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Pinpointing Problematic Behavior: A Practical Guide

This guide is designed to help professionals, educators, leaders, and therapists recognize and understand behaviors that interfere with growth, relationships, or productivity. Problematic behaviors often show up subtly at first — through avoidance, resistance, aggression, or withdrawal — but if left unaddressed, they can escalate and create greater challenges.

Why it matters:

Identifying problematic behaviors early allows for timely intervention.

Understanding the underlying causes (stress, trauma, unmet needs, or environmental triggers) prevents mislabeling or overreacting.

Precise identification guides effective solutions, whether in therapy, education, or workplace leadership.

What the guide offers:

Observation Strategies — Practical steps for noticing patterns without bias.

Behavioral Context — Tools for distinguishing between situational reactions and persistent problems.

Checklists & Frameworks — Therapist- and leader-friendly methods to quickly assess behavior.

Root Cause Exploration — How to look beyond the surface to the psychological, emotional, or environmental drivers.

Intervention Pathways — Evidence-based approaches for responding in ways that de-escalate conflict and promote change.

Practical Use:

For therapists: A structured way to map out behaviors interfering with treatment progress.

For educators: Quick recognition of learning-related or disruptive behaviors in classrooms.

For workplace leaders: Identifying conduct that undermines collaboration and performance.

Shervan K Shahhian

Behavioral Health Services, what is it:

Behavioral Health Services are a broad range of professional supports and treatments designed to help people manage challenges related to mental health, emotional well-being, and substance use. The term behavioral health is often used interchangeably with mental health, but it is slightly broader, as it also includes behaviors that affect physical health (like substance use, eating habits, or lifestyle choices).

Here’s a clear breakdown:

1. What Behavioral Health Services Include

Mental Health Care — Counseling, psychotherapy, psychiatric evaluations, and medication management for conditions like depression, anxiety, bipolar disorder, schizophrenia, PTSD, etc.
Substance Use Services — Prevention, assessment, detox programs, outpatient/inpatient rehabilitation, relapse prevention, and recovery support.
Crisis Intervention — Hotlines, emergency psychiatric services, mobile crisis units, and hospitalization if necessary.
Community Support — Case management, peer support groups, housing assistance, and vocational training.
Prevention & Education — Programs in schools, workplaces, or communities that promote coping skills, stress management, and healthy lifestyle behaviors.

2. Who Provides These Services

Psychologists, psychiatrists, therapists, counselors
Social workers, psychiatric nurses, case managers
Peer support specialists (people with lived experience)

3. Where Services Are Offered

Hospitals and clinics
Community health centers
Private practices
Rehabilitation centers
Schools, workplaces, and even online/telehealth platforms

4. Why They Matter

Behavioral health services don’t just treat illness; they aim to:

Improve quality of life and daily functioning
Support emotional resilience and coping strategies
Reduce stigma around mental health and addiction
Prevent crises before they escalate
Help integrate mental, emotional, and physical health

In short: Behavioral health services are about helping people live healthier, more balanced lives by addressing both psychological struggles and the behaviors that impact overall well-being.

Shervan K Shahhian

Mental Health First Aid, explained:

Mental Health First Aid (MHFA), explained simply:

It’s like traditional first aid — but for mental health. Instead of learning how to help someone with a cut, burn, or broken bone, you learn how to help someone who may be experiencing a mental health challenge, crisis, or developing problem.

What it is:

An educational program that teaches people how to identify, understand, and respond to signs of mental illnesses and substance use challenges.
Not therapy or treatment — it’s about offering initial support until appropriate professional help is available (or until the crisis resolves).

Key Goals:

Recognize warning signs of mental health or substance use issues.

Provide reassurance and support in a nonjudgmental way.

Encourage appropriate professional help (therapist, doctor, counselor).

Promote self-help strategies (coping skills, community resources).

What you learn:

IF YOU ARE FEELING SUCIDAL PLEASE GO TO THE NEAREST HOSPITAL, E.R., OR CALL YOUR LOCAL EMERGENCY NUMBER and ASK FOR HELP, ASAP.

What will the Hospital Emergency Room do for a mental health crisis?

Assessment: A complete assessment will be done to understand the person’s mental health status, medical history, and any immediate risks. This process may involve interviews, medical physical exams, and maybe laboratory tests. Intervention: The Treatment might include crisis intervention techniques, medication, and observation.

MHFA courses usually cover:

Common mental health conditions (depression, anxiety, psychosis, substance use, trauma).
Crisis situations (panic attacks, suicidal thoughts, self-harm, overdose).
A structured action plan, often summarized as ALGEE:
Assess for risk of suicide or harm
Listen nonjudgmentally
Give reassurance and information
Encourage professional help
Encourage self-help and other supports

Who it’s for:

Anyone — not just healthcare workers. It’s designed for teachers, parents, coworkers, first responders, and community members.

Why it matters:

Mental health challenges are common, but stigma often stops people from reaching out.
MHFA helps reduce stigma, increases understanding, and empowers people to step in confidently when someone needs support.

Think of it as “CPR for the mind” — a way for ordinary people to be the first line of support in a mental health emergency.

Shervan K Shahhian

Screening, Brief Intervention and Referral to Treatment (SBIRT), what is it:

SBIRT stands for Screening, Brief Intervention, and Referral to Treatment. It’s a public health approach used in medical, mental health, and community settings to identify and help people with risky or harmful substance use before it develops into a more serious disorder.

Here’s the breakdown:

1. Screening

Purpose: To quickly assess whether a person is at risk for substance use problems.
Method: Standardized questionnaires or short conversations (e.g., AUDIT, DAST, CRAFFT).
Focus: Alcohol, drug use, sometimes other risky health behaviors.
Goal: Identify individuals who may benefit from early intervention.

2. Brief Intervention

Purpose: To increase awareness of substance use risks and motivate change.
Method: A short, structured conversation (often 5–15 minutes) using motivational interviewing techniques.
Focus: Providing feedback, exploring ambivalence, and helping the person consider healthier choices.
Goal: Encourage reduction or cessation of risky use.

3. Referral to Treatment

Purpose: For individuals whose screening indicates a more severe substance use disorder.
Method: Connecting them with specialized treatment providers (inpatient, outpatient, counseling, recovery programs).
Goal: Ensure those needing intensive support receive it quickly.

Why SBIRT is valuable

Early detection prevents escalation.
Cost-effective and reduces strain on healthcare and justice systems.
Can be integrated into primary care, ERs, schools, mental health clinics, and community programs.
Helps normalize conversations about substance use and reduces stigma.

Shervan K Shahhian

Understand how early intervention can prevent substance use:

Early intervention plays a powerful role in preventing substance use because it addresses risk factors before they escalate into full-blown addiction.

Here’s how it works:

1. Identifying Risk Early

At-risk youth and adults (those with family history of substance use, trauma, mental health challenges, or academic/behavioral difficulties) can be recognized early.
Screening tools in schools, healthcare, or community settings help spot early warning signs like experimentation, withdrawal, or mood/behavioral changes.

2. Building Protective Factors

Early programs focus on strengthening coping skills, emotional regulation, and decision-making.
Supportive relationships with parents, teachers, and mentors create resilience, making individuals less likely to turn to drugs or alcohol.

3. Education and Awareness

Teaching people — especially children and adolescents — about the real risks of substances helps them make informed choices.
Correcting myths (e.g., “everyone is doing it”) reduces peer pressure effects.

4. Reducing Risk Factors

Addressing mental health issues like anxiety or depression early reduces the likelihood of self-medication with substances.
Tackling environmental risks (poverty, family conflict, exposure to drug use) makes substance use less appealing or necessary as a coping strategy.

5. Short-term Interventions Prevent Long-term Harm

Programs like SBIRT (Screening, Brief Intervention, and Referral to Treatment) or school-based prevention programs can stop experimentation from becoming dependence.
Early help often requires fewer resources than treating full addiction later.

6. Improved Life Trajectory

By stepping in early, people are more likely to stay in school, maintain healthy relationships, and avoid criminal justice involvement — reducing the social and economic costs of substance use.

In short: early intervention interrupts the cycle before it begins. It shifts focus from reacting to addiction toward building resilience, equipping individuals with tools to thrive without substances.

Shervan K Shahhian

Covert Hypnosis, what is it:

“Covert hypnosis refers to influencing another person’s unconscious mind without making them aware that hypnosis is taking place. Often called conversational hypnosis or sleight of mouth, the term is most commonly associated with proponents of neuro-linguistic programming (NLP), a widely criticized and pseudoscientific approach to communication and persuasion.”

Shervan K Shahhian

Conversational Hypnotherapy, what is it:

“Conversational hypnotherapy uses everyday dialogue and subtle suggestions to help a person reach a relaxed, receptive state where the unconscious mind can integrate positive change. Rather than relying on formal trance induction, it emphasizes rapport, storytelling, and metaphors to naturally support the therapeutic process.”

Shervan K Shahhian

Conversational Hypnosis, what is it:

“Conversational hypnosis, sometimes called covert hypnosis, is a method of subtly guiding a person’s thoughts and behaviors through everyday dialogue without their conscious awareness. By using techniques such as storytelling and rapport-building, it engages the unconscious mind while the individual stays relaxed and fully awake, often with their eyes open.”

Shervan K Shahhian

Understand How Early Intervention Can Prevent Substance Use:

Early intervention plays a powerful role in preventing substance use because it addresses risk factors before they escalate into full-blown addiction.

Here’s how it works:

1. Identifying Risk Early

At-risk youth and adults (those with family history of substance use, trauma, mental health challenges, or academic/behavioral difficulties) can be recognized early.
Screening tools in schools, healthcare, or community settings help spot early warning signs like experimentation, withdrawal, or mood/behavioral changes.

2. Building Protective Factors

Early programs focus on strengthening coping skills, emotional regulation, and decision-making.
Supportive relationships with parents, teachers, and mentors create resilience, making individuals less likely to turn to drugs or alcohol.

3. Education and Awareness

Teaching people — especially children and adolescents — about the real risks of substances helps them make informed choices.
Correcting myths (e.g., “everyone is doing it”) reduces peer pressure effects.

4. Reducing Risk Factors

Addressing mental health issues like anxiety or depression early reduces the likelihood of self-medication with substances.
Tackling environmental risks (poverty, family conflict, exposure to drug use) makes substance use less appealing or necessary as a coping strategy.

5. Short-term Interventions Prevent Long-term Harm

Programs like SBIRT (Screening, Brief Intervention, and Referral to Treatment) or school-based prevention programs can stop experimentation from becoming dependence.
Early help often requires fewer resources than treating full addiction later.

6. Improved Life Trajectory

By stepping in early, people are more likely to stay in school, maintain healthy relationships, and avoid criminal justice involvement — reducing the social and economic costs of substance use.

Shervan K Shahhian

Practice brief intervention techniques that motivate real change without judgment or confrontation:

Yes — you can practice Brief Intervention (BI) techniques in a way that encourages change through empathy, curiosity, and collaboration rather than judgment or confrontation. These techniques are often rooted in Motivational Interviewing (MI), which focuses on helping people resolve ambivalence and strengthen their own motivation for change.

Here’s a practical breakdown you can use:

Core Principles

Express Empathy — Listen actively and validate the person’s feelings without labeling or lecturing.

Develop Discrepancy — Help the person see the gap between their current behavior and their goals or values.

Roll with Resistance — Avoid arguments. Resistance is a signal to change your approach, not to push harder.

Support Self-Efficacy — Emphasize the person’s strengths and their ability to make change.

Practical Techniques (BI in Action)

1. Use Open-Ended Questions
Encourage reflection rather than yes/no answers.

“What do you enjoy about drinking? What worries you about it?”
“How does your current habit fit with the goals you have for yourself?”

2. Reflective Listening
Mirror back what you hear, showing you’re listening and helping them clarify their own thoughts.

“It sounds like you feel drinking helps with stress, but you also notice it’s causing problems at work.”

3. Affirmations
Highlight strengths, efforts, or positive intentions.

“It took courage to talk about this today.”
“You’ve already started thinking about changes — that shows commitment.”

4. Summarizing
Wrap up key points to reinforce their motivations and concerns.

“So on one hand, alcohol helps you relax, but on the other, it’s straining your relationships. You’re wondering if cutting back could help.”

5. Elicit Change Talk
Gently guide them to voice reasons for change.

“What would be the good things about making this change?”
“If you decided to cut back, how might your life improve?”

A Simple BI Flow (the “FRAMES” model)

Feedback: Offer personalized, nonjudgmental observations.
Responsibility: Emphasize their autonomy.
Advice: Provide options, not directives.
Menu of choices: Offer strategies to try.
Empathy: Maintain an accepting tone.
Self-efficacy: Reinforce their ability to succeed.

Practice tip: Role-play these techniques with a colleague or even by journaling different “client responses” to practice reflective listening and eliciting change talk.

Shervan K Shahhian