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1 Practice Toolbox Lauren Exinia MSW, Walden University SOCW 6111: Advanced Social Work Practice I Dr. Folusho Otuyelu October 30, 2023

2 Practice Toolbox Child Assessment Behavior Assessment System for Children Why did you select the assessment tool? The Behavior Assessment System for Children (BASC) facilitates a full analysis of a child's behavior from three distinct perspectives: the child's self-perception, the parent's observation, and the teacher's evaluation. In addition, the assessment encompasses the utilization of observation techniques and a comprehensive structured developmental history, thereby facilitating the acquisition of additional insights about the child (Swart, 2005). Why might it be especially helpful for use with children? This instrument is employed to evaluate children over a broad range of age groups and diverse behavioral patterns. This tool enables ongoing monitoring and evaluation of a child's conduct and emotional state to identify any potential alterations (BASC, 2018). Moreover, the validity and reliability of this technique has been established, leading to its widespread use in several studies (Swart, 2005). What challenges or limitations might there be for this assessment tool? The BASC presents certain challenges, namely financial costs and the need for dependence on external parties (such as parents or teachers) to accurately fulfill their respective roles in the assessment process. Additionally, the practitioner administering the BASC is required to possess a higher level of understanding of measurement and scaling concepts to make accurate interpretations of the gathered data (Flanagan, 2000).

3 Adolescent Assessment Severity Measure for Generalized Anxiety Disorder, Child Age 11 to 17 Why did you select the assessment tool? Anxiety frequently prevents people from engaging with others and participating in events, which can lead to depression. Perhaps an earlier diagnosis of anxiety will help lower the likelihood of a depression diagnosis. Furthermore, reducing the potential for depression could potentially lower the risk of suicide. Why might it be especially helpful for use with adolescents? An adolescent may be more comfortable "checking boxes" than talking at first. Additionally, it can open the door for the therapist to ask targeted questions, which can make the adolescent feel less questioned. What challenges or limitations might there be for this assessment tool? One of the main challenges is the subjective nature of self-report measures. Due to poor self-awareness or a tendency to underreport or overreport anxiety symptoms, adolescents may have trouble appropriately assessing and reporting their symptoms (Beesdo et al., 2009; Brandell, 2020; Glassofer, 2020). Adolescence is a time of significant physical, emotional, and cognitive changes, which might affect how anxiety manifests itself (Brandell, 2020). The scale may not capture these nuances properly, resulting in insufficient knowledge of the severity of GAD in this population.

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4 Adult Assessment Level 2- Substance Use Why the Assessment Tool was Selected: Level 2- Substance Use-Adult assessment tool was adapted from the NIDA-Modified ASSIST. This tool was selected for its specificity in identifying risky substance use among adults. Drug addiction is often a result of a client self-medicating due to an underlying issue such as PTSD or other trauma (Brandell, 2020). If the client can obtain sobriety, the client may then begin to address any unresolved trauma they may have. This tool can provide a sense of power as well as promote honesty and transparency in the assessment process due to being a self-report measure. Why it Might be Especially Helpful for Use with Adults: Level 2- Substance Use-Adult Assessment Tool has a user-friendly format that provides privacy and confidentiality. Adults may be more inclined to provide honest and accurate information about their substance use when they can complete the assessment privately. For adults who are struggling with substance use, early identification is essential to early intervention and support, potentially preventing the escalation of substance-related problems. The tool provides an objective measure of substance use, which can be valuable when discussing treatment options and progress with the individual. It moves beyond subjective self- reporting and relies on a structured scoring system. A 5-point scale (0=never to 4=nearly every day) is utilized to assess the severity and frequency of substance use. This nuanced approach helps clinicians and individuals better understand the extent of the problem, which is crucial for developing appropriate intervention strategies.

5 Another benefit of this assessment tool is it covers a broad spectrum of prescription medications and illicit substances. A comprehensive approach is essential for capturing the full scope of an adult's substance use, as adults may use a variety of substances for different reasons. By identifying the substances of concern and their severity, the tool helps tailor treatment plans to address the specific needs of the individual. Additionally, it allows clinicians to focus on the substances that pose the most significant risk to the individual's well-being. Level 2- Substance Use-Adult Assessment Tool is designed to be used in clinical settings, and its results can guide clinicians in assessing the severity and complexity of substance use. This clinical guidance is valuable for tailoring interventions and treatment plans to meet the specific needs of the individual. Furthermore, this assessment can be used to track progress by completing it at regular intervals to observe changes in substance use severity and patterns, which is especially helpful for individuals in various stages of recovery or behavior change. Challenges or Limitations of the Assessment Tool: The accuracy of the assessment may be affected because it is based on the self-reports of individuals, which may be affected by stigmatization, bias, fear of legal penalties, and minimizing, or denial of substance use (Oga et al., 2020). People who have diminished capacity, such as those who suffer from dementia, are required to have the measure completed by a caregiver or another party who is equipped with the knowledge of the client’s substance use. It's possible that this will introduce some subjectivity into the evaluation. According to Sullivan (2020), a study was conducted utilizing this tool and toxicology testing on a group of sixty participants. This study identified twenty-seven instances

6 among the sixty participants of self-reported substance use that was not detected by toxicology testing. This discrepancy can occur due to the timing of the test, or the specific drug used. Elderly/Aging Adult Assessment Severity Measure for Depression Why did you select the assessment tool? The assessment tool "Severity Measure for Depression, Adult," which was adapted from the Patient Health Questionnaire-9 (PHQ-9), is a valuable instrument for assessing depression through nine specific questions that cover key aspects of depression symptoms as well as thoughts of death or suicide (APA, n.d.). Depression is a common mental health issue among the elderly or aging adults, often underdiagnosed and undertreated in this population, which is why it was selected. Depression can have a significant impact on an individual's overall well-being, cognitive functioning, physical health, and social functioning. Identifying the severity of depression allows for appropriate intervention planning and monitoring of treatment outcomes. This tool is easy to administer and has structured scoring. The Severity Measure for Depression, Adult assessment tool, can also be utilized to track changes in the individual’s depression. This tool has been validated and used in research studies and clinical practice, making it a reliable measure for accurately assessing depression severity in adult populations.

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7 Why might it be especially helpful for use with elderly/aging adults? The "Severity Measure for Depression, Adult" assessment tool is objective and can be used for early detection of depression and to indicate a possible suicide risk. Identifying depression early will not only improve their quality of life but will also decrease their risk of suicide. The self-report format may boost an aging individual’s sense of autonomy. Depression is often underdiagnosed in older adults, as symptoms may be attributed to normal aging or other medical conditions. Depression can increase the risk of suicide (HHS.gov, 2022). This assessment tool allows for early detection and intervention, preventing the worsening of depressive symptoms and their negative impact on the individual's life. Older adults may have complex medical and psychosocial histories, making the need for an objective assessment tool essential. This tool provides a structured approach to assessing depression, reducing the risk of misdiagnosis, or overlooking depressive symptoms. The assessment tool also includes questions that will trigger a suicide assessment if answered in a specific way. According to the National Council on Aging (2022), older adults are especially vulnerable to suicide for reasons such as grief over the passing of loved ones to suffering from a chronic illness.  While older adults comprise just 12% of the population, they make up approximately 18% of suicides (Smith, 2021).  In 2020, among the nearly 46,000 suicides that took place in the U.S., 9,137 were attributed to people aged 65 and up (CDC, n.d.).  Older adults tend to plan suicide more carefully. They are also more likely to use more lethal methods (Conwell et al., 2011).

8  Among people who attempt suicide, one in four seniors will succeed, compared to 1 in 200 youths (Smith, 2021). Even if a senior fails a suicide attempt, they are less likely to recover from the effects.  Men 65 and older face the highest overall rate of suicide (Axelrod, et al., 2019). What challenges or limitations might there be for this assessment tool? While the "Severity Measure for Depression, Adult" assessment tool has its merits, there are some challenges and limitations to consider, such as cognitive limitations, disabilities, self- reporting, bias, stigmatization, and types of depression. Some elderly individuals may have cognitive impairments such as dementia, a disability such as I.D., or comprehension difficulties that affect their ability to respond accurately to the assessment questions. In such cases, the results may not fully represent their mental health status. The accuracy of the assessment may be affected because it is based on the self-report of the individual, who may have withheld or minimized information for various reasons, such as fear or worry about bias, stigmatization, or the possibility of requiring additional treatment. Additionally, it likely will not indicate whether it is lifetime depression or late-life depression. Two common MH diagnoses associated with the elderly/aging population; how might the assessment tool assist with Dx? Anxiety and depression are two common mental health diagnoses in the elderly population and often co-occur. According to Bryant et al. (2008, as cited in Brandell, 2020), a relatively high proportion of older adults exhibit symptoms of excessive worry and fear.

9 Depression is not a normal aspect of aging, despite the fact that it is frequently misdiagnosed or undertreated due to the misconception that it is. Providers of healthcare frequently presume that complaints of pain and depression are normal indicators of aging. Confusion, difficulty with executive function, and loss of memory are symptoms shared by both depression and dementia. Depression is difficult to distinguish from sadness, according to Drageset, Eide, and Hauge (2016, as cited in Brandell, 2020), so it is essential to look for changes in affect and to inquire about recent losses and changes in medication or living conditions. According to Brandell (2020), observation, self-rating scales, and certain screening instruments, such as the Geriatric Depression Scale, are diagnostic tools for depression. Therefore, it is possible the selected tool may indicate depression for an elderly individual and not be accurate because of missing factors. There are questions within the tool that can indicate a concern for anxiety and lead to further assessment. Child Intervention Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) Why did you select the intervention? The selection of TF-CBT is based on its well-documented efficacy and its comprehensive approach, in addition to firsthand professional observations of its benefits (Psychology Today, n.d.). TF-CBT combines elements of cognitive-behavioral therapy with trauma-

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10 specific techniques, providing a systematic and evidence-based framework for aiding children and adolescents in effectively managing trauma-related symptoms. Numerous studies have demonstrated that Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) yields significant reductions in post-traumatic stress symptoms, depression, and anxiety among children who have been exposed to diverse traumatic events. Why might it be especially helpful for use with children? Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a therapeutic approach that places a strong emphasis on the child's involvement and active engagement (Idaho Youth Ranch, n.d.). This approach provides a secure and nurturing atmosphere for the child to freely communicate their thoughts, feelings, and experiences. The intervention employs play-based strategies, such as artistic expression and narrative construction, as modalities that effectively engage children in the processing of their traumatic experiences, while minimizing potential threats to their emotional well-being. TF-CBT offers a structured and organized framework for addressing trauma, providing a sense of reassurance to children who may find themselves overwhelmed by their traumatic experiences. TF-CBT also involves parents or caregivers, facilitating their comprehension and provision of support in their child's healing journey (Brandell, 2020). What challenges or limitations might there be for this intervention? While TF-CBT is a highly effective intervention, it is essential to acknowledge there are challenges and limitations: TF-CBT has the potential for temporary exacerbation of trauma symptoms, therefore, it is essential for clients to exhibit a certain level of proficiency in

11 practicing distress tolerance skills (Idaho Youth Ranch, n.d.). TF-CBT currently lacks official accreditation, however, there are supplementary training and courses available (Psychology Today, n.d.; Ungvarsky, 2020). Given this consideration, it is critical to identify a therapist who possesses significant experience in this domain. Moreover, rural regions may face significant constraints in terms of the availability of competent therapists, hence impeding access to this domain (Idaho Youth Ranch, n.d.). TF-CBT may not be universally applicable in all instances. TF-CBT is not appropriate for children or adolescents who are actively experiencing serious suicide ideation, psychosis, or engaging in self-harm behaviors (Psychology Today, n.d.; Ungvarsky, 2020; Idaho Youth Ranch, n.d.). TF-CBT is also not recommended for individuals who are currently under the influence or who are grappling with a substance use disorder. Some children may initially resist engaging in therapy or discussing their traumatic experiences, which can pose challenges in the therapeutic process. Additionally, ensuring cultural sensitivity and relevance in interventions for children and their families can be a challenge for therapists due to the need to be cognizant of cultural variables and norms. Adolescent Intervention Solution-Focused Brief Therapy (SFBT) Why did you select the intervention? Solution-Focused Brief Therapy (SFBT) was chosen as the intervention because it is a widely utilized therapeutic approach renowned for its emphasis on uncovering practical solutions in the present and fostering an individual's hope for the future (Ferguson, 2023; Psychology

12 Today, n.d.). Unlike traditional therapies, which focus on the "why" of problems, SFBT emphasizes "how" to resolve them, providing a rapid and pragmatic approach to problem- solving. This method is based on the belief that individuals can improve their own lives and that with the proper guidance and questions, they can identify optimal solutions. SFBT is goal- oriented and strengths-based, promoting rapid change and supporting a collaborative problem- solving approach. It is especially advantageous when addressing the unique needs of adolescents, who may be less receptive to conventional problem-centered therapies due to their developmental stage. The SFBT's focus on recognizing and enhancing their existing skills and resources prove especially empowering and motivating. Why might it be especially helpful for use with adolescents? Solution-Focused Brief Therapy (SFBT) offers several advantages when working with adolescents. First, it employs a strengths-based strategy that can appeal to adolescents navigating the complexities of identity and independence (Ferguson, 2023; Psychology Today, n.d.). By emphasizing adolescents' strengths and available resources, SFBT empowers them to assume responsibility for their lives and the challenges they face. Moreover, SFBT's brief and solution-oriented nature aligns well with the characteristics of adolescents, such as shorter attention spans and a preference for practical, results-driven approaches. This makes it a more engaging and applicable therapeutic option for this age group, which may be less inclined to engage in long-term therapy. SFBT also promotes a collaborative process, emphasizing a therapeutic relationship where adolescents actively participate in goal setting and defining their desired future. This collaborative participation not only tailors the therapy to the patient's particular needs but also

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13 increases the patient's investment in the therapeutic process, thereby enhancing its efficacy. Perhaps most notably, SFBT avoids labeling or pathologizing adolescents. This is essential for preserving their self-respect and cooperation. SFBT ensures that adolescents do not feel stigmatized or labeled by reframing their struggles as common challenges that can be surmounted, thereby facilitating their engagement in the therapeutic process. What challenges or limitations might there be for this intervention? However, there are limitations and factors to consider when applying Solution-Focused Brief Therapy (SFBT) to adolescents. SFBT may not be the most appropriate therapy for adolescents with severe mental health issues or deeply rooted problems requiring intensive, long- term treatment (Ferguson, 2023; Psychology Today, n.d.). It's concise and solution-oriented nature may lack the required depth and intensity to address such complicated cases. Furthermore, the active participation of the adolescent is crucial to the success of SFBT. Some adolescents might exhibit resistance to any form of therapy, presenting a challenge for SFBT. The efficacy of SFBT may be compromised if the adolescent is uncooperative or unwilling to engage in the therapeutic process. In scenarios where parental involvement is crucial for addressing the adolescent's issues, SFBT's primary focus on the adolescent's perspective may not adequately address broader family dynamics or issues. It may fall short in accounting for the necessary family context and interventions, thus limiting its efficacy in such circumstances. As with any therapeutic approach, cultural sensitivity is of the utmost importance when implementing SFBT with adolescents. Tailoring the therapy to the adolescent's cultural and

14 social environment is crucial to ensure its appropriateness and effectiveness. Without this consideration, the therapy may not fit with the adolescent's cultural background, potentially impeding progress and rapport within the therapeutic relationship. Adult Intervention Dialectical Behavior Therapy (DBT) Why did you select the intervention? I chose Dialectical Behavior Therapy (DBT) because it is an established, multi-faceted, and evidence-based treatment approach that has been shown to be effective in treating a variety of mental health disorders, including self-harm, post-traumatic stress disorder, eating disorders, depression, anxiety, and substance use disorder, among others (Brandell, 2020; Mogalia, 2023; Psychology Today, n.d.). Additionally, it has been demonstrated that dialectical behavior therapy results in clinically significant improvements in borderline personality disorder-related behaviors (Cristea et al., 2017; Juanmart & Pérez Lizeretti, 2017; Leppanen et al., 2016, as cited in Brandell, 2020). It is a comprehensive therapy that addresses emotional dysregulation and interpersonal difficulties, which are common symptoms of numerous mental health disorders (Brandell, 2020; Mogalia, 2023; Psychology Today, n.d.). The DBT emphasis on acceptance, mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness provide a holistic approach to therapy. Why might it be especially helpful for use with adults? DBT can be useful with adults because it addresses complex emotional and interpersonal

15 issues that become more pronounced with age. Many of the conditions for which DBT is recommended, such as borderline personality disorder, are typically diagnosed during late adolescence or early adulthood. As people age, they may have a harder time modulating their emotions, managing their relationships, and overcoming life's challenges. DBT equips individuals with the skills necessary to effectively navigate these issues and live more fulfilling lives (Cleveland Clinic, n.d.; Mogalia, 2023; Psychology Today, n.d.). It also aids in the development of healthier coping mechanisms, which can be especially beneficial as individuals confront the stresses and responsibilities of adulthood. What challenges or limitations might there be for this intervention? There are challenges and limitations associated with DBT such as cost, accessibility, time, and commitment. DBT is a rigorous therapy that requires a substantial commitment from both the therapist and the patient (Mogalia, 2023; Psychology, n.d.). Typically, it consists of monthly group sessions, individual therapy, and homework assignments. This level of dedication can be difficult for some individuals. In certain regions, locating a qualified DBT therapist can be difficult. Not all mental health personnel are trained in dialectical behavior therapy (DBT), and the number of certified DBT therapists may be limited, making DBT less accessible to those in need (Psychology Today, n.d.). DBT can be expensive, particularly when long-term therapy and individual sessions are required. Insurance coverage can vary, and some individuals may face financial barriers to accessing this treatment. DBT is a longer-term treatment, therefore significant improvement can take time (Mogalia, 2023; Psychology Today, n.d.). Studies have demonstrated positive outcomes; however, some patients may require several years of treatment to achieve the intended outcomes. DBT is a complex therapy that requires

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16 specialized training (Psychology Today, n.d.). The treatment's complexity may not be suitable for everyone, and some individuals may find it difficult to comprehend and implement all of its components. While DBT has been extensively researched and found to be effective for certain conditions, its efficacy for other conditions, such as bipolar disorder, remains a subject of ongoing research and debate. Elderly/Aging Adult Intervention Cognitive Behavioral Therapy (CBT) Why did you select the intervention? Cognitive Behavioral Therapy (CBT) was chosen as the intervention for the elderly due to its adaptability and demonstrated effectiveness in addressing a wide range of mental health issues. Operating on core principles, CBT primarily involves cognitive restructuring, which focuses on challenging unhelpful thinking patterns contributing to emotional distress and encouraging more balanced ways of thinking. Additionally, the therapy incorporates behavioral strategies targeting specific behaviors contributing to emotional difficulties. These strategies might involve exposure to feared situations, learning coping skills, or practicing alternative behaviors, collectively aiming to modify thinking patterns and behaviors to alleviate emotional distress and enhance mental well-being. The CBT process involves assessment, goal setting, and a collaborative approach, often including homework assignments. CBT has demonstrated wide applicability and efficacy in treating various mental health conditions, spanning different age groups, and its structured, goal-oriented nature, coupled with a collaborative approach, empowers individuals to manage their emotions and behaviors effectively, fostering resilience

17 and improved mental health. This evidence-based success and adaptability have made CBT a preferred choice for therapists and clients seeking solutions for a diverse range of psychological challenges. Cognitive Behavioral Therapy (CBT) employs several essential techniques to address and improve mental health challenges. Thought Records involve tracking thoughts and emotions to recognize and confront negative thinking patterns. Cognitive Restructuring focuses on actively challenging and transforming these negative patterns into more realistic and positive thoughts. Behavioral Activation encourages participation in enjoyable or meaningful activities, aiming to uplift mood and enhance overall well-being. Exposure Therapy involves a systematic and gradual approach to facing feared or avoided situations, gradually reducing anxiety by desensitizing individuals to these triggers. Additionally, CBT incorporates Problem-Solving Strategies, teaching effective techniques to approach and solve life's challenges. These techniques collectively empower individuals to reframe negative thoughts, engage in positive activities, confront fears gradually, and develop problem-solving skills to improve their mental health and quality of life. Why might it be especially helpful for use with the elderly or older population? Cognitive Behavioral Therapy (CBT) stands out as a well-suited approach for working with older adults due to several key reasons. Firstly, its adaptability allows for tailoring to the specific needs and abilities of the elderly, accommodating challenges such as cognitive changes and memory issues commonly associated with aging. Moreover, CBT's effectiveness is supported by strong empirical evidence in treating prevalent mental health concerns among the aging population, including depression, anxiety, and adjustment disorders. The structured and

18 goal-oriented nature of CBT resonates well with older adults who prefer a direct, problem- solving approach, thereby fostering a sense of reassurance. Furthermore, CBT's emphasis on cognitive restructuring—identifying and modifying negative thought patterns—proves particularly beneficial in assisting older individuals in coping with the changes in lifestyle, physical health, and social relationships that often accompany the aging process. What challenges or limitations might there be for this intervention? Utilizing Cognitive Behavioral Therapy (CBT) with the elderly population comes with specific challenges and limitations, despite its recognized strengths. Cognitive and sensory limitations, such as cognitive decline, memory issues, or sensory impairments, among some elderly individuals, may necessitate adapting CBT techniques. This adaptation often requires therapists to employ creativity and flexibility in their approach. Moreover, older adults might exhibit resistance to change or new ways of thinking, particularly if long-held beliefs are deeply ingrained, making cognitive restructuring a potentially challenging task. The prevalence of physical health issues and chronic conditions within the elderly population can affect their full engagement in therapy, impacting their ability to focus or participate effectively. Additionally, ensuring cultural sensitivity is crucial in CBT. Therapists must consider the cultural backgrounds and belief systems of elderly clients to align the therapeutic approach with their values and perspectives, allowing for a more effective and respectful therapeutic process. Although Cognitive Behavioral Therapy (CBT) is a valuable tool for the elderly, therapists must be aware of the unique challenges faced by this population. To ensure the maximum effectiveness of CBT when working with older adults, therapists must adapt their

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19 techniques to meet individual needs while being mindful of cultural and cognitive considerations. Summary Describe your ideal population to work with, based on research and term work. Same population? Identify the ethical, moral, and value challenges working with this population. Throughout my journey, I continue to recognize children as my ideal population to work with. My experience and research have reinforced the belief that supporting children through their formative years can have a profound and lasting impact on their lives and the wider community. Children represent a dynamic and diverse population. They are resilient, adaptable, and possess an innate capacity for growth and change. However, they are also uniquely vulnerable and impressionable, making them particularly in need of guidance, protection, and support (Disla de Jesus et al., 2022; Finch et al., 2015; Raman, 2016). Ethical challenges abound when working with children. The fundamental ethical dilemma often revolves around the balance between a child's right to autonomy and their need for protection (Disla de Jesus et al., 2022; Finch et al., 2015; Raman, 2016). Issues such as confidentiality and informed consent become particularly complex when dealing with children, especially in cases where there might be potential harm or abuse. Determining when to breach confidentiality for the child's welfare is a significant ethical challenge. Moral considerations frequently arise when dealing with cultural or familial differences (Disla de Jesus et al., 2022; Finch et al., 2015; Raman, 2016). Respecting diverse cultural

20 practices while ensuring the child's well-being can create moral dilemmas. Additionally, navigating situations where a child's best interest might conflict with the beliefs or preferences of their family or community can be ethically and morally challenging. Value conflicts also emerge in the context of children. Social work values such as empowerment and self-determination might conflict with the developmental stage and capacity of children to make decisions. Balancing a child's autonomy with the need for their protection can be a significant ethical consideration (Disla de Jesus et al., 2022; Finch et al., 2015; Raman, 2016). The emotional toll on a social worker when dealing with children is another significant challenge. Witnessing the hardships, trauma, and struggles that children face can be emotionally taxing. Finding the balance between empathetic involvement and maintaining professional boundaries becomes crucial to avoid burnout. Despite these challenges, the rewards of working with children are immeasurable. Witnessing their growth, resilience, and positive response to interventions reinforces the importance of advocating for policies that protect and support children's rights. In conclusion, my perspective on working with children as a social worker has only been strengthened and deepened throughout the term. The ethical, moral, and value challenges associated with this population are substantial, but the ability to positively impact a child's life and future makes the challenges worthwhile. This reaffirms my dedication to supporting and advocating for the well-being of children as my ideal population to work with as a social worker.

21 References American Psychiatric Association. (n.d.). Online assessment measures. https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/assessment- measures Arnold, V. P., (2022). The Effect of Education on the NIDA Modified Assist (NMASSIST) Tool on Knowledge and Screening for Substance Use Disorder among Clinicians Axelrod, Josh; Balaban, Samantha; Simon, Scott. (2019, July 27). National Public Radio. Isolated and Struggling, Many Seniors are Turning to Suicide. https://www.npr.org/2019/07/27/745017374/isolated-and-struggling-many-seniors-are- turning-to-suicide. Beesdo, Katja; Knappe, Suzanne; Pine, Daniel S. (2009). Anxiety and Anxiety Disorders in Children and Adolescents: Developmental Issues and Implications for DSM-V. Psychiatric Clinics of North America. (Vol. 32, Iss. 3, 483-524). ISSN 0193-953X. https://doi.org/10.1016/j.psc.2009.06.002. Behavior assessment system for children (BASC). RAND Corporation. (2018, October 3). https://www.rand.org/education-and-labor/projects/assessments/tool/1992/behavior- assessment-system-for-children-basc.html

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22 Brandell, J. R. (Ed.). (2020). Theory & practice in clinical social work (3rd ed.). Cognella Centers for Disease Control and Prevention (CDC). (n.d.). WISQARS. Fatal Injury Reports, National, Regional, State. https://wisqars.cdc.gov/fatal-reports. Chan, P., Bhar, S., Davison, T. E., Doyle, C., Knight, B. G., Koder, D., Laidlaw, K., Pachana, N. A., Wells, Y., & Wuthrich, V. M. (2018). Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review. JMIR research protocols , 7 (7), e164. https://doi.org/10.2196/resprot.9902. Chand, Suma and Grossberg, George T. (2013). How to adapt cognitive-behavioral therapy for older adults. CurrentPsychiatry.com. https://cdn.mdedge.com/files/s3fs- public/Document/September-2017/1203CP_Chand.pdf Cleveland Clinic. (n.d.). Dialectical Behavior Therapy (DBT). https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt Conwell, Y., Van Orden, K., & Caine, E. D. (2011). Suicide in older adults. The Psychiatric clinics of North America, 34(2), 451–ix. https://doi.org/10.1016/j.psc.2011.02.002 HHS.gov. (2022). Does depression increase the risk for suicide? https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-depression- increase-risk-of-suicide/index.html.

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23 Disla de Jesus, Vanesa., Liem, Annette., Borra, Dileep., and Appel, Jacob. (2022 Apr 22). Who’s the Boss? Ethical Dilemmas in the Treatment of Children and Adolescents. Psychiatry online. Focus. https://doi.org/10.1176/appi.focus.20210037 Elman, A., Rosselli, S., Burnes, D., Clark, S., Stern, M. E., LoFaso, V. M., Mulcare, M. R., Breckman, R., & Rosen, T. (2020). Developing the emergency department elder mistreatment assessment tool for social workers using a modified Delphi technique. Health & Social Work, 45(2), 110–121. https://doi.org/10.1093/hsw/hlz040 Ferguson, G. (2023). Solution-Focused Brief Therapy (SFBT). Salem Press Encyclopedia of Health. Finch, Alfred J., and others, 'Ethical Issues When Working with Children and Adolescents' , Specialty Competencies in Clinical Child and Adolescent Psychology , Specialty Competencies in Professional Psychology ( New York, 2012; online edn, Oxford Academic , 1 Jan. 2015 ), https://doi.org/10.1093/med:psych/9780199758708.003.0008 . Flanagan, Rosemary. A review of the Behavior Assessment System for Children (BASC): Assessment consistent with the requirements of the Individuals with Disabilities Education Act (IDEA), Journal of School Psychology, Volume 33, Issue 2, 1995, Pages 177-186, ISSN 0022-4405, https://doi.org/10.1016/0022-4405(95)00003-5.

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24 Gitterman, A., & Knight, C. (2019). Non-death loss: Grieving for the loss of familiar place and for precious time and associated opportunities. Clinical Social Work Journal, 47 (2), 147– 155. https://doi.org/10.1007/s10615-018-0682-5 Glasofer, Deborah R. (2023, June 21). Generalized Anxiety Disorder: Symptoms and DSM-5 Diagnosis. Mental health professionals use the DSM-5 diagnostic criteria to identify GAD. Very Well Mind. https://www.verywellmind.com/dsm-5-criteria-for-generalized- anxiety-disorder 1393147. Hung, M., Voss, M. W., Bounsanga, J., Graff, T., & Birmingham, W. C. (2019). Assessing spousal support and health in an aging population: Support and strain amidst changing social dynamics. Social Work in Health Care, 58(4), 345–367. https://doi.org/10.1080/00981389.2019.1569577 Idaho Youth Ranch. (n.d.). Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). https://www.youthranch.org/tf-cbt Moglia, P. (2023). Dialectical behavioral therapy (DBT). Salem Press Encyclopedia of Health. Oga, E. A., Mark, K., Peters, E. N., & Coleman-Cowger, V. H. (2020). Validation of the NIDA- Modified ASSIST as a Screening Tool for Prenatal Drug Use in an Urban Setting in the US. Journal of Addiction Medicine, 14(5), 423.

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25 Psychology Today. (n.d.). Dialectical Behavior Therapy. https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy Psychology Today. (n.d.). Solution-Focused Brief Therapy. https://www.psychologytoday.com/us/therapy-types/solution-focused-brief-therapy Psychology Today. (n.d.). Trauma-Focused Cognitive Behavior Therapy. https://www.psychologytoday.com/us/therapy-types/trauma-focused-cognitive-behavior- therapy Raman, Vijaya. (2016 October 21). Ethical Issues in Working with Children in the Consultation- Liaison Context. Ethical Issues in Counselling and Psychotherapy Practice. https://link.springer.com/chapter/10.1007/978-981-10-1808-4_4 Reynolds, C. R., & Kamphaus, R. W. (2015). Behavior assessment system for children 3rd edition: BASC 3. https://www.pearsonassessments.com/store/usassessments/en/Store/Professional- Assessments/Behavior/Comprehensive/Behavior-Assessment-System-for-Children-%7C- Third-Edition-/p/100001402.html Smith, Michael W., (2021, March 21). What to Know About Suicide in Older Adults. WebMD. https://www.webmd.com/healthy-aging/features/suicide-rates-older-adults

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26 Specialized Care Management Inc. (n.d.). A Holistic Approach to Wellness for Seniors. https://specializedcaremanagement.com/2018/07/a-holistic-approach-to- wellness-for-seniors Sullivan, M. C., Strainge, L., Blackmon, J. E., Cruess, S. E., Wheeler, D., & Cruess, D. G. (2020). Assessing an epidemic: Utility of the diagnostic and statistical manual of mental disorders, level 2 substance use screener in adult psychiatric inpatients. Journal of Addictions Nursing, 31(1), 9-16 Swart GT. The Clinician’s Guide to The Behavior Assessment System For Children. Can Child Adolesc Psychiatr Rev. 2005 Aug;14(3):90. PMCID: PMC2542918 Tampi, R. R., & Tampi, D. J. (2020). The most prevalent psychiatric disorder in older adults. Psychiatric Times, 37(7), 44–45. https://www.psychiatrictimes.com/view/most- prevalent-psychiatric-disorder-older-adults Ungvarsky, J. (2020). Trauma-focused cognitive-behavioral therapy (TF-CBT). Salem Press Encyclopedia of Health. Walden University, LLC. (2022). Clinical social work interventions [Interactive media]. Walden University Canvas. https://waldenu.instructure.com

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