Basically..... how do you know when its time for change?

Much my internship work is completed by working with substance abusers. Therefore today we'll discuss the Stages of Change, a model that can be used extensively by counselors to gauge a client's willingness to change and begin a life in sobriety. There are 5 stages that clients go through in the process of getting sober.

1. Precontemplation - this stage there is no thought or urge to even entertain the thought of quitting substances. In this stage you as a counselor will have to roll with any resistance you might encounter from clients. 
2. Contemplation - step 2 is the stage where clients become aware of some of the negative consequences that they are facing due to substance abuse - but they are NOT ready to change yet. Here clients have identified a problem and are only entertaining the though of doing something different. 
3. Preparation - the "I want to change" stage. Here clients will be seeking change and begin going through proper steps to change. Many clients might skip this stage and go straight to the action step, which mat lead to them relapsing because they are ill prepared. Some preparations include entering rehab facilities, intensive outpatient programs, seeking out counselors, or searching for help from other professionals such as medical doctors or psychologists. This stage prepares clients for sobriety by informing them of the action and maintenance stages they'll be engaging in. 
4. Action  - this is the actual working stage. Going to AA/NA meeting, meeting with helping professionals, changing their social setting, and/or engaging in self-directed behavioral change are just some things you can expect to see from your clients in this stage. In this stage your clients are working to remain sober, you aren't convincing them to not use but instead are strategizing with them healthy social/environmental alternatives so they can remain sober. 
5. Maintenance - this is where you clients will continue to do what they have learned while in the active phase. Such activities include going to AA meeting, continuing to meet with counselors, continuing to engage in activities that contribute to their sobriety. Its important to note that although AA was noted as an example, this is not a requirement for clients' sobriety, many people get sober without the help of AA or their services. 
1. In the case of relapse, this process begins all over the again with precontemplation. According to the National Institute on Drug Abuse,  approximately 40-60% of all substance abusers relapse, so there is a high possibility that you will have clients that are constantly going through this process. Although this is not always the case and it would not be advised that you approach your clients with this mentality. 

Minus the maintenance stage, which ideally should be life long, the stages of change should take a couple of months. As a counselor you should be able to see your clients progressing through the stages - also be mindful that this is not a fluid process. That means that once your clients have to fully complete one stage before moving on to the next, so if your client is looking at detox centers in one session but then continues to use - your client is still in the precontemplation/contemplation stage. Below is a diagram that expresses the stages in a circular manner (incorporating relapse into the change process.)

Here you can hear me further discuss stages of change when dealing with adolescents. Enjoy!

Basically.... Let's go international!!

As you have already suspected, people ll over the world experience depression, anxiety, suicidal ideations, bi-polar disorders, and other mental health illnesses. Today we look at international counselors, in the sense of American counselors who travel to another country to counsel and counselors in born and raised in different countries. Lets start by discussing opportunities for counseling abroad.

For those like me who are interested in traveling and living abroad, international counseling may be a route for counselors to consider. There are many jobs abroad that are now coming to seek counselors to help infleuence their communities and companies. So if you're like me, you're probably thinking "well can I go abroad to counsel?" Well of course you can! You just have to go out and look for the opportunity to do so!

Where do I start?

Glad you asked, I'll go over some job sites that are currently seeking counselors. However you should be advised that some of these job offers are through individual organizations so you should do extensive research before you go divulging your personal information online. Abroad.com has a section devoted to counseling jobs overseas, however this jobs are independent organizations. Some of the countries listed are Japan, New Zealand, China, and Germany to name a few.
International School Services has a list of international schools that are seeking counselors for different countries. However if you are not wanting to work closely with children, this site is not the one for you. Lastly USAJobs.gov has a section for recent graduates seeking employment, so for those in my position, this is an ideal place to start for me.  Listed below are other sites that I've come across but have mixed feelings about their authenticity, so proceed with caution:

• http://www.oacac.com/jobs
• http://www.learn4good.com/jobs/schoolcounselor/united_arab_emirates_uae/postings/
• http://boards.bootsnall.com/volunteeringworking-as-a-therapist-abroad-t30139.html

So I've looked over the sites and I'm ready to start the applications! But wait, what's the catch-22?

Well here are some stipulations to counseling abroad that I've come across:

• Your should be fluent in the language of the host country that you are traveling to.
• Well if you think about it this makes perfect sense, why would you hire a someone from a different country who you are unable to communicate with?
• You'll have to be licensed.
• Almost all the positions that I looked into required a licensed counselor, social work, MFT, etc. They also usually specified that there be a minimum time period that you experience in the specific job area. 
• Think about it - as an employer I'll have to go through hoops to legally employ you so I better make sure you're worth the trouble!
• You might have to work in a rural area.
• Many of the positions that I've come across have been with partner organizations that are targeted at improving developing countries where you might not have certain luxuries.
•  You might have to be willing to take a pay cut.
• Like I've previously stated you might be staying in rural areas where your working with a private organization that has low funding but high enthusiasm for helping others. You'll probably receive food, shelter, and other basic needs met, however there actual pay that you'll receive may be much lower than you're used to. 
• This disclaimer does not apply to jobs offered through the US government, such as being a traveling counselor on military bases.
• Your position might be temporary. 
• Depending on the stipulations in your contract or the agency you go through, the gig might be up in a couple months! This means that you have to consider if you're financially stable enough to move, if your family would be moving with you (if you have a partner and/or children), among many other things.

Those were just some of the things that I noticed or thought might be useful to consider when applying to jobs abroad. Although some of the considers might seem overwhelming, my suggestion would be to apply. You's rather say apply and have to turn them down than never to apply at all and spend the rest of your days thinking of what could have been!!

Till next time! 

Basically.... mental health looks different on each person!

This is a little different from my normal posts, however I think that it is important to emphasize the true importance of encouraging others to seek treatment for their mental illness. At my internship site there has been a recent death of a former patient. One of the patients was going through detox and having difficulty with that experience of a newfound sobriety. This patient was a middle aged man with a wife and children, working, and an overall productive member of society. He had recently decided to stop his substance use and begin the path to sobriety. One dilemma that quickly arose for the patient was his pain increased pain from his chronic illness. Although the patient had been suffering with this pain for years, recently his pain had worsen so much that he eventually began experiencing anxiety surrounding the spontaneous onset of his pain as well as depression from his inability to stop the pain. When I saw this patient he was very much upset about his life in general, he spoke very little and when he did he spoke negatively about his life and his circumstances. Shortly after our initial meeting at the hospital, I was informed that this patient had committed suicide Initially this incident took me by surprise because I felt that there were no warning signs that he gave to me, my supervisors, or other groups members that he was even thinking or planning on committing suicide. After a couple days of dwelling on this patient, I was still highly bothered by the actions of the patient. From my perspective this patient had everything to live for, he was sober, going to seek treatment from the doctor about his pain, and was rebuilding his relationship with his family. It was at that moment that I was reminded of the magnitude of mental health on an individual. Just like other illnesses, mental health can be severe such as bi-polar disorder or schizophrenia, or less severe such as depression or anxiety. Regardless of the case, this is a serious disease that can ultimately claim one's life if untreated. One way to ensure treatment is through discussion and information of illnesses.  Regularly talking about the signs and symptoms of mental illness not only normalizes it, but helps other to realize that they are not alone and that help is out there if they seek it!

Basically.... you don't have to do it alone!

The beauty of technology is that it can connect various people all around the world and cause strangers to feel like best friends, however that same connection can make those feel lonely once they are no longer online. This week we'll go over some websites the help bridge the gap to where the internet meets the real world.

As I'm sure you are aware of there are various blogs sites and chat rooms nowadays that allow for the people to make genuine connections and interact with likeminded individuals. (And in case you didn't realize it -you're on a blog site now!) Back to the sites and chat rooms, what happens when your computer shuts downs and you lose your internet buddy? Do you not speak to anyone else in your non-internet life? Are the only ones you can relate to only found on the internet and not within your home town/city? Well of course not silly! You find the help you need when until you can get the help you want. The question now lies in where will you find this help?

Here - Find Youth Info!! This is a great site for a plethora of reasons, one being that there is an option to find local resources that can connect you to real people in your city/town that can be of services or support. This site provides information not only for mental health illnesses, but also other issues that youth face. There is information about teen dating violence, gang prevention programs, substance abuse, LGBT youth, teen pregnancy, and those are just a few of the topics. This site also gives research information, which are empirically based - meaning that these are research papers where there have been experiments conducted and the results were reviewed by other professionals. The Map my Community link will allow for youth to connect to local resources. So lets put things into perspective. Suppose you're doing distant counseling with a youth living in an area within another state that you're unfamiliar with. Every time you speak with your client you feel as though you're making progress, but the next week you find out he was not as proactive as you would like him to be. You know your client is in always online and loves the friends he has online  but doesn't think he can find "cool" people in his city. You can direct your client to the community site where he can pick from various options that he's seeking help for, including mental health, and then find the local resources. Although this sounds simple as pie, the difficulty lies in actually having your client go to meet others in person and separating themselves from the online connections and branching out.

There are many other websites that offer similar services, not only in person options but online options also. if you would like a list of blogs, websites, and other things online connection options - you can visit my information page and see the list of about 30 sites. Hope they help!

Until next time readers!!