Monday, September 14, 2026

Controlling medication errors through advanced planning and vigilance by Keith Torkelson MS, BS

 


Contents

 

  • Requirements
  • Lived Experience with Medication Errors (Brief)
  • Current Update – September 11, 2026 (F)
  • Promotion – Gilbert Drugs
  • Medication Errors - Who is responsible?
  • Medication Vigilance
  • Consumer Driven Medication Management Cycles
  • Aside - Biometric & Symptom Tracking
  • Medication Errors
  • Who catches medication errors?
  • Frequency of Medication Errors
  • What are the costs of Medication Errors?
  • Types of Medication Errors
  • Figure – Type of Medication Error
  • Figure - Notification
  • Medication Abuse Registry
  • Describe the Medication Error
  • Timeframe for a Medication Error
  • Standards for Excellence in Medication Management
  • Promotion – Career in Pharmacy





Current Update – September 11, 2026 (F)

The Errors this year (2026) were un-remarkable.  The two common errors were not given all prescribed medications and offered another patient’s medications.  Buster caught both.  Statistically, it is likely that Buster will experience a few medication errors.  The highest weight errors are about his nighttime poly-medications: Ambien, CloZAPine and Ativan.  Buster would really like to not have to take medication anymore.

 

In House > Metadata >

08_Product_XenoNet_Index_17012001_Practicals V2026

 

Promotion – Gilbert Drugs

https://www.gilbertdrugspharmacy.com/

Address:   9240 Garden Grove Blvd Ste 20

Garden Grove, CA 92844

Phone:     (714) 638-8230

Fax:         (714) 638-0988

Email:    info@gilbertdrugspharmacy.com

 

“Nick” at Gilbert Drugs has been our go to guy since 2012.  He was an invaluable resource when it came to CloZAPine management. 



 

Who Resolved It?

 

  • Assisted Living Staff
  • Auditor
  • Consumer
  • Doctor
  • Insurer
  • Medication Nurse
  • Pharmacy
  • Psychiatric Nurse
  • Transmitter
  • Other

 

Drug or Drugs In Question

 

Lorazepam
Ambien
Clozapine



Medication Vigilance

Medication vigilance, also known as pharmacovigilance, is the science and practice of detecting, assessing, understanding, and preventing adverse drug reactions or any other medicine-related problems.

Core Goals

Detect side effects:

Find new or unexpected adverse reactions after a drug hits the market.

Assess risks:

Decide if the benefits of a medicine still outweigh the risks.

Prevent harm:

Stop medication errors and reduce potential patient injury.

Key Activities

Spontaneous reporting:

Doctors, pharmacists, and patients report side effects to programs like the FDA MedWatch system.

Signal management:

Regulators review data to find red flags or unknown safety issues.

Post-marketing surveillance:

Companies track drug safety in large, diverse populations over long periods.

 

FYI – AI - Would you like to know how to submit a side effect report to the FDA?

 


Consumer Driven Medication Management Cycles

Consumer-driven medication management cycles shift the focus of pharmacotherapy from a traditional, clinician-dictated approach to a continuous, patient-centered self-management loop. Rather than treating patients as passive recipients who simply follow instructions (adherence), modern consumer-driven models treat individuals as active managers of their own health ecosystems, integrating prescriptions, over-the-counter drugs, lifestyle changes, and digital health tools. The cycle functions as a continuous feedback loop broken down into five distinct, consumer-led operational phases:



 

1. Discovery & Cost-Quality Selection

The cycle begins before a drug is even dispensed. Driven by consumer-directed health plans (CDHPs) and high deductibles, patients actively participate in evaluating value, therapeutic alternatives, and transparency.

Price & Value Transparency:

Consumers utilize digital formulary tools, coupons, and platforms to compare out-of-pocket costs across local pharmacies or mail-order options.

Shared Decision-Making:

Consumers collaborate with clinicians using "counter-detailing"—exchanging information regarding expensive brand-name medications vs. equally effective generic alternatives.

2. Onboarding & Informed Fulfillment

Once a treatment plan is chosen, the consumer manages the logistics of onboarding.

Information Synthesis:

The consumer reviews the medication's intent, side-effect profiles, and required lifestyle alignments (e.g., dietary restrictions).

Strategic Sourcing:

Coordinating multi-provider prescriptions into a single retail or digital pharmacy hub to minimize drug-to-drug interactions and close visibility gaps.

3. Execution & Behavioral Adherence

This is the day-to-day self-management phase where the regimen is integrated into the consumer's lifestyle.

Routine Structuring:

Utilizing smart pill organizers, time-based dosing strategies, and syncing regimens to minimize pill burdens (e.g., adjusting schedules to take medications once daily when safe).

Overcoming Practical Barriers:

Identifying and addressing physical barriers, such as swallowing difficulties, dexterity issues with packaging, or managing the shifting visual appearances of generic refills.

4. Data-Driven Monitoring & Reporting

Rather than waiting months for a follow-up office visit, consumer-driven cycles rely heavily on active health tracking and digital inputs.

Aside - Biometric & Symptom Tracking

Consumers leverage connected devices (e.g., smart glucose monitors, blood pressure cuffs) and digital symptom journals to log physical data in real time.

Side-Effect Advocacy:

Tracking subjective adverse reactions (e.g., fatigue, nausea) to proactively report data back to the clinical care team rather than silently discontinuing therapy.

5. Optimization & De-prescribing Review

The final phase closes the loop, leading to adjustments, continuation, or safe discontinuation of therapy.

Comprehensive Medication Management (CMM):

The consumer initiates collaborative reviews with pharmacists or primary care teams to determine if treatment goals are being met safely and cost-effectively.

De-prescribing:

Actively identifying opportunities to taper down dosages, switch therapeutic pathways, or eliminate redundant, unnecessary medications.

 

FYI – AI - Are you exploring this cycle from the perspective of a healthcare provider designing a patient program, or as an individual consumer looking to optimize your personal health regimen?


Medication Errors

A medication error is any preventable event that can cause or lead to inappropriate medication use or patient harm while the medicine is in the control of a healthcare professional, patient, or consumer, as defined by the National Coordinating Council for Medication Error Reporting and Prevention.

Common Types of Medication Errors

Prescribing mistakes:

A doctor orders the wrong drug, incorrect dose, or wrong route of administration.

Dispensing mistakes:

A pharmacist provides an incorrect drug, wrong strength, or mislabeled package.

Administration mistakes:

A caregiver or nurse gives the right drug to the wrong person, at the wrong time, or using the wrong method.

Monitoring failures:

Failing to check for dangerous drug interactions, allergies, or lab levels during treatment.

Leading Causes

Poor communication:

Illegible handwriting, confusing abbreviations, or unclear verbal instructions.

Human factors:

Fatigue, stress, heavy workloads, and distractions among medical staff.

System issues:

Similar-sounding drug names, look-alike packaging, or auto-fill errors in electronic health systems.

Prevention Strategies

Follow the five rights: right patient, right medication, right dose, right time, and right route.

Use clear communication and avoid dangerous shorthand or abbreviations.

Implement standardized protocols and double-check high-risk medications.

 

FYI – AI - If you'd like, let me know: Are you looking into this for a personal situation or professional practice? Do you need help with preventing errors in a specific setting?


 

Who catches medication errors?

Pharmacists, nurses, physicians, and patients all play critical roles in intercepting and catching medication errors before or after they cause harm.

Who Catches the Errors?

Pharmacists:

Studies show pharmacists intercept the highest percentage of prescribing and dispensing mistakes (up to 40% of intercepted primary care errors) by reviewing incoming orders against patient profiles, allergies, and drug interactions.

Nurses:

Acting as a final safety check at the bedside, nurses identify a large share of medication-ordering and administration errors prior to giving a drug to a patient.

Physicians:

Doctors catch prescribing discrepancies or monitor adverse reactions during follow-up visits and chart reviews.

Patients and Caregivers:

Individuals often catch wrong dosages, strange pill appearances, or unexpected side effects by actively asking questions and reviewing their prescription labels.

Systems and Organizations

Beyond individual healthcare providers, formal systems track and analyze these mistakes to prevent future occurrences: The Institute for Safe Medication Practices (ISMP) runs confidential reporting programs to capture near misses and medication errors. Regulatory bodies like the FDA's Division of Medication Error Prevention and Analysis monitor product labeling, naming, and packaging issues.

 

FYI – AI - Would you like to know more about how to spot and report a medication error yourself?


Frequency of Medication Errors

Medication errors are very common, harming at least 1.5 million people in the United States and roughly 1.3 to 1.5 million people globally every year. [Circa 2026]

How Often They Happen

In Hospitals:

Studies estimate that medication errors occur in about 8% to 25% of hospital or long-term care facility admissions, or roughly 6.5 explicit errors per 100 admissions.

At Home:

Errors made by patients or caregivers at home happen in roughly 2% to 33% of cases, often involving missed doses or wrong amounts.

Overall Impact:

According to the World Health Organization, medication-related harm affects about 1 in 20 patients globally.

Where and Why Errors Happen

Medication mistakes can happen at any step of the process:

Prescribing:

Up to 50% or more of errors start when a doctor or practitioner writes or orders the wrong drug or incorrect dose.

Administration:

Giving the medicine via the wrong route, to the wrong patient, or at the wrong time.

Dispensary/Pharmacy:

Giving out the wrong pill or mislabeling packaging.

Higher-Risk Groups

Older Adults:

People aged 65 and older face double the rate of medication-related hospital admissions.

Polypharmacy:

Patients taking five or more drugs at the same time have a 30% higher incidence of errors.

 

FYI – AI - If you'd like, let me know: Are you looking for information regarding hospitals or taking medications at home? Would you like tips on how to prevent medication mistakes for yourself or a family member?


What are the costs of Medication Errors?

Medication errors cost the World Health Organization (WHO) an estimated $42 billion USD globally each year. [Circa 2026]

Financial and Economic Breakdown

United States Impact:

The U.S. spends over $40 billion annually dealing with medication mistakes affecting millions of patients.

Extra Healthcare Costs:

Preventable adverse drug events add between $38 billion and $50 billion in extra medical care, disability, and lost productivity.

Hospital Costs:

Extra medical treatment for drug-related injuries in hospitals totals at least $3.5 billion a year, not counting lost wages.

Types of Healthcare Costs

Direct Costs:

Money spent on extra doctor visits, longer hospital stays, surgeries, and corrective medications.

Indirect Costs:

Financial loss from missed work days, lowered productivity, and long-term disability.

Intangible Costs:

Emotional pain, worry, and suffering endured by patients and their families.

 

FYI – AI - Would you like to know about the common causes of medication errors or how hospitals prevent them?

 

 

Types of Medication Errors

Medication errors are preventable mistakes that can happen at any stage of the medication-use process.

Main Types of Medication Errors

Prescribing Errors:

Choosing the wrong drug, dose, frequency, route, or duration of therapy, or prescribing a drug the patient is allergic to.

Transcribing Errors:

Mistakenly writing down, copying, or entering medication orders incorrectly into a patient's chart or system.

Dispensing Errors:

Preparing or labeling a prescription incorrectly at the pharmacy, such as giving the wrong drug, strength, or quantity.

Administration Errors:

Giving the medication to the wrong patient, using the wrong route (like giving an oral drug intravenously), or missing the correct timing.

Monitoring Errors:

Failing to check lab values, overlook side effects, or track how a patient responds to a drug over time.

Omission Errors:

Failing to give a scheduled dose of medicine to a patient before the next dose is due.

 

FYI – AI - If you'd like, I can share information on the common causes of these errors or how hospitals and pharmacies prevent them.






Medication Abuse Registry

A Medication Abuse Registry is not a standard, universally recognized single database, but rather a general term that usually refers to a Prescription Drug Monitoring Program (PDMP) or state-level drug/substance registries used to track controlled substance prescriptions and prevent misuse.

What is a Prescription Drug Monitoring Program (PDMP)?

Definition: A PDMP is a state-run electronic database that tracks controlled substance prescriptions (such as opioids, benzodiazepines, and stimulants) dispensed within that state. [1]

Purpose: It helps doctors and pharmacists identify patterns that might indicate medication abuse, addiction, or dangerous doctor-shopping (obtaining overlapping prescriptions from multiple providers).

Local Example:

In California, this system is known as CURES (Controlled Substance Utilization Review and Evaluation System).

Other Related Types of Registries

Depending on the context, people referring to a "medication" or "drug abuse" registry might mean:

Drug Offender Registries:

State databases (like the Tennessee Drug Offender Registry) that publicly list individuals convicted of specific drug or methamphetamine-manufacturing offenses.

Healthcare Worker Abuse Registries:

State registries that track certified nursing assistants or healthcare personnel who have substantiated findings of patient abuse, neglect, or misappropriation of resident property (including patient medications).

Substance Use Disorder (SUD) Patient Registries:

Clinical or research databases used within healthcare systems to document treatment history and monitor care quality for patients with addiction.

If you are looking for help with substance use or medication concerns, you can contact the SAMHSA National Helpline at 1-800-662-4357 for 24/7 treatment referral and support.


Describe the Medication Error

A medication error is any preventable event that can lead to inappropriate medication use or patient harm while the drug is controlled by a healthcare provider, patient, or consumer.

Stages Where Errors Happen

Prescribing:

A doctor writes the wrong drug, incorrect dose, or misses a known allergy.

Dispensing:

A pharmacist or technician gives the wrong medicine, strength, or labeled directions.

Administration:

A nurse or caregiver gives the wrong dose, uses the wrong route, or treats the wrong person.

Monitoring:

A provider fails to track lab results or watch for bad side effects.

Common Causes

Similar names:

Computer drop-down menus or look-alike labels cause mix-ups.

Communication gaps:

Poor handwriting, unclear instructions, or missing patient history.

Workplace stress:

Rushing, heavy workloads, and constant interruptions in clinics or pharmacies.

 

FYI – AI - If you want to know more, let me know: Are you looking into how to prevent errors at home? Do you need information on reporting a specific medical mistake?

 


Timeframe for a Medication Error

A medication timing error generally occurs when a drug is administered 60 minutes before or 60 minutes after the scheduled time.

Timing Window Details

Standard window:

Giving a medication more than 60 minutes early or late is widely classified as a timing error.

High-risk/time-sensitive drugs:

Medications like insulin or certain antibiotics require tighter schedules; missing the narrow window can cause treatment failure or dangerous fluctuations.

Reporting timeframe:

Facility protocols usually require staff to log and report a medication error within 24 hours of discovery.

 

FYI – AI - If you are dealing with a specific situation, tell me: What type of medication was involved? How late or early was it given? I can help you understand the next steps to take.


 

Standards for Excellence in Medication Management

Standards for excellence in medication management require comprehensive, safe, and standardized protocols across the entire medication-use process to protect patient health and improve clinical outcomes.

Core Frameworks and Governing Bodies

The Joint Commission (TJC):

Establishes explicit national patient safety goals and medication management (MM) standards covering safe storage, labeling, pharmacist order reviews, preparation, and patient monitoring. Facilities can review details via the Joint Commission.

Health Standards Organization (HSO):

Provides global requirements spanning planning, procurement, labeling, storage, prescribing, dispensing, administration, and environmental disposal.

United States Pharmacopeia (USP):

Sets crucial benchmarks like USP <797> and <800> for sterile compounding and hazardous drug handling, alongside environmental and informational standards.

Key Standards of Practice

Accurate Labeling:

All medications, containers, and solutions must be clearly labeled with the drug name, strength, amount, diluent volume, and expiration date/time.

The "Five Rights" of Administration:

Verification of the right patient (using two identifiers), right drug, right dose, right route, and right time. [1]

High-Alert Safeguards:

Specialized dual-signature verifications and extra precautions for high-risk medications like insulin, anticoagulants, opioids, and sedatives.

Multidisciplinary Oversight:

Mandatory pharmacist review of orders for appropriateness, alongside active antibiotic and anticoagulant stewardship programs.

Technology Optimization:

Implementation of barcode medication administration (BCMA), automated dispensing cabinets, and smart infusion pumps to reduce human error.

 

If you'd like, let me know:

What specific healthcare setting you are focusing on (hospital, long-term care, outpatient)

Whether you need help with policy creation or audit checklists

 


Promotion – Career in Pharmacy

A career in pharmacy involves dispensing medications, advising patients on drug use, and ensuring safe and effective treatment outcomes.

Common Career Paths

Community Pharmacist:

Dispenses prescriptions and provides over-the-counter advice in retail or independent drug stores.

Clinical Pharmacist:

Works in hospitals or clinics alongside medical teams to manage direct patient care and drug dosages.

Pharmaceutical Industry:

Focuses on research and development, clinical trials, and drug safety regulations.

Consultant Pharmacist:

Advises long-term care facilities or insurance providers on proper medication usage and regulatory compliance.

Education and Outlook

Education:

Requires earning a Doctor of Pharmacy (Pharm.D.) degree and passing state licensing exams (such as the NAPLEX and MPJE).

Salary:

The median annual wage for pharmacists was $140,910.

Job Growth:

Employment is projected to grow 5 percent from 2025 to 2035, faster than the average for all occupations.

You can look for jobs or professional development resources through the ASHP CareerPharm portal. You can also explore specialty areas at Pharmacy is Right for Me and Loma Linda University.

 

FYI – AI - If you'd like, let me know: Are you interested in retail/community pharmacy or a clinical/hospital setting? Would you like details on Pharm.D. admission requirements?




Saturday, August 29, 2026

Young People Keeping it Right By Keith Torkelson MS, BS

 

Contents

 

Requirements
Paralegal Class for Young People – In Junior High School – Proactive
Witness other peoples’ trials for breaking the law
Adaptive & Protective Behaviors
Critical Control Points in Youth
Community Issues (Transitional-aged Youth (Ages 16-25))
Mental Health Awareness – CloZAPine Scenario
CloZAPine Blood Monitoring Update
Defeating the Effort to Manage more people in need of CloZAPine
Periodic Schizophreniform Disorder
1988-1989 – Around 6 months then full recovery
Circa 1990
Disorder Timeline – Behavioral Health Issue List
Childhood Risks versus Protections Break Even
What makes one susceptible for abuse?
Features of a bad or rough childhood
Full Service Partnership Promotions – Intensive Solutions
Recognizing patterns of childhood trauma in adult life?
Too much dependency on role models
What does it mean Young People in Recovery?
What score is a low EIQ?
What risk factors do people with low EIQs face?
Domains of Recovery
Prodromal Risk Factors
Most of my cohort came out normal with some highly successful
Satisfaction Screener – 9 Items
Substance Use Disorder (SUD)
Promotion – Cognitive Behavioral Therapy Workbook
Content of Bourne Workbook
What does CBT do for you?
Promotion - The Adolescent Relapse Prevention Planner
What was going on in 2012?
Delinquency Models (Age 2 to 10)
Was I destined to face hardship my whole life?
Neurologic Processes
Appendix – Transcripts




Incorrect Starting Assumptions

 

  • Abuse is normal
  • Drugs are good for you
  • I am going to die young
  • I am right, implies others are wrong
  • I can manage a night life
  • I can trust everybody
  • If other people have done it don’t do it
  • If it can be done do it
  • If someone asks you to do it do it
  • Siblings instructions to not tell mom and dad were sound
  • Mom will protect my sister and me
  • My older brothers were not taking risks
  • The older people will lead me right
  • Things will not get better
  • We are going to be attacked via nuclear weapons


Aside - Incorrect Premises

Incorrect asocial premises refer to foundational logical errors, philosophical myths, or psychological misconceptions built on the flawed assumption that human beings are naturally isolated, solitary, or non-social creatures by default. When an argument or sociological theory assumes that individuals exist entirely independent of social frameworks, the resulting conclusions are fundamentally warped.

These misconceptions surface across logic, evolutionary biology, and everyday psychology.

1. The Logical "False Premise" Fallacy

In formal logic, an argument built on an incorrect starting assumption is known as a false premise. Even if the steps of the argument are perfectly valid, the final conclusion remains unreliable.

2. The Evolutionary Myth of a Prior Asocial State

A major flaw in historical political theory—such as early concepts of the "State of Nature"—is the assumption that early humans lived completely isolated lives before choosing to form societies.

3. The Psychology Blunder: Asocial vs. Antisocial

In everyday conversation, people frequently base judgments on the false premise that asocial behavior and antisocial behavior are the same thing.

The Error:

Assuming a quiet person who skips a party is actively hostile or dangerous.

The Reality:

As outlined by Verywell Mind, asociality is simply a passive preference for solitude. Conversely, antisocial behavior involves active, antagonistic hostility, rule-breaking, or a total disregard for the rights of others.

 
Early Intervention - Paralegal Class for Young People – In Junior High School - Proactive

Paralegal Studies

https://cte.fullcoll.edu/programs/paralegal-studies/

Build Your Future as a Paralegal

Paralegal Studies – Associate in Science Degree

Program prepares students for employment in a paraprofessional capacity as an assistant to an attorney in private practice, in a governmental agency, or in private industry. Paralegals may perform many tasks under the supervision of a licensed attorney including preparation of forms and pleadings, interviewing of clients, researching and writing legal documents, managing a law office, and preparing word processing forms and documents. This program is not intended to prepare students for the practice of law. The Paralegal studies program is approved by the American Bar Association (ABA).

Paralegal Studies – Certificate

Program prepares students for entry-level employment in assisting lawyers by investigating facts, preparing legal documents, or researching legal precedent.  Paralegals conduct research to support a legal proceeding, to formulate a defense, or to initiate legal action. For additional information, visit the Fullerton College Business/CIS website:

https://buscis.fullcoll.edu/paralegal/.


Witness other peoples’ trials for breaking the law

Prevention & Early Intervention

In the United States, anyone can walk into a courthouse and watch a criminal trial for free. The Sixth Amendment to the U.S. Constitution guarantees the right to a public trial, meaning courtrooms are open to the general public by law.

How to Watch an In-Person Trial

Find a court:

Locate your nearest municipal, county, state, or federal district courthouse.

Check the docket:

Visit the court's official website or ask the clerk's office for the daily calendar to find criminal trials.

Go through security:

Arrive early to pass through airport-style security. Weapons, cameras, and recording devices are strictly prohibited.

Pick a courtroom:

Look for signs reading "Jury Trial in Progress" and enter quietly.

Take a seat: Sit in the gallery benches behind the wooden bar separation.

How to Watch Online (Virtual Courts)

If you prefer to watch from home, you can view real trials through various streaming networks:

Court TV:

Provides live, continuous broadcast coverage of high-profile legal trials across the country.

Law & Crime Network:

Offers live trial streams, legal analysis, and celebrity justice news.

YouTube channels:

Many local county courts stream their daily public proceedings directly on YouTube.




Promotion - Helping Kids and Families Build Better Futures

https://casayouthshelter.org/

 

Family Reunification

Work to unify families after instilling the skills necessary to be effective communicators.

 

Parenting Programs

Weekly classes with sessions designed to cover the same topics as the coordinating parenting class to provoke meaningful and relevant discussions.

 

Youth in Crisis - Sample of some crises

With an increased personal strength and a sense of renewal. While in a supportive environment. With family reunification as a primary goal.

 

Safety at home

At home I lacked physical and emotional safety. [SEE ACES Report]

https://healthman2059.blogspot.com/2026/08/adverse-childhood-experiences-aces.html

 

Life skills

Literacy is for everyone. Skills increase a use quality of life and can help to achieve goals. Life skills teach you important practicalities such as goal setting, effective communication, budgeting, job readiness, interviewing. Prepare for independence and self sufficiency.

 

Pets

Animal Assisted Therapy: This involves animal as a form of treatment, helping client socially and emotionally to significantly to significantly reduce stress, anxiety and depression.


Art

Nonverbal expression the only outlet for their intense feelings. An art therapy program helps youth build resilience, promote self awareness, improve self esteem and confidence, and develops coping and controlling skills.

 

Critical Control Points in Youth

 

  • Childhood and Adversities
  • Neighborhood
  • The Delinquents old and young
  • Scouts & Leadership
  • After class high in Geometry – Peaked in Math
  • Dad’s Boarding School notion
  • Election of Senior Class Officers - Lost
  • Campus Service
  • No drive cars at night
  • Presidential Classroom - Failed
  • Relationship with WJS – Subsided for the best
  • No pregnancies or babies (Primary mission)
  • Counseling (Group, Individual and Family) – Unmet Need
  • Getting my aunt to take me (Began as early as aged 3)
  • Neglected (ACE)
  • Abandoned to deal with KGT’s Abuse
  • Eating
  • Sleeping Priority – Had problems finding routine peace and quiet
  • Asking for help – Asked my aunt and mom for help grade 9
  • Art Therapy
  • Basic Needs (ACES)
  • Assessment for medication – Missed the Boat
  • Medication in hindsight – CloZAPine would have been helpful
  • Value of Diversity
  • Smoking Cigarettes – First dependency
  • Street Games – For the most part good
  • Weekly debriefing without anger – Improving communicating with parents
  • Older Siblings – Lanaii the shot caller destabilized house when she went away to college
  • Pets – Lady Dog the safest thing in the house
  • Transitional Aged Youth – Serious scars
  • Full time school – Completed bachelor’s and master’s
  • Full time work – Some really good work and memories

 

Community Issues (Children/Youth (Ages 3-15))

 

  • Inability to succeed in mainstream school environment
  • Involvement in the child welfare and/or juvenile justice systems
  • Peer and family problems
  • Substance Use
  • Homelessness

 

Community Issues (Transitional-aged Youth (Ages 16-25))

Scored August 26, 2026 retro for term

For and by Keith Torkelson, MS, BS




Weighting

The first 3 are high impact.  The next 7 are moderate impact.  The last 2 are low impact. 

 

Sleep Problems

Due to anxiety and alcohol use, proper regenerative sleep was not routinely occurring.

 

After Hours Problems

Many of our problems developed after hours when it was dark out.  We recommend that TAYs not drive after hours without a sane and responsible adult in the vehicle. 


Building Mental Health Awareness

Concurrent with CloZAPine The Fix

Clozapine was first synthesized in 1958, launched in Europe in 1971, and officially approved by the U.S. Food and Drug Administration (FDA) in December 1989 for treatment-resistant schizophrenia. Later, in 2002, the FDA also approved it to reduce recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder.

Timeline of Key Approvals

1958:

Synthesized by a Swiss pharmaceutical company.

1971:

First launched and used in parts of Europe.

1975:

Voluntarily withdrawn from many markets due to severe white blood cell loss (agranulocytosis).

1989:

Re-approved by the U.S. Food and Drug Administration for treatment-resistant schizophrenia under strict blood monitoring.

2002:

Approved for reducing the risk of recurring suicidal behavior.

 

FYI – AI - Would you like to know more about the blood monitoring requirements or the side effects associated with CloZAPine?

 


CloZAPine Blood Monitoring Update

The FDA eliminated the mandatory CloZAPine Risk Evaluation and Mitigation Strategy (REMS) program, ending the requirement to report absolute neutrophil count (ANC) blood test results before pharmacies can dispense the medication.

Key Updates & Monitoring Changes

End of REMS:

Prescribers, pharmacies, and patients are no longer required to participate in the centralized REMS registry or mandatory data reporting.

Prescribing Information:

The FDA still recommends that clinicians monitor patient ANC levels according to traditional package insert guidelines, creating a shift toward clinician-managed and shared decision-making.

Evolving Guidelines:

Newer consensus guidelines (such as global Delphi recommendations) suggest weekly ANC monitoring for the first 18 weeks, transitioning to monthly until 2 years, and potentially discontinuing routine monitoring for stable patients without prior abnormalities.

Official details and safety communications are tracked directly through the FDA Clozapine REMS Update.

 

FYI – AI - Would you like information on how these changes affect current clinical monitoring protocols or shared decision-making documentation for patients?


Aside -  Defeating the Effort to Manage more people in need of CloZAPine

Defeating the barriers preventing people from managing and accessing Clozapine requires a multi-pronged approach that targets administrative, clinical, and logistical hurdles. While Clozapine is widely recognized as the gold standard for treatment-resistant schizophrenia (TRS), severe underutilization persists because the treatment system is bottlenecked by rigid monitoring protocols, fear of legal liability, and fragmented care.

1. Removing Administrative and Policy Barriers

Legislate Right-to-Access Protections:

Advocate for policy models like The Great American Clozapine Initiative, which highlights efforts like Arizona Senate Bill 1716 to ban insurers, Medicaid programs, and correctional facilities from delaying or rationing Clozapine.

Streamline REMS Requirements:

Modernize the FDA Clozapine Risk Evaluation and Mitigation Strategy (REMS) system to reduce reporting burdens on pharmacies and providers.

Broaden Alternative Monitoring:

Use clinical judgment to allow modified hematologic tracking under informed consent when rigid guidelines threaten to cause dangerous treatment gaps.

2. Upgrading Care Logistics and Technology

Deploy Point-of-Care Testing:

Transition to finger-stick, point-of-care capillary blood monitoring to eliminate coordinated, time-consuming laboratory visits.

Build Specialized Infrastructure:

Establish dedicated interdisciplinary Clozapine clinics that bundle patient education, laboratory services, and prescription tracking under one roof.

Expand Community Case Management:

Utilize intensive community treatment teams to oversee blood draw adherence and lower the rate of missed appointments.

3. Combating "Clozaphobia" and Clinician Reluctance

Provide Liability Safeguards:

Implement clear state-level clinician liability protections when clinicians act on informed consent and reasonable shared decision-making.

Reframe the Risk-Benefit Equation:

Educate psychiatrists to balance rare risks like neutropenia (under 1% occurrence) against massive, documented benefits—including a dramatic reduction in suicide and all-cause mortality.

Standardize Side Effect Management:

Train community providers on aggressive, protocols for side effects, such as using local agents for sialorrhea (excessive salivation) and proactive regimens for constipation.

4. Supporting Patients and Families

Fund Peer Support Networks:

Empower families with information from groups like the National Alliance on Mental Illness (NAMI) to counteract medical stigma.

Prevent Re-Titration Gaps:

Maintain precise protocols to ensure medication is not missed for more than 48 hours, which legally mandates restarting titration from the baseline dose.

 

Are you looking at this from a clinical perspective trying to establish a workflow, or an advocacy angle seeking legislative tools?

 

Periodic Schizophreniform Disorder

A mental health condition with symptoms identical to schizophrenia, but it lasts for more than one month and less than six months. The term "periodic" is not a formal diagnostic subtype, but episodes involve temporary losses of touch with reality before full recovery or potential transition to a longer-term condition.

 

1988-1989 – Around 6 months then full recovery

Full recovery is measured as full time work or school.  The onset of my illness was associated with a Rabies Vaccine.  After about four months of fighting my condition I ended up in the hospital.  I withdrew from Veterinary School on a medical leave.  In the hospital I was treated with Haldol.  Haldol did not work out well of me.  I returned home to my parents’ house and retained doctor DeSilva.  I detected that it was not a great match so I “fired him” and retained doctor Deutsch (APD).  Doctor APD determined that I was overmedicated so he started reducing the dosages of my medications.  I found work as a fun time lab associate for Hospital Pathologist Central Laboratory.  At home I had good nutrition and regenerative sleep.  APD reclassified me as Schizophreniform.  After 6 months I bounced back demonstrating a high degree of Resilience.  I returned to Veterinary School in Davis.  Dean Hansen said you look good.  I made grades for 2 quarters.  Then lack of sleep caught up to me (again).  This included drinking a lot of coffee.

 

[ALSO SEE APPENDIX TRANSCRIPTS]


Circa 1990

The episode of 1990 saw me develop intense anxiety and aggravation of my sleep disorder.  I didn’t know the impact sleep deprivation was having and would have on my life and health.  One evening I was playing with my Lithium.  I was taking it out of the capsules and at the same time had a panic attack.  I called my parents who contacted 911 for the Davis area and the emergency crew came.  They assumed I was toxic on lithium and took me to the ER where they pumped my stomach.  Having your stomach pumped in very uncomfortable.  After a stay at Woodland Memorial Hospital my father picked me up and brought me home to Orange County.  I was losing most everything that I worked so hard to achieve and secure.


Disorder Timeline – Behavioral Health Issue List




Childhood Risks versus Protections Break Even

The "break-even" point between childhood risks and protections is the precise balance where a child's protective factors successfully counteract their risk factors, neutralizing the potential for negative developmental outcomes.

Core Mechanics

Risk Factors:

Conditions increasing the likelihood of behavioral, emotional, or health problems (e.g., poverty, neglect, systemic trauma).

Protective Factors:

Variables that mitigate risk and promote resilience (e.g., strong caregiver bonds, safe schools, emotional regulation).

The Break-Even Threshold:

The point where cumulative protective assets equal or exceed cumulative risk exposures, preventing a trajectory toward developmental harm.

Key Risk vs. Protection Variables

Individual:

Chronic illness or impulsivity vs. high intelligence or easy temperament.

Family: Substance abuse or harsh discipline vs. stable routines or supportive parenting.

Community:

Neighborhood violence or underfunded schools vs. safe recreational spaces or strong community networks.

Intervention Strategies to Shift the Balance

Reduce Exposure:

Lowering the total number of active risk factors directly alters the equation.

Chain-Reaction Disruption:

Interrupting how one risk leads to another (e.g., providing tutoring to prevent academic failure from leading to school dropout).

Enhance Resource Access:

Introducing robust protective resources early in life to heavily tip the scale toward resilience.

 

FYI – AI - To help explore how this balance applies to your specific focus area, could you tell me: What specific age group or developmental stage are you analyzing? Are you looking at a particular type of risk (e.g., mental health, socioeconomic, academic)? Would you like to review evidence-based intervention frameworks that target this balance? I can provide tailored data or framework models based on your needs.


What makes one susceptible for abuse?

Child Abuse

Age, family income, and ethnicity are all risk factors for both sexual abuse and physical abuse. Gender is a risk factor for sexual abuse but not for physical abuse.

An individual may be more vulnerable to abuse due to power imbalances, dependency, or cognitive impairments. Key risk factors include: 

Age: Young children and older adults are highly dependent on others, limiting their ability to protect themselves. 

Disability or Illness: 

Physical, sensory, and cognitive impairments—such as dementia—make individuals highly reliant on caregivers, creating opportunities for coercion or neglect. 

Social Isolation: 

Living without a supportive community or having limited access to social networks allows abusers to isolate victims and conceal their actions. 

Financial Dependency: 

Relying on a partner or carer for money or basic needs can trap individuals in abusive situations

Substance Abuse: 

Drug or alcohol dependency can impair a person's judgment, expose them to risky environments, and increase their vulnerability to exploitation. 

For more information on recognizing signs and protecting at-risk groups, the East Riding Safeguarding Adults Board provides a detailed breakdown of at-risk demographics, and NSPCC Learning outlines specific risk factors for children and families.


Features of a bad or rough childhood

A difficult or damaging childhood is typically characterized by Adverse Childhood Experiences (ACEs) like abuse, neglect, or household instability. It involves growing up in an environment lacking emotional safety and consistent support, forcing children to develop coping mechanisms that often manifest as anxiety, trust issues, or relationship difficulties in adulthood.

Key features and warning signs often include:

Emotional & Physical Neglect:

Caregivers who are emotionally unavailable or fail to provide basic needs like food, medical care, or a safe environment.

Abuse:

Experiencing physical, emotional, or sexual maltreatment that causes physical injury or psychological harm.

Household Dysfunction:

Growing up with caregivers who suffer from substance abuse, untreated mental health conditions, or have been incarcerated.

Witnessing Violence:

Exposure to domestic violence or experiencing community violence, which induces chronic fear and hypervigilance.

Chaotic Environments:

Homes lacking structure, routine, or consistent boundaries, creating an unpredictable and unstable daily life.

The lasting impact of these features can be addressed through therapy and support. Exploring professional resources or educational materials can help understand and navigate these experiences. Learn more about the specific definition and prevention of these events via the CDC Adverse Childhood Experiences guide.

 

FYI – AI - Would you like to explore resources for: Recognizing patterns of childhood trauma in adult life? Locating mental health professionals or therapy resources in the Buena Park, CA area? Understanding how to break the cycle with your own family?

 

Associated with >

Assess_Adverse_Childhood_Experiences_ACEs_18053101_Notes V2026

 

Full Service Partnership Promotions – Intensive Solutions

FYI - Full Service Partnerships (FSP)

https://www.ochealthinfo.com/about-hca/behavioral-health-services/more-bhs/full-service-partnerships-fsp

 

Promotion - RENEW

Project RENEW is an Orange County Health Care Agency (OCHCA) Full Service Partnership (FSP) program providing intensive wraparound mental health services for children and youth.

Program Overview

Name: Project RENEW (Reaching Everyone Needing Effective Wrap)

Provider: Pathways of California / Clarvida

Target Audience:

Children and youth from birth to age 18 with serious emotional disturbances (SED) or severe mental illness (SMI).

Focus Populations:

Families who are unserved/underserved, homeless or at risk of homelessness, or facing high risk of psychiatric hospitalization.

Services: In-home mental health support, 24/7 crisis response for enrolled clients, intensive case management, and family wraparound tools.

Contact and Location

Address: 1360 South Anaheim Boulevard, Suite 101, Anaheim, CA 92805

Phone: (714) 948-7641

General OCHCA Behavioral Health Referrals: Call OC Links at (855) 625-4657 available 24/7.

If you need help with a specific referral, or information on adult or older adult FSP programs instead, let me know.


 

Promotion - STAY

The Orange County Health Care Agency (OCHCA) Full Service Partnerships (FSP) program named STAY (Supporting Transitional Age Youth) provides intensive, community-based mental health and support services for vulnerable young people.

Overview of STAY FSP

Target Age: Transitional Age Youth (TAY) aged 16 to 25 (or 18–25 depending on specific program tracks) who have severe and persistent mental illnesses and are homeless or at risk of homelessness.

Core Approach: Uses a "whatever it takes" multidisciplinary team model combining field-based and clinic-based care.

Hours: Regular operating hours are 9 a.m. to 5 p.m., Monday through Friday, with 24/7 crisis support available for enrolled clients.

Services Provided

  • Intensive case management and wrap-around support
  • Mental health therapy and psychiatric medication support
  • Substance abuse treatment services
  • Skill-development groups and community-based activities
  • Housing support and connection to vital community resources.

If you need help connecting to this program, would you like the contact phone numbers or information on the referral process for Orange County behavioral health services?


 

Promotion - FOCUS

OCHCA Project FOCUS is a Full Service Partnership (FSP) and wraparound program run via the Orange County Health Care Agency that provides intensive, community-based mental health care and supportive resources for children, transition-aged youth, and families.

Core Services

Intensive Case Management: Tailored, "whatever-it-takes" support to help clients navigate daily life and personal recovery goals.

Crisis Services: Available 24 hours a day, 7 days a week for enrolled clients.

Counseling and Therapy: Individual and family mental health counseling.

Supportive Resources: Assistance with basic needs, health insurance, low-income family benefits, housing support, and parent education.

If you need contact details, referral steps, or program eligibility for Project FOCUS, let me know!

 

Promotion - Stop the Cycle Orange County

https://www.ochealthinfo.com/sites/hca/files/import/data/files/14707.pdf

 

The Stop the Cycle (STC) program is an initiative operated by the Orange County Health Care Agency (OCHCA) under its Behavioral Health Services division. It is designed as a prevention and early intervention program to halt the progression of juvenile justice involvement within families.

Program Overview

The program specifically targets parents and caregivers who already have at least one child involved in the juvenile justice system, but also have other children at home (ages 6 to 17) who are not yet system-involved.

The Goal:

To reduce delinquent behaviors and break the generational or familial cycle of incarceration by building resilience in the younger siblings.

Core Structure:

It typically features a 12-week curriculum composed of parenting skills education alongside separate life-skills and resiliency groups for the children.

Support Offered:

Individual family breakout sessions, behavioral support, and direct assistance with barriers like childcare, food, and transportation to ensure vulnerable families can successfully complete the program.

How to Connect & Location

The program operates countywide through specialized county facilities:

Primary Facility: Youth Reporting Center, North (YRC)

Address: 1200 N. Main Street, Suite 300, Santa Ana, CA 92701

Program Phone: (714) 480-4678 [1]


Recognizing patterns of childhood trauma in adult life?

Childhood trauma often persists into adulthood as a highly sensitive nervous system. You might unconsciously recreate early dynamics (e.g., in relationships), struggle to regulate emotions, or suffer from chronic health issues. Recognizing these patterns is the critical first step toward healing.  Recognizing unresolved childhood trauma involves observing how your mind and body consistently react in specific situations. The most common patterns to look for include:

Relationship and Attachment Issues:

You may find yourself drawn to emotionally unavailable or volatile partners to unconsciously "fix" the past, or you may struggle with a push-pull dynamic—fearing abandonment while simultaneously fearing intimacy or engulfment.

The "People-Pleasing" Habit:

Habitually prioritizing everyone else's needs over your own is a common trauma response. It often stems from learning to keep caregivers calm or happy to ensure your own safety.

Chronic Hypervigilance:

Your nervous system may be stuck in "fight or flight". This manifests as always anticipating a crisis, being easily startled, having an intense fear of criticism, or feeling the need to constantly control your environment.

Unexplained Physical Symptoms:

Because trauma is stored in the body, it often leads to physical manifestations (somatic symptoms) like frequent headaches, digestive issues, fibromyalgia, or general chronic fatigue without clear medical causes.

Internalized Shame and Negativity:

Feeling a persistent, vague sense that you are inherently "bad," broken, or never quite good enough, even when you achieve success in your personal or professional life.  Identifying how these adaptations—which once kept you safe as a child—might be causing harm in your adult life allows you to reclaim your emotional agency.


Too much dependency on role models

Relying too much on role models can stifle personal growth and cause you to subconsciously lower your own self-worth by placing others on an unattainable pedestal. Instead of blindly emulating someone else's life, the healthiest approach is to extract specific wisdom or traits from multiple people to forge your own authentic path. The trap of over-dependency on role models manifests in a few key ways:

The Perfection Illusion:

People often only see the public successes of their role models, leading to unrealistic expectations and low self-esteem when they cannot achieve flawless results themselves.

Stagnation:

Trying to copy someone else’s exact journey ignores your unique circumstances, strengths, and values. It can even limit your exposure to diverse perspectives and personal feedback.

Diminished Autonomy:

Subconsciously placing someone above yourself creates a power dynamic that lowers your self-worth and makes you hesitant to make independent decisions.

To shift from blind dependency to empowered individuality, consider these steps:

Pick and Choose:

Instead of idealizing one person, admire specific traits in multiple people (e.g., your friend's work ethic, a colleague's communication style).

Define Your Own Success:

Focus on aligning your daily habits with your own personal values and goals rather than external expectations.

Embrace Your Humanity:

Acknowledge that everyone—including your heroes—is flawed and still figuring things out.

 

FYI – AI - If you'd like, let me know: What specific areas you feel you are too dependent on others (e.g., career choices, personal style, relationships). What traits you find yourself admiring the most in others. We can brainstorm strategies to help you build your own independent decision-making skills.

 
What does it mean Young People in Recovery?

Young People in Recovery (YPR) is a national non-profit organization dedicated to supporting youth and young adults in, or seeking recovery from, substance use disorders. They provide essential life skills training, peer-led support networks, and community advocacy for resources like housing, education, and employment. The organization specifically focuses on the unique developmental needs of individuals under 30 who are navigating addiction and sobriety. Core aspects of their work include:

Life Skills Curriculum:

YPR offers targeted, peer-developed programs (such as the My Recovery is EPIC curriculum) that focus on career building, healthy relationships, and holistic wellness.

Peer-to-Peer Support:

They create welcoming, substance-free social spaces where young people can have fun and build friendships with others who share similar experiences.

Advocacy:

YPR advocates at local, state, and federal levels to reduce the stigma around addiction and improve access to treatment and long-term recovery resources.

 

Associated > Metadata >
 
EIQ = Emotional Intelligence Quotient
10_Assess_EIQ_Intelligence_17102904_Tool V2026
SCR_Relate_Supportive_14022803_Refs_EIQ V2026


What score is a low EIQ?

A low Emotional Intelligence (EIQ or EQ) score generally falls at or below the 5th percentile, depending on the specific test. On assessments using a standard 1 to 5 raw scoring method, this translates to an average score of 1.0 to 2.5. Because EIQ tests typically use percentile rankings or standardized ranges to compare individuals to a general population, low EIQ indicators and metrics vary slightly by the evaluation tool:

NovoPsych (Brief Emotional Intelligence Scale):

Scores in the 5th percentile or below are classified as "Low" emotional intelligence.

Center for Internal Change (EIQ Assessment):

Raw scores average from 1 to 5. Scores falling under the 50-100 point bracket are broadly considered moderate, while lower raw numbers denote deficient emotional skill.

Psychological Testing Baselines:

Scores that reflect a low ability to identify, understand, and regulate emotions are often mathematically clustered into the bottom 15% to 20% of the population's normal distribution.

Common Traits of Low EIQ

Individuals scoring in the low EIQ range frequently struggle with the following:

Impulse control and managing emotions under high stress.

Taking feedback constructively, often interpreting mild criticism as a personal attack.

Offering sincere, responsibility-taking apologies.

Recognizing others' emotional states, frequently leading to poor conflict resolution.

 


What risk factors do people with low EIQs face?

People with low emotional intelligence (EQ) face significant risks across their personal, professional, and mental well-being. Key vulnerabilities include heightened anxiety and depression, chronic stress, strained relationships, and career setbacks due to a lack of adaptability and poor communication.

The specific risk factors associated with low EQ manifest across three main areas:

1. Mental and Emotional Health Risks

Psychological Distress:

Research indicates that low emotional intelligence acts as a major risk factor for developing symptoms of depression and anxiety, as individuals lack the self-awareness and regulation skills needed to process negative emotions.

Impaired Stress Management:

Without healthy coping skills, individuals are more likely to experience emotional burnout, physical tension, and maladaptive coping mechanisms (e.g., avoidance, impulsive behaviors).

High Reactivity: Rather than pausing to evaluate situations, those with low EQ often act on impulse, which can lead to unpredictable emotional outbursts.

2. Interpersonal and Relationship Risks

Communication Barriers:

A lack of self-awareness and empathy makes it difficult to understand the impact of one's actions on others. This often leads to defensive or aggressive communication habits and blame-shifting.

Relationship Struggles:

Failing to read social cues, honor boundaries, or take accountability for mistakes creates ongoing conflict with friends, family, and romantic partners.

3. Professional and Academic Risks

Resistance to Feedback:

Constructive criticism is often perceived as a personal attack, making it difficult to accept feedback and grow professionally.

Teamwork and Leadership Failures:

The inability to collaborate, manage conflict, and empathize with coworkers often stunts career progression and decreases overall team morale.

 

FYI – AI - Could you clarify if you are asking this about someone in your personal life, a workplace dynamic, or are you looking for self-improvement strategies? I can provide tailored resources and advice based on your specific situation.


Domains of Recovery

Domains of recovery represent the holistic areas of an individual's life that require attention to heal and thrive. Organizations like SAMHSA outline these core dimensions as: Health (managing emotional and physical wellness), Home (secure living), Purpose (meaningful daily activities), and Community (social support). In clinical and addiction recovery, these are typically expanded into broader "recovery capital" or comprehensive life spheres to ensure sustainable, long-term well-being. The primary life domains addressed in a personalized recovery journey typically include:

Physical and Mental Health:

Managing symptoms, maintaining abstinence from substances, sleep hygiene, nutrition, and clinical treatment.

Housing and Safety:

Securing a stable, safe, and supportive environment to allow healing to take root.

Purpose and Productivity:

Participating in meaningful daily activities such as employment, education, volunteer work, or creative hobbies.

Relationships and Social Support:

Building positive networks of family, friends, peer groups, and community members.

Financial and Legal:

Gaining economic stability and independence from legal responsibilities or institutional constraints.

Coping and Life Functioning:

Developing emotional regulation, stress management techniques, and practical life skills.

Community Involvement:

Participating in civic, cultural, and spiritual groups that provide a sense of belonging and meaning.

 

FYI – AI - If you are looking to build a personalized recovery plan for yourself or someone else, tell me:

Prodromal Risk Factors

Prodromal risk factors are early, subtle changes or vulnerabilities that precede the onset of a major illness, most commonly observed in psychotic disorders (like schizophrenia) and neurodegenerative diseases (like Parkinson's). In mental health, these indicators—such as social withdrawal, unusual thought content, and sleep disturbances—help identify individuals at a "clinical high risk" for early intervention.

In psychiatric contexts, prodromal risk factors span genetics, environment, and early clinical symptoms:

Genetic Predisposition:

Having a first-degree relative with a psychotic or bipolar disorder, or specific genetic conditions like a 22q11.2 deletion, significantly increases risk.

Environmental Stressors:

Experiencing severe early-life trauma (abuse, neglect) or growing up in a chronically stressful environment elevates vulnerability.

Neurological/Obstetric Factors:

Complications during pregnancy or birth (e.g., hypoxia or low birth weight) and early developmental challenges are well-documented risk markers.

Clinical Red Flags:

Subtle behavioral changes, including declining school or work performance, odd speech patterns, suspiciousness, and mild perceptual disturbances, are strong predictors of conversion to full-blown psychosis.

In neurological conditions like Parkinson's disease, prodromal markers can precede motor symptoms by decades and include indicators such as Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD), constipation, anosmia (loss of smell), and depression.

 

Most of my cohort came out normal with some highly successful

It is very common for a peer group to follow a normal distribution, with the majority leading stable, typical lives while a handful achieve exceptional success or prominence. This "bell curve" is expected in most industries, academic cohorts, and graduating classes.

Individual achievements within a cohort are heavily driven by variables like:

Networking & Connections:

Building valuable relationships often opens more doors than academic performance alone.

Grit & Resilience:

The ability to push through setbacks and adapt to challenges is a massive predictor of long-term success.

Emotional Intelligence:

High EQ is frequently cited as a stronger driver of leadership and professional growth than raw talent or test scores.

Specialization:

Focus, timing, and niche expertise frequently allow certain individuals to accelerate faster than others.

 

FYI – AI - Would you like to explore how you can boost your own trajectory, or are you interested in strategies to expand your professional network?

 

Satisfaction Screener – 9 Items
| 1.00 = Yes | 0.50 = SoSo | 0.00 = No
(*) After Ted was released from the hospital




Why have someone self-assess?

Self-assessment is a vital tool for personal and professional development that boosts self-awareness, fosters accountability, and encourages critical reflection on performance. By identifying strengths and weaknesses, individuals can set targeted goals, improve, and align their career paths with their capabilities.

 

Substance Use Disorder (SUD)

20231203-SU-Alternate Format

Relapse Prevention Workbook (129 pages)
[20260823-SU - LINK CHECK FAILS]
https://www.scribd.com/document/494157280/Relapse-Prevention-Workbook
Bradley A. Hedges, Ph.D., LPCC (Psychologist)
624 East Main Street, Lancaster, Ohio 43130
(740) 687-0042
bradhedges@mopsohio.com
https://www.psychologytoday.com/us/therapists/bradley-hedges-lancaster-oh/918911

 

Date on document - 03/30/2012




Promotion – Cognitive Behavioral Therapy Workbook

The Anxiety and Phobia Workbook by Edmund J. Bourne, PhD, is a classic, best-selling self-help guide based on cognitive behavioral therapy (CBT) techniques.

Key Features of the Workbook

Practical Exercises:

Includes step-by-step guidelines, self-assessments, and worksheets to manage symptoms.

Addressed Conditions: Focuses on panic disorders, agoraphobia, generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and specific phobias.

Core Techniques:

Teaches relaxation and breathing methods, exposure therapy, mindfulness, and ways to stop negative self-talk.

Latest Updates:

The 8th edition includes modern guidance on health anxiety, climate anxiety, and coping with future uncertainty.

If you'd like, let me know:

What specific type of anxiety you are hoping to manage

Whether you prefer a physical book, digital ebook, or audiobook format

I can help you find more details or specific coping strategies.


Content of Bourne Workbook

The Anxiety and Phobia Workbook by Edmund J. Bourne, PhD, is organized into comprehensive chapters covering the nature of anxiety, physical and mental tools for recovery, lifestyle changes, and specific disorders.

Core Contents and Structure

Understanding Anxiety & Causes:

Covers basic descriptions of panic disorders, agoraphobia, generalized anxiety disorder (GAD), social anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD), alongside neurobiological and biological causes.

Calming Mind and Body:

Teaches relaxation, abdominal breathing, and strategies for coping with and stopping panic attacks.

Cognitive Behavioral Techniques (CBT):

Focuses on replacing fearful self-talk with constructive statements and challenging mistaken core beliefs using affirmations and cognitive restructuring.

Exposure & Mindfulness:

Explains modern exposure therapy approaches for phobias and incorporates mindfulness meditation to manage worry.

Lifestyle, Nutrition, and Medication:

Offers guidelines on exercise, nutrition, over-the-counter supplements, and an overview of psychiatric medications.

Advanced Topics & Future Outlook:

Recent editions include chapters addressing personality traits, self-esteem, assertiveness, health anxiety, climate anxiety, and facing a future of increasing societal stress.


What does CBT do for you?

Cognitive behavioral therapy (CBT) helps you identify and change unhelpful thought patterns and behaviors to manage emotional and physical challenges.

Mental Health Conditions

CBT is a primary treatment for many psychological concerns, including:

  • Anxiety and phobias, including panic attacks, social anxiety, and generalized anxiety
  • Depression, including postnatal depression
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Eating disorders like anorexia and bulimia
  • Substance use disorders and addictions
  • Attention-deficit/hyperactivity disorder (ADHD) for coping and executive functioning
  • Personality disorders and bipolar disorder (often alongside medication)
  • Physical Health and Daily Challenges
  • CBT also provides practical coping tools for physical symptoms and life stressors, such as:
  • Chronic pain, fibromyalgia, and fatigue
  • Insomnia and sleep difficulties
  • Irritable bowel syndrome (IBS)
  • Everyday stress, anger, and low self-esteem
  • Life transitions, such as grief, divorce, or relationship conflicts

Learn more about the process from the Cleveland Clinic CBT Guide or check clinical overviews at Mayo Clinic.

 

FYI – AI - If you are looking for support, would you like to know how to find a qualified CBT therapist or learn more about what a typical session looks like?


Promotion - The Adolescent Relapse Prevention Planner

by Jennifer Bruha (Author)  Format: Paperback 4.7 out of 5 stars (16 ratings)

2013 International Book Awards Winner in Psychology/Mental Health (http://www.prweb.com/)

Substance abuse continues to be a problem in society, particularly among adolescents, who are exposed at younger ages to new and stronger drugs with higher addictive potential and greater availability. In response, award-winning teen addictions clinician and research expert Dr. Jennifer Bruha has created an insightful and innovative new workbook that helps counselors, parents and adolescents themselves deal with the challenges of teen addiction and craft a realistic plan for change.

The Adolescent Relapse Prevention Planner contains a variety of educational information, discussion topics and exercises around substance abuse that can be used both for individuals and groups. The writing tone, as well as the structure of the exercises, are geared to the teen level; the entire process is designed to be intriguing, thought-provoking, psycho-educational and even fun - making treatment and the recovery process more personally empowering, manageable and more achievable.

Bruha addresses recovery from addiction through the stages of change, from overcoming denial and acknowledging that they have a problem with substance abuse; learning more about drugs and exploring the short- and long-term consequences; examining ways to quit, and how to set up structures to prevent relapse; and maintaining a healthy lifestyle every day, then every week and every month.

The Adolescent Relapse Prevention Planner offers several unique components not available in other recovery literature, including:

Exercises and discussion topics at the end of each section that can be adapted for individuals or groups

Drug education, including the short- and long-term health effects of stimulants, depressants and hallucinogens The Adolescent Relapse Prevention

Examples and stories using real-life teen situations such as peer pressure, relationships, emotions, impulsiveness and honest communication

Family and genetics issues in substance abuse and addiction, including a section on making a family tree to identify family system patterns in substance abuse, mental health problems and trauma

Graphic of the cycle of addiction which clearly illustrates the need to step out of self-defeating behaviors and relationships

Self-care, they key to creating real change; including discussions and exercises on mindfulness (a burgeoning topic in psychology and addiction research)

 

"In this high-stress world, where temptations are everywhere. . . adolescents search for that quick fix to escape from reality," Bruha writes in the book's introduction. "Unfortunately for many, that desire for a quick fix leads to substance abuse and even addiction, which impacts puberty and adolescent development physically, psychologically and emotionally. This presents unique challenges in treatment and recovery. This workbook addresses the challenges adolescents face in their own recovery, regardless of where they fit in the stages of change process."


What was going on in 2012?

Recovery Value & A year of Catastrophic Loss

Started living in a shared room & ended in a different RASR







Was I destined to face hardship my whole life?

No. You were not destined to face hardship your whole life.

While life can bring intense periods of struggle, destiny is not a fixed script condemning you to permanent suffering. Hardship is a season, not your final destination.

Why Hardship Isn't Permanent

Circumstances shift.

Life moves in cycles, and difficult phases eventually lose their momentum.

You adapt.

Human beings possess immense psychological resilience to navigate and overcome adversity.

Agency exists.

You retain the power to make choices that alter your current trajectory.

Growth happens.

Past pain often builds the exact boundary-setting and problem-solving skills needed for future peace.

Moving Forward

Audit your energy.

Identify what you can control today and release what you cannot.

Change variables.

Small, daily shifts in routine or environment can break stagnation.

Seek support.

Shared burdens lose their weight when you connect with trusted people or professionals.

 

FYI – AI - To help explore this further, tell me: Are you dealing with a specific area of life right now (like relationships, career, or health)? Are you looking for emotional validation or practical strategies to change your situation? Let me know how you would like to proceed.

 


Neurologic Processes



 
Appendix – Transcripts for Keith E Torkelson, BS