Monthly Archives: October 2013

When disaster strikes twice: Helping Jersey shore residents cope

Heather Rudow October 11, 2013

(Kristi Funderburk/The Asbury Park Press/AP)

(Kristi Funderburk/The Asbury Park Press/AP)

Nearly a year ago, historic “superstorm” Hurricane Sandy tore up the East Coast, claiming at least 117 lives in the U.S. and 69 more in Canada and the Caribbean, leaving an unthinkable path of destruction in its wake.

New Jersey was especially hard-hit: half of the city of Hoboken flooded, communities all up and down the shore sustained significant damage and, at one point, more than 2.6 million residents were without power. At least 34 people were killed in the state, and damages have been estimated at $29.4 billion.

In the town of Seaside Heights, the storm reduced its boardwalk from a famed tourist attraction to piles of wood and wrecked amusement park rides. Perhaps no image was more representative of the destruction than the now-iconic photo of Seaside’s JetStar roller coaster rolling out with the tide.

But just as life for those N.J. residents was perhaps returning to normal, a massive fire erupted along the Seaside Heights and Seaside Park boardwalks on Sept. 12, destroying more than 50 businesses. Adding insult to injury, it was revealed that the fire was caused by damage in electrical wiring under the boardwalk and subfloor that had first been compromised by flooding from Hurricane Sandy.

Now, those N.J. residents are left to deal with the first anniversary of the hurricane, compounded by the destruction of the recent fire.

On the anniversaries of disasters, an “anniversary effect” or “anniversary reaction” can impact primary survivors — those who directly experienced the disaster — and secondary survivors, or those who indirectly experienced the disaster through TV and other media outlets.

Karin Jordan, founder of the American Counseling Association’s Traumatology Interest Network, notes that anniversaries of disasters can already be difficult for survivors to process; adding another trauma or disaster event can make coping during this time even more difficult.

“These dates can mark a time of heightened vulnerability and psychological impact,” Jordan explains. “Anniversaries are difficult for disaster survivors as they are often a time of remembering the losses and rekindling the sadness, fear, anxiety and stress. Experiencing multiple disasters can be difficult and puts survivors at higher risk of having trouble dealing with the disaster event’s anniversaries.”

Jordan says traumatic events such as Hurricane Sandy tend to have a “desensitizing effect on the acquisition of coping skills for later disasters. For example, the fire [that] destroyed New Jersey’s boardwalk after a furious rebuilding effort subsequent to Hurricane Sandy left some of the populace with a sense of hopelessness, sadness and a range of other emotions, and [wondering] ‘Haven’t we gone through enough? What is going to happen next?’”

Juneau Mahan Gary, a counselor educator at Kean University, can personally attest to this. Gary, a member of the New Jersey Counseling Association, a state branch of ACA, lives off New Jersey’s Barnegat Bay, across the water from where the fire took place.

“From my deck, I can look at Seaside Heights, so I can see it every day,” says Gary, a N.J. native. “On that particular day, I was not home, but my husband and my neighbors were able to see the smoke rising from Seaside Heights.”

When Gary saw the fire and its destruction on TV, she felt “overwhelmed and speechless. My brain just couldn’t absorb what I was seeing, it was that overwhelming.”

Due to the fire’s massive size and a lack of working hydrants nearby, firefighters even pumped water out of Barnegat Bay to fight the flames. Watching the efforts upon returning home, Gary and her neighbors felt “sadness, disbelief and empathy.”

“We felt helpless that night,” she recalls.

However, Gary and fellow residents have been feeling this way for nearly a year.

“Even before the fire occurred, we still have, just a half mile from me, houses that are condemned, either because of the major destruction or the mold,” she says. “Some people are still dislocated, there are a number of houses that are for sale and some will [mention] hurricane damage. I suspect the houses are for sale because owners can’t make sufficient repairs.”

She describes it as a “double-whammy” for residents.

Jane Webber, former president of the New Jersey Counseling Association, says the sheer force of the blaze makes for an especially difficult recovery.

“Although the unpredictability and danger of hurricanes and floods are part of Jersey shore life, no one was prepared for the shock of the boardwalk inferno,” says Webber, a counselor in private practice and adjunct professor of counselor education at Kean University. “The Seaside Park fire was intense and terrifying, spreading rapidly to Seaside Heights, while residents and business owners heroically tried to protect buildings even after their own stores burned.”

Webber, a member of the ACA Crisis Response Planning Task Force and co-editor of the second and third editions of Terrorism, Trauma and Tragedies: A Counselor’s Guide to Preparing and Responding, says now is a “critical time for outreach counselors to support clients and to be available for those residents who may not have needed assistance after Sandy. The terrifying fire and the financial losses added to Sandy’s toll, testing our hope and endurance when the reservoir of resources has been depleted.”

Jordan agrees, recommending that counselors follow a treatment plan that includes “a structured interview to get a better understanding of the client’s trauma exposure, such as the magnitude, duration, whether they are an imminent risk to their self or others, previous trauma experiences, present level of functioning and their present support system.”

The goal of treatment, she says, is helping clients to “develop a cognitive frame of his or her own feelings, emotions and behaviors in order to be able to discriminate between disaster triggers and reality.”

The client needs to be supported in finding the appropriate language to describe the experience “so they can remember what happened and when the disaster struck without being emotionally charged and experiencing the trauma all over again,” with the ultimate goal of “making the trauma memory like any other memory through reconstructing [it] into a meaningful narrative.”

Webber finds active interventions to be helpful in lowering clients’ anxiety levels and suggests “taking a walk on the beach together or talking with clients as they work on repairs. Search the beach together for a worry stone to hold when they are feeling over-stressed. Decide together on one task to tackle and list steps and progress dates on the calendar to reduce confusion and stress when so much needs to be done.”

Gary says it’s important for counselors to know of referral sources and support groups providing free and low-cost services. Also important, she says, is for counselors themselves to offer pro-bono services for individuals and groups.

“Consult with local mental health agencies and schools to offer or co-sponsor psychoeducation sessions, counseling or special clinical supervision and/or consultation to mental health staff who work with affected clients,” Gary adds.

New Jersey Hope and Healing, a N.J. Division of Mental Health and Addiction Services-sponsored crisis organization, is a good place to start, Gary says. In addition, Gary created a free repository of websites that school counselors and school personnel can use to assist students.

It’s a counselor’s role to educate survivors and clients about common anniversary reactions and provide information for those who are not directly impacted by the disaster, Gary says.

It is also up to counselors living in affected areas to make sure they are in the appropriate mindset to assist others.

“Seek clinical or peer supervision or personal counseling as necessary,” Gary says. “Exercise, eat healthy, get rest, set limits and [learn to] say ‘no.’ Practice counselor self-care.”

Gary, a certified disaster response crisis counselor for the state of New Jersey, had to assess her emotional well-being when the hurricane hit.

“[Though] not significant, we suffered damage to our house,” she recalls, “and at that point, I knew I was too raw to help anyone. Those first two months, I needed to take care of myself and my surroundings. You need to … do your own self-assessment and ask, ‘Am I strong enough and ready to help someone?’”

Webber says counselors should be alert to changes in survivors’ behaviors and moods and whether “day-to-day tasks become more difficult or insurmountable. Watch for signs of depression, hopelessness or anxiety.”

Gary, Webber and Jordan say that counselors should be on the look out for some of the following reactions:

  • Denial of any emotional impact
  • Avoidance of discussing the hurricane or the fire
  • Inability to recall the event
  • Flashbacks and intrusive recall of the event
  • Anxiety, depression, fear that another hurricane or fire might happen
  • Depression or feeling easily overwhelmed
  • Anger over the loss of people, property and community
  • Changes in appetite (overeating or inability to eat)
  • Substance abuse and self medication
  • Nightmares and other sleeping problems

The difference between recovering from a natural disaster as opposed to man-made trauma is that, unlike other trauma, natural disasters do not typically involve human error.

“Although we are unable to change the course of natural events, we are spared the terror inflicted by mass violence,” Webber says. “As superstorm Sandy roared through towns, survivors were determined to outlast nature’s fury, comforted by the courage and compassion of neighbors who protected them from the hurricane’s path. On the anniversary, many will remember how they lived through Sandy, sharing stories of survival and affirming the resilience of the human spirit to endure the elements.”

Webber, a N.J. native who remembers riding her bike along the Seaside Heights boardwalk and working there as a teenager, says the determination and optimism of the state’s residents will help them cope.

“Residents pledge not to let this latest tragedy block the Jersey shore recovery,” she says. “The resilience and commitment of the community will sustain them to be ready for Memorial Day’s beach opening next year.”

 Heather Rudow is a staff writer for Counseling Today. Contact her at hrudow@counseling.org.

Filmmaker spotlights EBD crisis in public schools

Heather Rudow October 10, 2013

wcakDan Habib, filmmaker in residence at the Institute on Disability at the University of New Hampshire, has personally seen the struggle children with disabilities can face within the public school system. His son, Samuel, has cerebral palsy, and is the subject of Habib’s first documentary, Including Samuel, which explores the educational and social inclusion of kids with disabilities.

Now, in his second documentary, Habib investigates the place of children with emotional/behavioral disabilities (EBD) within our educational system as well as society in Who Cares About Kelsey?. The documentary follows New Hampshire teen Kelsey Carroll, whose one goal is to graduate high school despite having attention-deficit/hyperactivity disorder (ADHD) and a past that includes homelessness, self-mutilation, failing grades and sexual abuse. Along with Kelsey’s personal life, Who Cares About Kelsey? also focuses on positive education reforms that help to empower EBD youth.

Counseling Today spoke with Habib about the filming experience and the role that counselors can play in helping students with EBD to find a place in the school system.

 Who Cares About Kelsey? is airing on public television channels nationwide throughout National Mental Health Awareness Week (Oct. 6-12). You can find a list of broadcast dates and channels here

How did you come up with the idea for this documentary?

I’ve personally screened and discussed my first film Including Samuel more than 400 times in the past four years since the film came out. Including Samuel explores the educational and social inclusion of kids with disabilities and focuses on my own son Samuel, who has cerebral palsy. At almost every event, someone asked a variation on this question: “What about kids with emotional or behavioral disabilities? Can they be fully included like Samuel?”

As I researched the topic, I found alarming statistics that motivated me to take on this film project.  Over two million young people in the United States have an EBD.  The Southern Poverty Law Center reports that students with EBD:

  • Have the worst graduation rate of all students with disabilities. Nationally, only 40 percent of students with EBD graduate from high school, compared to the national average of 76 percent.
  • Are three times as likely as other students to be arrested before leaving school.
  • Are twice as likely as other students with disabilities to live in a correctional facility, halfway house, drug treatment center, or on the street after leaving school.

Those are awful outcomes, and I wanted to create a film project that – like Including Samuel – could be a catalyst for progressive educational reform.  I set out to create a project that focused on the voices of youth, families and educators to shows innovative educational approaches that help these students to succeed – while improving the overall school culture and climate.

 Describe the filming process:

The first step in creating a documentary is to find the most powerful subject for the film. I was fortunate to find a New Hampshire school just one hour from my home that has become a national model for supporting and including students with EBD. Somersworth High School implemented the evidence-based framework called Positive Behavioral Interventions and Supports in 2006. For those students who were at greatest risk of dropping out of school, Somersworth implemented a youth-led planning model called RENEW (Rehabilitation for Empowerment, Natural Supports, Education, & Work).  The results were dramatic: in four years, Somersworth reduced its dropout rate by 75 percent, and behavior problems were reduced by 65 percent.

I asked Principal Sharon Lampros if I could spend a year documenting life at SHS, and she bravely opened up her high school to my camera and me. I spent the spring of 2009 getting to know the students and staff as well as documenting the school culture and climate.

Kathy Francoeur was the school’s crisis intervention counselor (she is currently pursuing her masters in education in school counseling) and in the fall of 2009 she introduced me to many teens that were struggling with emotional/behavioral disabilities ­­- most were at risk of dropping out of school. 

When I met Kelsey Carroll, I knew Kathy could stop making introductions. When Kelsey entered Somersworth High School, she was a more likely candidate for the juvenile justice system than graduation. She had a diagnosis of ADHD and carried the emotional scars of homelessness and abuse, as well as the actual scars of repeated self-mutilation. As a freshman, she didn’t earn a single academic credit and was suspended for dealing drugs.

During our first interview, Kelsey was incredibly open about her struggles past and present.  She was brash and funny. She told me about bouts of self-mutilation, her mother’s substance abuse and her pride at being a cheerleading captain. Kelsey agreed to let me film her in school, at home and in the community, and she was able to largely ignore the camera (a must for the subject of a documentary film).

From the beginning, I told Kelsey that she was a collaborator, not just a ‘subject’ of this process. At any time, she could tell me to turn off my camera (she used that prerogative a number of times). She watched many rough cuts of the film and suggested valuable edits.

Who Cares About Kelsey? follows Kelsey through the ups and downs of her senior year, and shows what successful educational approaches look like on the ground, in a real school.  And it shows educational reform through the eyes of a student, from the inside looking out.

 What surprised you the most while you were filming?

I continue to be surprised by how many schools still implement harsh ‘zero tolerance’ style disciplinary approaches to control behavior despite zero evidence that these approaches are effective. In fact, studies show that students with EBD typically do not respond well to traditional discipline policies and educational programs, and that these harsh approaches further reinforce the characteristics of EBD (anxiety, depression, low self-worth, aggression), which leads to cycles of discipline referrals.

By focusing solely on punishment, zero-tolerance neglects to examine the root causes of problem behavior. Rather than increasing school safety, zero-tolerance often leads to increased suspensions and expulsions for both serious and mild infractions and disproportionately impacts students with disabilities.

The evidence shows that zero tolerance policies don’t improve behavior or student outcomes, but they do send an awful lot of kids into the juvenile justice system.  That should not be our society’s goal.

Can you describe the evidence-based intervention program that the documentary is based around?

The greatest strength in Kelsey’s support network is her RENEW team. RENEW is a structured school-to-career transition planning and individualized wraparound process for youth with emotional and behavioral challenges. Developed in 1996 by staff at the Institute on Disability (IOD), RENEW is being provided by schools, community mental health centers, community-based providers and IOD staff members to youth. The model focuses on supporting each youth to design and pursue a plan for the transition from school to adult life. RENEW has substantially increased the high school completion, employment and post-secondary education participation rates among youth with EBD.

Through RENEW, Kelsey works with her mentor, Somersworth High School crisis intervention coordinator Kathy Francoeur, to assemble a team of trusted adults that meets with her weekly. She tells them her dreams, her fears, her likes and dislikes as they furiously record everything on poster paper taped to the walls.

In the film, Kathy reaches out to Kelsey in times of academic and personal crisis with empathy and practical guidance, always reminding Kelsey of the benefits of finding out what she wants and who she is beyond her past, her family and her relationships.

While interacting with the individuals around her, we can see how easily Kelsey could fall into what she describes as “family patterns”—early parenthood, dropping out, substance abuse, limited life options.  It is the team of educators at Somersworth who give Kelsey the chance to define a role for herself.  Who Cares About Kelsey? shows what she does with that chance.

What can counselors take away from this documentary?

 Although a school may or may not choose to implement RENEW, the key features of this approach are worth replicating:

  • Self Determination
  • Personal Futures Planning
  • Creative and Individualized School-to-Career Planning
  • Strengths-based Approach
  • Unconditional Care
  • Building Family and other Natural and Community Supports
  • Wraparound
  • Systemic Support and Consultation

 Why is it important for counselors and other mental health professionals watch this documentary?

 Providing a quality education and support network is not easy, so films about education strive to be complex and balanced – like any good documentary journalism.  People tell me that my films don’t sugarcoat the issues, and that the content is real and raw.  Waiting for Superman was an engaging film but its message boiled down to “Unions Bad. Charter Schools Good.”  I think that’s a vast oversimplification of the challenges in education.

I don’t make films that prescribe easy solutions, because there are none. Although Kelsey’s story is quite far-reaching, I still couldn’t capture all the issues I wanted to address in one film, which is why I made ten mini-films that look at different but related subjects and can be watched for free on our website.

Do you think enough is being done for kids with emotional and behavioral issues within the school setting?

 No, I think we have a long way to go before kids with EBD are fully supported and included in our schools and communities.  We have a key statistics page that I think makes a compelling case that we as a society are NOT doing enough.

 What do you think needs to be done to make sure students, like the ones featured in your documentary, don’t slip through the cracks?

It’s critical that the general public understands what most school counselors already know; behavior is a form of communication. My hope is that Who Cares About Kelsey? will make viewers reconsider the “problem kids” in their own high schools and spark new conversations about empowering — not overpowering — youth with emotional and behavioral disabilities.

What can counselors and school counselors do?

 School counselors can push for positive, rather than punitive approaches to disciplinary policies and efforts to improve school climate and culture.  We have just launched a take action campaign as part of the film’s outreach called I Care By (icareby.org). School counselors can use this website as a resource to provide students, families, educators and policy makers with simple but effective actions to support students with emotional and behavioral challenges.  As an example, we’ve made the RENEW youth-directed planning portfolio available for free download in the ‘student’ section of the site.

Additional thoughts:

 This film is not a fairy tale — Kelsey still has challenges and obstacles. But by sharing her life story, she has already made a dramatic impact on the way tens of thousands of people view hidden disabilities like ADHD and other mental health disorders.

 Heather Rudow is a staff writer for Counseling Today. Contact her at hrudow@counseling.org.

Clinical Rehabilitation Counseling Standards and Accreditation Process Now Available

cacrepCACREP and its corporate affiliate CORE have released the newly adopted Clinical Rehabilitation Counseling Standards (ClRC) for immediate use by masters degree counseling programs seeking to become accredited. The standards can be found on the web at either cacrep.org or core‐rehab.org.

Along with the release of the Clinical Rehabilitation Counseling Standards, CACREP and its corporate affiliate CORE have developed a conversion policy that outlines a process for 60 semester hour clinically‐based programs that are currently accredited by CORE to seek dual accreditation as both a clinical rehabilitation counseling and a clinical mental health counseling program. While it is the intent to develop additional processes for applying for accreditation as a Clinical Rehabilitation Counseling program, currently only applications meeting criteria for the conversion policy process are being accepted for review. The conversion policy is accessible at cacrep.org or core‐rehab.org.

CACREP and its corporate affiliate CORE will be presenting details of their new agreement and processes at the ACES conference in October 2013, the NCRE conferences in November 2013 and March 2014, the AASCB conference in January 2014, and the ACA conference in March 2014. Additional updates will be published on the CACREP and CORE websites, in ACA’s e‐News and Counseling Today, as well as posted on CESNET, NCRE, and other counseling listservs.

ACA attends Committee for Education Funding gala

October 9, 2013

IMG_2191

ACA President Cirecie West-Olatunji, former ACA Presidents Lynn Linde and David Kaplan, ACA CEO Richard Yep and staff  are all smiles as they attend The Committee for Education Funding’s 2013 Gala honoring Senator Tom Harkin (D-IA).

(From left: Richard Yep, Guila Todd, Art Terrazas, David Kaplan, Cirecie West-Olatunji, Lynn Linde, Danielle Irving)

Affordable Care Act: What you need to know

October 7, 2013

(President Obama signs the Patient Protection and Affordable Care Act into law. Photo: Wikimedia Commons)

(President Obama signs the Patient Protection and Affordable Care Act into law. Photo: Wikimedia Commons)

With the recent opening of the healthcare exchanges, we thought that it may be beneficial to share some information regarding the implementation of the Affordable Care Act. ACA’s public policy department has prepared a handout that will answer most of your questions regarding the new laws. It is important that you familiarize yourself with the facts surrounding the law as a lot of misinformation has been spread. Review the document here.

If you have any other questions regarding the Affordable Care Act, you can access information through the CMS website or visit healthcare.gov for the latest news and updates.