Blogging on Good Therapy

A GoodTherapy.org General Announcement

The GoodTherapy.org Team is thrilled to announce that Google has recently promoted our organization’s website to PageRank (PR) Level 6. This new level is awarded on the basis of a number of things, notably: the quality of content and the number of websites that link back to us. GoodTherapy.org’s increased PageRank means increased rankings for all GT web pages, results the GT team have already seen. GoodTherapy.org is now ranked in the top 1, 2, or 3 positions in Google for nearly every location we aim to rank for. This development makes GT information about psychotherapy more visible to the general public and brings GT closer to achieving its goal of promoting collaborative and non-pathological forms of psychotherapy, all in an effort to reduce harm and to bring more “health” into the field of mental health.

By Jennifer Lehr, MA, MFT

Click here to contact Jennifer and/or see her GoodTherapy.org Profile

I was in a therapy session the other day when the person I was working with, who had been struggling with some challenges, said that he was taught that things had to be easy to be okay. I found myself responding…it is a privilege to struggle and have the opportunity to find out who we are, what we are made of.

When life is easy, we can enjoy ourselves and that is wonderful. But what about when life is not so easy? What about when we are up against challenges that really scare or overwhelm us?

It seems that it would be great if our lives were always easy and happy rather than challenging. But if we can only feel happiness when we are in the right situations or conditions, born into the right family or the right socio-economic group, we are trapped by the external. Adversity allows us the opportunity to find out what we are capable of, to access aspects of ourselves that we did not know existed, inner resources we didn’t know we had, and to develop our strengths. (more…)

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

On Tuesday, the United States House of Representatives and Senate passed legislation to ensure parity between mental health coverage and other medical care. The law would apply to group health plans with 51 or more employees. Differences in the bills’ language must be worked out before it goes to President Bush, who is expected to sign it.

The legislation does not mandate that group health plans cover mental health or addiction treatment, only that when plans do so, the coverage must be equitable to other medical coverage.

Jim Ramstad, R-Minn., helped lead efforts to pass the bill in the House, and spoke inspiringly of his own experience as a person in recovery, ”I am alive and sober today only because of the access that I had to treatment following my last alcoholic blackout on July 31, 1981. I woke up that day in a jail cell in Sioux Falls, South Dakota, and I am living proof that treatment works and recovery is possible. But far too many people in our country don’t have the same access to treatment that I and other members of Congress, other federal employees have.”

Because private companies will be able to deduct more health expenses from federal income taxes, the projected cost to the government is about $3.4 billion over 10 years. There is also a loophole in the bill that may concern mental health advocates: (more…)

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

The economic downturn has lead to a spike in the demand for psychological crisis services, according to several sources.

In New York, calls to Hopeline, a telephone crisis service for people experiencing severe depression increased by about 75 percent between the summer of 2007 and the summer of 2008. Hopeline received a record 10,368 in July of this year, and expects a continued climb as the economy worsens and financial stressors – and the incumbent potential damage to self-esteem, hopefulness, relaxation, and other areas of ego strength and functionality – increase nationwide. (more…)

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

How many people have found solace by calling a friend on the telephone in a difficult time?

Northwestern University is reporting research indicating that telephone psychotherapy seems not only to be effective, it may be an even better treatment for depression than face to face meetings. The new study was small and more research is needed to draw any certain conclusions, but the initial data are compelling. In this study, only 7.6 percent of patients ended therapy, compared to the well-established attrition rate of nearly half in traditional therapy.

And before you ask: The researchers found no indication that telephone therapy is any less effective in improving mood.

There may be other benefits, as well. Time management is less of an issue if client can get therapy anywhere they happen to be at appointment time.

Perhaps more controversially, clients who are depressed or anxious may be unmotivated, agoraphobic, or otherwise experience barriers to showing up for appointments. Phone therapy may help overcome these obstacles.

Or will it enable them? Could such an approach inhibit growth in important areas of social functioning? This study did not address the point. A skilled therapist would ideally recognize such a circumstance as distinct from those times when phone therapy is the only way to engage a client.

Past research on phone therapy has shown similar results, especially in the treatment of depression.

Click here to contact Daniel and/or see his GoodTherapy.org Profile©Copyright 2008 by GoodTherapy.org All Rights Reserved. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Daniel and/or see his GoodTherapy.org Profile
Therapist Seattle

By Deborah Reeves MGPGP, LPC, CGP

Click here to contact Deborah and/or see her GoodTherapy.org Profile

What is a Psychotherapy Process Oriented group and how does it work?

A process group usually consists of around eight people who meet regularly for the common purpose of finding out more about who they are and what it is perhaps that they would like to see change with in their personal lives and in their relationships with others.

The life of a process group from the beginning to the end parallels different developmental stages of growth and maturity. As the natural cycles of the group move progressively forward, the members and the “group-as-a-whole” are assisted with guided feedback and process comments from the leader and or co-leaders. The group inherently knits together with an abundance of experiences forming and emulating a social microcosm that bears its own unique culture and identity.

A remarkable and natural phenomenon in the earlier phases of a working group is the way in which individuals, and sub-groups alike repeat the many characteristic ways once developed to survive the stressors and strains in the very first group…the family. Members will remind each other of significant others in their past or present circumstances bringing feelings, thoughts, ideas and fantasies to the fore. (more…)

By Jennine Estes, MFT Intern

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Many people have heard of the advice to never go to bed angry. This relationship advice has such a great value. It addresses the idea of how couples may feel if going to bed angry, such as feeling emotionally disconnected and unattached, or fear of having unresolved issues getting in the way. This advice is absolutely a great and valuable tool for staying connected and securely attached to your partner. Think about it…going to bed angry in the relationship can create a terrible feeling; it can keep people up all night, have terrible sleep, or many other painful experiences. For many couples, this advice is perfect for their relationship. Obviously, I am a therapist and I truly believe in resolving any and all conflicts, but this doesn’t work for everyone.

Couples faced with relationship conflict often attempt to resolve the issue to the best that they can. When in conflict, couples try to resolve the issue through continuous fighting, arguing, and then resulting into a more damaged relationship. Damaging a relationship is far more dangerous than going to bed angry. (more…)

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

Click here to contact Mary Ellen and/or see her Profile
Click here to contact Ed and/or see his Profile

We recently returned from a conference on alcohol treatment called “New Perspectives.” The conference, hosted by Edgewood treatment center in Nanaimo, Vancouver Island, British Columbia, was, indeed, as advertised. Presenters echoed the same theme: the usual methods of “treating” alcohol abuse and dependence don’t work. While this isn’t news to some of us who’ve looked at the statistics for over twenty years, it is the first time we’ve ever attended a conference that wasn’t hyping the same old failed models. Perhaps being Canadian – a country not quite as enamored with the Minnesota 12-Step Model – helped. Whatever the case, it was a refreshing change. (more…)

By Jeanine Austin, Ph.D.

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Because I am a huge comedy fan and was saddened by the recent passing of George Carlin, I have been watching many of Carlin’s comedy vignettes on television and on the internet. One of his central themes throughout the years was that of materialism. George was never shy to poke fun at our country’s insatiable and gluttonous desire for things. He observed again and again that Americans will work tirelessly for material things, pack their houses to the brim and then find themselves needing to buy a bigger house to accommodate all of those purchases. The jokes about inane spending always got a laugh for George because it invariably rang true for the audience.

Other comedians have also had a big tease regarding materialism. I once heard Robin Williams say during a stand up routine to a woman in the front row that her necklace was very beautiful and could coincidently easily feed the entire nation of Thailand. Similarly, in the British comedy television show Absolutely Fabulous, Jennifer Saunders leaves her home for a holiday wearing every conceivable signature piece of England’s Burburry line of high end plaid wear: raincoat, luggage, scarf, handbag, hat and umbrella. The writers are making their own statement of course. Conspicuous consumption is funny, if not somewhat tragic. (more…)

By Mary Disharoon, MA, LMFT

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Author’s Note: This article was written as a way of introducing the idea of inner selves and the benefits of Voice Dialogue to my new clients.

The word multiplicity means “the state of having many parts or aspects”. Recognizing that you have many different parts or aspects that make up the wholeness of who you are indicates that you are complex and that you’re able to accept that fact.

You might have grown up hearing about someone in the news or a character in a book or a movie who had “multiple personalities” and you learned to associate it with being crazy. You chose to think of yourself as one coherent self, with one inner identity, operating in one body because that was your idea of psychological health and normalcy. (more…)

By Ernest S. Schmidt, LCSW

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

When people come to therapy they are often unsure of what to expect and sometimes ask me about how to get the most out of our meetings. There are several important things that you can do to increase your chances for success in therapy. I define “successful therapy” as achieving one’s desired results in the most comfortable and efficient way possible. This article will briefly lay out my recommendations on how clients can be successful in therapy.

Honesty
This is one of the most important aspects to successful therapy. When clients are forthright about their current struggles and fully disclose what has been going on, it makes the therapy move that much faster. Although it may seem obvious to be truthful to your counselor, it is often harder than you think. Depending on your situation, feelings of shame and guilt may get in the way of your ability to be open and honest. If clients allow these feelings to prevent them from sharing freely, it limits their chances to move forward and to make substantial progress. (more…)

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

A recent study by the Center for Disease Control, published in the American Journal of Preventive Medicine, is being touted as evidence that some very common treatments for trauma lack empirical evidence of success in helping children and adolescents. The study, which reviewed a small percentage of the available literature, found evidence for the effectiveness of cognitive behavioral treatment, but not for six other kinds of therapy, including what may be the most widely used interventions – play and art therapy.

But the data may not be as convincing as the researchers, and especially the mainstream media (http://uk.reuters.com/article/healthNewsMolt/idUKN0933795420080909?pageNumber=2&virtualBrandChannel=0&sp=true), conclude. (more…)

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

Given that brain research and universal religious values support basic goodness and natural altruism, why is it that there is so much misuse and abuse of power? This is a question I have been tracking since I was a youngster at camp and I became very distressed and just could not understand why one of my tent-mates had stolen another camper’s comic books.

This is a question that has also concerned Dr. Dacher Keltner, a professor of psychology at the University of California. He has done considerable research about who gets power and how they use it once they get it. It seems we have been “guided by centuries of advice from Machiavelli” and more recently “from Robert Greene’s The 48 Laws of Power, (for example: Conceal Your Intentions, Use Selective Honesty and Generosity to Disarm Your Victims, Crush Your Enemy Totally, Keep Others in Suspended Terror) to tend to believe that attaining power requires force, deception, manipulation, and coercion. Indeed, we might even assume that positions of power demand this kind of conduct-that to run smoothly, society needs leaders who are willing and able to use power this way.”

New research on power, supported by brain research on hard-wired morality referred to earlier in this chapter, reveals, however, that “power is wielded most effectively when it’s used responsibly, by people who are attuned to and engaged with the needs and interests of others. Years of research suggests that empathy and social intelligence are vastly more important to acquiring and exercising power than are force, deception, or terror. [However,] studies also show that once people assume positions of power, they’re likely to act more selfishly, impulsively, and aggressively, and they have a harder time seeing the world from other people’s points of view. This presents us with the paradox of power: The skills most important to obtaining power and leading effectively are the very skills that deteriorate once we have power.” (more…)

By Jolyn Wells-Moran, PhD, MSW

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Obsessive Compulsive Disorder (OCD) is an anxiety disorder that can cause significant damage to the sufferer’s life. OCD begins with obsessive thoughts. These lead to the development of behaviors meant to control the thoughts. The behaviors then become compulsive rituals. The person feels strongly compelled to perform the rituals in response to the disturbing thoughts, even though relief may be very short-lived. Serious trouble with relationships, self-confidence, depression, quality of life and, perhaps, a related or other disorder in addition to the OCD, often accompany the disorder. OCD can make life a non-productive, empty, frustrating and lonely endeavor. There is evidence that OCD is caused by a brain dysfunction and that the most effective treatment is a combination of an antidepressant and cognitive-behavioral therapy (CBT). (more…)

By Sherry Gaba, LCSW

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A frantic mother of a 15 year old daughter of a local suburban neighborhood tells her therapist that her daughter has quit the cheerleading squad, no longer dreams of college and becoming a lawyer, and her childhood friends have been replaced with friends she has never met. Her daughter has been isolating, reading all the latest celebrity gossip magazines, and becoming more rebellious at home. Clearly her daughter is pulling away which can be one of the hallmarks of addiction, depression, or an adolescent trying to form an identity. When you think of addiction, you think of drugs, alcohol, or even an eating disorder. What about the newest addiction teenagers are being struck with called “Celebrity Addiction.” One third of Americans are being struck with this phenomenon which is linked to depression, anxiety, body-image problems, and addiction. (more…)

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

A new study examining the effects of the common antidepressent Citalopram (brand name: Celexa) has found clinically significant differences in how the genders respond to its use in treating depression. A study of nearly three-thousand Americans found women 33% more likely to acheive a full remittane of depressive symptoms, despite the fact that their depression was overall more severe than men’s.

What to conclude from this? Researchers believe chemical differences in men’s and women’s biology are responsible, and are focusing on hormones. But there are certainly other possible explanations. It may be that cultural factors make non-pharmacological interventions more necessary for men. It may be that severe depression responds better to pills than moderate depression, and that women - as is well documented, for reasons, biological or environmental, not addressed in this study - are more likely to be more severely depressed. And of course, it may be a fluke - though the numbers in this study are fairly compelling.

Perhaps most important is one confounding variable not addressed by these researchers: Study participants were allowed to continue talk therapy if they were already engaged in that work, and no statistial analysis of that variable was calculated in the findings. Since we know women are more likely than men to seek talk therapy when depressed, this omission is significant. It could be talk therapy - not hormones - that explains women’s superior response to drug treatment. The fact that biology is assumed as the cause, and psychotherapy overlooked, is a telling and diturbing indication of how dominant allopathic thinking has become in the mental health field.

The research was completed at the Unviersity of Michigan this year and showed no differences between men and women in terms of side effects, the amount of time that patients complied with the medication regime, or the time necessary for remission of symptoms. These findings are the largest and most comprehensive study of gender differences in antidepressant treatment ever completed, and are published online in the Journal of Psychiatric Research.

Click here to contact Daniel and/or see his GoodTherapy.org Profile©Copyright 2008 by GoodTherapy.org All Rights Reserved. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Daniel and/or see his GoodTherapy.org Profile
Therapist Seattle

By Jeanine Austin, Ph.D.

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Because most of us like to think of ourselves as nice, thoughtful and kind, saying no may be something that can be difficult for us. We all seek behavior that is consistent with our self concept. If we think that saying no makes us unloving and unaccommodating, therefore in conflict with our valued self image, we will struggle with saying no.

I recently saw the movie 10 Questions for the Dalai Lama. In the movie the Dalai Lama, the leader of the Buddhist religion, turned away interviewers who seemed disrespectful or disingenuous. This was a revelation for me. I was surprised somehow because I believed that he would most likely entertain anybody who asked. It was personally liberating to see that he didn’t suffer fools gladly. He quickly sent away those people he felt were wasting his time. In other words, he said no. (more…)

A GoodTherapy.org Featured Column written by John Rhead, Ph.D.

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Lately I have been reading about solitude and writing about surrender. They seem to go together and have much to say about the spiritual dimension of psychotherapy.

Solitude is usually defined as a period of time away from the company of other humans. However within that definition there is a great deal of variation in terms of how much contact one has with the natural world other than humans. Solitude can be structured to minimize or maximize one’s contact with the natural world. The minimalist version is the Catholic monk living in a hermitage where he stays inside to pray and meditate, living on food that is left for him by other monks whom he never (or rarely) sees. An intermediate version would be spending a few days and nights on a vision quest on a mountain, usually not far from one’s community of supporters down below. The maximum version of contact with the natural world that I have come across is Robert Kull’s new book, Solitude: Seeking Wisdom in Extremes. It is a diary, edited and with added commentary, of his year alone on a remote island off the southern coast of Chile, relying completely on the food he brought with him and catching fish for his sustenance. There the climate made physical survival an ongoing challenge as Kull sought psychological and spiritual sustenance through encountering the psychological and spiritual challenges of such deep solitude. He spent a good deal of his time outside the basic shelter he had built for himself, exposing and surrendering himself to being part of the wild forces of the natural world. (more…)

A GoodTherapy.org Featured Column written by Sarah Jenkins, MC, LPC

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“NOBODY expects the Spanish Inquisition.” - Monty Python

Tuesday was not really a day that I foresaw throwing me any major “surprises.” It would be a mellow one, with little planned outside of my favorite yoga class. The universe, obviously, had something else in store for me. Of course, you don’t see surprises coming. That’s the point.

I strolled into yoga class. (Okay, I was running a bit late. So, here’s the reality. I probably plowed through the door.) Nevertheless, I was grounded and ready for class with one of my “favorite” teachers, in a class that, certainly, stretches me beyond my mental and physical limits. The class was familiar, known, and one that I have a certain “attachment” to. (more…)