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Wellness for Behavioral Health Clinicians: Keeping Healthy Boundaries, Part Two

In a previous blog post, we talked about the importance of maintaining healthy boundaries with your clients. This can help you stay compliant with behavioral health standards and protect both you and your clients.

However, boundaries don’t just apply to client relationships. Healthy boundaries with employers, employees, and partners are also valuable. They help differentiate roles, define responsibilities, and set standards for your workplace.

Good boundaries are an important part of a healthy work-life balance. Without clear work boundaries, it may be easy for a clinician to:

Cover for an associate even when they are too busy for it
Take on more clients than they can realistically manage
Perform tasks that could be delegated to others
Miss out on personal or family obligations
Become too emotionally involved in coworkers’ lives

Too many demands with too few boundaries can create provider burnout. This has serious consequences that can ripple through your work and personal life.

What are good work boundaries?

Boundaries essentially define where you end and others begin. They can vary for different people and environments.

Some examples of boundaries at work include:

Strictly defining what tasks or results you are responsible for in your practice
Deciding how many projects or clients you can reasonably take on, and sticking to that limit
Creating standards for workplace behavior and employee relationships, such as physical contact or time spent together outside of the office
Defining what you and your coworkers owe to each other, such as keeping each other up-to-date on schedules or covering sick days
Setting standards for how you will manage after-hours work and communications

Your individual boundaries will depend on your personal needs and the type of work you do. Life is always changing, and that means that our boundaries may have to change, as well.

How do you start setting boundaries?

If you feel frustrated, exhausted, resentful, or guilty at work, that could indicate boundary violations. However, you may not be sure how to define those boundaries, or when they have been crossed.

Start with some self-reflection when you feel stressed, anxious, guilty, or resentful. Consider which people or situations may be involved in those feelings, and why. This can indicate where you need to make changes.

For example, if you feel resentful because you often cover for a partner who misses too much work, you may need to get better at saying no. If you’re exhausted because you are the only therapist at a practice, you may want to hire a partner or an assistant. If you feel guilty for not spending enough time with your family, consider setting rules for after-hours work.

It’s okay to ask for help with creating and managing boundaries. Discuss the issue with a manager or trusted coworker, or even your own therapist. They may have valuable input to help you create and protect boundaries.

If you struggle with boundaries and burnout, you’re not alone. Many behavioral health clinicians struggle to minimize frustrations at work while serving their clients and meeting their own personal needs.

At BestNotes, we believe that the right tools can help manage work-life balance without sacrificing professional standards. BestNotes EHR solutions were designed so you can run an efficient practice with better client results, higher revenue, and lower stress. Contact us today to take the next step in making your career even more satisfying!

date:  Sep 29, 2021
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Three Big Ways Virtual Reality Could Transform Mental Healthcare

When you think of virtual reality, what comes to mind?

Consumers may imagine interactive video games, or mind-bending movies like The Matrix. But healthcare professionals have been watching virtual reality (VR) move far beyond entertainment. In fact, the global healthcare VR market was $885.7 million in 2020, and is projected to grow to $11.7 billion in 2028.

What does that mean for behavioral health?

Here are three big ways that VR could help providers and clients.

1. Effective Trauma Treatment

Although the technology has advanced rapidly in the last decade, the use of VR for mental health is older than you may realize. Since the 1990s, the U.S. Veterans Affairs has been studying the use of VR to help treat combat veterans with post-traumatic stress disorder (PTSD). VR allows veterans to revisit disturbing memories under controlled conditions, with a therapist’s guidance.

VR serves as a type of prolonged exposure therapy. Research indicates that VR treatment could help with schizophrenia, dementia, PTSD, anxiety disorders, paranoia, delusions, and some phobias. It can be helpful in individuals who have not gotten satisfactory results with standard treatments, such as talk therapy or medications.

2. Substance Misuse Prevention

Many patients who experience severe pain, whether acute or chronic, only experience relief with strong opioid medications. However, the use of opioid painkillers carries the risk of misuse and dependence, creating additional problems for patients.

Researchers have been finding that VR could help with pain management instead. VR programs can help create environments that reduce anxiety before a procedure, or even provide a soothing distraction during a procedure. The Los Angeles-based company AppliedVR has developed an opioid-sparing treatment for chronic pain that incorporates elements of cognitive behavioral therapy.

3. Advancing Telehealth

After getting a big push forward during the COVID-19 pandemic, telehealth is not going anywhere. VR promises to keep the momentum going with new opportunities for remote mental healthcare.

Writing for the World Economic Forum, Poppy Brown of the University of Oxford notes that many types of VR-based therapy can be automated, allowing clients to receive guidance from a virtual coach. This removes the need for a human therapist to be physically present for every session. This can allow more people to access treatment, lower therapy cost, and reduce burdens for clinicians.

VR carries enormous potential for many behavioral health conditions. While the technology is still improving (physical issues like motion sickness can still be an issue), it can help create a controlled environment for clients receiving mental health treatment. Because of its relative novelty, and because not all VR software or programs have been thoroughly studied, both clinicians and consumers should use caution and good judgment when choosing to use VR in healthcare.

Staying on the cutting edge of behavioral healthcare is essential for keeping your practice valuable and effective. While we’re not in the VR business yet, BestNotes is committed to developing software that helps your practice function more efficiently, reducing the administrative burden for clinicians so they have more time to do what they do best.

Get in touch with us today to take the next step in a more profitable and less frustrating workflow!

date:  Sep 27, 2021
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Disordered Eating is Increasing, but There Are Plenty of Barriers to Treatment

As many Americans struggle with mental health, new reports show that eating disorders in particular increased in the last year. Unfortunately, many people are not getting the treatment they need.

Ongoing waiting lists and backlogs have delayed treatment for people with eating disorders. Because eating disorders often accompany other physical and mental health conditions, long-term success can be difficult to achieve. And finally, many experts are challenging the way that providers and the general public think about disordered eating and how to treat it.

Delays in getting eating disorder treatment

A report by nonprofit FAIR Health found that, from January to November 2020, eating disorders increased among individuals aged 13-18 years. (Download the PDF here.) This has created an increased demand for treatment that providers are scrambling to meet.

According to NPR, a nationwide network of 15 different hospitals have reported a doubling in average admissions for eating disorders in teens. In fact, health leaders in Milwaukee, Wis., have noted this has led to a backlog in services.

New patients may have to wait weeks or even months to be seen. Isolation and limited physical activity may have worsened preexisting depression. Disruption of routines and structure also make healthy habits difficult.

Eating disorders can be complicated to treat

According to the National Institutes of Health, eating disorders can increase the risk of medical issues and even mortality. In particular, anorexia nervosa is associated with the highest mortality rate of any mental health condition.

Eating disorders also can accompany other mental health conditions. Researchers reported in the Journal of Psychiatric Research that individuals diagnosed with an eating disorder are more likely to also have obsessive-compulsive disorder.

Besides finding an effective treatment, relapse is also an ongoing problem. A new study of adolescents with anorexia found that many of them can predict their future weight after discharge from an inpatient treatment program. Clients who expect to lose weight after discharge should receive more intensive aftercare, the researchers note.

Changing how we think of eating disorders

Eating disorders have long been thought of as a problem of the wealthy, especially among white females. However, research shows that disordered eating is also found at lower socioeconomic levels.

Writing in Eating Behaviors, researchers from the University of Minnesota found that women of lower socioeconomic status were more likely to show high body dissatisfaction and unhealthy weight control behaviors, such as skipping meals. Men of low economic status were more likely to engage in extreme behaviors, such as taking diet pills. However, differences between socioeconomic groups decreased with models that adjusted for race and body-mass index.

Michael Lowe, PhD, a professor in Drexel University’s College of Arts and Sciences, has been reevaluating how researchers and the public define dieting and view weight loss. He notes that the greater availability of food in wealthier nations goes against the body’s natural survival drive, making it difficult to control food intake.

Treating eating disorders is a complex, sensitive concern for you and your clients. The right EHR solution can help you track outcomes and make better treatment decisions, increasing your practice’s value.

BestNotes EHR software has been designed specifically for behavioral health providers and their clients, so you both get the results you deserve. Get in touch with us today to learn more.

date:  Sep 17, 2021
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Wellness for Behavioral Health Clinicians: Maintaining Healthy Boundaries

Working as a behavioral health clinician is rewarding but emotionally exhausting. This can lead to serious burnout, which can harm relationships, physical health, and the future of your career.

Practicing healthy boundaries is important for managing your career responsibilities. Here’s how to recognize and keep healthy boundaries with your behavioral health clients.

What do healthy boundaries look like?

In general, healthy boundaries between a clinician and client means that interactions only occur in the office (or facility), during scheduled times. The clinician is not emotionally involved with the client beyond normal, professional concern.

Perhaps most importantly, clinicians and clients should not have another type of relationship outside of therapeutic sessions (what is known as a “dual relationship”). Your client should not also be your accountant, family member, coworker, and so on.

This may be more challenging in less populated areas, or communities with fewer mental health professionals. You may unintentionally meet a client outside of sessions, such as at the grocery store. In that case, do not initiate a conversation. If you cannot avoid it, keep the interaction brief and professional, and avoid discussing anything that belongs in your scheduled sessions.

What are some examples of boundary violations?

Crossing boundaries can harm the therapeutic relationships, jeopardize your career, and put a client’s wellness at risk. Clinician boundary violations may include:

Interacting with a client on social media
Accepting gifts from a client
Forming a business, social, or sexual relationship with a client
Inappropriate physical touching
Revealing too much about yourself
Excessively long sessions
Lengthy or deliberate interactions with a client outside of therapy sessions

Different organizations, settings, and cultures may have different boundaries. For example, if a client is excessively afraid of flying, their therapist may accompany them on a flight as part of their exposure therapy. Child therapists may hug their clients or visit them in the hospital.

How do you maintain healthy boundaries?

Even if you understand what appropriate or inappropriate boundaries look like, they can be difficult to maintain. Here’s how to help you keep healthy boundaries:

Decide what you will and will not disclose about yourself to a client, and under what circumstances.
Set specific rules with clients and let them know what is and is not appropriate.
Practice speaking up for your boundaries. For example, if you have trouble keeping to your set session time, practice saying, “I’m sorry, but our time is up. We can schedule another session to continue this discussion.”
Get familiar with professional standards for boundaries, including state laws and licensing boards.
Do not give your clients access to your social media profiles. Set your profiles to private or restricted access.

You may struggle with boundaries in other ways, such as taking on too much work. Preserving healthy client boundaries can help you develop good habits in other areas of your life.

Behavioral health clinicians may struggle to prevent burnout while maintaining professional standards. At BestNotes, we believe that the right tools can help you do both.

BestNotes EHR solutions were designed with you in mind, so you can run an efficient practice with better client results, higher revenue, and lower stress. Contact us today to take the next step in making your career even more satisfying!

date:  Sep 14, 2021
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Opioid Lawsuit Payments, Health Inequities, and Other Florida Behavioral Health News

Are you a behavioral health provider operating in Florida? Here is a quick roundup of some of the mental health and substance use treatment news emerging from the Sunshine State.

Florida Receiving Funds in National Opioid Lawsuit

Florida will receive over $1.3 billion from pharmaceutical distributors AmerisourceBergen, Cardinal Health, and McKesson, in a national opioid lawsuit agreement reached in late July. Opioid manufacturer Johnson & Johnson will pay Florida $300 million over nine years.

Florida communities may join in the agreement within 150 days. After that, they could start receiving some of the funding next year. Localities in Florida have been working with the state attorney general’s office to draft a memorandum of understanding for how the money will be distributed.

New Florida Law Focuses on Health Disparities

Florida Gov. Ron Desantis recently signed into law HB-183, which is intended to improve healthcare for minorities and directs $4.4 million to the Office of Minority Health and Health Equity. Under the new law, the office will create county liaisons across Florida to improve local health issues.

Dr. Kyaien Conner, Associate Professor of mental health law and policy at the University of South Florida, helped create this new law. In her work in low-income, African-American areas, she says she saw lower rates of mental health treatment, driven partly by negative community attitudes toward seeking mental healthcare.

Self-Medicating a Problem for Opioid Epidemic

Mental health has gained more attention in recent years, especially during the COVID-19 pandemic. Unfortunately, many people struggling with mental health needs have been increasingly self-medicating, especially with opioids. Jaime Bridges, a clinical social worker with Orlando Health, notes that the use of fentanyl has become a major problem, even outside of the COVID-19 pandemic.

This month, the Orange County Drug Free Office launched a new initiative in response to increased opioid-related overdose emergency calls. Volunteers are offering toolkits that include nasal naloxone, sold under the brand name Narcan.

Charlotte County Introduces Interactive Health Dashboard

The Department of Health in Charlotte County (DOH-Charlotte) has launched an interactive dashboard that allows residents to access insightful health data. Designed by DOH-Charlotte and mySidewalk, the dashboard provides information about social and economic determinants of health. Public health experts hope this will help them better target specific community needs.

For example, dashboard data show that Charlotte County’s ratio of residents to mental health providers is 885 to 1, compared to a statewide rate of 622 to 1. This may indicate a need to bring more mental health resources into the county to help reduce that disparity.

Researchers Examine Whether Psychedelics Can Reduce Alcohol Consumption

Florida-based biotech company Psilera is working with University of South Florida (USF) researchers to research the possibility of using psychedelic derivatives to reduce alcohol consumption. The preclinical studies will conduct in-vivo screening of Psilera’s psychedelic-inspired new chemical entities. The study will also use the psilocybin compound mimic psilacetin, known as 4-AcO-DMT, which may reduce opioid and nicotine dependences.

Florida behavioral health organizations continue to address challenges related to substance misuse, underserved communities, and addressing social determinants of health. BestNotes’ EHR solutions are designed specifically for behavioral health practices, with customizable, easy to implement options for meeting these challenges.

We help make your organization run smoothly, reducing stress for your staff and improving your clients’ health outcomes. Contact us today to schedule your free demo.

date:  Sep 07, 2021
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