Like Play Therapy, Sand Tray was originally designed to help children communicate, and has generalized for adolescent and adult therapy. While clients might build in the sand itself, traditional sand tray includes tiny houses, vehicles, figurines, etc, and the client is able to produce a microcosm in which to enact situations and resolve conflict. Often, the design and interplay within the sand tray is without direction from the therapist, and can reflect unconscious aspects for later analysis.
Persons with schizophrenia suffer auditory and visual hallucinations, general thought disorders and delusional thoughts, straining personal relationships tremendously and making some professional relationships impossible. Schizophrenic symptoms usually emerge from 16 and 30, with very low initial onset after the age of 45. Schizophrenia has a genetic predisposition, can be viral or chemically-induced, and likely has certain brain structures and neurotransmitter relevance. Medication is regularly used to stabilize escalated thought patterns.
Some children refuse school due to social phobia (the debilitating fear of being judged, often for seemingly innocuous behaviors, occurring consistently over weeks), sometimes exacerbated by the challenges of school participation; the typical jostling for social status and/or bullying also exacerbates these children’s anxiety. (see Academic Failure) from NIMH’s nimh.nih.gov/health/topics/social-phobia-social-anxiety-disorder/index.shtml
Seeking Safety is a present-focused treatment for substance abuse, PTSD and trauma that does not include a requirement for investigating the trauma narrative. It has 5 main principles: safety, integrated treatment, focus on ideals, 4 common content measures, and a commitment to therapist self-care.
The Seven Challenges (http://www.sevenchallenges.com) is a drug and alcohol cessation program/philosophy, distinctly different from the 12 Steps. Firstly, the philosophy acknowledges that many younger users/adolescents are not willingly trying to stop using and often find themselves compelled (by involuntary treatment, legal or other life challenges) to reduce use. The Seven Challenges mindset is that because substances often help alleviate emotional stressors, healthy adults - through purposeful, respectful interactions, can quickly help adolescents and young adults develop better skills and thereby provide options for previous obstacle situations. Individual and group counseling components are often included, but the model is highly flexible for the needs of the clients. This treatment model is used by a few of the treatment programs in the FCBHI.
Severe learning disabilities are typically diagnosed at birth or in childhood. A sign of a developmental delay might noticed pediatrician, teacher, or family member and can be the catalyst to prompt a formal assessment. Many of the children diagnosed with a severe learning disabilities have other diagnosis that make finding the right school or program a complex process and sorting out their learning profile.
"Compulsive sexual behavior can be called hypersexuality, hypersexual disorder, nymphomania or sexual addiction. It's an obsession with sexual thoughts, urges or behaviors that may cause you distress or that negatively affects your health, job, relationships or other parts of your life."
Although these are not part of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are varying treatment centers which are treating love addiction and/or sex addiction for all different ages. There are also treatment programs for adolescents who have issues related to sexual abuse, pornography addiction and related compulsive behaviors. These addictions are sometimes referred to as Compulsive sexual behaviors (CSBs) or hypersexuality or hypersexual disorder.
These disorders are characterized by the inability to set healthy boundaries with regard to emotional and/or sexual attachment. Individuals suffering from love or sex addiction compulsively engage in emotional and/or sexual behaviors as a way to deal with inner issues regarding a fear of abandonment or loneliness or a confusion between love and neediness. For the sex or love addict, these behaviors become destructive to the individual’s physical, social, and emotional well being and often lead to significant consequences such as divorce, legal trouble, or financial difficulty. In the case of children and adolescents the behaviors affect academics, family and peer relationships, especially where isolation and unhealthy relationships with electronics exist.
Submitted by: Cosette Rae, MSW, LICSW, ACSW, CDWFCEO, Founding Member, Program Director, reSTART
Combining the words sex and texting, sexting is the practice of electronically sending sexually explicit images and messages between cell phones; this practice is legal amongst consenting adults. Sexting has become more and more common among teens whose cell phones now have texting and digital camera functions. While consensual sharing is more common between teenagers in a sexual relationship than expected, recent research is also finding girls are sometimes pressured to send pictures. There can be severe consequences: beyond humiliation and the expense and difficulty of interrupting internet distribution if the image is disseminated, teens who are caught possessing these images can be prosecuted for child pornography.
Some of the shorthand of sexting like:
- RU18 -- Are you 18?
- CD9/ Code 9 -- Parent / Adult Around
- NALOPKT -- Not a lot of people know this.
Workshops are intense, short-term group exercises to highlight and grapple with common issues focused on by the individual participants, where each can become aware of and practice challenging old dysfunctional patterns and to formulate support and planning for the future. Generally, these multi-day workshops are held in dramatically natural environments, with plush creature comforts overnight and during meals. There are different types of clinical underpinnings to these programs and it important for a participant to understand their need and if this model will help to meet that need. A workshop might focus on intimate relationships, family of origin issues, shame or trauma or other general topics, with the group working to discover and test concepts that were unspoken or even unconscious; intensity and value builds as the trust and quick honesty (‘congruence’) generates. Workshop facilitators provide the value of a gentle coaching and guidance, and officiate the need for patience and sensitivity as participants rub up against insecurities and the more raw, untested beliefs.
Workshops are inappropriate as primary treatment; however, they can be profoundly valuable for invigorating individuals and families under duress or seeking new perspectives to life’s challenges.
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Sober Living environments or houses are living places for is generally referred to alcohol and drug dependence that provide a place between a rehabilitation center or residential treatment center to either home or a new life in a community. They have their roots in California and are generally not licensed by the state. The Sober Living Network (SLN) is a wonderful place to start.
The essential characteristics include:
- An alcohol and drug free living environment for individuals attempting to abstain from alcohol and drugs
- No formal treatment services but either mandated or strongly encouraged attendance at 12-step self-help groups such as Alcoholics Anonymous (AA)
- Required compliance with house rules such as maintaining abstinence, paying rent and other fees, participating in house chores and attending house meetings
- Resident responsibility for financing rent and other costs
- An invitation for residents to stay in the house as long as they wish provided they comply with house rules.
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Sobriety means different things to different people. Culturally, many tie it to the 12 Step model which means abstinence. However, how a program or model defines sobriety has evolved in recent years. (See Recovery) In legal terms, sobriety refers to a maximum level of intoxication permissible for operating motor vehicles, etc.
Social Life Skills are tied to an individual’s interpersonal skills with peers, family and the public. They are synonymous with one’s ability to problem solve in the moment, read social cues, or ask or explain what is needed for one’s self.
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While the 12 Step (AA model) is an authoritative approach for entrenched substance addiction, there are some compelling reasons why teens with addiction or substance use histories do not connect with it. SOS offers the social construct of 12 Step but in a secular milieu. “All those who sincerely seek sobriety are welcome as members in any SOS group. SOS is not a spin-off of any religious or secular group. There is no hidden agenda. SOS is concerned with achieving and maintaining sobriety or abstinence. SOS seeks only to promote sobriety amongst those who suffer from addictions.”
Also known as “K2,” “fake weed,” “Bliss,” “Black Mamba,” “Bombay Blue,” “Genie,” “Zohai,” “Yucatan Fire,” “Skunk,” and “Moon Rocks.” Spice is a mix of herbs (shredded plant material) and man made chemicals with mind-altering effects. It is often called “synthetic marijuana” because some of the chemicals in it are similar to ones in marijuana but its effects are sometimes very different from marijuana, and frequently much stronger. Generally labeled “Not for Human Consumption” and sold as incense, Spice has been available for purchase stores that sell drug-related products, gas stations, and online. Because the chemicals used in Spice have a high potential for abuse and no medical benefit, the Drug Enforcement Administration has made the five active chemicals most frequently found in Spice illegal. However, the people who make these products try to avoid these laws by using different chemicals in their mixtures. Sellers of Spice products try to lead people to believe they are “natural” and therefore harmless, but they are neither.
Student and Exchange Visitor Program (SEVIS) is an arm of the Immigration and Customs Enforcement Department of Homeland Security, which oversees international nonimmigrant students and exchange visitors in the United States; the special student extension is based on the consistent requirement that both the school curriculum and then the student conforms to strict educational requirements, while the student remains in the United States.
The relevance for treatment is that this bureaucratic approval is tremendously helpful for non-American students to remain in un-interrupted treatment for longer than the typical “visitor” visa would allow.
To meet the clinical criteria for substance abuse, there must be a “pattern of substance use leading to significant impairment or distress, as manifested by one or more of the following during in the past 12 month period:
Failure to fulfill major role obligations at work, school, home such as repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household
Frequent use of substances in situation in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
Frequent legal problems (e.g. arrests, disorderly conduct) for substance abuse
Continued use despite having persistent or recurrent social or interpersonal problems (e.g., arguments with spouse about consequences of intoxication, physical fights)”
Programs that tackle substance abuse issues may be 12 Step oriented, rational recovery, CBT and many other approaches to helping users curtail their use.
Different treatment programs and residential treatment assess and work with substance dependence in different ways and some residential settings do not intend to work with substance abuse or dependence at all.
In order to meet the criteria for substance dependence or “significant impairment or distress, as manifested by 3 or more of the following during a 12 month period:
Tolerance or markedly increased amounts of the substance to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount of substance
Withdrawal symptoms or the use of certain substances to avoid withdrawal symptoms
Use of a substance in larger amounts or over a longer period than was intended
persistent desire or unsuccessful efforts to cut down or control substance use
Involvement in chronic behavior to obtain the substance, use the substance, or recover from its effects
Reduction or abandonment of social, occupational or recreational activities because of substance use
Use of substances even though there is a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance