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My name is Lara Rowe. I am in the last semester of the Online LPC Bridge program with hopes professional goal of becoming a therapist within my current school district's counseling clinic. A personal goal of mine is to be a mental health advocate on social media by creating mental health multimedia and graphics through Canva.

One thing I would like to get out of this course is to learn what resources and guides I can use to better recognize and identify mental health disorders.

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Assessing prior knowledge during unit one was a great way to start this course. Assessing prior knowledge is important in identifying an individual's strengths and weaknesses. As a current school counselor, I have prior knowledge on several topics and issues in the counseling field, but reflecting on my prior knowledge made me stop and realize what my weaknesses are, which pushed me towards taking my weaknesses and making them strengths by the end of this course. One piece that I took from this unit was my knowledge about Adverse Childhood Experiences (ACEs). This assessment is very beneficial for not only children but also adults as it provides a good measurement of one's traumatic experiences throughout life.

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Reference Guide for Mental Health Disorders 

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Reference Guide for Mental Health Disorders 

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Section two focused on creating a reference guide for mental health disorders. As a future LPC, I feel this assignment was a great way to get ahead on providing hands-on resources for myself to that I can refer to in the future when working with clients and students. I was familiar with several of the disorders that were covered, but there were some that I did not have any knowledge about, which will also be helpful in the future. My favorite part of the assignment was researching interventions that could potentially be put into place for each disorder. This I feel was very beneficial as I know have knowledge of what steps to take to put interventions in place for my clients and students in the future as an LPC.

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Discussing what trauma in this portion of the course was very interesting. Part of the assignment requirements for this week was a class discussion board. Reading different classmates posts and what their take on trauma has helped me continue to keep an open mind on this topic as every individual is different, especially regarding their trauma and experiences in life. Part of this assignment was to independently research trauma informed and grief informed practices. Throughout the resources in blackboard, I came across the Texas School Mental Health website which had tons of great information related to trauma informed practices that can be implemented in schools. As a current school counselor, I was never informed of this website. I love that I am now familiar with this website so that I can refer back to it if needed.

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ASCA Ethical Standards for School Counselors 

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ASCA Ethical Standards for School Counselors 

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Texas Administrative Code for Professional Counselors 

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Texas Administrative Code for Professional Counselors 

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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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American Counseling Association Code of Ethics 

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American Counseling Association Code of Ethics 

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Psychological First Aid (PFA) Certificate

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Psychological First Aid (PFA) Certificate

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Complete the online training to obtain the Psychological First Aid Certificate has so far, been my favorite assignment. The purpose of Psychological First Aid is to assess an individual's needs and resources who has experienced a crisis or natural disaster event. I also loved that the training not only provided how to take care of an individual's needs and resources, but it also featured a section on how to take care of an aid's well-being so that they are also taking care of themselves. I can see myself using this as a current school counselor, as well as my future role as a licensed professional Counselor.

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Crisis Prevention and Threat Assessment Presentation

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Crisis Prevention and Threat Assessment Presentation

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School Violence is a very huge topic in Texas right now, which was the reason I chose this topic for the group project. In my opinion, there are so many things we can do better to protect our schools and the students we serve, so I wanted to learn about the policies and laws Texas currently has in place for school districts. I am currently a school counselor and this assignment encouraged me to take some of the ideas we created in this presentation and bring them to my campus admin to better our system for threat assessment and interventions on campus. From our group dealing with adversity when a group member dropped the class, and Wendy and I having to take on this project together without a third person, it was stressful. This assignment was the toughest throughout this course, but the most helpful and insightful to learn about.

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The ABC Crisis Model assignment I feel was the most beneficial in the entire course. I truly felt like the objectives, purpose, and assignment task made it seem like a real-world situation. At first, I was a tad bit intimidated by the "crisis" word in the assignment as I felt I was not truly prepared and ready for the assignment, but it truly prepared me and taught me about crises and how to manage a client or student in a crisis. I loved that the ABC model is an acronym that I can easily remember and quickly reference in the future. The resources were also very helpful and the information was easy to retain.

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Websites with resources for mental health supports for Texas schools

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Skip to content

Research shows that students who are taught skills for managing emotions, establishing and maintaining positive relationships, and responsible decision-making have better academic performance, and students whose mental health needs are met with effective school and community supports are more likely to stay in school, graduate, and have positive life outcomes. The Texas School Mental Health website strives to provide districts and campuses with the resources and tools needed to develop a comprehensive school mental health system.

Find out about upcoming events related to student mental health.

Find tools and resources to help build school mental health systems.

Participate in online training on school mental health.

Texas School Mental Health is a Partnership Between:

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The Texas School Mental Health website strives to provide districts and campuses with the resources and tools needed to develop a comprehensive school mental health system.

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Dustin McDonald ABC Model of Crisis Intervention

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Dustin McDonald ABC Model of Crisis Intervention

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A simple model of crisis intervention is the ABC Model. A number of crisis intervention models use this same three step process. Essentially, it involves establishing a relationship (A), understanding the problem (B), and taking action (C).

This model uses Achieving Rapport, Boiling down the Problem and Contracting for Action. You can see a video of this post here.

Brief History of the ABC Model

In the 1980s, the Alberta Model was designed by a team of suicidologists who were responding to a spike in the suicide rate caused by a bottoming out in the economy. In addition to developing the CPR Risk Assessment they also developed the ABC Model of Crisis Intervention dictated below.

Achieving rapport describes the emotional and physical aspects used to establish a connection with the suicidal person you're working with. This involved physical safety, emotional connection and good rapport.

Physical ways that you can establish rapport include:

Ensuring there is no obstacles between yourself and the suicidal person (e.g. chairs, tables); rapport is improved when there is nothing between you

Solid eye contact; when you look at someone rather than looking away it establishes that you're able to talk openly about suicide

Orienting your body towards someone; this is a subconscious cue that you think positively of that person

Keeping your arms uncrossed and legs open; Crossed-arms and legs pressed together are signs of anxiety or dislike

Emotionally, you can establish safety and comfort through the following:

Validate what the person is saying.

Use empathy statements, which are statements that highlight an emotion while responding. For instance, if someone says that they've had a fight with their wife, and that it keeps happening you might say "It sounds like you're feeling really frustrated." This captures the emotion underlying the experience and is an important part of helping someone feel understood.

Use a calm, even voice-tone - don't speak too quickly and don't cut off the other person

Avoid judgement such as "why" questions. Instead ask "How come?"

When rapport is established, the suicidal person will be comfortable and able to express themselves.

Boiling Down the Problem

The next step in the ABC Model of Crisis Intervention is boiling down the problem. This involves a careful mix of open and closed questions to make sure that you fully understand what is making the person suicidal. You can start by asking them what they think is the source of their suicidal pain.

Suicidal thoughts are often the result of events that overwhelm a person's personal coping methods. These methods can be different for every person and so it is unwise to assume that something isn't an issue for the suicidal person unless you've spoken to them about it.

For example, a student who has never failed a test before could become suicidal over a perceived threat to their Ivy League college hopes based on failing a test, while another student may have had many ups and downs and therefore has learned to cope with this loss.

Contracting for Action

When you feel that you have a good understanding of the suicidal person's problems, it's important to work with them to implement some long-term changes. If you think back to the CPR Model, we need to assess whether the person is Low Risk, Medium Risk or High Risk.

Contracting for action means developing plans with the client that they can do within the next 24 hours (or another short period) in order to ensure their safety.

When the suicidal person is low risk, your role should be to help with any practical referrals and building up their support network. For instance, someone who is having financial issues, referral to debt counselling would be helpful. Exploring the person's resources to see if there are those they can rely on who they may not be seeing will also be helpful.

Emotional support is most important at this stage so that the person feels comfortable expressing themselves without feeling judged or stigmatized.

When the suicidal person is medium risk, it's important to work collaboratively. Getting the suicidal person to agree to more comprehensive support will be easier if they know that you care. Taking steps to reduce risk by encouraging the person to remove access to suicide methods is also important.

Ensure that you follow up with the person to make certain that they've taken advantage of the referrals. By checking in with them frequently and continuing to assess their suicide risk (even on a simple 1-10 scale) will help you tell if their suicidal risk is being reduced.

When the suicidal person is high risk, it's important to take immediate steps to reduce that risk. You should be directive with the person, taking immediate steps to guarantee their safety. This will involve checking for suicide attempts in progress, referrals that you make with the suicidal person and possible hospitalization if they don't think they can remain safe throughout the night.

In order to assess for immediate risk, you should ask questions like, "Are you in danger?", "Have you taken anything tonight?", "Have you done anything tonight to hurt or kill yourself?" If the person admits that yes, they have, than it's important to get details and make the call to 911 if necessary.

If not, you should explore what they can do to ensure their safety. This may involve calling a crisis line if they don't feel safe, calling 911 or going to a hospital emergency room or staying with you (or someone else they can rely on) to keep them safe.

Further Reading

The book Crisis Intervention Strategies, 7th Edition provides a review of the ABC Model of Crisis Intervention and other basic and advanced crisis intervention skills. I also provide a number of crisis intervention articles in this area.

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ABC Model of Crisis Intervention - Dustin K MacDonald

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Updated for 2018! See below. A simple model of crisis intervention is the ABC Model. A number of crisis intervention models use this same three step process. Essentially, it involves establishing a relationship (A), understanding the problem (B), and taking action (C). This model uses Achieving Rapport, Boiling down the Problem and Contracting for Action....

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Local Emergency Numbers:

Suicide & Crisis Center of North Texas: 214-828-1000

ADAPT Community Solutions and Mobile Crisis Team Services: 866-260-8000

Parkland Psychiatry Emergency: 214-590-8761

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Scenario: When students need outside therapy, you always refer them to one particular counselor in the community, who came to your attention when a parent raved about the help he provided her incorrigible teenager. You routinely give out just his contact information for students with similar problems. You have given little thought to the fact that he was not on the district's vetted list for outside therapists. Are there any legal and ethical issues with the way you make referrals?

In Smith vs. The School Board of Orange County, Florida (1994), the parents of 14-year-old K.W. sued the school district because a school counselor was required to give a list of multiple district-approved resources and allegedly gave only one resource, Ron Markham. Markham ran an outpatient treatment center licensed by the Department of Health and Rehabilitative Services, but his name was not on the school district's approved list nor was he licensed for in-patient care. K.W's mother immediately had misgivings when Markham insisted he be given 24-hour custody of her child and sought more information from a school employee, who said if the school counselor thought Markham was "okay" then he must be "okay." Unknown to K.W.'s mother and apparently to the school counselor, Markham "placed" K.W. in his own home, and for two-and-a-half months sexually abused her.

The Florida Court of Appeals dismissed the complaint, but a dissenting justice issued the opinion that the case should have been allowed to proceed to a jury trial. "The foreseeability of K.W.'s injury - sexual battery by Markham - is a jury issue. In my view, the school had at least a threshold duty to make a referral only to 'approved' programs. ... Further, K.W.'s mother's specific inquiry about Markham, after meeting him, should also have triggered a follow-up by the school counselor, which was not done in this case."

The Smith case underscores these principles:

It is best practice to always gives multiple resources and never just one resource.

If a district provides a list of resources, it should be basic information that the resource is currently licensed or certified by the state licensing board. Other basic information might be provided such as whether the resource uses a sliding-fee scale so parents can make an informed financial decision.

When districts don't provide a vetted list and school counselors have to develop a list on their own, it should include a disclaimer stressing that the list isn't exhaustive nor is it an endorsement.

Schools need to advise parents to check references and current licensure themselves and to discontinue the relationship if they feel there is something troubling or ineffective about the counseling or counselor.

Arlington Public Schools (Va.) provides a model disclaimer for their vetted list of resources: "This list is of known providers of a particular service. The providers on the list are from a variety of sources. The list is being provided as a courtesy, for information only, and the user should understand that no assurances or guarantees regarding the providers on the list are being made by providing this list. Arlington Public Schools neither endorses, approves, nor recommends any specific provider listed below. This list is not inclusive of all community agencies, services or organizations that provide the particular service, and the omission of an agency, service or organization from this list does not imply disapproval. It is the responsibility of the user of this list to determine whether any of the content is of value to them and whether or not the agency, service or organization meets their specific needs."
ASCA's Ethical Standards for School Counselors drive home the point: "School counselors provide a list of resources for outside agencies and resources in their community to student(s) and parents/ guardians when students need or request additional support. School counselors provide multiple referral options or the district's vetted list and are careful not to indicate an endorsement or preference for one counselor or practice. School counselors encourage parents to interview outside professionals to make a personal decision regarding the best source of assistance for their student."

You are a school counselor in a rural community with very little community-based counseling and social services support. In addition to being the school counselor at the only K-8 school, you and your wife are two of the few licensed counselors in the community. Can you provide outside counseling to your own students and/or refer them to your wife?

School counselors need to avoid dual relationships such as this. If it's not possible to do so, you must minimize the risk of harming your student/school counselor relationship. It is not a valid argument to say you must provide the service or the student will not receive help. It is a conflict of interest to serve as your students' outside counselor or to refer them to your spouse. It is a serious problem when the community offers few options for counseling, but this doesn't mean a dual relationship is appropriate. According to the ASCA Ethical Standards for School Counselors, section A.6.h. Appropriate Referrals and Advocacy, "Ensure there is not a conflict of interest in providing referral resources. School counselors do not refer or accept a referral to counsel a student from their school if they also work in a private counseling practice."

Carolyn Stone, Ed.D., is a professor at the University of North Florida and chair of ASCA's Ethics Committee. She can be reached at cstone@unf.edu.

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Legal and Ethical Issues in Referrals to Mental Health Providers

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Scenario: When students need outside therapy, you always refer them to one particular counselor in the community, who came to your attention when a parent raved about the help he provided her incorrigible teenager.

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As a black woman in America, I am all too familiar with ensuring I am being culturally competent when implementing responsive services. I have also been a high school counselor at a large 6A high school in an urban area for five years, where diversity is very prevalent. I have learned so much and have adapted many times to ensure cultural competency when implementing responsive services as I always want my students and future clients to know I have their best interests at heart not only with their mental health but in all aspects.

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Mental Health Concerns: JED Resource Center 

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Mental Health Concerns: JED Resource Center 

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The Jed Foundation's Mental Health Resource Center provides essential information about common emotional health issues and shows teens and young adults how they can support one another, overcome challenges, and make a successful transition to adulthood.

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Mental Health Resource Center | The Jed Foundation

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Provides essential information about emotional health issues and shows young people how to support each other and make a successful transition to adulthood.