Multimedia
SBIRT is considered an evidence-based practice that uses a preventive public health approach to identify and intervene with persons whose pattern of use puts them at risk for, or are experiencing substance-related health problems, and facilitate referrals to specialty care for persons with a high potential for substance use disorders.
Many people who do not meet the criteria of an alcohol or substance use disorder are potentially impacting their health and wellness. SBIRT addresses a person’s risky behavior and as a practice model, can be integrated into health care and behavioral health settings. This course will review validated instruments to screen for substance use, how to provide a brief intervention, essential components of successful facilitation of referrals to specialized care, and billing criteria for qualified professionals.
Participant Criteria: This SBIRT 4-hour course met NYS OASAS training requirement for Qualified Health Professionals (i.e., Licensed Social Workers, occupational therapists, physicians, PAs, RNs, licensed psychologists, certified rehabilitation counselors, therapeutic recreation specialists, licensed marriage and family therapists, and licensed mental health counselors), who intend to bill for SBIRT services in their settings.
This training was approved for 4 renewal hours (CASAC, CPP, CPS) and 4 initial hours (CPP, CPS) through New York State’s Office of Addiction Services and Supports (NYS OASAS). As an IC & RC member board, OASAS accredited courses are were reciprocal approval by the New Jersey Division of Consumer Affairs, Alcohol and Drug Counselor Committee. Many other states offered reciprocity.
Published: August 14, 2024
Multimedia
Motivational interviewing is an evidence-based, conversation model for evoking and enhancing intrinsic motivation to change behaviors. In this video-conversation, participants will discuss the core components of this model and practice using the skills of Motivational Interviewing, particularly in the context of substance use behavior change(s). Prior knowledge of Motivational Interviewing is not required. This learning community is open to everyone engaging in conversations about behavior change - educational degrees or credentials are also not required.
Published: July 10, 2024
Multimedia, Presentation Slides
This 1.5-hour webinar is intended for mental health professionals who work with individuals who have post-traumatic stress disorder (PTSD) and substance use disorder (SUD) comorbidity. According to research, PTSD and SUDs are extremely prevalent co-occurring disorders, with each diagnosis raising the chance of the other. The Substance Abuse and Mental Health Services Administration (SAMHSA) has established six principles of trauma-informed care that are intended to promote a supportive and healing environment for those who have suffered trauma. The presenters will go over these six principles and how to implement them when assisting clients recover. These principles guide the delivery of trauma-informed care, ensuring that services are compassionate, respectful, and successful in meeting the varied needs of trauma survivors. This webinar aims to provide attendees with evidence-based methods and practical tools for facilitating change and promoting recovery in this dual-diagnosis population.
LEARNING OBJECTIVES:
Discuss the prevalence and impact of co-occurring PTSD and SUD
Understand the six principles of trauma-informed care
Implement trauma-informed care in clinical practice
TRAINERS:
Mark Sanders, LCSW, CADC, is an international speaker in behavioral health whose presentations have reached thousands throughout the United States, England, Canada, Spain, Lithuania, West Indies and Guam. He is the recipient of five behavioral health lifetime achievement awards including the prestigious NAADAC Enlightenment Award. He is Founder of The Museum of African American Addictions, Treatment and Recovery which is the 2023 winner of the Faces and Voices of Recovery Innovations In Recovery Award. He is the author of 5 books on recovery and had had a 30-year career as a university educator.
Isa Vélez Echevarria, PsyD is a Puerto Rican clinical psychologist. She is the Ohio State Project Manager for the Great Lakes Addiction, Mental Health, and Prevention Technology Transfer Centers managed by the Center for Health Enhancement Systems Studies at the University of Wisconsin-Madison. During her pre-doctoral internship at Children’s Institute in Los Angeles, CA, she obtained a certification as Interpersonal Psychotherapy Clinician. She was trained in Trauma-Focused Cognitive Behavioral Therapy and Family Therapy. In addition, she provides telehealth services to communities of color in Massachusetts and Puerto Rico. Her clinical work has focused on culturally tailored and trauma-informed services to Latinx communities.
The Great Lakes A/MH/PTTC is offering this training for individuals working in HHS Region 5: IL, IN, MI, MN, OH, WI. This training is being provided in response to a need identified by Region 5 stakeholders.
Published: June 26, 2024
eNewsletter or Blog
The Great Lakes Current is the e-newsletter of the Great Lakes ATTC, MHTTC, and PTTC.
The June 2024 issue features content celebrating Pride Month, PTSD Awareness Month, and Intersection of Addiction and Racism: A Curated Bibliography‒a new comprehensive resource created by AMERSA, the ATTC NCO, and the PTTC NCO. You will also find links to upcoming trainings focused on the therapeutic benefits of humor in treatment and recovery, prevention efforts in rural communities, and trauma-informed care for transition-age youth.
Make sure you're subscribed to our email contact list so you never miss a month of The Great Lakes Current newsletter, and thank you for reading!
Published: June 6, 2024
eNewsletter or Blog
The Great Lakes Current is the e-newsletter of the Great Lakes ATTC, MHTTC, and PTTC.
The May 2024 issue features content celebrating Mental Health Awareness Month, Asian Pacific American Heritage Month, Hepatitis C Awareness Month, and National Prevention Week. You will also find links to upcoming trainings focused on the therapeutic benefits of humor in treatment and recovery, prevention efforts in rural communities, and trauma-informed care for transition-age youth.
Make sure you're subscribed to our email contact list so you never miss a month of The Great Lakes Current newsletter, and thank you for reading!
Published: May 10, 2024
Curriculum Package
Discover the Benefits of DBT for Individuals in Substance Use Disorder Recovery
Dialectical Behavioral Therapy (DBT) has emerged as a powerful evidence-based approach to addressing the complexities of substance use disorders, offering a comprehensive toolkit that extends beyond conventional methods. In this six-hour training, participants will delve into the core principles and techniques of DBT, exploring how they enrich SUD treatment by fostering mindfulness, enhancing interpersonal skills, regulating emotions, and bolstering distress tolerance.
This training package includes a 6-hour PowerPoint presentation (full curriculum) and a 13-page handout packet. There are various options for presenting the 6 hours of content, including through a 1, 2, or 3-hour workshop, a single full-day (6-hour) training session, or two 3-hour sessions, which allows for convenient scheduling while maintaining satisfactory coverage of the material. All materials contained in this training package are 508 compliant.
Learning Objectives:
At the end of this training, participants will be able to:
Distinguish two (2) specific behaviors that DBT is designed to treat and the origins of DBT
Describe the four (4) groups of skills utilized in DBT (Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance)
Identify two (2) ways in which DBT skills can be useful for substance use disorders
Apply one (1) specific DBT Skill pertaining to one of the four (4) DBT skills
Explain two (2) specific ways in which DBT can be integrated into an SUD treatment setting
In-Depth Description of Training: Originally developed to address chronic suicidal ideation and borderline personality disorder (BPD), DBT blends cognitive behavioral therapy (CBT) with a dialectical philosophy, emphasizing acceptance and change simultaneously. Over time, research has shown its effectiveness in treating a spectrum of mood disorders including depression, post-traumatic stress disorder (PTSD), eating disorders, and importantly, substance use disorders. This training explores how DBT goes beyond its original purpose, becoming a pivotal intervention in reshaping behavioral patterns and becoming a crucial tool in reshaping behaviors, particularly concerning substance misuse. Through this structured curriculum, participants will gain insights into the four core skill sets (modules) of DBT: Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance.
Throughout this training, participants will examine the nuanced ways in which each skill set intertwines with SUD treatment, promoting a holistic approach toward recovery. Mindfulness, as the cornerstone of DBT, encourages individuals to embrace the present moment, detaching from harmful thought patterns and impulses. Interpersonal Effectiveness skills equip individuals with strategies for building healthy relationships, crucial in navigating support networks during recovery journeys. Emotion Regulation skills teach mechanisms for managing intense feelings, providing tools to modulate emotional responses without resorting to substance use, while distress tolerance skills empower individuals to withstand cravings and urge to use, fostering resilience in recovery.
Moreover, this training underscores the importance of DBT in addressing co-occurring mental health disorders, breaking down barriers to recovery, and promoting sustained abstinence from substances. By fostering engagement, trust, and collaboration, DBT sets the stage for long-term success, enabling individuals to reclaim agency over their lives and forge a path toward lasting wellness.
In summary, this six-hour training serves as a roadmap towards integrating DBT principles into SUD treatment, equipping participants with the knowledge and skills necessary to effect transformative change in the lives of those grappling with substance misuse.
Published: April 30, 2024
Multimedia
Talking To Change: A Motivational Interviewing Podcast, hosted by Glenn Hinds and Sebastian Kaplan, is a series of conversations exploring Motivational Interviewing (MI) and its influence on supporting individuals and groups as they make positive health and lifestyle changes.
Talking to Change: An MI Podcast. Episode 70: MI in the Treatment of Obsessive-Compulsive Disorder, with Dr. Jim Carter
In this episode, hosts Glenn and Sebastian talk to Dr. Jim Carter, a licensed clinical psychologist who recently founded a specialized online clinic called OCD123. Dr. Carter talks about what obsessive-compulsive disorder (OCD) is, how to help people with OCD, and how our minds work and alternatives for when we get stuck. The episode ends with the group performing and then debriefing a role play focused on helping a new father with fears of contamination/germs.
Published: December 20, 2023
Multimedia
Talking To Change: A Motivational Interviewing Podcast, hosted by Glenn Hinds and Sebastian Kaplan, is a series of conversations exploring Motivational Interviewing (MI) and its influence on supporting individuals and groups as they make positive health and lifestyle changes.
Talking to Change: An MI Podcast. Episode 70: MI in the Treatment of Obsessive-Compulsive Disorder, with Dr. Jim Carter
In this episode, hosts Glenn and Sebastian talk to Dr. Jim Carter, a licensed clinical psychologist who recently founded a specialized online clinic called OCD123. Dr. Carter talks about what obsessive-compulsive disorder (OCD) is, how to help people with OCD, and how our minds work and alternatives for when we get stuck. The episode ends with the group performing and then debriefing a role play focused on helping a new father with fears of contamination/germs.
Published: November 22, 2023
Other
The New England ATTC, in partnership with RICARES, held the next monthly installment of the Recovery Science and Harm Reduction Reading Group series. We discussed a paper titled, “Mobile low-threshold buprenorphine integrated with infectious disease services” by Rosecrans and colleagues. A summary of the discussion is available for download.
Published: October 31, 2023
Multimedia
Presenter: Deborah Hasin, PhD (Columbia University)
Over the last two decades, the cannabis landscape in the U.S. has changed considerably. Legalization, product potency and commercialization have increased while perceived risk has declined. In this context, national increases in cannabis use and cannabis use disorder will be reviewed, including particular subgroups in which the increases have been disproportionately large, e.g., individuals with pain and with psychiatric disorders, including psychosis.
Learning objectives:
To be able to describe time trends in the prevalence of cannabis use and cannabis use disorder;
To be able to describe the influence of state-level legalization of cannabis on rates of cannabis use and cannabis use disorder;
To be able to describe sub-groups of the population at particular risk for increases in cannabis use and cannabis use disorder, and some potential explanations of these differences.
Download slides | View recording
Published: October 19, 2023
Multimedia
The risk of fatal overdose has changed significantly in recent years, most notably with the emergence of the illicit opioid fentanyl and the increasing prevalence of polypharmacy.
In this webinar, presenters Michael Hite, MBA and Desislav Hite, MD discussed trends and patterns in overdose cases over the last 5 years, factors that can increase overdose risk including identifiable life events and mental health co-occurring conditions, and how different populations are affected across Region 10. They also discussed actionable interventions to enhance overdose safety including new medical devices and digital resources, harm reduction strategies, and collaboration with local community organizations.
Download slides | View recording
Published: August 24, 2023
Multimedia
The Great Lakes A/MH/PTTC is offering this training for individuals working in HHS Region 5: IL, IN, MI, MN, OH, WI. This training is being provided in response to a need identified by Region 5 stakeholders.
Alcohol is STILL a Drug: An Exploratory Webinar Series (June 7, 2022) Recording
DESCRIPTION
Alcohol is STILL a drug. The opioid crisis, increase in stimulant misuse, and marijuana legalization dominate the news— yet alcohol remains the number one substance causing health, social, legal and financial problems throughout the US.
While this series will focus on the hopefulness of recovery from alcohol use disorder, we’ll also take a deep dive into what we know about the full
SERIES LEARNING OBJECTIVES
These are the overall learning objectives for the full 10-session series:
Summarize the current impacts of problematic alcohol use in various/special populations, including pregnant women, youth, rural, and minority populations.
Assess and prioritize alcohol reduction efforts in targeted settings.
Describe the current efforts to curb problematic alcohol use, including best practices in providing treatment.
TRAINER
Tim Devitt, Psy.D., LCPC, CADC, has a 30+ year commitment to providing and leading recovery-oriented mental health and substance use services, including integrated mental health and substance use treatment, permanent supported housing, assertive community treatment, and substance use outpatient and intensive outpatient programing. Tim has presented nationally and co-authored peer-reviewed journal articles and a book chapter on the integration of evidence-based practices to best meet the comprehensive needs of people with substance use and mental health conditions. Tim is a member of the Motivational Interviewing Network of Trainers (MINT), a lecturer at the Crown Family School of Social Work, Policy and Practice, The University of Chicago, and a board member of Serenity Academy Chicago, a 501(c)(3) with the mission to launch Alternative Peer Groups (APGs) and a recovery high school in Chicago.
Published: June 7, 2022
Print Media
The Tip card provides a brief review of information that providers need to know about traumatic brain injury and behavioral health/substance use disorders. It summarizes the key points from the TBI toolkit that is also available on the website.
Published: March 15, 2022
Print Media
The Client Workbook for Substance Use and Brain Injury was developed by the SUBI Project Team Second Edition (2021) Carolyn Lemsky, PhD, CPsych, ABPP/ABCN, Tim Godden, MSW, RSW, Advanced Practice Clinician and Maria Crowley, MA, CRC-Consultation, Editing, and Design, the National Association of State Head Injury Administrators (NASHIA). It is available online for free and it can be used in conjunction with the TBI Toolkit developed in collaboration with Region 7 Mid-America ATTC.
Published: March 1, 2022
Toolkit
Traumatic Brain Injury and Substance Use Disorder Toolkit now available!!
Traumatic Brain Injury and Substance Use Disorders: Making the Connections merges the content on traumatic brain injury (TBI) and substance use disorders (SUD) to expand capacity to address both issues in treatment. The author, Dr. Carolyn Lemsky, is a board-certified neuropsychologist with over 25 years of experience working in rehabilitation settings in the U.S. and Canada. The toolkit provides valuable and practical information for advancing behavioral health providers’ capacity when serving persons who have brain injuries.
Click here to download a free digital copy
Click here to order a hard copy (shipping and handling fees apply)
This toolkit is a collaboration between the National Association of State Head Injury Administrators, Mountain Plains Addiction Technology Transfer Center (Mountain Plains ATTC), and the Mid-America Addiction Technology Transfer Center (Mid-America ATTC).
Published: October 27, 2021
Multimedia
Presenters: Tana Russell and Maureen Greeley, Evergreen Council on Problem Gambling.
Problem gambling can have devastating impacts on individuals, families, and communities. It can have an impact on personal finances, individual well-being, family and business relationships, employment, mental health, suicidal thoughts or attempts, and more. Compared to other addictive disorders, problem gambling (including Gambling Disorder) is associated with a high rate of suicide attempts. This session offered a broad overview of problem gambling and its impacts. It included an overview of gambling, recreational gambling, problem gambling, and Gambling Disorder. Information on how to pursue Gambling Counselor Certification was also provided in the session.
Learning Objectives:
Understand the difference between recreational gambling, problem gambling, and Gambling Disorder.
Know where to go to get more information and training, and where to refer clients for gambling help services.
Know where to go to learn more about becoming a Certified Gambling Counselor
Webinar category: Other
Published: August 24, 2021
eNewsletter or Blog
Monthly e-newsletter of the Great Lakes ATTC, MHTTC, and PTTC. May 2021 issue includes a focus on mental health awareness month, calendar of events, and new publications from SAMHSA.
Published: May 14, 2021
Presentation Slides
Participants in this webinar will be able to name two brain systems impacted by exposure to adverse childhood experiences, describe three social, emotional, and behavioral impacts of exposure to ACEs during adolescence, and identify stigma in self and in others.
Published: May 5, 2021
Presentation Slides
Participants in this webinar will be able to name ways addiction impacts the maternal and infant brain, identify prevention strategies, describe the significance of attachment parenting to promote infant resilience, and discuss the risk of inherited genetics.
Published: May 5, 2021
Multimedia
The occurrence of the combined problem of TBI and Substance Use Disorder is common and presents major complications in the usual course of rehabilitation. Physical, cognitive, and emotional issues related to this combination of disorders require an acute understanding of brain function, cognitive assessment, and various modifications to the usual rehabilitation approach. Understanding the prevalence and scope of the issue of TBI and SUD will be reviewed along with a full description of the processes of assessment, treatment, and long-term care of people with this complex disorder.
Learning Objectives:
Review the scope of the SUD problem in the US
Review the scope of the TBI problem in the US
Review neurobiological systems relevant to working with people experiencing TBI and SUD
Review assessment procedures
Describe specific treatment planning components
Describe typical treatment modifications needed in treating TBI and SUD
Presenter Information
Dr. Sparadeo began his career as the Director of the Mayor’s Task Force on Substance Abuse in the City of Providence, R.I. and he was also the Director of Substance Abuse Services for the Providence Mental Health Center at that same time. After creating a system of clinical services for the City of Providence he was appointed as CEO of Talbot House. Talbot House was the largest residential substance abuse treatment facility in New England. Dr. Sparadeo then completed his doctoral studies with a residency at the Boston V.A. Medical Center followed by a 2-year fellowship at Brown University and Rhode Island Hospital (RIH). The focus of his clinical training was neuropsychology and chronic pain. He completed his fellowship and was appointed to the Brown University School of Medicine faculty and the Rhode Island Hospital medical staff in the position of Director of Rehabilitation Psychology. Dr. Sparadeo trained numerous interns and fellows at Brown University. As Director of Rehabilitation Psychology, Dr. Sparadeo created the first comprehensive outpatient rehabilitation program for survivors of traumatic brain injury. After 8 years in his position at RIH Dr. Sparadeo was appointed National Director of Substance Abuse and TBI rehabilitation services at New Medico Health Systems in Boston, Massachusetts. He created inpatient substance abuse treatment programs in 8 rehabilitation facilities throughout the U.S. He returned to RIH and Brown University to become the director of the Concussion Care Center in the Emergency Department at RIH. He was also the chief clinical consultant to the Trauma Center and Stepdown Unit, and he was the co-director of the Interdisciplinary Spine Center in the Neurosurgery Department at RIH for 5 years before opening a private practice specializing in the neuropsychological assessment, pain assessment and pain management. He developed a specialized substance abuse treatment program for people with both TBI and substance abuse. Eventually, he developed a specialized treatment program for people with chronic pain and opiate addiction. Over the many years of his career Dr. Sparadeo has been a consultant to many agencies and healthcare programs throughout the U.S. He has also served on numerous boards of directors. He was the founder and president of the Brain Injury Association of Rhode Island. He was also the Chairman of the Governor’s Permanent Advisory Commission on TBI. He was also a member of the national committee on substance abuse and disability at SAMHSA in Washington, D.C. Most recently, Dr. Sparadeo has been a consultant and chief trainer on a federally funded grant at the Massachusetts Rehabilitation Commission. Dr. Sparadeo’s career has also included the publication of many scientific papers and book chapters, and he has been on the faculty of Salve Regina University graduate program in Rehabilitation Counseling where he teaches the Neuroscience of Substance Abuse and Mental Illness, Psychopharmacology for Counselors and the Neuroscience of Opioid Abuse.
Traumatic Brain Injury and SUD Part 1 Implications of Brain Injury Addiction
This training is a collaboration between Mid-America ATTC, Mountain Plains ATTC, and NASHIA.
Published: April 28, 2021
Print Media
Download the slides for the first session of the Traumatic Brain Injury & SUD Series: Brain Injury 101.
This session will provide participants with an overview of brain injury including information on what brain injury is and the prevalence within the general population. The session will then describe brain injury in the context of high-risk populations such as intimate partner violence and criminal and juvenile justice. Finally, participants will gain an understanding for how to screen for brain injury and they will learn strategies for supporting individuals with brain injury within the addictions setting.
Learning Objectives:
Participants will be able to describe the prevalence of brain injury in the general and within special populations.
Participants will learn about best practices for screening individuals for brain injury.
Participants will learn how to support individuals identified with brain injury.
Presenter Information:
Judy Dettmer has been working in the field of brain injury for 30 years. Ms. Dettmer is currently the Director for Strategic Partnerships and a Technical Assistance Lead for the Traumatic Brain Injury Technical Assistance and Resource Center at the National Association of State Head Injury Administrators. Ms. Dettmer has worked extensively with adults, children and family members of individuals with brain injury. She has provided direct and systems consultation to improve the lives of individuals with brain injury. Judy has also assisted with research efforts related to brain injury and has conducted countless presentations, classes and seminars on brain injury both in the state of Colorado and Nationally. Ms. Dettmer has provided technical assistance to numerous states including but not limited to; screening on brain injury, developing infrastructure within state systems such as departments of education, criminal justice, and in developing and managing advisory boards and councils. Ms. Dettmer is currently a co-facilitator for the National Collaborative on Children’s Brain Injury.
Published: April 1, 2021
Multimedia
This session will provide participants with an overview of brain injury including information on what brain injury is and the prevalence within the general population. The session will then describe brain injury in the context of high-risk populations such as intimate partner violence and criminal and juvenile justice. Finally, participants will gain an understanding for how to screen for brain injury and they will learn strategies for supporting individuals with brain injury within the addictions setting.
Learning Objectives:
Participants will be able to describe the prevalence of brain injury in the general and within special populations.
Participants will learn about best practices for screening individuals for brain injury.
Participants will learn how to support individuals identified with brain injury.
Presenter Information:
Judy Dettmer has been working in the field of brain injury for 30 years. Ms. Dettmer is currently the Director for Strategic Partnerships and a Technical Assistance Lead for the Traumatic Brain Injury Technical Assistance and Resource Center at the National Association of State Head Injury Administrators. Ms. Dettmer has worked extensively with adults, children and family members of individuals with brain injury. She has provided direct and systems consultation to improve the lives of individuals with brain injury. Judy has also assisted with research efforts related to brain injury and has conducted countless presentations, classes and seminars on brain injury both in the state of Colorado and Nationally. Ms. Dettmer has provided technical assistance to numerous states including but not limited to; screening on brain injury, developing infrastructure within state systems such as departments of education, criminal justice, and in developing and managing advisory boards and councils. Ms. Dettmer is currently a co-facilitator for the National Collaborative on Children’s Brain Injury.
Video Link
This training is a collaboration between Mid-America ATTC, Mountain Plains ATTC, and NASHIA.
Published: March 24, 2021
Multimedia
This virtual presentation is sponsored by the Southeast ATTC Regional Center and will focus on emphasizing not only our mandate to "do no harm" in working with those who have previously been wounded but also will focus on ways to help re-establish a sense of empowerment to those who may have come to feel disempowered and who are at risk for negative life experiences in Alabama, Georgia, Florida, Kentucky, Mississippi, Tennessee, North Carolina, South Carolina. Treatment providers, peer support communities, and community-based organizations in Region 4 are encouraged to register for free.
1. Utilize and interpret the results of the Adverse Childhood Experiences Questionnaire,
2. Articulate at least three adverse experiences covered in the Adverse Childhood Experiences Questionnaire,
3. Identify at least three negative outcomes correlated with experiencing adverse childhood experiences,
4. List at least three experiences that are correlated with greater resiliency in individuals,
5. Verbalize two practical steps they can take to help mitigate adverse childhood experiences and foster greater resiliency in those they serve.
....................................
James E. Campbell, LPC, LAC, MAC, CACII has worked professionally in the human services field for over twenty-five years in a wide range of clinical settings, currently serving as the Training and Technical Assistance Manager for Southeast Addiction Technology Transfer Center. His passion is helping individuals and families heal and build on the strengths they possess. He’s a member of both NAADAC and ACA and is a past president of APSC/SCAADAC. James is a nationally recognized, author and speaker.
Published: March 20, 2021
Presentation Slides
Mary McCarty-Arias, M.A.
Research Project Manager
Division of Substance Use Disorders
New York State Psychiatric Institute
Department of Psychiatry, Columbia University Medical Center
This course will introduce participants to stigma and discrimination around substance use disorders (SUDs). Other disabilities will be discussed, including mental health disorders and HIV. Participants will be able to reflect on their own practice and those used by their agencies.
Published: March 11, 2021