Paul Brasler – High Risk Clients: Effectively Handle Five of the Most Critical Scenarios You’ll Face as a Clinician

Description

Crises are never scheduled, convenient or easy. But they do happen and you will face them. Clients at risk for crisis often present with so many symptoms and issues, it’s hard to know where to start.
Paul Brasler – High Risk Clients: Effectively Handle Five of the Most Critical Scenarios You’ll Face as a Clinician
Many clinicians, anxious about how to proceed, often miss or avoid asking the right questions to effectively intervene and keep clients (and themselves) safe.
As a clinician, have you ever felt:

Worried about the safety of your clients, even feared for their lives, but felt unprepared to handle the situation?
Unsafe in the clinical environment, or unsure of how to handle situations where someone connected to your client might be in danger?
Caught off guard when you’re wrapping up a session and a client discloses suicidal thoughts?
Unsure if a client was using drugs, and ill equipped to identify the signs and symptoms of drug abuse?
Concerned that you’re doing more harm than good for traumatized clients, despite your best intentions?

In this recording, Paul Brasler, LCSW, navigates you through five of the most difficult scenarios in mental health today. Through real-life examples and live role plays, Paul will share the concrete strategies that he’s used over the last two decades to safely and effectively intervene in the challenging, urgent, and sometimes alarming situations that mental health professionals face. Full of practical tools and tips, this recording will teach you to how to make crises situations more manageable, overcome your worries, and improve your readiness to handle mental health emergencies related to suicide, violence, substance abuse, trauma, and medical issues.
Better still, instruction on professional liability management techniques, tips for documentation, and detailed reproducible assessment forms will have you feeling confident that you can focus on doing what’s best for your clients without fear of litigation. And, Paul’s guidance is applicable to your work regardless of your setting or clinical background.
You’ll be left feeling equipped to help your most vulnerable clients with the real-life skills and knowledge they don’t teach in graduate school!

Handouts
Manual (4.8 MB) 79 Pages Available after Purchase

Outline

Client Assessment: Ask the Right Questions

Conduct comprehensive assessments

Mini mental status exam
Lethality assessment: Suicide and homicide
Substance use assessment
Trauma assessment

Tips and strategies for eliciting the right information

The Suicidal Client: More than 13 Reasons Why

High-risk populations—who is most at risk?
Implicit and explicit expressions of suicidal ideation and intent
Self-injurious behavior and suicidal ideation
Suicide assessment and interviews: Ideation, plans, means, intent
What do I do now? —Disposition & safety planning

Why “No-Harm Contracts” are harmful
Breaking client confidentiality
When in doubt, do what?

Hospitalization process
After the ER: When clients are not admitted
Case studies:

Michelle—Teenagers experiencing suicidal ideation
William—The intersection of substance use, mental illness and suicidality

The Violent Client: Manage Dangerous Situations

Dealing with our fears: Clinicians’ safety concerns
When the clinician is the target
When others are the target
De-escalation techniques
Preventative planning

Office layout
Keeping good boundaries
Police involvement before a crisis

Safety planning
When to call 911
Hospitalization process
Duty to warn
Case studies:

George—Handle a violent client
Dale—Practice Duty to Warn

The Addicted Client: What ALL Clinicians Need to Know

How misdiagnosis harms clients
Signs of intoxication
Imminent risk: Signs and symptoms of overdose
Identify withdrawal syndromes
Accurate diagnosis and treatment matching
Drug basics that clinicians should know:

Opioids and the opioid crisis (heroin, fentanyl and emerging drugs)
Stimulants (cocaine, “bath salts,” methamphetamine)
Cannabinoids (“shatter,” spice)
Other chemicals (DXM, “Special K,” Ayahuasca)

When and how to refer to a higher level of care
Case studies:

Percy—Opioid crisis in the waiting room
Cathy—Bipolar Disorder? Think again

The Traumatized Client: Help Without Hurting

Recognize trauma in clients
The risk of misdiagnosis
Dangers of improper treatment
Strategies for trauma-informed care

First and foremost: Safety inside and outside the clinic
The role of mindfulness
Go slow…but go

Understand Levels of Safety
Triune Brain Model and trauma
Bereavement: Not always trauma
The intersection of trauma, mental health, substance abuse and medical problems
Case studies:

Brian—Trauma missed
Mick—“How deep can I bury this?”

Medical vs. Psychiatric Problems: Limiting Harm

“What Could Kill the Patient First?”
Collaborative care with primary physician
Medical emergencies that present with psychological symptoms
Signs and symptoms: Limit client harm by recognizing a medical emergency

Medication-Related Disorders
Traumatic Brain Injury (TBI)
Neurocognitive Disorders
Other Neurological Illnesses

Case studies:

Steven and the Zombies—Organic disorders
“Granny has schizophrenia!”

High Risk Clinicians: After the Crisis

Protect your license and manage liability
Documentation: What you need to know
Debriefing and supervision
Vicarious trauma
Addressing compassion fatigue
Case study:

Dave and me

Limitations and Potential Risks

Limited controlled studies
Seek supervision when necessary
Weigh out risk of intervening versus not intervening