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Hearing Voices

Hearing Voices. Tania Walsh, LCSW Sgt. Terry Tilley MWCPD. Learning Goals:. Understanding the day to day challenges Learning about the subjective experience of hearing voices Becoming more empathic Changing some of the things we do to address needs of people who hear voices

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Hearing Voices

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  1. Hearing Voices Tania Walsh, LCSW Sgt. Terry Tilley MWCPD

  2. Learning Goals: • Understanding the day to day challenges • Learning about the subjective experience of hearing voices • Becoming more empathic • Changing some of the things we do to address needs of people who hear voices • Identify the impact of severe emotional disturbance on young people

  3. Overview • The simulation experience • Word search • Reading comprehension • Crossword • Report interview GOAL: The key is to be moving through the real world to perform tasks while experiencing the distressing voices

  4. Rules • Do not talk to each other • Keep busy • Just be yourself • Do not leave the facility • Do not change the volume • Do not stop the tape until I tell you the simulation is over. • Take care of yourself and if you need to, turn the MP3 player off.

  5. Push start now

  6. Development of audiotape • Patricia E. Deegan, PHD. • Director of Training for the National Empowerment Center and an experienced voice hearer. • Sampler of voice hearing • Professional recording studio • Two females and one male who also hear voices

  7. Experience and QuestionsDiscussion • How did you feel emotionally? • How did you feel physically? • Heartbeat? • How long was the simulation?

  8. Now that you have had this experience, what will you do differently in your work with people who hear distressing voices?

  9. Youth Experiencing Sever Emotional Disturbance

  10. Learning Goals: • Understanding the day to day challenges young people face with severe emotional disturbance • Becoming more empathic • Changing the way we engage and address the needs of young people experiencing signs and symptoms of mental illness • Identify the impact of severe emotional disturbance on young people

  11. Cultural Perspective • “Understanding the cultural dynamics of youth in behavioral health crisis" OJA/DHS Case Worker Family Dynamics Brain Development Dynamics Youth Poverty Dynamics History of Trauma Dynamics Mental Health Substance Abuse Dynamics

  12. Brain Research Findings The brain continues to develop during adolescence. Areas under construction: • Prefrontal cortex – responsible for organizing, setting priorities, strategizing, controlling impulses • Brain functions that help plan and adapt to the social environment • Brain functions that help put situations into context; retrieve memories to connect with gut reactions

  13. Their Brains are being Re-Wired Because…

  14. The Developing Brain, Adolescence and Vulnerability to Drug Abuse

  15. Risk Taking Behavior? But there is concern – Adolescents overestimate their capacities, rely on their immature ability to judge, or give in to peer pressure It is normal! -Exploration of new behaviors, decision making skills, identity development

  16. Sensation-seeking Declines with Age

  17. Risk Perception Declines and Then Increases After Mid-Adolescence

  18. Self Harm vs. Harm to Others

  19. Self Harmful Behavior Examples of self harmful behavior 1. Banging head rapidly and repeated 2. Running into traffic (with the intent to harm self) 3. Suicide attempt 4. Actions of self mutilation and disfigurement

  20. Self Harmful Behavior Key things to remember • Acknowledge the youth’s distress. • Active listening without interruption. • Ask open-ended questions. • Ask less direct question to start: A. Have you been unhappy lately? B. Have you been very unhappy lately? 4. Ask more direct questions as communication builds: A. Have you ever wanted to hurt yourself?

  21. Intentional Harm to Others Example of intentional harm to others • A detailed plan to intentionally harm family members, neighbors and/or animals with weapons or objects. http://www.youtube.com/watch?v=H55Oz92Kh-A&feature=results_main&playnext=1&list=PL9F0592A142852ED2 http://www.youtube.com/watch?v=ME2wmFunCjU&feature=mfu_in_order&list=UL

  22. Functional and Problem Solving Scales • Things to consider when investigating a youth’s functional and/or problem solving ability. • Problem Solving Questions • Is the young person arguing with others and threaten to murder an individual • Is the young person getting into fights and threaten individuals with a weapons • Is the young person yelling, swearing, or screaming at others erratically • Is the young person displaying fits of anger and aggressive behavior that’s unprovoked and unpredictable • Is the young person causing trouble for no reason • Is the young person using drugs or alcohol • Is the young person a repeat offender of breaking rules or breaking the law (out past curfew, stealing) • Functional Questions • Is the young person getting along with friends • Is the young person getting along with family • Is the the young person able to care for themselves (taking medicines or brushing teeth) • Is the young person controlling emotions and staying out of trouble • Is the young person feeling good about oneself • Is the young person thinking clearly and making good decisions • Is the young person able to concentrate, pay attention, and completing tasks Functional Ability Problem Solving Behavioral Health

  23. Common Behavioral Health Challenges for Youth and Young People OPPOSITIONAL DEFIANT DISORDER ADJUSTMENT DISORDER ATTENTION DEFICIT/ HYPERACTIVITY DISORDER (ADHD) MAJOR DEPRESSION DISORDER CONDUCT DISORDER ANXIETY DISORDER OBSESSIVE COMPULSIVE DISORDER BIPOLAR DISORDER BORDERLINE PERSONALITY DISORDER (BPD) SCHIZOPHRENIA

  24. SAMHSA National Survey Any Mental Illness in the Past Year Among Adults (18+), By Age and Gender 8 7.3 7 6.4 5.9 6 4.8 5 4 3.2 2.8 3 2 1 0 18 or Younger 18 to 25 26 to 49 50 or Older Male Female Age Group Gender Percent with Serious Mental Illness (SMI) in the Past Year

  25. SAMHSA National Survey Any Mental Illness in the Past Year Among Adults (18+), By Age and Gender 32 30.0 28 23.8 24 22.3 19.9 20 15.6 16 13.7 12 8 4 0 18 or Younger 18 to 25 26 to 49 50 or Older Male Female Age Group Gender Percent with Any Mental Illness in the Past Year (2009)

  26. Strategies to Communicate with Youth

  27. Mental Health Response vs. Criminal Arrest • If crime, but no mental illness = Arrest • If mental illness, but no crime = Diversion • If crime + mental illness, consider: • Seriousness of crime • Lethality of risk to self or others • Capability of jail/lockup to manage/treat person • Mental health history • Availability of services

  28. Thank you for ParticipatingQuestions? • Contact Information Tania Walsh, LCSW trubiorosas@odmhsas.org Sgt. Terry Tilley MWCPD opie3232@gmail.com Marqus Butler MHR mbutler@odmhsas.org

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