Putting Health back into Clinical Mental Health Counseling

Presented by: Jim Messina, Ph.D. , NCC, CCMHCAt: Utah Mental Health Counselors AssociationDate: May 10, 2013

From Dream to Reality in 1976On an impulsive whim Nancy and Jim:•Coined term “Mental Health Counselor”•Coined Association Title: The American Mental Health Counselor’s AssociationAs the process caught fire •Established the Profession of Mental Health Counseling•Set out to create its “Hallmarks of a Profession”

What are the Hallmarks of a Profession?

1. Professional Membership Organization

2. Code of Ethics3. Certification and Licensure4. Accreditation5. Research into Effectiveness of

Service Delivery

History Timeline of Creation of Mental Health Counseling

Profession• 1976 – Coining of term Mental Health Counselor

and formation of American Mental Health Counselor’s Association as Division of ACA

• 1979 – Creation of the National Academy of Certified Clinical Mental Health Counselors

• 1981 – First State Law to license Mental Health Counselors put into effect in Florida

• 1985 – AMHCA had over 12,000 members• 2011 – AMHCA put out its newest Standards of

Practice in Mental Health Counseling-Helping to put Health back into Clinical Mental Health Counseling

• 2013 – AMHCA has over 7,000 members

The National Professional Association of Clinical Mental

Health Counselors

American Mental Health Counselors Association

Founded in 1976 when term Mental Health Counselor was coined

Initial Definition of Scope of CMHC PracticeThe 1979’s initial AMHCA’s Journal of Mental Health Counseling included first published definition of mental health counseling as: “an interdisciplinary, multifaceted, holistic process of:•Promotion of healthy lifestyles•Identification of individual stressors & personal levels of functioning•Preservation or restoration of mental health” (Seiler & Messina, 1979)

AMHCA’s Revised Scope of Practice in 1986The 1986 AMHCA Board of Directors adopted:“Clinical mental health counseling is the provision of professional counseling services involving the application of principles of:1.Psychotherapy2.Human Development3.Learning Theory4.Group Dynamics5.Etiology of mental illness & dysfunctional behaviorto individuals, couples, families and groups, for the purpose of promoting optimal mental health, dealing with normal problems of living and treating psychopathology…

1986 Scope of Practice (2)The practice of clinical mental health counseling includes, but is not limited to: 1.Diagnosis & treatment of mental & emotional disorders2.Psycho‐educational techniques aimed at the prevention of Mental & emotional disorders3.Consultations to individuals, couples, families, groups, organizations & communities4.Clinical research into more effective psychotherapeutic treatment modalities.”

Regional Chapters of State MHCA’s

State Chapters of AMHCA

AMHCA Belongs to

American Counseling AssociationWas known as APGA-American Personnel and Guidance Association in1976 and in 1983 as AACD American Association of Counseling and Development until 1992 when it changed to ACA

CODES OF ETHICS Governing

Clinical Mental Health Counselors

National Certification

NBCC’s National Certifications for Mental Health Counselors•NCC: National Certified Counselor – Over

48,000

•CCMHC: Founded 1979- Certified Clinical Mental Health Counselor – Today only 1,000 + are CCMHC’s which needs to change if we are to put Health back into the professional identity of Clinical Mental Health Counseling

State Licensure for Counselors and Related Fields

In USA•120,429 Licensed Professional Counselors•54,785 Licensed Marriage & Family

Therapists•202,924 Licensed Social Workers

All 50 States have Licensed Professional Counselors but only 15 have Mental Health Counseling in their Title (Major way of taking Health out of Clinical Mental Health Counseling!)

15 States with MHC’s in Title• Delaware-License Professional Counselor of Mental Health (LPCMH)• Florida-Licensed Mental Health Counselor (LMHC) First Licensed 1981• Hawaii-Licensed Mental Health Counselor (LMHC)• Indiana-Licensed Mental Health Counselor (LMHC)• Iowa-Licensed Mental Health Counselor (LMHC)• Massachusetts-Licensed Mental Health Counselor (LMHC)• Nebraska-Licensed Independent Mental Health Practitioner (LMHP)• New Hampshire- Licensed Clinical Mental Health Counselor (LCMHC)• New Mexico-Licensed Mental Health Counselor (LMHC)• New York-Licensed Mental Health Counselor (LMHC)• Rhode Island-Licensed Clinical Mental Health Counselor (LCMHC)• South Dakota-Licensed Professional Counselor-Mental Health (LP-MH)• Tennessee-Licensed Professional Counselor-Mental Health Service

Provider (LPC/MHSP)• Utah-Licensed Clinical Mental Health Counselors (LCMHC) as of 2012 • Vermont-Licensed Clinical Mental Health Counselor (LCMHC)• Washington-Licensed Mental Health Counselor (LMHC)

Major Recommendation to Promote Professional Identity of CMHC’s

Given only 15 out 50 states licensed CMHC’s, it is imperative that we who have LMHC licensure encourage the LPC’s in the other 35 states to gain Certified Clinical Mental Health Counselor (CCMHC) status through the NBCC which would be a clear way of putting HEALTH into Clinical Mental Health Counseling and a way to get counselors in all 50 states enabled to call themselves Clinical Mental Health Counselor

AMHCA’s Online Newsletter

Research in the field is Reported in AMHCA’s Journal

Accreditation: Standards for Training of CMHCCACREP (The Council for Accreditation of Counseling & Related Educational Programs)1988 CACREP set out its first Standards for accreditation of CMHC Programs using 60 hour requirement put out in 1979 by AMHCA – But it also had Community Counseling Programs with up to 48 hours – Most went Community Counseling2009 CACREP adopted standards for CMHC which included 60 hour requirement

2009 CACREP Standards for CMHCRequired both core CACREP areas & specialized training in clinical mental health Core CACREP areas include:1.Professional Orientation and Ethical Practice2.Social and Cultural Diversity3.Human Growth and Development across the lifespan4.Career Development5.Helping Relationships6.Group Work7.Assessment8.Research and Program Evaluation

2009 CACREP Standards for CMHC Specialized CMHC Training:1. Ethical, Legal & Practice Foundations of CMHC2. Prevention & Clinical Intervention3. Clinical Assessment4. Diagnosis & Treatment of Mental Disorders5. Diversity & Advocacy in Clinical Mental Health

Counseling6. Clinical Mental Health Counseling Research &

Outcome EvaluationThese areas of CMHC preparation address clinical

mental health needs across the lifespan (children, adolescents, adults and older adults) & across socially & culturally diverse populations.

AMHCA 2011 Standard Additional Requirement for CMHC TrainingThe 2011 AMHCA standards also recommend these additional areas of training for CMHC Training programs:1.Biological Bases of Behavior (including psychopathology and psychopharmacology)2.Specialized Clinical Assessment3.Trauma4.Co-Occurring Disorders (mental disorders and substance abuse)

Implications of AMHCA’s 2011 Expanded Clinical Standards for Training of CMHC’s1. Evidenced-Based Practices

a. Diagnosis and Treatment Planning using EBP’sb. Diagnosis of Co-Occurring Disorders & Trauma

2. Biological Basis of Behaviorsa. Knowledge of Central Nervous Systemb. Lifespan Plasticity of the Brain

3. Psychopharmacology4. Behavioral Medicine

a. Neurobiology of Thinking, Emotion & Memoryb. Neurobiology of mental health disorders (mood,

anxiety, psychosis) over life spanc. Promotion of optimal mental health over the

lifespan

Accreditation-CACREP in 2009:74 Clinical Mental Health CounselingIn Florida they are:

1.Argosy Sarasota2.Barry University3.Florida Atlantic University4.Florida Gulf Coast University5.Florida International University6.Florida State University7.Rollins College8.Troy University Southeast Region9.University of Central Florida10.University of Florida11.University of North Florida12.University of South FloridaOnline:1.Cappella University2.Walden University

In Utah:University of Phoenix-Mental Health Counseling

NOTE: things will change now that Utah has in 2012 implemented the LCMHC

CACREP 2016 Standards for CMHC

1. FOUNDATIONSA. development of mental health counselingB. theories and models related to mental health counselingC. principles of mental health counseling, including prevention,

intervention,consultation, education, and advocacy, and networks that promote mental

healthD. medical foundation and etiology of addiction and co-occurring

disordersE. principles, models, and documentation formats of biopsychosocial caseconceptualization and treatment planning

2. CONTEXTUAL DIMENSIONSF. etiology, process, nomenclature, treatment, referral, and prevention of mental andemotional disordersG. mental health service delivery modalities such as inpatient, outpatient, partial treatmentand aftercare and the mental health counseling services networksH. diagnostic process, including differential diagnosis, and the use of current diagnostictools, such as the current edition of the (DSM)I. potential for substance use disorders to mimic and/or co-occur with a variety of medicaland psychological disordersJ. impact of crisis on individuals diagnosed with mental illnessK. classifications, indications, and contraindications of commonly prescribedpsychopharmacological medications for appropriate medical referral and consultationL. public policy and government relations on local, state, and national level to enhanceequity funding and promote programs that affect the practice of mental health counselingM. cultural factors relevant to mental health counselingN. professional organizations, preparation standards, and credentials relevant to the practiceof mental health counselingO. legal and ethical considerations specific to mental health counselingP. record keeping, third party reimbursement, and other practice and management issues inmental health counseling

3. PRACTICEQ. intake interview, mental status evaluation,biopsychosocial history, mental health history,and psychological assessment for treatment planning andcaseload managementR. strategies for interfacing with the legal system regardingcourt referred clientsS. techniques and interventions related to a broad range ofmental health issues

• What does this tell us? Little change is being recommended for the next round of CACREP Standards & AMHCA’s 2011 Standards have had little impact on what is being proposed at the current time.

• Let’s see if this will matter based on future trends.

The Growth of Mental Health Counseling as a Profession•In 2008, according to US Department of

Labor: 120,000 Mental Health Counselors were employed & only 6.7% of them were self-employed

•By 2018 43,000 jobs will be added (for a for a total of 163,000), representing a 36.3% growth

• Median annual wages in 2008 for Mental Health Counselors was $38,150. This is High when compared to other jobs.

Parity with the Other Mental Health ProfessionsThe median reimbursable fee for service:•Clinical Mental Health Counselors is $63 •Psychologists is $75 for psychologists•Clinical Social Workers & Marriage and Family Therapists is $60

(January 2006 study by Psychotherapy Finances)

SO! What do Mental Health Counselors Currently Do?

Mental Health Counselors offer full range of services:

•Assessment & diagnosis•Treatment planning and utilization review•Psychotherapy•Brief and solution-focused therapy•Alcoholism and substance abuse treatment•Psycho-educational & prevention programs•Crisis management•Trauma Intervention

ACA’s 20/20 Commission’s Definition of Counseling

Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goalsThey also established:The counseling profession shall establish uniform licensing standards with LPC as an entry-level title for counselor licensure.

BUT THINGS ARE GOING TO CHANGE!

The emerging health needs of Americans

is changing and as a result the roles and function of mental health practitioners will be changing as well

New AMHCA Clinical Standards Help CMHC to Get Ready for Changes in SystemThe Affordable Care behavioral medicine interventions

1. ACA calls for the coordination and integration of medical services through the primary care provider for a “whole person orientation” to medical treatment - model currently implemented at some level in VA & Federally Qualified Health Centers (FQHC’s)2. The ACA calls for creation of Affordable Care Organizations (ACO’s) to provide comprehensive services to Medicare recipients with a strong primary care basis3. The ACA model includes integration of mental & behavioral health services into the Patient-centered medical home (PCMH) which can enhance patient outcomes4. The ACA model integrates mental, behavioral and medical services under one roof with potential of controlling the costs for patients5. The ACA integrated behavioral medical approach opens a massive opportunity for clinical mental health counselors6. To be prepared to fill this evolving behavioral medicine role, it is imperative that clinical mental health counseling training programs establish training for future practitioners in these integrated medical settings.

The Affordable Care Act (ACA)•Beginning 2014 ACA increases access to

quality health care including coverage for mental health & substance use disorder services

• All new small group & individual private market plans will be required to cover mental health & substance use disorder services as part of the health care law's “Essential Health Benefits” categories

The Affordable Care Act (ACA)

•Behavioral health benefits will be covered at parity with medical & surgical benefits

• Insurers will no longer be able to deny anyone coverage because of a pre-existing behavioral health condition

•ACA already ensures that new health plans cover recommended preventive benefits without cost sharing, including depression screening for adults & adolescents as well as behavioral assessments for children

Results of the Affordable Care Act•Primary care providers receive 10% Medicare

bonus payment for primary care services•A new Medicaid state option is created to

permit certain Medicaid enrollees to designate a provider as a health home & states taking up the option receive 90% federal matching payments for two years for health home-related services.

•Small employers receive grants for up to five years to establish wellness programs

Results of the ACA continued:• The Center for Medicare & Medicaid Innovation

launches the Accountable Care Organization (ACO) Model & Advance Payment ACO Model, which offers shared savings & other payment incentives for selected organizations that provide efficient, coordinated, patient-centered care

• Some States established American Health Benefit Exchanges & Small Business Health Options Program Exchanges to facilitate purchase of insurance by individuals & small employers

• Teaching Health Centers are established to provide payments for primary care residency programs in community-based ambulatory patient care centers

Two Healthcare Organizational Models which are Driving ChangeTwo New Medicare/Medicaid models are

driving a change in healthcare delivery:

1.Patient Centered Medical Homes

2.Accountable Care Organizations (ACO’s)

Medical Homes1. Patient Centered - Empowers them with

Information and Understanding2. Comprehensive - Co-location of care

providers in physical and behavioral health3. Coordinated Care - Through Health

Information Technology all providers are kept in touch

4. Accessible – same day appointment & 24/7 availability through technology online

5. Committed to Quality & Safety – Quality Improvement Goals which are tracked

Benefits of Medical Homes1. Patients seek out the right care which is

needed-which is often behavioral vs. physical2. Less use of ER’s or delays in seeking care3. Less duplication of tests, labs & procedures4. Better control of chronic diseases & other

illnesses improving health outcomes5. Focus on wellness & prevention – reduce

incidence & severity of chronic disease or illnesses

6. Cost savings less use of ER’s & Hospitals

What is moving the Patient Centered Home Health ModelIn April 2013 the Patient-Centered Primary Care

Collaborative Pointed out on it website these factors driving the Home Health Model

1. Unsustainable cost increases in health care delivery

2. Growing availability of data3. Vast change in the way we communicateExample: In Denmark, more than 80 percent of health-care

encounters & transactions are electronically based & vastly different method of communicating is coming online and it's coming fast, driven by younger generations of patients and physicians.

Potential Role of Mental Health Counselors in Medical Homes

•Address the stressors which lead folks to seek out medical attention in the first place

•Assist in increasing compliance of patients with the medical directives given them by primary care staff

•Wellness educational programming to help ward off chronic or severe illnesses

•Assisting clients to cope with the medical conditions for which they are receiving medical attention

Primary and Behavioral Health Integration Grants based on Medical Home Model in ACAIn Utah: Weber Human Services-Ogden, UtahIn Florida: 1.Apalachee Center–Tallahassee2.Community Rehabilitation Center-Jacksonville3.LifeStream Behavioral Center-Leesburg4.Lakeside Behavioral Center–Orlando5.Coastal Behavioral Health Care-Sarasota6.Miami Behavioral Health Center-Miami

Accountable Care Organizations•Have a look at the CMS video which

overviews the ACO model:

http://innovation.cms.gov/initiatives/aco/

•Now let’s look at the announcement of the Role Out of the ACO rules in 2011 to see what is hoped for in this model:

http://www.healthcare.gov/news/factsheets/2011/03/accountablecare03312011a.html

Goal of ACO’s

The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

So what are ACO’s 1. ACO assumes financial risk rather than 3rd party payers

(government, business or insurance companies) for group of patients assigned to it

2. Consists of more than one hospital & number of primary care clinics with full array of medical & health specialists-who self-refer to their own specialists

3. Control costs by being responsible for full care of patients4. Integration of mental & behavioral health services into

Patient-centered medical homes5. Enhance patient outcomes through emphasis on

prevention, compliance, and immediate 24/7 attention6. Utilize an integrated behavioral medical approach

How will ACO’s Work?The Affordable Care Organizations (ACO’s) is a large local health system1.It usually includes more than one hospital and a number of primary care clinics. 2.It is this whole system which is in charge of the care of its patients3.The providers refer to other specialists inside of their own system 4.These ACO’s have their own group of providers (which could include Clinical Mental Health Counselors) & by referring within the system controls costs5.ACO’s are then responsible not only for their costs but also for the quality of their services to their patients6.Providers are paid a flat fee that is risk adjusted for the severity of the issues facing the patients7.The ACO organization assumes the financial risk rather than the government, business or insurance companies8.Where Clinical Mental Health Counselors work and how they will be paid may change greatly in the future as these ACO’s become reality after full implementation of the ACA in 2014

Utah’s Efforts under ACA• Utah is one of 16 states which proposes to design an

innovative statewide initiative to facilitate improved physician/patient communication & care coordination

• Goal of improving health care quality & lowering costs

• The state will convene a multi-stakeholder group that will address strategies for healthcare transformation in five key areas:

1.Expanded health information technology2.Adequate healthcare workforce3.Wellness & healthy lifestyle promotion4.Payment reform5.Medical malpractice & dispute resolution.

Key Players in Utah working on ACA innovationsOrganizations

1.IHC Health Services (Intermountain Health Care)

2.Trustees Of Dartmouth College3.State of UtahHospital working on ACA innovationSalt Lake Regional Medical CenterUtah’s Innovation Advisors1.Nancy Murphy MD2.Victoria Wilkins MPH, MD3.Sarah Woolsey MD,

Accountable Care OrganizationsCurrent Utah ACO’s

•Health Choice at http://www.healthchoiceutah.com/ •Healthy U at University of Utah at http://uhealthplan.utah.edu/healthyu/index.html •Molina at http://www.molinahealthcare.com/medicaid/providers/ut/pages/home.aspx •SelectHealth at http://selecthealth.org/Pages/new.aspx •Central Utah Clinic, P.C. (Provo, Utah) •IASIS Health Care Org at http://www.iasishealthcare.com very open to creation of ACO’s in their hospital localities:•IASIS Utah Hospitals Davis Hospital and Medical Center, Layton, UTJordan Valley Medical Center, West Jordan, UTPioneer Valley Hospital, West Valley City, UTSalt Lake Regional Medical Center, Salt Lake City, UT Health Choice Utah Accountable Care LLC

Prevention Services Mandated by ACAAfter September 23, 2010, the following preventive services must be covered without policy holder having to pay copayment or co-insurance or meet deductible but only applies when these services are delivered by a network provider:•Alcohol Misuse: screening & counseling•Alcohol and Drug Use: assessment for adolescents•Behavioral Assessment for children of all ages•Depression: screening for adults & adolescents•Developmental screening: for children under age 3 & surveillance throughout childhood•Diet: counseling for adults at higher risk for chronic disease•Obesity: Screening & counseling for adults & children•Sexually Transmitted Infection (STI): prevention counseling for adults & adolescents at higher risk who are sexually active•Tobacco Use: screening for all male & female adults & cessation interventions for tobacco users & expanded counseling for pregnant tobacco users•Domestic & interpersonal violence: screening & counseling for all women•Well-woman visits: to obtain recommended preventive services for women under 65

Potential Clinical Setting Openings for CMHC’s with ACA ImplementationClinical Mental Health Counselors will be ideally situated to provide Behavioral Medical Interventions based on their expanded training and implementation of AMHCA’s Clinical Standards. They will then need to promote themselves in the following settings:

General Practice: Family Practice & Internal Medicine Clinics

Rehabilitation In-patient and out-patient Centers

General and Specialized HospitalsSenior Citizen’s Independent housing,

Assisted Living & Nursing Homes

What are the future prospects for the profession?

•Recognized for VA Positions in VA Hospitals and Field Agencies which is good given the OIF and OEF veterans complex health issues

•AMHCA hopes to soon be recognized for Medicare Services

• Increased work in Behavioral Medicine in Hospitals, Rehab Centers & Primary Care Physicians’ Offices

• Increased work in Substance Abuse & Alcohol Treatment Facilities

Mental Health Needs of OEF & OIF Vets

•The invisible wounds which our OIF and OEF vets return with are staggering

•PTSD and TBI along with Combat Depression are staggering disorders which are impacting from 1/3 to 2/3’s of these vets. The Mental Health system over the next 5 to 10 years will become overwhelmed in meeting their individual as well as marital and family needs.

•CMHC’s need to be ready to serve this population

Baby Boomer Generation are Aging

•The increase in Boomers aging and their impact on the medical and mental health field cannot be ignored or underestimated

•It is imperative that CMHC’s be armed with Behavioral Medicine techniques to address the needs of this geriatric population to address their chronic health issues, disabilities and cognitive decline needs

What Skills Do Mental Health Counselors Need?

•Ability to understand dynamics of Human Development to capture good psychosocial history of clients

•Diagnosis of and treatment for behavioral pathology

•Evidenced based practices in psychotherapy to provide credible treatment to clients

•Understanding of basic neuroscience of brain and nervous system to understand roots of emotional responses to life’s stressors

•Understanding of psychopharmacological treatment of psychopathology

SO what’s Up in Utah? Related to all these Changes?State of Utah, UT (DCFS,DJJS) Diagnostic and/or Rehabilitative Mental Health

This multi-step procurement is issued on behalf of the State of Utah, Department of Human Services for the purpose of identifying and contracting with all qualified Offerors interested in providing Diagnostic and/or Rehabilitative Mental Health Services for clients in the custody of DHS, DHS/DCFS, or DHS/DJJS   (Outpatient Mental Health)

The initial submission date for Responses is: Monday, May 13, 2013 on or before 3:00pmSubmissions end: September 30, 2014 3:00 pm

Some Requirements for Contractors1. Use of Evidenced Based Practices with targeted youth

2. Use of SMART Goals: Specific, Measurable, Attainable, Realistic and Timely

3. Responsivity Principle: varying treatment according to the relevant characteristics of Client such as gender, culture, developmental stages, trauma, IQ, motivation, mental disorders, & psychopathy

4. “Telehealth” practice of mental health care delivery through interactive video communications when distance or other hardships create difficulty with consistent access to services. Telehealth occurs in real-time or near real-time.

5. Trauma Informed Care: providers must assess childhood maltreatment & may need to modify treatment based on understanding of neurological, biological, psychological & social effects of trauma.

Evidence Based or Evidence-Informed Treatment – Utah Model1. The treatment regimen shall be individualized based on the Client’s age, diagnosis & circumstances. This includes, but is not limited to, addressing grief, loss, trauma, and criminogenic factors affecting Client.2. Maintain fidelity of the approved evidence-based or evidence informed treatment program through monitoring effectiveness of program.3. Maintain documentation of staff training received and/or skills in t evidence based treatment for which Client will be engaged to restore the highest possible level of function.

CMHC Tools Needed to Put Health Back into Clinical Mental Health

1. Evidenced Based Practices2. Apps that Work3. Neuroscience4. Psychopharmacology5. Behavioral Medicine6. Military Focus Materials7. Multicultural Perspective as a

Mental Health Counselors8. Focus on the Military

Evidenced-Base Practiceshttp://coping.us/evidencedbasedpractices.html

1.Overview of Evidenced Based Practices2.Anxiety Disorder3.Obsessive-Compulsive Disorder (OCD)4.PTSD5.Phobias6.Depressive Disorders7.Bipolar Disorder8.Alcohol Dependence9.Substance Abuse10.Anorexia11.Bulimia12.Autism13.ADHD14.Guidebooks for EBPs15.Resources on Evidenced Based Practices

Apps that Work

•For Clients•For Practitioners•Moving the concept of Telehealth to new

levels

http://coping.us/evidencedbasedpractices/appsthatwork.html

Neuroscience

http://coping.us/introtoneuroscience.html

1.Basics of Neuroscience2.Stress Response of Humans3.Lectures on Neuroscience

Psychopharmacologyhttp://coping.us/psychopharmacology.html

Psychopharmacology ChartDrug Classifications to treat the following conditions:

ADHDAlcohol DisorderSchizophrenia and other Psychotic DisordersDepressive DisordersBipolar DisorderAnxiety DisordersEating DisordersDementia

Generic names of each drugCommercial names of each drugTime to reach clinical level for each drugBenefits of each drugSide effects of each drug

Behavioral Medicine

http://coping.us/introbehavioralmedicine.html

1.Background on Behavioral Medicine2.Lectures on Behavioral Medicine3.Behavioral Medicine Introductory Bibliography4.Internet Resources on Behavioral Medicine

Multicultural Competencyhttp://coping.us/multiculturalcompetency.html

1.Why the Need for Multicultural Competency?2.Cultural Immersion3.Multicultural Self-Assessment4.Challenging Your Cultural Biases5.Resources for Multicultural Competencies

Focus on the Military &Their Familieshttp://coping.us/focusonthemilitary.html

•Virtual Boot Camp for Civilian Mental Health Practitioners•Impact of Deployment on the Military and their Families•Psychological First Aid for Returning Military and their Families•Building Resilience in Tough Times•Addressing Compassion Fatigue in the Family and Workplace•Background Resources on the Deployment's Impact•Resources for Active and Veteran Military Service Members and their Families

So far so Good! So what else does COPING.US have which will help CMHC’s put health into CMHC which are Evidence Based Practice oriented so that they can be trusted to meet the needs of both the counselors and their clients?

EBP Tools on www.Coping.usTools for Coping: CBT based Client Workbooks1.SEA’s: 12 Step Program in Self-Esteem Recovery2.Laying the Foundation: Tools for overcoming

Patterns of Low Self-Esteem3.Tools for Handling Loss and Grief 4.Tools for Personal Growth5.Tools for Relationships6.Tools for Communications7.Tools for Anger Work-Out8.Tools for Handling Control Issues9.Growing Down: Tools for Healing the Inner Child10.Tools for a Balanced Lifestyle: weight

management program

How can CMHC use Tools for Coping Series

Clinical mental health counselors can utilize these workbooks with their clients to:

Expedite their treatmentEncourage their recoverySustain their well-beingIdentify triggers for & steps to prevent relapse

Tools for Coping Handbooks enable CMHC’s to challenge clients to:

Maintain personal growth in between sessions by use of: Exercises Tools for changing behaviors Journal writing

These workbooks are cost effective interventions based in clinically sound principles which have an evidenced based support in Cognitive Behavior Therapy for their efficacy & positive results

In SummaryToday we looked at How to put Health back into Clinical Mental Health by reviewing:1.The implications of the new Affordable Care Act (ACA) and how available tools can help clinical mental health counselors prepare themselves to be better able to present themselves to the medical community as legitimate partners in the prevention and treatment of mental illness in the next century2.The new 2011 AMHCA CMHC Clinical Standards and how they put Health into CMHC3.The need for Counselors to become Behavioral Medicine Specialists armed with understanding of Neuroscience, Psychopharmacology, Evidenced Based Practices and the needs of people who have experienced severe trauma such as the Vets from OIF and OEF.

THANK YOU ALL!

•Any further questions or clarifications you would like at this time?

End of Program

ACO’s Announced in 2013 in FL1. Accountable Care Coalition of North Central

2. American Health Alliance 3. BAROMA Health Partners4. Central Florida Physicians Trust5. Collaborative Care of Florida6. Diagnostic Clinic Walgreens Well Network7. Integral Healthcare8. MCM Accountable Care Org 9. Nature Coast ACO 10. Northeast Florida Accountable Care 11. Paradigm 12. Physicians Collaborative Trust ACO 13. Primary Care Alliance 14. ProCare Med 15. South Florida ACO 16. Primary Partners17. ProCare Med

Accountable Care Organizations in Florida First announced 2012

1. Accountable Care Coalition of Northwest Florida-NW Florida2. Accountable Care Partners – Jacksonville3. Allcare Options – All Florida4. Florida Medical Clinics-Hillsborough & Pasco Counties5. FPG Healthcare – All Florida6. HealthNet-Dade, Broward & Palm Beach Counties7. Integrated Care Alliance-North Central Florida8. Medical Practitioners for Affordable Care-Broward County9. Meridian Holdings – Florida10. Palm Beach ACO–Palm Beach/Broward County11. ProHEALTH Accountable Care Medical Group - Florida12. Reliance Healthcare Management Solutions-N & C Florida13. TP-ACO - Florida