Articles & Trainings

This class meets the requirements for Domain 3, Ethics & Professional Conduct, of the Maine MHRT/Community curriculum.

About this event Tickets


This class meets Tuesdays and Thursdays from 9:00am-12:15pm from February 1 to March 3, 2022 via Zoom. You must be able to attend all classes.

In this training, we will study the knowledge and application of ethics and professional conduct in your work as an MHRT/C.

The following knowledge competencies will be reviewed:

Knowledge Competencies for Domain 3: Ethics and Professional Conduct

Demonstrate a standard of professionalism and integrity in practice, and confront and resolve ethical challenges by seeking appropriate collaboration and consultation.

  1. Explain ethics and how to conduct practice within the context of a professional code of ethics. Give examples of inappropriate behavior. Define appropriate contexts for dual relationships and how to set and maintain clear, professional, and culturally sensitive boundaries.
  2. Relate the intersection of ethics with state and federal laws.
  3. Define confidentiality requirements and how to communicate these policies to staff, consumers, families, guardians, and others.
  4. Describe the evolution of HIPAA and what constitutes protected health information, including communication requirements within the context of health information technology.
  5. Explain how to secure informed consent from a consumer.
  6. Maintain sound documentation that reflects an adherence to individualized, person-centered care.
  7. Explain a provider’s ethical responsibility to empower consumers.
  8. Identify a number of strategies, consistent with professional practice, to empower consumers.
  9. Collaborate and interact effectively with community members and other professionals.
  10. Describe what it means to be an effective contributing member of an interdisciplinary team.
  11. Model appropriate professional behavior at all times, apply ethical guidelines and demonstrate the effective use of supervision.
  12. Practice using a supervisory relationship to resolve ethical challenges.
  13. Summarize the importance of evaluating the effectiveness of personal practice.
  14. Describe how individuals working in the behavioral health field practice self-care. Utilize supervision effectively to prevent compassion fatigue and vicarious traumatization.

Course Expectations

1. Attendance:

Students must attend each day of class (5 units) and receive an 80% or above on the final exam to earn a certificate of completion. If a student misses a day, they are responsible for arranging to attend the next offering of the missed unit, with either the same trainer or another organization. Unit 5 is optional for students with the required academic preparation.

2. Make‐up work:

Students must attend all five units (or four with a related degree) as stated above, and complete and submit any missed assignments.

3. Class size:

The standardized MHRT/C curricula are interactive. The recommendation is that classes have no fewer than six (6) participants and no more than 20.

4. Class participation guidelines:

  1. Students will arrive on time and stay until the end of the unit (no early dismissals).
  2. Students will demonstrate respect for others. This means:
    • Listening completely before interjecting.
    • Use appropriate pronouns. Respect the pronouns individuals choose for themselves.
    • Use person‐first language. This language puts the individual before the disability. For example, “a person with schizophrenia” or “an individual with bipolar” as opposed to “a schizophrenic” or “bipolar woman” or “mentally ill man.”
    • Use first person language, such as “I” messages. [For example, “I didn’t understand his response to my question” as opposed to “He overreacted to my question.”] This allows students to take responsibility for their feelings and experiences rather than blame them on someone else.
    • Keep personal reflections and stories shared in class confidential.
  3. Cell phone use: Cell phones should be placed on vibrate or silenced at all times during the class. Cell phone calls must be taken in the hallway or in private.
  4. This course requires demonstration of knowledge and skills, therefore, students are expected to participate in all activities.

5. Course evaluations

Participants will receive a link to complete an online evaluation the last day of their training. The Muskie School Center for Learning will summarize the evaluations and share results with the trainers and DHHS/OBH.

About the Presenters:

Marylena Chaisson, LCSW, is a clinical supervisor in the case management program at Health Affiliates Maine. She is a clinical mental health counselor (LCPC) who has worked in rural, under-resourced Maine communities for nearly 20 years both in agency and private practice settings. She also enjoys her work as a Disaster Mental Health contracted trainer for the state of Maine’s Disaster Behavioral Health Team, part of the Maine CDC and Maine DHHS.

Mary Gagnon, LMFT, is a Licensed Marriage and Family Therapist and the Training and Clinical Development Specialist for Health Affiliates Maine. Mary has worked in private practice as well as a variety of community mental health settings throughout her career. Her most recent work at Health Affiliates Maine includes oversight of clinicians in private practice and development and facilitation of trainings for schools and conferences throughout the state. She is a certified trainer for Domains 1, 2, 3, 4, 6, and 7 for the MHRT/C Non-Academic Curriculum.


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The holidays can be a time of perpetual joy, faith and connection. However, there are many ways our mental health can worsen during this time. There’s the stress of buying gifts and attending family gatherings. The feeling of loss and nostalgia for those who are no longer with us. And the last two years during the pandemic, a lot of us are feeling more isolated and distanced than ever. But there is hope. You can manage your mental health, stay connected, and lean into the holiday spirit with the following reminders.  

  1. Reset routine: Think about your daily routine. What’s working for you and where can you improve? Keep in mind that your health practices such as eating nutritious foods, exercising regularly, and getting restful sleep are all beneficial to your mental health.  
  2. Boost brain power: Have you ever wanted to learn something new? Maybe it’s yoga, cooking a gourmet meal, or learning a musical instrument. Even 5-10 minutes per day of practicing a new skill or hobby can boost your mental and emotional health and take your mind off any stresses of the season. 
  3. Slow down: The way we gather and celebrate may have changed, but it has also forced us to slow down and take stock of our lives. Allow yourself to move at a slower pace to be more present and mindful of the holiday season. What or who are you grateful for? What memories or events bring you joy this time of year? Writing these things out in a journal or on a notepad and seeing them will help. 
  4. Adjust traditions: The way we come together has changed, but it can be an opportunity to adapt rather than to be upset for how the holidays “should be.” How does this time of year make you feel? Share this with your family (along with their feelings) to see where new traditions can align.
  5. Reach out: We can still be connected while being apart. Keep connected to your loved ones by text, phone or video call, or writing a letter or holiday card. Let them know you’re thinking of them, share how you’re celebrating, and let them know you’ll always be there. 


It’s important to recognize that having a mixed bag of emotions during the holiday season is normal and that existent mental health issues can worsen due to holiday stresses. We all may need extra help this holiday season and that’s okay. The following are signs that professional guidance may be necessary:  

  • Fear and worry 
  • Self-isolation 
  • Fatigue, sleep changes 
  • Irritability, mood changes 
  • Impulsive or risky behavior 
  • Worsening chronic health issues 
  • Worsening mental health issues (such as anxiety and depression) • Increase in substance use (such as alcohol, drugs and smoking) 


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Running your own practice allows you to determine your caseload, clients, and your schedule so that your business aligns with your principles. However, if you’ve had your private practice for a while (or even if you’re just starting out) you may have experienced seasons of isolation or loneliness.

Being a solo entrepreneur has its advantages, but having workplace relationships can offer needed support, camaraderie, and guidance. We know you can go it alone, but you don’t have to for your practice to be successful! Consider our advice on building your community:

Attend trainings, workshops, and other CE opportunities. They will keep you learning and up to date with best practice standards and clinical intervention methods which will benefit your practice. They will also connect you with other mental health professionals that you can bounce thoughts and ideas off with.

Join professional organizations from local, regional, and national chapters. Reach out to small business owners via email, connect with mental health professionals with a similar niche and network during events. Don’t be afraid to make and maintain connections.

Offer consulting services to local businesses and organizations. Think employeeworkshops on interpersonal communications or HR topics such as diversity and inclusion among peers. This will grow your public speaking skills, grow your business, and expand your network and opportunities for referrals.

Submit advice to a local publication or website. Perhaps there’s an expert’s section where readers submit questions looking for professional advice or maybe it’s a monthly column with a guest speaker. Think of the audience of the publication and offer a proposed article that would benefit them.

Teach a class or workshop at a childcare center, community college or corporate event. Important and common topics are stress management, establishing boundaries, and effective communication.

Lean on one another and use colleagues for support. If there’s an individual needing help, but at the moment you are unable to take on new clients, refer them to another in your network. And let them do the same for you!

You started your private practice to serve clients your way. But when you have a community of colleagues lifting you up, your wellbeing, your clients, and your practice will thrive.

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Presented by John Yasenchak, Ed.D.

Friday, November 5, 2021 or Friday, November 19, 2021


About This Training

There is no doubt that the pandemic has pushed helping professionals toward new levels of technological competence. Every advance in technology raises new levels of ethical awareness. Often, technology seems to outpace the development of ethical standards. Bots, apps, AI, avatars, telehealth—how do we keep up with it all? 

In this workshop, we will look toward the future of the helping professions and examine the impact that technology will have on our practice. We will review basic professional ethical norms, apply them to emerging trends and present a model for ethical decision making. We will also explore the philosophy of transhumanism and how its assumptions impact the fundamental questions our profession has been asking since its inception: “What does it mean to be human? Why should I be ethical?”

Ultimately, this will be an opportunity to reflect on our relationship to technology and its application to mental health and substance use counseling. It will also be an opportunity to reflect on how we view the service we provide in the context of our rapidly changing techno-culture. 

Training Details 

Registration now open!

Location: Online event 

Time: 8:30 am – 4:00 pm

Dates: Friday, November 5, 2021 OR Friday, November 19, 2021 

Cost: FREE for Health Affiliates Maine affiliates
$59 for clinicians not affiliated with HAM

Register here for Friday, November 5 session!

Register here for Friday, November 19 session!

About the Presenter 

John Yasenchak, Ed.D., holds a doctorate in Counselor Education from the University of Maine as well as a masters degree in philosophy, a course he also taught from 1982-1985. He has been teaching graduate counseling courses since 1996 and has been a practicing clinical counselor and supervisor in a variety of clinical settings since 1985. His expertise is in clinical mental health counseling.

Dr. Yasenchak’s experience includes inner city work with co-occurring disorders, university student development, and 20 years as clinical supervisor for a Native American counseling facility. Currently, he provides consultation and training services and is a contributing faculty member of Walden University.

Dr. Yasenchak’s primary areas of interest are in mental health and addictions counseling. He also has specific interests in spirituality and religion in the practice of counseling, as well as in digital ethics.

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This article originally appeared in Macaroni Kid on October 1, 2021, by Mary Gagnon, LMFT, and Clinical Development and Training Specialist for Health Affiliates Maine. 

Question: I have three children ages 4, 3, and 6 months. How do I get my 4- and 3-year-olds to listen without raising my voice and losing my temper? My 4-year-old is sensitive and doesn’t respond well to anger.

Answer: Ah, those early years are certainly a challenge! So much growth, so little attention span and capacity for self-regulation.

You’re off to a great start. Self-awareness is one of the most important tools in your parenting toolbox. An awareness of your child’s unique personality traits and tolerances is another. And, of course, most people don’t respond well to anger, nor do you want to spend your time with your children feeling angry. So, what else can you do?

Let’s start with you. Are you taking care of yourself? Having three children under five is a great deal of work, and it absorbs a lot of your time and energy. Make sure that you’re meeting some basic self-care needs: nutrition, exercise, sleep (a tough one with young children, I know), time with family and friends, engagement in meaningful activities (paid or unpaid, hobbies, spiritual fulfillment, etc.), whatever you think you need to feel whole and healthy. You may need to ask for help in getting your needs met. You may feel selfish or like you don’t want to “burden” anyone else, but time for yourself helps you to be a better parent, friend, partner, and so on. It’s a win for everyone.

Envisioning and setting intentions for the day can be very helpful. Knowing what you want out of the day and how you want to be as a parent that day helps your mind walk that path. So, for example, you can say to yourself at the beginning of the day, “Today I want to show my children that they are loved. I’m going to make cookies with them.” If things go awry, remind yourself that plans don’t always work out as you hope, and grant yourself and your children grace and the benefit of the doubt, and that even if the cookies don’t get made, there are many ways to show your children that they are loved.

Now, about your children. They’re in exciting times in their development. The world is a big place, an interesting place, an unknown and sometimes even scary place. They’re newbies in this world, newbies even to their own bodies and minds, and they don’t know how to read the map. It’s our job as parents to help them navigate this brave new world, to help them feel secure enough to explore. If we’re doing our job, then they’ll do just that…and sometimes they’ll go too far and we must pull them in. They won’t always like it (just as we don’t like it when our desires are thwarted), and we’ll have to endure the inevitable challenges to our limit-setting—tantrums. Young children have less experience in the world, less understanding and control of their emotions and bodies, and though we may not appreciate their outbursts, they’re perfectly normal.

Young children, too, aren’t known for their high attention spans. Developmentally, their brains are absorbing many, many things, and they don’t know what to pay attention to. It’s a parent’s job to help them learn what to pay attention to and how to act, physically and emotionally, in the world.

So, how do you do that? Here are a few concrete tips:

  • Speak to them at their level. This is both physical and mental. Get down onto your knees when you talk to them, so that you are eye-to-eye with them. Use words that they understand. Use short sentences that don’t have multiple commands in them (“You need to get dressed, pick up your toys, and eat your breakfast” is a lot for a young brain to process).
  • Use a firm but loving voice. Your voice should be calm and loving, but also confident and firm. You’re their teacher, and you’re teaching them how to act.
  • Touch (or not). Some children find touch comforting and grounding, others find it overstimulating. Look for clues that tell you how your child feels about touch.
  • Warn them of consequences. Tell them what behavior you don’t like and warn them that if the behavior continues, what consequence will occur as a result. Consequences should relate to the behavior when possible (“If you keep pulling the dog’s fur, you won’t be allowed to pat the dog anymore. Use gentle hands, please. Let’s do it together.”).
  • Calmly follow through with consequences. Again, you’re teaching them. Their education should be calm and matter-of-fact.
  • Talk about it later. None of us can talk about an issue when we’re still overly emotional about it. When everyone has calmed down and is more focused, that’s the time to review what happened. Keep it simple (“You pulled the dog’s fur again, and that hurts the dog, so you couldn’t pat the dog anymore. Next time, please use gentle hands with the dog so you don’t hurt him.”)
  • Repetition is your friend. Kids (and adults, too) don’t typically learn something the very first time. They need lots of practice and repetition. This might be a bit tiring for parents, but it’s vitally important to understand that they’re not trying to upset you; they just need more time to learn what you’re trying to teach them.

Remember that everyone has a bad day, children and parents alike. If you do end up raising your voice and losing your temper, take time to apologize to your child and speak calmly about what happened. They may not understand everything you’re saying, but they’ll remember how it felt to have their parent speak to them kindly and acknowledge their mistakes. It’s a wonderful lesson for when they make their own mistakes, giving them both the blueprint for how to handle those situations and a safe space with you to admit them and try again.

Raising children is a marathon, not a sprint, and you’re bound to get a charley horse or two along the way. What’s most important is that your children know how much you love them. Best of luck to you!

Mary Gagnon is a Licensed Marriage and Family Therapist and Clinical Development and Training Specialist at Health Affiliates Maine.

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We know that your time is important to you, but are you using it to your advantage? When running your own practice, it’s easy to let time—and your ability to leverage it—get the better of you. To keep your business running smoothly, your clients’ appointments scheduled, and all your paperwork submitted on time, you need to incorporate a time management strategy.

Scheduling. Schedule your week so that each day has an equal (or nearly equal) amount of tasks and appointments that you can commit to. It’s also not realistic to schedule every hour of your work day to be productive. Plan some time each day for distractions, breaks, or small moments of whatever brings you joy. These moments of “non-productivity” can oftentimes be moments of great inspiration and renewal.

Boundaries. Although you want to “do it all” and often try, the effort most likely leaves you feeling defeated, stressed, and uninspired. In order to do your best work and serve the clients who depend on us, it’s necessary to work on creating boundaries. Create office hours and stick to them. Resist answering emails or phone calls immediately (and certainly not if you’re on vacation!). When you respect your time, others will too. 

Chunking or Grouping. It may be a silly name, but chunking or grouping is simply putting all of your tasks together by type of task or project. Then dedicate chunks of time on your calendar to work on that specific set of tasks. This helps to eliminate the dreaded multi-tasking that we all try to do (but which never truly works).

Incorporating self-care. Let’s nip this in the bud now—self-care isn’t selfish and it doesn’t “take up time.” Incorporating self-care into your schedule helps to create a work-life balance, clear your mind or make you feel better, which all ultimately helps you work more effectively and to a higher standard.

Task prioritization. During those times where it seems like you have a thousand things to do and not enough time to do them, task prioritization is the answer. There are several different methods out there, so finding which one works best for you may take some trial and error.

The ABCDE method is simple yet effective. Make a list of all your tasks and responsibilities. Then sort them using the parameters below. You can use this method for daily, weekly and monthly tasks.

  • A – highest priority tasks
  • B – medium priority tasks
  • C – low priority tasks
  • D – delegate tasks to another person
  • E – eliminate task

The GTD or “Getting Things Done” method is slightly more complex but worth the effort. After you have established all of your tasks, you then sort them using a “decision tree” to put them in their proper place.

With each task, ask yourself:

  • Is this task actionable?
    • No? Throw in the trash or file for later if it’s a reference or a resource
    • Yes? Determine which “pile” it should belong in.
      • Right away: If you can complete the task in under two minutes
      • Waiting for: if you’ve delegated the task to someone else
      • Next action: if you don’t have to finish actions with multiple tasks right away
      • Calendar: if your task has a deadline, always add it to the calendar


It may take a while to figure out which tools work best for you, but when it comes to running your own practice, efficient tools of time management are the secret key. As you manage your time within your business, remember that it’s all about balance and growth. Recognize what works for you today and realize that it may change as your business changes.

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An estimated 22 million Americans among every gender, race, and social class are currently in recovery. For those in recovery, it is not a one-size-fits-all situation but one completely unique to one’s life experiences and circumstances.

What does “in recovery” mean?

It’s a common misconception that abstinence and sobriety alone equates to being in recovery. The definition provided by the Substance Abuse and Mental Health Services Administration (SAMHSA) is as follows: Recovery is “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach
their full potential.” While in recovery, it’s important to also recognize the significance of focusing on one’s physical and mental health. Continued success is more likely once an individual has gained insight regarding any unresolved trauma, or underlying emotional and mental health issues in order to better understand how these factors may have impact on their recovery process.

Recovery varies by person, but may include:

  • 12-step programs such as Alcoholics Anonymous or Narcotics Anonymous
  • In-patient treatment, Medication Assisted Treatment (MAT) or an Intensive Outpatient Program (IOP)
  • Avoiding triggering situations
  • Meditation and prayer
  • Regular counseling sessions
  • Trying a new hobby or resuming an old one
  • Building strong + positive support systems
  • Being physically active on a regular basis
  • Developing structure and routines
  • Focusing on nutrition, sleep, and stress management

How do I support a loved one in recovery?

When you discover that a friend or loved one is in recovery, you may be nervous or unsure of how to act or speak around them. Remember, people in recovery are humans just like you! If someone discloses that they’re in recovery, you can say the following:

  • “How’s it going?”
  • “I’m proud of you!”
  • “That’s great! You deserve to live a happy and fulfilling life.”
  • “How can I support you in your recovery?”

The statements above show your genuine support of their health. A simple phrase of encouragement and recognition can go a long way for someone in recovery. If someone discloses that they’re in recovery, avoid the following statements:

  • “You don’t look like an addict.”
  • “How do you know you’re an addict?”
  • “When did you hit rock bottom?” or “How do you know you hit bottom?”
  • “If you were addicted to drugs, can you still drink alcohol?”

The statements have the potential to result in hurt or upset feelings for a person in recovery. While you may be curious about their recovery process, it’s essential to allow the person in recovery to share their perspective on their own terms.

Health Affiliates Maine continuously strives to address the stigma associated with mental health and substance use. We work to increase access to supportive services for all Mainers so that they have a successful journey to recovery. We have a network of counselors, LADCs, and community resources (such as our telehealth IOP) that aims to help anyone in need of treatment. While you can’t force anyone to get help (only they can make that decision), you can offer validation and encouragement. If you’re equipped with resources and education, you’re already supporting them in their journey to recovery.

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This article originally appeared in Macaroni Kid on September 3, 2021, by Cindy Mailhot, LCSW, CCS, Assistant Director of the Outpatient Therapy Program, Health Affiliates Maine. 

Question:  My 13-year-old is struggling with mental health and starting to act out in concerning ways. How can I help and be supportive while also parenting and setting healthy boundaries with screens, dating, and outbursts toward younger siblings?

Answer:  First, I want to commend you on considering the two sides to every parent’s dilemma…how to be their biggest supporter and their disciplinarian at the same time. That is not an easy job! At thirteen years old you are on the starting line of those all-important teen years, so considering this now will help you set the tone for your relationship in the coming years. I think the answer lies in achieving a balance between these things. There are situations when you will be able to take on a stronger role as a supporter while offering gentle guidance and other times where you will need to fall heavier on the disciplinarian side. 

Being prepared can help alleviate stress for everyone in many situations. It is important to establish the rules and consequences for breaking those rules ahead of time (I.e. outbursts toward others). It helps both parents and children when navigating those emotionally charged moments. To ensure consistency, be sure to include anyone that might be significant in co-parenting (parents, stepparents, grandparents, etc.). Rules and consequences allow parents to remain levelheaded in these situations. Without them, heightened emotions can lead us to giving consequences (i.e., “you are grounded for a month”) and giving in later when the emotions are lower.   

Screen time is generally recommended to be no more than two hours per day.  That being said, you will want to determine what is right for your child and family. Once you establish that, set some clear rules around that. Does it need to be done after homework is complete? Do their grades factor in? What about chores? Do you want to change your Wi-Fi password daily and provide it after they meet your established boundaries? These are all things to consider before the issue arises.

Dating is another topic that you will want to consider before the need arises. When can they meet a date somewhere? What age will you have the date pick them up? Do you meet dates ahead of time?  What is the curfew and the consequence if broken? This is a great topic to have some discussion around so that your child understands your concerns. This is a great topic for safe dating discussions as well—internet safety, safety planning if a date if going poorly, red flags in choosing dating partners, etc. Allowing opportunities for your child to discuss this topic before and during their dating experiences will be important to you feeling comfortable with their plans and them feeling comfortable talking to you if challenges or questions arise.

The supportive parent may also incorporate several strategies to be sure that the relationship does not become defined as a series of arguments and punishments:

  • Incorporate time together to just have fun and talk.  Maybe take turns planning those “dates” or plan them together.  It is important to engage in activities that your child likes to do too (even if you do not).
  • Listen to your children about all topics. These are great times to teach them your family values but also how to think for themselves and make informed decisions. Listening also sends the message that they can talk to you—and even disagree with you—and it is okay. These are great skills for them to learn and will preserve your relationship for those harder times.
  • While very challenging, try to keep emotion level when disciplining. It is all too easy to fall into shaming and blaming when we are responding out of our own fear or anger. Those parenting behaviors may put a rift in your relationship, making the discipline times more challenging. Be firm about the discipline, acknowledge your emotions, and allow them to express theirs.   
  • Just like in adult relationships, talking when both parties are angry is probably not a great idea.  Come back to discipline and discussion later when you both have a chance to calm down.

In summary, know the rules and consequences for your family and be consistent with them but always leave communication lines open. 

If you notice anything concerning (you know your child best), reach out to a mental health specialist for assistance. Behavior changes could include a change in social activities, isolation, sadness, anger, acting out, or essentially any behavior that is outside the norm for your child.

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As a nation and throughout Maine communities, there is an ever-increasing need for mental health services. To continue providing quality care during the pandemic, many clinicians, agencies, and mental health workers quickly pivoted from their normal day-to-day operations to include an underused technology—telehealth. The following are three benefits of telehealth services to consider in order to better reach your clients and grow your practice.

Access. If patients have access to a phone, computer and/or WiFi internet, telehealth services may be a great option for continuity of care. Clients who live in a rural setting, don’t have reliable transportation, or have limited mobility, can utilize telehealth right from the comfort of their home without the need or cost to travel. Telehealth sessions may also offer more availability when scheduling, and provide access to health care for those who may be vulnerable to isolation.

Flexibility. Telehealth offers flexibility for both patients and clinicians. With remote and hybrid learning options becoming more prevalent at schools, telehealth may assist those with childcare challenges. With work-from-home policies becoming more popular among organizations, patients and clinicians may be able to schedule their sessions during a part of the day where they couldn’t before. Telehealth services may also be convenient during inclement weather and reaching those with emergency healthcare needs.

Savings. Providing telehealth services to your patients can save time and money. Patients will save money on transportation, childcare costs, and potential health insurance costs and will save time commuting and waiting in the office. As a clinician, you may realize these same benefits, in addition to lower overhead costs, patient retention/new clients, and the ability to be productive in other areas of your practice’s growth.

To get started with telehealth options in your practice, it’s important to consider the following:

  • Find a HIPAA compliant platform. A free, HIPAA-compliant option that we often recommend is There is also a list available here, with popular options including certain subscriptions from Zoom, Skype for Business, Webex and Microsoft teams.
  • Establish a BAA (business associate agreement) with your chosen platform vendor. This agreement describes each party’s responsibilities and safeguards used and can enable and ensure HIPAA compliancy.
  • Private space. Make sure you and your clients have a safe, private place to conduct your session.
  • Secure network. It’s best to ensure that your internet connection is private and secure and you’re able to use encryption where possible.
  • Informed Consent Form. You may already use this form at your practice, but it’s wise to include specific instructions, guidelines, and boundaries regarding telehealth.

Providing telehealth services may seem daunting for some clinicians because of lack of technical familiarity, concern regarding quality of clinical care with telehealth versus in- person sessions, or simply being overwhelmed with where to begin. It’s important to note that each clinician and client relationship is unique, and some patients may or may not like this method of providing care. Telehealth is not meant to replace in-person sessions, rather supplement an already existing method of care.

At Health Affiliates Maine, it’s part of our mission to expand access to health care and increase the quality of life for all Mainers. Although not a requirement for affiliation, many of our affiliates are finding that offering telehealth services has greatly impacted their practice in a profound way.

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This article originally appeared in Macaroni Kid on August 15, 2021, by Marylena Chaisson, LCPC, Case Management Supervisor, Health Affiliates Maine. 

Question: My sister is six years older than me. Growing up, she was responsible for a lot of my care and was abusive both verbally and physically. We barely speak now which is fine by me. She has been living in another state but recently told us she is moving back to Maine. My parents live in Maine also. If it were not for them, I would have no relationship with my sister. However, I know that now I will see her at every holiday. I am dreading it. The only time I spoke to my mother about this (as an adult) she brushed me off as being dramatic. I am feeling a lot of anxiety around seeing my sister more (even though I know she can no longer hurt me). I’m struggling with the need to talk with my parents to let them know I may not be able to visit at the same time as my sister. I do not want to be hurt but nor do I want to be hurt. I know seeing my sister regularly will bring up many bad feelings. Am I best to avoid my sister, talk to my parents, or just try and suck it up?

Answer: I first want to express that your feelings about this are valid, and you are doing a fabulous job thinking about these potential changes ahead of time.  It is natural for you to want to protect yourself from a person who hurt you in the past. Your mother brushing off these concerns when you attempted to speak to her in the past about it does not invalidate your experiences or need to protect yourself in the slightest. I most certainly do not endorse the idea of you choosing to “suck it up” because that feels inauthentic and invalidating of the hurt you have experienced.

There is an array of paths you can take in this situation.  This is not an all-or-nothing, nor is it a one-time permanent decision for which path to take.  It is okay to decide that, for your own sense of emotional safety, you are not ready to have in-person contact (or any contact) with your sister.  You can choose to explain or not explain this to your parents in whatever level of detail you feel comfortable.  You do not owe anyone, including your parents or your sister, an explanation of what you are doing to make yourself feel safe and comfortable in the world.  You also reserve the right to change your mind in the future whenever you feel fit. This is a time where it is important to put your own emotional safety and needs ahead of your desire to please your parents or attempts to help them avoid feeling any discomfort.  They might experience uncomfortable feelings about what you say (or don’t say), but managing their feelings is their responsibility, not yours.  You must look out for your own best interest.

Here are some examples of explanations, varying from matter-of-fact statements with no detail, ideas for redirection, or all the way to including a more thorough, detailed explanation:

“I’m going to miss this family event.”  

“I want to start a new tradition of taking you [parents] out to dinner for holidays – just you and me.”

“I am not interested in seeing [sister] so I will not be attending events where she is present.”

“Remember I told you about the times that [sister] hurt me in the past.  I do not feel able to be in the same room as her right now.  That might be upsetting for you to hear and upsetting you is not my intent, but I need to do what I feel comfortable with. I am seeing a counselor with the hope that I might be able to attend events with her in the future, but I can’t right now.”

That last example leads me to my next thought: this is a perfect situation to bring to a counseling relationship if you have any interest in working through some of the stress you are experiencing related to this.  You have competing desires here—you want to participate in family events and see your parents during the holidays and you also want to avoid seeing your sister. These desires are coming into direct conflict, so something is going to have to give.  The only part of this dynamic you have control over is your own responses and decision-making.  There is room here, should you choose, to develop skills for distress tolerance and self-management while being physically present with her.  A counselor, especially one trained in family dynamics like a LMFT (Licensed Marriage & Family Therapist), could be helpful in supporting you to build skills for managing your reaction, memories, and stress related to the past abuse you experienced. With skills and support, you very well could find yourself able to attend family gatherings with her present without experiencing an unbearable level of distress.  This path is only recommended if you feel that she will not engage in further abusive behavior now that you are both adults—I would never encourage you to expose yourself to further abuse.  

Please remember, your path forward here should be focused on what feels emotionally safest to you, and not based on a misplaced sense of owing your parents contact with your sister. You can choose to work towards increasing your ability to be around her in the future—or not—again, that is totally up to you and may evolve over time.  Stay authentic to your truth and honor yourself and you will see the best path forward in this complicated situation.

Marylena Chaisson, LCPC is a clinical social worker and the Case Management Supervisor at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children, and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website and click on “Referrals.” 


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