Monday, November 23, 2020

On the DCF/DOJ settlement on parents with disabilities

The backstory and coming changes are outlined in this WBUR article

I do think there's a big piece missing here, which is that while there are certainly problems with folks at DCF relying on stereotypes of disabilities rather than objective facts (as the story discusses), there's also a problem with DCF not even usually recognizing objective behavior as part of a disability and not being able to appropriately assess what the objective behavior does or doesn't mean. 

I have evaluated a large number of DCF-involved parents who I perceive to have undiagnosed neurodevelopmental or psychiatric disabilities, but who never had access to educators or healthcare professionals who recognized this and provided appropriate support. These folks don't have the privilege that wealthier and whiter disabled folks often have in which they have a diagnosis, have done the work on self-awareness, and can tell anyone who is concerned that they have a diagnosis of X and struggle with Y, but have no major trouble with daily parenting tasks or safety. They instead just present as unusual to the non-clinicians at DCF who are evaluating them, and aren't able to explain why or ask for appropriate accommodations. 

Depending on my role with the family, I may be able to provide a full psych eval and appropriate diagnosis if hired privately or through CPCS, or I may be more limited and only able to attest to observed/reported skills and deficits if hired by DCF to evaluate parenting.

What I often find is patterns of folks at DCF who use particular buzzwords describing a parent and insinuating their child(ren) are at risk because of this. Common ones are "flat affect," "off-topic," "mental health issues," "cognitive issues," and "personality traits." DCF workers are rarely independently licensed clinicians and do not use empirically validated clinical tools to complete full assessments of parents. They do, however, submit affidavits to the court stating that a child should be placed in their custody due to these buzzwords. They are not generally required to substantiate how they determined that these terms apply or to give more specific information as to what exactly they mean. These buzzwords are usually sufficient to seek custody of a child. 

(There are of course plenty of ethical DCF workers who do provide concrete examples of observable behaviors, seek out extensive consultation with collaterals, and only seek custody when they have grounds to do so and a child is truly at risk. I am specifically discussing the instances when alarmist workers take custody unnecessarily and put up barriers to reunification, which is why they ended up with the DOJ civil rights division investigation.) 

This DOJ order doesn't seem like it will alter those situations in which DCF is implying a disability (and often the wrong disability). It seems that alarmist workers are already listing observable behaviors rather than referring to a known or suspected disability; the behaviors are just usually vague, often inaccurately perceived, and don't necessarily have anything to do with a child's safety. The workers know that while "cognitive issues" correctly refers to anything from mild AD/HD through profound intellectual disability, writing it in an affidavit implies significant intellectual disability. While "off-topic" can describe either any anxious parent making sure they cover everything important or a parent who is actively psychotic, most people are going to assume it must have been the latter if someone bothered to mention it as an alleged safety concern. While "personality traits" are something every single person has, anyone working adjacent to clinical settings knows it implies someone has active narcissism/antisocial/related behaviors. 

The hiring of a disability coordinator is not likely going to do much when most of the disability discrimination I observe is toward parents who don't have a diagnosed disability. (The ADA does offer protections to those wrongly perceived to have a disability, but I don't see this working in practice even if DCF does extend disability coordinator services to anyone who wants them. The workers don't generally recognize disability in the sense of being able to be competent when given appropriate accommodations, and parents facing DCF who do not identify as disabled are not likely to want to see a disability coordinator.)

What we need is reforms to the whole way the system operates. The agency is in massive need of anti-bias training. The employees need to look like the communities in which they work. Evaluation by licensed clinicians needs to happen from the start, rather than be something that has to be insisted upon once a family is risking termination of rights. The agency needs to be required to accept evaluations from families' own providers as just as valid as their assessments (and likely more valid, for reasons that should be obvious). They need a major culture shift, in which every person employed there believes the research that all contact with that system is traumatic and destabilizing, and the research that children do better with their families in all except the most extreme circumstances. 

Friday, November 6, 2020

Rounding up free/inexpensive MA LMHC CEUs

To follow up on my previous post wondering about this, the Massachusetts Board of Registration of Allied Mental Health and Human Services Professions has issued an emergency policy for 2020-2021 allowing all 30 CEUs to be earned via online or home study programs.

It also appears that they updated their policy in 2011 to clarify that "The Board has determined that LIVE tele-seminars and LIVE webinars would be accepted by the Board as "live" CEUs. Re-broadcasts are not be accepted as "live" CEUs." This is of course buried on their page in a board policy section, rather than mentioned in any of the several sections about licensure renewal or CEU requirements that are easily navigable from their front page. (Calling anything "easily navigable" on these new pages is giving them entirely too much credit, of course; the page layouts and navigation are terrible.)

Anyway, this does seem that they have in fact caught up with the times and recognized that live online events are quite different from asynchronous online courses. I am pleased to find this, even if it took some serious digging to find.

On that note, since this is a good time to get some CEUs completed, I'm rounding up free/low-cost CEUs (both "regular" online and live online). I'm going to post pretty much anything I find that has NBCC credits, and will post ones offering other credit if the content looks particularly good. (For those who are unaware, the LMHC board accepts credits approved by NBCC or MaMHCA, and MaMHCA will "convert" CEUs from APA/NASW/other state boards etc. for a small fee, which is just really some ridiculous bureaucracy, but it is what it is.)

Without further ado...

Cultivating Post Traumatic Growth in Kids and Families through Mindfulness during COVID
4 NBCC CEUs, Free
William James College
Self-study online, available through December 31

Ethics and Boundary Issues
5 NBCC CEUs, Free
Self-study online, appears to be available pretty indefinitely

(And since it's a topic on which I teach a lot of trainings and know the research quite well, I want to mention that I assume this course follows the status quo and suggests "better safe than sorry" mandated reporting practices, which have been shown to cause harm and not increase safety, and which laws and ethics codes absolutely do not require. Take the course to get your free CEUs, then educate yourself elsewhere as to how to ensure safety and satisfy liability without excessive reporting.)

Providing Inclusive, Respectful Care to Your Gender Questioning, Transgender, & Nonbinary Clients
1 CEU (NBCC and others), Free
Clearly Clinical
Self-study online, appears to be available pretty indefinitely

Note: Unless stated otherwise, I have no affiliation with courses, presenters, or organizations, posts are not any type of endorsement. I am committed to publicizing low-cost CEU opportunities to assist fellow clinicians in locating these, and will generally publish any I encounter.

Sunday, May 24, 2020

Will the COVID-19 situation finally convince the MA LMHC board to update guidelines for online CEUs?

Since I became licensed in 2005, the policy of the Massachusetts Board of Allied Mental Health and Human Services Professionals has always been that no more than 50% of LMHC CEUs can be earned "on line or via home study." (Interestingly, this is stated in various documents of theirs such as this one, but the actual law regulating the continuing education requirements, 262 CMR 7.00, doesn't specify anything about online vs. in-person.)

When I was first licensed, the only type of online education available was largely text-based and did not generally occur in real time. Most people were using dialup internet at this time. Streaming media existed, but wasn't something most people's home setups could handle. College courses taught online from about 1995-2010 or so were generally something like a text-based discussion forum with papers submitted by e-mail or upload. There were maybe a few pre-recorded YouTube videos of lectures if the instructor was savvy. Similarly, the only "online" professional continuing education available at the time they made this regulation was the type (still widely in use today) in which the learner reads through some array of articles or slides, maybe a few short video clips, then takes a multiple-choice quiz, with no interaction with the instructor at any point. There were also home study courses that could be purchased that were similar –– read some stuff, take a quiz, get some credits.

For the past five years or so, I have been thinking the "no more than 50% online" regulation seemed a bit outdated. So many organizations are now offering trainings and conferences online using interactive Zoom sessions limited to a classroom-sized group. Actually, if we want to get into whether interaction is a necessary component of a training worthy of credits, a number of conferences I've attended do give one CEU for attending a keynote speech with hundreds of people present and no discussion or interaction. How is that any different from watching a video at home?

We should also be considering that best practices in the field mean we have plenty of providers of all different socioeconomic backgrounds and those living with disabilities, among other folks who make our field look more like the folks we serve. Many of the people we should be encouraging to work in our field are more comfortable with courses that can be taken at home, as these are generally less expensive and are often much more accessible to people with psychiatric or other disabilities who may have a hard time with travel and/or being in a conference setting all day.

This year, a number of well-established conferences that typically meet in person (thus usually awarding what would be considered in-person CEUs by the licensing board) have moved their conferences online. Sessions are taking place over Zoom or similar. Attendees are able to have discussions with presenters and break into small groups to do activities, just like at in-person conferences.

Based on what is still listed on the licensing board web site, these conferences will no longer count as in-person CEUs, despite being the same conference as the one that usually occurs in person, and despite having a similar level of face-to-face interaction. Many conferences for early 2021 have already made the decision to cancel the in-person event. I am surmising that a large percentage of LMHCs renewing licenses in December of 2021 will be in the position in which more than 50% of our CEUs were taken online, despite being high-quality offerings through universities, medical centers, established conferences, and so forth. My hope is that rather than just issuing an emergency waiver allowing for 100% online CEUs, the board will actually take this as an opportunity to review what constitutes an acceptable course. I hope that they will move into modern times and recognize that the "distance learning" of pre-2005 is not the distance learning of 2020, and change the policy to reflect the high-quality interactive offerings that now take place online.

Monday, March 16, 2020

Online trans/queer/LGBTQ+ youth support groups offered free or at a steep discount

E-mail me for details.

Black-owned yoga website offering free online classes until April 11

From an e-mail I received and wanted to pass along:

To support the community during these times, the 11 online classes below are free to everyone until April 11. These classes are focused on relaxation and restoration which may be useful during these increasingly stressful times. Share this email with your family and friends so they have access too. Class descriptions are on our website.
  1. 15-Minute Midday Yoga with Chanel Sledge
  2. Breathing Techniques to Relieve Stress & Anxiety with Nikki Dixon-Ewing
  3. Grounding Practice for Vata with Jo-Jo Jackson
  4. Chair Yoga - Erica Rascon
  5. Family Yoga - Jerrell Simpson
  6. Meditation for Calmness and Centeredness - Jessica Young
  7. Meditation for Healers - Tenci Campbell
  8. Yoga for Healing and Restoring - Raikeis Timm
  9. Gentle Faith & Flow - Sherrell Moore-Tucker
  10. Yoga for Neck & Shoulders with Biola Akanni
  11. Yoga Nidra - Jessica Young

I have no affiliation with Yoga Green Book, other than having done some of the classes with my own family.