By: Jordan Thurman, MSW, LISW-S

I have naturally curly hair. I am the only one in my immediate family that has such hair, which made it very hard for them to understand my hair care. I remember my grandmother trying to brush my hair while I screamed and then cried when I looked in the mirror at the frizzy mess before me. They had no idea what to do with it, and as a consequence, neither did I. I was taken to hair salons that would spend two hours trying to straighten my hair after they trimmed it, only for my hair to instantly curl back up the minute it was washed.


As I grew up and muddled my way through trying to discover how to best care for my hair, I found myself able to locate salons that didn’t attempt to straighten my hair, but that was really it. No one really noticed the unique needs of my hair. It wasn’t until recently, I decided I was going to go to a hair salon that specializes in curl care. It was such a unique and wonderful experience for me. I felt understood and seen for the needs I had, and everything was all customized to me. I was able to be educated on things to better help my hair, and I left with a sense of pride in this part of me. I felt more confident and empowered.


Why do I share that story on a blog post about Pride Month? The answer is simple: to help us recognize the differences between tolerance and affirming and why it is important to understand these differences. Many already know that intolerance is a bad thing. However, we think it’s enough to just say, “Oh you’re part of the LGBTQ+ community? Cool!” The reality is that this is far from enough.


To start, we need to look at what tolerance is. If you were to do a quick Google search of the word “tolerance,” you would find that it is defined as the willingness to tolerate something “in particular the existence of opinions or behavior that one does not necessarily agree with.” It is often described as an ability to endure something painful or unenjoyable. The essence of tolerance in the LGBTQ+ community is this: it sends a message that the individual makes us uncomfortable. There are many people out there that will go, “I’m okay with you being gay or whatever, but I would prefer you to not discuss that.”


Imagine being on the receiving end of that for just a minute. Imagine going to a doctor, going on a date, or just any encounter with a person where you start talking about something important to you. Maybe you bring up your family, your job, a hobby, or anything else you love and enjoy. As soon as you bring that up, the person you are talking to becomes visibly uncomfortable. Two things would likely happen: 1. You would never bring up that part of you that is essential to you and keep a wall up or 2. You will make efforts to avoid seeing this person again.


Many health care professionals, including therapists, fall into this category of tolerance citing that they do not believe it is necessary for treatment. These professionals are often left wondering why their patients stopped showing up to appointments despite doing what they believed was effective treatment for their patient’s needs. The reality is that a clinician in this mindset did more harm to a patient by promoting a sense of shame and guilt. As mental health professionals, it is important for us to remember we are to be culturally competent clinicians who embrace a comprehensive, biopsychosocial approach that meets the individual needs of a patient seeking services. When there is an aspect of a patient’s identity or culture that is not
welcomed into the time together because it makes the clinician uncomfortable, then that clinician has failed to uphold best practice standards.


The definition of affirming is simple: offering someone emotional support or encouragement. That’s like Therapy 101, isn’t it? We know taking this approach is what can help our patients believe that they are capable of growth. An affirming approach with the LGBTQ+ patient is an approach that invites that part of their identity to be part of the conversation with welcome arms. “I would love to hear more about your relationship. How long have you two been together?” “I go by Jordan, and my pronouns are she/her/hers. What name and pronouns do you go by?” In these moments, we can show we welcome that part. This is a place you can talk about that piece of you and what it means. This is important because as therapists, we should recognize that many systems can contribute to stressors as well as protective factors and resources.


The harmful culture of tolerance and the effectiveness of affirmation is evident in research. In 2014, a study conducted Durso and Meyer found that 39.3% of bisexual men, 32.6% of bisexual women, 10% of gay men, and 12.9% of lesbians did not share their sexual orientation with health care providers. Another article written in 2015 by Sabin, Riskind, and Nosek found that stigma, lack of cultural sensitivity, and reluctance to address sexuality may hamper effectiveness of care. A study in 2006 by Steele, Tinmouth, and Lu found that positivity and inquiry about sexual identity led to disclosure, and disclosure led to regular health care use.


Tolerance alone is not enough and could potentially cause more harm, particularly in a health care setting as it could lead to patients disengaging from services. If we want to keep patients engaged in treatment, we must embrace an attitude of affirmation. If we want to be a better ally to our friends and family, we must embrace an attitude of affirmation.




Resources:


Durso, L. E., & Meyer, I. H. (2013). Patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbians, gay men, and bisexuals. Sexuality Research and Social Policy, 10(1), 35-42.


Sabin, J. A., Riskind, R. G., & Nosek, B. A. (2015). Health care providers’ implicit and explicit attitudes toward lesbian women and gay men. American journal of public health, 105(9), 1831-1841.


Steele, L. S., Tinmouth, J. M., & Lu, A. (2006). Regular health care use by lesbians: a path analysis of predictive factors. Family Practice, 23(6), 631-636.

Author, Stacy Ruse LPC, EMDRIA Approved Consultant, DBT Certified Therapist, IFS Intensively Trained

We can all make a difference, even in small ways, to help uplift, support, and be an ally for LGBTQIA+ and other marginalized communities.
We believe in empowering and advocating for ALL persons and beings and supporting marginalized groups by standing up against systemic bias and oppression for LGBTQIA+ and ultimately for everyone.

We believe in more inclusion, and that at the deepest level we are all connected. We open our hearts and creative energy centers to welcome a full spectrum of ways to identify with in terms of sexuality, gender, and beyond, including but not being limited to queer, intersex, asexual, pansexual, non-binary, and more.
We believe we are all connected, energy is fluid, and that we all are empowered to have our own unique ways of expressing ourselves. So it is best to be in the present and to have ways to describe what we experience creatively among one another, and if we learn to accept and love ourselves, we will love and accept others and vice versa.

Some Ways to Empower and Ally

• Support activist organizations
• Speak up for greater equality
• Listen to the needs of LGBTQIA+ community members
• Attend Pride and other gatherings to celebrate
• Support LGBTQIA+ business owners and artists
• Do things in your local community, workplace, gov't, and beyond to ensure that everyone in the LGBTQIA+ has a bright future ahead
• Support access to mental-health resources for LGBTQIA+ people — particularly for teens, elders, and those who are transitioning
• Do not ignore, enable, or encourage other's biases and unacceptable behaviors; set healthy boundaries around this
• Rally for change in legislative bills that are oppressing
• Join collective actions and advocacy groups that match your values to support marginalized populations
• Understand life experiences as valid, when others have been under-represented and have faced biases and systematic oppression
• Don’t be afraid to have uncomfortable conversations, open yourself to seeing different perspectives
• Take accountability for and work through your own biases, yes, we all have them
• Seek qualified help if they are causing suffering, relationship issues, or isolation
• Learn more about LGBTQIA+ values and identifies
• Diversify what you read, watch, view, and listen to
• Use inclusive language that doesn’t make others feel judged, “othered”, outed, or isolated
• Identify your assumptions of others, forgive your humanness, and DO NOT let it direct your actions
• Practice loving-kindness meditations and send compassion to others and yourself
• Add personal pronouns to your email signatures, business cards, social media, zoom, and etc.
• Promote more inclusive policies at work for LGBTQIA+ and other marginalized employees

Sadly, statistics still show a rise in homelessness and suicide among LGBTQIA+ youth who have left home and family due to rejection after coming out. All of the above actions and ways of being help support change organizations that are dedicated to making change.
Other ways you can help may include volunteering at shelters and participating in and/or donating to groups like the Trevor Project in providing national resources.  
PFLAG (formerly known as Parents and Friends of Lesbians and Gays) connects parents, families, friends, and allies of LGBTQIA+ community members to support one another and the members of the LGBTQIA+ community members in their lives.
Counseling Services
Looking for compassionate and supportive counseling services, Contact Us.  Learn more about our services & our specialties or join one of our DBT Skills Groups!  Check out our Trauma Talks YouTube Series & Blog 
Read Article "How to talk to children About Gender, Inclusivity, Sexuality, and LGBTQIA+
Author, Stacy Ruse LPC, EMDRIA Approved Consultant, DBT Certified Therapist, IFS Intensively Trained.  Stacy is a modern-day Light-Worker, Trauma-Crusader, Shame-Untangler & Star-Seeker.

by Charles Roberts, ED.D, LPCC-S, LICDC-CS

It will be years before we fully understand how the coronavirus pandemic has changed society. But one thing that is certain: teletherapy is here to stay.

Last spring, teletherapy became a lifeline for clients during the lockdown. Almost a year later, therapists and clients are still seeing benefits to this mode of treatment. It’s convenient for clients. It has expanded access for those who have transportation barriers or who face community stigma. And most important, research is finding that symptom reduction and client satisfaction rank about the same for teletherapy as for in-person sessions.

Yet despite the widespread adoption of telehealth tools in the past year, obstacles for therapists are still prevalent. Very little formal training exists that is specific to mental health providers. Telehealth has unique policies and procedures above and beyond in-person visits. Technology issues can derail a session. And there are a host of legal risks to navigate.

Continuous improvement is at the heart of what we do. In the spirit of continually improving how we serve clients, here are three video teletherapy best practices therapists need to incorporate into their teletherapy sessions now.

Creating the right ambience is just as important on a video platform as it is for in-person sessions. Dress professionally and be on time. Remove visual clutter and physical distractions from your practice space. And don’t overlook lighting—it should be adequate without being harsh. Always position your camera so that light sources, including windows, are in front, rather than behind, you.

Pro tip: always look at your camera, not your client’s face, to show engagement. Keep in mind that positioning the camera too close to your face can make a client perceive that you are in their space. It may also cut off nonverbal cues, like hand gestures.

#2 – Know Your Technology
You may need to pull double duty as IT support, so make sure you understand how your technology works before diving in. Start by ensuring your internet connection is fast enough to support video conferencing. Test your video and audio connections before every session. And always create a back-up plan with each client during your first session. Even with preparation, technology and internet connectivity can fail without notice. You and your client should both know what to do when this occurs so that their care is not interrupted.

#3 – Protect Patient Privacy
Teletherapy presents a host of risks related to the Healthcare Insurance Portability and Accountability Act (HIPAA) standards. At the most basic level, sessions need to be conducted in spaces that are free from interruption. You will also need to ensure that your device has a lock and is not used by any members of your household.

From a technology standpoint, all text messaging, email applications and videoconferencing platforms must be HIPAA compliant.  All emails, text messages, instant messages, chat history and clinical records will need to be preserved and stored in the client’s file.

Compass Point uses HIPAA-compliant video and email platforms, and all Compass Point therapists have access to these tools.

More Best Practices for Teletherapy
Mental health providers have a challenging ethical landscape to navigate. Keeping current with new guidelines can feel overwhelming at times.

Compass Point is offering a one-day webinar called Best Practices in Private Practice (Ethics). The webinar will be available in March, May, September and November as a live webinar. It will be offered in June and August on location in Mason, Ohio.

The course will be worth three CEUs. This training will clarify Ohio Counselor, Social Worker, and Marriage and Family Therapist board and insurance company rules. We’ll also look at best practices for using teletherapy, including avoiding common legal risks. Register for the course today.

Charles Roberts, ED.D, LPCC-S, LICDC-CS

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​Interested in signing up? Please give the front office a call at 513-939-0300 to ask about the next available start date. 

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Compass Point Counseling Services, a mental health private practice, is partnering with Lee Side Wellness, a psychiatric practice, to bring comprehensive mental health and psychiatric services to a brand new location in Mason.

The new Mason location will open Monday, August 5th in a 1,600-square-foot located conveniently right off of interstate 71 at 3615 Socialville-Foster Rd, Mason, Ohio 45040.
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This partnership will allow a “one stop” comprehensive experience to our mutual clients who are looking for quality mental health care In addition to medication management as well as TMS treatment for chronic depression. Both mental health facilities are grounded in the core values that all people matter, are of sacred worth, and warrant the finest in mental health and psychiatric healthcare.

The office will open with 7 clinicians: Chrisha Anderson, Stephanie Baker, Debra Bruemmer, James Canfield, Geralyn Cleary, Mariah Goodwin and Dana Mcdonald. The new location will have 5 individual therapy rooms along with a large group therapy space.

This is for family/friends of people who have an addiction.  NOT the person with the addiction.  

Group Lead: Greg Pratt MSW,LISW-S has worked in the Mental Health Field in the Greater Cincinnati area for over eleven years.  He graduated from Thomas More College with a BA in Psychology and from the University of Kentucky with a Master’s Degree in Social Work (MSW). He has worked with individuals and families struggling with a wide range of concerns and specific needs, including individuals with both mental health and substance use struggles.

$25 per group paid upfront at our Anderson Office or Dayton office

Co-Occurring Disorders
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​A person with a co-occurring disorder has been diagnosed with a substance abuse disorder and another mental health disorder. Co-occurring disorders, sometimes called dual disorders, are best treated through integrated treatment that addresses both issues at the same time.

The brain is a complicated and delicate organ. It’s not surprising that alcohol and other drugs can cause symptoms of mental illness. The substances work by changing the way the brain operates. People who use drugs feel buzzed or high because the substances affect chemicals in the brain and the way brain cells communicate with one another.

In response to those changes, the brain adapts to the presence of alcohol and other drugs, increasing the chances that a person will develop a substance use disorder. Substance use disorders are types of mental health disorders that are more commonly called addiction.
It’s possible to have more than one mental health disorder. Substance use disorders often co-occur alongside other mental illnesses. More than half of people with substance use disorders also have a mental illness. Sometimes the mental illness comes first. In other people, substance abuse occurs first. In both situations, each disorder amplifies the symptoms of the other.
“A large number of people with substance use disorders also have some psychiatric disorders which may or may not be major,” Dr. Timothy Huckaby, medical director of Orlando Recovery Center, told DrugRehab.com. “A lot of people have underlying depression or underlying anxiety.”
Other common co-occurring disorders include personality disorders, behavior disorders and psychotic disorders. With comprehensive treatment, individuals can recover from addiction and most co-occurring mental health disorders. But failing to address co-occurring disorders during addiction treatment increases the chances of relapse.

What Are Mental Health Disorders?

The phrases “mental illness,” “mental health disorder” and “mental health issue” are often used synonymously. In its diagnostics manual, the American Psychiatric Association uses the term mental disorder to define mental illnesses, but the organization also recommends using the term mental health challenge.
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The American Psychiatric Association defines a mental disorder as: “a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning.”

Some mental disorders are more common than others. Conditions such as anxiety and depressive disorders, for example, occur more frequently than schizophrenia and psychosis. Each type of mental disorder can range in severity from mild to severe.
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Developmental Disorders

Mental disorders are different from developmental disabilities. Developmental disorders, such as autism spectrum disorder and learning disabilities, impair social interaction, mobility, language and self-sufficiency.

Substance use disorders and other mental health disorders can co-occur alongside developmental disorders. But the term co-occurring disorder most commonly refers to substance use disorders and mental disorders.

Dual Diagnosis & Comorbidity

Dual diagnosis is an outdated term for co-occurring disorders. Both of these terms are sometimes confused with comorbid disorders.
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Comorbidity is a broad term used to denote the existence of multiple physical or mental diseases or disorders. Co-occurring disorders and dual diagnosis are specific to substance use disorders and other mental health conditions.
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Mental Disorders that Co-Occur with Substance Abuse

Any mental health disorder can co-occur alongside substance use disorders. The most common types of co-occurring disorders include mood, anxiety, psychotic, eating, personality and behavioral disorders. Each category includes numerous types of mental disorders that can range in severity.

Symptoms of personality disorders vary widely based on the type and severity.

Behavioral Disorders
Behavioral disorders most commonly occur in children. Many healthy people exhibit behavior problems, such as inattention, defiance and hyperactivity. However, behavioral disorders are characterized by chronic behavior problems that last at least six months.
Common behavioral disorders include:

• Attention-deficit/hyperactivity disorder
• Oppositional defiant disorder
• Conduct disorder

Symptoms of Co-Occurring Disorders
The physical and emotional symptoms of co-occurring disorders vary depending on your life circumstances, the type of substances you use and the type of mental illness you possess.

​The symptoms of mental health disorders are similar to the side effects of addiction. Thus, it can be difficult to determine whether a mental illness is caused by substance abuse or vice versa. Reputable addiction treatment centers screen patients for mental illnesses and develop plans for treating co-occurring disorders simultaneously.
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