Bullying

  

 Bullying has become such a problem for children in school these days that state legislatures have been forced to pass "anti-bullying statutes" allowing schools to handle and address the problems associated with bullying.  It is estimated that everyday, thousands of children wake up afraid to go to school due to bullying.  Although the exact definition of bullying is debatable, most everyone agrees that it occurs when one person is picked on over and over either by an individual or a group with more power, either in physical strength or social standing.

     The two biggest reasons children are bullied include 1) appearance 2) social status.  Those children who are believed to possess a lower social status or those deemed not as "attractive" as other students are those most likely to be the targets of bullies.  Unfortunately, children who are openly gay or lesbian bear the brunt of bullying although bullies can target individuals because of how they look or act or because of race or religion.

     Bullying may include name calling, social stigmatism, tripping or even physical violence.  Girl bullies may resort to slander, emotional manipulation (inviting someone to a party only to discover there is none), isolating others or even shunning them.  Girls are also known to spread viscious and untrue rumors as well as refer to other girls as "slut," "whore," "bitch," or other degrading names.  In the case of Phoebe Prince, she was cyber bullied as well as bullied at school to the point of committing suicide.  On January 14, 2010 she reportedly hanged herself after relentless bullying by older girls for dating a football player.  In May of 2010 a Jemison, Alabama High School student jumped to her death from an interstate overpass after relentless bullying at school.  There are numerous other stories of children committing suicide due to bullying, hence the need for legislation regulating and controlling this phenomenon.

     TIPS FOR DEALING WITH BULLIES

     1) Ignore the bully and walk away - remember, bullies thrive on the attention they receive from bystanders.  As soon as you begin to feel the victim of a bully attempt to leave the situation to go to the bathroom, the other side of the playground or even go stand near the teacher and strike up a conversation asking a question.

     2) Don't get angry - remember, bullies thrive on knowing they can control your emotions.  If you become visibly angry you have most likely given them the exact thing they are looking for.

     3)  Practice Confidence - practice ways in which to respond to the bully which show you are self confident and have no regard for their opinions.  For instance if your looks have been criticized you may respond with an answer which reflects your complete disregard for their opinion.

Above all, you should TALK about the bullying to someone you can trust and keep going until you find an adult who can help you manage and/or deal with the situation.  No one should have to endure bullying and remember, you are as valuable as YOU feel you are.  Bullies do not get to decide or determine someone's worth as an individual!!

DSM-5

     The DSM-5 also known as the "Diagnostic and Statistical Manual of Mental Disorders" is scheduled for release in May of 2013.  The DSM "task force" as they call themselves have worked to develop and implement changes to the current DSM-IV and the new revisions will include updated guidelines for diagnosing and recognizing bipolar disorder as well as schizophrenia.  It is also believed that the upcoming DSM-5 will include the diagnosis of "Premenstrual Dysphoric Disorder."

     For social workers working in the area of mental health the DSM manual is often the "guideline" or "blueprint" used in recognizing and identifying different psychiatric conditions.  While in most states (in Alabama for sure) social workers do not "diagnose" patients it is still helpful to know and understand the criteria of the DSM manual when working with patients who have a diagnosed and mental illness and sometimes, even with those who do not have a confirmed diagnosis of a mental illness.

     It is important to note that BEFORE any revisions where made to the DSM field trials "utilizing the new criteria" where completed in two different settings "1) a series of large, academic-medical institutions, and 2) a wide selection of clinical practice settings, such as solo and small group practices," (http://www.dsm5.org/).  The "Task Force" will also be making the topics of "Feeding and Eating Disorders" as well as "Elimination Disorders" part of the DSM-5. 

     "This restructured organization is designed to better reflect scientific advances in our understanding of psychiatric disorders, as well as to make diagnosis easier and more clinician-friendly. For instance, all of the chapters are organized in a developmental lifespan fashion, starting with Neurodevelopmental Disorders, which often are diagnosed in infancy and early childhood, and progressing through diagnostic areas more commonly diagnosed in adulthood, such as Sleep-Wake Disorders. Within each diagnostic category, the individual disorders are similarly arranged such that those typically diagnosed in childhood are listed first," (http://www.dsm5.org/).  

     For those who would like some more information regarding the DSM-5 scheduled for release in 2013 the "task force" has developed a web site filled with information on the new upcoming DSM as well as information regarding revisions.... you can check out their web site at http://www.dsm5.org./

An Insurance Disaster...

     It was in August of 2010 that I realized I was pregnant and that soon... there would be a little munchkin on the way. At 30 years old and having been told once "you have ovarian cancer," (at about 23 years old), followed by "you'll probably never be able to have children," you can imagine my surprise and sheer joy. Finally!!... there would be a baby to call my own. I soon found out it would be a little girl and both my husband and I were delighted that everything looked great for both mom and baby.

     Eventually, things took a turn for the worse and what started out as a cake walk (no morning sickness, no nausea or even vomiting!) ended up every woman's worst nightmare! I began to have complications with blood pressure, terrible swelling, in not just my ankles, but hands and face. After two hospitalization I learned that I was pre-eclampsic and at risk for seizures and possible death if it couldn't be controlled.

    It was somewhere around this time I learned that my ALFA managed Blue Cross Blue Shield health insurance policy would not only cover any of my physician visits, ultrasound appointments or lab work.... they wouldn't even be covering ANY of the labor and delivery for what was already a complicated pregnancy. WHY??? you ask? ... Because ALFA managed health insurance policies do not provide maternity benefits for ANY woman who is not the "spouse of a MALE policy holder." So, because my HUSBAND did not have "family coverage" with them and I was "single" at the time of conception, ALFA's "policy" did not "allow them" to cover the pregnancy.

     When I questioned a representative from the insurance company on how this was even legal or possible to do (to someone who had been paying premiums for about 6 years) .... I was told that they in fact, did not have to cover ANY pregnancy for any of their "single, pregnant" policy holders. They further stated that I would need their "family coverage" to have "maternity benefits." Well, "Why in the world would a SINGLE woman need FAMILY coverage?" was the question that came to mind... but I knew I was fighting a loosing battle and with already sky high blood pressure, jeapordizing the health of myself, as well as my baby, I knew the conversation could no longer continue.

     What they were doing was 100% legal. They were not violating any laws because in this country it is legal to deny maternity benefits to women who are forced to purchase their health insurance on the own. The reason I decided to purchase my own health insurance in the first place was because I married my first husband at the young age of 20. After a very difficult divorce I attempted to find work on my own (after moving back in with my parents three years later.)

     As you can imagine, there isn't much work available for a recently divorced, 23yo female with no education. So.... I decided to go back to college. While pursuing my bachelor's in Criminal Justice and Master's in Social Work from the University of Alabama I made the decision to purchase my own health insurance, unfortunately through ALFA, so that I would be insured incase of any medical emergencies.

     Well, ... as of today, I am over $30,000 in debt to the physicians and hospital due to a complicated pregnancy. My credit rating is ruined and I may most likely seek out the option of bankruptcy as social workers aren't exactly known for "making the money." It is not an option I want. I would love to be able to pay my bills... even if I could do it through monthly payments.. however, the hospital only allows credit for "9 months" and I'm sure you can imagine the monthly payments on paying off $30,000 within 9 months. It just wasn't something I could ever even feesibly do.

     However, through it all I now have a healthy, happy and beautiful baby girl and someday I hope SHE can live in a country where this type of blatant gender discrimination through insurance isn't even a concern.

Spice.... The New (& Now Illegal) Marijuana

         

          It seems there's a new drug in town. It's marketed by the name of "Spice." It's psychoactive and chemical compunds mimic that of marijuana. Officials believe it is mostly consumed by younger people. The Children's hospital of Alabama has reported approximately 67 phone calls since October of 2010 from those who have been affected by this marijuana like drug.

          In many states it can be purchased at gas stations,on-line, herb & tobacco shops and incense stores.  It has recently been declared illegal in Alabama and it could just be a matter of time before other states follow suit.

          It's side effects include nausea,vomiting, hallucinations,paranoia, headaches and increased heart rate. Officials also report that three of the recent victims were ages 6-12, 15 of them were teenagers and 22 of them were in their 20's. Approximately 6,700 phone calls have been made to the poison control center since the introduction of "spice" which also goes by the names of "K2," "spice gold," "sence," "genie," Yucatan fire," "smoke," and "skunk."

The Drug Enforcement Agency has considred "spice" to be a synthetic form of marijuana and a "drug of concern."

Substance Abuse & Triple C's

Recreational drug use has been a part of societal culture for as long as I can remember. Cannabis, Cocaine, Methamphetamines and a slue of other drugs have been used recreationally for years by teens and adults alike. One drug I am beginning to see more and more in my professional career as psychiatric social worker is the use of "triple c's," or "cold, cough and congestion" medication. Because these medications usually have some degree of ephedrine (a stimulant) many have learned they can take one or more boxes at a time to achieve a 'high.' These drugs have been abused for years by those who manufacture methamphetamine because the ephedrine is needed for the production of meth. What's more surprising is that a majority of individuals using these 'triple c's' are teenagers and young adults as they are more readily available than alcohol or other street drugs. They are found in most stores and unsuspecting parents are unlikely to question their child's needs for a cold, cough and congestion medication.

Trials & Triumphs of Social Work

Ahh... the tragedies, trials, joys and triumphs that come with the territory of social work. It doesn't matter if you work with patients, clients, children or adults there are certain qualities unique to all forms of social work. Frustration and joy, despair and excitement, accomplishments and failures. No matter what you do in social work or who you work with it is certain all of the aforementioned emotions have been or will be experienced. If you haven't expreienced these emotions....just give yourself some time, you will.

In everything we do, what's right for the patient takes precedent. However, does this mean if a patient has poor insight and no clue what they are in need of that social workers should intervene? Does this mean that if a patient yearns for the absolute worse thing they need that social workers intervene? Or, could it possibly mean that compromise reigns paramount and finding a solution acceptable to all is the appropriate answer?

No matter what your personal opinion regarding the matter is, we can remain certain that all emotions within the realm of human emotions are certain to be experienced in the occupation of social work.

AXIS II

Axis II. It's one of the most complicated Axes for clinicians to treat. Primarily because the prognosis for individuals who fall under this Axis is only fair at best. Aside from Mental Retardation, Axis II also holds the diagnoses of Personality Disorders.

Personality is ultimately the determining factor for how we will live our lives. It is directly related to how we think, make decisions and take action. An individual with a Personality Disorder develops traits which are maladaptive and inflexible and ultimately lead to behaviors which cause discomfort, distress and impair an individual's ability to function in society in a manner that reflects stability, security and sound judgement.

There are approximately 11 recognized Personality Disorders. The DSMIV-TR provides the following information regarding Personality Disorders:

"General diagnostic criteria is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas: cognition (i.e., ways of perceiving and interpreting self, other people, and events); affectivity (i.e., the range, intensity, lability, and inappropriateness of emotional response); interpersonal functioning; and impulse control. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. The individual's pattern is stable of long duration and its onset can be traced back at least to adolescence or early adulthood."

Now, the booming question most clinician's will ask regarding individuals with Personality Disorders is "How do I manage them and their destructive behaviors?"

According to the High Conflict Institute there are 12 tips for managing individuals with high conflict personalities. 5 Do's and 7 Dont's:

Part I: Understanding High Conflict People

Tip #1: Don’t Take Their Personal Attacks Personally

Tip #2: Don’t Give Them Negative Feedback

Tip #3: Don’t Bend Boundaries With Borderlines

Tip #4: Don’t Diss the Narcissists

Tip #5: Don’t Get Hooked by Histrionics

Tip #6: Don’t Get Conned by Antisocials

Tip #7: Don’t Be a Negative Advocate



Part II: Managing High Conflict People

Tip #8: Connect Using Your E.A.R.

Tip #9: Analyze Your Realistic Options

Tip #10: Respond Quickly to Misinformation

Tip #11: Set Limits on Misbehavior

Tip #12: Choose Your Battles

If you would like more information regarding managing individuals with Personality Disorders and those with High Conflict Personalities you might want to consider reading the following book IT'S ALL YOUR FAULT! 12 TIPS FOR MANAGING PEOPLE WHO BLAME OTHERS FOR EVERYTHING.