Author: Kayla Quesnel

Ask the Experts: Transition for College Kiddo with High Anxiety

This article originally appeared in Macaroni Kid on June 10, 2021, by Marylena Chaisson, LCPC, Case Management Clinical Supervisor, Health Affiliates Maine. 

Question: My son is a senior and will be going out of state for college next year. He has fairly high anxiety and lacks executive functioning skills. I am feeling very anxious about him being far from home. How do we both prepare for this big change?

Answer: Big changes ahead! Let me tell you that you’re already doing great just by thinking about these challenges ahead of time and acknowledging there might be a couple of bumps here and there for both of you, so first off, please give yourself a pat on the back for being a caring and nurturing parent! Changes like this can be stressful for the whole family. Please remember to take care of yourself and attend to your own anxiety and stress over this change by seeking the support of a counselor, even if just for a few short-term, solution-focused sessions. 

Here are some specific thoughts about your son and his transition to college life:

  • I would encourage him (maybe with a little support from you) to reach out to the college’s student counseling staff right away–even this summer. This could be something you can support him with. Counseling staff at college are well-versed in the array of transitional struggles that frequently occur with this population of young adults and can better support new college students if they know ahead of time what challenges might surface. I will be surprised if the college does not have a counseling option for their students. If they don’t, reaching out to the Dean for guidance towards locally available counselors might be the next thing I’d try.
  • Review with your young adult the various strategies that you’ve both been implementing already for him to keep up with his high school classes and helping out around the house–if he’s passed high school and been accepted to college, that tells me he has some capacity for executive functioning as long as there are some supports in place. Is he a list-maker? Does he use a planner? Does he have a calendar on his phone? Do you use a weekly chore chart in the house? Every family and every individual is different, and it’s very common for most of us to use one or more helpful strategies or tools to stay on track. You will want to encourage him to replicate these same tools/strategies in his new college environment as soon as he moves out of the house. 
  • Begin the transition to more independence early.  Sit down with your young adult and discuss what activities he will need to accomplish independently when at college–doing laundry, making it to the cafeteria during mealtime, waking up to an alarm so he can make it to his classes on time, being responsible about bedtime–and think of ways you can start promoting independence on these things this summer. Follow through with natural consequences. If he commits to waking up by himself to an alarm to get to a summer job, and then sleeps through the alarm and ends up getting in trouble at work–that’s a natural consequence that he might need to experience and learn from. It can be very hard as a parent of a transitional-age youth to avoid jumping in and “rescuing” them from poor decision-making or low responsibility, but that is part of your work as a parent right now to assure a smoother transition to independent living.
  • Look at the college schedule for the academic year and plan ahead about staying connected during the week through video chats or phone calls, and make a plan for his trips home so you both know what to expect. For the extended times he plans to remain on campus, make sure you come up with some fun activities to keep yourself occupied–have there been hobbies or activities you’ve been wanting to get back into or try that you haven’t had time for? This can be a great time of personal growth for you, too!

Remember that times like this are a great opportunity for growth for everyone in your family. Sometimes growth doesn’t feel good at first (remember growing pains as a kid?), but a little bit of discomfort isn’t necessarily a bad thing. Open and honest communication and great boundaries are some of the biggest stepping stones towards this transition being as smooth as possible!  I’m excited for you!

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Posted on by Author Kayla Quesnelin Categories Macaroni Kid, Q+A

What is PTSD?

Post-Traumatic Stress Disorder (PTSD) is caused by experiencing or witnessing an event such as an injury, death, war or combat, natural disaster, abuse or assault. Trauma is not rare—it’s estimated that 70% of Americans of all ages, genders, and ethnicities go through at least one trauma in their lifetime.

While not every trauma will result in PTSD, a traumatic event actually changes the cognition in the brain causing a person to continuously release stress hormones and always be on high alert. Constant, high stress and other symptoms of PTSD can have a negative impact on mental, physical and emotional health.

PTSD vs. Stress and ASD

A PTSD diagnosis is not the same as daily stress or Acute Stress Disorder (ASD). Daily stress is a normal part of life and something we all navigate in our own way. PTSD can develop if ASD (whether professionally diagnosed or not) wasn’t properly resolved or the person didn’t have access to appropriate coping tools. A PTSD diagnosis can occur months or years after a distressing event.

Acute Stress Disorder is usually diagnosed immediately after a traumatic event and can last for days or several weeks; however, it usually resolves naturally with healthy coping strategies or with counseling. If left untreated, ASD can develop into PTSD. This can lead to other serious conditions such as depression, anxiety disorders, eating disorders, or substance abuse.

The symptoms of ASD and PTSD are quite similar, but duration and timing of the diagnosis sets them apart. Signs and symptoms can include

  • Irritability or anger
  • depression or deep sadness
  • intense stress or anxiety
  • nightmares and trouble sleeping
  • feeling isolated
  • troubles controlling or expressing emotions
  • problems trusting others
  • difficulty maintaining relationships
  • flashbacks, pervasive negative thoughts and memories

 

 

Can PTSD be treated?

Psychotherapy, or talk therapy, is highly beneficial to those working through PTSD. Talk therapy helps to bring up feelings, memories and emotions associated with the traumatic event so that proper processing and management can occur. Some individuals will take medication in conjunction with talk therapy and/or group counseling.

In addition to counseling and medication, here are some examples of healthy coping strategies for living a content, fulfilled life.

Physical Health: By exercising, eating and sleeping well, and avoiding drugs and alcohol, you can relieve feelings of intense stress. Research shows that by setting goals and being consistent with your workout routine you can reduces stress.

Emotional Health: Practicing mindfulness, meditation or prayer keeps your mind in the moment. These practices allow for you to acknowledge feelings or memories and then “let them go.” Starting small with one or two minutes at a time can help limit stress, anxiety, depression and increase feelings of being grounded and present.

Community connections: Spending time with others especially understanding loved ones and people in a support group can help with feelings of isolation, avoidance or wanting to shut down.

Counseling: A professional counselor offers a comfortable, judgement-free safe space so that you can process your thoughts, feelings and memories in a healthy way. Be kind and patient with yourself. Consistent appointments allow for progress in your recovery.

Journaling: Writing your thoughts, feelings and memories rather than ignoring them or pushing them away allows you to work through them and also help to identify any triggers you may have. Remember that recognizing and processing emotions is a form of strength.

Be honest: If you’re ready, tell your loved ones that you’re living with PTSD—it’s nothing to be ashamed of. Maintain healthy boundaries and communication within your relationships can aid in your recovery.

Educate yourself: By learning about PTSD, it can help you and your loved ones better relate to one another. Let your loved ones know that even just listening to you and your experiences can helpful and is appreciated.

We all struggle at times, but help is here. If you’re unable to express your thoughts, feelings or have trouble with daily functions, consider reaching out to a friend or a healthcare professional.

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Posted on by Author Kayla Quesnelin Categories News

A warm HAM welcome to our new clinical supervisors!

Jay Burrows, LCPC, LADC, CCS
Jay Burrows is a Licensed Professional Counselor, a Licensed Alcohol Drug Counselor and Certified Clinical Supervisor. In addition to providing counseling services to clients, Jay assists his colleagues and helps to develop their counseling skills.

Jay attended the University of Southern Maine for his undergraduate degree and for his Master of Science in Counseling with a Clinical Mental Health Concentration. Prior to graduation, Jay completed his internship at a residential program treating mental health disorders along with co-occurring substance use disorders. After graduation, Jay joined Catholic Charities Counseling Services in Portland as a clinical counselor providing outpatient services. He stayed with Catholic Charities for more than eight years. During this time, Jay worked with a co-occurring population who were often incarcerated or involved in the criminal justice system.

This experience led Jay to establish an Intensive Outpatient Group at Catholic Charities, which he facilitated for five years. Here he helped people gain more pro-social attitudes and behaviors, increasing their ability to successfully reintegrate into their communities and decrease their rates of recidivism.

In his role as clinical supervisor at HAM, Jay is dedicated to helping colleagues deliver quality services to their clients while also developing strong professional ethics. He also mentors clinical internship students, preparing them for a future in case work.

Outside work, Jay can be found reading a captivating book or volunteering with his community’s little league. He spends his summers traveling to Bar Harbor with his wife and four children.   

 

Lindsay McKeen, LCSW, CCS
Lindsay McKeen is a Licensed Clinical Social Worker and Certified Clinical Supervisor. In this role, Lindsay reviews client treatment plans, clinical records and the professional concerns and goals of other practitioners.

After attending the University of Maine Orono for her undergraduate degrees in social work and psychology, she then earned her Master of Social Work from the University of New England in Portland. Since then she has worked as a clinician at St. Mary’s Regional Medical Center in Lewiston in the Psych and Chemical Dependency Unit. While there, Lindsay used a strengths-based approach with her clients to identify their goals and treatment plans.

Lindsay received the “Service Star Employee” and “MVP” awards while at St. Mary’s. She is a lifelong learner, always looking to continue her education and professional career (ask her how quickly she can solve a Rubik’s cube)! She has completed many professional trainings including trauma-informed care in behavioral health, cognitive behavioral therapy certification, ethics in boundary setting, motivational interviewing, and art interventions for addiction, anxiety and chronic pain.

When away from work, Lindsay’s favorite place to disconnect is Rangeley, Maine, where she can rejuvenate and be one with nature. There you can find her hand-feeding chipmunks, watching birds and indulging her creative, artsy side.

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Posted on by Author Kayla Quesnelin Categories News

What Is All the Hype About Behavioral Health Homes?

Studies have shown that adults with severe mental illness have a shorter lifespan than adults without a diagnosis by an average of 25 years. Additionally, 68% of adults with a mental health diagnosis have at least one chronic disease that limits their daily functioning.

Behavioral Health Home (BHH) programs are evidence-based care-coordination programs designed to reduce the impact of preventable diseases in people with mental health diagnoses by ensuring the coordination of medical and mental health treatment.

This coordination is done by BHH team members, including a wellness coordinator, peer/parent support person, nurse, consulting psychiatrist and primary care provider. The common goal is to address the gaps between physical health and mental health care plans.

BHH participation, when delivered with core principals, improves the outcomes of the individuals served—reducing emergency care visits and hospitalizations and increasing overall quality of life.

How can BHH help my client?

  • BHH creates treatment plans that address client life experiences, chronic stressors, poverty and isolation to reduce the risk of premature death.
  • A BHH team shows clients how to self-manage physical and mental health symptoms through education, coaching, forming support systems and connecting to community resources.
  • Emergency room use, appointment attendance and medication refills are monitored, and clients who have had two or more refills of antipsychotic medications have their blood sugars monitored.
  • Educational and peer support for adults in the program, and support to parents with children in the program, gives clients and their families the opportunity to learn from each other and to foster a sense of belonging and community engagement.

How does it benefit me as a healthcare provider to recommend BHH to my client?

  • Unlike other case management programs, BHH is an easier program to access. It does not require specific criteria relating to mental health diagnoses and you don’t need to write a section 17 letter.
  • The BHH team will ensure that the tools used during a client’s session encourage positive treatment outcomes, and that they continue to use the tools in their home and community.
  • Clients that struggle with chronic illness also struggle to attend appointments. As clients begin to feel better, they find it easier to attend sessions and take advantage of other resources available in the program.

Why HAM is the right BHH provider to partner with.

  • We don’t have a waitlist. We will assign your client within 24 hours and have a team member see them within 4-7 days.
  • We are not case management as usual. We worked with Maine Quality Counts to help design an effective program that adheres to the highest standards of BHH. We are fully committed to model fidelity.
  • We welcome client feedback and offer the ability to participate on an advisory board.
  • Our partnerships are important. We will be proactive in our collaboration with you and you can reach us at any time.
  • We collaborate with other case management programs. If we aren’t the right fit for your client, we will transfer them appropriately. (If your client would benefit from Section 13 or 17, they may still want to continue with BHH to work on self-management skills.)
  • We regularly consult with psychiatrists and primary care providers to ensure that we are educated and that we understand the impact of client treatment plans and interactions.

Do clients need to have a chronic illness to benefit from BHH?

No. If you have clients with mental health diagnoses and they are having challenges at school, work, home or community related environments, BHH can offer them help. The BHH program allows us to work on prevention activities that help with the overall well-being of your client such as nutrition, stress relief, physical activity and tobacco cessation.

Does my client need to have MaineCare?

Yes. A client must have full eligibility in MaineCare to qualify for BHH.

How do I refer a client?

We offer BHH services in Androscoggin County, and are accepting referrals for adults in Oxford and Southern Franklin County and surrounding communities.

Referrals can be made by calling us at (207) 333-3278 or (877) 888-4304. Click here for our online referral form. 

References:
Reisinger-Walker, E & Druss, B. (2011, February). Mental health disorders and medical co-morbidity. The Synthesis Project. Retrieved from: http://www.integration.samsha.gov/workforce

The Center for Integrated Health Solutions, SAMSHA-HRSA. (2012, May). Behavioral health homes for people with mental health and substance abuse conditions: The core clinical features. Retrieved at: http://www.integration.samsha.gov/workforce

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