Author: Joseph Gerard

Why Acute Stabilization Isn’t Enough for Long-Term Recovery

Posted on by Joseph Gerard

Poor choices and bad coping can lead to addiction. Please also review AIHCP's Substance Abuse Counseling Certification

Written by Kazar Markaryan

I. Introduction

While acute stabilization is a sine qua non of modern recovery practices, it shouldn’t be the point where treatment ends. Stabilization secures medical safety, manages withdrawal, and provides immediate symptom relief; the clinical team’s goal is to reduce physical risk and restore basic functioning. After this phase, patients confront habits, triggers, relationships, and psychological structures that once supported substance use. Long-term recovery demands planning, consistent support, and skill development that continues far beyond the hospital. The answer to why acute stabilization isn’t enough shows us a clinical reality: short-term safety must connect with sustained care that treats cognition, emotion, and behavior within the context of real life. Evidence from multiple longitudinal studies shows that relapse risk remains high when aftercare is sporadic or completely absent. Ongoing therapy, monitoring, and structured community support greatly reduce readmission rates and improve social functioning. In the most literal sense, stabilization is the starting line of a lifelong course, not its finish.

A. Substitution and the Silent Shift

Addiction transfer is a not-so-rare clinical phenomenon in which one dependency replaces another. A person who stops drinking might begin to use prescription stimulants, or someone who quits opioids might start to develop compulsive spending or gambling behaviors. The underlying mechanism remains the same – seeking relief or stimulation. An escape through repetitive reward cycles. Preventing this from happening requires vigilance during treatment planning. A therapist can begin by identifying the conditions under which substitution behaviors arise: stress, loneliness, or boredom. The focus then moves to building tolerance for discomfort and developing new emotional regulation methods. One important element for long-term sobriety is the patient’s active role in noticing the early pull toward replacement behaviors. Recognizing patterns before they try to consolidate can allow clinicians to intervene early with behavioral or pharmacological supports. This is the reason why acute stabilization isn’t enough, but requires a more thorough approach.

B. Stabilization Treats Physiology First

Stabilization treats physiology first. We’re talking detoxification, medical management, and psychiatric monitoring, restoring the body to safety. Nurses and physicians work together to reduce acute withdrawal and to prevent seizures, dehydration, or cardiovascular complications. The patient receives medication to manage cravings and mood instability. For many, this marks the first full night of sleep in months. The brain begins to recover biochemical balance; thinking becomes clearer. Yet this clarity will expose emotional pain that had been numbed by substance use. Without follow-up care, the newly sober person faces this unmediated pain alone, and that’s not such a good thing.

C. The Goal of Stabilization

The goal of stabilization is not a lifetime of abstinence alone but readiness for therapy. Medical stability opens up a brief but crucial window, and that window must be used to align goals and engage motivation. Acute stabilization isn’t enough because it is only a short-term solution. The patient should understand treatment as a continuous process rather than a discrete, one-time event. The medical team’s role shifts from crisis control to capacity building. Discharge planning should begin during stabilization, not after it. Every hour spent preparing for continuity will increase the probability of sustained recovery.

II. Continuing Care and Its Limits

Research consistently demonstrates that continuity of care represents best practice, yet a large proportion of individuals fail to engage or maintain contact after discharge.

A. Continuity of Care and Engagement Challenges

Continuity of care represents best practice, yet a large proportion of individuals fail to engage or maintain contact after discharge. Some don’t attend the first follow-up session. Others start but drop out within weeks. And we’ve got a smaller portion that continues to use substances while attending outpatient care. One longitudinal study of post-acute programs reported that patients who had engaged in structured aftercare for more than 90 days had double the rate of long-term abstinence compared to those who didn’t. Still, the data has also revealed persistent difficulty maintaining engagement. These findings suggest that while the infrastructure for continued care exists, human behavior and external conditions often undermine participation.

B. Barriers That Block Ongoing Treatment

The barriers to follow-up can be both practical and psychological. Transportation, employment conflicts, childcare, and financial strain all limit attendance. Shame and fatigue play equal roles. A person leaving detox might feel cured because the body feels stronger, and the mind feels lighter. This false sense of completion can lead to avoidance of continued care. Addressing these barriers requires anticipatory guidance: clinicians have to talk about them before discharge. Transportation vouchers, telehealth sessions, flexible scheduling, and early motivational outreach are low-cost interventions that can change attendance rates dramatically. When these supports exist, dropout declines, and continuity improves.

C. Coordination Between Hospital and Outpatient Teams

Continuity is sustained through coordination. Hospitals and outpatient clinics have to communicate directly rather than hand patients a referral sheet. A practical discharge plan names providers, confirms appointments, and transmits medical records. Ideally, the patients leave with the next session already scheduled and transportation arranged. Medication continuity is equally essential. Interruptions in pharmacotherapy for opioid use disorder, for example, will probably trigger acute relapse within days. Coordination ensures dosage accuracy and prevents treatment gaps. When care fragments, the risk will rise.

D. Measurement and Monitoring as Tools for Retention

Programs that record attendance, toxicology results, and functional indicators can intervene quickly once the warning signs have appeared. Data-driven monitoring allows for personalized adjustment – more frequent visits during stress periods or medication adjustments in response to cravings. Routine outcome tracking will also create accountability across teams. It moves treatment from intuition to evidence. The habit of measurement embeds recovery in a transparent, observable framework that patients and clinicians can follow together.

III. Therapeutic Components Beyond Stabilization

Psychotherapy becomes the core of post-stabilization care. Cognitive-behavioral models train the brain to recognize distorted thinking and automatic reactions.

A. Psychotherapy as Core Post-Stabilization Work

Psychotherapy is key to long-term recovery. Clients learn to map their triggers, to identify the sequence leading to use, and to practice alternative responses. Behavioral rehearsal is essential. The brain rewires through repetition, not insight alone. A therapist might run through simulated scenarios – arguments, celebrations, boredom – and help the patient practice adaptive reactions. This is work done weekly, sometimes daily. The skills should replace old reflexes gradually; it can’t happen instantly. Over time, this structured practice builds confidence and autonomy.

B. Medication-Assisted Treatment and Biological Stability

For opioid, alcohol, or nicotine dependence, pharmacological aids help to reduce cravings and blunt reward sensitivity. These medications must be managed through long-term follow-up. Doctors monitor adherence and evaluate emotional side effects. Adjustments are common as the patient’s metabolism, stress, and environment change. When pharmacotherapy is combined with behavioral therapy, outcomes improve significantly. Stabilization without this ongoing medication support often leads to early relapse because underlying neurochemical imbalances remain uncorrected.

C. Social Support as a Living Buffer

Peer groups, therapy collectives, alumni programs, and family systems create accountability. Group formats normalize the struggle and reduce the feeling of isolation. Family sessions can rebuild trust and clarify roles. Stable housing programs offer predictable routines that reduce exposure to triggers. Employment support or vocational training adds meaning and daily structure. These practical conditions protect against the emptiness that often precedes relapse. The idea of why acute stabilization isn’t enough reappears here: detox can cleanse the body, but without reintegration into social systems, it can’t sustain psychological health. Programs that merge social support with ongoing therapy consistently produce better long-term outcomes and lower relapse rates.

D. Relapse Prevention as Maintenance Protocol

Relapse prevention functions as a maintenance protocol. Skills degrade without reinforcement. Scheduled booster sessions – monthly or quarterly – refresh coping mechanisms and reestablish connection. Clients are reminded that relapse is a process. Early detection often begins with subtle emotional shifts – irritation, secrecy, disconnection. Therapists teach awareness of these precursors. When these are addressed early, full relapse can often be completely avoided. Ongoing contact provides space to process slips without shame and to rebuild momentum quickly. The continuity itself becomes therapeutic.

IV. Systems and Policy That Sustain Recovery

Recovery exists within systems. When healthcare institutions create continuity between acute, outpatient, and community-based services, relapse rates go down.

A. Integrated Systems and Financial Coverage

Effective systems assign a case manager who remains involved from detox to stable housing. This person coordinates appointments, medications, and documentation. The patient sees recovery as a continuum rather than a series of separate programs. Financial coverage is another determinant. Insurance that reimburses only for acute care inadvertently encourages premature discharge. Policy must reflect the chronic nature of substance use disorders; it must be able to fund extended therapy, medication maintenance, and vocational rehabilitation. More weeks in structured treatment equal better long-term recovery rates.

B. Training and Data-Driven Improvement

Clinical training also shapes outcomes. Professionals trained in motivational techniques, trauma-informed care, and collaborative discharge planning increase patient retention. Motivational interviewing, for example, helps clinicians evoke intrinsic motivation instead of imposing compliance. When a counselor expresses genuine curiosity rather than control, patients stay longer in treatment. In addition, systems that collect and share outcome data can refine their programs iteratively. Learning from each discharge, successful or not, builds institutional knowledge. When systems track performance and adjust care paths, the standard of recovery rises across populations.

V. Conclusion

Clinical practice should redefine stabilization as the starting point, not the endpoint. The question of why acute stabilization isn’t enough arises wherever relapse data is analyzed.

A. Stabilization as the Starting Point

Short stays deliver safety but rarely deliver stability of identity or purpose. Long-term recovery requires layers of care – medical, psychological, and social – woven together with deliberate continuity. Extended treatment, active aftercare, and consistent community engagement translate to improved employment, health, and emotional regulation. Hospitals that link patients directly to outpatient services within one week of discharge witness markedly higher retention rates. Each contact – each session, call, or check-in – will extend the protective structure around recovery.

B. Systems Must Evolve to Reflect Evidence

Systems must evolve to reflect this evidence. Funding structures should reward continuity rather than crisis management. Clinicians should receive resources to track outcomes, conduct outreach, and coordinate with community programs. Recovery housing and vocational support should be viewed as treatment components, not optional add-ons. When these layers coexist, relapse declines and quality of life improves. Every year of sustained remission strengthens neural recovery and social stability. Society benefits as individuals return to productive roles, families regain cohesion, and communities experience fewer overdoses and hospitalizations.

Stabilization, though necessary, can never serve as the finish line. The process of healing extends into behavior, relationships, and environment. Long-term recovery grows in the space where structure, purpose, and connection meet. Understanding why acute stabilization isn’t enough invites clinicians, policymakers, and patients to build systems that reflect the real timeline of change – one measured not in days of detox, but in years of growth.

 

Author’s bio: Kazar Markaryan is the Chief Operations and Financial Officer at Tranquility Recovery Center in Sun Valley, California, where he oversees financial strategy, operations, and organizational growth. He believes real healing can begin only when people feel seen, supported, and ready to begin again.

References:

Baker, M. (2025, April 11). What Is Post-Acute Care and Why It’s Key to Recovery. Advantis Medical Staffing. https://advantismed.com/blog/what-is-post-acute-care

Leno, D. (2023, November 16). The Importance of Stabilization During Treatment | Malibu Wellness Ranch. Malibu Wellness Ranch. https://malibuwellnessranch.com/the-importance-of-stabilization-during-treatment/

Vogel, L. (2018). Acute care model of addiction treatment not enough for substance abuse. Canadian Medical Association Journal, 190(42), E1268–E1269. https://doi.org/10.1503/cmaj.109-5668

 

 

Please also review AIHCP’s Meditation Substance Abuse Counseling Certification and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

How to Counsel Male Patients on Multivitamins

Posted on by Joseph Gerard

Vitamin supplements can treat a deficiency within the body but should be started under the guidance of a healthcare professional or holistic and integrative healthcare specialist

Written by Emily Stokes. 

Men hoping for a boost in energy levels or a more robust immune system may be inclined to consider taking multivitamins. And especially as men age, the quest for improved health starts to become top of mind. If you’re a provider, you’ll want to be ready with accurate information to answer questions and help men make the right choice given their current health considerations, diet, and bloodwork. 

 

In this article, we’ll unpack the best practices you can use to counsel male patients as they weigh the benefits of adding multivitamins to their regimen. Ultimately, using simple and direct language is best to help patients make informed decisions. 

Screen Patients First

Whether you’re a primary care provider or a nutritionist, you’ll want to start your interaction with a male patient the same way. Begin with a screening where you gather information about their current diet, lifestyle habits, medications, and health priorities. 

You can ask your male patient to map out a normal day of eating. Are they consuming well-balanced meals and snacks? Are they adhering to a vegan diet or pursuing other types of unique nutritional choices? Ask about their alcohol intake, too, and inquire about smoking or vaping habits. When you have a clear picture of their nutritional habits, you’ll be able to identify lapses or fine-tune your suggestions. 

Ask whether your patient is taking medications, including both prescription and OTC drugs. Maybe they’re managing a chronic health condition or stress through medications, for example. And if they’re already taking specific vitamins, it’s important for you to know about those. Lastly, work to understand their goals with multivitamins. They may be eager to enhance energy levels or support their immune system. Make sure you write down all of their answers so you have them in your records. 

 

Consider Using Labs to Inform Guidance

A low-dose vitamin regimen is simple enough for most men to add to their diet. But labs can also be a useful resource when you’re trying to advise on multivitamin supplements. While labs might not be necessary for everyone, there are certain scenarios where they can make sense. 

Blood tests can involve comprehensive panels or specific tests targeting certain vitamins. In either case, tests can spot deficiencies and offer a better understanding of a patient’s nutritional status. For instance, labs might confirm suspected anemia by showing low iron levels and red blood cell counts. Or, if the initial interview with a patient indicated that they’re eating a poor diet, labs can reveal deficiencies of vitamin B12 or D. Labs also can make sense for individuals considering higher-dose regimens for iron or vitamin A. Similarly, older patients should have labs to help spot vitamin levels that could be adjusted. 

Ordering labs can establish a baseline against which providers can compare future results once a patient has started a multivitamin regimen. It’s wise to clarify to patients that vitamin deficiencies and surpluses both can be problematic. Over time, labs can offer a factual indication of whether adding multivitamins is a helpful decision. The benefits of taking multivitamins for men can be great, but it’s always good to check progress. 

 

Understand Your Patient’s Goals

Interacting effectively with patients is key to building a positive rapport and helping patients trust your guidance. Plan on prioritizing the patient by asking clear yet open-ended questions that encourage them to talk. Start by asking them to share what their goals are with adding a multivitamin to their diet. Confirm what they’re saying by repeating it to them before moving to follow-up questions. This step ensures that you fully grasp what they’re reporting to you. 

Some male patients may enter this conversation having done personal research on multivitamins. In other cases, they may have heard about multivitamins through conversations with a friend, but know very little about them. Use questions to figure out what your patient knows and thinks. And share honest, fact-based research to demonstrate the efficacy of multivitamins. While multivitamins don’t lower the risk of cancer or heart disease, they can help individuals with certain vitamin deficiencies or dietary issues. It can be helpful to create and practice a script prior to a patient’s appointment. For example, tell a patient your plan for them, given their existing condition, lab results, and other information. Then explain that you’ll follow up within a few months to see if the multivitamins are helping. 

 

Tailor Your Plan to the Patient’s Needs

Does your patient want to improve their immune system’s resiliency? Are they feeling tired and eager to increase their energy levels each day? Use your patient’s goals to help guide your advice. 

If a patient wants stronger immune support, inform them that multivitamins are only one small part of a care plan. Your patient will need to focus on rounding out their diet and getting more sleep to see real results. Further, if a patient wants to feel less fatigued, do bloodwork first to check for problems like low vitamin D or anemia, as well as thyroid issues. If lab results reveal a specific deficiency, it may be best to target it with a specific vitamin. 

Some patients may want to take multivitamins to manage prostate health. In those instances, it’s critical to help your patient understand that supplements with one ingredient can actually have a negative impact and won’t prevent prostate cancer. Some men may enter an appointment assuming any sort of supplement is good. Present research-based information and resources to back up your statements. Focus on helping patients set reasonable expectations for how multivitamins can play a role in their daily health.

 

Avoid Over-Supplementing

In general, providers can follow a few key guidelines when working with male patients to determine a multivitamin dosage plan. For starters, in most cases, it’s best to recommend low-dose multivitamins over more concentrated vitamins that contain only single nutrients. And help your patient steer clear of iron in their chosen multivitamins. While many women deal with iron deficiencies, it’s not as common a problem in men. If men have too much iron, they could suffer from gastrointestinal discomfort, like stomach pain or constipation. More severe problems like diabetes and organ damage are possible, as well. And does your patient smoke? Too much beta-carotenene in a multivitamin can contribute to a rising risk of lung cancer. 

Make sure your patient targets only high-quality vitamin brands, as well. Seals from USP or ConsumerLab add credibility, indicating that products have been verified by third-party testing. Vague or misleading labels should be avoided. Make sure to provide information about independent reviews or proper dosage, too. 

 

Offer Reasonable Dosing Suggestions

It’s not enough to simply recommend a type of multivitamin. Your patients will need clear advice regarding how often to take multivitamins and in what context. One of the best options for patients is a one-a-day formula. With these, patients will only need to remember to take a pill consistently each day.

Communicate specific instructions or drawbacks connected to different options. For instance, some multivitamins may need to be taken with food. Caution your patients that failing to do so could result in an upset stomach or poor nutrient absorption. Olive oil and other fats can help facilitate better absorption. And while gummies may sound more convenient to take, they can come with added sugar or a smaller list of nutrients. 

Older patients who require more specific nutrient quantities may be better off opting for tablets, capsules, or softgels. Additionally, advise patients currently taking other medications to space out their doses. Medications could impact absorption, and patients will need to be aware of potential drug interactions. Multivitamins with too much vitamin K or fish oil could contribute to bleeding if the patient is already on blood thinners, for instance. Calcium and iron can harm the effectiveness of some thyroid medications if taken too close to the medication dosage. Be sure to gather a comprehensive list of your patient’s medications to help determine their best path forward. And encourage your patient to go over dosage instructions with their pharmacist. 

 

Create Thorough Documentation and a Follow-Up Plan 

Ultimately, it’s wise to document everything when you’re working with patients and trying to address a problem. With proper documentation, it’s easier to determine whether a care plan is effective and where changes can be made. This documentation can be your point of departure as you look toward follow-up visits. 

Create a chart that outlines the patient’s current status, including their baseline labs and dietary practices. Write down the goals that they’re hoping to achieve, such as improved immunity or prostate health. Indicate that you’ve talked through potential risks that come with adding a multivitamin, including drug interactions, and provided them with educational handouts.

The chart also should include details like the name of the recommended multivitamin and its dosage. And indicate when the patient will have his next appointment. Six months or even a year can be a reasonable timeframe before meeting to reassess. You’ll help ensure compliance and audit standards, and ensure that you’re offering the best care possible when you commit to thorough documentation. 

 

Help Patients Make the Right Decisions

Counseling male patients effectively boils down to creating a detailed plan that considers their current health status, goals, and drug interactions. Begin with an interview and, in some cases, labs, to determine what their diet looks like and where the patient may have deficiencies. Explain what the best multivitamin options are for men and offer fact sheets from trusted sources to help guide their understanding. Caution your patient about drug interactions and dosages to help ensure a healthy integration of multivitamins into their lifestyle. And set up a follow-up appointment to check results. With a targeted, organized approach, you’ll help patients feel confident about their plan going forward.

 

Author’s Biography

Emily Stokes is a Midwest-based writer. Her writing explores a range of topics, including fine arts, real estate, and wellness practices. With experience in academic and blog writing, she can tailor her style to fit a variety of needs. 

 

Please also review AIHCP’s Meditation Holistic Nursing Certification and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Subtle Signs of Emerging Psychosis: Early Intervention for Better Outcomes

Posted on by Joseph Gerard

Counselor seeing a teen girl in crsis

Written by Michael J. Wilson,

Psychosis seldom begins with something dramatic. It starts in fragments. A person forgets small things, loses focus mid-conversation, or seems distant for reasons no one can name. You may not immediately see the crisis. Days pass. The change deepens. Knowing how to spot the signs of emerging psychosis can stop those quiet beginnings from turning into something far harder to treat.

When Stress Stops Explaining It

People get tired, anxious, or overwhelmed. That’s normal. What’s different here is how the feeling sticks. The person stays detached even after the stress fades. They stop finding joy in things that once relaxed them. You notice they answer slowly, or not at all. Maybe they stare through you. Something in their tone feels empty, like the emotion has gone missing.

It’s easy to think they just need sleep. Sometimes they do. But if each week feels stranger than the last, the change is more than stress. Early psychosis often hides inside what looks like ordinary fatigue. They may claim to be fine, though their voice lacks energy. The eyes move differently, darting away or lingering too long. You start doubting your own instincts, then realize something deeper is off.

Even daily routines begin to bend. They forget appointments, skip meals, or stay awake all night. The balance between effort and reward disappears. They may say work feels pointless or claim that time moves more slowly. Such vague but persistent feelings are often the first cracks in perception.

Emotion Begins to Shift

You might see sudden anger or quiet tears with no cause. A friend who used to joke now laughs at the wrong moments. Expressions feel mismatched. The reaction doesn’t fit the event. They might say they feel fine, yet their eyes show confusion. At dinner, conversation fades into silence. Small noises irritate them. Even familiar places start to feel foreign.

Withdrawal follows. Calls go unanswered, meals are skipped, and the room stays dark. Hygiene fades. At first, the family thinks it’s a phase. Then weeks pass, and energy keeps dropping. In this early stage, those emotional breaks and odd silences belong to the signs of emerging psychosis that clinicians warn about.

People close to them start adapting without noticing. They speak more slowly, avoid confrontation, and walk on eggshells. The house feels tense for reasons no one can explain. When fear enters the space, relationships strain. Yet beneath the unease is still the person you know — struggling to hold onto what feels real.

How Emotion Differs from Person to Person

Symptoms do not look identical. Men often have an earlier onset with more negative symptoms, while women may present later with more mood symptoms. Tailor observations to the person in front of you. Understanding these unique emotional experiences helps caregivers see past stereotypes.

Without this context, warning signs get mislabeled. The angry young man becomes “lazy.” The withdrawn woman becomes “too sensitive.” Both risk being ignored. Real understanding means listening to tone, rhythm, and expression, not just words.

Cultural expectations shape reactions, too. Some families discourage open emotion, so silence hides distress. Others interpret unusual experiences as spiritual events rather than mental symptoms. Awareness of these differences improves empathy and accuracy in care.

Thinking Feels Tangled

Thoughts no longer connect the same way. Someone begins to drift mid-sentence or jump from one idea to another. They might describe coincidences as fate or believe a comment on TV is meant for them. At first, it sounds harmless. Then it becomes the only thing they talk about.

It doesn’t always look chaotic. Sometimes it’s subtle signs — a slower pace, a puzzled pause, an answer that doesn’t quite match the question. Teachers notice disorganized writing. Coworkers see missed details. The thread of logic bends until it’s hard to follow.

They may begin writing notes to “remember clues” or deleting old posts online for reasons that make no sense to others. Conversations turn circular. Questions feel like traps. You sense they’re hiding something, but it’s confusion, not deceit.

The World Starts to Look Different

Perception begins to shift before clear hallucinations appear. You might hear someone say, “Did you call me?” when you didn’t. Or they glance behind them as if sensing movement: a shadow, a whisper, a flash — brief, uncertain, yet disturbing.

They may describe colors as sharper, sounds as layered, or time as stretched. These moments fade fast, but they leave fear behind. When they keep returning, the mind may be crossing a boundary between ordinary perception and altered reality. Catching these flickers early makes treatment simpler.

They often try to rationalize it. “Maybe I’m just tired,” they say. But their shoulders tense when a sound repeats, or they check windows before bed. The body reacts before the words admit it. These reactions are early protective instincts. They reveal fear where logic hasn’t yet caught up.

Words and Movements Give It Away

Speech becomes a window. Some people trail off; others repeat words or invent new ones. They might mumble to themselves or talk faster than usual. Small errors appear in grammar or tense, as though speech can’t keep up with thought.

Body language tells the same story. Their gestures may freeze mid-motion. Posture stiffens. Smiles appear at odd times. Eye contact feels either too sharp or missing entirely. None of this proves psychosis alone, but together it draws a clear outline.

When you observe closely, you see tension in stillness — the body bracing for something unseen. The person may start holding objects for comfort or pacing narrow spaces. These acts look meaningless but express a need for control. Psychosis begins where certainty ends.

Alt: a man with a serious expression

Caption: Changes in speech and body language, such as erratic gestures, tense posture, and odd eye contact, signal underlying psychosis, often reflecting a deep need for control and certainty.

Why It Happens More Easily for Some

Family history, unresolved trauma, and isolation each raise the risk. So does drug use, especially cannabis and hallucinogens. Sleep loss often sits at the center. Nights grow longer; the mind begins to blur. After several sleepless weeks, reality bends.

Genetics plays a role, but doesn’t decide fate. A person with family risk might never develop psychosis if their environment stays stable. Stress, poor diet, and sensory overload increase vulnerability. Even constant online stimulation can worsen detachment. The brain starts losing its natural rhythm, caught between wakefulness and dream.

These risks overlap. A teenager juggling pressure, grief, and insomnia stands closer to the edge than most realize. Recognizing that pattern early can prevent hospitalization later.

Acting Before It Escalates

When changes stay for more than a few weeks, act. Talk gently. Ask if things feel strange. Encourage medical evaluation instead of waiting for a crisis. Many hospitals and community clinics offer early psychosis programs focused on therapy, education, and stress control.

Keep a short record of daily behavior — sleep, appetite, mood, communication. Patterns show what a single day hides. Professionals use this information to decide if the symptoms fit an early psychotic phase or something else.

Medication isn’t always first. Therapy and support often come before that. Reducing stress, cutting drugs, and restoring rest can slow the process. Families that learn to stay calm during episodes of confusion often prevent escalation just by maintaining routine.

Why People Miss It

Families fear exaggerating. They wait. They hope. Some blame screens or hormones. Stigma keeps everyone silent. By the time they decide to act, the condition has grown.

The person themselves often denies it. They believe others are overreacting or conspiring. Trust breaks down. That’s why patience counts. Gentle conversation works better than confrontation. Consistency rebuilds a connection where logic cannot.

Communities can help too. Schools and workplaces that teach basic awareness encourage faster response. When more people know what early warning looks like, fewer cases slip through unnoticed.

Support That Truly Helps

The right network changes everything. Families can set routines, ensure rest, and help with appointments. Friends can offer company without judgment. Simple structure — meals at the same time, limited caffeine, quiet evenings — steadies the mind.

Peer support groups also help reduce fear. Talking with others who have lived through similar experiences shows recovery is possible. A supportive environment reduces relapse and improves long-term stability.

Therapists encourage creative expression through journaling, music, or gentle physical activity. These small outlets return a sense of control. Over time, they become tools for grounding and awareness. Healing works best when it restores trust in daily life.

Staying Watchful After Recovery

Early episodes often fade with treatment, but vigilance must remain. Keep monitoring mood, behavior, and sleep. A sudden change may signal relapse. Continued therapy, balanced routines, and honest communication are the strongest protection.

Recovery rarely means returning to the old normal. It builds a new one — steady, informed, and supported. Progress is quiet but real. Each small act of care helps maintain it. Over months, confidence returns. With enough support, the person rediscovers rhythm, laughter, and purpose.

The Final Takeaway

Psychosis doesn’t strike all at once. It whispers. You notice strange pauses, disconnected ideas, or emotions that no longer match the moment. Then it grows. Catching it early matters more than naming it perfectly. When you stay alert to the signs of emerging psychosis, you give recovery a head start. Early action saves health, trust, and hope. It restores balance before the mind fully loses it.

Aynsworth, C., Waite, F., Sargeant, S., Humpston, C. S., & Dudley, R. (2024). Visual hallucinations in psychosis: What do people actually see? Psychology and Psychotherapy: Theory, Research and Practice, 98(1), 58–73. https://doi.org/10.1111/papt.12553 ResearchGate

Cannon, T. D., Caspi, A., Moffitt, T. E., Harrington, H., Poulton, R., Murray, R. M., … & Houts, R. (2016). The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review. JAMA Psychiatry. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/1392281 JAMA Network

Miller, B. J., McGorry, P. D., Wyman, P. A., Yung, A. R., Addington, J., Cornblatt, B., … & McGorry, P. (2012). Prediction and prevention of psychosis in youth at clinical high risk. Annual Review of Clinical Psychology, 8, 269-289. https://doi.org/10.1146/annurev-clinpsy-032511-143146 Annual Reviews

Singh, S. P., Borgwardt, S., Fisher, H. L., Goikolea, J. M., Papageorgiou, K., … & McGorry, P. (2005). Early intervention in psychosis. The British Journal of Psychiatry, 187(s48), s14–s20. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/early-intervention-in-psychosis/86B99C54FAB96D7C53FB5480FF2AFE92

 

Author: Michael J. Wilson
With over 30 years of personal and professional experience in the addiction recovery field, Michael J. Wilson brings a deeply informed, compassionate, and family-centered approach to his work. As a recovery specialist, he focuses on bridging the gap between clinical knowledge and real-world understanding of mental health. His writing reflects both empathy and expertise, helping readers recognize early warning signs and find practical ways to support recovery.

 

Please also review AIHCP’s Crisis Intervention Certification programs and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

How to Build a Telehealth Nutrition Referral Pathway

Posted on by Joseph Gerard

Telehealth nurse working at a computerWritten by Jane Carter

Telehealth nutrition referral pathways enhance access to dietitians, enabling patients to make meaningful dietary changes without the need for in-person visits. By establishing an efficient workflow, care managers and clinicians can streamline referrals, enhance patient engagement, and support improved health outcomes.

From determining who qualifies for a referral to selecting the right virtual platform, each step requires careful consideration and planning.

Here’s a comprehensive overview of what’s involved. You’ll learn how to build a clear pathway that simplifies the process while maintaining high standards of care.

Establishing Screening Criteria for Nutrition Referrals

Screening ensures the right patients receive nutrition support. Start by identifying common health conditions that benefit from dietary intervention, such as diabetes, hypertension, or malnutrition. Use standardized screening tools like the Malnutrition Universal Screening Tool (MUST) to flag nutritional risk factors, particularly in high-risk patients.

Collaborate with clinicians to define referral thresholds. For example, should patients with a BMI above 30 automatically qualify, or only if they have coexisting conditions? Align criteria with evidence-based guidelines.

Incorporate these into electronic health record systems to automatically prompt referrals when specific conditions are met. This reduces guesswork and improves consistency across providers.

Finally, ensure all team members understand and apply these criteria uniformly. A simple decision tree or quick-reference guide can help everyone stay on track without delays in care.

This step not only saves time but also ensures patients most in need have access to virtual dietitian services promptly.

Simplifying the Patient Consent Process

Clear communication facilitates the process of obtaining patient consent. Begin by explaining how virtual dietitian referrals work, emphasizing privacy and convenience. Use simple language to reassure patients about secure platforms and confidential sessions.

Offer a brief, pre-written script for clinicians that outlines the benefits of nutrition counseling. For example: “A dietitian can provide personalized advice to help you manage your condition more effectively.”

Streamline paperwork by integrating digital consent forms into your referral system. Patients can review and sign electronically during their visit or through a secure patient portal.

For those who are less tech-savvy, keep printed versions on hand as backups; however, ensure that all forms are concise and free of legal jargon.

Following up with an email summary or FAQ sheet reinforces understanding while building trust in the process. These steps ensure smoother transitions to telehealth care without adding extra burdens for patients or staff members.

Selecting and Integrating a Telehealth Platform for Referrals

Select a platform that facilitates seamless referrals and integrates seamlessly with your existing workflows. Look for features like HIPAA compliance, secure messaging, video capabilities, and scheduling tools. Platforms such as Doxy.me or Zoom for Healthcare are commonly used in telehealth settings.

Ensure the system integrates smoothly with your electronic health records (EHR) to prevent data entry duplication. Integration enables providers to track referrals, view updates from dietitians, and streamline billing processes without needing to toggle between systems.

Involve IT staff early to set up connections securely while minimizing downtime during implementation. Training sessions can help clinicians feel confident in using the platform before it is widely launched.

Patient-friendly interfaces also matter, so test usability from their perspective by checking ease of access and compatibility across devices. This makes virtual visits convenient for all users while reducing missed appointments due to technical issues or confusion about how the platform works effectively.

Documentation Best Practices to Streamline Workflow

Accurate documentation is essential for effective nutrition referrals. Begin by standardizing templates within your EHR system to capture necessary details like the reason for referral, patient history, and desired outcomes. This ensures consistency across all cases. If you’re using a cloud-based EHR, this will be simpler.

Use dropdown menus or checkboxes for common conditions to save time during data entry. Free-text fields should only be used when a specific context is required.

Set up automatic notifications that inform care teams when dietitians complete initial assessments or follow-ups. This keeps everyone informed without extra manual tracking.

Document feedback from dietitians directly into the patient’s record instead of maintaining separate logs. Consolidating information prevents miscommunication and enables effective guidance of ongoing care decisions.

Regular audits can identify gaps in documentation processes, allowing for timely corrections while maintaining compliance with regulatory standards, such as HIPAA. A well-documented workflow not only supports continuity of care but also reduces unnecessary administrative burdens on staff members on a daily basis.

Evaluating Success in Nutrition Counseling

Outcome tracking measures the effectiveness of your referral pathway. Start by defining clear metrics, such as improvements in lab results (e.g., A1C levels for diabetes), changes in weight, or reductions in medication use. Include patient-reported outcomes, such as increased energy or improved meal planning skills.

Integrate these metrics into follow-up appointments and dietitian feedback reports to inform ongoing care. Use EHR systems to track progress over time, creating visual trends that clinicians can easily review.

Set specific timelines for reassessments. 30 days, 90 days, and six months post-referral are common benchmarks. These intervals provide insight into both short-term wins and long-term impact.

Patient satisfaction surveys provide an additional layer of valuable data. Ask patients about their experience with virtual sessions to refine the process further.

Tracking results doesn’t just measure success; it helps justify the value of telehealth nutrition services to stakeholders while ensuring continuous improvement in patient care delivery systems.

Collaboration Agreements with Virtual Dietitian Services

Partnering with reliable virtual dietitian providers ensures patients receive expert care. Start by researching services that specialize in your patient population, whether it’s chronic disease management or preventive care. Look for certifications, testimonials, and compliant platforms to ensure the quality of the service.

Draft collaboration agreements that detail the responsibilities of both parties. These should outline referral procedures, expected response times, documentation practices, and communication protocols between your team and the dietitians.

It’s now easy to find registered dietitians online which means patients can access help quickly when partnerships are well-structured. Offer flexibility while maintaining clear expectations about service standards.

Establish a feedback loop where providers regularly share progress reports on referred patients. This enhances continuity of care while identifying areas for adjustment in the partnership as needed.

Strong collaborations save time for clinicians and simplify transitions into telehealth nutrition support systems, benefiting everyone involved, from staff to patients themselves.

Educating Patients About the Benefits of Virtual Dietitians

Helping patients understand the value of virtual dietitian services encourages them to engage. Begin by addressing common questions during consultations, including what to expect, how sessions work, and why the approach is effective. Highlight convenience as a key advantage, as appointments can be conducted from home without the need for travel.

Use relatable examples to illustrate benefits. For instance: “A dietitian can help you adjust your meals for better blood sugar control or create easy meal plans based on foods you already enjoy.”

Provide patients with accessible materials, such as brochures or digital handouts, that outline the role of dietitians and share success stories from others with similar conditions.

Ensure staff are equipped with simple scripts to recommend referrals during routine visits confidently. Emphasize privacy protections for telehealth platforms.

Ongoing reminders through follow-up calls or patient portals reinforce education while boosting participation rates in nutrition counseling programs designed for long-term health improvements.

Addressing Common Barriers to Telehealth Referral Adoption

Patients and providers may face barriers when adopting telehealth referrals, but these can be resolved with practical solutions. For patients, concerns about technology or internet access are common. Offer step-by-step guides on using the platform, and consider scheduling a test session for those unfamiliar with virtual tools.

Language barriers also arise in diverse populations. Partner with services offering multilingual dietitians or provide translation support during sessions to ensure understanding.

For clinicians hesitant to adopt new workflows, offer hands-on training that demonstrates time-saving features of referral systems. Highlight examples of improved patient outcomes from other practices to build confidence and credibility.

Financial concerns, such as insurance coverage for telehealth nutrition, should also be addressed early by confirming reimbursements under state policies or federal regulations.

By anticipating these challenges upfront and implementing targeted strategies, both staff and patients will feel more confident embracing telehealth as part of their care journey.

Automating Referral Workflows for Greater Efficiency

Automation simplifies the referral process, saving time and reducing errors. Start by integrating your EHR system with telehealth platforms to enable automatic triggers for referrals based on pre-set criteria, such as lab results or flagged screening tools.

Set up referral templates within your software to standardize information shared with dietitians. This ensures that every referral includes key details, such as patient history, current medications, and goals.

Automated appointment reminders sent via email or text help patients stay engaged while minimizing missed sessions. Select systems that track scheduling status, allowing staff to monitor progress without requiring manual follow-ups.

Workflow dashboards give care managers a real-time overview of pending referrals and outcomes at a glance. Use these to identify bottlenecks quickly and make data-driven adjustments. Also consider how AI can enhance this aspect of your operations, and consider adopting it as part of your wider patient portal.

By leveraging automation in daily operations, clinics streamline communication between teams while enhancing efficiency in delivering telehealth nutrition services that are consistent and reliable.

The Bottom Line

Building a telehealth nutrition referral pathway ensures patients receive accessible, personalized dietary care that fits into their routines. Thoughtful planning at each stage, from screening to outcome tracking, creates a seamless process.

When supported by automation, collaboration agreements, and patient education, these workflows become efficient and impactful. Both clinicians and patients benefit from the streamlined experience.

Investing time upfront to design an effective pathway improves long-term outcomes for your practice while empowering patients to take control of their health.

Author Bio

Jane Carter is a healthcare writer specializing in telehealth innovation and patient-centered care strategies. With over a decade of experience in health communications, she focuses on creating practical resources that help clinicians improve access to nutrition and wellness services.

 

Please also review AIHCP’s Health Care Life Coach Certification and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

How Case Managers Coordinate OTP Care

Posted on by Joseph Gerard

Bottle of pills left open

Written by Jackson KM

Opioid abuse. Opioid overdose. Opioid addiction. You may have come across these terms a couple of dozen times if you’re a healthcare professional. That’s especially if you keep close tabs on industry news.

A real crisis continues to unfold, not only in the US, where over 130 people die every day from opioid-related overdoses, but also around the world. The scale is huge. Research from the UNODC and CDC shows more than 16 million people globally suffer from opioid use disorder—over two million in the US alone as of 2021.

Coordinating care for this group is complex work for case managers. They guide referrals to treatment programs that fit each person’s needs and situation. They bridge gaps when resources or access fall short. They also track recovery through sometimes messy setbacks or relapses.

Staying organized helps, but there’s more to it than keeping tidy notes or making reminder calls. There are critical checkpoints. Decisions need context. Every patient story adds nuance.

Let’s break down how case managers actually coordinate comprehensive care—step by step—and what details make all the difference.

Understanding the Basics of OTP Care: An Overview

OTP here is not to be confused with Outpatient Therapeutic Programs, which focus on caring for malnutrition-affected children in communities.

Many patients struggling with opioid use disorder find their path to recovery shaped by more than medication. Easy access, clear expectations, and a strong support system can mean the difference between staying in treatment and falling through the cracks and relapse.

Reliable opioid treatment programs deliver structured daily dosing for medications like methadone or buprenorphine, combined with counseling and regular monitoring. Intake starts with medical screenings and a review of prior substance use history.

Each patient must also meet strict federal qualifying criteria before getting started. For those new to this area, you can reference an overview that spells out these criteria. It should at the very least detail medication choices and explain intake steps on day one, ensuring your approach fits real needs right away.

Key Medications Used in Treatment

Managing opioid use disorder requires more than just willpower or support groups. Medication plays a central role for most patients. The right drug reduces cravings. It curbs withdrawal and helps the brain recover stability.

Some medications act like opioids themselves but with controlled, safe dosing to prevent the rush that leads to addiction. These are called agonists. Others work by blocking opioid receptors entirely so that if a patient uses again, the drug has little effect. These are known as antagonists.

Understanding these options matters because each path offers distinct benefits and challenges depending on a patient’s history and current needs.

When you break it down, some major medications include:

Methadone

A full opioid agonist, methadone is perhaps the most popular of its kind. It binds to brain receptors much like heroin or prescription painkillers, but in a managed way. With careful daily dosing and close supervision, it prevents withdrawal symptoms and significantly reduces cravings.

Buprenorphine

Buprenorphine, a partial agonist, works by attaching to opioid receptors too, but produces milder effects than full opioids. It lowers the risk of overdose and can be prescribed in outpatient settings, making it a flexible choice for many patients.

Naltrexone

Unlike the others, this one is an antagonist. Naltrexone blocks opioid receptors completely, stopping any high from opioids. It works best for patients who are already detoxed and can be taken as a daily pill or a monthly injection.

Navigating Patient Intake and Screening Tools

Upon receiving an opioid use disorder referral, case managers know the next steps shape everything that follows. Every patient starts with a confidential interview covering:

  • Drug history,
  • Mental health background,
  • Social factors,
  • And previous treatments.

Standardized screening tools help sort out substance severity and other health concerns quickly. Many clinics rely on assessments like the Clinical Opiate Withdrawal Scale or the ASAM Criteria for medical necessity.

These details matter for more than paperwork. Accurate intake sets expectations for care planning. Moreover, solid documentation guides medication choice and determines what extra supports might be needed along the way.

Addressing Eligibility and Certification Checks

Proper certification stands as a non-negotiable in this field. Federal and state rules tightly govern who can offer opioid treatment services, so verification is more than a box to tick. Case managers thus review licensure, DEA numbers, and program status before any referrals proceed.

Eligibility for patients involves checking:

  • Recent opioid use history,
  • Age requirements,
  • Pregnancy status,
  • Previous treatment attempts,
  • And other medical considerations.

A clear understanding of these criteria ensures only qualified individuals receive care while programs stay compliant with all regulations.

Methadone versus Buprenorphine: Choosing a Path

While on treatment for opioid addiction, some patients need daily supervision to stay safe. Others manage better with more independence.

Methadone requires visits to specialized clinics for monitored dosing, often each day at first. Buprenorphine can be prescribed in primary care or mental health offices, sometimes allowing take-home use.

There are also additional factors case managers should consider, like:

  • Substance severity
  • Past relapses
  • Medical history
  • Patient preference.

All help guide which medication path best supports sustained recovery.

Handling Legal and Consent Requirements under 42 CFR Part 2

Protecting patient privacy is central when managing opioid treatment. Federal law—specifically 42 CFR Part 2—strictly controls how and when substance use records can be shared, even among healthcare providers.

Patients must sign detailed consent forms before information leaves the clinic. Any unauthorized disclosure of substance use disorder (SUD) information could trigger severe penalties for both staff and organizations.

Case managers stay up to date with legal standards, always confirming that documentation meets regulatory expectations before releasing any details about a patient’s care or history.

Overcoming Common Barriers: Transportation, Cost, and Stigma

OTP patients often face a myriad of challenges beyond cravings and withdrawal.

For instance, getting to daily clinic visits can be tough without reliable transportation. Treatment costs may put care out of reach for those with tight budgets or no insurance. Stigma around opioid use adds another layer of difficulty… sometimes discouraging people from even seeking help.

Case managers connect clients with ride services, funding programs, or supportive community networks to reduce these obstacles so recovery stays possible.

Supporting Special Populations: Pregnant Patients, Veterans, Low-Income Groups

Complex social and medical needs shape how care is delivered for certain groups in opioid treatment. Addressing barriers goes beyond standard protocols and requires coordination with specialized services that support better outcomes.

Pregnant Patients:

Care teams must balance fetal health and maternal stability. Methadone is often preferred due to established safety records, while regular monitoring helps catch complications early for both mother and child.

Veterans:

Veterans face high rates of chronic pain or mental health issues from service-related experiences. Case managers partner with VA resources for trauma-informed counseling, alternative therapies, and housing support when needed.

Low-Income Groups:

Limited insurance coverage means more obstacles to paying for medication or transportation. Programs offering sliding-scale fees, public transit vouchers, or community grants bridge access gaps so cost does not block essential care.

Tracking Progress with Practical Follow-Up Metrics

No one wants to simply refer a struggling patient out and call it a day. That’s not good practice or compassionate care. Ongoing support makes all the difference in long-term outcomes.

Case managers use several strategies to stay involved:

  • Scheduled check-ins: Regular phone calls, clinic visits, or video sessions track medication adherence as well as personal challenges.
  • Monitoring relapse risk: Urine screens and self-reported data flag setbacks early so interventions happen before full relapse.
  • Adjusting support plans: What if someone’s circumstances change, like housing loss or perhaps a new mental health diagnosis? With follow-up, plans can shift quickly to keep recovery stable without missing a beat.

Besides building trust, such an approach helps prevent people from falling through cracks as they navigate treatment.

Building Community Resource Connections for Lasting Recovery

Care extends well past the clinic walls. Recovery happens in everyday settings—at work, at home, and in community spaces where support systems matter most.

Case managers develop partnerships with local organizations to connect patients with opportunities like:

  • Job training,
  • Housing programs,
  • Food assistance,
  • Childcare resources,
  • And more.

The goal is stability that reinforces clinical progress made during treatment.

When people lose access to these supports, relapse risks climb fast.

Collaboration with social workers or peer mentors keeps care personalized and ongoing. These links also give case managers insight into a patient’s day-to-day realities outside formal healthcare settings. And, real-time feedback helps spot gaps early and prevent disruptions before they threaten recovery progress.

Practical partnerships create safety nets so patients have backup when challenges come up—a necessary piece of any comprehensive opioid use disorder care plan focused on lasting change.

Staying Adaptive in a Changing Opioid Treatment Landscape

Case managers now face shifting rules, changing patient needs, and an expanding menu of therapies every year. Building new skills, learning local resources, and connecting with fellow professionals never loses relevance. What worked yesterday might not serve tomorrow’s patients.

A flexible approach is essential for effective care. As our understanding deepens and best practices evolve, one thing is for sure. Continued focus on coordinated opioid treatment keeps the door open to better outcomes for everyone involved—patients, providers, and communities alike.

References:

  1. Wang, S., He, Y., & Huang, Y. (2025). Global, regional, and national trends and burden of opioid use disorder in individuals aged 15 years and above: 1990 to 2021 and projections to 2040. Epidemiology and Psychiatric Sciences, 34, Article e32. https://doi.org/10.1017/S2045796025100085
  2. Health Resources and Services Administration. (n.d.). Opioid crisis. https://www.hrsa.gov/opioids
  3. Centers for Disease Control and Prevention. (n.d.). About opioid use during pregnancy. https://www.cdc.gov/opioid-use-during-pregnancy/about/index.html
  4. Dydyk, A., Jain, N., & Gupta, M. (2024). Opioid use disorder: Evaluation and management. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553166/
  5. Wesson, D. R., & Ling, W. (2003). The clinical opiate withdrawal scale (COWS). Journal of Psychoactive Drugs, 35(2), 253-259. https://nida.nih.gov/sites/default/files/ClinicalOpiateWithdrawalScale.pdf

 

Author Bio:

Jackson KM is a passionate writer and former microbiologist who contributes to numerous health publications. With a deep love for sharing healthcare inspiration, he blends scientific insight with engaging storytelling to empower readers and spark curiosity whenever the opportunity arises.

 

Please also review AIHCP’s Case Management Certification program and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

8 Provider Tips for Safer Cannabis Conversations

Posted on by Joseph Gerard

I am relieved to tell you everything is okay. a confident mature male doctor consulting with a patient inside of his office during the day

Written by Elissa Capelle Vaughn,

As the evolving outlook on cannabis continues to shape conversations on the topic, how do clinicians approach the subject of cannabis safety for patients? 

Creating a safe and educational space for these crucial discussions is critical to patient care. Medical professionals need a comprehensive tool set, from screening tools like questionnaires to education on product labeling, to ensure patient conversations are effective and focused on safe management of alternative treatments and harm reduction.

 

1. Strategies for Screening and Assessments for Cannabis Safety

The more information clinicians and nurses have, the more effective the patient communication process will be. Before asking about cannabis use specifically, you should have the patient’s medical history available. This history may include both physical and mental conditions, as well as any current medications. 

Clinicians must use validated screening tools when asking questions. A consistent, evidence-based framework is needed to accurately identify signs of problematic use, which may prompt necessary conversations for intervention.

 

2. How to Ask Questions

When inquiring about cannabis use, ensure questions are relevant to the patient’s location and medical history. 

For example, if a patient lives in a location where recreational cannabis is legal, asking whether they use “street drugs” wouldn’t yield a relevant answer. The patient would most likely say “no” since they’re less likely to view their cannabis use in this way.

Instead, you would ask if they use recreational or medical cannabis; this question accurately reflects the legal and social landscape of the patient’s location. Framing the question this way opens the door to a more substantive conversation between clinician and patient. 

The next set of questions can focus on cannabis use itself, including the amount, frequency, type, and preferred methods of use. 

In addition to patients’ medical histories and cannabis use habits, it’s important to understand the distinction between various strains. For example, reviewing this article on cannabis types and strains can help medical professionals develop more specific questions that yield valuable information relevant to patient health.

 

3. Cannabis Use Screening Tests

If you want to ascertain marijuana abuse patterns in patients, you can run a Cannabis Abuse Screening Test, also known as a CAST test. 

This screening test identifies use patterns that can (or have) resulted in possible negative impacts on social, mental, and physical wellness. CAST tests can be effective when screening cannabis use in adolescents and young adults, providing necessary information for intervention planning. 

Identifying potential cannabis abuse patterns is critical for an age group with ongoing development of the prefrontal cortex.

The Cannabis Use Disorders Identification Test-Revised, or the CUDIT-R, is a multi-item screening tool for adults that assesses cannabis use disorder. A CUDIT-R test produces a score; if that score meets or is higher than a certain threshold, there may be a need for more in-depth screening. 

Additional screening may be necessary to understand the impact of cannabis use on a patient’s health. Conducting a Timeline Followback (TLFB) test can reveal more insight into cannabis consumption patterns. A TLFB is a calendar-based screening method that better visualizes (and quantifies) frequency, including the amount consumed, during specific time frames.

 

4. Risk Assessments for Interactions and Comorbidities

The next set of inquiries can reveal a deeper understanding of the impact of a patient’s cannabis use on current medications, both OTC and prescribed. The assessment should also be relevant to any pre-existing conditions the patient may have. This information is vital to preventing any adverse reactions. 

The cannabinoids in Cannabis, THC and CBD, can potentially impact the effectiveness of patient medication or trigger side effects. Interactions may occur if both cannabis and medication are metabolized by the same cytochrome P450 (CYP450) enzyme system. 

At this stage of the assessment, gather information about possible high-risk combinations and counsel patients if necessary. For example, patients who have prescriptions for sedative-hypnotics like benzodiazepines should be aware of the risks of cannabis use. Possible side effects may include: 

  • Depression of the central nervous system 
  • Heightened risk of impairment
  • Dizziness
  • Heightened risk of falls or accidents 

Include questions about anticoagulants in your risk assessment. Patients who take blood thinners should be aware of the impact cannabinoids can have on their prescription drugs’ metabolism. Interaction could potentially affect the potency, increasing the risk of bleeding. 

Patients taking prescription medications for a cardiovascular disease should know that cannabis can temporarily increase heart rate and blood pressure. Additional physiological stress from cannabis could also potentially increase the risk of a cardiac event.

Psychiatric disorders, including anxiety, comorbid mood disorder, and any known psychiatric disorders, should be assessed for risk during a cannabis use screening. The THC in cannabis can potentially intensify symptoms of these, even heightening the risk of psychosis.

 

5. Harm Reduction Strategies for Cannabis Use 

The harm reduction approach requires clinicians to take a more compassionate and realistic angle. When it comes to discussing the risks of cannabis use, meeting patients where they are can make a positive difference, especially when it comes to discussing strategies for minimizing or ceasing cannabis use. 

Harm reduction is about reducing any adverse impacts on patients. Clinicians, especially those in the alternative treatment space, can discuss safe cannabis consumption through a harm reduction lens. 

For example, advising a patient to start with low doses of cannabis at a slower frequency can lower the risk of potential side effects. This advice should be tailored toward specific use; medical-grade edibles, for instance, have a delayed onset for several hours, producing stronger effects which can heighten side effects like anxiety, rapid heart rate, or dizziness. 

An assessment may lead to a recommendation about a consumption method. For example, a patient with documented respiratory issues should be advised to switch from smoking medical cannabis to consuming it as an edible in gummy form.

It’s important to warn patients against using any kind of synthetic cannabinoids on the market. 

 

6. Product Safety

Regardless of assessment results, all patients should be advised never to drive a car or operate any kind of machinery while under the influence of cannabis. Safety discussions should also extend to best practices for purchasing; for example, patients should only buy products that are regulated and tested for safe consumption.

 

7. Safe Consumption Advice for Specific Populations

Since the impact of cannabis use varies across age groups, conversations on harm reduction and safe consumption must be tailored to address the unique variables of different segments. 

For example, when addressing cannabis use in adolescents and young adults, patients must understand that their brains are still developing. Therefore, continued use can impact learning, memory recall, and mental health, such as anxiety.

It’s essential to adopt an empathetic tone with this age group and all segments. However, since this age bracket is particularly vulnerable to the adverse effects of cannabis use on brain development, creating a non-judgmental space where young patients feel comfortable discussing the roots of their cannabis use can pave the way toward harm reduction strategies. 

Use visual aids to convey the science behind THC and how it can interfere with the brain development of adolescents. Highlight studies and statistics about the increased risk of mental health challenges (and even addiction) later in life.

The success of these conversations relies on trust. Assure patients of the confidentiality of these assessments. 

Adults of all ages must also be aware of the risks of cannabis use, especially as metabolism changes with age. There are also age-related health issues to consider. For example, older adults who are taking medical cannabis, or considering it, should be counseled on fall risks; this is an opportunity for a safe consumption conversation, especially if an older adult is taking cannabis or CBD for pain. 

The harm reduction approach may also advocate the use of cannabis products with low THC levels and higher CBD content. THC is the psychoactive compound, while CBD can help manage issues with sleep disturbances or pain management. CBD products carry much lower risks for side effects.   

 

8. Product Labels 

As a clinician, you also assume the role of educator. Therefore, a complete cannabis use screening should include education on cannabis product labeling and marketing. These conversations may involve clarifying the differences in consumption methods, including how long the effects last. When describing CBD topicals, you could explain how the product provides localized relief for joint pain without the psychoactive effects of THC. 

Always focus on real data when counseling patients. Use visual aids to discuss what product label data means. For example, the percentage of THC and CBD is a critical data point to discuss; this data helps patients understand the potency of the product. This discussion can help guide patients toward safer products with higher CBD percentages versus THC. 

Follow up with patients and update assessments accordingly with new information as it arises. 

 

Incorporate Cannabis Safety Conversations Into Your Methodology

Remember to prioritize harm reduction, safe consumption, risk assessments, and proper education in your cannabis use screenings moving forward. Leverage all available (and valid) cannabis use tests, including CAST, CUDIT-R, and TLFB, to determine intervention strategies, especially for adolescent patients. Integrate engaging visual aids and practice empathy to empower patients to regulate (or even lower) their consumption, opening the door to a healthier future.

 

Author bio:

Elissa Capelle Vaughn is a New York-based content writer who covers trending topics in health and wellness. She also brings a diverse background in sales and marketing to her work when discussing communication strategies in the health field.

 

Please also review AIHCP’s Holistic Nursing Certification program and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Supporting clients with homesickness: a guide for counselors Recognizing homesickness 

Posted on by Joseph Gerard

Stressed and homesick Asian woman.

By Evelyn Leed,

Homesickness is a common human experience, yet in a clinical setting, its impact can be profound and complex. It’s more than just a feeling of longing for one’s home – rather, homesickness is an emotional state typically triggered by the perceived or actual separation from a familiar environment, attachments, and routines. It often involves a preoccupation with home-related thoughts and a sense of anxiety and distress about the new, unfamiliar surroundings.

At its core, homesickness is often a grief response. Clients are grieving the loss of their support systems, their sense of identity tied to their previous environment, and the comfort of predictability. This psychological distress can present itself in numerous ways, such as:

  • Intrusive thoughts: A persistent focus on what is being missed.
  • Negative feelings: Sadness, anxiety, loneliness, and irritability.
  • Behavioral changes: Social withdrawal, lack of motivation, and changes in eating or sleeping patterns.

Your client may have experienced their homesickness being dismissed as a transient phase. Despite their best efforts to navigate the emotions themselves, it can further manifest as a significant stressor contributing to anxiety, depression, and social withdrawal. 

So, for counselors, recognizing and addressing homesickness is a crucial aspect of providing holistic support, particularly for clients navigating major life transitions such as studying abroad, relocating for work, or immigrating. 

 

Approaches for client support

By applying empathetic and structured approaches, counselors can effectively guide clients through the distress of homesickness. What methods you choose to use will be tailored to your approach and relationship with the client, but the following can all be helpful to further supplement your work.

Normalizing

The first step is to assure the client that their feelings are normal and valid. You can explain that homesickness is a common response to a major life change and recommend that they frame it not as a weakness, but as a sign of their capacity for strong attachment. For example, you may say things like: “It makes sense that you feel this way. It shows how much your home and the people there mean to you.”

By providing information about why they may feel this way, it can help them understand and manage their symptoms more effectively.

CBT techniques 

You may find clients struggle with many negative feelings and put themselves down – by saying things like “I’ll never make friends here”, for example. Cognitive Behavioral Therapy (CBT) is highly effective for addressing the negative thought patterns associated with homesickness. 

Your role as a counselor is to help clients identify and challenge automatic negative thoughts. Referring to the example of making friends, you could explore evidence to the contrary or reframing it to “making new friends takes time, and I can take small steps to meet people.” Through cognitive restructuring, your aim should be to help them to examine the evidence for and against their belief, consider alternative explanations, and reframe the thought into a more balanced and realistic perspective.

Maintain a connection to home

Technology allows for constant connection, but this can sometimes hinder adjustment, so it’s about finding a healthy balance. Work with your client to create a connection schedule. Instead of constant, sporadic contact that highlights their absence, encourage them to schedule specific, meaningful calls. This allows them to be more present in their new environment between calls and gives them something to look forward to.

Something which may come up is the impact of social media. One of the challenges is that it often creates a distorted and idealized view of life, showcasing highlight reels that can leave individuals feeling as though they are missing out on something important. Counselors need to delve into strategies for managing social media use more mindfully, such as setting time limits, curating feeds to include uplifting or realistic content, and taking regular breaks to focus on the present moment.

Steps to integration

A common negative thought around homesickness is the sentiment that “everything was better back home.” This can be challenged by encouraging clients to acknowledge both the positives of their past and the potential opportunities in their present, thereby fostering a more nuanced view.

Using an “both/and” approach, acknowledge that they can both cherish their home and build a meaningful life here. Encourage them to explore ways to integrate parts of their old life into the new one. This could involve cooking a familiar meal, finding a community of people from their home region, or sharing their culture with new friends.

Grounding techniques

When feelings of anxiety or sadness become overwhelming, grounding techniques can help clients stay in the present moment. By teaching them certain methods, you can provide them with a toolkit of what to do when you’re not around. This could include:

  • The 5-4-3-2-1 technique (naming five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste). It’s a powerful one to pull a client out of a spiral of homesick thoughts and back into their immediate surroundings.
  • Deep breathing techniques like box breathing (inhale for 4, hold for 4, exhale for 4, hold for 4) or diaphragmatic breathing, focusing on expanding the belly with each inhale and contracting it with each exhale.
  • Body scans, where you encourage your client to mentally scan their body, noticing any tension or relaxation, starting from their toes up to their head. The goal is simply to observe without judgment, connecting them to their physical presence in the moment, creating relaxation.

By applying these empathetic and structured approaches, counselors can provide crucial support and effectively guide clients through the emotional distress of homesickness. This process of supporting them through the transition does more than just address their immediate discomfort; it also empowers them. By learning to navigate these feelings, clients not only find the strength to overcome their current challenges but also build a foundation of resilience that will serve them well in future life changes and transitions.

 

Author bio 

Evelyn Leed is a mental health specialist dedicated to guiding individuals through significant life transitions. Evelyn is passionate about empowering her clients to navigate change effectively, helping them build resilience and coping strategies needed to adapt and thrive. Her work is centered on providing compassionate, practical support that fosters lasting personal growth.

 

 

Please also review AIHCP’s Stress Management Consulting CE courses and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Creating an Assessment On Caffeine Use for ADHD Patient Evaluations

Posted on by Joseph Gerard

table full of coffee cups full of coffeeWritten by Elissa Capelle Vaughn

Assessing a patient’s caffeine intake is a vital part of any health assessment. While a cup of coffee is part of a normal morning routine, it’s still a natural chemical stimulant that impacts a patient’s central nervous system. However, for patients with Attention-Deficit/Hyperactivity Disorder, also known as ADHD, coffee may go beyond the typical morning pick-me-up. 

Patients with ADHD who regularly manage symptoms like hyperactivity, impulsive thoughts or actions, and attention issues may use coffee or other caffeinated beverages to manage these core symptoms. While caffeine may assist some patients in managing these symptoms, especially focus, it can also have a paradoxical effect on ADHD itself, including heightened anxiety or irritability, which can worsen attention.   

Clinicians and nurses need a proper structure for effectively assessing caffeine use in patients that includes questions and patient counseling on the effects of caffeine, including possible risks for ADHD symptoms.  

Here are several points to consider when developing a caffeine use health assessment for patients with ADHD. 

 

Inquiring About Caffeine Sources and Consumption 

A complete caffeine use questionnaire for patients with ADHD should start with a thorough discussion on caffeine use itself, primarily, the daily amount consumed, and sources of caffeine. Asking focused questions on caffeine habits will allow medical professionals to better identify areas where more education on ADHD response to caffeine is needed, especially when it comes to potential risks for core symptoms. 

For example, a discussion on daily caffeine intake should start by asking a patient about the amount of caffeinated beverages they consume daily. The next questions should target the sources of that caffeine, including coffee, energy drinks, tea, and so forth. Answers should also include any over-the-counter (OTC) supplements that contain caffeine. 

The objective of these questions is to establish the patient’s total daily caffeine intake. If a patient is not aware of the adverse effects of too much caffeine on their ADHD symptoms, understanding their daily intake can help them make necessary modifications. Patients who take prescribed medication for their ADHD diagnosis must understand the potential risks of consuming too much caffeine. 

Your next question should inquire about the timing of the patient’s caffeine use. Caffeine can remain in a patient’s body for several hours. Since up to 70% of ADHD patients may experience insomnia, according to Frontiers in Psychology, inquiring about the last cup of coffee of the day can prompt further discussion about sleep quality and ADHD. If left unaddressed, patients with ADHD may experience increased fatigue. 

 

Assessing Energy Drink Consumption

Inquiring about caffeine sources is critical since some beverages contain considerably more caffeine than others. 

For example, one can of a popular energy drink can contain over 200 milligrams of caffeine, in addition to increased levels of sugars and other stimulants like ginseng or guarana. This question is particularly important for assessing the health of younger patients with ADHD, especially adolescents to young adults in their 20s.  

These types of beverages can increase the risk of anxiety and even cardiovascular issues like heart palpitations. Consuming them in large quantities is particularly concerning. 

 

Tiredness and Caffeine Use

It’s not uncommon for a caffeine stimulant to cause tiredness. This reaction is an example of a paradoxical effect. 

Tiredness may also be due to sudden fatigue once the caffeine wears off. Caffeine blocks the adenosine receptors that promote sleep, but those levels rise as caffeine levels dip. 

The next question should assess how long it takes a patient to fall asleep. These answers can provide more clarity about the effect of caffeine consumption on sleep quality. This would be a good opportunity to educate patients about ADHD comorbidities like sleep disturbances. 

Caffeine use can cause blood sugar levels to rise temporarily before leading to a “crash.” This cycle can lead to an increased feeling of fatigue. 

Answers to these questions can help medical professionals gain more insight into a patient’s sleep troubles, opening the door to discussions on caffeine moderation for ADHD management. 

ADHD patients who consume more caffeine per day may develop a tolerance, causing more symptoms of withdrawal, as well as dehydration, since caffeine is a diuretic. Increased tiredness, headaches, and irritability from withdrawals also contribute to tiredness. 

Asking patients specifically about the frequency of withdrawal symptoms, like headaches and irritability, can provide more information on caffeine dependence. Asking a patient whether they’ve tried to cut back on caffeine or quit altogether is also crucial information. These answers help clinicians provide safer and more effective recommendations for caffeine decreases.

 

Caffeine Use and Anxiety

The next set of questions should focus on the relationship between caffeine and anxiety. Questions should assess for the following symptoms: 

  • Anxiety
  • Restlessness
  • Racing heart
  • Jitteriness

If patients are experiencing these symptoms after consuming caffeine, over-caffeination may be the cause. Too much caffeine can cause overstimulation, worsening ADHD symptoms. Assessing this information correctly can prevent misdiagnosis of other conditions or the possible prescribing of unneeded medications.

 

Caffeine and Medication Use  

Next, screening protocols should establish if patients are currently taking any prescription medication. Patients diagnosed with ADHD may be prescribed a type of stimulant-based medication for their diagnosis. The next question should ask about any caffeine-related symptoms while taking medication concurrently.  

For patients with ADHD, caffeine and medication may increase the risk of paradoxical symptoms like insomnia. Patients may experience an increase in anxiety or elevated heart rates. Determining whether there’s a combined impact can help medical professionals recommend changes to caffeine intake or ADHD medication schedules.

 

Listening to Patients

Once an assessment is complete, there will be enough information to shift to caffeine use education and collaborative strategies between clinicians and patients. This process starts by asking about the patient’s perspective on caffeine use. Empathy is key. If tapering or quitting caffeine is highly recommended, a patient with ADHD may feel differently if they feel caffeine genuinely helps them manage core symptoms like focus.  

This process is all about informing. Clinicians should validate patients’ positive experiences with caffeine. This validation is necessary for building trust, which is a foundation for receptiveness. 

It’s a good opportunity to discuss how caffeine works, including how it can temporarily improve focus by increasing alertness. Using visuals can help patients understand how caffeine blocks the adenosine neurotransmitter that promotes better sleep and relaxation; this illustration can give patients more insight into their sleep troubles, which may encourage them to accept advice on healthy caffeine tapering. 

Some patients may note a reduction in their ADHD-related hyperactivity (and fidgeting) after consuming caffeine. This calming effect is likely due to a temporary release of dopamine and norepinephrine. Individuals with ADHD may have lower levels of these neurotransmitters. Therefore, they may perceive caffeine use as essential to regulating brain activity.

Memory may also come up in these patient conversations. 

For example, a study cited by Johns Hopkins University noted that caffeine could have a positive impact on working memory. Such findings can tie into patients’ feelings of a cognitive boost after caffeine consumption. Clinicians should validate such studies in discussions, should they come up. Referencing studies is another opportunity to illustrate how caffeine blocks certain neurotransmitters to heighten alertness temporarily.   

 

Discussing the Potential Risks of Caffeine for ADHD

After establishing trust with patients, the next stage is to discuss the potential risks of caffeine use. For example, clinicians should take this time to illustrate connections between caffeine-related overstimulation and an increase in anxiety and agitation in patients with ADHD. Patients can better understand how caffeine may be negatively impacting them. 

Patients who’ve described an increase in impulsivity can better connect their caffeine use to these increases. Clinicians can describe how caffeine enhances the brain’s natural “reward” system through dopamine increases. This effect can lead to an increase in ADHD-related impulsivity as the brain naturally seeks stimulation and gratification. 

If a patient made a note earlier about nervousness, jitters, migraines, and even stomach problems, medical professionals can further elaborate on these issues as side effects of high caffeine intake. Such symptoms can interfere with daily activities.

One of the most critical risks to discuss with patients is the co-use of prescription medication for ADHD, especially if it’s a stimulant, and caffeinated beverages. Clinicians must explain to patients that this combination can trigger symptoms related to over-medication, including: 

These symptoms can negatively impact the effectiveness of a prescribed ADHD treatment.

 

Making Recommendations

After assessing a patient’s caffeine use, listening to their perspectives, and discussing possible risks, the next conversation should focus on recommendations. This should be a collaborative process, focusing on informed decision-making.  

One recommendation is to keep a log of caffeine intake, similar to food allergy logs. Patients are encouraged to start fresh, logging their first dose of caffeine or their first cup of coffee of the day. The amount of caffeine should be logged in milligrams. After consuming caffeine, patients should document how they feel. 

Being mindful of how caffeine affects the body can encourage patients to decrease their intake naturally and avoid over-caffeination. 

 

Moving Forward

Ultimately, the goal of these ADHD caffeine assessments is to empower patients to make smart choices about their ADHD diagnosis and overall health. Physicians and nurses are in a position to make a profound difference in the lives of patients with ADHD. Developing detailed caffeine use assessments is part of a holistic approach to managing ADHD on all fronts, from clinical interventions to wellness-focused strategies.   

Author bio:

Elissa Capelle Vaughn is a New York-based content writer who covers trending topics in health and wellness. She also brings a diverse background in sales and marketing to her work when discussing communication strategies in the health field.

 

Please also review AIHCP’s Attention Deficit Counseling Certification programs and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Trauma in Teens: How Parents Can Recognize It and Help Their Kids Heal

Posted on by Joseph Gerard

sad teenager sitting alone clip art

Written by Kim Hobbs.

Teens can hide their pain well. That makes it likely for parents to miss red flags in their child. Maybe you think the mood swings are just teenage angst. Or maybe you assume quietness is them being shy. But sometimes, these are signs of trauma. When they go through something dark, it’s vital to be present.

Sure, your teen might seem fine. But trauma can be hiding underneath. They need guidance. And that starts at home with their parents. You are their gateway to healing.

In this guide, we’ll uncover what teen trauma looks like, why it matters, and how parents can respond with care.

Common Reasons for Trauma in Teens

Teenagers face more than just schoolwork and friendship issues. Sometimes, they go through experiences that shake them to their core. Trauma when you’re that young can come in many forms. That includes things like:

  • Abuse in relationships: Teens can, unfortunately, experience trauma from bad relationships. Many times, it happens within the family. It can also occur in their romantic relationships. Abuse can be physical, like being hit. Unwanted touching is another form of physical abuse. Sometimes, it can be emotional. Verbal abuse can break down their confidence. Gaslighting can make them doubt themselves.
  • Bullies: Bullying at school is a reality many teens face. Most of the time, it happens face-to-face at school. But it can also happen online through cyberbullying. School then becomes anxiety-inducing instead of a place for learning.
  • A grave loss: Teens aren’t always equipped to handle grief. Losing a parent or a close friend can trigger a profound sadness in them. Facing loss can get in the way of their daily routines. It’s always too much for a young person to go through.
  • Natural disasters: Events like floods, tornadoes, or wildfires can make teens feel powerless. Trauma after natural disasters destroys their sense of safety. Sure, they may escape physical harm. But losing their home is deeply unsettling. Teens may struggle with anxiety after the event.

Why Trauma Hits Teens Differently

Trauma hits teens hard because their emotions are still developing. That’s why when bad things happen, they don’t know how to act. Trauma can negatively affect young people’s mental health. That’s alarming, considering depression is already prevalent in teens. 

One in seven adolescents globally experiences mental health issues. Coupled with trauma, these challenges can get more intense. It makes anxiety harder to manage. It ends up putting extra strain on their well-being.

There’s also the subject of identity formation. Teens are still figuring out who they are. Social pressures shape their identity. So does the approval of friends. Trauma can distort these experiences. As a result, it can make them question their worth.

Teens also haven’t had years to develop coping strategies after getting hurt. They may not know how to process it. Without guidance, fear becomes overwhelming. It can lead to risky behaviors. That’s why parental support is so crucial.

Warning Signs of Trauma Parents Shouldn’t Ignore

Teens don’t always tell you when something is wrong. But trauma shows up through little clues. Pay attention to your teens. That way, you can step in right away if you see any of these warning signs.

Sudden Mood Swings

Trauma can make emotions feel more intense. Your teen may go from happy to irritable in minutes. Small things can trigger big reactions. This isn’t just sheer moodiness. It’s the stress of trauma showing up mentally.

Help your teen manage their anger by staying calm. Avoid reacting with anger, too. Don’t scold them for their “attitude.” Instead, validate their feelings. Say, “I see you’re upset. I’m here.” Ask why they feel that way. Soon, they’ll feel safe to open up.

Withdrawing from Family and Friends

Withdrawal from people is one of the many early signs of mental health issues. And in many cases, it stems from trauma. Teens facing a dark time may feel misunderstood. So, they’ll skip hangouts. They won’t take phone calls. They may spend long hours alone instead.

Gently check in without pressure. Invite them to small activities at home. Even a quick snack in the kitchen together is enough. Let them know you’ve noticed. Asking to spend time with them in little ways shows them that you care.

Reckless Behavior

Trauma can lead to impulsive decisions. You may notice your teen sneaking out more. Maybe they don’t respect house rules anymore. They could even use risky behaviors to cope. That can include substance abuse, which is very serious.

If you’ve noticed these behaviors, talk to them. Don’t aggressively confront them, though. Sit them down and chat. Talk openly about the risks of their actions. But keep in mind not to shame them. Set clear boundaries. 

Encourage them to manage stress in healthier ways. Introduce them to enjoyable hobbies. Consider journaling or yoga. These coping outlets are much safer and more effective than risky behaviors. They’re great for helping your teen regain control of their emotions.

Strong Startle Responses

Going through something traumatic can leave the nervous system on high alert. Your teen might jump at loud noises. They may flinch at touch. It’s like they’re constantly bracing for danger. That’s because their bodies are stuck in “fight or flight” mode.

Don’t make them feel like they’re overreacting. Keep a calm environment at home. If their anxiety gets worse, practice grounding techniques together. Deep breathing is a great option for this.

They Don’t Talk About Their Feelings

Teens might avoid discussions about sadness. When asked how they are, they might say, “I’m fine.” But if they shut everyone out, it’s not good.

Trauma can make feelings scary. So, teens might shove those emotions down. This is called emotional bypassing. It’s a way to protect themselves from pain.

As a parent, stay patient and present. Give them space to open up. However, don’t pressure them. Check in regularly, even with small questions. If they share how they feel, validate them. 

If they’re not ready, encourage expression in other ways. Writing and art are great for young people to express their emotions without talking about the hard stuff right away. Over time, the trust will grow. And they’ll start sharing more.

How Parents Can Help Teens Dealing with Trauma

Helping a teen through trauma can be overwhelming. You might feel helpless as a parent. But don’t just give up. Try various ways to get them to open up. If they trust you, you can guide them toward healing. Here are several ways to make them feel safe again.

Listen More Than You Talk

Traumatized teens often carry heavy thoughts. Oftentimes, they don’t know how to express these out loud. Talking over them can make them shut down even more. So, listen to them intently. Give them a space to feel heard.

When they share how they feel, make eye contact. Nod gently to show them you’re actively listening. Hold their hand when they’re getting emotional as they speak. The goal is to make them feel validated. It builds trust. So, over time, your teen can open up more.

Create a Safe, Calm Home Environment

When dealing with trauma, teens become hyper-aware of stress. A tense home adds to that anxiety. Make sure your home environment is calm. That way, they’ll always feel safe at home, never on edge.

Have quiet spaces in the house for rest. Don’t fight with your spouse in front of the kids. Little things like these can help struggling teens regulate emotions better. Soon, stress decreases. It reinforces that home is a safe space, not a source of pressure.

Emphasize That Speaking Up Matters

Teens may hide abuse for fear of retaliation. Your job is to make sure their fear doesn’t win. They need to know it’s okay to voice their concerns. Remind them that it’s okay to tell you anything, even if it’s scary. Tell them you’ll always be on their side. Showing no judgment. That way, they might feel safer opening up to you.

Talk to them about stories where speaking out made a difference. For instance, the McLean County Juvenile Center sexual abuse lawsuit in Illinois might be difficult to talk about. But it shows how speaking up against abuse can protect them and others. It tells them that speaking up can prevent future harm.

Connect Them With Professional Help

There are many reasons why teens need therapy. Struggling after a traumatic experience is one of them. Trauma affects mental health in ways parents can’t always fix. So, sometimes, professional guidance is the way to go.

Schedule therapy sessions for your teen. Group therapy is also a great idea if they’re not comfortable with one-on-one conversations yet. Here, they’ll learn healthy coping strategies. They’ll also have a safe space to share their feelings. These professionals are trained to make them feel understood.

Encourage Healthy Coping Habits

Introduce your teen to healthy habits. Choose ones that can help them cope with negative feelings. Suggest things like exercise and meditation. Journaling and painting are also fantastic options for creative teens. 

Make the activities fun. Try to make them social, too. That way, they meet new friends. This allows them to stay engaged, not just cooped up in their room.

These activities help your teen release built-up tension inside. It also lets them process emotions safely without turning to reckless behavior. It boosts their mood. It increases their confidence. Over time, they’ll learn how to handle stress better. 

Conclusion

Small steps can make a huge difference when your teen is struggling with trauma. By noticing subtle cues, you can create a safe space for your teen. Trauma doesn’t always show itself clearly. But a caring presence always helps.

So, create a calm home for your struggling teen. Listen intently when they share their feelings. Encourage coping habits they’ll enjoy. Remind them they’re never alone in their journey. When you do, you’ll notice small changes. There’s less tension in them. Their trust in you will grow. And one day, they’ll feel confident in themselves again.

Healing trauma in teens is possible. You just have to be there to support them. Make them feel safe. With your love to ground them, they will find their light again.

Author Bio

Ms. Kim Hobbs is an accomplished writer, storyteller, and creative thinker whose passion for the written word has captivated readers worldwide. With a keen eye for detail and a gift for weaving compelling narratives, Kim explores themes of resilience, transformation, and the human experience.

 

Please also review AIHCP’s Crisis Intervention Certification programs and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

How Cleaning Protocols Influence Patient Safety and Accreditation Metrics

Posted on by Joseph Gerard

clean hospital room and bedsWritten by Veronica Turner.

Not too long ago, the idea that doctors had to wash their hands in between patients was absurd. It took trailblazers such as Ignaz Semmelweis to realize the existence of germs and understand the effects of pathogens. Thanks to them, hygiene, which includes thorough handwashing, is now a fundamental, non-negotiable standard for healthcare providers worldwide.

Modern healthcare units today have well-established cleaning procedures whose efficacy is reviewed periodically by accrediting organizations (like The Joint Commission) and enforced by regulators like the Centers for Medicare & Medicaid Services (CMS).

Such organizations use adherence to these protocols and infection prevention outcomes as key factors in their scoring systems. This means that, besides patient safety, a lapse in environmental hygiene can affect an organization’s financial health and accreditation status. 

In this article, we investigate how scientific evidence connects environmental cleaning to infection prevention, how monitoring systems enhance compliance, and the way in which these activities have a direct effect on accreditation metrics and reimbursement models.

Cleaning Protocols and Patient Safety

There is overwhelming evidence of the association between environmental cleaning and patient safety in the literature. Studies have confirmed that high-touch surfaces, such as sink and nurse call buttons, can be a source of pathogens such as Clostridioides difficile (C. difficile), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE).

Without proper cleaning protocols, only about 48% of high-touch surfaces situated near patients are cleaned correctly, according to a multi-hospital study. This shows that gaps in routine protocols directly contribute to pathogen persistence and the risk of onward transmission. It’s also the reason why healthcare-associated infections (HAIs) are one of the greatest hospital and long-term care facility risks and a factor leading to increased hospitalizations, increased cost of treatment, and additional mortality.

The Results of Proper Cleaning Protocols

Based on results from randomized controlled trials, we know that comprehensive cleaning schemes can prevent infection. A comprehensive cleaning scheme usually combines the latest disinfectant strategies, advanced technologies, and proper training to kill a broad spectrum of pathogens on various surfaces.

For example, in a trial (the BETR study), rooms that were cleaned using ultraviolet-C (UV-C) adjunct disinfection were associated with a 11% decrease in patient acquisition of target organisms. That meant fewer C. difficile and VRE infections hospitalwide. Additional clinical studies support that thorough terminal cleaning, especially in rooms previously housing infected patients, can reduce surface contamination by approximately 99%.

Many healthcare workers and even patients still remember the recent COVID-19 outbreak and the chaos it ensued. It was also a time for patients and healthcare workers to understand just how important cleaning can be. Sadly, the lack of well-established cleaning standards and monitoring systems led to numerous avoidable deaths.

Cleaning Protocols and Their Impact on Accreditation Metrics

Healthcare units everywhere should consider the existence and implementation of proper cleaning protocols as a part of their standard of care. In the U.S, organizations are somewhat forced to do this because their procedures are in plain view and open to scrutiny.

All patients have the right to fill in a standardized patient satisfaction survey after they’ve been treated in a hospital or clinic. The most important ones (that are also reported to authorities) are: 

  • HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems): available at the national level, and collects information on what patients think of the care they received during treatment.
  • CAHPS (Consumer Assessment of Healthcare Providers and Systems): a collection of surveys that allow patients to grade their experience in different healthcare scenarios, like hospitals, home healthcare, and specialty providers.

In addition to patient surveys, U.S. healthcare organizations are judged based on the Hospital-Acquired Infection (HAI) rates. The HAI rate represents the frequency with which patients develop an infection while receiving care for another condition. This infection must not be present in the patient or incubating at the time of admission. High HAI rates signal a problem with the quality and safety of care in that unit.

In short, cleaning protocols are a direct and effective method for improving patient outcomes and boosting a unit’s accreditation and safety ratings.

The Role of Monitoring and Auditing

Healthcare units need consistent monitoring to maintain effective cleaning practices. U.S. hospital data demonstrate that audit-and-feedback programs can increase cleaning effectiveness from less than half of surfaces cleaned (~47%) to more than 80% within months. 

Monitoring also encourages behavioral changes in hospital or clinic staff. When it’s clear that the organization keeps track of cleaning performance and brings up the topic during staff training, you create accountability mechanisms that are hard to ignore.

The methods used also have an impact on efficiency. Medical cleaning personnel are more likely to use easy-to-implement interventions that provide accurate, immediate feedback, such as fluorescent gel markers and adenosine triphosphate (ATP).

For example, fluorescent gel is the go-to in many units because of its ease of use. Cleaning services staff apply the gel to surfaces before cleaning, then shine a UV light on the surface to check for any glowing residue. If it glows, the surface is not entirely clean or thoroughly disinfected. 

The Financial Impact of Accreditation Metrics

Due to rules established by accredited bodies, there is a direct connection between Hospital-Acquired Condition (HAC) rates and institutional performance, accreditation, and reimbursement structures. This is also a way to encourage healthcare organizations to prioritize the safety of their patients and staff.

For example, the CMS established the HAC Reduction Program, which penalizes hospitals that fall into the worst-performing quartile based on their Total HAC Score. These organizations face a 1% reduction in Medicare payments. It may not sound like much, but it can amount to millions of dollars for large organizations. 

Another regulating body is the Joint Commission International (JCI), which evaluates and accredits more than 20,000 healthcare organizations in the United States and internationally. This agency considers infection control and cleaning protocols when evaluating performance.

The JCI “Gold Seal of Approval” is a strong indicator that a hospital or clinic is committed to patient safety and best practices. If an on-site inspection finds deficiencies in environmental cleaning, that organization could lose accreditation and face public scrutiny. 

Lastly, hospital-acquired conditions themselves are a financial burden, costing hospitals and clinics billions every year. Meanwhile, the cost of housekeeping and environmental services is between 3 and 6 million per hospital per year, on average (excluding extremely specialized infection control beyond normal protocols). 

In short, it’s more affordable to have proper cleaning protocols than to take shortcuts and gamble your patients’ safety and the organization’s reputation and accreditation.

How to Operationalize High-Quality Cleaning Protocols

Well-designed, high-quality cleaning protocols use a strategic, multifaceted approach that integrates staff training, modern technology, and a commitment to quality assurance.

Staff Training and Competency

Every healthcare unit needs an on-site environmental services team. These professionals are the first line of defense against HAIs and HACs and a cornerstone of a safe patient environment.

They must be well-trained in basic areas such as:

  • Scientific Principles: how pathogens are transmitted and why specific disinfectants are effective against certain microbes.
  • Protocol Adherence: Detailed, hands-on instruction on proper cleaning techniques for different surfaces and areas, including the correct sequence of cleaning to avoid cross-contamination.
  • Safety and PPE: Proper use of Personal Protective Equipment (PPE) to protect both the worker and the patient.

Each healthcare unit must have a regular training schedule (e.g., once every three months) and a competency assessment system to ensure that staff maintain their skills and stay current with new best practices. Cleaning protocol training is not a one-and-done kind of thing. 

Technology and Innovation

Technology can make cleaning protocols more effective and efficient while reducing human error. It also makes the job safer and easier for cleaning staff, benefiting everyone involved in the process.

Here are a few examples of how modern technologies transform medical cleaning:

  • UV-C light disinfection (UV-C robots): These are automated systems that use ultraviolet light to destroy the DNA of germs, rendering them unable to replicate. They’re fast and can disinfect entire rooms, including hard-to-reach areas, in minutes.
  • Electrostatic Sprayers: This technology applies a positive charge to disinfectant droplets, causing them to cling to negatively charged surfaces. This ensures a more even and thorough coverage of complex and irregularly shaped objects like bed rails and medical equipment.
  • Monitoring and Verification Systems: As discussed earlier, systems like adenosine triphosphate (ATP) testing and fluorescent markers provide objective, data-driven feedback on cleaning effectiveness.

Commercial Cleaning Services

Healthcare organizations tend to partner with specialized providers of healthcare facilities cleaning, even if there’s an in-house team that handles routine daily tasks. Commercial services can provide access to a highly trained workforce, advanced technology, expertise in complex regulatory standards, and additional labor for specific needs.

For example, after a patient with an infectious disease is discharged, a commercial service can perform a deep, comprehensive terminal clean using advanced techniques and equipment to ensure the room is completely decontaminated.

Commercial services are also trained and certified to handle the cleanup and disposal of biohazardous materials, a task that requires specific protocols and a high level of expertise. 

In Conclusion

As we’ve proven, cleaning protocols are central to patient safety, accreditation, and financial sustainability. Evidence shows that thorough, audited cleaning reduces infections, protects vulnerable patients, and safeguards hospitals from penalties and reputational damage. 

Author Bio: Veronica Turner is a health and lifestyle writer with over 10 years of experience. She creates compelling content on nutrition, fitness, mental health, and overall wellness.

 

References

Weber, David J. et al. Role of hospital surfaces in the transmission of emerging health care-associated pathogens: Norovirus, Clostridium difficile, and Acinetobacter species, American Journal of Infection Control, Volume 38, Issue 5, S25 – S33, https://www.ajicjournal.org/article/S0196-6553(10)00408-6/fulltext 

Verhougstraete, M., Cooksey, E., Walker, J., Wilson, A. M., Lewis, M. S., Yoder, A., Elizondo-Craig, G., Almoslem, M., Forysiak, E., & Weir, M. H. (2024). Impact of terminal cleaning in rooms previously occupied by patients with healthcare-associated infections. PLoS ONE, 19(7), e0305083. https://doi.org/10.1371/journal.pone.0305083 

Carling, P. C., Parry, M. M., Rupp, M. E., Po, J. L., Dick, B., & Von Beheren, S. (2008). Improving cleaning of the environment surrounding patients in 36 acute care hospitals. Infection Control and Hospital Epidemiology, 29(11), 1035–1041. https://doi.org/10.1086/591940 

Anderson, D. J., Moehring, R. W., Weber, D. J., Lewis, S. S., Chen, L. F., Schwab, J. C., Becherer, P., Blocker, M., Triplett, P. F., Knelson, L. P., Lokhnygina, Y., Rutala, W. A., Sexton, D. J., & CDC Prevention Epicenters Program (2018). Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover design (BETR Disinfection). The Lancet. Infectious diseases, 18(8), 845–853. https://doi.org/10.1016/S1473-3099(18)30278-0 

Izadi, N., Etemad, K., Mehrabi, Y., Eshrati, B., & Hashemi Nazari, S. S. (2021). The Standardization of Hospital-Acquired Infection Rates Using Prediction Models in Iran: Observational Study of National Nosocomial Infection Registry Data. JMIR public health and surveillance, 7(12), e33296. https://doi.org/10.2196/33296 

Centers for Medicare & Medicaid Services (2025). Hospital-Acquired Condition (HAC) Reduction Program: Scoring Methodology. ttps://www.cms.gov/files/document/fy-2026-hac-reduction-program-methodology-infographic-updated-08/04/2025.pdf 

Haag, C., Archulet, K., RN, & Chau, A. (2024, November 7). Closing the gap: Maximizing the potential of UV-C technology to reduce Health Care-Associated infections. Infection Control Today. https://www.infectioncontroltoday.com/view/closing-gap-maximizing-potential-uv-c-technology-reduce-health-care-associated-infections 

Environmental cleaning procedures. (2024, March 19). Healthcare-Associated Infections (HAIs). https://www.cdc.gov/healthcare-associated-infections/hcp/cleaning-global/procedures.html 

Gastaldi, S. et al. (2025). Tools and strategies for monitoring hospital environmental hygiene services. Journal of Hospital Infection, Volume 159, 52 – 61. https://doi.org/10.1016/j.jhin.2025.01.011. 

Please also review AIHCP’s Certification programs and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification