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My name is Heidi Cardona-Tejera. I am currently in the Mental Health and Well Counseling Master's program. One of my personal goals is to accomplish my master's degree, and my professional goal is to be able to work with veterans and service members once I obtain my license. I would like to further understand how different disorders can affect our daily functions, as well as how to go about dealing with the symptoms that come with each disorder.

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Legal requirements for Licensed Professional Counselor and Ethical Code  

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Legal requirements for Licensed Professional Counselor and Ethical Code  

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Texas LPC Requirements, Counselor Licensing TX, Certification (counselor-education.com)

In order to obtain a license in counseling in the State of Texas, there are some prerequisites that must be done before taking the exam. Prerequisites include such as a minimum number of hours working directly with clients and a 60-semester hour master's degree in counseling or related field.

Code Of Ethics:
ACA 2014 Code of Ethics (counseling.org)

The ACA code of ethics pertains to the confidentiality, privacy and overall relationship one must have with their clients.

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Texas LPC Requirements, Counselor Licensing TX, Certification

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Visit Counselor-Education.com to learn about the education, certification, and licensure needed to practice professional counseling in Texas.

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Introductions and Assessing Prior Knowledge

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Introductions and Assessing Prior Knowledge

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From the information provided in the module, what stood out to me was the statistic of individuals (32.1%) that engage in substance abuse have some sort of mental disorder. This statistic propelled me to further research substance abuse and mental health with veterans and service members. Psychotherapist Lorraine Slivetz interviewed several veterans that experienced traumatic events during their time in the military. A common theme that was across the board, no matter which branch of the military, was the sense of guilt that each of them felt. This sense of guilt drove most of them to consume some type of drug, let it be pills, alcohol, etc. Anything to suppress the feeling of hopelessness.
When asked why not speak to a professional therapist, many were hesitant to trust that any information that was said would not stay confidential. Slivets explains how most of the veterans had been exposed to a world that was no longer safe, finding it difficult for them to trust themselves let alone anyone else. Instead, how most of them lived was through dissociating. Through dissociating, the veterans try to push back any emotions or feelings associated with their traumatic experiences. Which in the long run, does further damage to both their psychological and physical health.

Resources for Substance Abuse:
Alcoholics Anonymous:  https://www.aa.org/

Narcotics Anonymous:   https://na.org/

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Reference Guide for Mental Health Disorders

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Reference Guide for Mental Health Disorders

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Based on the statistics found in 2022 by the center for disease control, 27.3% of Americans over the age of 18 have symptoms of anxiety (Julia, 2023).  Anxiety is the rational or irrational fear that causes an individual to experience emotional or physical reactions to occur. There are different types of anxiety such as generalized anxiety disorder, phobic disorder, and post-traumatic stress disorder to name a few.  Each disorder experiences different symptoms and is diagnosed based on specific requirements that an individual possesses. We will focus on generalized anxiety disorder, which is when an individual does not have a specific event or scenario in which they are stressed but instead experiences stress about a multitude of scenarios (Admin, 2020). Examples would be their financial state, the well-being of a family member, and so on. Some symptoms that the individual may experience are elevated heart rate, sweaty palms, and/or trouble sleeping.

Dr. Will Meek lists some healthy mechanisms to cope with generalized anxiety disorder. He discusses three strategies in which an individual can help cope with their symptoms. First are social coping strategies. This consists of getting involved in activities that require social interaction or speaking to someone. Dr. Meek states that getting involved socially gives individuals a sense of belonging. Second, are emotional coping strategies.  Some examples are learning one’s triggers and practicing mindfulness. If one is aware of what triggers them, then they can mentally prepare themselves for how they will react to the situation, place, or thing. Practicing mindfulness allows the individual to take a step back, take a deep breath and focus on the present. The third is physical coping strategies. This consists of exercising, eating well, and getting enough sleep. Exercise allows individuals to release tension and food also affects our overall mood. Sleep allows our minds to relax from any pressing matter that we might be facing (Meek, 2021).

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When deciding in pursuing a career in mental health counseling, it is important to understand the secondhand trauma that many counselors face. Vicarious trauma is when a professional or even volunteer is surrounded by the trauma that their clients face and is transmitted to them (Oklahoma Department of Mental Health and Substance Abuse Services, 2023). It is important for counselors to prioritize their own self-care and seek help to be effective for the clients. What can occur as well, is something called Compassion Fatigue. Compassion fatigue or what others argue is empathy fatigue, is “the emotional residue or strain of exposure to working with those suffering from consequences of traumatic events” (Webmaster, 2022).  This is a big factor in why many counselors decide to leave their professional field. Individuals with little to no support system, an overload of trauma daily, or those with their own personal traumas are at higher risk of developing compassion fatigue.

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According to The National Child Traumatic Stress Network, psychological first aid is an evidence-informed approach that helps individuals after a disaster or act of terrorism (5). This immediate first aid plays an important role in addressing any concerns such as medical assistance, essential resources, and/ or overall feeling of distress that individuals may need after experiencing a disaster. There are eight core actions discussed in psychological first aid training that allows individuals to best asset victims. They are contact and engagement, safety and comfort, stabilization, information gathering, practical assistance, connection with social supports, information on coping, and lastly linkage with collaborative services (National Child Traumatic Stress Network, 19). These eight core actions will not necessarily be applied to each victim. Although a group of individuals may have experienced the same disaster, does not mean that they all require the same type of assistance. It is important to gather as much pertinent information to correctly assist everyone.

When referring to individuals, there is a certain method one must follow to successfully assist with their needs.  The counselor should summarize their discussion with the individual to address any needs and concerns. Verify that what was discussed was accurate. Then describe the option for a referral. Explain to the individual what the purpose of the referral is and what will be the outcome if they decide to continue with the referral. When referring, take account of cultural or religious beliefs that the individual may have, to best assist them in their needs and concerns. Ask about what they think about the referral and if they agree, give a written referral, or assist in making an appointment for them (National Child Traumatic Stress Network, 94). The National Child Traumatic Stress Network provides providers with a worksheet that describes the symptoms and needs to assess victims after the disaster.

Link to Provider Worksheet:

file:///C:/Users/maran/Downloads/mental%20health%20counseling/Provider%20Worksheet.pdf

Resources:

If looking for shelter after a disaster text SHELTER(and your zip code) to 4FEMA (43362).

If searching for a lost child call 1-800-THE-LOST (1-800-843-5678).

Get help locating a missing person by using the National Missing and Unidentified Persons System (NamUS). The program can help with printing missing person posters, getting free forensic services like DNA analysis, and more.

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The National Library of Medicine defines domestic violence as including “economic, physical, sexual, emotional, and psychological abuse of children, adults, or elders.” (2022).  When determining the level of risk there are three levels low, moderate, and high. Low-risk behavior consists of a threat that is not likely to be executed. In cases where it is low risk, the person is more likely to feel remorse after the incident and even apologize afterward. Moderate-risk behavior is when the threat is plausible but does not have any specific details. In these cases, it is advised to go to counseling and receive educational resources about domestic violence. High-risk behaviors are when a threat is specific in detail and/or targets and views violence as the only means to solving issues. In these cases, calling law enforcement immediately is of the utmost importance. After, mental health services may be contacted to assess and help victims through any traumatic events that may have occurred.

As a counselor, it is important to know one’s limitations in a patient’s care. In the 2014 ACA Code of Ethics C.2.a, goes on about the boundaries of competence. It states that counselors should counsel “based on their education, training, supervised experience, state, and national professional credentials, and appropriate professional experience” (8). There are numerous outside programs/organizations and resources that can further assist clients that have faced or are facing domestic violence. Child welfare services investigate any report of abuse while law enforcement responds to any report of abuse. There are domestic violence support groups/ organizations that provide shelter, food, and resources to victims and children.

Resources for assessing for domestic violence:
https://chestnut.app.box.com/v/GAIN-SS-Materials/file/63780170337

https://www.dangerassessment.org/uploads/DA_NewScoring_2019.pdf

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There are three elements that make up the ABC Model of Crisis Intervention. The first step in facilitating the counseling process is basic attending behavior. This allows the client to trust that the counselor is listening to what they are saying. It creates trust between the client and the counselor as well as allowing for the session to flow seamlessly. The second step is what Art for Libraries states as identification and therapeutic intervention (2017). This is where the counselor begins to ask questions to further understand what the client is feeling. Open-ended questions allow the client to dive deeper into detail and allow them to further dwell on how they are feeling. Whereas closed-ended questions allow for direct and concise answers from the client. From there the counselor can assess what the client needs and how to go about the client’s continuing care. The last step in the crisis intervention is a coping mechanism. The counselor educates the client on different methods of coping. This allows the client to feel some sort of security upon leaving the safety of the counseling session.

Resource:
Website lists some coping methods when dealing with crisis and or trauma.
Tips for Coping with Stress|Publications|Violence Prevention|Injury Center|CDC

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Silvetz, L. (2022, May). Substance Abuse: A Crisis of Hope. The Exceptional Parent, 52(5), 58+. https://link.gale.com/apps/doc/A708521732/PPPC?u=cfsc&sid=bookmark-PPPC&xid=0830b30e

Julia, N. (2023, January 5). Anxiety Statistics & Facts (2023). CFAH. https://cfah.org/anxiety-statistics/

Admin, F. (2020, September 24). Generalized Anxiety. Mental Health Foundation. https://mentalhealthfoundation.org/health-conditions/anxiety-disorders/generalized-anxiety/?gclid=EAIaIQobChMI8J-_yPbt_AIVD73ICh09FABREAAYASAAEgKK2vD_BwE

Meek, W. (2021, January 5). How to Live Well With Generalized Anxiety Disorder. Verywell Mind. https://www.verywellmind.com/how-to-cope-with-generalized-anxiety-disorder-1393164

Oklahoma Department of Mental Health and Substance Abuse Services. (2023). TRAUMA CATEGORIES: THERE ARE DIFFERENT TYPES OF TRAUMA. https://oklahoma.gov/content/dam/ok/en/odmhsas/documents/a0001/hh-oksoc-trauma-categories-types-of-trauma.pdf

Webmaster, C. (2022, March 2). Grappling with compassion fatigue. Counseling Today. https://ct.counseling.org/2020/08/grappling-with-compassion-fatigue/

National Child Traumatic Stress Network. (n.d.). Psychological First Aid: Field Operations Guide 2nd Edition. Retrieved February 26, 2023, from https://www.ncptsd.va.gov

Huecker, M. R. (2022b, September 9). Domestic Violence. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499891/#:~:text=Domestic%20and%20family%20violence%20includes%20economic%2C%20physical%2C%20sexual%2C,and%20family%20violence%20can%20be%20difficult%20to%20identify.

American Counseling Association. (2014). 2014 ACA Code of Ethics. https://www.counseling.org/docs/default-source/ethics/2014-code-of-ethics.pdf?sfvrsn=2d58522c_4

ABC Model of Crisis Intervention. (2017). Actforlibraries.org. http://www.actforlibraries.org/abc-model-of-crisis-intervention/#:~:text=ABC%20Model%201%20A%3A%20Basic%20Attending%20Skills%20The,skills%20and%20support%20mechanisms%20for%20the%20client.%20