Tuesday, January 23, 2018

Partnerships Strengthen Community: Focusing on Social and Emotional Learning in Local Schools


With their hands resting on the piece of paper in front of them, everyone closed their eyes and awaited instructions. Tara Lawyer, a School-Based Behavior Consultant (SBBC) from Northwestern Counseling & Support Services (NCSS), delivered sloppy and ambiguous directions, quickly moving from one ask to another, while eyeing the hesitant participants. They folded and unfolded, creased and pressed.

Some giggled at their gross misunderstanding of the task; others sighed in exasperation and quit folding their papers altogether. Murmurs could be heard throughout the room.

“I can’t follow along.”

“What did she say?”

“That doesn’t make sense.”

“Okay, open your eyes,” said Lawyer.

With raised eyebrows, one participant reviewed his amorphous creation. “What is it?”

“You were making a frog!” Lawyer said. She proudly displayed her cute little frog, perched on the palm of her hand. The point of the exercise was to understand what a student might be feeling in a classroom when they don’t understand the directions, can’t follow along or they feel their work is all wrong.

Even for those working with kids every day, it can be easy to forget what it feels like to be a student in a classroom, muddled and diffident. Many of us—as adults—have vast experience with frustration and failure, but it’s countered by years of success, collaboration, and support; we know what it feels like to come out on the other side.

“I knew it wasn’t important, but I felt anxiety anyway,” said one of the participants whose folded paper looked more like a crumpled ball than a frog. “I wanted to get it right.”

Others said they would have done better if the directions were repeated, if Lawyer spoke more slowly, or if people around them were quiet. Lawyer and her presenting partner, Colleen Pastina, both SBBC at Enosburg and Swanton Elementary respectively, nodded their heads in agreement to the participants’ frustrations.

This particular training, attended by para-educators, administrators and special educators and titled Effective Communication, was one of several trainings offered on October 19, 2017. In total, there were eight trainings ranging from an introduction to Applied Behavior Analysis, Trauma, Characteristics of Autism Spectrum Disorder, the Impact of a Disability on Families, to specific strategies for working with students in public schools. In all, 155 individuals from 13 schools engaged in learning activities with their professional peers. “The community response to these free trainings was so tremendous, we had to split the trainings into three separate locations,” says Amy Irish, team leader for the School-Based Behavior Consultant Team at NCSS. “Discussion has already begun with school administrators for how to continue to broaden the scope of this type of collaboration in the near future.”

The presentations were facilitated by NCSS employees from the School Based Behavior Consultant Team, School Based Autism team, and the Collaborative Achievement Team, all teams that are integrated in schools across Franklin and Grand Isle Counties. The 2017-2018 school year marks the seventeenth year that NCSS has partnered with schools in the area. “The partnership that has developed between NCSS and the schools in Franklin Northeast is something we feel is making a real difference for our students and families,” says Lynn Cota, superintendent of Franklin Northeast Supervisory Union. “We are living and working in a time when children and families need more support than ever,” she says.

As a SBBC, Lawyer may provide behavior consultation to both classroom teachers and support staff. She acts as a resource in a variety of ways, whether it is a minor adjustment or a long term intervention with a learner. A behavior plan may be created by a SBBC like Lawyer when particular needs of a student are identified. A student may need to work toward sitting still in the classroom, entering the classroom appropriately, or using a respectful tone of voice and staying safe. Teachers, parents, administration, support staff and the guidance department then collaborate to assure the best possible outcome. “This position allows me to share knowledge with others and build capacity of social and emotional development in an ever-changing learning environment,” says Lawyer.

Ginger Miles works in an alternative kindergarten classroom for a couple hours of the day, then moves on to small group instruction for third and fifth grade. A few times a week, she works one-on-one with a third grader on specific skills. In her position, she has come to appreciate and rely on Lawyer at Enosburg Elementary. “Tara is very much a part of the Hornet culture,” says Miles. “She is out and about in the school, always checking in with students and staff.” Miles says Enosburg has always been incredibly supportive; the behavior plans created by Lawyer add another layer of support and consistency.

“These interactions have fostered inclusion for me within the school. I appreciate being a part of a tight knit community,” says Lawyer. “One of the many things that I love at Enosburg is the staff’s desire to learn and support each student in the best way possible. There are so many opportunities for success and small victories every single day.”




From left to right, top to bottom: Dan Bebernitz, SBBC at Swanton Elementary; Amy Irish, Team Leader for the School-Based Behavior Consultant Team; Carrie Hatch, SBBC at Sheldon Elementary; Tara Lawyer, SBBC at Enosburg Elementary; Sarah Tebbetts, SBBC at Berkshire Elementary; Sierra Smith, SBBC at Highgate Elementary; Colleen Pastina, SBBC at Swanton Elementary

 
Irish commends Franklin Northeast Supervisory Union for being such an innovative community partner, continually pushing NCSS to evolve in the relationships with partners and in the supports to children and families. “This partnership has resulted in the development of new and creative initiatives that focus on prevention and resiliency for all students,” says Irish. While NCSS employees are based within school settings, the ultimate goal is for those staff to become truly integrated as part of the school team.

“Not only does NCSS provide high quality support for children demonstrating extraordinary levels of need within the school setting,” says Cota, “they also provide our faculty and staff with training and resources to help us all better understand how best to support children with behavioral and mental health needs in the classroom.” The partnership that NCSS shares with local schools represents an understanding of the importance of academics as well as behavioral and mental health needs, notes Lawyer. Many students have experienced trauma or have mental health needs; it is important to emphasize the significance of social and emotional learning in the academic setting.

The common goal for NCSS and for our local schools is to provide the best possible outcomes for local students. Working together, through integrated partnerships, allows for everyone’s expertise to be utilized in difficult situations. “It’s not fair to ask one person to be responsible for raising a child, to make sure their experiences are positive and healthy,” says Riley Benway, CAT Behavior Consultant and a presenter at the October 19th trainings. Through partnerships with agencies like NCSS and our local schools, we are a bit closer to assuring local students have the best opportunities possible.

“It’s up to all of us,” says Benway.

 
Written by Meredith Vaughn
 

 

 

NCSS values all the partnerships in our community. Below are the schools NCSS has partnered with in a variety of capacities:

Alburgh Elementary

Bakersfield Elementary

Berkshire Elementary

BFA Fairfax (Elementary)

BFA Fairfax (Middle/High)

BFA St. Albans

Enosburg Elementary/Middle/High School

Fairfax Elementary

Fairfield Elementary

Georgia Elementary

Highgate Elementary

Montgomery Elementary

MVU

Richford Elementary/Middle/High School

Sheldon Elementary

St. Albans Town (SATEC)

Swanton Elementary

Thursday, September 14, 2017

New Tools for Difficult Conversations with Youth


It’s never easy to know what to say when a child is in an emotional crisis, but the counselors at three YMCA summer camps may have added some tools to their belts after a training by Samantha Thomas and Lance Metayer of Northwestern Counseling & Support Services. There were about 100 counselors in attendance from Camp Abnaki in Grand Isle; Camp Koda with locations in Burlington, Georgia, Waterbury, and Essex; and Camp Greylock in Ferrisburgh. The training focused on mental health in youth and traumatic stress in childhood, topics that are all too often unexplored and misunderstood.
One of the most powerful messages behind the training was in the way we think about mental
Samantha Thomas presents to the group
illness and mental health crises. Samantha Thomas, Team Leader for the Children’s Initial Response Team at NCSS, phrases it as a paradigm shift.  When we alter our questioning from “What’s wrong with you?” to “What happened to you?”  and “Why are you acting that way?” to “Why are you reacting that way?”, we respect each individual’s experiences.  A child’s behaviors may suggest intent, yet often the behaviors of traumatized children are not intentional; they are reactions, or stated differently, these behaviors are coping mechanisms learned over time.


These coping mechanisms can be misperceived as manipulation, intentional defiance, and aggression for example, says Thomas. A child with complex trauma—multiple traumatic events overtime, often within the childcare-giving system—may act out due to a trigger in their immediate environment.  These behaviors often stem from a child’s trauma history.  Behaviors that are rooted in traumatic experience, such as name calling, can appear to be plain old aggression. It is certainly challenging not to take it personally when someone is yelling and calling names, but these behaviors are what the child has learned to do in the moment to navigate their experience and feel safe.
Other questions and approaches become more natural when one makes that paradigm shift.
Lance Metayer presents to the group
Thomas and Metayer would like counselors to use language that expresses clearly what they want the child to do in the midst of an outburst or crisis, not what they want the child to stop doing. In moments of crisis, a child may not know what an adult expects of them. “We’d like adults to ask questions like ’What is it going to take to help this child regulate and get in a better space? What are some strategies I can use to help calm them so they can process?’” explains Thomas.


Some common triggers for traumatized children may seem banal: transition from one setting to another; noises such as slamming doors or ringing bells; redirections from teachers and peers. While many young people have developed coping skills to manage these everyday situations, children who have experienced complex trauma are acting in whatever manner they have determined will keep them safe within an environment they assume will cause them harm.  Some possible Adverse Childhood Experiences, known as ACES, are exposure to domestic violence; parental substance abuse; sexual or physical abuse; neglect; poverty; caregiver incarceration.  The prevalence of Vermont children who have experienced one ACE is 50.6%, compared to the U.S. prevalence of 47.9%. The prevalence of Vermont children who have experienced more than one ACE is 23.3%, compared to the U.S. prevalence of 22.6%, according to www.childhealthdata.org.  

ACEs often last a lifetime, but they don’t have to. Healing can occur. The cycle can be broken. Safe, stable, nurturing relationships can heal the caregiver and child. “One misperception about mental illness is that there is no recovery,” says Lance Metayer, who works for NCSS as the project manager for Aware Vermont, a statewide initiative that brings no-cost Youth Mental Health First Aid training to educators and communities throughout Vermont. Many of us might think of traditional talk therapy as the only treatment, “but the truth is, everyone can help,” Metayer says. While that may be true—that we can help—talking about mental illness is not always easy. Trainings like the one recently offered at Camp Abnaki may make those conversations feel a bit less intimidating.  
Other more physical health issues are comfortable topics for everyday conversation in ways that mental illness is not, and the difference is not always explicable. Going to the doctor for a
swollen knee, chronic migraines, or high blood pressure is often something people are more than willing to share with their family, friends or co-workers. But mental illness is not viewed through the same lens. It’s rather shocking to consider the level of stigma related to mental illness, given that 1 in 5 people will experience a mental health condition in their lifetime. There are two kinds of stigma: public stigma and self-stigma. Public stigma is the reaction the general population has to those with mental illness. Self-stigma, which can be very damaging, is the prejudice one turns against oneself. And what is more powerful than the things we believe about ourselves. Stigma often prevents people from accessing care and talking about what is going on. Yet, talking about mental illness is just the way to normalize it.

Trainings like this can be particularly helpful in helping people feel more comfortable talking about suicide. “There’s a big misperception that if you ask someone about suicide, you will drive them to it,” Metayer says, “and that’s not true.” Another myth is that if someone speaks about suicide, they are not serious about their thoughts; in fact, talking about suicide may reveal the true depth of someone’s feelings. There are some common warning signs of suicide: withdrawing from family or friends, having a dramatic change in mood—sometimes an individual with a plan will appear extremely happy. Other warnings signs may be sleeping all the time, being unable to sleep, and giving away prized possessions. In the training, the counselors were reminded of the importance of asking the question directly, learning the warning signs, and reaching out to the crisis system if a situation seems dire. One should not avoid the direct questions. Asking, “Are you having thoughts of suicide?” with confidence can actually be reassuring for an individual with suicidal thoughts.

The reality is that camp is inherently a healing structure, Thomas points out. “The routine is established; the expectations are clear.” At camp, the counselors build strong, personal relationships with the campers. And with that, “counselors are sometimes the best people to provide an intervention,” notes Metayer.


Thomas and Metayer with Sara Robertson Ryan, Director of School Aged Programs
and Jon Kuypers, Director of Camp Abnaki
The training also touched on ways that leadership can approach policy from a trauma-informed care lens. There are guidelines or policies that businesses, schools, or camps might have held for a long time, and so they feel customary and comfortable. Metayer explains that looking at those policies through a trauma lens pushes leadership to ask questions about current processes: Does this process feel comfortable for everyone? Does it cause any harm? Does it call anyone out? Does it make anyone feel unsafe?
Thomas and Metayer were impressed by the counselors who took this training. They were a very thoughtful group who genuinely cared about the kids they worked with at camp. Several counselors asked pointed questions about kids they had worked with before and what a meaningful intervention would have looked like.
It is never easy to have difficult conversations with loved ones, friends, strangers, or those we meet at camp. Talking about mental illness makes it feel just a little more normal, which is powerful, since it is all around us.

 Written by Meredith Vaughn

 

AWARE VERMONT is a statewide collaboration between state designated mental health agencies (DA’s), identified youth serving community partners, the Vermont Cooperative for Practice Improvement and Innovation and Vermont Care Partners.  

The development and implementation of AWARE VERMONT is made possible by a grant from Substance Abuse and Mental Health Services Administration (SAMHSA).  For more information about AWARE VERMONT or to sign up for a training near you, contact Lance Metayer at lance.metayer@ncssinc.org or 802-582-8039.

 

 

Tuesday, July 25, 2017

A Most Natural Approach




Amy Anderson smiles as she repeats the phrase. “Dignity of risk and the right to fail.” She lets the phrase sit quietly for a moment before she continues. “Being a human means you can choose to do something or not do something. It doesn’t matter what I think you should do; it belongs to you,” Amy says. Amy feels the importance of breaking assumptions about people with intellectual and developmental disabilities. There is a sense sometimes that everyone with a disability is the same, she states, but we should really be asking ourselves, “How are we all alike? What about our dreams, passions, and fears?” Amy works directly with clients a few days a week as well as in the Learning for Living program, which aims to provide independent living skills to individuals with intellectual
Amy Anderson and Randy Lizotte
and developmental disabilities. She also acts as a coordinator for the peer training team and as an ally for the Next Step Peer Support Group, which gives her multiple contacts with clients and allows for relationship building.
Many people are told what to do their whole lives, Amy notes, and part of being a peer advocate is demonstrating what it looks like to make choices and speak up for yourself in a way that works for you. It’s giving people the confidence to speak up without fear of retribution. It’s believing in them,” Amy says simply. Heather, a peer advocate, sits next to Amy with her hands folded tidily across her lap. “Amy believed in me when I was studying for my learner’s permit and I actually got it.” Her face lights up as she recalls her triumph.
We all know how hard it can be to speak up for ourselves, especially if we feel like it’s not our place or we don’t have the right to express our opinions. Maybe we don’t know what to say. Or we just don’t want to do it alone.

Green Mountain Self Advocates (GMSA) is a statewide organization with a purpose of supporting people with intellectual and developmental disabilities to take control of their lives, solve problems, make decisions, and advocate for themselves. GMSA offers assistance with voting registration and helps to unify voices at the state level to affect legislation by offering information and education about the legislative process, as well as accommodations to allow groups face-to-face opportunities with politicians. About 15 years ago Randy Lizotte became a member of GMSA and he has served as president of the Board since 2010. Self-advocacy has always been Randy’s passion. He actually met his wife at a GMSA meeting, and two and a half years later, he moved to St. Albans where his wife resided. Shortly after Randy began volunteering at NCSS, there was a job posting in the Developmental Services division, which Randy landed right away.

GMSA started out as a small self-advocacy group in Burlington and has now expanded to a network of 23 local groups located in towns across the state, including the St. Albans’ group. Next Step, the St. Albans GMSA group, meets every Friday at the Academy of Learning, one of NCSS programs within the Developmental Services division. Though the group is not affiliated with NCSS, Kathy Brown, Developmental Services director, wanted to show her support for the group by offering up NCSS space as a meeting zone. “It is an honor to be given
Academy of Learning
access to the Next Step peer advocates voices,” Kathy says. “They are insightful, honest, and dedicated to pushing all of us at NCSS to deliver person-centered services. The Next Step peer group has allowed our Local Standing Committee to join them monthly; this unified collaborative gives a significant consumer voice to all our new initiatives and divisional decision making.”
Amy feels grateful that there is such support and that their group is valued. “It’s really cool,” she says brightly. “It’s a real luxury at NCSS to work with open-minded, flexible people,” she adds.

Individuals in the Next Step group share in a confidential setting and participate in activities like the monthly movie showing, the occasional bowling trip, or the rare excursion to the water park. Heather has been a part of Next Step since 2008. Her first meeting was made a little easier, she remembers, because she knew someone in the group, and it quieted some of her discomfort about showing up to a room full of strangers. Now, she couldn’t feel more comfortable. “The meetings are mostly run by us, peers, not by Randy and Amy,” she notes proudly. “I have confidence in everyone that’s there.”

Even though the group is accommodating and accepting by nature, it doesn’t mean showing up the first time is free of anxieties. Randy, nodding agreeably, eyes Heather as she recalls her first group. He, too, felt nervous when he attended his first group. “You don’t quite know your role right away,” he explains. “I had to learn what I was good at, discover it on my own. Had my good points and things I had to work on. Work on this, accomplish that.” Self-advocacy is something you learn as you go along. Heather and others in the group help with these anxieties by providing welcome baskets with information and goodies.

Amanda, short-haired and bespectacled, chimes in. “The group helps me connect with people. I’ve made a lot of friends. I met some people I otherwise wouldn’t have, and it got me out of my shell.” Finding this kind of genuine support feels incredible for anyone; it offers an even deeper layer of support for individuals with disabilities, who can be at higher risk for social isolation. The peer 
Amy Anderson and Randy Lizotte
support group offers a non-judgmental setting to discuss personal issues and concerns. Sometimes the concerns shared are about services received, and that’s okay. Amy points out that receiving services can something feel controlling, especially if an individual does not feel as if they have a voice to contribute to the conversation about how their services are delivered. These feelings are by no means a slight to providers—who always aim for the highest quality of care—but we all need a little support sometimes in asking for what we need and articulating our fears, desires, and hopes.

As an alternative to asking someone to speak up solely for themselves, Randy and Amy can help to facilitate peer support within an Individual Support Agreement (ISA) meeting. This aspect of peer support really inspires Heather who loves to “help people speak up and help them talk with their case managers about their dreams and goals.” Heather can sit there with her friend and guide them through the difficult conversation. If her peer so chooses, Heather may speak for them based on what they discussed ahead of time.
Someone may feel they need help making their feelings clear, but it doesn’t mean they need to speak alone. Self-advocacy is a choice.
 
 “There’s a real community for people with disabilities now where there wasn’t before,” says Amy. When it comes to advocacy, most of Amy’s background was in crisis management and recovery services. Her work at NCSS within peer advocacy felt new. “I was used to speaking for those who couldn’t, but stepping aside is new and encouraging. Helping people speak up for themselves has really worked for me,” she says.
Randy and Amy both believe that peer services will be the future of care, and that makes sense when considering the ripple effect the groups have had on individuals. There have been fewer calls to crisis because, now, people are calling their friends instead.  “Peer to peer support is the most natural approach in all of our lives,” says Kathy Brown. “NCSS is very fortunate to have such a strong cohesive group of men and women helping to guide our future.”

 
Written by Meredith Vaughn

Wednesday, April 26, 2017

A Spectrum of Services



There are many types of autism and understanding of its causes and diagnoses have changed over time. In 2013, four diagnoses that were once separated in the Diagnostic and Statistical Manual of Mental Disorders (DSM) were combined into the umbrella diagnoses of Autism Spectrum Disorder (ASD) in the DSM-5. These four diagnoses were autistic disorder, childhood disintegrative disorder, pervasive development disorder-not otherwise specified (PDD-NOS), and Asperger syndrome. ASD in more prevalent in boys; the Centers for Disease Control and Prevention estimates the prevalence of ASD as 1 in 68 children in the United States.

Autism is a complex brain-based disorder that affects a person’s behavior, social and communication skills. Symptoms can range from mild to severe and no two children with autism are exactly alike. Each person with autism, like all of us, has unique strengths and differences. Common problems exhibited by those with ASD are difficulty in social situations; some never learn to speak, while others speak, but use language in unusual ways. Others are sensitive to loud noises or bright lights. There is no single treatment for autism, though many benefit from highly structured educational programs and other services. You can visit our website for more information about these services.

If a child is diagnosed with autism, early intervention is critical to gain the maximum benefit from existing therapies. In addition, after children have been diagnosed by psychologists, developmental pediatricians, psychiatrists and neurologists, the need for treatment and services are abundant.

At NCSS, there are several programs designed to serve individuals with autism. The School-Based Autism Program assists local schools in providing effective, strengths-based interventions and programming for students with ASD, intellectual and developmental disabilities and/or Down Syndrome. The program is based on the principals of Applied Behavior Analysis (ABA); students typically need a behavior support plan to help decrease maladaptive behaviors while increasing prosocial and coping skills. 

We, at NCSS, believe that students, regardless of their abilities, belong in their local community schools. The school-based services include behavioral interventionists, available on a one-on-one basis; individualized services like this provide opportunities for students to maintain positive relationships with peers and access their education on a level that works for them. Behavior specialists, autisms specialists, service coordination and case management are also available.  The programming is flexible and the child drives the program, making service delivery unique and individually tailored.

The Program for Adaptive &Expressive Arts (PAEA) offers therapeutic and recreational music, art and sensory exploration experiences to children and adults with autism and developmental disabilities as well as communication supports and socialization opportunities. Like the services within the School-Based Autism Program, PAEA sessions—private and group—are consumer-driven, allowing individuals to explore personal goals set by them and their support teams. Music, art and sensory exploration offer emotional, social, and physical benefits by facilitating creative expression, fine and gross motor skill practice, and stress reduction.
The PAEA music and art room at The Family Center is brightly lit and filled with instruments and art supplies; the space invites creativity! The newly upgraded sensory room provides a relaxed space with a variety of sensory stimulators that can enervate or calm depending on the participant’s needs.  At NCSS’ various events, such as the Buddy Walk and the Autism Walk, you can find the PAEA Team at their station, a large table full of instruments and sensory items. PAEA also offers workshops in cooperative play, family life and sexual health, American Sign Language (ASL) and Alternative and Augmentative Communications (AAC). There are seasonal concerts and recitals and art shows where everyone can show to the community-at-large what they’ve accomplished!

Camp Rainbow, a creative summer camp for children with autism or other developmental disabilities, provides stimulating activities such as swimming, singing, crafts, outdoor play and more. Camp Rainbow incorporates sensory exploration, fine/gross motor skills, communication skills, academic skills and social skills into the activities each day. This year, Camp Rainbow will run from August 7-August 11, 2017 and be held at the Soar Learning Center. And who knows…there might be some surprises in store! You can find registration information here by visiting our website.

The Applied Behavior Services team of Northwestern Counseling & Support Services provides treatment in the home, community setting, and in our new building, the Applied Behavior Center. Services are provided to children of all ages diagnosed with Autism Spectrum Disorder and other developmental disabilities using Applied Behavior Analysis (ABA). This team adheres to best practices and ethical guidelines of ABA.

Each program is tailored to meet the needs of the individual child and their family, with a strong emphasis on specific skill acquisition, behavior, and communication. These skills are taught through ABA and B.F. Skinner’s model of Verbal Behavior. Individual acquisition and behavior management programs are created from individual assessments.

Skills are reassessed frequently and progress is monitored and measurable via weekly data tracking. Teaching strategies and content are modified as needed to fit each child’s needs and all teaching techniques are based on what research studies have proven to be the most effective.

Program Components:

  • Functional language skills: vocals, sign language, picture exchange communication system
  • Consultative model consisting of parent training in ABA procedures
  • Self-care: toilet training, tooth brushing, dressing, shoe tying
  • Reductive procedures for non-desired behaviors
  • Video modeling
  • Skill acquisition
  • Social stories
  • Social skills

 

NCSS believes daily programs for people with autism or intellectual and developmental disabilities should also be unique and individualized to each person’s specific needs.



we’re here for you

Wednesday, February 8, 2017

Winter's Effect



Vermont is a wonderful place to live for many reasons—clean air, open space, small town charm—but it also offers its challenges, especially in the winter.  Anyone who has spent considerable time in Vermont and lived through a winter can recognize the trouble! It’s frigid, windy, dark, wet, and long.

While many of us might feel a bit starved for sunlight or warmth during the winter months, for some people, the seasons can have a dramatic effect: seasonal affective disorder, or SAD, is a condition that can have a tremendous impact on a person’s well-being. SAD is a form of depression that comes and goes depending on the time of year. Spring-onset SAD—a type of SAD that starts in the spring and goes away in the fall and winter—can truly impact someone’s life, though it is much less common than the most common form, fall-onset SAD, a type of SAD that starts in late fall and goes away in the spring and summer.

Individuals with fall-onset SAD might notice increased appetite, especially for starchy and sweet foods; low energy; increased sleep; weight gain; hypersensitivity to rejection; feeling of heavy arms and legs; and irritability. Dr. Steve Sobel of NCSS says that individuals experiencing these symptoms often have to distinguish their feelings from other possible triggers in the season, such as the holidays, which can be a real stressor for many. There are plenty of things in everyday life that can make us feel blue from time to time, or make us want to indulge in carb-heavy meals and sweet treats; but if an individual experiences these symptoms for days at a time, they should not be tempted to brush them off. Like with other forms of depression, SAD can worsen if not treated.
A primary care provider can be a great resource; depending on the severity of the symptoms, varying treatments are available. For mild symptoms, phototherapy (light therapy), talk therapy, and lifestyle changes can be effective. Talk therapy can be helpful in managing symptoms, and individuals might be less likely to experience SAD in the future. Being diagnosed with depression with a seasonal pattern might indicate that an individual is more likely to experience SAD year after year; it doesn’t guarantee it. For those whose symptoms are having a pronounced and significant impact on daily life, medication, along with other treatments, might be considered.

There are several lifestyle changes—some of them small—that can improve symptoms associated with SAD.

1.       Try to go for a walk during the day. Even if it is cloudy and cold outside, outdoor light can help.

2.       Expose yourself to as much sunlight as possible. If you have a window in your office, open up the curtains or blinds. If you work on a desk at home, try to move your desk closer to the window to soak up as much light as possible.

3.       Incorporate exercise into your daily routine. Exercise is beneficial on so many levels; it can increase self-esteem, relieve stress, and help you sleep, all of which can reduce SAD symptoms.

It’s not always easy to work up the energy to go for a walk or get outside when it’s blustery and cold. Good news is, spring is right around the corner!
 
Check out these links for more information about SAD:

Written by Meredith Vaughn

Friday, December 23, 2016

When Something Isn't Right


Heather Wilson, Early Childhood Support Team Leader at NCSS, notes that many expectant mothers feel thrilled about the upcoming birth of their child; they expect motherhood will be fulfilling and sublime, but when the baby is born, they might not feel that way at all. Mothers may experience depression, anxiety, Obsessive Compulsive Disorder or Post Traumatic Stress Disorder following a traumatic birthing experience. Feelings of depression, compulsion, or anxiety do not mean someone is a bad mother and they do not mean she doesn’t love her baby. Every mother has her own story, says Heather. “We want [expectant and postpartum mothers] to know we’re here to help. We want to be a source of light during a time of darkness and provide comfort to unsettling distress.”   

Anna Gabaree knew throughout her pregnancy that she was at risk for postpartum depression and anxiety, and she knew what signs to look for. As soon as her baby was born, she felt a change instantly, like something wasn’t right. For Anna, the symptoms didn’t manifest in depression—as most people might associate with struggling new mothers—rather, she feared for her baby’s safety to a degree that was harmful. She would sit awake and stare at her daughter through the night fearing that something would go wrong and her baby would die. After feeding, Anna wouldn’t allow herself to leave her baby’s side for even a moment, worrying that something terrible would occur in her absence. As her daughter grew a bit older, she felt intense anxiety that she was doing everything wrong: she hadn’t read to her daughter enough; she hadn’t cleaned up enough; she hadn’t completed enough puzzles with her child. Like many mothers, Anna held it together at work and with her friends—people who saw her every day didn’t even know anything was wrong—but on the inside, she was bubbling over with anxiety. On the day she found herself screaming into a pillow to release, she knew she needed to seek help.

As supervisor of the Northwestern Medical Center Birthing Center, Anna was in a knowledgeable position; she knew she was at risk and she also had an understanding of symptoms and the kinds of resources that could help. For expectant or postpartum mothers who are not as familiar, there are screening tools to help identify troubling feelings, like the Edinburgh Postnatal Depression Scale (EPDS) that is used at Northwestern Medical Center (NMC). The EPDS is a 10-question screening tool that asks mothers to consider their feelings over the week leading up to the test. It is intended to be administered with the mother privately; this way the mother has the best opportunity to feel comfortable being honest. The EPDS can reveal results that are then reviewed with the mother’s provider, and referrals can be made from there.
While referrals can come from anywhere, a majority of the referrals to the NCSS Perinatal Mental Health Counseling program come from NMC do to their thorough screening process. The EPDS is conducted after delivery; in the two-three days that a mother stays in the NMC Birthing Center; two weeks after delivery; and again six weeks postpartum.

Sometimes a mother in the birthing unit might feel like something is wrong, but she can’t identify it. These upsetting thoughts or emotions can start during pregnancy. “It can be easy to brush off,” Anna says. “But it’s okay to say that. It’s okay to say ‘something isn’t right. I’m not okay.’” When a woman does say this, Anna and the other nurses in the Birthing center might follow up with questions like, “Can you tell me more about that?” “What are you afraid of?” “What does it look like?” Expectant or postpartum mothers can speak with any of the nurses in the Birthing Center; the nurses can help attach vocabulary and understanding to feelings and also connect mothers with programming at NCSS that can offer further supports. It’s important to have quick access to programs and support, says Anna. A mother experiencing these unsettling and forbidding feelings does not want to wait days to hear from a provider. Within hours, a mother can be referred to the Perinatal Mental Health Counseling program and feel like support is on the way.

The Perinatal Mental Health Counseling program is a unique one at NCSS. Expectant mothers or new mothers who may be experiencing troubling symptoms can receive counseling in their homes from a traveling counselor:  Jessica Dewes, Early Childhood Specialist. Packing up the car and driving to NCSS might not feel feasible for new mothers just adopting a routine at home. Jessica will sit amidst a pile of laundry, or push aside diapers and rattles to engage in a conversation. “Messes don’t matter,” she says, laughing, as though she is recalling messes in her own home that might invite judgement. Jessica can work with families and mothers to reduce symptoms so motherhood can feel enjoyable and fulfilling. Jessica is also able to make referrals to other programs for the family while she works with the mother; as can be expected, the entire family can be affected when one is struggling with a mental health issue. Jessica loves the work she does with mothers, and she is moved by how many community members and mothers are open to the program. It can be difficult to seek treatment; some mothers are experiencing these feelings for the first time, and unfortunately, like many mental health issues, there is stigma attached to postpartum depression and anxiety.

Part of that stigma might come from the media’s portrayal of mothers experiencing depression or anxiety. Often, in movies, TV, and even the news, stories are sensationalized and depict mothers as dangerous to their babies. Within NCSS’s program, counselors and other staff try to break the cycles of stigma. Every mother has her own story and her own journey, and for each of those mothers NCSS can help them to develop some strategies for success. Prior to a diagnosis of symptoms, everything can feel strange, misunderstood, and weird. Jessica says she can tell a mother’s situation is improving when the mother begins to be honest with herself about her feelings. Surrendering can lead to important understanding and reduction of symptoms.

Finding a solid support system that encourages open, honest communication can make all the difference for expectant and postpartum mothers.  For Anna, that meant talking to her family and her doctor. For other mothers, maybe that support person is a sister or a spouse, a partner or a neighbor; maybe it’s the person who delivers the paper in the morning.

The Perinatal Mental Health Counseling program at NCSS is intended for expectant or postpartum mothers in Franklin and Grand Isle counties. If you know of someone who is experiencing any of these troubling symptoms, please reach out. There is no wrong door at NCSS; if you are looking to make a referral to the Perinatal Mental Health Counseling program, please call our main number, 802-524-6554 and someone will be happy to assist you.
 
Please click on the link to watch the NCSS Here for You episode on Perinatal Mental Health Counseling. In this episode, you can hear Heather Wilson, Jessica Dewes, and Anna Gabaree talk about this unique program.

we’re here for you.

Written by Meredith Vaughn

 

Monday, November 14, 2016

The Paths That Lead Us

 
When you think about why you do your job, what comes to mind? Maybe you always dreamed of your career from when you were a little kid, or perhaps you developed a passion for a trade and worked at it, made it your life’s work.  Or possibly you’re still searching for the thing that will fulfill you. Sometimes, like in Kathy Brown’s case, our work finds us.
Kathy Brown
Brown, Director of Developmental Services at NCSS, eagerly entered the mental health field in 1979 after graduating from college.  For two years, she worked at the state hospital, and things were different back then for those with disabilities. It wasn’t until 1990 that the Americans with Disabilities Act was passed, a civil rights law that prohibits discrimination against individuals with disabilities, and it wasn’t until 1995 that the Vermont Developmental Disabilities Act was passed. To say the least, Brown has been witness to some pretty big changes on the Vermont hill. Brown notes that when she first entered the field, the population she served was institutionalized; now they are living in the community with their families, and have access to education and a fulfilling life just like everyone else.
Brown smiles as she reflects on the start of the career. Apparently, she surprised herself by getting married—something she swore she’d never do—and then again by having two sons—something else she said she’d never do! Everything changed for Brown when her oldest son Kyle got into an accident and endured a severe traumatic brain injury. He spent a year and a half in rehab, regaining skills he had learned once as a very small child. There is intensity in Brown when she talks, especially when she recalls reentering the field of developmental services in 1996. Brown left mental health in 1981 and worked as a program manager at what is now Mylan for 23 years. But her son’s journey lit a fire in her, she says, and that’s when she applied at NCSS. Over the last ten years, she’s worn a number of hats at the agency: she started working on the employment team, then oversaw the behavioral team; she then became interim director, got her master’s in rehabilitative counseling, and in 2014, Brown found herself in the director’s chair where she currently sits. This is quite a seat to settle into, as there are over 250 clients receiving services, 157 staff working in the division, and 110 contracts with shared living providers. Brown certainly doesn’t do it alone; she has help from many people, like her leadership team: Amy Bronson, Assistant Director; Emily Norris, Assistant Director; and Amber Schaeffler.

Schaeffler, a licensed clinical social worker in the DS division, was on the NCSS Here for You television show and also presented at the last Grand Rounds seminar along with Brown. She coordinates the Clinical Oversight Committee and the Internal Behavior Support Review. Schaeffler is also getting certified in biofeedback and neurofeedback, both alternative forms of therapy that are quite effective with those with developmental disabilities. Biofeedback refers to the clinical applications where physiological signals from the body are used for auditory or visual feedback. When given this feedback during a therapy or training session, an individual can learn how to alter their breathing or behavior. Biofeedback provides a visual representation of a client’s stress, thereby giving them the tools to learn about their body and shift behavior—even slightly—to work toward a goal. A client’s ideal BPM (breaths per minute) will provide the most restorative functions for the body; this information can be gathered from biofeedback. With biofeedback, an individual’s tension is visually displayed on a screen, providing a powerful tool for recognizing stress within the body. The visual graphs allow individuals to see the control they have over their own Autonomic Nervous System and that can be very powerful in healing. This form of therapy is especially beneficial for those who may not find success with traditional talk therapy.
 This is just one of the many programs available within the DS division.* Maybe you’re wondering what makes someone eligible for DS services. There are several criteria: an individual must have an IQ of 70 or less and have significant adaptive behavior challenges in at least two areas of daily living—in other words, everyday social and practical skills.  The Intellectual Disability must have originated before the age of 18. This last criterion can prove tricky for staff in the DS division, especially if an individual who has never sought services before attempts to access DS services as an adult. Before services can be provided, staff must sift through years of documentation to find evidence of the disability prior to the age of 18; this might mean contacting previous school placements or family members conducting intensive interviews to establish functioning as a child. It can be challenging for our Intake Coordinator Samantha Burnell to locate, engage, and scour through information to uncover this proof; staff wants to deliver services in the most meaningful way and when they are needed.
Amber Schaeffler
Schaeffler, like Brown, followed an interesting path before coming to NCSS, and hers was punctuated by several advance degrees. Given her position now, you might not know that she has a bachelor’s degree in sociology and criminology and a master’s in criminal justice. That’s not all! She has a master’s in social work too! Schaeffler isn’t just wealthy in degrees; she’s also rich in life experience: before she moved to Vermont, where she met her husband, Schaeffler worked with the Deaf, Hard of Hearing, Late-Deafened and Deaf-Blind who had experienced domestic violence and/or sexual violence. It’s special that she found herself working at NCSS—given her background—since NCSS is home to the only developmental deaf services team in the state.

Talking to Brown and Schaeffler, it’s easy to see how they landed where they are. Schaeffler is approachable, unassuming, and gentle; she sits with her hands folded in her lap and smiles as she answers questions. Brown is soft spoken but pointed in her speech, and it’s evident that she’s passionate about her work. She knows what she’s fighting for every day. The most common misperception of those with intellectual disabilities, Brown says, is that they are not intelligent or capable of living a life like everyone else in their communities. “They are extremely capable of that,” Brown says. “They should have the same rights as all of us.” Brown says that the laws have heightened awareness and given advocates some teeth, but there is still a lot of stigma. Anyone doing this work day in and day out is doing it because they care about crushing the stigma that follows individuals with disabilities. They care about every individual being able to fulfill their goals.
Some of that stigma is in the way we talk. Putting the disability before the individual can perpetuate stigma, and you might be surprised by how commonplace this language is. How often have you heard the following phrases? “She’s autistic.” “He’s learning disabled.” “They’re in special education.” This kind of language defines the individual as their disability, rather than a person who has a disability. “She has autism.” “He has a learning disability.” “They receive special education services.” Think about it: Would any of us want to be defined by just one thing?
 
*There are many services and programs available within the DS division of NCSS. You can read more about these services on our website by clicking on the “Developmental Services” tab at the top of page or by clicking on this link: http://www.ncssinc.org/developmental-services
 
Written by Meredith Vaughn