4 Lessons for Everyone from the Rural Behavioral Health Practice Conference

Last week, we were proud to sponsor the Rural Behavioral Health Practice Conference. Since BreezyNotes EHR was built by a rural clinician, it was a great chance for us to return to our roots.

Four fantastic presenters covered hours of content relevant to rural behavioral health clinicians. Here are the most important points we took away from each presentation.

1. Place limits on electronic communications in informed consent forms

James L. Werth, PhD, discussed the importance of setting limits on electronic communications in your informed consent paperwork. Why? Because not doing so could set you up for a lawsuit.

For example: A client sends you an email at 3 a.m. stating they are having suicidal thoughts. You are asleep and do not respond, and the client commits suicide. Because you didn’t outline the hours you would be available to answer email, you could be sued for not responding to the client in time.

That is why it is important to set limits on electronic communications, including the hours during which you’ll respond and the forms of communication to which you will respond.

2. With suicidal clients, ask a lot of questions

Julie Rickard, PhD, presented on managing the risks of suicidal clients. One intervention she suggested using questions to prompt a narrative of the client’s suicide.

Some questions she suggested include:

• What event would trigger your suicide?
• What method(s) would you use to commit suicide?
• Have you rehearsed or prepared to commit suicide?

Asking these questions can help in numerous ways. First, it can help you understand the emotional factors driving the client’s suicidal ideation. Second, friends and family can remove potential or prepared weapons that the client could use. Third, going through this narrative and discussing their suicide can be therapeutic for the client.

One very important point to note is that you should not interrupt the narrative to suggest next steps. Allow the client to tell the story and follow up with questions to prompt more discussion of the narrative. Only when the client has finished should you start to discuss next steps and treatments.

3. Be aware of the challenges of addressing opioid use in rural areas

While opioid use is slightly less prevalent in rural areas, it is still a problem that needs to be addressed, according to Jennifer D. Lenardson, MHS, and John A. Gale, MS. Unfortunately, any “fix” is complicated. You just can’t do it on your own as an independent therapist.

But, you should still be aware of measures that could be taken to combat opioid use in rural areas. One measure includes reducing criminalization and stigma for people who use opioids. Comprehensive care is also a must in rural areas, since those residents have less access to behavioral health providers and specialists who treat substance use disorders. Finally, more focus is needed on what comes after treatment, including support groups, therapy, and much more.

4. Motivational interviewing can be a good first intervention for youth with substance use disorders

Chloe Ackerman, PsyD, and Joe Skariah, DO, advocated for using motivational interviewing as an initial intervention for youth with substance use disorders. While “giving advice” can trigger resistance, motivational interviewing instead helps cultivate a desire for change in the client. It also supports their “self-efficacy and sense of independence.”

They also cautioned that motivational interviewing must be practiced before being implemented.

This is only a sampling of the content presented at this year’s conference. If you found it useful, we hope you’ll attend the 2017 Rural Behavioral Health Practice Conference on October 6, 2017. Registration will start next summer on the Minnesota Psychological Association’s website.

Did you attend the 2016 conference? Tell us what you learned on Facebook, Twitter (make sure to tag @RBHPC2016), LinkedIn or Google+.