10 women on how couples therapy saved their relationshipFrom tackling cheating to porn addiction, counselling helped these women strengthen their relationships.
Relationship counselling, couples counselling and couples therapy are thought of by most people as something you consider once things have got so bad you're on the verge of breaking up. And sure, these services can be used in times of relationship crisis. But therapists will tell you this isn't always the best way to go about things. More and more couples are seeing counsellors before anything major happens in their couple, and some are seeing it as more of a relationship health check.
Here, women who've been to marriage counselling and couples therapy explain how it changed their lives.
"We didn't have any glaring problems but it was great""We did counselling right after we got engaged and it was great. We didn't have any glaring problems and I think people don't think they need it until the problem has gotten way out of hand - and in a lot of cases, that's too late. But for us, we sharpened the tools in our toolbox, and for some of the things that caused annoyance or strife in our relationship, it was great to talk it out with a neutral party."
"It helped with my boyfriend's commitment issues""Recently went through couples counselling with my long-term boyfriend who suddenly was having commitment issues. To be honest it was a bit of an ultimatum. We were either breaking up (which he didn't want to do) or we were going to counselling (which he willingly agreed to). TBH I felt like the whole process was more for him than me because he was the one with commitment/communication issues. But really anything that ultimately gave clarity to the situation - that was for us.
"And since the process definitely helped clarify his worries/anxieties, I felt it was very beneficial. I will caution that couples counselling is limited in its helpfulness if the issues have nothing to do with the couple. If the problem really lies with you or your partner as individuals, consider seeing a therapist on your own as well. That's ultimately the path my boyfriend is taking. At the very least the counselling gave me a lot of insight into his fears, as well as revealing to us both that there was nothing in this world I could do to ameliorate them. That's a battle he has to face himself and he's still working on them."
"We saw a therapist for my boyfriend's porn addiction"
"My boyfriend had a porn problem a year or two ago. It was pretty grim, he was spending a lot of money and choosing it over sex. I actually had no idea it was going on at all until I saw an email notification about how much money he'd been spending on watching camgirls. He'd never done anything like that before so I was really blindsided. I was so upset and considered breaking up with him, but I told him if he wanted me to ever trust him again the first step was couples therapy. It ended up being more just sex therapy and mostly him alone because we both agreed it was a him problem, not really an us problem.
"It went really well. I was there for the beginning and the end, but the middle was just him. From what I understand they broke down the issues that had led him to the porn habit (family dynamics, watching porn since literal childhood, job stress leading to tiredness leading to not really having the energy for proper sex but still wanting that release). As far as I know, he hasn't watched porn since. While I was furious and miserable and felt betrayed for a long time (and still do if I think about it too long) I did, even when it was still very raw, have a grudging respect for how he handled it. He put his hands up and took ownership of everything and then, more importantly, worked on the issues."
"It saved our dying relationship"
"Marriage counselling not only saved our dying relationship, it gave us the tools and knowledge to keep it going. We have the best relationship we’ve ever had now, we needed someone to teach us how to speak each other’s language. Know that counselling alone isn’t enough to sustain you through the next rough patch you have, you have to both be willing to see and accept your shortcomings and work hard to over come them together."
"It taught me a lot about myself"
"While marriage counselling didn't work in the traditional way for my ex and I (hence he is an ex) I learned a lot about myself and how I needed to work on some unhealthy coping mechanisms that I brought into the relationships. I learned effective ways of communicating and boundaries are a good thing."
"My relationship is completely different now"
"The key is finding a GOOD therapist. My experience has been great and eye-opening and I’m in a completely different relationship now thanks to therapy. But also because we chose a good therapist. We tried one out before switching. She did a lot of conflict resolution and listening stuff but didn’t go any deeper into actual relationship problems and deeper-seated issues." [via]
"It saved us after my husband cheated"
"My husband and I went through couples counselling after there was infidelity and frankly it was the best move we could have ever made. Being able to have a neutral space with a neutral person to talk through stuff allowed us both to feel comfortable in saying what really needed to be said. We learned a lot about ourselves as individuals, and a lot about ourselves as a couple. The main takeaway from it all was the handful of new tools we learned, the biggest one was how to better communicate. Needless to say it has been over a year and things are better then ever. I cannot recommend going to a counsellor enough, as long as both are willing to be open and put the work forth it can be a useful tool to combat a lot of issues."
"There wasn't anything 'wrong' in our marriage"
"I don’t have an awesome story or anything, but my husband was going to counselling and I just happened to know the counsellor through my work, so I just tagged along one day. There wasn’t really anything necessarily 'wrong' in our marriage, we just figured that we might as well go and help our relationship to continue to be strong. It was nice. He asked questions that made me think about things I do in our marriage and why I do them, as well as where we both need to grow. It helped us feel closer."
"Therapy is the only reason we didn't break up""My husband and I have been in couples therapy for a little over a year. It is without a doubt the only reason we didn’t end up breaking up. We’d separated due to my husband's drinking problem. I was very reluctant to go, but he asked and I agreed to try it, and we never stopped going. We have been back together since the winter, and our relationship is finally back on track. My husband is just over one year sober, and I’ve been able to work through my anger and resentment for what he put me through. I can’t recommend counselling/therapy enough for couples working through something difficult."
Posted 05.08.19 https://www.pasadenavilla.com/2019/05/08/why-is-a-work-life-balance-important/
Why is a work-life balance important?
As we celebrate Mental Health Month, we are continuing to look at ways to help our mind and body. One way is to strike a work-life balance. Finding a balance between work and life can be challenging. The constant demands we place on ourselves to work harder and longer can take a toll on our physical and mental health. Of US adults employed full time, nearly 40% reported working at least 50 hours per week, and 18% work 60 hours or more.
While companies are offering more flexible schedules that allow employees to be away from the office, there are still other obstacles that contribute to the unbalance. Technology has opened the door for a constant connection to work, interrupting home life at any given moment. And for those with children, the work-life balance can prove even more difficult as over 60% of first-time mothers return to work just 12 weeks after giving birth.
What is the risk of an unbalance?Studies show that we are working harder and longer and sleeping less. But getting in a full night’s rest isn’t the only problem that can come from an unbalanced work and home life.
How do I achieve a work-life balance?When we have a work-life balance, we feel more satisfied with our job and our overall life. Individuals who are able to balance a busy work schedule and their daily activities often have fewer symptoms of depression and anxiety. But how do you do it? We all know there are ways to set limits and prioritize, but here are a few ideas that may help.
How do I eliminate my stress?One of the most important things we can do to help eliminate or reduce stress is to take care of ourselves. When we are on the go at a frantic pace, we tend to forget how important self-care can be physically and mentally. Remember these tips when you are feeling stressed.
It is important to remember that we get run down both physically and mentally and we all need help from time to time. Creating a work-life balance is a process, and we need to examine our priorities from time to time and make changes when necessary. Finding the balance between work and home can help you improve and focus on your mind and body.
Just wanted to show you a video about how much improvement for trauma a vet received through ART.
Watch this video: https://www.youtube.com/watch?v=utq6JDuqS_w&feature=youtu.be
Let us know how we can help here at AccessGrace with our ART program.
our link: https://accessgrace.weebly.com/accelerated-trauma-resolution.html
Thank you for thinking of us,
by Jamie Dean
LGBT activists are dialing up the heat on parents and researchers who question transgender dogma, while peer influence may be leading some teens into life-changing hormone treatmentsOn an online forum for parents concerned about their teenagers’ sudden change in sexuality, one mother confesses: “I am desperate. My 14-year-old daughter just told me that she is trans. These past weeks have felt like a hundred years.”
Another grieving parent says that nothing in her 14-year-old daughter’s demeanor or history explains her sudden declaration of transgenderism. “She has exchanged her pointe shoes for a chest binder, her ballerina bun for a buzz cut,” the mother wrote. “All because some stranger on the internet told her that being uncomfortable in her developing body meant she must be a boy.”
Unlike the growing trend of children expressing gender confusion at a younger age, the teens these parents describe are part of a different phenomenon some therapists and researchers are calling rapid-onset gender dysphoria.
As the name suggests, the affected teenagers—usually girls—go from a seemingly normal gender expression to a sudden declaration that they are in the wrong body. It usually happens at puberty or shortly after. Many of the teens request cross-sex hormones.
Some ask for mastectomies.
Many clinicians and therapists oblige—at least with hormones—and they persuade parents to go along by using frightening leverage: They warn the alternative could be suicide. Terrified parents often give in.
But some researchers and physicians warn against the rush, and they point to another common thread among the teens: Sometimes their transgender declarations happen in clusters.
These researchers think the trend shares similarities with at least one other phenomenon therapists have observed for years: teenage girls in groups of friends who develop eating disorders suddenly and at the same time.
In a similar way, these experts say the influence of peers and social media can lead some girls to search for meaning in a transgender identity or to grasp for answers to other forms of distress by assuming their angst is rooted in dysphoria with their sex.
This isn’t a popular theory, and those who speak out about it—or even study it—often pay a price. But the price for staying quiet is far greater, as teenagers plunge into radical medical interventions often with irreversible effects.
Meanwhile, many parents—often from non-conservative backgrounds—express despair at what they see as a fad. “We are a progressive family caught in the teenage transgender wave,” wrote one commenter on the parental blog 4th Wave Now.
“What we are seeing are pockets of teens … who are declaring themselves either non-binary [neither male nor female] or transgender. … Peer influence is just so huge on these kids … Very, very scary.”
LISA LITTMAN found out the price of raising questions firsthand. When the Brown University researcher published the first academic study exploring rapid-onset gender dysphoria (ROGD) last fall, the blowback was swift.
Some critics questioned Littman’s methods. Others said ROGD wasn’t a legitimate theory. Transgender activist Julia Serano called ROGD “scientifically specious” and an excuse for parents to “disbelieve and disaffirm their child’s gender identity.”
Eleven days after the academic journal PLOS One published Littman’s peer-reviewed study, the editors said they were looking into concerns about her methodology. The same day, Brown University removed a news release about the study from its website.
Critics of Littman’s methods noted she studied ROGD by surveying parents concerned about the phenomenon in their children. (Critics thought she should survey a wider sample.) But the purpose of Littman’s research was to survey parents concerned about ROGD in their teens, not to study all parents of transgender children. And Littman acknowledged the study was a starting place in a field with no other formal research available.
Though editors at PLOS One mentioned Littman’s methods, they also responded to complaints from transgender activists. One person described as a transsexual dominatrix complained on Twitter: “The linked article was written using transphobic dogwhistles (sex observed at birth, for example), so it’s most likely they have a transphobic contributor who knows exactly what they’re doing.”
PLOS One replied and assured the activist the journal was looking into it.
Jeffrey Flier, a former dean of Harvard Medical School, openly questioned the move to sideline the study immediately: “In all my years in academia, I have never once seen a comparable reaction from a journal within days of publishing a paper that the journal already had subjected to peer review, accepted and published.”
Brown University officials said they weren’t squelching academic inquiry on a controversial topic by pulling the school’s news release about the study. But their statement also underscored “Brown is proud to be among the first universities to include medical care for gender reassignment in its student health plan.”
Meanwhile, beyond the publishing controversy, Littman’s findings were disturbing. She received 256 responses from a slew of parents concerned about their teenage children declaring transgenderism with no previous signs of gender dysphoria. More than 85 percent of the survey respondents said they support gay marriage—establishing that the parents likely weren’t concerned about transgenderism for religious or ideological reasons.
Instead, they worried about its onset in their children—mostly girls with an average age of 16 years old. Nearly 70 percent of the parents suspected their child used language they found online to explain their transgenderism, and many said their teens had spent an excessive amount of time on the internet before declaring they were transgender.
Indeed, thousands of videos and forums on popular networking sites feature teens documenting their attempted transition and sometimes offering guides for how to convince parents or physicians to prescribe hormones. One parent in the study said she overheard her teenager boasting about convincing a doctor to prescribe cross-sex hormones and proclaiming, “Easiest thing I ever did.”
When it comes to the theory of clusters, nearly 70 percent of the parents said their teen had been part of a friend group where one or more friends came out as transgender during a similar timeframe. That’s consistent with other comments from parents on 4th Wave Now—a site for parents skeptical of ROGD. (Some participants in Littman’s study learned about the survey from the 4th Wave site.)
In the comments section of the blog, one parent said her daughter was friends with some of the girls in her high school’s color guard team: “Last year my daughter told me that almost all of them felt they were lesbian. This year, most of them feel they are transgender, agender, or, at the very least, are questioning their gender identities.”
In Littman’s survey, 60 percent of the parents said they thought their teens’ declaration of transgenderism increased their child’s popularity at school. One parent wrote, “Being trans is a gold star in the eyes of other teens.”
If being trans is a gold star, being straight is unacceptable to some teenagers. “To be heterosexual, comfortable with the gender you were assigned at birth, and non-minority places you in the ‘most evil’ of categories with this group of friends,” one parent wrote.
Another common characteristic: More than 60 percent of the parents said their child had been diagnosed with a mental health disorder before claiming gender dysphoria, suggesting the teens do need help, but perhaps for other underlying problems.
Other parents said they thought their teens were using an extraordinary method to cope with a common experience: “I believe my child experiences what many kids experience on the cusp of puberty—uncomfortableness!—but there was an online world at the ready to tell her that those very normal feelings meant she’s in the wrong body.”
The pressure on parents to allow their children to take cross-sex hormones, or even undergo mastectomies, is often intense. The claim their child might commit suicide looms large, though some studies show the rate of suicide attempts among transgender people remains high, even after they attempt transition to the opposite sex. Still, Diane Ehrensaft, a psychologist who advocates letting small children dictate their gender, has called transgender interventions for children and teens “suicide prevention.”
That’s enough to leave some parents reeling.
THOUGH SOME CRITICS lambasted the study, Littman isn’t alone in her findings.
Lisa Marchiano, a secular therapist in Pennsylvania, wrote a blog post in 2016 cautioning parents about plunging into medical interventions with children and teens claiming to be transgender. Afterward, she began taking phone consultations with parents of teens experiencing ROGD. A year later, she wrote, “I am overwhelmed by the sheer volume of parents who call me.”
Some parents plead with Marchiano to allow them to fly their children into town for therapy or to help them find a therapist who won’t push their teens to transition with cross-sex hormones.
“At times I am able to offer advice that helps a family steer clear of drastic medical intervention of dubious benefits or necessity,” she wrote. “But sometimes all I can do is stand helpless and watch the wreckage.”
Marchiano described working with a family whose daughter declared transgenderism at age 18. The young woman had experienced other mental health problems but hadn’t expressed a conflict with her sex until high school. The parents had taken her to a clinician, and after a 30-minute consult, a physician’s assistant made an appointment for the teen to begin testosterone injections the following week.
Her parents convinced her to wait, but by the end of her freshman year of college the teenager had begun taking cross-sex hormones and had undergone a mastectomy—paid for by student health insurance. (Eighty-six colleges nationwide have student health plans that include cross-sex hormones and cross-sex surgery.)
Marchiano says the parents reported the radical physical steps didn’t decrease their daughter’s mental anxiety. She had dropped out of college and remained mostly isolated in her home.
Some teenagers report feeling relief after taking hormones or pursuing surgery, and some transgender activists claim social acceptance is a key to transgender adolescents becoming happy. But given that many parents who worry about their teenagers’ decline after experiencing ROGD also expressed left-leaning views of sexuality, social conditions alone don’t account for the distress some adolescents and young adults still feel.
And short-term relief doesn’t negate the long-term consequences of a person rejecting his or her sex and beginning lifelong medical interventions. For example, cross-sex hormones can cause sterility, leaving teenagers to decide whether to forgo having biological children later in life.
Other experts say cross-sex hormones increase risk of stroke and that puberty blockers could decrease bone density in adolescents. And since the practice of giving cross-sex hormones to children is only about a decade old, even pro-transgender physicians admit they don’t know the long-term outcomes.
More studies make sense, including research into the dangers of pursuing such paths. But while studies like Littman’s are under fire, the federally funded National Institutes of Health has given more than $5 million in grants to a group of doctors and psychologists tasked in part with studying transgender children over a period of decades.
The views of at least some of the researchers seem clear from the outset: Norman Spack is a Boston physician who opened the nation’s first gender clinic for children. Johanna Olson-Kennedy is a pro-transgender pediatrician who sees hundreds of children at the Center for Transyouth Health and Development at Children’s Hospital Los Angeles.
Late last year, the American Academy of Pediatrics (AAP) for the first time officially recommended that parents accept and encourage the preferred gender expression of their children.
That cuts across decades of therapists who argued parents should encourage their children to embrace their birth sex, knowing that some studies show as many as 80 percent of children who express gender dysphoria will outgrow those feelings by adulthood.
But in 2016, Cora Breuner, a pediatrician and head of the AAP’s committee on adolescence, told PBS she wanted to see gender clinics available to children all over the United States: “My goal is to make this absolutely mainstream.”
Research into alternate ideas doesn’t promise to become mainstream again any time soon.
Michael Bailey is a psychologist at Northwestern University who faced intense criticism a decade ago for challenging the prevailing ideas about male transgenderism. He still raises questions: “Right now there’s this bias for the narrative that all gender dysphoria is real and that it’s great to transition—and against people who are concerned about this.”
He doubts he’d be able to get a government grant to study the issue. Instead, Bailey’s working on a study similar to the one Littman released last year. He’s conducting a survey in conjunction with the website Parents of Rapid-Onset Gender Dysphoria Kids. (He notes it’s possible some of the same parents may respond to his survey as responded to Littman’s study.)
He says the study will likely be published later this year, but so far, he says the results are very similar to what Littman found. He thinks the reaction against her study was “clearly ideologically motivated” and that it communicated, “This is not valid … and let’s punish anyone who tries to study this.”
Bailey says he knows other psychologists who are worried about the push to encourage children to pursue medical interventions, but who don’t want to speak out for fear of retribution.
Paul Hruz, an endocrinologist at Washington University in St. Louis, says a substantial number of his colleagues feel the same way, but won’t speak up either: “It’s one of the ways we’re failing our patients.”
Hruz notes that when children or teens come seeking cross-sex hormones, they are usually physically healthy, but entering into lifelong dependency on hormones. And he emphasizes the biologically obvious: No one can change his or her sex.
“Sex is biologically determined from at the moment of conception” says Hruz. “It’s recognized at the time of birth, it’s not assigned at the time of birth. And even if you modify the appearance of the body, you don’t do anything to change the sex.”
Despite that biological reality and the many unknowns about the long-term consequences of cross-sex hormones (as well as the already-known side effects), he’s dismayed to see physicians and psychologists pushing such medical procedures on children:
“I’ve not in my career encountered another condition where we’ve moved ahead so rapidly and so vigorously to affirm one particular intervention with this level of evidence.” He hopes the medical community will wake up to the dangers: “But I don’t know how many children will have been harmed by then.”
ANDREW WALKER, author of God and the Transgender Debate and a fellow at the Ethics and Religious Liberty Commission, thinks in a hundred years people will look back on this era of medicine the way we now look back on the eugenicist movements of the early 20th century.
While many obvious biological reasons exist for opposing the embrace of transgenderism, Walker says Christians also should be well-versed in the Biblical teaching about God creating people male and female in His image.
He says that’s particularly important for parents talking with children about these issues: “And I err on the side of having the conversation sooner than later because if you don’t have the conversation with your children, the culture will.”
(Walker says a parent can teach even a young child that some people are confused about the way God made them, and that we should have compassion on those who are suffering in this way and help when possible.)
The suffering is intense for many.
Hacsi Horvath, a lecturer in epidemiology and biostatistics at the University of California, San Francisco, has written about his own experience of trying to live as a woman for 13 years. He says he stopped taking estrogen in 2013 and “very rapidly came back to my senses.”
Today, he says he grapples with anger but writes about his experience because “I am far angrier that thousands of young people are being irreversibly altered and sterilized as they are inducted into a drug-dependent and medically maimed lifestyle.”
He hopes to spare others what he’s suffered: “an inward bruise … I have been badly harmed.”
Weak executive functions make it hard for children with ADHD to clean up—and their distracted brains don’t care anyway! Use these practical organization tips to fix that and to clear the clutter for good.
Do you forget the color of the carpet in your child’s messy bedroom? Does her backpack look like a tornado turned it upside down? Disorganization is a common ADHD trait. The good news is there are ways to get your child more organized. Here are our best kid- friendly clutter-control tips!
Use Visual Cues
Many children with ADHD are visual processors. For school binders, papers,
and notebooks, consider color-coding with a dierent color for each subject. Trying using one color for homework, and another color for papers that stay home. Around the house, use open shelving or clear containers with labels to keep rooms tidy. Clear-plastic, over- the-door shoe holders are a great place to keep small items that are easily lost.
Show — Don't Just Tell
ADHD is passed down in families, so there's a good chance you or your partner has
ADHD and is just as disorganized. It is hard to teach organization skills if you don’t have them yourself. If that’s the case, working hard to set up organizational systems in your house will benet everyone, not just your child. When your child sees that organization is important to you, it reinforces why it should be important to him.
Ask for Your Child's Input
When creating organizational systems for your home, ask for your child’s input. When he is involved in structuring the routines, he has more of a stake in the outcome and may be more likely to follow the routine. If the system isn’t working, bring your child into the discussion to find out what you can change to make it more effective.
Simplify and Declutter
Simplify and Declutter
If you are like most people, you have a lot more "stu" than you use. Simplify and declutter your home, so it is easier to keep it neat. Keep ve toys out and pack the rest in a box; every few weeks, rotate the toys. If your child "needs" a toy from the box, let him know he must put one away. Go through your child’s room and do the same with books and clothes. The less he needs to put away, the tidier the room stays.
Hang Up a Laminated List
"Clean up your room" means different things to different people. You may mean make the bed, pick up the toys, put dirty clothes in the hamper, and so on — but to your child, it may mean throw everything under the bed. Be clear about what you expect. Make a checklist of tasks, laminate it, and tack it up on the back of your child’s bedroom door. When you say, "Clean up your room," he can follow the checklist and mark o each item as it is completed.
Ease the Morning Rush
Getting out the door in the morning is much easier if everything your child needs is in one place. Place a shelf or basket by the front door designated for school items. The night before, when homework is completed, all school items go right into the backpack and/or the basket. Deposit any extra papers, lunch, sport clothes, equipment, or miscellaneous items for school in the basket. Your child knows he has everything he needs when the basket is empty.
Practice Backpack Hygiene
Referred to as "black holes," backpacks are a gathering place for every piece of paper your child touches each day. Make backpack organization a part of daily homework. Before your child begins homework each evening, take the rst two minutes to clean papers out of his backpack and organize them into folders. Bonus: This simple habit helps students transition into doing homework.
Think In the Box
"I can’t do my homework because I can’t nd a pencil." Have you heard that before? Homework time goes much smoother when school supplies are easily accessible. Use an old shoebox to create a homework supply box with pencils, pens, crayons, paper, a ruler, glue sticks, a calculator, and any other items your child regularly needs. Once homework is completed, all supplies go right back into the box.
Work on Timing Tasks
Children with ADHD nd it hard to estimate how long a task will take. Your child
may think that washing the dishes will take ve minutes, but you know, it probably will take 20. When starting a new routine, have your child use a kitchen timer or a stopwatch to time how long each step takes. Try these apps for some high-tech help.
Praise Eort, Not Results
Focus on what your child is doing right. If he attempted to organize his backpack, let him know you appreciate the eort. If he went through the checklist to clean his room but forgot one step, praise him for sticking with it and completing most of the tasks. Experts suggest that parents give ve positive statements for every negative, disapproving one.
By CAROLINE COVINGTON
Lauren Walls had lived with panic attacks, nightmares and flashbacks for years. The 26-year-old San Antonio teacher sought help from a variety of mental health professionals — including spending five years and at least $20,000 with one therapist who used a Christian-faith-based approach, viewing her condition as part of a spiritual weakness that could be conquered — but her symptoms worsened. She hit a breaking point two years ago, when she contemplated suicide.
In her search for help, Walls encountered a psychiatrist who diagnosed her with post-traumatic stress disorder. As a result, she sought out a therapist who specialized in trauma treatment, and that's when she finally experienced relief.
"It was just like a world of difference," Walls says.
Seeing herself as someone with PTSD was odd at first, Walls recalls. She isn't a military veteran and thought PTSD was a diagnosis reserved for service members. But her psychologist, Lindsay Bira, explained that Walls most likely developed the mental disorder from years of childhood abuse, neglect and poverty.
PTSD has long been associated withmembers of the military who have gone through combat and with first responders who may face trauma in their work. It's also associated with survivors of sexual assault, car accidents and natural disasters. But researchers have also learned it can develop in adults who have experienced chronic childhood trauma — from physical, emotional or sexual abuse by caregivers or from neglect or other violations of safety.
Walls was fortunate to find a therapist trained to treat PTSD. Outside of military and veterans' health facilities, finding knowledgeable help is often difficult.
A limited number of the more than 423,000 mental health counselors, therapists, psychologists and psychiatrists in the U.S. are trained in two key therapies, called cognitive processing therapy and prolonged exposure therapy. These are treatments recommended as part of a patient's care by the American Psychiatric Association and the Department of Veterans Affairs, which has studied treatments for PTSD since it affects many service members.
There is no definitive tally of people trained in these therapies, and neither the American Psychiatric Association nor the American Psychological Association tracks those data. A 2014 study by the Rand Corp. found that only about a third of psychotherapists had the training. The VA says over 6,000 of its therapists have, though rosters for the CPT and PE organizations list just a few hundred total practitioners.
Nonetheless, the VA's National Center for PTSD wants to expand access to these treatments, and regional groups, including those in Texas, are following its lead. Texas has a need for more PTSD providers: It ranks No. 2 nationwide in the number of human-trafficking victims; it's the leading state for refugee resettlement; it has the most unaccompanied child migrants of any state; and it's second only to California in the number of military service members — all factors that raise the risk of PTSD.
UT Health San Antonio, a research and academic center that is part of the University of Texas System, teaches community mental health providers how to provide the two PTSD therapies through its Strong Star Training Initiative. Funded by the Texas Veterans + Family Alliance grant program and the Bob Woodruff Foundation, the initiative has trained 500 providers since it started in 2017. Most training takes place in San Antonio, and many of the mental health professionals who participate are Texas-based, though they also come from Florida, Illinois and other states.
In February, about 20 therapists gathered in a conference room at the medical school for instruction. Calleen Friedel, a San Antonio-based marriage and family therapist, was one of them. She said she is seeing more people with PTSD and often felt inept at helping them.
"I would just do what I know and do my own reading," Friedel said. "And what I was taught in graduate school, which was, like, over 20 years ago."
The group learned about one of the mainstream therapies, prolonged exposure therapy, which gradually exposes patients to trauma memories to help reduce PTSD symptoms. Strong Star also teaches cognitive processing therapy, which involves helping the patients learn to reframe their thoughts about the trauma. But both therapies — often called "evidence based" because of the research backing their effectiveness — have been slow to gain traction among psychotherapists because they require the therapist to follow a script and they differ from the common therapeutic approach to mental health issues.
Edna Foa, who created prolonged exposure, said in a 2013 journal article that many psychotherapists believe delving into a patient's inner life and history is central to their work. By contrast, the highly structured, evidence-based treatments — with their pre- and post-session evaluations and their focus on symptom relief — can seem "narrow and boring," she wrote.
In addition, some people living with PTSD have complained that the treatments don't work for everyone. But Foa and others say the focused approach targets the brain mechanisms that cause PTSD symptoms, and symptom relief is what many living with PTSD want.
Edwina Martin, a psychologist in Bonham, Texas, says treatments such as the ones she is learning at Strong Star weren't mainstream when she finished graduate school more than 10 years ago. She is now employed at a VA health center after working for a decade in prisons, and she says she wants these PTSD therapies in her "tool bag."
The push to expand the trained workforce coincides with a growing understanding of trauma's effects. The National Council for Behavioral Health, a nonprofit organization of mental health care providers, calls trauma a "near universal experience" for people with mental and behavioral health issues.
Because so many patients think PTSD is mostly a military problem, psychologist Bira says, they encounter a roadblock to recovery.
"I get that all the time," Bira says. "The beginning stages in treatment that I find with civilians are really about educating [them] about what PTSD is and who can develop it."
Ever wonder if the media your tweens and teens are watching influences their moods and mental health? Consider this. In the month following the release of the critically acclaimed but controversial Netflix show “13 Reasons Why” the suicide rate among Americans ages 10-17 jumped by nearly 30 percent! The series, which began streaming on Netflix in 2017, follows the story of a teenage girl who took her own life and left behind 13 audiocassettes for her friends that unravel the reasons why she did it.
The study, which was funded by the National Institute of Mental Health (NIMH) and appeared in the Journal of the American Academy of Child and Adolescent Psychiatry, analyzed five years of suicide rates among people between the ages of 10 to 64. Although there was no change in suicide rates for adults in the month after the show’s release, the rate among those under 18 rose dramatically. And it was particularly evident among boys.
These findings are troubling and should be a wake-up call for parents.
Young Brains Still Under ConstructionYoung people’s brains are still developing until their mid-20s, with girls’ brains typically developing faster than boys’ brains. In particular, the prefrontal cortex is the last area of the brain to mature at about age 25.
This brain region is involved in judgment, planning, forethought, and impulse control. So, you can understand why teens—and especially male teens—are more likely to make rash decisions. Even car insurance companies know this. It’s why they charge more until a driver reaches their mid-20s.
Troubled Teen BrainsSadly, suicide is a growing problem in our society. The overall rate of suicide has increased 33 percent since 1999. It is the second leading cause of death among people ages 10 to 34. And teens today are more likely to have suicidal thoughts or to suffer from depression compared with Millennials when they were the same age.
Reducing the Teen Suicide RiskThere are many things parents can do to help protect their kids from falling victim to suicide.
1. MONITOR THEIR MEDIA CONSUMPTION.Parents need to understand that what your kids and teens watch on television, online, and on social media can play a role in the development of their brain. Set limits, use parental controls, and talk to your kids about what they’re watching.
2. DON’T LET ADOLESCENTS SMOKE MARIJUANA.Research shows that using cannabis as an adolescent raises the risk of depression and increases suicidal thoughts and suicide attempts when they become young adults.
3. ENCOURAGE HEALTHY SLEEP HABITS.Did you know that teenagers who average just one hour less of sleep at night are 38 percent more likely to feel sad and hopeless, 42 percent more likely to consider suicide, and 58 percent more likely to attempt suicide?
4. PROTECT THEIR BRAIN.Head injuries and concussions—even mild ones that are never diagnosed—increase the risk for suicide. Make sure young people always wear a helmet when riding a bike and don’t let your kids hit soccer balls with their heads.
5. SEEK HELP FOR MENTAL HEALTH ISSUES.If your child is experiencing symptoms of depression, anxiety, or ADD/ADHD, it’s critical to seek help for those issues. Be aware that medications don’t always work, and in some cases, they can make a teen worse. Getting a comprehensive evaluation is key to finding solutions that work.
When our anxiety gets the best of us, it’s difficult to connect with new people. Here’s how to be more present.
BY NICOLE BAYES-FLEMING, MAY 17, 2019 WELL-BEING
Confidence is a quality that many of us wish we could have more of—especially when we’re in a new place, or with a group of people that we don’t know very well. For some, confidence appears to come naturally. But what about the rest of us?
According to Andrew Horn, the founder of Dreams for Kids DC, much of confidence comes from our sense of presence.
“Presence is that embodied existence in the moment, it’s when you’re only responding and reacting to what’s happening right now,” Horn says. “There’s no story from the past, there’s no fear of the future, and it’s a magical thing when we can create that in conversation.”
Here’s how you can soothe social anxiety, and uncover your confidence:
Understanding Shyness and Social Anxiety
Often, what stops us from participating in conversation or events is a simple case of shyness.
“One of the most common symptoms of starting out or being early in our career is shyness, is just these feelings of being intimidated, feeling unworthy,” Horn says.
These feelings of unworthiness often spring up from comparison: we look at someone with confidence and think, “I’ll never be as intelligent or well-spoken as them.” So we stay silent—and then because we stay silent, we criticize ourselves for not being outgoing and confident, further eroding our self-esteem.
“If we’re constantly comparing ourselves with other people, we’re not going to be able to enjoy the [conversation],” Horn says.
Self-doubt not only prevents us from partaking in conversation—by occupying our minds with worry and doubt, it also prevents us from being fully present in the moment. So what can we do about it?
Practice Naming and Taming Your Thoughts
“Our brains are really good at telling us what is going to go wrong in social situations,” Horn says. “It wants to keep us safe; it wants people to like us.”
By cultivating this sense of awareness, you will be able to notice your anxious thoughts when they surface and accept them for what they are.
In order to be less anxious in the moment, Horn recommends envisioning what may cause you to be anxious in a certain situation before the situation actually happens.
For example, if you’re attending a large work conference later in the month, you may already feel nervous about going. Instead of dreading the days leading up to the event, use that time to question what is driving your anxiety—it could be fear of saying the wrong thing, anxiety that no one you know will be there, or imposter syndrome telling you that you don’t belong there.
“Just by actually articulating the undesired state, you are naming it, and you’re taming it,” Horn says. “You’re going to be more aware when those undesired states manifest.”
By cultivating this sense of awareness, you will be able to notice your anxious thoughts when they surface and accept them for what they are. This will help keep you from getting sucked into them, so you can direct your attention back to where it needs to be in the moment.
Try It Out: Practice “Turning” the Conversation
A common anxiety many people have is that they believe they have nothing interesting to say, or will make a fool of themselves in conversation. Horn recommends overcoming this fear by practicing mindful listening.
“One of the easiest ways that we can practice active listening and avoid a conversation dead-end is to make sure that we are ‘turning’ the conversation more than we’re ‘taking’ it,” he says.
By this, he means consistently remembering that we are engaging with another person by turning the conversation back to them—not taking it all for ourselves.
For example, if someone says they ate at a new restaurant, we might respond with, “Oh, I went there last weekend and had the pasta. What did you try?” instead of, “Oh, I went there last weekend. It was ok.” “If we commit to turning the conversation back three and four times, we’re going to peel off those layers and get more depth out of our conversations,” Horn says.
BY EILEEN BAILEY
If you feel unable to rein in sudden outbursts of rage or anger over sometimes small beans, then we recommend taking this symptom test for Intermittent Explosive Disorder and sharing the results with a medical professional.If you feel unable to rein in sudden outbursts of rage or anger over sometimes small beans, then we recommend taking this symptom test for Intermittent Explosive Disorder and sharing the results with a medical professional.
Intermittent Explosive Disorder (IED) is characterized by repeated and sudden episodes of aggressive or violent behavior that can be verbal or physical in nature and are disproportionate to the triggering situation. IED typically appears for the first time during the teen years, but symptoms can continue into adulthood; it is most common in people under the age of 40, according to the Cleveland Clinic.
Answer the following questions to determine whether you show possible signs of IED, and then share the results with a medical professional for further evaluation.
When an episode has ended, do you feel great remorse and regret? Do you promise to never behave in that way again? But then, when the anger builds again, do you feel you are unable to control it?
Can’t see the self-test questions above? Click here to open this test in a new window.
What To Do Next:
1. Take This Test: Oppositional Defiant Disorder in Adults
2. Take This Test: Hyperactive and Impulsive ADHD Symptoms in Adults
3. Find a specialist nearby who could help in our ADDitude Directory
4. Read Why You Lash Out — Sometimes for No Good Reason
5. Download Get a Grip on Tough Emotions
Jeff Stull DMin PhD
Dr. Jeff Stull is an Individual, Marriage and Family Counselor who enjoys assisting his clients in developing creative alternatives to everyday life, love and work challenges. As a Licensed Professional Counselor and Mental Health Counselor he has specialized trainings in Relationship Repair, Abuse Recovery, Adolescents, and Mindfulness. He holds certifications including Professional Counseling Supervision, Clinical Sexology, Professional Christian Counseling and Accelerated Resolution Therapy(ART). He serves his clients in Alpharetta, Cumming and Dahlonega, Georgia and all over the world via Skype.