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

Autism and Grief in Children Video Blog

Posted on by Mark Moran

Autism manifests grief in different ways.  With so much diversity within the spectrum, it is important for Grief Counselors and other caregivers to understand how Autistic children grieve and respond to loss.  This video presents a detailed response to helping autistic children with loss and grief

Please also review AIHCP’s Grief Counseling Program as well as its Grief Diversity Counseling program

 

Stress Management and Understanding Panic Attacks

Posted on by Mark Moran

I. Introduction

Panic attacks are indeed a notable mental health worry, marked by abrupt and powerful bursts of fear. Often, these episodes bring along physical symptoms, like a racing heart and breathlessness. This issue has been getting more and more notice in psychology and psychiatry circles, leading to some rethinking of how we classify them. The DSM, or Diagnostic and Statistical Manual of Mental Disorders, has traditionally sorted panic disorders using set criteria. However, recent talks suggest it’s time to look at these setups again, aiming to better reflect how intricate panic experiences can be (Bracha et al., 2006). Besides, different models, like the complex network approach, give us helpful looks into how panic attack symptoms link together. They highlight the need to see these episodes as part of a bigger network, not just isolated events (Curtiss et al., 2016). Getting a grip on these dynamics is super important for creating helpful therapeutic methods, with the end goal of boosting mental health results for those dealing with panic attacks.

Please also review AIHCP’s Stress Management Consulting Program and see if it meets your academic and professional goals.

Panic attacks can emotionally and mentally paralyze a person. Please also review AIHCP’s Stress Management Program
A. Definition of panic attacks

Sudden, intense fear or discomfort—that’s often how panic attacks show up, bringing along physical stuff like a racing heart, feeling like you can’t breathe, or getting dizzy. Sometimes they seem to come out of nowhere; other times, something specific sets them off. This can make people really scared of having more attacks, which we call anticipatory anxiety. You’ll find these episodes classified as anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and it’s noted how much they can mess with daily life. It seems anger and neurobiological factors play a big role in how panic attacks happen (Barlow et al., 2016). Also, if we get a better handle on the neuroevolutionary side of how our brains process fear, we might understand why people react so differently to different triggers, which would give us a more complete definition of panic attacks (Bracha et al., 2006). Generally speaking, these attacks really impact one’s well-being.

B. Prevalence and significance in mental health

Panic attacks can tell us a lot about the mental well-being of different groups of people. Studies show that people who have panic attacks frequently struggle with other problems, such as anxiety or depression; this highlights how interconnected these conditions can be. It’s worth noting that the role of anger in emotional disorders, such as anxiety, often doesn’t get the attention it deserves in psychology, but it’s really important for understanding mental health in general ((Barlow et al., 2016)). Additionally, how we process emotions and think during traumatic experiences can really change whether someone develops panic attacks, or make existing ones worse, so this gives some useful background for why they matter in discussions about mental health. The creation of tools to track these emotional responses emphasizes that we need to really understand how panic attacks show up and change over time, which is why there’s a big need for more complete research on how they interact with other psychological things ((Grimm et al., 2012)). To improve treatments and intervention plans, we really need to focus on all of these things.

C. Purpose and scope of the essay

This essay seeks to explore panic attacks, aiming to explain what causes them, what they feel like, and how they affect a person’s mental health. In most cases, we’ll look at how panic attacks involve emotions, especially anger, which isn’t always talked about (Barlow et al., 2016). Beyond just listing symptoms, the essay will also consider how well different treatments work and how panic attacks affect a person’s life and relationships. With anxiety disorders becoming more common these days (Butterworth et al., 2010), it’s important to understand and address panic attacks; generally speaking, doing so is essential. This essay hopes to provide a better understanding of panic attacks, with practical advice on how to manage them, connecting what doctors know with what people actually experience.

II. Causes of Panic Attacks

Panic attacks? They usually come from a mix of psychological stuff and what’s going on in your body. You know, big life changes or losing someone can really set things off, turning into a full-blown panic attack. Now, some folks think about it differently; they see it as not just one problem, but more like a bunch of connected things in how you feel and think all tangled up together (Curtiss et al., 2016). It’s important to see how different stresses can play off each other in someone’s life, pushing them to where normal worry turns into serious fear. Take musicians, for example. All that pressure to perform can make anxiety way worse, causing panic attacks that mess with their ability to even play (Lockhart et al., 2019).

Panic attacks are a type of anxiety disorder based in unresolved anxiety that can be triggered in any setting.
A. Biological factors and genetic predisposition

It’s generally understood that both our biology and genetic make-up are key to figuring out what causes panic attacks. Studies have shown that certain brain pathways, especially those involving the amygdala, are really important when it comes to feeling fear and anxiety (Bracha et al., 2006). Our genes might affect how well these pathways work, possibly making some of us more likely to have strong anxiety reactions, which, in turn, could lead to panic attacks. To illustrate, allele-variant polymorphisms potentially developed during the Neolithic era could manifest as symptoms of conversive disorders and even panic-related phenomena in vulnerable individuals today (Bracha et al., 2005). By understanding these biological and genetic factors, we can get a better handle on how to treat and help people, which suggests that treatments could be designed to address both the psychological symptoms *and* the biological factors that contribute to them. This idea highlights why it’s so important to include genetic information in the broader discussion of panic disorders.

B. Psychological triggers and stressors

It’s really important to get a handle on the psychological stuff that kicks off panic attacks, like triggers and stressors, if we want to come up with treatments that actually work. Things like feeling super anxious or stressed, especially when you’ve got pressure to perform, can make those symptoms way worse. Take the Sport Interference Checklist (SIC), for example. It shows how thinking and behavior issues can mess with how well athletes do, pointing out that they often feel anxious because of stressors in their sport environment (Scott et al., 2018). Thinking about mental disorders as a complex web also underlines how connected psychological stressors can play a role in panic attacks starting. Instead of just seeing panic as a symptom of some underlying problem, this way of thinking shines a light on how important it is to understand how symptoms work together and connect. It hints that things can change pretty fast once certain psychological lines are crossed (Curtiss et al., 2016). So, figuring out what sets off each person is key to making treatments that can ease panic symptoms. Ultimately, knowing what those individual triggers and stressors are is critical for developing the right interventions.

C. Environmental influences and lifestyle factors

Panic attacks? Well, it’s really about how your environment and lifestyle kind of mix together, if you think about it. Like, stressors at home or just tough living situations definitely don’t help anxiety, you know? It’s been seen that if you’re always stressed, you might just be more likely to have those panic moments because of how your brain reacts. Plus, things like how much you move around, sleep, and even what you eat seem to play a part in keeping anxiety in check. Not getting enough exercise or eating poorly? That can make anxiety worse and almost set you up for panic attacks. And, interestingly enough, it looks like anxiety and panic can affect cardiac patients as well, which makes it important to deal with these issues when we’re taking care of medical stuff (Abrignani et al., 2014). Acknowledging all these lifestyle pieces is really important if we are going to figure out what starts panic attacks and how to approach them effectively (Bracha et al., 2006).

III. Symptoms of Panic Attacks

Panic attacks present with a range of symptoms and, it’s fair to say, can seriously impact daily routines. Often marked by a sudden, intense wave of fear, these attacks frequently involve physical reactions like a racing heart, breathlessness, and profuse sweating – all contributing to a feeling of intense dread or, perhaps, an impending sense of doom. Spotting these symptoms is really important, especially since repeated attacks can sometimes lead to agoraphobia, where people may start avoiding situations that could set off another attack (Federici et al., 2014). The connection between these physical symptoms and the psychological distress they cause can make diagnosing and treating panic disorder quite complex. Newer research has really highlighted the need to understand these symptoms more broadly, connecting them to potential biological causes and other triggers that might worsen the condition (Scott et al., 2018). Ultimately, having a solid understanding of panic attack symptoms is vital for creating effective ways to help and support those who experience them.

Panic attacks can cause extreme mental and physical discomfort. Please also review AIHCP’s Stress Management Program
A. Physical symptoms and bodily sensations

Understanding panic attacks hinges significantly on how individuals experience physical symptoms and bodily sensations, which can amplify feelings of fear and a sense of being out of control. Many who deal with panic disorder often mention increased anxiety levels related to how their body works, especially worrying about their bowel and bladder control; this, in most cases, can really affect their day-to-day lives. Studies suggest that around 78% of those dealing with these worries also have panic attacks, and a lot of them worry about losing control of their bladder during these times. This creates a worrying cycle where physical sensations affect mental well-being ((Chevalier et al., 2013)). We also can’t ignore the family environment because parental actions, particularly those showing sensitivity to anxiety, might strengthen worries about physical arousal during teenage years. This kind of sick role reinforcement can create a negative cycle, potentially making someone more likely to experience panic symptoms and complicating how they understand their body’s signals ((Bilsky et al., 2016)). Therefore, addressing both the physical and mental aspects of panic attacks requires focused treatment strategies.

B. Emotional and psychological symptoms

Panic attacks bring on some serious emotional and mental stuff that can really mess with your life. You’re talking about intense anxiety, a sense of impending doom, and just feeling totally out of it – and it often hits you out of nowhere. Studies have shown that big, scary events, like the COVID-19 pandemic, can make these issues even worse. For example, research pointed to about 31.9% of people dealing with anxiety and 33.7% struggling with depression as a result of all the trauma (Salari N et al., 2020). What’s more, there’s a clear link between having panic attacks and feeling super emotionally stressed, which means we really need to focus on providing good mental health support, especially for those who are already struggling (Hossain MM et al., 2020). Knowing what these symptoms look like can help us spot people who might need help. It also drives home how important it is to come up with specific ways to help people cope with the distress that comes with panic attacks and to boost their overall mental health.

C. Duration and frequency of panic attacks

Panic attacks present quite differently from person to person; both how long they last and how often they occur can really shape the intensity of the symptoms as well as the overall anxiety disorder experience. You see, a panic attack usually hits its highest point pretty quickly, generally within minutes. While the worst might only last around 10 to 30 minutes, some folks might feel that anxiousness lingering for hours, which is something to keep in mind. This timing is really important, particularly because frequent, repeated attacks might cause anticipatory anxiety—this is where someone starts fearing they’ll have another attack. Consequently, they might start avoiding things, which can complicate their lives even more. Now, anger is often missed when looking at emotional disorders, but studies (Barlow et al., 2016) suggest it can actually worsen panic attacks and even make treatments less effective, showing just how complex panic experiences can be. Because of this, truly grasping how long these episodes last and how frequently they happen is vital for putting together solid treatment plans and ultimately helping folks better manage their panic disorders (Yao et al., 2019).

IV. Treatment and Management Strategies

Dealing with panic attacks often calls for a combined strategy, using both therapy and medication. Cognitive-behavioral therapy, or CBT, is often considered the best approach. It helps people spot and change the thought patterns that make panic worse. Also, exposure therapy, which is part of CBT, lets people slowly face what they fear. This can lead to them becoming less sensitive and less anxious. Medications, like selective serotonin reuptake inhibitors (SSRIs), can also help by balancing mood and anxiety. One study pointed out how anger plays a role in emotional issues and how it’s linked to how bad the symptoms are and how well treatment works, which means dealing with anger could help with treating panic disorder (Barlow et al., 2016). Plus, special tools, such as the Sport Interference Checklist, highlight how mental health impacts performance and well-being, which can shape custom treatment plans (Scott et al., 2018).

Managing panic attacks are a possible skill one can learn and utilize in life.
A. Therapeutic approaches, including CBT and exposure therapy

When it comes to tackling panic attacks, cognitive-behavioral therapy (CBT) and exposure therapy really stand out as effective treatments. CBT hones in on spotting and changing those unhelpful thought patterns that fuel panic symptoms, equipping people with useful skills for dealing with their anxiety. Exposure therapy nicely complements CBT by slowly introducing patients to situations or feelings they’re afraid of, which can dial down their anxious reactions. Studies have pointed out that bringing these two approaches together can lead to considerable symptom relief. For example, the Panic Online (PO) program has shown promise, whether it’s used with a therapist or on its own, in easing symptoms of panic disorder and agoraphobia; this highlights how online programs can be a great option for people looking for self-guided help (Austin et al., 2008). Also, a transdiagnostic approach blends these methods, showing how versatile and wide-ranging these treatment strategies can be for different anxiety disorders (Barlow et al., 2017). All in all, these therapeutic methods offer strong options for people struggling with panic attacks.

B. Medication options and their effectiveness

When it comes to handling panic attacks, several medications have become known for how well they ease symptoms and make life better for patients. Often, you’ll see selective serotonin reuptake inhibitors, or SSRIs, and benzodiazepines prescribed, mainly because they start working quickly and are good at lowering anxiety. Yet, there’s a worry about becoming dependent on these drugs, especially benzodiazepines, which are usually only suggested for a short time. Now, a small study looking at the Panic Online (PO) program showed that doing internet programs on your own might be a good choice for folks dealing with panic disorder (PD), which points to other ways to treat this without drugs (Austin et al., 2008). What’s more, mixing in behavioral therapies seems to really boost how well treatment works, cutting down on how often and how bad panic attacks are, all while lowering the risks that come with taking medicine (Arruda et al., 2016).

C. Lifestyle changes and coping mechanisms

For people dealing with panic attacks, making some lifestyle tweaks and learning good coping skills can really make a difference, helping dial down anxiety and generally boosting how they feel. Take regular exercise, for example. It’s known to lift your spirits and cut down on stress, which is a great way to offset the physical stuff that goes along with panic attacks. Mindfulness stuff, like meditation and those deep-breathing exercises, can help people take charge of their anxiety again, making it easier to handle their emotions when things get tough. Getting involved with groups that offer support can also give you a sense of community, which might help with the loneliness that often hits people with panic disorders. Musicians, for instance, who struggle with Music Performance Anxiety (MPA), often find that figuring out and using coping methods tailored for them leads to better performances and less stress (Lockhart et al., 2019). Additionally, things like The BodyMind Approach (TBMA) give you a whole picture of how your mind and body work together, putting emphasis on how changing your lifestyle can help you deal with panic-related issues (Payne et al., 2015).

V. Conclusion

To truly understand panic attacks, we need to look at things from both a psychological and a brain-based point of view. Research into how our brains evolved to handle fear shows us the deep connections between our fear responses and the things that cause us stress. When doctors understand this better, they can better understand what causes panic disorder. It’s important to think about both the fears we’re born with and the fears we develop over time when figuring out what’s wrong, which can help us create better treatments for each person. As research keeps going, diagnostic tools like the DSM-V will probably need to change, maybe even adding new ways to classify problems that come from stress and fear (Bracha et al., 2006). Programs like the ProCEED study demonstrate that specialized treatments can really help people dealing with panic (Buszewicz et al.). In the end, dealing with panic attacks means using both what we know from experience and what we learn from research, so that we can take good care of the people who are struggling with them.

Please also review AIHCP’s Stress Management Training Program

Please also review AIHCP’s Stress Management Consulting Program as well as its many mental and behavioral health programs
A. Summary of key points discussed

To put it briefly, exploring panic attacks uncovers a complex landscape encompassing their essence, catalysts, and therapeutic avenues. A key realization is that panic attacks can stem from a mix of psychological and bodily contributors, for example, anxiety issues or high-stress situations. Signs and symptoms can hit without warning, igniting intense dread that feels crushing. Significantly, we’ve seen talk of useful treatments, spanning cognitive-behavioral therapy and meds, all designed to assist people in managing their experiences. The dialogue really drives home how critical awareness and knowledge are to taking the mystery out of panic attacks, cutting stigma, and growing empathy among those affected as well as society as a whole. Diving into recent research adds much to this area, painting a vivid picture of panic attack intricacies while stressing the need to keep digging for fresh treatment approaches, as detailed in (Romero C, 2014) and (Oates et al., 2008).

B. Importance of understanding and addressing panic attacks

It’s pretty important to get a handle on panic attacks, not just for the sake of those dealing with them directly, but also to build a society that’s more clued-in about mental health generally. As folks wrestling with mental illness and the stigma that comes with it can tell you, panic attacks can be a real emotional weight. As (Bocado et al., 2020) points out, embracing both the emotional and the symptomatic sides of these experiences really drives home the need for understanding and, well, compassion. Plus, when you bring psychoanalytic ideas into the mix for treatment, you can boost therapeutic interventions in ways that really get at the complicated nature of panic attacks in different settings. This kind of approach not only helps with recovery but also underlines how empirical research could potentially bolster mental health policies, helping them tackle these common issues more effectively (Briggs et al., 2010). Bottom line: By truly recognizing – and managing – panic attacks, we stand to create a supportive space that fosters healing and resilience for those going through it.

C. Call to action for awareness and support

It’s pretty important to get the word out about panic attacks and push for more support; this helps everyone understand things better and cuts down on the stigma around mental health. More and more people worldwide are dealing with anxiety disorders, panic attacks included, so it’s kind of a must that we all recognize the struggles people face. If we take a page from those global conferences on human rights and digital safety, initiatives pushing mental health education could really help people spot the signs of panic attacks and know how to react. Healthcare folks, teachers, and even policymakers need to team up to build supportive places where people feel okay asking for help. Advocates can spark real conversations and get people involved in boosting mental health awareness just by sharing what they’ve gone through and using tech to spread info. When it’s all said and done, a group effort will not only give the public a better understanding but also nudge us toward a society that’s more understanding and ready to help those dealing with panic attacks and similar issues.

AIHCP Blogs

Anxiety Disorders- Access here.

Stress and Mental Exhaustion- Access here

Additional Resources

Panic Attacks. Mayo Clinic. Access here

Bence, S. (2023). “What Are the Symptoms of Panic Attacks?”. Very Well Health.  Access here

“Panic Attacks & Panic Disorder”. Cleveland Clinic. Access here

Smith, J, (2025). “How can you stop a panic attack?”  Access here

Mental Health Medications and Herbal Solutions for Anxiety and Depression

Posted on by Mark Moran

I. Introduction

In recent years, the growing interest in mental health has prompted a significant examination of both herbal and pharmaceutical approaches to managing conditions such as depression and anxiety. This exploration is particularly relevant given the chronic nature of these disorders, where traditional medications may not always yield satisfactory outcomes for patients. With the rise of integrative medicine, there is an increasing recognition of the potential benefits derived from herbal remedies alongside conventional treatments. While herbal options may offer a path less traveled, they are not without risks; interactions between these remedies and pharmaceutical drugs must be carefully considered to ensure patient safety (Aiello et al., 2018). Furthermore, the role of dietary choices, such as the Mediterranean diet, can also contribute positively to mental health, highlighting the intricate relationship between nutrition, lifestyle, and well-being (Emerson et al., 2009). This essay will delve into these dimensions, evaluating their efficacy and applicability in treating depression and anxiety.

Understanding how herbal and pharmaceutical drugs help affect mental wellness. Please review AIHCP’s Holistic Nursing as well as its Stress Management programs
Please also review AIHCP’s Holistic Nursing Program as well as AIHCP’s numerous mental health certifications in Stress Management, Grief Counseling and Crisis Counseling.

A. Definition of depression and anxiety

Understanding the definitions of depression and anxiety is crucial for comprehending their pervasive impact on mental health. Depression is characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities once enjoyed, affecting daily functioning. Conversely, anxiety manifests as excessive worry or fear, often leading to physical symptoms such as increased heart rate, restlessness, and fatigue. Both conditions are deeply intertwined and can exacerbate one another, complicating diagnosis and treatment. Recent research has established the efficacy of certain herbal remedies, like saffron, in alleviating symptoms associated with these mental health disorders. In a study featuring teenagers with mild-to-moderate anxiety and depression, saffron extract (affron®) demonstrated significant improvements in internalizing symptoms, suggesting its potential as a complementary treatment option (Drummond et al., 2018). Further exploration into nonpharmacological approaches alongside traditional pharmaceuticals continues to be vital in addressing these prevalent mental health challenges (Swezey et al., 2018).

B. Overview of treatment options

The landscape of treatment options for depression and anxiety encompasses both herbal and pharmaceutical interventions, reflecting a diverse approach to managing these pervasive conditions. Herbal treatments, such as St. Johns Wort and kava, have gained prominence due to their perceived efficacy and fewer side effects compared to traditional pharmaceuticals. Research indicates that these herbal remedies may offer relief by modulating neurotransmitter levels, thereby alleviating symptoms of mood disorders. Conversely, pharmaceutical drugs, including selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines, are often prescribed for their established effectiveness in treating severe cases. However, concerns regarding potential adverse effects and long-term dependency have prompted interest in complementary therapies. The integration of nutritional supplements, like Pycnogenol, into treatment regimens could further enhance therapeutic outcomes by addressing underlying physiological imbalances (Emerson et al., 2009), (Ceulemans et al., 2017). Ultimately, a comprehensive treatment approach that combines both modalities may provide optimal relief for individuals suffering from depression and anxiety.

In utilizing these treatments, stress management consultants also can use a variety of calming techniques and therapies to help teach individuals to calm themselves in stressful situations, as well as grief counselors can help utilize other cognitive treatments to help individuals cope with grief.

C. Importance of understanding both herbal and pharmaceutical approaches

Integrating both herbal and pharmaceutical approaches in the treatment of depression and anxiety is essential for a holistic understanding of patient care. The efficacy of traditional herbal remedies often lies not solely in their active constituents but also in the therapeutic experience associated with their use, as underscored by findings that highlight a hedonic placebo effect contributing to high satisfaction levels among users of traditional medicines (Costa-i-Font et al., 2012). Furthermore, advancements in pharmaceutical formulations, such as the development of Bacopa Naturosome, which illustrates the potential for enhancing the bioavailability of herbal extracts, demonstrate that a synergistic approach can lead to improved clinical outcomes (Bobde et al., 2016). Recognizing the complexities of both modalities allows healthcare providers to tailor interventions that resonate more effectively with patients, ultimately enhancing treatment satisfaction and outcomes in managing depression and anxiety. Thus, a comprehensive approach that values both systems is imperative for informed clinical practice.

II. Overview of Pharmaceutical Drugs

An overview of pharmaceutical drugs used in treating depression and anxiety reveals a range of therapeutic options, each with unique mechanisms and effects. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly prescribed due to their efficacy in enhancing neurotransmitter levels, which can alleviate common mood disorders. Furthermore, benzodiazepines and various sedative antidepressants serve as alternatives, particularly for rapid symptom relief. Despite their benefits, these drugs are not without drawbacks, including potential dependence and adverse side effects. Recent guidelines suggest incorporating cognitive-behavioral therapy (CBT) as a primary intervention, which may be supplemented with pharmacological options when necessary, especially in cases of treatment-resistant insomnia associated with anxiety and depression (Riemann D et al., 2023). Moreover, evolving research underscores the necessity for a comprehensive understanding of age factors in clinical trials, as studies often overlook older adults, thereby affecting treatment outcomes (Fiona E Lithander et al., 2020).

Benzodiazepines help reduce anxiety. Please review AIHCP’s Stress Management program

 

A. Commonly prescribed medications for depression and anxiety

The landscape of depression and anxiety treatment often prominently features pharmaceutical interventions, particularly selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. SSRIs, such as fluoxetine and sertraline, are commonly prescribed due to their efficacy in increasing serotonin levels in the brain, which can positively influence mood regulation.  Common brand names include Prozac, Luvox, Zoloft, Lexapro, and Celaxa.  Benzodiazepines, including drugs like diazepam and lorazepam, serve as anxiolytics, providing rapid relief from acute anxiety symptoms; however, their potential for dependence limits their long-term use. Common brand names include Xanax, Ativan and Valium. Recent studies highlight a concerning trend regarding the prescribing patterns of these medications, underscoring significant variances across different regions and patient demographics (Bjornsdottir et al., 2014). Furthermore, the rise of nootropics, aimed at cognitive enhancement, draws attention to the nuanced interplay between mental health and performance in contemporary society, suggesting a shift toward multifaceted approaches in managing depression and anxiety (Bersani et al., 2020). This evolving understanding emphasizes the importance of tailoring treatment plans to individual needs and contexts.

SSRI – Selective Serotonin Reuptake Inhibitor

B. Mechanisms of action of pharmaceutical drugs

Understanding the mechanisms of action of pharmaceutical drugs is crucial for addressing depression and anxiety effectively. The majority of these drugs target neurotransmitter systems, primarily involving serotonin (5-HT), norepinephrine, and dopamine. For instance, selective serotonin reuptake inhibitors (SSRIs) enhance serotonergic activity by inhibiting the reabsorption of serotonin in the brain, thus increasing its availability and improving mood. This approach highlights the significance of neurotransmitter balance in mental health, where disruptions can lead to various mood disorders. However, the pharmacodynamics of these drugs remain complex, as evidenced by the varied responses observed among patients, necessitating ongoing research into more effective and tailored treatments. Moreover, the lack of approved pharmacological options for conditions such as tinnitus exposes the need for novel therapies. As noted, effective relief from symptoms is still a pressing challenge, underscoring the potential of advancements in pharmacotherapy to revolutionize treatment approaches (Bel Aén Elgoyhen et al., 2009), (Overy et al., 2013).

Benzodiazepines increase GABBA in the brain.  By reducing Gamma-aminobutyric acid, a neurotransmitter that helps the efficiency of transmitting messages between neurons, the overall process is slowed through the increase of GABBA hence relaxing the mind.  Some of the more common brand names include Xanax, Valium and Ativan.  All have addictive qualities and have potential minor side effects.  The dose and frequency is determined by a physician or prescribing mental health professional.  It is imperative to discuss any herbal supplements with a provider if already taking a prescribed benzodiazepine.

C. Potential side effects and risks associated with pharmaceutical treatments

The growing reliance on pharmaceutical treatments for depression and anxiety raises significant concerns regarding potential side effects and risks associated with these medications. Many prescribed drugs can elicit adverse reactions, ranging from mild symptoms like drowsiness and headaches to more severe effects such as mood changes, anxiety, and substance dependence. For instance, the uncontrolled availability of certain medications has been linked to the induction of psychological symptoms, which may exacerbate existing conditions in vulnerable populations, particularly those with psychiatric disorders (Chillemi E et al., 2014). Furthermore, while complementary and alternative therapies are often sought for their perceived safety, they too can contain active ingredients that pose risks when combined with pharmaceutical treatments; thus, the safety and efficacy of both conventional and alternative options warrant careful evaluation within this context (Ekstein et al., 2014). Consequently, the assessment of side effects must be integral to the discourse on optimal treatment for mental health disorders.

Any pharmaceutical drug can have a potential side effect and some can be addictive

The potential of side effects is always a possibility and that is why prescribers work with their patients starting with lower doses over the first weeks to see if any reactions exist.  Sometimes, a different type of SSRI or Benzodiazepine is needed.  While closer related, different types of generic names within the family can sometimes work for different individuals.  In addition, these same reactions push many individuals to more herbal solutions.  This is fine but it must be done with caution and guidance since many prescriptions are important or need to be gradually weaned off of to avoid withdraw.  In addition, many other grief and anxiety related therapies and counseling techniques exist to help individuals cope.  Whether or not someone needs pharmaceutical or herbal or merely treatment or a combination of all depends on the individual and the guidance of the mental health and primary physician teams.

III. Herbal Remedies for Depression and Anxiety

The exploration of herbal remedies for depression and anxiety has gained significant traction in both clinical settings and popular belief systems. Among these remedies, Lavandula angustifolia, commonly known as lavender, has been shown to exhibit promising results. In a study involving patients receiving Citalopram, those who consumed a lavender infusion alongside their medication exhibited a notable decrease in depression scores after both four and eight weeks, suggesting its potential as an adjunct therapy (Asghari et al., 2013). The implications of such findings position herbal treatments as a viable complement to pharmaceuticals, particularly for individuals seeking holistic approaches to mental health. Additionally, the conversation surrounding nootropics emphasizes the cultural shift towards enhancing cognitive function and overall well-being, revealing an increasing interest in natural substances that may improve quality of life without the adverse effects often associated with conventional medications (Bersani et al., 2020). As research continues to unfold, the integration of herbal remedies into mainstream treatment protocols remains a promising avenue for further investigation.

A. Popular herbal treatments and their uses
Valerian Root is an excellent herbal remedy for anxiety

The increasing prevalence of mental health disorders has spurred interest in popular herbal treatments, particularly for conditions such as depression and anxiety. Among these treatments, herbs like St. Johns Wort and valerian root have garnered significant attention for their therapeutic potential. St. Johns Wort, for instance, has been extensively studied for its ability to alleviate mild to moderate depression, with some research supporting its efficacy comparable to conventional antidepressants.  In addition to St John’s Wort, is lavender, passion flower, chamomile,  and other natural serotonin reuptake inhibitors.  In regards to anxiety, Valerian root, known for its calming effects, is often utilized as a natural remedy for anxiety and insomnia, promoting improved sleep quality without the sedative side effects commonly associated with pharmaceutical alternatives. Furthermore, the anti-inflammatory properties of curcumin, a compound found in turmeric, suggest a broader role in addressing mood disorders linked to chronic inflammation, making it a compelling candidate for further study in the development of herbal treatments (Peng Y et al., 2021).  In addition to valerian root,  Understanding the abundance and biodiversity of these medicinal herbs is crucial for sustainable sourcing and effective drug development (Heinrich M et al., 2021)

 

B. Scientific evidence supporting herbal remedies

There’s a growing buzz around using herbal remedies to ease depression and anxiety. Interestingly, a rising amount of research is trying to back up whether they actually work and are safe to use. For example, lots of studies have looked at how well-known herbs might work, and some have found that particular plants contain active ingredients that can tweak the brain’s mood-regulating chemicals. That said, it’s important to be careful about jumping to conclusions. The research on many herbal treatments isn’t always solid or consistent. It’s really important to put these treatments under a microscope, especially because how the herbs are extracted and how much you use can change things. What’s more, even though some people swear by these remedies based on what they’ve seen, we often don’t have the scientific proof to say for sure that they work. More research is needed to figure out if they truly cause the improvements or if something else is going on (Ghosh et al., 2010), (Elliott et al., 2002). So, it’s best to keep an open mind when thinking about using herbal remedies alongside standard treatments.

C. Safety and efficacy concerns regarding herbal treatments

Herbal treatments for things like depression and anxiety definitely call for some serious thought, especially when it comes to how safe and effective they really are. Sure, there are studies suggesting that certain herbal supplements, saffron, could help with mental health. But the thing is, how consistent are these results, really? Take, for example, a controlled trial where they saw some improvement in young people dealing with mild to moderate anxiety and depression. Even there, the researchers pointed out that what the kids said and what their parents noticed didn’t always line up, suggesting it might work differently for different people (Drummond et al., 2018). Then you’ve got a review looking at acupuncture and herbs for premenstrual syndrome. It showed some relief, but the studies themselves weren’t that big, and the methods used weren’t always top-notch, which makes you wonder if the results hold up in the long run, or apply to everyone (Kim DI et al., 2014). So, while herbal treatments might seem like a good option, we need to make sure we really nail down how safe they are, how well they actually work, and that we put them to the test in proper clinical trials.

IV. Comparative Analysis of Herbal and Pharmaceutical Approaches

When exploring treatments for depression and anxiety, it’s useful to compare herbal and pharmaceutical options, focusing on how well they work, how safe they are, and how patients feel about them. Medicines like SSRIs are clinically proven to help, but side effects can push people toward other options. Herbal remedies, like St. John’s Wort, are popular because they seem natural and have fewer side effects reported. It’s worth noting that Ginkgo biloba, for instance, comes up a lot when talking about possible benefits and drawbacks, so it’s good to be careful (Chillemi E et al., 2014). Additionally, some research suggests that acupuncture and herbal remedies can really help with things like premenstrual syndrome, hinting that these approaches could work for some people (Kim DI et al., 2014). So, while both ways have something to offer, more research would help us understand how they stack up against each other for mental health overall.

It is important to understand how drugs work and how they can interact with herbal remedies in positive or negative ways. Always contact a holistic nursing specialist or mental health professional or primary physician before mixing herbs with pharmaceutical drugs

A. Effectiveness of herbal vs. pharmaceutical treatments

The discussion around how well herbal treatments work for depression and anxiety, when stacked up against pharmaceutical options, has really picked up steam in both the academic world and in clinical practice. Pharmaceutical drugs, which often come with side effects and the risk of dependency, are usually the go-to treatment. But herbal remedies, like St. John’s Wort and other plant-based therapies, have become alternatives people are considering. Studies seem to be showing that these herbal options could help ease symptoms, and maybe with fewer bad side effects, hinting at them being fairly safe. For example, one review pointed out that treatments like acupuncture and herbal medicine led to noticeable improvements in things like premenstrual syndrome, with more than half the people in the study saying their symptoms got better. This underlines how they might help with mood issues and stress-related symptoms (Kim DI et al., 2014). Plus, as integrative medicine becomes more popular, it’s super important to look at how herbal supplements and regular medications might interact, especially for groups like veterans, where other health problems might make treatment trickier (Aiello et al., 2018). So, taking a good look at and comparing these different treatment methods is key for creating well-rounded and effective ways to tackle mental health.

B. Patient preferences and accessibility issues

When we look at how patients feel about herbal versus pharmaceutical treatments for depression and anxiety, alongside how easy it is for them to get these treatments, it’s clear that how happy they are with their treatment really affects how well it works. A lot of people seem to like old-fashioned herbal medicines better, thinking they’re easier to get and fit better with what they believe. This might be because of something called the hedonic placebo effect, where just taking traditional medicines makes people feel better, even if there’s not a lot of scientific proof (Costa-i-Font et al., 2012). Also, getting access to treatments is a big deal. Patients often have trouble getting regular pharmaceutical drugs because they cost too much, aren’t available, or the healthcare system doesn’t work well. It’s really important to think about how people try to get healthy. Discussions at events like the 3rd Java International Nursing Conference highlight the need to consider patient experiences when treating them in clinics and in their communities (Nurmalia (Editor) et al., 2015).

C. Integration of both approaches in treatment plans

Combining herbal and pharmaceutical methods in depression and anxiety treatment is becoming a really important step forward in mental health. Healthcare providers can create full treatment plans that deal with both the symptoms and the root causes by mixing the power of regular medicines with the overall health benefits of herbal treatments. For example, patients might feel better emotionally when they use herbal medicines with their regular antidepressants, which can lead to a better life and easier management of side effects (Howard et al., 2015). This combined method not only makes the treatment options wider but also takes into account what patients like, helping them stick to their treatment plans. Plus, knowing things like a patient’s age, education, and how far their illness has progressed can help doctors choose the right herbal and pharmaceutical treatments, making sure the plans fit what each patient needs (Catalani et al., 2019). So, putting these two treatment types together looks like it could provide more useful and customized care in mental health.

Holistic nursing professionals can also guide individuals in properly utilizing in a safe way the integration of herbal remedies with pharmaceutical medications.

V. Conclusion

To conclude, combining herbal remedies with pharmaceutical drugs presents a potentially beneficial strategy for treating depression and anxiety, offering a more comprehensive approach to mental health care. Research has demonstrated, for example, that compounds such as curcumin possess notable anti-inflammatory effects, indicating a possible role in affecting mood disorders (Peng Y et al., 2021). This highlights the value of integrating both traditional and modern medical practices to potentially improve treatment effectiveness and patient results. Additionally, as emphasized in current guidelines, the importance of personalized treatment plans highlights the necessity of accounting for individual patient needs and preferences when managing these mental health issues (Sharon L Kolasinski et al., 2020). As clinicians and researchers further investigate the interactions between herbal treatments and conventional medications, a deeper understanding of these dynamics will probably result in improved care for depression and anxiety, leading to better overall mental well-being across various populations.

Medical and herbal remedies can help anxiety and depression when under the guidance of a licensed and qualified professional. Please also review AIHCP’s numerous mental health certifications in stress management, holistic nursing and grief counseling

It is always important to consult a physician or mental health professional when supplementing herbal remedies with pharmaceutical ones.  Sometimes, they share similar traits that can enhance the prescription in power and increase a desired effect, or another herb may counteract a different medical prescription.  Ultimately, herbal remedies can serve as a long term supplement when used correctly and under care with less side effects but many require pharmaceutical treatments in more acute cases.

Please review AIHCP’s Stress Management Program, as well as its Holistic Nursing Program.

A. Summary of key findings

When we consider the main points about using both herbal remedies and prescribed drugs for depression and anxiety, we see that these two types of treatments affect each other in complicated ways. Lots of people use herbal medicines together with their prescriptions, especially older folks; numbers show that anywhere from about 5% to almost 90% do this (A Cherubini et al., 2017). Antidepressants are often taken with herbs like St. John’s Wort, which worries doctors because these combinations might cause problems, particularly with bleeding (A Cherubini et al., 2017). Also, even though we don’t have a lot of scientific proof that traditional medicine works well, people seem happy with it, maybe because of a strong placebo effect that makes them feel good. Because of all this, it’s important for doctors to really understand what their patients are doing to take care of themselves and to think about how helpful treatments are, both in terms of the process and the results.

B. Implications for future research and treatment

Delving into both herbal and pharmaceutical approaches to tackle depression and anxiety carries weighty implications for what’s next in research and treatments. The latest breakthroughs in grasping how G protein-coupled receptors (GPCRs) work hint that we might be able to design drugs that are much better at targeting mental health issues (Yang D et al., 2021). On another front, looking at herbal remedies that have historically been used for breathing problems, especially during today’s health scares, has shown they could be helpful additions to treatment plans (Dâmaris Silveira et al., 2020). This blend of old herbal wisdom and new pharmaceuticals really drives home the point that we need thorough clinical trials to check if these combinations are both effective and safe. If we push for these combined methods, future research could really open doors to tailored treatments that improve how patients do overall, all while tackling the many-sided challenges of mental health more broadly.

C. Final thoughts on the role of herbal and pharmaceutical drugs in mental health care

To sum up, looking at both herbal remedies and pharmaceutical drugs in mental health care, you find a tricky mix that really needs some thought. Things are always changing in mental health, and both ways of treating it have their good points. For quite a few people dealing with depression and anxiety, pharmaceutical drugs have shown they can work well. On the other hand, herbal treatments might add some extra help, maybe without as many side effects as some of the drugs. Still, there’s a chance that drugs could interact with each other, especially for certain groups like veterans, who might have specific health concerns. That’s why it’s so important to tailor treatment to each person. (Aiello et al., 2018) Also, nootropics are becoming more popular, showing that people are really interested in boosting their brainpower, probably because society is pushing for better mental performance in demanding situations. (Bersani et al., 2020) So, when it comes down to it, the best way forward could be a whole-person approach that focuses on being safe, giving personalized care, and putting different methods together. This could really help folks who are having a hard time with their mental health.

AIHCP Blogs and Videos

Holistic Herbs Video- Access here

Additional Resources

Pope, C (2023). “Benzodiazepines”. Drugs.com.  Access here

“Benzodiazepines”. Medicine.net. Access here

Pope, C. (2023). “SSRI Drugs List” Drugs.com. Access here

Syed, P & Kubala, J. (2025). “6 Herbal Treatments That May Help Depression Symptoms”. Healthline. Access here

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

Understanding Substance Abuse and Addiction: The 12 Steps of AA Video Blog

Posted on by Mark Moran

Addiction is more than physical but an emotional and spiritual journey. AA and its 12 Step Program has helped many through the difficult process.  This video reviews the 12 steps and why they are important.  Please also review AIHCP’s Substance Abuse Practitioner Program and see if it meets your academic and professional goals.

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

Healthcare Certification Blog: Empathy in Counseling

Posted on by Mark Moran

Empathy is big word in counseling.  It is also foundational in how counselors and pastors help others heal.  One of the biggest misnomers of counseling is the counselor fixes the person and details the agenda a person must follow to heal.  This is farther from the truth.  Emotional pain is not so easy to heal as if a recipe in a cook book.  Instead it is a messy, usually not outlined path of progress and regress, emotions, and time.   The counselor is more a beacon that guides than a drill sergeant who commands.  Empathy is one of the key skills that serves as a way to help the client heal and become resilient.  This does not mean that confrontation is not sometimes needed when maladaptive ideas and practices are destroying a client’s life but it does mean that empathy gives room for mutual sojourning and walking together in the feelings of the situation.  This allows for self awareness and real conversion within the person instead of superficial direction and forced change that never lasts.  So why counselors would on many occasions love to tell the client this is what the you need to do and how to do it, the science of psychology and counseling suggests otherwise.

Listening and responding with empathy means as a counselor you feel what your client feels. Please also review AIHCP’s Healthcare Certifications

In this short blog we will take a closer look at the role of empathy in the therapeutic counseling relationship.  Please also review AIHCP’s Healthcare Certifications and see which ones best match your academic and professional goals.

Empathy vs Sympathy

Carl Rogers emphasized in counseling the critical importance of genuineness, empathy and unconditional positive regard.   While these may seem like fluffy and soft terms that overlook right and wrong, they are critical to counseling in helping individuals discover right and wrong without scolding, admonishing, or ridiculing.  Those in trauma or pain need a non-judgmental caring ear to listen and through that listening, foster change.  The traumatized, mentally ill, and emotional unstable face a cold world already where they are marginalized, ridiculed, and judged.  While abuse destroys human bonds, empathy can restore them.  Counseling is a therapy that is not meant to make judgements but to help individuals discover healthy and good ways to heal.  Instead of the dogmatic voice that says this is right or wrong (and it has a place), the counseling session looks to heal via listening and understanding and helping the person come to self actualization of the correct course.  The counseling room is not the pulpit, but is a healing modality that looks to guide via a different route.  Counseling understands empathy best produces change rather than lectures that only create more anger and disobedience and resistance.  Ultimately empathy in counseling can lead a client to higher self-awareness, self experience and find a true joy in connecting and continuing the communication and connection with the counselor (Cochran, 2021, p. 64-67).

According to Cochran, empathy is not a thought process (2021, p. 56).  Instead it is a natural connection with a person.  It permits the counselor to feel what the other person feels.  So when a gay man traumatically describes abuse at a young age, a counselor who is heterosexual does not see different sexual orientations, but the feeling of rejection and pain with their fellow human being.  Likewise, a Caucasian counselor, can find empathy with a African American client who discusses the trauma of being racially profiled by the police.  One does not need to share the event, or even agree with the client but they share the emotions felt by the client.  This is the key difference between empathy and sympathy.  Sympathy does not share in the feeling but it feels sorry for the person.  Sympathy is good to have for someone but in counseling it is counter productive.  Clients are not looking for someone to feel sorry for them but for someone to help them.  They are looking for someone to feel what they feel and help them move forward.  Empathy is hence walking with the person not just merely observing and offering condolences (Cochran, 2021, p. 57). Rogers states, empathy means to “sense the client’s private world as if it were your own but without ever losing the “as if” quality” (Cochran, 2021, p. 58).  Of course, this does not mean, one who is empathetic must agree with the person’s choices, life styles or past actions, but it allows the counselor to help the person at a deep level to find healing and change.

This closely ties into Unconditional Positive Regard which is another key concept of Rogers which demands counselors fully accept the client in all their complete wholeness and shower them with unconditional understanding.   Unconditional Positive Regard retains the autonomy of the client to learn how to change on their own terms. Rogers listed warmth, acceptance and prizing as three key elements of UPR.   Warmth represents the care of the client and genuine empathy.  It is the fertile soil that produces a an atmosphere of trust and disclosure.  Acceptance is the ability of the counselor without bias to accept the immediate emotions of a person in counseling-whether illogical, angry, hateful, confused or resenting (Cochran, 2021, p. 103).  Prizing involves raising the self esteem of the patient by accepting them with praise as they are but also highlighting their strengths and weaknesses in a honest and genuine way.  Again, this type of emotional connection does not mean counselors accept statements, values, or actions of a client, but it does mean the regard is sincere and grants the client a sense of trust that if they make a mistake or trip and fall emotionally, there is no condition.  When conditions are placed for approval, then the healing process becomes manufactured.  It is through this type of positive regard that a client can flourish and heal because the client knows someone has their back in the good and the bad.  This type of positive relationship in fact helps the client at an internal level look to become better intrinsically based not on reward but because it is the right thing to do.  Once a client believe it is the right path without being told, then the client begins to truly transform and change.  Through empathy, genuineness and employment of unconditional positive regard, the necessary emotional seeds can plant natural and self employed change at the guidance of a gentle counseling hand.

 

Displaying Empathy

Sometimes the hardest part for empathy to flourish in a counseling relationship is the counselor.  Whether lack of practicing it or lack of patience for its fruits to develop, the counselor is ultimately responsible for establishing a secure and trusting environment where difficult emotions can be felt and discussed.  One element is the fear of letting go.  Some counselors may feel the need to control and direct a session and conditionally expect certain behaviors and decisions.  They lack an empathetic skillset to confront a client with an emotional situation.   It is hence important for counselors sometimes to allow the session to develop as the client dictates and to attempt to understand the client by what is revealed.

There are a variety ways counselors can employ empathy and exhibit it in their practice.

In expressing empathy, counselors need to match emotions with tones, expressions, movements and words (Cochran, 2021., p. 79 to 80). Sometimes naming the emotion and restating it to a client can help reflection but also show empathetic listening.  This is also true when expressing empathetic confrontation which looks to indirectly help a person reflect on a statement.  When stating a statement about what the person is feeling, state in in a declarative statement, but if uncertain, express it in a tentative declarative tone that is open for correction. In these reflections, a counselor can also reflect themes in paraphrasing one’s feelings.  Themes that keep appearing in a person’s story or how one feels can be expertly restated and paraphrased to an individual to again not only show the counselor is listening but also to emphasize.  This can be done in a statement but also in an attempt to empathetically confront a particular feeling (Cochran, 2021, p. 81-82).  Empathetic confrontation eliminates the fear to allow clients to be confronted with some of their own statements.  Counselors should be prepared to be corrected at times, if they misstate what a client said, or if their tentative declaration is misspoken.  In these cases, this should not be seen as an affront but for a better opportunity to understand and help heal.  Most clients will not be offended by this but thankful the counselor is listening and trying to understand.  This can open to further and deeper exploration of the topic.  Of course, it is also good to use appropriate questions to better understand.  The questions must be natural however and  not in the probing nature that looks to pick.  This can make a client feel as if he or she is being interrogated.

Within empathetic counseling, it is important as the counselor to avoid making assessment statements or make the client feel as if he or she is being assessed. In addition, the counselor should not have a surprise hidden agenda that the counselor hopes to reveal and have the client realize.  This leads to an unnatural direction that is void of truly listening and feeling.   Counselors should also avoid doing most of the speaking and talking in these types of sessions, as well as avoid “me too” or “must feel” statements that can assume or take away from the client’s expression of feelings (Cochran, 2021, p. 82).

Counselors hence need to be able to employ empathy in multiple ways.  Compton lists numerous ways, counselors can better express empathy and utilize it in counseling.  He suggests becoming attuned with the client.  Through attunement the counselor resonates the feelings of the victim/survivor (2024, p. 181).  In addition Compton emphasizes the importance of co-regulation where the counselor is better able to help the client manage emotions.  This is accomplished through mirroring and reflecting back, modeling after the client’s tone and motions and checking in on the level of distress a victim/survivor is feeling (2024, p. 182).  The counselor enters into a posture of curiosity that portrays a genuine desire to understand the client (Compton, 2024, p. 183).  In helping with emotions, counselors can also via prizing help highlight strengths of clients and adopt a perspective that looks how those strengths helped them survive and continue to survive.

Counselors also need to practice humility with empathy.  Humility realizes that not all the right answers or skills are found within oneself but to look to the client as well as other professionals to find the needed solutions.  This leads to not becoming over defensive if one is wrong with assumption, as well as being humble before a person’s experience as well as a person’s cultural identity (Compton, 2024. p. 183-184).   Through this humility, the counselor looks to empower the victim/survivor to take an active role in healing and working with the counselor to find it.

Counselors in empathy must also display patience.  The healing process is not linear or fast.  It takes time to help someone find healing.  When in empathy, feelings are not rushed but felt as they truly are and experienced until resolution and healing is found.  During this process, empathy shares in the small victories and joys of self actualization, self worth and healing as the person transforms (Compton, 2024. p. 185).

Of course in all empathy, one finds that all important circle of trust.  Within that trust comes a no-judgement zone and unconditional positive regard.  However, trust is earned.  Individuals suffering from abuse and trauma may not trust at first and be wary of words and especially physical touch.  Through time and patience, confidentiality will be restored but again, empathy demands to feel what the moment dictates and the state of being currently within the client (Compton, 2024, p. 187).

Conclusion

Please also review AIHCP’s Healthcare certifications and see which ones meet your academic and professional goals

Empathy is critical to helping people change because it is not authoritarian or dogmatic.  Counseling is a healing modality and through empathy, one heals but also is guided through an empathetic ear with unconditional positive regard and genuineness that permits the person to see him/herself and come to conclusions that are healthy and good for his/her feeling.  Counselors must be willing to let go of control, face hard feelings, eliminate personal judgement and bias, and allow the person to learn about oneself as the sessions continue.  This does not mean the counselor can disagree internally, or not confront negative thoughts and emotions in an empathetic way, but it does does mean it gives the client a driver seat in pushing forward in self discovery, healing and a future way of living.  Counselors need to facilitate the environment for this by displaying certain skills of empathy, unconditional positive regard and genuineness as espoused by Carl Rogers to achieve these results. Ultimately empathy in every venue of care is essential.  It not just a counseling issue but also in all venues of healthcare itself.

Please also review AIHCP’s Healthcare Certifications, especially in Crisis Intervention, Grief Counseling, Christian and Spiritual Counseling and Trauma Informed Care programs.

Additional Blogs

Counseling When Trauma Emerges- Click here

Rogerian Counseling- Click here

Resource

Cochran, J & Cochran, N. (2021). “The Heart of Counseling: Practical Counseling Skills Through Therapeutic Relationships” 3rd Ed. Routledge

Compton, L & Patterson, T (2024). “Skills for Safeguarding: A Guide to Preventing Abuse and Fostering Healing in the Church” Intervarsity Press.

 

Additional Resources

The Role of Empathy in Effective Counselling. (2024). Mental Mastery. Access here

“Accurate Empathic Understanding: A Core Component of Client-Centered Counseling” (2024). Psychology Town. Access here

Sutton, J. (2021). “Unconditional Positive Regard: 17 Worksheets & Activities”. Positive Psychology.  Access here

Cherry, K. (2024). “Unconditional Positive Regard in Psychology”. Very Well Mind. Access here

 

 

 

 

 

The Devastating Impact of Trauma on Children and Adolescents

Posted on by Mark Moran

The mental health crisis in the world is not just due to mental pathologies but also equally due to trauma induced upon children.  The World Health Organization estimates that 2 out of 3 children in the United States to 75 percent of children worldwide will experience some type of trauma before age 16 (Compton, 2024., p. 199).  This can range from a variety of natural traumas but also human induced traumas and social settings that lead to Adverse Childhood Experiences or ACE.    Aside from natural disasters or deaths of family members, many traumas include physical violence, sexual abuse, emotional abuse and neglect and communal levels of poverty, lack of resources, or communities with higher crime rates (Compton, 2024, p. 200).   Other children may experiences war zones, terrorism, refugee life, human trafficking, or famine and disease.

Trauma has devastating effects on children’s life schemas, neural development and social and behavioral interactions. Please also review AIHCP’s Behavioral and Mental Healthcare Certifications

Innocent minds that are exposed to the cruelty of life at an early age without care or guidance can lead to future mental crisis that lashes out against the world and society.  While never justified, many of these injured individuals later injure others through crime, violence, shootings, and abuse.  Broken creatures abused can sometimes fail to see a loving God, or fair world and see life as a competition of kill or be killed.  Amazingly, many still become good people but nonetheless suffer from immeasurable emotional and mental pain that can cripple them from having a successful life in interacting and behaving with others.

The corruption of innocence is the purest form of evil.  When littles ones are corrupted, one can only think of the verse from the Bible and the words of Jesus Christ, “Whoever causes one of these little ones who believe in me to sin, it would be better to him to have a great millstone fastened around his neck and drowned in the depth of the sea (Matt 18:6).  I think whether Christian or Atheist, religious or secular, one can agree with these words and understand the importance of protecting children and helping them heal.  The scars of trauma can cause future traumas to society, so it is important to understand the affects of trauma on children and how if left untreated can realign a child’s future into one of increased pain, maladaptive coping and social dysfunction.

Please also review AIHCP’s Mental and Behavioral Health Certifications, including its Trauma Informed Care Certification.

The Vulnerability of Children to Effects of Trauma

The innocence of children makes them more susceptible to abuse.  In addition, their size and inability to defend themselves emotionally and physically also make them targets for further abuse or less able to defend themselves against various threats.  Since children’s brains are still developing, trauma of any type can have greater long term negative effects on their development.  Trauma and abuse can stunt social development because of the  increased neuroplasticity of the child’s brain as compared to any other age,  During this phase, the brain is forming new neuropathways and cognitively is learning and associating learning and new experiences with how one interacts and properly behaves.  Neglect, trauma and abuse can alter proper pathways and instead create negative lasting impressions on the brain that reduce trust and the concept of safety, as well as mental health, relationships, and overall life schemas (Compton, 2024, p. 141).

The brain itself during developed can be damaged due to severe trauma in children. Trauma in children can negatively affect the brain’s ability to cooperate and communicate with other parts of the brain.  Compton refers to this as Neural dis-integration (2024, p. 142). When trauma occurs the brain dis-integrates neural networks causing this lack of communication and cooperation which leaves some parts of the brain disrupted from certain important neurochemicals.  This can also lead to various issues with the amygdala, hippocampus and other prefrontal cortex regions (Compton, 2024, p. 142).  The longer chronic trauma remains, the more altered the child’s world view may become leading to less reasoning, learning and impulse control and replaced with distorted thinking and feelings about the world.

Children who respond to trauma exhibit the same responses adults experience when the sympathetic nervous system is activated.  Children will fight, flight, freeze or fawn like anyone else but these reactions by children also exhibit within their daily lives.  Children in chronic stress due to abuse or neglect will experience not only physical health issues but also cognitive and emotional issues.  Children who display fight as a primary response will exhibit more aggressive, defiant or confrontational behavior in life.  Children who display flight as a primary response will exhibit avoidance and escapism in life.  Children who display freeze as a primary response will exhibit lack of lack of normal emotional responses or motor activity in life.  Finally, children who display fawn will exhibit more appeasing and pleasing behaviors in life (Compton, 2024, p. 143).

 

ACE AND PCE

Adverse childhood experiences and Positive childhood experiences play a large role in a person’s life and their future mental health.  It also plays a large role in a person’s ability to form healthy attachment schemas in life.  Adverse childhood experiences refer to events that affect a child’s life in a negative way. These adverse childhood experiences can be  actual events but also deeper seeded social issues that act as roots to the trauma tree and its many branches and fruits.  Adverse Community Environments or roots of the problem include multiple negative social issues such as poverty, discrimination, community disruption, lack of economic mobility and opportunity, poor housing and frequent exposure to social violence.

Braffenbrenner proposed various systems that play a large role around one’s development.  The microsystem is a person or child’s immediate circle of family, friends, school, or for adults work.  The next phase in the circle includes the exosystem which includes mass media, extended family, as well as local government.  The macrosystem and next layer to the circle includes major economic, political and cultural issues.  Finally, the most outward layer i the chronosystem of major changes and shifts in life which can be personal losses, or major national changes in life such as a pandemic or war.  These shifts are predictable and unpredictable, as well as positive and negative.   These systems can all affect other systems which in turn can affect the child or person.

In regards to positive childhood experiences, or PCE, the Hope National Research Center did substantial research on the effect of PCE in a person’s life.  Obviously, a person with more positive events in childhood will have a more stable mental outlook in life.  Even those with 1 to 2 positive experiences, according to the research, showed a 51 percent of better mental health outcomes.  3 to 5 positive experiences led to 75 percent better chance of good mental health, and 6 to 7 PCE illustrated over 90 percent better mental health.  Even if one experienced 4 ACE or adverse childhood experiences, the presence of PCE balanced out less stability in the person’s mental health.  Those with higher PCE in their childhood, move on to not only have better mental health, but also better academic scores, degrees, income and employment.   Even more amazing is the fact that even individuals with very little ACE, but also very little PCE or none, grew up to have more mental health issues just due to the fact there was nothing positive as a child.  This leads to the crucial importance of PCE laid out by the Hope National Research Center.  Children need stability and positive experiences to balance out any bad but to also give them the tools they  need to grow into healthy adults.  This falls into place with healthy and stable relationships, environments, engagements in social developments, and emotional growth opportunities.  In many ways, these correlates with Maslow’s Hierarchy of Needs and ensuring these basic needs are met for children to promote healthy emotional and mental health.

In essence, as caregivers, what we give our children is what our future will be.

Attachment Schemas

A child void of unnecessary traumas and who is supported by loving caregivers during times of distress form a healthy worldview about life.  There is trust and there is safety and there are resources available to overcome negative events.  These secure attachment schemas leave the child with hope and as the child enters into adulthood, presents the child with the necessary beliefs and skills to form health and secure relationships.  In addition, the child will have a healthier self worth of one’s value as a human being.  This does not mean, the child’s life was perfect.  No-one has a perfect and suffering free life, but the child was given support in the good and bad days physically, emotionally and mentally (Compton, 2024, p. 145).

Children who are neglected, abused, exposed to trauma and receive no support, care, or safety grow up with a very different view on life.  Different attachment schemas develop from this neglect.  Anxious attachment in children is one type schema that develops from lack of a safe and loving environment.  Children with anxious attachment schemas possess a fear and uncertainty of how a caregiver will respond in a negative event.  Due to lack of consistent love and care, these children experience a lack of self confidence. They may doubt their own abilities and became very dependent on others.  Anxious attachment is closely associated with heightened anxiety to threats which in turn leads to children have exaggerated responses that deny the child the ability to soothe oneself (Compton, 2024, p. 146).  This type of anxious disorder leads to a behavior that does not trust, nor is able to with confidence handle life long issues without dependence upon others.  Children can exhibit this when stressors strike.

Children who experience trauma and neglect from primary caregivers can develop anxious, avoidant or disorganized attachment schemas to understand life

Another schema that can develop is the Avoidant attachment schema.  This dismissive attitude is the opposite reaction of the Anxious attachment schema because it leaves the child to avoid all help from caregivers.  It forges a unhealthy self reliance that fears intimacy and the words of others.   These individuals are hesitant to ask for help and are skeptical of others intentions.  In turn, they have a difficult time forming relationships and working with others.  This prevents the child and later adult from forming meaningful and emotional relationships (Compton, 2024, p. 147).

Finally, some children develop a Disorganized attachment schema.  Due to inconsistent and unpredictable caregiver outcomes, these children do not form a consistent reaction but present a disorganized reaction that at times can turn to someone and in other instances push someone away.  This chaos results from the caregivers inconsistent approaches of giving security at one moment, then perhaps abuse in another moment.  This type of chaos creates a very confused child with multiple internal conflicts.  This leads to severe dysregulation and lack of emotional control.  Many who develop Disorganized attachment are at higher risk for mental health issues such as anxiety, depression, PTSD, and ADHD (Compton, 2024, p. 147).

Reestablishing Health Schemas

Fortunately, safe-guarders such as teachers, educators, counselors, pastors, or even friends can help reestablish healthier schemas.  The brain can re-learn that security exists but this takes time, patience, and love.  The relearning of healthier schemas is referred to as “earned-secure attachment” (Compton, 2024, p.148).  Helpers can reinitiate the attachment cycle and help children heal.  Calm caregivers can help children by hoping them co-regulate their emotions.  The child can borrow and regulate from the safety and peace of a regulated adult (Compton, 2024, p. 148).  Through this newly forged relationship, new trust and new secure schemas can re-emerge.  This is by far not easy.  The previous schemas are firmly planted but they can slowly give way to new ways of thought within the neuroplasticity of the brain and form new neuropathways with better experiences.  It is important to note that individuals from trauma go through phases of reintegration.  First they feel unsafe with the world.  As security arises, they may start to feel safe but still trust no-one.  Once trust and security is given, victims can begin to regain power, build self esteem and then finally reconnect in secure attachments.

Counselors and caregivers can help children recover and heal from abuse.

Compton lists a few key elements that must be present in this re-scheming of a child’s worldview.  Children should feel safety in the emotional connection with the counselor or pastor.  They should feel a nurturing environment that accepts them.  When the child feels unconditionally loved and also secure, then the child can begin to lower his/her defenses.  Safety must also be experienced in guidance and discipline.  Children should be able to express their emotions without fear of ridicule or scolding or judgement.  Behavioral outbursts due to trauma need to be measured and understood as negative reactions to a traumatic event.   Instead of discipline, the child needs to learn to express and emotionally regulate and communicate the distress.  Instead, the counselor or new caregiver needs to communicate boundaries and the expected and consistent behavior associated with those boundaries.  Boundaries that are given with consistency, empathy and love can help the child understand better appropriate and inappropriate reactions that he/she has developed due to bad attachment schemas.   These types of boundaries lead to predictability.  When establishing a new and healthy schema, the child needs to again find security in a consistent responses to situations.  The inconsistent care is what caused the anxious and avoidant and disorganized schemas, so a consistent care plan can help a child feel security and what to expect in life.  This consistency and predictability gives order and the order gives the child security.  Finally, Compton emphasizes the importance of safety in play and connection.  Children need to play.  Play is a key part of their growth and where they also express themselves.  Children need to understand they are safe when playing and able to grow in a safe environment.  When such safety to play and feel secure is afforded on a consistent basis, the child is able to form more secure attachments (2024, P.149-152)>

Conclusion

The most criminal act is to steal a childhood from a child and rip away the innocence through abuse and trauma.  Unfortunately, many children suffer from trauma worldwide without any loving or healing voice.  Some may experience trauma at the hands of persons, others due to extreme poverty and crime, while others due to war and natural disaster.  These traumas negatively effect the whole child.  In turn, abused and traumatized children experience distorted schemas and views on life which included various mental and emotional issues that later creep into adult life. In regards to relational attachments, many children exhibit anxious, avoidant or disorganized patterns that negatively affect their socialization and trust.  Without trust, safety, and predictability many children develop anxiety, depression, and PTSD.  Fortunately, the human soul is resilient.  Caregivers can reconnect with children and help them form new experiences by allowing them to lean on and borrow from their healthy regulated mind.  In addition, new secure schemas can be reformed by providing safety, security, empathy, love, patience and forming boundaries and schedules that help the child heal and grow from past experiences.

Caregivers can help children and their minds heal. Please review AIHCP’s Trauma Informed Care Certification Program

Please also review AIHCP’s Behavioral Healthcare Certifications, as well as its Trauma Informed Care Certification.

Additional Blogs

Attachment Disorder: Click here

RAD: Click here

Trauma and Counseling: Click here

Resource

Compton, L & Patterson, T (2024). “Skills for Safeguarding: A Guide to Preventing Abuse and Fostering Healing in the Church”.  Academic

Additional Resources

“Understanding Childhood Trauma and Its Long-Term Impact”. (2025). American SPCC. Access here

Copley, L. (2024). “Childhood Trauma & Its Lifelong Impact: 12 Resources”. Positive Psychology.  Access here

Morin, A.. (2023). “Understanding the Effects of Childhood Trauma” Very Well Mind.  Access here

“Post-Traumatic Stress Disorder in Children” (2025). CDC. Access here

“Child Trauma” SAMHSA.  Access here

 

 

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