Stopping Schizophrenia in Its Tracks

Tuesday, October 28, 2014

Stopping Schizophrenia in Its Tracks

By Darcy Gruttadaro, Director, NAMI Child and Adolescent Action Center

http://blog.nami.org/2014/10/stopping-schizophrenia-in-its-tracks.html

For those experiencing psychosis, early identification and intervention matter—a lot. It lessens the long-term severity and often prevents psychosis from worsening. An effective early identification and intervention program should include the following coordinated array of services and supports:

·      Supported education and employment.
·      Cognitive behavioral therapy.
·      Peer support.
·      Family support and education.
·      Case management.
·      Community outreach.
·      Low dose antipsychotic medication.

These services work so well because they are offered together to provide the skills and support that youth and young adults need to get better. They also take into account the context of a young person’s life and the key role that peers and families play in recovery.

FEP (First Episode Psychosis) programs reduce costly hospitalizations and put youth and young adults with psychosis on an early path to recovery.

When you fund upstream interventions, you can prevent the tragedies associated with untreated mental illness: school failure, unemployment, hospitalizations, homelessness, jail and suicide. Investing in effective programs that intervene early produces far better outcomes for individuals, families and communities.

There are effective strategies available, so why aren’t more young people getting help? One of the main reasons is that these services and supports are simply not available in communities. However, there has been progress made recently that to help ensure the availability of these resources in more towns and cities across the U.S.

One significant event is that Congress has now required states to use 5 percent of their Mental Health Block Grant for First Episode Psychosis (FEP) programs. This means that states are obligated to set aside a certain amount of their federal funding to address the importance of early intervention.

How Is NAMI Helping

We recognize the urgency in expanding these programs. Our advocacy work and involvement in these programs is happening at all levels of the organization.

NAMI NYC Metro is partnering with OnTrackNY, an FEP program, in providing support groups and peer support for youth and young adults experiencing early psychosis. NAMI Connecticut is offering peer-run young adult support groups located close to FEP programs to make it easy for young adults to join. NAMI Minnesota has partnered with an FEP program and is creating education and support programs for youth experiencing early psychosis and their families.Oregon was an early adopter of these services and supports, having witnessed the success of these programs in Australia. Tamara Sale, the director of the Early Assessment and Support Alliance (EASA) in Oregon and a former long-time NAMI Oregon board member, shared how their program works successfully with youth and young adults experiencing early psychosis.

The EASA program recognizes that it can be difficult to engage youth and young adults experiencing early psychosis, so it uses strategic community approaches that meet young people where they are with messages of hope and relevance to their lives. They are flexible and persistent, even with youth and young adults that seem entirely uninterested in mental health care.

What You Can Do

FEP programs exist in a handful of communities and more must be done to spread these programs across the country. Here is how you can make sure that happens. Learn more about FEP programs. Understand why these programs are pivotal in creating better outcomes.Email or Tweet your Congressional members to thank them and to ask for their continued support of FEP programs.

Connect with your NAMI Affiliate in advocating at the state and federal levels for FEP programs so that youth and young adults experiencing early psychosis can access effective services and supports.

We can and must change the trajectory of people’s lives by intervening early with recovery-oriented and effective services. We simply cannot afford to wait.

Collaborating with students: Invite them to the IEP process

   

Collaborating with students: Invite them to the IEP process

Written by: Dr. Pamela Hill (http://exclusive.multibriefs.com/content/collaborating-with-students-invite-them-to-the-iep-process/education)

In the typical special education scenario, the special education team sets the goals for the student receiving an Individual Education Plan. However, at the age of 14 the student reaches the age of transition and begins to collaborate with the special education team to plan goals for his future.

The law intends that students can be involved with any transition decisions before age 14, which may include discussion of student goals and accommodations needed to be successful in school. But it is rare that a student attend his own IEP meeting before age 14, and there is little research to show that students are participating in developing their own IEP goals before age 14.

Does it really matter if the student participates in his IEP meeting before the law recommends he does? A poignant article written in 2006 called "Why is this cake on fire?" compared attending an IEP meeting to attending a child's own birthday party. The child was not invited year after year, and then when he finally was invited as a teenager he saw no reason to attend.

The meaning of the metaphor was clear. The child needs to attend — and be involved in a greater way — well before he is a teenager if we expect him to understand that the IEP is written as a plan for his success.

The crux of the IEP are the goals set to guide the student's educational process for one school year. There is plenty of support for students writing educational goals as a means for improving their own learning. Student-written goals can be a motivating factor for achievement in school and for attainment after school.

Wood, Karvonen, Test, Browder and Algozzine have delineated that students can begin to write simple goals with adult assistance at age 6. Beyond age eight they can set goals independently, determine actions and make changes to actions to meet the goals. Teaching students to write goals in the classroom can lead to a natural transition for teacher-student collaborative IEP goal development.

Discussion with students regarding their school goals will begin the process of looking to the future and then planning the steps to get there. Students can be taught that all types of goal development follow a simple pattern of questioning to guide decision-making.

·      What do you want to happen and why is it important?

·      By when do you want it to transpire?

·      What steps will be needed to make it measurable and successful?

·      How will you know when it is met?

Students need to develop goals that are realistic and achievable, and ones that are mastery-type goals. According to Alexandra Usher and Nancy Kober, mastery goals "involve demonstrating increased understanding, skills and content knowledge" which leads the student to "deeper cognitive processes, strategize more effectively, and more adaptable to changes."

Many students — especially those with learning disabilities — do not understand that a desired effect occurs by planning and negotiating the actions that lead to an outcome. Many think they have no control of their school accomplishments. However, students who develop and follow their own goals have an increased opportunity of developing positive motivation, self-efficacy and self-determination when meeting goals and experiencing success.

Once an educator makes the choice to include the student in the IEP process and not just "do it for them," she is making a choice that will influence the student for the future. The goals belong to the students, not the educators. It makes sense that the students take hold of the process early, and when they reach the age of transition they will already have a plan that has deep roots in success.

WEBINAR: 4 Critical Steps to Obtaining Coverage for Residential Treatment

Two recent court decisions weigh heavily in favor of families getting residential therapy coverage from their health insurance plans through the Mental Health Parity Act. The non-profit Autism Health Insurance Project, as one example, has successfully helped two families obtain insurance coverage for 7 months of their child's residential stay.

In order to build on this, the Autism Health Insurance Project is hosting a Webinar on how RTCs can help their patients get insurance coverage on Aug 5, 2014 at 1:00 pm, eastern daylight time. It is a no-cost webinar that can clue you in on the most effective ways to help families obtain insurance coverage of medically necessary treatments.  

If you’d like to take part in this Webinar, you may register by clicking on the following link:

http://www.autismhealthinsurance.org/webinar-4-critical-steps-to-obtaining-coverage-for-residential-treatment

Teenagers and Pornography: A New Look

excerpts taken from, "The Interpreted Rock"

World-wide, the porn industry earns more than $57 billion every year. In the U.S. alone, porn rakes in about $12 billion each year. That's more than the combined income of all professional football, baseball and basketball teams.  The audience numbers are equally astounding.  Family Safe Media, a media watchdog group, reports children aged 12 to 17 are the largest viewers of internet pornography.

Dr. Kimball says a crisis is looming. “As a clinician, the biggest increase in private practice and couples therapy are couples coming to counseling because one of them is entrenched in porn. The impact on marriages and families is immense.  And it starts when people are in their teens.”

Most of the children Kimball treats for sexual dependencies are between the ages of 14 and 16. Dr. Kimball believes these teens have been struggling with pornography problems for some time before their parents seek treatment. 

In “Teenagers and Pornography Addiction,” Dr. Haney wrote, “When a teenager is subjected to an arousing image, the adrenal gland secretes epinephrine into the bloodstream, where it proceeds to the brain.  Other body chemicals, such as serotonin, adrenaline, endorphins, and dopamine also are at play creating a euphoric state in the user. Teens who experience this biochemical thrill will, not surprisingly, want to experience it again.”

Lott worries that children are becoming sexualized at increasingly younger ages, mostly because of television and Internet. “It’s a very powerful medium that people react to differently.  As a general whole, Internet pornography could be described as a gateway medium to more serious sexual dependencies, obsessions and compulsions.  It impacts every youth differently.  For some, it really captures them.”

Most experts feel the best way to help your child is by getting a proper assessment of the problem.

“Call someone who specializes in treating sexual addictions,” advises Dr. Kimball.  “In these children, sexual addiction is one small part of the problem.  The program should also address depression, anxiety and social skills.”

Kimball cautions parents to realize there is a difference between experimenting with pornography and being addicted to it.  “You don’t just throw a child into an in-patient setting. Assess the problem and then address the level of care.”

Lott says a teen who has crossed the line and gone from watching pornography to touching or abusing another person will require in-patient care in a highly specialized environment. 

Conference: Failure to Launch- Understanding and Addressing the Increase in Struggling Young Adults

Please join me and the other incredible panelists as we explore the issues of Failing to Launch. This will be a great luncheon geared towards families and professionals. June 6, 11:00-1:00pm at Maggianos, Woodland Hills. $15.00 admission includes a great lunch! Please follow the link below to register. Seats are limited and filling up. Looking forward to seeing you there.

http://www.optimumperformanceinstitute.com/events/optimum-performance-institute-to-host-failure-to-launch-panel-discussion/

ICC-LA Conference "Guidance for Therapeutic Placements for Teens and Young Adults with ASD"

Here are a couple of slides from my presentation today... It was a great day and I enjoyed meeting everyone! Thank you again to Greenhouse Therapy for inviting me to present.

Promises Treatment Center Annual Spring Conference

I am looking forward to presenting at the upcoming Promises Spring Conference. I will be speaking about young adults and potential reasons why they are failing to launch. We will explore the concept of emerging adulthood, heightened risks, and available resources. Thanks again to Promises for this great opportunity. Free CEUs will also be available.
http://www.ebhevents.com/upcoming-events/promises-hosts-spring-annual-ceu/
http://www.prweb.com/releases/promises/young-adult-rehab/prweb11747489.htm

2014 Thinking Positive Panel presented by CIP

Last night I had the pleasure of presenting along with other industry professionals. The night was full of great information and inspiration! CIP: Thinking Positive Event

Addressing the Needs of Young Adults with Learning Differences (High-Functioning Autism, Asperger’s Syndrome, ADHD)

Insight Into College, Employment and Independence for Young Adults with Learning Differences including High-Functioning Autism, Asperger's Syndrome and ADHD

Featuring panel presentations by several expert guest speakers who work with the Autism and Learning Differences community and young adult transition; offering advice on the key stages of transition to adulthood including: letting go, adjusting to college, finding success in the workplace and achieving independence. 

Professional Endorsement: Thank you Kimball DeLaMare

Kimball DeLaMare

Senior Vice President at InnerChange:

In over thirty years of working with professionals who provide support to families seeking direction on how to make healthy changes individually and collectively it is rare to find one who truly understands sophisticated methods of assessment, the inner workings of behavioral health programs, and the variety of treatment approaches available to assist with such change. Jessica's rich clinical and administrative background coupled with her vast knowledge of programs is impressive. Most importantly, Jessica "gets it" when it comes to the tender emotions we all experience when faced with crises, disappointments, triumphs and loss. I highly recommend Dr. Romeyn

‘TOP 10’ tips for High School Students Getting Ready to Transition to College

NCLD’S ‘TOP 10’ TIPS FOR HIGH SCHOOL STUDENTS

by Dr. Sheldon H. Horowitz

Director of Professional Services, NCLD

All students, including those with learning disabilities (LD) are faced with a unique set of challenges as they approach the transition from high school to college. It is especially important, however, that students with LD understand their areas of strength and weakness, and manage

their transition to college by planning carefully and lining up the right kinds of services and supports that are essential to their success.

The following is a ‘top 10’ list of ways for students with LD to orchestrate a successful transition to college. And remember: self-insight, self-advocacy, flexibility and perseverance are all important factors in the transition process.

 1. Know your strengths and weaknesses and be able to share them with others.

Talking about your LD in ways that can be understood by professors (and even fellow students) is very important. It’s best to assume that people are not familiar with the challenges posed by LD. Be sure to be specific about the nature of your LD and the accommodations that will help you succeed.

 2. Get to know the college campus and the resources and activities it has to offer.

Knowing your way around campus can make a huge difference, especially at the start of your college career. Whether it’s scoping out the perfect nook in the library, finding the quickest route to the cafeteria, or locating the Student Support Center and the campus health center, having a good sense about where things are in and around campus can save time and avoid confusion later on. And don’t forget to target the laundry room, late night pizza places, and the campus book store while you’re at it.

 3. Identify task demands or situations that could prevent you from achieving success.

Lots of term papers? Long reading assignments? Taking notes during a class lecture? Preparing for quizzes and exams? These are not going away any time soon! Know what to expect in each of your classes, and make a special effort to discover any and all unexpected demands so you’re not surprised and overwhelmed when they arise.

 4. Be proactive, anticipate problems and be prepared with solutions.

Make a wish list of the types of help you will need to be successful, and don’t waste any time putting them in place. For example: if you know that writing essays does not come easily,check out the campus Writing Center (often very helpful, and almost always free of charge!)or get feedback from someone before submitting. You can also ask professors to review your work and provide comments before assigning a grade, allowing you to resubmit with corrections (most professors are more than willing to accommodate this request). If reading is an area of weakness, consider a subscription to Recordings for the Blind and Dyslexic or other sources that read texts aloud.

5. Know where to go for help BEFORE you need it.

On campus and off, there are lots of places you can turn to for help-- parents, counselors and therapists, and friends are all possible sources. The key is not to wait until it’s too late and you have to “catch up” with deadlines or use up valuable time figuring out the best source for help.

 6. Keep your emotions in check.

Getting upset or angry at yourself, professors, parents, or friends will drain energy and attention better spent getting work done. Being in a college environment means juggling all kinds of emotions, and there are times when this will seem like a monumental task. Don’t be reluctant to seek help when sorting out you feelings! Everyone needs someone to talk to, and you don’t earn extra points by suffering alone.

 7. Balance school demands and social time, without letting either one be all-consuming.

All work and no play is a prescription for exhaustion and aggravation. All play and no work is a fast road to failure in school (and in life!). Set reasonable goals for yourself, make sure to devote enough time and attention to schoolwork, and rather than “winging it,” try to schedule down time to relax and be with friends.

 8. Don’t forget to eat well and get enough sleep.

An endless array of foods (some better than others) and all kinds of social distractions await you in college. Don’t underestimate the importance of a healthy diet and getting enough rest. Everyone’s internal clock for sleep is different and some people do just fine with less sleep and frequent power naps. Some people enjoy frequent snacks and small meals while others need more substantial meals on a regular basis. Know how you function best, and be thoughtful about building these important activities into your schedule. (And no, this is not a message from your mother!)

 9. Think and plan ahead.

Routines are worth their weight in gold during your college career. Thinks about how you would like to spend your time, whether you prefer classes in the early hours or later in the day, clustered on a few days or spread throughout the week, and do your best to organize your schedule accordingly. Don’t wait until the last minute to speak to professors or submit class requests to avoid being closed out of your top choices. And to paraphrase the poet Robert Burns, “the best-laid plans of mice and men often go awry.” Routines are great, but when they need to be changed, try to rethink your needs and priorities without delay. (And again, don’t hesitate asking for help working out new options).

 10. Don’t assume!

In high school, parents and teachers are monitoring your progress via report cards, reviewing IEP goals and other informal channels of communication. Once you are in college, YOU are the one in charge! If you want something to get done, don’t wait for someone else to do it. And always to follow up to ensure that it happens.

For more information about these and other important topics, visit the Living with LD section of

NCLD’s web site at www.LD.org.

 © 2008 National Center for Learning Disabilities, Inc. All rights reserved. This publication is provided free of charge by NCLD. Wide distribution, with proper citation, is encouraged.