In the News- If Your Child Is Aggressive: Seven Major Steps for Parents

Many of the children in Shorehaven’s In-Home or Outpatient mental health and psychiatry programs display aggressive or hostile behaviors.  We work to change these behaviors, to replace them with more effective, appropriate behaviors.

In this essay, we are going to go over seven steps for parents to take when a child has persistent aggressive behavior.  Such behaviors may be mostly verbal threats or negative remarks, such as “I hate you,” “You’re the worst parent,” “You’ll pay for this.”  The behaviors may be mostly physical abuses, such as throwing or breaking objects, holding kitchen knives while make threats, or hitting.  The behavior may be frequent or intermittent.  The behaviors may be in several environments such as home, school, and with peers, or only in one environment, such as at mother’s house, but not at father’s house.                      

You may have tried everything you can think of to change the behavior on your own.  Or you may have sought treatment or medications without seeing the behavior change.  If this sounds familiar, then consider these steps.

In The News: Talking with Children About Violence

In the wake of recent shootings in school, children are very aware of such events in the world.  Their understanding may be accurate or may be filtered and distorted in some way.  The child could be very anxious or concerned.  Here are some simple recommendations for talking with your child about these events.

1. Make it OKAY to talk to you.   The child’s feelings and concerns are very serious to the child. Take your child’s concerns seriously.  Don’t dismiss his or her feelings or think those feelings are silly or unwarranted.  “You are pretty worried.”  “Of course that bothers you.”  “Isn’t it sad that happened?”  “I’m glad you came to talk to me about it.”  “I see you are worried, and it’s okay for us to talk about it.”

The best time to talk is at or after a meal, but not before bedtime.

Find out what the child knows or heard about recent events; often the information is incomplete or distorted through a child’s lens, so you can correct that.

2. Empathize with the child’s feeling.  The child needs to know his or her sense of what is real and important is accepted by adults.  Otherwise the message is to hide those feelings.  So we can say, “You are really worried.”  “You feel for those children.”  “You wonder if it’s safe for you.”

Clinical News You Can Use: New Medicaid Rules for Trainees

Medicaid has paid for psychotherapy for over 30 years, long before mental health professionals were licensed in Wisconsin.  So Medicaid created a credential, Approved Provider, to identify those who could be providers of reimbursed services.  The purpose of the credential was to identify persons who had met a minimum level of presumed competence. That credential is the well-known “3000-hour letter” formerly called the “Dan Crossman letter,” then when he retired, the “Otis Woods letter,” and more recently the “Mark Hale letter.”

Psychologists have been licensed since around 1977 and approved for insurance payments since around 1978.

In the early 1990s, a law was passed creating certification of Marriage and Family Therapists, Social Workers and Clinical Social Workers, and Professional Counselors.  Certification only meant that no one could use those titles unless they met certain minimum requirements and were approved by the Department of Regulation and Licensing.

A law passed in 2001 upgraded certification to licensure.  That meant not only were the titles protected, but the very practice of psychotherapy was limited to those with one of these licenses.

All along, graduate students could practice under Medicaid and bill under a supervisor.

All this time, around 34 years, those who had graduated with a masters or doctorate, but who had not completed the Approved Provider credential or, after 1993, certification, could not practice under Medicaid – their services could not be billed to Medicaid.  This gap left new Masters level clinicians scrambling to get 3000 hours.

Finally, this week, Medicaid issued a bulletin, 2012-64, rectifying this long-standing problem.  From now on, masters-level clinicians who procure a training license and PhD/PsyD level clinicians who are on post-doctoral training will be able to credential as Medicaid providers.  They will be known as Qualified Treatment Trainees (QTT), a title defined under DHS35.03.  These provisions ONLY apply when the clinician works for a licensed mental health clinic.

This a major step to enable clinicians to train for licensure and to increase the capacity of the mental health community to serve Medicaid clientele.