Counselor Toolbox Podcast with DocSnipes

Chapters:

00:00:00 - Understanding Pornography and Its Effects

00:05:09 - Reasons for Engaging in Sex and Porn

00:10:37 - Motives for Having Sex

00:15:45 - Negative Consequences of Overusing Porn

00:20:46 - Dysfunction of the HPA Axis and Problematic Use

00:25:29 - The Impact of Pornography on Relationships

00:30:32 - Objectification in Pornography and its Interpersonal Effects

00:36:13 - The Impact of Pornography on Relationships

00:41:30 - Challenges and Perceptions of Sexual Schema

00:46:31 - Promoting Stigma and Shame

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Video Title: Ethics, Counseling Skills Development, Self-Care, and Ongoing Supervision

Presenter: Dr. Dawn-Elise Snipes

Chapters:

00:00:00 - Ethical Imperatives in Counseling

00:07:00 - Exploring Treatment Options

00:14:07 - The Impact of Gut Health on Mood

00:21:19 - Resources for Continuing Education

00:28:48 - Impact of Past Experience on Current Interaction

00:35:47 - Authoritarian leadership and its impact on burnout

00:42:49 - Job Sharing and Work Environment

00:49:49 - Tips for Maintaining Work-Life Balance

00:56:43 - Treatment Plan Reassessments

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Video Title: Managing Depression: Tips and Strategies

Presenter: Dr. Dawn-Elise Snipes

Chapters:

00:00:00 - Developing Respect

00:06:02 - Valuable qualities and respect inventory

00:11:49 - The Importance of Respect in Relationships

00:18:02 - Communicating Expectations

00:24:11 - Addressing Disrespect in Relationships

00:30:16 - Respecting Personal and Partner's Boundaries

00:36:21 - Respecting Boundaries in Relationships

00:42:12 - Communication and Respecting Boundaries

00:48:11 - Unequally Yoked with Unbelievers?

00:54:05 - Examining Facts and Beliefs in Relationships

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Chapters:

00:00:00 - Differential Diagnosis of Personality Disorders from a Trauma-Informed Perspective

00:06:56 - Characteristics of Paranoid Personality Disorder

00:13:38 - Trauma's effect on mood and libido

00:20:22 - Unusual Perceptions and Magical Thinking

00:27:13 - Characteristics of Dependent Personality Disorder

00:33:59 - Borderline Personality Characteristics

00:40:54 - Differential Diagnosis and Co-occurring Disorders

00:47:27 - Differential Diagnosis of Personality Disorders

00:54:12 - Differentiating Personality Disorders from Other Conditions

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Here is a structured bullet-point summary of the video titled "Restoring Your Marriage with God: Developing Endurance" presented by Dr. Dawn-Elise Snipes:

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---

Chapters:

00:00:00 - Developing Endurance in Your Marriage

00:04:21 - The Endurance of Mistakes and Fallout

00:08:59 - Endurance in the Bible

00:13:19 - Increasing Motivation for Growth

00:17:29 - Distress Tolerance Skills in Relationships

00:21:51 - Calming Down and Having Productive Discussions

00:26:01 - Overcoming Resistance to Change

00:30:10 - Building Endurance and Courage in Relationships

00:34:08 - Making a Plan and Facing Challenges

00:38:16 - Increasing Endurance through Effective Communication

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### Treatment Planning

- **Importance**: Many clinicians and interns struggle with writing effective treatment plans.

- **Tools**:

 - **Integrative Summary**: Provides an executive summary of the patient's story, supports diagnosis, and identifies problems to drive treatment planning.

 - **Standardized Instruments**: Used for guiding treatment planning, such as FARS, CANS, ASAM, and LOCUS.

### Integrated Summary

- **Purpose**: Summarizes the patient’s condition, diagnosis, and impacts of identified problems.

- **Use**: Drives treatment planning by connecting symptoms to the diagnosis and planning interventions.

- **Key Components**:

 - Summarize presenting problems and evidence of impairments.

 - Define the diagnosis and support it with evidence.

 - Provide treatment recommendations.

 - Include a relapse prevention plan.

### Reassessment

- **Purpose**: Evaluate patient progress, note any changes in their condition, and adjust treatment plans as needed.

- **Frequency**: Recommended to be done at least monthly to ensure up-to-date care.

- **Components**:

 - Reassess the patient’s current status.

 - Evaluate progress on goals and identify new challenges or strengths.

 - Adjust treatment plan accordingly.

### Standardized Instruments

- **FARS (Functional Assessment Rating Scale)**:

 - Evaluates various symptoms such as depression, anxiety, and cognitive performance.

 - Helps in tracking progress by rating symptoms at regular intervals.

- **CANS (Child and Adolescent Needs and Strengths)**:

 - Focused on trauma and development issues in children and adolescents.

 - Considers family, developmental needs, trauma, and substance use.

- **LOCUS (Level of Care Utilization System)**:

 - Assesses risk of harm, functional status, and recovery environment.

 - Used often with clients to determine the appropriate level of care.

- **ASAM (American Society of Addiction Medicine Criteria)**:

 - Measures the need for treatment in six dimensions, including substance use and biomedical conditions.

 - Broad and effective for evaluating comprehensive needs.

### Effective Treatment Planning

- **Goals**: Set measurable and achievable targets.

- **Client Involvement**: Engage the client in the planning process to ensure motivation and adherence.

- **Reassessment**: Conduct frequent reassessments to monitor progress, identify obstacles, and adjust plans as needed.

### Common Pitfalls in Treatment Planning

- **Lack of Measurable Goals**: Goals should be specific and measurable.

- **Insufficient Client Feedback**: Clients should be involved in their treatment planning process to ensure they are motivated and invested.

- **Failure to Reassess Frequently**: Regular reassessments are critical to adjusting treatment plans and maintaining client motivation.

### Time-Effective Strategies

- **Client Participation**: Involving clients in the treatment planning and documentation process.

- **Use of Worksheets**: Clients fill out treatment planning worksheets at home, focusing on what's important to them and identifying problems.

### Conclusion

- **Empowerment**: When clients participate in the treatment planning process, they are more empowered and motivated.

- **Concurrent Documentation**: Involving clients in documentation during sessions can improve their engagement and understanding of the treatment process.

Chapters:

00:00:00 - Treatment Planning and Reassessment

00:05:21 - Supporting Diagnoses with Evidence

00:10:34 - Integrated Summaries and Reassessments

00:15:45 - Treatment Plan and Family Involvement

00:20:56 - Enhancing Motivation and Reassessing Progress in Treatment

00:26:01 - Identifying Resources and Strengths

00:31:41 - Assessing Presenting Issues and Needs for Treatment

00:37:09 - Addressing Fatigue: Learning and Planning

00:42:37 - Client Participation in Treatment Process

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(Release was delayed, unreleased episode 980)

### Summary of the Video

**Introduction**

- Welcome to Part Three of Interpersonal Skills series.

- Focus on how past impacts present relationships, especially primary attachment relationships.

- Host: Dr. Donell Snipes.

- Objectives: Identify signs of relationship insecurities, explore past relationships' impact on present ones, and identify interventions for addressing relationship insecurities.

**Signs of Relationship Insecurities**

- Difficulty trusting partner.

- Regularly comparing oneself or partner to others.

- Requiring frequent reassurance.

- Anxiety when separated.

- Internalizing negative thoughts and creating self-fulfilling prophecies.

- Feeling of distance or detachment.

- Reading negative into partner’s words or actions.

**Impact of Past Relationships**

- Past relationships, including primary attachment and friendships, influence current relationships.

- Carrying baggage from past relationships can impact new relationships.

- Holding current partners responsible for past hurts.

- Idealizing past relationships and comparing them to present ones.

**Unhealthy Relationship Characteristics**

- Chaos, abuse, neglect, boundary violations, invalidation.

- Appearance-focused rather than genuine connection.

- Role reversals in parent-child dynamics.

- Low self-esteem and feeling inadequate despite best efforts.

- Difficulty trusting people due to past unpredictability.

**Interventions and Activities**

1. **Relationship Inventory:**

  - Assess primary attachment relationships and significant adult relationships.

  - Identify learned behaviors and characteristics from these relationships.

2. **Brick and Backpack Activity:**

  - Write names of past relationships on bricks, carry them in a backpack.

  - Reflect on the weight and impact of carrying past relationship baggage.

3. **Venn Diagrams:**

  - Compare and contrast past and current relationships to identify unique aspects.

4. **Collage and Advertising Campaign:**

  - Create a collage of self-appreciation.

  - Develop an advertising campaign highlighting personal strengths.

5. **Thought Stopping and Handling Hecklers:**

  - Techniques to manage and redirect negative self-talk.

6. **Heartbreak Pot:**

  - Break and reassemble a terracotta pot, symbolizing healing and support systems.

**Embracing Imperfection and Communication**

- Accepting that neither partner will be perfect 100% of the time.

- Importance of open communication and mindfulness.

- Articulating needs and expectations clearly.

- Developing rules for resolving challenges.

- Regular self and relationship maintenance.

**Grieving Past Relationships**

- Understanding the grieving process for past relationships.

- Reviewing messages received about dealing with loss.

- Identifying and processing continuing issues from past relationships.

**Summary**

- Recognizing and addressing insecurities stemming from past relationships.

- Importance of self-awareness, communication, and maintenance in healthy relationships.

- Encouragement to embrace imperfections and work towards synergistic partnerships.

---

### Major Time Codes

0:00 Introduction by Dr. Donell Snipes, overview of session objectives.

3:20 Signs of relationship insecurities, common indicators of problems.

10:15 Impact of past relationships on current dynamics, carrying baggage.

18:45 Unhealthy relationship characteristics, examples and consequences.

26:30 Interventions and activities, practical exercises for addressing issues.

39:00 Embracing imperfection and communication, tips for healthier interactions.

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### Summary

#### Introduction

- Presenter: Dr. Dawn-Elise Snipes

- Topic: Understanding triggers and cravings

- Goals: Define triggers and cravings, identify personal triggers, and discuss coping methods

#### Defining Triggers and Cravings

- **Triggers**: Anything prompting a rewarding or survival response.

 - Examples: Touch (hot stove), sounds (alarm clock), sights (child's smile), smells (fall air), places (dentist's office), people (reminding you of someone), situations (new job).

- **Cravings**: Repetitive, consuming thoughts or desires caused by triggers.

 - Example: Food commercials triggering hunger at night.

#### Components of Triggers

1. **Sensory Awareness**:

  - Body perceives a stimulus and sends it to the brain.

  - Brain retrieves a schema to interpret and respond to the stimulus.

  - Neurochemical release depending on the schema (fight or flight, pleasure).

2. **Cognitive Awareness**:

  - Includes flashbacks and intrusive thoughts.

  - Brain determines how to handle the situation based on past experiences.

3. **Systemic Awareness**:

  - Body notices imbalances (blood sugar, dopamine levels).

  - Brain looks for past coping mechanisms to address the imbalance.

#### Coping with Triggers and Cravings

1. **Identify Personal Triggers**:

  - Recognize triggers for specific feelings, thoughts, and behaviors.

  - Example: Hunger, tiredness, environmental factors (places, times of day).

2. **Developing Awareness**:

  - Be mindful of surroundings and internal states.

  - Journal recent triggers and analyze early warning signs.

3. **Increase Positive Triggers**:

  - Enhance the environment with positive stimuli (pictures, smells, music).

4. **Addressing Negative Triggers**:

  - Reduce or manage negative triggers (broken locks, unsafe situations).

  - Use coping strategies like deep breathing, meditation, exercise.

#### Practical Strategies

1. **Four Square Breathing**: 

  - Trigger relaxation response by deep breathing.

2. **Loving Kindness Meditation**:

  - Reduce stress response by fostering positive emotions.

3. **Increase Physical Safety**:

  - Modify environment to reduce stress (mirrors, locked doors).

4. **Address Comfort and Ergonomics**:

  - Improve physical comfort to enhance mood and focus.

5. **Build Positive Relationships**:

  - Use assertive communication and manage boundaries to feel secure.

6. **Recondition Responses**:

  - Change associations with negative triggers (e.g., payday as positive).

  - Make triggers more unpleasant if necessary (e.g., Antabuse for alcohol).

7. **Mindfulness and Journaling**:

  - Reflect on triggers and responses to understand and manage them better.

#### Handling Cravings

1. **Stop, Look, Listen, and Feel**:

  - Recognize cravings as clues to unmet needs.

2. **Alternative Actions**:

  - Identify what is truly needed and find healthier ways to fulfill that need.

3. **Dealing with Persistent Cravings**:

  - Understand cravings as similar to a child's tantrum; resisting strengthens resolve.

### Time Codes for Major Points

00:00 Introduction and goals of the video

02:00 Definition and examples of triggers

06:30 Components of triggers (sensory, cognitive, systemic)

10:45 Understanding cravings and their impact

15:30 Identifying personal triggers and increasing awareness

20:00 Developing positive triggers and addressing negative ones

25:45 Practical strategies for coping with triggers

30:00 Handling cravings and alternative actions

35:00 Reflecting on personal experiences and journaling

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### Summary

#### Introduction

- Presenter: Dr. Dawn-Elise Snipes

- Topic: Listening without defensiveness

- Goals: Understanding causes of defensiveness, enhancing assertiveness, and reducing defensiveness

#### Understanding Defensiveness

- **Defensiveness**: Indicates a lack of safety; behavior or feeling when feeling unsafe.

- **Causes**:

 - Prior negative experiences (verbal/physical aggression, invalidation).

 - Low self-esteem leading to fear of rejection.

 - Triggering topics related to trauma or powerlessness.

#### Creating Safety

1. **Recognize Emotional State**:

  - Defensiveness arises from feeling unsafe or powerless.

  - Brain prioritizes fight or flight over processing information.

2. **Criticism vs. Behavior**:

  - Separate criticism of behavior from criticism of self.

  - Understand that feedback is about actions, not personal worth.

3. **Constructive Feedback**:

  - Take useful parts of feedback and leave the rest.

  - Consider the intention behind feedback; if it's aggressive, set boundaries.

#### Enhancing Communication

1. **Realistic Expectations**:

  - Not everyone will like you or your actions.

  - Nurture multiple sources of support.

2. **Set and Maintain Boundaries**:

  - Physical, emotional, and cognitive boundaries.

  - Communicate discomfort and establish respectful interactions.

3. **Self-Esteem**:

  - Confidence reduces defensiveness.

  - Respect differing opinions without feeling threatened.

#### Strategies to Reduce Defensiveness

1. **Empathy and Curiosity**:

  - Understand differing perspectives.

  - Explore underlying reasons behind others' views.

2. **Manage Reactions**:

  - Reflect and ground yourself when feeling defensive.

  - Validate others' experiences without agreeing.

3. **Objective Language**:

  - Use "I" statements to express feelings without blame.

  - Avoid vague or accusatory language.

#### Practical Steps

1. **Ground Rules**:

  - Establish clear boundaries for interactions.

  - Ensure safe environments for discussions.

2. **Avoid Mind Reading**:

  - Don't assume intentions behind others' words.

  - Focus on one issue at a time during conflicts.

3. **Rehearse and Prepare**:

  - Practice conversations to build confidence.

  - Identify triggers and prepare responses.

4. **Apologize When Necessary**:

  - Acknowledge mistakes to build trust and reduce defensiveness.

5. **Collaborative Solutions**:

  - Work towards win-win outcomes.

  - Respectfully disagree and find common ground.

### Time Codes for Major Points

00:00 Introduction and goals of the video

02:00 Understanding defensiveness and its causes

05:45 Creating safety in communication

08:30 Criticism vs. behavior and constructive feedback

12:15 Realistic expectations and nurturing support

15:00 Setting and maintaining boundaries

20:00 Enhancing self-esteem and respecting opinions

25:00 Empathy, curiosity, and managing reactions

30:00 Using objective language and practical steps

35:00 Rehearsal and preparation for difficult conversations

38:00 Apologizing and collaborative solutions

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### Summary

#### Introduction

- Presenter: Dr. Dawn-Elise Snipes

- Topic: Toxic guilt and shame - signs, causes, and solutions

- Goals: Understanding guilt and shame, their causes, effects, and ways to overcome them

#### Definitions and Differences

- **Guilt**: Anger at oneself for a behavior; feeling you did something wrong.

- **Shame**: Feeling that you are inherently bad; about the person, not just behavior.

- Importance of separating behavior from self-worth.

#### Healthy vs. Toxic Guilt

- **Healthy Guilt**:

 - Motivates positive change and learning.

 - Anger at oneself for a behavior or omission.

 - Helps align actions with values.

- **Toxic Guilt**:

 - Drains energy and erodes self-esteem.

 - Leads to ongoing self-anger without productive action.

 - Often paired with shame.

#### Effects of Toxic Guilt

- Continuous stress response activation.

- Desperate attempts to prove worth.

- Leads to behaviors like fawning or overcompensating.

#### Causes of Toxic Guilt

- Holding onto “shoulds” imposed by others or oneself.

- Feeling responsible for things outside one’s control.

- Survivor’s guilt and guilt over others' feelings.

- Guilt for not being perfect or successful.

- Societal and familial messages about worth and success.

#### Solutions and Strategies

1. **Identify the Source**:

  - Determine if the guilt stems from internal values or external pressures.

  - Evaluate the “shoulds” and decide if they align with personal values.

2. **Healthy Boundaries**:

  - Recognize and assert personal beliefs and values.

  - Don’t let others dictate what should make you feel guilty.

3. **Cognitive Restructuring**:

  - Write down situations causing guilt.

  - Distinguish between controllable and uncontrollable aspects.

  - Use energy positively to address controllable factors.

4. **Acceptance and Letting Go**:

  - Accept that some things are beyond control.

  - Reflect on personal growth and changes over time.

  - Practice self-compassion for past mistakes.

5. **Self-Care**:

  - Prioritize personal well-being to prevent burnout.

  - View self-care as a model for others.

6. **Assertiveness**:

  - Stand firm in personal beliefs even when others disagree.

  - Practice expressing your values respectfully.

#### Practical Steps

- Write down situations causing guilt.

- Identify controllable and uncontrollable aspects.

- Take action on what you can control.

- Reflect on whether you’ve done all you can.

- Accept powerlessness over some outcomes.

- Practice forgiveness and self-compassion.

- Set and maintain healthy boundaries.

- Model self-care and healthy boundaries for others.

### Time Codes for Major Points

00:00 Introduction and overview of toxic guilt and shame

02:15 Differences between guilt and shame

05:00 Healthy guilt vs. toxic guilt

08:45 Effects of toxic guilt on stress and behavior

12:30 Causes of toxic guilt

18:00 Solutions and strategies for overcoming toxic guilt

25:45 Importance of healthy boundaries

30:00 Cognitive restructuring and acceptance

35:00 Practical steps to manage guilt and promote self-care

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