Question/Answer Corner: What’s On Your Mind?

Q: Suicide assessment/prevention –

This month I’m passing along a tip gleaned from my August 28^th training: Self-Protective, Ethical Practices with High-Stress Clients/Situations: Walking the High Wire in Stressful Clinical Situations and Legal Involvement through Beyond Ethics, LLC. One of the participants, Logan, who works with a lot of high-risk clients suggested a useful tool for assessing and (hopefully) preventing suicide. It’s called CAMS, which stands for “Collaborative Assessment and Management of Suicidality.” The web site for further research is: https://cams-care.com/cams/.

Here is a quote from the home page:

“CAMS is first and foremost a clinical philosophy of care. It is a therapeutic framework for suicide-specific assessment and treatment of a patient’s suicidal risk. It is a flexible approach that can be used across theoretical orientations and disciplines for a wide range of suicidal patients across treatment settings and different treatment modalities.”

Logan said he has been using this tool for quite some time and finds it very useful in helping predict suicidality of clients. Then, an honest dialogue can be engaged in with the client.

We discussed this tool in relation to the suggestion I give in trainings to use Mental Health Directives with clients; that is, have client write down a list of people who could be called if the client presents on a certain day as likely to cause harm to self or others. The client gives emergency people’s cell numbers and signs giving permission for the therapist to use own discretion in calling. I encourage clinicians to utilize this as a clinical tool as well, by inviting the client to consider having one or more of the trusted others come into session to better understand the depth of depression and/or possible triggers for self-harm (or harm to others).

CAMS offers consultation and online training to have access to the assessment instruments. (No conflict of Interest Disclaimer: I have no relation with nor do I get any kickback from CAMS).

A: Although suicide assessment tools vary, it is essential for the clinician to protect him/herself by documenting very thoroughly each session where the clinician was making any type of suicide assessment.

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Engagement

I recently started teaching again in a masters level social work program (DUGSSW). It is such a fulfilling experience to be in a room with 20 fresh-hearted MSWs-to-be … so idealistic and full of compassion and curiosity and … engagement with our group. No one was secretly playing with the cell phone (hey, we all do that at meetings, right?). No one was yawning and slumping lower and lower in the desk chair (well, the iron rods I had installed in the back that they strap onto may have helped prevent the slumping). Impressively, all were listening to each other with rapt attention and adding their own pieces to the discussions.

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Therapy Office Available For Sublet

Deb’s therapy office in Lakewood (Green Mountain area) is available for subletting – only evenings and one half day left. Please check out her listing on Craigslist Denver or call her for more info or to schedule a time to visit the office. 504.232.8884

You can view photos of the office and read specifics of subletting at:
https://denver.craigslist.org/off/6303527092.html

DORA: What’s On the Various Boards’ Radar?

I try to attend many of the public Board meetings of all the Mental Health Boards: Social Work, Professional Counselors, Psychologists, Marriage & Family Therapists, Addiction Counselors, and Registered Psychotherapists. Each newsletter, this section will address current issues that arise in various Board meetings that may seem helpful for practicing clinicians.

NEWSFLASH: About 2% of all mental health disciplines except psychologists (CPD requirement just became effective) will be audited this year. If you are selected for audit, the notice will be appearing in the mail mid-November: just in time for the holidays! Wow. What timing. Failed audits will be reported in detail to your licensing board.

Here are some issues to consider from the LPC Board meeting this month:

1. In reviewing 23 Complaints (the Board broke for lunch and I had a class to teach, so I only heard reports on 23), only 4 were dismissed in the public portion of the Board meeting (others were referred to the private, Executive Session where details and discipline are discussed. Sometimes, matters may go to Exec. Session and be dismissed upon further discussion.)
2. Of the 23 Complaints, 3 involved allegations of sexual misconduct by the therapist with the client.
3. Of the 23, several involved divorce as the underlying context where one parent had filed against the other one’s therapist or against the therapist of the children.
4. Of the 23, there were 2 DUIs – one was a self-report and one was reported by a colleague (anonymously).
5. Of the 23, there was one supervision case where the supervisor refused to sign off on the hours and the supervisee filed a grievance about the lack of quality, regular supervision. The Board sent it to investigation to obtain all supervision notes.

Additional issues will be listed in the coming newsletters and Deb is always available to consult with your agency, private practice groups, clinical consultation groups, or with you individually to discuss potential high-risk situations.

Training/Consultation For Clinicians/Agencies

Deb has been providing training for high risk clinical situations and legal involvement of the therapist for groups here in Colorado. Deb consults with individual practitioners, small groups of clinicians, and agencies to help therapists prepare for deposition or trial testimony, or to handle a subpoena request for clinical records.

Deb is available to meet with individual therapists who need risk prevention consultation and/or with groups of any size for any type of self-protective, clinical practice in this litigious age. Deb can custom tailor training to your particular agency or small group with questions submitted in advance by participants, if desired.

COLORADO training

Nothing scheduled at present, but Deb is available to present a 3-hour (or more or less time) for your agency, private practice group, or any clinical group. Deb also offers individual consultations.

Some of the participants had this to say about Deb’s training:

• “Very helpful and informative. Thank you!”
• “Great info – very knowledgeable and great examples. Great reminders as well as some new nuggets.”
• “Could have listened to you all day! Great info. Lots to think about.”
• “Very good! Lively! Engaging! Knowledgeable! Very important information. Perfect timing.”
• “Deb presented excellent information that I feel will help me with my practice. Excellent info! Great workshop.”
• “I attend multiple, legal, ethical practice trainings and Deb is excellent in presentation. Thank you!”
• “Great advice about staying balanced/grounded in testifying.”
• “I appreciate Deborah being both a clinician and an attorney. Frightening possibilities regarding DORA, but [she helped me] know what possible protections I can possibly provide for clients and myself.”

Deb will be scheduling additional trainings concerning The Troublesome Interface of Legal and Clinical Issues in the near future in the Denver area.

LOUISIANA training

Deb will be doing another 3-hour Beyond Ethics training in New Orleans on November 3, 2017 entitled:

Ethical, Clinical Practice in the Electronic Age

Deb’s Clinical Practice

(1) Post-Divorce Facilitation and Mediation (if not already divorced) – if any of your clients are considering divorce or have recently gotten divorced, I am available to help facilitate the process between the parents with the co-parenting of their children. It takes a new headset to become successful, non-conflictual co-parents, especially when the baggage of divorce litigation is hanging heavy over their heads. If you want more information about the co-parenting facilitation, feel free to email or call me or have the interested client contact me.

(2) Deb will be teaming up with a Yoga instructor who offers Trauma Sensitive Yoga for survivors – both a teen group and a women’s group. We will be offering short-term (probably 6-week) groups starting in the New Year. These groups will be structured around providing a safe space for survivors of any type of trauma. Here is the blurb about the group:

Certified Trauma-Sensitive Yoga Instructor Rachel Stroud and Therapist Deborah M. Henson, LCSW are collaborating to offer two 6-week Trauma-Sensitive Yoga Workshops. One workshop is aimed towards teens who have survived or are enduring any type of trauma and the other is geared towards women trauma survivors. We are reaching out to the communities in Denver/Lakewood and surrounding areas to invite trauma survivors to start or continue their healing journey. If you are a trauma survivor or know of someone who could benefit from this type of workshop, we’d love to hear from you so we can come together to find a 6-week slot that works for the majority. Please email Rachel Stroud at [email protected] or call at 405-640-5132 to express interest and to collaborate meeting times.

Rachel & Deb are passionate about helping trauma survivors navigate through their healing journey and offering a safe place for them to heal from the deep places where trauma is held within the body. Trauma-Sensitive Yoga provides survivors with the opportunity to heal from the source, empowering them with renewed relationships with their bodies.

• Learn how to connect with your breath, mind and body to provide calm and safety within
• Learn techniques to help release stress, tension and anxiety
• Find connection, strength and support with others in a safe setting
• Learn to process your trauma & healing through movement, optional group sharing, journaling and mindfulness.

Trauma is different for everyone. The exact same traumatic event can, and likely will, affect individuals differently. Trauma can be, but it not limited to:

• PTSD of any kind
• Childhood trauma
• Sexual trauma
• Surviving a natural disaster
• Surviving/witnessing an attack
• First responders holding trauma from their first-hand accounts on the job
• LGBTQ processing/marginalization/discrimination/questioning…etc.
• Emotional/spiritual/physical abuse or trauma
• Death of a loved one and/or close encounters with death
• Surviving an accident
• Surviving or witnessing anything horrific and/or traumatizing

Again, please email Rachel Stroud at [email protected] or call at 405-640-5132 for inquiries and interest. Thank you!

(3) Deb offers family counseling to those who have a LGBTQ kid or family member of any age coming out. If sufficient referrals come forth, Deb and another clinician will start a multi-family group, which is very potent for families who feel isolated as in these situations. For more info, please call or have the family member call Deb at 504.232.8884. Deb is also a new Board member for PFLAG and will be assisting with the support groups in the near future, including the family and significant other support groups.

Legal Services Offered

• Legal Representation & Consultation for grievances (complaints) to licensing boards and/or malpractice lawsuits
• Training & Consultation for Clinicians and Agencies (e.g., respond ethically to subpoenas while protecting yourself and your clients; identify high-risk clients and situations to avoid client disciplinary complaints and harm to clients or third parties)