1. Understanding the Therapeutic needs of parents in the CPS system
Presented by
Lorena Medellin
LCSW
Patricia Boone
Carlos Castillo-Nunez M.A., LPC-S

2. Overview
Effective Communication
Timing of Services
Personality Disorders

3. Effective Communication
Trauma
Communication Breakdown
Emotional Status
Filters
Entitlement and Second Chances
Cheat Sheets... What are you telling me???
MTP, ATP, Mediation (acronyms)
Expectations and Boundaries
Unconscious Conflict
Court Culture
Criminal Cases vs DFPS cases
Therapeutic clarity
What is and is not therapy

4. Timing of Services Sobriety: Tailor Services: -#1Priority
-Understand the disorder
-Treatment
Tailor Services:
-Based on client needs
-Compliment each other not be counterintuitive

5. What is a Personality Disorder?
Definition: A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school.
By Mayo Clinic
What is a Personality Disorder?
Your gut tells you something might be off, but just don’t know what it is and you might disregard.
Personality disorders are often missed in initial assessments or psycho-socials by professionals.
That’s the importance of psychological exams they usually pick this up or an experience therapist might
Usually parents with these disorders will eventually show these behaviors as case progresses.

6. What causes personality disorders?
Both Environmental and Genetic Factors
There is a history of childhood trauma and or sexual trauma. They could have experienced constant verbal abuse as children.

7. Is the drug use covering up something deeper?
Percentage that have personality disorders in society
(9.1%) National Institute of Mental Health
vs DFPS cases (60-70%)
The numbers are staggering.
The percentage was consulting with several providers who work with DFPS clients.
(Look at the people in your table 6/7 of you represent how many parents have this diagnosis
So could a personality disorder be the core issue behind abuse, neglect, substance abuse, domestic violence.
Clients come in an express I have completed services I did inpatient/outpatient and all the classes and not sure why they have to continue counseling services. Substance counselor focuses on sobriety.

8. The different types of personality disorders
(There are three Classes but will only talk about the ones we usually come across which are in class B and C
Antisocial- disregard for others (They come off as erogantic or rico suaves) long history of legal issues; sociopaths
Border Line Personality disorder- (2% in pop % DFPS) Black or white no gray area you might have difficulty compromising/reasoning with them and if don’t agree they think you are against them
(divide court rooms); These cases are extremely difficult and require lots of time…
Histrionic- Dramatic its like a (soap opera);
Narcissist- feel entitled, lack empathy and readily lie and exploits others to achieve their aims
Avoidant-avoid social interaction due to fear of rejection
Dependent- tend to be an abusive relationships; high incident of domestic violence (people with this disorder tend to attract partners with anti social traits)
Obsessive compulsive disorder Personality disorder- don’t confuse with OCD it is not an anxiety disorder; they tend to be perfectionist/need for control of their environment at the expense of flexibility. (eq. cameras all over their home inside and outside) (authoritarian parenting)

9. Environment was Chaotic
Learned Manipulation
Overmedicated
Having a parent diagnosed with a personality disorder has many effects on the child’s behavior and environment.
-Environment was Chaotic (no structure and unstable) therefore children are going to have difficulty following rules at placements, trusting or adjusting to placement, have lots of anxiety)
-Learned Manipulation (parents continually lied and were manuplaitive) parents don’t take responsibility for removal so children might display the same behaviors at school or placement. You want to believe children when they make an outcry in placement but have to be cautious.
-Overmedicated-- if children came from this environment they might be modeling same behaviors should medication be the first option in dealing with their behaviors
Especially teenage children they might be mimicking their previous environment they are learned behaviors.
Attorneys advocate for time for children to adjust to environment before considering medication (Remember medication is not effective with personality disorders)

10. Treatment Complexity of Diagnosis
Time allotted for counseling services
Medication does not treat personality disorder and has limited effectiveness.
Cognitive Behavioral Therapy (CBT)
Dialectical Behavior Therapy (DBT)
These clients might be difficult to work with, but understanding them can help. Suggest a strong therapist that has experience working with these types of clients who will hold them accountable that’s what they will need to succeed.
We have to Consider Complexity of Diagnosis treatment can be complex if client has Major depression, anxiety and personality disorder) (medication can help with mood stabilization but not personality disorder)
Time allotted for counseling services. might not be sufficient to make significant progress under the time they are given . Once they have established some sobriety they need to be engaged in counseling services. Minimum of six months is needed when dealing with personality disorders to see some progresss; weekly basis should be recommended. There are times parents don’t start counseling till 6 months (reasons they think other services were more important, were not referred to counselor, change in case worker. Attorneys be proactive and encourage them to enagage in counseling ASAP.
CBT:- It focuses on changing patterns of dysfunctional thinking, challenging maladaptive thinking; focuses on solutions and change destructive behaviors
DBT-teaches skills to control intense emotions, reduce self destructive behaviors. Most effect with BPD

11. Q & A
Thanks for your time!!!