Monday, May 14, 2018

Chronic Marijuana Use and Its Impact on Mental Health: Tips for School Counselors

Monday, May 14, 2018

The end of the year is quickly approaching and part of my job is to push seniors to the finish line.  Since January, I have been pushing one particular senior who is taking an online course with  our virtual campus.  When I speak to him about his course, he is always polite and says the right things; however, he is just not very motivated. When I say he is not motivated, I mean he has not logged into his class in two months and he is supposed to graduate in two weeks. The last time I met with him, he starred at me blankly and said, "Everything is just gray."  Confused and fed up with his empty promises, I decided to go to his school and speak to a former colleague of mine who is working as the assistant principal.  I looked at my colleague and said, "Okay, what is the deal with Chuck (not his real name). We have met with him numerous times, called his mom, offered him times to come in and meet with the teacher, but he is not taking advantage of any opportunities. Is he using?"  She gave me an affirming look and my suspicions were confirmed that he was a chronic marijuana user. 


Mental Health and Addiction

Since May is mental health awareness month, I wanted to share the impact of marijuana on students' mental health and school performance. Although marijuana use is not legal for minors in legalized states, a national report found that students, ages 12-17, believe there are nominal risks for smoking marijuana (for instance some teens believe marijuana makes you a better driver...yikes!). These beliefs have increased marijuana use and the chance for addiction. Many students with addiction to drugs, like marijuana, have a co-occurring mental health disorder and the purpose of their use is to simply alleviate their symptoms (Spotting Signs of Addiction in Students)  The National Institute on Drug Abuse  found that students who smoke have poorer academic performance than nonsmokers.  Medical studies from the New England Journal of Medicine have found that early use of marijuana can impact school progress and ultimately impact functioning of the adult brain. A University of Waterloo study also found that students with prolonged marijuana use had a significant decline in interest to attend an university after high school. Not only does marijuana use negatively impact academic performance, but can affect the mental health of adolescents as well.  The National Institute on Drug Abuse  also reported that marijuana use can increase the risk of psychosis (impaired thoughts and emotions) and schizophrenia (distressing hallucinations and paranoia) among those who who may be genetically predisposed to mental illness.  This fact is displayed in the graphic below...


Source: Di Forti et al. Biol Psychiatry. 2012.

Other negative impacts of chronic marijuana use can include dropping out of school, possible lower wages, unemployment, lower life satisfaction emergency room visits, and even suicide. Unfortunately with the rise of legalization in many states, schools will see more and more students adversely impacted by cannabis misuse. Researchers found that adults who started smoking as teens had “impaired neural connectivity".  In other words, their prolonged use impacted their "memory, alertness, and processing of basic routines." The graphics below show states that have legalized marijuana for recreational/medical purposes and the correlation between legalization and the increasing trend of marijuana use among adolescents.

States That Have Legalized Marijuana
States that have legalized marijuana
Source: Mental Health America

Daily Marijuana Use Increasing



Long Term Trends in Adolescents

Long Term Use Among Students in grade 8-12
With marijuana outselling ice cream in the US in 2017, there should be a real cause for concern for school counselors.  As a school counselor, I often feel overwhelmed and helpless in my efforts to educate and inform students and parents of the real dangers of chronic marijuana use.  Truthfully, I feel that many school counselors don't know what to do so they just don't address the issue.  In this post, I want to give you some practical information of how you can identify chronic marijuana use, how you can help students who chronically abuse marijuana, and provide some helpful resources to share with your colleagues, students, and parents.

First, let's talk about how to identify the signs of chronic marijuana use among teens.  As a school counselor, there are notable signs that may signal possible addiction. These signs include:

  • Change in academic performance; such as a decline grades;
  • Change in social group;
  • Skipping school and tardiness;
  • Decline in overall hygiene;
  • Physical signs such as bloodshot eyes, falling asleep in class, and a lack of responsiveness;
  • Conversations about drugs or getting high;
  • Apathy and feelings of ambivalence.
Although identifying chronic marijuana is important, where do you go from here?  Having the information is one thing, but helping students reduce their chances of addiction and mental health concerns is another.

So, What Can School Counselors Do?

Now that we know marijuana use is on the rise among our students and causes lifelong issues, we must have strategies for working with these students. As a school counselor, we can be the first ones to notice that a student has begun to decline academically and disengage from school.  If you suspect marijuana use, you can educate parents and students about when marijuana use has become problematic.  Mental Health America says that marijuana use becomes a problem "when it interferes with a person's ability to function in their personal and/or professional lives."  Some questions that Mental Health America has provided for marijuana users include...

In the past year have you:
  • Used marijuana in large amounts for longer than intended?
  • Wanted to stop using marijuana, but weren’t successful in attempts to quit?
  • Spent a great deal of time getting, using, or recovering from marijuana?
  • Had strong cravings or urges to use?
  • Failed to perform work, school, or home duties because of marijuana?
  • Continued use despite it causing problems with relationships?
  • Stopped participating in activities you used to enjoy because of marijuana use?
  • Used  marijuana in physically dangerous situations (driving, etc.)?
  • Continued using marijuana despite physical or mental health problems that it has caused or made worse?
  • Developed a tolerance to marijuana (needed more to get the desired effect)?
  • Felt withdrawal symptoms when you stopped using marijuana, possibly using again to relieve your discomfort?
Once identified, how can school counselors help students who have developed chronic marijuana use? When talking to students about addiction, it is easy to get into a moral discussion about consequences and legal repercussions; however, these arguments seldom make a difference in changing students minds. Instead, We Are Teachers,  recommends talking about brain science and long term impacts. The National Institute on Drug Abuse For Teens, provides great information to provide to teens and parents.  This graphic form Chen (2004), gives students a great visual on how marijuana impacts the brain.  Also, I am attaching a video from Dr. Nora Volkow that may be helpful for you to view about how drug addiction impacts the brain.






In addition, here are some tips from Mental Health America that may be helpful in working with chronic users:

  • Keep track of your marijuana use to see if you notice patterns.
  • Be specific with yourself about how you would like to change your marijuana use (how often, when, where, etc.) and your reasons for making changes.
  • Take a month-long break from marijuana. This enables your body to get rid of the drug, reduce tolerance, and get over the discomfort of withdrawal that some people feel when stopping.
  • Identify what triggers the urge to use, and think about what you can do to manage those triggers.
  • Avoid using marijuana before activities that require thinking and remembering, like school and work, or before an important or new challenge.
  • Don’t mix marijuana with alcohol or other drugs.
  • Get immediate help if you are unable to control your use or if you have a medical emergency.
Talking to students about chronic use is not easy.  Therefore, I have attached a list of talking points from The American Academy of Pediatrics that can be helpful for school counselors.  Here is a list of ten points (six for students and four for parents) that you can reference in your conversations.

For Students

  1. Marijuana is not a benign drug for teens. The teen brain is still developing, and marijuana may cause abnormal brain development.
  2. Teens who use marijuana regularly may develop serious mental health disorders, including addiction, depression, and psychosis.
  3. There are no research studies on the use of medical marijuana in teens, so actual indications, appropriate dosing, effects, and side effects are unknown. The only data available on medical marijuana in the pediatric population are limited to its use in children with severe refractory seizures.
  4. Recreational use of marijuana by minors and young adults under the age of 21 years is illegal and, if prosecuted, may result in a permanent criminal record, affecting schooling, jobs, etc.
  5. Never drive under the influence of marijuana or ride in a car with a driver who is under the influence of marijuana. Adults and teens regularly get into serious and even fatal car accidents while under the influence of marijuana.
  6. Marijuana smoke is toxic, similar to secondhand tobacco smoke. The use of vaporizers or hookahs does not eliminate the toxic chemicals in marijuana smoke.
For Parents

  1. You are role models for your children, and actions speak louder than words. So if you use marijuana in front of your teens, they are more likely to use it themselves, regardless of whether you tell them not to.
  2. It is important to keep all marijuana products away from children. As with other medications and toxic products, containers that are child-proof and kept out of reach should be used. For small children, marijuana edibles and drinks can be particularly dangerous.
  3. Remember that intoxication and euphoria are predictable effects of using marijuana products. Being “high” from your own recreational or medical marijuana use may alter your capacity to function safely as a parent or to provide a safe environment for infants and children.
  4. If your child asks you directly whether you have used marijuana, a brief, honest answer may help the child feel comfortable talking with you about drug use issues. However, it is best to not share your own histories of drug use with your children. Rather, discussion of drug use scenarios, in general, may be a more helpful approach.
In addition to education, school counselors may use Motivational Interviewing as a strategy to help adolescents who chronically use marijuana.  Motivational Interviewing is a counseling technique that is instrumental in reducing ambivalence and supporting a commitment to change. This technique is not confrontational and points out discrepancies in thought patterns.  If you are interested in learning more about Motivational Interviewing, check out Reagan North's book for school counselors.




Organizations and Other Resources

Need more information?  There are several organizations that are determined to educate the public about the non publicized side effects of marijuana.  

Organizations:


Let’s Be Clear Georgia – Website that focuses on preventing and reducing marijuana abuse among youth in Georgia. 
Smart Approaches to Marijuana (SAM) – Project SAM provides a breakdown of up-to-date information involving marijuana, such as legalization, public health and cannabis-based medications; fact sheets and talking points; and opportunities to get involved in their efforts.
The Marijuana Report – This site provides fact sheets, infographics and toolkits that detail information on the dangers of marijuana.
The American Academy of Pediatrics – Medical site that includes information about the drug, signs of use and steps parents can take in prevention.

National Institute on Drug Abuse –Provides up-to-date facts on marijuana, including how it is used, how it affects the brain and other health effects on the brain.
Resources:

Tuesday, May 1, 2018

Over 70 Resources to Help School Counselors During the Senior Year

Tuesday, May 1, 2018

Even as the school year comes to a close, school counselors are always making plans for the next school term. As I was searching through Google Docs for some information that I needed, I found an old counseling file that I had made several years ago.  I was pleasantly surprised to find a lot of helpful tools and resources that I could share with my colleagues for seniors.  In this post, I want to share some of these resources that I have saved over the years so that you may use and share with others. As a bonus, I have added some other additional sites and older posts from my blog.  Check out over 70 senior resources, forms, and links that may help you in working with your rising seniors.

Counselor Resources:

ACT College Planning Guide

Campus Visit Checklist

College Application Bootcamp

College Application Checklist

College Application Organizer

College Cost Comparison List

College Entrance Test Flowchart

College Pennant Activity


College Planning Presentation

College Prep 101

College Research Worksheet

College Signing Day Kit

Community Service Form

Conference Document Form

Counselor Questionnaire for Recommendation Letter

FAFSA Presentation 

Financial Aid Presentation

Grade Point Average Calculator

Grade Point Average Presentation

Grade Point Average Worksheet


Graduation Check List

High School Activity and Community Service Tracker


Navigating the College Admissions Process

Parent Brag Sheet


Rising Senior Action Plan

Senior Advisement Presentation

Senior Advisement Presentation

Senior Awards Night

Senior Class Meeting Presentation

Senior Checklist

Senior Resume and Recommendation Packet

Senior Checklist

Senior Checklist

Senior Brag Sheet


Senior Classroom Presentation 


Senior Information

Senior Newsletter

Senior Packet

Senior Parent Letter

Senior Parent Night Information

Senior Profile

Senior Recommendation Form

Senior Success Strategies

Senior Timeline

Senior Websites

Senioritis Presentation


Testing (SAT/ACT)

Testing Presentation

Tips for Writing a Recommendation Letter

Welcome to Adulthood

What Colleges Look for in a Student

Other Resources:

Big Future

Campus Tours

College Week Live Chat

Get 2 College

Livebinder lesson plans for counselor Jaclyn Lussenhop

Missouri Center of Career Education Senior Lesson Plans

NCAA Requirements

Preparing for College Lesson Plans 

School Counselor Toolkit from Western Association for College Admissions

Surviving the First Year After High School

West Virginia Department of Education Senior Lesson Plans

Older posts from the For High School Counselor Archives:



ACT or SAT: Preparing Students With a Plan, Resources, and Study Guides


College Decision Day Ideas

Host an Apply to College Event


National College Application Month


School Counselor Bucket List for Seniors


School Counselors: Tis the Season to Write a Recommendation Letter


What College Brochures Don't Say: Developing Skills for College



Whose on First? A List of College Counseling Tools and Resources to Help 1st Generation Students Reach College


Wednesday, April 4, 2018

Free List of Counseling Worksheets for Working With Challenging Students

Wednesday, April 4, 2018

Ahhhhh...Spring Break!  For the last couple of days,  I decided to actually enjoy my break and not do any "work."  So, my chihuahua Belle and I went on a You Tube music video spree for about three hours.  However, after the third hour,  I had had enough and started going through my For High School Counselor's Face Book feed.  Going through my posts, I noticed that many of the worksheets I had shared were getting a lot of likes.  In fact, I liked them as well and thought that many of them would have been helpful with many of my challenging students.  Therefore, I decided to break from my mindless music video binge and write a post about these handouts and how school counselors can use them with their challenging students.  


See even Belle is tired of watching videos...
Disclaimer: These handouts are not my creation and come from several different sources. I have categorized each worksheet under a specific topic, but I feel that many can be used for multiple purposes. 

Anxiety

If you are like me, you may have noticed that anxiety has increased among our students.  Trying to get students to self regulate their emotions is not always easy and school counselors seldom have time to effectively calm down one student.  What I like about these two activities is that they give the student individual space to work out those anxious feelings so that he or she can regain equilibrium.  

Simple Art Activity that Provides Stress Relief 

The goal of the activity is to help the student release pent up emotions until he or she feels in control. 

Materials needed for this activity:
colored pencils or markers
black pen
sturdy paper
music
a safe space for the student to draw
blind fold 

See the above link for directions on how to use this activity with your anxious students. 

The Movie in Your Head is Not Real

This worksheet allows students to compare their irrational fears to a horror movie. Students are directed to draw out their most disturbing fear as though it was a horror movie.  The student should put in as many details as possible and even give it a title. After completing this activity, the student is given series of observations to make about their fear.

Attendance Issues

This is a major issue for my district! We have an incredible attendance issue and few answers to solve this problem.  However, if a student can understand the importance of school attendance, then he or she has a higher probability of maintaining regular school attendance. 

Secondary School Attendance Plan

To this day, I have a difficult time working with students who are chronically absent.  If you have students with attendance concerns and you are not sure what to do, I suggest checking out Attendance Works.  Attendance Works has provided a free editable handout to help students create healthy school attendance goals.  Also, consider viewing the Attendance Works webinar on school attendance. 

Bullying

Okay, this is another huge issue in our district and one that requires knowledge and education by the school professional.  After following all the legal mandates when reporting bullying, it is important that we know how to support our students during a bullying episode.

Bullying Action Plan from Pacers

Pacers has provided a action plan that takes a student who has experienced, witnessed, or participated in bullying and breaks it down into actionable and realistic steps.  By the completing the plan, the student is encouraged to find realistic and healthy ways of working through this difficult situation.

Depression

Although we cannot diagnose a student with depression, we often notice changes in behavior that can include extreme sadness and isolation from others. According to psychobiologists, isolation has just as high of a mortality rate as smoking. 

Building a Support System

We know that students who are sad tend to isolate themselves which can be very dangerous.  One strategy when working with students, who may be in this situation, is to create a list of contacts who they can call when they are feeling alone.  This form will allow students to think of a broad list of people from adults to peers who may be sources of support.  

Drama

I don't know about you, but I detest drama and I don't have time built in my schedule to continually address it!!! If you work with a bunch of 9th graders then you really need some tools about how to teach them to kill the drama in their day-to-day lives.  


I love this illustration and have used it with my students, who engage in drama, to help them understand this unhealthy cycle.  This link will connect you to the explanation of the drama triangle, the role of each person in the drama, and tips on how to delete the drama.  



Emotions


Unfortunately, many of our students have unmanaged emotions that can get them into some serious trouble. Teaching a group of students how to manage emotions can be a productive use of our time. I want to share some fun ways you can help students learn to manage their emotions effectively by using the fortune telling game by Joel Shaul.

Exploring Upsetting Emotions Fortune Telling


I remember playing a game with my friends in which we would try to predict who we would marry, how many kids we would have, how many rooms would be in our homes, and the type of car we would drive. It was fun and it opened a variety of options whether positive or negative.  

Joel Shaul who manages the Autism Teaching Strategies Website has created a great strategy for using this simple game to work with students who have a difficult time managing their emotions.  Shaul suggests these directions for using the fortune telling game with students.

1. Ask the student to spell out the name of his/her mom, dad, best friend, dog, cat, or whatever you like. Have the student move the fortune teller for each letter.
2. This will take the student to either a "problem thought" or a "new thought."
3. Have the student open the petal.
4. Tell the student to pick, A, B, C, or D.
5. Have the student read what he or she picked.
6. If it is a problem thought, ask the student "When have you had a thought like this?" What kind of thoughts could help you when this happens?"
7. If it is a new thought, ask the student "When is a time you needed a thought like this in order to get over a problem?"

See an illustration of Shaul's free downloadable fortune teller activity.

Joel Shaul's fortune telling game
Low Self-Esteem

Another issue many of our students deal with on a daily basis is the feelings of low self worth.  In fact, I had a student for three years who came to see me weekly and never had one positive word to say about anything.  She always felt that life had dealt her a raw deal and that she could not do anything right.  I tried my best to encourage her, but even through my best efforts she never accepted my well intended affirmations. Now I see that her affirmations needed to come from within herself and not just from me.

Self Esteem Journal from Grow Therapy

This seven day journal can help students, who see life through a "negative" lens, look for the positives during their week.


Rage

I have had my share of students who came to my office in a rage.  I learned very early that you cannot reason with a kid who is in a rage and tell them to "calm down."  The sooner you can learn this the better!  So, what do you do when you have a kid in a full out fit of rage?  

Calm Down Kit for Older Kids


If you have ever had a teen to go into a temper tantrum or fit of rage, you know that it is useless to try to reason with them until they are able to calm themselves.  One key that I found that really worked with students was trying to find strategies to help them to self soothe before they went into a rage.  See this list for ideas of ways for students to self soothe.

An Emotional Emergency Kit

This is an additional resource for managing everyday mental health.

Self Harm

Self harming behaviors are prevalent in our students. Whether it includes cutting, burning, binge drinking, or unprotected sex, it is important to identify and get the students the help that they need. If you have students who self harm. it is important to provide them with strategies for self regulation.  Besides the resource below, check out how to make your own comfort kit for students.

Self Harm CBT Worksheets


This 81 page CBT workbook gives copious strategies for working with students who exhibit self harming behaviors.  The end result is that the student walks away with a toolkit of healthy activities that take the place of the self harming behaviors.


Social Skills

There is a misguided notion that students have acquired the social skills they need in society by the time they reach high school. With this misconception, it is important that we have teachable moments with students that include  teaching skills like knocking on the door before entering a room, saying "thank you", or waiting your turn to speak. Again, teaching social skills can be fun and Joel Shaul provides another great activity through the fortune telling game.

Social Skills Paper Fortune Teller

This is another great paper activity to explore different ways to handle social situations. In addition, the author suggests that this activity can be used with students who have Autism.

How to use the Paper Fortune Teller activity by Joel Shaul.

I hope this list of worksheets has been helpful to you!  As always, if you have some ideas, I would love to add your suggestions to this list. Feel free to email me at cynthia_morton@yahoo.com.