38 Secondary Emotionsdialectical Behavioral Training



38 Secondary Emotionsdialectical Behavioral Training

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  1. PDF The article studies the theoretical foundations of technologization of student behavior management in the modern system of secondary vocational. Find, read and cite all the research you.
  2. WATCH THE FOLLOWING VIDEOS: PRIMARY EMOTIONS At least once.
  3. Evaluation of behavioural skills training for teaching abduction-prevention skills to young children. Journal of Applied Behavior Analysis, 38, 67-78. Miles, N.I., & Wilder, D.A. The effects of behavioral skills training on caregiver implementation of guided compliance. Journal of Applied Behavior Analysis, 42(2), 405-410.
  4. (c) Development. The development of evidence in connection with claims for service connection will be accomplished when deemed necessary but it should not be undertaken when evidence present is sufficient for this determination. In initially rating disability of record at the time of discharge, the records of the service department, including the reports of examination at enlistment and the.

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Within the Emotional and Behavioral Health Area of Emphasis, the Waisman Center works to promote healthy social and emotional development. We support positive behaviors for individuals with developmental disabilities and special health care needs, including co-occurring mental health conditions. Emotional health, expression of positive behaviors, and social skills are foundational to an individual's success, beginning in infancy and progressing across the lifespan. When not addressed, challenging behaviors such as aggression, destruction, or self-injury can result in a greater restriction of life opportunities.

Research and practice demonstrate that a blend of positive practices systematically implemented increases the success of individuals with developmental disabilities who are experiencing complex behavioral and mental health challenges. With proper support across settings, individuals who exhibit challenging behaviors can successfully live, be educated, work, and recreate in the community.

Areas of UCEDD activity focus are: infant and early childhood; family mental health and outreach; and consultation for challenging behaviors for people with developmental disabilities and special health care needs.

Challenges to Emotional and Behavioral Health

Identification and Intervention for Mental Health Needs. Identifying and accessing appropriate interventions at the earliest signs of mental health and behavioral challenges can be daunting for both families and the health and educational professionals providing supports to children, youth, and adults with these challenges. There is increased recognition of mental health disturbances in very young children including disturbances in mood; difficulties in regulation of feeding, sleep, or attention; sensory or relational difficulties; and withdrawn or aggressive behavior (Clark, 2010). For individuals with developmental disabilities and other special health care needs, the social and emotional needs associated with healthy development are often overlooked until these challenges escalate into behavior challenges.

How do we go about assuring that all providers and agencies have the proper screening tool and strategies as well as effective training protocols?

Relationship-Based Context for Intervention. All learning, behavior, and socialization occur in the context of relationships. The promotion of healthy social emotional development begins in infancy and continues throughout the lifespan. Early onset of severe and persistent emotional and behavioral issues in children with developmental disabilities can sometimes prevent the development of these important relationships. The development of strong and healthy relationships in early childhood lays the foundation for all later relationships. For adults, the therapeutic relationships across the various providers is a key component to a successful supported lifestyle.

How can family members and providers be educated and supported effectively and in a timely manner in order to establish and maintain these essentials emotional bonds?

38 Secondary Emotionsdialectical Behavioral Training Post Test

Bias toward People with Disabilities. The belief that people with developmental disabilities and challenging behaviors cannot participate in community life with appropriate supports is a common occurrence. This notion is compounded by those who also have mental health issues. It is imperative that families recognize potential trajectories for their children within community life, regardless of the level of support that may be needed. Too often, professionals and community members prepare families for a more limited future based solely on a diagnosis and observable behaviors, rather than a combination of possibilities within the child, family, and community. For families with young children, this often begins in the early childhood years. Their children are not accepted into child care settings due to behavioral or other special needs, and these types of exclusions continue throughout the school years. For adults in supported living, 'Severe Reputations' may emanate from past incidents that may have only occurred a few times and within the context of poorly-planned supported lifestyles.

How do we go about educating families, professionals as well as attitudes within communities to how people with disabilities and mental health challenges can thrive in the community, with proper support; and furthermore, how communities can be enriched though the participation of people with disabilities and mental health challenges?

Safety. Assuring safety for individuals with challenging behaviors, providers, and citizens is an essential component of a well-crafted community support plan. When safety issues are not properly addressed, children are at risk for out-of-home placement or segregated education. A growing number of preschoolers are expelled from child care settings each year due to challenging behaviors (Gilliam, 2005). Schools struggle with providing individualized special education in the least restrictive environment and recognizing parent and child rights while also looking out for the safety of all children. Children struggling with emotional regulation issues that are not addressed often continue to experience emotional volatility in adult years. Adults are at risk for arrest, unnecessary psychiatric stays, or institutionalization. In developing programs that assure safety, Community Support Teams sometimes need to incorporate more intensive strategies. These approaches sometimes need to also include what are termed Restrictive Measures. When developed properly and incorporated within positive behavioral supports, Restrictive Measures can protect individuals, providers, and the community from those low frequency and high intensity behaviors that may include aggression, destruction, or self-injury.

How do we assist these teams in considering whether to use restrictive measures, and if so, how they can be used for the purpose of safety and not as a form of punishment or potential abuse?

Education and Training of educational and healthcare professionals, including those in mental health fields, as well as direct support providers and families is a key component to successful school and community life for people with challenging behaviors. Many professionals earn their degrees and practice without specific knowledge of very young children or people with developmental disabilities who also have mental health and behavioral needs. Without appropriate training, disparities in access to appropriate services will continue throughout the lifespan. In the early childhood years, this means increasing the capacity of early care and educational providers from diverse programs (e.g., child care, Head Start, schools, Birth to 3, home visiting, family resource centers) to address the emotional and learning needs of all children. The challenge is to create a coordinated, cross-system professional development system that reaches all people who touch the lives of children. This cross-system attention to professional development is also necessary for professionals working with adults. In both early childhood and supported community programs for adults, direct care positions are typically under-funded, which results in low wages and leads to high turnover rates. Additionally, provider agencies often do not have access best practice training strategies related to challenging behaviors and/or do not have the resources to properly educate the direct providers.

How do we go about assuring that there are an adequate number of providers who are educated, adequately compensated supervised, and remain in their positions over time?

Service to Individuals and Families

  • Community TIES provides outreach behavioral consultation to individuals with DD, parents, provider agencies and schools. The Community TIES program has blended various approaches in establishing this style of positive behavioral supports that also promotes Community Inclusion. The approach subscribes to the belief that people with disabilities and challenging behaviors can thrive in the community with proper supports.
  • TIES Clinic offers psychiatric consultation to patients with DD and co-occurring mental health issues
  • Adaptations and Modifications Program offers environmental accommodations to living spaces that assure safety and promotes continued participation in community life.
  • The Waisman Early Childhood Program provides an enriching environment that supports healthy social and emotional development in young children and supports young children with challenging behaviors in an inclusive early childhood environment.
  • The Waisman Center Clinics offer assessments of social emotional development, parent child interactions, and challenging behaviors within interdisciplinary clinical evaluations. The clinics include highly qualified professionals (e.g., psychologists, developmental pediatricians, and speech and language therapists) who are able to conduct assessments and make recommendations for interventions to address social and behavioral challenges in children and youth with developmental disabilities and special health care needs.

Pre-Service Training

Outreach Consultation on Challenging Behaviors

  • The Community TIES Program offers field placements (one or two semesters) for UW Social Work and Rehabilitation Psychology Undergraduate and Masters students. Experiences focus on the development of consultation skills for providing positive behavior supports to address challenging behaviors.
  • Community TIES also serves as a rotation site for UW Psychiatric Residents. In this experience, residents learn about behavioral and medical management of psychiatric disorders. http://www.waisman.wisc.edu/cedd/Student_Postdoc_Opportunities/field_experiences.php

Community Training and Technical Assistance

Infant, Early Childhood and Family Mental Health

  • The Waisman Center collaborates with, the UW-Madison Department of Psychiatry and the Wisconsin Alliance for Infant Mental Health, on the Capstone Certificate Program in Infant, Early Childhood and Family Mental Health, University of Wisconsin. This Capstone Certificate Program is an intensive, interdisciplinary, one or two year academic program for practicing professionals from the disciplines of mental health, health, social services and education who work with families in the prenatal and postpartum periods and with children ages birth through five years.
  • Social Emotional Foundations in Early Learning (SEFL) is a statewide professional development initiative adapted for Wisconsin through a partnership with the national Center for Social Emotional Foundations in Early Learning http://www.vanderbilt.edu/csefel/ . Staff of the Early Childhood Professional Development Hub of the Waisman Center serve on the State Leadership team and are members of a cohort of approved SEFEL trainers. who provide training on social and emotional development in a variety of early childhood settings.

School Age Children/ Youth and Adults

  • Training and Consultation is a comprehensive offering of seminars and trainings for caregivers, support brokers/case managers, consumers, families, program administrators/supervisors and anyone interested in learning more about related topics in the field of Developmental Disabilities. Training and Consultations has a series of seminars related to behavioral support.
  • Behavioral Consultations are offered through Community TIES. Short term consultations for individual with DD and challenging behaviors for provider agencies, Family Care programs, families and schools across Wisconsin are provided

Advisory Group Membership

UCEDD staff and faculty serve on the following committees and boards relevant to this Area of Emphasis:

  • State Leadership Team for the Social Emotional Foundations in Early Learning
  • Participation on committees to provide direction and oversight for use of positive behavioral supports that also include Restrictive Measures
    • Statewide for children receiving waiver services
    • Family Care – Care Wisconsin
    • Dane County Human Services children and adults

Infant, Early Childhood and Family Mental Health

Positive Behavioral Supports and Crisis Prevention

Effective Psychiatry

Key References

Infant, Early Childhood and Family Mental Health

  • Zeanah, C. H., Jr. (Ed.). (2009). Handbook of infant and mental health. (3rd edition). New York, NY: The Guilford Press.
  • Landy, S. (2002). Pathways to Competence: Encouraging Healthy Social and Emotional Development in Young Children. Baltimore, MD: Paul H Brookes Publishing Co.

School Age Children/ Youth and Adults

Influences on positive behavioral supports

Foundational:

Emotionsdialectical
  • John McGee – Gentle Teaching
  • Dr. Herbert Lovett – Integrated approach to Challenging Behaviors

Current:

  • David Pitonyak – Relationships and Challenging Behaviors
  • Martha R Leary -Accommodations and sensory regulation

§ 3.304 Direct service connection; wartime and peacetime.

(a)General. The basic considerations relating to service connection are stated in § 3.303. The criteria in this section apply only to disabilities which may have resulted from service in a period of war or service rendered on or after January 1, 1947.

(b)Presumption of soundness. The veteran will be considered to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service. Only such conditions as are recorded in examination reports are to be considered as noted.

(1) History of preservice existence of conditions recorded at the time of examination does not constitute a notation of such conditions but will be considered together with all other material evidence in determinations as to inception. Determinations should not be based on medical judgment alone as distinguished from accepted medical principles, or on history alone without regard to clinical factors pertinent to the basic character, origin and development of such injury or disease. They should be based on thorough analysis of the evidentiary showing and careful correlation of all material facts, with due regard to accepted medical principles pertaining to the history, manifestations, clinical course, and character of the particular injury or disease or residuals thereof.

(2) History conforming to accepted medical principles should be given due consideration, in conjunction with basic clinical data, and be accorded probative value consistent with accepted medical and evidentiary principles in relation to value consistent with accepted medical evidence relating to incurrence, symptoms and course of the injury or disease, including official and other records made prior to, during or subsequent to service, together with all other lay and medical evidence concerning the inception, development and manifestations of the particular condition will be taken into full account.

(3) Signed statements of veterans relating to the origin, or incurrence of any disease or injury made in service if against his or her own interest is of no force and effect if other data do not establish the fact. Other evidence will be considered as though such statement were not of record.

Dialectical Behavioral Therapy For Children

(Authority: 10 U.S.C. 1219)

(c)Development. The development of evidence in connection with claims for service connection will be accomplished when deemed necessary but it should not be undertaken when evidence present is sufficient for this determination. In initially rating disability of record at the time of discharge, the records of the service department, including the reports of examination at enlistment and the clinical records during service, will ordinarily suffice. Rating of combat injuries or other conditions which obviously had their inception in service may be accomplished pending receipt of copy of the examination at enlistment and all other service records.

(d)Combat. Satisfactory lay or other evidence that an injury or disease was incurred or aggravated in combat will be accepted as sufficient proof of service connection if the evidence is consistent with the circumstances, conditions or hardships of such service even though there is no official record of such incurrence or aggravation.

(e)Prisoners of war. Where disability compensation is claimed by a former prisoner of war, omission of history or findings from clinical records made upon repatriation is not determinative of service connection, particularly if evidence of comrades in support of the incurrence of the disability during confinement is available. Special attention will be given to any disability first reported after discharge, especially if poorly defined and not obviously of intercurrent origin. The circumstances attendant upon the individual veteran's confinement and the duration thereof will be associated with pertinent medical principles in determining whether disability manifested subsequent to service is etiologically related to the prisoner of war experience.

(f)Posttraumatic stress disorder. Service connection for posttraumatic stress disorder requires medical evidence diagnosing the condition in accordance with § 4.125(a) of this chapter; a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. The following provisions apply to claims for service connection of posttraumatic stress disorder diagnosed during service or based on the specified type of claimed stressor:

(1) If the evidence establishes a diagnosis of posttraumatic stress disorder during service and the claimed stressor is related to that service, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

38 Secondary Emotionsdialectical Behavioral Training Techniques

(2) If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

(3) If a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of posttraumatic stress disorder and that the veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. For purposes of this paragraph, “fear of hostile military or terrorist activity” means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror.

(4) If the evidence establishes that the veteran was a prisoner-of-war under the provisions of § 3.1(y) of this part and the claimed stressor is related to that prisoner-of-war experience, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

(5) If a posttraumatic stress disorder claim is based on in-service personal assault, evidence from sources other than the veteran's service records may corroborate the veteran's account of the stressor incident. Examples of such evidence include, but are not limited to: records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians; pregnancy tests or tests for sexually transmitted diseases; and statements from family members, roommates, fellow service members, or clergy. Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources. Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes. VA will not deny a posttraumatic stress disorder claim that is based on in-service personal assault without first advising the claimant that evidence from sources other than the veteran's service records or evidence of behavior changes may constitute credible supporting evidence of the stressor and allowing him or her the opportunity to furnish this type of evidence or advise VA of potential sources of such evidence. VA may submit any evidence that it receives to an appropriate medical or mental health professional for an opinion as to whether it indicates that a personal assault occurred.

Dialectical Behavioral Therapy Definition

(Authority: 38 U.S.C. 501(a), 1154)
[26 FR 1580, Feb. 24, 1961, as amended at 31 FR 4680, Mar. 19, 1966; 39 FR 34530, Sept. 26, 1974; 58 FR 29110, May 19, 1993; 64 FR 32808, June 18, 1999; 67 FR 10332, Mar. 7, 2002; 70 FR 23029, May 4, 2005; 73 FR 64210, Oct. 29, 2008; 75 FR 39852, July 13, 2010]