Seasons Center undergoing shifts in programs, focus

(Photo by Kris Todd) Changes to programs and services offered by staff at Seasons Center for Community Mental Health offices in Rock Rapids, Sibley, Spirit Lake, Estherville, Emmetsburg, Storm Lake, Sheldon and Spencer are under way. Clinical Director Char Nissen, front row from left, along with current center interns Alicia Gamache, Penny Nordstrom, Laura Konkle-King and Nikki Van Ginkle are among the staff taking part in implementing the variations.

Daily Reporter Staff

Staff at Seasons Center for Community Mental Health are finding themselves driving along a path laid out for them by state officials. They're doing so, in part, with help and additional insights being offered from a handful of graduate students interning in the center's offices located throughout northwest Iowa.

Part of this mandated drive is based upon the fact that Iowa was one of 12 states to receive failing grades in regard to its infrastructure, information access, services and recovery supports in a 2006 "Grading the States" score card issued by the National Alliance for the Mentally Ill (NAMI). In an effort to correct this, Char Nissen, Seasons Center's clinical director in Spencer, reported a majority of staff members are diligently working to shift their focus toward meeting the needs of individuals they encounter on a daily basis through the implementation of evidence-based practices and co-occurring treatment strategies.

"We are running to catch up. We were way out ahead when I first started in the late 70s, early 80s - and other states were running to catch up to us," Nissen said. "Well, we just kind of rested on our laurels (as a state), and they passed us. So now, we're scurrying to catch up."

Specific programs and processes being revamped throughout the eight-county area are supported by federal block grant funds. Nissen also mentioned that she heard it articulated during a national convention last year that Iowa almost did not receive such funding last year because of its failing marks by NAMI.

"It's not going to happen again unless we really get our act together," Nissen warned of future health services-related block grant funding opportunities. "So this is serious - and we'll do it."

Another force influencing the change is Dr. Allen Parks, the appointed director of the Division of Mental Health and Disability Services. The new division was established within the Iowa Department of Human Services during the 2006 legislative session. Its leader, a clinical psychologist by training, is advocating for mental health workers to move forward in two ways.

"One is that we will treat co-occurring disorders," Nissen explained. "Co-occurring in this realm are people who have a mental illness diagnosis and a substance abuse problem. The reason that's a challenge for us is because we've been loyal and cooperative with the Alcoholism and Drug Treatment Unit (ADTU) here in our area; we've been referring back and forth. But research has shown that if you do treatment in a back-and-forth way like that, ... there's no better outcome than if you hadn't had treatment at all. So now the effort will be to have sequential, or parallel, treatment."

Parks is pushing Iowa professionals one step further. He's also insisting a "no wrong door" policy be implemented. With this, no matter where a client visits, he or she would be able to receive treatment. According to Nissen, approximately two-thirds of Seasons Center therapists are going through an extensive training in order to not only lift their competencies, but also to augment their confidence in delivering addiction treatment.

"There will be a new licensing in Iowa for co-occurring treatment, and there will eventually be a co-occurring certification," she explained.

While Iowa facilities offering services, such as Seasons Center, are required to be capable of providing co-occurring treatment by June 30, 2008, they are also being mandated to implement more "evidence-based practices."

Introducing Seasons Center interns

Four women, who are observing and learning before they begin to officially see agency clients later this school year, are among those taking part in the changes. The graduate-level interns, in turn, are offering their specific expertise and pieces of knowledge to Seasons Center treatment staff.

"The reason we do this is we feel like people then have a connection to northwest Iowa and a commitment to this particular population and area of the world. And then, by working with us, hopefully that grows into a mutual commitment to each other for employment," Nissen said of the center's graduate student training program in place.

Three of the four women involved are currently seeking their master's in social work. Storm Lake native Alicia Gamache, who is based in the Spencer center, is seeking her master's in mental health counseling from Argosy University in Florida. After working in the community mental health arena for a few more years, possibly at Seasons Center in the co-occurring treatment area, Gamache indicated she'd like to eventually enter private practice.

Headquartered in the Spirit Lake and Estherville branch offices of Seasons Center, Penny Nordstrom is enrolled in the weekend master's program at Augsburg College. She returned to Spirit Lake four years ago. The former Sioux Falls at-home mother was looking to return to the field of social work. While Nordstrom recently said she appreciates the "general overview of counseling" Seasons Center is providing her, she also suggested that she'd like to eventually concentrate on becoming a family therapist. She's also contemplating geriatric social work.

Interns Nikki Van Ginkle and Laura Konkle-King are both enrolled at the University of Iowa. Both are expected to be spotted throughout Rock Rapids and Spirit Lake this month spearheading several community education efforts.

Van Ginkle, who is based in the Rock Rapids and Sheldon offices of Seasons Center, has already worked at an adolescent residential program at Hope Haven in Rock Valley, done in-home work with children and families in Sioux, Lyon and Plymouth counties, and served as a school liaison in Le Mars for the juvenile Department of Corrections. Her postgraduate goal is to become a therapist in the area.

Headquartered in the Sheldon and Spirit Lake branch offices, Konkle-King is also offering insights to Seasons Center staff she gained from her experiences of working with mentally retarded children in Massachusetts, as well as her present job serving as a peer support specialist at Hope Haven.

New block grant program emphases

Besides their new co-occurring treatment emphasis, which is currently in place, Seasons Center staff members are also earmarking some of their "adult block grant money" for a new dialectic behavior therapy (DBT) program, also already in place.

"For many, many years we've been doing cognitive-based therapies," Nissen said. "This is just a more defined approach to cognitive therapy. It's highly evidence-based and it's really out there on the forefront in regard to personality disorders, addictions, affective but depressive symptoms, eating disorders and the elderly. It's been proven, which is why we chose this particular approach, to begin broadening our scope of practice here at Seasons."

An example of how this will translate to patients is they will now attend a two-hour session on a weekly basis in order to learn a different way of viewing their problems and challenges.

Another block grant-funded segment, centered on older Iowans, is also being added to Seasons Center's emphases.

"Our purpose in that is to begin educating in places that older Iowans gather, to educate about mental health," Nissen explained. "...We want to begin screening even in the medical settings for depression. The ultimate goal, which won't happen this year, but we hope it will happen next year, is that in some of the medical clinics we will actually place a therapist to be available for half a day a week for appointments."

The clinical director continued, explaining that the approximately $29,000 allocated in block grant "adult money" to the center for these three focuses is expected to also cover training costs. Nissen also mentioned that the expertise-building demands placed upon Seasons Center and its staff had no extra funding attached from the previous fiscal year.

Another $29,000 in federal block grant funds received by Seasons Center will target a 16-week Adolescent Coping with Depression course.

In regard to the alterations people will notice because of these program and service changes, Nissen suggested the "first impact" will probably be witnessed in the area of Seasons Center staff now assessing for substance abuse as well as mental health issues.

"We'll continue to refer to ADTU, but we also are mandated to be capable to do that treatment here also," she said. "With the older Iowans, I think we'll start showing up more at the senior center and other places, just to be friendly, open and visible. The (Coping with Depression - Adolescent) one is pretty much what we do already in the schools, but it will be more defined. And (DBT) will broaden as it progresses. Right now, we're using it with a group called borderline personality disorder."