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My name is Carmen R. Perales, I am enrolled in the LPC Bridge program. A personal goal of mine is to lose 15 pounds by December 2024 and a professional goal is to pass the NCE in October 2024. I would like to refresh my memory on theories that I learned about when I got my Master's degree in 2010 and which theories work best with supporting traumatic events with children and adults.

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Reflection - Developmental Discussion on Trauma

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Reflection - Developmental Discussion on Trauma

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I enjoyed this assignment because I love a good documentary. I do not have much free time between work, family, and school, but when I do, that is how I spend my time. Some of the documentaries I had already seen, but I have noted some I need to watch. My group project and documentary relate to gun violence in schools, and last week, there was another school shooting at Apalachee High School in Georgia.

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Reflection - Introductions and Assessing Prior Knowledge

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Reflection - Introductions and Assessing Prior Knowledge

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Reading everyone's introductions and having so much in common with my classmates was great. I realized I know more about trauma than I initially thought I did. It has been a while since I earned my master's, but many of the theories, disorders, and concepts are still fresh in my mind.

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Texas State University established Texas School Safety Center, offering a variety of training programs for teachers, counselors, administration, and school resource officers. These training programs can be used as continuing education hours/units for school counselors and LPCs.

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This has been a reference, I have had bookmarked that I have tried to become more familiar with and have used as I prepare for the NCE.

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(a) A licensee must not make any false, misleading, deceptive, fraudulent or exaggerated claim or statement about the licensee's services, including, but not limited to: (1) the effectiveness of services; (2) the licensee's qualifications, capabilities, background, training, experience, education, professional affiliations, fees, products, or publications; or (3) the practice or field of counseling. (b) A licensee must not make any false, misleading, deceptive, fraudulent or exaggerated claim or statement about the services of a mental health organization or agency, including, but not limited to, the effectiveness of services, qualifications, or products. (c) A licensee must discourage a client from holding exaggerated or false ideas about the licensee's professional services, including, but not limited to, the effectiveness of the services, practice, qualifications, associations, or activities. If a licensee learns of exaggerated or false ideas held by a client or other person, the licensee must take immediate and reasonable action to correct the ideas held. (d) A licensee must make reasonable efforts to discourage others whom the licensee does not control from making misrepresentations; exaggerated or false claims; or false, deceptive, or fraudulent statements about the licensee's practice, services, qualifications, associations, or activities. If a licensee learns of a misrepresentation; exaggerated or false claim; or false, deceptive, or fraudulent statement made by another, the licensee must take reasonable action to correct the statement. (e) Regardless of setting, a licensee must provide counseling only in the context of a professional relationship. Prior to providing services, a licensee must obtain from an individual a signed informed consent, signed written receipt of information, or in the case of involuntary treatment a copy of the appropriate court order, including the following: (1) fees and arrangements for payment; (2) counseling purposes, goals, and techniques; (3) any restrictions placed on the license by the Council; (4) the limits on confidentiality; (5) any intent of the licensee to use another individual to provide counseling treatment intervention to the client; (6) supervision of the licensee by another licensed health care professional including the name, address, contact information and qualifications of the supervisor; (7) the name, address and telephone number of the Council for the purpose of reporting violations of the Act or this chapter; and (8) the established plan for the custody and control of the client's mental health records in the event of the licensee's death or incapacity, or the termination of the licensee's counseling practice. (f) A licensee must inform the client in writing of any changes to the items in subsection (e) of this section, prior to initiating the change. (g) Technological means of communication may be used to facilitate the therapeutic counseling process. (h) In accordance with §503.401(a)(4) of the Act, a licensee must not intentionally or knowingly offer to pay or agree to accept any remuneration directly or indirectly, overtly or covertly, in cash or in kind, to or from any person, firm, association of persons, partnership, corporation, or entity for securing or soliciting clients or patronage. (i) A licensee employed or under contract with a chemical dependency facility or a mental health facility must comply with the requirements in the Texas Health and Safety Code, §164.006, relating to soliciting and contracting with certain referral sources. Compliance with the Treatment Facilities Marketing Practices Act, Texas Health and Safety Code Chapter 164, will not be considered as a violation of state law relating to illegal remuneration. (j) A licensee must not engage in activities for the licensee's personal gain at the expense of a client. (k) A licensee may promote the licensee's personal or business activities to a client if such activities, services or products are to facilitate the counseling process or help achieve the client's counseling goals. Prior to engaging in any such activities, services or product sales with the client, the licensee must first inform the client of the licensee's personal and/or business interest therein. A licensee must not exert undue influence in promoting such activities, services or products. (l) A licensee must set and maintain professional boundaries. (m) Except as provided by this subchapter, non-therapeutic relationships with clients are prohibited. (1) A non-therapeutic relationship is any non-counseling activity initiated by either the licensee or client that results in a relationship unrelated to therapy. (2) A licensee may not engage in a non-therapeutic relationship with a client if the relationship begins less than two (2) years after the end of the counseling relationship; the non-therapeutic relationship must be consensual, not the result of exploitation by the licensee, and is not detrimental to the client. (3) A licensee may not engage in sexual contact with a client if the contact begins less than five (5) years after the end of the counseling relationship; the non-therapeutic relationship must be consensual, not the result of exploitation by the licensee, and is not detrimental to the client. (4) For purposes of paragraphs (2) and (3) of this subsection, the licensee must be able to demonstrate there has been no exploitation and the non-therapeutic relationship is not detrimental to the client in light of all relevant factors, including, but not limited to, the factors set forth in §681.42(b)(4)(A) - (G) of this title (relating to Sexual Misconduct). (5) The licensee must not provide counseling services to previous or current: (A) family members; (B) personal friends; (C) educational associates; or (D) business associates. (6) The licensee must not give or accept a gift from a client or a relative of a client valued at more than $50, borrow or lend money or items of value to clients or relatives of clients, or accept payment in the form of goods or services rendered by a client or relative of a client. (7) The licensee must not enter into a non-professional relationship with a client's family member or any person having a personal or professional relationship with a client if the licensee knows or reasonably should have known such a relationship could be detrimental to the client. (n) The licensee must not knowingly offer or provide counseling to an individual concurrently receiving counseling treatment intervention from another mental health services provider except with that provider's knowledge. If a licensee learns of such concurrent therapy, the licensee must request release from the client to inform the other professional and strive to establish positive and collaborative professional relationships. (o) A licensee may take reasonable action to inform medical or law enforcement personnel if the licensee determines there is a probability of imminent physical injury by the client to the client or others, or there is a probability of immediate mental or emotional injury to the client. (p) The licensee must take reasonable precautions to protect clients from physical or emotional harm resulting from interaction: (1) within a group; or (2) individual counseling. (q) For each client, a licensee must keep accurate records of: (1) signed informed consent, signed written receipt of information, or, in the case of involuntary treatment, a copy of the appropriate court order (2) intake assessment; (3) dates of counseling treatment intervention; (4) principal treatment methods; (5) progress notes; (6) treatment plan; and (7) billing information. (r) In the absence of applicable state and federal laws, rules or regulations, records held by a licensee must be kept for a minimum of seven (7) years from the date of termination of services with the client, or five (5) years after the client reaches the age of majority, whichever is greater. (s) Records created by licensees during the scope of their employment by agencies or institutions that maintain client records are not required to comply with (q) and (r) of this section. (t) Billing Requirements. (1) A licensee must bill clients or third parties for only those services actually rendered or as agreed to by mutual understanding at the beginning of services or as later modified by mutual written agreement. (2) Relationships between a licensee and any other person used by the licensee to provide services to a client must be so reflected on billing documents. (3) Pursuant to Texas Health and Safety Code, Chapter 611, on the written request of a client, a client's guardian, or a client's parent (sole managing, joint managing or possessory conservator) if the client is a minor, a licensee must provide, in plain language, a written explanation of the types of treatment and charges for counseling treatment intervention previously made on a bill or statement for the client. This requirement applies even if the charges are to be paid by a third party. (4) A licensee may not knowingly overcharge a client. (5) With the exception of an unkept appointment, a licensee may not submit to a client or a third party payor a bill for counseling treatment intervention the licensee knows or should know is improper, unreasonable, or unnecessary. (u) A licensee must comply with all requirements of Texas Health and Safety Code Chapters 611 and 181 concerning the release of mental health records and confidential information. (v) Prior to the commencement of counseling services to a minor client who is named in a custody agreement or court order, a licensee must obtain and review a current copy of the custody agreement or court order, as well as any applicable part of the divorce decree. A licensee must maintain these documents in the client's record and abide by the documents at all times. When federal or state statutes provide an exemption to secure consent of a parent or guardian prior to providing services to a minor, a licensee must follow the protocol set forth in such federal or state statutes. (w) A licensee must terminate a professional counseling relationship when it is reasonably clear the client is not benefiting from the relationship. (x) Upon termination of a relationship if professional counseling is still necessary, the licensee must take reasonable steps to facilitate the transfer to appropriate care. (y) A licensee must not evaluate any individual's mental, emotional, or behavioral condition unless the licensee has personally interviewed the individual or the licensee discloses in the evaluation the licensee has not personally interviewed the individual. (z) A licensee must not knowingly overtreat a client. (aa) A licensee must not aid or abet the unlicensed practice of professional counseling by a person required to be licensed under the Act. (bb) A licensee must report to the Council knowledge of any unlicensed practice of counseling. (cc) A licensee or an applicant must not participate in the falsification of any materials submitted to the Council. (dd) A licensee must not provide services while impaired by a physical, mental, or medical condition or by medication, drugs or alcohol

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(a) A licensee must not make any false, misleading, deceptive, fraudulent or exaggerated claim or statement about the licensee's services, including, but not limited to: (1) the effectiveness of services; (2) the licensee's qualifications, capabilities, background, training, experience, education, professional affiliations, fees, products, or publications; or (3) the practice or field of counseling.

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Reflection - Reference Guide for Mental Health Disorders

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Reflection - Reference Guide for Mental Health Disorders

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Although the reference guide was time-consuming, it provided a good review of some terms/disorders I knew and a learning experience for those I did not know much about. I have bookmarked it so I can easily refer to it, and it has become part of my toolbox as I prepare for the NCE.

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Psychological First Aid Continuing Education 

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Psychological First Aid Continuing Education 

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Psychological First Aid (PFA) Online_Certificate

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American Counseling Association - Code of Ethics

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American Counseling Association - Code of Ethics

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The update to the ACA Code of Ethics includes new or expanded guidelines on the use social media with clients; distance counseling; confidentiality; multiculturalism and diversity; the use of technology; record keeping; diagnosis; end-of life care; and preventing the imposition of counselor personal values.

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Reference Guide for Mental Health Disorders TEMPLATE

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What is your opinion on the ACE studies? Do you consider it to be a good representative of the population? Why or why not?

I believe the ACE studies are a good representation of the population because I have seen it firsthand. When I was teaching, I worked with teenage parents and many of them shared stories with me, they were trying break the vicious cycle of pregnancy, poverty, and neglect. According to the CDC, 61% of adults had at least one ACE and 16% had 4 or more types of ACEs.

Identify and explain, in your own words, three types (categories) of trauma you found most interesting in the course readings. Provide an example for each type of trauma.

Childhood traumatic grief has been interesting to me since the school shooting at Robb Elementary in Uvalde, Texas. I live about 53 miles from Uvalde and lived in Uvalde while attending Southwest Texas Junior College in 2002. Survivors may be afraid to sleep alone at night because of nightmares about a shooting that they witnessed.

Post-traumatic stress disorder (PTSD) is fascinating to me because my husband served during Iraqi Freedom and Operation Enduring Freedom in combat search and rescue (CSAR), with one deployment to Afghanistan and one to Iraq. However, military members are not the only ones who suffer from PTSD. Many survivors of gun violence suffer from gun violence as well.

Burnout is physical, mental, or emotional strength or motivation exhaustion, usually due to prolonged involvement in a demanding situation. It gradually builds to a breaking point from stress and frustration. Burnout appears from all work-related stressors, such as paperwork and bureaucratic issues.

Why do you think children are especially susceptible to trauma?

I believe children are especially susceptible to trauma because of their innocence. Since birth, children rely on their parents for their basic needs. Erick’s first stage of psychosocial development is trust vs. mistrust. Therefore, when a child’s safety is jeopardized, or a child loses trust, a child is susceptible to trauma. Children may also feel disadvantaged when confronted by a threat because of their size. If a school shooter enters an elementary, the only ones who can protect the children are the adults, whereas if he enters a high school, he will be met with more young adults his/her size.

Identify at least two grief informed or trauma informed strategies that can be used to help a student/client.

Cognitive behavioral therapy (CBT) is a highly effective strategy to use with children. Unlike traditional talk therapies, CBT involves hands-on activities, games, and role-playing techniques to engage children to make therapy more enjoyable. By utilizing CBT techniques, therapists can help children develop the tools they need to overcome challenges and improve theiroverall functioning.

Childhood traumatic grief (CTG) is a condition in which a child or adolescent has lost a loved one in circumstances that are objectively or subjectively traumatic (p.819). Children with CTG may experience avoidance and numbing, including sleep disturbance, irritability, anger, decreased concentration, or hypervigilance. Children who experience traumatic grief may blame themselves for the death of a loved one and experience survival guilt.

Do you think it should be mandated that all health professionals receive education about the effects of trauma and how to assess for trauma?

I think all health professionals should receive education about the effects of trauma and how to assess for trauma. Most employers require training when you get hired and every year after that on topics such as sexual harassment, food allergies, and CPR/AED. Trauma education can equip healthcare professionals to implement preventive measures and promote intervention strategies if needed.

From your professional perspective, why is it important to have a basic knowledge and understanding of the effects of grief and trauma? (How is this important in your future role?)

As a counselor, it is essential to possess a comprehensive knowledge and understanding of the effects of grief and trauma. These experiences can have profound impacts on the mental, emotional, and physical well-being of individuals, and understanding them is crucial for providing effective support and guidance. Having a comprehensive knowledge and understanding of the effects of grief and trauma is crucial. It allows counselors to provide adequate support and guidance to clients who are grieving or have experienced traumatic events. By understanding the complexities of grief and trauma, counselors can help clients navigate and heal from these difficult experiences, ultimately promoting their overall well-being.

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Reflection - Psychological First Aid (PFA) Online Course

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Reflection - Psychological First Aid (PFA) Online Course

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I enjoyed completing the five-hour interactive course. This online course was new to me, and I enjoyed the videos and activities. The PFA is a tool that I will renew once it expires because it puts the participant in the role of a provider in a post-disaster scene, but it is also good for experienced therapists who need a refresher as well.

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The crisis intervention model was the first time I had seen or completed a crisis model. The level of impact crises has on an individual can vary greatly, as a therapist, it is important to be knowledgeable on prevention and threat assessment strategies and be prepared to carry out responsive services in crisis situations.

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Local Emergency & Non-Emergency Support Services

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Local Emergency & Non-Emergency Support Services

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Non-Emergency Police Department (830) 931-2222

Non -Emergency Fire & EMS Department (830) 931-0300

Local AA - Braden Keller Community Center (830) 423-6363

Alsace Urgent Care and Family Practice (830) 538-3550

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Reflection - Crisis Prevention and Threat Assessment

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Reflection - Crisis Prevention and Threat Assessment

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I think my group members and I did a good job of working together. It was a subject we were all passionate about. I had not worked with a group in distance learning before, but we were able to come together and complete it.

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https://docs.google.com/document/d/1e8REv_7jxoWZYadPS0QIn0lXf8MMD9PR5VYsPgnYDPk/edit?usp=sharing