Browsing articles tagged with " OCD"

End The Stigma Surrounding Mental Health Rhode Island

End The Stigma Surrounding Mental Health Rhode Island

According to the World Health Organization, 1 in 4 people in the world will be affected by mental illness or some sort of neurological disorder at some point in their lives. This places mental disorders among the leading causes of ill health and disability worldwide affecting more than 450 million people. However, mental illness is still the highest untreated disease. The National Institute of Mental Health estimates that 40-50% of individuals with bipolar or schizophrenia go untreated each year, and the number of those suffering from anxiety and depression is greater. Many ask why so many individuals will not seek treatment, and the simple answer is because of Stigma.

Stigma is a mark of disgrace associated with a particular circumstance, quality, or person. Those struggling with mental health illnesses feel fear of disclosing their condition to a complete stranger thinking they may be judged or mistreated. They feel shame or embarrassment that they can’t handle their problems on their own. And others don’t believe they need any help at all.

The populations most affected by stigma include young people such as teens and adolescents, men, minorities, military personnel, and those who work in the medical/health field. These people are found to be in the most need of mental health services but most likely will not pursue them.

Many “A” list celebrities such as Lady Gaga, Catherine Zeta Jones, Mel Gibson, Robin Williams, Demi Lovato, and Chris Brown have all been diagnosed with Mental Health conditions and have openly discussed such topics with the public. Lady Gaga goes as far as singing about being “Born this way” as she suffers from depression. We recently just laid Robin Williams to rest after his battle with depression.

It is not uncommon for many of us to be experiencing symptoms of a mental health issue. However, it is common that many of us will not get help due to stigmatized reasons. No illness should go untreated because of stigma. Here at Anchor Counseling Center, our mission is to provide superior, family-oriented, mental health services through dependability, integrity, and social responsibility across Southern New England through education to understand that mental illness should be regarded the way physical illness is – as something to be diagnosed and treated without judgment or stigma of any kind.

We at Anchor Counseling Center want to help you, no Stigma attached. If you or a loved one is in need of mental health treatment, please call our office at 401-475-9979 to schedule an appointment.

You can also find us on our website at www.AnchorCounselingCenter.com

Written by Sarah Porier

References:

http://www.nimh.nih.gov/index.shtml

http://www.who.int/mental_health/en/

http://www.anchorcounselingcenter.com

What is DBT? How does it work? Can it help me?

What is DBT?  How does it work?  Can it help me?

The Queen of DBT

At Anchor Counseling Center, Inc. in RI we offer individuals Dialectical Behavior Therapy or better known as DBT.  Dialectical Behavior Therapy, Founded by Dr. Marsha Linehan in the late 1970’s, is a modification of Cognitive Behavior Therapy that focuses its main goals on teaching clients how to cope with stress, regulate emotions and improve relationships with others and their inner self. DBT can be used to treat a number of mental health conditions including those suffering from Borderline Personality Disorder, Depression and mood disorders, anxiety disorders, personality disorders, those who have suicidal thoughts and feelings, and those who exhibit self-destructive behavior such as eating disorders and substance abuse. DBT works on the foundations of radical acceptance of the self and validation of client’s capabilities and behavioral functioning.

Dialectical Behavior Therapy works in four stages: Emotional Regulation, Mindfulness, Interpersonal effectiveness and Distress tolerance.

Stage one: Emotional Regulation- seeks to regulate client’s emotions by teaching them techniques and giving them tools to regain control of their behaviors. This stage will help the client develop healthy coping skills to dealing with their emotions. The main goal of this stage is to help clients stop self-harmful behaviors or behaviors that interfere with their logical thought process.

Stage Two: Mindfulness -seeks to help the client focus on experiencing their emotions. This stage teaches clients to completely experience all of their emotions without the feeling of losing control.

Stage Three: Interpersonal Effectiveness- seeks to help clients deal with everyday life, its stressors and accepting them for what they are. This stage expands on working to have more successful relationships, careers and social lives by really understanding the self and accepting the inner you.

Stage Four: Distress Tolerance-seeks to reintegrate and connect the client to their everyday world. This is the stage clients will use what have learned in stages 1-3 and put them to use to help deal with relationships, careers and social life. This stage encourages the client to engage and takes steps into making their life more meaningful to challenge what they have learned.

We at Anchor Counseling Center want to help you, If you feel that you or a loved one would benefit from this type of therapy, a number of Clinicians at Anchor Counseling Center offer this treatment please call our office at 401-475-9979 to schedule an appointment.  Or you can visit our website:  AnchorCounselingCenter.com

Article written by Sarah Porier.

Treating Opioid Dependence with Suboxone in Rhode Island

Opioid Dependence and Suboxone

By Kate Logan LMHC, LCDP

What are opioids and what are the characteristics of opioid dependence?

Opioids are drugs that are either derived from, or chemically related to opiates or opium. They include, but are not limited to, vicodin, morphine, codeine and heroin. Many of these drugs are commonly used painkillers, and people often become addicted as a side effect of long term pain management treatment.

Common Characteristics of opioid dependence include:

  1. Tolerance to the Opioids—this happens when you require more of the drug to get the same effect, or getting less effect from the same amount of the drug
  2. Withdrawal Symptoms are present when opioids are not used. These symptoms generally occur about 6-12 hours after the last use of the drug, and the most common symptoms are sweating, muscle pains/aches/cramps, nausea, vomiting, diarrhea, “goosebumps”, dilated pupils and insomnia.
  3. Taking larger amounts of opiods than planned or for longer periods of time than planned
  4. Persistent desire for the drug, or inability to quit using
  5. Spending a lot of time and effort to obtain, use, or recover from use
  6. Giving up or significantly reducing social activities or obligations
  7. Continued use regardless of the negative consequences

What is Suboxone?

Suboxone is a medication used for treatment of opioid dependence. It is a combination of buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that blocks opioids from attaching to the opioid receptors in the brain. This medication reduces withdrawal symptoms as well as cravings. Naloxone is typically used to treat opioid overdose, by knocking other opioids off the receptors and therefore preventing the negative effects of the drug. The naloxone is present in Suboxone to deter people from injecting the drug. If it is injected, the naloxone can cause serious withdrawal symptoms.

By using the combination of buprenorphine and naloxone, suboxone works to suppress opioid withdrawal symptoms as well as reduces opioid cravings.

What will my treatment be like?

Here at Anchor Counseling Center, we work hard to provide you with the correct amount and type of support to make your treatment successful. We provide you with a psychiatrist to handle your suboxone treatment, as well as a counselor to provide support and education for you and your family. Working together, they will develop a treatment plan perfectly suited to meet your needs. Typically, you will be seen weekly by a therapist and anywhere from 1-4 times monthly by the psychiatrist. There is no time limit to treatment, and the length of time that you are on suboxone is a decision only you and your psychiatrist can make together.

If you want to take the first step in receiving treatment for opioid addiction, call the office at 401-475-9979. We will be happy to answer any questions you have and get you on your way to health and recovery!

References:

Suboxone Sublingual Film. Reckitt Benckiser Pharmaceuticals Inc. September 14, 2012. www.suboxone.com

Clinical Guidelines for the use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series, No. 40. Rockville, MD. 2004

Counseling for Children, Adolescents, Adults, Couples and Families in Cranston

Mar 9, 2012   //   by Richard Figueira   //   Blog, East Providence, Lincoln, Rhode Island, Marriage, Mental Health, Stress, cranston  //  No Comments

Anchor Counseling Center

Cranston Office

At Anchor Counseling Center we offer counseling, therapy, psychiatry, coaching for children, adults, families, and couples.  The center also offers group therapy and consultation to school districts to assist with providing appropriate education to those children who need the assistance in order to be able to access the general curriculum.

Our services also include:

  • Adult psychotherapy
  • Child psychotherapy
  • Play Therapy
  • Holistic Counseling
  • Addiction Counseling
  • Suboxone Treatment
  • Social Skills Groups
  • Couples/Marriage Counseling
  • Psychiatric Evaluations
  • Medication Management
  • Services for Children with Autism
  • EAP Services and Consults
  • Life Coaching
  • ADHD evaluations for children and Adults

Our clinical staff are all independently licensed therapists and are committed and capable of providing quality care by listening to our clients and together creating a plan for change.

In each of our locations, we have created an environment where they are warm, welcoming, calming, and relaxing for your therapeutic process to begin.  We work closely with all medical professional involved in your life and take you, the entire person into account to allow the most exceptional care.  We believe in working in collaboration with all the people involved in your life.

Everyone presents with different issues at different times.  Our integrative approach allows us to partner you with the most qualified therapists.  With over 25 therapists, each with different areas of expertise, we will find one that best suits your needs.

We believe in helping our clients facilitate their own ability for change.  He or she will become an expert by being offered education, groups, and or workshops.  We also use social media to reach out to our population with journals, quotes, and information on a daily basis.

Our mission and vision:

Our Mission

Here at Anchor Counseling Center our mission is to provide superior, family oriented mental health services through dependability, integrity and social responsibility.

Our Vision:

To provide the tools to heal through reliable support, coordination of care, psychoeducation, medication, and counseling.

To teach the maintenance of mental well being to patients, their families and the community.

To service all ages, from children through the elderly, without prejudice, prejudgment or bias.

Our vision is t o provide superior, family oriented mental health services through dependability, integrity and social responsibility throughout Southern New England.

To ease the pain of mental illness and provide hope to patients and their families.

To help others help themselves.

To advocate for patients to get them the care they need and deserve.

To reverse the negative stigma attached to mental illness.

At Anchor Counseling Center…

We are here for when you need help…Now.  No waiting lists.

We listen

We help

We support

Let us be the Anchor in your life.  We promise to be reliable and consistent.  No issue to big or small.  We want to help.  Together, we can attain your goals towards a better tomorrow.

You can click on contact for immediate assistance.

You can follow us on Facebook.

You can follow us Twitter.

You can email us @ info@AnchorCounselingCenter.com

or call us 401.475.9979


Creative Group Therapy! Using creative measures with teens!

Jan 25, 2012   //   by Richard Figueira   //   Blog, East Providence, Lincoln, Rhode Island, Marriage, Mental Health, News, Self Help, Stress, Uncategorized, cranston  //  No Comments

The Adolescent Struggle for Autonomy and Self-Identity:

Using Creativity in Group Therapy

By: Aryssa Washington, Roger Williams University (2011)

Therapeutic work with adolescents is often seen as a challenging task, especially in the initial stages of the therapy processes (Allen, 2005). It is important to remember that while some adolescents may be in therapy voluntarily, others are required to participate in therapy by parents and/or court mandate. Since adolescents are not often in the position to initiate the process of therapy, they may express apprehensive attitudes that work against the formation of a healthy therapeutic relationship. As with adults, some teens may not have the insight to perceive the need for therapy. Also, adolescents involuntarily participating in therapy may feel that clinicians are allied with their adult guardians, as opposed to with them. Regardless, if the therapeutic experience is new, most youth will be processing feelings of discomfort in the therapy environment; thus, creative and culturally-aware approaches that address adolescents’ uneasiness and resistance become a necessary feature in therapy (Allen, 2005).

According to Erikson, social and cultural experiences are integral to human development (Zayas, 2001). His theory expressed the need to cogitate both the individual and the common needs all humans share (Zayas, 2001). During latency and preadolescent development, youth are challenged with assuming socially-specified roles and balancing a sense of autonomy with the sense of inferiority (Erikson as cited in Zayas, 2001). For adolescents, developing a sense of individuation and independence is an important achievement, and the society surrounding the youth “provides the guidance, opportunities, challenges, motivation, experience, counsel, and instruction for accession into adulthood” (Zayas, 2001, p.363). In accordance with Erikson’s theory, youth will rehearse the roles that perceived to be essential to later success in life, as observed within his/her social culture (Zayas, 2001). The confidence that is associated with a sense of autonomy helps form the adolescent’s identity, and occurs when he/she feels supported (Zayas, 2001). Because of the universal adolescent struggle with self-identity and independence, group therapy is often thought to be an effective option. Aadolescents, with and without a clinical disorder, have ongoing issues with low self-esteem, and developing problem solving skills (Hartz & Thick, 2005; Richmond, 2000). Group work with adolescents often aims to address this over-arching issue, in the process of targeting more specific issues such as, behavioral/conduct problems, trauma, medical illness, and substance abuse (Veach & Gladding, 2007). One way of targeting the issue of self-esteem, self-identity, and autonomy, as it is associated with more specific clinical issues, in adolescent group therapy is through creative therapy modalities.

Creativity, in the therapeutic setting may be described as the “ability to produce work that is both novel, and appropriate” (Sternberg & Lubert, as cited in Veach & Gladding, 2007, p.72 ). Creativity is the creation of original work by clients that is useful to the therapeutic goal. Contrary to popular belief, creativity is not to be misconstrued as unstructured work. Many therapists recommend the use of creative therapies within the construct of some theory basis—most often found as an adjunct to cognitive behavioral or client-centered group therapy (Veach & Gladding, 2007; Pardeck, 1994).  In fact, working creatively in groups with youth requires structure, albeit a subtle use of directives when facilitating groups (Vick, 1999; Backos & Pagon, 1999; Pifalo, 2002).  For the purpose of this paper, creative therapies and expressive art therapies are used interchangeably.

Expressive arts therapy, as posited by person-center theory, includes “movement, art, music, writing, sound , and improvisation  in a supportive setting  in order to facilitate growth and healing” (Rogers, 1993, pg. 3). Person-centered theory supports the notion that all individuals are innately creative, thus expressive art therapy can be used as a process of self-discovery through emotional depth and self-expression. Humanistic principles support that the focus of expressive art therapy has nothing to do with the end product or the mechanical principles of any art form, but its focus is on the clients ability to “let go, express, and release emotions and to gain insight from studying the presented symbolic and metaphoric messages” (Rogers, 1993, pg.4). For adolescents, the production of artwork operates as a medium of ownership and a means to explore personal identity. The group setting provides the social support necessary in increasing confidence, as well as provides another modus to gain insight and learn new ways of thinking from social peers. Based on the adolescent struggle for self-identity, and desire to be self-productive, this paper examines the use of several creative therapy methods with different adolescent populations.

Music Therapy

Music therapy may include the creation and/or deconstruction of musical pieces. This could comprise the analysis of musical lyrics, the composition of musical pieces, or even playing beats on a drum (Towse, 2007). In their overview of the literature on creative techniques with adolescent groups, Veach and Gladding (2007), found that music therapy was often used to help improve social communication and as a preventative measure by increasing the development of coping skills. DeCarlo and Hockman (2003), found that the use of RAP therapy in conjunction with psychoeducational therapy promoted prosocial behaviors. These researchers posited the use of rap music in order to connect with African American juvenile offenders, status offenders, and high school students (with no record) from the same urban setting. The rap music served as a connection between therapy and the contemporary customs of the youth.  The rap therapy condition analyzed the lyrics of chosen songs that related to the specified psychodeducational topic of the day. While very much a goal-oriented treatment, DeCarlo found it was important to use cultural customs, to relate to the adolescents on their level, in order to influence desired behaviors.

Movement

A common use of movement, or dance, therapy is with adolescent female groups (Veach & Gladding, 2007). Movement therapy often has a preventative focus for young females experiencing radical body changes, or with teenage females struggling with self-image or self-identity conflicts (Block, 2001). In her clinical work with female adolescents and in dance, Block (2001) has created a framework for dance therapy in efforts to address young women’s issues with self-confidence, identity, and image. Again, the group setting functions as social support and a forum for discussion and insight development. In her framework, Block (2001), proposes that the members chose an undesired body part to lead with in a sequence of movements. Then the girls go into a group and discuss how social media and cultural assumptions contribute to their own perceptions of their self-image and self-concept. Following this, the group works as a team to build a dance with their new perceptions of the previously unwanted bodily feature.  The final stage is for the members to create a dance that illustrates how they view their bodies now (Block, 2001). In this type of dance therapy, transformation occurs when the teens become aware of his/her Self, and how society may contribute to the formation of one’s Self. The members must also become aware of others and how they relate (physically and mentally) to others (Block, 2001).  The resultant creation is an external demonstration of how he/she views him/herself. The performance of the Self for the group helps to facilitate confidence in how the youth identify themselves.

Literature

The use of literature in therapy is often termed “Bibliotherapy.” In essence, participants read specifically themed books, poems, or news articles, to explore particular issues that the members of the group may be dealing with (Pardeck, 1994; McArdle & Byrt, 2001). Bibliotherapy is often used as an adjunct to cognitive behavioral therapy with teen groups because it is a creative method that allows for therapists to address cognitive distortions or faulty impressions adolescents may have. Group members work through the stages of identification, catharsis, insight, and universality in relation to the main character and the other group members. Group bibliotherapy usually includes interactive projects, writing exercises and discussions (Pardeck, 1994). This creative methodology has been effective with various teen and even adult populations, but there has been a large amount of research done with the use of bibliotherapy and juvenile delinquent populations, or with teens that have emotional and aggressive regulation difficulties (Bogestad et al., 2010; Schetman, 2000; McArdle & Byrt, 2001).  McArdle and Byrt (2001), and Pardeck (1994), found that bibliotherapy was efficient in providing a place for emotional purging, problem solving opportunities, increased personal insight, and a medium for positive expression.

Expressive Writing

Prominent psychologist, Stanley G. Hall’s “intellectual emancipation” concept coincides with Aristotle’s notion of empowerment through understanding language and how it is used (Leary, 2006). The idea of teaching writing principles and then allowing the individual to narrate his/her own story applies to the use of expressive writing in group therapy with adolescents. As with bibliotherapy, expressive writing provides the means for emotional purging, self-expression, and personal insight. Expressive writing is often used with juvenile offenders, youth suffering from chronic or acute illness, or with youth who have suffered some form of trauma (Baerg, 2003; McArdle & Byrt, 2001; Veach & Gladding, 2007). The issue, as it relates to these aforementioned populations, is the youth’s feelings of powerlessness and/or low self-esteem.  According to Dr. Kane (as cited in McArdle & Byrt, 2001), the aim of expressive writing is to generate creativity and empowerment which is likely to assist in the establishment of self-identity.  In most cases, the group members are taught basic writing principles and are given a writing prompt, the resultant product provides each member with a narration of his or views and experiences (McArdle & Byrt, 2001). Basically, it provides teens with a tangible visualization of his/her thought processes and cognitive patterns.  This provision of self-understanding promotes feelings of power and self-esteem in situations where adolescents may not actually have/ or did not have a lot of control over. McArdle and Byrt, (2001), also found that in adolescent forensic populations, expressive writing promoted social interest, helped develop decision-making skills, as well as aided in increasing youth accountability.

Drama Therapy

Drama in group therapy with adolescents can be used as both a preventative or intervention method. For instance, group members may be asked to role play and act out parts of life in order for them to practice different behaviors (Veach & Gladding, 2007).  One study used Shakespeare’s play Hamlet, to explore the idea of consequences in relation to personal choices and accountability (Veach & Gladding, 2007). Participants were asked to act out the play and discuss the various choices the characters made in relation to how they would respond and the associated consequences.

With the intention of promoting positive youth development, Dutton (2001) used drama as a preventative measure for preadolescent youth. Positive youth development included building competencies, increasing the teens self-worth, and promoting the recognition of individual and group strengths (Dutton, 2001). In this type of drama therapy, the initial step is to form a group, then to get the group to form an identity, and then to get the group to use the forum as a place to enhance decision-making skills. In Dutton’s study (2001), a group of ten members was formed and then asked to put on a performance using any art medium they chose. The group facilitator acted as a monitor, mediator, and was there to reflect the ideas of group members. The main decisions had to be made by the group as a whole. The ten members agreed to do a Hip Hop drama, and created their own group name. The group was provided with a snack, over which they discussed ideas, concerns, and problems. They also created their own session times to accommodate students with busy schedules, and agreed to go see a different play outside of therapy to get ideas. Eventually, the group chose and performed Romeo and Juliet, which included setting up a dress rehearsal, charging admissions, advertising, and selling concessions during intermission. Allowing the teens to create together and agree on all major decisions, promoted a sense of autonomy, and helped in the development and verbalization of problems, concerns, and decisions. Granted this creative modality generates a sense of autonomy and prosocial behaviors, certain populations of youth may not benefit from such a therapy as it relies heavily on participant responsiveness and group work.

Activity Therapy

Activity therapy is basically the extension of play therapy with children, however, developmentally appropriate (Paone, Packman, Maddux, & Rothman, 2008). For the most part, the literature shows that activity therapy with adolescents is often used to promote a sense of achievement, teamwork, and prosocial behaviors (Veach & Gladding, 2007). Paone et al. (2008), used activity therapy with at-risk ninth grade students to examine the effects of group work on the development of moral reasoning. Paone et al. (2008), measured moral reasoning via pre and post test scores on the Maintaining Norms Schema Subscale of the Defining Issues Test 2 (DIT-2). This study addressed issues regarding the adolescent struggle of autonomy versus the constraints of social authority. Paone et al., (2008) posited that the moral values that help humans make decisions about what is right versus what is wrong, are formed by the observed patterns each individual learns(or perceives) in his/her social surroundings. This notion supported the use of the group as a social support unit and environment to observe and re-learn new behaviors or thoughts.

Participants were split into 12 small groups (N = 61) and received either group activity therapy (GAT) or group talk therapy (GTT). Each group was given 5 different dilemma situations over the course of 10 weeks.  While the GTT group simply talked through the issues and consequences presented with the dilemma, the GAT group had several stages.  First, the GAT group was presented with the dilemma by the group facilitator, then the group participated in a developmentally appropriate structured activity relating to the dilemma. Afterwards, the members could have free play by themselves or with other members, and the final stage consisted of a snack and discussion table.  Throughout all of these stages the facilitators reflected feelings, content, and behaviors to be incorporated in the activity (Paone et al., 2008).  The results revealed that the increase in moral reasoning was greater for those who had received the group activity therapy intervention. This creative therapy is heavily structured, but implements movement, interest (or fun), and interaction. The idea that youth can learn by simply being youth and having fun, was important in understanding how group activity therapy works. With this technique, teens can do developmentally appropriate activities that are set up within the context of situation the group facilitator desires the youth to derive knowledge from. Activity therapy allows for adolescents to actively make personally relevant choices/decisions as it relates to a problem, as well as see other ways to handle the same problem.

Art Therapy

Art therapy (visual art) has been used with a variety of juvenile populations. Hartz and Thick (2005), used visual art therapy with female juvenile offenders and found that it improved their self-esteem. They also found relevance for the discussion of social change elements when the group was discussing each other’s art work. Fliegel (2000) and Vick (1999), found that art therapy was useful in short-term psychiatric inpatient treatment programs for adolescents. An abundance of literature exists on the use of art therapy with sexually abused adolescents, and adolescents who suffer from chronic and acute illnesses. Unfortunately, most of the research with these two populations of teens in particular is focused on females. The emotional component of expressive art is used to its advantage with these two juvenile populations.

Pifalo (2002) found that art therapy provided female adolescents with a sense of power and control, which increased their overall self-esteem. Allowing the adolescents to explore their emotions in creating art and then attaching their own meaning to it put the power back into the hands of the victim. Pifalo (2002) also found that therapy through art reduced the anxiety, posttraumatic stress, and overt disassociation of adolescent victims. Backos and Pagon (1999) revealed similar results with their study of female adolescent sexual abuse survivors. They found that art therapy allowed survivors to first withdraw, then reflect, and finally explore their associated emotions and thoughts. The goal of their experiment was to assist adolescent survivors in forming a sense of a unified persona, with a feeling of mastery, or control over his/her life (Backos & Pagon, 2008).

According to Baerg (2003), many adolescents may not have the words to effectively express the depth of emotion they feel with regards to their sexual abuse or medical illness—art operates as a modus to express first, explore, and then attach meaning. Baerg (2003), who does art therapy with adolescents with chronic or acute illness, states that her role as the therapist is to make general and encouraging comments about the artwork group members present, and allow that individual to discuss their own work further, find their own meaning, and provide their own insight. The use of art in this fashion allows adolescents to feel in control, and provides them with the opportunity to explore those emotions and thought processes. Baerg (2003) also found that with adolescents suffering from a medical illness, showcasing his/her art work was an important part of group and individual therapy, because it enabled the members to tell their story as they perceive it in a very supportive setting (which an individual may or may not have outside of the group; Pifalo, 2002).

Conclusion

What seems to be an important focus of group therapy with adolescents is the fact that during this developmental stage, an individual may be struggling with more than a clinically diagnostic disorder (i.e. psychotic disorder, personality). Most teenagers are in that stage where they are trying to figure out who they are and who they want to be. Alongside the question of self-discovery, adolescents struggle to be independent, productive and successful, but they also fear the responsibilities associated with independence (Richmond, 2000). Both of these concerns result in conflicts with self-confidence and self-esteem, especially if the youth exist in an environment that lacks social support or proper role models of the desired success. What I found interesting was that the use of creative mediums in group therapy with adolescents often aimed to address these two over-arching issues.

Structure is a major element of therapy to be conscious of when using creative techniques, because adolescents do require more structure than adults in order to reach a therapeutic goal. In some art therapy settings, facilitators actually went as far as lighting a candle at the beginning of the session and blowing out the candle before the end of the session. The symbolic boundaries the lighting created allowed for the emotions or trauma an adolescent may have been expressing during the session to remain contained in that setting so the depth of the experienced emotions did not flow over into participants daily lives. In another study, the art materials were set up as a demarcation of creative space versus discussion and instruction space.  There also appeared to be more use of foods/snacks in group therapy with adolescents, which, from my experience, is a fantastic idea.  In a couple of the studies I presented, a snack was set up to separate the space of creation and activity, from the discussion and social interaction space.

Prior to doing the research on various creative group therapy methods, I thought that expressive arts was seen as ineffective or a waste of time in the therapeutic arena, but I found that most of the creative art therapies with adolescents are used in brief, or short-term therapy. For example, the predominate number of the studies presented in this paper had a therapy period of approximately 10 sessions or 10 weeks. Because I desire to do clinical work with both children and adolescents in individual and group settings, I was excited to discover that these creative methods really are not all that unconventional. I was impressed with how easily applicable creative methods are to theories such as cognitive behavioral, positive, existential, and humanistic.

References

Allen, N. (2005). Exploring hip hop therapy with high-risk youth. Praxis, 5, 30.

Backos, A. & Pagon, B. (1999). Finding a voice: Art therapy with female adolescent sexual

abuse survivors, Art Therapy, 16, 126-132.

Baerg, Susan (2003). “Sometimes there just aren’t any word”: Using expressive therapy with

adolescents living with cancer. Canadian Journal of Counselling, 37, 65-74.

Block, B. (2001). The psychological cultural relational model applied to a therapeutic,

educational adolescent dance program. The Arts in Psychotherapy, 28, 117-123.

Bogestad,A., Kettle, R., & Hagan, M. (2010). Evaluation of a cognitive intervention program

for juvenile offenders. International Journal of Offender Therapy and Comparative

Criminology, 54(4), 552-565.

Cordon,R. (2006).  Writing is more than ‘exciting’: Equipping primary children to become

reflective writers. Reading Literacy and Language, April, 18-26

DeCarlo, A. & Hockman, E. (2003). RAP therapy: A group work intervention method for urban

adolescents. Social Work With Groups, 26,45-59.

Dutton, S. (2001). Urban Youth Development-Broadway Style: Using Theatre and Group Work

as Vehicles for Positive Youth Development. Social Work With Groups, 23(4), 39-58

Fliegel, L. (2000). An unfound door: Reconceptualizing art therapy as a community-linked

treatment. American Journal of Art Therapy, 38, 81-89

Fried, C., & Reppucci, D. (2001). Criminaldecision making: The development of adolescent

judgment, criminal responsibility, and culpability. Law and Human Behavior, 25(1), 45-

61.

Greenwood, P. (2008). Prevention and intervention programs for juvenile offenders. The Future

of Children, 18(2), 185-210.

Hartz, L. & Thick, L. (2005). Art therapy strategies to raise self-esteem in female juvenile

offenders: A comparison of art psychotherapy and art as therapy approaches. Art

Therapy, 22(2), 70-80.

Leary, D. (2006). G. Stanley hall, a man of many words: The role of reading, speaking and

writing in his psychological work. History of Psychology, 9(3), 198-223.

Leve, L., & Chamberlain, P. (2005). Association with delinquent peers: Intervention effects for

youth in the juvenile justice system. Journal of Abnormal Child Psychology, 33(3), 339-

347.

McArdle , S., & Byrt, R. (2001). Fiction, poetry and mental health: expressive and therapeutic

uses of literature. Journal of Psychiatric and Mental Health Nursing, 8, 517-524.

Paone, T., Packman, J., Maddux, C., & Rothman, T. (2008). A School-based group activity

therapy intervention with at-risk high school students as it relates to their moral

reasoning. International Journal of Play Therapy, 17(2), 122-137.

Pardeck, J. (1994). Using literature to help adolescents cope with problems. Adolescence, 29(114), 421-428.

Pifalo, T. (2002). Pulling out the thorns: Art therapy with sexually abused children and

adolescents. Art Therapy, 19, 12-22.

Persons, R. (2009). Art therapy with serious juvenile offenders: A phenomenological analysis.

International Journal of Offender Therapy and Comparative Criminology, 53(4), 433-

453.

Richmond, L. (2000). Reflections on a Thirty Five Year Experience with Adolescent Group

Psychotherapy. Journal of Child and Adolescent Group Therapy, 10, 113-118.

Shechtman, Z. (2000). An innovative intervention for treatment of child and adolescent

aggression: An outcome study. Psychology in the Schools, 37(2), 157-167

Smith, M., Usinger-Lesquereux, J., & Evans, W. (1999). Rural juvenile first offenders describe

what is working and what is not. International Journal of Offender Therapy and

Comparative Criminology, 43, 322-337

Smyth, J., & Pennebaker, J. (2008). Exploring the boundary conditions of expressive writing: In

search of the right recipe. British Journal of Health Psychology, 13, 1-7.

Veach, L. & Gladding, S. (2007). Using creative group techniques in high schools. The Journal

For Specialists in Group Work, 32, 71-81.

Vick, R. (1999).Utilizing Prestructured Art Elements in Brief Group Art Therapy with

Adolescents. Art Therapy, 16 (2), 68-77.

Zayas, L. (2001). Incorporating struggles with racism and ethnic identity in therapy with adolescents. Clinical Social Work Journal, 29 (4), 363.

What is OCD?

Oct 25, 2011   //   by Richard Figueira   //   Blog, East Providence, Lincoln, Rhode Island, Mental Health, cranston  //  No Comments

Obsessive-Compulsive Disorder

As clinicians at Anchor Counseling Center, a question we don’t often hear anymore is, “what exactly is obsessive-compulsive disorder?” Many times we see character depictions of an individual with OCD, such as Nicholas Cage in “Matchstick Men,” or Jack Nicholson in “As Good as it Gets,” but is that really what having OCD is like? Most people don’t actually realize that an obsessive-compulsive disorder does not look the same for every one person. Generally when we hear OCD we picture someone constantly cleaning for fear of attacking germs, or an anal retentive person that must have everything symmetrically in order. Neither of these illustrations should go unnoticed when considering an OCD diagnosis; however, an obsessive-compulsive disorder takes on many forms.  You may recall San Francisco Detective Adrian Monk from the television show Monk and his obsessive-compulsive cleaning behaviors.  For some people, OCD can be that severe, or disruptive to their daily lives. However, according the Diagnostic Manual used by psychologists, OCD can be defined by either obsessions or compulsions and obsessions—you don’t necessarily have to have both.

Obsessions are generally viewed as recurrent and persistent thoughts, images, or impulses that the individual deems intrusive and/or inappropriate. Take for example, Joe Smith. Mr. Smith comes into therapy because his wife says he refuses to help with their newborn child—he even avoids being left alone with the baby.  Mr. Smith then tells the therapist that he has persistent thoughts that he will hurt his infant child, despite the fact that he doesn’t think he could ever hurt his kid, the thoughts still persist.  As seen with Mr. Smith, obsessive thoughts are not extreme real-life worries; they are thoughts, impulses, or images the everyday person does not encounter consistently.

Compulsions, on the other hand, are repetitive behaviors or mental acts that the person does to reduce the anxiety produced by an obsession or prevent some dreaded event from occurring. There have been clients who’ve feared that unless they closed a door eight consecutive times, the house would be robbed while he/she is gone. Other clients have feared that they would hurt themselves even though they didn’t have the desire to die, and to reduce the distress from that thought he/she would repeat the same word twelve times and then be okay.  Other repetitive behaviors include, hand washing, placing things in specific orders, checking and rechecking items (i.e. the door is locked, the lights are off).  Most people don’t think about compulsions as mental acts, but they can include counting or repeating words/phrases silently.

Two other important aspects of OCD is that these obsessions or compulsions are time consuming, and that at some point the individual does recognize the obsessions/compulsions as excessive or unreasonable (usually adults). Many OCD clients will describe their thoughts and compulsions as making “no sense.” Often-times clients feel frustrated because the thoughts and impulses continue to persist even though they know that it’s an illogical thought.  The more severe the case of OCD the more time-consuming the thoughts and compulsions are.  It’s important to recognize how much time acting out the compulsive behaviors takes from your daily routine or how much it interferes with your ability to do your job (or school work) and your ability to function in social or relational situations.

At Anchor Counseling Center we treat many clients suffering from OCD, and we know that for many clients the first step to getting help may be embarrassing or distressing.  OCD is not a disorder that usually just disappears on its own, often times it will rear its ugly head again if the individual is not taught how to take control of his/her thoughts.  At Anchor, we use a variety of techniques to first reveal clients thinking and behavior patterns to themselves, teach them how to address their thought process and adjust their behavior accordingly, and finally we allow them to experience a new way of being. At Anchor we generally use cognitive behavioral therapy (CBT) in conjunction with exposure and response prevention therapy when possible. If you are struggling, and would like to take back control of your thoughts and behavior, please come see us at Anchor Counseling Center.

By: Aryssa Washington

References

Abramowitz, J. (2008). Obsessive-compulsive disorder. In E.Craighead, L. Craighead & D.Miklowitz, Psychopathology: History, Diagnosis, and Empirical Foundations (pp.159-191). Hoboken, NJ: John Wiley & Sons

Abramowitz, J., McKay, D., & Taylor, S. (2009). Obsessive-Compulsive Disorder. Lancet, 374,491–99

Coles, M. & Hayward, L. (2008). Elucidating the relation of hoarding to obsessive compulsive disorder and impulse control disorders. Journal of Psychopathology Behavioral Assesments, 31, 220-227. doi: 10.1007/s10862-008-9106-0.

Jane L Eisen; Meredith E Coles; M Tracie Shea; Maria E Pagano; et al (2006). Clarifying the convergence between obsessive compulsive personality disorder criteria and obsessive compulsive disorder. Journal of Personality Disorders; 20(3) 294-305.

Frost, R., Mataix-Cols, D. & Pertusa, A. (2010). When hoarding is a symptom of OCD: A case series and implications for DSM-V. Behaviour Research and Therapy, 48, 1012-1020.

Anxiety & I

Aug 30, 2011   //   by Richard Figueira   //   Blog, Mental Health  //  No Comments

Anxiety, my old, old friend
Has been with me since day one
She is of the clingy sorts
Which is never very fun

A self-righteous girl, and jealous, too
She keeps a watchful eye
To ruin every opportunity
I have to pass her by

She and I, acquainted for years
Yet I never felt at home
Her constant, nagging presence
Made me feel even more alone

Though she claims to be my friend
I know it can’t be true
The way she tries to control my thoughts
Is not what a friend would do

Anxiety, please go away
For once, just let me be
To make my own decisions
Instead of overpowering me

OCD: Poem by Julia Melidossian

May 5, 2011   //   by Richard Figueira   //   Uncategorized  //  No Comments

Poem by Julia Melidossian: OCD

by Quotes to Remember: Anchor Counseling Center on Wednesday, May 4, 2011 at 10:35pm

Many people have heard of OCD,

But few of them know how debilitating it can be.

It could start with hand washing cycles of four,

But after awhile, you have to wash eight times more.

Or eating your food in a particular way,

Just to be sure no one dies that day.

Completing everything in multiples of two,

Is certainly a time consuming thing to do.

The brain is telling you these rituals make sense,

But continuing to do them just makes you tense.

But you may be very surprised to know,

There is a way to let these compulsions go.

Resisting the ritual is the hardest thing to do,

And you may think its something you’ll never get through.

But believe me, friend, if you work super hard,

The compulsions will ease, and you’ll let down your guard.

Trust me, I’ve been there and I can totally relate,

But soon OCD will subside, and you will feel great.

Anxiety Disorder: Anchor Counseling can help!

Mar 13, 2011   //   by Richard Figueira   //   Blog, Mental Health  //  No Comments

Richard Figueira is a Licensed Independent Clinical Social Worker (LICSW) who completed his Master of Social Work at Boston College. In addition to his work in private practice, Richard is also an Assistant Director of Special Education for a local town in Massachusetts. He is known for creating Emotional and Behavioral Programs that allow children and families to access public education despite having mental health issues.

Richard has dedicated over ten years of clinical work with children and adults having serious emotional, social, or behavioral issues in residential placements, homes, and school settings. Richard has been responsible for the direct supervision of staff including clinicians and teachers.

He has experience working with adults, families, and couples. Specializing in Mood, Thought, and Anxiety Disorders. He uses an eclectic approach depending on the client’s needs. Through the use of therapeutic interventions he has been able to help provide his clients with the psycho-education, positive and healthy coping skills, and an environment where they feel comfortable discussing everyday issues. As always, the goal is to improve the clients overall functioning in their daily lives.

Although, Richard treats many individuals with an array of issues, he specializes in the treatment of Anxiety Disorders. This includes OCD, PTSD, Panic Disorder with or without Agoraphobia, or Generalized Disorder. His dedication to providing the most recent research based interventions have allowed him to be a leader in the treatment of anxiety with children, adults, couples, and families in the state of Rhode Island.

Richard uses primarily a Cognitive Behavioral Approach. His understanding of the disorder allows him to provide his patients with the appropriate psycho-education needed to first understand the illness that affects millions of Americans. With Anxiety, many different approaches are used, but he has been successful using mindfulness techniques along with imagery. Breathing techniques modified with a EMDR, allows to completely understand the function of the anxiety and the role it maybe playing in an individuals life.

For those with fears/phobias he uses exposure therapy in or out of the office. With exposure therapy, he has also been successful at treating Obsessive-Compulsive Disorder or better known as OCD.

Many times children maybe angry, oppositional or defiant and the primary emotion is fear based. They react in order to gain control over their lives. This is especially true for those with attachment or an adverse childhood experience. He completes and fully analyzes the function of this behavior and teaches how to appropriate recognize the emotion behind the thoughts. This will allow to teach appropriate coping skills to modulate emotions.

He will also help his clients understand irrational thoughts or thinking by using Rational-Emotive Behavioral Therapy. The thoughts are questioned and put in perspective when attempting to create a more healthy thinking process. This also allows for a change in cognitive restructuring.

Richard takes most insurances and sees patients in Lincoln, Cranston, and East Providence.

To schedule an appointment please call 475-9979 or click here to send an email.

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