http://www.milestonesclinic.com/rss/newsXML.phpMilestones Newshttp://www.milestonesclinic.com/index.php?pageId=210&newsId=89http://www.milestonesclinic.com/index.php?pageId=210&newsId=89http://www.milestonesclinic.com/index.php?pageId=210&newsId=88http://www.milestonesclinic.com/index.php?pageId=210&newsId=88Patti Torp, Columbus Milestones therapist,successfully completed her exam and certification process and is now a Licensed Mental Health Counselor.Congratulations!http://www.milestonesclinic.com/index.php?pageId=210&newsId=77http://www.milestonesclinic.com/index.php?pageId=210&newsId=77By Maureen GahanMilestones DirectorThrough funding made possible by a Community Foundation of Bloomington and Monroe County grant, Deb Mishler, LCSW; Lynda Ransburg, LCSW; and Maureen Kipp, LCSW recently attended a three day intensive workshop in Group Leader Training in Seattle Washington in the acclaimed Incredible Years Parent Training Series. This prevention and treatment approach is based on behavioral/social-learning principles that produce positive changes for families and children who are struggling with conflict and behavior problems.  This award winning parenting program was recommended by Deb Mishler, the lead therapist of Milestones’ project, who currently conducts the successful and well attended Dino Club and Coping Cats Group Therapy treatment programs for children with behavior problems.  We are pleased to be able to expand our menu of services and add such excellent treatment options to our community.  The Milestones therapists are in the process of designing and planning parent groups which will be offered starting this fall.   THE INCREDIBLE YEARS PROGRAM Milestones currently offers the Incredible Years Training Series, a set of comprehensive, multi-faceted and developmentally based curricula for parents and children.  Learn more about the program’s goals below.Goals for Children• to increase social skills and emotional language• to increase problem solving skills and effective anger management strategies• to decrease negative attributions and increase empathy skills• to decrease aggressive behavior and related conduct problems such as: non-compliance, bullying and rejection, stealing and lying• school readiness skillsGoals for Parents• to increase positive relationships and bonding with their children through child directed play and special time together• to increase understanding of temperament, normal developmental landmarks and to encourage appropriate developmental expectations• to increase positive communication skills such as the use of coaching, praise and positive feedback to children, and reduce the use of criticism and unnecessary commands• to improve limit setting skills by replacing physical punishment with non-violent discipline techniques and by promoting positive strategies such as ignoring the child’s misbehavior, imposing logical consequences, providing redirection and developing problem solving and empathy skills• to improve understanding of how to set up predictable routines, promote children’s responsible behavior & successfully monitor children’s behavior• to improve problem solving skills and anger management• to increase family support networks and parents’ involvement in schoolshttp://www.milestonesclinic.com/index.php?pageId=210&newsId=76http://www.milestonesclinic.com/index.php?pageId=210&newsId=76Milestones Psychiatrists Dr. Mindy Weakley and Dr. Lia Kettenis received the award for Outstanding Community Service for their work with the students of the College Internship Program (CIP) at the Bloomington Center.  CIP provides individualized, post-secondary academic, internship and independent living experiences for young adults with Asperger’s Syndrome and other learning differences.http://www.milestonesclinic.com/index.php?pageId=210&newsId=75http://www.milestonesclinic.com/index.php?pageId=210&newsId=75By Deb MishlerMilestones TherapistWhy early intervention?  Research has shown repeatedly that aggression in young children is a rising phenomenon.  Studies have found that 10% to 25% of preschool and early school age children with chronic aggression progress to the clinical diagnosis of Early Onset Conduct Disorder.  As they age, children with chronic aggression are more likely to demonstrate escalating academic problems, school dropout, drug abuse, depression, and violence.  Acts of assault, murder, drunk driving, etc. are often carried out by adults with a history of chronic aggression beginning in childhood.  Is early intervention important?  Without intervention, child conduct problems intensify.  Relationships are affected and strained.  Children entering school without treatment are at high risk for peer rejection and poor social skills development.  If elementary school age children with aggression and social difficulties do not receive intervention, these behaviors are likely to become entrenched or worsen.  The middle school age child with chronic aggression frequently has a negative reputation and peer group, and chronic patterns of rejection make it difficult for the child to use effective skills to change his or her image.  A child’s social competence and emotional security impact the ability to learn. How has the need been addressed?  Over the past two decades, parenting and school interventions have been used to help children who have conduct problems.  Evaluations consistently show that the younger the child at the time of intervention, the better he or she is able to adjust at home and at school.   Parent training programs have been the most successful treatment for addressing aggression, defiance, and non-compliance in the home.  A variety of parent training programs have had long-lasting improvements in two-thirds of young children treated. However, these programs fall short outside of the child’s home, as they do not address relationships at school and with peers.  Studies have found that approximately one-third of children with conduct problems continued to have classroom aggression and peer problems at a clinically significant level. Additionally, some parents may be unable to get parent training because of work conflicts or other obstacles, or may struggle to implement or maintain use of strategies taught in parent training programs due to various challenges within their lives.Limitations of parent training programs led to the approach of directly training children in social skills, anger management and problem solving.  Children with conduct problems show cognitive and behavioral social skills deficits with significantly more negative attributions, fewer positive social problem-solving strategies, and significant social skill delay in play activities with friends.  Milestones is privileged to be able to offer several therapist-led programs for behavior problems in children using The Incredible Years Series (IYS). This series works with both parents and children, and includes prevention and intervention components developed to reduce problem behaviors and enhance children’s social and emotional competency.  The series has won multiple awards for proven outcomes.  The curricula were developed for use by parents, children and teachers and can be used independently or in conjunction with each other.For learn more or to sign up for the next training session email Deb Mishler or call 812-333-6324, ext. 231.http://www.milestonesclinic.com/index.php?pageId=210&newsId=73http://www.milestonesclinic.com/index.php?pageId=210&newsId=73By Maureen KippMilestones Clinical SupervisorGroup therapy is one of the treatment interventions used by therapists to address emotional, psychological and/or behavioral problems.  Individuals with similar challenges come together in a safe and healing environment facilitated by a skilled therapist; they interact socially and gain new skills along side their peers.  Evidenced based studies stress the importance of interpersonal learning.  In a group setting, participants learn to better mange and reduce symptoms of anxiety, depression, isolation, and aggression by using the coping mechanisms learned from both their peers and therapists.Children benefit from group therapy by learning to get along with other children, to express their feelings, and to respectfully listen and discover that they are not alone.  Children have a strong need to feel connected; a group gives them a consistent and reliable place to build self-esteem and learn coping skills.  Teasing, bullying, and ridicule are unacceptable and alternative behaviors are practiced and encouraged as replacements.  Often the underlying causes for destructive behaviors are brought to light and better understood.  Group activities are fun and educational, designed to allow children to learn and change at their own developmental level.Teens benefit from group therapy because in their developmental stage they are most invested in being validated by peers.  They want to be social by improving their interpersonal skills, exploring basic identity questions, and by recognizing and changing maladaptive thinking and behavioral patterns.  They’re learning to “leave the nest” of their family where life may be secure and predictable.  In a group of their peers, teens can learn to take responsibility for their actions, develop the capacity for cooperation, cope with feelings of envy and aggression, and learn to control impulsive thoughts and behaviors.Parents benefit from support group therapy by coming together with their peers to discuss similar challenges that they are experiencing with their children.  Therapists provide parents with tools for addressing behaviors and making positive family-inclusive life changes.  And the other parents in the support group reinforce that none of the participants are alone in facing the challenges of parenting children with unique needs and modes of self-expression.Individuals with intellectual and cognitive disabilities can often feel estranged and isolated, and see themselves as different from others in their community.  Group work with others who face similar experiences can be very validating and comforting.  They learn, practice and teach social skills in an encouraging environment and then transfer these skills to their home, work and educational settings.  This issue of the Milestones newsletter unveils our extensive fall group therapy calendar.  We invite you to take a look at the wide array of programs, and to be in touch to ask questions and to register for any of the sessions we offer.  We look forward to continuing to expand our menu of group therapy experiences in the months ahead.  Questions?  Email Maureen Kipp or call 812.333.6324, ext. 238.http://www.milestonesclinic.com/index.php?pageId=210&newsId=72http://www.milestonesclinic.com/index.php?pageId=210&newsId=72By Maureen GahanMilestones DirectorMilestones has had a busy summer increasing our clinical expertise and preparing to expand our menu of services for the fall, including new parent support groups, as well as new groups for individuals with disabilities in the areas of healthy living, self-determination, social skills development and management of emotions.  We are committed to delivering the highest quality treatments and services based on cutting edge research and advances in the mental health field.   We believe that partnerships and collaborations in the community lead to success.  We are now working with a select group of MBA students from the prestigious Kelley School of Business at Indiana University.  As we make strategic decisions about how to transition to electronic medical records and billing, these students are providing analysis and the development of a business model to enable us to most effectively serve our clients.  We are also partnering with Middle Way House, an award-winning domestic violence organization in Monroe County, to provide workshops for individuals with disabilities on the building and maintaining of healthy relationships.  And our clinical staff and agency leadership have been asked to represent Milestones on a number of critical mental health task forces throughout South Central Indiana and the State.  We are proud that our expertise is utilized in larger discussions of mental health supports in our community.    We continue to build our program not only in Monroe County, but in Lawrence and Bartholomew Counties, as well.  We anticipate moving into our permanent location in the newly constructed United Way Building in Columbus in January of 2011, at which time we will have a full service psychiatric and counseling outpatient office with the capacity to serve 100+ clients each week.      The generosity of individual donors, coupled with foundation awards and grant opportunities, insure that we have the necessary resources to support excellence and innovation.   We are excited about our growth and the new services we offer to improve the lives of our clients.  We invite you to contact us for more information on our programs of excellence and to find out how you can partner with us in the creation of a healthier community.http://www.milestonesclinic.com/index.php?pageId=210&newsId=71http://www.milestonesclinic.com/index.php?pageId=210&newsId=71Milestones Clinical & Health Resources, a division of Stone Belt, has been awarded the 2010 Indiana Association of Play Therapists (IAPT) "Vivian Thompson Award for Outstanding Play Therapy Services". The award was presented during the group's June 25 annual membership luncheon in Carmel, Indiana. Special congratulations to Milestones Play Therapists Bree Russo, Rosie Falls, Lynda Ransburg and Claudia Dominik for their superb clinical work and their continued efforts to increase their education, improve their skills and reach official play therapist certification. The Vivian Thompson Award is given to individuals or organizations that have made outstanding contributions in the field of play therapy over a period of at least five years. This award is named in memory of an extraordinary child therapist, social worker and supervisor. Milestones Director Maureen Gahan had the privilege of working with the Award's namesake, Vivian Thompson for three years while she was studying for her degree in family therapy. http://www.milestonesclinic.com/index.php?pageId=210&newsId=83http://www.milestonesclinic.com/index.php?pageId=210&newsId=83By Cindi Winegardner, MSW, LCSW Milestones TherapistTransition times can be anxiety-inducing for all of us: changing jobs, moving to new city, meeting new people, etc.  For children, the transition of back to school can induce anxiety ranging from none to mild to incapacitating.Anxiety disorders are the most common mental health issue in the U.S.  It is estimated that 13% of children and adolescents suffer from an anxiety disorder.  Of course, it is also quite “normal” for all of us to experience anxiety at times.  Some common anxieties in elementary age children include real world dangers — fire drills, storms, burglars, or illness. In middle school, we see an increase in anxiety around social acceptance and academic and athletic performance.  In high school, social acceptance continues to be anxiety producing as do thoughts about the future.  Often these anxieties decrease and/or resolve through experience, support from others and learning the facts about a given situation.Parents can help their anxious child by listening to his/her feelings and not minimizing the emotion.  Modifying expectations and being flexible within your normal routine can also be helpful for transitory anxiety.  Small accomplishments should be recognized positively.  Do not compare an anxious child to his/her siblings.  Be patient and realize that progress will be individualized to your child and should not be measured by any absolute standard.  It is also important to let your child’s teacher know how your child’s anxiety manifests, and keep in communication about what is happening at home and at school.Teachers can be helpful by checking things out with a student who appears to be having difficulty.  Anxious children often appear to be oppositional; however, their behavior is fear-based and not necessarily intentional.  For example, calling on a socially anxious child who has not volunteered a response may result in clenched fists, a red face, the appearance of being unprepared or angry.  Responding to this child with negative consequences will likely escalate the situation.  Moving on and privately checking in with child later will likely save time and energy.  More importantly, it shows the child you are willing to listen and are not making assumptions about him/her.  Checking in with the child’s parents can also provide good information.When does anxiety move from being “normal” to becoming a disorder?  It is not what the child worries about but rather the impact the worry has on the child’s day-to-day functioning that results in a diagnosis.  Some of the signs to be on the alert for include:•  Repeated “what if” questions that do not respond to logic•  Being inconsolable•  Physical symptoms such as headaches, stomachaches, vomiting, distractibility and sleep disruption• Avoidance of activities — refusing to go to school; not participating in expected activities•  Being overly self-critical•  Perfectionism — nothing is ever “good enough”•  Being overly concerned about pleasing others•  Worrying excessively well in advance of situations•  Disruption of daily activities for the child and family If a child’s anxiety is significantly impacting his/her day-to-day functioning, it is important to have an evaluation by a qualified mental health professional.  This level of anxiety typically does not resolve on its own, nor do children “grow out of it.”  When children and their parents are motivated, anxiety disorders are among the most treatable mental health issues f you have any additional questions about anxiety disorders or their treatment email Cindi Winegardner or call her at 812.333.6324.http://www.milestonesclinic.com/index.php?pageId=210&newsId=82http://www.milestonesclinic.com/index.php?pageId=210&newsId=82By Maureen GahanMilestones DirectorOur community, like all communities, experiences both situational and seasonal moments of transition.  As the summer comes to a conclusion, our community’s children and young adults return to the structures of the academic schedule, and they encounter new classrooms and teachers, new peer dynamics, and new rigorous demands.  This Fall, Milestones focuses on back-to-school challenges faced by many children and their families during this hectic time of year.  We are pleased to introduce you to the myriad of new group therapies, parent education, and support programs that we have put in place to best help families navigate social, behavioral and cognitive obstacles in order to live healthfully and happily. This truly reflects the values, vision and mission both of Milestones and of our parent agency, Stone Belt.Milestones Clinical and Health Resources provides the community with a unique set of interdisciplinary services – including treatment plans and communication – that bridge across our psychiatric, behavioral, and therapy supports.  Our menu of services represents cutting edge best practices facilitated by highly trained clinicians; and our programs reflect our dedication to supporting individuals and families in reaching toward success.  As a nonprofit service provider in the community, Milestones’ success is insured through the visionary giving of individual and corporate donors.  Recently, we concluded a fundraising campaign through the Neighborhood Assistance Tax Credit Program (NAP) administered by the State of Indiana.  Stone Belt and Milestones were awarded tax credits, which we were able to pass along to our donors as an expression of thanks for their contributions.  These essential dollars will be utilized in the providing of more than 1500 hours of therapy in upcoming months to individuals who would otherwise not be able to afford these services; unfortunately, this grant program from the state has been dwindling on a yearly basis, at the same time that our client base and the need for services has dramatically increased.Although we have successfully completed this year’s NAP campaign, there are many more unfunded and under-funded programs in the Milestones strategic vision – projects which will allow us to provide the best possible supports to the community.  Individuals, businesses and medical practices who are interested in investing in the mental health of our community are invited to email our Community Engagement Director, Amy Jackson, or call her at 812.332.2168, ext. 314 to discuss exciting giving opportunities.  Every day, Milestones receives referrals from throughout the region and the state, as word spreads about our unique and highly effective set of programs and services.  We look forward to continuing to strengthen the positive relationships we have with other professionals in the field, including service providers, school and community social workers, and other mental health clinicians.  Together we can partner to make a lasting difference in the life of the community.http://www.milestonesclinic.com/index.php?pageId=210&newsId=81http://www.milestonesclinic.com/index.php?pageId=210&newsId=81 By Cindi Winegardner, MSW, LCSWMilestones Therapist What first comes to mind when you think of someone with Obsessive-Compulsive Disorder (OCD)?  Maybe it’s the television character Monk or Howie Mandel from “Deal or No Deal” bumping fists rather than shaking hands.  Maybe you laugh out loud thinking “those people….”What is OCD?  It is a disorder best viewed from a neurobehavioral framework (“neuro” = neurological; “behavioral” = manifested in thoughts, feelings and behaviors).  Those with OCD have intrusive, unwanted thoughts (obsessions) and feel they must perform repeated, ritualistic behaviors and routines to try to decrease their anxiety.  It is not something that is under their control if only they would “try harder.”  Common obsessions include:  contamination, harm to self or others, agression, sex, honesty/religiosity, forbidden thoughts, symmetry urges, and the need to tell, ask or confess.  Common compulsions include:  washing, repeating, checking, touching, counting, ordering/arranging, hoarding and praying.For a child or adolescent with OCD, it is an often frightening experience.  They feel embarrassed and alone and frequently attempt to hide their thoughts and actions.  They may be punished and/or humiliated for behaviors over which they have no control.  These symptoms cause significant interference in their usual daily activities.According to the Anxiety Disorders Association of America, as many as 1 in 100 children may suffer from OCD while other sources place the frequency closer to 1 in 50.  The peak age for diagnosis is 10 years old.  It can strike as young as 2 or 3.  Boys are more likely to develop OCD before puberty while girls tend to develop it during adolescence.Since children and adolescents may go to great lengths to hide their symptoms, what are signs to watch for?  Some common indications include:  rough, red hands from incessant washing; a sudden increase in laundry; an inordinately long time spent completing homework; holes erased through tests or on homework; pleas to family members to repeat phrases over and over; recurrent fears that something bad will happen; and extreme distress or tantrums if a ritual is interrupted.There are, of course, other factors to be considered in diagnosing OCD.  It is crucial to have an evaluation conducted by a trained mental health professional.  Once diagnosed, OCD typically responds well to treatment.  Treatment options include:  cognitive-behavioral therapy (CBT), exposure and response prevention therapy (E/RP) and medication.  Recent research indicates that CBT and E/RP alone or in combination with medication is more effective than medication alone.  Another important factor when seeking treatment for a child or adolescent with OCD is the individual’s comfort level with the provider.  Several of our clients have had multiple trials of therapy before finding someone with whom they felt comfortable enough to share all their symptoms.Milestones currently has two therapists who have completed 16 hours of continuing education in the treatment of OCD (10 of those hours are specific to treating children and adolescents) and one therapist with 6 hours of continuing education in treating OCD.  All three of these therapists are providing CBT and E/RP therapies.  We have also begun a bi-monthly peer supervision group to staff cases and further our knowledge.  Additionally, Milestones has two board-certified psychiatrists who can provide psychiatric assessments and medication management.               If you have any additional questions about OCD or its treatment email Cindi Winegardner or call her at 812.333.6324.http://www.milestonesclinic.com/index.php?pageId=210&newsId=80http://www.milestonesclinic.com/index.php?pageId=210&newsId=80Milestones has received a grant from the Community Foundation of Bloomington and Monroe County to support the implementation of the Incredible Years program.  The nearly $7,000 grant provides for training and certification for two Milestones therapists, as well as all curricular materials.  The Incredible Years is a cutting-edge group therapy program for children and parents, designed to cultivate healthy social skill development.  This grant is being paired with a prior grant from the Bloomington Anesthesiologists to support the full implementation of this exciting program.The Incredible Years Social Skills Training Program, developed by Carolyn Webster-Stratton, PhD, of the University of Washington, is an award-winning comprehensive set of curricula designed to promote social competence; and to prevent, reduce, and treat aggression and related conduct problems in very young and school-aged children.  The interventions that make up this nationally recognized series are guided by developmental theory concerning the role of multiple interacting risk and protective factors (child, family, and school) in the development of conduct problems.  The program’s success rests in its evidence-based foundational principles of family-centered intervention.Milestones’ implementation of The Incredible Years will be geared to children 4-12 years of age, along with their parents.  The program will be offered three times throughout each calendar year, and will include 12 sessions, 90 minutes in length, which will take place weekly.  Groups will be organized by age.  In addition to group activity, all children and families will have individual therapy available. Milestones will partner with regional mental health and education communities to insure that at-risk children and their families are directed to Milestones for these invaluable supports.  We will also cooperate with our partners in the school system to communicate information back and forth regarding both needs and behavior modifications of the participants.The Community Foundation of Bloomington and Monroe County administers more than 150 funds that produce grants which help provide a better quality of life for the people of Bloomington and Monroe County, Indiana.  The grant for the Incredible Years program will impact not only Milestones’ clients in Bloomington and the surrounding areas, but also individuals supported in all of the agency’s service areas, including Bartholomew and Lawrence Counties.For more information on Milestones’ Incredible Years program, email Therapist Deb Mishler.http://www.milestonesclinic.com/index.php?pageId=210&newsId=79http://www.milestonesclinic.com/index.php?pageId=210&newsId=79Milestones is pleased to be partnering with the Arc of Indiana to provide new training opportunities to help parents, additional family members and non-paid caregivers receive much needed education for supporting children, adolescents and adults with developmental disabilities.The Arc’s newly established Family and Caregiver Training Services Program will allow The Arc to pay the upfront costs of family and caregiver training used by parents, other family members and non-paid caregivers of recipients of the Developmental Disabilities, Autism and Support Services Medicaid waivers.  Training can be received through registered providers such as Milestones.How it WorksWhen an individual is approved to receive services from the DD, Autism or Support Services Medicaid Waiver, an Individual Support Plan (ISP) is established to outline what services will be provided under the waiver. Up to $2,000 can be allocated in the ISP for Family and Caregiver Training.Family and Caregiver Training can provide training, education and other services in a variety of categories.  Milestones will specifically provide training opportunities in the following areas:  Behavioral Intervention Strategies; Stress Management; Mental Health; Parenting; Family Dynamics.By utilizing The Arc of Indiana to receive training service, families and non-paid caregivers will have the flexibility to receive timely supports and education. In addition, there will be no out of pocket costs, as The Arc will pay the upfront costs and then seek Medicaid reimbursement.Simple Enrollment ProcessIf an individual receives services from the Developmental Disabilities, Autism or Support Services Medicaid Waiver, it will be necessary for them to first designate a dollar amount – up to $2000 – in the Individual Support Plan (ISP) for use with the Family and Caregiver Training.  Those interested in participating should then call the Arc of Indiana to enroll in the program.  The Arc of Indiana will set up individual accounts based on the amount allocated in the ISP, and will provide information and training over the telephone on how to utilize the program so that there will be no out of pocket expenses.Milestones and the Arc of Indiana are Here to HelpMilestones is pleased to be a provider through this exciting new program, and to assist families and caregivers to receive much needed quality educational services.  For more information on the Caregiver Training Program, email Milestones Director, Maureen Gahan or call her @ 812.333.6324, ext. 284 or email the Arc of Indiana's Katie Russell-Sullivan or call her at 317.977.2375, ext. 206.http://www.milestonesclinic.com/index.php?pageId=210&newsId=78http://www.milestonesclinic.com/index.php?pageId=210&newsId=78Twenty five years ago this past November, Milestones Director Maureen Gahan marked her first day of work at Stone Belt.During Maureen’s tenure, she has played an instrumental role in the growth and development of Stone Belt’s expansive residential programs and of Milestone’s Clinical & Health Resources.  As assistant residential director, Maureen helped oversee two major group home building expansions that grew the program from two adult “cottages” and a children’s group home to 12 homes that supported over 70 individuals to live in the community.  As Residential Director she started and vigorously grew the supported living program.  All along the way she kept developing a talented group of clinical staff to provide behavioral, nursing and social work services.  After completing her Masters Degree in Marriage and Family Services, while working a more-than-full-time job, she had the vision for creating a program where these professional services could be offered not only to Stone Belt clients, but to the community at large.  Thus was born the Milestones program, which currently serves more than 3,000 people per year.  Under Maureen’s direction Milestones has become one of the premier certified mental health clinics in the area for services to families, children and individuals with disabilities.  The innovative services offered speak measures to her leadership style and vision.The impact that Maureen has had on Stone Belt can only be measured by the countless lives that have been so positively changed because of Maureen’s courageous vision, tenacious work ethic and uncompromising belief in the dignity, worth and right to self-determination for all.  Congratulations to Maureen on this “milestone” anniversary.  Stone Belt owes her a great debt of gratitude for helping to make the agency one of excellence that it is today.