Rule of Thumb: Getting Involved

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In some ways college students are more connected than ever. Social media has provided multiple methods of staying in touch with friends and sharing information and content. Gaming has also provided a venue of being connected with others and having fun at the same time.

But in other ways many students are not connected at all, and they struggle with “face-time” that is real and not just virtual. Many living environments are both heavily wired and private; if one chooses one may isolate for huge chunks of time and “communicate” widely, yet not actually interact with anyone at all. This is a recipe for diminishing mental health.

So here is a rule of thumb to protect against that deterioration: at least twice a week, get involved in something that takes you out of your living environment, puts you in physical contact with others, and has nothing to do with class, work, or partying. This simple strategy incorporates crucial skill sets which, once learned, will benefit you for a lifetime. The skills also promote good mental health and are also related to retention and academic success.

So what kinds of things can you do? Most students had interests and hobbies in middle and high school, but they may have drifted from them in the excitement of starting college. Consider returning to them, or perhaps be more adventurous and take up new ones. Psychologists believe that learning new skills every five years or so is actually protective of brain health, so it will be good for you on that score as well. On most campuses there are dozens if not hundreds of student organizations, covering topics such as sport, politics or advocacy, environmental awareness, outdoor recreation, art, and so on. If you can’t find one that suits you, start your own. You can also see some ideas on this listThere is really no excuse not to try something.

On the other hand, there is no need to get over-involved, as this can lead to meaningless activity and burnout. Trying new activities also does not have to lead to long-term commitment. Simply try some and if they don’t feel like a good fit, move on and try another. Frankly, what you pick does not matter. What matters is that you pick something in the first place, and that you expand your skills and relationships. This is part of the recipe for feeling satisfied and in good emotional health, and generally your grades will improve too. That’s hard to beat!

Annals of Idiocy: Discouraging Students who Need Help

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Getting right to the point, it is highly irresponsible for anyone to discourage others who need help, especially adolescents and young adults.  It is tough enough for them to deal with fear, stigma, and the labyrinth of mental health care systems.  For them to break through such barriers only to have someone discourage them should outrage all of us.

In recent months there have been at least two cases of this irresponsibility.  In one, a journalist covering the issue of withdrawals from campus due to mental health issues, an admittedly complex process, allowed the following title to be used in a Huffington Post article: “Using College Mental Health Services Can Lead To Students Getting Removed From Campus”.  In another an attorney allowed the following title in a Chronicle of Higher Education piece concerning the alleged mismanagement of therapy records in a rape case: “Raped on Campus? Don’t Trust Your College to Do the Right Thing”, and then added further damage by stating “Students: Don’t go to your college counseling center to seek therapy.”

It is not that the authors had no point to make.  I do not take issue with advocates calling attention to allegations that there may be problems in the application of procedures on some campuses.  But making sweeping condemnations of an entire field in a large country goes well beyond that.  The number of cases mentioned in articles or blog posts like these is typically very small, as it was in these articles.  This, friends, is what you call over-generalization.  There are over 1,000 college counseling centers in the United States providing millions of therapy sessions annually and they, I dare say, do so competently and with good results.  OK, so the ethics of blogging may be loose indeed, fine.  But these authors are advising potentially millions of our youth to avoid the most convenient, least costly, most specialized services for the college student population.  Doing so is patently absurd, hurtful, and wrong.

Sometimes, actual college counselors are quoted in the articles, but generally very few.  Even rarer are articles written by someone who actually does the work.  Say what you will about attorneys and journalists, but the fact is they do not know, and cannot know, the work from the inside.  They are not managing extremely challenging circumstances while being intimately knowledgeable about and adhering to our specific professional codes of ethics.

Students, listen to those who do the work.  Use your campus counseling service.

Emotional Wellness for Law Enforcement Curriculum

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I am hoping to be starting the Master Instructor Certification Course (MICC) sponsored by the California Commission on Peace Officers Standards and Training (POST). 
All MICC students are required to design a law enforcement course from 3-5 days in length, which will be submitted to POST for approval. If approved, it will become a POST reimbursable course offered statewide. POST courses tend to have much better attendance because officers get CPT credit for them. 
My course will be on Emotional Wellness for Law Enforcement. 
In addition to having grown up in a law enforcement family, I am an 11 year police veteran, and a licensed Marriage and Family Therapist. While my professional and personal experience in this area have a place in the design of the course, it is far from enough. 
I would like to correspond with others who feel strongly about the need for our peace officers to be as emotionally healthy as possible  throughout the span of their lives. If you are one of the following and would be willing to share your ideas on the development of this course, please contact me.
  • Law Enforcement Officers (LEO)  
  • LEO, mental health clinician or others that who teach in this area
  • Mental health professionals working with LEO’s
  • LEO peer supporters
  • Researchers
  • LEO family members
  • Anyone else with a verse to contribute
For those of us with a vested interest in this topic, this is a fantastic opportunity.  My goal here is to learn as much as possible from as many different people as I can. 
In addition to collaborators, I will be looking for subject matter experts (SME) for various topical areas (e.g., John Violanti for LEO stress). If you are a SME or know someone who may be willing to donate a bit of their time to a good cause, please let me know. I will be interviewing SME’s at some length. 
It is important to note the focus of this project will be on “Lifetime Emotional Wellness.” To use an analogy, at the basic police academy in CA, the class on physical training is called, “Lifetime Fitness.” Recruits begin physical training on the first day of the academy. Their last day of PT is usually the day before graduation.  It is pounded into our heads that fitness is not to stop once we leave the academy; that it is for life. This is the type of framework I intent to use for emotional wellness. 
While the course will include secondary and tertiary prevention (i.e., what to do once problems exist), a focus will be on developing, maintaining, and constantly improving one’s emotional wellness. I see a gap here in the literature and training. My bias is that, as peace officers, we should go beyond “surviving” this career [no jab here toward Gilmartin’s invaluable work]. We should know about and be willing to work toward lives filled with meaning, happiness, and healthy relationships. 
Finally, something about the design of the course. The fundamental question the CA POST IDI program asks is, how do adults learn? Everything in the program is geared toward adult student learning. To explain what is meant by “learning” here, let me contrast it with “going to a training.” 
As most of us know, the typical training involves someone lecturing to the class for long periods of time, with a PPT in the background. In fact, sadly perhaps, this is how I’ve conducted most of my trainings (which is part of the reason I started the IDI program). So, lecture, PPT, the odd video or two and get out a half hour early. Sound familiar? 
In designing this course, my question will be, what learning exercises, delivery methods, learning styles and modes, and learning verification tools will I use to ensure the greatest chance that students will actually use what is taught? In other words, rib sticking stuff. Ultimately, this will not be “Jeff Shannon’s” training. It will contain enough detail and clarity that any law enforcement trainer will be able to use the lesson plan and teach the same stuff. My question to you is, What “stuff” should be in there? 
Thank you in advance for anything you can offer. 
Kind regards,
Ofc. Jeff Shannon, LMFT
        Berkeley Police Department
(510) 981-5779
(510) 595-5580 Office

Healthy Relationships in College

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On this Valentine’s Day, let’s take a brief look at the ingredients of a good, healthy relationship. While the focus of this blog is on college students, what follows can certainly apply to anyone, at any age. College students have many opportunities to meet new friends and develop enriching relationships on campus. Such relationships can make the difference between a positive and negative college experience. It is important to know the difference between healthy and unhealthy relationships, and to know how to make choices to preserve the former and improve the latter. Here are a few hallmarks of a healthy relationship:

  • Mutual respect and civility
  • A sense of reciprocity, or “give and take”
  • Feeling supported and supporting the other
  • A significant degree of trust and honesty
  • Fairness and equality as adults
  • Comfort with emotional intimacy or closeness
  • Comfort with distance and “separateness”, or being able to have your own life apart from the other
  • Open, direct communication without fear of reprisal, hidden agendas, or manipulation
  • Good “boundaries”, or being able to set personal limits with self and others
While no relationship is perfect and we all have bad days, students should be able to evaluate their relationships and feel, on the whole, that they are positive and healthy. If they are less than healthy, steps should be taken to improve them. Such steps involve both assertiveness and listening. If you have concerns about the state of your relationships with family members, friends, roommates, faculty, co-workers or others, contact your campus counseling service for assistance.

A Problem with Brain-based Models

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We are living in a time of obsession with the brain.  It is true that neuroscience is producing discoveries which are interesting an may be useful (time will tell), though humans will always amount to much more than what we carry in the cranium.  On a daily basis I see in my news feeds items like “Gene found responsible for chronic tardiness”, or “CAT scan shows region involved in ADHD”, or “Bipolar Disorder rise attributed to increase in brain abnormality”.

A problem I have with research like this, and like so much that we consume, is that it does not appear to take into account developmental, contextual, and environmental factors. Because of this the dialog focuses on a reductionist and brain-based model as though the person-in-environment does not exist. This facilitates intrusive and authoritarian “treatments” and is often a dead end in improving human welfare. To say that diagnosis X is rising really does not tell us what we need to know, which is why or how. And that’s putting aside all the arguments involving inadequate support for diagnoses and the inter-rater reliability problems associated with them. Sometimes it seems as though the research paradigm is oriented toward simplistic goals for the purpose of developing efficient delivery of interventions, mainly drugs. And by efficient I mean not having to develop human relationships or spending much face time with people.

The “innovations” all seem to actually reduce time spent in human contact, thereby increasing the ROI in billing.

I am not an expert in the technicalities of diagnosing, though I think I do well in the formulation of human life problems.  I do know that our young adults are functioning in a context which is often pathogenic in and of itself. Here are some of the factors we see as relevant:

  • Stress related to global political and marketplace influences
  • Extremely poor sleep routines and hygiene
  • Arrhythmic lifestyles, or more simply put, chaos
  • Too much screen time, not enough play and exercise
  • A paucity of trusting, mutually satisfactory relationships, in any sphere
  • Racism and discrimination
  • Increased sense of threat and diminished opportunity for affiliation
  • Poverty
  • Alcohol and drug abuse
  • Poor nutrition
  • The inherent “volatility” of the late adolescent and young adult
  • The seasonal nature of the stresses in the academic environment
  • Corruption, or at least mutual and self-serving contamination, among our leaders including those involved in healthcare and the Pharma-Insurance conglomerate
  • Violence, rape, sexual assault, harassment
  • Environmental toxins and their suspected role in some diagnoses (see

If I bathed your brain in even half of these factors, what would you look like?

I have personally worked with many young folks who “looked” Bipolar (or ADHD or Whatever 209.45), but who were really experiencing intense emotion which they could not articulate in language nor act to soothe. The intense emotion was, more often than not, a result of a pathogenic environment of people, places and things, some of which they created themselves.

This is not a new problem.  Some years back we hanged and drowned and burned some women in Salem, MA.  It wasn’t even thought until the 1970s that there might have been a fungus in the rye they ate which caused some alarming behavior.  Never mind whatever proportion of them were being assaulted.  But they were killed, because it was easier to attribute behavior to the individual rather than her context.  This is still the case.

Please recall Seurat and his pointillism, the painting style consisting of a series of dots.  A diagnosis is a few dots.  You have to stand back from the painting to see the darn thing.  It is much the same with humans.

I am sure there are other views. This is mine, and it does not necessarily foreclose on the concept of serious illness.  But I submit the threshold for this is much higher than what many appear to believe, especially those with an investment in the “treatment” for the illness.

Organizational Fragmentation is Hurting Us

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Mental health professionals are like cats. We are hard to herd. Perhaps this is due to our independent and autonomous nature, at which most of us seem to arrive after years of study and work as strong advocates of the individual. Perhaps this is an example of western philosophy taken to an extreme.

Whatever the source this has resulted in an unfortunate situation in which we have created a seemingly endless array of professional organizations with which we affiliate. These organizations appeal to narrow sensibilities or professional pursuits. Here are a few examples from the college mental health profession alone:
  • ACCA
  • APA’s Division 17 and its Commission on College Counseling
  • NASPA and its programs on mental health
  • ACPA and its programs on mental health
  • And professional organizations representing several disciplines within college mental health, such as APA, ACA, NASW, AMFTA, and those for psychiatry.

This is just a partial list. Other professions may have multiple associations as well, but often rely on a single one to speak on their behalf, such as ACHA or AMA for those in medical fields.

This degree of fragmentation is a major obstacle to advancing our specialty, which I believe it is. Due to all the voices, all the principles and customs on which these organizations were founded, it is next to impossible to form meaningful and potent alliances, position statements, and agenda for advocacy at any level. Attempts have been made, such as through HEMHA, but these may be limited in scope due to funding and staffing realities. Without appropriate funds and executive staff to carry out its goals, such efforts will always be quite limited in spite of the very best intentions behind them.

It is past time for us to correct this situation. Due to forces in the economics and politics of health care in the United States, some organizations are pursuing an agenda which often does not incorporate respect for other professions or their core philosophies, especially regarding youth and young adults. Trends toward pathologizing normal life experiences, such as bereavement, so that intrusive interventions may be deployed are but one example. Take note of the buzzwords associated with these efforts: evidence-based care, best practices, integrated care, and so on. As I covered in a previous post, these buzzwords mask another reality, which is integration without true integration, and selective review of research to support whatever may be called a best practice.

The professional organizations representing college mental health need to be consolidated in order to form a more active and potent and focused association. It is an irony that in our appreciation for diversity, we may have neglected the greatest diversity of all: the full range of our professional philosophies and service models. Without such a consolidation and re-calibrating of our efforts, this diversity will continue to suffer and may disappear altogether.

Wants and Needs

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As higher education institutions have adopted business models a customer service orientation toward students has taken root. This is not always a bad thing. It helps faculty and staff stay on their toes and work hard to address legitimate needs of our consumers. It can serve to market the school well and also to advance its image and brand.

As with most things, however, there is a pernicious shadow to these trends, one that is anathema to college mental health which is all about addressing the needs of students. But customer service many times becomes more about satisfying wants. This in turn has created a phenomenon in which those around a student, such as parents, faculty, staff, administrators, and other stakeholders, have taken on a positively entitled, demanding posture concerning something they think should be done for a student. Sometimes there may be a positive basis for the expressed want, sometimes not.

Counseling and psychotherapy is about an individual’s need to change something about themselves, something that is contributing to their own unhappiness. The things which need changing are determined by a trained professional, working collaboratively, who evaluates the individual’s needs. Many times, early in therapy, clients focus on their wants and not their needs, but this is what may have led to the cultivation of life problems in the first place. Wants are often about being comfortable, while counseling, at least in the beginning, will entail a degree of discomfort. Lasting change is rarely if ever a comfortable process.

So we may face scenarios in which insisting on wants may actually lead to harm for a student, and therefore represent an abuse of counseling services. This we are obligated to prevent or stop altogether. Just as no one can dictate how a physician treats your ailing kidney, no one can dictate how psychotherapy is to be conducted (though insurance companies try to do this all the time). It is unhealthy for anyone to attempt to control what ought to be a collaborative working relationship between client and therapist. Counselors are obligated to uphold standards around this issue, so don’t be surprised when they say “No.” Of course, folks can seek other opinions elsewhere, where it it will be less convenient and more costly, if they like. Or they could give it several sessions first, say five or six, and then make judgements about the effectiveness of therapy after the discomfort begins to wane.

Optimism. In Law Enforcement? by Jeff Shannon, LMFT

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The other day as I was driving, I saw a twenty something guy skateboarding down the sidewalk. His clothes were dirty and torn, and he carried a piece of card board under one arm with writing on it. Within only a few seconds of seeing this young man, a rather harsh judgement popped into my mind, the specific words of which I’ll plead the 5th on. 

In this same few seconds, however, something quite amazing happened. Before I even completed the sentence in my mind, replete as it was with a colorful adjectives, I stopped myself. Not only did I stop myself, but I turned my attention to the young man’s lime green beanie cap. I said to myself, “I like that cap!” I said it again as he faded off beyond my side view mirror, “Cool cap.” 

What I realized in this very brief moment in time was that I’m becoming more “positive.” Having worked in law enforcement for ten years now, this is no small accomplishment. As just about every cop knows, the more years we have on, the more pessimistic we tend to become. Pessimism, along with its ugly cousin cynicism, follow naturally as we spend years interacting with people at their “Maddest, baddest and saddest,” as Kevin Gilmartin puts it (Gilmartin is the author of Emotional Survival for Law Enforcement). 

Optimism helps us bounce back from adversity of all kinds. Getting punched in the face is adversity. While I certainly hope no LEO has this experience, if it does happen, getting punched in the face does offer a moment of truth regarding ones’ ability to bounce right back and stay in the fight. Adversity can also take the form of events as routine as being stuck behind someone with no driving skills, working for a horrible boss, or being exposed to a critical incident. 

Dr. Dennis Charney at the Mt. Sinai School of Medicine, makes his living by studying how people respond to adversity. Specifically, he’s interested in those who are excellent at bouncing back. He interviewed Vietnam veterans who were held in captivity, tortured and kept in solitary confinement for many years. He came up with ten characteristics of those who didn’t suffer from PTSD or depression after their imprisonment. Guess what the number one characteristic of resilient individuals was. Yeah, it was optimism. 

Your daily experience reveals that some people seem to be naturally more optimistic than others. By the way, we’re not talking about those who are obnoxiously and unrealistically happy about everything. We’re talking about those who understand the gravity of the adversity before them and yet see the cup as half full. Regardless of how naturally optimistic you are, the fact is we can work toward being more optimistic (and therefore more resilient) if we so choose. 

Having made baby steps myself toward being more optimistic, I can report the following benefits, 

  • I’m less pissed off. 
  • I feel better in my skin.
  • People like being around me more (I think). 
  • I’m a better role model for my kids. 
  • I have less toxic stress hormones coursing through my veins.
  • My overall life satisfaction is better. 

Okay, assuming I’ve sold you on working toward being more optimistic, how do you “do” it? Step One is the most difficult. It involves bringing conscious awareness to our thoughts, feelings and bodily sensations. The great thing is, we have lots and lots of opportunities to practice this stuff. 

Angry, impatient, pessimistic thoughts are all opportunities! If you bring conscious awareness to them – in other words, you catch yourself in the act – you can choose to shine the light of conscious awareness on to something more positive (like the guys’ cool beanie). Doing it just one time will show you it’s possible. 

Suddenly realizing that you’re feeling angry, tense, or irritable also presents the opportunity to ask yourself why you’re feeling that way. Then, you can add some positive (and probably more realistic) thoughts into the mix of your mind. Feelings don’t come out of the blue, they are the logical result of thoughts (e.g., if you think “I’m late!” you will begin feeling anxious and your body will tense up). You can also take a few belly breaths to relax. 

Finally, if you don’t catch yourself in the act of thinking or feeling, your body may tip you off. If you’re sitting at a computer banging out a report and you suddenly realize you have a knot in your neck, again opportunity time. 
Although I’ve used a lot of words to describe this process, keep in mind it can happen lightning fast (like the example I used at the beginning). 

If you’re disciplined enough to exercise regularly as most LEO’s are, then your disciplined enough to work on your optimism. It’s one of the best investments in your overall wellness you can make. 

 Jeff Shannon is a Police Officer, law enforcement instructor, and Licensed Marriage and Family Therapist in northern California. 

Supporting the Role of Psychotherapy in Modern Life

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Psychotherapy has proven over and over to be effective. In some cases its has proven superior to other interventions, including medication. And yet, over the last 20-30 years there has also been a variety of factors which has limited access to these services.  From the time of the rise of accountable care or health maintenance organizations, many of which have limited its approval and duration, psychotherapy has been struggling to stay alive much less to thrive.

Numerous other societal influences have contributed to this problem.  These include:

  • The reduction of time in psychological services provided in medical settings, which have claimed to integrate such services but have only cursorily done so.
  • Shifting emphases away from psychotherapy in training programs.  It is now not uncommon to meet trainees with only a handful of therapy contacts under their belts. This is partly due to the sources of grant funding, an orientation toward other health care activities and settings, and the development of manualized treatment programs which place less value on the relationship dyad.
  • Burdensome issues relating to overhead costs and below market-pricing for those in private practice, a disincentive to engage in this work.
  • Clear valuing of medication delivery in the medico-pharma-insurance conglomerate, to the exclusion of other approaches.  (This may change as pharmaceutical development for mental health slows down due its reaching a ceiling in benefit to humans.)
  • A public which has been encouraged to seek quick, effortless relief from life’s ordinary challenges.
  • A parallel trend in which the public has been convinced that ordinary challenges, such as bereavement, are mental illnesses requiring a biological intervention.
  • A reduction in mental health funding at the state level, which actually releases the hospitalized back into the community where they will face long waits just to talk to someone.
  • The erosion of privacy in healthcare settings.
  • The digital age, which has directed the attention of individuals to devices and away from the support of each other.
  • A lack of humanizing development in psychotherapy itself.  All recent “innovations” I can think of actually reduce human contact, as in the cases of online therapy and telemental health services.

In an era in which humans crave and need human contact and community, psychotherapy has a role which is more relevant than ever.  But on top of that, IT WORKS!  There is an ample base of evidence for this.  When you or yours need assistance with one of life’s many challenges, seek out a competently trained therapist first.  Look for those trained in accredited, residential programs, who are fully licensed in their jurisdiction, and who will meet you face to face for no less than a full 50-minute session per week, just to start. Insist on a high degree of privacy such that only you and your therapist know your concerns, so that you may experience trust.  (As stated in a previous post, confidentiality is the magic behind therapy.)  When dozens have access to your record, this is lost.

Life-changing therapy relationships are possible.  Don’t settle for inferior or illusory “interventions”.  Seek out the best psychotherapy possible.  College counseling services are one of the last true preserves of psychotherapy; encourage your student to take advantage of this opportunity which may never be as cost-effective or convenient during their lifetimes.

Service Models in College Counseling Centers

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An earlier post focused on one role and philosophy for campus counseling services based on my professional experiences.  But discussion on this subject would not be complete without an at least a brief overview of various service models already in use across the United States and perhaps other countries as well.

I have been surprised, 
even dismayed, to repeatedly observe how little literature or direction is available concerning these guiding philosophies or models.  Since very few mental health professionals receive any management training prior to becoming the manager of counseling services, this places new or emerging directors in a vulnerable position.  In the haste to develop services sorely needed by students, we can create a patchwork of disjointed programs and services which may not be rationally related nor focused on any particular values or orientations.  Further, we may also be vulnerable to other influences which are better schooled in business models but which have little to nothing to offer in the area of psychotherapy or relationship-based healing.

A comprehensive view of existing models is beyond the scope of a brief blog post.  Suffice it to say that what is offered here is a sample, a taste if you will, of the choices available to campus leaders.  It is my hope that this may whet appetities to examine this more deeply, and to investigate what models may best suit a particular campus, its culture, and its student body.  The reader will note that definitions are not presented here.  This is partly because the literature is so scanty I am not sure there are agreed upon definitions available, and partly because I do not want to constrain the imaginations of managers working to grow a center (more on that later).

The list below was developed by a convenience email sample of counseling service directors in August of 2014.  It is not to be construed as complete or exhaustive.  Each of the models listed have advantages and disadvantages, and none, in my opinion, is inherently superior to the others in all contexts, though some may claim otherwise.  And context is the key: understand yours first.  Then select the models or models which you think may best suit campus needs.  Then investigate and experiment and evaluate and refine.

A Sample of Service Models

1. Bio-Psycho-Social Model

2. Brief Therapy Models

     a. Brief Intermittent Model

     b. Short Term Episodic Model

     c. Time Attendant Model

3. Building Resiliency and Supporting Personal Success and Goals Model

4. Campus Stakeholder Model

5. Client-Directed, Outcome Informed Model

6. Community Mental Health Model

    a. Brief Campus-wide Services Model

7. Consultation or Organizational and Community Development Model

8. Contextual/Environmental/Ecological/Systemic Models

9. Cube Model

10. Developmental Model

    a. Broad-based Comprehensive Student Development Model

11. Educational Services Model

12. Feminist Model

13. Human Service Model

14. Medical, Health Service or Clinical Model

15. Multicultural and Cross Cultural Models

16. Public Health Model

17. Strengths-based Model

18. Hybrid (of two or more)

Significant Areas of Emphasis in Centers

1. Training Emphasis

2. Evidence-based Therapy