Why Licensure Matters

Why Licensure Matters

Dogs are cute, but would you want to see one driving? Well, okay, I might! 🙂 There’s a reason why we have to learn how to drive before we can get a license to. This concept also applies to healthcare professionals. We have to train (through years of college) and prove we are capable (through testing and certification) before we can gain licensure and help the people we did all this for.

For licensed dietitians in Florida, things have been a bit up in the air. Recently, a movement has challenged the way dietitians are licensed – arguing that, in fact, they shouldn’t be licensed at all. Florida, they say, should be what is called a “title state.” Like other states, such as California, this would allow people to practice as “nutritionists” without being licensed as dietitians. And for those in the field – especially those who have spent years and thousands of dollars on their education – this has brought up a very salient point – licensure matters, not just for dietitians, but for all health professionals.

Standards of Care

For many us of, standards of care are an expectation. We don’t think much about the ingredients in the vitamins we choose, the safety of airlines we fly on, or whether the pediatrician we take our children to is qualified. We simply expect it.

We expect that when we buy 1000 mg. of Vitamin C, that it’s what we are getting. We expect that what the personal trainer we just hired – a purportedly qualified health professional – knows what he’s saying when he talks about our diet.

But here’s an example of why we need to do more than expect: A man in recovery from a kidney transplant due to renal failure decides he is going to join a gym and begin regaining his fitness. Upon seeing his muscular atrophy, the personal trainer prescribes him a diet of 300g of protein daily. Within a few days of following this diet, the man begins to feel weak, sluggish, and lightheaded. When he sees his doctor, he learns that his kidney has been rejected and he is back in renal failure due to the extremely high protein diet.

This is why standards of care matter – because they give consumers protection about what they are getting. When you hire a personal trainer who is only qualified to give you fitness advice, that is what you get – and nothing more. When you hire a marriage counselor to help improve your relationship with your spouse, you have the assurance that this professional is trained to work with couples like you, and is truly qualified to help you. When you ask this same professional about your son’s addiction problems, you would expect that they would refer you to another professional trained in addiction. When we remove licensure requirements, what we get is blurry lines, unqualified “professionals,” and an “anything goes” philosophy, that ultimately, consumers pay the price for.

Code of Ethics

Like standards of care, we often take ethics for granted. But here is why they become indispensable for health professionals – because the client is in a vulnerable position. In a typical health professional-client relationship, it is the health professional that is often seen as the expert, and the one who has the power in the relationship. It’s the doctor that tells you what to do about X condition, the psychotherapist who has the knowledge about why you are feeling the way you are, and the psychiatrist that knows what to prescribe to make you feel better. In each of these situations, it is the code of ethics that guides each professional’s decisions. It’s the reason that the doctor who sees that you have an auto detailing business doesn’t ask you to detail his car. It’s reason that the marriage counselor doesn’t suggest that you divorce your spouse and start dating her cousin. And it’s the reason that the psychiatrist doesn’t prescribe more of an addictive medication than you need.

Health professionals don’t have to follow the code of ethics, yet if they don’t, there a repercussions. Suspensions can be rendered, fines can be imposed, and yes, licenses can be lost. Incidentally, the largest category of ethical violations for marriage and family counselors is the category of sexual violations with clients.

Establishment of a Regulatory Agency

Standards of care and codes of ethics are just two reasons why licensure matters, however, without establishing a regulatory agency, they don’t hold much weight.

Standards of care are created through a licensing body which, after much deliberation and study of the field of practice and the client needs therein, determine what is considered a standard for practice in that particular field. Similarly, it is this same regulatory agency that, when ethical violations are made, can be reported to.

So let me give you another example. A “nutritionist” working at a residential fitness camp is told by one of her clients that she is having trouble sleeping. Knowing that this is a concern for the client who is attempting to work out up to eight hours a day in an effort to lose weight, the nutritionist asks one of her other clients to give this client some of her Ambien (a prescription sleep medication) to help her sleep. Let’s say that the client who receives the medication had a negative reaction to it. Who is liable? In a case like this, it depends on the state. In a title state, where nutritionists can practice without license, there is no regulatory agency to report her to. So then the liability falls upon the client who dispensed the Ambien. And while she shouldn’t have given out her prescription medication (there are both federal and state laws that make using or sharing prescription drugs illegal), she was under the care of a nutritionist, and likely expected that this professional would not have asked her to do something illegal.

Practicing without ramifications isn’t only dangerous, it’s unethical, because, ultimately, as in cases like this, it is the client, and not the professional, who pays the price.

Achieving licensure for health professionals is a rite of passage – one that grants entrance into a world where hard earned knowledge, skills, and abilities can be used in the most honorable of ways – to help others in need. And licensure keeps health professionals accountable to practice to the best of their ability, not extend beyond their level of competence, and comply with the standards of care, code of ethics, and rules of a regulatory agency that was created to protect their profession, and the people it serves. Ultimately, licensure isn’t just about those who practice, it is about those who receive care – and it helps us all.

By Claire Dorotik-Nana, LMFT

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We provide accredited, online continuing education courses for licensed healthcare professionals for the purposes of expanding their education and improving patient care.

The purpose of continuing education is to assure high standards of practice by requiring licensees to participate in on‑going educational activities. Through these experiences, licensees increase their competence and ensure they are providing evidence-based care to their patients/clients.

We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Legally High? Prescription Drug Abuse

Prescription Drug Abuse

They seem safe enough – after all the doctor prescribed them. Yet, according to a new study in Journal of Public Policy & Marketing, legal drugs such as OxyContin now kill more people than heroin and cocaine combined.

The CDC has now classified the situation as an epidemic, perhaps due in part to the fact that prescription drug use has been found to increase in direct proportion to psychological states such as anxiety, and use of other restricted substances such as alcohol (Netemeyer et al., 2014). Moreover, in research conducted with Scot Burton of the University of Arkansas, Barbara Delaney of the Partnership for Drug Free Kids, and Gina Hijjawi of the American Institutes for Research, prescription drug abuse was found to accelerate exponentially under specific conditions, such as when the level of anxiety or desire to be popular was at its very highest (Netemeyer et al., 2014).

“Prescription drugs are seen as blessed by a trusted institution, the FDA, while increasingly aggressive advertising by drug companies simultaneously floods parents and children with messages that these substances are safe, popular, and beneficial,” notes Richard Netemeyer of the University of Virginia (Netemeyer, 2014).

Another study published in the Mayo Clinic Proceedings found that 70 percent of Americans are on some form of prescription drug. The second most common prescription was for antidepressants, and the third most common drugs were opioids. Further, in just 2009 alone, spending on prescription drugs accounted for 12 percent of total personal health care expenditures (Sauver et al., 2016).

The problem is also not exclusive to the United States. Investigating nonmedical prescription drug use in five European countries – Denmark, Germany, Spain, Sweden and the UK, a research team led by scientists at RTI International in the US examined three different classes of subscription drug – opioids, sedatives, and stimulants.

Defining nonmedical prescription drug use as either the self-treatment of a medical condition using prescription medication that was not prescribed to the user, or as the use of prescription medication to achieve euphoric states, the researchers found that the most common sources of prescription drugs for nonmedical use were family and friends – 44% for opioids and 62% for sedatives. The next most common source was taking drugs from another person without their knowledge.

Nonmedical prescription drug use was also more common among men than women, among white than non-white people, and among those who were unemployed than those with other levels of employment. Young people aged 12 to 17 years were at lower risk of nonmedical prescription drug use than people aged 18 years or older. Of the five countries examined, Germany had the lowest levels of nonmedical prescription drug use, while the UK, Spain and Sweden had the highest levels (Novak et al., 2016).

Dr. Scott Novak, who led the study, concluded, “Previously it was thought that the prescription drug epidemic was limited to the United States, but this study shows that the epidemic extends well beyond the US” (Novak, 2016).

Combatting the epidemic begins with understanding what drives it, what diagnoses are related to it, the significant warning signs, and the screening, assessment, diagnosis, and treatment that is effective against it.

By Claire Dorotik-Nana, LMFT

Related Online Continuing Education (CE) Courses:

Prescription Drug Abuse CE CoursePrescription Drug Abuse is a 3-hour online continuing education (CE) course that examines the misuse of prescription drugs (including opioids) in the United States. Misuse of prescription drugs means “taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria” and is a serious public health problem in the United States. When taken as prescribed, medication can be of great benefit to a patient, helping reduce pain, save lives, and improve one’s overall quality of life. However, when individuals misuse their prescribed medications or take medications not prescribed to them, the consequences can be disastrous. Illicit drug use, including the misuse of prescription medications, affects the health and well-being of millions of Americans. Among other deleterious effects, cardiovascular disease, stroke, cancer, infection with the human immunodeficiency virus (HIV), hepatitis, and lung disease can all be affected by drug use. The important thing to remember is that the medications are not inherently bad in and of themselves – it is how people use (and abuse) them that creates a problem. This course will discuss what drives people to abuse prescription drugs and how they obtain them; diagnostic criteria for substance use disorder; history and progression of prescription drug abuse, including types and classes of drugs used; and the cost of prescription drug abuse on addicts and non-addicts alike. The course will then review the sequence of treating individuals who have a prescription drug use disorder, including screening, assessment, diagnosis, treatment, and maintenance. Screening tools, assessment instruments, treatment programs, and evidence-based recommendations are included. Comorbidity between substance use disorder and mental disorders is also discussed. Course 31-00 | 2018 | 50 pages | 20 posttest questions

Anxiety: Practical Management TechniquesAnxiety: Practical Management Techniques is a 4-hour online continuing education (CE) course that offers a collection of ready-to-use anxiety management tools. Nearly every client who walks through a health professional’s door is experiencing some form of anxiety. Even if they are not seeking treatment for a specific anxiety disorder, they are likely experiencing anxiety as a side effect of other clinical issues. For this reason, a solid knowledge of anxiety management skills should be a basic component of every therapist’s repertoire. Clinicians who can teach practical anxiety management techniques have tools that can be used in nearly all clinical settings and client diagnoses. Anxiety management benefits the clinician as well, helping to maintain energy, focus, and inner peace both during and between sessions. Course #40-12 | 2007 | 41 pages | 30 posttest questions

Medical MarijuanaMedical Marijuana is a 3-hour online continuing education (CE) course that presents a summary of the current literature on the various medical, legal, educational, occupational, and ethical aspects of marijuana. In spite of the fact that nearly half of the states in this country have enacted legislation legalizing marijuana in some fashion, the reality is that neither the intended “medical” benefits of marijuana nor its known (and as yet unknown) adverse effects have been adequately examined using controlled studies. Conclusive literature remains sparse, and opinion remains divided and contentious. This course will address the major questions about marijuana that are as yet unanswered by scientific evidence. What are the known medical uses for marijuana? What is the legal status of marijuana in state and federal legislation? What are the interactions with mental health conditions like anxiety, depression, and suicidal behavior? Is marijuana addictive? Is marijuana a gateway drug? What are the adverse consequences of marijuana use? Do state medical marijuana laws increase the use of marijuana and other drugs? The course will conclude with a list of implications for healthcare and mental health practitioners. Course #30-86 | 2016 | 55 pages | 24 posttest questions

These online course provides instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Sponsored By:

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Are You Culturally Competent?

Are you culturally competent?

Multicultural awareness – which refers to an awareness of, comfort with, and sensitivity toward issues of cultural diversity – has been emphasized through decades of policy reforms, is often taught in health care professions, and from all perspectives, is becoming more important every day.

What we believe about other cultures has a tremendous impact on how effective we are when working with them. One study found that multicultural beliefs are tied to student teachers’ ability to create strong and nurturing classroom environments, measured during student teaching observations by master teachers (Cherng & Davis, 2017).

Interestingly, this same study also found that Black and Latino preservice teachers report greater multicultural awareness than their White counterparts, and that prior experience working with minority cultures is linked to greater multicultural awareness (Cherng & Davis, 2017).

Being aware of cultural differences also becomes crucial when working with families after a suicide. According to Karen Rizzo MD, president of the Pennsylvania Medical Society (PAMED), suicide “is an alarming public health problem that needs to be addressed in a clinically compassionate way being culturally sensitive to the needs of those seeking to find answers to their personal loss” (Rizzo, 2012).

As Rizzo notes, the warning signs of suicide typically involve factors like previous suicide attempts, feeling alone, drug use, a family history of suicide, a history of depression, stressful life events and access to lethal methods, but can very according to an individual’s culture (Rizzo, 2012).

How much a person identifies with their culture can also influence their sense of belonging, well-being, and according to work done by Led by Kamaldeep Bhui, Professor of Cultural Psychiatry and Epidemiology at Barts, predicts their mental health later in life (Bhui et al., 2016).

Working effectively with people from different cultures means not just understanding the cultural norms, expectations, and pressures of an individual’s culture, but also how the individual experiences them. They may be highly identified with their culture and finding a sense of belonging in it, they may be resisting their culture in favor of integrating more fully into the majority culture, and they may not know how they feel about their culture, or the majority culture in which they live. All of these factors demand a culturally competent and sensitive approach – one that overcomes biases, stigmas, and includes the client in the process of improving mental health.

By Claire Dorotik-Nana, LMFT

Related Online Continuing Education (CE) Courses:

Cultural Awareness in Clinical PracticeCultural Awareness in Clinical Practice is a 3-hour online continuing education (CE/CEU) course that provides the foundation for achieving cultural competence and diversity in healthcare settings. Cultural competence, responding to diversity and inclusion, are important practices for healthcare professionals. This course will help you to gain an awareness of bias and provide strategies to adjust your clinical mindset and therapeutic approach to adapt to “the other” – people who differ in color, creed, sexual identification, socio-economic status, or other differences that make inclusion difficult. Inclusion is defined as “the state of being included” or “the act of including,” which is something all clinicians should strive for. This course is designed to provoke thought about culture, diversity, and inclusion. Even though research for evidence-based practice is somewhat limited in this area, the concept of cultural competency (however it is defined and measured) is a key skill for healthcare professionals to create an inclusive therapeutic environment. Course #31-07 | 2018 | 57 pages | 20 posttest questions

Suicide PreventionSuicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults. Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt. Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs. Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies so that healthcare professionals are informed on this complex subject. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2017 | 60 pages | 20 posttest questions

These online CE courses are sponsored by:

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Therapists’ Lessons from Shooting Victims

Three Things I Learned from Working with the Aurora Theatre Shooting Victims

By Claire Dorotik-Nana, LMFT

I remember the morning clearly. I had just gotten up, and it was early. I had been preparing for my morning run when I received a strange text from a friend of mine asking if I was okay. Confused, I responded, “I’m fine. Why wouldn’t I be?” Then my friend sent over a link to a news article and asked, “Didn’t you see this?”

Clearly I hadn’t. Yet, as I read through the article, it seemed almost unreal. I lived across the street from the Aurora theatre. I could walk to it. I had, many times.

I frantically texted my younger brother. He also lived in Aurora, and we had discussed going to see The Dark Knight Rises – the very movie that James Holmes also chose – in that very theatre. Thankfully we had decided not to, but I wondered if perhaps he had gone with his wife anyway.

He texted right back. He was okay, but he too hadn’t seen the news.

When I walked in the door at the private practice where I counseled clients regularly, the office secretary informed me that likely, our office – and myself – would be getting calls from some of the people who had been in that theatre.

She was right. And in the next few weeks, I had the opportunity to work with some of the shooting victims. Here are three things I learned:

Counseling Victims of Mass Shootings

1. Traumatic Events Often Lead To A Tremendous Reverence For Life.

Perhaps one of the things that astounded me the most about every one of the victims that I worked with was that, even after what had been the most horrific experience of their lives, they expressed a profound sense of reverence for life. Some said things like, “I took way too many things in my life for granted,” “I didn’t appreciate the life I had, or the people in my life,” “Life is so precious, and we don’t realize how quickly it can be taken from us.” While they did struggle with feelings of guilt over the ones they had lost – and felt they should have done more to save – they also realized on a very deep level that lives were spared that day. Further, the experience shifted their perspectives about what is really important in life. One example is a woman who decided to pursue a different career, feeling like, “I don’t have any time to waste.”

2. Trauma Brings Out Our Innate Courage.

Initially my goal in working with the victims was simply to listen – to hear their stories without judgement, criticism, or even advice. I wanted to be a listening ear for whatever they needed to say. And I had no idea what to expect. But what I heard was story after story of tremendous strength. One man, who had been sitting right in front of one of my clients, dove across his seat to shield his young child from the gunfire. That man lost his life, but his child survived. Another man wrapped himself around his wife and pulled her under the seat. Thankfully, they both survived. The man’s best friend, however, who was huddled on top of them did not. There were numerous stories just like this of people sacrificing their lives to save others. And as I sat and listened to each one of these accounts, what emerged was the real story of courage that day.

3. Trauma Can Lead To Tremendous Growth.

There is one thing that can’t be argued about trauma – it forever changes us, and changes our lives. Early on, I had expected many of the victims to struggle mightily with flashbacks, an elevated stress response, feelings of hypervigilance, insomnia, and difficulty functioning. This is what I had learned in graduate school about trauma. Yet while there were some of these elements, there was something else. Something much more profound. I wasn’t aware of the term at the time, but what I experienced working with the victims of that theatre shooting is now known as post-traumatic growth. The idea is that it is because traumatic events fundamentally change our lives, we are forced to search for meaning in what has become of our lives. It is in that search that we come to better understand what is important to us, we become acutely aware of the fleeting nature of life, our perspectives on life change, and through the experience, we emerge stronger. I saw this in every single one of the people I worked with. And while the process was not easy – many coped with at times overwhelming feelings of sadness, grief, guilt, and anger – each one experienced a strength within themselves that they had no idea existed.

Claire was profoundly affected by working with the victims of this theatre shooting, and by each and every mass shooting since. Following the Vegas shooting, she decided to write an online CE course to help other therapists:

Counseling Victims of Mass ShootingsCounseling Victims of Mass Shootings is a 3-hour online continuing education (CE) course that gives clinicians the tools they need to help their clients process, heal, and grow following the trauma of a mass shooting.

Sadly, mass shootings are becoming more widespread and occurring with ever greater frequency, often leaving in their wake thousands of lives forever changed. As victims struggle to make sense of the horror they have witnessed, mental health providers struggle to know how best to help them. The question we all seem to ask is, “Why did this happen?”

This course will begin with a discussion about why clinicians need to know about mass shootings and how this information can help them in their work with clients. We will then look at the etiology of mass shootings, exploring topics such as effects of media exposure, our attitudes and biases regarding mass shooters, and recognizing the signs that we often fail to see.

We will answer the question of whether mental illness drives mass shootings. We will examine common first responses to mass shootings, including shock, disbelief, and moral injury, while also taking a look at the effects of media exposure of the victims of mass shootings.

Then, we will turn our attention to the more prolonged psychological effects of mass shootings, such as a critical questioning and reconsideration of lives, values, beliefs, and priorities, and the search for meaning in the upheaval left in the wake of horrific events. This course will introduce a topic called posttraumatic growth, and explore the ways in which events such as mass shootings, while causing tremendous amounts of psychological distress, can also lead to psychological growth. This discussion will include topics such a dialectical thinking, the shifting of fundamental life perspectives, the opening of new possibilities, and the importance of community. Lastly, we will look at the exercises that you, the clinician, can use in the field or office with clients to promote coping skills in dealing with such horrific events, and to inspire psychological growth, adaptation, and resilience in the wake of trauma. Course #31-09 | 2018 | 47 pages | 20 posttest questions

This online continuing education (CE/CEU) course for healthcare professionals is sponsored by:

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

School Shooting Survivor Speaks Out

By Claire Dorotik-Nana, LMFT

School Shooting Survivor Speaks Out

The recent shooting in Parkland, Florida has brought up numerous issues, and even more questions.

  • What causes school shootings?
  • Is gun control the answer?
  • Does mental illness lead to violence?
  • What is going on with our country?

While many of these questions will go unanswered, I recently had the opportunity to speak with a school shooting survivor and ask a few myself. (Please note no name is given to protect identity.)

Can you tell me a bit about your experience? It happened 17 years ago, and to my knowledge, was the only school shooting where the perpetrator was a female. She came to school that day with 4 handguns, 377 rounds of ammunition, and put it in her locker. Then, in the middle of my second class, just as the class was about to be over, the teacher gets a call, and stands up and locks the door, and we are not allowed to leave.

Did the teacher tell you what was going on? No, nobody told us anything. Even when we were bused to a church a few miles away, they still didn’t tell us what was going on. But you know, this was before cell phones, or any of that, so even my parents didn’t know. My dad only found out because my uncle had seen it on the news and called him.

So the media knew before you or your family did? Yes, it took five hours to evacuate the whole school and take us to the church, and the whole time, we had no idea what was going on. That was the scariest part.

How was the experience for your parents? They were terrified. Nobody would tell them anything. Not even if I was okay.

So how did that day finally end? Once the whole school was in the church, the parents were finally let in to see their children, and told we could all go home.

What was it like seeing your parents again after that experience? It was huge relief. My mom was so worried. And I was just worried. I mean we had no idea what was going on.

What did your learn later about the shooter? She was girl we all knew because she was bullied. Every day, she was harassed after she got off the bus. When they interviewed her, she said she couldn’t take it anymore and she had brought the guns to school to shoot herself and let everyone see how bad she felt.

Knowing that now, do you think you would have done anything differently? I would have gotten to know her. Talk to her. You know, find about her. I don’t think anyone had reached out to her, gotten to know her at all.

You think that would have made a difference? Yes I do. Even now, looking at the Parkland shooting, all we know about him is what he has been labeled. A loner, crazy, etc. Do we really know him? Has anyone really spent time talking to him to find out why he did it?

Now that it is in the news again, what would you like to say about school shootings? We have become so selfish as people. We lack compassion. We don’t take time to get to know one another. There is no sense of community anymore. We are not sensitive to the pain of others. We don’t think about the sanctity of life anymore.

What do you think is the biggest problem we face when it comes to mass shootings? The media. Definitely the media. In my experience – even 17 years ago – they were in front of my school every morning for two weeks. Some mornings the vice principle would have to escort us in and shield us from them. Now, they make the shooter into a celebrity. But they also spread so many incorrect ideas. Like the AR-15 being an assault rifle. It’s not, and in fact, because it takes longer to load than a handgun, you could kill more people in a short amount of time with two handguns than one AR-15. But nobody hears that message. And even worse, what happens is that for people who are likely to turn to violence, the media attention makes them have to up the ante each time, so as the killings go on, they become more severe. You know, this is not a gun issue, it’s a people issue. We used to have guns in schools. Some schools even had gun ranges. The guns have always been there, but now we are different.

What advice would you give to people going through a mass shooting? Turn off the media. Stop watching the news. Find out for yourself what is going on. Spend time with your kids, your community. If you see a kid struggling, reach out to them instead of labeling them. I know of one school who implemented a yoga and meditation program to deal with violence and aggression, and it dramatically lowered acts of violence. Like I said, it’s not a gun issue, it’s a people issue.

Claire Dorotik-Nana, LMFT, is a Licensed Marriage and Family Therapist who specializes in post-traumatic growth, optimal performance, and wellness. She is licensed to practice in California and Colorado. Claire earned her BS in Kinesiology and worked as a personal trainer for years before becoming a course developer for International Sports Science Association. Claire is always thinking about ways to improve physical fitness and nutrition as a modality for improving mental health. She also writes in her popular blog, Leveraging Adversity on Psychcentral.

Related Online Continuing Education (CE) Course:

Counseling Victims of Mass ShootingsCounseling Victims of Mass Shootings is a 3-hour online continuing education (CE) course that gives clinicians the tools they need to help their clients process, heal, and grow following the trauma of a mass shooting.

Sadly, mass shootings are becoming more widespread and occurring with ever greater frequency, often leaving in their wake thousands of lives forever changed. As victims struggle to make sense of the horror they have witnessed, mental health providers struggle to know how best to help them. The question we all seem to ask is, “Why did this happen?”

This course will begin with a discussion about why clinicians need to know about mass shootings and how this information can help them in their work with clients. We will then look at the etiology of mass shootings, exploring topics such as effects of media exposure, our attitudes and biases regarding mass shooters, and recognizing the signs that we often fail to see.

We will answer the question of whether mental illness drives mass shootings. We will examine common first responses to mass shootings, including shock, disbelief, and moral injury, while also taking a look at the effects of media exposure of the victims of mass shootings.

Then, we will turn our attention to the more prolonged psychological effects of mass shootings, such as a critical questioning and reconsideration of lives, values, beliefs, and priorities, and the search for meaning in the upheaval left in the wake of horrific events. This course will introduce a topic called posttraumatic growth, and explore the ways in which events such as mass shootings, while causing tremendous amounts of psychological distress, can also lead to psychological growth. This discussion will include topics such a dialectical thinking, the shifting of fundamental life perspectives, the opening of new possibilities, and the importance of community. Lastly, we will look at the exercises that you, the clinician, can use in the field or office with clients to promote coping skills in dealing with such horrific events, and to inspire psychological growth, adaptation, and resilience in the wake of trauma. Course #31-09 | 2018 | 47 pages | 20 posttest questions

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Nutrition and Mental Health – New Online CE Course

@pdresources.org

Nutrition and Mental HealthNutrition and Mental Health: Advanced Clinical Concepts is a 1-hour online continuing education (CE/CEU) course that examines how what we eat influences how we feel, both physically and mentally. While the role of adequate nutrition in maintaining mental health has been established for some time, just how clinicians go about providing the right nutritional information to the patient at the right time – to not just ensure good mental health, but actually optimize mood – has not been so clear. With myriad diets, weight loss supplements and programs, clients often find themselves reaching for the next best nutritional solution, all the while, unsure how they will feel, or even what to eat to feel better. On the other side of the equation, clinicians so often face not just a client’s emotional, situational, and relational concerns, but concerns that are clearly mired in how the client feels physically, and what impact his/her nutritional health may have on these concerns. For example, research into the role of blood sugar levels has demonstrated a clear crossover with client impulse control. Additionally, the gut microbiome, and its role in serotonin production and regulation has consistently made clear that without good gut health, mitigating anxiety and depression becomes close to impossible.

So if good mental health begins with good nutritional health, where should clinicians start? What advice should they give to a depressed client? An anxious client? A client with impulse control problems? This course will answer these questions and more. Comprised of three sections, the course will begin with an overview of macronutrient intake and mental health, examining recent popular movements such as intermittent fasting, carb cycling and ketogenic diets, and their impact on mental health. In section two, we will look specifically at the role of blood sugar on mental health, and research that implicates blood sugar as both an emotional and behavioral regulator. Gut health, and specifically the gut microbiome, and its influence on mood and behavior will then be explored. Lastly, specific diagnoses and the way they are impacted by specific vitamins and minerals will be considered. Section three will deliver specific tools, you, the clinician, can use with your clients to assess, improve and maximize nutrition to optimize mental health. Course #11-06 | 2017 | 21 pages | 10 posttest questions

About the Author:
Claire Dorotik-Nana, LMFT, is a Licensed Marriage and Family Therapist who specializes in post-traumatic growth, optimal performance, and wellness. She is licensed to practice in California and Colorado. Claire earned her BS in Kinesiology and worked as personal trainer for years before becoming a course developer for International Sports Science Association. Claire is always thinking about ways to improve physical fitness and nutrition as a modality for improving mental health. She also writes in her popular blog, Leveraging Adversity on Psychcentral.
This online continuing education course is offered by Professional Development Resources, a nonprofit educational corporation 501(c)(3) organized in 1992. Our purpose is to provide high quality online continuing education (CE) courses on topics relevant to members of the healthcare professions we serve. We strive to keep our carbon footprint small by being completely paperless, allowing telecommuting, recycling, using energy-efficient lights and powering off electronics when not in use. We provide online CE courses to allow our colleagues to earn credits from the comfort of their own home or office so we can all be as green as possible (no paper, no shipping or handling, no travel expenses, etc.). Sustainability isn’t part of our work – it’s a guiding influence for all of our work.
We are approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within one week of completion).

What’s Wrong with the Game of Weight Loss?

By Claire Dorotik-Nana, LMFT, Author of Behavioral Strategies for Weight Loss

Behavioral Strategies for Weight LossWeight loss is a game we keep playing the same way – even when we are not winning. We continue to diet, purchase gym memberships, go on crash diets, and buy weight loss supplements. In fact, the weight loss industry has outgrown inflation rates, all the while remaining unaffected by economic downturns. By all accounts, weight loss matters to us – an awful lot. Yet what we fail to consider is that when it comes to weight loss, there is a lot more that we don’t know than we do. For example, while we may know that eating fewer donuts will help us lose weight, we fail to consider that thinking about eating fewer donuts now is not the same as actually turning down the donut your co-worker offers you next Friday. Just what influences those decisions and why we may not always make the choices we intend to make – even when we know they are good for us – is what this course is all about.

Limited Resources, Fading Benefits, and Tempting Options

The number one resolution of 2015 was to lose weight. Yet losing weight, for most of us, is like playing the lottery – the odds are not very good. In fact, it’s estimated that only 8 percent of those who make New Year’s resolutions actually keep them.

It’s not so much that we can’t lose weight; it’s that, like keeping a resolution, we can’t keep it off. For this reason, the National Weight Control Registry (NWCR) determines the difference between weight that is lost unsuccessfully – meaning it is lost and regained – and that which is lost successfully as a three year deal. If we can keep at least thirty pounds off for three years, we can consider ourselves successful.

If not, we have some interest to pay. Studies show that the majority of dieters will actually gain back more than they originally lost. Yet for those who work with dieters this isn’t surprising. The problem, as Diane Robinson, PhD, a neuropsychologist and Program Director of Integrative Medicine at Orlando Health, notes is that, “Most people focus almost entirely on the physical aspects of weight loss, like diet and exercise. But there is an emotional component to food that the vast majority of people simply overlook and it can quickly sabotage their efforts.”

What we ignore is that while weight loss is regulated by what we eat – those choices are regulated by something much larger, and more powerful. For example, consider the emotional attachment we have to certain foods. From the time we are young, we are conditioned to have preferences for certain foods, and food marketing to children has dramatically increased in recent years. In response to this dramatic increase, in 2008 Congress called for a Federal Trade Commission review of marketing food to children and adolescents. In that report, experts found not only that the total of dollars spent on food marketing to children 0-12 and adolescents was well over the previous figure of 1.6 billion, but that more than half of all television advertising dollars were directed toward children. Ranking second only to television advertising was money spent on toys included in kids’ foods (which also includes restaurant foods) – which came in at a whopping $427 million. And even more surprising, if you add the dollars restaurants spend on child directed marketing to the toys they include with the child’s meals, that figure jumps to $520 million – more than twice the amount of child directed marketing in any other category. As Robinson explains, “If we’re aware of it or not, we are conditioned to use food not only for nourishment, but also for comfort. That’s not a bad thing, necessarily, as long as we acknowledge it and deal with it appropriately.”

Click here to learn more.

Behavioral Strategies for Weight LossBehavioral Strategies for Weight Loss is a 2-hour online continuing education (CE) course that exposes the many thought errors that confound the problem of weight loss and demonstrates how when we use behavioral strategies – known as commitment devices – we change the game of weight loss. While obesity is arguable the largest health problem our nation faces today, it is not a problem that is exclusive to those who suffer weight gain. For therapists and counselors who work with those who wish to lose weight, there is ample information about diet and exercise; however, one very large problem remains. How do therapists get their clients to use this information? Packed with exercises therapists can use with their clients to increase self-control, resist impulses, improve decision making and harness accountability, this course will not just provide therapists with the tools they need to help their clients change the way they think about weight loss, but ultimately, the outcome they arrive at. Course #21-13 | 2016 | 31 pages | 15 posttest questions

Professional Development Resources is approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

Employ Humility to Create Flow

Course Excerpt from “In the Zone” by Claire Dorotik-Nana, LMFT

In the Zone: Finding Flow Through Positive Psychology

The concept of flow, also known as optimal performance, is a condition we are all capable of, yet seldom cultivate. When in flow we experience a profound and dramatic shift in the way we experience ourselves, our capabilities, and the world around us. Our focus sharpens, our strengths are heightened, we feel an intense sense of euphoria and connection to the world around us, and we often realize capabilities we didn’t know were possible. For clients, flow doesn’t help them become more capable, it dramatically improves their lives – teaching them not just to expect more from themselves, but how to cultivate the very conditions that make expecting more possible.

Employ Humility to Create Flow

Employ humility to create flow in your lifeThe extreme athletic feats that are commonly associated with the state of flow often carry an air of machismo with them. We think of the Laird Hamiltons of surfing, the Danny Ways of skateboarding and the Usain Bolts of sprinting as extreme dudes – brimming with confidence, bravado, and a hefty sense of arrogance. However, nothing could be farther from the truth. Kotler quotes director of the Krasnow Institute for Advanced Study at George Mason University, James Olds, “When you’re arrogant and egotistical, you’re shutting out complexity, novelty, and unpredictability to preserve a distorted self-image. Any incoming information that could lead to self-doubt is stamped out. It’s a massive data reduction. Humility moves in the other direction, it opens up and increases incoming information. As a result, there is more opportunity for pattern recognition, more dopamine, and less need for judgmental metacognition” (Kotler, 2014).

In humility we are open – open to information (without judgment), open to trying out new things (that may lead to failure), and open to learning. Arrogance – humility’s opposite – like outcome orientation, keeps us attached to maintaining our status, and not surprisingly, comes with a weighty dose of anxiety. Arrogance, which is a form of overcompensation, often exists to protect a fragile and inferior sense of self, and in doing so, blocks out any information that exposes it. The anxiety comes from fear of exposure. Humility, on the other hand, accepts the self as it is, and accepts any information about the self – often experienced as feedback – whether or not it preserves a contrived image. Humility, because it represents an honest interpretation of the self, is a vital ingredient of flow. If we don’t honestly assess our skills we cannot possibly get the challenge ratio right. In arrogance, we are likely to overestimate our talents, ignore any information that tells us how we are doing so, and manufacture our interpretation of the situation to protect our image – none of which generate flow.

So how do you help your client become more humble? The answer is simply to teach your client to be honest about her skills. One helpful way is to take an unbiased assessment of where she is really at, while encouraging her to let go of any need she has to be seen a certain way, garner praise or acclaim, achieve any accomplishments, or maintain any particular status. When your client can see herself as she really is, not as she needs to be or wants to be, adopting an attitude of humility, not only reduces anxiety – she no longer needs to be something she is not – but also opens the door for how to get to where she wants to be. It is the way of flow.

In the Zone: Finding Flow Through Positive PsychologyIn the Zone: Finding Flow Through Positive Psychology is a 2-hour online continuing education (CE) course that offers a how-to guide on incorporating flow into everyday life. According to the CDC, four out of ten people have not discovered a satisfying life purpose. Further, the APA reports that most people suffer from moderate to high levels of stress, and according to SAMSHA, adult prescription medication abuse (primarily to counteract attention deficit disorders) is one of the most concerning health problems today. And while clinicians now have a host of resources to mitigate distress and reduce symptomatology, the question remains: how do clinicians move clients beyond baseline levels of functioning to a state of fulfillment imbued with a satisfying life purpose? The answer may lie in a universal condition with unexpected benefits…

This course will explore the concept of flow and is packed with exercises, tips and tools to demonstrate just how flow can be incorporated into your everyday life, and used to help your clients move from simply surviving to a life that harnesses and builds upon their own unique potential to thrive. Course 21-11 | 2016 | 30 pages | 15 posttest questions

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

Claire Dorotik-Nana, LMFT, is a Licensed Marriage and Family Therapist who specializes in post-traumatic growth, optimal performance, and wellness. She is licensed to practice in California and Colorado. She has developed several courses for Zur Institute, International Sports Science Association, and Personal Trainer Central. Claire is also the author of Leverage: The Science of Turning Setbacks into Springboards. In The Zone is inspired by her popular blog, Leveraging Adversity on Psychcentral.

 

 

In the Zone: Finding Flow Through Positive Psychology

By Claire Dorotik-Nana, LMFT

According to the CDC, four out of ten people have not discovered a satisfying life purpose. Further, the APA reports that most people suffer from moderate to high levels of stress, and according to SAMSHA, adult prescription medication abuse (primarily to counteract attention deficit disorders) is one of the most concerning health problems today. And while clinicians now have a host of resources to mitigate distress and reduce symptomatology, the question remains: how do clinicians move clients beyond baseline levels of functioning to a state of fulfillment imbued with a satisfying life purpose? The answer may lie in a universal condition with unexpected benefits…

In the Zone: Finding Flow Through Positive PsychologyIn the Zone: Finding Flow through Positive Psychology is a new 2-hour online continuing education (CE) course that explores the concept of flow, a condition we are all capable of, yet seldom cultivate. When in flow we experience a profound and dramatic shift in the way we experience ourselves, our capabilities, and the world around us. Our focus sharpens, our strengths are heightened, we feel an intense sense of euphoria and connection to the world around us, and we often realize capabilities we didn’t know were possible. For clients, flow doesn’t just help them become more capable, it dramatically improves their lives – teaching them not just to expect more from themselves, but how to cultivate the very conditions that make expecting more possible.

This course, packed with exercises, tips, and tools, will demonstrate just how flow can be incorporated into your everyday life, and used to help your clients move from simply surviving to a life that harnesses and builds upon their own unique potential to thrive. Course 21-11 | 2016 | 30 pages | 15 posttest questions | $28

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document).

Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more.

Professional Development Resources, Inc. is a Florida nonprofit educational corporation 501(c)(3) that offers 150+ online, video and book-based continuing education courses for healthcare professionals. We are approved by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (b); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.