Better Prediction of Suicide Risk

Posted on August 7, 2018 by Gina Ulery

In the aftermath of a horrific event like a suicide, we all ask the same question: What could we have done to prevent it?

Yet for some, that is the wrong question. For researchers at Kaiser Permanente, what we should be asking is how we can better predict suicide risk.

In one of the largest studies to date – involving seven large health systems serving a combined population of 8 million people in nine states, and examining almost 20 million visits by nearly 3 million people age 13 or older, including about 10.3 million mental health specialty visits and about 9.7 million primary care visits with mental health diagnoses – the researchers combined a variety of information from the past five years of people’s electronic health records and answers to questionnaires, taken from five Kaiser Permanente regions.

Not only were they able to more accurately predict suicide risk than before, they found that in the 90 days following an office visit, suicide attempts and deaths among patients whose visits were in the highest 1 percent of predicted risk were 200 times more common than among those in the bottom half of predicted risk; patients with mental health specialty visits who had risk scores in the top 5 percent accounted for 43 percent of suicide attempts and 48 percent of suicide deaths; patients with primary care visits who had scores in the top 5 percent accounted for 48 percent of suicide attempts and 43 percent of suicide deaths (Simon et al., 2018).

The researchers also found that the strongest predictors of future suicide attempts included prior suicide attempts, mental health and substance use diagnoses, medical diagnoses, psychiatric medications dispensed, inpatient or emergency room care, and scores on a standardized depression questionnaire (Simon et al., 2018).

“We demonstrated that we can use electronic health record data in combination with other tools to accurately identify people at high risk for suicide attempt or suicide death,” explained Gregory E. Simon, MD, MPH, a Kaiser Permanente psychiatrist in Washington and a senior investigator at Kaiser Permanente Washington Health Research Institute (Simon, 2018).

Better prediction of suicide risk, says Simon, is the foundation of suicide prevention. When better informed, health care providers and health systems can make better decisions, such as how often to follow up with patients, refer them for intensive treatment, reach out to them after missed or canceled appointments – and whether to help them create a personal safety plan and counsel them about reducing access to means of self-harm.

Related Online Continuing Education (CE) Courses:

Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt.

Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs.

Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies so that healthcare professionals are informed on this complex subject. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2018 | 61 pages | 20 posttest questions

The Suicide Survivor is a 2-hour online continuing education (CE) course that provides an understanding and means of helping the people who have lost loved ones to suicide.

One of the most difficult and complex emotional adjustments many individuals will ever face is the challenging and often lengthy process of dealing with the suicide of a family member or other loved one. These people are called suicide survivors; the family members and close friends who have experienced the death of a family member or loved one by suicide.

Unfortunately, this is a common occurrence because nearly 45,000 people die by suicide each year in the United States alone. Estimates are that an average of six individuals experience major life disruption as a consequence of every suicide. The cascade of emotions that follow can be both unexpected and overwhelming, and many of the survivors who most need assistance in the form of supportive counseling do not receive it.

This course will provide information and helping strategies for health professionals who work with individuals who are struggling with both “normal” grief and complicated grief, sometimes described as “persistent complex bereavement disorder.” Also discussed are myths about coping with grief, the progression through the grief of suicide, stigmas associated with suicide, assessing for religious help, theories of grief, role of the therapist, needs of suicide survivors, and, finally, moving on. Course #21-26 | 2018 | 40 pages | 15 posttest questions

Course Directions

Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

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Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: Psychologists, Counselors, Social Workers, Marriage & Family Therapist (MFTs), Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), Registered Dietitian Nutritionists (RDNs), School Psychologists, and Teachers

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Grief Work: What Do I Say?

Posted on May 17, 2018 by Gina Ulery

If you have not been trained in grief work, it can be intimidating to have a client expressing grief by crying, being upset, or angrily responding to you. You may not have easy access to a social worker, psychologist, or other mental health professional. The primary ideas to remember are these:

It is not about you. Grief is not a problem to be solved. It is a process to live through.

Talking to someone who is grieving stirs up your own feelings. This can trigger inappropriate responses to the grieving person. Think about what you are about to say, and why. If you start to talk about yourself, stop. This is not about you. It is about the grieving person.

If you are a problem-solver, you may be tempted to find a solution for the person’s grief. It may be appropriate to refer the person to a mental health professional, but you will not solve the problem and make the person feel better today, tomorrow, or even a month from now. Grief must take its course, and the course will be different for everyone. Your best response is to listen supportively, without judgment and without giving advice (Devine, 2017).

Use these basic ideas to respond to a grieving person:

Say, “I can’t imagine how you are feeling.” Do not tell the person you know how they feel. Their grief is unique to them. You may have a similar experience, but it will not be the same.
Ask, “What can I do to help right now?” The person may not know what you can do to help, but asking provides the person a small amount of control in a situation that feels wildly out of control.
Say “It sounds as if you loved her/him very much. Would you like to tell me what made him/her so special?”
Be silent with the person and wait. Offer a tissue if needed.
Say, “I am not sure what to say to comfort you, but please know I care” (What’s Your Grief, 2014).

Course excerpt from:

Grief: The Reaction to Loss is a 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief.

Grief is the reaction to loss, and any kind of loss can trigger grief. People grieve for the loss of someone they love, but they also grieve for the loss of independence, usefulness, cognitive functioning, and physical abilities. Grief is also a lifelong process: a journey rather than a disease that is cured. It changes over time to deal with different kinds of losses. It is an experience that is intellectual, physical, spiritual, and emotional. It is affected by the person’s culture, support system, religious beliefs, and a host of other factors.

Grief is often not recognized by healthcare professionals, in patients or themselves. This course will teach healthcare professionals to recognize grief, as well as how to respond appropriately to the grieving person. The progression of aging and dying will be discussed in order to normalize the process, one of the most important aspects of working with a grieving person. Screening guidelines for depression, suicide risk, and grief are included, as are treatment strategies for anticipatory and complicated grief. A final section on compassion fatigue, burnout, and secondary stress includes strategies for professional self-care. Course #21-25 | 2018 | 35 pages | 15 posttest questions

Click here to learn more.

Related Online Continuing Education (CE) Courses:

The Grieving Self is a 3-hour online continuing education (CE) course that looks at stories of the bereaved to determine the major issues to address to reconnect those who grieve to a stable sense of self. The annual number of deaths reported in the United States in the early part of this century was 2.4 million, about four per minute. This course looks at the stories of a few of those who are recently bereaved to determine the major issues for those who grieve: aloneness, loss of self, social connections, anniversaries and holidays, self and others’ expectations, the need to continue living, ambivalence of recovery, grief dreams, medical problems. Studies are reviewed which indicate some researchers’ conclusions as to: 1) Gender differences between men and women who grieve; there are important questions regarding the recruitment of subjects and the data gathering process for gender differences research. 2) And, who among the grief survivors are best served by counseling and psychotherapy. This author, while agreeing with much of the research, challenges the belief that the emotional loneliness suffered by the bereaved is the single, major dynamic of the bereaved, and can only be alleviated through passage of time. It is felt that an effort to reconnect those who grieve to a stable sense of self can help the bereaved regain better function and reduce the length of the time they are consigned to painfully distressing lives. Course #30-49 | 2010 | 34 pages | 20 posttest questions

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Suicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults. Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt. Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs. Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies so that healthcare professionals are informed on this complex subject. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2017 | 60 pages | 20 posttest questions

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Overcoming the Stigma of Mental Illness is a 2-hour online continuing education (CE/CEU) course that explores the stigmas around mental illness and provides effective strategies to overcome them. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines mental illness stigma as “a range of negative attitudes, beliefs, and behaviors about mental and substance use disorders.” Mental health and substance use disorders are prevalent and among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. This course will explore the stigmas surrounding mental illness and provide effective strategies clinicians can use to create a therapeutic environment where clients can evaluate their attitudes, beliefs, and fears about mental illness, and ultimately find ways to overcome them. We will explore the ways in which mental illness stigmas shape our beliefs, decisions, and lives. We will then look at specific stigmas about mental illness, from the fear of being seen as crazy to the fear of losing cognitive function and the ways in which we seek to avoid these fears. We will then look at targeted strategies that, you, the clinician, can use to create a therapeutic alliance where change and healing can overcome the client’s fears. Lastly, we will look at the specific exercises you can use in session with your clients to help them address and overcome their biases and stigmas about mental illness. Course #21-24 | 2018 | 35 pages | 15 posttest questions

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Course Directions

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Link Between Screen Time & Suicide

Posted on April 23, 2018 by Gina Ulery

It’s no secret that screen time is increasing exponentially in teenagers, and that it contributes to several mental health issues. New research suggests that screen time should be considered a modern-day risk factor for depression and suicide.

Studying the rise in mental health problems among teens since 2010 that coincides with an increase in ownership of cell phones – by 2015, 92 percent of teens and young adults had a cell phone, along with CDC statistics that show that suicide rate increased 31 percent among teenagers from 2010 to 2015 – Twenge and Joiner found “a concerning relationship between excessive screen time and risk for death by suicide, depression, suicidal ideation and suicidal attempts” (Joiner & Twenge, 2017).

Explains Joiner, “All of those mental health issues are very serious. I think it’s something parents should ponder” (Joiner, 2017).

Specifically, Joiner and Twenge discovered 48 percent of teenagers who spent five or more hours per day on electronic devices reported a suicide-related behavior. That compared to 28 percent of adolescents who spent less than an hour using electronic devices.

Twenge concludes that the results clearly showed that teens who spent more time on the devices were more likely to be unhappy. Those who focused more on non-screen activities like sports and exercise, talking to friends face to face, doing homework and going to church were more likely to be happy.

Joiner and Twenge emphasized their research does not prove that screen time causes depressive symptoms or suicide-related behaviors, but the findings do show a link.

The takeaway, however, is that screen time is just one of the many factors that may contribute to suicide – and one that healthcare professionals should be aware of. By being aware of the many factors that contribute to depression and suicide, as well as the evidence-based strategies that can prevent it, clinicians can better help to reduce the risk factors and promote resilience among our youngsters.

Related Online Continuing Education (CE) Courses:

Effects of Digital Media on Children’s Development and Learning is a 3-hour online continuing education (CE/CEU) course that reviews the research on media use and offers guidance for educators and parents to regulate their children’s use of digital devices. Today’s world is filled with smartphones used by people ignoring their surroundings and even texting while driving, which is criminally dangerous. Are there other dangers that may not be as apparent? Media technology (e.g., smart phones, tablets, or laptop computers) have changed the world. Babies and children are affected and research reveals that 46% of children under age one, and up to 59% of eight-year-old children are exposed to cell phones. In England, nearly 80% of senior primary-school staff reportedly are worried about poor social skills or speech problems of children entering school, which they attribute to the use of media devices. Media technology affects family life, children’s readiness for entering school or preschool, and classroom learning. Recent research delineates a developmental progression of understanding information on devices for children between ages 2- 5 years. Younger children may believe false information if it is on a computer. This research is important for understanding technology uses in education. There are also known health risks and possible adverse effects to social-emotional development. Statistics describing the increase of media technology and developing trends in media use are presented along with guidelines and position statements developed to protect children from risks and adverse effects. Course #30-96 | 2017 | 50 pages | 20 posttest questions

Finding Happiness: Positive Interventions in Therapy is a 4-hour online continuing education (CE) course that explores the concept of happiness, from common myths to the overriding factors that directly increase our feelings of contentment. We will start with a discussion on why you, the clinician, need to know about happiness and how this information can help in your work with clients. We will then uncover mistakes we make when trying to attain happiness and look carefully at the actions we take and the beliefs that do not just obfuscate our happiness efforts, but often leave us less happy. Next, we will explore the ways in which our mindset influences our feelings of happiness and the many ways we can fundamentally change our levels of well-being, not just immediately, but for many years to come. The final section of this course contains exercises you can use with clients to cultivate and sustain a lifelong habit of happiness. Course #40-45 | 2018 | 57 pages | 25 posttest questions

Course Directions

Online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

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Are You Culturally Competent?

Posted on April 10, 2018 by Gina Ulery

Multicultural awareness – which refers to an awareness of, comfort with, and sensitivity toward issues of cultural diversity – has been emphasized through decades of policy reforms, is often taught in health care professions, and from all perspectives, is becoming more important every day.

What we believe about other cultures has a tremendous impact on how effective we are when working with them. One study found that multicultural beliefs are tied to student teachers’ ability to create strong and nurturing classroom environments, measured during student teaching observations by master teachers (Cherng & Davis, 2017).

Interestingly, this same study also found that Black and Latino preservice teachers report greater multicultural awareness than their White counterparts, and that prior experience working with minority cultures is linked to greater multicultural awareness (Cherng & Davis, 2017).

Being aware of cultural differences also becomes crucial when working with families after a suicide. According to Karen Rizzo MD, president of the Pennsylvania Medical Society (PAMED), suicide “is an alarming public health problem that needs to be addressed in a clinically compassionate way being culturally sensitive to the needs of those seeking to find answers to their personal loss” (Rizzo, 2012).

As Rizzo notes, the warning signs of suicide typically involve factors like previous suicide attempts, feeling alone, drug use, a family history of suicide, a history of depression, stressful life events and access to lethal methods, but can very according to an individual’s culture (Rizzo, 2012).

How much a person identifies with their culture can also influence their sense of belonging, well-being, and according to work done by Led by Kamaldeep Bhui, Professor of Cultural Psychiatry and Epidemiology at Barts, predicts their mental health later in life (Bhui et al., 2016).

Working effectively with people from different cultures means not just understanding the cultural norms, expectations, and pressures of an individual’s culture, but also how the individual experiences them. They may be highly identified with their culture and finding a sense of belonging in it, they may be resisting their culture in favor of integrating more fully into the majority culture, and they may not know how they feel about their culture, or the majority culture in which they live. All of these factors demand a culturally competent and sensitive approach – one that overcomes biases, stigmas, and includes the client in the process of improving mental health.

By Claire Dorotik-Nana, LMFT

Related Online Continuing Education (CE) Courses:

Cultural Awareness in Clinical Practice is a 3-hour online continuing education (CE/CEU) course that provides the foundation for achieving cultural competence and diversity in healthcare settings. Cultural competence, responding to diversity and inclusion, are important practices for healthcare professionals. This course will help you to gain an awareness of bias and provide strategies to adjust your clinical mindset and therapeutic approach to adapt to “the other” – people who differ in color, creed, sexual identification, socio-economic status, or other differences that make inclusion difficult. Inclusion is defined as “the state of being included” or “the act of including,” which is something all clinicians should strive for. This course is designed to provoke thought about culture, diversity, and inclusion. Even though research for evidence-based practice is somewhat limited in this area, the concept of cultural competency (however it is defined and measured) is a key skill for healthcare professionals to create an inclusive therapeutic environment. Course #31-07 | 2018 | 57 pages | 20 posttest questions

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These online CE courses are sponsored by:

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Cyberbullying: What You Need To Know

Posted on February 21, 2018 by Gina Ulery

Cyberbullying is defined as intentional, repeated harm to another person using communication technology. Cyberbullying is also not accidental or random, and those who engage in it choose their victims carefully – those with less perceived power.

In the first large scale study of a low-tech, high-harm form of online harassment known as doxing – which involves collecting and publishing sensitive personal information to exact revenge, seek justice, or intimidate victims – researchers from the New York University Tandon School of Engineering and the University of Illinois at Chicago found that the primary motivations for cyberbullying are revenge or justice (Snyder et al., 2017).

It is perhaps not surprising then that another study done by researchers at The Pennsylvania State University found that youth cyberbullying was dramatically more likely to occur between current or former friends and dating partners than between students who were never friends or in a romantic relationship (Felmlee et al., 2017). As Diane Felmlee, a professor of sociology at Penn State explained, “The large magnitude of the effects of close relationships on the likelihood of cyberbullying, even after controlling for many other factors, was particularly surprising” (Felmlee, 2017).

The psychological effects of cyberbullying are no less concerning. Children involved in cyberbullying are much more likely to also view web content containing self-harm and suicide (Gorzig, 2016) and develop substance abuse and internet addictions (Gamez-Guadix et al., 2013). Further, a review of cyberbullying found that it has been consistently associated with an increased likelihood of depression (Hamm et al., 2015).

Cyberbullying is also increasingly common as children now have access to a wide variety of social media platforms – from Facebook and Twitter to Snapchat, websites, forums, and blogs – where communication and harassment are immediate means of imposing deliberate harm on others.

For clinicians, it almost goes without saying that cyberbullying is a fast-growing area of concern, and knowing how to identify it, what causes it, and what strategies can be used to prevent or manage it are essential skills in today’s social media reliant world.

Related Online Continuing Education (CE) Courses:

Cyberbullying is a 2-hour online continuing education (CE/CEU) course that reviews evidenced-based research for identification, management and prevention of cyberbullying in children, adolescents and adults. Bullies have moved from the playground and workplace to the online world, where anonymity can facilitate bullying behavior. Cyberbullying is intentional, repeated harm to another person using communication technology. It is not accidental or random. It is targeted to a person with less perceived power. This may be someone younger, weaker, or less knowledgeable about technology. Any communication device may be used to harass or intimidate a victim, such as a cell phone, tablet, or computer. Any communication platform may host cyberbullying: social media sites (Facebook, Twitter), applications (Snapchat, AIM), websites (forums or blogs), and any place where one person can communicate with – or at – another person electronically. The short and long-term effects of bullying are considered as significant as neglect or maltreatment as a type of child abuse. This course will describe specific cyberbullying behaviors, review theories that attempt to explain why bullying happens, list the damaging effects that befall its victims, and discuss strategies professionals can use to prevent or manage identified cyberbullying. Cyberbullying is a fast-growing area of concern and all healthcare professionals should be equipped to spot the signs and provide support for our patients and clients, as well as keep up with the technology that drives cyberbullying. Course #21-09 | 2016 | 32 pages | 20 posttest questions

Stalking: Recognizing and Responding is a 1-hour online continuing education (CE) course that examines the prevalence of stalking and provides therapists with the means to identify and assist victims/survivors. Stalking is a crime that is far more prevalent and more dangerous than most people realize. It is a crime that is not well understood and that often goes unrecognized. Findings from various studies examining the prevalence of stalking suggest that community-based interventions are critical to raising awareness about this crime and promoting prevention efforts. Mental health professionals have an important role in identifying and treating victims/survivors of stalking through educating themselves about this crime. Researchers have found that stalking victims have a higher incidence of mental disorders and comorbid illnesses compared with the general population, with the most robust associations identified between stalking victimization, major depressive disorder, and panic disorder. Additionally, intimate partner stalking has been identified as a common form of IPV experienced by women veterans that strongly contributes to their risk for probable PTSD. These findings indicate that it is important to assess for these symptoms and diagnoses when working with victims/survivors of stalking. This course is designed to enhance your understanding of stalking by reviewing key findings from research on stalking, identifying common tactics used by stalkers, and exploring the intersections between stalking, intimate partner violence, and sexual violence. This course will also examine common reactions experienced by victims/survivors of stalking and discuss ways to assist victims/survivors in clinical practice. Course #11-17 | 2018 | 18 pages | 10 posttest questions

These online courses provide instant access to the course materials (PDF download) and CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

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Breaking the Cycle of Violence

Posted on January 4, 2018 by Gina Ulery

Violence, while it often demands our attention in the immediate, begins much earlier than it actually transpires. Often, it is the chain reaction of several incidents, each pushing the person closer to the edge of anger – and further from the very support systems than could possibly intervene.

Let me give you an example. Sam, a fifth grade student, whose parents have just divorced, begins having trouble in recess. He often seems irritable, fights easily with other children, and displays rigid and inflexible behavior. When his teacher attempts to intervene, Sam is inconsolable. Eventually he begins disrupting the class. After speaking with Sam’s parents – who both state that the “other parent” should have to deal with Sam’s behavior – Sam’s teacher decides to send him to a remedial class.

In the remedial class, Sam is exposed to many other angry kids, several who are more violent than he is. In an attempt to fit in, Sam begins to act like the other kids in his class and his behavior grows more aggressive. When he threatens a teacher, Sam is sent to the principal who decides to remove him from school altogether.

Now in an alternative school, Sam is labeled “dangerous,” and removed from many of the school’s extra-curricular activities. As time has progressed, Sam’s home life has gotten worse. Each time he gets in trouble, his parent sends him to the “other parent’s house,” telling him that unless he “shapes up” he won’t be allowed to return. Sam soon begins leaving home for long periods of time and starts hanging out with a gang. After a few months, he no longer attends school, and has had two brushes with the authorities.

For kids like Sam, the emergence of violence is only a matter of time. Yet Sam is not a violent kid, rather, he is caught in a cycle of violence. Through a collection of events, Sam’s needs went unnoticed, and as he felt more unheard, and less important, his behavior worsened. Instead of being offered support to manage his feelings and behavior, Sam was sent away, and even worse, exposed to more violence – the very thing he was sent away for. Reaching Sam now seems almost impossible.

Changing the behavior of kids like Sam would be much easier if the cycle that helped create it was identified when it first started. When trained clinicians can recognize the signs of violence early on, intervene to identify kids at risk, and reach out to help them through effective strategies to express their feelings and advocate for their needs – as oppose to sending them away – the cycle of violence could be broken. Kids like Sam would no longer be labeled violent and dangerous.

Related Online Continuing Education (CE) Courses:

How Children Become Violent is a 6-hour online continuing education (CE/CEU) course that examines the cycle of youth violence and sexual offending and how this cycle can be broken. This course was written for professionals working in the mental health, child welfare, juvenile justice/criminal justice, and research fields, as well as students studying these fields. The authors’ goal is to make a case for the fact that juvenile and adult violence begins very early in life, and it is both preventable and treatable. The author draws on her 30 years of experience working in and researching violence to demonstrate that society must intervene early in the lives of children living in violent, neglectful, criminal, and substance-dependent families. This course provides information about the problems of violence — in its various forms of abuse, neglect, and just plain senseless killing — that takes place in this country. These are problems that are seldom handled well by governmental agencies of child welfare, juvenile justice, education, and mental health. This results in more problems, turning into a cycle of youth violence and sexual offending that will potentially continue for generations. However, with the correct intervention, this cycle can be broken, which creates a safer environment for all of society. Closeout Course #60-68 | 2006 | 136 pages | 36 posttest questions

Domestic Violence: Child Abuse and Intimate Partner Violence is a 2-hour online continuing education (CE) course intended to help healthcare professionals maintain a high state of vigilance and to be well prepared with immediate and appropriate responses when abuse is disclosed. Domestic violence, in the form of child abuse and intimate partner violence, remains a pervasive part of contemporary life in the U.S. Its effects are deep and far-reaching. This course will teach clinicians to detect abuse when they see it, screen for the particulars, and respond with definitive assistance in safety planning, community referrals, and individualized treatment plans. There is a special section on the complexity of an abuse victim’s decision about if and when to leave an abuser. This course meets the Domestic Violence license renewal requirement of all Florida licensees. Course #21-12 | 2016 | 42 pages | 15 posttest questions

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Pennsylvania Psychologists Renewal Info

Posted on September 28, 2017 by Gina Ulery

Online Continuing Education (CE) @pdresources.org

Pennsylvania psychologists can save 20% on CE for their upcoming license renewal deadline of November 30, 2017. Up to 15 of the 30 required hours per biennium are allowed from APA-sponsored online CE courses.

CE Required: 30 hours every 2 years
Online CE Allowed: 15 hours (home study)
License Expiration: 11/30, odd years
National Accreditation Accepted: APA
Notes: 3 hours in ethics required each renewal

Pennsylvania psychologists can earn up to 15 hours required for renewal through online courses offered by Professional Development Resources, and save 20% on courses. Click here to view APA-approved online CE courses.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Over 100 courses are available!

Suicide Prevention Continuing Education (CE): On July 8, 2016, the governor of Pennsylvania signed into law the Matt Adler Suicide Prevention Continuing Education Act. This legislation requires that licensed psychologists, social workers, marriage and family therapists, and professional counselors seeking to have their licenses renewed complete at least one hour of continuing education in the assessment, treatment, and management of suicide risk. To fulfill the growing requirement for suicide prevention training, Professional Development Resources created a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults:

Online CE Courses for Psychologists:

E-Therapy: Ethics & Best Practices is a 3-hour online continuing education (CE) course that examines the advantages, risks, technical issues, legalities and ethics of providing therapy online. E-therapy can be used to address age-old problems, such as how to reach out to those who might not otherwise avail themselves of psychotherapy services even though they are in acute need. At the same time, it is clear that many providers have embraced the new technologies without a firm grasp on the new and serious vulnerabilities that are introduced when their patients’ personal health information goes online. Included in this course are sections on video therapy, email, text messaging, smart phone use, social media, cloud storage, Skype, and other telecommunications services. This course is focused upon the ethical principles that are called into play with the use of e-therapy. Among them the most obvious concern is for privacy and confidentiality. Yet these are not the only ethical principles that will be challenged by the increasing use of e-therapy. The others include interjurisdictional issues (crossing state lines), informed consent, competence and scope of practice, boundaries and multiple relationships, and record keeping. In addition to outlining potential ethical problems and HIPAA challenges, this course includes recommended resources and sets of specific guidelines and best practices that have been established and published by various professional organizations. Course #30-87 | 2016 | 52 pages | 20 posttest questions

Obsessive-Compulsive Disorder (OCD) is a 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD. Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders. The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

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Why Resilience Matters

Posted on September 14, 2017 by Gina Ulery

By Claire Dorotik-Nana, LMFT @pdresources.org

Before Angela Duckworth began her research on grit, she was a teacher. Among the many things that Duckworth noticed with her children was that, when facing challenges, some fare much better than others. Naturally Duckworth became curious about what separated the children who met challenges with perseverance and determination from those who seemed to back down.

Of all of the factors that Duckworth studied – from economic backgrounds, to race, culture, and gender – the one factor that defined a child’s success most significantly was grit. Grit, in Duckworth’s words, is defined as, “a perseverance and passion for long term goals, as well as zeal and persistence of motive and effort.” For Duckworth, grit is conceptualized as a stable trait that does not require immediate positive feedback.

Often the difference between children with and without grit can be seen immediately in their response to setbacks. While children without grit give up easily, children with grit persevere, and try harder after a setback. Ultimately, it is their long term persistence that leads to success, as evidenced by Duckworth’s study of West Point graduates. Among all factors from grade point average, standardized test scores, and even a family history of success, grit emerged as the one strongest predictive factor of success among West Point graduates.

Grit matters. But for many clinicians working with young clients, the question is: How do you build grit and resilience? Are there exercises that can be done or skills that can learned?

The answer is yes. Thanks to the work of Penn State Psychology Professor and former APA President, Martin Seligman, there are several cognitive, social, and problem solving skills that build and promote lifelong resilience.

Through learning to think more flexibly, avoiding cognitive traps, and acting in proactive and self-efficacious ways, clients can become not just more resilient and gritty, but ultimately more successful.

Related Online Continuing Education (CE) Courses:

Building Resilience in your Young Client is a 3-hour online continuing education (CE/CEU) course that offers a wide variety of resilience interventions that can be used in therapy, school, and home settings. It has long been observed that there are certain children who experience better outcomes than others who are subjected to similar adversities, and a significant amount of literature has been devoted to the question of why this disparity exists. Research has largely focused on what has been termed “resilience.” Health professionals are treating an increasing number of children who have difficulty coping with 21st century everyday life. Issues that are hard to deal with include excessive pressure to succeed in school, bullying, divorce, or even abuse at home. This course provides a working definition of resilience and descriptions of the characteristics that may be associated with better outcomes for children who confront adversity in their lives. It also identifies particular groups of children – most notably those with developmental challenges and learning disabilities – who are most likely to benefit from resilience training. Course #30-98 | 2017 | 53 pages | 20 posttest questions

Active Listening: Techniques that Work for Children and Parents is a 3-hour online continuing education (CE/CEU) course that offers a valuable compilation of practical and ready-to-use strategies and techniques for achieving more effective communication through active listening. One of the fundamental tools of clinicians who work effectively with children and adolescents is the art of listening. Without this set of skills, clinicians are likely to miss essential pieces of information their clients are trying to communicate to them, whether with words or with behavior. When the word “active” is added to “listening” it alters and amplifies the communication process to include a dynamic feedback loop in which the speaker and the listener validate that each party has been accurately heard. Appropriate use of listening skills by a clinician can increase self-esteem in young clients and motivate them to learn. Using active listening skills, clinicians become more confident and manage their therapy and counseling sessions with a broader and mutually respectful dialogue. This course will teach clinicians how to employ innovative and practical communication and conversational skills in their individual and group therapy sessions with clients and their families, as well as in their working relationships with other professionals. These techniques can be applied to a wide variety of clinical, classroom and home situations, and case examples are included. Also included are sections on positive thinking and resilience, problem-solving skills, and the communication of emotion. Course #30-90 | 2017 | 70 pages | 20 posttest questions

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These online courses provide instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion.

Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the American Speech-Language-Hearing Association (ASHA Provider #AAUM); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), Speech-Language Pathology and Audiology, and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501) and the Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

Perfectionism: A Suicide Predictor

Posted on June 19, 2017 by Gina Ulery

Course excerpt from Suicide Prevention: Evidence-Based Strategies

One of the intriguing risk factors for suicide from recent research is perfectionism. In a literature review, Flett, Hewitt, and Heisel (2014) report consistent evidence linking suicide ideation with long-term exposure to a source of external pressure to be perfect. Perfectionism has been shown to predict suicide above the predictor of hopelessness. Perfectionism coupled with self-concealment (not allowing others to see one’s faults) is a risk for suicide without warning. The authors also note the risk for perfectionists for life stress, hopelessness, and overgeneralization.

The risk for perfectionists is that the person’s emotional perfectionism does not allow for disclosure of suicidal thoughts. Flett and colleagues warn behavioral health professionals to “beware the mask” of people who hide their distress until they kill themselves. Self-concealment and silencing the self – not allowing oneself to admit to distress – are perfectionistic traits which can lead inexorably to suicide. This suicide risk is high because the person will avoid seeking any kind of help, whether the help is from family, friends, or professionals.

The pressure to be perfect may come from a parent, an employer, spouse, or other significant person. This might include a hypercritical parent, a workplace that does not tolerate any mistakes, or a romantic partner who seemingly cannot be pleased. Flett and colleagues list the dimensions of perfectionism from research: high personal standards, doubts about one’s actions, high expectations of parents, and high criticism from parents. The perfectionist has a feeling of continually falling short of their own and others’ standards. This leads to other key risk factors for suicide: the perception of being a burden and thwarted needs for belonging.

A study found a significant suicide potential in children and adolescents with perfectionist traits. The study found evidence validating the perfectionism social disconnection model. This model states that interpersonal perfectionism creates a sense of isolation and alienation that increases suicide risk (Roxborough et al., 2012). The researchers found the link between suicide potential and the need to seem perfect to others was accompanied by a history of high interpersonal hopelessness and being bullied.

Click here to learn more.

Suicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults. Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt. Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs. Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies on this complex subject for psychologists, marriage & family therapists, professional counselors, and social workers. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2017 | 60 pages | 20 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more.

About the Author:

Laura More, MSW, LCSW, is a healthcare author and licensed clinical social worker. Laura was one of the founding partners of Care2Learn, a provider of online continuing education courses for the post-acute healthcare industry. She now provides healthcare authoring services. She has authored over 120 online continuing education titles, co-authored evidence-based care assessment area resources and a book, The Licensed Practical Nurse in Long-term Care Field Guide. She is the recipient of the 2010 Education Award from the American College of Health Care Administrators.

CE Information:

Mind-Healing Activities: A Suicide Toolkit

Posted on June 10, 2017 by Gina Ulery

By Jennifer Scott @spiritfinder.org/

When you are faced with suicidal thoughts or have even made a past attempt, it can feel as though you have lost all control over your mind. You don’t want to feel this way, but your brain simply won’t give it a rest. Rest assured, it is nothing you’ve done and it is possible to break free. Take a look at the resources in this toolkit for guidance, and use the mind-healing activities to re-focus your thoughts and turn them into something positive.

Mental Health Resources

The first step on the road to healing is to seek help. Although you may feel alone, you are far from it. Getting a support system together will enable you to jumpstart the process, and these resources are a great place to begin:

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Mind-Healing Activities:

Mindfulness Meditation

Often times when you are experiencing negative thoughts, you feel as though you can’t get a handle on them. As hard as you try, you can’t seem to gain control. Mindfulness meditation is a focused approach to taking control of your thoughts in which you are paying attention to the present moment, including your thoughts, emotions, and sensations. Using breathing techniques, you can achieve a heightened sense of awareness in a matter of minutes no matter where you are.

Mindfulness meditation not only refocuses your thoughts, but research has shown that it physically alters your brain. Participants in a 2016 study practiced meditation for three days. At the end of those three days, brain scans showed increased activity in the areas of the brain that process stress and give you a sense of calm. While there isn’t an ideal dose for meditation, it can be done in a matter of minutes, fitting into even the busiest of schedules.

Prayer

Prayer is a powerful coping mechanism. People of faith who regularly pray are less likely to fall into depression and commit suicide due to the hope and optimism they hold onto for the future. Scientists have found that prayer and spirituality are sources of hope and strength which act as buffers against stress, anxiety, pain, addiction, and depression. Prayer is also an effective way to keep stress and anxiety at a minimum or banish them all together. Releasing your day’s worries and giving them over to a higher power can be liberating and leave you ready to set new goals.

There are also many health benefits of a positive spiritual life. For example, engaging in prayer triggers a relaxation response. When your mind is calm and relaxed, blood pressure, heart rate, and respiratory rate lower. You can think more clearly and your body stays in a low stress state, leaving you centered and focused on recovery. In addition, your body will have more resources to devote to healing if you are feeling positive and less stressed.

Journaling

Have you ever had so many thoughts going through your head that you don’t know where to turn? Journaling is a great way to get everything out in the open so you can start to understand your feelings one thought at a time. The two main objectives are to recapture the moment and learn from it. At the end of the day, take a second to write down how you felt throughout the day or reacted to certain events. This is a safe place for you to write about everything you are experiencing.

While you may have had a rough day, try to find lessons you’ve learned and recognize the positive moments. Even if it was something as simple as a greeting from the mailman or finding your favorite movie on television, write it down. You may gain perspective into how you see yourself and the world. Journaling is also a great way to track your progress, and may alert you to patterns in your thoughts and even your actions.

Further Healing

The above activities are a great start, but keep in mind that anything that engages your mind and promotes positive thinking is considered a method of healing. You can come up with your own ideas, but here are some more suggestions:

Practice yoga.
Read an empowering book.
Get some exercise.
Download an app.
Simplify your life.

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With the right resources and activities, you can find relief from your thoughts and finally start moving forward. Remember, healing takes time, but with the right help and tools, you can overcome this.

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Related Online Continuing Education (CE) Course:

Suicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults. Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt. Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs. Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies on this complex subject for psychologists, marriage & family therapists, professional counselors, and social workers. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2017 | 60 pages | 20 posttest questions

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