Behavioral health is an umbrella term that includes mental health care and alcohol and substance abuse treatment. Choices Mental Health Counseling PLLC offers individual psychotherapy, group, couple, and family counseling with adults, adolescents and children for trauma history, mood and anxiety disorders, attentional and communication problems, parent-child issues for risk reduction and prevention, pre-adoption home studies and follow-up, psychoeducational services in mental health and abuse of alcohol and other drugs, evaluations for courts, and for the NYS DMV as an OASAS approved provider of clinical screening and assessment services for impaired driving offenders to consider restoration of driving privileges after a DWI, and other behavioral health needs.

Choices Mental Health Counseling office at 433 Broadway in Monticello

Tom and Carmen Rue on the porch at 433 Broadway The offices of Choices Mental Health Counseling, PLLC are now located at 433 Broadway, across from Landfield Avenue, a half block west of Rotary Corner at the intersection of Saint John Street.

Please use private parking in the rear, or park on Broadway. The public is invited to use the side entrance. The front entry is wheelchair accessible. Free wireless connectivity is available in the waiting room for the convenience of guests. The move took place in late February and was completed by the end of March 2013.

The new site includes a larger rooms than the former location for group and individual counseling sessions, and a comfortable waiting room. (See interior photos.)

Tom and Carmen Rue in front of 433 Broadway

The practice continues to provide private and confidential outpatient counseling treatment for mental health for substance abuse recovery, for individuals, groups, couples, and families. Referrals are accepted from healthcare providers, the legal system, schools, human service agencies, and managed care organizations, or by interested individuals. Reimbursement by most insurances, and several employee assistance programs, is accepted (see list at left).

Office hours are presently limited to evenings and Mondays during the day, but the plan is to expand to full-time in the fall of 2013. The practice has been in operation since August 2010, most recently on Pelton Street and originally in an office in the historic rectory of St. John's Church. Presently, the only site address for Choices Mental Health Counseling PLLC is 433 Broadway, though mail should still be addressed to PO Box 706, Monticello, NY 12701.

Bilingual Support Services

Office manager Carmen Rue, who is fluent in English and Spanish and can assist with translation when needed, graduated in nursing from Federico Villarreal National University in Lima, Peru. A woman of many talents, in her spare moments away from serving the Village of Monticello as an elected Trustee (an office she continues to hold), Carmen was behind the office's decoration and selection of comfortable new furnishings.

Experience and Specialties

Licensed as a mental health counselor (LMHC) by the NYS Department of Education and credentialed by the NYS Office of Alcoholism and Substance Abuse Services as a credentialed alcoholism and substance abuse counselor (CASAC), Mr. Rue is state-approved to provide courts with assessments and evaluations of people charged with impaired driving; as well as being qualified under rules of the US Department of Transportation as Substance Abuse Professional (SAP), as well as experience giving input to Family Court on adoptions, custody, visitation, and parenting concerns.

He has worked as a mental health and addiction counselor since earning his Masters degree at Rider University in New Jersey in 1985, including working 13 years for New York State and 6 years for the Sullivan County Department of Community Services, 7 years as a family therapist for Berkshire Farm Center & Services for Youth, and a few years in the 1980s as a probation officer in Sullivan County. He has been certified as a clinical mental health counselor (CCMHC) and National Certified Counselor (NCC) by the National Board for Certified Counselors (NBCC) since 1990.

Building History

The building at 433 Broadway was erected in 1910, a year after Broadway was decimated by a massive fire. It was built by John F. Tyson, who opened a hardware store across Broadway in 1870. Mr. Tymeson left his property to his son-in-law, the Rev. Emmet Sloat, who served as a local minister from 1923 to 1925.

Rev. Sloat continued to serve community causes, including as treasurer of the American Red Cross of Sullivan County until as late as 1929. More recently, the building housed the healthcare offices of chiropractors Paul Sinew, DC; and from 1967 to 1984 of Jack Bosches, DC.

For more information, call 845-513-5002 or visit

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The building at 433 Broadway as photographed by Tom Rue on August 3, 2008 prior to road renovation by the NYS Department of Transportation.

Giving Public Thanks To Public Sector Workers, While Increasing Accessibility To Private Outpatient Mental Health And Substance Abuse Counseling In Sullivan County

This a public thank you to co-workers at the State of New York and County of Sullivan I have worked with over the years, many of whom for whom I have the greatest respect. Having spent 13 ½ years at Richard C. Ward Addiction Treatment Center in Middletown – plus more than half that with the Sullivan County Department of Community Services as a Staff Social Worker, in mental health day-treatment and at the outpatient addiction clinic; with adult men and women; six years as a child and family therapist for a private agency under a public contract with Sullivan County Division of Health and Family Services children’s Preventive Services; and previously as a Sullivan County Probation Officer; a houseparent in publicly-operated adolescent group home; and clinical coordinator for a not-for-profit after-school program for teens, since 1985 I have done counseling work with adults and adolescents who suffer from mental illness and addiction, and runaway and ungovernable and delinquent youth, as well as family and couples therapy, with goals of family preservation, reunification, and adoption.

US DOT Qualified Substance Abuse Professional

SAP Evaluations

A transportation worker who has violated DOT regulations must follow specific procedures before being considered by an employer for return to safety-sensitive function. A SAP credentials packet is available for those wishing to confirm my qualifications under DOT rules.

This process, conducted by a qualified Substance Abuse Professional (SAP), includes:

  • Conducting an initial face-to-face clinical evaluation, including standardized testing.
  • Developing recommendations for treatment and/or education.
  • Sending an initial evaluation report to the employer or, if employee has been released from employment, maintaining information for future employer.
  • Assisting the employee in contacting the treatment provider and arranging for services.
  • Maintaining regular contact with the treatment provider, to monitor the employee's treatment progress.
  • Conducting a face-to-face, follow-up clinical evaluation to determine if the employee has complied with recommendations, and to measure success of treatment.
  • Sending a follow-up report and follow-up testing plan to the employer.
  • It is up to the employer to determine whether or not the employee returns to work, not the SAP.
  • If the employee has been released from employment, this information is held for the future employer.

Tom Rue, MA, LMHC, CASAC, a mental health counselor since 1985 and a credentialed alcohol and substance abuse counselor since 1996 (certified through the International Certification and Reciprocity Consortium [IC&RC]), completed fourteen (14) contact hours of training in October 2012, successfully completing the exam requirement later the same month, both sponsored by the Employee Assistance Professionals Association. This training and exam meet the requirements of 40 CFR Part 40.281(c), Qualification Training for Federal DOT Regulations and Assessment Requirements for the Substance Abuse Professional (SAP).

If you are seeking to schedule an appointment for an assessment, call 845-513-5002. Please be prepared to provide the following information during the initial call or fax it in advance to 866-428-0282:

  • Your name, title, company name, address, phone number
  • DOT Mode, i.e., FMCSA, FRA, FTA, FAA, RSPA or USCG
  • Employee name, address, phone number
  • Social security number
  • Date of birth
  • Violation and date of violation
  • Current employment status
  • Name of Designated Employer Representative (DER)
  • Who is responsible for payment? If employer is, provide name and phone number of DER for verification and arrangements.

For an additional fee, the SAP can conduct ongoing monitoring following the employee's return to work, including monthly in-person interviews and revision of the employee's follow-up testing program, when appropriate.

SAP Service Payments

If fees are paid by the employer, full payment can be forwarded to the SAP at the time of the referral or SAP will provide an invoice when initial report is sent.

If fees are paid by the client, full-payment is required prior to the evaluation. Payment must be in exact amount by cash or money order.

SAP Service Payments

For more information, visit and DOT/FMCSA Drug & Alcohol Testing Program: Substance Abuse Professionals

See my listing on SAP List listing.

Connecting Trauma Stress and Chronic Pain (Informational Brochure)

Old Traumas Add To Present Pain

Many women, and more men than might be generally assumed, who suffer chronic physical pain were sexually abused as children. Many others of both genders experienced physical or verbal abuse during their youth.

There can be little doubt that traumatic experiences in childhood invite chronic pain during later life. Childhood trauma can lead to lasting depression or anxiety, sometimes including flashbacks to the original experience, a condition known as Post-traumatic Stress Disorder, or other complications.


Ties between physical pain and psychiatric conditions – including PTSD, mood and anxiety disorders, or intimacy problems – caused by abuse are close. The appearance of pain, even decades after the abuse, may be accompanied by flashbacks and nightmares, emotional numbness, or an impaired body image.

Thoughts > Beliefs > Perceptions > Experience

Childhood abuse may contribute to multiple chronic physical complaints or sexual problems in adulthood. Grown children who experienced trauma may undergo depression, anxiety, and low self-esteem, made worse by a vicious cycle of negative thoughts, self-talk, and beliefs. Changing these thought patterns and perceptions can lead to shifts that are both subtle and radical in how one experiences the world and relationships. Life can improve!

Everyone feels pain differently. Some can readily cope with a degree of discomfort that others may find unbearably severe. It comes down to learning.

Newly Published Book - "FIGHTING FAIR"

Fighting Fair by Tom Rue is available immediately for Kindle readers, and hard copies will soon be sold on Amazon. Click the image at left for a front and back preview of the cover.

Anger is a manifestation of pain that forces humans to summon and expend energy, often inefficiently. In real terms, anger hurts. Mindful and constructive self-expression can help relieve pain, strengthen relationships, and improve personal health. Mindless anger expression can lead to not only physical aggression and injury, but to difficulties including blocking healthy communication, damaged or lost relationships, legal or medical problems.

Monticello, New York: Home Of The Dental Dam

Sanford Christie BarnumAn effective barrier of body fluids used to prevent the spread of human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome (AIDS) and other diseases transmitted through sex, is the dental dam.

Less known than its present-day role in disease prevention, and that it was originally created in 1862 as a tool allowing dentists a saliva-free space on which to grind or drill teeth, is the fact that it was invented in Monticello, New York, about three blocks east of the offices of Choices Counseling Services PLLC.

The beneficent inventor donated the intellectual property rights to his invention for the public good. It got him internationally recognized, but it never earned him a dime.

Sanford Christie Barnum, son of George W. and Caroline Griswold (Clowes) Barnum, was born in Oakland Valley, Town of Forestburgh, Sullivan County, New York, on August 24, 1838. Dr. Barnum obtained his early education at the public schools, and at the Monticello Academy, a well known private educational institution of that time. The academy was located at the corner of Landfield and Bushnell avenues, the present site of a county-owned parking lot near the Lawrence H. Cooke Sullivan County Court House.

What Is A Treatment Mandate? Free Will, Natural Law And Choice Supersede Legislation, Court Orders.

National Recovery Month

What does it mean to be "mandated" to treatment? Is a court order truly equivalent to leading a horse to water? Maybe. But such mandates are as much a legal fiction as the metaphorical horse who can't be made to drink. In reality, mandates do not exist.

Drug addiction (including to alcohol) is a chronic disease. It does not go away. But like asthma, diabetes, hypertension, or other organic conditions of the human body, there are tools and techniques by which it can be managed. If it is not treated, it will progress. Its course is predictable. At the end of its course, if it is left untreated, it is fatal, if some other disease or accident does not cause death first. Like someone diagnosed with cancer, the choice is not whether or not one will die, but on improving the odds of when and how.

Death is mandatory for all, but recovery remains an option as long as life persists.

"Mandates" sometimes construed as a measure of social control. But free will is a natural law. Natural laws always take precedence over legislation or court orders.

I have had discussions with countless patients, both those who claim they are in addiction treatment because they have "no choice" due to being "mandated" to attend; and those who feel that they enjoy a different status than their peers who are "not there for the right reasons" (i.e. "they" are mandated and "I" am not). The reality is that every addict who enters treatment is mandated - if not by the justice system, then by a spouse or child, by a parent, by a landlord, by an employer, by their liver, or by a desire to live rather than die.

Everyone in the treatment room is mandated or they would not be present. No one in the room is there because they enjoy spending their days talking about how to manage a chronic and progressive disease that has left their lives in chaos and resulted in innumerable losses.

On the other hand, it is equally true to say that no one is mandated. Everyone who enters treatment has freely chosen between that healthy option (recovery) and the less desirable option that some, but not all, describe as a "mandate" - whatever that alternative might be.

I have interviewed enough incarcerated inmates over the years to demonstrate this point by telling me they would rather serve their time in jail than be bothered with rehab. Choosing to engage in treatment is an exercise of free will. One with no desire to change their life may find it more convenient and comfortable to sit in a cell-block watching a television show selected by a corrections officer than to be bothered with the annoyance of counseling sessions and meetings.

The mere presence of a legal mandate is not nearly as influential as the patient's attitude about the significance of legal consequences.

Framed this way, I would hope, patients should be able to identify the nature of the "mandate" (with reference to alternative consequences) which places her or him on the same level as peers whose mandate is jail. We are all the same level; addiction is part of the human condition. It attacks its sufferers by undermining their free will. Paradoxically, they lose their choice over alcohol or drugs, until they make the choice to surrender.

It does not discriminate. Neither does recovery.

"The only requirement for membership is a desire to stop using," the third tradition says.

It doesn't matter what factor tipped the decisional scale motivating a person wants to stop using; or exactly where they might fall on a 10-point motivation scale. If 10 represents someone who is taking action to change, and 1 represents someone with no interest whatever in changing, as long as someone falls between 5 and 10, they are in the same category. It doesn't matter if their incentive is to stay out of jail, not to die of an overdose, or simply to enjoy life more fully. If they have that desire, they have started to get better.

This is more than a semantic point. Identifying with a recovering community is essential to recovery. The 12-step slogan, "Identify, don't compare" urges recovering people to look for similarities between others' stories and their own, rather than differences.

Looking around the room in group and saying, "These people are different from me" is comparison. Looking around for similarities is identifying. One leads to isolation, and the other to peer support.

The reason behind selection of word "Choices" in naming my counseling practice is to stress that free will and motivation are essential ingredients in behavioral change and recovery. If you want to get better, you can. There are no mandates. Some choices are easy, some difficult. The fewer the options that are on the table, the easier it may be to select the healthiest choice that leads to recovery.

Legal coercision, with respect to addiction treatment, often refers to the identity of the referral source. If ordered by a judge, or referred by a probation or parole officer, is more likely to be perceived by the patient as "mandated" by the patient. A perception of coersion occurs when personal autonomy is undermined. Perceived loss of self-determination may result in negative affect and disengagement from treatment activities.

I prefer to recognize the reality that people chart their own course basing informed decisions on awareness of benefits, risks, likely consequences, drawn from both what they learn from both identifying with the stories heard from others, and from their own experiences. Projecting or promoting the legal fantasy of a "mandate", when compulsory recovery is an impossibility, does nothing to promote psychological or physical healing.

Question: "What can those who work with children do to help them develop a strong self-concept?"

1. Respect the child's emerging physical, psychological and social space and privacy.

2. Respond to the child's questions and concerns in a thoughtful and respectful manner appropriate to the child's age and developmental stage.

3. Recognize and provide approval for the child's efficacy or accomplishments in skill areas, as well as acknowledging pro-social behavior in day-to-day life.

4. Value the child's unique talents and contributions by both praise and encouragement, while avoiding comparisons with other children.

5. Focus on the child's strengths and assets, with positive expectations.

6. Participate with the child in diverse experiences which expand general fund of knowledge, including multicultural and gender awareness.

7. Guide the child with an appropriate level of reasoned and loving discipline, emphasizing that the child is in control of their behavior and its consequences.

8. Show faith in the child's abilities by permitting appropriate levels of freedom and responsibility.

9. Be open to the child's opinions and suggestions, encourage participation in group decisions.

10. Communicate unconditional love, even in the midst of discipline.

Relate Links

Two Excellent Reads For Survivors of Childhood Sexual Trauma, Loved Ones, And Therapists Who Work With Them

One of the most compelling and engaging books I have read on this subject, which I recommend both to therapists who work with former victims, as well as to clients, is Healing Sex: A Mind-Body Approach to Healing Sexual Trauma by Staci Haines (Felice Newman, Editor; Chicago: Cleis Press, 1999, 2007).

On the premise that the impact of abuse is located in pre-verbal areas of the brain, and that the pain and coping mechanisms are held within the body as a whole, the author advocates a somatic treatment orientation, which she explains as "a new interpretation of the self as well as the collective 'body'..."


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