8.31.20: International Overdose Awareness Day

Today is International Overdose Awareness Day – a global event held on August 31st each year and aims to raise awareness of overdose and reduce the stigma of a drug-related death. It also acknowledges the grief felt by families and friends remembering those who have died or had a permanent injury as a result of drug overdose.

Drug overdose has a devastating impact on our communities, supports those who struggle with drug use or abuse and reinforces the belief that no one should feel shame or disgrace due to an overdose related death of a loved one.

Experiencing a drug overdose is something many people think will never happen to them or touch their family or loved ones. Unfortunately, drug overdose happens all over the country and it is important to encourage conversation about overdose with loved ones.

• Things to know: Narcan and Naloxone
  • Narcan and Naloxone can help someone start breathing again (for opioid painkillers and heroin only), but it wears off and more might be needed from the ambulance/first responders. If you call 9-1-1 or report an overdose you are protected by the HOPE law in Wisconsin. Call Vivent Health 608-785-9866 for more information on Narcan and Naloxone

• What to do in the situation of an overdose:
  • Check your surroundings
  • Call 9-1-1
  • Provide CPR/rescue breathing
  • Give a dose of Narcan

If someone you know and love is struggling with addiction take time to educate yourself, seek support, get counseling, and don’t forget to also take care of yourself.

It’s time to remember and time to react. Take part in understanding how overdose affects all of us and learn how you can make a difference for your community.

Local & National Resources:

• Great Rivers 2-1-1 – Great Rivers 2-1-1 offers free, confidential community information and referrals 24 hours/day. Dial 2-1-1 to talk to an information and referral specialist.
• SMART Recovery – Self-Management And Recovery Training (SMART) is a global community of mutual-support groups. At meetings, participants help one another resolve problems with any addiction (to drugs or alcohol or to activities such as gambling or over-eating). Participants find and develop the power within themselves to change an lead fulfilling and balanced lives guided by our science-based and sensible 4-Point Program®.
• SAMHSA National Helpline – SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and   families facing mental and/or substance use disorders.

Anxiety in Children – When is it Normal? What can I do?

written by Kip Zirkel, Ph.D.

I have had an increasing number of parents expressing worry about the anxiety they see in their children. They tell me that their kids are fearful about leaving the house, clingy with their parents, pitching fits when a parent has to leave, refusing to sleep in their own beds at night. Many say that their kids have developed physical symptoms such as tummy aches, headaches, or bowel problems.

Is this normal? Well, yes and no. Separation anxiety is quite common, usually showing up around 7-8 months of age and tending to diminish around age 4-5. However many kids don’t easily ‘get over it’ and symptoms may continue into the mid to late elementary school years. And with the current pandemic it is no surprise that these symptoms are increasing.

Separation anxiety is actually a good thing, and shows that a child indeed knows where his or her ‘safe places and safe people’ are. And given the added stresses on families now with the pandemic, it would be surprising if your child DIDN’T show any signs of separation anxiety!

There is evidence that a predisposition to anxiety can be inherited–anxious parents often have anxious children. There is also some consistent research showing that about 15% of all kids have a shy and sensitive temperament no matter what a parent’s personality happens to be. These kids will be more inclined to show anxiety symptoms nowadays related to the pandemic and the stress it has caused families.

Many parents report a sort of vicious circle occurring, where an anxious and fearful child will cause you to become more anxious and worried, which is then picked up by the child, further increasing their own anxiety and clinginess!

Changes in customary routines may trigger anxiety in kids also. A change in a parent’s work demands and availability, a caregiver moving away, a new sitter or daycare provider coming into the child’s life, all these can trigger anxiety and panic in kids. Most kids however tend to work through these disruptions and adjust, but many have trouble doing so.

There are things you can do to help your child become less fearful and more confident. I will list these below:

1. First of all, children do reflect their parent’s moods and anxiety. So try your best to ACT less anxious around your children, even if it means putting on a good act.

2. Say encouraging and supportive things to your child–before a potential meltdown occurs, because trying to reason with a child who is in the throws of a tantrum or panicky crying spell is like trying to reason with a drunk. Remind your child about all the positive traits they have, and how proud you are of them when they accomplish something no matter how small it may seem.

3. Some parents, out of frustration, take a more hard-line approach, especially parents who are feeling at the end of their rope. “Oh for Pete’s sake, knock it off and get in the #&%%$* car!” Actually some kids find this reassuring and often will indeed ‘knock it off.’ I cannot tell you however if this approach will work on your child. Often dads have a better success rate with this, given most dads’ tendency to talk less and tolerate less dissent. (Yeah, this sounds sexist, no need to remind me.)

4. Remember to design small experiences of success for your child. If for example they are playing alone and you leave the room for a bit, and they keep playing happily, be sure to praise them for how capable and brave they are! Don’t prolong goodbyes–use the “kiss and go” method when leaving your child with a sitter or daycare provider. Use humor and distraction to derail your child when they start to ‘crank up’ their panic around you.

5. You can do this while at the same time expressing empathy for your child, reminding them how you yourself were anxious and afraid, and how you will always love them no matter what, and how you know that someday they will grow up and be less afraid. These kind of short talks are best done when your child seems happy, or when you are driving with them in the car, or when you are tucking them in bed at night.

6. I forgot to mention what I had sent out in an earlier email; namely, the need to turn off the TV so that your child is not exposed to bad news day in and day out. Also, put on music that your child likes, it may help their moods in a kind of subliminal fashion. And try some aromatherapy–there is some evidence that taking a sniff of lavender will calm not only you but also your child! I am sure you have found other techniques to ‘nudge’ your child in a positive direction.

7. Be sure to maintain consistent and predictable routines in your household. Routines are one of the best “medications” you can give your child. Consistent schedules during the day reduce anxiety for both parent and child.

8. Have your child do a little art therapy or play therapy–if they are afraid of the pandemic, or of some other fearful thing, have them draw pictures showing their feelings about it. Or get down on the floor with their toys and help them re-create some worrisome scenario–such as a child saying goodbye to a parent who has to leave for work. Try communicating a more lighthearted view of what is worrying your child: “Oh it must be terrible being a tiny virus, floating around in the air, getting sucked up into somebody’s nose, ewww gross!” You get the picture. Be creative.

Finally, remember that this too will pass. Nothing lasts forever. Kids get over moods and in time they will be more normal. As will you!

VIRTUAL – September Circle of Security® Class

Join us for our latest Circle of Security® Parenting Class – Tuesday evenings September 8 – October 27th, 2020!

At times all parents feel lost or without a clue about what our child might need from us. Imagine what it might feel like if you were able to make sense of what your child was really asking from you. The Circle of Security® Parenting program is based on decades of research about how secure parent-child relationships can be supported and strengthened.

Learning Objectives of the Class:

• Understand your child’s emotional world by learning to read the emotional needs
• Support your child’s ability to successfully manage emotions
• Enhance the development of your child’s self-esteem
• Honor your innate wisdom and desire for you child to be secure

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Presented by: Stein Counseling and Consulting Services, Ltd.

Sponsored by: Stein Counseling and Consulting Services, Ltd. Family Services Program

Location: via Google Meet (from the comfort of you home or office – HIPPA compliant)

Dates: Tuesday evenings September 8 – October 27th, 2020

Time: 6:00 – 7:30 pm

Cost: $100 per person or $150 per couple. A non-refundable deposit of 50% of the registration fee is due at the time of registration. Remaining payment is due by 5:00 pm on September 1, 2020.

How to register: Please call (608) 785-7000 x 221 to register for class. Maximum of 8 participants is accepted. Deadline for registration is September 1, 2020.

Who should attend: The Circle of Security® Parent Course is a specialized program for parents, kinship, adoptive, and long-term foster parents, as well as any professional caring for children up to 12 years of age, for their personal use.

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For more information, and to view a clip of the training, CLICK HERE!

#checkthespread

We’re proud to be a part of the checkthespread.org pledge for La Crosse County.

COVID-19 & Anxiety

written by Tiffany Merchant, MS, LPC

The safer-at-home order has ended and many questions have begun to enter our mind and daily conversations. It seems that just as the world was beginning to settle into the “new normal” life is changing yet again. When the routines and rules that we live by  shift, there can be a significant sense of uncertainty and this uncertainty can lead to anxiety. 

Anxiety does not have a one size fits all definition. There are varying degrees of anxiety that present in significantly different ways. However, there are common threads that lead mental health professionals to a formal diagnosis including overthinking, excessive worry with the inability to stop the worry, and difficulty “turning off” the brain. It is also common for someone living with anxiety to experience physical symptoms such as increased heart rate, sweaty palms, shaking, and being restless. 

These thoughts and behaviors are connected to a well-known response called fight, flight, or freeze. This response serves an important purpose in self-preservation. When the brain detects a threat to its existence, the brain signals the body to either defend itself, run away, or be very still. For example, if you are camping and come upon a bear, you want your brain to feel like it is in grave danger! However, when a person is exposed to prolonged stress or trauma, the brain can interpret certain harmless stimuli as harmful and causes the body to respond as if it were in significant danger. 

This is especially relevant with prolonged exposure to the news or social media concerning COVID-19, as it could cause elevated stress levels over an extended period of time. Your brain could then interpret any exposure to information about COVID-19 as harmful, in turn, causing anxiety. 

Dr. Bruce Perry’s extensive research shows that one contributor to an increased stress level is “novelty” or anything new. With COVID-19, something changing everyday, so it is no surprise that more people are likely experiencing an increase in anxiety symptoms. If you have noticed that you are having difficulty “turning off your brain” or are restless, here are some practical suggestions that you might try: 

• Meditation – There are numerous free apps that can be downloaded onto your phone as well as many YouTube videos that can guide you. Here is a link to a 5 minute meditation on YouTube. https://www.youtube.com/watch?v=inpok4MKVLM
• Deep Breathing – Deep breathing helps to direct your focus on the present. Take a look at this article for step by step instructions on how to practice deep breathing. https://www.uofmhealth.org/health-library/uz2255
• Exercise – Getting your body moving (taking a walk, using your home gym, hiking, or playing catch with your children) is one of the easiest ways to manage stress in your body. 
• Daily Structure and Routine – Keeping our routines make things predictable, and safe for us. 

Some anxiety is necessary and helpful to protect us against danger. When it begins to interfere with a person’s daily functioning, it can be problematic. If you find yourself having difficulty performing daily tasks that were previously common and easy to perform or endless ruminating or catastrophic thinking (IE: thinking the worst frequently)it might be time to seek a therapist’s assistance. Stein Counseling is open and taking new clients and can help you process these thoughts and feelings, and assist you in coping more effectively with the changes we face everyday, or in times of stress. To schedule an appointment call 608-785-7000 x 221.

Updated: COVID-19 Precautions

The Stein Counseling Leadership Team is continuing to work hard to ensure the safety of our providers, office staff, and clients. As many of our providers return to the office this week for in-person appointments, we wanted to make sure we share our increased safety protocols to ensure a safe and smooth transition. Our safety procedures include:

• We ask that you wash or sanitize your hands when you enter the waiting room. Hand sanitizer is provided in several locations throughout the waiting room.
• We encourage all unscheduled guests (children, spouses, friends, etc.) to stay home during your appointment, or wait outside in the car.
• Masks are recommended but not required. If you choose not to wear one, we will ask you to wait for your provider outside of the office either on the benches provided or in your vehicle. (You will be alerted when your provider is ready for you.) Disposable masks are also available for guests who do not have one.
• Please bring minimal items with you into the office.
• Traffic flow to-and-from provider’s offices will be one-way and you may be asked to schedule additional appointments with your provider in their office instead of returning to the front desk after your appointment.
• We will continue to frequently disinfect our high traffic areas such as the check-in/check-out desks. Arm chairs, counter tops, and door handles in common areas will continue to be sanitized throughout the day, and at the end of each day.
• Coffee, water, hot chocolate, and tea are unavailable until further notice.
• Books, magazine, and children’s toys are also being removed from the waiting room.

We ask for your continued assistance as well by:

• If you have been sick, or around someone that has been sick, we ask that you cancel your appointment.
• Do not shake hands and avoid touching your face.
• Cover your cough/sneeze with your sleeve or a tissue, not with your hand.
• Be mindful of the space between you and others, and practice social distancing
• Remember to also sanitize personal cell phones, desk phones, desk tops, pens, door handles, etc.

May is National Mental Health Month

May is #MentalHealthMonth! This year’s theme, #Tools2Thrive, explores practical tools that can everyone make small changes that have a big impact on their mental health, and increase resiliency regardless of the situations they are dealing with.

You can be supportive of those who are struggling with life’s challenges and their mental health. The Tools2Thrive toolkit created for #MentalHealthMonth includes practical tools that everyone can use. Download the toolkit at: mhanational.org/may. #mhm20 #mentalhealth

Recovery Resources

written by Tiffany Merchant, MS, NCC, LPC

During this difficult time of social distancing, many have reconnected with their immediate family, slowed down, and enjoyed the calm. For some, their mental health issues have increased. And for still others, their lives are physically on the line. While the front line “essential” workers are putting their lives at risk, there is another group of people whose danger is hidden in plain sight. Their fight is daily and takes courage, strength, and energy. They are mothers, fathers, sisters, brothers, sons, and daughters. They are professionals and workers of a trade. They are fun and full of life. They are grateful. And they must choose everyday to live life to its fullest. They are also in recovery from substance abuse. 

Recovery can include someone who has been sober for three months or thirty years. While there are multiple stages in the recovery process, there is one constant –  the need for support. This support is an essential part of relapse prevention. Famed researcher, journalist, and author, Johann Hari, has completed extensive research on addiction and one of his conclusions was that the opposite of addiction is not sobriety. The opposite of addiction is connection. The invisible ties between you and me, between each of us.

Please watch this brief video to understand more about the connection between recovery and relationships.

During the “Safer-at-Home” order, all of us have been cut off in some capacity from our clan, our tribe, our “persons” and are feeling it’s effects. Loneliness and isolation can settle in. Fear, anxiety and frustration overtakes us sometimes. Those in recovery may be feeling even more isolated than ever before. Without their support system they are at much more risk of relapse and falling into coping in an “old manner.” So, if you know and have a relationship/friendship with someone who is in recovery, reach out to them. Say “Hi” and see how they are doing. Drop a note in the mail to say hello and that you are thinking about them. Be still, be present and listen. Empathize and understand. The struggle is real. The battle is real. Victory is one day, one hour, and one minute at a time and when someone is in the trenches with us, we often feel comfort and not as alone. These small gifts can mean so much. 

Additionally, here are some online resources for those in recovery and loved ones of those in recovery. 

Alcoholics Anonymous (AA): https://aa-intergroup.org/ or https://www.aaonlinemeeting.net/

Al-Anon Family Groups https://al-anon.org/al-anon-meetings/electronic-meetings/

Cocaine Anonymous https://www.ca-online.org/

Co-Dependents Anonymous https://coda.org/find-a-meeting/online-meetings/

Face it Together https://www.wefaceittogether.org/pricing

Families Anonymous https://www.familiesanonymous.org/meetings/virtual-meetings/

LifeRing Secular Recovery https://www.lifering.org/online-meeting-schedule

Narcotics Anonymous (NA) https://virtual-na.org/

Parents of Addicted Loved Ones https://palgroup.org/find-a-meeting/pal-telephone-meetings/

Partnership for Drug-Free Kids   https://drugfree.org/article/online-support-community-for-parents-caregivers/

Recovery Dharma https://recoverydharma.online/

SMART Recovery https://www.smartrecovery.org/community/ or https://www.smartrecovery.org/community/calendar.php 

Young People in Recovery Chapters’ All Recovery Meetings http://youngpeopleinrecovery.org/virtual-event-schedule

Is Telehealth really effective?

written by Tiffany Merchant, MS, NCC, LPC

It started as something half a world away from the United States in December 2019. In January 2020 the World Health Organization (WHO) declared the novel coronavirus, COVID-19, a public health emergency of international concern. As the number of positive tests for COVID-19 grew exponentially in the United States the President of the United States declared a national emergency and Wisconsin Governor, Tony Evers, declared a public health emergency. On March 24, 2020 our definition of “normal” changed severely when Governor Evers enacted a Safer-At-Home order. 

This order has left many places of employment scrambling to understand what is considered “essential” and how they could continue to support their employees and customers. Doctors began cancelling “non-essential” appointments. Schools closed. Parents and guardians were now left questioning what they needed to do to educate their children and teachers began a journey of transforming the way they teach and inventing new ways of teaching. And many citizens were left with the question of how they would access the mental health services they have come to depend on. 

“Is it effective?”

Absolutely! Jonathan G. Perle and Barry Nierenberg completed a literature review (1) that found telehealth to be an effective mode of therapeutic treatment for people who are unable to access face-to-face mental health services. 

“Is it safe and secure?” “Will it be just us?”  

SCCS uses the safe and secure platform of Google Hangout Meet for telehealth ensuring HIPPA is followed even in these changing times.. Providers are diligent in protecting the rights of clients. Providers are alone in their office or home and use headphones if needed in order to ensure that client information is kept confidential.  

“Is it legal?”   

Telehealth is legal in the state of Wisconsin. Under the Emergency Order 16 and 2019 Act 185, mental health providers in the state of Wisconsin are authorized to provide telehealth services so long as the services provided are within the scope of practice of that provider, and the client is in the state of Wisconsin. Telehealth services were legal before COVID-19, however, under the Emergency Order 16 and 2019 Act 185 the provider does not need to be credentialed specifically for telehealth. There is no test to pass or further education required to obtain that credential. 

“What can you do with my elementary aged child on video?”  

SCCS providers that work with children are skilled in finding creative ways to connect with their younger clients. They will use numerous ways to connect including games, coloring, drawing, conversation about interests, and lego blocks.  

“There is no way that we can connect over video! I will feel so awkward!”

This is a common fear of telehealth. However, this fear should not keep you from seeking mental health care. In the times of COVID-19 and social distancing, it can become easier to connect in ways previously more difficult. SCCS providers will gauge the conversation and adjust as needed to find a way to connect with you. We are also continuing to provide counseling at the office in person.

“Will insurance cover it?”

Many insurance companies have shifted to cover telehealth, however it’s important to note, every insurance is different. If you are uncertain if your insurance will cover telehealth for mental health services, call the SCCS office and contact your insurance company to verify benefits. 

While transitions are difficult for many of us, most mental health clinics, including SCCS, have been providing telehealth options since the “Safer at Home” order. Hopefully, the answers above have helped you feel comfortable with the option of telehealth. SCCS providers and support staff are here to answer any other questions that you might have. And, again, we continue to provide services in person at both the Onalaska and Black River Falls locations.

To continue your mental health journey, or if you have discovered that you need someone to talk to and process just how upside down your world has turned in the last 6 weeks, call Stein Counseling at (608)-785-7000. We’re here to help!

(1) Jonathan G. Perle & Barry Nierenberg (2013) How Psychological Telehealth Can Alleviate Society’s Mental Health Burden: A Literature Review, Journal of Technology in Human Services, 31:1, 22-41, DOI: 10.1080/15228835.2012.760332

Trauma Informed Information

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