Posts tagged with ‘therapy’

20 jul

Taking the Steps to Addiction Recovery

RobertCordrayDual diagnosis treatment is a relatively new development in mental health care and addiction recovery. Until recently, clinicians treated mental illness as a separate condition from drug or alcohol addiction. When the conditions overlapped in a dual diagnosis, mental health treatment came only after addiction rehab. This was known as “sequential treatment.”

The Problem with Sequential Treatment

Sequential treatment was the norm as recent as a decade ago. Until then, most clinicians subscribed to a division between mental health treatment and addiction recovery. This meant that people with a dual diagnosis were excluded from one treatment area until they were stable in the other. For example, a depressed alcoholic could not receive therapy for depression until he went through detox and rehab.

Since addictions often stem from psychiatric disorders, people with a dual diagnosis need different types of therapy. When research showed that sequential treatment led to high rates of addiction relapse, its popularity diminished. Today, dual diagnosis treatment centers combine successful aspects of mental health care with substance abuse treatment. The clinicians have credentials and training in co-occurring disorders.

The Benefits of Dual Diagnosis

According to the Department of Health and Human Services (HHS), only 12 percent of the four million Americans with a dual diagnosis in 2002 were treated for both conditions. Today, many rehab centers offer personalized treatment services for those with dual conditions. Nevertheless, finding the right program is a challenge.

Rehab centers that offer parallel services increase recovery chances. They offer supportive therapies that bolster self-esteem and build self-confidence. The most effective treatments bring spouses and other family members into therapy for individual and group counseling.

Many addicts feel immense relief when they receive a dual diagnosis, especially if they lived with an undiagnosed condition for a long time. If they suffered with long-term depression, severe mood swings, painful flashbacks, hallucinations or suicidal thoughts, giving their condition a name can give them hope. A properly trained rehab team can help them can help them recover from mental illness while they battle their addictions.

Dual Diagnosis Therapy Options

People who meet the criteria for a dual diagnosis are classified when they enter treatment. They generally suffer with a condition such as depression, schizophrenia or bipolar disorder as well as alcoholism, drug addiction or another addictive disorder. The most effective treatment considers both conditions.

No single treatment works for everyone with a dual diagnosis. There are many mental health disorders, and the relationship between mental illness and addiction is complicated. Individual recovery plans address specific disorders as well as personal histories of addictive behaviors.

Residential Treatment

People with severe mental illness or heavy drug or alcohol use may benefit from residential treatment programs. This type of therapy offers intensive, 24-hour care and monitoring. It is especially helpful for those who experience psychotic episodes or suicidal thoughts.

Outpatient Treatment

Addicts who are physically and mentally stable may benefit from outpatient treatment, where they can live at home and go to work during their rehabilitation. Because of the minimal supervision, outpatient therapy requires a high level of dedication to recovery to prevent relapse.

Pharmacological Therapy

Pharmacological therapy is usually a key component of dual diagnosis treatment. People with mental illness usually require medications to stabilize their moods, reduce anxiety and prevent flashbacks or hallucinations. While psychiatric medications are often discouraged in substance abuse treatment programs, dual diagnosis patients can benefit from pharmacotherapy during rehab.

Family Counseling

Family counseling is an important part of addiction recovery. This type of therapy educates spouses, children and siblings about addiction and mental health. As they begin to understand their loved one’s condition, they are more likely to provide support for recovery.

Group Therapy

Group therapy is also essential to the recovery process. Peer support groups and 12-step programs are available for addicts, friends and loved ones. Group sessions remind those with drug and alcohol addictions that they are not alone in their struggles.

Most people benefit from a combination of treatment therapies. Getting their lives back on track requires help and hope, and dual diagnosis treatment provides both. Relying on members of their treatment team as well as their loved ones can make rehabilitation easier and more effective.

If you felt moved, inspired, touched, helped, annoyed, or anything after reading this, please let us know. Our wonderful bloggers really do appreciate your comments and feedback. It’s super easy and takes a minute. Click on comments below.

Posted by Robert Cordray on July 20th, 2014 in Health | No comments Read related posts in , , , , ,

16 oct

Make Change an Evolution, Not a Revolution

MaricleMaricle3A young woman was telling me recently how torn she feels about whether or not to leave her boyfriend. They have been together for years, but now they spend less time together, he isn’t supportive, doesn’t like her friends, and gets jealous when she wants to go out without him. Should she leave him? Sounds like a no brainer, right?

Not really.

Each one of us follows a set of routines and habits that make up what we think of as our “reality.”

Consider this: there’s a consistent pattern to how you get ready in the morning, when and how you contact friends and family, where you get coffee, and where you go out for fun. What I am suggesting is that this young woman’s current habits make her boyfriend seem like integral part of her life. She texts him, talks to him, and may hang out with him on the weekend. Despite the fact that they no longer get along, they have habits that keep them connected. She is uncomfortable with their lack of connection, but the habits of their relationship are still comfortable, and therefore she has not changed them yet.

Because our habits and routines are so ingrained, we don’t have to consciously think about them.

This creates the sense that our reality is fixed, when in truth, it’s highly impacted by our habits.

Someone who is outgoing and seeks adventure likely has a different view of themselves and the world than a person who is a homebody. However, if either of these people wanted to change, a first step might be to slightly shift a habit or two.

As our experiences, interactions, and what we see changes, so does our perspective, and therefore our behavior and feelings.

If you think you want to change something, you might experiment with shifting one small habit and see what you notice.

For example, this young woman might be subtly avoiding conversations with men in order to not anger her jealous boyfriend. Perhaps she might experiment in low-pressure situations with making small talk, such as with the barista who makes her coffee, or the man in the elevator. She might notice that these men are kind to her and make her laugh. She might even feel desirable. Wouldn’t that experience shift her view of herself and her “reality?”

Sometimes change is simply peeking around the corner to see what else is there. We tend to think of change as big, sudden, and sweeping, but frequently change is more evolution than revolution. We have to prime ourselves for change through mini exposures to new experiences. This allows us to experiment slowly, deciding what we like and don’t, therefore incurring minimal risk. That’s a change most of us could tolerate.

DISCLAIMER: This information is not a substitute for professional psychological advice, diagnosis, or treatment. All content provided by Maricle Counseling and Amy Maricle, LMHC, ATR-BC is intended for general information purposes only. Never disregard professional medical or psychological advice or delay seeking treatment because of something you read here.

If you felt moved, inspired, touched, helped, annoyed, or anything after reading this, please let us know. Our wonderful bloggers really do appreciate your comments and feedback. It’s super easy and takes a minute. Click on comments below.

Posted by Amy Maricle on October 16th, 2013 in Career, Health, New Directions, Relationships | No comments Read related posts in , ,

26 sep

Stressed Out? What’s in Your Coping Toolbox?

MaricleMariclePost25SeptHow Do You Cope with Stress?

Something my clients talk about a lot is how to cope with stress and anxiety. What does “coping” really mean? Coping is simply what we do, think, or feel that helps us deal with our feelings, without getting too overwhelmed. You already have a number of these skills that you use all the time, whether you think about it or not.

People who cope well with stress and change have a large “toolbox” of skills. Examples of skills might include:

• Telling yourself, “It’s not worth it,” instead of getting into an argument
• Seeking the positive in difficult situations (See a more detailed post here)
• Journaling
• Talking to a friend about your troubles
• Taking a walk to “cool off”

I like to think about having a coping toolbox. My toolbox is comprised of skills in two overlapping categories: self-care and coping skills.

Self-Care: Self-care is the time I dedicate to myself daily, whether alone or with someone else, in order to meet my basic needs, relax and have fun, or enrich or benefit myself in some way. I like to think about self-care as “useful selfishness.” Without taking care of myself, I have nothing to give.

Coping Skills: Coping skills are the techniques I use in the moment to relieve stress, anger, fear, or anxiety.

Taking Care of Myself

When I let my own self-care fall down on my priority list, it shows. I feel grumpy, snappy, and not my usual happy self. Self-care for me includes: running and exercise, talking with my husband, social time with friends and family, being goofy with my kids, making art or music, spending time with my dogs, cooking, and getting enough sleep.

Adequate coping skills also help me stay on an even-keel. Talking directly with someone about what is bothering me, looking for solutions to my problem, reframing a difficult situation in terms of the benefits it brings, running, making art, and journaling all help me deal with very difficult feelings.

Usually though, coping well with stress requires more than just good self-care or one good coping skill. We are complex and dynamic beings, and so our responses to our problems need to be too. Any one skill will probably help me feel a minimum of about 10% better, so I need to use a combination of good self-care and coping skills to cope effectively.

What’s in your toolbox?
Which tools work the best for you? Do you take a shower, go for a drive, dance, build things, or vent? What’s a sure sign that you are letting go of your self-care? Share your insights in the comments section. Thanks for reading and be well.

DISCLAIMER: This information is not a substitute for professional psychological advice, diagnosis, or treatment. All content provided by Maricle Counseling and Amy Maricle, LMHC, ATR-BC is intended for general information purposes only. Never disregard professional medical or psychological advice or delay seeking treatment because of something you read here.

If you felt moved, inspired, touched, helped, annoyed, or anything after reading this, please let us know. Our wonderful bloggers really do appreciate your comments and feedback. It’s super easy and takes a minute. Click on comments below.

Posted by Amy Maricle on September 26th, 2013 in Uncategorized | No comments Read related posts in , , , , ,

01 sep

3 Steps to Avoid Power Struggles

MaricleWhy Do We Power Struggle with Our Kids?

Do you find yourself caught in power struggles with your kids? Most of us do, and sometimes, just making a few small changes can have a big impact. At every stage of development, having a sense of power is critical to a positive self-image. Whether your child is on the Autism spectrum and needs to feel a high level of control, or he is just feeling the usual growing pains of adolescence, all kids need to have some decision-making power.

Giving choices can help kids feel more independent, capable, and in control.

MaricleImageInterestingly enough, when your child feels this way, you will too! The next time you find yourself in a power struggle, look for a way to offer a choice. Better yet, don’t wait for a power struggle – build your child’s self-esteem and save yourself frustration by proactively looking for opportunities to offer choices. Younger children don’t have the tools to understand many things, but we can empower them with little choices: Peanut butter and jelly, or turkey? Yellow shoes or grey shoes? Would you like to brush your teeth before or after the story? Teenagers can understand more and have more input into more significant decisions.

Building decision making skills is one of our most important jobs as parents.

Making choices builds critical thinking, perspective taking, planning, and other important cognitive skills. Just think how many times a day you use these skills yourself. If you help your children practice decision making when they are with you, they are better equipped and more likely to make good decisions when they are alone.

Choice, Stick to It, Praise
This is an easy three-step approach that I teach parents. It can help empower families to avoid power struggles while teaching decision-making skills.

1. Choice:
Take the example of 3 year-old Maggie, who is at the Please Touch museum. Mommy is ready to move on, but Maggie’s not. She refuses to put down a stick. Instead of getting into a power struggle, her mom might say something like: “Maggie would you like to put the stick back here on the blue ledge, or on the red one?”

It’s amazing how giving even a small choice empowers kids and helps them to feel more in control. In this example, Maggie enjoys age appropriate independence and decision-making power. When she completes the task, she can feel proud of her accomplishment. Secondly, by giving her a choice of where to place the stick, her mom uses distraction to shift her focus away from the transition and onto something else.

Now consider an example with 14 year-old Max. He really wants to play both soccer and baseball this year. Unfortunately, there is only enough money for one sport. What if his parents gave him an appropriate amount of information and then involved him in the decision? They might say something like: “Max, we have $200 for sports for you this season. Soccer costs $150 and baseball costs $190. If you choose soccer, then you would have enough money left over to buy new cleats. If you choose baseball, there’s only $10 left over, so you will have to use your old equipment. What would you like to do?” Max has enough information to understand the rationale, and has power in prioritizing what he wants. Now instead of focusing on how it’s “not fair,” or feeling that you don’t care, he is engaged in problem solving and prioritizing together with you.

2. Stick to it:
You need to be consistent. If you tell your child that you have only $200 for sports, you can’t miraculously produce an extra $150 because he whines or begs.

Consistency and predictability make kids feel safe, let your child know that she can trust your word.

3. Praise:
Let her know she did a good job. Most of us love to get a pat on the back. Most kids do too and you will help build a positive self-concept by reinforcing their positive choices and qualities.
Make praise concrete, earnest, and focused on their innate personal qualities or effort.

Try phrases like:
“Wow, you worked so hard.”
“Great job figuring this out,” or
“You’re such a good cook.”

What’s your experience with power struggles? What are your worst or most typical power struggles with your kids about? Which struggles pull you in every time? What are some strategies that have worked for you? (Or which strategies haven’t worked?)

Amy Johnson Maricle, LMHC, ATR-BC is a psychotherapist and art therapist in Foxboro, MA. She loves helping teens and adults find ways to live happier, healthier, and smarter. You can find out more at: www.amyjohnsonmaricle.com

DISCLAIMER: This information is not a substitute for professional psychological advice, diagnosis, or treatment. All content provided by Maricle Counseling and Amy Maricle, LMHC, ATR-BC is intended for general information purposes only. Never disregard professional medical or psychological advice or delay seeking treatment because of something you read here.

If you felt moved, inspired, touched, helped, annoyed, or anything after reading this, please let us know. Our wonderful bloggers really do appreciate your comments and feedback. It’s super easy and takes a minute. Click on comments below.

Posted by Amy Maricle on September 1st, 2013 in Family, Teens | 2 comments Read related posts in , , , ,

02 aug

When Negative = Positive

MaricleHow Negative Thoughts Can Lead to Success

You wish you could make a change, but feel stuck. How do you move forward? One way is to tune into your doubts and negative thoughts. We don’t do this very often. Most of us get stuck in a cycle of criticism, “What an idiot. I did it again,” or we make excuses: “I’m just not that kind of person.” Periodically that inner voice that believes in us might speak up and say, “Wow, you could do that!” but once we hear that inner doubt, we get discouraged, and give up.

Rather than begrudging these negative thoughts, why not invite them to say more? Find out what’s driving all this negativity. When you say you “meant to eat better,” one part of you is on board, but another is not. (Hence the empty box of donut holes on your desk.) So what do those negative thoughts have to say?

Write it out:
Sit down with paper and pen (or computer if that’s your style). To get yourself internally focused and centered, close your eyes, take a few moments to breathe deeply, and focus on your breath.

1. In one sentence, write down the change you want to make. If there were no boundaries, and anything was possible, what would you do?
2. Now write down all the negative thoughts that come up in response to that idea on the left side of your paper. (i.e. You don’t have time. You won’t do a good job. You aren’t attractive enough.)
3. On the right side of your paper: Each statement conveys a belief about yourself and the world? What is it? Can you challenge these beliefs?
4. Looking at the right column, do you see any valid roadblocks? How can you address them? Start brainstorming and researching how others do it.
5. If you have concluded that the negative voice is just speaking out of fear of failure, rejection, or not being good enough: What would it look like if you asked this part to take a back seat and let the positive part(s) take action?

How I Used Negativity to My Advantage
For years I had fantasized about having a private therapy practice – a large art studio where folks could come to explore the contents of their hearts with humor and grace. However, as someone who thrived working as part of a team, I was anxious about a solo practice. I vacillated between visions of feeling fulfilled, independent, and effective with clients, and seeing myself feeling dazed and overwhelmed. This was my problem: part of me saw myself as the “type of person” to have a private practice, and part of me did not.

When I began to entertain the idea of starting my own business, I knew that in order to move forward, I needed to explore my doubts and negative thoughts. Using the questions above, I defined some key roadblocks and came up with creative ways to clear the path to success.

I realized that feeling “alone” was my biggest concern. A key part of my research into building a private practice was identifying how to build contact with other professionals. I joined two local clubs, subscribed to professional blogs, signed up for weekly clinical supervision, set up regular peer supervision meetings, and began inviting other professionals to networking lunches. I have been surprised by how satisfying all this is, and how much I enjoy the time I am working “alone.” Without having tuned into those negative voices, I would not have cleared these obstacles and would never have had the courage to pursue my dream.

Have you surprised yourself recently by reaching a goal you never thought you would? Has tuning into a doubting voice helped you get un-stuck? Tell us about it in the comments section.

Amy Johnson Maricle, LMHC, ATR-BC is a psychotherapist and art therapist in Foxboro, MA. She loves helping teens and adults find ways to live happier, healthier, and smarter. You can find out more at: www.amyjohnsonmaricle.com

DISCLAIMER: This information is not a substitute for professional psychological advice, diagnosis, or treatment. All content provided by Maricle Counseling and Amy Maricle, LMHC, ATR-BC is intended for general information purposes only. Never disregard professional medical or psychological advice or delay seeking treatment because of something you read here.

If you felt moved, inspired, touched, helped, annoyed, or anything after reading this, please let us know. Our wonderful bloggers really do appreciate your comments and feedback. It’s super easy and takes a minute. Click on comments below.

Posted by Amy Maricle on August 2nd, 2013 in New Directions | No comments Read related posts in , , ,

04 mar

The King and I

SaskiaShakinAt the Oscars show this year, it came as no surprise to me that The King’s Speech won four little gold bald guys. What did surprise me was the fact that a movie was made about my line of work. Aside from Professor Higgins in My Fair Lady, I don’t know of another character who comes close to portraying what I have done for a living over the past 30 years.

Let me be clear: I am not a speech therapist. But I do coach people to give speeches, talks, interviews, media appearances, and all manner of utterances where they are expected to shine and to express something unique about themselves.

I am known as The Keynote Coach. And as such, like the creators of The King’s Speech, I have found a lot of drama, intrigue, and joy helping people figure out what is of value to them and, therefore, of value to their audience.

In my surprising career, I have constantly been amazed that even the best of speakers often quake at the thought of addressing an audience. Why should this be?

I have finally come to the conclusion that we all quake at the thought of taking the podium because we think we will be judged and that the judgment will not be in our favor. That’s when performance anxiety takes hold and questions like the following come up:

“What right have I to claim the stage?”
“Why would anyone want to listen to me?”
“What do I know that isn’t obvious already?”
“What do I have to say that is newsworthy … interesting … meaningful?”

Our cranky critic sits upon our shoulder wagging a finger at our every word, nay saying every thought, making us feel stupid, incapable, unconfident, and mirthless.

I have also concluded that the solution to our worst fears is not a laundry list of tips & tricks that might boost our confidence. For those would only be band-aids on an open wound.

We fear the spotlight not because of the number of people facing us; we fear the spotlight because we have not faced ourselves…our own demons whispering sweet nothings in our ear. For they are sweet nothings – devoid of substance, devoid of threat once we take the time to look within instead of without.

Most people preparing to address a group are consumed with:

“What will they think of me?” Instead, we should be asking:

“What do I think is of value?”
“Why am I passionate about this?”
“Why should they care about my words?”
“How can my thoughts inspire (me, and then, my listeners)?”

Most of us go to the podium seeking perfection. That is wrong. What I suggest to my clients is to forget perfection and seek connection. When we are at our most authentic, that is when we will commune with our listeners. When we can afford to be vulnerable, that is when we will connect. Audiences may admire perfection but they relate to our humanity more than to our false persona.

No one is perfect, and on some subliminal level we all know this. So when speakers get real, when they speak their truth, they give us permission to do the same. Heart to heart is where the real connection happens. And The King’s Speech moves us precisely because it is so real, so vulnerable, so authentic.

When we embrace authenticity, we shine. We cannot help it – for only then does our cranky critic know he is licked.

So know that before you can connect to an audience you must connect to yourself – whether you are a king or a commoner. It is a lesson that King George VI had to learn, that Princess Diana had to learn, and that you have to learn as well. But don’t hesitate to do so; you’ll be in excellent company!

Know too, that when you find your voice, no audience will feel daunting. For you then approach the stage knowing that it is your authenticity that makes you unique. And no one, not king, not foe, not boss, not critic can take that away from you.

Saskia Shakin

Author, More Than Words Can Say: The Making of Inspired Speakers

www.TheKeynoteCoach.com

Saskia is available for interviews, media appearances & as a keynote speaker.

If you felt moved, inspired, touched, helped, annoyed, or anything after reading this, please let us know. Our wonderful bloggers really do appreciate your comments and feedback. It’s super easy and takes a minute. Click on comments below.

Posted by Saskia Shakin on March 4th, 2011 in General, Uncategorized | No comments Read related posts in ,