Blogging on Good Therapy

A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW

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Mental health services will be an important part of the response to Hurricane Gustav, as government agencies like FEMA, NGO’s including the Red Cross and area hospitals, and cadres of volunteers from nearly all 50 states prepare to intervene with the more than 3 million people throughout the Gulf states that will likely be affected by the storm.

Red Cross representative Joe Becker told local media that the Red Cross is “focusing very hard on our mental health preparations and deploying large numbers of our mental health professionals to help these people. We want to be there for people who have already seen what awful looks like.” (more…)

A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW

Click here to contact Daniel and/or see his GoodTherapy.org Profile

A team of researchers – three at Florida State University and one at Yale – have completed a persuasive study of Behavior Management Training (BMT) for treating Reactive Attachment Disorder (RAD). The study, published in the journal Child Maltreatment, offers findings are encouraging to proponents of the classic reward and punishment system, and will likely lead to larger control studies.

RAD is a severe childhood disorder in which children display extremely inappropriate social behaviors, such as near total withdrawal and introversion (the inhibited form) or an almost complete lack of boundaries with strangers (the disinhibited form) sometimes with sexual or aggressive tendencies. These two ends of a behavioral spectrum may both be present in the same child at different times.

The disorder is rare, and its causes are well recognized. While in the general population it probably occurs in less than half a percent of children, among neglected children between ten and twenty percent are likely to develop RAD, and as many as one third of maltreated or abused children will meet the criteria for this diagnosis. In other words, this is an illness undoubtedly caused almost entirely by environmental factors. (more…)

A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW

Click here to contact Daniel and/or see his GoodTherapy.org Profile

Both John McCain and Barack Obama have pledged to make mental health treatment, especially for returning veterans, a priority in the new Presidential administration.

Obama has spoken against cuts in services for both Medicare patients and veterans, though he has not been as specific as lobbyists would like.

Speaking to a crowd of veterans in Billings, Montana, where Obama briefly traveled from the Denver Democratic convention, the candidate decried current policy and pointed out that armed services veterans are seven times more likely to be homeless than Americans who don’t serve.

In Montana, roughly half the veterans suffering from post-traumatic stress disorder go untreated for the psychological condition, Obama said. (more…)

By Patti Desert, LCSW-C, CEMDR, CP

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Post Traumatic Stress Disorder (PTSD) is conventionally diagnosed when a person has been in some way exposed to an event that involved actual or threatened death or serious injury to self or others. The person must also have experienced intense fear, helplessness, or horror and currently is re-experiencing these states in some form or other. In children these feelings may be expressed instead by disorganized or agitated behavior.

However, the experience of trauma does not always fit the clinical category of Post Traumatic Stress Disorder. A person can experience trauma in ways other than involvement with an actual injury or threat to self or others. It is inadequate understanding of this expanded awareness of trauma that stimulates further confusion, depression, anxiety, and stress in an already traumatized individual and has many therapists misidentifying the problem and thus effective treatment. (more…)

By Arthur Becker-Weidman, Ph.D.

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Attachment is the base upon which emotional health, social relationships, and one’s worldview are built. The ability to trust, and form reciprocal relationships, will affect the emotional health, security, and safety of the child, as well as the child’s development and future inter-personal relationships. The child with disordered attachment may be impulsive, doing whatever the child feels like, with no regard for others. This child may be unable to feel remorse for wrongdoings, mainly because the child is unable to internalize right and wrong. The child may tell you that something is wrong, but that will not stop the child from doing it. (more…)

By Deborah Reeves, MGPGP, LPC, CGP

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Finding the best trained therapist is an excellent investment in one’s future. Effective psychotherapy can help resolve conflict(s) and can greatly assist in helping all people to gain the emotional and cognitive tools necessary to better solve future problems.

Making a conscious decision to be in psychotherapy is the first step and perhaps not such an easy task because it can bring to mind the awareness of uncomfortable feelings, thoughts and ideas about the problems at hand and about being in therapy. It is a good idea to take the time to choose a therapist thoughtfully and with care. Why? Because it is essential that you feel comfortable and confident with the therapist you select. It is important that your therapist is compassionate, sincere and genuine but these attributes are not sufficient in and of themselves. Well-trained therapists are open and able to work with all emotions for example, feelings such as jealousy, love, disgust, hate, dread, anxiety, shame and more. It is also helpful when you feel you are being heard. Working with a therapist who has good listening skills and who responds in a clear, genuine and honest way with out being superficial is paramount to good treatment. (more…)

A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW

Click here to contact Daniel and/or see his GoodTherapy.org Profile

The profession of psychology is experiencing tremendous controversy and internal division over the issue of psychologists aiding interrogators in the United States’ “War on Terror”.

Many psychologists object to the practice on ethical grounds, citing the ethical imperative to “do no harm” and protect the interests of individuals under their care, and contrasting these ethical issues with the obvious risks of psychological harm inherent in the intense questioning tactics used by the military and intelligence agencies.

However, according to a report by the New York Times, other psychologists insist their presence protects detainees from the extreme harm that would be possible if no mental health professional were present. Opponents of the practice say this argument is a disingenuous cover for the highly-paid service of assisting questioners in “breaking” their subjects. (more…)

By Chesley C. Swanson, LMSW

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What Are The Negative Effects of Divorce on Children?

Most children are confused, afraid, hurt, sad, angry, and anxious when they sense or are told about their parents’ divorce. Interestingly, these are the same emotions that their parents often experience during the divorce process. It is no secret that there are many possible negative effects children experience both during and after a divorce. These negative effects are exacerbated when parents are fighting over “custody” and minimized when parents make parental decisions together, out of sincere concern for their children’s needs. The list of potential negative effects is long and includes: (more…)

A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW

Click here to contact Daniel and/or see his GoodTherapy.org Profile

From the good news / bad news department: Mainstream media sources are reporting that American psychiatrists have essentially stopped practicing psychotherapy – except with private paying clients, and even then only rarely – and are dealing almost exclusively with medication management. Over the last twenty years, the percentage of psychiatrists offering talk therapy has declined from a little less than half to a little more than one quarter, according to the most recent National Ambulatory Care Survey. As a result, the success rates for treating depression and anxiety have slipped, since a combination of talk and medicine is always the preferred treatment.

The cause? Mainly, managed care. Insurance companies prefer the faster and cheaper route to symptom management: pills. This would seem to be bad news for clients, bad news for therapists, and bad news for anyone concerned about the mental health of the general public. So what good news could there possibly be? (more…)

By Jennifer Lehr, MA, MFT

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“I am in the middle of my beautiful life”. I tell myself this on occasion, and it always moves me into gratitude and also opens me up to feeling. It is a way of honoring my life, with all of its complexities, flaws, joys, heartaches, etc. Even the parts of me that hurt or are small or broken are part of the beauty of my life. It moves me out of a perfectionistic attitude and into an owning of what it is to be human: beautiful and amazing, yet imperfect and wounded. It allows me to see my life stretched out from infancy to a future I have not yet created. I honor this life, this moment, this journey that I am on. This moment is part of a bigger picture, a bigger pattern, a bigger life than I may realize. I open up space for myself. I create grace. (more…)

By Jim Hutt, Ph.D., MFT

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Differentiation is a clinical term, and when therapists talk or write about it, it often leads to confusion. I’m going to try anyway, because I think the concept is a good one, and can be helpful for couples who are trying to make their relationship more satisfying. It is a concept/theory that has a practical application.

I like the term because it has the word ‘different’ in it. And that’s what you and your partner are: different—not the same—two separate, distinct people with your own thoughts, feelings and behaviors. That is part of what differentiation means—you are different.

Differentiation also means: You see the world through your eyes, and your partner sees it through theirs. When observing the same thing, such as an abstract painting, or experiencing the same event, such as a movie, neither of you are likely to see, or experience, them the same way.

This probably all seems so obvious—you see and experience stuff your way, the other their way. Here’s the rub: will you do the same when under stress with each other? In other words, will you see, and take responsibility for, your role in the issue, take responsibility for your part in the conflict? Can you, will you, take your inventory, and make it safe for your partner to take their own inventory? When you do, you are living a differentiated moment, and your partner will respect your efforts.
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by Jeanine Austin, Ph.D.

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My dad is an easy going and open minded man. It is funny for me to contemplate that he has a daughter with my temperament. I can see his face looking down at me as a young girl, perplexed by his daughter’s inability to let anything go, even when it clearly didn’t serve me to do so. As a child I could easily be described as intransigent, perfectionsitic and stubborn. Unfortunately, many of these qualities followed me into adulthood. Looking back, I can see how my own tenacity caused me many troubles. I just couldn’t seem to get out of my own way.

I now understand why I was so rigid with my desire to control my life. My hard driving ways were nearly constantly positively reinforced by everything and everyone around me. If I worked hard enough I saw that I could achieve nearly anything I wished for in my little world. Whether it was making the cheerleading squad, getting straight A’s or having the attentions of the most desirable boys in school, I saw that striving would pay dividends. The problem was that relying on my own energies and overdriving everything in my life was exhausting. By my teenage years I had burned myself out. In addition, I couldn’t help but notice the things I pursued and attained weren’t offering me much satisfaction. I knew there had to be another way. (more…)

By Arthur Becker-Weidman, Ph.D.

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This article describes the effects of chronic maltreatment, such as can occur in an orphanage, on a child’s psychological development, brain development, and later relationships. There are clear links between maltreatment and later psychological, emotional, behavioral, and interpersonal disorders. The basis for this linkage is the impact that maltreatment has on brain development. Daniel Siegel, medical director of the Infant and Preschool Service at the University of California, L.A., has found important links between interpersonal experiences and neurobiological development

Neglect, physical abuse, and sexual abuse have profound immediate and long-term effects on a child’s development. The long-term effects of abuse and neglect of a child can be seen in higher rates of psychiatric disorders, increased rates of substance abuse, and a variety of severe relationship difficulties. Child abuse and neglect is an inter-generational problem. Most frequently the perpetrators of abuse and neglect are profoundly damaged people who have been abused and neglected themselves. (more…)