Jill Garroway - CEU Creations

You Matter: A Reflection for National Suicide Prevention Month

September 23, 2026 by Jill Garroway

Saturday morning, I headed out for my usual morning exercise, a five to six-mile walk/jog through the trails and paseos near my home.

It is a routine I enjoy. It gives me time to exercise, clear my head and explore the miles of trails that wind through our community.

But this particular Saturday was different.

As I made my way down one of the trails, I began noticing signs posted every 50 yards or so. Each offered a simple message of encouragement and affirmation.

“You matter,” “You are not alone,” “You are strong”

I actually stopped several times to take pictures of them. There was something powerful about encountering these messages one after another on an otherwise ordinary Saturday morning.

One of the signs I encountered on my morning jog along Herriman’s Trail of Hope.

I later learned that I had stumbled onto the Trail of Hope, a section of the Midas Creek Trail in Herriman, Utah, created with the involvement of students from Herriman High School’s Peer Leadership Team and Hope Squad. The effort grew out of a particularly difficult period in which the community had been deeply affected by student suicides. Students and community members came together to create a place centered not on loss, but on hope, connection and mental health support.

I found myself thinking about those signs long after I finished my walk.

Perhaps it affected me so strongly because suicide prevention is not simply an issue I know about professionally. For me, like far too many, it’s personal.

When the Issue Becomes Personal

Years ago, when my child was a young adolescent, our family found ourselves confronting this issue in a very personal and frightening way.

As a parent, there are few things more unsettling than realizing that your child may be struggling with something you cannot simply fix for them.

Parents spend so much of our children’s early lives solving problems. They fall down, we pick them up. Something breaks, we repair it. They are frightened, we reassure them.

Mental health does not always work that way.

Sometimes love alone is not enough. Sometimes good intentions are not enough. Sometimes a family needs someone with the training and experience to step into an incredibly difficult moment and help a young person, and the people who love them, find a path forward.

That experience changed the way I think about mental health care. It also changed the way I think about the people who provide it.

Today, I have the privilege of belonging to an organization whose mission is Helping Those Who Help Others. Through CE4Less, CEU Creations, AATBS, NurseCE4Less and the other organizations within Level Education Group, we support hundreds of thousands of nurses, social workers, counselors, psychologists, therapists, and other behavioral health professionals.

For me, that mission will never be an abstract corporate statement.

I know what it feels like to be the parent who needs you.

A simple message with an essential reminder: You are not alone.

The Need Remains Enormous

September is National Suicide Prevention Month – a time to increase awareness, encourage connection and remind people that suicide is preventable.

The scope of the challenge remains sobering. In 2024, 48,824 people in the United States died by suicide. The Centers for Disease Control and Prevention reports that suicide remains a leading cause of death in the United States and affects people across ages, families and communities.

But statistics tell only part of the story.

Behind every number is a person, a son or daughter, a spouse, a parent, a friend, a student.

And surrounding each of those individuals are people desperately hoping to recognize the signs, find the right words, connect them with help and remind them that their story is not over.

That is one of many reasons why the work of mental and behavioral health professionals matters so much.

Sometimes Hope Looks Remarkably Ordinary

One thing struck me about the Trail of Hope: there was nothing complicated about the messages.

“You Matter,” “You are loved,” “You are not alone”

Yet those simple ideas are incredibly powerful.

The CDC emphasizes that suicide prevention extends far beyond intervening during a moment of crisis. Connection to family and community, access to health care, supportive environments and other protective factors can all help reduce suicide risk.

That means prevention happens in countless places.

It happens in a therapist’s office. It happens when a school counselor notices that a student has changed. It happens when a social worker asks one more question. It happens when a parent decides not to dismiss something as ‘just a phase’. It happens when a friend checks in again.

And sometimes it happens on a walking trail, where a teenager helped put up a sign reminding a complete stranger that they matter.

We may never know which conversation, which professional, which friend, or which sign, reaches someone at exactly the moment they need it.

That does not make those moments insignificant. It makes them essential.

You are strong.

You are not broken.

To Those Who Do This Work: Thank You

During National Suicide Prevention Month, much of the attention appropriately focuses on those who are struggling and on helping people recognize when someone may need support.

I also want to recognize the people who have chosen careers dedicated to providing that support.

To the nurses, counselors, psychologists, social workers, marriage and family therapists, addiction professionals and all other behavioral health providers reading this:

Thank You!

Thank you for sitting with people during moments most of us will never see.
Thank you for asking difficult questions.
Thank you for listening when the answers are not easy.
Thank you for continuing to learn, train and improve your skills.
Thank you for helping families navigate situations they never imagined they would face.
And thank you for doing work whose impact you may not always get to see.

There is a family somewhere that remembers the professional who helped their child.

I know, because mine is one of them.

Keep Putting Up the Signs

As I continued down the Trail of Hope Saturday morning, I found myself looking forward to seeing the next sign.

One message after another, one small reminder after another…

And I thought about how fitting that is for the work of suicide prevention.

There is no single sign, conversation, intervention or person capable of solving this challenge.

Instead, we keep showing up. We keep talking about mental health. We keep reducing stigma. We keep improving access to care. We keep training professionals. We keep checking on people. We keep reminding people that asking for help is an act of strength.

And we keep putting up signs, literal and figurative, that say:

“You matter,” “You are loved,” “There is help,” “There is hope”

To everyone doing this work, and to everyone who has ever needed that message, that is worth remembering…not only during National Suicide Prevention Month, but every day.

If you or someone you know needs emotional support or is experiencing a suicidal crisis, call or text 988, or chat through the 988 Suicide & Crisis Lifeline. Support is available 24/7.

You’re Licensed. Here’s Why Certification in Behavioral Health Is Next.

September 16, 2026 by Jill Garroway

Many therapists, counselors, and social workers reach a point a few years into their license where something feels off. Not burned out exactly; more like the work has flattened. The cases that used to challenge you don’t anymore, or you keep running into situations you wish you had better tools for.

That’s the gap certification fills.

The Field Moves, Even When Your Day to Day Doesn’t

Trauma-informed approaches, telehealth ethics, new frameworks for diagnosis and treatment. Your original training gave you a strong foundation, but the field keeps building on top of it. Certification programs get updated around current clinical practice, so they’re a fast way to add what’s newer to what you already know. That benefits your clients directly. More tools in your hands usually means more options for the person sitting across from you.

What Sets Certified Clinicians Apart

A license says you’re qualified to practice. Certification says you chose to specialize. Clients pick up on that. So do referral sources and employers, especially when they’re comparing candidates whose licenses look identical on paper.

If you run a private practice, a certification in an area like trauma or addiction does a lot of quiet marketing for you. People searching for a specialist find one.

It Opens Doors Before You Know They’re Closed

Some roles, supervisory positions, hospital contracts, and court-appointed work list certification as a requirement or a strong preference. Having it already means you can go after those opportunities the moment they show up, instead of starting the training after the fact. Certified clinicians in a specialty also tend to command higher rates, since it sets them apart in a market where a lot of practitioners look the same on paper.

Growth Is Part of What Keeps This Work Sustainable

Adding a new skill set changes how a caseload feels. New frameworks, new populations, new ways of thinking through a case, all of it brings back some of the energy that drew you to this field in the first place.

Building on What You Already Have

AATBS offers certification courses in Artificial Intelligence, Clinical Supervision, EMDR Basic Training, Group Counseling, Hypnosis & Hypnotherapy, Motivational Interviewing, and Telemental Health & Ethics. Most fold in CE credit at the same time, so it’s not extra hours on top of what you already need to maintain your license. Pick the one that fits where your caseload or your interests are already headed, and go deeper. Your license got you started. Certification is what you build on top of it.

Important Note About Certification
These certifications are educational credentials issued by AATBS and are not equivalent to state licensure, board certification, or certification in proprietary treatment modalities (e.g., EMDR, DBT, etc.). They are intended to recognize advanced continuing education and subject mastery, not to authorize clinical use of trademarked models or fulfill requirements set by other certifying bodies. Please refer to your professional board or the official certifying organization for guidance if you are seeking formal credentialing in a specific therapy or modality.

Goodbye, Dolly: Understanding and Treating Parasocial Grief

September 9, 2026 by Jill Garroway

When Dolly Parton died on August 25, the response was immediate and enormous. Within days, Google searches for her name had surged dramatically; 8 days after her death, “Dolly Parton” was still the top trending Google search, with search interest reportedly up 9,900%. Online, fans shared memories, tributes, photographs, favorite songs and stories about what Dolly had meant to them. Even a post published to her social media accounts after her death quickly filled with comments from grieving fans.

Most of those people never met Dolly Parton, much less knew her personally. Their grief, however, was still very real.

What is parasocial grief?

A parasocial relationship is a one-sided relationship with a public or media figure, someone who does not personally know us, but who may nevertheless become meaningful in our lives. Research suggests these relationships can provide some of the same benefits as social relationships, including comfort, connection, improved mood, and a sense of identification.

When that person dies, the resulting parasocial grief may include profound sadness, crying, emptiness, disbelief and even disruptions in eating, sleeping, working or other daily activities. For some, the loss can also feel tied to identity: a musician may represent adolescence, an actor may represent a beloved childhood character, or a public figure may represent values that helped someone understand who they wanted to be. And parasocial grief comes with a unique complication: The mourner may feel embarrassed that they’re grieving at all, and the people around them may reinforce that belief.

“But you didn’t even know them.”

“Grief policing” – judging who is allowed to grieve, how deeply, and for how long – can happen with any loss, but parasocial grief may be especially vulnerable to a particular form of it: questioning whether the mourner has any legitimate claim to grief in the first place. A client might already be asking themselves, “Why am I this upset about someone I never met? Is this ridiculous? What will my therapist think of me?” A dismissive response from another person can then reinforce the client’s own uncertainty, pushing them to grieve in private.

Social media has added another dimension by giving fans unprecedented opportunities to grieve together. After David Bowie’s death, for example, more than 4.3 million tweets appeared under #RIPDavidBowie, reaching 20,000 tweets per minute. While that can be a very positive outlet, those same platforms can expose grieving fans to public ridicule and criticism. The internet can simultaneously provide a community that validates the loss and an audience ready to tell someone that their grief is inappropriate.

Making room for the grief

For helping professionals, one of the most important interventions may also be one of the simplest: Take the loss seriously. Rather than focusing on whether a client personally knew the deceased, explore what that person represented. What memories are attached to their music, performances, or work? What needs did the relationship meet? What feels different now that they’re gone?

Many of the same approaches used with other forms of grief can be adapted for parasocial loss. One is psychologist J. William Worden’s Four Tasks of Mourning, a flexible framework that views grieving as an active, individual process rather than a predictable series of stages. The tasks involve:

accepting the reality of the loss,
processing the pain of grief,
adjusting to a world without the person who died, and
finding an enduring way to remember that person while continuing with life.

That last task can be especially meaningful in parasocial grief. A client does not have to stop listening to a beloved musician, watching an actor’s films or feeling connected to what a public figure represented in order to “move on.” Those activities can instead become part of an ongoing connection to the person’s influence.

None of this requires deciding whether a client “should” be grieving this much. The relationship may have been one-sided, but the comfort, identity, memories and meaning attached to it were not imaginary. When helping professionals recognize that distinction, clients don’t have to defend their right to grieve before they can begin processing the grief itself.

How to Choose an Unlimited CE Plan That Actually Meets Your Needs

September 2, 2026 by Jill Garroway

Imagine you’re considering buying an unlimited access pass to one of your local amusement parks. One park has roller coasters; another is strictly a water park. The value of “unlimited access” depends a lot on what you’re looking for.

For continuing education, an unlimited package can make license renewal simpler: pay one price, choose from a library of courses, and complete your CEs throughout the year. But different plans meet different needs, so before you choose, take a closer look at your renewal requirements, how you prefer to learn, what the plan actually offers, and what you’ll realistically be able to use.

Start With Your License Renewal Requirements

Before even looking at options, start with the most important question: What do you actually need for your next renewal? Check your licensing board’s current requirements, including:

Your total number of required CE hours
Required topics, such as ethics or suicide prevention
Limits or requirements related to self-study, asynchronous, live, or synchronous education
Any special requirements related to supervision or your area of practice
Your renewal deadline

Requirements vary considerably by profession and jurisdiction, so don’t assume that every course (or every learning format) will count toward your license. Once you know exactly what you need, you can compare unlimited CE options based on how well they actually meet those requirements.

Course Library – Bigger Isn’t Necessarily Better

A catalog of 1,000 courses isn’t especially useful if only a few of them apply to your profession, interests, or licensing requirements. Explore the catalog itself:

Are there plenty of topics relevant to your work?
Are new courses added regularly?
Can you find required subjects as well as topics you’re genuinely interested in learning more about?

The goal isn’t to find the biggest library – it’s to find one you’ll actually use.

Take a Close Look at Livestream CE

This is one area where the limits of unlimited really come into play.

A subscription may provide unlimited access to a course library with extremely limited (or even nonexistent) livestream programs. If synchronous education is part of your requirements, limited livestream availability could mean paying for additional courses elsewhere – or discovering too late that the dates you need aren’t available before your renewal deadline.

Before subscribing, look at the provider’s actual upcoming livestream calendar. Consider:

How many livestream hours are available?
How frequently are programs scheduled?
Are they available consistently throughout the year?
Are there enough programs before your renewal deadline?
Do the topics apply to your profession and interests?

Even if your licensing board doesn’t require synchronous education, think about whether you value it as a learner. Livestream programs can provide opportunities to ask questions, participate in discussions and polls, hear perspectives from other professionals, and engage with an instructor in real time. For complex or evolving subjects such as ethics, trauma, suicide prevention, cultural competency, clinical practice, and emerging issues, that interaction can be particularly valuable.

Think About How CE Fits Into Your Life

The format that works best today may not be the one that works best next month.

Sometimes you may want to put a livestream training on your calendar and devote a few hours to learning with other professionals. At other times, you may have an hour between appointments or a quiet Saturday morning when an on-demand course makes more sense. Having access to multiple formats makes it easier to fit continuing education into your professional and personal life, rather than rearranging your life around your CE..

Consider Your Timeline

Your renewal date should also factor into your decision.

If you have a year to complete your remaining hours, a provider’s upcoming schedule may give you plenty of options. If your license expires in 6 weeks, the question becomes much more practical: Can you actually complete the hours and topics you need in time? Pay particular attention to anything you can’t simply complete on demand, such as required synchronous hours.

Compare What You’ll Actually Spend

Price matters, but compare the total cost of completing your requirements, not simply the subscription price.

A less expensive plan is a great choice if it provides everything you need, but if you’ll have to purchase additional livestream courses, required topics, or other CE separately, factor those expenses into your comparison. The same principle applies to a more expensive subscription: additional cost only represents better value if you’ll actually use what’s included.

Make the Choice Based on Your Needs

There isn’t one unlimited CE option that will be best for every professional. Before choosing yours, ask yourself: Can I complete the hours I need, in the formats I need, before my renewal deadline?

Then consider the rest of the picture:

Are there enough relevant topics?
Does the provider offer the kinds of learning experiences you prefer?
Will you have choices when your schedule changes?
And can you realistically complete most (ideally all) of your continuing education without purchasing additional courses elsewhere?

A little research before subscribing to a plan can make your CE easier to manage throughout your renewal cycle. Continuing education isn’t an amusement park, but it should be something you can enjoy, especially when you know that “unlimited” is giving you access to the education you actually need.

You Can’t Predict Everything: What the Research Says About Doing This Work Well

August 26, 2026 by Jill Garroway

If you’re a mental health provider, there’s a good chance you carry a quiet, specific fear that most clinicians rarely say out loud: What if I miss something? What if the thing I didn’t catch is the thing that mattered? That fear deserves to be taken seriously and so does the research on where it comes from, what it distorts, and what it doesn’t actually say about your competence.

Hindsight makes the unpredictable look obvious

One of the most consistent findings in the clinical risk literature is hindsight bias: once an outcome is known, people, including trained psychiatrists, systematically overestimate how predictable it was beforehand. A study published in the Journal of the American Academy of Psychiatry and the Law found that clinicians reviewing case files after a bad outcome rated the risk as more foreseeable than clinicians reviewing the identical file without knowing what happened. That same body of research has found that simply telling an evaluator a patient went on to be violent makes them judge the treating clinician’s original decisions as less reasonable, even when nothing about those decisions actually changes.

This isn’t a character flaw in the people doing the judging. It’s how human cognition works under the weight of a known outcome. But it means that the internal replay so many clinicians do after a hard case, such as “The signs were right there, how did I not see it,” is running on a distorted instrument. The signs are only “right there” now, because now you know where to look.

It’s also worth saying plainly: the research on violence risk assessment consistently shows that prediction, even by experienced clinicians using validated tools, has real and well-documented limits. Studies have found that clinicians’ confidence in a risk assessment doesn’t reliably track its accuracy. That’s not a reason to stop assessing risk carefully. It’s a reason to stop expecting yourself to be a perfect instrument.

The legal standard was never “perfect”

Many clinicians hold themselves to an unspoken standard that no court or licensing board actually applies to them. Malpractice law is explicit on this point: it holds providers to a standard of reasonable care, not perfect care. That distinction was sharpened further in 2024, when the American Law Institute updated its Restatement of the Law governing medical malpractice to center negligence determinations on reasonable care rather than simply the customary practices of one’s peers. The standard a psychiatric or mental health provider is held to is what a reasonably prudent practitioner in similar circumstances would have done with the information available at the time, not the outcome that later became known, and not the theoretical best-case treatment with unlimited resources and hindsight.

Practically, that standard is built on things that are within your control: a documented and clinically sound risk assessment, appropriate consultation or referral when a case exceeds your setting’s capacity, adherence to your organization’s protocols, and decisions that a respected portion of your professional community would recognize as reasonable. It is not built on an expectation of never being wrong about a human being’s future behavior. No field of medicine holds its practitioners to that.

The toll this takes on you is real, and it’s common

There’s a name for what a lot of clinicians experience after a patient’s outcome goes badly, even one they had no part in causing: second victim phenomenon. It describes the guilt, intrusive replay, sleep disruption, and eroded confidence that can follow an adverse event. Estimates suggest roughly half of healthcare workers experience some version of this over the course of a career, and surveys of clinicians have found a troubling gap: a meaningful share report distressing work-related events in any given month, most say they’ve watched a colleague struggle with the same thing, but only a fifth feel they have adequate support available.

If you’ve ever left a hard case rattled, replaying old interactions, or quietly wondering if you’re cut out for this work, that reaction is not a sign you’re in the wrong field. It’s a documented, common response to doing emotionally weighty work in a system that doesn’t always build in enough support for the people doing it.

What actually builds confidence here

Lean on consultation and documentation as your actual safety net, not as paperwork. A well-reasoned, documented risk assessment is both good clinical practice and the concrete record of reasonable care if it’s ever questioned.

Notice when you’re doing a hindsight review on yourself, and name it. If you catch yourself reconstructing a past case with information you didn’t have at the time, that’s the bias at work, not evidence of a missed obvious sign.

Talk to peers. The research on second victim phenomenon is consistent that peer support is the intervention that helps most, and the one most clinicians say they don’t have enough of. A five-minute conversation with a colleague after a hard week counts.
Hold the standard you’re actually accountable to: Reasonable, informed, good-faith care, rather than the standard hindsight can make you feel like you should have met.

None of this is a case for complacency. Good clinicians keep sharpening their judgment precisely because the stakes are real. But sharpening judgment and carrying an impossible burden are two different things, and only one of them is asked of you. You do this work inside real limits: limits on what any human being can foresee, limits on the information available in the room, limits on what one provider can hold alone. Practicing well inside those limits, with sound judgment and the support of your peers, is not a lesser version of the job. It’s the job.

References

Hindsight Bias Among Psychiatrists, Journal of the American Academy of Psychiatry and the Law — jaapl.org/content/35/1/67
Examining Systemic and Interpersonal Bias in Violence Risk Assessments of Patients in Acute Psychiatric Care, Psychiatric Services, 2024 — psychiatryonline.org/doi/full/10.1176/appi.ps.20240108
Accuracy and Confidence in Clinical Assessment of Psychiatric Inpatients’ Risk of Violence, ScienceDirect — sciencedirect.com/science/article/abs/pii/S0160252798000326
Medical Malpractice: Coming Changes and Their Impact on Psychiatry, Psychiatric Services, 2025 — pubmed.ncbi.nlm.nih.gov/40432374
Second Victim Phenomenon: Impact on Healthcare Professionals, Organizational Responsibility and Support Strategies, PMC, 2025 — pmc.ncbi.nlm.nih.gov/articles/PMC12283087
Second Victim Phenomenon’s Impact in Male and Female Healthcare Workers: A Scoping Review, International Journal for Quality in Health Care, 2025 — academic.oup.com/intqhc/article/37/2/mzaf034
Peer Support Targeting the Second Victim Phenomenon: Implementation and Outcomes, PMC, 2025 — pmc.ncbi.nlm.nih.gov/articles/PMC11821368

When Family Time Feels Like One More Thing on the To-Do List

August 19, 2026 by Jill Garroway

August is Family Fun Month, a great reminder to make time for laughter, play, and connection. But for many of the families helping professionals serve, “have more family fun” may sound easier said than done. Between work, school, caregiving responsibilities, financial stress, household tasks, and everything else competing for attention, planning special family activities can quickly become one more item on an already crowded to-do list.

The good news? Meaningful family connection doesn’t have to involve an elaborate outing, an expensive activity, or hours of carefully planned “quality time.” Sometimes, simple moments of play and creativity can provide valuable opportunities for families to connect.

Why Play Matters

For children and adolescents, play of any type is more than entertainment. It is a natural way to communicate, explore experiences, express feelings, and develop coping skills. Creative activities involving art, music, movement, and play can also offer ways to communicate when finding the right words is difficult.

Helping professionals can encourage parents and caregivers to think less about creating the perfect family activity and more about creating opportunities to be present together. That might mean coloring while talking, playing a favorite board game, taking a walk, turning on music and dancing in the living room, or creating something together. What matters is not how impressive the activity is but the opportunity it provides for shared attention and interaction.

Put Connection Into the Activity

A familiar activity can also become an opportunity to learn more about one another. For example, families might play a simple game while occasionally answering questions such as:

What is one of your favorite family memories?
What is something you appreciate about someone in our family?
What is something you’re looking forward to doing together?
What is something you would like our family to work on?

Music offers another easy avenue for connection. Family members can take turns choosing favorite songs, create a shared playlist, have a dance party, or make simple rhythms together using whatever they have available. Taking turns leading and following can add another element of listening and cooperation.

Art can be equally approachable. Family members could trace their hands on paper, write their names in the center, and add positive qualities they see in one another. Even sitting together and coloring can provide a lower-pressure setting for conversation.

Make Connection Fit Into Real Life

For families who already feel stretched thin, even a simple activity can sound like one more obligation. Helping professionals can help parents and caregivers look for ways to build connection into the life they already have rather than asking, “Where can we find another free hour?”

Start by looking for small pockets of time that already exist. A car ride, the walk to the bus stop, ten minutes before bedtime, dinner preparation, or the time between getting home and starting homework may offer opportunities for connection without adding another event to the calendar. A favorite song in the car, a quick card game after dinner, or drawing together for ten minutes all count.

It can also help to attach connection to an existing routine. Families might choose Friday night for a 15-minute game, make one evening’s dinner preparation the time when everyone takes turns choosing music, or take a short walk after Sunday lunch. When an activity has a predictable place in the family’s routine, caregivers don’t have to continually find time or make a new plan.

Encourage families to start smaller than they think they should. Ten focused minutes may be much more realistic than setting aside an entire evening – and easier to repeat. A small activity that happens regularly can provide more opportunities for connection than an ambitious plan that rarely makes it onto the calendar.

When working with your clients, explore questions such as:

When are you already together during the week?
When does your family feel least rushed?
Is there something you already enjoy that you could do together more intentionally?
What would feel manageable enough to try once this week?

Finally, remind caregivers that this isn’t another standard they have to meet perfectly. Routines will get interrupted, children won’t always be interested, and some weeks will simply be busier than others. The goal is not to maintain a flawless family-fun schedule – it’s to notice the opportunities for connection that are already available and, when possible, make a little more room for them.

Aerosols and Antihistamines: Adolescent Substance Abuse and Everyday Products

August 12, 2026 by Jill Garroway

When parents worry about adolescent substance use, they may picture marijuana, alcohol, prescription painkillers, or illegal drugs. They probably aren’t thinking about the can of whipped cream in the refrigerator, the aerosol deodorant in the bathroom, or the vanilla extract in the kitchen cabinet…but maybe they should be.

Teenagers have experimented with an astonishing range of ordinary household products in search of a high, from aerosol sprays, computer-cleaning products, gasoline, glue, and nail polish remover to mouthwash, hand sanitizer, cooking extracts, and even spices such as nutmeg. Part of the danger is precisely how ordinary these products seem. A teenager who would never consider trying an illegal drug may be much less cautious about something purchased at a grocery store. And unlike alcohol or illegal substances, there’s no dealer, fake ID, or suspicious purchase involved; the substance is already in the home.

Social Media Turns Experimentation Into a Trend

Thanks to social media, risky behavior that might once have spread among a few friends can now reach thousands of adolescents almost instantly, and it’s often packaged as a funny challenge rather than substance misuse.

Consider “chroming,” a term associated with inhaling fumes from aerosol products and other volatile substances to get high. Inhalants like these can produce a rapid feeling of euphoria, dizziness, or lightheadedness, but the effect is short-lived, which can encourage repeated use. Meanwhile, the chemicals can interfere with oxygen reaching the brain, affect the heart and other organs, and cause unconsciousness or death. Worst of all, sometimes it only takes one time for the consequences to be fatal.

Another example is the social media-driven “Benadryl Challenge,” which encouraged participants to take excessive amounts of the over-the-counter antihistamine diphenhydramine in an attempt to hallucinate. As the saying goes, “poison is in the dose” – large doses of diphenhydramine can cause serious heart problems, seizures, coma, and death. The FDA issued a warning after reports of teenagers requiring emergency treatment or dying after participating in the challenge.

The lesson for teens is simple but important: Something doesn’t become safe just because it’s legal, familiar, or sitting in your bathroom cabinet.

What Should Parents and Clinicians Look For?

Some warning signs of adolescent substance use are generic to all substances: sudden personality changes, disrupted sleep, declining grades, withdrawal from activities, secretive behavior, new friend groups, or neglect of responsibilities. Household-product misuse, however, may leave some unusual clues. These can include chemical smells on a teen’s clothing or breath; irritation around the mouth or nose; unexplained dizziness, nausea, confusion, or headaches; and aerosol cans, medicines, solvents, or other products disappearing unusually quickly.

The context matters. One empty can of computer duster isn’t proof that a teenager is using inhalants. Repeated missing products accompanied by behavioral or physical changes, however, deserve attention.

Mental Health Professionals Can Help Families Look Deeper

For clinicians, one of the most important steps may be simply asking the right questions. A teenager who answers “no” when asked whether they use drugs may be telling the truth as they understand it. They may not think inhaling an aerosol, taking too much cold medicine, or participating in an online challenge counts as “drug use.” Screening can therefore include direct, nonjudgmental questions about inhalants, over-the-counter medications, household products, and social media challenges.

It is equally important to ask what is happening underneath the behavior. Adolescents with substance use problems frequently struggle with depression, anxiety, trauma, impulsivity, or other mental health concerns. Experimentation may begin because of curiosity or peer pressure, but for some teens, substance use becomes a way to numb painful emotions or cope with problems they don’t know how to manage.

Approaches such as cognitive behavioral therapy and motivational interviewing can help adolescents recognize triggers, examine their choices, and develop healthier coping strategies. Family therapy can help parents respond with appropriate monitoring and boundaries while keeping communication open. That communication matters – families don’t need to turn their homes into locked fortresses, but they do need to recognize that prevention has changed.

Adolescents’ brains are sponges for information, no matter where it comes from. When peer groups, marketing, and social media are the loudest and most constant voices, it’s easy for teens to assume they’re trustworthy. That’s why mental health professionals and families need to be proactive about highlighting more than just illegal drugs and alcohol – because the most dangerous substance just may be sitting under the kitchen sink.

Resource Spotlight: The H.R.1 Hub from the National Council for Mental Wellbeing

August 4, 2026 by Jill Garroway

As behavioral health professionals, you’re constantly balancing client care, documentation, continuing education, and your own wellbeing. Few of us have time to keep up with every new toolkit, guide, or downloadable resource that becomes available. That’s why CEU Creations occasionally likes to highlight resources we believe are genuinely worth bookmarking.

This week, we’re focusing on the topic of H.R.1, which introduces significant changes to Medicaid funding, eligibility, and coverage. Key provisions include:

more frequent eligibility reviews,
work or community-engagement requirements for many adults in the Medicaid expansion population,
reduced retroactive coverage, and
limits on certain state Medicaid funding mechanisms.

The law also establishes a $50 billion Rural Health Transformation Program to support rural health providers affected by these changes. Although mental health and substance use disorder services are exempt from some new cost-sharing requirements, the broader changes may still affect access to coverage and the organizations that provide behavioral health care.

The National Council for Mental Wellbeing has assembled a free online H.R.1 resource hub. Rather than searching across multiple websites, you’ll find articles, guides, webinars, toolkits, and practical resources organized in one place. Some areas you may find particularly helpful include:

An implementation timeline
General implementation support
Information on the Rural Health Transformation Program (RHTP)
Work requirements
Eligibility redeterminations
Provider taxes and SDPs
FAQs

CEU Creations’ goal is to help you stay current through high-quality continuing education. We also recognize that learning doesn’t stop when a course ends. Having trusted organizations you can turn to for current information is an important part of lifelong professional development.

If you’re looking for a reliable collection of free behavioral health resources, we encourage you to explore the National Council’s hub and bookmark it for future reference.

Gut Feeling: How Epigenetics and Holistic Nutrition Can Support Healing

July 29, 2026 by Jill Garroway

We often think of nutrition and mental health as two separate conversations — one focuses on what we eat, while the other focuses on our thoughts, emotions, and experiences. Emerging research suggests the relationship is far more interconnected. While our genes provide the blueprint, our environment (including chronic stress, trauma, sleep, movement, relationships, and nutrition) can influence how those genes are expressed. This is where epigenetics and holistic nutrition intersect, offering helping professionals another lens through which to understand healing.

More Than Your Genes: What Is Epigenetics?

Epigenetics is the study of how environmental and lifestyle factors affect gene expression without changing the DNA itself. In other words, while we can’t rewrite our genetic code, our experiences can influence which genes are more or less active over time.

Instead of insisting that “biology is destiny,” epigenetics highlights the body’s remarkable capacity for adaptation and resilience. Researchers continue to explore how chronic stress and trauma affect the body’s stress-response systems, inflammation, and overall health. Encouragingly, epigenetic changes are dynamic: positive lifestyle changes, supportive relationships, effective therapy, and healthy habits may all contribute to healthier patterns of gene expression.

Holistic Nutrition: Looking Beyond the Plate

Traditional nutrition often focuses on nutrients, calories, and biochemical processes. Holistic nutrition takes a broader view, recognizing that food is only one piece of overall well-being.

A holistic approach considers how digestion, stress, sleep, movement, emotions, and individual differences all influence health. Instead of assuming every client benefits from the same diet, it acknowledges that nutritional needs vary based on genetics, lifestyle, environment, and personal circumstances. Food becomes more than fuel; it becomes one component of an interconnected system that supports physical and emotional health.

The Missing Link: Gut Microbiota, Stress, and Mental Health

One of the most fascinating connections between epigenetics and holistic nutrition is found in the gut microbiota, the trillions of bacteria, fungi, and other microorganisms that live in the digestive tract. These microbes don’t simply help digest food, they also communicate constantly with the brain through what’s known as the gut-brain axis, a network involving the nervous, immune, hormonal, and metabolic systems. The vagus nerve serves as one of the primary communication pathways, carrying signals between the gut and brain throughout the day.

This communication has meaningful implications for both physical and mental health. Gut microbes help produce or regulate neurotransmitters including serotonin, GABA, and dopamine, all of which play important roles in mood, motivation, sleep, and emotional regulation. In fact, about 95% of the body’s serotonin is produced in the gut lining, helping explain why digestive issues and mood disorders so often occur together. When the gut microbiome becomes imbalanced, a condition known as dysbiosis, clients may experience anxiety, depression, brain fog, irritability, or difficulty managing stress alongside gastrointestinal symptoms.

Chronic stress can make this cycle even more difficult to break. Elevated cortisol levels can weaken the intestinal lining, reduce beneficial bacteria, and increase intestinal permeability (“leaky gut”), allowing inflammatory molecules to enter the bloodstream and influence brain function. Rather than existing as separate issues, emotional distress, inflammation, and digestive symptoms often reinforce one another through this gut-brain feedback loop.

This is where holistic nutrition complements an epigenetic perspective. While nutrition alone cannot erase trauma or eliminate chronic stress, dietary patterns that support a healthy microbiome may also help support neurotransmitter production, reduce inflammation, and improve the body’s resilience to stress. Together, these approaches reinforce the idea that caring for mental health also means caring for the biological systems that support it.

Supporting Clients Through a Whole-Person Lens

Helping professionals don’t need to become registered dietitians to recognize when nutrition may be influencing a client’s overall well-being. Instead, they can broaden their assessment to include factors that are often overlooked.

For example, clients who present with both emotional symptoms and digestive complaints may benefit from gentle questions about sleep, eating habits, digestive health, recent antibiotic use, or whether they notice changes in mood after eating certain foods. These conversations stay well within scope while helping identify when collaboration with a physician or registered dietitian may be appropriate.

Just as importantly, holistic nutrition emphasizes small, sustainable changes rather than restrictive diets. Encouraging clients to incorporate more fiber-rich foods, fermented foods, or other nutrient-dense whole foods may help support a healthy gut microbiome over time. The goal isn’t to prescribe a specific eating plan but to recognize that nutrition, lifestyle, stress, and emotional health are interconnected pieces of the same puzzle.

Beyond the Individual: Understanding Intergenerational Trauma in BIPOC Communities

July 22, 2026 by Jill Garroway

Trauma is a universal human experience. Whether it stems from a single life-altering event or ongoing adversity, trauma can affect the way people think, feel, and respond to the world around them. Our bodies are remarkably adaptive, activating familiar survival responses (fight, flight, freeze, or fawn) when faced with danger.

Most of the time, those systems return to baseline once the threat has passed. But not all trauma is experienced – or carried – in the same way.

For many individuals, trauma is not limited to a single moment in time. It can be shaped by history, community, and generations of lived experience, creating patterns that extend far beyond one person’s lifetime.

What Is Intergenerational Trauma?

Intergenerational trauma refers to the transmission of trauma’s effects from one generation to the next. While researchers continue to study exactly how this occurs, evidence suggests that trauma may be passed down through a combination of biological stress responses, family dynamics, learned behaviors, and cultural narratives.

Parents and caregivers inevitably teach children how to navigate the world. Sometimes those lessons are empowering; other times, they are protective responses born from hardship: warnings about who can be trusted, how to stay safe, or what dangers to expect. Even when those messages come from love, they are often rooted in experiences of trauma.

This doesn’t mean trauma defines future generations. Rather, it reminds us that our personal stories are often connected to much larger historical ones.

Why It Matters in BIPOC Communities

Intergenerational trauma can affect anyone, but it carries particular significance for many Black, Indigenous, and People of Color (BIPOC) communities because of the cumulative impact of systemic racism, discrimination, forced displacement, inequitable policies, and other historical injustices.

These experiences are not confined to history books. Housing inequities, disparities in healthcare, educational barriers, economic inequality, and disproportionate exposure to violence continue to shape daily life for many communities. When those stressors persist across decades, the nervous system may remain on heightened alert, making it more difficult to experience lasting safety.

In today’s world, trauma can also be reinforced through repeated exposure to images and stories of violence affecting people who share one’s identity. News coverage and social media can create a constant stream of reminders that reactivate fear, grief, and vigilance, even when the events occur hundreds of miles away.

Understanding this broader context helps explain why a person’s response to trauma may not always fit neatly into a single diagnosis or event. Sometimes what appears to be an isolated reaction is part of a much larger story.

What This Means for Helping Professionals

For clinicians and other helping professionals, recognizing intergenerational trauma begins with curiosity rather than assumptions.
Trauma-informed care asks a simple but powerful question: What happened to this person? instead of What’s wrong with this person?

Creating safety is often the first and most important intervention. Before meaningful healing can occur, clients need environments where they feel physically, emotionally, and psychologically secure. That may involve asking permission before discussing difficult topics, validating lived experiences without minimizing them, and acknowledging the role that systemic factors can play in a person’s well-being.

It’s equally important to avoid rushing toward reassurance or “fixing” painful experiences. Validation communicates that clients have been heard, a foundational step in building trust and fostering resilience.

Growing as Trauma-Informed Professionals

Intergenerational trauma is only one form of trauma, but understanding it broadens our ability to provide compassionate, culturally responsive care. Every client brings a unique history into the therapeutic relationship, and those histories are often shaped by experiences far larger than any one individual.

The more we learn about the many ways trauma develops and manifests, the better equipped we become to recognize its impact, build meaningful therapeutic relationships, and support healing that honors each person’s lived experience. For helping professionals, that knowledge isn’t simply another clinical skill, it’s an opportunity to meet clients with greater empathy, understanding, and effectiveness.

Georgia License Renewal Is Open for Counselors, Social Workers, and Marriage & Family Therapists

July 8, 2026 by Jill Garroway

Note: CEU Creations is an independent continuing education provider. We are not affiliated with Propelus CE Broker, the Georgia licensing board, or any state licensing board, and we do not have authority over state licensing requirements, systems, or renewal processes.

Click here to view our accreditations.

The Georgia Composite Board’s current renewal period opened July 1, 2026, and licenses expire September 30, 2026. The late renewal period begins October 1, 2026, and runs through November 15, 2026, according to the Georgia Secretary of State’s Professional Licensing Boards Division.

If you received a renewal email from the Georgia Secretary of State, now is the time to create your CE Broker account to log your continuing education, and also log into the Georgia Online Application Licensing System, known as GOALS, and complete your renewal. The online process only takes a few minutes and includes updating your contact information, answering renewal questions, paying the renewal fee, verifying renewal, and printing your updated license.

What Changed?

There are two major changes:

CE Broker: You must now submit your continuing competency documentation through CE Broker.
GA GOALS: Renewals are now being completed through the GOALS portal, Georgia’s online licensing system. The Georgia Secretary of State’s office notes that GOALS is now used for professional licensing services, including renewal applications, account verification, contact updates, and license printing.

This means licensees should not wait until the last minute. You may need time to verify your account, confirm your login information, update your address or email, and resolve any portal issues before the renewal deadline.

Continuing Education Documentation: CE Broker

You need to submit your continuing education documentation through CE Broker, which offers a free basic plan that can be used by most people. You will NOT have to upload all certificates. It does ask for all Ethics certificates to be uploaded as well as randomly chosen CEs you submit.

To be prepared, have all your certificates downloaded as PDF files ready for upload if asked. Also, you will use information from your certificates to enter for each credit. Certificates will be uploaded under one of the required categories of Ethics, Core or Related.

For future renewals, you can document your continuing education in CE Broker at any time of the year; you do not have to wait until the renewal period for GOALS.

Renewal Checklist

Create a GA GOALS account if you have not already (https://sos.ga.gov/goals).
Create a CE Broker account (https://cebroker.com/) and upload your CEs.
Return to GA GOALS and log in.
Click the License Renewal link.
If needed, update your mailing address, physical address, phone number, and email address.
Answer all renewal questions.
Pay the renewal fee.
Print your payment receipt.
Verify your renewal online.
Once approved, print your renewed license.

Don’t Wait!

It is strongly advised that you RENEW NOW and do not wait until the deadline. Logging in and completing the steps early is the best way to avoid additional delay & late fees.

Renewal notices are helpful reminders, but Georgia Board rules state that responsibility for license renewal remains with the license holder. For this board, licenses expire September 30 of even-numbered years, and late renewal may require an additional penalty fee.

The best approach is to renew early, confirm your renewal was processed, and save copies of your receipt, license, and CE records.

Need Help?

Questions about the licensing portal or renewal process should be directed to the Georgia Board of Professional Counselors, Social Workers and Marriage & Family Therapists.

Questions about the CE Broker application should be directed to Propelus CE Broker.

Questions about CEU Creations courses or certificates? We’re happy to help – email us at [email protected].

Click here to view CEU Creations’ accreditations.

FAQ

Why don’t your certificates say “core” or “related”?

“Core” and “related” are Georgia-specific licensing terms; our certificates are designed to meet the requirements of national accrediting bodies such as ASWB, NBCC, and APA, whose standards apply across multiple states. Because accreditation requirements are national rather than state-specific, our certificates reflect contact hours and applicable accreditation approvals, but they do not classify hours according to individual state licensing regulations.

For Georgia licensees, the Georgia Composite Board defines core and related hours based on the content of the course and the profession in which you are licensed, not on wording printed on the certificate. According to the State of Georgia Rules and Regulations:

Core hours are “continuing education hours acquired in activities in the specialty in which the license is held,” e.g., social work for social workers or professional counseling for counselors.
Related hours are “continuing education hours acquired in activities in a specialty other than the one in which the license is held or in the allied professions of psychiatry, psychiatric nursing or psychology.”

All of CEU Creations courses are approved by ASWB and/or NBCC, and many also carry APA or other professional approvals, depending on the course. When reporting your continuing education, simply apply the Georgia Board’s definitions to determine whether a course should be reported as core or related based on its content and the approvals it carries.

Click here to view CEU Creations’ accreditations.

What type of live event are your courses?

Based on the definitions listed on the State of Georgia Rules and Regulations website, our livestream courses would be considered webinars.

Are CEU Creations courses accepted in Georgia for social workers, counselors, or marriage and family therapists?

According to the State of Georgia Rules and Regulations, Georgia accepts courses approved by professional associations in the specialties of professional counseling, social work, marriage and family therapy. All CEU Creations courses are approved by ASWB (social work) and NBCC (counselors), which are professional associations.

*Please note that for MFT CORE hours, the Georgia board site says, “A professional association in the specialty in which the license is held” and it is unclear if NBCC is considered a professional association for Marriage and Family Therapists by the Georgia board. If you are concerned, please reach out to the state of Georgia Board of Professional Counselors, Social Workers and MFTs: Call center agents available at 404-424-9966 or email them at THIS LINK.

Click here to view CEU Creations’ accreditations.

Fireworks and Furbabies: How to Keep Your Four-Legged Family Members Safe This Fourth of July

July 1, 2026 by Jill Garroway

Anxiety and stress aren’t limited to humans; animals experience them too. With the Fourth of July coming up, we turn our attention to the four-legged family members, because for pets, the holiday can be one of the most frightening days of the year.

Animal shelters across the United States report a 30%–60% increase in lost pets between July 4 and July 6, and July 5 is consistently one of the busiest days of the year for stray dog intakes. Fireworks are one of the biggest reasons why otherwise well-behaved pets panic and run away. (American Animal Hospital Association [AAHA], 2024; Shelter Animals Count, 2025).

Is Your Pet Stressed?

Some signs of stress are obvious:

Trembling or shaking
Whining, barking, or yowling
Trying to hide
Pacing
Attempting to escape

But many other signs are just as important yet can be easily overlooked:

Excessive panting when it’s not hot
Lip licking or repeated yawning
Dilated pupils
Refusing treats or food
Becoming unusually clingy or unusually withdrawn
Restlessness or inability to settle

Cats, in particular, often respond by disappearing under furniture or into closets rather than vocalizing their fear. Because their stress can be quieter, it’s easy to assume they’re coping well when they’re actually experiencing significant anxiety.

The Safest Place Is Home

Veterinarians and animal welfare organizations overwhelmingly recommend keeping pets indoors during fireworks displays. Before the celebrations begin:

Walk dogs early in the day before neighborhood fireworks start.
Close windows, curtains, and blinds to reduce flashes and noise.
Turn on a television, fan, or calming music to help mask the sounds outside.
Create a quiet “safe space” with favorite blankets, toys, or a crate if your pet already sees it as a secure retreat.
Double-check that doors, gates, and windows are securely closed, especially if you’ll have guests coming and going.

Even pets that have never tried to escape before can bolt when startled by a loud explosion.

What If You Want to Bring Your Pet?

The simplest advice is: don’t. Public fireworks displays combine loud noises, crowds, unfamiliar smells, children running, dropped food, and flashing lights – all things that can overwhelm even a confident animal.

If you absolutely must bring your pet:

Keep them on a secure leash or in a well-ventilated carrier at all times.
Make sure they wear an ID tag with your current phone number.
Have them microchipped and verify that your contact information is up to date.
Bring fresh water and avoid crowded areas when possible.
Be prepared to leave immediately if your pet begins showing signs of stress.

Microchips are especially important because collars and harnesses can slip off during a panic. A microchip provides permanent identification that greatly improves the chances of being reunited if your pet gets lost (American Veterinary Medical Association [AVMA], n.d.).

“But My Pet Loves Fireworks!”

Some owners insist their dog sleeps through fireworks every year, or that their cat watches them from the window without concern. That certainly happens, but it’s worth asking: Are you sure?

Animals often express stress differently than humans expect. A dog sitting quietly may actually be frozen in fear. A cat watching the window may be hypervigilant rather than fascinated.

If your pet truly remains relaxed, that’s wonderful. Even then, it’s still wise to keep them securely contained, since a single unexpected blast or nearby firework can produce a very different reaction than in years past.

If You Find a Lost Pet During the Holiday

The same fireworks that frighten your own pet may send someone else’s running. If you come across a loose dog or cat, your first instinct may be to chase after it, but that can actually cause a frightened animal to run farther or into traffic. Instead:

Stay calm and avoid sudden movements.
If the animal seems approachable, speak softly and offer treats or water if you have them.
If it’s safe to do so, secure the pet with a leash or guide it into a fenced yard, garage, or other enclosed space until help arrives.
Check for an ID tag and call the owner immediately if contact information is available.
If there is no visible identification, take the pet to a veterinarian or animal shelter to be scanned for a microchip. Many will do this free of charge.
Report the found pet to your local animal shelter or animal control agency, and consider posting clear photos and the location where the pet was found in reputable local lost-and-found pet groups.

Remember that even the friendliest pet may react unpredictably when frightened. Protect yourself as well as the animal, and don’t put yourself in danger by entering traffic or attempting to catch an aggressive or severely distressed pet. A few minutes of kindness and patience can make all the difference in helping a scared pet find its way back home.

Can Pets Get Used to Fireworks?

Sometimes.

Behaviorists often recommend gradual desensitization, which involves playing recordings of fireworks at a very low volume while pairing the sounds with treats, toys, or other positive experiences. Over time – and never by forcing exposure – the volume can be increased gradually. This process is most successful when started well before fireworks season.

For pets with severe noise anxiety, talk with your veterinarian. Prescription anti-anxiety medications, pheromone products, anxiety wraps, or other treatment options may be appropriate.

You may also have seen “noise-canceling headphones” marketed for dogs. While hearing protection for pets does exist, experts generally view it as an adjunct, not a substitute, for proper training, environmental management, and veterinary guidance. Some dogs tolerate them well, while others find wearing them stressful.

A little planning before the first firework launches can help ensure that everyone – including your four-legged family members – has a safer, calmer holiday.

References

American Animal Hospital Association. (2024). Fireworks aren’t fun for everyone. https://www.aaha.org/newstat/publications/fireworks-arent-fun-for-everyone/
American Veterinary Medical Association. (n.d.). July 4 safety. https://www.avma.org/resources-tools/pet-owners/petcare/july-4-safety
Shelter Animals Count. (2025). Stray dog intakes spike after July 4th, new data from Shelter Animals Count confirms.