporting:

Reporting (6/13)
Reporting animal abuse and cruelty (5/17)
Recognizing and addressing elder abuse (9/18)
Implications of red flag gun laws for counselors (1/19)

Resolving Ethical Issues:

Client Complaint (2/14)
Licensure Board Complaints (9/14)
Non-client Board Complaints (10/14)

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The American Counseling Association (ACA) is no longer offering risk management services. Risk management is a very complex area. ACA believes that, whenever questions arise, counselors should consult with a lawyer licensed in the jurisdiction in which they practice.

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Psychological First Aid Certificate - Unit 3 Assignment 1

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Psychological First Aid Certificate - Unit 3 Assignment 1

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This assignment was dedicated to training and receiving a certificate for psychological first aid response. The course is a free online 5 hour self paced session that details the proper responses to mental care following a community crisis event. In receiving this certificate, I have gained the knowledge in effective responses to caring for individuals primarily in shelter scenarios due to being negatively impacted by a crisis. This knowledge will be highly useful in my future career as a LPC and any volunteer work that I may presume for community crisis response.

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Texas Suicide Prevention Collaborative offers substantial information over support, resources, & training (Texas Suicide Prevention | Know the Signs. Save a Life., n.d.). https://texassuicideprevention.org/

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The Texas Suicide Prevention Collaborative relies on generous contributions from community members like you to support our work. The fact is that persons who are impacted by mental illness or who need support for suicide prevention, suicide loss, or a previous attempt rarely come into contact with the public mental health system. Many go without treatment or support at all.

To help communities, we must build and support locally available resources for those who may be at risk of suicide-and that's the essential work of the Texas Suicide Prevention Collaborative. Given the size of Texas, this task is challenging, but with your support, we can accomplish it-together.

We now accept crypto donations along with traditional monetary donations. Please support those who need help in your community today.

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Texas Suicide Prevention | Know the Signs. Save a Life.

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The Texas Suicide Prevention Collaborative relies on generous contributions from community members like you to support our work. The fact is that persons who are impacted by mental illness or who need support for suicide prevention, suicide loss, or a previous attempt rarely come into contact with the public mental health system.

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This PDF resource offers a complete list of Texas laws in relation to suicide prevention, NSSI, & Suicide. Titled, “Texas Statutes Regarding Suicide”. https://www.sccenter.org/wp-content/uploads/2016/11/Texas_laws_suicide.pdf

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Crisis Prevention & Threat Assessment for Suicide & NSSI - Unit 3 Assignment 2

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Crisis Prevention & Threat Assessment for Suicide & NSSI - Unit 3 Assignment 2

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This assignment is a group project that details the crisis prevention & threat assessment plans as a crisis management team. For this project we utilised Google slides and collaboratively worked together to fulfill the needed requirements. As a group, we assigned specific topics amongst us and individually worked on them then collaborated to ensure all areas were effectively met. The main topics consist of;  Types of Mental Health & Threat Assessment, At-Risk Behaviours, Multi-Agency Collaboration, Screening Assessment, Community Training, and Legalities & Ethics.

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ACA Code of Ethics - Suicide & NSSI Exceptions

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ACA Code of Ethics - Suicide & NSSI Exceptions

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B.2.a. Serious and Foreseeable Harm and Legal Requirements
The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues.

B.2.b. Confidentiality Regarding End-of-Life Decisions Counselors who provide services to terminally ill individuals who are considering hastening their own deaths have the option to maintain confidentiality, depending on applicable laws and the specific circumstances of the situation and after seeking consultation or supervision from appropriate professional and legal parties.

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ABC Model of Crisis Prevention - Unit 3 Assignment 3

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ABC Model of Crisis Prevention - Unit 3 Assignment 3

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The ABC Model of Crisis Prevention is a case study that allowed me to gain insight into a trauma case. The case was a mock situation, in which I chose Melynda, a college student who finds it difficult to fulfilll her father's high expectations and is suffering from depression, starvation, and suicidal ideation. In this assignment, I clarified how to A) ACHIEVE a relationship, B) BREAK down the problem, and C) COMMIT to action. Throughout these sections, it was required to focus on the physical, emotional, social, and cognitive aspects of Melynda's crisis. Overall, this assignment taught me how to organize my treatment plans for crisis therapy. This lesson will become highly useful for my crisis clients.