Author: Hanna Gilley

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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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 Doxy.me. 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 class meets the requirements for Domain 1, Behavioral, Psychological and Rehabilitation Intervention Models of the Maine MHRT/Community curriculum.

  • Tickets: $300
  • Location: Online Event
  • Presented By: Mary Gagnon, LMFT
  • Registration: Register Online
  • Refund Policy: Refunds up to 7 days before event

Do I Need This Training?

The MHRT/C certification is a Maine-based certification for mental health professionals wishing to work directly in patient care. Consider this MHRT/C training if:

  • You wish to work in Maine as a case worker, in a group home, or community support work
  • You currently do not have a college degree that included all accredited coursework
  • You need continuing education credits relating to ethics and professional conduct
  • You are working towards a provisional or full MHRT/C and need priority domain training

About this Event

This course will examine the knowledge, attitudes, and skills Mental Health Technicians need to establish rapport, communicate effectively and respectfully, and work collaboratively with consumers regarding their care to support recovery, with awareness of changing needs across the lifespan.

The following training objectives will be studied:

  1. Explain the concept of community inclusion and the use of natural supports to enhance recovery.
  2. Relate human development theory, including the interaction of social, psychosocial development across the lifespan./li>
  3. Give examples of evidence‐based models and approaches that integrate treatment and rehabilitation.
  4. Demonstrate general knowledge of the current diagnostic manual and be able to name basic diagnostic categories.
  5. Define the treatment complexities for co‐occurring disorders and addictions within vulnerable populations.
  6. Identify community resources to assist in the recovery process for individuals who have co‐occurring mental health and substance use disorders.
  7. Recognize the consumer’s development and life stage, and where they are in relation to the Stages of Change Model, in order to develop individualized treatment plans.
  8. Be aware of common strengths‐based assessments, including instruments that identify or screen for co‐occurring disorders and/or trauma history, and tools that evaluate the level of care needs.
  9. Demonstrate a collaborative, person‐centered, recovery‐oriented, shared decision‐making approach to working with consumers. Identify strengths and challenges and how to incorporate natural supports into individualized treatment plans.
  10. Describe common factors of effective helping strategies when working with consumers, e.g., therapeutic relationship, empowerment, consumer choice, and respect for the consumer.
  11. Demonstrate active listening skills, basic interviewing skills, and demonstrate respect for the consumer at all times.
  12. Illustrate an understanding of crisis planning, advance directives, crisis intervention strategies, and use of a warm line.

Course Expectations

1. Attendance:

Students must attend each day of class and receive an 80% or above on the final exam to earn a certificate of completion.

2. Make‐up work:

Students must attend all classes 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 6 participants and no more than 20./p>

4. Class participation guidelines:

  1. Students will arrive on time and stay until the end
  2. Students will demonstrate respect for others.
  3. 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.
  4. Cell phones should be placed on vibrate or silenced at all times during the class.
  5. 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.

About the Presenter:

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 and 6 for the MHRT/C Non-Academic Curriculum.

Register Online

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This article originally appeared in Macaroni Kid on July 1, 2021, by Lindsay McKeen, LCSW, CCS, Outpatient Therapy Supervisor, Health Affiliates Maine. 

Question: My husband and I divorced last year and while initially our daughter (11) was adjusting well to the big change in her life, she seems to be struggling more and more. We want to find a counselor for her to talk with. I’m wondering if you can suggest what types of questions are good ones to ask when trying to find the right counselor? My ex and I want to be sure it’s a good fit. Thank you so much.

Answer: It can be difficult to take that first step in getting yourself or a loved one into counseling, and even more so when you are navigating a new family dynamic and trying to find that support for your child. It is important that you and your ex-husband are on the same page here. In sharing this awareness of her needs and interest in finding a counselor that is a good fit for her, you are off to a good start.

Before looking at what to ask of the counselor, it is important to be sure the right questions have been asked within the family. While your child may not be hands-on in the search for a counselor, it will end up being her service and provider and so including her voice early on may help enhance her connection and engagement. What is her understanding of counseling? Is she agreeable to seeing a counselor? Are there any questions she would like answered before seeing the counselor? Does she have any questions for you? While parents are the decision makers, children value being heard and having a sense of control where appropriate. Giving her this voice before starting the counseling relationship can set a good tone for creating a trusting environment where she feels she can be open about the struggles she has been having.

Then, when it comes time to ask questions of the potential counselor, it may also be helpful to ensure you and your ex-husband have similar definitions of what a “good fit” would look like. You may have already had this dialogue, or you might try answering the questions below with one another to see if your definitions align. Many counselors also have online profiles and viewing these together could be another way to get a sense for what you both are looking for in a counselor for your daughter. Here are some topics and questions to consider when looking for a counselor:

Experience: While it is possible for counselors to work with people of all ages, many counselors find their niche in working with certain client populations. This niche may be developed around age group, diagnoses or presenting concerns, and/or specialized treatment approaches. Asking about the counselor’s experience may help you feel more comfortable with their ability to support your daughter with her needs.

  • Does the counselor have experience working with children or your child’s particular age group?
  • Does the counselor have experience working with families, especially those navigating divorce?
  • What is the counselor’s therapeutic modality or approach to working with children?

If you have spiritual beliefs or other cultural considerations you would like considered by the counselor:

  • What is the counselor’s understanding of that belief/culture?
  • How does the counselor manage differences in beliefs/culture and/or how does the counselor understand the ways in which the belief/culture may impact a child’s mental health care?

Potential Scenarios: In learning about the counselor’s experience and approach in therapy, you may get a sense for how the clinician will interact with the child and family, or you may want to ask more questions to get a better understanding. You might try thinking ahead to potential scenarios that might arise using the questions below:

  • How will the counselor navigate confidentiality and privacy for the child in relation to parental involvement?
  • How will the counselor handle concerns that they themselves or the parent(s) have identified?
  • How does the counselor foresee handling differences in opinion that may arise between parent(s), child, and/or counselor?

Logistics: Though the counselor’s experience and approach are likely most influential in selecting the right provider, the logistics are important too. Having discussions about the logistics upfront can help clarify expectations of both parties and minimize disruptions to the counseling relationship once it has begun.

  • Does the counselor provide in-person or telehealth-based services?
  • Does the counselor have the availability to offer a standing appointment? Or is their scheduling flexible/varying depending on the week?
  • Does the counselor have any policies in place around attendance or payment?

  • What are the counselor’s practices for communicating information to parents?
  • Are there expectations for parental involvement?
  • What is the best way to communicate with the counselor?


Though this article presents many questions and considerations for finding the right counselor, know that this is not all-inclusive. Having conversations with your ex-husband and child may expand or narrow this list to what feels most relevant to her needs. Most important in this process is open communication, with one another and the counselor, keeping in mind that the common goal is to support your child, and that the search can continue if you find yourselves feeling like the counselor is not a good fit.

 

Lindsey McKeen, LCSW, CCS is a clinical social worker and Outpatient Therapy Supervisor at Health Affiliates Maine.

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Discovering life’s joyful moments fuels our creativity, our purpose, and our overall wellbeing. Although it can be challenging to allow ourselves to truly appreciate what brings us joy daily, it’s well worth the effort as all aspects of our lives can benefit.

Be present. Joy is experienced in the present moment. It’s normal to think about the past or plan for the future (and in some cases it’s necessary). Try allowing yourself to soak in smaller moments that resonate with you throughout your day. The smell of coffee brewing, a cherished hug from your child, or the way your body feels after a long stretch. Whatever it is, relish it as it’s happening in the moment.

Search for meaning. We tend to get caught up in our to-dos and responsibilities making us forget or push aside meaning and purpose in our lives. During the 2020 quarantine, people had the opportunity to slow down, recognize what’s truly important to them and re-direct their lives accordingly. Dismiss what you should do and dig deep for what you want to do— and do it!

Make time for a passion. Prioritize time for activities that you love. Joy can be found when pursuing something you’re passionate about and can also help you better understand yourself and what may bring more meaning into your life. Bonus points if you go outside of your comfort zone – for a challenge and personal growth. Both will excite and motivate you.

Seek authenticity. Particularly on social media, we can get lost in comparisons and lose sight of our true selves. Ask yourself: am I living how I genuinely want to live? Am I pleasing others rather than myself? Choose to live in a way that feels right to your authentic self. This includes surrounding yourself with positive people. We subconsciously absorb the energy of those around us so choose carefully who you spend your time with.

Connect with nature. Studies have proven that when we spend more time outdoors, we experience less anxiety and reduce our stress levels. When in nature, we not only gain the benefits of fresh air, but we also tend to slow down, be present, and reconnect with a higher power/our spirituality.

As helpers, we provide this feedback to our clients every day. At the end of a frenzied day, it can be daunting to think about putting to practice our own teachings. However, when we choose to prioritize ourselves by finding joy and relishing in it, we know that these efforts can reduce stress and anxiety, boost our immune system, reconnect with life’s meaning and add significance to our life. If you’re having a difficult time finding the positive in your life, do just one simple thing each day only for you. Even if for five short minutes—you’ve earned it. We all deserve to feel life’s joys!

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Mental health can and should be a daily practice, taken into consideration more often than “when something is wrong” or when going through a particularly difficult time. Taking care of your mental health is a preventative form of care and by incorporating daily rituals and practices into your life, you can give your mental health the attention it deserves.

Here are nine things you can do to take care of yourself so you can take care of others:

Take a mental health day. You know yourself best. If you feel that you need a break, take one. If you don’t have vacation or paid time off, consider taking mini breaks throughout the day to renew your energy and spirit. It’s okay to slow down and not feel rushed to cross everything off the to-do list at once.

Switch up your evening routine. Try winding down in a different way than you typically do if you’re feeling particularly stressed or “off.” Think about what relaxes you and adopt that into your routine: reading a book, taking a long bath, chatting with a friend.

Adopt a vacation mentality. Put your phone setting on do not disturb between 9pm-7am. Go swimming instead of sweating at the gym. Walk in the park with a friend during lunch. Ignore emails after you’ve clocked out for the day/week. Whatever you do on vacation that feels relaxing and rejuvenating, try bringing some of that into your daily life.

Meditate for five minutes every day. Perhaps you’ve heard this advice before, but the science doesn’t lie! Meditation eases stress and anxiety, calms your nervous system, helps with memory and so much more. There’s no need to put pressure on yourself to gain some important insight or enlightenment. Sit quietly, focused on your breathing with no judgment of the thoughts in your head. With regular practice, you’ll begin to feel the benefits.

Be mindful of what you eat and drink. It’s a common coping mechanism to comfort our emotions with food, drink or other substances. We all have different nutritional and lifestyle choices, but we suggest being extra mindful when experiencing stress, anxiety or depression as sugar, junk foods and alcohol will make you feel worse (even if you feel better temporarily).

Consider reaching out for professional help. There is no barometer, specific feeling or event that warrants a person to “need” or want professional counseling. We all have varying life circumstances and coping strategies. If you feel like you “shouldn’t be this upset” or that “others have it worse” we suggest allowing yourself permission to seek help. We all deserve it.

Prioritize rest. Our culture values the “hustle” and though hustle has it’s time and place, we also need rest. You know your body and mind best—if you need a morning off work, take it. If you need a long weekend alone, take it. If you need to sleep in just a little bit longer, sleep in! The to-do list is not going anywhere and you’ll need your physical and emotional health in top shape to do your best.

Write down as many inspiring messages as you can. They can be lyrics, affirmations, reminders to move your body, drink water, have gratitude—any message that uplifts you. Keep them close by, such as in a desk drawer, a large jar or your phone’s notebook app. If you need a pick-me-up, reach for one. Alternatively, download an app that sends positive affirmations to your phone daily. It’s proven that we bring to life the thoughts that we tell ourselves (even unconsciously), so let yourself think positive thoughts!

When we feel that we are in control of our thoughts, feelings and emotions we’re bound to continue the work that allows us to feel that way. However, if you think you may need professional help, reach out. Everyone needs help at some point in life. It takes courage and strength to recognize when help is needed and seek it out.

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As mental health professionals, you may suggest the importance of self-care to your clients, but do you have a difficult time implementing a practice in your own life? During the last year specifically there’s been an increase in demand for mental health services as individuals are navigating the effects of the pandemic. It’s essential as a counselor, therapist or clinician that you recognize any signs of stress or fatigue and implement self-care into your daily routine.

This may differ from person to person, but look for the following:

  • Losing your sense of humor
  • Problems developing at home
  • Having low or no energy
  • Becoming irritated with clients
  • Other physical and mental signs of stress include change of appetite, trouble
    sleeping, feelings of overwhelm or that things can never seem to go right

Consistently as a mental health professional, you give so much of yourself to your clients. This has every potential to leave you feeling emotionally depleted if there is an absence of other forms of support or self-fulfilling activities. Further, the cumulative stressor of an ongoing pandemic has been a shared trauma experienced by both client and clinician concurrently. This has presented us with an environmental parallel process while engaging with our clients. As such, it becomes increasingly more vital for us, as helpers, to ensure that we find ways in which to enrich our lives outside of session as a way of practicing self-care.

Outside of your career, you’ll want to be sure that your relationships are not “one-way streets.” It may be second nature for you to always listen and always give, but your personal relationships need full participation and commitment from all parties.

Why is practicing self-care important for mental health professionals?
When mental health professionals do not consider their emotional, physical and spiritual wellbeing as a priority, their outlook on their careers or the profession itself can change which may lead to severe stress or burnout.

Here are ways to implement talking the talk and walking the walk:

  • Join a peer group
  • Consider attending counseling
  • Create boundaries with clients
  • Set office hours (and stick to them!)
  • Take vacations/holidays

How can mental health professionals incorporate self-care into their daily practice?
Nurturing your wellbeing looks different for everyone and also may differ in the various stages of your life. Look for moments within your day-to-day to reflect and care for yourself. Make it a part of your routine and non-negotiable on your calendar.

Small acts of daily self-care include:

  • Go for a walk
  • Meditate, pray or practice mindfulness
  • Journal or write down thoughts and feelings as they arise
  • Nourish yourself with water, movement/exercise and nutritious foods
  • Set priorities on your to-do list ensuring there’s time for yourself

It may feel difficult or selfish at first to make yourself a priority. However, when you take proper care of your wellbeing, you’ll be able to increase the quality of care, impact more lives, and serve your clients better. That starts with taking care of yourself on a consistent, guilt-free daily basis.

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This article originally appeared in Macaroni Kid on May 13, 2021, by Cindy Mailhot, LCPC, LADC, CCS; Health Affiliates Maine. 

Question: My daughter was touched sexually without consent by a classmate last year. She has not had in-person classes with the student this year due to mostly remote classes. She has lately been expressing a lot of anxiousness about seeing him in person when classes resume to normal. How can she best prepare for seeing him again and feeling safe? (The school is aware and spoke to the boy and his parents when this happened. He received a school suspension.)

Answer: I can just imagine how stressful this situation has been for your daughter and for you as a parent. You are doing an amazing job as a parent in supporting your daughter and working with the school to ensure her safety and sense of safety with the world around her.

Not knowing the age of your daughter, here are some suggestions for a variety of ages:

  • Work with the school to determine a schedule and plan that involves minimal interactions with this other student and a plan for when interaction may happen.
  • Sit down with your daughter and review the potential spaces and places she expects to see this other student in school–in the classroom, in the halls, at lunch. Explore the possible interactions she can imagine (good and bad) and brainstorm how she might manage in different situations–walk away, go to the principal or guidance counselor’s office, find her friend group, calmly but firmly say “leave me alone.”
  • Try to understand her “ideal” situation and brainstorm how that might be able to happen.
  • Remind her that the other student might be feeling awkward and uncomfortable, too, and may also be worried about seeing her.
  • Find out what the return to the classroom will look like and perhaps try a trial run rather than going back full-speed immediately.
  • Find out who her supports would be in the school if she’s having a difficult time and work on familiarizing her with these supports (if she isn’t already familiar with them) so she might feel more comfortable seeking help if needed.
  • Explore who the safe people are to talk to if something were to happen that she is uncomfortable with.
  • Stay hopeful. Try something on this list each day. Dwell on thoughts of when the pandemic ends and of all the things you will want to do and explore with your child. Do not hesitate to reach out for help.
  • Find one friend that can be her “buddy” for the first few days or weeks, so she won’t feel alone as she gets a feel for the situation.
  • A transition object from home that she can keep in her pocket that reminds her of your unconditional love and support throughout her day may ease the transition.
  • Provide plenty of opportunities to discuss her worries and concerns with you and anyone else she might feel comfortable with.

To know if she’s adjusting well, keep the lines of communication open. Check-in with her regularly and ask how she’s feeling, if the plans that were made are working and if anything needs to change. I also recommend that you watch for behavior changes. If you notice anything concerning (you know your daughter 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.

 

Cindy Mailhot, LCSW, CCS is a clinical social worker and the Assistant Director of Outpatient Therapy at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on April 29, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I recently found out my 17-year-old is smoking marijuana. He said he does it to help with anxiety and that he finds a lot of relief in it. I don’t love the idea at all, but I also feel powerless to stop him. How can I talk to him about the risks but also be supportive if I lose this battle?

Answer: This is a difficult time for parents. At 17, your son is on the cusp of becoming a legal adult. This can give teens a feeling of not needing guidance or permission. Passing the milestone of 18 will not suddenly make him mature enough to all make decisions that are in his best interest. However, if your son is just starting to use at 17, studies show he is less at risk than a teen who starts at a young age, who smokes/vapes for years. A University of Montreal study says that the more teenagers delay smoking marijuana (cannabis) until they are older, the better it is for their brains, but there may be little ill effect if they start after age 17. That may give you some comfort. However, the human brain takes 26 years to reach full development so introducing substances does have risks when it comes to full potential.

That being said, I find a troubling issue in your question. What is causing the anxiety at age 17 for him to self-medicate with marijuana to relieve it? Many people have found cannabis calming, yet at seventeen or any age really, understanding the underlying cause of the anxiety is key. There are many non-drug ways of treating anxiety worth exploring.

Teens have lots of reasons to feel anxious and the pandemic has increased this anxiety. Life looks uncertain, relationships and future plans may be on hold, decreased social activity can add to general unsettledness and hopelessness. Under normal times, this age is challenging—adult responsibilities and major life decisions loom and teens question themselves. They are also developmentally pulling away from parental influences which can sometimes cause problems at home.

I commend you for wanting to address his marijuana use, but an overall conversation needs to include healthy coping and understanding of what is contributing to his anxiety. Living with anxiety can be a lifelong struggle and he should seek help at an early age to prevent this. Assure him that he does not have to talk to you about it, but a counselor might be a great help to him. Cognitive Behavioral Therapy (CBT) is an evidence-based successful treatment for anxiety which many therapists use in their work.

I urge you to do more research to give you what you need for the discussion. For parents with younger children, talking about marijuana and substance abuse needs to happen before they start using and should be an ongoing conversation. Here are some talking points (taken from the references below) for you and other parents to begin a conversation about marijuana use.

Marijuana can affect driving. It is extremely important that teens who drive understand how dangerous driving under the influence of marijuana can be. Reaction time and judgment can be impaired coupled with inexperience behind the wheel.

Importantly, marijuana is illegal. The fact that many states have legalized recreational marijuana has given a lot of young people the idea that it is legal and okay for them to use. It is not. Recreational marijuana is only legal for adults age 21 and older. Legal trouble can be incurred by a teen for possession and/or dealing.

Marijuana is not good for teen brains. Studies have shown that early marijuana use (16 and younger) causes problems with judgment, planning, and decision-making that may lead to risky behaviors. Some studies show problems with memory, motivation, and academic performance. Not the best situation with which to step into adulthood. The teens who may have a predisposition (possible family history) to mental illness and/or addiction may find themselves struggling with depression, psychosis, or further substance use.

There are very real health reasons not to smoke/vape cannabis. A 2017 study in the American Journal of Respiratory and Critical Care Medicine states that teens who vape are twice as likely to experience respiratory problems along with coughs, bronchitis, congestion, and phlegm than peers who do not vape.

Lastly, I like that you want to have a conversation with your son about marijuana. This is hard for parents who are often confused themselves or have mixed messages on the subject. I also like that you want to be supportive no matter the outcome. It is a conversation worth having and it will show your love for him.

Here is further information about cannabis use in teens and about anxiety:

https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Anxiety-Disorders.aspx
https://www.verywellmind.com/marijuana-use-by-teens-statistics-2610207
https://www.sciencedaily.com/releases/2017/01/170125214606.htm#:~:text=2,Delaying%20marijuana%20smoking%20to%20age%2017%20cuts,teens’%20brains%2C%20new%20study%20suggests&text=Summary%3A,they’re%20less%20at%20risk.

Click to access evidence-brief-youth-13-17-e.pdf

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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If you are asking this question, you are probably not alone. In fact, 18 million Americans struggle with misusing alcohol or with the symptoms of Alcohol Use Disorders (AUD). If you feel as though your relationship with alcohol is a problem or could become a problem, it is important to know that you are not alone. There are resources that can provide help and guide you through a recovery journey. Arming yourself with information is a good first step.

What is Alcohol Use Disorder (alcohol addiction)?

There are hereditary and environmental factors to addiction, but many times the cause is not known. The following are some of the symptoms that characterize AUD.

The individual:

  • drinks more or longer than they initially intended to
  • has tried to moderate or stop drinking in the past, but has been unable to
  • spends a lot of time drinking or recovering from the effects of drinking
  • experiences cravings, or strong desires to drink
  • drinks even though it interferes with home, family, work, or school responsibilities
  • drinks even though it causes trouble in their personal life
  • gives up activities or obligations that were once important, in order to drink
  • gets into situations while drinking that may be risky or cause harm
  • continues to drink even if it causes depression, anxiety, or other health problems
  • has to drink more to produce the desired effects
  • has withdrawal symptoms when not drinking

NOTE: According to the DSM-5 Diagnostic and Statistical Manual for Mental Disorders, showing two-three of these symptoms in the last year may indicate a mild alcohol use disorder, while showing four-five symptoms indicates a moderate AUD. Displaying six or more symptoms signifies a severe alcohol use disorder.

Who is at risk for alcohol use disorders?

Drinking alcohol in moderation can be okay for some people. This means that while they may feel the effects of alcohol consumption, they do not feel compelled to keep drinking. Moderate drinking is classified as no more than one or two drinks per day for men and women.

Using alcohol when bored, stressed, lonely, depressed, or if there is a genetic predisposition to addiction (family members with AUD), can lead to further serious problems. If you or someone you care about is drinking to get through the day, it may be time to reach out for help.

How does alcohol affect physical health?

Like any substance consumed in excess, there will likely be side effects. Alcohol may also interact negatively with prescription medications and make it difficult to diagnose other health concerns.

When drinking to excess there can be problems with:

  • Alcohol poisoning
  • Sexual dysfunction
  • Reduced inhibitions or risky behaviors
  • Inability to focus, impaired memory
  • Affected vision, reflexes, and coordination

Long-term effects of active addiction:

  • Impaired learning and/or brain development
  • Increased depression and anxiety
  • Major organ damage; increased risk for heart disease
  • Cirrhosis (chronic liver disease)
  • Cancer

How does alcohol affect mental health?

Alcohol is a depressant. Therefore, it slows down your brain and alters its chemistry. There are many effects including changes to mood, energy levels, memory, concentration, and sleep patterns.

Alcohol may also impact decision making. While drinking, a person may “do things without thinking” or say or do things they would not do or say while sober such as pushing away or hurting the people who care most about them. It can give a person courage to engage in risky situations like unsafe sexual encounters, trouble with law enforcement or getting into fights. Alcohol can contribute to life falling apart, causing withdrawal from important relationships and social situations, and even self-harm. A combination of factors along with intoxication has led to many dying by suicide.

Where do I go for help with AUD?

Talk with your primary care practitioner. There are multiple treatment options ranging from hospitalization for detox if needed, to outpatient therapy with a counselor or group, to rehabilitation or participation in an intensive outpatient program (IOP). There is also residential treatment. There are even medications that can provide support for building a sober life.

Lastly, there are many recovery communities like AA, Smart Recovery, and Women for Sobriety that provide support and assistance in learning how to live a healthy, sober life.

sources: healthline.com, headspace.org, recoverycentersofamerica.com, cdc.org, apibhs.com

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