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This article originally appeared in Macaroni Kid on Dec 6, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: I have always been a giver. This is especially true at Christmas. I tend to overbuy for those I love and over give for those that I probably shouldn’t. What I mean by that is I will often buy gifts for everyone in the office even though it is not expected. I buy far too many gifts for our kids. It is embarrassing but I am still paying on credit cards from gifts I bought last year. I am really trying hard this year to not over give but I feel like I should lay the groundwork for those I have over-given to in the past. How do I best do that without hurting feelings? This will be an especially hard message to give to my kids.

Answer: The best part about this is that you recognize what you are doing and that you want to change. Good for you; that is often the hardest part! Gift giving has been a way you express your affection. Knowing that you need to get it under control doesn’t mean you have to stop, but you will need to modify. Gifts for co-workers, if allowed in your workplace, are usually a handwritten card with meaningful sentiments, a home-baked treat, a delicious jelly, chocolate or the like. More elaborate and expensive gifts can put your co-workers in an uncomfortable situation, especially if they can’t afford or are not inclined to buy for workmates. Remember, because you are creating debt, you cannot afford it either. If you are the only one doing it, you may want to explore why. 

Shopping for the holidays can be a time that pulls at our heartstrings. Retailers know this and make their merchandise talk to us. Some ways to combat this is to leave the store before buying or go to your car and think about your prospective purchases without the influences of the holiday atmosphere. If you do buy, leave the tags on for a while, and evaluate the cost and appropriateness of the gift for each receiver. You can always make a return. You will get better at doing this on the spot, as you make changes.

When it comes to your children, as with all parenting, you are modeling for them how to give and receive gifts, the meaning behind the giving, and also healthy financial management. Talk with them. One of the big gifts parents can give their kids is to teach them how to live within their means. Choose a budget figure of what you can spend on each child. Focus on the one most important gift on their list if it is financially reasonable. Then fill in with smaller, less expensive items which might be fun and challenging. Stay within the budget! If it is a big change from past years, you may want to add a family activity which will help the celebrating move past the gift giving. 

Lastly, if this is not something you feel you can get under control without help, and your spending is causing problems in other areas of your life and relationships, seek the help of a counselor. Sometimes there are reasons we overspend and over-give. A counselor can help you gain the insight you need to make important changes. 

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director 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 www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Nov 15, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: My husband and our son do not get along very well. My husband has recently been saying some damaging things to my son such as calling him a loser and an idiot. I know my husband is frustrated with our son but I can see the name-calling is hurting their relationship. When I speak up to my husband he says I’m choosing sides and letting our son get away with bad behavior. I feel stuck in the middle. What do I do?

Answer: It is hard to be in the middle in this kind of situation. Thank you for asking this question because many parents identify with this sort of problem. Your husband’s behavior may be based on a true desire to help your son become a healthy, functioning adult. Or, he may have been treated the same way as a child and he is replicating the behavior with his child. Either way it is not helping, it is hurting your son. Unrealistic expectations on the part of parents can also create the misbehavior or underachievement in the child. It is the “which came first question.” There are many ways to help children and teens get their behavior under control without insults. Insults, like calling a child “loser” or “idiot” actually are a form of emotional abuse. Emotional abuse refers to any act by an adult which results in injury to a child’s health and wellbeing. 

Here is a list of kinds of emotional abuse:

  • Yelling or swearing 
  • Name calling or insults; mocking
  • Threats and intimidation
  • Ignoring or excluding
  • Isolating
  • Humiliating
  • Denial of the abuse and blaming of the victim

These are the effects of this sort of emotional abuse: lowered self-esteem (hinders success in life); increases rebellion in the child or teen; teaches the child to become aggressive toward others; increases depression (fosters feelings of worthlessness) and, causes the child to lose respect for the parent.

It is important that you help your husband to understand the damage that he is doing. If you are unable to do this, consider that you may also feel intimidated by him. If you feel you need help figuring out how to help your husband and your son, please talk to a counselor. Change can happen. Counselors can help the whole family. Your husband may just need to learn about another way to relate to his son. Children need parents to set realistic expectations, to respect them, to be consistent, and to model appropriate behavior and coping. This is the tough, but important part of parenting.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director 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 www.healthaffiliatesmaine.com and click on “Referrals.”

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James Bellmore (Jimi) is reaching out to the community to share his endeavor to educate professionals by offering his personal perspective about living with mental illness. Jimi hopes to continue to grow his motivational speaking by extending his services to more providers locally. Health Affiliates Maine (HAM) has been utilizing Jimi’s presentations to support new providers upon orientation monthly. Consistently HAM gets the feedback that he is the best part of the orientation process and truly outlines the needs of our consumers with real examples.

So far, Jimi has reached over 3,000 providers. Jimi currently speaks for the CMMC residency program annually, Ascentria Community Alliance and HAM on a monthly basis; Jimi shares his experiences with providers as a person who was diagnosed with schizophrenia unspecified type in 1976. Jimi went into remission in 2003- having no psychotic symptoms. He had a brief relapse in 2013 but because of his previous experiences was able to reach out to supports and go into remission again quickly.  He attributes his success to understanding his triggers and managing them, to having a great network of friends he considers his family, and honoring his friends and experiences through painting. He helps others by his example. Jimi wants to continue to reach providers, educate them on what it is like to be a consumer, as well as, how to look for and encourage recovery. He also shares how to support consumers with relationships, how to not judge lifestyles and individual choices, and engage consumers in hobbies. It is through his story Jimi is able to express constructive criticism that resonates with the providers.

During his engagements, he explains how he had good providers, not so good providers and amazing natural supports, referred to as “street people” who were often discouraged by his providers. Jimi recalls his “homies” being the biggest part of his recovery and offering encouragement and he often turned to this support even when providers thought they were the wrong crowd. Jimi first and foremost reminds providers that natural supports are the people that consumers can turn to all of the time. These relationships are crucial to success so do not talk badly about people’s friends and offend them. Second, he states, “don’t look for recovery and then deny it!” Jimi found at times that his medication and counseling providers would look to identify and treat symptoms when he it was clear he was in recovery. Third, he suggests that providers,  “be honest and compassionate, be real, do not trick, do not go in with a desired outcome, listen to the consumer and work on their goals; tell the consumer about mandates, answer questions and listen to feedback”. 

Jimi continues to look for ways to grow his motivational speaking opportunities and share his experiences to help shape the future of mental health care and bring a consumer perspective to the discussion at local agencies. Jimi can be reached for additional questions and scheduling for speaking engagements at bellmorejames61@gmail.com

Below is Jimi pictured with Health Affiliates Maine staff as he donates art work that he has created as a reminder of the work he is doing with Health Affiliates Maine Staff.

From left to right Trena Jackson, Compliance & Privacy Officer, Alan Holbrook, Case Management Supervisor, James Bellmore, Motivational Speaker, Kate Marble, Director of Case Management Services, Janet Verrill, Utilization Review Supervisor.

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This workshop will help clinicians and behavioral health organizations identify and respond to common ethical issues in the context of family and intimate partner violence.  Since technology plays a significant role in clients’ lives and in or practices, we include ethical guidelines for technology use and responses to digital abuse.

At the conclusion of this workshop, participants will:

  • Be aware of the ethical standards for common issues that arise in the behavioral health response to clients with current or past exposure to violence and abuse;
  • Have a summary understanding of ethical issues in: scope of practice; IPV risk assessment; confidentiality and privilege; safety planning; record management; justice system liaison; digital/technological risk, as well as best practice policy recommendations for behavioral health agencies or practices;
  • Have trauma-informed, safety-focused behavior health strategies for clinicians and practices for ethical concerns arising in the context of intimate partner violence;
  • Know where to find additional resources and advocacy services as needed.

This workshop has content relevant for clinicians who are preparing to meeting Maine licensing requirements for ethics and for family and intimate partner violence education.

AGENDA

8:30 – 9:00 Continental Breakfast and Registration
9:00 – 10:30 Setting the Frame: Ethical standards and common ethical issues when violence and/or abuse are present.
10:30 – 10:45 Break
10:45 – 12:00 Ethical policy and protocol for the clinical/technology interface when abuse is present.  Orientation to current technology: the use and potential abuse of social media, texting, sexting, GPS and more.
12:00 – 1:00 Lunch and networking discussions.
1:00 – 1:30 Defining the scope of practice: Risk Assessment and safety strategies.
1:30 – 3:00 Clinical response pathways for survivors and abusers; Diagnosis, treatment modalities, documentation, confidentiality.
3:00 – 3:45 Self Care: Ethical requirements for self-care; is your organization/practice trauma-influenced or trauma-informed?
3:45 – 4:00 Conference Summary and Certificate Distribution.

BangorFri, December 1, 2017 from 8:30am – 4:00pm
Spectacular Event Center
395 Griffin Road
Bangor, ME 04401
Register
LewistonThu, December 7, 2017 from 8:30am – 4:00pm
Franco Center
46 Cedar Street
Lewiston, ME 04240
Register
PortlandFri, December 8, 2017 from 8:30am – 4:00pm
Season’s Event Center
155 Riverside Street
Portland, ME 04101
Register

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This article originally appeared in Macaroni Kid on Oct 10, 2017 by Mary Gagnon, LMFT; Health Affiliates Maine

Question: I have a thirteen-year-old son. He brought up his desire to go trick-or-treating with friends this year. My husband immediately jumped in to say he is far too old to go trick-or-treating. I disagree. I think kids grow up too fast and should enjoy the pleasures of childhood while they can. My husband thinks the idea is immature and not healthy for a kid his age. I know adults that still enjoy dressing up in costumes and they aren’t immature. Is it wrong for us to allow our son to trick or treat?

Answer: It’s not really a question of right or wrong, but rather a question of perspective. While you value the playfulness of childhood, your husband may see your son as a person who is working on becoming an adult and leaving childhood behind. Developmentally, your son is straddling the two worlds of childhood and adulthood, and sometimes he may want to do things that are considered more “childish,” and other times he may assert himself as if he is already an adult. It can be a confusing time for adolescents and parents alike!

Why does he want to go trick-or-treating? Is it dressing up, getting candy, the independence of being with his friends, or something else that is appealing? Knowing why he’d like to go may help you and your husband understand his point of view and come up with a solution that feels right for all of you. 

There’s no age at which a person is no longer allowed to go trick-or-treating, although in our culture it is frowned upon more and more as a child gets older. Some adults may see an adolescent trick-or-treating as “not acting their age,” while others may be concerned about greediness or the possibility that the adolescents are out to cause mischief or trouble of some sort. If, after discussing it with your husband, you allow your son to go trick-or-treating, make sure he understands the rules you set (such as curfew, neighborhoods he can go to, and trick-or-treating “etiquette”) and some of the possible reactions he may receive at the neighbors’ doors and how he should respond. 

Happy Halloween!

Mary Gagnon, LMFT is a professional marriage and family therapist and the Training and Clinical Development Specialist 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 www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Sep 21, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: My son’s friend has ADHD. He often comes to our house to play and sometimes spends the night. He seems not to have much of a filter and says some inappropriate things for his age. He is also impulsive. I get concerned about him using good judgment. I don’t want to discourage the friendship but am not sure how to best talk to my son about what’s appropriate and what’s not when his friend is over. I’ve talked to the parents and they are aware of the issues and have spoken to their son but they have left the parenting up to me when he is at our home. What’s the best way to deal with this when it’s not my kid?

Answer:

 This is a bit difficult to answer without knowing the age of the children. I will give you some general interventions which I hope will apply in your situation. I think you have taken an important first step in talking with the parents. In this way you have already communicated your concerns and they have an expectation that you will address what might come up. 

Having family ground rules for behavior is good for children. This also means that when kids come to play they are under your rules. When behavior starts to cause problems, review the rules of the house, and the consequences for not following. You can say, “We really like it when you come to play, but we have rules in our house about jumping on the sofa. I need you both to find another activity.” Rules can be “no ‘potty’ talk” “no roughhousing inside” “no backtalk to adults,” and the like. When rules are broken it is important to speak up and to have a number of consequences to fit the situation, like having to play separately for a short period, to having to go home. Sometimes finding out that you mean what you say can make better behavior the next time. Kids thrive with rules and boundaries; ultimately they make them feel safe. 

Children with ADHD get lots of negative messages around their behavior which can cause problems with self-esteem. Along with enforcing rules, try to also make a point to reinforce positive behavior. Look for those times to reward positive play by adding extra time to an activity or by giving positive praise. As to your concern about this child’s impulsiveness and judgment; again this can mean very different things at different ages. Adult supervision may be really appropriate for the young ones, with repeated focus on acceptable behavior. Older children need to know to come and talk about behaviors or topics which make them feel uncomfortable. 

The most important thing is to be clear about what the expectations are in your home and to follow through when discipline or positive reinforcement as needed. Lastly, sometimes it is appropriate to discourage friendships that you do not feel are right for your child.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director 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 www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Aug 24, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: My 13-year-old daughter recently told me that she is gender fluid. I’ve heard the term before but am not that familiar. I want to be supportive but don’t know where to start to learn more. The web has a lot of conflicting information. Please assist.

Answer: Gender fluid describes a person who identifies with both genders, and moves between expressing themselves as male and female. They can have characteristics and traits of both sexes. Many are comfortable not being either/or, but both. For young people with developing bodies, perspectives, and personalities, it can be confusing. Our culture is also confused, and messages about gender can be hurtful sometimes.

It is great that your first impulse is to be supportive and learn more. That is really good parenting! While your daughter explores her gender identity, provide time of open conversation without judgment and “shoulds.” Let her know you want to understand. Each child is individual and all kinds of uncertainties and insecurities are common. Some children try on different identities while they are finding their way, ultimately settling into one as they develop. 

Counseling is an important option for her to learn more about herself and form healthy self-esteem in the process. Look for a counselor who specializes in these issues. Counseling can also be helpful for you, as you try to understand. Sometimes the picture in our head of how life will go, for us and for our children, doesn’t match the current reality. Sharing this journey with a counselor can give you the information you need going forward.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director 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 www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Jul 19, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: My husband and I do not agree politically. It has never been too much of an issue before but after the November election, it has become one. We actually have had yelling fights in front of the kids. Afterward, we came to an agreement as a family that we would just not discuss politics. However, I am rethinking this as I’m not sure it’s healthy to demonstrate to our kids that if we cannot agree, we just won’t discuss. What are some other options we might consider trying?

Answer: This is a challenging time for lots of people. As a country, we are polarized in our political views. You are already thinking appropriately to want to be able to discuss in front of, and with, the children things about which you and your husband disagree. It is also a good sign that you have already come together as a family to try to solve this issue. Arguing and expressing anger is normal and healthy; children need to see it and learn about it in a safe environment. Your children will encounter many people who get angry and disagree with them throughout their lives. It is the parent’s job to teach them that disagreements can happen and people can still love and work together. 

When you discuss political things you will need to be able to do it mindfully, recognizing that you are symbolically “walking through a minefield.” Choose words carefully and remember that you are modeling for the children.

Both of you should agree that your points should not belittle or make a mockery of the other’s viewpoint or resort to snide comments on someone’s physical attributes; to do so is not helpful and supports the bullying mentality.

Present your side of the discussion calmly and supported by facts and intelligent, thoughtful opinions. Once you do that, it will be your turn to be quiet and listen. This shows respect, even when disagreeing. Inject humor when possible and decide together when it is time to put the conflict away for a while. For the sake of sanity, make a habit of also looking for the topics or points about which you agree. When marital conflict becomes too pronounced and it is “sucking the air out of the room,” it is time to get some help from a counselor in sorting it out. Good luck.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director 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 www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Jun 21, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: I was widowed last year and am now the single mum to 2 great kids. I’ve been dating for some time a man with 2 kids of his own. We have gotten our families together several times. The kids get along well but have significantly different personalities. My boyfriend and I have discussed the possibility of moving in with one another, and I am looking for advice on how to broach the subject with my children. I’m not sure they will see this as happy news. Thank you for your consideration.

Answer: I am going to start out by asking you to bear with me because the first part of my answer is not really what your question was about. I will come back to it, but there are things (and people) I want you to consider first. Importantly, you are first. You shared that you just lost a husband in the last year and are new to the single mum experience. Then there are your two children who have lost a dad and are getting used to having only one parent. Then, there is your new boyfriend to think about since this is a new relationship for you, and him. Then, there are his two kids to consider. This is not just one new relationship, it is six. To answer you, I would like to pose my own questions. How have your children expressed their grief over the death of their father? Are either of them having problems at school or any disturbance of mood or behavior since his death? This would be the same question I would ask of someone entering a new relationship following a divorce. Everyone handles these loses differently. You may be ready to move on, but your children may not. Also, after a loss, it may be difficult to trust your own emotions. What feels like love may just feel better than being alone. You have lots to consider. Moving in together is a really big step. My advice would be to consider this carefully. If your children do really like this person, but you decide it isn’t right, then they will experience another loss. Since you are already sensing that they may not see this as happy news, slow the pace down and see how things go as the relationships develop. Now, let’s look at your question on broaching the subject with your children. When you feel you have assessed and responded to the concerns above, start with a series of discussions about blending the families. Introduce it. Give the children time to process it. Talk about it again and hear their concerns. Think about and address their concerns. Then talk about it again. During this time, join the families together repeatedly and watch the dynamics and also how your boyfriend parents his children. How you handle major things in your children’s lives can impact them positively and negatively. This new blended family relationship is an important one. It may be a wonderful one. Moving carefully and lovingly around how these changes affect your children, shows the high value you put on their well being.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director 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 www.healthaffiliatesmaine.com and click on “Referrals.”

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How to Help Someone Who Is Thinking of Suicide

This article originally appeared in Macaroni Kid on May 30, 2017 by Mary Gagnon, LMFT; Health Affiliates Maine

What do you do when someone you love is feeling down? We’ve all been down at some point, and understand when our friends or family feel the same way. Most of us try to take a little extra special care – make them tea, give them a hug, and tell them everything will be okay. 

But what happens when things aren’t okay? What happens when a down mood turns into depression? What happens when your loved one can’t see their way forward, and you are worried they might be thinking of suicide?

Cause for Concern — Most people show some warning signs that they are thinking of suicide. The most concerning sign is when someone communicates in some way that they are thinking about dying or suicide. They may do this verbally or non-verbally (such as by writing about it). Other signs include:

  • Increased substance use
  • Anxiety or depression
  • Feeling purposeless, hopeless, or trapped
  • Anger
  • Recklessness
  • Mood changes
  • Withdrawing from loved ones or activities (such as work, school, or hobbies)

The highest risk groups are males, particularly those ages 45-64 and those over 75. However, younger people (ages 15-24) have a high number of attempts, and suicide is the second leading cause of death for this age group. Although it might be hard to imagine, even younger children can feel like they want to die. Look for mood and behavior changes, including anger or sadness, impulsivity, and play that may have themes of death.

What Can You Do?
Remember, for a person considering suicide, a crisis point has been reached and their pain feels unbearable. However, ambivalence often exists, communicating their distress is common, and they often show you in some way that they are hurting – by expressing their feelings or thoughts or by their behavior. Remember, though, that they might not ask you for help directly. Many people are afraid of what will happen, or they don’t want to upset others. We might even be afraid to ask someone – because we might not know what to do, or we’re afraid of saying the wrong thing, or we’re afraid of the answer. We don’t like to see our loved ones hurting, and it’s frightening to think that a loved one might be thinking of ending their lives. However, if you’re worried enough to wonder if they might be thinking about suicide, it’s time to ask. 

You can intervene, and you don’t need any special training to do it. There are three steps:
1) Show you care – tell your loved one what you’re noticing and why you’re concerned. Allow them to talk.
2) Ask the question – ask your loved one “Are you thinking about suicide?” It is hard to do, but important to know. Sometimes, you might be the only person they tell, or they might be relieved that someone finally cared enough to ask. For younger children, ask them in words they will understand – but do ask.
3) Get help – If the answer is yes, don’t leave them alone. Assure them that you will get some support for them, together. 

Getting Help
Several resources are available to you, including:
911/Police
Statewide Crisis Hotline 1-888-568-1112
Local Crisis Agency
Hospital emergency room staff
Physicians/health care providers
Private mental health clinicians and facilities

Your care and intervention can make a real difference. 

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