Bebe Moore Campbell is a renowned advocate and author whose best-selling books on mental health topics among African Americans are standard reading for anyone interested in the subject. But she’s best known for creating MHAM.

When Congress made MMAM official, Bebe Moore Campbell opened up about her personal, family connection to the issue of mental health:

“Once my loved ones accepted the diagnosis, healing began for the entire family, but it took too long. It took years. Can’t we, as a nation, begin to speed up that process? We need a national campaign to destigmatize mental illness, especially one targeted toward African Americans…It’s not shameful to have a mental illness. Get treatment. Recovery is possible.”

Mental Health America (MHA) typically chooses a basic theme for the month, which they use as a jumping-off point for their advocacy efforts. Here’s our article on MMHAM 2023, a year with a concise theme:

Minority Mental Health Month 2023: Culture, Connection, Community

MMHAM 2024 is slightly different. Rather than a headline-type theme, organizers chose to focus on raising awareness about the mental health-related challenges common in minority communities. These challenges include:

1. Cultural and social stigma around mental health.
2. Generational differences in understanding of and approach to mental health.
3. Reluctance of people in minority communities to talk about mental health.

Mental Health America provides this free and helpful toolkit to help anyone interested in participating in MMHAM:

BIPOC Mental Health Month Toolkit

In this article, we’ll narrow the scope of our discussion to one section of the toolkit: debunking mental health myths prevalent in minority communities.

Mental Health Mythbusters: Breaking Down Stigma

In the BIPOC toolkit, Mental Health America (MHA) identifies at least six myths about seeking mental health support that persist in minority communities.

Note: BIPOC stands for Black, Indigenous, and People of Color. It’s a relatively recent acronym designed to foreground diversity in minority communities, and counter the idea that minority communities are homogenous, and only exist as the binary opposite of majority communities.

We’ll address these myths one at a time, including how the organizers at MMHAM suggest we can debunk them.

Myth 1:  Asking for help/talking about my feelings is a sign of weakness.

We understand. Everyone wants to feel strong and capable of handling their own problems and managing their own affairs without any outside help. However, evolutionary science teaches us humans evolved in groups, and behavioral science demonstrates that most of us don’t do well in isolation. What that means is that it’s in our nature to rely on the help and support of others.

Showing vulnerability takes courage and is a sign of strength.

Your friends are likely to be willing to help in any way they can. If you can’t talk to your friends or peers, though, consider your close family. If you’re not comfortable doing that, then consider talking to aunts, uncles, or people in the community you trust. For ideas about how to start a conversation, click here.

Myth 2: What happens in the family should stay in the family.

In some minority cultures, the family unit is primary. This is true for many minority communities in the U.S. For a variety of reasons, there’s a powerful tradition of keeping any challenges or problems behind closed doors. The goal is for the family to present a strong, self-sufficient, unified image to the outside world: we can take care of ourselves.

What’s important to understand, from inside of this cultural frame of reference, is that getting support for mental health challenges by any single member of the family benefits the whole family. A person can take the tools they learn in treatment and use them to improve family communication, help keep the family dynamic smooth and balanced, and help other family members overcome the challenges they face.

Myth 3: Therapy is for crazy people.

Here’s what MHA has to say about this:

“Therapy is for everyone.”

It doesn’t matter who you are, how old you are, where you’re from, or whether you have a clinical diagnosis or not. Talking to a trained professional who takes the time to listen, get to know you, and help you overcome obstacles can help improve your life. Consider these BIPOC people who discuss how therapy has helped them:

• Charlamagne tha God
• Halle Berry
• Jay Z
• Simone Biles
• Naomi Osaka

Going to therapy can help you make connections between your emotions, thoughts, and actions, which can help promote productive behavior and reduce counterproductive behavior. In addition, a therapist can teach you practical skill to manage stress and effectively process challenging emotions.

Myth 4: Mental illness is a white people problem.

First, see Myth 3, above.

Second, consider the statistics from the 2022 National Survey on Drug Use and Health (2022 NSDUH), which show the following rates of any mental illness among minority groups for people age 18+:

• Non-Hispanic, Multi-Racial: 35.2%
• Hispanic: 21.4%
• Black: 19.7%
• American/Alaskan Indigenous: 19.6%
• Asian: 16.8%

There’s another factor at work here. Data shows that around 85% of psychologists are white, but that has nothing to do with whether mental illness is exclusive to white people: it means there are more white therapists. This is slowly changing, though, and right now it is possible to find minority therapists and anti-racist therapists.

Myth 5: If you’re struggling, you aren’t praying enough.

Having a relationship with prayer, embracing spiritual traditions, and committing to spiritual development are at the root of many people’s lives. If spirituality, whether informal or organized, is important to you, you can find a therapist who shares your faith. To find counseling that aligns with a specific spiritual tradition, simply search online with terms that match your faith.

Myth 6: My ancestors and family had it worse, so I don’t have a right to feel how I do.

The people at MHA have an excellent take on this: two things can be true at the same time. Yes, your ancestors and family may have experienced racism and discrimination that’s far more extreme than anything you face, and you can feel immense gratitude for the strength and courage it took for them to survive. At the same time, you live in the here and now. It’s not only fine, but it’s beneficial for you, your family, and your descendants to recognize, discuss, and process your emotions in a healthy and productive manner. If you’ve heard of generational trauma, taking steps to heal yourself is the first step toward addressing the consequences of this persistent, damaging phenomenon.

Talking About Mental Health: Minority Mental Health Across the Generations

An important part of MMHAM this year is the fact that it’s relatively inward-directed. In the past, organizers focused on getting the message out to everyone. Minority groups, of course, but also non-minority groups in a position to leverage resources to support the immediate needs related to minority mental health. This year, the organizer target issues relevant to minority communities in general and offer insight and help for specific minority communities.

They also offer valuable resources people can use right away. They provide as tips on how younger and older generations can support one another, help finding BIPOC therapists, suggestions for how to ask for help from friends, and advice about how to get a mental health screening from a licensed, qualified professional – and then seek treatment if a screening indicates a clinical mental health issue.

This year, you can help. First, visit the Mental Health America website. Second, download the free toolkit (link in intro above). Third, share the excellent social media graphics far and wide.

The post Minority Mental Health Awareness Month 2024: Debunking Mental Health Myths appeared first on Pinnacle Treatment Centers.

But we digress.

May is Mental Health Month (MHM) in the U.S., and during the process of preparing an article to join in the annual MHM advocacy movement, we found an instructive set of statistics in the 2022 National Survey on Drug Use and Health (2022 NSDUH). Researchers asked survey respondents two questions that interest us:

If you needed treatment for a substance use disorder, why didn’t you get treatment?

If you needed treatment for a mental health disorder, why didn’t you get treatment?

We’ll share the answer in just a moment. First, we encourage you to navigate to the blog section of our website and read out article on Mental Health Month 2024:

What is Mental Health Month 2024? Learn, Act, Advocate

Now let’s look at the answers to those two survey questions.

Reasons for Not Receiving Mental Health or Addiction Treatment

The NSDUH is an important resource for two reasons: its size and its frequency. Researchers distribute surveys to over 70,000 participants across the country. Data from a sample set this large allows us to make population level generalizations. For example, if 50 percent of the sample set says “yes” to a specific question, statistical analysis tells us that – because of the large sample size – it’s almost certain 50 percent of all similar people will answer “yes” to the same question: that’s what we mean by population level generalization.

And that’s why we pay attention when the NSDUH includes questions on why people who need treatment don’t get treatment. We ask ourselves the same question every day. Now – with this reliable data – we can begin to understand.

Let’s see that the survey respondents said.

Substance Use Disorder: Reasons for Not Getting Treatment

• 78.2% of people said they thought they should be able to handle their alcohol or drug use without outside help.
• 61.3% of people said they weren’t ready for treatment.
• 52.9% said they didn’t want to go without alcohol or drugs.
• 52.2% said they didn’t know where or how to find treatment.
• 47.9% though treatment would be too expensive.
• 46.1% worried about what other people would think/say.
• 42.4% said they didn’t have time.
• 41.9% said their insurance wouldn’t cover treatment.

We’re amazed at the first bullet point, and need to editorialize immediately. Please remember:

Asking for help is a sign of strength, rather than a sign of weakness.

We understand the rest of the bullet points, too, and we spend a great deal of time working to remove barriers associated with access, cost, time, and awareness.

Now let’s look at reasons people who needed mental health treatment cited for not getting treatment.

Mental Health Disorders: Reasons for Not Getting Treatment

• 58.9% thought it would be too expensive.
• 51.6% said they weren’t ready.
• 51.2% said they didn’t know where or how to find treatment.
• 48.9% said they didn’t have time.
• 46.8% said they couldn’t find a program or provider they wanted to go to.

We see, hear, and understand – and work every day to remove these barriers to care. We encourage people who need treatment but defer for financial reasons to read these two pages published by Medicaid.gov:

• Medicaid: Substance Use Disorders
• Medicaid: Behavioral Health Disorders

For people who don’t know where or how to find treatment, these free resources can help:

• For alcohol/substance use disorder support: the SAMHSA treatment locator.
• For mental health support: The American Psychological Association (APA) treatment locator
• For opioid use disorder (OUD) treatment:
  • MAT with buprenorphine
  • MAT with methadone

In addition, you can contact us here at Pinnacle Treatment Centers: we’re always just an email or phone call away.

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As a counselor, you know all the catchphrases: “Physician, heal thyself,” “You do you,” “Become your own #1 fan.” But when it comes to taking care of yourself as a counselor, actions speak louder than words, and that action is taking the therapeutic steps you need to stay mentally fit and spiritually healthy so you can better serve your community.

Is It Wrong for a Counselor to Need Counseling?

Undoubtingly and unequivocally, it is NOT wrong for a counselor to need counseling. As a matter of fact, quite the opposite is true. Every job has its challenges and bad days, but the very nature of counseling makes it imperative that counselors are also counseled.

Why Counselors Need Counseling

People don’t go to counseling because they are happy and just want to share it with someone. They go because something is bothering them and they need help sorting it out. In this profession, a counselor wakes up every morning knowing that they are going to have to consider:

• Tough calls about steps to take
• No-win situations where you have to choose the lesser of two evils
• Continual clinicity—an incredible balance of understanding your patients’ feelings, yet staying professional and not allowing yourself to become emotionally influenced

As a concept, counseling is inherently empathetic. In addition to your own daily health, relationship, family, and spiritual needs, you are absorbing the trauma, fears, and emotions of your clients or patients. You have to in order to do a good job.

You also haul a tremendous amount of confidentiality cargo. You know about so many horrible things that are happening to people, but you can’t tell a soul. That is a tremendous weight to carry and could sink any ship. It is hard to help someone with a life preserver when you, yourself, are over your head and drowning.

Overcoming the Shame Roadblock

There are a number of interpretations of the shame roadblock. Some counselors will begin to feel ashamed because they “have it so good” compared to their patients. They may even start feeling guilt for charging fees to people who are already hurting.

Some counselors also believe that if they feel stressed, they must be doing something wrong and hit a shame roadblock because of it. This misguided thought process leads a counselor to believe, “If I can’t help myself, how can I help anyone else?”

Taking care of yourself as a counselor by talking to a therapist yourself can be your “check engine” light. It’s time to take a look at the machinations of your practice and your life, and make the necessary tune-ups and repairs.

The Benefits of Counseling to a Counselor

The beauty of getting counseling as a counselor is that there are benefits for you personally and professionally, and thus in turn for your patients. During your sessions, you can be enjoying:

• A confidant who is neutral and non-judgemental, yet understands your experiences and feelings personally.
• An outlet for your personal problems as well as concerns about your professional life.
• Time that is all about YOU.
• The opportunity to do a better job for your patients, because when you clear your mind of tensions and concerns, you will be less distracted, less guarded, and more receptive to and able to help with patient concerns.

Burn Bright, Not Out

We are all in the pandemic together, sharing fears and isolation. While that may make it easier to help a patient because you are sharing the experience, it can also make it more frustrating because you cannot comment on said shared experience.

Counselors are needed now more than ever. In March of 2020, the Disaster Distress Helpline saw a 891% increase in call volume as compared to March 2019, which in turn saw a 338% jump from February 2020.

People are scared. People are hurting. People are grieving. As a counselor, you are the soldier and hero coming to their aid. Don’t forget to allow yourself time to heal and be well.

The post Taking Care of Yourself as a Counselor appeared first on Pinnacle Treatment Centers.

What is CBT?

Cognitive behavioral therapy is based on the premise that our thoughts, feelings, and behaviors are interconnected and stem from underlying core beliefs.  For example, negative feelings are fueled by negative thoughts and frequently lead to unhealthy or blatantly self-destructive behaviors (e.g. drinking or using to escape).  The self-destructive behavior, in turn, can further fuel the negative thoughts and feelings, creating a vicious cycle.  Learning to intervene in and change our negative thoughts to healthier, more positive thoughts can help create more positive feelings and lead to more positive behaviors.

An example of all this in play would be an alcoholic who has the underlying belief, “I’m worthless”.  Life situations that involve any type of perceived rejection or abandonment – which everyone experiences from time to time – trigger an array of negative automatic thoughts related to this belief, such as “Why bother, nobody cares anyway”, “Everyone always leaves”, and, “Nothing I do is ever good enough”.  Those beliefs trigger negative feelings, which the alcoholic knows will go away – at least temporarily – after a few drinks, which is the self-destructive behavior.  Each time alcohol provides an escape the behavior is reinforced, leading to more negative thoughts about being worthless and a failure due to the drinking.  Cognitive behavioral therapy can help the alcoholic learn ways to intervene in and stop this vicious cycle.

Reframing Perception

Cognitive behavioral therapy helps individuals change their perception of situations by thinking about those situations differently.  For example, if the alcoholic individual (in the example above) experiences a relationship break-up, she can use cognitive behavioral techniques to change her perception of the situation from, “I’m worthless; no one will ever love me, and everyone eventually leaves” to “I have a lot to offer the right person.  This wasn’t the right relationship for me and, although it will hurt for a while, the end of this relationship isn’t a reflection of my worth as a person”.  The first perception causes distress and increases the likeliness of using alcohol to cope.  The second “reframed” way of looking at the situation decreases distress and bolsters more positive feelings and behaviors.  

Features of CBT

There are several features of cognitive behavioral therapy that make it a valuable component in the treatment of substance use disorders:

• CBT is focused on addressing a specific problem
• It’s goal-oriented and collaborative. Client and therapist work together to reach the mutually agreed-upon treatment goal
• It’s a short-term treatment, typically lasting 16 to 20 sessions
• Therapy typically includes homework assignments to be completed in between therapy sessions and discussed at the next session
• The therapist takes an active role in the treatment process
• It’s geared more towards helping clients learn healthy coping skills they can start practicing and using right away rather than helping them gain insight into deeper, underlying issues

Key Elements of CBT

There are several key elements of cognitive behavioral therapy, which are identified and addressed throughout the therapy process.  They include:

• Automatic Thoughts
• Cognitive Distortions
• Self-Talk
• Thoughts Feelings Actions Triangle
• Core Beliefs

CBT Elements Explained

Automatic Thoughts

American psychiatrist Dr. Aaron Beck, who originated cognitive behavioral therapy over 50 years ago, noticed his depressed patients seemed to struggle with a stream of spontaneous negative thoughts.  These “automatic thoughts” fueled and exacerbated their depressed mood.  CBT helps individuals identify and challenge their negative automatic thoughts by looking at evidence that contradicts them. 

Cognitive Distortions

Negative thoughts and beliefs come in a variety of forms known as cognitive distortions or “thinking errors”.  Cognitive distortions are irrational and flawed.  They’ve been found to play a role in anxiety, depression, substance abuse and addiction, and a variety of other psychological problems.

Common Cognitive Distortions

• All-or-nothing thinking (also called black-and-white thinking) (e.g. “If I don’t get this job then there’s no point in continuing to look”; “This entire week was a complete loss!”)
• Catastrophizing (e.g. “I relapsed again; my life is ruined”)
• “Should” statements (e.g. “I should do everything perfectly”)
• Overgeneralization – typically includes “always” or “never” (e.g. “I always screw up everything”)
• Disqualifying the positive – (e.g. “The only reason she went out with me is because she didn’t have anything better to do”)
• Labeling (e.g. “I’m worthless (or a loser, a failure, etc.)”)
• Blaming (e.g. “I wouldn’t be an addict if I’d had a better childhood”)
• Filtering – Focusing on any negative aspect of something, such as yourself or a situation, while dismissing or ignoring any positive aspects
• Mind reading (e.g. “My friend didn’t return my call so he’s obviously mad at me”)
• Personalizing (e.g. “I didn’t get that promotion because my boss doesn’t like me”)
• Emotional reasoning – making decisions based on feelings not values (e.g. “I’m not going to my NA meeting because I don’t feel up to it”), or assuming something is true based on how you feel (e.g. “I feel like an idiot so I must be an idiot”).

Cognitive behavioral therapy helps individuals recognize their cognitive distortions and learn to replace them with healthier, more rational ways of thinking.

Self-Talk

Self-talk is something we all engage in throughout the day.  It’s the internal commentary we have about ourselves, other people, and events or situations.  Individuals who struggle with depression, for example, often have a lot of negative self-talk.  Examples include thoughts like “Nothing will ever get better”, “I’m such a loser”, and “Why bother trying, nothing ever works out for me so I might as well keep using”.

Thoughts Feelings Actions Triangle

The thoughts-feelings-actions triangle concept in CBT  demonstrates the connection between our self-talk/automatic thoughts, our feelings, and our actions – which comprise the three corners of the triangle. Each one affects the other two.  CBT helps individuals learn to notice their distorted, negative thoughts and stop them, challenge, and replace them with thoughts that are more rational and positive.  Doing this helps create a positive shift in their emotions and actions.

Core Beliefs

Our “core beliefs” about ourselves, others, and the world form the basis of our thoughts, feelings, and actions.  All of us have a unique combination of core beliefs.  Cognitive behavioral therapy helps individuals identify and challenge their distorted and irrational core beliefs.  It’s these problematic beliefs that underlie unhealthy choices and self-destructive behaviors, such as abusing substances.

Techniques used in CBT

Therapists use a variety of techniques in CBT.

CBT: Common Therapeutic Techniques

Keeping a Thought Diary

In addiction recovery treatment it can be helpful to keep a diary or record of negative thoughts and self-talk.  This provides an ongoing opportunity to critically evaluate each thought (and underlying beliefs) by considering objective evidence that contradicts it as well as supports it. 

Behavioral Experiments

This CBT technique involves testing the validity of our thoughts (e.g. assumptions we tend to make) and beliefs.  These experiments can also help determine which thoughts support more desirable behaviors. 

Situation Exposure Hierarchies

This technique involves creating a list of distressing situations or activities and ordering the items on the list based on which causes the least distress to which causes the most.  Then, start by facing the first (least distressing) item on the list several times over a period of a few days until the distress decreases by at least half.  Therapists frequently use exposure techniques to treat anxiety and related disorders (e.g. PTSD and OCD).  They may be especially useful to individuals who frequently drank or used when feeling anxious.

Pleasant Activity Schedule

One of the most effective ways to create more positive emotions is to do something you enjoy.  Scheduling at least one fun activity each day helps individuals with substance use disorders have fewer negative thoughts and feelings, which in turn decreases the urge to drink or use as an escape.

Imagery Based Exposure

This CBT strategy involves purposely remembering a distressing event that triggered intense negative feelings and, subsequently, an unhealthy coping response (e.g. the urge to get drunk or high). Individuals are instructed to continue vividly picturing the incident until the amount of distress it elicits is at least 50% less than it was initially.  Whenever the memory resurfaces in the future it’s much less painful, thus greatly reducing the need to self-medicate.

Benefits of CBT

Cognitive behavioral therapy has been well-researched over the years, and the potential benefits have been well-documented.  It can help individuals:

• Communicate more effectively
• Learn to manage painful emotions in a constructive, rather than self-destructive, manner
• Process and heal from trauma
• Learn to stop negative thoughts and rumination
• Address and resolve challenges in their relationships with others
• Develop healthy ways to cope with stress, loss, and difficult situations
• Reduce their symptoms of depression, anxiety, and other psychiatric disorders
• Identify and change flawed beliefs and negative thought patterns that perpetuate self-destructive behavior and interfere with positive change

Cognitive behavioral therapy can play a significant role in reducing the likeliness of relapse.  It’s almost impossible for someone with an addiction to stay clean and sober without addressing the underlying flawed thought patterns and beliefs, and without instilling healthy new coping skills to manage the painful emotions that are an inevitable part of life.

Why CBT is an Ideal Component of Substance Abuse Treatment

Cognitive behavioral therapy fits well into drug and alcohol treatment because:

• It helps individuals identify the underlying flawed beliefs that lead to self-destructive behavior.
• The concepts are practical and relatively easy to understand
• It usually involves completing homework between sessions, which enhances the therapy process
• It’s easy to start applying the concepts in one’s daily life
• CBT is based on a collaborative effort between the individual and the therapist
• It’s a time-limited, relatively short-term therapy, usually lasting between 10 and 25 sessions (16 total sessions are common)
• It’s effective in both group settings and individual settings
• It’s effective in the treatment of substance use disorders and many other psychiatric disorders, which makes it a valuable part of any dual diagnosis treatment program

While there’s no “one-size-fits-all” approach to therapy, CBT has helped countless individuals on their journey to establish a substance-free lifestyle.  Although CBT can be quite effective on its own, it’s generally the most effective when combined with other forms of treatment for anyone with a substance use disorder as well as individuals requiring dual diagnosis treatment.

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