Mental Health/AODA Assessment Counseling and Life Coaching at the Free/Charitable Clinics.

1. Mental Health/AODA Assessment Counseling and Life Coaching at the Free/Charitable Clinics. HarsimranKaur LPC-IT, AC/LC

2. Outline • Free/Charitable Clinics and Mental Health • Types of Mental Health Services Offered at Clinics • Benefits of Life, Wellness and Health Coaching • Life Coaching Tools and Techniques • Coaching versus Counseling • Legal Implications • Assessment Counselor /Life Coach Algorithm • Collaborations between Non-Profit Organizations and Free Clinics • Closing Remarks • References

3. Free/Charitable Clinics and Mental Health • In March 2014, AmeriCares conducted a survey that demonstrated “that responding free and charitable clinics are burdened by high rates of mental illness and that the demand for free and heavily subsidized mental health services will remain strong even in the post-Affordable Care Act environment”. (O’Brien et al., 2014, p.1). • The poor and the uninsured who suffer from serious mental illness also “has a higher rates of hypertension, diabetes, obesity, cardiovascular disease and HIV/AIDS. They also have a higher frequency of multiple medical conditions and have a premature death rate two times higher than the general population” (O’Brien et al., 2014, p.1).

4. Continue….. • “Results from the survey indicate that free and charitable clinics play a key role in caring for low-income patients with mental illness. There is a scarcity of mental health providers in the U.S. in general and this particularly true for those that provide free or low-cost services to the poor and uninsured. Mental health programs have increased quality of life and productivity for people with mental illness and have shown to reduce health care and emergency department costs, decrease criminal and juvenile justice spending, and cut down on educational expenditures”. (O’Brien et al., 2014, p.5).

5. Types of Mental health services offered at Free and Charitable Clinics(O’Brien et al., 2014, p.3)

6. Services at Clinics Continue… • Assessment Counseling “Assessments are a systematic way to obtain information about the client’s problems, concerns, strengths, resources and needs”. (ACA) • AODA Assessments • Suicide-Risk Assessment • Adult Mental Health Assessments • GAD-7 Assessment • Other Assessments • http://psychcentral.com/quizzes/

7. Services Continue..... Lifestyle Coaching (Mind/Body Connection) “Lifestyle factors can be potent in determining both physical and mental health. Even small differences in lifestyle can make a major difference in health status”(Walsh, 2011)

8. Benefits of Life, Wellness and Health Coaching • Diabetes Management • Physical Injuries • Heart Disease • Cancerous Diseases • Other Chronic Conditions and Physical Ailments • Stress Management • Personality Issues • Goal Setting • Interpersonal Relationships • Career and Professional Issues • Motivation and Concentration • Procrastination • Time Management

9. Services Continue • The Care Transitions Intervention • “Transition Coach is the vehicle to transfer skills, build confidence and provide tools to support self-management. • Model behavior for how to handle common problems • Reconcile pre-and post-hospital medications • Practice or “role-play” next encounter or visit. • www.caretransitions.org • Watch Transitions Coach in Action Video • http://caretransitions.org/what-is-a-transitions-coach/

10. Life Coaching Tools and Techniques • Life Coaching Kit (COHC) • International Coach Federation http://www.coachfederation.org/ • Cognitive Behavioral Approach • Solution-Focused • http://www.samhsa.gov/ • https://www.youtube.com/watch?v=dFX4FuBazAU • https://www.mindtools.com/ • https://www.youtube.com/watch?v=ImfU12epYcI • http://beatcancer.org/

11. Coaching versus Counseling Coaching Counseling • "Coaching is about discovering” (Paterson, 2008) • Goal Oriented, Short-Term and Limited. “The coach's orientation is prospective, focusing on goals, untapped potential, and critical success factors in a whole person who seeks to maximize his or her fulfillment in life and work” (Hart et al., 2001) • Focuses more on the Present and Future. • No formal education is required however various certifications are available through ICF. • “Therapy is about uncovering and recovering” (Paterson, 2008) • Long-Term and Arduous Process. “The focus is typically retrospective, dealing with unconscious issues and repair of damage from earlier experiences”(Hart et al., 2001) • Focuses more on the Past. • Masters degree and a license in Counseling is required to practice.

12. Legal Implications • Coaching Agreement and Informed Consent. • An agreement or a contract between a client and coach to establish and set rules for both parties. • It protects both parties. • An agreement could entail but not limited to services provided, feedback, session time, policy about cancellations, call-procedures, and termination. • Informed Consent and Confidentiality. • Disclaimer. • Some coaches also have clients sign the disclaimer/waivers. • HIPPA Laws and Regulations.

13. Assessment Counselor/Life Coach Algorithm Each patient seen at COHC will be given assessment forms for completion. Assessment forms should be completed every 6 months and as needed. The patient’s chart will be noted regarding the date the assessment is completed.Receptionists will hand out assessment packets on clipboards every 6 months and document date in chart when assessment forms are completed. Assessment Counselor/Life Coach will either: 1. call patient regarding their assessment score and make appointment, if patient agrees to be seen; or 2. See patient in exam room during clinic hours for introduction of self/role. If patient is interested, appointment will be made for future visit. All assessment forms will be evaluated by COHC/ARC Assessment Counselor/Life Coach. Patients will be contacted if assessment scores are not WNL Patient is not interested in further care from Assessment Counselor/Life Coach. Documentation made in chart. Patient makes appointment with Assessment Counselor/Life Coach for more detailed assessment. Patient’s assessment score is WNL. Patient given information regarding Life Coaching opportunities at COHC and patient can make appointment with Assessment Counselor/Life Coach. Patient noted to need further medical/clinical care – using Table 1 - Therapy vs. Coaching and Table 2 - ICF’s Top 10 Indicators: When to Refer to Mental Health Professional Patient noted to need further guidance with the Life Coaching model. Patient makes appointment with COHC Assessment Counselor/Life Coach for strategy development to support achieving their desired goals Patient is referred out to community resource or volunteer Psychiatrist for further care.

14. Collaborations between Non-Profit Organizations and Free Clinics Benefits of partnering with Non-Profit Organizations: • More efficient and diverse programs • Reaching to wider population • Forming new networks • Exchange of ideas and information • Funding and Charity

15. Collaborations continue.. • Addiction Resource Council, Inc: "not for profit organization dedicated to provide support for Waukesha County residents and their families struggling with substance abuse, addiction and alcoholism. Furthermore ARC provides information, education, assessment and referral services, sponsoring or co-sponsoring community events, providing leadership and direction in collaboration with other Waukesha community-based organizations, institutions and providers of care to improve health and well-being of our community” http://www.addictionresourcecouncilwaukeshawi.org/ • IMPACT 2-1-1 “established a productive collaborative relationship with leading businesses, funders, community stakeholders and other non-profit organizations” http://www.impactinc.org/impact-2-1-1/ Northern Area Services: 211wisconsin.org “All clients/patients/free clinic staff have to do is call ‘211’ and any of their (8) call centers across the state. Will respond to the call and provide appropriate referrals for services in the area. 

16. Collaborations Other Agencies and Organizations • http://oneidacountypublichealth.org/support-organizations/ • http://greatnonprofits.org/organizations/state/Wisconsin/search:chippewa%20falls • http://www.stjoeschipfalls.com/our_services/mental_health_treatment_center.phtml • http://newmentalhealthconnection.org/ • http://www.mhawisconsin.org/screening • http://www.mentalhealth.gov/talk/community-conversation/services/ • http://www.samhsa.gov/treatment • http://www.parentcenterhub.org/repository/mentalhealth/

17. What Constitutes a Healthy Individual? I am on a Quest To Find Simple Solutions To Live a Healthier Life.

18. References • O'Brien, Lindsay., Mcguire, Leslie., Fernando, Geethika (2014). Free and Charitable Clinics: Helping to Fill the Mental Health Treatment Gap Among the Poor and Uninsured. AmeriCares, U.S.Medical Assistance Program. Mental Health Survey Report. Retrieved from http://www.safetynetcenter.org/sites/default/files/images/AmeriCares%20MH%20Survey%20Report%20052914.pdf • Assessment. (2015). American Counseling Association. Retrieved from http://www.counseling.org/knowledge-center/browse-by-topic/assessment. • Paterson, Jim. (2008). Counseling vs Life Coaching. Counseling Today. Retrieved from http://ct.counseling.org/2008/12/counseling-vs-life-coaching-2/ • Walsh, Roger. (2011). Lifestyle and Mental Health. American Psychologist. American Psychological Association. Vol. 66, No. 7, 579-592 DOI: 10.1037/a0021769. • Hart, Vicki., Blattner, John., & Leipsic, Staci. (2001). Coaching vs Therapy: A Perspective. Consulting Psychology Journal: Practice and Research, Vol.53, No.4, 229-237. DOI 10.1037//1061-4087.53.4.229.